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Owusu NO, Sousan S, Richards SL, Balanay JAG. Occupational exposure to solar ultraviolet radiation in an eastern North Carolina university outdoor setting during the four seasons. JOURNAL OF OCCUPATIONAL AND ENVIRONMENTAL HYGIENE 2024; 21:77-85. [PMID: 37756362 DOI: 10.1080/15459624.2023.2264331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/29/2023]
Abstract
Outdoor workers perform tasks throughout the year that expose them to solar ultraviolet radiation (UVR) and increase their risk of UVR-related adverse health effects. Multiple studies on occupational solar UVR exposures during summer have been published but similar investigations during other seasons are limited. The purpose of this study was to assess solar UVR exposure in an eastern North Carolina university setting during all four seasons (fall, winter, spring, and summer) to assess risk for outdoor workers, particularly groundskeepers, throughout the year. UVR effective irradiance (UVReff) was measured by area monitoring using a digital data-logging radiometer and a weatherproof UVR detector for 164 days from October 2020 to October 2021. Results showed that hourly and daily mean UVReff exceeded the 1-hr and 8-hr ACGIH Threshold Limit Values (TLVs), respectively, in all months and seasons at varying degrees. Winter had the lowest mean UVReff (3.4 × 10-3 ± 1.7 × 10-3 mW/cm2), but 91.1% and 100% of the hourly and daily UVReff measurements, respectively, still exceeded the TLVs. This study demonstrates the risk of overexposure to solar UVR among outdoor workers during cold months and seasons and the importance of implementing UVR protection throughout the year.
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Affiliation(s)
- Nana-Obaayaa Owusu
- Environmental Health Sciences Program, Department of Health Education and Promotion, East Carolina University, Greenville, North Carolina
| | - Sinan Sousan
- Department of Public Health, Brody School of Medicine, East Carolina University, Greenville, North Carolina
| | - Stephanie L Richards
- Environmental Health Sciences Program, Department of Health Education and Promotion, East Carolina University, Greenville, North Carolina
| | - Jo Anne G Balanay
- Environmental Health Sciences Program, Department of Health Education and Promotion, East Carolina University, Greenville, North Carolina
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Diffey B. When should sunscreen be applied: The balance between health benefit and adverse consequences to humans and the environment. Int J Cosmet Sci 2023; 45 Suppl 1:45-51. [PMID: 37799082 DOI: 10.1111/ics.12906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 12/30/2022] [Accepted: 02/08/2023] [Indexed: 10/07/2023]
Abstract
OBJECTIVE To propose a strategy for using sunscreens that optimizes the balance between skin health and adverse effects to humans and the environment. METHODS A model was developed to explore the relationship between sunscreen usage and personal sun exposure throughout the year in populations resident at different latitudes. RESULTS There is little biological justification in terms of skin health for applying sunscreen over the 4-6 winter months at latitudes of 45° N and higher, whereas year-round sunscreen is advised at latitudes of 30° N and lower. Avoiding sunscreen application at times when it is biologically unnecessary results in an annual reduction in sunscreen use of 25%. Furthermore, using products containing UV filters over the winter months at more northerly latitudes could lead to a higher number of people with vitamin D deficiency. The single largest use of sunscreen is on a sun-seeking holiday and encouragement to make more use of clothing and shade would appreciably reduce the sunscreen burden to the environment. CONCLUSION We need to use sunscreens wisely so that we gain the health benefit from their use while at the same time limiting possible harm to ourselves and the environment.
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Affiliation(s)
- Brian Diffey
- Translational and Clinical Research Institute (Dermatology), Newcastle University, Newcastle upon Tyne, UK
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3
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Weather-Related Human Outdoor Behavior with Respect to Solar Ultraviolet Radiation Exposure in a Changing Climate. ATMOSPHERE 2022. [DOI: 10.3390/atmos13081183] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Abstract
Climate-related changes in human sun exposure behavior can be an important influence on future ultraviolet radiation (UVR) related disease risks. In particular, active leisure mobility and leisure activities are more dependent on weather conditions than routine activities. However, the direction and extent of the effects vary. For temperate and cold climates, the available studies provide indications that a possible increase in UVR exposure would primarily result from a reduction in clothing and only secondarily from changes in the time spent outdoors. Existing studies suggest a nonlinear, bell-shaped relationship with threshold value effects for the relationship between outdoor time and thermal conditions. If the local climate is already very warm and there are only minor seasonal differences, there is no statistically significant evidence of changes in behavior. If there is significant warm discomfort, there is a tendency to avoid being outdoors or in the sun. It is not justified to simply transfer and generalize results and conclusions to different climates and seasons and between different leisure activities and forms of active mobility. The geographical context must be considered also in terms of cultures and habits, adaptations, traffic and land use (urban, rural). In addition, changes in behavior can develop differently depending on individual characteristics of people such as heat affinity, leisure type, age and gender. Differentiated analyses are required that take into account and balance opposing effects.
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4
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Liddle L, Monaghan C, Burleigh MC, Baczynska KA, Muggeridge DJ, Easton C. Reduced nitric oxide synthesis in winter: A potential contributing factor to increased cardiovascular risk. Nitric Oxide 2022; 127:1-9. [PMID: 35792235 DOI: 10.1016/j.niox.2022.06.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 06/27/2022] [Accepted: 06/29/2022] [Indexed: 11/18/2022]
Abstract
BACKGROUND Nitric oxide is a key signalling molecule that elicits a range of biological functions to maintain vascular homeostasis. A reduced availability of nitric oxide is implicated in the progression of cardiovascular diseases and increases the risk of pathogenic events. AIMS To compare the concentration of nitric oxide metabolites in healthy adults between winter and summer months. DESIGN An observational study of healthy adults (age 32 ± 9 years) living in central Scotland. METHODS Thirty-four healthy adults (13 females) were monitored for 7 days in summer and winter to record sunlight exposure (ultraviolet-A (UV-A) radiation), diet, and physical activity. At the end of each phase, blood pressure was measured, and samples of blood and saliva collected. The samples were analysed to determine the concentrations of plasma and salivary nitrate and nitrite and serum 25-hydroxyvitamin D (25(OH)D). RESULTS The participants maintained similar diets in each measurement phase but were exposed to more UV-A radiation (550%) and undertook more moderate-vigorous physical activity (23%) in the summer than in winter. Plasma nitrite (46%) and serum 25(OH)D (59%) were higher and blood pressure was lower in the summer compared to winter months. Plasma nitrite concentration was negatively associated with systolic, diastolic, and mean arterial blood pressure. CONCLUSIONS Plasma nitrite, an established marker of nitric oxide synthesis, is higher in healthy adults during the summer than in winter. This may be mediated by a greater exposure to UV-A which stimulates the release of nitric oxide metabolites from skin stores. While it is possible that seasonal variation in nitric oxide availability may contribute to an increased blood pressure in the winter months, the overall impact on cardiovascular health remains to be determined.
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Affiliation(s)
- Luke Liddle
- Institute for Clinical Exercise and Health Science, University of the West of Scotland, Blantyre, UK; School of Sport and Health Sciences, St. Luke's Campus, University of Exeter, Exeter, UK
| | - Christopher Monaghan
- Institute for Clinical Exercise and Health Science, University of the West of Scotland, Blantyre, UK
| | - Mia C Burleigh
- Institute for Clinical Exercise and Health Science, University of the West of Scotland, Blantyre, UK
| | - Katarzyna A Baczynska
- Laser and Optical Radiation Dosimetry Group, Centre for Radiation, Chemical and Environmental Hazards, UK Health Security Agency, Chilton, UK
| | | | - Chris Easton
- Institute for Clinical Exercise and Health Science, University of the West of Scotland, Blantyre, UK.
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5
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A revised action spectrum for vitamin D synthesis by suberythemal UV radiation exposure in humans in vivo. Proc Natl Acad Sci U S A 2021; 118:2015867118. [PMID: 34580202 PMCID: PMC8501902 DOI: 10.1073/pnas.2015867118] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/14/2021] [Indexed: 11/24/2022] Open
Abstract
Solar UV radiation (UVR) causes sunburn but initiates the first step of vitamin D synthesis, which is the formation of previtamin D3 (pre-D3) in skin. The gold standard for assessing vitamin D is serum 25-hydroxyvitamin D3 [25(OH)D3]. Public health advice for optimal solar exposure requires UVR wavelength-dependence (action spectrum) data on risks and benefits. An action spectrum for pre-D3 in human ex vivo skin was established over 30 y ago, but its validity has been questioned. We tested this action spectrum in healthy volunteers using serum 25(OH)D3 as the endpoint. Our analysis shows that the pre-D3 action spectrum can be improved with a systematic correction. This will result in better risk–benefit calculations for public health advice on solar exposure. Action spectra are important biological weighting functions for risk/benefit analyses of ultraviolet (UV) radiation (UVR) exposure. One important human benefit of exposure to terrestrial solar UVB radiation (∼295 to 315 nm) is the cutaneous synthesis of vitamin D3 that is initiated by the photoconversion of 7-dehydrocholesterol to previtamin D3. An action spectrum for this process that is followed by other nonphotochemical steps to achieve biologically active vitamin D3 has been established from ex vivo data and is widely used, although its validity has been questioned. We tested this action spectrum in vivo by full- or partial-body suberythemal irradiation of 75 healthy young volunteers with five different polychromatic UVR spectra on five serial occasions. Serum 25-hydroxyvitamin D3 [25(OH)D3] levels, as the most accurate measure of vitamin D3 status, were assessed before, during, and after the exposures. These were then used to generate linear dose–response curves that were different for each UVR spectrum. It was established that the previtamin D3 action spectrum was not valid when related to the serum 25(OH)D3 levels, as weighting the UVR doses with this action spectrum did not result in a common regression line unless it was adjusted by a blue shift, with 5 nm giving the best fit. Such a blue shift is in accord with the published in vitro action spectra for vitamin D3 synthesis. Thus, calculations regarding the risk (typically erythema) versus the benefit of exposure to solar UVR based on the ex vivo previtamin D3 action spectrum require revision.
