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International Journal of Cosmetic... Oct 2023The adverse effects of solar ultraviolet radiation (UVR) on normal skin are well established, especially in those with poorly melanized skin. Clinically, these effects... (Review)
Review
The adverse effects of solar ultraviolet radiation (UVR) on normal skin are well established, especially in those with poorly melanized skin. Clinically, these effects may be classified as acute, such as erythema or chronic such as keratinocyte and melanocyte skin cancers. Apart from skin type genetics, clinical responses to solar UVR are dependent on geophysical (e.g., solar intensity) and behavioural factors. The latter are especially important because they may result in 'solar overload' with unwanted clinical consequences and ever greater burdens to healthcare systems. Correctly used, sunscreens can mitigate the acute and chronic effects of solar UVR exposure. Laboratory studies also show that sunscreens can inhibit the initial molecular and cellular events that are responsible for clinical outcomes. Despite public health campaigns, global trends continue to show increasing incidence of all types of skin cancer. Large-scale epidemiological studies have shown the benefits of sunscreen use in preventing skin cancer, though it is likely that sunscreen use has not been optimal in such studies. It is evident that without substantial changes in sun-seeking behaviour, sunscreen use is a very important part of the defence against the acute and chronic effects of solar exposure. Ideally, sunscreens should be able to provide the level of protection that reduces the risk of skin cancer in susceptible skin types to that observed in heavily melanized skin.
Topics: Humans; Sunscreening Agents; Ultraviolet Rays; Sunlight; Skin; Skin Neoplasms
PubMed: 37799076
DOI: 10.1111/ics.12897 -
Journal of Cancer Education : the... Jun 2022Kitesurfing is one of many water sports that are growing in popularity throughout the world. In such sports, practitioners are exposed not only to direct sunlight but...
Kitesurfing is one of many water sports that are growing in popularity throughout the world. In such sports, practitioners are exposed not only to direct sunlight but also to reflection from the water surface, which aggravates the impact of solar radiation on the skin. This study sought to analyse the photoprotection and photoexposure habits and knowledge of elite kitesurfers and their beliefs and attitudes in this respect. A sample of convenience of 72 male kitesurfers completed a validated questionnaire in full. By Fitzpatrick phototype, the most common classes were types I and II (69.4%). On average, kitesurfers had been practising their sport for 10.93 years, at a rate of 13.93 h per week. During the last sports season, 84.7% of respondents had suffered at least one sunburn, while 43.1% had been sunburned at least three times. The sun protection practice most commonly adopted was the use of sunscreen cream, which was used by 79.2% of respondents. Although 43.2% of respondents recognized to be worried about they might get skin cancer from the sun, 31.9% does not like using sunscreen and 44.4% like sunbathing. Regarding the respondents' knowledge of facts about sun exposure, the average rate of correct answers for the items evaluated was 66.9%. In conclusion, elite kitesurfers are potentially exposed to dangerous levels of UV radiation, which caused numerous sunburn episodes during the last sports season. It is necessary to raise these athletes' awareness of their risk of developing skin cancer and of the need to improve their sun protection and skin surveillance practices.
Topics: Habits; Health Knowledge, Attitudes, Practice; Humans; Male; Skin Neoplasms; Sunburn; Sunlight; Sunscreening Agents
PubMed: 32720132
DOI: 10.1007/s13187-020-01838-7 -
Public Health Research & Practice Mar 2022Exposure to ultraviolet (UV) radiation from the sun has both risks, including skin cancer and premalignant lesions, skin aging and cataracts, and benefits, including the... (Review)
Review
IMPORTANCE
Exposure to ultraviolet (UV) radiation from the sun has both risks, including skin cancer and premalignant lesions, skin aging and cataracts, and benefits, including the production of vitamin D. Health policies guide informed decision making about balancing these risks and benefits. However variability in advice given by different agencies (e.g. government, health organisations, consumer organisations) may lead to confusion among the general public, resulting in suboptimal health-related behaviours by consumers.
OBJECTIVE
To review and assess the consistency of recommendations in relevant guidance documents in Australia and New Zealand regarding the risks and benefits of sun exposure. Study type and methods: A rapid desktop review of publicly available sun exposure guidance documents from government and nongovernment websites was undertaken between February and April 2021. Four major themes and their subthemes were extracted from documents: sun protection; balance between risks and benefits of sun exposure; non-vitamin D benefits of sun exposure; and sun exposure and vitamin D production. We then undertook a more detailed analysis of recommendations regarding sun exposure to maintain sufficient vitamin D status.
