Sunscreens and melanoma: the future looks bright

Effects of TiO2 and ZnO nanoparticles on the growth of phytoplankton assemblages in seawater

Compounds in sunscreen such as ultraviolet (UV) filters protect human skin from damage caused by UV radiation exposure. However, sunscreen components reach marine ecosystems after their release from human skin during activities such as swimming and washing, and are potentially toxic to marine organisms. TiO₂ and ZnO nanoparticles (NPs) are commonly used as inorganic UV filters. In this study, we explored the effects of TiO₂ and ZnO NPs on natural phytoplankton assemblages in coastal seawater. Growth rates of natural phytoplankton assemblages were significantly decreased by 10 mg L^-1 TiO₂ and 1 and 10 mg L^-1 ZnO NP treatments. NP addition also modified the size structure of phytoplankton assemblages, and small phytoplankton (mainly cyanobacteria) are vulnerable to NPs. Because herbivore food preferences depend strongly on algal cell size, NP contamination could also affect higher trophic levels. Notably, small phytoplankton are an important component in microbial loop, and this energy transfer pathway may be more vulnerable to NP contamination.

Sunscreens With High Versus Low Sun Protection Factor and Cutaneous Squamous Cell Carcinoma Risk: A Population-Based Cohort Study

Evidence on sunscreen use and cutaneous squamous cell carcinoma (cSCC) risk is limited. Most studies have not taken sun protection factor (SPF) into consideration and used nonusers of sunscreen as the reference group. Nonusers are likely a priori at lower cSCC risk than users. No study has investigated the effect of high- versus low-SPF sunscreens on cSCC, appropriately adjusting for time-varying confounding. Using data from the Norwegian Women and Cancer Study (1991–2016), we investigated whether use of SPF ≥15 versus SPF <15 sunscreens reduces cSCC risk. We used a marginal structural Cox proportional hazards model with inverse probability of treatment and censoring weights to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). During follow-up of 148,781 women (mean follow-up, 14.3 years), 653 women were diagnosed with cSCC. The effect on cSCC risk of sunscreens with SPF ≥15 versus SPF <15 was close to the null when used at any latitudes (HR = 1.02, 95% CI: 0.82, 1.27) and when used in lower-latitude settings (HR = 1.05, 95% CI: 0.84, 1.32). In conclusion, we found no indication that sunscreens with SPF ≥15 reduced Norwegian women’s cSCC risk more than sunscreens with SPF <15, suggesting that either there is no difference in their effects long-term or the difference is diluted by incorrect application.

Sunscreens and their usefulness: have we made any progress in the last two decades?

Sunscreens have now been around for decades to mitigate the Sun's damaging ultraviolet (UV) radiation which, although essential for the existence of life, is a recognized prime carcinogen. Accordingly, have suncreams achieved their intended purposes towards protection against sunburns, skin photo-ageing and the like? Most importantly, however, have they provided the expected protection against skin cancers that current sunscreen products claim to do? In the last two decades, there have been tens, if not hundreds of studies on sunscreens with respect to skin protection against UVB (280‒320 nm)-traditionally sunscreens with rather low sun protection factors (SPF) were intended to protect against this type of radiation-and UVA (320‒400 nm) radiation; a distinction between SPF and UVA protection factor (UVA-PF) is made. Many of the studies of the last two decades have focused on protection against the more skin-penetrating UVA radiation. This non-exhaustive article reviews some of the important facets of what is currently known about sunscreens with regard (i) to the physical UV filters titanium dioxide (TiO₂) and zinc oxide (ZnO) and the mostly photo-unstable chemical UVB/UVA filters (e.g., octinoxate (OMC) and avobenzone (AVO), among others), (ii) to novel chemical sunscreen agents, (iii) to means that minimize the breakdown of chemical filters and improve their stability when exposed to UV sunlight, (iv) to SPF factors, and (v) to a short discussion on non-melanoma skin cancers and melanoma. Importantly, throughout the article we allude to the safety aspects of sunscreens and at the end ask the question: do active ingredients in sunscreen products pose a risk to human health, and what else can be done to enhance protection? Significant loss of skin protection from two well-known commercial suncreams when exposed to simulated UV sunlight. Cream I: titanium dioxide, ethylhexyl triazone, avobenzone, and octinoxate; Cream II: octyl salicylate, oxybenzone, avobenzone, and octinoxate.

