Tom Fleming (Kerry South, Independent) | Oireachtas source

Medical evidence accepted by authoritative bodies such as the World Health Organization shows that exposure to ultraviolet radiation occurring during sunbed use may cause skin cancer, eye damage and premature skin ageing. Skin cancer is the most common form of cancer in Ireland. It is estimated that 794 deaths per year in the EU-18 countries are attributable to sunbed use.

A 2010 survey for the Irish Cancer Society estimated that nearly 140,000 people in Ireland use sunbeds and most of these are women and one in five are aged between 15 and 24. In a report in 2012 it was ascertained that about one in 20 cases of the most dangerous form of skin cancer can be attributed to sunbed use. Researchers from the International Prevention Research Institute in France and the European Institute of Oncology in Italy analysed the results of 27 studies on skin cancer and sunbed use carried out in European between 1981 and 2012. The number of skin cancer cases included in the analysis was 11,428. A study published by the British Medical Journal enabled doctors to calculate that out of 643,942 new cases of malignant melanoma diagnosed each year in Europe, an estimated 3,438, or 5.4%, are related to sunbed use. The authors estimate that from 69,942 new cases of melanoma diagnosed every year in the EU countries 498 female and 296 male deaths would be caused by sunbed use. Some 721 cases of melanoma are diagnosed in Ireland each year.

Modern indoor tanning equipment mainly emits rays in the ultraviolet A range, a fraction of the spectrum is in the ultraviolet B range. Powerful ultraviolet tanning units may be ten to 15 times stronger than the midday sunlight on the Mediterranean Sea and repeated exposure to large amounts of rays in the ultraviolet A range delivered to the skin in a relatively short period, typically ten to 20 minutes, poses a huge risk to humans.

The International Agency for Research on Cancer has classified the whole ultraviolet spectrum and indoor tanning devices as carcinogenic. A study from 2005 found a 75% risk of developing melanoma if sunbed sessions were started during adolescence or early adulthood. Adolescence is the most dangerous period in the lifecycle. However, no studies since then have estimated the impact of melanomas due to sunbeds in western Europe. This latest research estimates the risk of skin cancer doubles if the sunbed use starts before the age of 35. The author of the report believes that earlier studies tended to underestimate the risks of indoor tanning because the use of these devices is relatively new. Furthermore, from 2005 to 2011 most risks have increased.

Further studies could therefore demonstrate an even higher risk, particularly for high risk Irish skin, which is more prone to cancer. Irish people are at a higher risk because three out of every four have skin type one or two which burns very easily and almost never tans. Sunbeds and sunlamps artificially recreate the sun's ultraviolet rays resulting in the development of a suntan but they also contribute to skin damage and increase the risk of cancer.

A report by the World Health Organization in 2009 showed that the chance of developing skin cancer increases by 75% if a person regularly uses sunlamps under the age of 35.

In July 2009, it reclassified sunbed use from a group 2A carcinogen, which is probably carcinogenic to humans, to a group 1 carcinogen, which is definitely carcinogenic to humans.

Sunbeds also raise the risk of non-melanoma skin cancers, particularly when people start using them before the age of 25. Research found that up to 28,000 people under the age of 25 use sunbeds in Ireland each year. Although indoor tanning devices are linked to the most deadly form of skin cancer, melanoma, a new study states they also trigger other damaging forms of the disease. Non-melanoma skin cancer is triggered by sun damage and, although not usually fatal, may be disfiguring without treatment. These non-melanoma skin cancers are slow-growth cancers that can look like a skin bump on the face, the scalp or the hands. The latest study shows that sunbed users have a 67% greater risk of developing squamous cell skin cancer and a 29% higher risk of basal cell carcinoma compared with people who have never used indoor tanning. It found that exposure to sunbeds before the age of 25 was significantly linked with a higher risk of basal cell carcinoma.

The European Commission has highlighted that the impact of sunbed use takes years to be fully known as there is often a long time delay between sunbed use and the onset of medical problems. Wide use of indoor tanning is also of relatively recent date, which means the detection of these long-term effects is still difficult. The British Association of Dermatologists has identified a number of groups who should never use sunbeds. These include people under 18 years of age, those with fair skin that does not normally tan with sun exposure, those with a large number of moles, those with a history of skin cancer and those with abnormal sensitivity to the sun due to sun allergies or medication. I believe there are very strong reasons to make amendments to this Bill to include some of the above categories and I hope some of these measures will be introduced on Committee Stage.

