UV Doses Worldwide¶†

Encouraging sun protection early in life: from a successful prevention programme in children to the identification of psychological barriers in adolescents

Children and adolescents have high rates of sunburn and high levels of ultraviolet radiation (UVR) exposure and are therefore at risk of developing skin cancer in later life. Minimizing UVR exposure in childhood and adolescence may be the most important component of skin cancer prevention efforts. Thus, age-adapted prevention campaigns, targeting children, adolescents and caregivers, are needed to change sun protection behaviour among individuals in these age groups. In the first part of this review, we describe the 'SunPass' programme, which was initiated in Germany in 2010 as the first nationwide educational intervention for sun safety designed to teach kindergarten children and their caregivers how to protect themselves from overexposure to the sun. Implemented in 55 kindergartens, this programme has been shown to be effective at improving sun protection behaviour (P < 0.001) and hat use (P = 0.029) among kindergarten children, as well as at improving shade practices and increasing demand for protective clothing (P < 0.001). Up to 40 000 children, 50 000 parents/grandparents and 2500 kindergarten caregivers took part in the SunPass programme in Germany from 2019 to June 2021. The programme has also been adapted and implemented in several other European countries and could be readily adapted for use elsewhere. In the second part of this review, we discuss the specific challenges faced by adolescents and consider how these issues may impact their sun protection behaviour. Adolescents have difficulties suppressing responses to reward-related cues and projecting themselves into the future. They also place a lot of importance on social acceptance and cosmetic appearance, and their higher risk of depression, addiction and impulsivity make them vulnerable to tanning addiction. These specificities need to be acknowledged by dermatologists, so they can adapt their therapeutic relationship and develop effective sun protection interventions for this generation.

High variability in anatomic patterns of cutaneous photodamage: a population-based study

BACKGROUND

Skin cancer is strongly associated with photodamaged skin, but body sites are often referred to as 'exposed' or 'unexposed' to sun without recognizing extent of site-specific variation.

OBJECTIVES

To assess whole-body patterns of photodamage in an Australian population.

METHODS

A random sample of adult residents of Queensland underwent imaging across 10 body sites. Photodamage was graded from images using an ordinal photonumeric scale. We used cluster analysis to identify whole-body photodamage patterns and prevalence proportion ratios (PPRs) to assess associated factors.

RESULTS

Of 190 adults (median age 52; 58% males), 58% showed severe or moderate-to-severe photodamage on most body sites. A higher proportion of woman had severe photodamage on the arms (upper: P = 0.002, lower: P = 0.034). A higher proportion of men had moderate or severe photodamage on the lower back (P = 0.004). We identified four photodamage patterns: 'severe general' (n = 24, 13%), 'moderate-severe general' (n = 86, 45%), 'moderate-severe v-neck' (n = 40, 21%) and 'mild-moderate upper body' (n = 12, 6%). All participants with 'severe-general' photodamage were >50 years and more likely to have past skin cancer (PPR: 2.54, 95% CI: 1.44-4.49) than those with 'moderate-severe v-neck' photodamage. Those with 'moderate-severe general' photodamage showed similar associations and were more likely female (PPR: 1.33, 95% CI: 1.04-1.69). Past or current smoking was associated with having higher levels of photodamage, with no smokers in those with 'mild-moderate upper body' photodamage.

CONCLUSIONS

Moderate-to-severe photodamage across much of the body is common in Queensland adults and associated with age, sex, past skin cancer and smoking. Assuming a universal pattern of site-specific sun exposure could lead to spurious correlations, while accurate and objective assessment of site-specific photodamage can add to understanding of the development of sun-associated skin cancers, in particular site-specific skin carcinogenesis. Additionally, degree of site-specific photodamage has the potential to assist skin cancer screening.

Electronic Sun Journal Versus Self-report Sun Diary: A Comparison of Recording Personal Sunlight Exposure Methods

This research compared personal sunlight exposure times monitored electronically within suburban Australian environments against self-report paper journals for determining the timing and total duration of individual exposure to daily solar radiation. A total of 90 Electronic Sun Journal (ESJ) daily readings and self-report timing and duration estimates of exposure for weekend and weekdays were compared. A Wilcoxon ranked sign test showed a significant difference (V = 157, P < 0.001) between the duration of exposure recorded electronically and the duration of exposure that was self-reported in a diary. There was also found to be a statistically significant difference between total exposure time measured using both methods for weekends (V = 10, P < 0.001) and weekdays (V = 87, P < 0.001). General trends in outdoor exposure timing confirmed that the most frequent daily exposures received over the weekend occurred between 1 and 2 h earlier than the most frequent exposures received on weekdays. This preliminary research found that exposure durations as recorded by the ESJ were longer on the weekends compared to weekdays (W = 402, P < 0.001) and confirmed that the ESJ is a viable alternative to self-reporting diaries.