Sunscreen products impair the early developmental stages of the sea urchin Paracentrotus lividus

Marine ecosystems are increasingly threatened by the release of personal care products. Among them, sunscreens are causing concern either for the effects on skin protection from UV radiation and for the potential impacts on marine life. Here, we assessed the UVA protective efficacy of three sunscreens on human dermal fibroblasts, including two common products in Europe and USA, and an eco-friendly product. The sunscreens' effects were also tested on Paracentrotus lividus, a marine species possibly threatened by these contaminants. We found that all tested sunscreens had similar efficacy in protecting human fibroblasts from UVA radiation. Conversely, the sunscreens' effects on embryo-larval development of P. lividus were dependent on the product tested. In particular, the USA sunscreen, containing benzophenone-3, homosalate and preservatives, caused the strongest impact on the sea urchin development, whereas the eco-friendly sunscreen determined the weakest effects. These results suggest that although the tested products protected human skin cells from UVA-induced damage, they might severely affect the success of recruitment and survival of the sea urchin. Our findings underline the importance of developing eco-friendly sunscreens for minimising or avoiding the impact on marine life while protecting human skin from UV damage.

Effects of TiO2 nanoparticles and sunscreens on coastal marine microalgae: Ultraviolet radiation is key variable for toxicity assessment

Given the large numbers of sunbathers on beaches, sunscreen compounds are being released into the coastal aquatic environment in significant amounts. Until now the effect of these potential pollutants on microbiota has been not well-known. Phytoplankton is a key component of the microbiota community. It forms the basis of the aquatic trophic networks, and any change in the natural population of phytoplankton can affect the structure of aquatic biota. This paper describes an experiment performed outdoors (in natural sunlight conditions including ultraviolet radiation (UVR) and with UVR blocked) on mixed microalgae populations (four species from different key marine taxonomic groups, Nannochloropsis gaditana, Chaetoceros gracilis, Pleurochrysis roscoffensis and Amphidinium carterae), for three days, exposed to a range of concentrations of three commercial sunscreens (with variable TiO₂ concentrations: highest concentration for sunscreen C, followed by sunscreen A; and sunscreen B did not contain TiO₂ in its composition). With regard to UVR effect, in the absence of sunscreens, the most sensitive species is the centric diatom, Chaetoceros gracilis, and the least is Nannochloropsis gaditana; this last species presented the same behavior in the absence of UVR and with high sunscreen concentrations. The toxicity gradient obtained for sunscreens and nanoparticles under UVR is: TiO₂ NPs>Sunscreen C>Sunscreen A>Sunscreen B. The differential sensitivity of microalgae to sunscreens and TiO₂ NPs can produce a change in the dynamics of phytoplankton populations and provoke undesirable ecological effects (such as giving dinoflagellates more prominence). The effects of UVR, commonly neglected in bioassays, could alter the results in important ways and should be considered when performing environmentally-relevant bioassays. The toxicity mediated by hydrogen peroxide production associated with the concentration of TiO₂ NPs cannot be considered the only factor responsible for the toxicity: the organic compounds in the sunscreens must also be taken into account.

Are sunscreens a new environmental risk associated with coastal tourism?

The world coastal-zone population and coastal tourism are expected to grow during this century. Associated with that, there will be an increase in the use of sunscreens and cosmetics with UV-filters in their formulation, which will make coastal regions worldwide susceptible to the impact of these cosmetics. Recent investigations indicate that organic and inorganic UV-filters, as well as many other components that are constituents of the sunscreens, reach the marine environment--directly as a consequence of water recreational activities and/or indirectly from wastewater treatment plants (WWTP) effluents. Toxicity of organic and inorganic UV filters has been demonstrated in aquatic organism. UV-filters inhibit growth in marine phytoplankton and tend to bioaccumulate in the food webs. These findings together with coastal tourism data records highlight the potential risk that the increasing use of these cosmetics would have in coastal marine areas. Nevertheless, future investigations into distribution, residence time, aging, partitioning and speciation of their main components and by-products in the water column, persistence, accumulation and toxicity in the trophic chain, are needed to understand the magnitude and real impact of these emerging pollutants in the marine system.

