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Schmalwieser AW, Lohr MA, Daly SM, Williams JD. Modeling acute and cumulative erythemal sun exposure on vulnerable body sites during beach vacations utilizing behavior-encoded 3D body models. PHOTOCHEMICAL & PHOTOBIOLOGICAL SCIENCES : OFFICIAL JOURNAL OF THE EUROPEAN PHOTOCHEMISTRY ASSOCIATION AND THE EUROPEAN SOCIETY FOR PHOTOBIOLOGY 2023; 22:1-20. [PMID: 36028652 DOI: 10.1007/s43630-022-00293-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 08/16/2022] [Indexed: 01/12/2023]
Abstract
Vacationers in a high-solar-intensity beach setting put themselves at risk of ultraviolet radiation (UV) over-exposure that can lead to acute and chronic health consequences including erythema, photoaging, and skin cancer. There is a current gap in existing dosimetry work on capturing detailed time-resolved anatomical distributions of UV exposure in the beach vacation setting. In this study, a radiative transfer model of the solar conditions of Tampa Bay, St. Petersburg, Florida, USA (27.8°N, 82.8°W) is combined with an in silico three-dimensional body model and data on typical beach vacation behaviors to calculate acute and cumulative body-site-specific UV exposure risk during a beach vacation. The resulting cumulative UV exposure calculated for a typical mix of clothing choices, settings, and activities during a week-long (7-day) beach vacation is 172.2 standard erythemal doses (SED) at the forearm, which is comparable with the average total annual UV exposure of European and North American residents and consistent with existing dosimetry studies. This model further estimates that vacationers choosing to spend a full day exclusively in the beach or pool setting can experience UV exposure in excess of 50 SED a day at multiple body sites. Such exposure indicates that significant sun protective measures would be required to prevent sunburn across all skin types in this setting. This work clarifies the significant role that beach vacations play in UV exposure and corresponding acute and cumulative health risks and highlights the importance of behavioral choices (including clothing, activity and photoprotection) as crucial factors in differentiating personal solar exposure risks.
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Affiliation(s)
- Alois W Schmalwieser
- Unit of Physiology and Biophysics, University of Veterinary Medicine, Veterinaerplatz 1, 1210, Vienna, Austria.
| | | | - Susan M Daly
- Johnson and Johnson Consumer Inc., Skillman, NJ, USA
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Grifoni D, Betti G, Bogi A, Bramanti L, Chiarugi A, Gozzini B, Morabito M, Picciolo F, Sabatini F, Miligi L. Protective Measures From Solar Ultraviolet Radiation for Beach Lifeguards in Tuscany (Italy): Shade and Clothing Strategies. Saf Health Work 2022; 13:421-428. [PMID: 36579014 PMCID: PMC9772484 DOI: 10.1016/j.shaw.2022.08.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 07/25/2022] [Accepted: 08/29/2022] [Indexed: 12/31/2022] Open
Abstract
Background The exposure to solar ultraviolet radiation is a significant risk factor generally underestimated by outdoor workers and employers. Several studies have pointed out that occupational solar exposure increased eye and skin diseases with a considerable impact on the lives and productivity of affected workers.The main purpose of this study was to evaluate the effectiveness against ultraviolet radiation of some measures recently undertaken for the protection of lifeguards in a coastal area of Tuscany. Methods Different shading structures (gazebos and beach umbrella) were tested during a sunny summer's day on a sandy beach by means of two radiometers; the UV protection offered by some T-shirts used by lifeguards was also tested in the laboratory with a spectrophotometer. Results The analysed shading structures strongly reduced the ultraviolet radiation by up to 90%, however a not always negligible diffuse radiation is also present in the shade, requiring further protective measures (T-shirt, sunglasses, sunscreen, etc.); the tested T-shirts showed a very good-excellent protection according to the Australian/New Zealand standard. Conclusion Results obtained in this study suggest how the adoption and dissemination of good practices, including those tested, could be particularly effective as a primary prevention for lifeguards who are subjected to very high levels of radiation for long periods.
