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Akerlof KL, Loevenich J, Melena S, Lipsky CA. Behaviorally segmented audiences for managing sunscreen chemical pollution risk in protected coastal natural resource areas. Risk Anal 2024; 44:349-365. [PMID: 37188329 DOI: 10.1111/risa.14152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 03/27/2023] [Accepted: 04/06/2023] [Indexed: 05/17/2023]
Abstract
This audience segmentation of visitors at coastal parks in Hawaii and North Carolina addresses an emergent natural resource management concern and risk to aquatic ecosystems: sunscreen chemical pollution. Four audiences were identified that correspond to different behavioral profiles: sunscreen protection tourists, multimodal sun protection tourists, in-state frequent park visitors, and frequent beachgoers who skip sunscreen. The second-largest audience, sunscreen protection tourists, represents 29% of visitors at Cape Lookout National Seashore and 25% at Kaloko-Honokōhau National Historical Park. This group ranks of most concern for chemical pollution because they use sunscreen, but not typically mineral formulations or other methods such as protective clothing, and they have lower levels of sunscreen chemical issue awareness. The identification of similar audience segments across regions with differing cultural characteristics and sunscreen regulation status suggests the robustness of the model and its indicator variables, with implications for both environmental protection and public health. Further, coastal visitors' interest in enacting pro-environmental sun protection behaviors during their next park or beach visit indicates the potential for natural resource managers to holistically address risks in both domains through targeted interventions with audiences of most concern.
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Affiliation(s)
- K L Akerlof
- Department of Environmental Science and Policy, George Mason University, Fairfax, Virginia, USA
| | - Jacqueline Loevenich
- Department of Aquatic Animal Health, University of Florida, Gainesville, Florida, USA
| | - Sara Melena
- Natural Resource Stewardship & Science Directorate, National Park Service, Fort Collins, Colorado, USA
| | - Christine A Lipsky
- Natural Resource Stewardship & Science Directorate, National Park Service, Fort Collins, Colorado, USA
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2
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van Bodegraven M, Kröger M, Zamudio Díaz DF, Lohan SB, Moritz RKC, Möller N, Knoblich C, Vogelsang A, Milinic Z, Hallhuber M, Weise JM, Kolbe L, Gallinger J, Graupner C, Klose H, Ulrich C, Meinke MC. Redefine photoprotection: Sun protection beyond sunburn. Exp Dermatol 2024; 33:e15002. [PMID: 38284193 DOI: 10.1111/exd.15002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 10/12/2023] [Accepted: 12/15/2023] [Indexed: 01/30/2024]
Abstract
Excessive exposure to ultraviolet (UV) light leads to acute and chronic UV damage and is the main risk factor for the development of skin cancer. In most countries with western lifestyle, the topical application of sunscreens on UV-exposed skin areas is by far the most frequently used preventive measure against sunburn. Further than preventing sunburns, increasing numbers of consumers are appreciating sunscreens with a medium- to high-level sun protective factor (SPF) as basis for sustainable-skin ageing or skin cancer prevention programs. However, recent investigations indicate that clinically significant DNA damages as well as a lasting impairment of cutaneous immunosurveillance already occur far below the standard of one minimal erythema dose (MED) sunburn level, which contributes to the current discussion of the clinical value of high-protective SPF values. Ex vivo investigations on human skin showed that the application of SPF30 reduces DNA damage for a day long sun exposure (24 MED) drastically by about 53% but is significantly surpassed by SPF100 reducing DNA damage by approx. 73%. Further analysis on different SPF protection levels in UV-exposed cell culture assays focusing on IL-18, cell vitality and cis/trans-urocanic acid support these findings. Whereas SPF30 and SPF50+ sunscreens already offer a solid UVB cover for most indications, our results indicate that SPF100 provides significant additional protection against mutagenic (non-apoptotic-) DNA damage and functional impairment of the cutaneous immunosurveillance and therefore qualifies as an optimized sunscreen for specifically vulnerable patient groups such as immunosuppressed patients, or skin cancer patients.
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Affiliation(s)
| | - Marius Kröger
- Department of Dermatology, Venereology and Allergology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Daniela F Zamudio Díaz
- Department of Dermatology, Venereology and Allergology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Silke B Lohan
- Department of Dermatology, Venereology and Allergology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Rose K C Moritz
- Department of Dermatology, Venereology and Allergology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Nadine Möller
- Research and Development, Beiersdorf AG, Hamburg, Germany
| | | | | | - Zorica Milinic
- Research and Development, Beiersdorf AG, Hamburg, Germany
| | | | - Julia M Weise
- Research and Development, Beiersdorf AG, Hamburg, Germany
| | - Ludger Kolbe
- Research and Development, Beiersdorf AG, Hamburg, Germany
| | | | - Cindy Graupner
- Research and Development, Beiersdorf AG, Hamburg, Germany
| | - Holger Klose
- artMED Private Practice for Plastic and Aesthetic Surgery, Berlin, Germany
| | - Claas Ulrich
- Department of Dermatology, Venereology and Allergology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- CMB Collegium Medicum Berlin GmbH, Berlin, Germany
| | - Martina C Meinke
- Department of Dermatology, Venereology and Allergology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
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Gutiérrez-Manzanedo JV, González-Montesinos JL, Aguilera-Arjona J, Rodríguez-Martínez A, Vaz-Pardal C, España-Romero V, Rivas-Ruiz F, Blázquez-Sánchez N, De Gálvez-Aranda MV, De Troya-Martín M. Ultraviolet sun exposure and sun protection behaviors in outdoor rock climbers. Photochem Photobiol Sci 2023; 22:2817-2826. [PMID: 37847459 DOI: 10.1007/s43630-023-00488-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2023] [Accepted: 09/21/2023] [Indexed: 10/18/2023]
Abstract
BACKGROUND Overexposure to sunlight and sunburn are the main preventable causes of skin cancer. Outdoor sports are associated with significant levels of sunlight exposure. AIMS We sought to quantify the sun radiation exposure received by outdoor rock climbers and assess their sun exposure habits, sun protection behaviors, attitudes, and knowledge regarding skin cancer. METHODS From April to June 2021, outdoor rock climbers contacted via email completed an online validated self-reported questionnaire on sun related habits, behaviors, attitudes and knowledge. As a pilot trial, ten participants wore a personal dosimeter during two outdoor climbing weekends in May and November 2021. Ambient ultraviolet radiation (UVR) was also recorded. RESULTS A total of 217 outdoor rock climbers (103 women), mean age 36.8 ± 8.8 years (range 20-70 years) and median climbing practice per week of 8 h (IQR 7.5) were studied. Two in three (65.9%) participants reported at least one sunburn event during the previous rock climbing season. Of the survey respondents, 49.3% reported using sunscreen with SPF ≥ 15, 47% wore sunglasses, and 14.3% indicated they reapplied sunscreen every two hours. The median personal UVR dose measured during the two outdoor climbing weekends analyzed was 5.2 (IQR 1.8) and 8.8 (IQR 1.1) standard erythemal doses, respectively. CONCLUSIONS The high rates of sunburn, the elevated personal UVR measured and the clearly insufficient sun protection practices followed during rock climbing together with unsatisfactory attitudes towards tanning reveal the need to develop explicit sun protection campaigns and educational strategies to reduce the risk of skin cancer among the athletes studied.
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Affiliation(s)
- José V Gutiérrez-Manzanedo
- Department of Physical Education, Faculty of Education Sciences, University of Cádiz, Avda. República Saharaui s/n, Puerto Real, 11519, Cádiz, Spain.
| | - José Luis González-Montesinos
- Department of Physical Education, Faculty of Education Sciences, University of Cádiz, Avda. República Saharaui s/n, Puerto Real, 11519, Cádiz, Spain
| | - José Aguilera-Arjona
- Photobiological Dermatology Laboratory Medical Research Centre, Department of Dermatology and Medicine, Faculty of Medicine, University of Málaga, Málaga, Spain
| | | | | | - Vanesa España-Romero
- MOVE-IT Research Group and Department of Physical Education, Faculty of Education Sciences, University of Cádiz, Cádiz, Spain
- Biomedical Research and Innovation Institute of Cádiz (INiBICA) Research Unit, Puerta del Mar University Hospital, University of Cádiz, Cádiz, Spain
| | | | | | - María Victoria De Gálvez-Aranda
- Photobiological Dermatology Laboratory Medical Research Centre, Department of Dermatology and Medicine, Faculty of Medicine, University of Málaga, Málaga, Spain
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Stump TK, Fastner S, Jo Y, Chipman J, Haaland B, Nagelhout ES, Wankier AP, Lensink R, Zhu A, Parsons B, Grossman D, Wu YP. Objectively-Assessed Ultraviolet Radiation Exposure and Sunburn Occurrence. Int J Environ Res Public Health 2023; 20:5234. [PMID: 37047850 PMCID: PMC10094127 DOI: 10.3390/ijerph20075234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 03/09/2023] [Accepted: 03/15/2023] [Indexed: 06/19/2023]
Abstract
Ultraviolet radiation (UVR) exposure is the primary modifiable risk factor for melanoma. Wearable UVR sensors provide a means of quantifying UVR exposure objectively and with a lower burden than self-report measures used in most research. The purpose of this study was to evaluate the relationship between detected UVR exposure and reported sunburn occurrence. In this study, a UVR monitoring device was worn by 97 parent-child dyads during waking hours for 14 days to measure instantaneous and accumulated UVR exposure. The results showed that the participants' total UVR exposure was associated with reported sunburn after adjusting for Fitzpatrick skin type and geographic location. It was observed that one standard erythemal dose (SED) increase in the participants' daily total UVR exposure was associated with reported sunburn (an odds ratio (OR) of 1.26 with a 95% CI of 1.13 and 1.41, and p < 0.001 for parents and an OR of 1.28 with a 95% CI of 1.12 and 1.47, and p < 0.001 for children). A one-SED increase in the participants' UVR exposure from 10 am to 4 pm was also associated with reported sunburn (an OR of 1.31 with a 95% CI of 1.15 and 1.49, and p < 0.001 for parents and an OR of 1.33 with a 95% CI of 1.12 and 1.59, and p = 0.001 for children). We found that elevated UVR exposure recordings measured by the UVR sensor were associated with reported sunburn occurrence. Future directions for wearable UVR sensors may include their use as an intervention tool to support in-the-moment sunburn prevention.
