Expatriates in high-UV index and tropical countries: sun exposure and protection behavior in 9,416 French adults

Solar Ultraviolet Exposure in Individuals Who Perform Outdoor Sport Activities

BACKGROUND

Skin cancer is the most common cancer in the USA. Therefore, it is important to review the contribution of ultraviolet radiation (UVR) exposure to skin cancer in individuals with the highest risk. Documenting the relationship between outdoor sports solar ultraviolet exposure and their risk of skin cancer along with appropriate risk mitigation strategies can help inform clinicians of practical information for counseling sun protective behaviors in this population.

METHODS

We conducted a review of the current evidence using PubMed to answer the following research questions: (1) How is ultraviolet radiation measured? (2) What is the modern utility of the ultraviolet index in modifying recreational sun protection behaviors? (3) What is the risk of developing skin cancer for outdoor sport participants? (4) What is the prevalence of skin cancer in sport participants? and (5) Is the number of nevi and solar lentigines elevated in outdoor sport participants?

RESULTS

Based on the literature, individuals who practice outdoor sport-related activities receive high ultraviolet radiation exposure, have a high risk for skin cancer, have a high prevalence for pigmented lesions, and may benefit from electronic sun protection educational interventions.

CONCLUSIONS

Individuals who practice outdoor sports experience substantially higher ultraviolet radiation exposure, routinely exceed the recommended exposure limits, and are at a higher risk of developing skin cancer. Therefore, those who are frequently engaged in outdoor leisure activities should be coached about efficient sun protective practices and relevant mobile technologies that may facilitate adherence.

Can natural products improve skin photoprotection?

Abstract Due to increased UV radiation on the Earth’s surface, caused by depletion of the stratospheric ozone, people have become more susceptible to different types of skin damage, such as erythema, sunburns, and cancer; this is especially of concern in tropical countries. Thus, efforts to improve awareness as well as the use of sunscreen are increasing worldwide. However, synthetic UV filters have been associated with deleterious effects such as photosensitization. Natural products have been used by ancient cultures for several purposes, including protecting the skin from the sun. However, there is still doubt today whether photoprotection is a real phenomenom or whether it is simply tanning of the skin. Plants have self-protective mechanisms and produce secondary metabolites that can protect themselves from UV radiation. Yet, can phytochemical compounds protect human skin? This review discusses the paradoxical effect of chemical UV filters and the influence of phytochemicals in in vitro and in vivo tests of photoprotection.

Awareness, understanding, use, and impact of the UV index: A systematic review of over two decades of international research

The ultraviolet radiation index (UVI) was adopted internationally to raise awareness about and encourage the public to protect their skin from skin cancer. The current paper is a systematic review of over 20 years of research investigating awareness, comprehension, use, and impact of the UVI. Thirty-one studies were included from the USA, Canada, Europe, Australia, New Zealand, and elsewhere. Awareness of the UVI varies by country, with samples from some countries demonstrating high awareness. However, comprehension and use of the UVI to inform sun safety behaviors are typically much lower. In fact, greater UVI awareness has sometimes been associated with riskier UV-related behaviors such as intentional tanning. Fewer studies have evaluated interventions, and their results have been mixed. In summary, more research is needed to determine how to help the public understand and use the UVI for effective skin protection. This review offers suggestions for future use of and research with the UVI.

Kite-surfers' sun risk in the tropics

A preliminary inquiry, conducted on Martinique Island, sought to determine kite-surfers' sun-protection knowledge and behaviours. Results revealed good levels of knowledge and behaviours, but very frequent sunburns (74% had at least one sunburn during the last 6 months), with particularly severe sunburns exclusively among vacationers. These results argue for the double need to focus sunburn-prevention programs on vacationers and technically adapt sun-protection means to a tropical maritime environment.

Professional skippers' sun-protection knowledge and behavior in the tropics

A preliminary inquiry, conducted on Martinique Island, sought to determine professional skippers' sun-protection knowledge and behavior. Fifty-two skippers (mean age: 41 years) completed a questionnaire; 39 (75 %) had a simple sunburn over the last 6 months and 3 (6%) severe sunburn; 54 (64%) declared achieving sun protection by wearing clothes during >90% of the day. Only 17% had used sun protection >90% of the time.

Sun exposure behavior and protection: recommendations for travelers

BACKGROUND

Although there have been recent advances in the development of photoprotective clothing and broad-spectrum sunscreens, few peer-reviewed publications have focused on photoprotection recommendations for travelers.

METHODS

In order to describe the adverse health effects of excessive ultraviolet (UV) radiation exposures; review recent studies of public perceptions regarding photoprotection and sun exposure behaviors; identify special populations at increased risks of drug-induced photosensitivity reactions and UV-induced skin cancers; and recommend several effective photoprotection strategies for travelers, Internet search engines were queried with the key words as search terms to examine the latest references on photoprotection and the epidemiology of UV-associated skin cancers.

RESULTS

Observational studies have demonstrated that the public knows little about proper sunscreen protection, selection, and use, and often abuses sunscreens for intentional UV overexposures. Cohort studies have identified special populations at increased risks of UV-associated skin cancers without the proper use of sunscreens and photoprotective clothing including children, fair-skinned persons, patients taking photosensitizing drugs, and organ transplant recipients (OTRs). Clinical investigations support the regular use of broad-spectrum sunscreens to prevent the development of premalignant actinic keratoses (AK) in all sun-exposed subjects, especially OTRs; to prevent the development of squamous cell carcinomas from new AK in sun-exposed subjects, especially OTRs; to possibly prevent the development of cutaneous malignant melanomas in children and adults; and to possibly prevent the development of basal cell carcinomas in OTRs.

CONCLUSIONS

Recommended photoprotection strategies for travelers should include avoiding intense sunlight, wearing photoprotective clothing, wearing sunglasses, and selecting the right sunscreen for their skin type. Travel medicine practitioners should counsel travelers about photoprotection and encourage travelers to take advantage of recent advances in the development of more effective broad-spectrum sunscreens and photoprotective clothing for themselves and their children.

Illness in French travelers to Senegal: prospective cohort follow-up and sentinel surveillance data

OBJECTIVE

To investigate travel-associated illnesses in French travelers to Senegal.

METHODS

A prospective cohort follow-up was conducted in 358 travelers recruited at a pre-travel visit in Marseille and compared to data from ill travelers collected from the GeoSentinel data platform in two clinics in Marseille.

RESULTS

In the cohort survey, 87% of travelers experienced health complaints during travel, which most frequently included arthropod bites (75%), diarrhea (46%), and sunburns (36%). Severe febrile illness cases, notably malaria and salmonella, were detected only through the surveillance system, not in the cohort follow-up. Food hygiene was inefficient in preventing diarrhea. Arthropod bites were more frequent in younger patients and in patients with pale phototypes. Sunburns were also more frequent in younger patients. Finally, we demonstrate that mild travel-related gastrointestinal symptoms and the lack of arthropod bites are significantly associated with poor observance of antimalarial prophylaxis.

CONCLUSIONS

In this study, we suggest the complementary nature of using cohort surveys and sentinel surveillance data. Effective protection of skin from arthropod bites and sun exposure should result in significantly reduced travel-associated diseases in Senegal. Travelers to Senegal should be informed that diarrhea is extremely common despite preventive measures, but it is mild and transitory and should not lead to the disruption of malaria chemoprophylaxis.