Opinion Article
Safety of UV Lamps for Cosmetic Use: Regulatory Considerations
La seguridad de las lámparas emisoras de radiación ultravioleta de uso cosmético desde el punto de vista de su regulación legal
a Departamento de Química y Bioquímica, Universidad San Pablo CEU, Campus Montepríncipe, Boadilla del Monte, Madrid, Spain
b FuturoTecnológico Español, Madrid, Spain
c Departamento de Ciencias Farmacéuticas y de la Salud, Universidad San Pablo CEU, Campus Montepríncipe, Boadilla del Monte, Madrid, Spain
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Revisión sistemática" ] ] "contieneResumen" => array:2 [ "en" => true "es" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1267 "Ancho" => 2420 "Tamanyo" => 172202 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Flow diagram for article handling and selection.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "M.J. Aguado-Romeo, S. Benot-López, A. Romero-Tabares" "autores" => array:3 [ 0 => array:2 [ "nombre" => "M.J." "apellidos" => "Aguado-Romeo" ] 1 => array:2 [ "nombre" => "S." "apellidos" => "Benot-López" ] 2 => array:2 [ "nombre" => "A." 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Baeza, L.A. del Río" "autores" => array:2 [ 0 => array:4 [ "nombre" => "D." "apellidos" => "Baeza" "email" => array:1 [ 0 => "baezams@ceu.es" ] "referencia" => array:3 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] 2 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "L.A." "apellidos" => "del Río" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] ] ] ] "afiliaciones" => array:3 [ 0 => array:3 [ "entidad" => "Departamento de Química y Bioquímica, Universidad San Pablo CEU, Campus Montepríncipe, Boadilla del Monte, Madrid, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "FuturoTecnológico Español, Madrid, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Departamento de Ciencias Farmacéuticas y de la Salud, Universidad San Pablo CEU, Campus Montepríncipe, Boadilla del Monte, Madrid, Spain" "etiqueta" => "c" "identificador" => "aff0015" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "La seguridad de las lámparas emisoras de radiación ultravioleta de uso cosmético desde el punto de vista de su regulación legal" ] ] "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleLabel">1</span><span class="elsevierStyleSectionTitle" id="sect0005">Current Regulatory Framework in Spain</span><p id="par0005" class="elsevierStylePara elsevierViewall">The classification of devices that emit UV radiation as electrical appliances is being updated under European harmonised standard EN 60335-2-27, which establishes specific requirements for appliances used to expose the skin to UV and infrared radiation.<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">1</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">Until they were first regulated by Royal Decree (RD) 1002/2002,<a class="elsevierStyleCrossRef" href="#bib0115"><span class="elsevierStyleSup">2</span></a> tanning devices in Spain were classified as home appliances equipped with UV emitters. As the use of tanning devices became generalized, several studies and extensive reviews, such as that published by the International Agency for Research on Cancer, have shown that these devices constitute a dermatologic and carcinogenic risk to the health and safety of users<a class="elsevierStyleCrossRefs" href="#bib0120"><span class="elsevierStyleSup">3,4</span></a> and the World Health Organisation has issued a warning concerning their use.<a class="elsevierStyleCrossRef" href="#bib0130"><span class="elsevierStyleSup">5</span></a> These developments have made it essential to regulate the use of these devices and, therefore, to impose a series of obligations on the owners of tanning facilities based on a set of minimum requirements: compliance with technical standards and specifications, proper training of indoor tanning professionals in the use and operation of the devices, and the inspection and certification of such equipment as defined in <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>. In Spain, competence for the regulation and control of indoor tanning facilities has been devolved to the Autonomous Communities (<span class="elsevierStyleSmallCaps">ACs)</span>. The appropriate regulatory body in each AC shall require operators to demonstrate that the equipment has passed technical inspections and meets the required standards by displaying the regulatory compliance notice affixed to the device in a position clearly visible to the user and, if applicable, a detailed description of the nature and compliance of any components that have been replaced (types and models) and new elements that have been installed.