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6
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Parsons BG, Nagelhout ES, Wankier AP, Hu N, Lensink R, Zhu A, Nottingham K, Grossman D, Jensen JD, Wu YP. Reactivity to UV Radiation Exposure Monitoring Using Personal Exposure Devices for Skin Cancer Prevention: Longitudinal Observational Study. JMIR Mhealth Uhealth 2021; 9:e29694. [PMID: 34581683 PMCID: PMC8512190 DOI: 10.2196/29694] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 06/23/2021] [Accepted: 08/03/2021] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Emerging UV radiation (UVR) monitoring devices may present an opportunity to integrate such technology into skin cancer prevention interventions. However, little is known about the effects of using a wearable UVR monitor on adults' and children's sun protection-related behaviors and attitudes (eg, cancer worry and perceived risk). Understanding the potential role of reactivity and seasonal effects will help inform the use of objective monitors in the context of skin cancer prevention research, including intervention studies. OBJECTIVE The aim of this study is to examine the potential reactivity associated with a wearable personal UVR monitor, specifically the effects associated with reported sun-protective behaviors and skin cancer-related attitudes, which are often the targets of skin cancer preventive interventions. METHODS Child-parent dyads (n=97 dyads) were asked to wear a UVR monitoring device during waking hours for 2 weeks. Participants were asked to sync the device daily with a smartphone app that stored the UVR exposure data. Participants were blinded to their UVR exposure data during the 2-week period; thus, the smartphone app provided no feedback to the participants on their UVR exposure. Participants completed self-report questionnaires assessing sun-protective behaviors, sunburn, tanning, skin self-examination, skin cancer-related knowledge, perceived risk, cancer worry, response efficacy, and intentions to change behaviors over the 2-week period. Linear regressions were conducted to investigate changes in the outcomes over time and to account for the role of the season of study participation. RESULTS Regression results revealed that there was a significant decrease over time for several sun protection outcomes in children, including time spent outdoors on weekends (P=.02) and weekdays (P=.008), sunscreen use (P=.03), reapplication (P<.001), and unintentional tanning (P<.001). There were no significant changes over time in children's and parents' UVR exposure, sunburn occurrence, or sun protection attitudes. Season of participation was associated with several outcomes, including lower sunscreen use (P<.001), reapplication (P<.001), sunburns (P=.01), intentions to change sun-protective behaviors (P=.02), and intentional (P=.008) and unintentional tanning (P=.01) for participants who participated in the fall versus the summer. CONCLUSIONS The findings from this study suggest that daily use of a UVR monitoring device over a 2-week period may result in changes in certain sun-protective behaviors. These results highlight the importance of identifying and addressing potential reactivity to UVR monitoring devices, especially in the context of skin cancer preventive intervention research. Ultimately, objectively assessed UVR exposure could be integrated into the outcome assessment for future testing of skin cancer prevention interventions.
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Affiliation(s)
- Bridget G Parsons
- Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, United States
| | | | - Ali P Wankier
- Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, United States
| | - Nan Hu
- Department of Biostatistics, Robert Stempel College of Public Health & Social Work, Florida International University, Miami, FL, United States
| | - Riley Lensink
- Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, United States
| | - Angela Zhu
- Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, United States
| | - Katy Nottingham
- Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, United States
| | - Douglas Grossman
- Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, United States
| | - Jakob D Jensen
- Department of Communication, University of Utah, Salt Lake City, UT, United States
| | - Yelena P Wu
- Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, United States.,Department of Dermatology, University of Utah, Salt Lake City, UT, United States
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7
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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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8
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Nagelhout ES, Lensink R, Zhu A, Parsons BG, Jensen JD, Wu YP. The Feasibility and Acceptability of Using a Wearable UV Radiation Exposure Monitoring Device in Adults and Children: Cross-Sectional Questionnaire Study. JMIR DERMATOLOGY 2020; 3:e15711. [PMID: 33043275 PMCID: PMC7546527 DOI: 10.2196/15711] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND In the United States, melanoma is the 5th most common cancer. Reducing ultraviolet radiation (UVR) exposure is essential for the prevention of melanoma. Objectively assessing individual-level UVR exposure with the use of wearable technology offers a promising tool for reducing UVR exposure. However, the feasibility and acceptability of using UVR monitoring wearable devices have not been assessed. OBJECTIVE The aim of this study was to assess the feasibility and acceptability of a commercially available UVR monitoring wearable device among adults and children. METHODS The study recruited families (one parent and one child) to test a new, commercially-available UVR monitoring device (Shade). Participants wore the Shade device for two weeks and completed questionnaires assessing the feasibility and acceptability of wearing the device. Qualitative analyses were conducted to summarize participants' open-ended responses regarding device feasibility. RESULTS A total of 194 individuals (97 adults and 97 children) participated. Participating children were on average 12.7 years old. Overall, adults and children reported moderate satisfaction with wearing the Shade device. Feasibility of use of the Shade device was adequate with 73% of adults and 61% of children reporting that they wore the device "all of the time they were outside." Through open-ended responses, participants reported appreciating the device's ease of use, compact size, and that it increased their awareness about their UVR exposure. CONCLUSIONS A new, wearable UVR monitoring device can be feasibly used by adults and children and use of the device was acceptable to participants. The device could be integrated into melanoma preventive interventions to increase individual's and families' awareness of their UVR exposure and to facilitate the use of recommended melanoma preventive strategies.
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Affiliation(s)
- Elizabeth S. Nagelhout
- Division of Public Health, Department of Family & Preventive Medicine, University of Utah, 375 Chipeta Way, Suite A, Salt Lake City, UT 84108
| | - Riley Lensink
- Huntsman Cancer Institute, 2000 Circle of Hope, Salt Lake City, UT 84112
| | - Angela Zhu
- Huntsman Cancer Institute, 2000 Circle of Hope, Salt Lake City, UT 84112
| | - Bridget G. Parsons
- Huntsman Cancer Institute, 2000 Circle of Hope, Salt Lake City, UT 84112
| | - Jakob D. Jensen
- Department of Communication, University of Utah, 255 Central Campus Dr #2400, Salt Lake City, UT 84112
| | - Yelena P. Wu
- Huntsman Cancer Institute, 2000 Circle of Hope, Salt Lake City, UT 84112
- Department of Dermatology, University of Utah, 30 North 1900 East, 4A330, Salt Lake City, Utah 84132
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9
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Volf C, Aggestrup AS, Petersen PM, Dam-Hansen C, Knorr U, Petersen EE, Engstrøm J, Jakobsen JC, Hansen TS, Madsen HØ, Hageman I, Martiny K. Dynamic LED-light versus static LED-light for depressed inpatients: study protocol for a randomised clinical study. BMJ Open 2020; 10:e032233. [PMID: 31988225 PMCID: PMC7045110 DOI: 10.1136/bmjopen-2019-032233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Revised: 12/19/2019] [Accepted: 01/07/2020] [Indexed: 11/09/2022] Open
Abstract
INTRODUCTION Retrospective studies conducted in psychiatric inpatient wards have shown a relation between the intensity of daylight in patient rooms and the length of stay, pointing to an antidepressant effect of ambient lighting conditions. Light therapy has shown a promising antidepressant effect when administered from a light box. The emergence of light-emitting diode (LED) technology has made it possible to build luminaires into rooms and to dynamically mimic the spectral and temporal distribution of daylight. The objective of this study is to investigate the antidepressant efficacy of a newly developed dynamic LED-lighting system installed in an inpatient ward. METHODS AND ANALYSIS In all, 150 inpatients with a major depressive episode, as part of either a major depressive disorder or as part of a bipolar disorder, will be included. The design is a two-arm 1:1 randomised study with a dynamic LED-lighting arm and a static LED-lighting arm, both as add-on to usual treatment in an inpatient psychiatric ward. The primary outcome is the baseline adjusted score on the 6-item Hamilton Depression Rating Scale at week 3. The secondary outcomes are the mean score on the Suicidal Ideation Attributes Scale at week 3, the mean score on the 17-item Hamilton Depression Rating Scale at week 3 and the mean score on the World Health Organisation Quality of Life-BREF (WHOQOL-BREF) at week 3. The spectral distribution of daylight and LED-light, with a specific focus on light mediated through the intrinsically photosensitive retinal ganglion cells, will be measured. Use of light luminaires will be logged. Assessors of Hamilton Depression Rating Scale scores and data analysts will be blinded for treatment allocation. The study was initiated in May 2019 and will end in December 2021. ETHICS AND DISSEMINATION No ethical issues are expected. Results will be published in peer-reviewed journals, disseminated electronically and in print and presented at symposia. TRIAL REGISTRATION NUMBER NCT03821506; Pre-results.
