Tanning salons are blamed for some of the increase. The American Academy of Dermatology estimates that every year, 30 million Americans visit the nation's more than 49,000 tanning parlors. About 7 out of 10 patrons are women between 16 and 60. A 15- to-30-minute session under the sunlamp, experts say, is the equivalent of a full day at the beach. Marie-France Demierre, M.D., director of the skin oncology program at Boston University Medical School, calls the trend "tanning bed addiction and sun worship."
According to the Looking Fit Tanning Fact Book 2002-2003, indoor tanning made its way to this country from Germany in 1979. By 1985, "The industry was very cosmopolitan and many people were making money." Tanning parlor patrons believe a tan makes them look fit and healthy. Says the National Institute on Aging: "The simplest and cheapest way to keep your skin healthy and young looking is to stay out of the sun….UV radiation from the sun is the main cause of skin cancer [and] artificial sources of UV radiation — such as sunlamps and tanning booths — can cause skin cancer."
Dermatologist Mark Naylor says: "Right now people think it's not a problem. [They think:] If I get a skin cancer, I can just go to my dermatologist and he can just take it off." Acknowledging that melanoma can be treated if it's caught early and hasn't spread, Naylor says to those whose melanoma is advanced: "Good luck." Donald L. Smith (North American Alliance of Tanning Salon Owners) responds to "the dermatology community": "…over 100 people die prematurely each year because of the adverse consequences associated with underexposure to ultraviolet radiation (UVR) for every one person who dies prematurely each year because of overexposure to UVR… [and] there is not one scintilla of evidence to show that sensible, moderate and responsible exposure to UVR is anything other than beneficial to human beings."
Like tanning, tattooing has entered the mainstream. According to Hoag Levins ("The Changing Cultural Status of Tattoo Art"): "The cultural status of tattooing has steadily evolved from that of an antisocial activity in the 1960s to that of a trendy fashion statement in the 1990s." He cites a Canadian study of the clientele at a popular Toronto tattoo art studio where "80% of the customers were 'upper middle-class white suburban females.'" He quotes U.S. News & World Report: "…tattooing was the sixth- fastest-growing retail business in 1996, after Internet, paging services, bagels, computer, and cellular phone stores. Since then, the industry has been expanding by more than one studio a day, a 13.9 percent increase in nine months."
Incidence of Hepatitis C: 1985-1999
The inset graph shows reported cases of hepatitis C. What does hepatitis have to do with tattooing? Hepatitis Weekly reports on a study showing that "getting a tattoo could be a key infection route for hepatitis C, the most common viral infection affecting almost 2% of the United States population." The newsletter points out that hepatitis C attacks the liver and is potentially fatal. Be trendy at your own risk.
Sources: Charts: Centers for Disease Control, National Cancer Data, Table XVI, "Melanomas of Skin (Invasive), http://seer.cancer.gov/csr/1973_1999/melama, and Statistical Abstract of the United States: 2001, Table 181. National Institute on Aging AgePage, http://www.nia.nih.gov/health/agepages/skin.htm. Lisette Hilton, "Get the Word Out to Patients About Melanoma," http://www.healthcarehub.com/. "Indoor Tanning Casts a Year-Round Shadow," American Academy of Dermatology, http://www.aad.org/ermnsights/. Centers for Disease Control, Facts and Statistics About Skin Cancer, http://www.cdc.gov/ChooseYourCover/skin.htm. John Jesitus, "Melanoma rates are on the rise: Other forms of cancer, meanwhile, take downward trend," Dermatology Times, September 2000, p. 23. Hoag Levins, "The Changing Cultural Status of Tattoo Art," http://www.tattooartist.com/history.html. "Study Finds Tattooing a Major Route of Hepatitis C Infection," Hepatitis Weekly, April 16, 2001. All Internet information retrieved July 12, 2002. Looking Fit Tanning Handbook, http://www.lookingfit.com/factbook/.
1 A caveat about drug use data: Different methods of calculating the number of drug users can produce widely different estimates. The Washington Post reports that "Measuring the drug war with any precision is a daunting task. Hard-core drug users are hard to find, much less question." In the same article is a quote from David Musto, Yale University medical historian and an expert on drug trends: "You really can't tell from the big debate that goes on in public what the big picture is … When I tell people about it, they're completely surprised by the fact there has been a decline [in drug use] since 1980." Jeff Leen, "Number Jumble Clouds Judgment of Drug War," Washington Post, January 2, 1998, pA01.
2 "Cigarette Prohibition in Washington, 1893-1911," retrieved July 22, 2002, from http://www.historylink.org/output.
