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UV-Radiation: From Physics to Impacts

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A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601).

Deadline for manuscript submissions: closed (31 August 2016) | Viewed by 93768

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Dr. Daniela Haluza

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Center for Public Health, Institute of Environmental Health, Medical University of Vienna, Kinderspitalgasse 15, A-1090 Vienna, Austria
Interests: telehealth; environmental health; open innovation in science; health communication; preventive medicine; public health
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Dr. Stana Simic

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Institute of Meteorology, University of Natural Resources and Life Sciences, Vienna, Peter-Jordan-Straße 82, Vienna A-1190, Austria
Interests: UV radiation; total ozone column meteorology; climatology

Dr. Hanns Moshammer

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Institute of Environmental Health, Center for Public Health, Medical University of Vienna, Kinderspitalgasse 15, A-1090 Vienna, Austria
Interests: environmental and occupational epidemiology; environmental health impact assessment
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Dear Colleagues,

Life on Earth evolved under the influence of UV-radiation, at least when living organisms left the oceans. Even within single species (including humans), local UV exposure shaped genotypes and phenotypes, especially regarding skin color. UV-radiation differs spatially and temporally both in overall intensity and in spectral composition. Biological effects are manifold ranging from acute to chronic and from adverse to beneficial. This complexity calls for a multi-disciplinary approach to a balanced appraisal of the topic.

We are therefore looking forward to your papers dealing with the broad range of topics including physical and meteorological fundamental studies, historical and anthropological considerations, the latest developments in UV research, as well as the interactions between UV radiation and global change, measurements, modeling and effects on ecosystems and living organisms, human health, behavioral aspects, and policy consequences.

Dr. Daniela Haluza
Dr. Stana Simic
Prof. Dr. Hanns Moshammer
Guest Editors

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Keywords

healthy lifestyle
behavioral change
health communication
health interventions
health education
illness prevention
health behaviors
quality of life
healthcare costs
health economics
public health policy

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Published Papers (12 papers)

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Editorial

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246 KiB

Open AccessEditorial

UV-Radiation: From Physics to Impacts

by Hanns Moshammer, Stana Simic and Daniela Haluza

Int. J. Environ. Res. Public Health 2017, 14(2), 200; https://doi.org/10.3390/ijerph14020200 - 17 Feb 2017

Cited by 5 | Viewed by 6110

Abstract

Ultraviolet (UV) radiation has affected life at least since the first life forms moved out of the seas and crawled onto the land. Therefore, one might assume that evolution has adapted to natural UV radiation. However, evolution is mostly concerned with the propagation of the genetic code, not with a long, happy, and fulfilling life. Because rickets is bad for a woman giving birth, the beneficial effects of UV-radiation outweigh the adverse effects like aged skin and skin tumors of various grades of malignancy that usually only afflict us at older age. Anthropogenic damage to the stratospheric ozone layer and frighteningly high rates of melanoma skin cancer in the light-skinned descendants of British settlers in Australia piqued interest in the health impacts of UV radiation. A changing cultural perception of the beauty of tanned versus light skin and commercial interests in selling UV-emitting devices such as tanning booths caught public health experts off-guard. Counseling and health communication are extremely difficult when dealing with a “natural” risk factor, especially when this risk factor cannot (and should not) be completely avoided. How much is too much for whom or for which skin type? How even measure “much”? Is it the (cumulative) dose or the dose rate that matters most? Or should we even construct a more complex metric such as the cumulative dose above a certain dose rate threshold? We find there are still many open questions, and we are glad that this special issue offered us the opportunity to present many interesting aspects of this important topic. Full article

(This article belongs to the Special Issue UV-Radiation: From Physics to Impacts)

Research

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2577 KiB

Open AccessArticle

Temporal Trends in Satellite-Derived Erythemal UVB and Implications for Ambient Sun Exposure Assessment

by Marvin Langston, Leslie Dennis, Charles Lynch, Denise Roe and Heidi Brown

Int. J. Environ. Res. Public Health 2017, 14(2), 176; https://doi.org/10.3390/ijerph14020176 - 10 Feb 2017

Cited by 11 | Viewed by 5863

Abstract

Ultraviolet radiation (UVR) has been associated with various health outcomes, including skin cancers, vitamin D insufficiency, and multiple sclerosis. Measurement of UVR has been difficult, traditionally relying on subject recall. We investigated trends in satellite-derived UVB from 1978 to 2014 within the continental United States (US) to inform UVR exposure assessment and determine the potential magnitude of misclassification bias created by ignoring these trends. Monthly UVB data remotely sensed from various NASA satellites were used to investigate changes over time in the United States using linear regression with a harmonic function. Linear regression models for local geographic areas were used to make inferences across the entire study area using a global field significance test. Temporal trends were investigated across all years and separately for each satellite type due to documented differences in UVB estimation. UVB increased from 1978 to 2014 in 48% of local tests. The largest UVB increase was found in Western Nevada (0.145 kJ/m2 per five-year increment), a total 30-year increase of 0.87 kJ/m2. This largest change only represented 17% of total ambient exposure for an average January and 2% of an average July in Western Nevada. The observed trends represent cumulative UVB changes of less than a month, which are not relevant when attempting to estimate human exposure. The observation of small trends should be interpreted with caution due to measurement of satellite parameter inputs (ozone and climatological factors) that may impact derived satellite UVR nearly 20% compared to ground level sources. If the observed trends hold, satellite-derived UVB data may reasonably estimate ambient UVB exposures even for outcomes with long latency phases that predate the satellite record. Full article

