Getting published in professional journals is nothing new in academia, but three different articles in three journals in the same week might be somewhat unusual.
Still, it’s something East Tennessee State University doctoral candidate Katie Baker experienced as co-author of those articles on different aspects of skin cancer prevention in three different academic journals, which reported research conducted in the Department of Community and Behavioral Health that focused on various aspects of indoor tanning.
The work Baker is doing, along with her nationally recognized adviser, Dr. Joel Hillhouse, is pretty detailed and its message is fairly simple — indoor tanning is dangerous and claims by the tanning industry that it’s safer because users don’t burn are not supported by ETSU’s studies.
“They’re cutting edge in their findings,” Baker said of the studies on which the articles are based. “But also, I think they serve to shed light on what a public health problem this is. Having a tanned appearance is very desirable in our society, especially for young women. Up until now, I don’t think our society or our policymakers have taken indoor tanning very seriously.”
Basically, the newly published articles detail those studies showing the prevalence of sunburn indoor tanners experienced, indoor tanning abuse and dependence — much like substance dependence — and how to promote behavior change among indoor tanners.
“By showing young women can become dependent on the behavior, thus increasing their exposure to ultraviolet radiation exponentially, and by showing the indoor tanning industry is being a tad bit dishonest by claiming that indoor tanning is safer than tanning in the sun, I think that these will help inform local leaders and even national-level policymakers to help protect young people,” Baker said.
“We’ve known for some time that the publications were coming, but what are the odds that all would happen in the same week?” Baker said.
That’s exactly what happened the third week of July. Baker, Hillhouse, and another of Hillhouse’s former students, Dr. Jerod Stapleton, were pleased with the publications, she said. The articles appear in the Archives of Dermatology, the “premier dermatology journal,” Dermatological Clinics and Translational Behavior Medicine, a monthly online journal.
“The first article about tanning abuse and dependence, it’s really the most important in this set,” she said. Previous studies showed a 55 percent of a sample being dependent on tanning.
“It was pretty unrealistic” for such a high number of the U.S. population to be tanning dependent, Baker said.
Baker said the study conducted by ETSU revealed a 10 percent tanning dependent population, dispelling the previous study of 55 percent.
“We set out to show a more accurate, valid measure. We found that 10 percent of our population met the criteria for tanning abuse and 5 percent met the criteria for tanning dependence,” she said.
One of the articles is based on “UV-exposure diaries” compiled over a 12-week period by subjects in a study Hillhouse conducted several years ago.
“The results showed that people are getting burned in the tanning bed. One of the messages the indoor tanning industry tries to send is tanning is safer than the sun because you can regulate your UV exposure in such a way that you won’t get burned. But this study serves to almost dispel that myth that you can’t get burned in the tanning bed,” she said.
“The statistic you always hear is that even one sunburn as a child or an adolescent can increase your chance of melanoma. This study showed that 66 percent experienced at least one episode of burning in the 12-week period from the tanning bed with nearly one in five tanning sessions resulting in sunburn,” she said.
The lead author on that article was Stapleton, who is now doing research at the Cancer Center of New Jersey.
Baker said she and Hillhouse are in no way totally opposed to sun exposure — particularly with all the outdoor recreational opportunities in East Tennessee — but they want sunless tanning promotion stopped and for people to take precautions when they are exposed to the sun.
“There are easy, easy guidelines to follow when you are outdoors to protect yourself. We are not of the ‘all or nothing camp,’ ” she said. “I do believe we are starting to have an impact. Teens have a hard time conceptualizing cancer.”
Getting the message out about the dangers of UV radiation, including the two types, is what’s so important in preventing cancer, Baker said.
“The message we try to send to young teens and young women is that tanning will actually damage their appearance now.”
Tanning beds emit mostly UVA radiation, which penetrates deep into the second layer of the skin, which damages collagen and elastin and causes wrinkling and sagging skin, Baker said. Sun has UVA and UVB rays, but mostly UVB, which are the burning rays.
“Both a sunburn and a suntan are ultimately our skin’s reaction to overexposure to UV and it’s trying to protect itself, so a tan is like a scab,” Baker said.
“We know that smoking causes lung cancer so we don’t allow teenagers to purchase cigarettes. Now the science shows, and we know, that UV radiation from tanning beds causes skin cancer. The UV radiation has been linked directly with melanoma, the deadliest skin cancer. So why wouldn’t we try to prevent our teenagers from accessing this carcinogen as well?” she said.
Baker, just finishing up her third year in the ETSU public health program, is in the process of writing her dissertation on a mother-daughter study about the influences a mother’s attitude toward tanning has on a daughter’s tanning behavior.