Transcriptional differentiation of UV-B protectant genes in maize landraces spanning an elevational gradient in Chiapas, Mexico

Globally, farmers cultivate and maintain crop landraces (i.e., traditional varieties). Landraces contain unique diversity shaped in part by natural and human-mediated selection and are an indispensable resource for farmers. Since environmental conditions change with elevation, crop landraces grown along elevational gradients have provided ideal locations to explore patterns of local adaptation. To further probe traits underlying this differentiation, transcriptome signatures can help provide a foundation for understanding the ways in which functional genetic diversity may be shaped by environment. In this study, we returned to an elevational gradient in Chiapas, Mexico, to assess transcriptional differentiation of genes underlying UV-B protection in locally adapted maize landraces from multiple elevations. We collected and planted landraces from three elevational zones (lowland, approximately 600 m; midland, approximately 1,550 m; highland approximately 2,100 m) in a common garden at 1,531 m. Using RNA-seq data derived from leaf tissue, we performed differential expression analysis between maize from these distinct elevations. Highland and lowland landraces displayed differential expression in phenylpropanoid and flavonoid biosynthesis genes involved in the production of UV-B protectants and did so at a rate greater than expected based on observed background transcriptional differentiation across the genome. These findings provide evidence for the differentiation of suites of genes involved in complex ecologically relevant pathways. Thus, while neutral evolutionary processes may have played a role in the observed patterns of differentiation, UV-B may have also acted as a selective pressure to differentiate maize landraces in the region. Studies of the distribution of functional crop genetic diversity across variable landscapes can aid us in understanding the response of diversity to abiotic/biotic change and, ultimately, may facilitate its conservation and utilization.

Senior managers' awareness of sun protection policy predicts implementation of worksite sun safety in a randomized trial

BACKGROUND

Outdoor workers experience chronic exposure to harmful ultraviolet radiation (UV) elevating their risk for skin cancer.

METHODS

A controlled randomized trial promoted the adoption of workplace sun safety policy and employee education at 98 public organizations in Colorado. A 2-year follow-up study with 68 organizations assessed the association of senior manager awareness of sun safety policies and implementation of sun safety actions.

RESULTS

Senior managers' awareness of existing sun safety policies, but not their personal sun protection behaviors, predicted implementation of sun safety actions including the number of sun protection messages and sun protection items in the workplace and increased communication about sun safety to employees.

CONCLUSIONS

Organizational adoption of sun safety policy must include efforts to broadly inform a workplace's senior management to ensure the policies are actually implemented and provide support for sun protection behaviors by outdoor workers to reduce UV exposure and skin cancer risk.

Exotic plant species are locally adapted but not to high ultraviolet-B radiation: a reciprocal multispecies experiment

Ultraviolet (UV) radiation intensities differ among global regions, with significantly higher levels in the southern hemisphere. UV-B may act as an environmental filter during plant invasions, which might particularly apply to plant species from Europe introduced to New Zealand. Just like for any other abiotic or biotic filter, successful invaders can cope with novel environmental conditions via plastic responses and/or through rapid adaptation by natural selection in the exotic range. We conducted a multispecies experiment with herbaceous plants in two common gardens located in the species' native and exotic ranges, in Germany and New Zealand, respectively. We used plants of German and New Zealand origin of eight species to test for adaptation to higher UV-B radiation in their new range. In each common garden, all plants were exposed to three radiation treatments: (1) ambient sunlight, (2) exclusion of UV-B while transmitting ambient UV-A, and (3) combined exclusion of UV-B and UV-A. Linear mixed-effect models revealed significant effects of UV-B on growth and leaf traits and an indication for UV-B-induced biomass reduction in both common gardens pointing to an impact of natural, ambient UV radiation intensities experienced by plants in the northern and in the southern hemisphere. In both common gardens, the respective local plants (i.e., German origins in Germany, New Zealand origins in New Zealand) displayed enhanced productivity and aboveground biomass allocation, thus providing evidence for recent evolutionary processes in the exotic range. Genetic differentiation between different origins in consequence of divergent local selection pressures was found for specific leaf area. This differentiation particularly hints at different selective forces in both ranges while only little evidence was found for an immediate selective effect of high UV-B intensities in the exotic range. However, reaction norm slopes across ranges revealed higher plasticity of exotic individuals in functional leaf traits that might allow for a more sensitive regulation of photoprotection measures in response to UV-B. During the colonization, New Zealand populations might have been selected for the observed higher phenotypic plasticity and a consequently increased ability to successfully spread in the exotic range.

