New advances in protection against solar ultraviolet radiation in textiles for summer clothing

A multicenter case-control study comparing sun exposure habits and use of photoprotection measures in patients diagnosed with different types of skin cancer

BACKGROUND

While skin cancer awareness programs have significantly furthered public understanding about the harmful effects of the sun, there is a disparity between photoprotection knowledge and protection practices.

OBJECTIVE

To compare sun exposure habits and photoprotection measures in patients diagnosed with basal cell carcinoma (BCC), squamous cell carcinoma (SCC), and melanoma versus controls.

METHODS

Multicentre case-control observational study carried out by 13 Spanish dermatologists between April 2020 and August 2022. Patients diagnosed with BCC, SCC, or melanoma were considered cases. The control group consisted of individuals with no history of skin cancer.

RESULTS

Of the 254 cases (56.2% female; mean age, 62.67 ± 15.65), 119 (31.2%) had BCC, 62 (16.27%) SCC, and 73 (19.1%) melanoma. The control group consisted of 127 (33.33%) individuals. Avoiding sun exposure between 12:00 and 16:00 was the most commonly used photoprotection measure (habitually/always: 63.1%), followed by the use of sunscreen (habitually/always: 58.9%). Patients with melanoma were less likely to use clothing and shade to avoid sun exposure (p < .05), whereas those with BCC and SCC reported greater use of head coverings (p = .01). BCC and SCC groups reported greater sun exposure 15 years prior, whereas controls reported greater use of sunscreen. However, at the time of this study all groups reported using SPF ≥ 21, and the majority SPF > 50. No differences were observed in photoprotection measures between people with and without a previous history of skin cancer.

CONCLUSIONS

We describe differences in photoprotection measures and sun exposure patterns among patients diagnosed with different skin tumor types. Whether these differences may influence the type of tumor each developed will require further investigation.

Assessment of UV Protection for Children's Summer Clothing

INTRODUCTION

 Excess ultraviolet (UV) radiation exposure during childhood poses a particular long-term risk of developing skin cancer later in life however recent studies have called attention to the absorption of chemical sunscreen ingredients into the bloodstream with unclear significance. This has led to recommendations to consider sun protection in the form of clothing to reduce the need for sunscreen products.

METHODS

 Ten brands of routine summer clothing not labeled as sun protective from five distributors marketed for children were identified with varying price ranges. Summer clothing items consisting of T-shirts and tops were evaluated for fiber composition, cost, and UPF testing was performed to determine UVA and UVB transmittance.  Results: Around 88.2% of blended textile compositions compared to 60% of 100% cotton textiles offered adequate UV protection with an Ultraviolet Protection Factor (UPF) greater than 15. 58% of blended fabrics compared to 50% of cotton textiles offered a UPF greater than 30. There was no correlation between brand and cost with UPF values.  Conclusions: In the absence of regulations for testing and labeling of all children's garments for UV protection, guidelines for the pediatric population for choosing clothing for the summer should reflect the information available to consumers that is easy to understand and more likely to result in higher UPF values. Based on fiber composition, blended textiles are more likely to have adequate UV protection compared to 100% cotton or 100% polyester.

Sun-protective Properties of Technical Sportswear Fabrics 100% Polyester: The Influence of Moisture and Sweat on Protection against Different Biological Effects of Ultraviolet (UV) Radiation

The use of technical sportswear is now widespread, but the degree of protection these fabrics offer against UV radiation is not known. We have analyzed the capacity of different types of technical sportswear fabrics to protect against different UV biological effects. A sample of 34 100% polyester t-shirts from different manufactures was classified by color, fabric structure, cover factor, and due to different tonalities, dark, and clear color. Ultraviolet protection factor was calculated according to UNE-EN13758. The protection factor for other biological effects as pre-vitamin D₃ production, non-melanoma skin cancer, photoimmunosuppression, and photoaging was analyzed. The effects of moisture and sweat in protection were also evaluated. From the analyzed sample garments, more than 75% achieved an excellent protection value (protection factor 40-50+). Higher values were found in double-layer type (P < 0.05). Cover factor was the main determinant of biological protection factors with correlation coefficients of 0.81 for UPF (erythema), 0.77 for NMSC, and 0.63 for photoimmunosuppression. Water or sweat humidity saturation increased biological protection factors over a 20% (P < 0.05). The 83% of the fabrics analyzed showed less than 5% of transmittance with labeling as UVA protective elements. No effect of fabric color was found related to biological protection factors. The 100% polyester sports T-shirts of the analyzed sample offer general protection against UV for different biological effects that can be increased by humidity but no affected by fabric color.

