BILL ANALYSIS Ó
SB 746
Page 1
Date of Hearing: June 28, 2011
ASSEMBLY COMMITTEE ON JUDICIARY
Mike Feuer, Chair
SB 746 (Lieu) - As Amended: March 22, 2011
SENATE VOTE : 25-9
SUBJECT : tanning facilities
KEY ISSUE : DUE TO THE SERIOUS AND POTENTIALLY LIFE-THREATENING
RISKS REPORTEDLY ACCOMPANYING OVER-EXPOSURE TO UV RADIATION,
should the use of INDOOR tanning facilities by MINORS BE
PROHIBITED?
FISCAL EFFECT : As current in print this bill is keyed fiscal.
SYNOPSIS
A substantially similar version of this bill with the same
author was passed by this Committee in 2007. This bill
prohibits minors from exposing themselves to UV tanning devices.
Current law already prevents anybody under age 14 from using
ultraviolet tanning devices but permits minors age 14 to 18 to
use such devices after obtaining the written consent of a parent
or legal guardian. This bill eliminates consent waivers and
bans all persons under age 18 from using ultraviolet tanning
devices. Skin cancer is the most common form of cancer in
America, with more than two million cases reported each year.
The most common cause of skin cancer is over-exposure to
ultraviolet radiation. Supporters state this measure is needed
to prevent the rapidly growing rate of skin cancer cases among
those 18 to 30 years old. Substantial evidence suggests that
those exposed to ultraviolet rays from tanning booths at a young
age face a 40 percent higher risk of skin cancer than those who
do not tan. The California Nurses Association notes that
"Melanoma is the leading cause of cancer death in women ages
25-30 and is second only to breast cancer women aged 30-34."
The bill is supported by numerous health insurance groups,
pediatric medical groups, and dermatological societies, and it
is opposed by the indoor tanning industry.
SUMMARY : Prohibits minors from using ultraviolet tanning
devices.
EXISTING LAW :
SB 746
Page 2
1)Provides for the regulation of tanning facilities by the
Department of Consumer Affairs. (Business and Professions
Code Sec. 22706.)
2)Requires tanning facilities to provide customers with a
written statement containing specified notices of the
potential harm caused by tanning devices and those customers
must sign the statement acknowledging the risks. (Business
and Professions Code Sec. 22705(a).)
3)Requires tanning facilities to post warnings on the dangers of
ultraviolet radiation in areas where tanning devices are used.
(Business and Professions Code Sec. 22706 (b)(1).)
4)Requires customers between the ages of 14 and 18 to give the
tanning facility a written consent from their parent or legal
guardian stating that the parent or guardian had read and
understands the warnings and consents to the minor's use of
the tanning facility. (Business and Professions Code Sec.
22706 (b)(3).)
5)Provides that the first violation of the law is an infraction
and that any subsequent violation is subject to a civil
penalty not to exceed $2,500. (Business and Professions Code
Sec. 22706.)
COMMENTS : A substantially similar version of this bill was
passed by this Committee in 2007. This bill seeks to prevent
persons under the age of 18 from being exposed to potentially
dangerous ultraviolet radiation by tanning in UV tanning
devices. The author states in support:
The connection between skin cancer and UV tanning is no
longer anecdotal. Children who use indoor tanning methods
can be exposed up to 12 times the normal amount of
ultraviolet radiation per year, which makes them 74% more
likely to be a victim of melanoma. Melanoma is the most
deadly type of skin cancer and is one of the most common
cancers diagnosed among young adults. It is the leading
cause of cancer death in women ages 25 - 30 and is second
only to breast cancer in women ages 30 -34.
As a result, the World Health Organization elevated tanning
beds to a level 1 carcinogen in 2009, alongside plutonium,
mustard gas, and cigarettes. The United States Department
SB 746
Page 3
of Health and Human Services and the United States Food and
Drug Administration have also added these UV emitting
tanning beds to the their list of most dangerous forms of
cancer-causing substances in humans.
And in February, the American Academy of Pediatrics joined
the world-wide chorus that governments need to ban minors'
access to UV tanning beds.
As of today, several countries have banned tanning for
minors, including sun-rich Brazil, where they have passed a
complete ban on tanning, regardless of age. Several states
and local governments have tougher bans than California.
Surprisingly, Texas has the most stringent.
