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Journal of Travel Medicine 2013Although there have been recent advances in the development of photoprotective clothing and broad-spectrum sunscreens, few peer-reviewed publications have focused on... (Review)
Review
BACKGROUND
Although there have been recent advances in the development of photoprotective clothing and broad-spectrum sunscreens, few peer-reviewed publications have focused on photoprotection recommendations for travelers.
METHODS
In order to describe the adverse health effects of excessive ultraviolet (UV) radiation exposures; review recent studies of public perceptions regarding photoprotection and sun exposure behaviors; identify special populations at increased risks of drug-induced photosensitivity reactions and UV-induced skin cancers; and recommend several effective photoprotection strategies for travelers, Internet search engines were queried with the key words as search terms to examine the latest references on photoprotection and the epidemiology of UV-associated skin cancers.
RESULTS
Observational studies have demonstrated that the public knows little about proper sunscreen protection, selection, and use, and often abuses sunscreens for intentional UV overexposures. Cohort studies have identified special populations at increased risks of UV-associated skin cancers without the proper use of sunscreens and photoprotective clothing including children, fair-skinned persons, patients taking photosensitizing drugs, and organ transplant recipients (OTRs). Clinical investigations support the regular use of broad-spectrum sunscreens to prevent the development of premalignant actinic keratoses (AK) in all sun-exposed subjects, especially OTRs; to prevent the development of squamous cell carcinomas from new AK in sun-exposed subjects, especially OTRs; to possibly prevent the development of cutaneous malignant melanomas in children and adults; and to possibly prevent the development of basal cell carcinomas in OTRs.
CONCLUSIONS
Recommended photoprotection strategies for travelers should include avoiding intense sunlight, wearing photoprotective clothing, wearing sunglasses, and selecting the right sunscreen for their skin type. Travel medicine practitioners should counsel travelers about photoprotection and encourage travelers to take advantage of recent advances in the development of more effective broad-spectrum sunscreens and photoprotective clothing for themselves and their children.
Topics: Adult; Child; Environmental Exposure; Humans; Patient Education as Topic; Photosensitivity Disorders; Protective Agents; Protective Clothing; Risk Factors; Risk Reduction Behavior; Skin; Skin Neoplasms; Sunlight; Sunscreening Agents; Travel; Ultraviolet Rays
PubMed: 23464719
DOI: 10.1111/j.1708-8305.2012.00667.x -
International Journal of Environmental... Jul 2021A set of four case-control ( = 109), randomized-controlled ( = 7), cross-sectional ( = 78), and intervention ( = 47) studies was conducted across three countries to...
BACKGROUND
A set of four case-control ( = 109), randomized-controlled ( = 7), cross-sectional ( = 78), and intervention ( = 47) studies was conducted across three countries to investigate the effects of sun exposure on worker physiology and cognition.
METHODS
Physiological, subjective, and cognitive performance data were collected from people working in ambient conditions characterized by the same thermal stress but different solar radiation levels.
RESULTS
People working under the sun were more likely to experience dizziness, weakness, and other symptoms of heat strain. These clinical impacts of sun exposure were not accompanied by changes in core body temperature but, instead, were linked with changes in skin temperature. Other physiological responses (heart rate, skin blood flow, and sweat rate) were also increased during sun exposure, while attention and vigilance were reduced by 45% and 67%, respectively, compared to exposure to a similar thermal stress without sunlight. Light-colored clothes reduced workers' skin temperature by 12-13% compared to darker-colored clothes.
CONCLUSIONS
Working under the sun worsens the physiological heat strain experienced and compromises cognitive function, even when the level of heat stress is thought to be the same as being in the shade. Wearing light-colored clothes can limit the physiological heat strain experienced by the body.
Topics: Cognition; Cross-Sectional Studies; Heat Stress Disorders; Hot Temperature; Humans; Skin Temperature; Sunlight
PubMed: 34300148
DOI: 10.3390/ijerph18147698 -
Frontiers in Public Health 2022A substantial proportion of all reported occupational illnesses are constituted by skin cancer, making this disease a serious public health issue. Solar ultra-violet...