An Overview of Ultraviolet-Protective Clothing

Protection from harmful ultraviolet radiation (UVR) can be achieved in a multitude of ways: sunscreen, chemical laundering additives, regular clothing, and photoprotective clothing. While sunscreen remains a popular sun-protective method, research has shown that its long-term use can lead to serious neurological, endocrine, and developmental consequences. Chemical laundering additives have been marketed as a means to absorb or reflect UVR, but data on its efficacy tests are not currently available, and skin contact with these chemicals may prove to be harmful. All clothing, regular or sun-protective, confers sun protection through dyes, weave patterns, and textile materials. However, photoprotective clothing is generally rated as more protective on the ultraviolent protection factor (UPF) scale and garment protection factor (GPF) scale. A combination of photoprotective clothing and sunscreen use over non-covered body areas is likely to be the optimal way for sun protection with minimal risk. However, further research on the topic is needed to gain deeper insights into it.

Photoprotection by clothing: A review

Clothing is recognized by leading health agencies as a primary method to protect against the harmful effects of photodamage caused by ultraviolet (UV) radiation and visible light. The photoprotective capacity of clothing is commonly measured as the ultraviolet protective factor (UPF). While the technology driving photoprotective clothing has been well-established, there continues to be efforts to discover new materials to improve the UPF of clothing. Here, we show increased Google searches for photoprotective clothing over the last decade, suggesting a high level of public interest in photoprotective clothing. In addition, we investigate the frequency of UPF-graded photoprotective clothing sold by large retail stores featured in Fortune 1000. We review factors that alter the UPF of clothing and describe emerging textile technologies used to increase clothing's photoprotective capacity. Finally, we compare how photoprotective clothing is regulated among different countries, the importance of photoprotective clothing in occupational health, and research in visible light and clothing photoprotection.

Slip versus Slop: A Head-to-Head Comparison of UV-Protective Clothing to Sunscreen

Simple Summary

Photoprotection reduces invasive melanoma incidence and mortality, but not all sun protection modalities are created equal. Dermatologists have long debated the pros and cons of photoprotective clothing and sunscreen, but few studies compare the effectiveness of these two modalities head-to-head. This study uses both in vitro and in vivo techniques to compare the ultraviolet radiation (UVR) protective capacity of four modern textiles and two commercially available, broad-spectrum sunscreens.

Abstract

Ultraviolet radiation (UVR) exposure is the most important modifiable risk factor for skin cancer development. Although sunscreen and sun-protective clothing are essential tools to minimize UVR exposure, few studies have compared the two modalities head-to-head. This study evaluates the UV-protective capacity of four modern, sun-protective textiles and two broad-spectrum, organic sunscreens (SPF 30 and 50). Sun Protection Factor (SPF), Ultraviolet Protection Factor (UPF), Critical Wavelength (CW), and % UVA- and % UVB-blocking were measured for each fabric. UPF, CW, % UVA- and % UVB-blocking were measured for each sunscreen at 2 mg/cm² (recommended areal density) and 1 mg/cm² (simulating real-world consumer application). The four textiles provided superior UVR protection when compared to the two sunscreens tested. All fabrics blocked erythemogenic UVR better than the sunscreens, as measured by SPF, UPF, and % UVB-blocking. Each fabric was superior to the sunscreens in blocking full-spectrum UVR, as measured by CW and % UVA-blocking. Our data demonstrate the limitations of sunscreen and UV-protective clothing labeling and suggest the combination of SPF or UPF with % UVA-blocking may provide more suitable measures for broad-spectrum protection. While sunscreen remains an important photoprotective modality (especially for sites where clothing is impractical), these data suggest that clothing should be considered the cornerstone of UV protection.

