Turning Evidence Into Opinion: An EU Scientific Committee Review And Risk Assessment Of Ultraviolet Radiation From Sunbeds

Lesley RUSHTON, Imperial College London, United Kingdom
EU WORKING GROUP ON SUNBEDS; S. 2

1 Department of Epidemiology and Biostatistics, Imperial College London, London, UK
2 EU Member States

Purpose: The European Commission requested the Scientific Committee on Emerging and Newly Identified Health Risks (SCENIHR) to review recent evidence on ultraviolet (UV) radiation from sunbeds and provide an updated opinion of the risk.
 
Methods: Information was primarily obtained from peer reviewed papers and reports covering epidemiologic, experimental and cell culture studies.
 
Results: UV emissions from sunbeds vary widely, with a tendency more recently towards higher UVA irradiance and are estimated to correspond to an UV index of 12, i.e. equivalent to midday tropical sun. The prevalence of sunbed use varies greatly by country being higher in white-skinned populations from Northern Europe, and in younger women.
 
Both UVA and UVB have an immunosuppressive effect on the skin and also a systemic immunosuppressive effect. Exposure to UVA and/or UVB enhances aging of the skin. There is consistent evidence of increased risk from cutaneous melanoma associated with sunbed use, with a dose-response proportional to the number of sessions and frequency of use. From a smaller number of studies there is also consistent evidence that sunbed use increases the risk of squamous cell carcinoma, especially when exposure takes place at a younger age, and to a lesser extent for basal cell carcinoma.
 
Evidence for carcinogenicity of UV exposure is supported by experimental animal and mechanistic studies. UVA has been shown to be as much involved as UVB in DNA damage and mutation induction.
 
In Europe, 3,438 (5.4%) of annual newly diagnosed cases of melanoma may be related to sunbed use (68% women).  
 
Conclusions: The SCENIHR concluded that UV is a complete carcinogen, both an initiator, and a promoter and that, because of this evidence and the nature of skin cancer induction (no indications for threshold levels of UV-irradiance and UV–dose), a safe limit for UV irradiance from sunbeds could not be established.