Chapter
U.S. Environmental Protection Agency’s UV Index
UV Exposure and Skin Cancer
Chronic versus Intermittent UV Exposure
Other Harms Caused by Excessive UV Exposure
Complex Relationship between Outdoor UV Exposure,
Vitamin D, and Human Health
Dietary Sources of Vitamin D
Medical Uses of UV Exposure
Benefits of Being Outdoors
Risks of Indoor Tanning Outweigh Any Potential Benefits
Current Trends in Sun Protection, Sunburn, and Indoor Tanning
Reducing the Risk of Skin Cancer
Sun Protection Strategies
Wear a Hat and Sunglasses
Avoid Times of Peak Sunlight
Avoid Indoor Tanning and Sunbathing
Barriers to Using Sun Protection
Barriers to Reducing Intentional Tanning
Social Norms Regarding Tanned Skin
For Communities and Schools
Current Evidence on Effective Community-Level Interventions
Prevention Policies in Schools
Barriers to Interventions in Schools and Communities
For Outdoor Work Settings
State and Local Policies, Legislation, and Regulation
Sun Protection Policies and Legislation
Indoor Tanning Policies and Legislation
SunWise: Sun Safety for Kids and Educators
Federal Policies, Legislation, and Regulation
Sun Protection Policies and Legislation
Indoor Tanning Regulations
Barriers to Addressing Indoor Tanning Through Policies, Legislation, and Regulation
Ubiquity of Indoor Tanning Devices
Lack of a Comprehensive Approach
International Efforts to Prevent Skin Cancer
Gaps in Research and Surveillance
Communities and Social Networks
Indoor Tanning Legislation and Multilevel Influence
Surveillance of Environmental Exposure
Vitamin D and Sun Protection
Potential Unintended Consequences of Interventions
Goal 1. Increase Opportunities for Sun Protection in Outdoor Settings
Strategy 1A. Increase Shade in Outdoor Recreational Settings
Strategy 1B. Support Sun-Protective Behaviors in Outdoor Settings
Strategy 1C. Increase Availability of Sun Protection in Educational Settings
Strategy 1D. Increase Availability of Sun Protection for Outdoor Workers
Goal 2: Provide Individuals with the Information They Need to Make Informed, Healthy Choices about UV Exposure
Strategy 2A. Develop Effective Messages and Interventions for Specific Audiences
Strategy 2B. Support Skin Cancer Prevention Education in Schools
Strategy 2C. Integrate Sun Safety into Workplace Health Education and Promotion Programs
Strategy 2D. Partner with Health Care Systems and Providers to Implement and Monitor Use of Recommended Preventive Services for Provider Counseling on Skin Cancer Prevention
Strategy 2E. Establish Partnerships between PUBLIC and Private Sectors to Disseminate Effective Messages About Skin Cancer Prevention
Strategy 2F. Enhance Ongoing Engagement of Federal Partners to Advance Our Nation’s Skin Cancer Prevention Efforts
Goal 3: Promote Policies That Advance the National Goal of Preventing Skin Cancer
Strategy 3A. Support Inclusion of Sun Protection in School Policies, Construction of School Facilities, and School Curricula
Strategy 3B. Promote Electronic Reporting of Reportable Skin Cancers and Encourage Health Care Systems and Providers to Use Such Systems
Strategy 3C. Incorporate Sun Safety into Workplace Policies and Safety Trainings
Strategy 3D. Support Shade Planning in Land Use Development
Goal 4: Reduce Harms from Indoor Tanning
Strategy 4A. Monitor Indoor Tanning Attitudes, Beliefs, and Behaviors in the U.S. Population, Especially among Indoor Tanners, Youth, and Parents
Strategy 4B. Continue to Develop, Disseminate, and Evaluate Tailored Messages to Reduce Indoor Tanning among Populations at High Risk
Strategy 4C. Support Organizational Policies That Discourage Indoor Tanning by Adolescents and Young Adults
Strategy 4D. Enforce Existing Indoor Tanning Laws and Consider Adopting Additional Restrictions
Strategy 4E. Address the Risks of Indoor Tanning with Improved Warning Labels and Updated Performance Standards
Goal 5: Strengthen Research, Surveillance, Monitoring, and Evaluation Related to Skin Cancer Prevention
Strategy 5A. Enhance Understanding of the Burden of Skin Cancer and Its Relationship with UV Radiation
Strategy 5B. Evaluate the Effect of interventions and Policies on Behavioral and Health Outcomes
Strategy 5C. Build on Behavioral Research and Surveillance Related to UV Exposure
Strategy 5D. Quantify the Prevalence of Tanning in Unsupervised Locations
Appendix 1: Scope and Definitions
Types of Ultraviolet Exposure
Appendix 2: Signs and Symptoms of Skin Cancer
Appendix 3: Skin Cancer Screening
Appendix 4: Success Stories in Skin Cancer Prevention
Federal Resources for Skin Cancer Prevention in Schools
RAYS Skin Cancer Prevention Program Shines Bright for New Mexico Schoolchildren
City of Toronto Shade Policy
Appendix5: Federal Departments, Agencies, and Policies
U.S. Department of Health and Human Services: Healthy People
National Cancer Institute
Centers for Disease Control and Prevention
Comprehensive Cancer Control Programs and Coalitions
Agency for Healthcare Research and Quality
U.S. Food and Drug Administration
U.S. Environmental Protection Agency
Occupational Safety and Health Administration
Appendix 6: Abbreviations and Acronyms
Chapter 3: False and Misleading Health Information Provided to Teens by the Indoor Tanning Industry: Investigative Report*
A. The Growing Popularity of Indoor Tanning
B. Cancer and Other Health Risks
C. Federal and State Regulation
III. Purpose and Methodology
A. Tanning Salons Provided False Information about the Health Risks of Indoor Tanning
B. Tanning Salons Provided Inaccurate or Misleading Information about Health Benefits of Indoor Tanning
C. Tanning Salons Regularly Disregarded FDA Safety Recommendations
D. Tanning Salons Targeted the Teen Market in Advertisements
E. Tanning Industry Websites Provide Misleading Information
Skin Cancer Prevention: A Call to Action
( Cancer Etiology, Diagnosis and Treatments )
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