3 McDonald's is not the only purveyor of fast-food meals. It recently introduced "What's On Your Plate," a series of twelve different public service announcements on "eating right," produced in partnership with the U.S. Society for Nutrition Education; see http://www.mcdonalds.com/countries/usa/food/eating_right
4 Vogel was commenting for WebMD on an Australian study reported in the June 2001 Journal of the American College of Cardiology. The study of 32 "healthy volunteers" showed that "After eating a simple meal of a ham and cheese sandwich with butter, and a serving of whole milk and some ice cream, the ability of the body's arteries to expand and accommodate the blood and fat traveling through them is reduced by about 25%. See http://content.health.msn.com/content/article/1728.80751.
5 Defined at http://www.cdc.gov/foodnet/: "The Foodborne Diseases Active Surveillance Network (Food- Net) is the principal foodborne disease component of CDC's Emerging Infections Program (EIP). FoodNet is a collaborative project of the CDC, nine EIP sites (California, Colorado, Connecticut, Georgia, New York, Maryland, Minnesota, Oregon and Tennessee), the U.S. Department of Agriculture (USDA), and the Food and Drug Administration (FDA). The project consists of active surveillance for foodborne diseases and related epidemiologic studies designed to help public health officials better understand the epidemiology of foodborne diseases in the United States." The project began in five states and surveilled laboratory- confirmed cases. Each year the surveillance area, referred to as the "catchment," expands. By 2002 it covered 38 million persons in nine states. Incidence rates for all food-borne pathogens can be found in table form at the back of this book.
6 Hazard Analysis and Critical Control Points, the U.S. Department of Agriculture's system for ensuring that meat and poultry plants meet food safety standards.
7 There actually was a terrorist attack on the food supply in the 1980s. An Oregon cult (followers of the Indian guru Bhagwan Shree Rajneesh) contaminated salad bars with salmonella bacteria. Cult members hoped that by incapacitating enough voters (750 people fell ill), they would see their candidates win in county elections.
8 A member of the National Advisory Committee for Meat and Poultry Inspection. Donley's six-year-old son Alex died in 1993 after eating a hamburger contaminated with E. coli 0157-H7.
9 For example, a 1997 outbreak of hepatitis in Michigan schoolchildren was traced to frozen strawberries from Mexico. The USDA vowed a crackdown on suppliers. NSLP products must be U.S.-grown.
10 Data are based on a 1996 Government Accounting Office report described in The Food Institute Report; see Source notes.
11 Based on "a nationally projectable sample of 1,200 people aged 18 and older."
12 American Psychiatric Association; Fourth Edition.
13 Anorexia Nervosa and Related Eating Disorders, Inc (http://www.anred.com/stats.html).
14 Bell is a history professor at Rutgers, The State University of New Jersey.
15 We use the definition of drug from Merriam-Webster online: "something and often an illegal substance that causes addiction, habituation, or a marked change in consciousness." Use of any of these substances is illegal for this age group.
16 Current users are those who used a drug at least once within the month prior to the study.
17 "Parental Influences…"; see Source notes.
18 Pride is designated by Federal law "as an official measure of the effectiveness of the White House drug policy." Their 2001-2002 survey of 101,882 students in grades 6-12 showed a significant decline over the previous year in alcohol, tobacco, and other drug use, a phenomenon attributed to family togetherness since September 11. Pride researchers claim that while their data tend to agree with the Monitoring the Future Survey, the NHS tends to show significantly lower drug use in the 12-to-17-year-old age group.
19 A Newsweek interview with soldiers stationed in Afghanistan elicited the information that some have resorted to huffing air freshener because alcohol is forbidden. In a somewhat similar vein, a 1971 report on a heroin "epidemic" among soldiers in Vietnam made headlines.
20 Survey of those who confessed to being current users, defined as those who used drugs at least once within the month prior to the survey. Based on a representative sample of the U.S. population aged 12 and over, including persons living in households and in some group quarters.
21 Current users are those who used a drug at least once within the month prior to the study.
22 A Washington Post story cited in the introduction to this chapter alleges "discrepancies in the habitual cocaine-use figures … but the discordant numbers keep appearing."
23 Any illicit drug includes the following: Marijuana/hashish, cocaine and crack cocaine, inhalants, hallucinogens including PCP and LSD, heroin, stimulants, sedatives, tranquilizers, and analgesics.
24 Legislation mandating this punishment was passed after the 1986 cocaine (mistakenly believed to be crack) overdose death of University of Maryland basketball star Len Bias, which allegedly gave ammunition to congressional drug warriors. Legislation introduced in December 2001 (the Drug Sentencing Reform Act) seeks to reduce the penalties for both powder cocaine and crack cocaine offenses.