</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0015" class="elsevierStylePara elsevierViewall">Under RD 1002/2002, the implementation of these regulations in accordance with Spanish law is the responsibility of the governments of the ACs, and implementation is currently a very difference stages throughout the country. The transfer of legal competence has not been an easy task and is not yet complete. <a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a> shows the date of implementation of the RD in each AC. It indicates which ACs have implemented the regulation and have established regular inspections, and the lack of action on the part of regional governments in other parts of the country. <a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a> lists the common requirements that must be complied with by all tanning facilities located in the ACs that have implemented the regulation.</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><p id="par0020" class="elsevierStylePara elsevierViewall">It is important to note, with respect to safety, that the RD establishes a system of monitoring by which the entity or person legally responsible for operating a tanning facility assumes responsibility for passing at least 1 technical inspection each year for all the devices in use and additional inspections whenever consumables are changed. These tests and inspections must be performed by officially accredited companies authorized by a public resolution issued by the competent authority. This means that inspectors may come from different areas of expertise and testing may differ from one AC to another.</p><p id="par0025" class="elsevierStylePara elsevierViewall">It should not be forgotten that, under RD 1002/2002, the use of and access to tanning devices is prohibited for persons under 18 years of age. Furthermore, tanning facilities are prohibited from supplying any products—whether chemical, dermatological or cosmetic—intended to accelerate tanning, act as sunscreen, or make possible longer exposures to ultraviolet radiation.</p><p id="par0030" class="elsevierStylePara elsevierViewall">The mandatory training of indoor tanning professionals is an important aspect of user safety; the RD specifies that any person responsible for the operation of any device emitting UV radiation must undergo training and delegates the responsibility for making such training available to the Health Department in each AC. These courses, which vary in content and can last for anything between 15 to 25<span class="elsevierStyleHsp" style=""></span>hours, have been provided since the RD went into effect. This training helps to ensure that employees will correctly determine the appropriate duration of exposure for each user at each session depending on the maximum emission of the lamps after irradiance has been properly verified. Maximum tanning time for each user is determined according to their skin type, which must first be established. Courses must also inform trainees about the risks and side effects of UV radiation and instruct them on how to complete the user's record form (including a targeted questionnaire on the client's health and possible contraindications) and how to check and maintain tanning devices to ensure that all the elements are operating correctly.