A substantial proportion of all reported occupational illnesses are constituted by skin cancer, making this disease a serious public health issue. Solar ultra-violet radiation (UVR) exposure is the most significant external factor in the development of skin cancer, for which the broad occupational category of outdoor workers has already been identified as high-risk group. Sun protection by deploying adequate technical, organizational, and person-related measures has to be understood as a functional aspect of workplace safety. To prevent skin cancers brought on by-typically cumulative-solar UVR exposure, outdoor workers must considerably lower their occupationally acquired solar UVR doses. Estimating cumulative sun exposure in outdoor workers requires consideration of the level of solar UVR exposure, the tasks to be done in the sun, and the employees' solar UVR preventive measures. Recent studies have highlighted the necessity for measures to enhance outdoor workers' sun protection behavior. In the coming decades, occupational dermatology is expected to pay increasing attention to sun protection at work. Also, the field of dermato-oncology will likely be concerned with sky-rocketing incidences of occupational skin cancers. The complete range of available alternatives should be utilized in terms of preventive actions, which seems pivotal to handle the present and future challenges in a purposeful manner. This will almost definitely only be possible if politicians' support is effectively combined with communal and individual preventive actions in order to spur long-term transformation.
Topics: Humans; Sunlight; Occupational Exposure; Occupations; Skin Neoplasms; Occupational Diseases
PubMed: 36620257
DOI: 10.3389/fpubh.2022.1110158 -
Nutrients Jan 2023Sunlight exposure is an essential source of vitamin D for many humans. However, hypovitaminosis D is a global public health problem. This study aimed to develop and...
Sunlight exposure is an essential source of vitamin D for many humans. However, hypovitaminosis D is a global public health problem. This study aimed to develop and validate a sun exposure score (SES) and correlate it with serum 25-hydroxyvitamin D levels in women of childbearing age. One hundred and sixty women aged 18 to 45 years residing in Meknes, Morocco, were included. A questionnaire estimating the sun exposure score and blood analysis of serum 25-OHD concentration were performed. The questionnaire's reliability and construct validity were evaluated using Cronbach's alpha and factor analysis. Spearman's test was used to assess the correlation between SES and 25-OHD levels. The score's reliability and construct validity were good, with Cronbach's alpha values >0.70 and factorial saturation ranging from 0.696 to 0.948. Serum 25-OHD levels were significantly associated with the total sun exposure score, and all SES domains (Rho was 0.615 ( < 0.0001), 0.307 ( < 0.0001), 0.605 ( < 0.0001), and 0.424 ( < 0.0001) for total SES, indoor exposure domain, outdoor exposure domain, and sun protection practice domain, respectively). In addition, median 25-OHD levels increased significantly when sun exposure was changed from insufficient to sufficient ( < 0.0001). The results suggest that the sun exposure score could be used as a clinical tool to assess vitamin D levels in women of childbearing age.
Topics: Humans; Female; Sunlight; Reproducibility of Results; Vitamin D; Vitamin D Deficiency; Vitamins
PubMed: 36771395
DOI: 10.3390/nu15030688 -
Archives of Disease in Childhood Feb 2006As skin cancer education programmes directed to children and adolescents continue to expand, an epidemiological basis for these programmes is necessary to target efforts... (Review)
Review
BACKGROUND
As skin cancer education programmes directed to children and adolescents continue to expand, an epidemiological basis for these programmes is necessary to target efforts and plan for further evaluation.
AIMS
To summarise the epidemiological evidence on sun exposure during childhood and adolescence and melanoma risk.
METHODS
A literature review was conducted using Medline (1966 to December 2004) to identify articles relating to sun exposure and melanoma. The review was restricted to studies that included sun exposure information on subjects 18 years of age or younger.
RESULTS
Migrant studies generally indicate an increased melanoma risk in individuals who spent childhood in sunny geographical locations, and decreasing melanoma risk with older age at arrival. Individuals who resided in geographical locations close to the equator or close to the coast during childhood and/or adolescence have an increased melanoma risk compared to those who lived at higher latitudes or never lived near the coast. The intermittent exposure hypothesis remains controversial; some studies indicate that children and adolescents who received intermittent sun exposure during vacation, recreation, or occupation are at increased melanoma risk as adults, but more recent studies suggest intermittent exposure to have a protective effect. The majority of sunburn studies suggest a positive association between early age sunburn and subsequent risk of melanoma.
CONCLUSION
Future research efforts should focus on: (1) clarifying the relation between sun exposure and melanoma; (2) conducting prospective studies; (3) assessing sun exposure during different time periods of life using a reliable and quantitative method; (4) obtaining information on protective measures; and (5) examining the interrelations between ability to tan, propensity to burn, skin type, history of sunburns, timing and pattern of sun exposure, number of nevi, and other host factors in the child and adolescent populations.
