Sightings
NEJM Perspective: Indoor Tanning — Science, Behavior, and Policy
David E. Fisher, M.D., Ph.D., and William D. James, M.D.
An estimated 1 million times per day, someone in the United States uses ultraviolet (UV) radiation for skin tanning. According to the indoor tanning industry, tanning beds are used by 30 million Americans, or about 10% of the U.S. population, each year (www.theita.com/indoor). These users include minors, who often have ready access to tanning beds. In response to considerable grassroots and political opposition to indoor tanning, in late March the Food and Drug Administration (FDA) convened an advisory panel to review the safety of the procedure. The FDA is expected to announce a decision soon on whether and how to reclassify tanning lamps and possibly to address minors’ access to them.
The concern arises from increases in the incidence of melanoma and its related mortality. In the United States, the incidence of melanoma is increasing more rapidly than that of any other cancer. From 1992 through 2004, there was a particularly alarming trend in new melanoma diagnoses among girls and women between the ages of 15 and 39. Data from the National Cancer Institute’s Surveillance, Epidemiology, and End Results registry show an estimated annual increase of 2.7% in this group. Researchers suspect that the increase results at least partially from the expanded use of tanning beds. The possibility that changes in diagnostic criteria may have contributed to the increased incidence is lessened by the fact that the trend is specific to a certain age range and sex. The incidence of thicker cutaneous melanomas (>1 mm) has also increased, and the incidence of regional and distant tumors has increased at an estimated annual rate of 9.2% — a change that could portend a surge in advanced melanomas in young women. Although substantial advances have been made in melanoma therapies, the risk of death from advanced disease remains high.
Abundant epidemiologic data have been examined to assess potential connections between indoor tanning and both melanoma and non-melanoma cutaneous cancers. According to a 2006 meta-analysis by the International Agency for Research on Cancer (IARC), among people who first used indoor tanning before 35 years of age, the relative risk of melanoma was 1.75 — a finding that prompted the World Health Organization to classify tanning beds as a group I carcinogen. Similarly, a recent case–control study in Minnesota showed an adjusted odds ratio of 1.74; the risk of melanoma increased as the number of years of tanning and hours of tanning sessions increased.
An even more dramatic association has been found between exposure to UV radiation and non-melanoma skin cancers. In the IARC study, history of any indoor tanning was associated with a relative risk of 2.25 for squamous-cell carcinoma. Although most of these lesions are successfully treated at an early stage, metastasis persistently occurs in a small minority of such lesions, at which point cure is rare. Although the overall rate of death from squamous-cell carcinoma is low, the high incidence of this form of cancer means that it accounts for 25 to 35% of skin-cancer–related deaths.
Read the rest of the NEJM Perspective on this topic:
FTC and the Clean Credit Report Repair Court Order
A credit repair operation has agreed to stop making false claims and stop charging up-front fees under a settlement with the Federal Trade Commission. The settlement is part of an ongoing crackdown on scams that target financially strapped consumers, in this case taking hundreds of dollars in fees to purportedly remove negative information from consumers’ credit reports even if the information is accurate and timely. The FTC filed the action in “Operation Clean Sweep” in October 2008.
Problems with State-Local Final Pay Plans; Options for Reform
The Center for Retirement Research at Boston College has published another Brief of interest August 2010
Introduction
As widely publicized, the financial crisis dramatically worsened the funded status of state and local pension plans. In response, public sector sponsors are making a number of changes. Most of these changes involve increasing employer and employee contributions and cutting benefits for new employees primarily by increasing the age for full benefits. A couple of states have cut cost-of-living adjustments for current retirees, but they are in the process of being sued. One item not on anyone’s agenda is reconsidering the basic design of public-sector defined benefit plans.
Website Houzz, Home Design
When we were gathering ideas for the house we built two years ago, we had folder upon folder of tear sheeets collected from numerous magazines. Unfortunately, a number of those magazines have disappeared, unappreciated by their publishers after years in mailboxes and on newstands. Two of those prized resources were House & Garden and Metropolitan Home. Some were recent newcomers in the magazine field, such as Domino, and a number of them are still sorely missed. Here's a website that might make that search for the perfect room easier. From their website:
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