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A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Environmental Health".

Deadline for manuscript submissions: closed (29 June 2018) | Viewed by 43919

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Special Issue Editor

Prof. Dr. Ann Webb

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Guest Editor

Department of Earth and Environmental Sciences, University of Manchester, Oxford Rd, Manchester M13 9PL, UK
Interests: (solar) ultraviolet radiation; UV radiation effects; vitamin D; radiative transfer in the atmosphere; ozone; UV index; health risks; benefits

Special Issue Information

Dear Colleagues,

Solar ultraviolet radiation has been described as a complete carcinogen, and yet is a part of our natural environment, more so in some parts of the world than others. Many people will have experienced UV damage to their skin in the form of erythema (sunburn), while protection against UV radiation, and hence sunburn and skin cancer, has formed a strong public health message for several decades. The protective message gained additional traction in the late 20th century with concerns about depletion of the ozone layer that protects life on earth from damaging UV radiation. More recent concerns have identified a lack of exposure to UV radiation as a health risk, through loss of vitamin D status. It is widely accepted that skin synthesis after exposure to sunlight is a major source of vitamin D, although there also exists an oral route to maintaining vitamin D status, either from food (natural content or fortified), or via supplementation. Vitamin D is widely recognised as necessary for a healthy musculoskeletal system, but has also been linked to a wide range of other health benefits including immunomodulation and chemoprevention. At the same time, exposure to UV radiation has other effects upon the immune system. Both positive and negative effects of UV exposure can also be induced by artificial radiation (e.g., sunbeds) although these usually have a spectrum different to that of the sun, and optimised for tanning. The complexities associated with quantifying the various health responses associated with exposure to UV radiation leads to difficulties in formulating public health messages that are both simple and widely applicable.

This Special Issue on “UV Radiation and Health” invites submissions that help to elucidate one or more of the health outcomes associated with exposure to UV radiation, be that the natural solar source, or artificial UV radiation. Articles addressing both the underpinning science, and the translation of that knowledge into the public health arena, are welcome.

Prof. Dr. Ann Webb
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2500 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

Ultraviolet radiation
Skin cancer
Vitamin D
Erythema
Immune response
Sunlight
Public health

Published Papers (7 papers)

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Research

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11 pages, 1000 KiB

Open AccessArticle

Shedding Light on the Shade: How Nurseries Protect Their Children from Ultraviolet Radiation

by Cornelia Fiessler, Annette B. Pfahlberg, Wolfgang Uter and Olaf Gefeller

Int. J. Environ. Res. Public Health 2018, 15(9), 1793; https://doi.org/10.3390/ijerph15091793 - 21 Aug 2018

Cited by 8 | Viewed by 3414

Abstract

Minimizing exposure to ultraviolet radiation (UVR) is strongly recommended as the most important primary prevention measure regarding skin cancer. The responsibility for adequate sun protection of young children lies with their parents and external caregivers. Since a high proportion of 3- to 6-year-old children in Germany attend nurseries, the practice of sun protection in this setting was assessed. A survey was conducted in 246 nurseries in southern Germany during spring and summer of 2014 and 2015. Shade coverage in the outdoor area of the nursery was assessed by study team members and UVR protective behavior of staff was assessed by an interview with the directors. On average, 52% of the entire outdoor area and 65% of the children’s outdoor play area were covered by shade, with a significant difference between nurseries of different sizes, pointing to a better shade coverage in larger nurseries. The daily outdoor stay was not regularly scheduled before or after peak sun intensity hours around noon to avoid intense UVR exposure. General sun protection rules were present in the majority of the nurseries and addressed predominantly wearing sunhats and applying sunscreen. Our findings show that current sun protection recommendations for children are only partially met in nurseries and indicate a lower level of sun protection in small institutions. Especially, avoidance of excessive exposure to UVR around noon and the importance of shade provision over play structures needs to be emphasized in future information campaigns. Full article

(This article belongs to the Special Issue UV Radiation and Health)