</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleLabel">2</span><span class="elsevierStyleSectionTitle" id="sect0010">The Impact of European Regulation</span><p id="par0035" class="elsevierStylePara elsevierViewall">In June 2016, the Council of the European Union passed a proposal for a regulation on medical devices<a class="elsevierStyleCrossRef" href="#bib0195"><span class="elsevierStyleSup">18</span></a> that has been under discussion since 2012. Regulations are lengthy and complex documents that are slow to implement from both the legal and the technical standpoint. Moreover, since proposals have binding legal force throughout the EU, unlike directives, they do not have to be incorporated into national legislation in each member country but rather become effective immediately. The legal framework created by the proposal effectively guarantees the protection of health, consistent with the rapid pace of technological developments in the sector, as well as greater transparency, supervision, and cooperation on the part of health authorities. It is important to note that medical appliances are currently classified as therapeutic devices so that the designation includes any instrument, apparatus, or other article to be used in humans for, among others, the purpose of diagnosis, prevention, monitoring, treatment, or alleviation of a disease, or to compensate for a deficiency, which does not achieve its principal intended action by pharmacological or metabolic means.<a class="elsevierStyleCrossRef" href="#bib0200"><span class="elsevierStyleSup">19</span></a> Depending on the intrinsic risk associated with the use of a product, the Council of the European Union has established explicit rules concerning the responsibility of manufacturers to monitor quality and to provide an after-sales service scheme and a strong monitoring system for the authorities.</p><p id="par0040" class="elsevierStylePara elsevierViewall">The aim of this new proposal is to expand the scope of the designation of a medical device beyond that of the current definition to include other products which we consider to be of interest to dermatologists. Indeed, the scant consideration of the safety of tanning lamps outside of our borders may now be corrected by the EU authorities because Annex <span class="elsevierStyleSmallCaps">xv</span> of the future regulation, for the first time, expands the definition of the term <span class="elsevierStyleItalic">medical device</span> to include products with no intended medical purpose. The annex includes, among other things, a series of high intensity electromagnetic radiation (infrared, visible, and UV) emitting equipment for use on the human body, including monochromatic and broad spectrum light sources, such as lasers (single wavelength, approx. 800<span class="elsevierStyleHsp" style=""></span>nm) and intense pulsed light equipment (e.g. between 450-1200<span class="elsevierStyleHsp" style=""></span>nm) used for skin resurfacing, cosmetic treatments, and hair or tattoo removal. Given their photothermal activity, they act on skin chromophores such as melanin. While in the USA these appliances are considered to be medical devices and are regulated by the FDA,<a class="elsevierStyleCrossRef" href="#bib0205"><span class="elsevierStyleSup">20</span></a> in Europe, they currently have to comply with the standards of the International Electrotechnical Commission ratified by the European Committee for Electrotechnical Standardization. However, the European political authorities have been no less concerned to ensure the proper use of such equipment.<a class="elsevierStyleCrossRef" href="#bib0210"><span class="elsevierStyleSup">21</span></a> The proposed regulation deems that these products, despite having a cosmetic rather than medical purpose, nonetheless have a particular functionality and risk profile. Therefore, we believe that it will also apply to tanning lamps. It is our understanding that this change will improve the safety guarantees of equipment intended for cosmetic use and will help to prevent the repetition of adverse incidents through the collection, evaluation, and dissemination of information and by adopting appropriate corrective measures.</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleLabel">3</span><span class="elsevierStyleSectionTitle" id="sect0015">Conclusions</span><p id="par0045" class="elsevierStylePara elsevierViewall">People who use tanning facilities must have guarantees during sessions that they are receiving an appropriate dose, taking into account the maximum emission of UV radiation of the equipment on the market and the user's skin phototype, as defined by the AC. Although, the Spanish ACs are now the competent authorities in the areas of industry, commerce, and health, some of them have not yet adequately implemented RD 1002/2002, and in those areas there is currently no control of this activity by any competent bodies. There are also differences in the way the RD has been implemented in different ACs, for instance in the training of operating personnel and the type of company that has been certified to perform mandatory inspections.