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Affiliation(s)
- Carlo Volf
- Psychiatric Centre Copenhagen, University Hospital Copenhagen, Copenhagen, Denmark
| | - Anne Sofie Aggestrup
- Psychiatric Centre Copenhagen, University Hospital Copenhagen, Copenhagen, Denmark
| | - Paul Michael Petersen
- Department of Photonics Engineering, Technical University of Denmark, Lyngby, Denmark
| | - Carsten Dam-Hansen
- Department of Photonics Engineering, Technical University of Denmark, Lyngby, Denmark
| | - Ulla Knorr
- Psychiatric Centre Copenhagen, University Hospital Copenhagen, Copenhagen, Denmark
| | - Ema Erkocevic Petersen
- The Copenhagen Trial Unit, Centre for Clinical Intervention Research, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Janus Engstrøm
- Centre for Clinical Intervention Research, Rigshospitalet, Kobenhavn, Denmark
| | - Janus C Jakobsen
- The Copenhagen Trial Unit, Centre for Clinical Intervention Research, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | | | | | - Ida Hageman
- Mental Health Services in the Capital Region of Denmark, Kobenhavn O, Denmark
| | - Klaus Martiny
- Psychiatric Centre Copenhagen, University Hospital Copenhagen, Copenhagen, Denmark
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Lin M, Torbeck R, Dubin D, Lin C, Khorasani H. Climate change and skin cancer. J Eur Acad Dermatol Venereol 2019; 33:e324-e325. [DOI: 10.1111/jdv.15622] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- M.J. Lin
- Department of Dermatology Icahn School of Medicine at Mount Sinai New York NY USA
| | - R.L. Torbeck
- Department of Dermatology Icahn School of Medicine at Mount Sinai New York NY USA
| | - D.P. Dubin
- Department of Dermatology Icahn School of Medicine at Mount Sinai New York NY USA
| | - C.E. Lin
- Harvard T.H. Chan School of Public Health Harvard University Boston MA USA
| | - H. Khorasani
- Department of Dermatology Icahn School of Medicine at Mount Sinai New York NY USA
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11
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Schmalwieser AW, Schmalwieser VT, Schmalwieser SS. Influence of Air Temperature on the UV Exposure of Different Body Sites Due to Clothing of Young Women During Daily Errands. Photochem Photobiol 2019; 95:1068-1075. [PMID: 30689211 PMCID: PMC6850624 DOI: 10.1111/php.13088] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2018] [Accepted: 01/18/2019] [Indexed: 11/30/2022]
Abstract
Clothing is one of the main influencing factors for personal ultraviolet radiation (UVR) exposure. Despite that, little attention was put on this topic till now. In this study, the clothing habits of young females have been investigated in dependence of meteorological conditions. Observations were made from spring to autumn during daylight in the urban region of Vienna, Austria. For this, a scheme dividing the body into six different sections was developed as well as a coding scale that corresponds to the different garments and indicates the body sites that are exposed. It was found that air temperature is the dominating factor for exposure. With increasing temperature, the first area of the body to be exposed to solar UVR is, aside from face and hands, the décolleté, followed by nape, ankles, instep and forearms. Observations further indicate that the frequency of people's being outdoors decreases significantly at temperatures higher than 30°C. This paper provides detailed frequency distributions of uncovered body sites in dependence of temperature. These can be used together with measurements of temperature and UVR to calculate the relative exposure at any time and at many locations, and could help to explain the body distribution of UVR caused skin alterations.
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Affiliation(s)
- Alois W Schmalwieser
- Unit of Physiology and Biophysics, University of Veterinary Medicine, Vienna, Austria
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12
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Grandahl K, Olsen J, Friis KBE, Mortensen OS, Ibler KS. Photoaging and actinic keratosis in Danish outdoor and indoor workers. PHOTODERMATOLOGY PHOTOIMMUNOLOGY & PHOTOMEDICINE 2019; 35:201-207. [PMID: 30687943 PMCID: PMC6850006 DOI: 10.1111/phpp.12451] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/16/2018] [Accepted: 12/23/2018] [Indexed: 11/30/2022]
Abstract
BACKGROUND The risk of photoaging and actinic keratosis caused by work related solar ultraviolet radiation exposure has not previously been investigated in Nordic countries. The objectives of this study were to describe the occurrence of photoaging, actinic keratosis, and keratinocyte cancer in a population of Danish outdoor and indoor workers, and investigate the association between these clinical findings and semi-objective measures of work related solar ultraviolet radiation exposure in the same population. METHODS A clinical cross-sectional study of the occurrence of facial wrinkles, actinic keratosis, keratinocyte cancer, and melanocytic nevi in a population of Danish outdoor and indoor workers and associations with semi-objective measures of work related solar ultraviolet radiation exposure based on a combination of dosimetry and self-report. RESULTS Work related solar ultraviolet radiation exposure was significantly positively associated with occurrence of facial wrinkles (α = 0.05). Actinic keratosis was associated to status as outdoor worker (OR = 4.272, CI [1.045-17.471]) and age (P < 0.001, CI [1.077-1.262]) and twice as common in outdoor workers (10.3% CI [0.05, 0.15]) compared to indoor workers (5.1% CI [0.00, 0.10]). Only two cases of keratinocyte cancer were diagnosed (<1%). Older age was negatively associated with occurrence of melanocytic nevi. CONCLUSION Outdoor work in Denmark is associated with increased occurrence of facial wrinkles and actinic keratosis from solar ultraviolet radiation exposure, thus justifying sun safety at Danish workplaces from a clinical perspective.
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Affiliation(s)
- Kasper Grandahl
- The Department of Occupational Medicine, Copenhagen University Holbaek, Holbaek, Denmark
| | - Jonas Olsen
- The Department of Dermatology, Zealand University Hospital Roskilde, Roskilde, Denmark
| | | | - Ole Steen Mortensen
- The Department of Occupational Medicine, Copenhagen University Holbaek, Holbaek, Denmark.,Department of Public Health, Section of Social Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Kristina Sophie Ibler
- The Department of Dermatology, Zealand University Hospital Roskilde, Roskilde, Denmark
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13
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Thieden E, Holm-Schou ASS, Philipsen PA, Heydenreich J, Wulf HC. Adult UVR exposure changes with life stage - a 14-year follow-up study using personal electronic UVR dosimeters. Photochem Photobiol Sci 2019; 18:467-476. [PMID: 30511738 DOI: 10.1039/c8pp00365c] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Over a period spanning 14 years (1999-2001, 2006 and 2012), 31 volunteers participated in sun behaviour studies with the same protocol wearing a personal, electronic wrist-borne UVR dosimeter and completed sun exposure diaries resulting in a total of 15 946 measurements days (126 days per person per year). The participants individually maintained their UVR dose level and behaviour over the years. No statistically significant differences were seen from year to year in the "estimated annual UVR dose", the "mean UVR dose per day", the "mean percentage of ambient UVR", "days sunbathing to get a tan", "days with intermittent exposure" or in "sunburn episodes". The 20 participants still active in the labour market used sunscreen on more days in 2012 than in 1999 (p = 0.019) and with a significantly higher SPF (sun protecting factor (p < 0.001)) resulting in significantly fewer days with risk behaviour without sunscreen applied in 2012 than in 2006 (p < 0.001) and 1999 (p < 0.003). This was in contrast to the 11 participants who retired during the study period. The retired group received a non-significant 45% higher UV dose in 2012 than in 1999 (p = 0.054). In an additional study, nine 30-year-old indoor workers (high school students in the 1999 study) had changed their sun exposure pattern and had fewer days sunbathing (p = 0.008) and fewer risk behaviour days without sunscreen applied in 2012 than in 1999 (p = 0.002). Conclusion: The participants still active in the labour market maintained their sun exposure behaviour over a 14-year period. The retirees had a higher UVR dose and riskier exposure behaviour after retirement, while the high school students had changed to less risky sun behaviour on becoming indoor workers.
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Affiliation(s)
- Elisabeth Thieden
- Department of Dermatology, Frederiksberg and Bispebjerg Hospitals, University of Copenhagen, Copenhagen, Denmark.
| | - Ann-Sofie Sonne Holm-Schou
- Department of Dermatology, Frederiksberg and Bispebjerg Hospitals, University of Copenhagen, Copenhagen, Denmark
| | - Peter A Philipsen
- Department of Dermatology, Frederiksberg and Bispebjerg Hospitals, University of Copenhagen, Copenhagen, Denmark
| | - Jakob Heydenreich
- Department of Dermatology, Frederiksberg and Bispebjerg Hospitals, University of Copenhagen, Copenhagen, Denmark
| | - Hans Christian Wulf
- Department of Dermatology, Frederiksberg and Bispebjerg Hospitals, University of Copenhagen, Copenhagen, Denmark
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14
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Heydenreich J, Wulf HC. Personal electronic UVR dosimeter measurements: specific and general uncertainties. Photochem Photobiol Sci 2019; 18:1461-1470. [PMID: 30958489 DOI: 10.1039/c8pp00379c] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Personal ultraviolet radiation (UVR) dosimetry has been performed for decades to objectively measure human exposure to UVR. These measurements have been used to investigate solar behaviour and its negative effects on human health such as skin cancer and positive effects such as vitamin D formation. A specific electronic dosimeter is described with a spectral sensitivity as the erythema response for human skin and temperature measurements for compliance control. Technical, methodological and environmental causes of uncertainties regarding personal UV dosimetry are investigated using this dosimeter as an example, which enables us to show the dosimeter's limitations and enables readers to compare their dosimeters with that described and to increase awareness of imperfections of dosimeters. The dosimeter's spectral response, cosine response, linearity, temperature dependency and sensitivity are investigated. As opposed to biological and chemical dosimeters, electronic dosimeters do not measure UV radiation continuously but at time-intervals (sampling). The error introduced by sampling is investigated for sampling intervals from 1 second up to 60 seconds for 3 groups of people (n = 18, 1.1-4.6 hours of positive UV measurements) on sunny (n = 12) and cloudy (n = 6) days. Increasing the sample time by 1 second added on average an uncertainty of maximum +0.29% to -0.27% per added second compared to the 1-second sample time. The importance of dirt on the sensor was investigated in 24 dosimeters after 6 months use by farmers. The reduction in the registered dose due to the dirty sensor was 2.3% (median = 2.0%, inter-quartile range = 2.0%, max = 5%) suggesting that dirt on the sensor generally does not play a significant role.