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Affiliation(s)
- Tammy K. Stump
- Department of Dermatology, University of Utah Health Sciences Center, Salt Lake City, UT 84132, USA
- Huntsman Cancer Institute, University of Utah, Salt Lake City, UT 84112, USA
| | - Suzanne Fastner
- Department of Dermatology, University of Utah Health Sciences Center, Salt Lake City, UT 84132, USA
- Huntsman Cancer Institute, University of Utah, Salt Lake City, UT 84112, USA
| | - Yeonjung Jo
- Department of Population Health Sciences, University of Utah, Salt Lake City, UT 84108, USA
| | - Jonathan Chipman
- Huntsman Cancer Institute, University of Utah, Salt Lake City, UT 84112, USA
- Department of Population Health Sciences, University of Utah, Salt Lake City, UT 84108, USA
| | - Benjamin Haaland
- Huntsman Cancer Institute, University of Utah, Salt Lake City, UT 84112, USA
- Department of Population Health Sciences, University of Utah, Salt Lake City, UT 84108, USA
| | - Elizabeth S. Nagelhout
- Division of Public Health, Department of Family & Preventive Medicine, University of Utah, Salt Lake City, UT 84108, USA
| | - Ali P. Wankier
- Huntsman Cancer Institute, University of Utah, Salt Lake City, UT 84112, USA
| | - Riley Lensink
- Huntsman Cancer Institute, University of Utah, Salt Lake City, UT 84112, USA
| | - Angela Zhu
- Department of Pediatrics, University of Utah, Salt Lake City, UT 84113, USA
| | - Bridget Parsons
- Huntsman Cancer Institute, University of Utah, Salt Lake City, UT 84112, USA
| | - Douglas Grossman
- Department of Dermatology, University of Utah Health Sciences Center, Salt Lake City, UT 84132, USA
- Huntsman Cancer Institute, University of Utah, Salt Lake City, UT 84112, USA
| | - Yelena P. Wu
- Department of Dermatology, University of Utah Health Sciences Center, Salt Lake City, UT 84132, USA
- Huntsman Cancer Institute, University of Utah, Salt Lake City, UT 84112, USA
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de Castro Maqueda G, Gutiérrez-Manzanedo JV, González-Montesinos JL, Vaz Pardal C, Rivas Ruiz F, de Troya Martín M. Sun Exposure and Photoprotection: Habits, Knowledge and Attitudes Among Elite Kitesurfers. J Cancer Educ 2022; 37:517-523. [PMID: 32720132 DOI: 10.1007/s13187-020-01838-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Kitesurfing is one of many water sports that are growing in popularity throughout the world. In such sports, practitioners are exposed not only to direct sunlight but also to reflection from the water surface, which aggravates the impact of solar radiation on the skin. This study sought to analyse the photoprotection and photoexposure habits and knowledge of elite kitesurfers and their beliefs and attitudes in this respect. A sample of convenience of 72 male kitesurfers completed a validated questionnaire in full. By Fitzpatrick phototype, the most common classes were types I and II (69.4%). On average, kitesurfers had been practising their sport for 10.93 years, at a rate of 13.93 h per week. During the last sports season, 84.7% of respondents had suffered at least one sunburn, while 43.1% had been sunburned at least three times. The sun protection practice most commonly adopted was the use of sunscreen cream, which was used by 79.2% of respondents. Although 43.2% of respondents recognized to be worried about they might get skin cancer from the sun, 31.9% does not like using sunscreen and 44.4% like sunbathing. Regarding the respondents' knowledge of facts about sun exposure, the average rate of correct answers for the items evaluated was 66.9%. In conclusion, elite kitesurfers are potentially exposed to dangerous levels of UV radiation, which caused numerous sunburn episodes during the last sports season. It is necessary to raise these athletes' awareness of their risk of developing skin cancer and of the need to improve their sun protection and skin surveillance practices.
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Affiliation(s)
- Guillermo de Castro Maqueda
- Department of Physical Education, Faculty of Education Sciences, University of Cádiz, Avda República Saharaui s/n, 11519, Puerto Real, Cádiz, Spain.
| | - José Vicente Gutiérrez-Manzanedo
- Department of Physical Education, Faculty of Education Sciences, University of Cádiz, Avda República Saharaui s/n, 11519, Puerto Real, Cádiz, Spain.
| | - José Luis González-Montesinos
- Department of Physical Education, Faculty of Education Sciences, University of Cádiz, Avda República Saharaui s/n, 11519, Puerto Real, Cádiz, Spain
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Different ways of estimating the amount of individual sun exposure. Br J Dermatol 2022; 186:e84-e109. [PMID: 35103991 DOI: 10.1111/bjd.20912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Linked article: Souedi et al. Br J Dermatol 2022; 186:266-273. The sun is the main source of exposure people have to ultraviolet radiation (UVR). Sun exposure has some health benefits but also some adverse effects (for example sunburn and skin cancer). Studies about the link between UVR exposure and long-term health outcomes have used a number of different ways to try and accurately measure how much UVR individuals have been exposed to. We set out to study how accurate three different ways of measuring exposure to UVR were over 6 months: (1) ambient UVR levels, (2) self-reported time spent outdoors, and (3) a statistical formula. The participants in this study were employees who worked either indoors or outdoors in Catalunya - Spain during the summer and winter months. Using a wristwatch with a dosimeter (a device made specifically to measure solar UVR levels) we measured each of the participants UVR levels daily during their working hours. Using a statistical formula, we calculated the daily dose of solar UVR each participant received by including their measured levels (from the dosimeter), the general ambient UVR levels of that day, and self-reported time spent outdoors. We then compared the results. Of our 39 participants, not surprisingly, we noted that the levels of UVR were higher for outdoor workers and during the summer. We discovered that the calculated levels and the self-reported time spent outdoors (methods 2 and 3) were more accurate than measuring general ambient UVR levels (method 1) alone. These results will be helpful to researchers who are deciding which are the best methods to use in future studies about the health effects of UVR exposure.
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Akintilo L, Gendler E. The State of Sunscreens in the US: Caveat Emptor. J Drugs Dermatol 2021; 19:799-801. [PMID: 32845592 DOI: 10.36849/jdd.2020.5388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Catanzaro E, Bishayee A, Fimognari C. On a Beam of Light: Photoprotective Activities of the Marine Carotenoids Astaxanthin and Fucoxanthin in Suppression of Inflammation and Cancer. Mar Drugs 2020; 18:E544. [PMID: 33143013 PMCID: PMC7692561 DOI: 10.3390/md18110544] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 10/25/2020] [Accepted: 10/29/2020] [Indexed: 12/14/2022] Open
Abstract
Every day, we come into contact with ultraviolet radiation (UVR). If under medical supervision, small amounts of UVR could be beneficial, the detrimental and hazardous effects of UVR exposure dictate an unbalance towards the risks on the risk-benefit ratio. Acute and chronic effects of ultraviolet-A and ultraviolet-B involve mainly the skin, the immune system, and the eyes. Photodamage is an umbrella term that includes general phototoxicity, photoaging, and cancer caused by UVR. All these phenomena are mediated by direct or indirect oxidative stress and inflammation and are strictly connected one to the other. Astaxanthin (ASX) and fucoxanthin (FX) are peculiar marine carotenoids characterized by outstanding antioxidant properties. In particular, ASX showed exceptional efficacy in counteracting all categories of photodamages, in vitro and in vivo, thanks to both antioxidant potential and activation of alternative pathways. Less evidence has been produced about FX, but it still represents an interesting promise to prevent the detrimental effect of UVR. Altogether, these results highlight the importance of digging into the marine ecosystem to look for new compounds that could be beneficial for human health and confirm that the marine environment is as much as full of active compounds as the terrestrial one, it just needs to be more explored.
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Affiliation(s)
- Elena Catanzaro
- Department for Life Quality Studies, Alma Mater Studiorum—Università di Bologna, corso d’Augusto 237, 47921 Rimini, Italy;
| | - Anupam Bishayee
- Lake Erie College of Osteopathic Medicine, Bradenton, FL 34211, USA
| | - Carmela Fimognari
- Department for Life Quality Studies, Alma Mater Studiorum—Università di Bologna, corso d’Augusto 237, 47921 Rimini, Italy;
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Abstract
Despite decades of public health campaigns, tanning and sunburn still occur at unacceptably high rates. Skin cancer prevention campaigns predominately focus on increasing awareness of the risk of excessive sun exposure. This study sought to assess the efficacy of this approach, by interrogating correlations between risk perception and sun exposure behaviour. A 31-item questionnaire assessing skin cancer risk factors, tanning attitudes, sunburn and tanning behaviour was undertaken by individuals who attended a workplace skin check. Validated questions were included to assess cognitive and affective risk perception and to frame risk as absolute, comparative and conditional. One hundred sixty-seven respondents completed the questionnaire. No aspects of risk perception (absolute cognitive, affective or conditional) significantly correlated with protective sun exposure behaviour, with the exception of perceived comparative severity of skin cancer. Instead, positive tanning attitudes were far more significantly correlated with sun exposure behaviour. Actual risk and risk perception have very limited impact on sun exposure behaviour. Instead, sun exposure behaviour was significantly linked with positive tanning attitudes. It is suggested, therefore, that campaigns focussing solely on education regarding risk factors appear to have been ineffective in behaviour mitigation, and innovative approaches, aimed at influencing tanning norms, might complement the existing educational campaigns.
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Affiliation(s)
- V L Venning
- The Skin Hospital (branch of the Skin & Cancer Foundation Australia), Sydney, Australia.