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13 pages, 2327 KiB

Open AccessCommunication

On the Nature of Evidence and ‘Proving’ Causality: Smoking and Lung Cancer vs. Sun Exposure, Vitamin D and Multiple Sclerosis

by Robyn M. Lucas and Rachael M. Rodney Harris

Int. J. Environ. Res. Public Health 2018, 15(8), 1726; https://doi.org/10.3390/ijerph15081726 - 12 Aug 2018

Cited by 15 | Viewed by 7361

Abstract

If environmental exposures are shown to cause an adverse health outcome, reducing exposure should reduce the disease risk. Links between exposures and outcomes are typically based on ‘associations’ derived from observational studies, and causality may not be clear. Randomized controlled trials to ‘prove’ causality are often not feasible or ethical. Here the history of evidence that tobacco smoking causes lung cancer—from observational studies—is compared to that of low sun exposure and/or low vitamin D status as causal risk factors for the autoimmune disease, multiple sclerosis (MS). Evidence derives from in vitro and animal studies, as well as ecological, case-control and cohort studies, in order of increasing strength. For smoking and lung cancer, the associations are strong, consistent, and biologically plausible—the evidence is coherent or ‘in harmony’. For low sun exposure/vitamin D as risk factors for MS, the evidence is weaker, with smaller effect sizes, but coherent across a range of sources of evidence, and biologically plausible. The association is less direct—smoking is directly toxic and carcinogenic to the lung, but sun exposure/vitamin D modulate the immune system, which in turn may reduce the risk of immune attack on self-proteins in the central nervous system. Opinion about whether there is sufficient evidence to conclude that low sun exposure/vitamin D increase the risk of multiple sclerosis, is divided. General public health advice to receive sufficient sun exposure to avoid vitamin D deficiency (<50 nmol/L) should also ensure any benefits for multiple sclerosis, but must be tempered against the risk of skin cancers. Full article

(This article belongs to the Special Issue UV Radiation and Health)

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10 pages, 1567 KiB

Open AccessArticle

UV Monitoring for Public Health

by Mario Blumthaler

Int. J. Environ. Res. Public Health 2018, 15(8), 1723; https://doi.org/10.3390/ijerph15081723 - 11 Aug 2018

Cited by 35 | Viewed by 3854

Abstract

Overexposure to solar ultraviolet (UV) radiation is a risk for public health. Therefore, it is important to provide information to the public about the level of solar UV. The UV-Index (UVI) is the relevant quantity, expressing the erythemally weighted irradiance to a horizontal plane on a simple scale. As solar UV irradiance is strongly variable in time and space, measurements within a network provide the best source of information, provided they can be made available rapidly. However, to ensure the information is reliable, strict quality assurance/quality control (QA/QC) procedures for the monitoring networks are necessary. Near real time presentation of the measured UVI on web-pages is the best way to inform the public. The interpretation of the data in terms of the individual ‘allowable’ exposure time is heavily impacted by skin type, behavior, and clothing, and must be learned for each person through experience and guidance. Nonetheless, reliable knowledge of the actual level of the intensity of erythemally weighted irradiance and its variability forms the basis of education and public awareness. The challenges and requirements in providing comprehensive UVI data for public health guidance are here considered. Full article

(This article belongs to the Special Issue UV Radiation and Health)

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11 pages, 1973 KiB

Open AccessArticle

Is Sunlight Exposure Enough to Avoid Wintertime Vitamin D Deficiency in United Kingdom Population Groups?

by Richard Kift, Lesley E. Rhodes, Mark D. Farrar and Ann R. Webb

Int. J. Environ. Res. Public Health 2018, 15(8), 1624; https://doi.org/10.3390/ijerph15081624 - 01 Aug 2018