Brazilian consensus on photoprotection

Brazil is a country of continental dimensions with a large heterogeneity of climates and massive mixing of the population. Almost the entire national territory is located between the Equator and the Tropic of Capricorn, and the Earth axial tilt to the south certainly makes Brazil one of the countries of the world with greater extent of land in proximity to the sun. The Brazilian coastline, where most of its population lives, is more than 8,500 km long. Due to geographic characteristics and cultural trends, Brazilians are among the peoples with the highest annual exposure to the sun. Epidemiological data show a continuing increase in the incidence of non-melanoma and melanoma skin cancers. Photoprotection can be understood as a set of measures aimed at reducing sun exposure and at preventing the development of acute and chronic actinic damage. Due to the peculiarities of Brazilian territory and culture, it would not be advisable to replicate the concepts of photoprotection from other developed countries, places with completely different climates and populations. Thus the Brazilian Society of Dermatology has developed the Brazilian Consensus on Photoprotection, the first official document on photoprotection developed in Brazil for Brazilians, with recommendations on matters involving photoprotection.

Human skin pigmentation, migration and disease susceptibility

Human skin pigmentation evolved as a compromise between the conflicting physiological demands of protection against the deleterious effects of ultraviolet radiation (UVR) and photosynthesis of UVB-dependent vitamin D(3). Living under high UVR near the equator, ancestral Homo sapiens had skin rich in protective eumelanin. Dispersals outside of the tropics were associated with positive selection for depigmentation to maximize cutaneous biosynthesis of pre-vitamin D(3) under low and highly seasonal UVB conditions. In recent centuries, migrations and high-speed transportation have brought many people into UVR regimes different from those experienced by their ancestors and, accordingly, exposed them to new disease risks. These have been increased by urbanization and changes in diet and lifestyle. Three examples-nutritional rickets, multiple sclerosis (MS) and cutaneous malignant melanoma (CMM)-are chosen to illustrate the serious health effects of mismatches between skin pigmentation and UVR. The aetiology of MS in particular provides insight into complex and contingent interactions of genetic and environmental factors necessary to trigger lethal disease states. Low UVB levels and vitamin D deficiencies produced by changes in location and lifestyle pose some of the most serious disease risks of the twenty-first century.

Evaluation of sun protection behaviour in patients following excision of a skin lesion

The present prospective study evaluated sun exposure and sun protection behaviours in patients diagnosed with a precancerous or cancerous skin lesion. Following signed informed consent, patients were given a questionnaire regarding sun protection and sun exposure behaviour. There were 50 patients (27 men, 23 women) with a mean age of 59 years. Following diagnosis of a cancerous or precancerous lesion, there was a significant increase (P<0.001) in sunscreen use, use of sun protection factor greater than 30, wearing a hat and avoidance of sun between 10:00 and 14:00. There were significantly more women who used sunscreen (P=0.04) and limited daily activities (P=0.03). There were significantly more patients with nonmelanoma lesions who wore hats (P<0.04) and more patients with melanoma who limited daily activities (P<0.04). While many patients in the present study did alter their sun protection and exposure behaviour, there were many patients who continued in risk-taking sun behaviour. Therefore, patients with precancerous or cancerous skin lesions who are not compliant with sun protective behaviour may benefit from more comprehensive patient education to encourage better sun protection behaviour.

Fator de proteção solar: significado e controvérsias

O Fator de Proteção Solar (FPS) é o principal dado para quantificação da eficácia fotoprotetora de um filtro solar, sendo universalmente aceito. Seu método é baseado na determinação da Dose Eritematosa Mínima (DEM), definida como sendo a menor quantidade de energia necessária para o desencadeamento de eritema, em áreas de pele protegidas e não protegidas pelo produto em estudo. O valor do FPS é, então, calculado como a razão numérica entre a DEM da pele protegida e a da pele não protegida. A primeira publicação demonstrando um método para determinação do valor do FPS foi apresentada em 1978 pela agência norte-americana FDA, seguida por outras publicações do próprio FDA e de outras agências regulatórias internacionais. Apesar de ser considerado o método referência para quantificação da eficácia fotoprotetora de produtos tópicos, existem controvérsias na literatura acerca do método para determinação do FPS e sobre as implicações das reais condições de uso na proteção atingida na prática pelos usuários

Reduced melanoma after regular sunscreen use: randomized trial follow-up

PURPOSE

Regular sunscreen use prevents cutaneous squamous cell carcinoma long term, but the effect on melanoma is highly controversial. We evaluated whether long-term application of sunscreen decreases risk of cutaneous melanoma.