- The University of Sydney, Sydney, Australia.
| | - L M Abbott
- The Skin Hospital (branch of the Skin & Cancer Foundation Australia), Sydney, Australia
- The University of Sydney, Sydney, Australia
| | - C L Thomas
- The Skin Hospital (branch of the Skin & Cancer Foundation Australia), Sydney, Australia
- The University of Sydney, Sydney, Australia
| | - P Fernandez-Peñas
- The Skin Hospital (branch of the Skin & Cancer Foundation Australia), Sydney, Australia
- The University of Sydney, Sydney, Australia
- Department of Dermatology, Westmead Hospital, Sydney, Australia
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Böttcher S, Buck C, Zeeb H, Laschewski G, Hauer C, Wagner G, Sachse MM. Randomised controlled trial to evaluate the influence of mHealth and eHealth skin cancer prevention education among young organ transplant recipients: the HIPPOlino intervention study. BMJ Open 2019; 9:e028842. [PMID: 31848158 PMCID: PMC6937057 DOI: 10.1136/bmjopen-2018-028842] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVES To determine whether a multicomponent sun protection intervention programme (mHealth) for young organ transplant recipients (OTR) leads to a higher increase of preventive knowledge and behavioural change than an e-learning education programme (eHealth). DESIGN Randomised controlled trial with one preintervention baseline survey and three follow-up surveys after 6 weeks, 6 and 12 months. Comparison of two different intervention schedules with a control group (CG). SETTING Multicomponent sun protection trainings in Germany, the Netherlands and Austria between June 2013 and September 2015. PARTICIPANTS 137 OTRs (5-22 years of age, 61 females/76 males) participated in the study. INTERVENTIONS (A) Intervention group 1 (IG1): personal training with subsequent forwarding of individual ultraviolet index-dependent sun protection recommendations via short message service (SMS); (B) intervention group 2 (IG2): e-learning training without SMS; (C) CG: regular information letters, online training after 1 year. OUTCOME MEASURES Key questions were used to form a knowledge and a behavioural score. Behavioural strategies and knowledge were quantified through self-administered questionnaires. RESULTS Analyses 6 weeks after the intervention showed a higher knowledge increase in both IG compared with the CG (IG1 to CG: OR 12.64, 95% CI 4.20 to 38.20; IG2 to CG: OR 2.59, 95% CI 0.95 to 7.04). Sun protection behaviour improved slightly but not significantly in both IG (IG1 to CG: OR 2.56, 95% CI 0.93 to 7.00; IG2 to CG: OR 1.22, 95% CI 0.45 to 3.32). One year after the intervention, no behavioural changes were observed in either IG compared with the CG. IG1 but not IG2 still scored significantly higher in sun protection knowledge than the CG 1 year after intervention (IG1 to CG: OR 4.46, 95% CI 1.48 to 13.43; IG2 to CG: OR 1.41, 95% CI 0.51 to 3.93). CONCLUSIONS This multicomponent sun protection programme provides a promising strategy to increase sun protection knowledge and possibly also protective behaviour in young OTR. TRIAL REGISTRATION NUMBER DRKS00011393.
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Affiliation(s)
- Silke Böttcher
- Leibniz-Institut für Präventionsforschung und Epidemiologie-BIPS, Bremen, Germany
| | - Christoph Buck
- Leibniz-Institut für Präventionsforschung und Epidemiologie-BIPS, Bremen, Germany
| | - Hajo Zeeb
- Leibniz-Institut für Präventionsforschung und Epidemiologie-BIPS, Bremen, Germany
- High-Profile Research Area Health Sciences, University of Bremen, Bremen, Germany
| | | | | | - Gunnar Wagner
- Department of Dermatology, Allergology and Phlebology, Klinikum Bremerhaven Reinkenheide, Bremerhaven, Germany
| | - Michael Max Sachse
- Department of Dermatology, Allergology and Phlebology, Klinikum Bremerhaven Reinkenheide, Bremerhaven, Germany
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Salvadori G, Lista D, Burattini C, Gugliermetti L, Leccese F, Bisegna F. Sun Exposure of Body Districts: Development and Validation of an Algorithm to Predict the Erythemal Ultra Violet Dose. Int J Environ Res Public Health 2019; 16:ijerph16193632. [PMID: 31569692 PMCID: PMC6801664 DOI: 10.3390/ijerph16193632] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/31/2019] [Revised: 09/20/2019] [Accepted: 09/24/2019] [Indexed: 11/16/2022]
Abstract
Solar Ultra-Violet (UV) radiation has positive and negative effects on human body tissues. Small doses of solar UV radiation are needed by the human skin for the activation of the vitamin D production. Overexposure to solar UV radiation can produce acute and long-term negative effects, such as sunburns and, in the worst cases, cataracts and skin cancers. For this reason, knowing the amount of UV doses received by people is essential to evaluate their risk to UV overexposure and to evaluate the adequate countermeasure to avoid the negative effects. The original contribution of the present study consists in having searched, collected, adapted and processed a series of technical information and analytical relations, developing an algorithm suitable for the calculation of the erythemal UV dose on sloped surfaces exposed to solar radiation, which at the moment is not present in the scientific literature. The results obtained by the algorithm have been compared to the results of a field measurements campaign, carried out in three different Italian sites. Results comparison indicated that measured and calculated values show a sufficient level of agreement, with a mean absolute error equal to 20%.
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Affiliation(s)
- Giacomo Salvadori
- Department of Energy, Systems, Territory and Constructions Engineering, University of Pisa, 56122 Pisa, Italy.
| | - Davide Lista
- Department of Energy, Systems, Territory and Constructions Engineering, University of Pisa, 56122 Pisa, Italy.
| | - Chiara Burattini
- Department of Astronautical, Electrical and Energy Engineering, Sapienza University, 00184 Rome, Italy.
| | - Luca Gugliermetti
- Department of Astronautical, Electrical and Energy Engineering, Sapienza University, 00184 Rome, Italy.
| | - Francesco Leccese
- Department of Energy, Systems, Territory and Constructions Engineering, University of Pisa, 56122 Pisa, Italy.
| | - Fabio Bisegna
- Department of Astronautical, Electrical and Energy Engineering, Sapienza University, 00184 Rome, Italy.
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12
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Murphy EC, Kao S, Wang H, Chen D, Nguyen H, Friedman AJ. A Survey-Based Comparison of Sun Safety Practices in a Representative Cohort of the General Public Versus Attendees of a Skin Cancer Screening. J Drugs Dermatol 2019; 18:649-653. [PMID: 31334624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
A large proportion of data on photoprotective practices is yielded from free skin cancer screenings. However, the sun safety practices of populations who seek these skin cancer screenings may differ from the general public. To examine differences in skin cancer prevention practices and risk factors, we surveyed pedestrians at six locations in Washington, DC (public group, n=285) and attendees of a free skin cancer screening (screening group, n=144) using an IRB-approved survey. The screening group was older and included more individuals with fair skin than the public group. Respondents from the screening group were significantly more likely to always wear sunscreen, always seeks shade, and always or sometimes wear sun-protective clothing than the public group (P<0.05). To examine whether younger and non-white participants, who were less likely to attend our free screening, have different practices and risk factors than older and white participants, respectively, we compared survey answers for all participants by age and race. White participants were more likely to always or sometimes wear sunscreen and sun-protective clothing than non-white participants (P<0.05). Patients over 61 years were more likely to always seek shade and wear sun-protective clothing than those younger than 31 years (P<0.05). Therefore, free skin cancer screenings need to be better popularized among non-white and younger populations or more effective educational vehicles are needed. J Drugs Dermatol. 2019;18(7):649-653.
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Abstract
Skin cancer is the most common cancer in the United States, and risk for melanoma is greatly increased with a serious sunburn in childhood or adolescence. Skin cancer also is one of the most preventable cancers, as sun exposure is an almost entirely modifiable risk factor. Proper skin protection should start early in life when infants begin to be exposed to the outdoors. [Pediatr Ann. 2019;48(6):e213-e214.].
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14
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Morgan M, Anderson R, Walburn J, Weinman J, Sarkany R. The influence of perceived medical risks and psychosocial concerns on photoprotection behaviours among adults with xeroderma pigmentosum: a qualitative interview study in the UK. BMJ Open 2019; 9:e024445. [PMID: 30782905 PMCID: PMC6377541 DOI: 10.1136/bmjopen-2018-024445] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND A high level of photoprotection is required by people with xeroderma pigmentosum (XP), a rare skin disease, to reduce skin cancer and other risks. However poor photoprotection is thought to be widespread. PURPOSE This study examines the influences on photoprotection behaviours in adults with XP. DESIGN Inductive qualitative study with semistructured interviews. Analysis employed a framework approach. SETTING National sample recruited through a specialist XP centre in London. METHODS Semistructured interviews at patients' homes. All transcripts were coded and themes charted for each participant. Comparisons within and across cases identified common themes and differing motivations and approaches to photoprotection. Credibility of interpretations assessed through patient/carer input and clinic adherence scores. PARTICIPANTS 25 adults (17 male, eight female) aged 16-63 years with diagnosed XP attending a specialist centre. 18 lived outside London. RESULTS Awareness of risks of ultraviolet radiation (UVR) and photoprotection was high. However, photoprotection behaviours varied according to perceived necessity and concerns. Three behavioural responses were identified: (1) 'dominated' by planning and routines to achieve a high level of photoprotection with significant activity restrictions and psychosocial impacts. (2) 'resistant' to photoprotection with priority given to avoiding an illness identity and enjoying a normal life. (3) Photoprotection' integrated' with an individual's life with little psychosocial impact. These responses were influenced by illness, personal and contextual factors including age, life stage and social support. Only the 'integrated' group achieved an equilibrium between perceived 'necessity' and 'concerns'. CONCLUSIONS The personal balance between perceived risks of UVR and social/psychological 'concerns' led to differing behavioural responses and contributes to an understanding of adaptation and normalisation in chronic illness. The study will also inform a series of individualised behavioural interventions to reduce measured UVR exposure among people with XP that are potentially applicable to other conditions with high risks of skin cancer.
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Affiliation(s)
- Myfanwy Morgan
- School of Cancer and Pharmaceutical Sciences, King’s College London, London, UK
| | - Rebecca Anderson
- School of Cancer and Pharmaceutical Sciences, King’s College London, London, UK
| | - Jessica Walburn
- School of Cancer and Pharmaceutical Sciences, King’s College London, London, UK
| | - John Weinman
- School of Cancer and Pharmaceutical Sciences, King’s College London, London, UK
| | - Robert Sarkany
- National Xeroderma Pigmentosum Service, Guy’s and St Thomas' NHS Foundation Trust, London, UK
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15
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Molleman J, Tielemans JF, van Steveninck JC, Braam MJI. [Sunburn of a reconstructed breast: risk of denervated tissue]. Ned Tijdschr Geneeskd 2019; 163:D3174. [PMID: 30816650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
More and more women opt for breast reconstruction with autologous tissue after breast removal. Reconstruction with a deep inferior epigastric perforator (DIEP) flap is the most common technique. In this operation, the nerves of the DIEP flap are cut. This creates a denervated reconstructed breast which is not only numb, but also lacks autonomic response. This makes the tissue more susceptible to thermal injury. We present a case of a 66-year-old woman who underwent uncomplicated breast reconstruction with a DIEP flap 8 months ago. She recently noticed a second-degree burn on her reconstructed breast after she had been sitting in the sun whilst dressed. She did not feel anything and noticed it by accident. Familiarity with this phenomenon is important for all parties involved in care and aftercare of breast cancer and breast reconstruction, so adequate information can be provided. Reinnervation of the reconstructed breast could be a solution, but more research is needed.
