In California, you can't smoke a cigar in Morton's Of Chicago after a great steak any more. It's too dangerous to the health of the waitresses and waiters. Legislators have recently tried to institute carseats practically until children are teenagers because of concerns about their safety.

Yet some adult film performers are put at risk of HIV and other sexually transmitted diseases because their employers prohibit the use of condoms.

If employers won't protect them, is it time to regulate the porn industry?

The San Fernando Valley in California generates about $1 billion annually in revenue. Nationwide, porn revenues are in the neighborhood of $12 billion. That's a lot of money to be unregulated but nothing like the $51 billion in revenue for food and beverage peddlers just in California. Still, the issue is worker safety. Because the industry is unregulated there is no firm number on how many workers in the porn industry actually have sex, but total employment is around 6,000 in the state.

So how many is enough to worry about?

The heterosexual adult film industry attempts to control the spread of sexual transmitted diseases by periodically conducting STD tests among performers. However, transmission can still occur. In 2004, for example, a male performer who had tested HIV negative only three days earlier infected three of 14 female performers.

How often should testing be done? Every day? What, in our considerable experience watching governments be inefficent, suggests that they will be error free simply because they regulate it?

The adult film industry itself, say Drs Grudzen and Kerndt in a PLOS report (1), lacks the "will or ability" to regulate itself, and needs state and federal legislation to enforce health and safety standards for adult film performers.

Since condoms are 90-95% effective at preventing HIV transmission, use should be mandated for all films, say the authors, and legislators could look to Nevada for a model for the successful regulation of a legal sex-related industry. Since the institution of mandatory condoms in Nevada's brothels in 1988, not a single sex worker has contracted HIV.

"Short of legislation mandating performer protection, restricting distribution of adult movies to condom-only films may be the one way to have an impact on the industry," they say. "If there were organized and truly effective advocacy for performers, then large hotel chains, video retailers, and cable networks could be pressured to purchase adult films under a condom-only 'seal of approval.'"

This doesn't seem like a practical solution. Forcing an industry to make a product customers don't want so that the unemployed people who used to work in the industry can feel safe sounds like a government solution.

At some point we have to achieve a minimum threshold on who and what we can regulate. An industry with at most a few hundred performers placing themselves at risk can't be regulated effectively and attempting to do so would drive the industry even farther underground where performers would be placed at even greater risk.

(1) Grudzen CR, Kerndt PR (2007) The adult film industry: Time to regulate? PLoS Med 4(6): e126.