PARTICIPANTS AND METHODS

In 1992, 1,621 randomly selected residents of Nambour, a township in Queensland, Australia, age 25 to 75 years, were randomly assigned to daily or discretionary sunscreen application to head and arms in combination with 30 mg beta carotene or placebo supplements until 1996. Participants were observed until 2006 with questionnaires and/or through pathology laboratories and the cancer registry to ascertain primary melanoma occurrence.

RESULTS

Ten years after trial cessation, 11 new primary melanomas had been identified in the daily sunscreen group, and 22 had been identified in the discretionary group, which represented a reduction of the observed rate in those randomly assigned to daily sunscreen use (hazard ratio [HR], 0.50; 95% CI, 0.24 to 1.02; P = .051). The reduction in invasive melanomas was substantial (n = 3 in active v 11 in control group; HR, 0.27; 95% CI, 0.08 to 0.97) compared with that for preinvasive melanomas (HR, 0.73; 95% CI, 0.29 to 1.81).

CONCLUSION

Melanoma may be preventable by regular sunscreen use in adults.

Multiparticulate carriers for sun-screening agents

Many molecular sunscreens penetrate into the skin causing photo-allergic and photo-toxic reactions as well as skin irritations establishing an urgent need for the development of a safer sunscreen formulation. The search for active substances, efficient combinations, and the design of novel vehicles or carriers has led to the implementation of new cosmetic systems in contrast to the classic forms such as creams or gels. Amongst various approaches utilized to improve performance of sunscreening agents, the use of multiparticulate delivery systems is gaining increasing attention amongst researchers. Multiparticulate delivery systems can be incorporated into gels, creams, liquids, powders or other formulations, and can release active agents depending on their temperature, moisture, friction, volatility of the entrapped ingredients or time. These systems also have the ability of scattering or reflecting incoming UV radiations and therefore can act as physical sunscreens on their own.

Sun protection factors: world wide confusion

The Sun Protection Factor (SPF) is a very popular instrument in the marketing of sunscreens. Unfortunately it is often not understood how sunscreens work and where the limitations of the SPF are. A lot of aspects of the SPF are confusing, e.g. the race for higher and higher numbers, the effect on SPF when less sunscreen is applied and if sunscreen should be used at all because they may block the Vitamin D synthesis. All this has a negative impact on compliance by the consumer or patient which is the most important influence factor in sun protection. This paper explains how sunscreens work, how the SPF is determined and where the limitations of the current methods exist. The dynamic view of 'UV radiation applied' and the 'UV dose transmitted' through the sunscreen onto the skin as well as onto a substrate in vitro help in the understanding and are also promising approaches in the in vitro assessment. A variation of the in vitro assessment of a sunscreen is the in silico calculation based on the absorption spectrum of the UV filters and an assumption about the irregular sunscreen film on the skin. The sunscreen simulator program can be used to determine how the SPF is affected by applying smaller amounts of sunscreen. Besides the SPF, UVA protection is also discussed. The degree of UVA protection determines the quality of the overall UV protection, whereas the SPF is an indication of the quantity of protection. Furthermore other protection factors such as IPF, iSPF, RSF and p53, and the inhibition of the Vitamin D3 synthesis by sunscreens are also discussed. In conclusion it is shown that the accuracy and robustness of the SPF and other Protection Factors will improve significantly with the availability of true broad-spectrum sunscreens rather than conventional UVB-biased sunscreens, because uniform protection profiles lead to protection independent of the action spectrum of the endpoint and the UV-radiation source.