SB 746 is a simple solution to a dangerous problem - it
will prevent minors from accessing dangerous ultraviolet
tanning devices. The health risk is just too great for
children.
Ultraviolet Rays and the Growing Occurrence of Skin Cancer:
Ultraviolet (UV) radiation is naturally emitted from the sun and
typically reaches the earth's surface in two forms: UVA
radiation and UVB radiation. UVA radiation reaches the earth in
fairly weak but long wave lengths and its rays can penetrate
deep into human skin upon contact. UVA rays lead to natural
skin aging, with moderate exposure over a long period of time.
UVB rays reach earth as a shorter, but far more intense wave.
Even short term exposure to UVB rays can lead to skin reddening,
more commonly known as sunburn. Exposure to both UVA and UVB
rays can lead to the development of skin cancer. According to
the American Academy of Dermatology prolonged, unprotected
exposure to ultraviolet radiation can be as cariogenic as
cigarette smoke.
In 2011, the American Academy of Pediatrics noted that there has
been a rapid increase in the rate of skin cancer occurrences in
the United States over the past 30 years. Skin cancer rates are
growing fastest, 3 percent per year, in young women ages 15 to
39 (the group most likely to tan). Alarmingly, skin cancer has
overtaken all other forms of cancer to become the most common
cancer in the United States with one in four Americans expected
to suffer from some form of skin cancer in their lifetime. The
California Nurses Association notes that "Melanoma is the
leading cause of cancer death in women ages 25-30 and is second
only to breast cancer women aged 30-34."
SB 746
Page 4
The Potentially Dangerous Cancer Risk of Ultraviolet Tanning
Devices: In response to increased exposure to UV radiation, the
skin will tan in order to protect itself. Cosmetically, tanning
has become extremely popular with many teenagers and young
adults to the point that many are seeking artificial sources of
UV radiation to increase their tans. Nearly one-quarter of all
"tanners" are between the ages of 13 and 19, and studies suggest
35 percent of teenage girls tan regularly. Important in
considering this legislation, overall 70 percent of those who
tan regularly reportedly are females ages 16 to 29.
Artificial tanning devices operate by exposing a person to an
ultraviolet light that attempts to mimic the sun's natural
light, exposing a person to 94 percent UVA and 6 percent UVB
rays. Despite attempts to mimic the sun's natural radiation, an
American Academy of Pediatrics survey of 62 randomly chosen
tanning facilities found that ultraviolet tanning devices were
actually exposing customers to extremely high levels of UVA
radiation 10 to 15 times greater than that emitted by the midday
sun. This increased exposure to radiation has been shown to
dramatically increase the cancer rate of frequent tanners. The
American Academy of Dermatology notes that a person that
frequently tans before the age of 35 (defined as tanning more
than 50 hours or 100 sessions per year) has a 70 percent greater
chance of developing skin cancer than somebody who never tans.
WHO Deems Tanning Devices Carcinogenic : Indeed, the increased
risk of UV tanning devices has led the World Health Organization
(WHO) to deem tanning devices a carcinogenic. Even more
worrisome, the American Academy of Dermatology notes that
studies have determined that tanning causes the body to produce
the same plasma endogenous opioids that are released when
consuming drugs or alcohol. The Academy also has noted that 41
percent of frequent tanners show tendencies "consistent with
aŻn]?addictive disorder." The addictive nature of tanning can
cause a person to seek the physical reward of tanning while
ignoring the known risks. Teenagers, whose brains are still
developing, are reportedly at increased risks for developing
addictions and dependencies.
Non-Compliance Issues at Tanning Facilities Appear To
Substantially Undermine Parental Consent Protection Goals: Many
states, including California, currently regulate aspects of the
indoor tanning industry. However a recent study showed that
only one of 32 randomly selected tanning facilities was fully
SB 746
Page 5
compliant will all FDA and state regulations. The same study
identified an average of seven infractions per facility. The
FDA study noted that 95% of tanners did not comply with FDA
exposure guidelines, with some tanners exposing themselves to
three times the level of UV radiation recommended by the FDA.
Furthermore, the American Academy of Dermatology cites a study
determining that many tanning facility staff members were
unequipped to properly inform customers of the risks of tanning,
and that many staffers failed to properly supervise patrons.