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Affiliation(s)
- Jeroen Molleman
- HagaZiekenhuis, afd. Plastische en Reconstructieve Chirurgie, Den Haag
- Contact: J. Molleman
| | - Jarl F Tielemans
- HagaZiekenhuis, afd. Plastische en Reconstructieve Chirurgie, Den Haag
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16
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Voigt AY, Michaud M, Tsai KY, Oh J, Sundberg JP. Differential Hairless Mouse Strain-Specific Susceptibility to Skin Cancer and Sunburn. J Invest Dermatol 2019; 139:1837-1840.e3. [PMID: 30742806 DOI: 10.1016/j.jid.2019.01.028] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2018] [Revised: 01/24/2019] [Accepted: 01/25/2019] [Indexed: 11/18/2022]
Affiliation(s)
- Anita Y Voigt
- The Jackson Laboratory For Genomic Medicine, Farmington, Connecticut, USA
| | - Michael Michaud
- The Jackson Laboratory For Genomic Medicine, Farmington, Connecticut, USA
| | - Kenneth Y Tsai
- Departments of Pathology and Tumor Biology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, USA
| | - Julia Oh
- The Jackson Laboratory For Genomic Medicine, Farmington, Connecticut, USA.
| | - John P Sundberg
- The Jackson Laboratory, Mammalian Genomics, Bar Harbor, Maine, USA
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17
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Young AR, Greenaway J, Harrison GI, Lawrence KP, Sarkany R, Douki T, Boyer F, Josse G, Questel E, Monteil C, Rossi AB. Sub-optimal Application of a High SPF Sunscreen Prevents Epidermal DNA Damage in Vivo. Acta Derm Venereol 2018; 98:880-887. [PMID: 29944164 DOI: 10.2340/00015555-2992] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The cyclobutane pyrimidine dimer (CPD) is a potentially mutagenic DNA photolesion that is the basis of most skin cancers. There are no data on DNA protection by sunscreens under typical conditions of use. The study aim was to determine such protection, in phototypes I/II, with representative sunscreen-user application. A very high SPF formulation was applied at 0.75, 1.3 and 2.0 mg/cm2. Unprotected control skin was exposed to 4 standard erythema doses (SED) of solar simulated UVR, and sunscreen-treated sites to 30 SED. Holiday behaviour was also simulated by UVR exposure for 5 consecutive days. Control skin received 1 SED daily, and sunscreen-treated sites received 15 (all 3 application thicknesses) or 30 (2.0 mg/cm2) SED daily. CPD were assessed by quantitative HPLC-tandem mass spectrometry (HPLC-MS/MS) and semi-quantitative immunostaining. In comparison with unprotected control sites, sunscreen significantly (p ≤ 0.001-0.05) reduced DNA damage at 1.3 and 2.0 mg/cm2 in all cases. However, reduction with typical sunscreen use (0.75 mg/cm2) was non-significant, with the exception of HPLC-MS/MS data for the 5-day study (p <0.001). Overall, these results support sunscreen use as a strategy to reduce skin cancer, and demonstrate that public health messages must stress better sunscreen application to get maximal benefit.
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Affiliation(s)
- Antony R Young
- St John's Institute of Dermatology, Kings College London, SE1 9RT London, United Kingdom.
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18
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Del Bino S, Duval C, Bernerd F. Clinical and Biological Characterization of Skin Pigmentation Diversity and Its Consequences on UV Impact. Int J Mol Sci 2018; 19:ijms19092668. [PMID: 30205563 PMCID: PMC6163216 DOI: 10.3390/ijms19092668] [Citation(s) in RCA: 120] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2018] [Revised: 07/24/2018] [Accepted: 07/27/2018] [Indexed: 12/27/2022] Open
Abstract
Skin color diversity is the most variable and noticeable phenotypic trait in humans resulting from constitutive pigmentation variability. This paper will review the characterization of skin pigmentation diversity with a focus on the most recent data on the genetic basis of skin pigmentation, and the various methodologies for skin color assessment. Then, melanocyte activity and amount, type and distribution of melanins, which are the main drivers for skin pigmentation, are described. Paracrine regulators of melanocyte microenvironment are also discussed. Skin response to sun exposure is also highly dependent on color diversity. Thus, sensitivity to solar wavelengths is examined in terms of acute effects such as sunburn/erythema or induced-pigmentation but also long-term consequences such as skin cancers, photoageing and pigmentary disorders. More pronounced sun-sensitivity in lighter or darker skin types depending on the detrimental effects and involved wavelengths is reviewed.
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Affiliation(s)
- Sandra Del Bino
- L'Oréal Research and Innovation, 1 avenue Eugène Schueller, 93601 Aulnay-sous-Bois, France.
| | - Christine Duval
- L'Oréal Research and Innovation, 1 avenue Eugène Schueller, 93601 Aulnay-sous-Bois, France.
| | - Françoise Bernerd
- L'Oréal Research and Innovation, 1 avenue Eugène Schueller, 93601 Aulnay-sous-Bois, France.
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19
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Diffey BL. Time and Place as Modifiers of Personal UV Exposure. Int J Environ Res Public Health 2018; 15:ijerph15061112. [PMID: 29848972 PMCID: PMC6025391 DOI: 10.3390/ijerph15061112] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/24/2018] [Revised: 04/04/2018] [Accepted: 05/28/2018] [Indexed: 11/16/2022]
Abstract
It is a common belief that, if we want to limit our sun exposure during outdoor recreational activities and holidays in order to avoid sunburn or reduce our risk of skin cancer, we need to reach for the bottle of sunscreen or cover up with clothing. As important as these measures are, there is another way to enjoy our time outdoors and still benefit from the experience. In this article, we consider the impact of time, place, and behaviour outdoors on our exposure to solar ultraviolet (UV) radiation. Some of the simple actions we can take in controlling our UV exposure include being aware of the position of the sun in the sky, understanding how we can use the UV index to guide our outdoor exposure, and the importance of reducing our sun exposure around the middle of the day. Finally we review our preferred holiday activities and destinations, and the influence of outdoor leisure pursuits. By planning where and when we spend our leisure time in the sun, we can maximise our enjoyment whilst limiting our UV exposure.
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Affiliation(s)
- Brian L Diffey
- Dermatological Sciences, Institute of Cellular Medicine, University of Newcastle, Newcastle NE2 4HH, UK.
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20
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Gomes-Neto A, Aguilera P, Prieto L, Seité S, Moyal D, Carrera C, Malvehy J, Puig S. Efficacy of a Daily Protective Moisturizer with High UVB and UVA Photoprotection in Decreasing Ultraviolet Damage: Evaluation by Reflectance Confocal Microscopy. Acta Derm Venereol 2017; 97:1196-1201. [PMID: 28661544 DOI: 10.2340/00015555-2736] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Patients with photodermatoses or actinic keratosis benefit from very high ultraviolet B-ultraviolet A (UVB-UVA) photoprotection. However, poor compliance is an issue that jeopardizes adequate protection, leading to disease recurrence. This study evaluated the efficacy of a daily protective moisturizer with high UVB and UVA photoprotection applied 8 h before irradiation. A monocentric, open-label, prospective, control pilot study was performed including 10 patients. Patients were irradiated with UVB and UVA before and 8 h after topical application of the product. Reflectance confocal microscopy (RCM) assessment was performed 24 h later. Clinical assessment showed a statistically significant increase in minimal erythema dose (MED) after application of the product (p <0.001). Signs of UV damage according to RCM were not observed on photoprotected skin (p <0.05). Skin irradiated 8 h after applying a daily protective moisturizer presented an increase in MED and RCM findings that equal the findings for non-irradiated skin.
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Affiliation(s)
- Antonio Gomes-Neto
- Melanoma Unit, Dermatology Department, Hospital Clínic and IDIBAPS (Institut d'Investigacions Biomèdiques August Pi i Sunyer), Barcelona, Spain
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21
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Lospinoso DJ, Lospinoso JA, Miletta NR. The impact of ultraviolet radiation on sunburn-related search activity. Dermatol Online J 2017; 23:13030/qt6cs1n9nd. [PMID: 29469736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2017] [Accepted: 08/17/2017] [Indexed: 06/08/2023] Open
Abstract
We establish a strong, positive relationship between the Ultraviolet Index and Google search engine activity for sunburn-related terms in the United States. Using the Google Trends utility and data available from the National Weather service, we combine data from a twelve-year period to produce panel data for each state. We fit a time-series regression model of search activity and perform statistical tests on the resulting parameter estimates. This study lays the groundwork for using search-related data to assess the prevalence of, and attitudes about sunburn. By tracking the frequency of searches about preventative measures like "sunscreen" or "protective clothing" versus treatment measures like "sunburn relief," researchers could measure the effectiveness of awareness and prevention programs.
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Affiliation(s)
- Danielle J Lospinoso
- Department of Dermatology - San Antonio Military Medical Center, San Antonio, Texas.
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22
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Kirk L, Greenfield S. Knowledge and attitudes of UK university students in relation to ultraviolet radiation (UVR) exposure and their sun-related behaviours: a qualitative study. BMJ Open 2017; 7:e014388. [PMID: 28289050 PMCID: PMC5353347 DOI: 10.1136/bmjopen-2016-014388] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2016] [Revised: 01/23/2017] [Accepted: 02/13/2017] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVES To explore whether knowledge about the harms of ultraviolet radiation (UVR) influences UK university students' sun-related behaviours and examine in depth their attitudes towards: sun protection, natural and artificial tanning behaviours. DESIGN Qualitative methodology with 15 semistructured, individual interviews. Thematic analysis using the Framework Method with analyst triangulation and member validation. SETTING One university in the West Midlands, UK. PARTICIPANTS 15 Caucasian male (n=4) and female (n=11) students, aged 18-22 years, from a UK university. Participants were recruited using convenience sampling from the university's main campus followed by purposive sampling for: gender, course and sun-related behaviours. RESULTS Five main themes emerged: (1) knowledge of UVR; (2) sun-protection practices; (3) attitudes towards tanning; (4) external influences and (5) internal influences. All students knew the associated skin cancer risks from the sun and sunbed use, but this did not appear an important influence in their sun-related behaviours. Body image strongly motivated sun-protection practices and the desire to tan naturally or artificially, across both genders. However, participants' final decision-making appeared to be influenced by their beliefs that practising known harmful sun-related behaviours would not affect them or the perceived susceptibility to sunburn. Beliefs about sunbathing and sunscreen use prompted improper use of sun protection and inadvertently caused more harmful practices. Participants' peers, family and the media had dual roles influencing the development of attitudes towards sun protection and tanning, which contributed to how participants behaved in the sun and their engagement in tanning methods. CONCLUSIONS Knowledge about the risk of skin cancer associated with UVR did not strongly influence sun-related behaviours, whereas body image appeared as a key motivator. Attitudes towards sun protection and tanning stemmed from the media, peers and family, and particularly from childhood habits. Public health strategies may benefit from appearance-related skin cancer prevention campaigns, encouraging safer parental sun-related habits and correcting sun-related misconceptions.
