1
|
Barón DR, Sánchez NB, Ruiz FR, Martínez AR, Arjona JA, de Castro Maqueda G, Araujo IG, de Gálvez Aranda MV, Martínez AR, de Troya Martín M. Occupational Sun Exposure Among Physical Education Teachers in Primary and Secondary Schools in Andalusia, Spain. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2023; 38:1157-1162. [PMID: 36701024 DOI: 10.1007/s13187-022-02242-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/20/2022] [Indexed: 06/17/2023]
Abstract
Chronic sun exposure and sunburns are the main preventable causes of skin cancer. Due to the nature of their work, physical education teachers are at high risk for occupational skin cancer. This descriptive, cross-sectional study analyzes primary and secondary physical education teachers in Andalusia, Spain. All participants were invited to monitor their ultraviolet (UV) radiation exposure using individual biologic dosimeters and record their photoprotection practices over 3 workdays. The teachers spent an average of 2.7 h outdoors and the mean personal UV radiation exposure was 309.9 J/m2 per day, a value three times higher than international recommendations. Based on the photoprotection diary, it was determined that classes held outdoors were not scheduled outside the hours with the highest UV index and that the percentage of participants who followed the photoprotective practices of remaining in the shade or wearing a hat during outdoor lessons were less than 20% and 60%, respectively. The results on sun exposure and photoprotection practices show a need for organizational and educational intervention strategies to mitigate sun exposure and increase compliance with photoprotection measures to reduce skin cancer risk among these workers and promote early diagnosis of the disease.
Collapse
Affiliation(s)
| | - Nuria Blázquez Sánchez
- Department of Dermatology, Costa del Sol Hospital, Marbella, Spain.
- PAIDI Group: CTS-1081: Photoprotection and Prevention of Skin Cancer (PHOTOPROTECTION), Marbella, Spain.
| | | | | | - José Aguilera Arjona
- Photobiological Dermatology Laboratory, Medical Research Center, Department of Medicine and Dermatology, University of Málaga, Málaga, Spain
| | | | | | | | | | - Magdalena de Troya Martín
- Department of Dermatology, Costa del Sol Hospital, Marbella, Spain
- PAIDI Group: CTS-1081: Photoprotection and Prevention of Skin Cancer (PHOTOPROTECTION), Marbella, Spain
| |
Collapse
|
2
|
Harrison SL, Buettner PG, Nowak MJ. Sun-Protective Clothing Worn Regularly during Early Childhood Reduces the Number of New Melanocytic Nevi: The North Queensland Sun-Safe Clothing Cluster Randomized Controlled Trial. Cancers (Basel) 2023; 15:cancers15061762. [PMID: 36980647 PMCID: PMC10046807 DOI: 10.3390/cancers15061762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 03/07/2023] [Accepted: 03/08/2023] [Indexed: 03/17/2023] Open
Abstract
Numerous pigmented moles are associated with sun exposure and melanomarisk. This cluster randomized controlled trial aimed to determine if sun-protective clothing could prevent a significant proportion of the moles developing in young children (ACTRN12617000621314; Australian New Zealand Clinical Trials Registry. Twenty-five childcare centers in Townsville (19.25° S), Australia, were matched on shade provision and socioeconomic status. One center from each pair was randomized to the intervention arm and the other to the control arm. Children at 13 intervention centers wore study garments and legionnaire hats at childcare and received sun-protective swimwear and hats for home use, while children at the 12 control centers did not. The 1–35-month-old children (334 intervention; 210 control) were examined for moles at baseline (1999–2002) and were re-examined annually for up to 4 years. Both groups were similar at baseline. Children at intervention centers acquired fewer new moles overall (median 12.5 versus 16, p = 0.02; 0.46 versus 0.68 moles/month, p = 0.001) and fewer new moles on clothing-protected skin (6 vs. 8; p = 0.021 adjusted for confounding and cluster sampling) than controls. Intervention children had 24.3% fewer new moles overall (26.5 versus 35) and 31.6% (13 versus 19) fewer moles on clothing-protected skin than controls after 3.5 years. Sunlight’s influence on nevogenesis is mitigated when children regularly wear UPF 30-50+ clothing covering half their body, implying that increased clothing cover reduces melanoma risk. Sun-protective clothing standards should mandate reporting of the percentage of garment coverage for childrenswear.
