BILL ANALYSIS Ó
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|Hearing Date:April 11, 2011 |Bill No:SB |
| |746 |
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SENATE COMMITTEE ON BUSINESS, PROFESSIONS
AND ECONOMIC DEVELOPMENT
Senator Curren D. Price, Jr., Chair
Bill No: SB 746Author:Lieu
As Amended:March 22, 2011 Fiscal: Yes
SUBJECT: Tanning Facilities.
SUMMARY: Prohibits the use of ultraviolet tanning devices by persons
under the age of 18.
Existing law, the Business and Professions Code:
1)The Filante Tanning Facility Act of 1988 (Filante Act) requires
tanning facilities to comply with specified requirements which
include:
a) Providing a customer with a written warning statement that
contains specified admonitions regarding the potential harms
caused by tanning devices.
b) Requiring customers to sign a written statement acknowledging
that they have read and understands the provided warnings. The
facility must retain this statement until the end of the calendar
year, at which time the customer must renew the acknowledgement.
c) Requiring tanning facilities to post warnings on the dangers
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of ultraviolet radiation in areas where tanning devices are used.
d) Requiring customers between 14 and 18 years of age to give the
facility a statement signed by their parent or legal guardian
stating that the parent or legal guardian has read and
understands the warnings, consents to the minor's use of tanning
devices and agrees that the minor will use protective eyewear
provided by the facility.
e) Prohibiting persons less than 14 years of age from using
tanning devices.
2)Provides that a first violation of the Filante Act is an infraction,
any subsequent violation is a separate misdemeanor and that a
violation makes a tanning facility liable for a civil penalty not to
exceed $2,500 per day for each violation in addition to any other
penalty established by law. (Business and Professions Code (BPC) §
22706)
This bill:
1) Prohibits persons less than 18 years of age from using an
ultraviolet tanning device.
2) Removes the consent provision for persons between 14 and 18 years
of age.
FISCAL EFFECT: Unknown. This bill has been keyed "fiscal" by
Legislative Counsel.
COMMENTS:
1. Purpose. This bill is sponsored by the California Society of
Dermatology & Dermatological Surgery (CalDerm) and the AIM at
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Melanoma Foundation . According to the Author, "ultraviolet (UV)
radiation-emitting tanning devices have been added to the U.S.
Department of Health and Human Services' and the World Health
Organization's list of the most dangerous forms of cancer-causing
substances in humans. Exposure to UV radiation during childhood
and adolescence increases the risk for a skin cancer diagnosis as
an adult." The Author states, "On average, more than one million
Americans use tanning salons. Of those Americans using a tanning
salon, nearly 70 percent are female, primarily 16- 29 years old."
The Author additionally asserts, "Those who use tanning beds before
age 35 increase their lifetime risk of melanoma by 75 percent."
2. Federal Law. The Food and Drug Administration (FDA) regulates the
tanning industry, focusing on the use of ultraviolet tanning, but
not necessarily prescribing appropriate use by certain categories
of the population. Some of the requirements of the FDA include the
use of protective eyewear in tanning devices, maximum timer
intervals, and the posting of warning signs near tanning devices.
The Affordable Care Act (ACA), which has been in effect since July
1, 2010, imposes a 10 percent tax on indoor tanning services. The
Act defines indoor tanning services as" any electronic product
designed to incorporate one or more ultraviolet lamps and intended
for the irradiation of an individual by ultraviolet radiation."
This definition excludes phototherapy services performed by a
licensed medical professional.
3. Ultraviolet Rays and Skin Cancer. Ultraviolet radiation (UVR)
consists of ultraviolet
A radiation (UVA), ultraviolet B radiation (UVB) and ultraviolet C
radiation (UVC). UVC is absorbed by the atmosphere but UVA and UVB
reach the earth's surface and have different effects on the human
body. UVA rays are long, relatively weak rays that penetrate deep
into the skin and cause wrinkles. UVB rays are shorter and more
intense and cause the reddening of the skin. Tanning bulbs mimic
the sun's radiation, which consists of a mixture of about 94
percent UVA and 6 percent UVB rays. Some studies show that the UVA
rays in tanning devices are stronger than those obtained from
exposure to natural sunlight. The Academy of American Pediatrics,
for example, states that the intensity of radiation produced by
large, powerful tanning units may be 10 to 15 times higher than
that of the midday sun.