</p><p id="par0050" class="elsevierStylePara elsevierViewall">It is our view that the new approach to the regulation of medical devices in the European proposal will, although this is not explicitly stated, include the lamps that emit UV radiation which are used in tanning devices, thus enhancing the safety of users. Given the high degree of concern in Spain about this activity, what is important at this point is to consolidate and expand the inspection of tanning equipment in tanning facilities by accredited bodies and to eliminate the differences between different regions in the country.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:4 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Current Regulatory Framework in Spain" ] 1 => array:2 [ "identificador" => "sec0010" "titulo" => "The Impact of European Regulation" ] 2 => array:2 [ "identificador" => "sec0015" "titulo" => "Conclusions" ] 3 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0030">Please cite this article as: Baeza D, del Río L. La seguridad de las lámparas emisoras de radiación ultravioleta de uso cosmético desde el punto de vista de su regulación legal. Actas Dermosifiliogr. 2017;108:87–90.</p>" ] ] "multimedia" => array:3 [ 0 => array:8 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at1" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:2 [ "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Technical Requirements \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Effective irradiance ≤ 0.30<span class="elsevierStyleHsp" style=""></span>W/m<span class="elsevierStyleSup">2</span><a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a><br>Wavelength ≥ 295<span class="elsevierStyleHsp" style=""></span>nm<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">b</span></a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " rowspan="2" align="left" valign="top">Compliance report (national authorities)</td><td class="td" title="table-entry " align="left" valign="top">Pass: If the tanning device passes inspection, the accredited body will affix a label indicating compliance on the device in a visible position. It will also provide a report certifying that the equipment has been inspected and has passed all required tests. \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Fail: If the device does not pass the inspection, the label affixed to the device will indicate this (Failed Inspection - Out of Service).<a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">c</span></a> \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab1352955.png" ] ] ] "notaPie" => array:3 [ 0 => array:3 [ "identificador" => "tblfn0005" "etiqueta" => "a" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Effective irradiance is the relative biological response corresponding to each of the wavelengths emitted by the UV lamps, and is the same as the dose received/time of exposure.</p>" ] 1 => array:3 [ "identificador" => "tblfn0010" "etiqueta" => "b" "nota" => "<p class="elsevierStyleNotepara" id="npar0010">RD 1002/2002 does not establish a quantifiable numerical value for the threshold for detection of radiation for λ <2 95<span class="elsevierStyleHsp" style=""></span>nm, leaving this limit to be defined by the Autonomous Communities. By common agreement the ACs have fixed a limit of 0.03<span class="elsevierStyleHsp" style=""></span>W/m<span class="elsevierStyleSup">2</span>, either explicitly (e.g. Balearic Islands and the Basque Country) or by omission (administrative silence) in other ACs.</p>" ] 2 => array:3 [ "identificador" => "tblfn0015" "etiqueta" => "c" "nota" => "<p class="elsevierStyleNotepara" id="npar0015">The device may not be used until the deficiencies are remedied. If the device is not repaired to the appropriate standard it should be removed from use definitely and this action should be notified to the competent authority responsible for maintaining the register of tanning devices.