Topics: Adolescent; Age Factors; Child; Emigration and Immigration; Environmental Exposure; Humans; Melanoma; Skin Neoplasms; Sunburn; Sunlight
PubMed: 16326797
DOI: 10.1136/adc.2005.086918 -
International Journal of Environmental... Oct 2021Most humans depend on sunlight exposure to satisfy their requirements for vitamin D. However, the destruction of the ozone layer in the past few decades has increased... (Review)
Review
Most humans depend on sunlight exposure to satisfy their requirements for vitamin D. However, the destruction of the ozone layer in the past few decades has increased the risk of skin aging and wrinkling caused by excessive exposure to ultraviolet (UV) radiation, which may also promote the risk of skin cancer development. The promotion of public health recommendations to avoid sunlight exposure would reduce the risk of skin cancer, but it would also enhance the risk of vitamin D insufficiency/deficiency, which may cause disease development and progression. In addition, the ongoing global COVID-19 pandemic may further reduce sunlight exposure due to stay-at-home policies, resulting in difficulty in active and healthy aging. In this review article, we performed a literature search in PubMed and provided an overview of basic and clinical data regarding the impact of sunlight exposure and vitamin D on public health. We also discuss the potential mechanisms and clinical value of phototherapy with a full-spectrum light (notably blue, red, and near-infrared light) as an alternative to sunlight exposure, which may contribute to combating COVID-19 and promoting active and healthy aging in current aged/superaged societies.
Topics: Aged; COVID-19; Healthy Aging; Humans; Infrared Rays; Pandemics; Phototherapy; SARS-CoV-2; Skin Neoplasms; Sunlight; Ultraviolet Rays; Vitamin D
PubMed: 34682694
DOI: 10.3390/ijerph182010950 -
Neurology Apr 2018To examine sun exposure and multiple sclerosis (MS) over the life course (ages 5-15 and 16-20 years, every 10 years thereafter).
OBJECTIVE
To examine sun exposure and multiple sclerosis (MS) over the life course (ages 5-15 and 16-20 years, every 10 years thereafter).
METHODS
Cases with MS (n = 151) and age-matched controls (n = 235) from the Nurses' Health Study cohorts completed summer, winter, and lifetime sun exposure history questionnaires. Cumulative ambient ultraviolet (UV)-B (based on latitude, altitude, cloud cover) exposure before MS onset was expressed as tertiles. Seasonal sun exposure was defined as low vs high hours per week (summer [≤9 vs >10 h/wk]; winter [≤3 vs >4 h/wk]). Relative risks (RRs) and 95% confidence intervals (CIs) were estimated via conditional logistic regression with adjustment for body mass index, ancestry, smoking, and vitamin D supplementation.
RESULTS
Most participants were white (98%); the mean age at MS onset was 39.5 years. Living in high (vs low) UV-B areas before MS onset was associated with a 45% lower MS risk (adjusted RR 0.55, 95% CI 0.42-0.73). Similar reduced risks (51%-52%) for medium or high exposure were observed at ages 5 to 15 years and at 5 to 15 years before MS onset (adjusted < 0.05). At age 5 to 15 years, living in a high (vs low) UV-B area and having high (vs low) summer sun exposure were associated with a lower MS risk (RR 0.45, 95% CI 0.21-0.96).
CONCLUSION
Living in high ambient UV-B areas during childhood and the years leading up to MS onset was associated with a lower MS risk. High summer sun exposure in high ambient UV-B areas was also associated with a reduced risk.
Topics: Adolescent; Adult; Age of Onset; Case-Control Studies; Child; Child, Preschool; Cohort Studies; Humans; Middle Aged; Multiple Sclerosis; Risk Factors; Seasons; Sunlight; Ultraviolet Rays; White People; Young Adult
PubMed: 29514944
DOI: 10.1212/WNL.0000000000005257 -
British Medical Bulletin Dec 2022Workplace exposure to solar ultraviolet (UV) causes malignant melanoma and non-melanoma skin cancer. The evidence for beneficial effects of solar UV exposure in reducing... (Review)
Review
BACKGROUND
Workplace exposure to solar ultraviolet (UV) causes malignant melanoma and non-melanoma skin cancer. The evidence for beneficial effects of solar UV exposure in reducing the risks for other cancers is increasing. The intensity of UV radiation at the Earth's surface is dependent on latitude, but even in northern European countries exposure can be high enough for outdoor work to cause skin cancer.
GROWING POINTS
Awareness of the health risks and benefits of occupational solar UV exposure is poor. Actions to reduce the risk of skin cancer have been identified and employers should recognize their responsibility to actively manage these risks. There is evidence for reduced risks for breast, ovarian and colorectal cancer and possibly other cancers linked to solar UV exposure.
SOURCES OF DATA
This narrative review draws on published scientific articles and material designed to assist identifying strategies to protect workers from solar UV exposure.