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Affiliation(s)
- Jakob Heydenreich
- Department of Dermatology, Frederiksberg and Bispebjerg Hospitals, University of Copenhagen, Copenhagen, Denmark.
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15
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Datta P, Philipsen PA, Olsen P, Petersen B, Andersen JD, Morling N, Wulf HC. Pigment genes not skin pigmentation affect UVB-induced vitamin D. Photochem Photobiol Sci 2019; 18:448-458. [DOI: 10.1039/c8pp00320c] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
The long-term UVB induced serum 25(OH)D increase was influenced by pigment gene polymorphisms rather than measured facultative skin pigmentation.
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Affiliation(s)
- Pameli Datta
- Department of Dermatology D92
- Copenhagen University Hospital
- Bispebjerg Hospital
- 2400 Copenhagen
- Denmark
| | - Peter Alshede Philipsen
- Department of Dermatology D92
- Copenhagen University Hospital
- Bispebjerg Hospital
- 2400 Copenhagen
- Denmark
| | - Peter Olsen
- Department of Dermatology D92
- Copenhagen University Hospital
- Bispebjerg Hospital
- 2400 Copenhagen
- Denmark
| | - Bibi Petersen
- Department of Dermatology D92
- Copenhagen University Hospital
- Bispebjerg Hospital
- 2400 Copenhagen
- Denmark
| | - Jeppe Dyrberg Andersen
- Section of Forensic Genetics
- Department of Forensic Medicine
- Faculty of Health and Medical Sciences
- University of Copenhagen
- 2100 Copenhagen
| | - Niels Morling
- Section of Forensic Genetics
- Department of Forensic Medicine
- Faculty of Health and Medical Sciences
- University of Copenhagen
- 2100 Copenhagen
| | - Hans Christian Wulf
- Department of Dermatology D92
- Copenhagen University Hospital
- Bispebjerg Hospital
- 2400 Copenhagen
- Denmark
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16
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Schmalwieser AW, Siani AM. Review on Nonoccupational Personal Solar UV Exposure Measurements. Photochem Photobiol 2018; 94:900-915. [PMID: 29856894 DOI: 10.1111/php.12946] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Accepted: 05/25/2018] [Indexed: 01/22/2023]
Abstract
Solar ultraviolet (UV) radiation follows people during their whole life. Exposure to UV radiation is vital but holds serious risks, too. The quantification of human UV exposure is a complex issue. UV exposure is directly related to incoming UV radiation as well as to a variety of factors such as the orientation of the exposed anatomical site with respect to the sun and the duration of exposure. The use of badge-sensors allows assessing the UV exposure of differently oriented body sites. Such UV devices have been available for over 40 years, and a variety of measuring campaigns have been undertaken since then. This study provides an overview of those studies which reported measurements of the personal UV exposure (PE) during outdoor activities of people not related to their occupation. This overview is given chronologically to show the progress of knowledge in this research and is given with respect to different activities. Special focus is put on the ratio of personal exposure to ambient UV radiation. This ratio, when given as a function of solar elevation, allows estimating PE at any other location or date if ambient UV radiation is known.
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Affiliation(s)
- Alois W Schmalwieser
- Unit of Physiology and Biophysics, University of Veterinary Medicine, Vienna, Austria
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17
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Hamann C, Andersen Y, Engebretsen K, Skov L, Silverberg J, Egeberg A, Thyssen J. The effects of season and weather on healthcare utilization among patients with atopic dermatitis. J Eur Acad Dermatol Venereol 2018; 32:1745-1753. [DOI: 10.1111/jdv.15023] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2017] [Accepted: 03/05/2018] [Indexed: 12/17/2022]
Affiliation(s)
- C.R. Hamann
- Department of Dermatology and Allergy; Herlev and Gentofte Hospital; University of Copenhagen; Hellerup Denmark
- Copenhagen Research Group for Inflammatory Skin (CORGIS); Herlev and Gentofte Hospital; Hellerup Denmark
- School of Health and Medical Science; Graduate Programme in Public Health and Epidemiology; University of Copenhagen; Copenhagen Denmark
| | - Y.M.F. Andersen
- Department of Dermatology and Allergy; Herlev and Gentofte Hospital; University of Copenhagen; Hellerup Denmark
- Copenhagen Research Group for Inflammatory Skin (CORGIS); Herlev and Gentofte Hospital; Hellerup Denmark
- School of Health and Medical Science; Graduate Programme in Public Health and Epidemiology; University of Copenhagen; Copenhagen Denmark
| | - K.A. Engebretsen
- Department of Dermatology and Allergy; Herlev and Gentofte Hospital; University of Copenhagen; Hellerup Denmark
- Copenhagen Research Group for Inflammatory Skin (CORGIS); Herlev and Gentofte Hospital; Hellerup Denmark
- National Allergy Research Centre; Herlev and Gentofte Hospital; Hellerup Denmark
| | - L. Skov
- Department of Dermatology and Allergy; Herlev and Gentofte Hospital; University of Copenhagen; Hellerup Denmark
- Copenhagen Research Group for Inflammatory Skin (CORGIS); Herlev and Gentofte Hospital; Hellerup Denmark
- National Allergy Research Centre; Herlev and Gentofte Hospital; Hellerup Denmark
| | - J.I. Silverberg
- Departments of Dermatology, Preventive Medicine, and Medical Social Sciences; Feinberg School of Medicine; Northwestern University; Chicago IL USA
| | - A. Egeberg
- Department of Dermatology and Allergy; Herlev and Gentofte Hospital; University of Copenhagen; Hellerup Denmark
- Copenhagen Research Group for Inflammatory Skin (CORGIS); Herlev and Gentofte Hospital; Hellerup Denmark
| | - J.P. Thyssen
- Department of Dermatology and Allergy; Herlev and Gentofte Hospital; University of Copenhagen; Hellerup Denmark
- Copenhagen Research Group for Inflammatory Skin (CORGIS); Herlev and Gentofte Hospital; Hellerup Denmark
- National Allergy Research Centre; Herlev and Gentofte Hospital; Hellerup Denmark
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18
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Grandahl K, Eriksen P, Ibler KS, Bonde JP, Mortensen OS. Measurements of Solar Ultraviolet Radiation Exposure at Work and at Leisure in Danish Workers. Photochem Photobiol 2018; 94:807-814. [PMID: 29603236 DOI: 10.1111/php.12920] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2018] [Accepted: 03/16/2018] [Indexed: 11/28/2022]
Abstract
Exposure to solar ultraviolet radiation is the main cause of skin cancer and may well present an occupational health and safety problem. In Denmark, skin cancer is a common disease in the general population, but detailed data on solar ultraviolet radiation exposure among outdoor workers are lacking. The aim of this study was to provide objective measurements of solar ultraviolet radiation exposure on working days and at leisure and compare levels of exposure between groups of mainly outdoor, equal-parts-outdoor-and-indoor and indoor workers. To this end, UV-B dosimeters with an aluminum gallium nitride (AlGaN) photodiode detector were used to measure the solar ultraviolet radiation exposure of 457 workers in the Danish summer season. Presented as semi-annual standard erythemal dose (SED) on working days, respectively, at leisure, the results are for mainly outdoor workers 214.2 SED and 64.8 SED, equal-parts-outdoor-and-indoor workers 131.4 SED and 64.8 SED, indoor workers 55.8 SED and 57.6 SED. The daily SED by month is significantly different (α = 0.05) between mainly outdoor, equal-parts-outdoor-and-indoor and indoor workers and across professional groups; some of which are exposed at very high levels that is roofers 361.8 SED. These findings substantiate that exposure to solar ultraviolet radiation is indeed an occupational health and safety problem in Denmark.