RESULTS
Nineteen documents met the inclusion criteria (13 Australian, five New Zealand, and one joint Australian and New Zealand document). Most documents provided extensive advice about sun protection and sun exposure and vitamin D production and their respective subthemes, while only 2/19 documents provided advice regarding the non-vitamin D benefits of sun exposure (benefits for melatonin production and reduction of sleep disorders). Documents varied widely in their recommendations in relation to sun exposure required for vitamin D production. For example, while three documents stated that sun exposure is required on most days of the week for adequate vitamin D production, two stated that sun exposure is required daily. One document advised that people with darker skin require three to six times more sun exposure than those with lighter skin, while another advised two to three times more sun exposure is required.
CONCLUSION
Current guidance documents show great variation in the advice for sun exposure and vitamin D production, and little advice is being provided on non-vitamin D health benefits. Extensive variations in the advice provided could be confusing for consumers and result in unhealthy behavioural action. Based on this evidence, better and more consistent guidance and advice about the risk and benefits of sun exposure is required.
Topics: Australia; Humans; New Zealand; Sunlight; Ultraviolet Rays; Vitamin D
PubMed: 35290996
DOI: 10.17061/phrp3212202 -
BMC Public Health Jul 2022Keratinocyte cancer (KC) rates are increasing in the U.S., particularly in older age groups. Use of hydrochlorothiazide (HCTZ), due to its photosensitizing properties,...
BACKGROUND
Keratinocyte cancer (KC) rates are increasing in the U.S., particularly in older age groups. Use of hydrochlorothiazide (HCTZ), due to its photosensitizing properties, and high sun exposure are two known NMSC risk factors, but their synergistic effects are undetermined. The purpose of this study was to examine the development of NMSC between adults who did and did not use HCTZ, as well as those with high and low sun exposure.
METHODS
A retrospective case-control sample was assembled from adult patients in north-central Wisconsin (USA). Duration of HCTZ use and occupational sun exposure were extracted from electronic health records, along with a linked survey of lifetime sun exposure.
RESULTS
There were 333 cases and 666 controls in the analytical sample. A significant main effect was observed for HCTZ duration in the full sample. Under low sun exposure, the odds of NMSC was 14% greater for each additional year of HCTZ use (aOR = 1.14 [1.11, 1.18], p < 0.001). In a sensitivity analysis of participants age 70 years and over, there was a borderline significant (p = 0.086) HCTZ use by high sun exposure interaction, suggesting modestly increased HCTZ risk in older, high sun exposure adults.
CONCLUSIONS
Consistent with prior studies, longer duration of HCTZ use was a predictor of NMSC in north-central Wisconsin adults. NMSC may be accelerated in HCTZ users with outdoor lifestyles, but future studies should attempt to further disaggregate specific effects of sun exposure time, HCTZ duration, and age on NMSC development.
Topics: Adult; Aged; Humans; Hydrochlorothiazide; Keratinocytes; Retrospective Studies; Skin Neoplasms; Sunlight; United States
PubMed: 35780087
DOI: 10.1186/s12889-022-13705-9 -
Photochemical & Photobiological... Dec 2023Overexposure to sunlight and sunburn are the main preventable causes of skin cancer. Outdoor sports are associated with significant levels of sunlight exposure. (Clinical Trial)
Clinical Trial
BACKGROUND
Overexposure to sunlight and sunburn are the main preventable causes of skin cancer. Outdoor sports are associated with significant levels of sunlight exposure.
AIMS
We sought to quantify the sun radiation exposure received by outdoor rock climbers and assess their sun exposure habits, sun protection behaviors, attitudes, and knowledge regarding skin cancer.
METHODS
From April to June 2021, outdoor rock climbers contacted via email completed an online validated self-reported questionnaire on sun related habits, behaviors, attitudes and knowledge. As a pilot trial, ten participants wore a personal dosimeter during two outdoor climbing weekends in May and November 2021. Ambient ultraviolet radiation (UVR) was also recorded.
RESULTS
A total of 217 outdoor rock climbers (103 women), mean age 36.8 ± 8.8 years (range 20-70 years) and median climbing practice per week of 8 h (IQR 7.5) were studied. Two in three (65.9%) participants reported at least one sunburn event during the previous rock climbing season. Of the survey respondents, 49.3% reported using sunscreen with SPF ≥ 15, 47% wore sunglasses, and 14.3% indicated they reapplied sunscreen every two hours. The median personal UVR dose measured during the two outdoor climbing weekends analyzed was 5.2 (IQR 1.8) and 8.8 (IQR 1.1) standard erythemal doses, respectively.
CONCLUSIONS
The high rates of sunburn, the elevated personal UVR measured and the clearly insufficient sun protection practices followed during rock climbing together with unsatisfactory attitudes towards tanning reveal the need to develop explicit sun protection campaigns and educational strategies to reduce the risk of skin cancer among the athletes studied.
