1. Dianne E. Godar, PhD FDA employee for 20 years Speaking as a public citizen The scientific opinions presented herein are not necessarily the same as those of the FDA’s.

3.  6 out of 20 epidemiologic studies showed a positive association between “ever use” tanning lamps with melanoma.  Their melanoma data from the SEER data base ONLY dates back to ~1975 (right after release of first Tanning Lamps)

4. Tanning Lamp and RR for Melanoma All Epidemiological studies in IARC report +1 6 Decreased Risk& 1 Neutral (0.73-1.00) Osterlind (Den; 0.73), Zanetti (Italy; 0.9), Holly (USA; 0.94 ), Bataille (UK etc; 0.90), Autier (Belg, Fran, Germ; 0.97), Naldi (Italy; 0.78), Kaskel (Germ; 1.00) 7 Weak Correlation (1.1-1.3) Westerdahl (Swed; 1.3 & 1.2), Holman (Aus; 1.1), Chen (USA, 1.13 ), MacKie (UK; 1.25), Dunn-Lane (UK; 1.16), Bataille (UK; 1.19) 6 Positive (1.5-2.94) Veierød (Norw/Swed;1.55), Swedlow (UK; 2.94), Adam (UK; 2.93), Walter (Canada; 1.54), Garbe (Germ; 1.5), Ting (USA; 1.64)

5. After Tanning Lamps Released

6. Tanning Lamps had NO Effect Incidence Melanoma 1940-2005 UVB UVA&UVB (2009) Godar DE, Landry RJ, Lucas AD. Med Hypotheses.;72(4):434-43. >30 yr before Tanning >30 yr after Tanning

7. Bonnie = Indoor work Clyde = Glass Windows Together they rob our Skin of Vitamin D3

8. Glass Windows

9. Sun Glass UVB

10. UVA (>320 nm) Breaks Down Vitamin D3 MacLaughlin JA, Anderson RR, Holick MF Science. 1982;216(4549):1001-3. Webb AR, DeCosta BR, Holick MF.J Clin Endocrinol Metab. 1989;68(5):882-7. Relative Biologic Effect Vitamin D3 UVB

11. “The American Cancer Society estimates that this year, 111,900 Americans will be stricken with melanoma, which is associated with excessive ultra- violet exposure.” Is the increasing incidence of melanoma dependent on excessive UV exposures as claimed by the American Cancer society?

12. Outdoor workers ~SAME incidence Melanoma as Indoor workers [1-4] [1]. Beral V, Robinson N. (1981) The relationship of malignant melanoma, basal and squamous skin cancers to indoor and outdoor work. Br J Cancer. 44:886-91. [2] Elwood JM, Jopson J. (1997) Melanoma and sun exposure: an overview of published studies. Int J Cancer.73(2):198-203. Review. [3] Vagero D, Ringback G, Kiveranta H. (1986) Br J Cancer 53:507-512. [4] Kennedy C, Bajdik CD, Willemze R, De Gruijl FR, Bouwes Bavinck JN. (2003) J Invest Dermatol 120: 1087-1093. Outdoor workers get 3-10 times UV dose as indoor workers.[5-7] *[5] Godar DE. UV Doses Worldwide. Photochem Photobiol 2005; 81:736-749. [6] Thieden E, Philipsen PA, Heydenreich J, Wulf HC. Arch Dermatol 2004;140:197-203. [7] Slaper H. 1987 Chapter 2, pp. 24-48, Ph. D. Dissertation, University of Utrecht. WHY? Melanoma Paradox

13. Sun Mon Tues Weds Thurs Fri Sat Summer -------------Work Year -----------Vacation Indoor Workers Outdoor Workers Vitamin D 3 in Living Skin

14. [1] Godar DE. 2001. UV Doses of American Children and Adolescents. Photochemistry Photobiology 74:787-793. [2] Pope SJ, Holick MF, Mackin S, Godar DE (2008) ASCF Photochem Photobiol. 8:1277-83. [3] Pope SJ, Godar DE (2010) Solar UV Geometric Conversion Factors: Horizontal plane to cylinder model. Photochem Photobiol. Jan 6. [Epub ahead of print]

15. Seifert M, Diesel B, Meese E, Tilgen W, Reichrath J. Expression of 25-hydroxyvitamin D-1alpha-hydroxylase in malignant melanoma: implications for growth control via local synthesis of 1,25(OH)D and detection of multiple splice variants. Exp Dermatol 2005;14:153-154. Melanoma cells make Calcitriol from Vitamin D3 (1,25-dihydroxyvitamin D3)

16. In Vivo [1] Chida K, Hashiba H, Fukushima M, Suda T, Kuroki T. Inhibition of tumor promotion in mouse skin by 1 alpha, 25-dihydroxyvitamin D3. J Cancer Res 1985;45:5426-5430. [2] Eisman JA, Barkla DH, Tutton PJ. Suppression of in vivo growth of human cancer solid tumor xenografts by 1,25-dihydroxyvitamin D3. Cancer Res 1987;47:21-25. [3] Frampton RJ, Omond SA, Eisman JA. Inhibition of human cancer growth by 1,25- dihydroxyvitamin D3 metabolites. Cancer Res 1983;43:4443-4447. In Vitro [1] Danielsson C, Fehsel K, Polly P, Carlberg C. Differential apoptotic response of human melanoma cells to 1 ,25-dihydroxyvitamin D3 and its analogues. Cell Death Different 1998;5:946-951. [2] Evans SR, Houghton AM, Schumaker L, Brenner RV, Buras RR, Davoodi F, Shabahang M. Vitamin D receptor and growth inhibition by 1,25-dihydroxyvitamin D3 in human malignant melanoma cell lines. J Surg Res 1996;61:127-133. [3] Colston K, Colston MJ, Feldman D. 1,25-dihydroxyvitamin D3 and malignant melanoma: the presence of receptors and inhibition of cell growth in culture. Endocrinol 1981;108: 1083-1086. Vitamin D3 > Calcitriol > Suicide

17. Vitamin D3 “One way street” into Blood Vitamin D3 binding protein only takes vitamin D3 from skin into blood and returns to skin “unarmed” to pick up more vitamin D3 Thus, taking vitamin D3 orally does not put high enough concentrations into the skin where it is needed to kill melanoma cells