Sunscreens effectiveness are not altered by concomitant use of moisturizing creams: An ultraviolet reflectance photography study

BACKGROUND

Sunscreens are widely used to protect the skin against the harmful effects of solar radiation. It is not known whether solar protection factor of a sunscreen is altered by the concomitant use of other cosmetic products.

OBJECTIVES

The aim of this study was to analyze changes in the protective effect of different commercial and ISO standards sunscreens with high SPF applied shortly before and after application of non-sunscreens galenic formulas type moisturizing creams.

METHODS

ISO 24444:2019 standard sunscreens, which claimed SPF 16 and 63, as well as 4 different claimed SPF 50 and 50+ commercial sunscreens were prepared and applied in different sequential order to the back of 25 volunteers and compared with different commercial moisturizing formulas. Ultraviolet (UV) reflectance photography followed by image analysis was used to compare untreated skin and skin treated with moisturizing creams alone and combined with sunscreens.

RESULTS

The UV reflectance analysis showed no significant changes of the skin color reflectance treated with moisturizing cream compared with untreated skin. Application of the sunscreen formulations were associated with a 35% - 70% decrease in color related to the in vivo expected SPF, indicating significant UV absorption for all sunscreen formulas. All standard and commercial sunscreens showed no significant differences in UV reflection color level when combined with the different moisturizing creams applied before or after the sunscreen.

CONCLUSIONS

Effectiveness of low- and high-protection sunscreens were not altered by the concomitant use of a moisturizing creams applied shortly before and after the sunscreens.

Novel sunprotection interventions to prevent skin cancer: A randomized study targeting Danes going on vacation to destinations with high UV index

Background

In Denmark, 16,500 cases of melanoma and keratinocyte cancers were registered in 2015, of which 90% could have been avoided by behavioral changes. We aimed to test novel interventions in a randomized design. The interventions targeted Danes going on vacation to high UVI destinations aiming to decrease sunburn by increasing use of sun protection to prevent skin cancer in the Danish population.

Methods

We report a randomized behavioral intervention during May-Dec 2018 with 1548 Danish adults on vacation in 2018 for a period of 1–3 weeks. The study population was population-based and aged 18–65 years. We tested two protection routines against minimal intervention control group (2-by2-factorial design): 1) Avoidance of the sun during peak hours and shade, use of the UV-index and planning of indoor/outdoor activity respectively and, 2) Coverage by increasing use of the hat advice and increasing sunscreen amount by application routine. Outcome was use of protection and sunburn.

Results

There were no differences in sunburn prevalence between intervention and control groups. Protection routine 1 and 2 both increased the overall protection score compared to non-users. Protection routine 1 increased the reported use of shade and decreased time exposed in the sun. Protection routine 2 increased the use of hat and sunscreen amount.

Conclusion

Simple measures can help avoid the majority of one of the most widespread cancers worldwide. Vacations to high UVI destinations is a major influence on the annual Danish UV-exposure. We influenced travelers to protect themselves better and to increase sun protection behavior.

Photoprotection by Workwear: Ultraviolet Protection Factors for Artificial Radiation from Welding Arcs

Photoprotection by clothing is one of the most effective protective measures against solar ultraviolet radiation (UVR), and the related concept of UV protection factors (UPF) for fabrics has proven itself for decades. Although immense work has been carried out regarding factors influencing textile sun protection, the idea of UPFs for artificial UVR, if necessary with different action spectra, is payed little attention. In this work, a modified UPF equation is proposed utilizing welding arcs and the ICNIRP action spectrum. These welding UPFs (wUPF) were calculated for some workwear as a function of welding power, technique and welded material. No wUPF welding power dependence existed. By means of normalized standard emission spectra, that were further clustered with regard to welding technique, it was found that the wUPF depends exclusively on the fabric’s transmittance and the ICNIRP weighting function yielding a reduced wUPF formula. Finally, a comparison of solar and welding UPFs, based on either their full or reduced equations, is discussed.