Given the reported lack of compliance with federal and state
guidelines evident in some if not many indoor tanning
facilities, parents who provide their teenage tanner with
consent may not realize the full extent of the risk for skin
damage facing their children. (And of course there is no way of
knowing how many children's "parental consent" forms have been
forged.) Existing California law requires a parent or legal
guardian to sign consent forms, in person, once per year to
enable their teenage children to use tanning facilities. After
the initial consent, the parent is not required to supervise or
accompany their child to tanning facilities so long as the
consent form remains valid. If the tanning facility is failing
to properly warn or supervise tanners, teenagers may overuse the
facility and increase the harm to their skin from overexposure
to UV radiation. Current analyses of the issue appear to make
clear a parental consent approach to this health and safety
issue is problematic, invites potential abuse by teenage
children, and is extremely difficult if not impossible for
tanning agencies to effectively oversee.
No Proven Health Benefits of Tanning: Proponents of indoor
tanning have claimed that artificial tanning devices can help
individuals suffering from a Vitamin D deficiency. Vitamin D is
naturally absorbed by the body through exposure to moderate
amounts of natural sunlight. Vitamin D has been shown to help
prevent several forms of cancer including prostate and
gastrointestinal cancer. Proponents of sunless tanning have
claimed that artificial sunlight devices that emit UV radiation
help those who cannot absorb sufficient amounts of Vitamin D in
their daily life.
Although sunless tanning does provide a person with Vitamin D,
health experts doubt the benefits of sunless tanning. The
American Academy of Dermatology has noted that the health risk
of sunless tanning significantly outweighs any benefit. There
reportedly is no scientifically known threshold at which UV
SB 746
Page 6
exposure is safe while allowing for the maximum amount of
Vitamin D synthesis, and no evidence showing any direct
relationship between tanning and the decrease in certain types
of cancers has ever been published. In 2010, the Federal Trade
Commission (FTC) went so far as to criticize and issue a
citation against the Indoor Tanning Association (ITA) for making
false health and safety claims about the benefits of indoor
tanning. In response to the false advertisements, the FTC
required the ITA to disclose the risks of developing skin cancer
related to the use of UV tanning devices and banned the tanning
industry from making the following claims in their
advertisements:
1)"Tanning, including indoor tanning, does not increase the risk
of skin cancer;"
2)"Tanning, including indoor tanning, is safe or poses no
danger;"
3)"Indoor tanning is approved by the government;"
4)"Indoor tanning is safer than tanning outdoors because in
indoor tanning facilities, the amount of ultraviolet light is
monitored and controlled;"
5)"Research shows that vitamin D supplements may harm the body's
ability to fight disease;" and
6)"A study in the Proceedings of the National Academy of
Sciences determined: (a) that sun exposure does not cause skin
cancer or melanoma, or that the risk of such cancer is only
hypothetical; (b) that getting a tan is health; (c) that the
risks of not getting enough ultraviolet light far outweigh the
risk of skin cancer; or (d) that vitamin D has been linked to
significantly decreasing the risk of contracting lung, kidney,
or liver cancer."
Despite the FTC's warnings, the author notes that the tanning
industry continues to make these claims in public, including at
hearings before the Legislature. In filing their opposition to
this bill with this Committee the ITA once again claimed that
sunless UV tanning provides health benefits and claims that
tanning beds are safer because they are more "controlled" than
outdoor tanning. As noted above numerous studies have shown
customers tend to ignore the recommended controls regarding time
and exposure at UV tanning facilities and that the health risks
far outweigh any potential benefit of using UV tanning devices.
Prior Support for This Approach to Regulating Tanning Devices:
When this Committee heard AB 105 (Lieu, Stats. 2007, Ch. 590),
the Committee requested the bill be amended "up" to do what this
SB 746
Page 7
current bill proposes, specifically, prohibit all minors under
the age of 18 from using UV tanning devices.
ARGUMENTS IN SUPPORT : In support of the bill, AIM at Melanoma,
an anti-skin cancer organization, states:
AIM is concerned about the growing incidence of skin
cancer. The International Agency for Research on Cancer, a
division of the World Health Organization, has moved UV
radiation from tanning beds to its highest cancer risk
category, labeling it as "carcinogenic to humans." UV
radiation from tanning beds is in the same risk category as
cigarettes and we do not allow anyone under the age of 18
to purchase tobacco products. (Emphasis in original.)