</p>" ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Technical Testing and Inspection of Tanning Lamps and Compliance Report.</p>" ] ] 1 => array:8 [ "identificador" => "tbl0010" "etiqueta" => "Table 2" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at2" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:2 [ "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Aragon, 2007<a class="elsevierStyleCrossRef" href="#bib0135"><span class="elsevierStyleSup">6</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Asturias, 2005<a class="elsevierStyleCrossRef" href="#bib0140"><span class="elsevierStyleSup">7</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Balearic Islands, 2004<a class="elsevierStyleCrossRef" href="#bib0145"><span class="elsevierStyleSup">8</span></a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Cantabria, 2011<a class="elsevierStyleCrossRef" href="#bib0150"><span class="elsevierStyleSup">9</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Castile-La Mancha, 2004<a class="elsevierStyleCrossRef" href="#bib0155"><span class="elsevierStyleSup">10</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Catalonia, 2003<a class="elsevierStyleCrossRef" href="#bib0160"><span class="elsevierStyleSup">11</span></a><a class="elsevierStyleCrossRef" href="#tblfn0020"><span class="elsevierStyleSup">a</span></a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Extremadura, 2004<a class="elsevierStyleCrossRef" href="#bib0165"><span class="elsevierStyleSup">12</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Galicia, 2004<a class="elsevierStyleCrossRef" href="#bib0170"><span class="elsevierStyleSup">13</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Madrid, 2007<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">14</span></a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Navarre, 2004<a class="elsevierStyleCrossRef" href="#bib0180"><span class="elsevierStyleSup">15</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Basque Country, 2003<a class="elsevierStyleCrossRef" href="#bib0185"><span class="elsevierStyleSup">16</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Other Autonomous Communities, not yet implemented<a class="elsevierStyleCrossRef" href="#tblfn0025"><span class="elsevierStyleSup">b</span></a> \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab1352953.png" ] ] ] "notaPie" => array:2 [ 0 => array:3 [ "identificador" => "tblfn0020" "etiqueta" => "a" "nota" => "<p class="elsevierStyleNotepara" id="npar0020">The Catalan government (Generalitat) drafted an initial decree<a class="elsevierStyleCrossRef" href="#bib0190"><span class="elsevierStyleSup">17</span></a> in 2001 before RD 1002/2002 was introduced.</p>" ] 1 => array:3 [ "identificador" => "tblfn0025" "etiqueta" => "b" "nota" => "<p class="elsevierStyleNotepara" id="npar0025">Andalusia and Castille-Leon have carried out inspections, but not with the required regularity; Melilla and Murcia have approved training courses and certified inspection companies; Valencia has submitted courses for approval; La Rioja, the Canary Islands, and Ceuta have not done anything to create a regulatory or a surveillance system.</p>" ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Implementation of RD 1002/2002 by the Spanish Autonomous Communities.</p>" ] ] 2 => array:8 [ "identificador" => "tbl0015" "etiqueta" => "Table 3" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at3" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:1 [ "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Registration of any business involving the use of sun tanning devices<br>A report providing a description of all the equipment on the premises<br>Protocol for the cleaning and disinfection of the premises and equipment<br>Technical description of the tanning machines in use<br>Protocol for daily operation and work methods<br>Name of the authorized maintenance company<br>Operator training certificates<br>Technical inspection by an accredited body and monitoring of the limits of UV radiation exposure<br>Provision of protective eyewear (goggles)<br>All clients must read and sign an informed consent form before using tanning devices for the first time. These forms must be retained by the salon for 5 years.