Background The World Health Organization classified the entire ultraviolet (UV) spectrum and artificial UV tanning devices as carcinogenic to humans. Italian law has prohibited the use of tanning equipment by children under 18 years of age and by high-risk populations. Objectives The present large survey aimed to determine the prevalence of current sunbed use in Italy and to identify user characteristics. This study identifies starting points for future national interventions to reduce the health risks of exposure to artificial UV radiation. Methods In 2011 we conducted a survey of 4703 people in an area on the sunny Mediterranean coast in Italy. Through multivariate logistic models we investigated the associations of sunbed use with phenotypical factors. Results Overall prevalence of sunbed use was 20%, higher among women (22% vs. 16%; P <0·0001), and young (22% vs. 17% for age <35 years; P <0·0001) and highly educated people (22% vs. 14%; P <0·0001). Subjects at high risk of melanoma used sunbeds significantly more; i.e. people with freckles (25% vs. 18%; P <0·0001), red hair (30% vs. 19%; P = 0·01) or fair eyes (22% vs. 19%; P = 0·006). Associations were confirmed in multivariate models. Conclusions More skin cancer monitoring is needed at tanning centres, and educational campaigns should be promoted, especially for young women and subjects at high risk of melanoma. What's already known about this topic? Solar ultraviolet (UV) radiation is the main environmental risk factor for the development of skin cancer, which is the most common cancer in white populations. In 2009, the International Agency for Research on Cancer classified the entire UV spectrum and artificial UV tanning devices as group 1 carcinogens for humans. Artificial UV radiation was significantly associated with melanoma and nonmelanoma skin cancer using a meta-analytical approach. What does this study add? This is one of the first surveys to show a higher prevalence of sunbed use in groups at risk for skin cancer. This study identifies starting points for future national interventions to reduce the health risks of exposure to artificial UV and for monitoring implementation of directives that in many countries have prohibited the use of tanning equipment by children under 18 years of age and high-risk populations.
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