Sunscreens: expectation and realization

BACKGROUND

The technical performance of sunscreens has improved dramatically over the past 20 years, so have we now succeeded in delivering protection that meets consumers' expectations?

METHODS

From a public health perspective, the desire to prevent sunburn and protect against skin cancer are the two major drivers for using sunscreen. This review examines how well consumers can expect to realize these expectations.

RESULTS

Sunscreens are used regularly by a minority of people, even during recreational summer exposure. The failure of sunscreen to prevent sunburn is almost always due to the way that sunscreens are applied rather than technical failure of the product. The mismatch between the labelled protection (sun protection factor) and that delivered in practice is a contributory factor to this 'failure'. Sunscreens have been shown to be effective in reducing the incidence of squamous cell cancer and with promising benefits for basal cell cancer. However, the evidence that they are effective in melanoma remains lacking.

CONCLUSION

The formulation and extinction of sunscreens have undoubtedly improved over recent years. Yet the notion that sunscreens provide unequivocal protection against the deleterious effects of sun exposure by everyone who uses them remains elusive.

Melanoma epidemiology and public health

This article reviews the research on, and examines the epidemiology and prevention of melanoma. Despite the great quantity of research into environmental and genetic causes, and the ease of diagnosis, incidence and mortality have risen in all developed countries during the last half century. Patient and physician education, and public health programs aimed at prevention, have had varied success. The authors conclude that, until we have better data on how to prevent skin cancer of all types, the best solutions are education of high-risk populations about skin self-evaluation in combination with physician examination to practice; and sun protection.

Solar ultraviolet irradiance and cancer incidence and mortality

Evidence supporting the UVB/vitamin D/cancer theory continues to mount with little detraction, although there are some inconsistent results, such as some from Nordic countries, with respect to serum calcidiol levels. Also, studies designed and conducted before it was realized that dietary sources are largely inadequate to have a pronounced effect on cancer risk were largely unable to confirm a beneficial role for vitamin D in reducing the risk of cancer. The analysis of the economic burden of solar UVB irradiance and vitamin D deficiencies compared to excess solar UV irradiance for the United States yielded interesting findings. One was that the US economic burden due to vitamin D insufficiency from inadequate exposure to solar UVB irradiance, diet and supplements was estimated at $40 billion to $56 billion in 2004, whereas the economic burden for excess UV irradiance was estimated at $6 billion to $7 billion. These findings are probably still approximately correct, if not on the low side, with respect to vitamin D because of the additional benefits found recently, such as protection against infectious diseases.

The effect of solar UVB doses and vitamin D production, skin cancer action spectra, and smoking in explaining links between skin cancers and solid tumours

The report of differences between skin cancer rates and solid tumours in sunny versus less sunny countries [Tuohimaa P, Pukkala E, Scelo G, et al. Does solar exposure, as indicated by the non-melanoma skin cancers, protect from solid cancers: Vitamin D as a possible explanation. Eur J Cancer 2007; 43: 1701-12] raised some important questions regarding the roles of solar ultraviolet (UV) irradiance and cancer risk. The findings can likely be explained based on the effects of UVB dose on cancer risk, the action spectra of different skin cancers, the amount of skin exposed, and the differential effects of smoking on cancer risk. Solar UVB has been found inversely correlated with about 20 types of cancer in ecological and cohort studies in sunny countries. Vitamin D and calcium were recently found to greatly reduce cancer incidence in a prospective double-blind study. Epidemiological studies suggest that the action spectra for skin cancers vary, with solar UVB most important for squamous cell carcinoma, UVA most important for melanoma, and both important for basal cell carcinoma. These differences may explain the different standardised incidence ratios for solid tumours with respect to the different skin cancers in sunny countries. Smoking has been reported as a risk factor for non-melanoma skin cancers, but has been found inversely correlated with melanoma, which may explain some of the differences in standardised incidence ratios for solid tumours linked to smoking with respect to type of skin cancer. In Nordic countries, less skin is generally exposed (in head and neck regions, the most frequent sites of squamous cell carcinoma) resulting in reduced vitamin D production.

The increase in melanoma: are dietary furocoumarins responsible?