(This article belongs to the Special Issue UV-Radiation: From Physics to Impacts)

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1723 KiB

Open AccessArticle

A Case Study of Upper-Room UVGI in Densely-Occupied Elementary Classrooms by Real-Time Fluorescent Bioaerosol Measurements

by Chunxiao Su, Josephine Lau and Fang Yu

Int. J. Environ. Res. Public Health 2017, 14(1), 51; https://doi.org/10.3390/ijerph14010051 - 8 Jan 2017

Cited by 14 | Viewed by 5557

Abstract

Recently, the requirement to continuously collect bioaerosol samples using shorter response times has called for the use of real-time detection. The decreased cost of this technology makes it available for a wider application than military use, and makes it accessible to pharmaceutical and academic research. In this case study, real-time bioaerosol monitors (RBMs) were applied in elementary school classrooms—a densely occupied environment—along with upper-room ultraviolet germicidal irradiation (UVGI) devices. The classrooms were separated into a UVGI group and a non-UVGI control group. Fluorescent bioaerosol counts (FBCs) were monitored on 20 visiting days over a four-month period. The classroom with upper-room UVGI showed significantly lower concentrations of fine size (<3 μm) and total FBCs than the control classroom during 13 of the 20 visiting days. The results of the study indicate that the upper-room UVGI could be effective in reducing FBCs in the school environment, and RBMs may be applicable in reflecting the transient conditions of the classrooms due to the dynamic activity levels of the students and teachers. Full article

(This article belongs to the Special Issue UV-Radiation: From Physics to Impacts)

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290 KiB

Open AccessArticle

Protection from Ultraviolet Radiation during Childhood: The Parental Perspective in Bavaria

by Olaf Gefeller, Wolfgang Uter and Annette B. Pfahlberg

Int. J. Environ. Res. Public Health 2016, 13(10), 1011; https://doi.org/10.3390/ijerph13101011 - 14 Oct 2016

Cited by 21 | Viewed by 4757

Abstract

During childhood, parents play a vital role in sun protection of their children. Their guidance is essential for avoiding excessive exposure to ultraviolet (UV) radiation, a risk factor for developing skin cancer in later life. In a population-based cross-sectional study conducted between October 2011 and February 2012, we assessed how 3281 parents implemented sun protection for their three- to six-year-old children in practice. In particular, clothing, shade-seeking behavior, wearing of sunhats and sunglasses, use of sunscreens and the amount of time spent outdoors were ascertained in two settings (beach, garden/playground). The results showed that the overall level of parental sun protection for their children in the beach setting, and to a lesser extent also in the everyday outdoor setting, is relatively high. Using sunscreens with a high sun protection factor and instructing children to wear a sunhat were very common. Lesser attention was paid to sun-protective clothing, seeking the shade and wearing sunglasses. The amount of time spent outdoors during summer days was high. Therefore, the recommendation to completely avoid sun exposure during peak UV times around noon during summertime needs to be reinforced. In addition, the observed difference in the protective behavior between the beach and an everyday outdoor setting points to the necessity to encourage better sun protection for children also in outdoor activities of daily living. Full article

(This article belongs to the Special Issue UV-Radiation: From Physics to Impacts)

1753 KiB

Open AccessArticle

Is Multidirectional UV Exposure Responsible for Increasing Melanoma Prevalence with Altitude? A Hypothesis Based on Calculations with a 3D-Human Exposure Model

by Michael Schrempf, Daniela Haluza, Stana Simic, Stefan Riechelmann, Kathrin Graw and Gunther Seckmeyer

Int. J. Environ. Res. Public Health 2016, 13(10), 961; https://doi.org/10.3390/ijerph13100961 - 28 Sep 2016

Cited by 14 | Viewed by 5881

Abstract

In a recent study, melanoma incidence rates for Austrian inhabitants living at higher altitudes were found to increase by as much as 30% per 100 m altitude. This strong increase cannot simply be explained by the known increase of erythemally-weighted irradiance with altitude, which ranges between 0.5% and 4% per 100 m. We assume that the discrepancy is partially explainable by upwelling UV radiation; e.g., reflected by snow-covered surfaces. Therefore, we present an approach where the human UV exposure is derived by integrating incident radiation over the 3D geometry of a human body, which enables us to take upwelling radiation into account. Calculating upwelling and downwelling radiance with a radiative transfer model for a snow-free valley and for snow-covered mountain terrain (with albedo of 0.6) yields an increase in UV exposure by 10% per 100 m altitude. The results imply that upwelling radiation plays a significant role in the increase of melanoma incidence with altitude. Full article