<br>A personal record must be kept for each client, including information on the sessions received and the total and partial doses administered, specific recommendations corresponding to the client's skin phototype and other appropriate advice.<br>A series of warning notices must be displayed in a prominent position. These include: Ultraviolet radiation can cause skin cancer and seriously damage your eyes; Protective eyewear must be worn; Certain drugs and cosmetic products can cause undesirable effects; Use of tanning beds by people under 18 years of age is prohibited; Tanning bed use is not advised during pregnancy; Maximum exposure times and intervals between exposures corresponding to your skin phototype must be respected. \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab1352954.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Common Requirements for Tanning Salons Fixed by the Spanish Autonomous Communities.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:21 [ 0 => array:3 [ "identificador" => "bib0110" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:1 [ "referenciaCompleta" => "Norma EN 60335-2-27, 1997. Aparatos electrodomésticos y análogos. Parte 2-27: requisitos para la exposición de la piel a las radiaciones ultravioletas e infrarrojas. Madrid: AENOR; 2014." ] ] ] 1 => array:3 [ "identificador" => "bib0115" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:1 [ "referenciaCompleta" => "Real Decreto 1002/2002 de 27 de septiembre, por el que se regula la venta y utilización de aparatos de bronceado de radiación ultravioleta. BOE, 10 de noviembre de 2002 [cited 15 Sept 2016]. Available from: <a id="intr0010" class="elsevierStyleInterRef" href="http://www.boe.es/buscar/doc.php?id=BOE-A-2002-19574">http://www.boe.es/buscar/doc.php?id=BOE-A-2002-19574</a>" ] ] ] 2 => array:3 [ "identificador" => "bib0120" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Tanning beds, sunlamps, and risk of cutaneous malignant melanoma" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "R.P. Gallagher" 1 => "J.J. Spinelli" 2 => "T.K. Lee" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1158/1055-9965.EPI-04-0564" "Revista" => array:7 [ "tituloSerie" => "Cancer Epidemiol Biomarkers Prev" "fecha" => "2005" "volumen" => "14" "paginaInicial" => "562" "paginaFinal" => "566" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15767329" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S0016508508023032" "estado" => "S300" "issn" => "00165085" ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0125" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:1 [ "referenciaCompleta" => "International Agency for Research on Cancer (IARC). IARC monographs on the evaluation of carcinogenic risks to humans. Vol. 100D: Solar and ultraviolet radiation; 2012 [cited 15 Sept 2016]. Available from: <a id="intr0015" class="elsevierStyleInterRef" href="http://monographs.iarc.fr/ENG/Monographs/vol100D/mono100D-6.pdf">http://monographs.iarc.fr/ENG/Monographs/vol100D/mono100D-6.pdf</a>" ] ] ] 4 => array:3 [ "identificador" => "bib0130" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:1 [ "referenciaCompleta" => "World Health Organization. Sunbeds, tanning and UV exposure. Fact sheet N°287 29/07/2010. Interim revision April 2010 [cited 15 Sept 2016]. Available from: <a id="intr0020" class="elsevierStyleInterRef" href="http://www.thetanningguru.com/downloads/WHO%20_%20Sunbeds,%20tanning%20and%20UV%20exposure.pdf">http://www.thetanningguru.com/downloads/WHO%20_%20Sunbeds,%20tanning%20and%20UV%20exposure.pdf</a>" ] ] ] 5 => array:3 [ "identificador" => "bib0135" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:1 [ "referenciaCompleta" => "Decreto 95/2007, de 5 de junio, del Gobierno de Aragón, por el que se aprueba el reglamento que regula la actividad de los centros de bronceado y la venta y alquiler de los aparatos de bronceado mediante radiaciones ultravioletas en Aragón. Boletín Oficial de Aragón, 15 de junio de 2007, n.