AREAS OF AGREEMENT
Solar UV exposure can be harmful. Wavelengths in the UVB range are more effective in causing erythema and DNA damage. Solar UV is the main source of vitamin D for most people. Primary and secondary prevention for skin cancer can potentially eliminate these risks but the evidence for effectiveness is limited.
AREAS OF CONTROVERSY
Potential health benefits of UV exposure, particularly for reduced cancer risk. Determining and communicating optimal exposure to maximize health benefits. The risk of non-melanoma skin cancers may be more than doubled for some workers in temperate latitudes.
AREAS TIMELY FOR DEVELOPING RESEARCH
Exposure-response epidemiological studies; studies of the health benefits of occupational UV exposure; studies of the effectiveness of intervention strategies to prevent skin cancer. Use of low-cost UV sensors in workplaces.
Topics: Humans; Ultraviolet Rays; Skin Neoplasms; Melanoma; Sunlight; Occupational Exposure
PubMed: 35973164
DOI: 10.1093/bmb/ldac019 -
The American Journal of Clinical... Aug 2008Ultraviolet radiation is a carcinogen that also compromises skin appearance and function. Because the ultraviolet action spectra for DNA damage, skin cancer, and vitamin... (Review)
Review
Ultraviolet radiation is a carcinogen that also compromises skin appearance and function. Because the ultraviolet action spectra for DNA damage, skin cancer, and vitamin D(3) photosynthesis are identical and vitamin D is readily available from oral supplements, why has sun protection become controversial? First, the media and, apparently, some researchers are hungry for a new message. Second, the controversy is fueled by a powerful special interest group: the tanning industry. This industry does not target the frail elderly or inner-city ethnic minorities, groups for whom evidence of vitamin D(3) insufficiency is strongest, but rather fair-skinned teenagers and young adults, who are at highest risk of ultraviolet photodamage. Third, evolution does not keep pace with civilization. When nature gave humans the appealing capacity for cutaneous vitamin D(3) photosynthesis, life expectancy was <40 y; long-term photodamage was not a concern; and vitamin D(3) deficiency, with its resulting skeletal abnormalities (rickets), was likely to be fatal in early life. In the 21st century, life expectancy approaches 80 y in developed countries, vitamin D(3) is available at the corner store, and the lifetime risk of skin cancer is 1 in 3 among white Americans. Medical and regulatory groups should avoid poorly reasoned, sensationalistic recommendations regarding unprotected ultraviolet exposure. Instead, they should rigorously explore possible cause-and-effect relations between vitamin D(3) status and specific diseases while advocating the safest possible means of ensuring vitamin D(3) sufficiency.
Topics: Biological Evolution; DNA Damage; Dose-Response Relationship, Radiation; Humans; Life Expectancy; Safety; Skin; Skin Aging; Skin Neoplasms; Sunlight; Sunscreening Agents; Ultraviolet Rays; Vitamin D
PubMed: 18689404
DOI: 10.1093/ajcn/88.2.570S -
International Journal of Environmental... May 2021The dramatic rise in allergic disease has occurred in tandem with recent environmental changes and increasing indoor lifestyle culture. While multifactorial, one...
The dramatic rise in allergic disease has occurred in tandem with recent environmental changes and increasing indoor lifestyle culture. While multifactorial, one consistent allergy risk factor has been reduced sunlight exposure. However, vitamin D supplementation studies have been disappointing in preventing allergy, raising possible independent effects of ultraviolet (UV) light exposure. The aim of this study was to examine whether UV light exposure influences the development of allergic disease in early childhood. Direct sunlight exposure (290-380 nm) in early infancy was measured via UV dosimeters. Outdoor exposure, sun protective behaviours, and allergy outcomes were assessed over the first 2.5 years of life with clinical assessment appointments at 3, 6, 12 and 30 months of age. Children with eczema had less ( = 0.038) direct UV light exposure between 0-3 months of age (median (IQR) 747 (473-1439) J/m) than children without eczema (median (IQR) 1204 (1717-1843) J/m); and less outdoor exposure time (7 min/day) between 11 a.m. and 3 p.m. compared to children without eczema (20 min/day, = 0.011). These associations were seen independent of vitamin D status, and after adjusting for other potential confounders. Whilst we could not find any associations between direct UV light exposure and other allergic disease outcomes, exposure to UV light appears to be beneficial in reducing the risk of eczema development in early childhood. Further research is required to determine optimal levels of UV light exposure while balancing the potential risks.
Topics: Child; Child, Preschool; Eczema; Food Hypersensitivity; Humans; Sunlight; Vitamin D; Vitamins
PubMed: 34069576
DOI: 10.3390/ijerph18105429