Borough of Poole – Leisure Services
BOROUGH OF POOLE
ENVIRONMENT OVERVIEW GROUP
29 JANUARY 2004
REPORT OF HEAD OF LEISURE SERVICES ON THE USE OF SUNBEDS
IN LEISURE CENTRES
1Purpose of Report
1.1In reply to the motion to full Council “In view of the recent disturbing reports from members of the Chartered Institute of Health, warning about the risks of using sunbeds, we request the removal of all sunbeds from Council Leisure Centres”.
1.2This report sets out the background to sunbed usage, the current situation and future possibilities.
2Recommendation
2.1Members are requested to decide if the offering of sunbeds at our Leisure Centres is appropriate.
3Background Information
3.1According to research from the Health Education Authority (HEA) 8% of the population (approximately 3.12 million people) have used a sunbed in the last year. 16 - 24 year olds are most likely to use them with 15% (approximately 800,000 people) of this group having at least one session on a sunbed in the last year.
3.2The Health Education Authority recognises that the phasing out of sunbeds is likely to be controversial to local authorities because there is a lack of evidence that sunbeds are a health hazard; also loss of revenue but most importantly if the local authority did not provide sunbeds, people would seek alternative and possibly less well regulated use, at home or with private operators.
3.3The Health Education Authority also state that ascertaining whether or not sunbed use increases the risk of developing skin cancer is complicated by several factors. Firstly, sunbed users tend also to be very regular sunbathers. Secondly, it may take one or more decades for skin cancer to appear and the sunbed industry, which now has a turnover in excess of £100 million each year is less than twenty years old.
3.4The sun emits ultraviolet (UV) radiation that is divided into three groups depending on how much energy they have, these are UVA, UVB and UVC.
(a)UVC is the strongest but it does not reach the earth’s surface as it is absorbed by the upper atmosphere;
(b)UVB levels fluctuate during the year and reach a peak during the summer months. The rays are partially absorbed by the ozone layer and in the atmosphere but some reach the earth’s surface. In the short term UVB is more likely to cause sunburn and eye damage but in the long term it is associated with skin cancer.
(c)UVA rays are at a constant level all year round and penetrate deeper into the skin than UVB, where it can cause lasting damage such as premature skin ageing and may act with UVB and lead to the development of cancers.
3.5UVB affects the upper skin layer (the epidermis), stimulates the melanocyte cells, and provides an important protection mechanism by thickening the skin. Melanocytes produce brown pigment, called melanin which influences skin colour. A suntan is caused by an increase in melanin. UVA penetrates the skin more deeply and damages elastin and collagen in the middle skin layer called the dermis. Dark skin has a greater amount of melanin which acts as an in-built natural protection from the sun and protects the body by absorbing damaging UV rays in sunlight. Lighter skins, which may be found in people of mixed race, are slightly more at risk than darker skins.
3.6There is growing evidence that over-exposure to UVA may cause skin cancer. Most skin cancers are fully curable but the most important distinction is between malignant melanoma, which is the least common but can be fatal, and non-melanoma skin cancers (NMSCs). There are around 40,000 new cases of skin cancer diagnosed every year; 4,000 of these cases are malignant melanoma (HEA - October 1998). While the causes of malignant melanoma are not fully understood, it is thought to be linked to occasional exposure to short periods of intense burning sunlight, such as at weekends or on holiday. NMSCs, however, are found most often in outdoor workers and in the over-50s and caused by cumulative exposure to the sun.
4Sunbeds as an Aid to Tanning
4.1Sunbeds are designed to produce a tan by emitting UVA radiation, although some will also emit small amounts of UVB. A suntan from UVA light mostly disappears after a few days. To get a tanned skin that holds longer it is necessary that UVB penetrates the skin and stimulates the production of new melanin pigment. The sunbeds in the Council’s three centres use UVA tubes only.
4.2An Imperial Cancer Research Fund (ICRF) report states that indoor tanning equipment screens out most of the burning UVB radiation but they give out two to three times more UVA than sunlight. Sunbeds do not produce a tan in everyone, just as people with particularly fair skins may never tan in sunlight, so they may not tan at all under sunbeds. ICRF also states that a tan from a sunbed is not as effective as one from the sun as UVA does not produce the thickening of the outer layer of skin which helps protect from sunburn.
4.3The HEA point out that the effects of UV radiation from sunbeds are similar to those caused by sunlight and in the short term may include sunburnt skin, skin dryness and itching, bumpy itchy rash, possible skin rash if certain medicines are taken, eye irritation or conjunctivitis if suitable goggles are not worn. Long term health effects may include premature ageing of the skin, skin cancer and increased risk of cataracts if suitable goggles are not worn.
4.4Sunbed sessions provide the potential for limited, timed exposures to take account of skin type and the type of sunbed used and allow people to follow disciplined tanning programmes. Sunbed users should not:
(a)exceed 20 sessions per year
(b)exceed 30 minutes each exposure
(c)have more than one session a day
(d)exceed the maximum exposure times recommended for the bed
(e)apply any skin preparations designed to intensify the effect of the sunbed (eg tanning accelerators)
(f)sunbathe on the same day
but sunbed users should:
(g)shower thoroughly before the session to remove cosmetics and deodorants which increase sensitivity to UV radiation
(h)wear the goggles provided at all times
(i)shower after the session and use a moisturiser to prevent dryness of the skin.
(j)stop the exposure if they notice any abnormal skin reactions and consult a doctor.