Vitamin D Actions on CD4(+) T Cells in Autoimmune Disease

This review summarizes and integrates research on vitamin D and CD4⁺ T-lymphocyte biology to develop new mechanistic insights into the molecular etiology of autoimmune disease. A deep understanding of molecular mechanisms relevant to gene–environment interactions is needed to deliver etiology-based autoimmune disease prevention and treatment strategies. Evidence linking sunlight, vitamin D, and the risk of multiple sclerosis and type 1 diabetes is summarized to develop the thesis that vitamin D is the environmental factor that most strongly influences autoimmune disease development. Evidence for CD4⁺ T-cell involvement in autoimmune disease pathogenesis and for paracrine calcitriol signaling to CD4⁺ T lymphocytes is summarized to support the thesis that calcitriol is sunlight’s main protective signal transducer in autoimmune disease risk. Animal modeling and human mechanistic data are summarized to support the view that vitamin D probably influences thymic negative selection, effector Th1 and Th17 pathogenesis and responsiveness to extrinsic cell death signals, FoxP3⁺CD4⁺ T-regulatory cell and CD4⁺ T-regulatory cell type 1 (Tr1) cell functions, and a Th1–Tr1 switch. The proposed Th1–Tr1 switch appears to bridge two stable, self-reinforcing immune states, pro- and anti-inflammatory, each with a characteristic gene regulatory network. The bi-stable switch would enable T cells to integrate signals from pathogens, hormones, cell–cell interactions, and soluble mediators and respond in a biologically appropriate manner. Finally, unanswered questions and potentially informative future research directions are highlighted to speed delivery of etiology-based strategies to reduce autoimmune disease.

What impact would effective solarium regulation have in Australia?

1) Leading international health organisations are concerned about high use of artificial tanning services and the associated risk of skin cancer. Similar concerns exist about the growing Australian solarium industry. 2) Pre-teens appear to be ignoring sun safety messages in their desire to tan and use solaria. 3) A significantly elevated risk of melanoma exists among people exposed to artificial ultraviolet radiation; the risk is higher for those younger than 35 years at first solarium use. For all users, the risk of squamous cell carcinoma is more than doubled compared with non-users. 4) We estimated the numbers of new melanoma cases and melanoma-related deaths attributable to solarium use by younger people in the five most populous Australian states and indirectly quantified potential costs to the health system that could be saved by effective regulation of the solarium industry. 5) Annually, 281 new melanoma cases, 43 melanoma-related deaths and 2572 new cases of squamous cell carcinoma were estimated to be attributable to solarium use. 6) The annual cost to the health system--predominantly Medicare Australia--for these avoidable skin cancer cases and deaths is about $3 million. 7) By successfully enforcing solarium regulations that ban use by people younger than 18 years or with fair skin, favourable health and cost benefits could be expected.

Agreement between diary records of time spent outdoors and personal ultraviolet radiation dose measurements

Little is known about the validity of self-recorded sun exposure and time spent outdoors for epidemiological research. The aims of the current study were to assess how well participants' self-recorded time outdoors compared to objective measurements of personal UVR doses. We enrolled 124 volunteers aged 40 and above who were identified from targeted subgroups of US radiologic technologists. Each volunteer was instructed to wear a polysulfone (PS) dosimeter to measure UVR on their left shoulder and to complete a daily activity diary, listing all activities undertaken in each 30 min interval between 9:00 A.M. and 5:00 P.M. during a 7 day period. In a linear regression model, self-recorded daily time spent outdoors was associated with an increase of 8.2% (95% CI: 7.3-9.2%) in the personal UVR exposure with every hour spent outdoors. The amount of self-recorded total daily time spent outdoors was better correlated with the personal daily UVR dose for activities conducted near noon time compared to activities conducted in the morning or late afternoon, and for activities often performed in the sun (e.g. gardening or recreation activities) compared to other outdoor activities (e.g. driving) in which the participant is usually shaded from the sun. Our results demonstrated a significant correlation between diary records of time spent outdoors with objective personal UVR dose measurements.

Seasonal Erythemal UV Doses in Belo Horizonte, Brazil

The ultraviolet radiation (UVR) emitted by the Sun causes many effects on the biosphere. On human beings they vary from the benefit of vitamin D synthesis to the harm of skin cancer induction. The biological dose depends on the effect, the exposure time to the Sun and the amount of UVR received. In this work we show that the measured incidence of erythemal dose (ED) in Belo Horizonte (19.92 degrees S, 43.94 degrees W, 858 m a.s.l., Brazil) for a cloudless day can vary from 7503 to 2926 J m(-2) in the summer-winter seasonal variation. In addition, supposing a linear relationship between the ED and the geophysical parameters of solar zenith angle cosine (cos(SZA)), column ozone and reflectivity from the ozone monitoring instrument overpass measurements, a model for the forecast of UVR incidence on a monthly-based period is developed. From this an annual ED of 1,451,099 J m(-2) is obtained.