Collapse
Affiliation(s)
- Simone L. Harrison
- Skin Cancer Research Unit, College of Public Health, Medical and Veterinary Sciences, James Cook University, Douglas, Townsville, QLD 4811, Australia
- Australian Institute of Tropical Health and Medicine (AITHM), Townsville, QLD 4811, Australia
- Correspondence: ; Tel.: +61-423489083
| | - Petra G. Buettner
- Skin Cancer Research Unit, College of Public Health, Medical and Veterinary Sciences, James Cook University, Douglas, Townsville, QLD 4811, Australia
- Australian Institute of Tropical Health and Medicine (AITHM), Cairns, QLD 4875, Australia
| | - Madeleine J. Nowak
- Skin Cancer Research Unit, College of Public Health, Medical and Veterinary Sciences, James Cook University, Douglas, Townsville, QLD 4811, Australia
- College of Medicine and Dentistry, James Cook University, Douglas, Townsville, QLD 4811, Australia
| |
Collapse
|
3
|
Calvache Ruales MF, Westerhausen S, Zapata Gallo HA, Strehl B, Naza Guzman SD, Versteeg H, Stöppelmann W, Wittlich M. UVR Exposure and Prevention of Street Construction Workers in Colombia and Germany. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:7259. [PMID: 35742508 PMCID: PMC9223545 DOI: 10.3390/ijerph19127259] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 06/09/2022] [Accepted: 06/11/2022] [Indexed: 12/10/2022]
Abstract
(1) Solar ultraviolet radiation (UVR) poses a major risk factor for developing skin cancer after years of chronic exposure. The irradiation is strongly dependent upon the activity or occupation carried out, but also on the climate conditions at the workplace. Knowledge of both has been tested within the occupational group of road construction workers in Colombia and Germany. (2) The GENESIS-UV measurement system has been used at both locations for consistency. A number of workers in both countries wore an electronic data logging dosimeter for several months to deliver detailed information on UVR exposure. (3) It was found that in a tropical climate, UVR exposure remains constant throughout the year, while in a temperate climate seasonal effects are visible, superimposed by behavioural aspects e.g., in springtime. The daily distribution of the radiation shows a distinct dip, especially in the Colombian data. Derived data show the high fraction of working days exceeding a threshold set by the skin type. (4) Road construction work involves high UVR exposure. In both countries, preventive measures are required to reduce the personal exposure to a minimum. Exceedance of the minimal erythema dose (MED) suggests a possible enhancing effect, especially in fair skinned people. Intercomparison of UVR exposure at workplaces is possible between countries and climate zones, emphasizing efforts for global action against skin cancer.
Collapse
Affiliation(s)
| | - Stephan Westerhausen
- Department of Ergonomics: Physical Environmental Factors, Institute for Occupational Safety and Health of the German Social Accident Insurance, D-53757 Sankt Augustin, Germany;
| | | | - Benjamin Strehl
- Department Accident Prevention: Digitalisation—Technologies, Institute for Occupational Safety and Health of the German Social Accident Insurance, D-53757 Sankt Augustin, Germany;
| | - Sergio D. Naza Guzman
- Risk Management Consultancy CGR, SURA, Cali 760046, Colombia; (M.F.C.R.); (S.D.N.G.)
| | - Helmut Versteeg
- Department Exposure and Risk Assessment, Institute for Occupational Safety and Health of the German Social Accident Insurance, D-53757 Sankt Augustin, Germany; (H.V.); (W.S.)
| | - Wiho Stöppelmann
- Department Exposure and Risk Assessment, Institute for Occupational Safety and Health of the German Social Accident Insurance, D-53757 Sankt Augustin, Germany; (H.V.); (W.S.)
| | - Marc Wittlich
- Department Accident Prevention: Digitalisation—Technologies, Institute for Occupational Safety and Health of the German Social Accident Insurance, D-53757 Sankt Augustin, Germany;
| |
Collapse
|
4
|
Abstract
During leisure time, people can decide if they want to expose themselves to solar ultraviolet (UV) radiation and to what extent. While working, people do not have this choice. Outdoor workers are exposed to solar UV radiation (UVR) on a daily basis. This may pose a certain health risk, which can be estimated when the personal solar UVR exposure (PE) is known. During past decades, a variety of studies were conducted to measure PE of outdoor workers and our knowledge of the PE of outdoor workers has increased remarkably. As shown by this review, studies clearly indicate that PE of most outdoor workers exceeds the internationally proposed threshold limit value, which is comparable to 1.0 to 1.3 standard erythema dose (SED), respectively, to 1.1 to 1.5 UV Index received over one hour. Besides working in a high UVR environ, monotonic workflow (limited movement, nearly static posture) is a risk factor. In such cases, PE can be higher than ambient UVR. In this review, we provide also a list of milestones, depicting the progress and the most important findings in this field during the past 45 years. However, in many respects our knowledge is still rudimentary, for several reasons. Different measuring positions have been used so that measured PE is not comparable. Few studies were designed to enable the extension of measured PE to other locations or dates. Although the importance of a proper calibration of the measuring devices in respect to the changing solar spectrum was pointed out from the beginning, this is often not performed, which leads to high uncertainties in the presented PE levels. At the end of our review, we provide some key points, which can be used to evaluate the quality of a study respectively to support the design of future studies.
