After smoking and booze, now sunbeds are demonised

So it looks like the UK Met Office’s promised ‘barbecue summer’ for England has turned into a washout. At least Londoners were offered a final glimmer of hope of getting a tan as a solarium chain handed out coupons for free, six-minute sessions in the city centre last week.

‘It’s summer… Are you ready! Great equipment. Great service. Great tan’, declared the flyer. Yet if yesterday’s screaming media headlines are to be believed, this small pleasure could be the start of a slow and painful death-by-frying. ‘“No doubt” sunbeds cause cancer’, announced the BBC. ‘Sunbeds are as dangerous as smoking’, explained the Telegraph. ‘Cancer experts raise sunbed warning level’, declared Sky News.

The scary headlines referred to a new study by the International Agency for Research on Cancer (IARC), which is part of the World Health Organisation. The study’s findings are revealed in the latest edition of the Lancet Oncology, a prestigious medical journal (1).

While there is nothing new about theories or studies on the cancer risk posed by sunbeds, the newsworthiness of the IARC’s study lies in the fact that the agency has decided to move UV tanning beds up to the highest cancer risk category: ‘carcinogenic to humans.’ Tanning beds were previously classified as ‘probably carcinogenic to humans’.

So what made the research team confident enough to remove the ‘probably’ bit? A statement by the report’s authors said: ‘A comprehensive meta-analysis concluded that the risk of skin melanoma is increased by 75 per cent when use of tanning devices starts before 30 years of age. Additionally, several case-control studies provide consistent evidence of a positive association between the use of UV-emitting tanning devices and ocular melanoma.’ (2)

The researchers found that the same genetic mutation that has long been attributed to UVB radiation – the kind that causes sunburn – was detected in UVA-treated mice and UVA-induced mouse skin tumours. This led the IARC to dismiss all probablys and maybes and to reclassify UV radiation as a whole (long-wave UVA, medium-wave UVB and short-wave UVC) as carcinogenic to humans.

However, Sam Shuster, emeritus professor of dermatology at the University of Newcastle-upon-Tyne and honorary consultant to the Department of Dermatology at Norfolk and Norwich University Hospital, is critical of the study’s terminology, methodology and conclusions. He tells me the study is ‘wrong, out of place and quite grotesque’.

The report’s authors claim that ‘use of UV-emitting tanning devices is widespread in many developed countries, especially among young women’; yet as Shuster points out, they do not bother to specify how many people use such devices or how often they use them, but instead make a sweeping remark on their supposed popularity.

Moreover, Shuster tells me, ‘the data is inadequate’. ‘This so-called “meta-analysis” relies on old and disparate data that runs in all sorts of directions and the researchers have simply selected data in order to draw certain conclusions. Their methodology is comparable to taking a statistical mean of an opinion poll. These people have simply accepted a given diagnosis when they did their meta-analysis, but that diagnosis was wrong. They have not gone back on the data – data that myself and many others have already shown to be erroneous.’

Shuster has previously pointed out in the British Medical Journal that ‘there is solid descriptive, quantitative and mechanistic proof that ultraviolet rays cause the main skin cancers (basal and squamous)’, but when it comes to melanoma, ‘the effect of ultraviolet light can only be minimal’ and ‘the effect of sunbed exposure is small and inconsistent’ (3). Basal and squamous account for around 90 per cent of skin cancers in Britain; they are slow-growing and fairly easily treated. The more serious melanoma accounts for around 10 per cent of skin cancers in Britain.

The IARC’s new classification puts sunbed use on a par with smoking or exposure to asbestos. It’s like a health campaigner’s wet dream. There it is in writing, in the Lancet in fact: all UV radiation can be bad for you. No ifs or buts were raised in the press release issued by the Lancet Oncology and so now campaigners feel they have been given a green light to call for tightened regulations, a ban on sunbed-use for under-18s, and the plastering of tanning salons with health warnings.