There is also a need for greater awareness of general health hazards of sunbeds and outdoor sun conditions. Legislation should be backed up by education and a public health campaign both for young people, through the schools, and for adults, through a public relations exercise. This campaign would provide the relevant information and outline the need for protective screening lotions in outdoor sun situations. We have a great opportunity to link in with the sunbed legislation to get the message across to a wider audience that, due to several factors, the sensitivity of Irish skin is an issue we need to address. I ask the Minister either to incorporate this into the Bill or have the HSE take strong action, with the Department of Health, to create a widespread sense of awareness of the sun and the elements we encounter every day.

Some 48% of respondents to a recent survey use sunscreen regularly in this country, which means more than half of the population do not avail of any type of screening. In addition, the majority of those who use protection use only a factor 15 screen. I believe cost is a disincentive to sunscreen use. Like the majority of drugs, the cost of sunscreen in Ireland is very high compared with the cost in most other countries. Irish people who go abroad to enjoy the Mediterranean sun in Spain, Portugal, Greece and so on are astounded by the high cost of general medication here, and the same applies to sunscreen. None the less, they must purchase it, for good reason, given the high level of sunshine when they go abroad. When we get the odd occasion of high sun exposure in this country, however, I believe we neglect to use sufficient sunscreen, and this is particularly the case among the younger generation.

Climate change and global warming are also a factor. We have seen extremities in the past month and also last summer, when we had unusual weather conditions for this country. We must be more careful in future to get the message across that people must use sunscreen regularly.

Melanoma is the most serious form of skin cancer and its incidence has increased in Ireland by 138% between 1994 and 2010. This is a very serious statistic. I know the Minister introduced the melanoma drug 12 months ago, which was a very welcome addition to the medication for the treatment of skin cancer. However, we must introduce more preventative methods and get the message out there. We should talk to and renegotiate with the drug companies. If there was additional demand and additional sales, perhaps the drug companies would reduce the cost of these products, which would make it more favourable to the consumer.

Traditionally, we are not very careful with sunshine when outdoors, for example, with regard to protective clothing. When we get the first splash of sun in May, people rush to the seaside and perhaps are not properly protected. In the past, when people in rural Ireland were in the meadow or the bog, they always wore straw hats but this is no longer the case. The older generation had a lot of common sense and those hats were a great protective measure, without having any other form of screening. Perhaps we need to get back to the old traditions given that generation were wise enough to use this form of protection.

Avoiding the most dangerous time of the day, from noon to 2 p.m., is important and there should be more awareness that people should stay indoors at this time.

We are very fortunate that there are a large number of recreational areas, playgrounds and facilities available outdoors for our younger generation and all age groups. The appearance, one hopes, of longer summers and days of sunshine is all the more reason we need to get the message across to people. We will save ourselves millions and avoid much suffering on the part of our citizens in future.

There is a high level of support for the regulation of sunbeds. According to a briefing paper from the Irish Cancer Society, 90% of people support a ban on sunbeds, be it a complete ban, of which 47% are in favour, or a ban for under 16 year olds, of which 43% are in favour. It is very interesting to see that 38% of sunbed users did not see guidelines posted or receive any verbal information on sunbed use from the sunbed operator. The briefing paper states that:

Self-regulation of the industry is clearly not working. In August 2012, the Irish Cancer Society found that a fair-skinned, seventeen year old child was encouraged to use sunbeds by all seven of the tanning shops she visited as part of an undercover survey. The advice from the tanning salons, which included well-known chains, told the girl that she should be tanning at least three times a week in order to be tanned for a wedding in October. One salon claimed that she would need to use a sunbed more frequently than someone with dark skin because she would find it harder to get a tan. None of the salons asked the child her age or advised her against using a sunbed because of her very fair skin. All salons pressured her to start using a sunbed as soon as possible. The survey revealed that without any regulation, children and people with fair skin are being actively encouraged to use sunbeds by sunbed operators. We are extremely concerned that without regulation that would prevent under 18s and those with Type 1 and Type 2 skin (very fair skin) from using sunbeds, those people most at risk from skin cancer are not being protected.

The paper also lists the jurisdictions that have introduced legislation prohibiting those under 18 from using sunbeds. The array of jurisdictions that have introduced the necessary legislation include Austria, Belgium, Finland, France, Germany, Italy, Norway, Portugal, Spain, Sweden, England, Northern Ireland, Scotland, Wales, British Columbia, Newfoundland and Labrador, Nova Scotia, Quebec, California, New York, Vermont and Iceland. Brazil has banned all tanning beds for commercial purposes and Tasmania, Victoria and Western Australia have introduced legislation that will ban tanning beds from 2014. We are lagging behind in respect of introducing the necessary legislation. It is long overdue for us to proceed with this and introduce the necessary safety measures. I hope we can over the next few weeks improve on what is contained in the draft Bill. I am sure we will have a better and safer country as a result of this.

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