Collapse
|
5
|
Keratinocyte skin cancer risks for working school teachers: Scenarios and implications of the timing of scheduled duty periods in Queensland, Australia. JOURNAL OF PHOTOCHEMISTRY AND PHOTOBIOLOGY B-BIOLOGY 2020; 213:112046. [PMID: 33074139 DOI: 10.1016/j.jphotobiol.2020.112046] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Revised: 09/20/2020] [Accepted: 09/29/2020] [Indexed: 01/01/2023]
Abstract
Relative keratinocyte skin cancer risks attributable to lifetime occupational and casual sunlight exposures of working school teachers are assessed across the state of Queensland for 1578 schools. Relative risk modeling utilizing annual ultraviolet exposure assessments of teachers working in different geographic locations and exposed during periods of measured daily playground duty times for each school were made for local administrative education districts by considering traditional school opening and closing hours, and playground lunchtime schedules. State-wide, basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) relative risk estimates varied by 24% for BCC and 45% for SCC. The highest relative risk was calculated for the state's north (sunshine) coast education district which showed that risk could increase by as much as 32% for BCC and 64% for SCC due to differences in teacher duty schedules. These results highlight the importance of playground duty scheduling as a significant risk factor contributing to the overall burden of preventable keratinocyte skin cancers in Queensland.
Collapse
|
6
|
Jebar MAA, Downs NJ, Parisi AV, Turner J. Evaluation of the Long-term Cumulative UVA Facial Exposure of Queensland School Teachers derived for an Extended Period from the OMI Satellite Irradiance. Photochem Photobiol 2020; 97:192-197. [PMID: 32885458 DOI: 10.1111/php.13329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Accepted: 08/21/2020] [Indexed: 11/28/2022]
Abstract
This research presents a novel methodology for deriving the total daily broadband solar UVA (320-400 nm) received by school teachers during their working day from Ozone Monitoring Instrument (OMI) satellite solar noon UVA irradiance measurements for a Queensland subtropical site (27.5°S, 152°E). Daily UVA exposures are weighted to the anatomical human cheek (anterior infra-orbital region) for teachers wearing and not wearing broad-brimmed hats. The method utilizes the OMI UVA irradiance data collected daily at high temporal resolution over 2005 to 2016 to derive the total daily UVA exposure to a horizontal plane. These horizontal plane exposures are scaled by factors to take into account the timing of outdoor activity. The relationship between exposures to a horizontal plane and those to a vertical plane and the protection provided by a broad-brimmed hat was assessed to evaluate the total daily UVA exposures to the cheek for classroom and physical education teaching staff expected to be outside at different periods of the day. The developed method enables the total daily UVA exposure to specific anatomical sites to be evaluated from the satellite solar noon irradiance at locations that do not have access to surface-based instrumentation capable of recording in the solar UVA waveband.
Collapse
Affiliation(s)
- Mustapha A A Jebar
- Faculty of Health, Engineering and Sciences, University of Southern Queensland, Toowoomba, Australia.,Physics Department, Faculty of Sciences, University of Thi Qar, Nasiriyah, Iraq
| | - Nathan J Downs
- Faculty of Health, Engineering and Sciences, University of Southern Queensland, Toowoomba, Australia.,Centre for Applied Climate Sciences, University of Southern Queensland, Toowoomba, Australia
| | - Alfio V Parisi
- Faculty of Health, Engineering and Sciences, University of Southern Queensland, Toowoomba, Australia.,Centre for Applied Climate Sciences, University of Southern Queensland, Toowoomba, Australia
| | - Joanna Turner
- Faculty of Health, Engineering and Sciences, University of Southern Queensland, Toowoomba, Australia
| |
Collapse
|
7
|
Kanellis VG, Kanellis AL. Knowledge of the meaning and utility of the ultraviolet index as a guide to sun-safe behaviors and attitudes toward hat wearing amongst Australian school students. Int J Dermatol 2020; 59:e240-e242. [PMID: 32301505 DOI: 10.1111/ijd.14874] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Revised: 03/09/2020] [Accepted: 03/20/2020] [Indexed: 11/28/2022]
Affiliation(s)
- Vangelis G Kanellis
- Department of Dermatology, Canberra Hospital, Canberra, ACT, Australia.,College of Health and Medicine, Australia National University, Canberra, ACT, Australia
| | | |
Collapse
|
8
|
Castro‐Maqueda GD, Gutierrez‐Manzanedo JV, Fernandez‐Santos JR, Linares‐Barrios M, Troya Martín MD. Sun Protection Habits and Sun Exposure of Physical Education Teachers in the South of Spain. Photochem Photobiol 2019; 95:1468-1472. [DOI: 10.1111/php.13147] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Accepted: 07/17/2019] [Indexed: 11/30/2022]
|
9
|