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Affiliation(s)
- Kasper Grandahl
- The Department of Occupational Medicine, Copenhagen University Holbaek, Holbaek, Denmark
| | - Paul Eriksen
- The Danish Meteorological Institute, Copenhagen, Denmark
| | | | - Jens Peter Bonde
- The Department of Occupational Medicine, Copenhagen University Bispebjerg, Copenhagen NV, Denmark
| | - Ole Steen Mortensen
- The Department of Occupational Medicine, Copenhagen University Holbaek, Holbaek, Denmark.,Section of Social Medicine, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
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19
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Togsverd-Bo K, Philipsen PA, Hædersdal M, Wulf HCO. Skin autofluorescence reflects individual seasonal UV exposure, skin photodamage and skin cancer development in organ transplant recipients. JOURNAL OF PHOTOCHEMISTRY AND PHOTOBIOLOGY B-BIOLOGY 2017; 178:577-583. [PMID: 29272850 DOI: 10.1016/j.jphotobiol.2017.12.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/14/2017] [Revised: 10/10/2017] [Accepted: 12/01/2017] [Indexed: 11/30/2022]
Abstract
IMPORTANCE Ultraviolet radiation (UVR)-induced skin cancers varies among organ transplant recipients (OTRs). To improve individual risk assessment of skin cancer, objectively quantified skin photodamage is needed. OBJECTIVES We measured personal UVR-exposure dose in OTRs and assessed the relation between individual UVR exposure, skin cancer and objectively measured photodamage in terms of skin autofluorescence, pigmentation, and black light-evaluated solar lentigines. MATERIALS AND METHODS Danish OTRs with (n=15) and without a history of skin cancer (n=15) kept sun diaries from May to September and wore personal dosimeters recording time-stamped UVR doses in standard erythema doses (SED). Photodamage was quantified as skin autofluorescence with excitation at 370nm (F370) and 430nm (F430), skin pigmentation (pigment protection factor, PPF), and black light-evaluated solar lentigines. RESULTS OTRs with skin cancer received a higher UVR dose than OTRs without skin cancer (median 116 SED vs. 67 SED, p=0.07) and UVR exposure doses were correlated with increased PPF (p=0.052) and F370 on the shoulder (F370shoulder) (p=0.04). We found that skin cancer was associated with F370shoulder (OR 10.53, CI 3.3-31,938; p=0.018) and time since transplantation (OR 1.34, CI 0.95-1.91, p=0.097). A cut-off at 7.2 arbitrary units, 89% of OTRs with skin cancer had F370shoulder values above 7.2 arbitrary units and F370shoulder was additionally related to patient age (p=0.09) and black light-evaluated solar lentigines (p=0.04). CONCLUSION F370 autofluorescence indicates objectively measured photodamage and may be used for individual risk assessment of skin cancer development in OTRs.
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Affiliation(s)
- Katrine Togsverd-Bo
- Department of Dermato-venerology, Bispebjerg University Hospital, 2400 Copenhagen, Denmark.
| | | | - Merete Hædersdal
- Department of Dermato-venerology, Bispebjerg University Hospital, 2400 Copenhagen, Denmark
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20
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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.
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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
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21
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Yi SX, Gantz JD, Lee RE. Desiccation enhances rapid cold-hardening in the flesh fly Sarcophaga bullata: evidence for cross tolerance between rapid physiological responses. J Comp Physiol B 2016; 187:79-86. [PMID: 27568301 DOI: 10.1007/s00360-016-1030-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2016] [Revised: 07/29/2016] [Accepted: 08/22/2016] [Indexed: 10/21/2022]
Abstract
Many insects use rapid cold-hardening (RCH), a physiological response to sub-lethal exposure to stressors, such as chilling and desiccation, to enhance their cold tolerance within minutes. Recently, drought-induced RCH, triggered by brief, mild desiccation, was described in larvae of the freeze-tolerant gall fly (Eurosta solidaginis). However, its prevalence and ecological significance in other insects is not known. Consequently, we used a freeze-intolerant model, the flesh fly, Sarcophaga bullata, to investigate the effects and mechanisms of drought-induced RCH. In addition, we investigated how drought- and cold-induced RCH interact by exposing flies to both desiccation and chilling. Desiccation for 3 h increased larval pupariation after cold shock from 28 to 40 %-the first example of drought-induced RCH in both a freeze-intolerant insect and in a non-overwintering life stage. We also found that desiccation and chilling together enhanced the cold hardiness of larvae and adults more than either did separately, suggesting that drought and cold trigger distinct physiological mechanisms that interact to afford greater cold tolerance. These results suggest that drought-induced RCH is a highly conserved response used by insects with diverse life history strategies. Furthermore, the protective interaction between drought- and cold-induced RCH suggests that, in nature, insects use multiple cues and physiological mechanisms to fine-tune their response to changing ambient conditions.
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Affiliation(s)
- Shu-Xia Yi
- Department of Biology, Miami University, 700 East High Street, Oxford, OH, 45056, USA.
| | - J D Gantz
- Department of Biology, Miami University, 700 East High Street, Oxford, OH, 45056, USA
| | - Richard E Lee
- Department of Biology, Miami University, 700 East High Street, Oxford, OH, 45056, USA
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22
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Bay C, Togsverd-Bo K, Lerche CM, Haedersdal M. Skin tumor development after UV irradiation and photodynamic therapy is unaffected by short-term pretreatment with 5-fluorouracil, imiquimod and calcipotriol. An experimental hairless mouse study. JOURNAL OF PHOTOCHEMISTRY AND PHOTOBIOLOGY B-BIOLOGY 2015; 154:34-9. [PMID: 26678673 DOI: 10.1016/j.jphotobiol.2015.11.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/11/2015] [Revised: 11/24/2015] [Accepted: 11/27/2015] [Indexed: 11/27/2022]
Abstract
BACKGROUND Photodynamic therapy (PDT) delays ultraviolet (UV) radiation-induced squamous cell carcinomas (SCCs) in hairless mice. Efficacy may be enhanced by combining PDT with antineoplastic or pro-differentiating agents. We investigated if pretreatment with 5-fluorouracil (5FU), imiquimod (IMIQ) or calcipotriol (CAL) before PDT further delays tumor onset. METHODS Hairless mice (n=224) were exposed 3 times weekly to 3 standard erythema doses (SED) of UV radiation. Methyl-aminolevulinate (MAL)-PDT sessions were given on days 45 and 90 before SCC development. Three applications of topical 5FU, IMIQ or CAL were given before each PDT session. Fluorescence photography quantified protoporphyrin IX (PpIX) formation. RESULTS PDT delayed UV-induced SCC development by 59 days (212 days UV-MAL-PDT vs. 153 days UV-control, P<0.001). Pretreatment with 5FU, IMIQ or CAL before PDT did not further delay SCC onset compared to PDT alone (207 days UV-5FU-MAL-PDT, 215 days UV-IMIQ-MAL-PDT, 206 days UV-CAL-MAL-PDT vs. 212 days UV-MAL-PDT, P=ns). PpIX fluorescence intensified by 5FU-pretreatment (median 21,392 au UV-5FU-MAL-PDT, P=0.011), decreased after IMIQ-pretreatment (12,452 au UV-IMIQ-MAL-PDT, P<0.001), and was unaffected by CAL-pretreatment (19,567 au UV-CAL-MAL-PDT, P=ns) compared to MAL alone (18,083 au UV-MAL-PDT). CONCLUSIONS Short-term three-day pretreatment with 5FU, IMIQ and CAL before PDT does not further delay tumor onset in UV-exposed hairless mice.
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Affiliation(s)
- Christiane Bay
- Department of Dermatology, Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark.
| | - Katrine Togsverd-Bo
- Department of Dermatology, Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Catharina M Lerche
- Department of Dermatology, Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Merete Haedersdal
- Department of Dermatology, Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark
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23
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Petersen B, Triguero-Mas M, Maier B, Thieden E, Philipsen PA, Heydenreich J, Dadvand P, Maier H, Grage MML, Harrison GI, Schmalwieser AW, Nieuwenhuijsen MJ, Young AR, Wulf HC. Sun behaviour and personal UVR exposure among Europeans on short term holidays. JOURNAL OF PHOTOCHEMISTRY AND PHOTOBIOLOGY B-BIOLOGY 2015; 151:264-9. [PMID: 26332747 DOI: 10.1016/j.jphotobiol.2015.08.022] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/17/2015] [Revised: 08/14/2015] [Accepted: 08/17/2015] [Indexed: 11/29/2022]
Abstract
Solar ultraviolet radiation (UVR) is known to be the main cause of skin cancer, the incidence of which is rising with national differences across Europe. With this observation study we aimed to determine the impact of nationality on sun behaviour and personal UVR exposure on sun and ski holidays. 25 Danish and 20 Spanish sun-seekers were observed during a sun holiday in Spain, and 26 Danish and 27 Austrian skiers were observed during a ski holiday in Austria. The participants recorded their location and clothing in diaries. Personal time-logged UVR data were recorded as standard erythema doses (SEDs) by an electronic UVR dosimeter worn on the wrist. Danish sun-seekers were outdoors for significantly longer, received significant higher percentages of ambient UVR, and received greater accumulated UVR doses than Spanish sun-seekers. Danish skiers were also outdoors for significantly longer than Austrian skiers, but the behaviour of the Danish skiers did not result in significantly greater accumulated UVR doses. Both Danish and Spanish sun-seekers and Danish and Austrian skiers received substantial UVR doses. The behaviour's influence on the UVR doses received by the Danish participants may indicate an explanation of the higher skin cancer incidence among Scandinavians compared with other European populations.