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Affiliation(s)
- Lucy Kirk
- College of Medical and Dental Sciences, Birmingham, UK
| | - Sheila Greenfield
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
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23
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de Troya-Martín M, Padilla-España L, Férnandez-Morano T, Delgado-Sánchez N, Blázquez Sánchez N, Rivas-Ruiz F, Herrera-Ceballos E, de Gálvez-Aranda MV. Sun Protection Habits and Attitudes Among Healthcare Personnel in a Mediterranean Population. J Cancer Educ 2016; 31:789-795. [PMID: 26370806 DOI: 10.1007/s13187-015-0913-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Health professionals are key agents in healthcare promotion. In the field of skin cancer, they play a crucial role in the development of prevention strategies in the community. This paper aims to describe the sun exposure attitudes and habits of public healthcare professionals in the western Costa del Sol (Spain). A cross-sectional descriptive study was conducted in the Costa del Sol healthcare district to analyse sun exposure and protection practices and habits, and attitudes to tanning and sun protection. The respondents, all healthcare personnel in various professional categories and workplace situations, were asked to complete a self-administered questionnaire. Six hundred forty-three workers in the Costa del Sol healthcare district took part in the study. Of these participants, 450 were healthcare professionals. Of the 450 health professionals, 226 (50.2 %) were nurses or auxiliary nursing staff, and the remaining 224 were doctors. These two groups presented differences regarding habits of sun exposure: 15.3 % of the doctors went to the beach at least 30 days a year, compared to 30.9 % of the nurses (p < 0.001). With respect to workplace situation, there were differences (p < 0.001) between the sunburn events reported by healthcare staff who worked in hospitals (52.4 %) compared to those working in primary healthcare (30.4 %); comparable differences were found with respect to attitudes toward the use of sunscreen creams (p = 0.014). This study identifies two distinct subgroups within healthcare personnel: on one hand, primary healthcare professionals, who are key agents for future policy strategies, and on the other, specialist healthcare professionals, who are more likely to suffer sunburn events and therefore toward whom strategies should be addressed to encourage them to change their sun exposure attitudes and habits and sun protection practices.
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Affiliation(s)
| | - Laura Padilla-España
- Dermatology Department, Costa del Sol Hospital, Autovia A-7, km 187, 29603, Marbella, Spain.
| | | | - Nuria Delgado-Sánchez
- Distrito Sanitario Costa del Sol, Hospital Costa del Sol, Autovia A-7, km 187, 29603, Marbella, Spain
| | - Nuria Blázquez Sánchez
- Dermatology Department, Costa del Sol Hospital, Autovia A-7, km 187, 29603, Marbella, Spain
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Abstract
This study aimed (i) to determine whether people could be differentiated on the basis of their sun protection belief profiles and individual characteristics and (ii) explore the use of a crowdsourcing web service for the assessment of sun protection beliefs. A sample of 500 adults completed an online survey of sun protection belief items using Amazon Mechanical Turk. A two-phased cluster analysis (i.e., hierarchical and non-hierarchical K-means) was utilized to determine clusters of sun protection barriers and facilitators. Results yielded three distinct clusters of sun protection barriers and three distinct clusters of sun protection facilitators. Significant associations between gender, age, sun sensitivity, and cluster membership were identified. Results also showed an association between barrier and facilitator cluster membership. The results of this study provided a potential alternative approach to developing future sun protection promotion initiatives in the population. Findings add to our knowledge regarding individuals who support, oppose, or are ambivalent toward sun protection and inform intervention research by identifying distinct subtypes that may best benefit from (or have a higher need for) skin cancer prevention efforts.
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Affiliation(s)
- Marimer Santiago-Rivas
- Department of Oncological Sciences, Icahn School of Medicine at Mount Sinai, Medical Institute, 1425 Madison Ave, Suite 3-50, One Gustave L. Levy Place, Box 1130, New York, NY, 10029, USA.
| | - Julie B Schnur
- Department of Oncological Sciences, Icahn School of Medicine at Mount Sinai, Medical Institute, 1425 Madison Ave, Suite 3-50, One Gustave L. Levy Place, Box 1130, New York, NY, 10029, USA
| | - Lina Jandorf
- Department of Oncological Sciences, Icahn School of Medicine at Mount Sinai, Medical Institute, 1425 Madison Ave, Suite 3-50, One Gustave L. Levy Place, Box 1130, New York, NY, 10029, USA
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25
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Zdrojewicz Z, Stebnicki M, Stebnicki M. [Sosnowsky's hogweed - toxicology and threat to health]. Pol Merkur Lekarski 2016; 41:165-168. [PMID: 27755521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Sosnowsky's hogweed (Heracleum sosnowskyi Manden.) is a genus of plants in the family Apiaceae which also includes Giant Hogweed (Heracleum mantegazzianum Sommier and Levier). They are both found in Central Europe, mainly in neglected green areas or riversides. Sosnowsky's hogweed was brought to Poland from the Soviet Union in the 1950s to be used in animal feed production. Intended goals couldn't be achieved and the plant spread throughout grounds distant to the primarily cultivated lands. Sosnowsky's hogweed is especially hazardous in direct contact with human skin. It results from the content of photoallergic substances called furanocoumarins in its essential oil. Clinically it is presented as burns, mainly of 2nd and 3rd degree. They mostly occur on the face, upper and lower limbs. Typical symptoms include pain, redness, swelling and heat in the area of exposure. Their extent depends on burn's depth and area and also on time of exposure to plant's toxins. In this article we present Sosnowsky's hogweed's activity and its influence on human health.
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Affiliation(s)
- Zygmunt Zdrojewicz
- Medical University of Wrocław, Poland: Faculty of Postgraduate Medical Training, Department and Clinic of Endocrinology, Diabetology and Isotope Therapy
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26
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Chang WS, Lin EY, Hsu SW, Hu PS, Chuang CL, Liao CH, Fu CK, Su CH, Gong CL, Hsiao CL, Bau DAT, Tsai CW. Baicalin Scavenged Reactive Oxygen Species and Protected Human Keratinocytes Against UVB-induced Cytotoxicity. In Vivo 2016; 30:605-610. [PMID: 27566079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2016] [Accepted: 07/06/2016] [Indexed: 06/06/2023]
Abstract
Ultraviolet B (UVB), with a wavelength of 280-320 nm, represents one of the most important environmental factors for skin disorders, including sunburn, hyperpigmentation, solar keratosis, solar elastosis and skin cancer. Therefore, protection against excessive UVA-induced damage is useful for prevention of sunburn and other human diseases. Baicalin, a major component of traditional Chinese medicine Scutellaria baicalensis, has been reported to possess antioxidant and cytostatic capacities. In this study, we examined whether baicalin is also capable of protecting human keratinocytes from UVB irradiation. The results showed that baicalin effectively scavenged reactive oxygen species (ROS) elevated within 4 h after UVB radiation and reversed the UVB-suppressed cell viability and UVB-induced apoptosis after 24 h. Our results demonstrated the utility of baicalin to complement the contributions of traditional Chinese medicine in UVB-induced damage to skin and suggested their potential application as pharmaceutical agents in long-term sun-shining injury prevention.
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Affiliation(s)
- Wen-Shin Chang
- Graduate Institute of Clinical Medical Science, China Medical University, Taichung, Taiwan, R.O.C Terry Fox Cancer Research Laboratory, China Medical University Hospital, Taichung, Taiwan, R.O.C
| | - En-Yuan Lin
- Department of Neurosurgery, Taipei Medical University Hospital, Taipei, Taiwan, R.O.C
| | - Shih-Wei Hsu
- Graduate Institute of Clinical Medical Science, China Medical University, Taichung, Taiwan, R.O.C Taichung Armed Forces General Hospital, Taichung, Taiwan, R.O.C
| | - Pei-Shin Hu
- Department of Ophthalmology, Changhua Christian Hospital, Changhua, Taiwan, R.O.C
| | | | - Cheng-Hsi Liao
- Graduate Institute of Clinical Medical Science, China Medical University, Taichung, Taiwan, R.O.C Taichung Armed Forces General Hospital, Taichung, Taiwan, R.O.C
| | - Chun-Kai Fu
- Taichung Armed Forces General Hospital, Taichung, Taiwan, R.O.C
| | - Chung-Hao Su
- Terry Fox Cancer Research Laboratory, China Medical University Hospital, Taichung, Taiwan, R.O.C
| | - Chi-Li Gong
- Department of Physiology, China Medical University, Taichung, Taiwan, R.O.C
| | - Chieh-Lun Hsiao
- Graduate Institute of Clinical Medical Science, China Medical University, Taichung, Taiwan, R.O.C Terry Fox Cancer Research Laboratory, China Medical University Hospital, Taichung, Taiwan, R.O.C
| | - DA-Tian Bau
- Graduate Institute of Clinical Medical Science, China Medical University, Taichung, Taiwan, R.O.C Terry Fox Cancer Research Laboratory, China Medical University Hospital, Taichung, Taiwan, R.O.C Department of Bioinformatics and Medical Engineering, Asia University, Taichung, Taiwan, R.O.C.
| | - Chia-Wen Tsai
- Terry Fox Cancer Research Laboratory, China Medical University Hospital, Taichung, Taiwan, R.O.C Department of Medical Laboratory Science and Biotechnology, Central Taiwan University of Science and Technology, Taichung, Taiwan, R.O.C.