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Affiliation(s)
- Daniele Grifoni
- CNR-IBE - Institute of Bioeconomy - National Research Council, Sesto Fiorentino, Italy,LaMMA Consortium, Sesto Fiorentino, Italy,Corresponding author. Institute of Bioeconomy - National Research Council, Via Madonna del Piano, 10, 50019, Sesto Fiorentino, Italy.
| | - Giulio Betti
- CNR-IBE - Institute of Bioeconomy - National Research Council, Sesto Fiorentino, Italy,LaMMA Consortium, Sesto Fiorentino, Italy
| | - Andrea Bogi
- Physical Agents Sector, Regional Public Health Laboratory, Siena, Italy
| | - Lucia Bramanti
- AUSL North West Tuscany, Hygiene and Health at Work Unit, Prevention Department, Versilia, Italy
| | - Alessandra Chiarugi
- Screening and Secondary Prevention Unit, Institut for Cancer Research, Prevention and Clinical Network (ISPRO), Florence, Italy
| | - Bernardo Gozzini
- CNR-IBE - Institute of Bioeconomy - National Research Council, Sesto Fiorentino, Italy,LaMMA Consortium, Sesto Fiorentino, Italy
| | - Marco Morabito
- CNR-IBE - Institute of Bioeconomy - National Research Council, Sesto Fiorentino, Italy
| | | | - Francesco Sabatini
- CNR-IBE - Institute of Bioeconomy - National Research Council, Sesto Fiorentino, Italy
| | - Lucia Miligi
- Environmental and Occupational Epidemiology Branch - Cancer Risk Factors and Lifestyle Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network (ISPRO), Florence, Italy
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Schmalwieser AW, Schmalwieser SS. Exposed Body Surface Area-A Determinate for UV Radiant Energy in Human UV Exposure Studies. Photochem Photobiol 2022. [PMID: 36308458 DOI: 10.1111/php.13737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Accepted: 10/09/2022] [Indexed: 12/14/2022]
Abstract
Solar ultraviolet (UV) exposure of people and related health risk is mainly examined by estimating the received UV radiant exposure. However, for several effects such as DNA damage, vitamin D photosynthesis or the probability of developing skin cancer, UV radiant energy is important and with that the size of exposed skin area. There is also a complex interaction between body shape and behavior like sun exposure habits, so that careful analysis is necessary when estimating health effects from UV exposure. In this paper, knowledge on body shape and methods of calculating the total body surface area (BSA) are summarized. BSA depends mainly on the height and weight of a person as well as on gender, ethnicity and body shape. BSA and body shape differ significantly between different populations and both change during life. This paper proposes formulas for BSA that consider height, weight, gender, ethnicity and body shape. As the exposed BSA depends on clothing, finally an approach is presented which aims to calculate the size of body parts released by real garments. In summary, this paper will enable future researchers to quantify the exposed BSA by best matching their study population and consequently investigate risks caused by solar UV exposure.
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Affiliation(s)
- Alois W Schmalwieser
- Unit of Physiology and Biophysics, University of Veterinary Medicine, Vienna, Austria
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Malinović-Milićević S, Mijatović Z, Stanojević G, Radovanović MM, Popović V. Health risks of extended exposure to low-level UV radiation - An analysis of ground-based and satellite-derived data. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 831:154899. [PMID: 35367258 DOI: 10.1016/j.scitotenv.2022.154899] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Revised: 03/08/2022] [Accepted: 03/25/2022] [Indexed: 06/14/2023]
Abstract
This study aims to indicate the importance of revising current health recommendations concerning the duration of exposure and individual sensitivity of the skin to solar ultraviolet (UV) radiation. For this purpose, a 16-year data series (2005-2020) of erythemal radiant exposure (Her) and UV index (UVI) for Serbia was analyzed. The UV-related risk was estimated for lighter skin (skin phototypes I-IV) under prolonged exposure on days when maximum UVI was below the recommended protection threshold (UVIlow days, for UVI < 3). Risk assessment was performed for seasonal exposure using satellite-derived data (OMUVBd product) previously validated by ground-based measurements in Novi Sad. The assessment of harmful effects included an analysis of the relation between the daily maximum UVI and the corresponding daily Her, the occurrence of UVIlow days, the exceedance of minimal erythema dose (MED), and the minimum duration of exposure to induce erythema (tMED) for all lighter skin phototypes. It was found that the share of UVIlow days in the total number of days in Serbia increases with the latitude, with the highest percentage in winter (up to 69.454%) and the lowest in summer (up to 3.468%). The results show that the daily Her frequently exceeded the harmful threshold for lighter skin phototypes I-IV (on average by 91.521, 84.923, 70.556, and 56.515%, respectively) on UVIlow days. It was found that prolonged exposure on days with a maximum of UVI = 2 poses a significant risk of erythema for all lighter skin phototypes, even for a duration of 3 h in the middle of the day, as well as medium risk for UVI = 1, and an absence of risk for UVI = 0. The results suggest that health recommendations should be revised, especially in the mid-latitudes, where the share of UVIlow days is large, and in areas where the population is predominantly lighter-skinned.