A Review on Development and Applications of Bio-Inspired Superhydrophobic Textiles

Bio-inspired engineering has been envisioned in a wide array of applications. All living bodies on Earth, including animals and plants, have well organized functional systems developed by nature. These naturally designed functional systems inspire scientists and engineers worldwide to mimic the system for practical applications by human beings. Researchers in the academic world and industries have been trying, for hundreds of years, to demonstrate how these natural phenomena could be translated into the real world to save lives, money and time. One of the most fascinating natural phenomena is the resistance of living bodies to contamination by dust and other pollutants, thus termed as self-cleaning phenomenon. This phenomenon has been observed in many plants, animals and insects and is termed as the Lotus Effect. With advancement in research and technology, attention has been given to the exploration of the underlying mechanisms of water repellency and self-cleaning. As a result, various concepts have been developed including Young's equation, and Wenzel and Cassie-Baxter theories. The more we unravel this process, the more we get access to its implications and applications. A similar pursuit is emphasized in this review to explain the fundamental principles, mechanisms, past experimental approaches and ongoing research in the development of bio-inspired superhydrophobic textiles.

An update to the recommended core content for sun safety messages for public education in Canada: A consensus report

Reducing ultraviolet radiation exposure decreases the risk of skin cancer and eye damage. Between 1996 and 2006, Canadians increased their time in the sun without improving protection. National consensus on sun protection information for the public was last achieved in 1994. Public messages have since been modified inconsistently. The Ontario Sun Safety Working Group initiated a review of messages and engaged a scientific panel to draft message content. Working Group members then delivered a national consensus process, engaging a National Steering Committee, a health communications expert and representatives from 28 organizations through a workshop with pre- and post-workshop surveys. The result of the consensus process is the updated Recommended Core Content for Sun Safety Messages in Canada. Four groups of statements comprise the new content: Key Facts, Primary Recommended Protective Action Statements, Additional Recommended Protective Action Statements, and Tips for Implementing the Primary Protective Actions. Organizations are encouraged to adopt, at minimum, the Primary Recommended Protective Action Statements as the basis for public messaging. The recommended core content establishes a common understanding of what is needed for effective sun protection. The underlying expectation is that, as a key next step, content will be tailored for different subpopulations and health promotion campaigns.

Incidence, risk factors and outcomes of de novo malignancies post liver transplantation

Liver transplantation (LT) is associated with a 2 to 7 fold higher, age and gender adjusted, risk of de novo malignancy. The overall incidence of de novo malignancy post LT ranges from 2.2% to 26%, and 5 and 10 years incidence rates are estimated at 10% to 14.6% and 20% to 32%, respectively. The main risk factors for de novo malignancy include immunosuppression with impaired immunosurveillance, and a number of patient factors which include; age, latent oncogenic viral infections, tobacco and alcohol use history, and underlying liver disease. The most common cancers after LT are non-melanoma skin cancers, accounting for approximately 37% of de novo malignancies, with a noted increase in the ratio of squamous to basal cell cancers. While these types of skin cancer do not impact patient survival, post-transplant lymphoproliferative disorders and solid organ cancer, accounting for 25% and 48% of malignancies, are associated with increased mortality. Patients developing these types of cancer are diagnosed at more advanced stages, and their cancers behave more aggressively compared with the general population. Patients undergoing LT for primary sclerosing cholangitis (particularly with inflammatory bowel disease) and alcoholic liver disease have high rates of malignancies compared with patients undergoing LT for other indications. These populations are at particular risk for gastrointestinal and aerodigestive cancers respectively. Counseling smoking cessation, skin protection from sun exposure and routine clinical follow-up are the current approach in practice. There are no standardized surveillance protocol, but available data suggests that regimented surveillance strategies are needed and capable of yielding cancer diagnosis at earlier stages with better resulting survival. Evidence-based strategies are needed to guide optimal surveillance and safe minimization of immunosuppression.