Cited by 26 | Viewed by 5774

Abstract

Solar ultraviolet radiation (UVR) is required for cutaneous vitamin D synthesis, and experimental studies have indicated the levels of sun exposure required to avoid a vitamin D deficient status. Our objectives are to examine the sun exposure behaviours of different United Kingdom sectors and to identify if their exposure is enough to maintain winter circulating 25-hydroxyvitamin D above deficiency (>25 nmol/L). Data are from a series of human studies involving >500 volunteers and performed using the same protocols in Greater Manchester, UK (53.5° N) in healthy white Caucasian adolescents and working-age adults (skin type I–IV), healthy South Asian working-age adults (skin type V), and adults with photodermatoses (skin conditions caused or aggravated by cutaneous sun exposure). Long-term monitoring of the spectral ambient UVR of the Manchester metropolitan area facilitates data interpretation. The healthy white populations are exposed to 3% ambient UVR, contrasting with ~1% in South Asians. South Asians and those with photodermatoses wear clothing exposing smaller skin surface area, and South Asians have the lowest oral vitamin D intake of all groups. Sun exposure levels prevent winter vitamin D deficiency in 95% of healthy white adults and 83% of adolescents, while 32% of the photodermatoses group and >90% of the healthy South Asians were deficient. The latter require increased oral vitamin D, whilst their sun exposure provides a tangible contribution and might convey other health benefits. Full article

(This article belongs to the Special Issue UV Radiation and Health)

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Review

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21 pages, 662 KiB

Open AccessReview

Ultraviolet Radiation Albedo and Reflectance in Review: The Influence to Ultraviolet Exposure in Occupational Settings

by Joanna Turner and Alfio V. Parisi

Int. J. Environ. Res. Public Health 2018, 15(7), 1507; https://doi.org/10.3390/ijerph15071507 - 17 Jul 2018

Cited by 21 | Viewed by 4719

Abstract

Ultraviolet (UV) albedo and UV reflectance are defined, compared and contrasted, to explain their roles and place in studies focusing on UV radiation and exposure measurements, in the context of localised albedo measurement and human UV exposure studies. This review recommends that the term UV albedo be used when investigating natural horizontal surfaces when the albedo is not known to change significantly over time. The term UV reflectance should be mostly used for non-natural surfaces and non-horizontal measurements and will change with respect to the geometry of the irradiances reflected and received, and due to the intrinsic nature of the surface itself. UV albedo measurements made in the literature have been compiled, in both broadband and spectral UV albedo measurements. Broadband measurements have been tabulated and spectral UV measurements have been displayed visually. The methodology of measurements is briefly discussed. Finally, studies that consider how high albedo or reflectance sites influence UV exposure are reviewed. It was concluded that there is currently no known relationship between the albedo or reflectance of a surface and the resulting influence it has on individual UV exposure. This presents an opportunity for researchers to continue exploring the influence of reflective UV surfaces. Full article

(This article belongs to the Special Issue UV Radiation and Health)

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Other

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5 pages, 238 KiB

Open AccessCommentary

Sun Exposure Public Health Directives

by David G. Hoel and Frank R. De Gruijl

Int. J. Environ. Res. Public Health 2018, 15(12), 2794; https://doi.org/10.3390/ijerph15122794 - 10 Dec 2018

Cited by 16 | Viewed by 12516

Abstract

There have been many public health recommendations for avoiding UV radiation exposures. This is primarily due to concerns about skin cancer and especially melanoma, the most serious type of skin cancer. However, UV radiation is also known as the primary source of vitamin D and other compounds needed for good health. This brief commentary lists several of the many important recent studies of adverse health effects associated with low sun exposure, including some specific cancers, multiple sclerosis, diabetes, cardiovascular disease, autism, Alzheimer’s disease, and age-related macular degeneration. Our conclusion is that non-burning UV exposure is a health benefit and—in moderation—should be recommended as such. Full article

(This article belongs to the Special Issue UV Radiation and Health)

16 pages, 5494 KiB

Open AccessFeature PaperCommentary

Time and Place as Modifiers of Personal UV Exposure

by Brian L. Diffey

Int. J. Environ. Res. Public Health 2018, 15(6), 1112; https://doi.org/10.3390/ijerph15061112 - 30 May 2018

Cited by 34 | Viewed by 5545

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. Full article

(This article belongs to the Special Issue UV Radiation and Health)

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