'There has been mounting concern over the past several years that people and, in particular, teenagers are using sunbeds excessively to acquire tans, which are seen as socially desirable. However, the consequence ... has been a precipitous rise in the number of skin cancer cases.'

There are an estimated 132,000 cases of malignant melanoma (the most dangerous form of skin cancer) in the world each year, and an estimated 66,000 deaths are attributed to malignant melanoma and other skin cancers, according to WHO.

These figures continue to rise: In Norway and Sweden, the annual incidence rate for melanoma is estimated to have more than tripled in the last 45 years, while in the United States, the rate has doubled in the last 30 years. The desire to have a tan and accompanying growth in the use of sunbeds are considered prime causes of the fast growth in skin cancers.

Tanning: Killer Fashion Trend

Worldwide, the incidence of melanoma varies more than 150-fold, WHO notes. The highest rates are found mainly in those nations where people are fairest-skinned and where the sun tanning culture is strongest: Australia, New Zealand, North America and northern Europe. One in three cancers worldwide is skin-related; in the United States, that figure is one in two. There are an estimated 1.1 million annual cases of skin cancer in the United States.

"There has been mounting concern over the past several years that people and, in particular, teenagers are using sunbeds excessively to acquire tans, which are seen as socially desirable," says Dr. Kerstin Leitner, WHO Assistant Director-General responsible for environmental health.

"However, the consequence of this sunbed usage has been a precipitous rise in the number of skin cancer cases," Dr. Leitner continues. "We are therefore calling attention to this fact, and we would hope that this recommendation will inspire regulatory authorities to adopt stricter controls on the usage of sunbeds."

Stronger Than Mid-Day Summer Sun

Some sunbeds have the capacity to emit levels of ultraviolet radiation many times stronger than the mid-day summer sun in most countries, WHO points out. At present, however, only a few countries have effective regulations on sunbeds or their use.

Belgium, France and Sweden have legislation limiting the maximum proportion of UV-B (the most dangerous component of UV radiation) in the UV output to 1.5% (a similar level of the carcinogenic UV that is emitted by the sun). In France, the regulations require all UV radiation-emitting appliances to be declared to the health authority, minors under the age of 18 are banned from their use, trained personnel must supervise all commercial establishments, and any claim of health benefit is forbidden.

The State of California in the United States prohibits anyone under 18 from using sunbeds/tanning salons. Often, however, effective implementation of regulations remains a challenging issue. WHO encourages countries to formulate and reinforce laws in order to better control the use of sunbeds -- such as the ban of all unsupervised sunbeds operations.

Don't Try This at Home

Some of the main consequences of excess UV exposure include skin cancers, eye damage and premature skin ageing. A study in Norway and Sweden, for example, found a significant increase in the risk of malignant melanoma among women who regularly had used sunbeds. Furthermore, excessive UV exposure can reduce the effectiveness of the immune system, possibly leading to a greater risk of infectious diseases.

Acute effects of UV radiation on the eye include cataracts, pterygium (a white colored growth over the cornea) and inflammations of the eye, such as photokeratitis and photoconjunctivitis. This is why protective goggles are recommended when using a sunbed.

Only in very rare and specific cases, WHO counsels, should medically supervised sunbed use be considered. Medical UV devices successfully treat certain skin conditions, such as dermatitis and psoriasis. These treatments should be conducted only under qualified medical supervision in an approved medical clinic and not unsupervised, either in commercial tanning premises or at home using a domestic sunbed.

Avoid Excess UV Exposure!

WHO's recommendation on sunbed usage is part of its overall effort to protect the health of those people who could be overexposed to UV radiation. WHO, along with its partners -- the International Commission on Non-Ionizing Radiation Protection, the United Nations Environment Programme and the World Meteorological Organization -- has elaborated the Global Solar UV Index, which now is used in many countries, including Argentina, Australia, Czech Republic, Finland, France, Germany, Greece, Israel, Mexico, Norway, Poland, Portugal, Spain, Sweden and Switzerland, and recently has been adopted for general usage in the United States and Canada.

"In all of our actions, we are clear: Avoid excess exposure to UV, and when you have to be in the sun, protect your skin. Malignant melanomas [and] other cancers and conditions are the consequence of not taking the proper precautions," Dr. Leitner concludes.