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Sachse MM, Böttcher S, Pape L, Wagner G, Mehls O, Klaus G, Laschewski G, Barz M, Jahn I, Zeeb H. Face-to-face Sun Protection Training and Text Messages Improve Sun Protection Behaviour in Adolescent Organ Transplant Recipients: HIPPOlino Feasibility Study. Acta Derm Venereol 2016; 96:341-5. [PMID: 26336924 DOI: 10.2340/00015555-2234] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Adolescent organ transplant recipients have an increased risk of developing skin cancer. The aim of this study was to evaluate the technical feasibility and acceptability of short messaging service-based sun protection recommendations for adolescent patients. Sun-protective knowledge and behaviour were also evaluated using standardized questionnaires and telephone interviews. Twenty-six organ transplant recipients aged 13-22 years participated in face-to-face sun protection training. Subsequently, participants received sun protection reminders via text messages for 4 weeks. Of the participants 95% reported that they checked text messages on a regular basis. Of the 26 organ transplant recipients 19 completed questionnaires before sun protection training and 4 weeks later; 16% (3/19) knew the meaning of the UV-index before training. After training, 74% (14/19) remembered that the term UV-index describes the maximum daily level of local UV radiation. Text message-based sun protection recommendations are well accepted and technically feasible in adolescent organ transplant recipients.
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Affiliation(s)
- Michael M Sachse
- Department of Dermatology, Allergology und Phlebology, Hospital Bremerhaven, Postbrookstr. 103, DE-27574 Bremerhaven, Germany.
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Doran CM, Ling R, Byrnes J, Crane M, Shakeshaft AP, Searles A, Perez D. Benefit Cost Analysis of Three Skin Cancer Public Education Mass-Media Campaigns Implemented in New South Wales, Australia. PLoS One 2016; 11:e0147665. [PMID: 26824695 PMCID: PMC4732951 DOI: 10.1371/journal.pone.0147665] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2015] [Accepted: 01/06/2016] [Indexed: 11/22/2022] Open
Abstract
Public education mass media campaigns are an important intervention for influencing behaviour modifications. However, evidence on the effectiveness of such campaigns to encourage the population to reduce sun exposure is limited. This study investigates the benefits and costs of three skin cancer campaigns implemented in New South Wales from 2006–2013. This analysis uses Australian dollars (AUD) and 2010–11 as the currency and base year, respectively. Historical data on skin cancer were used to project skin cancer rates for the period 2006–2020. The expected number of skin cancer cases is derived by combining skin cancer rates, sunburn rates and relative risk of skin cancers due to sun exposure. Counterfactual estimates are based on sunburn exposure in the absence of the campaigns. Monetary values are attached to direct (treatment) and indirect (productivity) costs saved due to fewer skin cancer cases. Monetary benefits are compared with the cost of implementing the campaigns and are presented in the form of a benefit-cost ratio. Relative to the counterfactual (i.e., no campaigns) there are an estimated 13,174 fewer skin cancers and 112 averted deaths over the period 2006–2013. The net present value of these benefits is $60.17 million and the campaign cost is $15.63 million. The benefit cost ratio is 3.85, suggesting that for every $1 invested a return of $3.85 is achieved. Skin cancer public education mass media campaigns are a good investment given the likely extent to which they reduce the morbidity, mortality and economic burden of skin cancer.
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Affiliation(s)
- Christopher M. Doran
- School of Human Health and Social Sciences, Central Queensland University, Brisbane, Queensland, Australia
- Hunter Medical Research Institute, University of Newcastle, Newcastle, New South Wales, Australia
- * E-mail:
| | - Rod Ling
- Hunter Medical Research Institute, University of Newcastle, Newcastle, New South Wales, Australia
| | - Joshua Byrnes
- Centre for Applied Health Economics, Griffith University, Brisbane, Queensland, Australia
| | - Melanie Crane
- Cancer Institute New South Wales, Sydney, New South Wales, Australia
- School of Public Health, University of Sydney, Sydney, New South Wales, Australia
| | - Anthony P. Shakeshaft
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
| | - Andrew Searles
- Hunter Medical Research Institute, University of Newcastle, Newcastle, New South Wales, Australia
| | - Donna Perez
- Cancer Institute New South Wales, Sydney, New South Wales, Australia
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Skonieczna J, Olejniczak D, Zakrzewska K, Duda-Zalewska A, Bodych A, Kitowska W, Cieślak I, Kielan A, Smoleńska E, Makaruk J, Lech-Wróblewska A, Jabłońska M, Fydryk D, Korczyńska M, Izdebski R, Zalewska M, Koczkodaj P, Gawińska E. Assessment of knowledge about the effects of UV radiation on health behaviors associated with sunbathing in gymnasium students. Przegl Epidemiol 2016; 70:65-145. [PMID: 27344477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
INTRODUCTION The health behaviors or health-related behaviors is behavior (or activity) that are part of everyday life, affecting the health of the individual. An example of the behavior of health is also sunbathing, or exposing the body to excessive solar radiation dosage. It may be positive and negative effects on health. AIM Evaluation of knowledge about gymnasium students. The impact of UV radiation on health and health behaviors associated with sunbathing. MATERIAL AND METHODS The study was a diagnostic survey, with author's questionnaire. The sample was comprised students from classes II and III. A total of 312 questionnaires were collected among 181 girls and 131 boys. Used purposeful sampling. Results were considered statistically significant at p < 0.05. RESULTS There is a statistically significant relationship between the stated sunbathing to get a sun tan, and sex of the respondent (p = 0.0002). Definitely more girls (77.35%) admit that tans in the sun to get a tan as compared to boys (58.02%). CONCLUSION It is recommended that further research aimed at checking the causes and incidence of sunburn among young people. Consideration should be given to create and implement the appropriate health programs taking about tanning that could be implemented under the School Health Promotion Program, or to supplement this knowledge on subjects such as Biology or Nature.
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Affiliation(s)
| | | | - Karolina Zakrzewska
- Medical University of Warsaw, Department of Epidemiology
- National Institute of Public Health - National Institute of Hygiene, Department of Virology
| | | | - Agnieszka Bodych
- Medical University of Warsaw, Students' Scientific Public Health Association, Health Promotion Section
| | - Wioleta Kitowska
- Medical University of Warsaw, Students' Scientific Public Health Association, Health Promotion Section
| | - Ilona Cieślak
- Medical University of Warsaw, Students' Scientific Public Health Association, Health Promotion Section
| | - Aleksandra Kielan
- Medical University of Warsaw, Students' Scientific Public Health Association, Health Promotion Section
| | - Elwira Smoleńska
- Medical University of Warsaw, Students' Scientific Public Health Association, Health Promotion Section
| | - Jolanta Makaruk
- Medical University of Warsaw, Students' Scientific Public Health Association, Health Promotion Section
| | | | - Magdalena Jabłońska
- Medical University of Warsaw, Students' Scientific Public Health Association, Health Promotion Section
| | - Diana Fydryk
- Medical University of Warsaw, Students' Scientific Public Health Association, Health Promotion Section
| | - Monika Korczyńska
- National Institute of Public Health - National Institute of Hygiene, Department of Epidemiology
| | - Radosław Izdebski
- National Institute of Public Health - National Institute of Hygiene, Department of Epidemiology
- Medical University of Warsaw,Department of Prevention of Environmental Hazards and Allergology
| | - Monika Zalewska
- Medical University of Warsaw, Students' Scientific Public Health Association, Health Promotion Section
| | - Paweł Koczkodaj
- Medical University of Warsaw, Students' Scientific Public Health Association, Health Promotion Section
| | - Emilia Gawińska
- Medical University of Warsaw, Department of Prevention of Environmental Hazards and Allergology
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Knight C. Here comes the sun. J Fam Health 2015; Suppl:10-12. [PMID: 26126390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
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Forbes PD, Davies RE. Quantity, quality and mode of UV administration as denominators of photocarcinogenesis. Curr Probl Dermatol 2015; 15:290-302. [PMID: 3948526 DOI: 10.1159/000412111] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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Cercato MC, Ramazzotti V, Sperduti I, Asensio-Pascual A, Ribes I, Guillén C, Nagore E. Sun protection among Spanish beachgoers: knowledge, attitude and behaviour. J Cancer Educ 2015; 30:4-11. [PMID: 24890922 DOI: 10.1007/s13187-014-0671-5] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
This study aims to investigate the level of awareness on the risks related to sun exposure, attitude towards sun protection and sun protection behaviour in Spanish beachgoers. During the summer of 2009, trained assistants conducted a structured interview with 630 sunbathers at the beaches of Valencia, Spain, via administrating a questionnaire including the following: (a) general data (age, gender, education, profession), (b) "knowledge" and "attitude" items and (c) self-assessed sun sensitivity, sun exposure and sun protection characteristics. The health belief model was used to evaluate factors that may influence on engaging healthy behaviour. The median age was 30 (2-82) years; the M/F ratio was 0.60. Despite the widespread regular ("often" or "always", 80%) use of high (>15) sun-protective factor sunscreens, current recommendations on sun protection were not regularly followed, and a history of sunburns is very common (70%). At multivariate analysis, female gender, age, fair hair, freckles, all-day use of sunscreens and wearing sunglasses were independent factors associated with having sunburn history. A high knowledge and a fairly good attitude emerged (median scores, 6/7 and 22/30, respectively). Age class (p = 0.032), educational level (p < 0.0001), sunscreen use (p = 0.048) and adequate timing of the first application of sunscreens (p = 0.015) were predictors of awareness, while factors associated with a more favourable attitude were educational level (p < 0.0001) and regular use of hats (p = 0.001). Wrong beliefs mainly concern sunscreens (false safety); the attractiveness of a tanned look is the main unfavourable attitude. Physical and motivational barriers are common (80%). The findings by highlighting constitutional and psychosocial factors involved in unhealthy behaviour provide useful information to promote sun-safe interventions in this population.