Ultraviolet rays have been declared carcinogens by the U.S.
Department of Health and Human Services and the FDA. The National
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Institutes of Health concluded that exposure to broad-spectrum UVR,
solar radiation and sunlamps can cause cancer, based upon
sufficient evidence which indicates a causal relationship between
exposure to broad-spectrum UVR, solar radiation, sunlamps and human
cancer. Studies of humans exposed to solar radiation, artificial
devices emitting broad-spectrum UVR or devices emitting
predominantly UVA or UVB demonstrate that exposure to
broad-spectrum UVR can cause all types of skin cancer (squamous
cell carcinoma, basal cell carcinoma and melanoma.
In 2011, the American Academy of Pediatrics found that there has
been an increase in the incidences of melanoma over a period of at
least 30 years. Most recently, rapid increases have occurred in
young white women, about 3 percent per year since 1992 in ages 15
to 39 years. Additionally, the Skin Cancer Foundation supports
this finding stating in 2010 that skin cancer is now the most
common cancer in the world and that the incidence of melanoma
continues to rise faster than that of any of the seven most common
cancers. This differs from the American Cancer Society which stated
in 2008 that the rate of increase of melanoma incidences slowed
from 6 percent in the 1970s to 3 percent between 1981 and 2000.
In 2011, the American Academy of Dermatology discussed two case
studies in Minnesota and Australia where indoor tanning use was
found to correlate strongly with melanoma risk. For example, in the
Minnesota study, a person who used tanning facilities with a
frequency of more than 50 hours, more than 100 sessions or 10 or
more years was 2.5 to 5 times more likely to develop melanoma than
a person who had never tanned indoors. The Australian study found
similar results, but also found that the associated risk was
stronger where first use was at an earlier age.
In an effort to reduce the occurrence of skin cancer, leading
health organizations such as the World Health Organization,
American Cancer Society, and the American Academy of Dermatology,
encourage individuals to limit their exposure to the sun during
mid-day hours (10 a.m. to 4 p.m.), wear protective clothing, use
sunscreen with a sun protection factor (SPF) of 15 or higher and
avoid the use of tanning beds and sun lamps. These organizations
also encourage additional sun protections for children arguing that
children are more exposed to the sun due to their outdoor activity
and contend that skin damage from ultraviolet radiation is
cumulative and irreversible and refer to studies which indicate
that up to 80 percent of a person's lifetime ultraviolet sun
exposure is received before the age of 18.
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In February of this year, the American Academy of Pediatrics called
for all U.S. tanning salons to bar minors. Sophie J. Balk, MD,
coauthor of the policy statement stated that on average, indoor
tanners are 74 percent more likely to develop melanoma, 2.5 times
more likely to develop squamous cell carcinoma, and 1.5 times more
likely to develop basal cell carcinoma. Today, more than a million
Americans use indoor tanning salons every day. Dr. Balk also noted
that there has been increasingly high use among females in their
teens and twenties; about 35 percent of 17-year-old girls use them.
Almost 36 percent of women and 12.2 percent of men aged 18-24
surveyed in a 2010 Archives of Dermatology study tanned indoors in
the past year, and many experts link such figures to the rapidly
rising incidence of melanoma among young people.
4. Health Benefits of Vitamin D. Humans obtain Vitamin D from
exposure to sun, dietary sources, and vitamin supplements. There
are documented benefits of Vitamin D sufficiency in adults such as
improved bone health, prevention of fractures, better muscle
health, and reduced risk of falling in older people. However,
while sun exposure increases Vitamin D concentration, the American
Academy of Dermatologists has stated that most people obtain enough
Vitamin D through incidental exposure during daily activities and
that maximum production of Vitamin D occurs after only limited
exposure to UV radiation. Therefore, the group argues against
intentional sun exposure to induce vitamin D production because UV
radiation is a known human carcinogen.
The American Academy of Dermatology also opines that most tanning
lamps primarily emit UVA rays rather than UVB rays which are not
necessarily an efficient source to induce vitamin D synthesis.