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Affiliation(s)
- Bibi Petersen
- University of Copenhagen, Bispebjerg Hospital (BBH), Department of Dermatological Research, Bispebjerg Bakke 23, Copenhagen 2400, Denmark.
| | - Margarita Triguero-Mas
- Centre for Research in Environmental Epidemiology (CREAL), Doctor Aiguader 88, E-08003 Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), C/ Melchor Fernández Almagro, 3-5 Pabellón 6, planta baja, 28029 Madrid, Spain
| | - Bernhard Maier
- University of Veterinary Medicine (UVM), Unit of Molecular Physiology and Biophysics, Veterinaerplatz 1, A-1210 Vienna, Austria
| | - Elisabeth Thieden
- University of Copenhagen, Bispebjerg Hospital (BBH), Department of Dermatological Research, Bispebjerg Bakke 23, Copenhagen 2400, Denmark
| | - Peter Alshede Philipsen
- University of Copenhagen, Bispebjerg Hospital (BBH), Department of Dermatological Research, Bispebjerg Bakke 23, Copenhagen 2400, Denmark
| | - Jakob Heydenreich
- University of Copenhagen, Bispebjerg Hospital (BBH), Department of Dermatological Research, Bispebjerg Bakke 23, Copenhagen 2400, Denmark
| | - Payam Dadvand
- Centre for Research in Environmental Epidemiology (CREAL), Doctor Aiguader 88, E-08003 Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), C/ Melchor Fernández Almagro, 3-5 Pabellón 6, planta baja, 28029 Madrid, Spain
| | - Harald Maier
- Medical University Vienna, Department of Dermatology, Währinger Gürtel 18-20, A-1090 Vienna, Austria
| | | | - Graham I Harrison
- King's College London (KCL), St John's Institute of Dermatology, Guy's Hospital, London SE1 9RT, United Kingdom
| | - Alois W Schmalwieser
- University of Veterinary Medicine (UVM), Unit of Molecular Physiology and Biophysics, Veterinaerplatz 1, A-1210 Vienna, Austria
| | - Mark J Nieuwenhuijsen
- Centre for Research in Environmental Epidemiology (CREAL), Doctor Aiguader 88, E-08003 Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), C/ Melchor Fernández Almagro, 3-5 Pabellón 6, planta baja, 28029 Madrid, Spain
| | - Antony R Young
- King's College London (KCL), St John's Institute of Dermatology, Guy's Hospital, London SE1 9RT, United Kingdom
| | - Hans Christian Wulf
- University of Copenhagen, Bispebjerg Hospital (BBH), Department of Dermatological Research, Bispebjerg Bakke 23, Copenhagen 2400, Denmark
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24
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Schalka S, Steiner D, Ravelli FN, Steiner T, Terena AC, Marçon CR, Ayres EL, Addor FAS, Miot HA, Ponzio H, Duarte I, Neffá J, Cunha JAJD, Boza JC, Samorano LDP, Corrêa MDP, Maia M, Nasser N, Leite OMRR, Lopes OS, Oliveira PD, Meyer RLB, Cestari T, Reis VMSD, Rego VRPDA. Brazilian consensus on photoprotection. An Bras Dermatol 2015; 89:1-74. [PMID: 25761256 PMCID: PMC4365470 DOI: 10.1590/abd1806-4841.20143971] [Citation(s) in RCA: 65] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2014] [Accepted: 10/28/2014] [Indexed: 12/14/2022] Open
Abstract
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.
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Affiliation(s)
- Sérgio Schalka
- Photobiology Department, Sociedade Brasileira de Dermatologia, São Paulo, SP, Brazil
| | | | | | | | | | | | - Eloisa Leis Ayres
- Center of Dermatology Prof. Rene Garrido Neves, City Health Foundation, Rio de Janeiro, RJ, Brazil
| | | | | | - Humberto Ponzio
- Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Ida Duarte
- Charity Hospital, Santa Casa de Misericórdia, São Paulo, SP, Brazil
| | - Jane Neffá
- Fluminense Federal University, Niterói, RJ, Brazil
| | | | | | | | | | - Marcus Maia
- Charity Hospital, Santa Casa de Misericórdia, São Paulo, SP, Brazil
| | - Nilton Nasser
- Federal University of Santa Catarina, Blumenau, SC, Brazil
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25
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Togsverd-Bo K, Lerche CM, Philipsen PA, Hædersdal M, Wulf HC. Artificial daylight photodynamic therapy with "non-inflammatory" doses of hexyl aminolevulinate only marginally delays SCC development in UV-exposed hairless mice. Photochem Photobiol Sci 2014; 12:2130-6. [PMID: 24064675 DOI: 10.1039/c3pp50152c] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Photodynamic therapy (PDT) is effective for actinic keratoses, but is associated with pain and post-treatment inflammation. Daylight-mediated PDT and PpIX-precursors at low concentrations reduce pain and inflammation intensity. The objective was to evaluate the effect of repeated low-concentration PDT combined with artificial daylight on SCC development. Mice (n = 265) were exposed to simulated solar UV-irradiation (UVR) 3 times weekly mimicking "summer-dose"-exposure (3 SED). Selected groups of mice received a "winter-dose"-exposure (0.6 SED) for the first 90 days. PDT was delivered with 0.1%, 0.05% and 0.02% hexyl aminolevulinate (HAL) cream and artificial daylight for 2.5 hours (6 J cm(-2)) in different treatment regimes (1-3 times weekly, 45-days intervals, days 1-180 and from day 180 onwards). The primary end-point was the time to first SCC (1 mm diameter). 0.1% HAL-PDT given 3 times weekly slightly delayed SCC development and induced minimal inflammation. In winter- and summer UVR-treatment regimes, 0.1% HAL PDT delayed the time to first SCC compared to control UVR and placebo-PDT when mice were PDT-treated on days 1-180 (median 213 vs. 199 days, p = 0.011) and from day 180 onwards (median 218 vs. 199 days, p = 0.006). PDT with 0.05% and 0.02% HAL did not influence SCC development (medians 206 days, p = ns). In summer UVR-exposed mice, 0.1% HAL-PDT marginally postponed the time to first SCC compared to control UVR (median 160 days) when treatments were given 3 times weekly for 180 days (median 166, p = 0.01), but not for 90 days (median 161, p = 0.112). In conclusion, repeated low-concentration HAL-PDT combined with artificial daylight is well-tolerated, but only marginally delays SCC development in mice.
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Sun J, Lucas RM, Harrison S, van der Mei I, Armstrong BK, Nowak M, Brodie A, Kimlin MG. The relationship between ambient ultraviolet radiation (UVR) and objectively measured personal UVR exposure dose is modified by season and latitude. Photochem Photobiol Sci 2014; 13:1711-8. [DOI: 10.1039/c4pp00322e] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Despite the widespread use of ambient ultraviolet radiation (UVR) as a proxy measure of personal exposure to UVR, the relationship between the two is not well-defined.
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Affiliation(s)
- J. Sun
- AusSun Research Laboratory
- School of Public Health and Social Work
- Queensland University of Technology
- Brisbane, Australia
- NHMRC Centre for Research Excellence in Sun and Health
| | - R. M. Lucas
- National Centre for Epidemiology and Population Health
- College of Medicine
- Biology and Environment
- Australian National University
- Australia
| | - S. Harrison
- JCU Skin Cancer Research Group
- School of Public Health
- Tropical Medicine & Rehabilitation Sciences
- James Cook University
- Australia
| | | | | | - M. Nowak
- JCU Skin Cancer Research Group
- School of Public Health
- Tropical Medicine & Rehabilitation Sciences
- James Cook University
- Australia
| | - A. Brodie
- AusSun Research Laboratory
- School of Public Health and Social Work
- Queensland University of Technology
- Brisbane, Australia
| | - M. G. Kimlin
- AusSun Research Laboratory
- School of Public Health and Social Work
- Queensland University of Technology
- Brisbane, Australia
- NHMRC Centre for Research Excellence in Sun and Health
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Petersen B, Thieden E, Philipsen PA, Heydenreich J, Wulf HC, Young AR. Determinants of personal ultraviolet-radiation exposure doses on a sun holiday. Br J Dermatol 2013; 168:1073-9. [PMID: 23301517 DOI: 10.1111/bjd.12211] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND A great number of journeys to sunny destinations are sold to the Danish population every year. We suspect that this travel considerably increases personal annual ultraviolet-radiation (UVR) exposure doses. This is important because such exposure is the main cause of skin cancer, and studies have shown a correlation between intermittent solar UVR exposure and malignant melanoma. OBJECTIVES To prospectively monitor the behaviour of a group of sun seekers during a winter sun holiday and to study the impact of behaviour on personal UVR exposure doses. METHODS In this observational study 25 Danish sun seekers were closely monitored by on-site investigators for 6 days during a winter sun holiday in the Canary Islands, thus avoiding the possible recall bias of retrospective studies with questionnaires. The volunteers recorded their location, clothing and sunscreen use in diaries, and their UVR doses were measured by personal UVR dosimeters worn on the wrist. This resulted in 3450 half-hour registrations during 150 participation days. RESULTS On average, each volunteer received a total UVR dose of 57 standard erythema doses over 6 days, which is 43% of the annual UVR dose of a Danish indoor worker. Their exposed body area, sunscreen use and percentage of body with sunscreen application were positively correlated with their personal UVR doses, and there was also a strong relationship between location and UVR doses received. CONCLUSIONS The behaviour of the volunteers had a major impact on their personal UVR doses. Our results emphasize the importance of changing the behaviour of sun seekers with protanning attitudes to reduce their personal annual UVR exposure doses, and possibly their risk of skin cancer.
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Affiliation(s)
- B Petersen
- Department of Dermatological Research, University of Copenhagen, Bispebjerg Hospital, DK-2400, Copenhagen, Denmark.
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Macdonald HM. Contributions of sunlight and diet to vitamin D status. Calcif Tissue Int 2013; 92:163-76. [PMID: 23001438 DOI: 10.1007/s00223-012-9634-1] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2012] [Accepted: 07/16/2012] [Indexed: 10/27/2022]
Abstract
Vitamin D is made in the skin using ultraviolet radiation of specific low wavelength, 290-315 nm (UVB). For many parts of the world there is a period when there is insufficient intensity of UVB to make vitamin D, which is reflected by a clear seasonal variation in vitamin D status. Sun avoidance practices, melanin in pigmented skin, and sun protection creams (sunscreen), if used properly, can dramatically reduce vitamin D synthesis. Few foods naturally contain vitamin D, although some countries fortify foods with vitamin D. Regulatory mechanisms in the skin mean there is no danger of vitamin D toxicity through sunlight synthesis. Although oral vitamin D is potentially toxic with high-dose supplements, there is a wide safety margin. Long-term safety data covering a range of potential adverse outcomes are limited.