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Affiliation(s)
- Slavica Malinović-Milićević
- Geographical Institute "Jovan Cvijić", Serbian Academy of Sciences and Arts, Djure Jakšića 9, 11000 Belgrade, Serbia.
| | - Zoran Mijatović
- Faculty of Sciences, Department of Physics, University of Novi Sad, Dositej Obradović Square 4, 21000 Novi Sad, Serbia
| | - Gorica Stanojević
- Geographical Institute "Jovan Cvijić", Serbian Academy of Sciences and Arts, Djure Jakšića 9, 11000 Belgrade, Serbia
| | - Milan M Radovanović
- Geographical Institute "Jovan Cvijić", Serbian Academy of Sciences and Arts, Djure Jakšića 9, 11000 Belgrade, Serbia; Institute of Sports, Tourism and Service, South Ural State University, 76 Lenin A, 454080 Chelyabinsk, Russia
| | - Vladimir Popović
- Geographical Institute "Jovan Cvijić", Serbian Academy of Sciences and Arts, Djure Jakšića 9, 11000 Belgrade, Serbia
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Schmalwieser AW, Eschenbacher S, Schreder J. UV-Biometer - The usage of erythemal weighted broadband meters for other biological effects. JOURNAL OF PHOTOCHEMISTRY AND PHOTOBIOLOGY. B, BIOLOGY 2022; 230:112442. [PMID: 35429827 DOI: 10.1016/j.jphotobiol.2022.112442] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Revised: 02/07/2022] [Accepted: 04/05/2022] [Indexed: 06/14/2023]
Abstract
In this paper, we pick up the idea of the "UV-Biometer": the use of erythemal weighted broadband meters for other photobiological endpoints. Therefore, nine different types of broadband meters were considered. A necessity for their calibration is the availability of an action spectrum for the respective effect over the complete solar ultraviolet (UV) radiation range. Unfortunately, such action spectra are rather rare. Here we used the action spectra for non-melanoma skin cancer, DNA-damage, clearing of psoriasis, ICNIRP's workers protection and persistent pigmentation. The action spectrum for vitamin D photosynthesis is taken to estimate the effect of missing effectiveness values in the UV-A range. Application shows that high uncertainties occur especially at low solar elevations. Calibration factors in dependence of total ozone and solar elevation were calculated for all broadband meters and all effects. Analysis shows, that not all of these effects are as appropriate as erythema. The calibration for all effects was applied for a broadband meter that measures the UV-Index operationally within the Austrian UV-Index network. As most of these action spectra have threshold limit values or minimum dose equivalents, irradiance was converted into threshold exposure times. Uncertainties from total ozone during routine operation are estimated. Additionally, we derived conversion factors for erythemally effective irradiance to these effective irradiances. This delivers an easy way to gain biologically effective irradiance without the need of knowing the properties of the instrument. However, this introduces additional uncertainties and not all conversions should be applied.