Downs NJ, Igoe DP, Parisi AV, Taylor O, Lazzaroni SL, Rawlings A, Garzón-Chavez DR, Harrison SL. Seasonal Minimum and Maximum Solar Ultraviolet Exposure Measurements of Classroom Teachers Residing in Tropical North Queensland, Australia. Photochem Photobiol 2019; 95:1083-1093. [PMID: 30623466 DOI: 10.1111/php.13081] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2018] [Accepted: 12/30/2018] [Indexed: 11/29/2022]
Abstract
The risk of keratinocyte skin cancer, malignant melanoma and ultraviolet radiation (UVR)-induced eye disease is disproportionately higher in Australia and New Zealand compared to equivalent northern hemisphere latitudes. While many teachers are aware of the importance of reinforcing sun safety messages to students, many may not be aware of the considerable personal exposure risk while performing outdoor duties in locations experiencing high to extreme ambient UVR year-round. Personal erythemally effective exposure of classroom teachers in tropical Townsville (19.3°S) was measured to establish seasonal extremes in exposure behavior. Mean daily personal exposure was higher in winter (91.2 J m-2 , 0.91 Standard Erythema Dose [SED]) than summer (63.3 J m-2 , 0.63 SED). The range of exposures represents personal exposures that approximate current national guidelines for Australian workers at the study latitude of approximately 1.2 SED (30 J m-2 effective to the International Commission on Non-Ionizing Radiation Protection). Similar proportions of teachers spent more than 1 h outdoors per day in winter (28.6%) and summer (23.6%) as part of their teaching duties with seasonal differences having little effect on the time of exposure. Personal exposures for teachers peaked during both seasons near school meal break times at 11:00 am and 1:00 pm, respectively.
Collapse
Affiliation(s)
- Nathan J Downs
- Faculty of Health, Engineering and Sciences, University of Southern Queensland, Toowoomba, Qld, Australia.,Skin Cancer Research Unit, School of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Qld, Australia
| | - Damien P Igoe
- Faculty of Health, Engineering and Sciences, University of Southern Queensland, Toowoomba, Qld, Australia
| | - Alfio V Parisi
- Faculty of Health, Engineering and Sciences, University of Southern Queensland, Toowoomba, Qld, Australia
| | - Olivia Taylor
- Skin Cancer Research Unit, School of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Qld, Australia
| | - Shari L Lazzaroni
- Skin Cancer Research Unit, School of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Qld, Australia
| | - Alex Rawlings
- Faculty of Health, Engineering and Sciences, University of Southern Queensland, Toowoomba, Qld, Australia.,Skin Cancer Research Unit, School of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Qld, Australia
| | - Daniel R Garzón-Chavez
- Faculty of Health, Engineering and Sciences, University of Southern Queensland, Toowoomba, Qld, Australia.,Skin Cancer Research Unit, School of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Qld, Australia.,School of Human Medicine, College of Health Sciences, Universidad San Francisco de Quito, Quito, Ecuador
| | - Simone L Harrison
- Faculty of Health, Engineering and Sciences, University of Southern Queensland, Toowoomba, Qld, Australia.,Skin Cancer Research Unit, School of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Qld, Australia.,College of Medicine and Dentistry, James Cook University, Townsville, Qld, Australia
| |
Collapse
|
10
|
Downs NJ, Parisi AV, Butler H, Rawlings A, Elrahoumi RS. An Inexpensive High-Temporal Resolution Electronic Sun Journal for Monitoring Personal Day to Day Sun Exposure Patterns. Front Public Health 2017; 5:310. [PMID: 29201865 PMCID: PMC5696337 DOI: 10.3389/fpubh.2017.00310] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2017] [Accepted: 11/03/2017] [Indexed: 11/13/2022] Open
Abstract
Exposure to natural sunlight, specifically solar ultraviolet (UV) radiation contributes to lifetime risks of skin cancer, eye disease, and diseases associated with vitamin D insufficiency. Improved knowledge of personal sun exposure patterns can inform public health policy; and help target high-risk population groups. Subsequently, an extensive number of studies have been conducted to measure personal solar UV exposure in a variety of settings. Many of these studies, however, use digital or paper-based journals (self-reported volunteer recall), or employ cost prohibitive electronic UV dosimeters (that limit the size of sample populations), to estimate periods of exposure. A cost effective personal electronic sun journal (ESJ) built from readily available infrared photodiodes is presented in this research. The ESJ can be used to complement traditional UV dosimeters that measure total biologically effective exposure by providing a time-stamped sun exposure record. The ESJ can be easily attached to clothing and data logged to personal devices (including fitness monitors or smartphones). The ESJ improves upon self-reported exposure recording and is a cost effective high-temporal resolution option for monitoring personal sun exposure behavior in large population studies.