As with risk assessments in other areas of modern life – from the threat of terrorism to the threat of pandemics – upward shifts in cancer risk categorisation also make for attention-grabbing, unsubtle headlines. Yet there is no direct causal link between occasionally lying on a sunbed and getting deadly skin cancer. Any effects of using tanning beds depend on frequency and duration of exposure.

As for the effects of UV on the skin, for Shuster it is ‘surprisingly clear’. As he points out in Panic Nation? Unpicking the Myths We’re Told About Food and Health, UV ‘has no effect on skin ageing, which is due to thinning of the skin and loss of collagen, although UV does give the same weather-beaten appearance that is caused by smoking. While UV is the main cause of epitheliomatous skin cancers, which are functionally benign, there is no hard evidence that UV is the principal cause of malignant melanomas.’

In fact, there is growing evidence that avoiding UV rays is bad for you. ‘Obviously, it is not good to burn yourself’, Shuster tells me, ‘but the level of acceptable UV has not yet been established. In fact, some research shows that the risk of melanoma can increase if you avoid UV. Also, UV-rays provide us with vitamin D.’

Regardless of which studies or researchers you choose to trust, one thing is certain: the War On UV is a bad thing. Today’s increasingly negative attitudes to the sun and UV-light are profoundly unhealthy. For the few precious weeks of the year that Brits get exposed to the warming and uplifting rays of the sun we get showered with confusing and exaggerated health warnings, with everyone from Cancer Research to the Health Education Authority weighing in with advice and tips on how not to enjoy the relatively warm weather.

We are told we must limit our exposure both to the sun and to tanning lamps. When temperatures hit 32 degrees Celsius in London at the end of last month, the Chief Medical Officer warned of an increase in deaths, while the Department of Health asked people to check up on vulnerable friends, relatives and neighbours and to draw the curtains at home in order to keep the sun out. We were told to stay out of the sun, and that if we had to venture outdoors we should wear a hat and apply plenty of sun lotion. We should also avoid hot drinks and alcohol, the DoH said. Enjoy a refreshing beer by the barbecue? Forget about it! (4)

What most people refer to as ‘summer’ is being talked about by health officials and meteorologists as a state of emergency. The sun, long regarded as a source of health, energy and vitality, is now depicted as a mortal threat. And those who actively seek it out are seen as irresponsible and ignorant. People who use tanning beds are regarded as particularly reckless, vain and selfish – not only are they putting themselves in danger, the anti-tanning brigade say, but they will also be a drain on the National Health Service if they end up seeking treatment for skin cancer in the future.

For Shuster, the IARC study and the media flurry it has caused are ‘completely out of place’. ‘It is quite grotesque to suggest that UV from sunbeds is such a disaster’, he tells me. ‘These researchers have simply jumped on a bandwagon – but it is the wrong bandwagon. They’re just scaring people.

‘The universal effect of this type of research – descriptive epidmeology which juggles with figures – is that it leads to greater distrust in medical reports. A lot of people are simply saying “we’ve heard it all before, we can’t trust all this conflicting research”. So the danger is that when it comes to something real and serious, they won’t believe that either.’

While health scares around food, alcohol and cigarettes have an impact on the individuals who enjoy these ‘guilty pleasures’, the Great Sun Scare impacts on all of us. The sun shines on everyone, not just on modern-day sinners like smokers or fast food eaters, and so morality lessons around the dangers of exposing yourself to supposedly poisonous rays apply to us all. In this context, those who choose to bronze on beaches, in parks or at tanning salons are viewed as morally compromised. They are held up as bad examples, as carcinogenic individuals who must be lectured through hectoring government health advice.

Although you wouldn’t believe it from looking at the weather forecasts, the sun is here to stay, so we had better learn to live with it. And if public health officials would only leave us alone, we might even be able to enjoy the summer while it lasts.

Nathalie Rothschild is commissioning editor of spiked.