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Affiliation(s)
- A W Schmalwieser
- Unit of Physiology and Biophysics, University of Veterinary Medicine, Vienna, Austria.
| | - S Eschenbacher
- Unit of Physiology and Biophysics, University of Veterinary Medicine, Vienna, Austria
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Bringing Light into Darkness-Comparison of Different Personal Dosimeters for Assessment of Solar Ultraviolet Exposure. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18179071. [PMID: 34501660 PMCID: PMC8431201 DOI: 10.3390/ijerph18179071] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/20/2021] [Revised: 08/20/2021] [Accepted: 08/25/2021] [Indexed: 11/23/2022]
Abstract
(1) Measuring personal exposure to solar ultraviolet radiation (UVR) poses a major challenges for researchers. Often, the study design determines the measuring devices that can be used, be it the duration of measurements or size restrictions on different body parts. It is therefore of great importance that measuring devices produce comparable results despite technical differences and modes of operation. Particularly when measurement results from different studies dealing with personal UV exposure are to be compared with each other, the need for intercomparability and intercalibration factors between different measurement systems becomes significant. (2) Three commonly used dosimeter types—(polysulphone film (PSF), biological, and electronic dosimeters)—were selected to perform intercalibration measurements. They differ in measurement principle and sensitivity, measurement accuracy, and susceptibility to inaccuracies. The aim was to derive intercalibration factors for these dosimeter types. (3) While a calibration factor between PSF and electronic dosimeters of about 1.3 could be derived for direct irradiation of the dosimeters, this was not the case for larger angles of incidence of solar radiation with increasing fractions of diffuse irradiation. Electronic dosimeters show small standard deviation across all measurements. For biological dosimeters, no intercalibration factor could be found with respect to PSF and electronic dosimeters. In a use case, the relation between steady-state measurements and personal measurements was studied. On average, persons acquired only a small fraction of the ambient radiation.
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Isaia G, Diémoz H, Maluta F, Fountoulakis I, Ceccon D, di Sarra A, Facta S, Fedele F, Lorenzetto G, Siani AM, Isaia G. Does solar ultraviolet radiation play a role in COVID-19 infection and deaths? An environmental ecological study in Italy. THE SCIENCE OF THE TOTAL ENVIRONMENT 2021; 757:143757. [PMID: 33272604 PMCID: PMC7678486 DOI: 10.1016/j.scitotenv.2020.143757] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 11/09/2020] [Accepted: 11/10/2020] [Indexed: 05/21/2023]
Abstract
A significantly stronger impact in mortality and morbidity by COVID-19 has been observed in the northern Italian regions compared to the southern ones. The reasons of this geographical pattern might involve several concurrent factors. The main objective of this work is to investigate whether any correlations exist between the spatial distribution of COVID-19 cases and deaths in the different Italian regions and the amount of solar ultraviolet (UV) radiation at the Earth's surface. To this purpose, in this environmental ecological study a mixed-effect exponential regression was built to explain the incidence of COVID-19 based on the environmental conditions, and demographic and pathophysiologic factors. Observations and estimates of the cumulative solar UV exposure have been included to quantify the amount of radiation available e.g., for pre-vitamin D3 synthesis or SARS-CoV-2 inactivation by sunlight. The analysis shows a significant correlation (p-value <5 × 10-2) between the response variables (death percentage, incidence of infections and positive tests) and biologically effective solar UV radiation, residents in nursing homes per inhabitant (NHR), air temperature, death percentage due to the most frequent comorbidities. Among all factors, the amount of solar UV radiation is the variable contributing the most to the observed correlation, explaining up to 83.2% of the variance of the COVID-19 affected cases per population. While the statistical outcomes of the study do not directly entail a specific cause-effect relationship, our results are consistent with the hypothesis that solar UV radiation impacted on the development of the infection and on its complications, e.g. through the effect of vitamin D on the immune system or virus inactivation by sunlight. The analytical framework used in this study, based on commonly available data, can be easily replicated in other countries and geographical domains to identify possible correlations between exposure to solar UV radiation and the spread of the pandemic.
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Affiliation(s)
- Giancarlo Isaia
- Department of Medical Sciences, University of Turin, Italy; Academy of Medicine of Turin, Italy.
| | - Henri Diémoz
- Regional Environmental Protection Agency (ARPA), Valle d'Aosta, Italy
| | - Francesco Maluta
- Department of Industrial Chemistry, University of Bologna, Italy
| | | | - Daniela Ceccon
- Provincial Environmental Protection Agency (APPA), Bolzano, Italy
| | - Alcide di Sarra
- Italian Agency for New Technologies, Energy and Sustainable Economic Development (ENEA), Italy
| | - Stefania Facta
- Regional Environmental Protection Agency (ARPA), Piemonte, Italy
| | | | | | | | - Gianluca Isaia
- Geriatrics and Metabolic Bone Diseases, AOU Città della Salute e della Scienza of Turin, Italy
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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.