Collapse
Affiliation(s)
- Nathan J. Downs
- Faculty of Health, Engineering and Sciences, University of Southern Queensland, Toowoomba, QLD, Australia
| | - Alfio V. Parisi
- Faculty of Health, Engineering and Sciences, University of Southern Queensland, Toowoomba, QLD, Australia
| | - Harry Butler
- Faculty of Health, Engineering and Sciences, University of Southern Queensland, Toowoomba, QLD, Australia
| | - Alex Rawlings
- Faculty of Health, Engineering and Sciences, University of Southern Queensland, Toowoomba, QLD, Australia
| | - Raja Salem Elrahoumi
- Faculty of Health, Engineering and Sciences, University of Southern Queensland, Toowoomba, QLD, Australia
| |
Collapse
|
11
|
Wainwright L, Parisi A, Downs N. Concurrent evaluation of personal damaging and beneficial UV exposures over an extended period. JOURNAL OF PHOTOCHEMISTRY AND PHOTOBIOLOGY B-BIOLOGY 2017; 170:188-196. [DOI: 10.1016/j.jphotobiol.2017.04.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/18/2016] [Revised: 04/10/2017] [Accepted: 04/12/2017] [Indexed: 12/27/2022]
|
12
|
Harrison SL, Garzón-Chavez DR, Nikles CJ. Sun protection policies of Australian primary schools in a region of high sun exposure. HEALTH EDUCATION RESEARCH 2016; 31:416-428. [PMID: 27093982 DOI: 10.1093/her/cyw020] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/17/2014] [Accepted: 03/17/2016] [Indexed: 06/05/2023]
Abstract
Queensland, Australia has the highest rates of skin cancer globally. Predetermined criteria were used to score the comprehensiveness of sun protection policies (SPP) of primary schools across Queensland. SPP were sought for schools in 10 regions (latitude range 16.3°S-28.1°S) from 2011 to 2014. Of the 723 schools sampled, 90.9% had a written SPP available publicly. Total SPP scores were low {mean 3.6 [95% CI: 3.4-3.9]; median 2 [interquartile range (IQR) 2, 4]}, with only 3.2% of schools achieving the maximum score of 12. Median SPP scores were higher in Northern and Central Queensland [both 2 (IQR 2, 6) and (IQR 2, 5), respectively] than in Southern Queensland [2 (IQR 2, 3); P = 0.004]. Clothing and hat-wearing were addressed in most policies (96% and 89%) while few schools used their SPP to plan outdoor events (5.2%) or reschedule activities to minimize sun exposure (11.7%). The SunSmart Schools program has been operating in Queensland for 17 years, and while most primary schools now have a written SPP, most are not comprehensive. Incentive-based approaches (5-star-rating award scheme and grants) may assist in addressing this issue, to reduce sun exposure of students and teachers. These data provide a baseline from which improvements in the comprehensiveness of school SPPs can be evaluated.
Collapse
Affiliation(s)
- S L Harrison
- JCU Skin Cancer Research Unit, College of Public Health, Medical & Veterinary Sciences, Room Eg-083 Ground Floor, The Townsville Hospital Education Wing, James Cook University, Townsville, QLD 4811, Australia The Anton Breinl Research Centre for Health Systems Strengthening, Australian Institute of Tropical Health and Medicine (AITHM), James Cook University, Townsville, QLD 4811, Australia
| | - D R Garzón-Chavez
- JCU Skin Cancer Research Unit, College of Public Health, Medical & Veterinary Sciences, Room Eg-083 Ground Floor, The Townsville Hospital Education Wing, James Cook University, Townsville, QLD 4811, Australia
| | - C J Nikles
- JCU Skin Cancer Research Unit, College of Public Health, Medical & Veterinary Sciences, Room Eg-083 Ground Floor, The Townsville Hospital Education Wing, James Cook University, Townsville, QLD 4811, Australia
| |
Collapse
|