25 Quoted in Reason; see Source notes.
26 Comparable data for 1999 are not available.
27 Total population aged 12 and over in 1990 was 199,956,202.
28 In U.S. News & World Report; see Source notes.
29 Smoking deaths from lung cancer, cardiovascular and respiratory diseases, and burns.
30 The category "drug-induced deaths" includes deaths from legal and illegal use of drugs and also poisoning from medically prescribed and other drugs. Drug-induced deaths excludes accidents, homicides, and other causes indirectly related to drug use. Also excluded are newborn deaths due to mother's drug use.
31 A nonprofit coalition of media professionals that produces most of the White House's anti-drug ads.
32 Schedule I is the most restrictive schedule under the Controlled Substances Act. According to the U.S. Drug Enforcement Agency (DEA), such a substance has a high potential for abuse, no officially accepted medicinal uses, and no safe level of use under medical supervision. On May 24, 2002, the U.S. Court of Appeals for the District of Columbia Circuit issued a ruling upholding DEA's determination that marijuana must remain a Schedule I controlled substance. DEA also seeks to declare hemp, an ingredient used in certain brands of pretzels, beer, bread and granola, a controlled substance.
33 Thomas (see Source notes) presents an estimate of the number of "marijuana only" (no other drug involved) prisoners in state and federal prisons in 1998: 27,600.
34 A 1997 report by researchers at Demos, a British public policy think tank, used data from a survey of more than 850 young people to compare the attitudes of 16- to 24-year-olds who consume drugs with the attitudes of young people in general. The surveys found that users "trusted and respected their families in much the same way as other teenagers; tended to be more independent and less introverted than those who did not use drugs; made their own decisions about drug use and disapproved of 'out of control' behaviour by problem users; led active lives, viewing drug-taking as an integrated part of certain social events; were no more fatalistic than other young people or lacking in self-esteem." (Source: "'Czar' warned to beware of myths about young people who use drugs, Joseph Rountree Foundation, retrieved August 2, 2002, from http://www.jrf.org.uk/pressroom/releases/051197.asp).
35 In 1991, the Journal of the American Medical Association charged R. J. Reynolds Tobacco Company with targeting children through the Joe Camel campaign. That year Attorney Janet C. Mangini became the first person to challenge the tobacco industry for targeting minors through advertising.
36 How successful is this kind of advertising? Before Joe Camel (1988), Marlboro targeted kids and Camel sales trailed Marlboro. By 1993 the three most heavily advertised brands were Marlboro, Camel, and Newport (CDC). While those brands accounted for 35% of overall cigarette sales, 86% of adolescent smokers bought one of the three brands. Between 1989-1993, Camel sales to adolescents were up 64%, Newport sales were up 55%, but Marlboro sales declined 13%.
37 Definition retrieved July 23, 2002, from http://www.stressfree.com/stress.html.
38 Based on a study of 500 healthy volunteers at Cardiff University. The 188 participants in the study who developed colds were also more likely to drink alcohol and smoke than were those who stayed healthy.
39 Surveys conducted by Northwestern National Life, Families and Work Institute, and Yale University; reported by NIOSH (see Source notes).
40 CCH Inc., a Chicago research firm, survey of human resources managers at 305 firms representing 800,000 employees. Other issues were family or personal needs. CCH reports that worker stress more than tripled between 1995-1999 (from 6% to 19%).
41 The trend in other industrialized nations is downward. In Australia, Canada, Japan, and Mexico, the average worker puts in about 100 hours per year less than we do. In Brazil and Britain, it's 250 hours less; in Germany, 500 hours less.
42 Kensington Technology Group, designers/manufacturers of computer accessories.
43 James P. Kiley, Ph.D., Director of the National Center on Sleep Disorders Research, says there could be as many as 1,500 fatalities and 100,000 sleep-related automobile accidents annually in the United States.
44 Modafinil is approved by the Food and Drug Administration as a treatment for narcolepsy (brief attacks of deep sleep). According to washingtonpost.com: "In trials on healthy people like Army helicopter pilots, modafinil has allowed humans to stay up safely for almost two days while remaining practically as focused, alert, and capable of dealing with complex problems as the well-rested. Then, after a good eight hours' sleep, they can get up and do it again — for another 40 hours, before finally catching up on their sleep." A possible application? "The Defense Advanced Research Projects Agency is searching for ways to create the 'metabolically dominant soldier.' Among the projects it is pursuing is the creation of a warrior who can fight 24 hours a day, seven days straight." (Source: http://www.washingtonpost.com/wp-dyn/articles/A61282-2002Jun16.html)
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