According to most cancer registries the incidence of cutaneous melanoma (CM) has been increasing for several decades. Unlike other skin cancers, CM does not clearly correlate with exposure to ultraviolet radiation. The strongest etiological evidence for CM in man is genetic predisposition, evidenced by very high risks in primary relatives of melanoma patients, and photochemotherapy with 8-methoxy psoralen in combination with ultraviolet-A radiation (PUVA) to treat psoriasis and vitiligo. Retrospective studies of PUVA patients show significantly increased incidence of CM. Psoralens, and other furocoumarins, are phototoxic and photocarcinogenic, intercalate DNA and photochemically induce mutations. Furocoumarins are botanical phytoalexins found to varying extents in a variety of vegetables and fruits, notably citrus fruits. The levels of furocoumarins present in our diets, while normally well below that causing evident acute phototoxicity, do cause pharmacologically relevant drug interactions. For the past approximately 50 years CM has increased at similar rates as the increased availability and consumption of citrus products. Recently in a large study of nurses, only orange juice drinking, indicative of dietary preference for citrus, was positively associated with significantly increased risk of developing CM. We hypothesize that the increases in cutaneous melanoma incidence may be in part related to concomitant increases in dietary photocarcinogenic furocoumarins.

Photoprotection

Sun exposure is the main cause of photocarcinogenesis, photoageing, and photosensitivity; thus, photoprotection is an important issue. In a skin cancer prevention strategy, behavioural measures--eg, wearing sun protective clothes and a hat and reducing sun exposure to a minimum--should be preferred to sunscreens. Often this solution is deemed to be unacceptable in our global, outdoor society, and sunscreens could become the predominant mode of sun protection for various societal reasons (eg, healthiness of a tan, relaxation in the sun). The application of a liberal quantity of sunscreen has been shown to be by far the most important factor for effectiveness of the sunscreen, followed by the uniformity of application and the specific absorption spectrum of the agent used. The sunscreen market--crowded by numerous products--shows various differences worldwide. Nevertheless, sunscreens should not be abused in an attempt to increase time in the sun to a maximum. Controversies about safety of sunscreens and clinical recommendations are discussed.

Melanoma, long wavelength ultraviolet and sunscreens: Controversies and potential resolutions

Although sunlight is known to cause melanoma, there has been considerable controversy as to the importance of short (UVB) and long (UVA) ultraviolet (UV) wavelengths in causing melanoma, leading to uncertainty in how best to prevent this cancer. This uncertainty has been compounded by the difficulties in assaying the UVA protection abilities of sunscreens, as compared to widely accepted measures of UVB screening by the sun protection factor (SPF). This review discusses the controversies surrounding UVA causation of melanoma in both human and animal models and the use of sunscreens to prevent melanoma. In addition, it details the development of an electron paramagnetic resonance (EPR) technique, initially used to determine the wavelength dependence (or action spectrum) of intramelanocyte radical generation to resolve these controversies in the Xiphophorus model. It is shown how this EPR technique allows a sunscreen protection factor to be determined, that is weighted to the melanocyte, and how this also allows study of the wavelength-dependent screening ability of sunscreens.

Comment on “The effects on human health from stratospheric ozone depletion and its interactions with climate change” by M. Norval, A. P. Cullen, F. R. de Gruijl, J. Longstreth, Y. Takizawa, R. M. Lucas, F. P. Noonan and J. C. van der Leun, Photochem. Photobiol. Sci., 2007, 6, 232

An increase in solar ultraviolet-B (UVB) radiation reaching the earth's surface is an important consequence of stratospheric ozone depletion. UVB has important effects on human health, both beneficial and harmful. Recent research has found that solar UVB reduces the risk of over 20 types of cancer, respiratory diseases caused by viruses, autoimmune diseases, and, likely, several other diseases, in addition to the well-known effects on bone diseases. On the other hand, solar UVB is an important risk factor for non-melanoma skin cancer and cataracts. Human epidemiological studies have provided evidence that solar UVA may be a more important risk factor for melanoma than UVB. If this result is correct, melanoma risk is not related to ozone depletion. We consider the net effect of solar UVB on human health to be beneficial at or near current levels.