° 71 [cited 15 Sept 2016]. Available from: <a id="intr0025" class="elsevierStyleInterRef" href="http://www.aragon.es/estaticos/GobiernoAragon/Departamentos/SaludConsumo/Documentos/docs/Profesionales/Legislacion/Recopilaci%C3%B3n%20Cronol%C3%B3gica/2006-2010/Decreto%2095-07.pdf">http://www.aragon.es/estaticos/GobiernoAragon/Departamentos/SaludConsumo/Documentos/docs/Profesionales/Legislacion/Recopilaci%C3%B3n%20Cronol%C3%B3gica/2006-2010/Decreto%2095-07.pdf</a>" ] ] ] 6 => array:3 [ "identificador" => "bib0140" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:1 [ "referenciaCompleta" => "Decreto 13/2005, de 3 de febrero, del Principado de Asturias, por el que se regulan los requisitos de formación del personal que presta servicios en centros de bronceado. Boletín Oficial del Principado de Asturias, 17 de febrero de 2005, n.° 39 [cited 5 Sept 2016]. Available from: <a id="intr0030" class="elsevierStyleInterRef" href="https://sede.asturias.es/bopa/disposiciones/repositorio/LEGISLACION09/66/1/001U0029TI0002.pdf">https://sede.asturias.es/bopa/disposiciones/repositorio/LEGISLACION09/66/1/001U0029TI0002.pdf</a>" ] ] ] 7 => array:3 [ "identificador" => "bib0145" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:1 [ "referenciaCompleta" => "Decreto 16/2004, de 13 de febrero, de las Islas Baleares, por el cual se regula el ejercicio de la actividad de bronceado artificial. Boletín Oficial de las Islas Baleares, 21 de febrero de 2004, n.° 026 [cited 7 Sept 2016]. Available from: <a id="intr0035" class="elsevierStyleInterRef" href="http://www.caib.es/sacmicrofront/archivopub.do;jsessionid=5734C0D0F675A548ED123344A0F72851?ctrl=MCRST19ZI148618%26id=148618">http://www.caib.es/sacmicrofront/archivopub.do;jsessionid=5734C0D0F675A548ED123344A0F72851?ctrl=MCRST19ZI148618&id=148618</a>" ] ] ] 8 => array:3 [ "identificador" => "bib0150" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:1 [ "referenciaCompleta" => "Decreto 20/2011, de 3 de marzo, del Gobierno de Cantabria, por el que se regula la actividad de los centros de bronceado mediante la utilización de radiaciones ultravioletas. Boletín Oficial de Cantabria, 11 de marzo de 2011, n.° 49 [cited 15 Sept 2016]. Available from: <a id="intr0040" class="elsevierStyleInterRef" href="http://boc.cantabria.es/boces/verAnuncioAction.do?idAnuBlob=202245">http://boc.cantabria.es/boces/verAnuncioAction.do?idAnuBlob=202245</a>" ] ] ] 9 => array:3 [ "identificador" => "bib0155" "etiqueta" => "10" "referencia" => array:1 [ 0 => array:1 [ "referenciaCompleta" => "Decreto 284/2004, de 21 de diciembre, de Castilla-La Mancha, por el que se establece el procedimiento para la autorización de organismos para la realización de revisiones de aparatos de bronceado mediante radiaciones ultravioletas. Diario Oficial de Castilla-La Mancha, 21 de diciembre de 2004, n.°14 [cited 15 Sept 2016]. Available from: <a id="intr0045" class="elsevierStyleInterRef" href="http://www.castillalamancha.es/sites/default/files/documentos/20120511/d2842004.pdf">http://www.castillalamancha.es/sites/default/files/documentos/20120511/d2842004.pdf</a>" ] ] ] 10 => array:3 [ "identificador" => "bib0160" "etiqueta" => "11" "referencia" => array:1 [ 0 => array:1 [ "referenciaCompleta" => "Decreto 276/2003, de 21 de octubre, Generalitat de Cataluña, que modifica el Decreto 348/2001, de 4 de diciembre, por el que se regulan los centros de bronceado artificial. Diario Oficial de la Generalitat de Cataluña, 19 de noviembre de 2003, n.° 4013 [cited 15 Sept 2016]. Available from: <a id="intr0050" class="elsevierStyleInterRef" href="http://noticias.juridicas.com/base_datos/CCAA/ca-d348-2001.html">http://noticias.juridicas.com/base_datos/CCAA/ca-d348-2001.html</a> (entrada 1 Sep 2016)" ] ] ] 11 => array:3 [ "identificador" => "bib0165" "etiqueta" => "12" "referencia" => array:1 [ 0 => array:1 [ "referenciaCompleta" => "Orden de 30 de abril de 2004, de Extremadura, por la que se regulan las normas relativas a la formación de los manipuladores de los aparatos de bronceado mediante radiaciones ultravioletas, al procedimiento de autorización de empresas y entidades de formación, y registro de centros de bronceado. Diario Oficial de Extremadura, 15 de mayo de 2004, n.