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Affiliation(s)
- M C Cercato
- Department of Epidemiology, "Regina Elena" National Cancer Institute, Via E. Chianesi 53, 00144, Rome, Italy,
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Viros A, Sanchez-Laorden B, Pedersen M, Furney SJ, Rae J, Hogan K, Ejiama S, Girotti MR, Cook M, Dhomen N, Marais R. Ultraviolet radiation accelerates BRAF-driven melanomagenesis by targeting TP53. Nature 2014; 511:478-482. [PMID: 24919155 PMCID: PMC4112218 DOI: 10.1038/nature13298] [Citation(s) in RCA: 156] [Impact Index Per Article: 15.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2013] [Accepted: 03/31/2014] [Indexed: 12/19/2022]
Abstract
Cutaneous melanoma is epidemiologically linked to ultraviolet radiation (UVR), but the molecular mechanisms by which UVR drives melanomagenesis remain unclear. The most common somatic mutation in melanoma is a V600E substitution in BRAF, which is an early event. To investigate how UVR accelerates oncogenic BRAF-driven melanomagenesis, we used a BRAF(V600E) mouse model. In mice expressing BRAF(V600E) in their melanocytes, a single dose of UVR that mimicked mild sunburn in humans induced clonal expansion of the melanocytes, and repeated doses of UVR increased melanoma burden. Here we show that sunscreen (UVA superior, UVB sun protection factor (SPF) 50) delayed the onset of UVR-driven melanoma, but only provided partial protection. The UVR-exposed tumours showed increased numbers of single nucleotide variants and we observed mutations (H39Y, S124F, R245C, R270C, C272G) in the Trp53 tumour suppressor in approximately 40% of cases. TP53 is an accepted UVR target in human non-melanoma skin cancer, but is not thought to have a major role in melanoma. However, we show that, in mice, mutant Trp53 accelerated BRAF(V600E)-driven melanomagenesis, and that TP53 mutations are linked to evidence of UVR-induced DNA damage in human melanoma. Thus, we provide mechanistic insight into epidemiological data linking UVR to acquired naevi in humans. Furthermore, we identify TP53/Trp53 as a UVR-target gene that cooperates with BRAF(V600E) to induce melanoma, providing molecular insight into how UVR accelerates melanomagenesis. Our study validates public health campaigns that promote sunscreen protection for individuals at risk of melanoma.
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Affiliation(s)
- Amaya Viros
- Molecular Oncology Group, Cancer Research UK Manchester Institute, The University of Manchester, Wilmslow Road, Manchester, M20 4BX, UK
| | - Berta Sanchez-Laorden
- Molecular Oncology Group, Cancer Research UK Manchester Institute, The University of Manchester, Wilmslow Road, Manchester, M20 4BX, UK
| | - Malin Pedersen
- Signal Transduction Team, The Institute of Cancer Research, 237 Fulham Road, London, SW3 6JB, UK
| | - Simon J. Furney
- Molecular Oncology Group, Cancer Research UK Manchester Institute, The University of Manchester, Wilmslow Road, Manchester, M20 4BX, UK
| | - Joel Rae
- Signal Transduction Team, The Institute of Cancer Research, 237 Fulham Road, London, SW3 6JB, UK
| | - Kate Hogan
- Molecular Oncology Group, Cancer Research UK Manchester Institute, The University of Manchester, Wilmslow Road, Manchester, M20 4BX, UK
| | - Sarah Ejiama
- Molecular Oncology Group, Cancer Research UK Manchester Institute, The University of Manchester, Wilmslow Road, Manchester, M20 4BX, UK
| | - Maria Romina Girotti
- Molecular Oncology Group, Cancer Research UK Manchester Institute, The University of Manchester, Wilmslow Road, Manchester, M20 4BX, UK
| | - Martin Cook
- Molecular Oncology Group, Cancer Research UK Manchester Institute, The University of Manchester, Wilmslow Road, Manchester, M20 4BX, UK
- Histopathology, Royal Surrey County Hospital, Egerton Road, Guildford, GU2 7XX UK
| | - Nathalie Dhomen
- Signal Transduction Team, The Institute of Cancer Research, 237 Fulham Road, London, SW3 6JB, UK
| | - Richard Marais
- Molecular Oncology Group, Cancer Research UK Manchester Institute, The University of Manchester, Wilmslow Road, Manchester, M20 4BX, UK
- Signal Transduction Team, The Institute of Cancer Research, 237 Fulham Road, London, SW3 6JB, UK
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Armed Forces Health Surveillance Center. Sunburn among active component service members, U.S. Armed Forces, 2002-2013. MSMR 2014; 21:2-6. [PMID: 25080329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Sunburn is caused by acute overexposure to ultraviolet (UV) radiation directly from the sun or from artificial UV sources. Service members are at risk of excessive exposure to sunlight due to the nature of their military duties, which often involve working and training outdoors, and deployment to environments where UV radiation is more intense. From January 2002 through December 2013, a total of 19,172 incident cases of clinically significant sunburn were diagnosed among active component service members. Most of the cases (80.2%) were first degree sunburn. The incidence rates of sunburn diagnoses were higher among females, white non-Hispanics, younger age groups, individuals in the Marine Corps or Army, and among enlisted service members. Additionally, the rate among recruits was more than 3.5 times the rate for non-recruits. Sixty-one percent of all diagnosed cases occurred from May through July. Sunburn cases occurred in all areas of the U.S., particularly near major recruit and combat training locations. Service members are strongly advised to practice sun safety as a part of heat illness prevention, including properly using broad-spectrum sunscreen, finding or constructing shade during work and rest, wearing protective clothing and military combat eye protection items, and avoiding tanning booths and sun lamps.
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Aigner B, Legat FJ, Schuster C, El Shabrawi-Caelen L. Sun-induced pustular dermatosis of the scalp - a new variant of erosive pustular dermatosis of the scalp? Acta Derm Venereol 2014; 94:457-8. [PMID: 24284942 DOI: 10.2340/00015555-1723] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Birgit Aigner
- Department of Dermatology and Venerology, Medical University of Graz, AT-8036 Graz, Austria
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Vilain R, Wilmott JS, Scolyer RA. A light shines on melanoma metastagenesis. Pigment Cell Melanoma Res 2014; 27:696-7. [PMID: 24890897 DOI: 10.1111/pcmr.12270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Falk M. Self-estimation or phototest measurement of skin UV sensitivity and its association with people's attitudes towards sun exposure. Anticancer Res 2014; 34:797-803. [PMID: 24511015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
BACKGROUND Fitzpatrick's classification is the most common way of assessing skin UV sensitivity. The study aim was to investigate how self-estimated and actual UV sensitivity, as measured by phototest, are associated with attitudes towards sunbathing and the propensity to increase sun protection, as well as the correlation between self-estimated and actual UV sensitivity. PATIENTS AND METHODS A total of 166 primary healthcare patients filled-out a questionnaire investigating attitudes towards sunbathing and the propensity to increase sun protection. They reported their skin type according to Fitzpatrick, and a UV sensitivity phototest was performed. RESULTS Self-rated low UV sensitivity (skin type III-VI) was associated with a more positive attitude towards sunbathing and a lower propensity to increase sun protection, compared to high UV sensitivity. The correlation between the two methods was weak. CONCLUSION The findings might indicate that individuals with a perceived low but in reality high UV sensitivity do not seek adequate sun protection with regard to skin cancer risk. Furthermore, the poor correlation between self-reported and actual UV sensitivity, measured by phototest, makes the clinical use of Fitzpatrick's classification questionable.
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Affiliation(s)
- Magnus Falk
- Department of Medical and Health Sciences, Division of Community Medicine, Primary Care, Linköping University, 581 85 Linköping, Sweden.
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Gałajda K, Kamińska-Winciorek G, Spiewak R. [Impact of the women's press on the attitudes of readers toward ultraviolet radiation--a survey of law and psychology students]. Pol Merkur Lekarski 2013; 35:100-103. [PMID: 24052990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
UNLABELLED Excessive exposure to ultraviolet radiation (UVA and UVB) leads to negative consequences including sunburn, carcinogenesis and photoaging. Therefore, educational campaigns promoting safe tanning and sunscreens are necessary. Helpful with this regard might be mass media including women's magazines, which for young people are important source of information on health, beauty and lifestyle. The aim of the study was to examine the influence of women's press in the attitude of non-medical students toward ultraviolet radiation (UV) as well as to analyse articles about tanning and skin protection against UV rays in selected magazines for women. MATERIAL AND METHODS The study group consisted of 68 psychology students and 60 law students (n = 128). An original author's questionnaire was used in this research, including 22 questions regarding frequency of reading articles about sunbathing, and the impact of women's press on the respondents' attitude toward suntanning. In the second part of the study 13 articles were examined from magazines "Twój Styl", "ELLE", "PANI" (years 2007-2011), which contained keywords "sun", "tanning bed", "tanning", "UV radiation". Selected articles were assessed whether they were encouraging to, or discouraging from sunbathing. RESULTS A majority (63%) of respondents declared that after reading the article in women's magazines, they began to apply a sunscreen with higher SPF rate than before. Moreover, 57% refrained from using tanbeds, and 48% began to regularly check melanocytic naevi and monitor their skin after sun exposures. The analysis of the articles showed that majority of articles discouraged from the sunbathing (11 articles discouraging versus and 2 encouraging). CONCLUSIONS Women's press in Poland generally promotes women's rational behavior against UV radiation and tanning.
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Affiliation(s)
- Karolina Gałajda
- Uniwersytet Jagielloński, Collegium Medicum, Wydział Farmaceutyczny, Koło Naukowe Kosmetologia Lecznicza i Estetologia przy Zakładzie Dermatologii Doświadczalnej i Kosmetologii, Katowice
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Calzavara-Pinton P, Sala R, Arisi MC, Bussoletti C, Celleno L. Photobiology, photodermatology and sunscreens: a comprehensive overview. Part 1: damage from acute and chronic solar exposure. GIORN ITAL DERMAT V 2013; 148:89-106. [PMID: 23407081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Sun exposure of the skin triggers several inflammatory pathways via a multitude of photochemical and photobiological effects. Furthermore, local and systemic immune suppression develops. The main clinical effects of UV exposure can be classified schematically into immediate, including sunburn, tanning, vitamin D production and exacerbation of inherited and acquired photosensitive skin disorders and long-term, including solar ageing and skin cancer. The protection against solar radiation is afforded by a healthy behavior of reasonable sun avoidance and the use of topical sunscreens as well as topical and oral antioxidants. However, users of sunscreen products should be able to choose correctly the more convenient product according to their needs. In Europe, the sun protection factor (SPF) and the UVA-protection factor (UVA-PF) are labeled to indicate the degree of protection against UVB and UVA, respectively. However, dermatologists must be aware that the present knowledge of UV effects on human skin needs to be clarified and several regulatory issues of photo-protection remain to be clarified and standardized. Finally, much work is needed to improve water resistance, spreadability, transparency and homogeneity of the sunscreen agents.