Occupational exposure to ultraviolet radiation: the duality dilemma

Human exposure to ultraviolet (UV) radiation is a component of everyday life and a significant hazard for outdoor workers. In addition, a large range of artificial sources also has the potential to provide extreme occupational UV exposure. Even though the human health risks of overexposure to UV are well documented, to date relatively little is known quantitatively about UV exposure. For example, the evidence indicates that workers who are exposed to particular sources (for example, welding arcs) are exposed to extreme UV exposures, despite the use of current control measures. In contrast, increasing evidence points to significant health impacts resulting from underexposure to UV, particularly with the production (or more correctly lack of production) of vitamin D in the skin. The latter poses a serious issue for the work-force, with specific risks for workers lacking adequate sun exposure-underground miners, long-haul flight crews, shift workers, and perhaps indoor workers. Using a risk-management approach, this paper provides a comprehensive review of occupational UV sources, health impact of occupational UV exposure, occupational exposure standards, and levels of exposure in various settings, and discusses the appropriate control measures. In addition, the duality aspect of health impacts from overexposure and underexposure to UV and the associated occupational health implications are specifically explored.

A viologen-based UV indicator and dosimeter

A UV indicator/dosimeter based on benzyl viologen (BV2+) encapsulated in polyvinyl alcohol (PVA) is described. Upon exposure to UV light, the BV2+/PVA film turns a striking purple colour due to the formation of the cation radical, BV*+. The usual oxygen sensitivity of BV*+ is significantly reduced due to the very low oxygen permeability of the encapsulating polymer, PVA. Exposure of a typical BV2+/PVA film, for a set amount of time, to UVB light with different UV indices produces different levels of BV*+, as measured by the absorbance of the film at 550 nm. A plot of the change in absorbance at this wavelength, DeltaAbs(550), as a function of UV index, UVI, produces a linear calibration curve which allows the film to be used as a UVB indicator, and a similar procedure could be employed to allow it to be used as a solar UVI indicator. A typical BV2+/PVA film generates a significant, semi-permanent (stable for >24 h) saturated purple colour (absorbance approximately 0.8-0.9) upon exposure to sunlight equivalent to a minimal erythemal dose associated with Caucasian skin, i.e. skin type II. The current drawbacks of the film and the possible future use of the BV2+/PVA film as a personal solar UV dosimeter for all skin types are briefly discussed.

Motives of Belgian Adolescents for Using Sunscreen: The Role of Action Plans

The first objective of this study was to analyze the differences between adolescents who use sunscreen frequently and those who do not. The second objective was to explore the importance of specific action plans when planning sunscreen use. Data was gathered among 602 Belgian secondary school students. Frequent and infrequent users of sunscreen were compared on several determinants related with sunscreen use, and a regression analysis on sunscreen use was done. Frequent users of sunscreen measures had significantly higher scores on attitudes, social influence, self-efficacy, some awareness factors, intention, and action plans. The integrated model for exploring motivational and behavioral change (I-Change model) explained 57% of the total variance of using sunscreen every 2 hours. Frequent sunscreen use was most strongly predicted by action plans, followed by positive intentions to use sunscreen, wearing protective clothing, seeking shade, attitude toward sunscreen use, education, social influence, and exposure to the sun. Our results suggest that skin cancer prevention programs aimed at promoting sunscreen use need to emphasize the advantages of sunscreen to infrequent users and to increase feelings of self-efficacy. Moreover, support by friends and parents should be stimulated. Finally, developing specific action plans for the use of sunscreen should be promoted to more effectively translate general intentions into actual sunscreen use.

Epidemiology and prevention of cutaneous melanoma

Melanoma incidence has continued to increase in all white populations, and mortality from melanoma remains high in older men worldwide. In Australia, Europe, and the United States, a substantial number of thick melanomas in older men are of the nodular subtype, a subtype lacking asymmetry or color change. Educating the public and professionals about the significance of evolving pigmented lesions as emphasized in the revised ABCDE of pigmented lesions is relevant. Targeting screening efforts toward older men will be necessary to decrease worldwide melanoma mortality. Among prevention strategies, emphasizing multiple methods of sun protection in early childhood, adolescence, and adulthood is needed to decrease sunburn rates. Chemoprevention research in melanoma should become a research priority to complement ongoing prevention strategies.