4.5Some people are more prone to skin damage caused by UV radiation than others and the following groups are advised not to use tanning equipment:
(a)if they are under 16
(b)have fair sensitive skin that burns easily or tans slowly or poorly
(c)have a history of sunburn especially in childhood
(d)have a large number of freckles and/or red hair
(e)have a large number of moles (more than 20) on their body
(f)are taking medicines or using creams which may sensitise the skin to sunlight
(g)have a medical condition that is worsened by sunlight
(h)have a family history of skin cancer
4.6Sunbeds are used by skin specialists in the treatment of certain skin conditions. In particular, psoriasis may respond to UV treatment. However, this is always undertaken using special sunbeds supervised by a dermatologist.
5Current Situation
5.1Sunbeds are provided at the Dolphin Swimming Pool, Rossmore Leisure Centre and Ashdown Leisure Centre. All three centres ensure the facilities are operated according to best practice. There are three main aspects to best practice: customer education, maintenance of equipment, staff training.
5.2Customers are educated on sensible sunbed use. Each customer will be issued with a card to enable every sunbed session to be recorded. Guidelines on the use and misuse of sunbeds, including what to do in the event of an emergency, should be displayed prominently and the information repeated on the record card.
5.3All three Centres comply with the recommendations of the Sunbed Association who are the trade association for the sunbed industry, recommends for sunbeds as follows:
(a)should be manufactured to recognised standards
(b)should be installed, maintained and serviced to recognised standards
(c)should receive daily and regular checks of important components, eg lamps, timers, filters
(d)are operated in a hygienic environment
5.4Staff are trained as follows:
(a)how to operate the sunbed
(b)to check the lamps are working
(c)how often to clean the sunbed
(d)to be able to identify those people who should not be using a sunbed
(e)to have a basic understanding of UV and how the skin tans
(f)to be able to allocate the correct length and number of sessions
(g)to ensure the customer wears goggles
(h)to warn customers of the risks of abuse
(i)to be able to answer a customer’s question
and the Health and Safety Executive (HSE) recommends that:
(j)understand the health risks to them of exposure to UV radiation
(k)centres should keep records of individuals’ usage of sunbeds.
6Considerations
Members are requested to consider:
(a)the continued provision of sunbeds in centres ensuring the guidelines for customer education, maintenance of equipment and staff training are adhered to.
(b)the continued membership of the trade association for the sunbed industry (TSA), a non-profit making organisation, who promote the benefits of membership to include: commitment to the Sunbed Code of Practice (see 5.3 and 5.4 above); recognition as a reputable operation offering reassurance to customers that care is taken to ensure their health and safety; advice, guidance and information to operate good practice; keeping in touch with news and developments; providing help with positive public relations.
(c)a report by Wright, Hart and Kernohan, British Medical Journal: BMJ 1997:314 1280 26 April, who state: “that there can be no doubt that sunbeds are widely used and that they carry a risk of inducing skin cancer. Clearly the higher the UV light output the greater the risk. We think that without further education of the public in the potential danger of sunbeds, their removal from local authority or council run premises will only drive those who wish to use them into the commercial sector, where the dangers may be greater. Rather than banning sunbeds from council premises a more sensible approach would be to provide greater education about sunbeds and set up national guidelines on the operation of sunbeds and their recommended power outputs.”
(d)the legal implications which could result in expensive lawsuits if claims were brought against the Borough of Poole. The Institute of Amenity Management (ILAM) strongly recommend that providers of sunbeds seek professional legal, medical and health and safety advice in determining their policies on future provision, as well as ensuring that public liability insurance will cover any prospective claim. The ILAM Fact Sheet 96/25 recommends that facilities are operated according to best practice as stated in 5.2, 5.3 and 5.4 above, together with additional precautionary measures as follows: Ask the customer to acknowledge in writing –
(i)that their proposed use will not exceed or contravene any of the restrictions, for example, frequency of use, number of moles on upper body, skin/hair colour, medical reasons.
(ii)that they will not gain any health benefit and that they are using the sunbed for purely cosmetic purposes.
(iii)that they have read and understood the instructions on the use of the equipment.
(e)The Head of Consumer Protection Services has been consulted on this report. He agrees with the view that evidence regarding the harmful effects is not definitive and that removing the well regulated provision in leisure centres may drive people to use facilities that are less well regulated. He has suggested that leaflets be considered advising users of the potential risks and how to spot the early signs of skin cancer.
(f)the financial implications concerning the removal of sunbeds from the Dolphin Swimming Pool, Rossmore Leisure Centre and Ashdown Leisure Centre. The loss of profit to these centres would be:
2002/2003 / 2003/2004 (Est)Dolphin Swimming Pool / £34,000 / £25,000
Rossmore Leisure Centre / £16,000 / £13,000
Ashdown Leisure Centre / £ 3,000 / £ 3,000
Total / £53,000 / £41,000
Clive Smith
Head of Leisure Services
Contact Officer: Allan Ferris
Background Papers
Health Education Authority and the Chartered Institute of Environmental Health:
‘Skin Cancer Prevention: Policy guidelines for local authorities’.
Head of Leisure Contract Services: ‘Sunbed Usage at Leisure Centres’.
January 1999
Imperial Cancer Research Fund: ‘Sunbeds and Skin Damage’. May 1997
The Sunbed Association: ‘Voice of the Industry’. February 1999
Health & Safety Executive: ‘UV Tanning Equipment’. Customer Information
British Medical Journal 1997: ‘Dangers of sunbeds are greater in the commercial sector’. 314:1280 (26 April):
Institute of Leisure and Amenity Management: ‘Sunbeds – Issues & Guidelines’. Factsheet 96/25
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