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Affiliation(s)
- Helen M Macdonald
- Musculoskeletal Research, Health Sciences Building, University of Aberdeen, Foresterhill, Aberdeen, AB25 2ZD, UK.
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Mavroeidi A, Aucott L, Black AJ, Fraser WD, Reid DM, Macdonald HM. Seasonal variation in 25(OH)D at Aberdeen (57°N) and bone health indicators--could holidays in the sun and cod liver oil supplements alleviate deficiency? PLoS One 2013; 8:e53381. [PMID: 23308207 PMCID: PMC3540094 DOI: 10.1371/journal.pone.0053381] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2012] [Accepted: 11/30/2012] [Indexed: 12/04/2022] Open
Abstract
Vitamin D has been linked with many health outcomes. The aim of this longitudinal study, was to assess predictors of seasonal variation of 25-hydroxy-vitamin D (25(OH)D) (including use of supplements and holidays in sunny destinations) at a northerly latitude in the UK (57°N) in relation to bone health indicators. 365 healthy postmenopausal women (mean age 62.0 y (SD 1.4)) had 25(OH)D measurements by immunoassay, serum C-telopeptide (CTX), estimates of sunlight exposure (badges of polysulphone film), information regarding holidays in sunny destinations, and diet (from food diaries, including use of supplements such as cod liver oil (CLO)) at fixed 3-monthly intervals over 15 months (subject retention 88%) with an additional 25(OH)D assessment in spring 2008. Bone mineral density (BMD) at the lumbar spine (LS) and dual hip was measured in autumn 2006 and spring 2007 (Lunar I-DXA). Deficiency prevalence (25(OH)D<25 nmol/L) was reduced in women who went on holiday to sunny destinations 3 months prior to their visit, compared to women who did not go on holidays [5.4% vs. 24.6% in Spring (p<0.001) and 3.8% vs. 25.6% in Winter (p = 0.001), respectively]. Similarly deficiency was lower amongst those who took CLO supplements compared to women that did not consume these supplements [2.0% vs. 23.7% in Spring (p = 0.001) and 4.5% vs. 24.8% in winter (p = 0.005), respectively]. There was no seasonal variation in CTX; 25(OH)D predicted a small proportion (1.8% variation) of LS BMD in spring 2007 [unstandardized β (SE): 0.039 (0.016), p = 0.017]. Seasonal variation of 25(OH)D had little effect on BMD and no effect on CTX. It appears that small increments in vitamin D (e.g. those that can be achieved by cod liver oil supplements of 5 µg/day) are sufficient to ensure that 25(OH)D is above 25 nmol/L for most people throughout the year. Similarly, holidays in sunny destinations show benefit.
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Affiliation(s)
- Alexandra Mavroeidi
- Musculoskeletal Research Programme, University of Aberdeen, Aberdeen, United Kingdom
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30
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Thieden E, Heydenreich J, Philipsen PA, Wulf HC. People maintain their sun exposure behaviour in a 5–7-year follow-up study using personal electronic UVR dosimeters. Photochem Photobiol Sci 2013; 12:111-6. [DOI: 10.1039/c2pp25138h] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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31
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Berwick M, Erdei EO. Vitamin D and melanoma incidence and mortality. Pigment Cell Melanoma Res 2012; 26:9-15. [PMID: 22947439 DOI: 10.1111/pcmr.12015] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2012] [Accepted: 08/31/2012] [Indexed: 11/30/2022]
Abstract
The role of vitamin D (25-OH-D, or 25-hydroxyvitamin D) and its potential confounders in relationship to melanoma risk and mortality is discussed. The paradox that ultraviolet radiation (UVR) exposure is the major environmental risk factor for melanoma etiology as well as a major source of vitamin D might be explained by viewing vitamin D levels as the result of a healthy lifestyle rather than a cause of health.
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Affiliation(s)
- Marianne Berwick
- Division of Epidemiology, Biostatistics and Preventive Medicine, Department of Internal Medicine, University of New Mexico Cancer Center, Albuquerque, NM, USA.
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Nair-Shalliker V, Clements M, Fenech M, Armstrong BK. Personal Sun Exposure and Serum 25-hydroxy Vitamin D Concentrations. Photochem Photobiol 2012; 89:208-14. [DOI: 10.1111/j.1751-1097.2012.01201.x] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Bogh M, Gullstrand J, Svensson A, Ljunggren B, Dorkhan M. Narrowband ultraviolet B three times per week is more effective in treating vitamin D deficiency than 1600 IU oral vitamin D3 per day: a randomized clinical trial. Br J Dermatol 2012; 167:625-30. [DOI: 10.1111/j.1365-2133.2012.11069.x] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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34
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Idorn LW, Thieden E, Philipsen PA, Wulf HC. Influence of having a home garden on personal UVR exposure behavior and risk of cutaneous malignant melanoma in Denmark. Int J Cancer 2012; 132:1383-8. [DOI: 10.1002/ijc.27734] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2012] [Accepted: 07/10/2012] [Indexed: 11/11/2022]
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35
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Togsverd-Bo K, Lerche CM, Philipsen PA, Poulsen T, Wulf HC, Haedersdal M. Porphyrin biodistribution in UV-exposed murine skin after methyl- and hexyl-aminolevulinate incubation. Exp Dermatol 2012; 21:260-4. [DOI: 10.1111/j.1600-0625.2012.01442.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Abstract
Ultraviolet B radiation exposure is responsible for the majority of natural vitamin D stores in humans. The physiologic role of vitamin D in health and disease is continually expanding, and at the same time the population that is vitamin D deficient is increasing. The environmental characteristics and personal physical traits that contribute to vitamin D3 synthesis from sun exposure are discussed, and the effects of photoprotection on vitamin D status are examined. It is concluded that sunscreen, in the manner used by the general public, does not cause vitamin D insufficiency. Implementing guidelines suggesting sun exposure duration for sufficient vitamin D3 production is limited by the complex interaction of contributory factors, and no recommendation can be made that is both safe and accurate enough for general public usage.
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Affiliation(s)
- Joseph W Diehl
- Department of Medicine, University of California, Los Angeles, 90095, USA
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37
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Hall LM, Kimlin MG, Aronov PA, Hammock BD, Slusser JR, Woodhouse LR, Stephensen CB. Vitamin D intake needed to maintain target serum 25-hydroxyvitamin D concentrations in participants with low sun exposure and dark skin pigmentation is substantially higher than current recommendations. J Nutr 2010; 140:542-50. [PMID: 20053937 PMCID: PMC2821886 DOI: 10.3945/jn.109.115253] [Citation(s) in RCA: 89] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Cutaneous cholecalciferol synthesis has not been considered in making recommendations for vitamin D intake. Our objective was to model the effects of sun exposure, vitamin D intake, and skin reflectance (pigmentation) on serum 25-hydroxyvitamin D (25[OH]D) in young adults with a wide range of skin reflectance and sun exposure. Four cohorts of participants (n = 72 total) were studied for 7-8 wk in the fall, winter, spring, and summer in Davis, CA [38.5 degrees N, 121.7 degrees W, Elev. 49 ft (15 m)]. Skin reflectance was measured using a spectrophotometer, vitamin D intake using food records, and sun exposure using polysulfone dosimeter badges. A multiple regression model (R(2) = 0.55; P < 0.0001) was developed and used to predict the serum 25(OH)D concentration for participants with low [median for African ancestry (AA)] and high [median for European ancestry (EA)] skin reflectance and with low [20th percentile, approximately 20 min/d, approximately 18% body surface area (BSA) exposed] and high (80th percentile, approximately 90 min/d, approximately 35% BSA exposed) sun exposure, assuming an intake of 200 iu/d (5 ug/d). Predicted serum 25(OH)D concentrations for AA individuals with low and high sun exposure in the winter were 24 and 42 nmol/L and in the summer were 40 and 60 nmol/L. Corresponding values for EA individuals were 35 and 60 nmol/L in the winter and in the summer were 58 and 85 nmol/L. To achieve 25(OH)D > or =75 nmol/L, we estimate that EA individuals with high sun exposure need 1300 iu/d vitamin D intake in the winter and AA individuals with low sun exposure need 2100-3100 iu/d year-round.
