Dowdy John C, Sayre Robert M, Shepherd James G
Rapid Precision Testing Laboratory, Cordova, TN 38016, USA.
Photodermatol Photoimmunol Photomed. 2009 Aug;25(4):216-20. doi: 10.1111/j.1600-0781.2009.00440.x.
BACKGROUND/AIMS: In 1979 the Food and Drug Administration (FDA) designated indoor tanning units would be regulated medical devices and that each must have an exposure timer. In 1985 FDA added a scheduled series of doses designed to allow tanning with little risk of concomitant sunburn. Subsequently FDA/CDRH maintained databases in which medical device associated injuries were reported. The databases, MAUDE and its predecessor MDR, are available online. While these records, in part, are not intended for evaluation of adverse event rates, analysis provides insight into the etiology of UV-related tanning injuries.
METHODS/RESULTS: We compiled 142 records reported for 1985-2006 including 22% noninjury malfunctions. Of the reported injuries approximately 50% resulted from UV exposure, an average of <1/year resulted in hospitalization. At least 36% of the UV-related injuries were attributable to various (user/operator) noncompliance with FDA sunlamp guidance policies. During 1985-1995 there were six times more UV injuries than 1996-2006, presumably reflecting cessation of much mandatory reporting in 1996. Injury reports declined steady from 1997 to 2006.
FDA guidance appears most efficacious in injury prevention and we encourage its incorporation into the enforceable performance standard. We also advise that tanning industry professional training programs seek standardization/accreditation of their personnel certifications through recognized accreditation bodies such as ANSI or ISO/IEC.
背景/目的:1979年,美国食品药品监督管理局(FDA)指定室内晒黑设备为受监管的医疗设备,且每台设备都必须配备曝光定时器。1985年,FDA增加了一系列预定剂量,旨在实现晒黑的同时降低晒伤风险。随后,FDA/药品评价和研究中心(CDRH)维护了相关数据库,用于报告与医疗设备相关的损伤情况。这些数据库,即医疗器械不良事件报告数据库(MAUDE)及其前身医疗器械报告(MDR),均可在线获取。虽然这些记录部分并非用于评估不良事件发生率,但分析可为紫外线相关晒黑损伤的病因提供见解。
方法/结果:我们汇总了1985年至2006年期间报告的142条记录,其中包括22%的非损伤性故障。在报告的损伤中,约50%是由紫外线照射导致的,平均每年少于1例导致住院治疗。至少36%的紫外线相关损伤可归因于用户/操作人员未遵守FDA的太阳灯指导政策。1985年至1995年期间的紫外线损伤数量是1996年至2006年期间的六倍,这可能反映出1996年许多强制报告的终止。1997年至2006年期间,损伤报告数量稳步下降。
FDA的指导意见在预防损伤方面似乎最为有效,我们鼓励将其纳入可强制执行的性能标准。我们还建议晒黑行业的专业培训项目通过美国国家标准学会(ANSI)或国际标准化组织/国际电工委员会(ISO/IEC)等认可的认证机构寻求其人员认证的标准化/认证。