° 55 [cited 15 Sept 2016]. Available from: <a id="intr0055" class="elsevierStyleInterRef" href="http://doe.gobex.es/pdfs/doe/2004/550o/04050254.pdf">http://doe.gobex.es/pdfs/doe/2004/550o/04050254.pdf</a>" ] ] ] 12 => array:3 [ "identificador" => "bib0170" "etiqueta" => "13" "referencia" => array:1 [ 0 => array:1 [ "referenciaCompleta" => "Decreto 253/2004, de 7 de octubre, Galicia, por el que se regulan las actividades de bronceado artificial mediante radiaciones ultravioleta. Diario Oficial de Galicia, 2 de noviembre de 2004. [cited 15 Sept 2016]. Available from: <a id="intr0060" class="elsevierStyleInterRef" href="http://noticias.juridicas.com/base_datos/CCAA/ga-d253-2004.html">http://noticias.juridicas.com/base_datos/CCAA/ga-d253-2004.html</a>" ] ] ] 13 => array:3 [ "identificador" => "bib0175" "etiqueta" => "14" "referencia" => array:1 [ 0 => array:1 [ "referenciaCompleta" => "Decreto 10/2007, de 22 de febrero, del Consejo de Gobierno, por el que se regulan los centros que utilizan aparatos de bronceado mediante radiaciones ultravioletas en la Comunidad de Madrid. Boletín Oficial de la Comunidad de Madrid, 16 de marzo de 2007, n.° 64 [cited 15 Sept 2016]. Available from: <a id="intr0065" class="elsevierStyleInterRef" href="http://www.madrid.org/wleg/servlet/Servidor?opcion=VerHtml%26nmnorma=4493%26cdestado=P">http://www.madrid.org/wleg/servlet/Servidor?opcion=VerHtml&nmnorma=4493&cdestado=P#_ftn1</a>" ] ] ] 14 => array:3 [ "identificador" => "bib0180" "etiqueta" => "15" "referencia" => array:1 [ 0 => array:1 [ "referenciaCompleta" => "Decreto Foral 24/2004, de 26 de enero, Navarra, por el que se regulan las condiciones para la apertura y funcionamiento de los centros de bronceado y el alquiler de aparatos de bronceado. Boletín Oficial de Navarra, 16 de febrero de 2004, n.° 20 [cited 15 Sept 2016]. Available from: <a id="intr0070" class="elsevierStyleInterRef" href="https://www.navarra.es/home_es/Actualidad/BON/Boletines/2004/20/Anuncio-0/">https://www.navarra.es/home_es/Actualidad/BON/Boletines/2004/20/Anuncio-0/</a>" ] ] ] 15 => array:3 [ "identificador" => "bib0185" "etiqueta" => "16" "referencia" => array:1 [ 0 => array:1 [ "referenciaCompleta" => "Decreto 265/2003, de 28 de octubre, País Vasco, por el que se regula la actividad de bronceado artificial mediante la utilización de radiaciones ultravioletas. Boletín Oficial del País Vasco, 13 de noviembre de 2003, n.° 222 [cited 15 Sept 2016]. Available from: <a id="intr0075" class="elsevierStyleInterRef" href="https://www.euskadi.eus/y22-bopv/es/bopv2/datos/2003/11/0306105a.shtml">https://www.euskadi.eus/y22-bopv/es/bopv2/datos/2003/11/0306105a.shtml</a>" ] ] ] 16 => array:3 [ "identificador" => "bib0190" "etiqueta" => "17" "referencia" => array:1 [ 0 => array:1 [ "referenciaCompleta" => "Decreto 348/2001, de 4 de diciembre, Generalitat de Cataluña, por el que se regulan los centros de bronceado artificial. Diario Oficial de la Generalitat de Cataluña, 27 de diciembre de 2001, n.° 3541." ] ] ] 17 => array:3 [ "identificador" => "bib0195" "etiqueta" => "18" "referencia" => array:1 [ 0 => array:1 [ "referenciaCompleta" => "European Parliament and of The Council (2016). Proposal for a Regulation on Medical Devices, and Amending Directive 2001/83/EC, Regulation (EC) No 178/2002 and Regulation (EC) No 1223/2009. [cited 15 Sep 2016]. 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| año/Mes | Html | Total | |
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| 2020 Mayo | 15 | 16 | 31 |
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| 2020 Marzo | 13 | 12 | 25 |
| 2020 Febrero | 8 | 0 | 8 |
| 2019 Diciembre | 4 | 0 | 4 |
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| 2019 Septiembre | 4 | 0 | 4 |
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| 2019 Julio | 4 | 0 | 4 |
| 2019 Junio | 4 | 0 | 4 |
| 2019 Mayo | 5 | 1 | 6 |
| 2019 Abril | 2 | 6 | 8 |
| 2019 Febrero | 2 | 0 | 2 |
| 2018 Diciembre | 5 | 0 | 5 |
| 2018 Noviembre | 1 | 0 | 1 |
| 2018 Octubre | 2 | 0 | 2 |
| 2018 Septiembre | 3 | 0 | 3 |
| 2018 Febrero | 15 | 3 | 18 |
| 2018 Enero | 18 | 2 | 20 |
| 2017 Diciembre | 23 | 9 | 32 |
| 2017 Noviembre | 20 | 2 | 22 |
| 2017 Octubre | 16 | 4 | 20 |
| 2017 Septiembre | 19 | 3 | 22 |
| 2017 Agosto | 18 | 8 | 26 |
| 2017 Julio | 18 | 6 | 24 |
| 2017 Junio | 37 | 8 | 45 |
| 2017 Mayo | 35 | 12 | 47 |
| 2017 Abril | 64 | 11 | 75 |
| 2017 Marzo | 61 | 38 | 99 |
| 2017 Febrero | 25 | 24 | 49 |
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