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Abstract
Ultraviolet (UV) radiation is known to cause both positive and negative health effects for humans. The synthesis of vitamin D is one of the rare beneficial effects of UV. The negative effects, such as sunburn and premature photoaging of the skin, increase the risk of skin cancer, which is the most detrimental health consequence of UV radiation. Although proteomics has been extensively applied in various areas of the biomedical field, this technique has not been commonly used in the cutaneous biology. Proteome maps of human keratinocytes and of murine skin have been established to characterize the cutaneous responses and the age-related differences. There are very few publications, in which proteomic techniques have been utilized in photobiology and hence there is no systematic research data available of the UV effects on the skin proteome. The proteomic studies have mainly focused on the UV-induced photoaging, which is the consequence of the long-term chronic UV exposure. Since the use of proteomics has been very narrow in the photobiology, there is room for new studies. Proteomics would offer a cost-effective way to large-scale screen the possible target molecules involved in the UV-derived photodamage, especially what the large-scale effects are after the acute and chronic exposure on the different skin cell populations.
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Affiliation(s)
- Riikka Pastila
- STUK - Radiation and Nuclear Safety Authority, 14, Helsinki, FI-00881, Finland.
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Parisi AV, Turnbull DJ, Downs N, Smith D. Dosimetric investigation of the solar erythemal UV radiation protection provided by beards and moustaches. Radiat Prot Dosimetry 2012; 150:278-282. [PMID: 22090417 DOI: 10.1093/rpd/ncr418] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
A dosimetric technique has been employed to establish the amount of erythemal ultraviolet radiation (UVR) protection provided by facial hair considering the influence of solar zenith angle (SZA) and beard-moustache length. The facial hair reduced the exposure ratios (ERs) to approximately one-third of those to the sites with no hair. The variation in the ERs over the different sites was reduced compared with the cases with no beard. The ultraviolet protection factor (UPF) provided by the facial hair ranged from 2 to 21. The UPF decreases with increasing SZA. The minimum UPF was in the 53-62° range. The longer hair provides a higher UPF at the smaller SZA, but the difference between the protection provided by the longer hair compared with the shorter hair reduces with increasing SZA. Protection from UVR is provided by the facial hair; however, it is not very high, particularly at the higher SZA.
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Affiliation(s)
- A V Parisi
- Faculty of Sciences, University of Southern Queensland, Toowoomba, Australia.
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Castanedo Cázares JP, Torres Álvarez B, Sobrevilla Ondarza S, Ehnis Pérez A, Gordillo Moscoso A. [Solar exposure time for sunburn in Mexican population]. GAC MED MEX 2012; 148:243-247. [PMID: 22820357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023] Open
Abstract
INTRODUCTION THe minimal erythemal dose (MED) quantifies an individual's sensitivity to UV radiation (UVR). To estimate it in our population and establish the time of exposure inducing it during daily activities would allow us to calculate risk intervals. METHODS From 2005-2012, the UV solar radiation was measured with terrestrial radiometry and compared to public UV index (UVI). We determined the MED in 90 individuals with the prevalent phototypes in Mexico (III, IV, V), and estimated the time needed for the development of sunburn. RESULTS The average MED for phototype III was 39 (IC 95%: 35-42) mJ/cm2, for IV 48 (IC 95%:42-53) mJ/cm2, and for V was 84 (IC 95%:75-92) mJ/cm2 (ANOVA, p ≤ 0.001). Approximately, 80% of the daily UVR was accumulated between 10:00-16:00 h, and 77% of the annual UV dose is received between March-October. The public UVI had a high correlation with the one quantified at terrestrial level (r = 0.89; p ≤ 0.001). CONCLUSIONS Mexico receives continuously high levels of UVR. Phototype III will present sunburn after 22-33 min in a summer day, while phototype V will require over one hour of exposure. This last group is at risk of chronic exposure without considering consequences.
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Affiliation(s)
- Juan Pablo Castanedo Cázares
- Departamento de Dermatología, Hospital Central Dr. Ignacio Morones Prieto, Universidad Autónoma de San Luis Potosí, SLP, México.
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Al Shaal L, Shegokar R, Müller RH. Production and characterization of antioxidant apigenin nanocrystals as a novel UV skin protective formulation. Int J Pharm 2011; 420:133-40. [PMID: 21871547 DOI: 10.1016/j.ijpharm.2011.08.018] [Citation(s) in RCA: 83] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2011] [Revised: 08/08/2011] [Accepted: 08/10/2011] [Indexed: 11/19/2022]
Abstract
Flavonoids have many positive effects on various cell layers of the skin (e.g. anti-oxidant, anti-allergic and anti-inflammatory effects). However, the limiting factor of the use of flavonoids is their low water solubility. To overcome the poor solubility, apigenin nanosuspensions were prepared using the combination technology (CT), i.e. bead milling and subsequently high pressure homogenization. Distinct reduction in particle size was observed after each bead milling passage resulting in z-average (PCS) of 413 nm and a polydispersity index of 0.202. The LD data showed a similar pattern of particle size reduction reaching a diameter 99% (d(v)99%) of 0.515 μm. The antioxidant capacity of apigenin nanocrystals were almost doubled compared to the original coarse suspension. The developed smartCrystals can be easily incorporated into gels, which makes apigenin nanocrystals available for dermal application as efficient antioxidant.
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Affiliation(s)
- Loaye Al Shaal
- Freie Universität Berlin, Institute of Pharmacy, Department of Pharmaceutics, Biopharmaceutics & NutriCosmetics, Kelchstr. 31, 12169 Berlin, Germany
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Fortes C, Mastroeni S, Boffetta P, Innocenzi L, Antonelli G, Giovinazzo R, Anzidei P, Melchi F, D' Atri S, Pasquini P, Venanzetti F. Polymorphisms of GSTM1 and GSTT1, sun exposure and the risk of melanoma: a case-control study. Acta Derm Venereol 2011; 91:284-9. [PMID: 21461548 DOI: 10.2340/00015555-1078] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Glutathione S-transferases (GSTs) are a family of enzymes that are known to play an important role in cellular protection against oxidative stress, including the oxidative stress caused by ultraviolet radiation. This study focused on the possible involvement of GSTM1 and GSTT1 polymorphisms in risk modulation of cutaneous melanoma. Within a case-control study, the presence of the null polymorphism at GSTM1 and GSTT1 was investigated in 188 cases of cutaneous melanoma and 152 controls. Information on socio-demographic characteristics, medical history, sun exposure and pigmentary characteristics were collected for all subjects. Logistic regression was used to estimate odds ratio (OR) and 95% confidence intervals (CI). An interaction was suggested between the GSTM1 and GSTT1 "null" genotype and episodes of sunburn in childhood OR of interaction (1.65, 95% CI (95% CI) 0.27-9.94). The risk of melanoma among the subset of participants who reported sunburns in childhood and who had both null variants, was nine (OR 9.16; 95% CI 1.18-70.9). The results suggest that subjects carrying both GSTM1 and GSTT1 null polymorphisms and experiencing sunburns in childhood have an extremely high risk of melanoma.
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Affiliation(s)
- Cristina Fortes
- Istituto Dermopatico dell'Immacolata, Clinical Epidemiology Unit, IDI-IRCCS, Rome, Italy.
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Song K, An SM, Kim M, Koh JS, Boo YC. Comparison of the antimelanogenic effects of p-coumaric acid and its methyl ester and their skin permeabilities. J Dermatol Sci 2011; 63:17-22. [PMID: 21530181 DOI: 10.1016/j.jdermsci.2011.03.012] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2010] [Revised: 03/30/2011] [Accepted: 03/30/2011] [Indexed: 11/19/2022]
Abstract
BACKGROUND p-Coumaric acid (PCA) inhibits human tyrosinase (TYR) activity and melanin synthesis in human epidermal melanocytes. OBJECTIVE The purpose of the current study was to examine the potential of PCA and its hydrophobic derivative, methyl p-coumarate (MPC), as hypopigmenting agents for topical use. METHODS PCA and MPC were comparatively tested against in vitro human TYR enzyme activity and cellular melanin synthesis in human epidermal melanocytes. Permeation studies were undertaken using an artificial lipophilic membrane and an excised porcine skin. In vivo hypopigmenting efficacy was assessed on the skin of melanin-possessing hairless mice exposed to UVB. RESULTS Although PCA was a stronger inhibitor than MPC against TYR activity in vitro, the former inhibited cellular melanin synthesis less effectively than the latter. A non-cell based permeability assay indicated that PCA was practically impermeable through the lipophilic barrier while MPC was highly permeable. In contrast, an ex vivo skin permeation study demonstrated that topically applied PCA in the form of a cream can diffuse into the aqueous medium underneath the skin. No MPC was released from a MPC cream but PCA was released instead as a bio-converted product. Topical application of PCA cream attenuated the UVB-induced erythema formation and pigmentation in mice models, more effectively compared with MPC cream. CONCLUSION PCA may be useful as an active ingredient for topical applications for a hypopigmenting effect. MPC has potential as a hypopigmenting agent but requires rather invasive methods for its delivery to the target cells.
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Affiliation(s)
- Kyosun Song
- Department of Molecular Medicine and Cell and Matrix Research Institute, BK21 Medical Education Program for Human Resources, Kyungpook National University School of Medicine, Daegu, Republic of Korea
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Ergul S, Ozeren E. Sun protection behavior and individual risk factors of Turkish Primary School Students associated with skin cancer: a questionnaire-based study. Asian Pac J Cancer Prev 2011; 12:765-770. [PMID: 21627380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023] Open
Abstract
AIM To determine the Turkish primary school students' sun protection behaviors and their individual risk factors associated with skin cancer. METHODS The sample of this descriptive study consisted of 6th-8th graders (11-14 age group) from a primary school in the western part of Turkey. A self-report questionnaire was administered. The response rate was 86.0 %. RESULTS The mean age of students was 12.8 years (SD =0.73). It was determined that the male students in the age group of 13-14 had more risks associated with skin cancer when compared to the female students in the same age group. In terms of the knowledge of the most dangerous hours of the sun and how to protect from their harmful effects, no significant difference was evident between females and males or across age groups. The average score of the students' frequency of use of sun protection methods is 3.40 ± 0.67 out of 5. The most frequent methods used for sun protection were found to be seeking shade during periods of peak ultraviolet radiation and wearing light-colored clothing. The average frequency score for sun-protective behavior of the 11-12 age group was significantly high (p < 0.05). CONCLUSION It was determined that the students did not practise sun protection behavior frequently enough.
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Affiliation(s)
- Safak Ergul
- Department of Public Health Nursing, School of Nursing, Ege University, Izmir, Turkey.
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Englander L, Friedman A. Iron overload and cutaneous disease: an emphasis on clinicopathological correlations. J Drugs Dermatol 2010; 9:719-722. [PMID: 20645540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
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Ilardi D. Extreme heat: a prevention guide to promote health and safety for all ages. School Nurse News 2010; 27:20-24. [PMID: 20476531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
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