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Affiliation(s)
- Laura M. Hall
- Nutrition Department and; Entomology Department and Cancer Center, University of California, Davis, CA, 95616; USDA Western Human Nutrition Research Center, Davis, CA, 95616; AusSun Research Laboratory, Institute of Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Queensland, 4059, Australia; Natural Resource Ecology Laboratory, Colorado State University, Fort Collins, CO 80523,To whom correspondence should be addressed. E-mail:
| | - Michael G. Kimlin
- Nutrition Department and; Entomology Department and Cancer Center, University of California, Davis, CA, 95616; USDA Western Human Nutrition Research Center, Davis, CA, 95616; AusSun Research Laboratory, Institute of Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Queensland, 4059, Australia; Natural Resource Ecology Laboratory, Colorado State University, Fort Collins, CO 80523
| | - Pavel A. Aronov
- Nutrition Department and; Entomology Department and Cancer Center, University of California, Davis, CA, 95616; USDA Western Human Nutrition Research Center, Davis, CA, 95616; AusSun Research Laboratory, Institute of Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Queensland, 4059, Australia; Natural Resource Ecology Laboratory, Colorado State University, Fort Collins, CO 80523
| | - Bruce D. Hammock
- Nutrition Department and; Entomology Department and Cancer Center, University of California, Davis, CA, 95616; USDA Western Human Nutrition Research Center, Davis, CA, 95616; AusSun Research Laboratory, Institute of Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Queensland, 4059, Australia; Natural Resource Ecology Laboratory, Colorado State University, Fort Collins, CO 80523
| | - James R. Slusser
- Nutrition Department and; Entomology Department and Cancer Center, University of California, Davis, CA, 95616; USDA Western Human Nutrition Research Center, Davis, CA, 95616; AusSun Research Laboratory, Institute of Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Queensland, 4059, Australia; Natural Resource Ecology Laboratory, Colorado State University, Fort Collins, CO 80523
| | - Leslie R. Woodhouse
- Nutrition Department and; Entomology Department and Cancer Center, University of California, Davis, CA, 95616; USDA Western Human Nutrition Research Center, Davis, CA, 95616; AusSun Research Laboratory, Institute of Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Queensland, 4059, Australia; Natural Resource Ecology Laboratory, Colorado State University, Fort Collins, CO 80523
| | - Charles B. Stephensen
- Nutrition Department and; Entomology Department and Cancer Center, University of California, Davis, CA, 95616; USDA Western Human Nutrition Research Center, Davis, CA, 95616; AusSun Research Laboratory, Institute of Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Queensland, 4059, Australia; Natural Resource Ecology Laboratory, Colorado State University, Fort Collins, CO 80523
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38
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Thieden E, Philipsen PA, Heydenreich J, Wulf HC. Vitamin D level in summer and winter related to measured UVR exposure and behavior. Photochem Photobiol 2010; 85:1480-4. [PMID: 19709382 DOI: 10.1111/j.1751-1097.2009.00612.x] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The influence of the summer UVR exposure on serum-25-hydroxyvitamin D (25(OH)D) in late summer and winter was investigated in an open study on 25 healthy, adult volunteers. The UVR exposure dose in standard erythema dose (SED) was monitored continuously during a summer season with personal, electronic wristwatch UVR dosimeters and sun exposure diaries. Constitutive and facultative skin pigmentation was measured in September. 25(OH)D was measured in September and February and was in mean 82 nmol/L +/- 25 (mean +/- SD) in September and 56 nmol/L +/- 19 (mean +/- SD) in February. The received cumulative UVR dose measured during a mean of 121 days was 156 SED +/- 159 (mean +/- SD). The following UVR exposure parameters correlated with 25(OH)D in September and February, respectively: (1) The cumulative UVR dose (r = 0.53; P < 0.01) and (r = 0.43; P = 0.03); (2) Mean daily hours with UVR measurements monitored by the dosimeter (r = 0.64, P = 0.001) and (r = 0.53; P = 0.007); (3) Days "with sun-exposed upper body" (r = 0.58, P = 0.003) and (r = 0.50; P = 0.01); (4) Facultative pigmentation (r = 0.47; P < 0.02) and (r = 0.7; P < 0.001); (5) Constitutive pigmentation (r = 0.06, n.s.) and (r = 0.43, P = 0.03). Neither days "sunbathing" nor days with "sunscreen applied" correlated with 25(OH)D. The fall in 25(OH)D during winter was dependent on the entry value.
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Affiliation(s)
- Elisabeth Thieden
- Department of Dermatology, Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark.
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39
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Togsverd-Bo K, Lerche CM, Poulsen T, Haedersdal M, Wulf HC. Reduced ultraviolet irradiation delays subsequent squamous cell carcinomas in hairless mice. PHOTODERMATOLOGY PHOTOIMMUNOLOGY & PHOTOMEDICINE 2009; 25:305-9. [PMID: 19906165 DOI: 10.1111/j.1600-0781.2009.00470.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Ultraviolet (UV) radiation induces non-melanoma skin cancer (NMSC), and UV prophylaxis is essential to prevent skin cancer. It is unclear whether patients diagnosed with squamous cell carcinomas (SCC) may benefit from reduced UV exposures in terms of delaying the development of new tumors. The objective was to evaluate the significance of discontinued or reduced UV exposure for the development of subsequent skin tumors. METHODS Seven groups of mice (n = 175) were irradiated with UV doses of 2 and 4 standard erythema doses (SED) that were continued, reduced or discontinued at the time of appearance of the first skin tumor. RESULTS The development of new tumors was delayed, corresponding to the degree of reductions in UV dose in an inversely linear manner. Discontinuation of UV doses delayed the median times to the second tumor by 24 days (2 SED, P = 0.0549) and 33.5 days (4 SED, P < 0.0001), and when reduced to 1 SED, the median delays were 18 days (2 SED, P = 0.0469) and 33 days (4 SED, P < 0.0001). The median delay to the third tumor was after UV reduction 47 days (4 SED, P < 0.0001) and 35 days (2 SED, P = 0.151), and after UV discontinuation 49 days (4 SED, P < 0.0001) and 44 days (2 SED, P = 0.111). CONCLUSION This suggests that patients with SCC may benefit from reduced UV exposure.
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Affiliation(s)
- Katrine Togsverd-Bo
- Department of Dermatology, Bispebjerg Hospital, Copenhagen University Hospital, Copenhagen, Denmark.
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Norval M, Wulf H. Does chronic sunscreen use reduce vitamin D production to insufficient levels? Br J Dermatol 2009; 161:732-6. [DOI: 10.1111/j.1365-2133.2009.09332.x] [Citation(s) in RCA: 117] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Affiliation(s)
- A K Bharath
- Department of Dermatology, University of Oxford, Churchill Hospital, UK.
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Thieden E, Jørgensen HL, Jørgensen NR, Philipsen PA, Wulf HC. Sunbed Radiation Provokes Cutaneous Vitamin D Synthesis in Humans-A Randomized Controlled Trial. Photochem Photobiol 2008; 84:1487-92. [DOI: 10.1111/j.1751-1097.2008.00372.x] [Citation(s) in RCA: 57] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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43
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McCarty CA. Sunlight exposure assessment: can we accurately assess vitamin D exposure from sunlight questionnaires? Am J Clin Nutr 2008; 87:1097S-101S. [PMID: 18400741 DOI: 10.1093/ajcn/87.4.1097s] [Citation(s) in RCA: 77] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
The purpose of this review is to summarize the peer-reviewed literature in relation to sunlight exposure assessment and the validity of using sunlight exposure questionnaires to quantify vitamin D status. There is greater variability in personal ultraviolet (UV) light exposure as the result of personal behavior than as the result of ambient UV light exposure. Although statistically significant, the correlation coefficients for the relation between personal report of sun exposure and ambient UV light measured by dosimetry (assessment of radiation dose) are relatively low. Moreover, the few studies to assess the relation between sunlight measures and serum 25-hydroxyvitamin D show low correlations. These low correlations may not be surprising given that personal factors like melanin content in skin and age also influence cutaneous synthesis of vitamin D. In summary, sunlight exposure questionnaires currently provide imprecise estimates of vitamin D status. Research should be directed to develop more objective, nonintrusive, and economical measures of sunlight exposure to quantify personal vitamin D status.
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Affiliation(s)
- Catherine A McCarty
- Center for Human Genetics, Marshfield Clinic Research Foundation, Marshfield, WI 54449, USA.
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Thieden E, Philipsen PA, Wulf HC. Compliance and data reliability in sun exposure studies with diaries and personal, electronic UV dosimeters. PHOTODERMATOLOGY PHOTOIMMUNOLOGY & PHOTOMEDICINE 2006; 22:93-9. [PMID: 16606414 DOI: 10.1111/j.1600-0781.2006.00207.x] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND/PURPOSE Skin cancer risk estimations are based on sun exposure data. However, the reliability of collected data in personal ultraviolet (UV) dosimeters studies has not previously been validated. We aimed at investigating the data reliability and subject compliance in a study of sun exposure behaviour among 407 subjects (age range, 4-68 years) during 54 943 days based on time-stamped personal UV dosimeter readings and diary records. METHODS By comparing diary records and UV dosimeter readings on a daily basis, we investigated subject compliance, total sun exposure record, reasons for non-responding along with rates of diary completing errors. Efforts to improve compliance were described. RESULTS The subject compliance rate was median 93.5% (percent days where the diary was completed and the UV dosimeter was worn). The total sun exposure record rate was median 84.1% (percent of participation days with both UV dosimeter and diary records and where the UV dosimeter was worn). Children, adolescents and golfers had lower sun exposure record rates than the rest of the groups (P<0.05). No significant difference was found between males and females (P=0.15). The 17 non-responders were 10 children, three adolescents, one sun worshipper, two golfers and one gardener. Correctable diary completing mistakes were found in 3.1% of the days. Children made more completing mistakes than adults (P=0.001). The average estimated error rate was 3.3% and was higher for children (6.3%) and adolescents (3.6%) than the adult groups (2.4%). CONCLUSION High subject compliance rate and data reliability were obtained because the investigators were service minded but persistent, offering dosimeter maintenance service within 24 h and scrutinized data for errors and mistakes.
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Affiliation(s)
- Elisabeth Thieden
- Department of Dermatology, Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark.
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