Also in support, the California Nurses Association notes that
"Melanoma is the leading cause of cancer death in women ages
25-30 and is second only to breast cancer women aged 30-34. UV
radiation exposure from the sun is a known cause of skin cancer,
and exposure to UV radiation during childhood and adolescence
increases the risk for a skin cancer diagnosis as an adult."
ARGUMENTS IN OPPOSITION : The Indoor Tanning Association
strongly opposes the bill claiming, among other things, that the
bill is based on distorted scientific claims:
Proponents have failed to consider the many studies
demonstrating the benefits of ultraviolet light on overall
health and disease prevention through the creation of
Vitamin D in the skin. Most teens do not get enough
vitamin D from their diets, and vitamin D has been shown to
protect against breast and other cancers, lymphoma,
cardiovascular disease, multiple sclerosis, osteoporosis
and other chronic conditions.
Furthermore, the ITA argues that, "Teenagers interviewed
regarding this and similar legislation in other states have
flatly stated that they will just go out in the sun. That will
mean more sunburns, which truly do create more melanoma risk.
Moreover, if teens aren't able to go to commercial tanning
facilities, they will not be aware of the advances in spray tans
and their availability." Furthermore, Heartland, a tanning
machine manufacturer claims that "for every report or opinion on
one side, there is a report or opinion that contradicts it."
However, as noted in the analysis above, tanning facility
customers frequently ignore posted warnings and overuse UV
SB 746
Page 8
tanning devices, and no study has apparently ever shown a direct
link between the use of sunless UV tanning devices and
reductions in cancer or other chronic conditions.
Additionally, the industry argues that prohibiting minors will
have a negative economic impact. Lewis Shender, the President &
CEO of Hollywood Tans, states that banning minors from UV
tanning devices would eliminate 5-10% of the consumer base for
sunless tanning facilities. William Sanders, the Owner of a
Palm Beach Tan franchise in Redding notes that his business
could lose upwards of $66,000 in annual revenue if this bill is
enacted, and this may lead to the elimination of some part-time
employees. Heidi Shultz, a fellow Palm Beach Tan franchisee,
states that her facility "provides jobs to our youth and
educates them on the importance of hard work and industry
knowledge" and that this bill would force her to eliminate some
part-time positions for young employees. Although this bill
will likely have an economic impact on tanning facilities,
opponents do not account for any potential increase in revenues
attributed to "spray-on" tanning services. Spray on services,
which do not involve any UV radiation exposure, are in fact
offered at many of the opponent's facilities. Further,
opponents appear to ignore the potentially enormous societal
costs attributed to the treatment of skin cancer and related
health problems resulting from over-exposure to UV radiation,
not to mention the familial costs and pain associated with
fatalities from melanoma and other skin cancers.
Finally, opponents argue that this bill denies parents the right
to make decisions for their children. Len Beckford a Club Tan
owner from Napa contends that parents should have the right to
allow their 16 year old to "develop a base tan in a controlled
environment" should a parent choose to. Mr. Beckford argues
that the existing parental consent laws are sufficient to
control teenagers and that parents can withdraw consent at
anytime. However, as the analysis notes above, studies suggest
that some tanning facilities do not adequately train employees
on the proper information to disclose to patrons and proper
customer supervision. As a result some parents naturally may
not fully appreciate the risk facing their children when they
consent to their use of UV tanning devices.
Prior Legislation : AB 2193 (Nation, Stats. 2004, Ch. 758):
Revised the Filante Tanning Facility Act of 1984 to prohibit the
use of UV tanning devices for persons under 14 years of age and
required parents to accompany minors aged 14-18 to tanning
SB 746
Page 9
facilities.
AB 105 (Lieu, Stats. 2007, Ch. 590): Required minors between
the age of 14 and 18 to obtain written and informed parental
consent before being allowed to use UV tanning devices and
tanning facilities.
REGISTERED SUPPORT / OPPOSITION :
Support
AIM at Melanoma Foundation
American Academy of Dermatology Association
American Cancer Society
Anthem Blue Cross
California Society of Dermatology & Dermatological Surgery
(CalDerm)
California Medical Association
California Nurses Association
Joanna M. Nicolay Melanoma Foundation
Kaiser Permanente
Sun Safety for Kids
Opposition
Indoor Tanning Association (ITA)
National Federation of Independent Businesses
Hollywood Tans
Palm Beach Tan
Analysis Prepared by : Drew Liebert & Nicholas Liedtke / JUD. /
(916) 319-2334