Topics: Female; Humans; Skin Neoplasms; Sunburn; Sunlight; Sunscreening Agents; Ultraviolet Rays; Young Adult; Adult; Middle Aged; Aged; Male
PubMed: 37847459
DOI: 10.1007/s43630-023-00488-0 -
Current Oncology (Toronto, Ont.) Feb 2023Sun exposure carries both harms and benefits. Exposing the skin to the sun is the main modifiable cause of skin cancers, which exert a considerable health and economic...
Sun exposure carries both harms and benefits. Exposing the skin to the sun is the main modifiable cause of skin cancers, which exert a considerable health and economic burden in Australia. The most well-established benefit of exposure to ultraviolet (UV) radiation is vitamin D production. Australia has the highest incidence of skin cancer in the world but, despite the high ambient UV radiation, approximately one quarter of the population is estimated to be vitamin D deficient. Balancing the risks and benefits is challenging and requires effective communication. We sought to provide a snapshot of public knowledge and attitudes regarding sun exposure and vitamin D and to examine the associations between these factors and sun protective behaviors. In 2020 we administered an online survey; 4824 participants with self-reported fair or medium skin color were included in this analysis. Only 25% and 34% of participants were able to identify the amount of time outdoors needed to maintain adequate vitamin D status in summer and winter, respectively and 25% were concerned that sunscreen use inhibits vitamin D synthesis. This lack of knowledge was associated with suboptimal sun protection practices. Public education is warranted to prevent over-exposure, while supporting natural vitamin D production.
Topics: Humans; Vitamin D; Sunlight; Vitamin D Deficiency; Ultraviolet Rays; Surveys and Questionnaires; Skin Neoplasms
PubMed: 36826149
DOI: 10.3390/curroncol30020188 -
Photodermatology, Photoimmunology &... Jul 2022Transplant recipients are particularly prone to the development of skin cancer, and overexposure to UV radiation during outdoor activities increases the risk of...
BACKGROUND
Transplant recipients are particularly prone to the development of skin cancer, and overexposure to UV radiation during outdoor activities increases the risk of carcinogenesis.
OBJECTIVE
The aim of this study was to analyze sun-related behaviors and knowledge in transplant athletes, examine the frequency of sunburns, and explore associations with a history of skin cancer.
MATERIALS AND METHODS
Cross-sectional descriptive study. Participants (n = 170) in the XXI World Transplant Games from >50 countries completed a questionnaire on sun protection habits and knowledge, type of transplant, immunosuppressive therapy, and personal history of skin cancer.
RESULTS
The most common transplanted organs were the kidney (n = 79), the liver (n = 33), and the heart (n = 31). Overall, 61.3% of athletes had been doing sport for >15 years and 79.5% spent >1-2 h a day outdoors. Fifteen % of athletes had a history of skin cancer. The prevalence of sunburn in the previous year was 28.9%, higher in athletes aged <50 years (37.2%); without a primary school education (58.3%), not taking cyclosporin (32.6%), and athletes who played basketball (75%). The main sun protection measures used were sunscreen (68.9%) and sunglasses (67.3%). Use of a hat or cap was the only measure significantly associated with a reduced prevalence of sunburn.
CONCLUSIONS
Despite high awareness that sun exposure increases the risk of skin cancer, sunburn was common in transplant athletes. Efforts should be made to strengthen multidisciplinary sun protection education strategies and ensure periodic dermatologic follow-up to prevent sun-induced skin cancer in this population.
Topics: Athletes; Cross-Sectional Studies; Habits; Health Knowledge, Attitudes, Practice; Humans; Skin Neoplasms; Sunburn; Sunlight; Sunscreening Agents; Surveys and Questionnaires
PubMed: 34817897
DOI: 10.1111/phpp.12755 -
Current Problems in Dermatology 2021Since time immemorial, people protected themselves from solar radiation. Limiting time in the sun by seeking shade or wearing clothing was a matter of course. In the... (Review)
Review
Since time immemorial, people protected themselves from solar radiation. Limiting time in the sun by seeking shade or wearing clothing was a matter of course. In the early 20th century, tanned skin - a result of exposure to sunlight - was associated with good health. At the same time, however, one also had to protect oneself against the potential of excessive exposure to avoid sunburns. Around 1945, the first sunscreen products for protection against solar radiation became available. In the years to follow and up to the recent past, a vast number of different sunscreen filters were developed and incorporated into a wide variety of product formats. Frameworks regulating filter substances and preparations and methods to characterize sunscreen products' performance parameters were developed. Over the past 50-70 years, the perception regarding the tasks of sunscreen products changed several times. It was initially promoted as a lifestyle product and had the task of preventing sun-related erythema (tan without burn). Later, the prevention of skin cancer was added. Only in recent times, sunscreen products have been increasingly advertised and perceived as beauty and lifestyle products again. Also, the use of sunscreen products for antiaging purposes is now commonplace. The different intended purposes (averting harm and prevention) and the widespread use of topical sunscreen products have promoted many investigations and generated a vast and ongoing need for consumer and patient information and education. In the following review, we analyze and discuss current topics from conflicting areas, such as sun protection products (e.g., ideal sun protection products, sun protection metrics), product safety (e.g., nanoparticulate sunscreen filters, regulatory issues), application in everyday life (e.g., wish to tan, vulnerable cohorts), as well as controversies and future challenges (e.g., risks and benefits of UV radiation).