Additionally, the same rays that induce Vitamin D synthesis are the
same wavelengths that cause DNA damage. Furthermore, the
Association found that repeated exposure did not increase Vitamin
D, but continued to inflict DNA damage.
The American Academy of Pediatrics (AAP) recommends Vitamin D
dietary supplements for children who receive less than 400
International Units of Vitamin D daily. The AAP concedes that even
this degree of supplementation may be insufficient for children
living in areas at or above 51 degrees latitude during the winter
months.
In contrast, a study published by the Rush University Medical
Center suggested that exposure to Vitamin D in sunlight suppresses
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growth of malignant melanoma cells in tissue cultures. Similarly,
another study published by Boston University stated that subjects
who used tanning beds had higher Vitamin D concentrations than
those who did not.
5. Response in Other States. Many states have confronted the issue of
prohibiting certain populations from using tanning devices.
Currently, the state of Delaware does not allow a minor between the
ages of 14 and 18 to use a tanning device unless he or she has
parental consent. Delaware law also specifies that minors under
the age of 14 may not use a tanning device unless it is medically
necessary. The states of Illinois, Maine, New Hampshire, New
Jersey, New York, North Carolina and North Dakota have similar
restrictions; however, not all states allow medical considerations
to be taken when banning that age group from using tanning devices.
Other states create more stringent restrictions on the use of
tanning devices, such as the ban for those under 16.5 years of age
in Texas and those under
16 years of age in Wisconsin.
In addition to California, several states currently have bills
pending in the Legislature to ban minors under the age of 18 from
using a tanning device, including Illinois, Iowa, Maryland,
Minnesota, New Jersey, New Mexico, New York, Ohio, Pennsylvania,
Rhode Island, Vermont, and Washington.
6. Arguments in Support. The California Medical Association (CMA)
supports this measure. CMA believes that this bill will, "Protect
young people from the health dangers of ultraviolet radiation." CMA
further states, "Rates of skin cancer, including melanoma, the most
serious form of skin cancer to-continue to rise, even in young
people." CMA cites a long history of known dangers that arise from
damage to the skin and eyes. Due to these dangers, CMA states,
"The World Health Organization, the American Medical Association,
the American Academy of Dermatology, and the American Academy of
Pediatrics all support prohibiting access to tanning salons by
children."
7. Arguments in Opposition. The Indoor Tanning Association (ITA)
opposes this measure. ITA believes that this bill would have a
negative impact on indoor tanning business statewide by eliminating
teens under the age of 18 from patronizing its member's businesses.
ITA estimates that this group of consumers makes up to 5-10 percent
of a tanning business's customer base. Additionally, since the
majority of tanning facilities are owned by women, ITA argues that
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this would disproportionately affect female business owners. ITA
also argues that tanning salons are already burdened by regulations
of the Department of Consumer Affairs and the FDA. Lastly, ITA
argues that the California regulations are already the most
stringent in the nation.
8. Previous Legislation. In 2004, this committee heard AB 2193
(Nation, Chapter 758, Statutes of 2004), which revised the Filante
Act to prohibit minors under the age of 14 from using an
ultraviolet tanning device. Also, minors over the age of 14 were
permitted to use ultraviolet tanning facilities if a parent or
guardian accompanied them. In 2007, this Committee heard AB 105 ,
also by the same Author, (Chapter 590, Statutes of 2007) which
further revised the Filante Act. Among the amendments was a
prohibition on minors between the ages of 14-18 from using an
ultraviolet tanning device unless there was signed parental consent
made in person at the tanning facility. This consent is valid for
12 months. Additionally, the bill required that proof of age be
provided.
An earlier version of AB 105 prohibited all minors under the age of
18 from using ultraviolet tanning facilities, as this bill now
does, but this prohibition was amended out of the final version
SUPPORT AND OPPOSITION:
Support:
AIM at Melanoma Foundation (Sponsor)
American Academy of Dermatology Association
American Cancer Society
California Society of Dermatology & Dermatological Surgery (CalDerm)
(Sponsor)
California Medical Association
Joanna M. Nicolay Melanoma Foundation
Opposition:
Indoor Tanning Association (ITA)
Consultant: Sarah Mason/Candace Choe
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