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Alfredsson L, Armstrong BK, Butterfield DA, Chowdhury R, de Gruijl FR, Feelisch M, Garland CF, Hart PH, Hoel DG, Jacobsen R, Lindqvist PG, Llewellyn DJ, Tiemeier H, Weller RB, Young AR. Insufficient Sun Exposure Has Become a Real Public Health Problem. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E5014. [PMID: 32668607 PMCID: PMC7400257 DOI: 10.3390/ijerph17145014] [Citation(s) in RCA: 55] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 07/01/2020] [Accepted: 07/04/2020] [Indexed: 12/13/2022]
Abstract
This article aims to alert the medical community and public health authorities to accumulating evidence on health benefits from sun exposure, which suggests that insufficient sun exposure is a significant public health problem. Studies in the past decade indicate that insufficient sun exposure may be responsible for 340,000 deaths in the United States and 480,000 deaths in Europe per year, and an increased incidence of breast cancer, colorectal cancer, hypertension, cardiovascular disease, metabolic syndrome, multiple sclerosis, Alzheimer's disease, autism, asthma, type 1 diabetes and myopia. Vitamin D has long been considered the principal mediator of beneficial effects of sun exposure. However, oral vitamin D supplementation has not been convincingly shown to prevent the above conditions; thus, serum 25(OH)D as an indicator of vitamin D status may be a proxy for and not a mediator of beneficial effects of sun exposure. New candidate mechanisms include the release of nitric oxide from the skin and direct effects of ultraviolet radiation (UVR) on peripheral blood cells. Collectively, this evidence indicates it would be wise for people living outside the tropics to ensure they expose their skin sufficiently to the sun. To minimize the harms of excessive sun exposure, great care must be taken to avoid sunburn, and sun exposure during high ambient UVR seasons should be obtained incrementally at not more than 5-30 min a day (depending on skin type and UV index), in season-appropriate clothing and with eyes closed or protected by sunglasses that filter UVR.
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Affiliation(s)
- Lars Alfredsson
- Institute of Environmental Medicine, Karolinska Institute, 171 77 Stockholm, Sweden;
| | - Bruce K. Armstrong
- School of Population and Global Health, The University of Western Australia, Perth 6009, Australia;
| | - D. Allan Butterfield
- Department of Chemistry and Sanders-Brown Center on Aging, University of Kentucky, Lexington, KY 40506, USA;
| | - Rajiv Chowdhury
- Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge CB1 8RN, UK;
| | - Frank R. de Gruijl
- Department of Dermatology, Leiden University Medical Centre, 2333 ZA Leiden, The Netherlands;
| | - Martin Feelisch
- Clinical & Experimental Sciences, University of Southampton Medical School and University Hospital Southampton NHS Foundation Trust, Southampton SO16 6YD, UK;
| | - Cedric F. Garland
- Division of Epidemiology, Department of Family Medicine and Public Health, University of California San Diego School of Medicine, La Jolla, CA 92093, USA;
| | - Prue H. Hart
- Telethon Kids Institute, University of Western Australia, Perth 6872, Australia;
| | - David G. Hoel
- Department of Public Health Sciences, College of Medicine, Medical University of South Carolina, Charleston, SC 29425, USA
| | - Ramune Jacobsen
- Department of Pharmacy, University of Copenhagen, DK-2100 Copenhagen, Denmark;
| | - Pelle G. Lindqvist
- Department of Clinical Science and Education, Karolinska Institute, 171 77 Stockholm, Sweden;
| | - David J. Llewellyn
- College of Medicine and Health, University of Exeter Medical School, Exeter EX1 2LU, UK;
| | - Henning Tiemeier
- Department of Social and Behavioral Science, Harvard T.H. Chan School of Public Health, Harvard University, Cambridge, MA 02115, USA;
| | - Richard B. Weller
- Centre for Inflammation Research, University of Edinburgh, Edinburgh EH16 4SB, UK;
| | - Antony R. Young
- St John’s Institute of Dermatology, King’s College London, London SE1 9RT, UK;
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