Topics: Health Education; Humans; Skin Aging; Skin Neoplasms; Sunbathing; Sunburn; Sunlight; Sunscreening Agents
PubMed: 34698021
DOI: 10.1159/000517590 -
Seminars in Oncology Feb 2020Sun-exposure can cause health problems, including melanoma and nonmelanoma skin cancer, especially in Australia where the incidence of skin cancer is particularly high.... (Review)
Review
PURPOSE
Sun-exposure can cause health problems, including melanoma and nonmelanoma skin cancer, especially in Australia where the incidence of skin cancer is particularly high. Childhood cancer survivors (CCSs) have an augmented risk due to previous cancer history and treatment. Despite recommendations advising sun protection, CCSs may be placing themselves at risk. We considered daily summer sun-exposure in an Australian cohort of CCSs and in community reference groups, and identified factors associated with sun-exposure in these populations.
METHODS
Summer sun-exposure data were collected on 471 CCSs (119 parents of survivors aged <16, and 352 survivors aged ≥16) and a reference group of 470 participants from the community (155 parents of children aged <16, and 355 adults aged ≥16). Survivors completed paper questionnaires and the reference groups completed an online survey. Medical records confirmed survivors' clinical information. Ordinal logistic regressions identified factors associated with daily summer sun-exposure.
RESULTS
More daily summer sun-exposure was reported by both parents reporting for the young survivors (U = 5,522.5, P < .001; U = 31,412, P < .001) and by older survivors (U = 5,039.5, P < .001; U = 29,913, P < .001). Among younger participants greater sun-exposure was associated with being a CCS, while in older participants, greater sun-exposure was associated with being a CCS, a male, smoker/ex-smoker and was also increased in those with more sensitive skin reaction to sunlight. Focusing only on the CCSs, when treatments were considered, none statistically predicted sun-exposure in young CCSs while older CCSs who received radiotherapy were less likely to spend excess time in the sun.
CONCLUSION
CCSs have sun-exposure at times of day when sun-related skin damage is highest, despite advice to avoid highest risk times. This data can inform sun-protection programs and lifestyle advice aimed at ameliorating the potential increased risk of skin cancer in CCSs.
Topics: Adolescent; Australia; Cancer Survivors; Child; Child, Preschool; Environmental Exposure; Female; Humans; Infant; Male; Neoplasms; Odds Ratio; Phenotype; Public Health Surveillance; Risk Factors; Self Report; Skin Diseases; Sunlight
PubMed: 32145971
DOI: 10.1053/j.seminoncol.2020.02.004 -
Gaceta Medica de Mexico 2021To know the prevalence of sun exposure and protection behaviors in a group of adolescents and to compare them with a group of adults in Mexico City. (Comparative Study)
Comparative Study
OBJECTIVE
To know the prevalence of sun exposure and protection behaviors in a group of adolescents and to compare them with a group of adults in Mexico City.
MATERIAL AND METHODS
Descriptive, cross-sectional study in students aged 16 to 18 years and in adults older than 18 years.
RESULTS
Seven-hundred and forty-eight students were surveyed; 60 % were females and 40 % males; 90 % seek shade, 70.1 % avoid exposing themselves to the sun from 10.00 to 16.00 hours and 30.6 % use sunscreen. Out of 620 adults, 67.5 % were women and 32.4 % were men; 82.6 % seek shade, 60.2 % avoid the sun from 10.00 to 16.00 hours and 48.1% use sunscreen; 72.9 % of adults and 80.8 % of adolescents are exposed to the sun due to domestic activities.
DISCUSSION
There is a similar trend in sun protection and exposure behaviors in adolescents and adults. The prevalence of sunscreen use in adults is high in comparison with adolescents.
Topics: Adolescent; Adult; Age Factors; Cross-Sectional Studies; Female; Health Behavior; Health Surveys; Humans; Male; Mexico; Middle Aged; Radiation Protection; Students; Sunlight; Sunscreening Agents; Time Factors; Young Adult
PubMed: 34270529
DOI: 10.24875/GMM.M21000536