(This article belongs to the Special Issue UV-Radiation: From Physics to Impacts)

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1233 KiB

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Time Effectiveness of Ultraviolet C Light (UVC) Emitted by Light Emitting Diodes (LEDs) in Reducing Stethoscope Contamination

by Gabriele Messina, Mattia Fattorini, Nicola Nante, Daniele Rosadini, Andrea Serafini, Marco Tani and Gabriele Cevenini

Int. J. Environ. Res. Public Health 2016, 13(10), 940; https://doi.org/10.3390/ijerph13100940 - 23 Sep 2016

Cited by 31 | Viewed by 8273

Abstract

Today it is well demonstrated that stethoscopes can be as contaminated as hands, which are a recognized source of Health-Care Associated Infections (HCAIs). Ultraviolet C (UVC) light has proven disinfection capacity and the innovative UVC technology of Light Emitting Diode (LED) shows several potential benefits. To verify whether the use of UVC LEDs is effective and reliable in stethoscope membrane disinfection after prolonged use, a pre-post intervention study was conducted. A total of 1668 five-minute cycles were performed on two UVC LEDs to simulate their use; thereafter, their disinfection capacity was tested on stethoscope membranes used on a previously auscultated volunteer. Then, a further 1249 cycles were run and finally the LEDs were tested to assess performance in reducing experimental contamination by Staphylococcus aureus, Pseudomonas aeruginosa and Escherichia coli on the stethoscope membrane. Baseline volunteer contamination identified 104 Colony Forming Units (CFUs) while treated Petri dishes had 12 and 15 CFUs (p < 0.001). Statistically significant differences (p < 0.001) were also found relating to the reduction of specific bacteria: in particular, after treatment no CFU were observed for S. aureus and E. coli. UVC LEDs demonstrated the capacity to maintain high levels of disinfection after more than 240 h of use and they were effective against common microorganisms that are causative agents of HCAIs. Full article

(This article belongs to the Special Issue UV-Radiation: From Physics to Impacts)

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292 KiB

Open AccessArticle

Sunbed Use Prevalence and Associated Skin Health Habits: Results of a Representative, Population-Based Survey among Austrian Residents

by Daniela Haluza, Stana Simic and Hanns Moshammer

Int. J. Environ. Res. Public Health 2016, 13(2), 231; https://doi.org/10.3390/ijerph13020231 - 19 Feb 2016

Cited by 16 | Viewed by 5224

Abstract

Recreational sunbed use accounts for the main non-solar source of exposure to ultraviolet radiation in fair-skinned Western populations. Indoor tanning is associated with increased risks for acute and chronic dermatological diseases. The current community-based study assessed the one-year prevalence of sunbed use and associated skin health habits among a representative, gender-balanced sample of 1500 Austrian citizens. Overall one-year prevalence of sunbed use was 8.9% (95% confidence interval (CI) 7.5%–10.4%), with slightly higher prevalence in females (9.2%, 95% CI 7.3%–11.2%) compared to males (8.6%, 95% CI 6.7%–10.6%). Factors predicting sunbed use were younger age (by trend decreasing with older age), place of living, smoking, skin type (by trend increasing with darker skin), sun exposure, motives to tan, and use of UV-free tanning products. Despite media campaigns on the harmful effects of excessive sunlight and sunbed exposure, we found a high prevalence of self-reported sunbed use among Austrian citizens. From a Public (Skin) Health perspective, the current research extends the understanding of prevailing leisure time skin health habits in adding data on prevalence of sunbed use in the general Austrian population. Full article

(This article belongs to the Special Issue UV-Radiation: From Physics to Impacts)

Review

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2458 KiB

Open AccessReview

25-Hydroxyvitamin D Status and Risk for Colorectal Cancer and Type 2 Diabetes Mellitus: A Systematic Review and Meta-Analysis of Epidemiological Studies

by Cem Ekmekcioglu, Daniela Haluza and Michael Kundi

Int. J. Environ. Res. Public Health 2017, 14(2), 127; https://doi.org/10.3390/ijerph14020127 - 28 Jan 2017

Cited by 71 | Viewed by 8897

Abstract

Epidemiological evidence suggests an association between low vitamin D status and risk for various outcomes including cardiovascular diseases, cancer, and type 2 diabetes mellitus (T2DM). Analyzing serum 25-hydroxyvitamin D [25(OH)D] is the most established means to evaluate an individual’s vitamin D status. However, cutoff values for 25(OH)D insufficiency as well as for optimal 25(OH)D levels are controversial. This systematic review critically summarizes the epidemiological evidence regarding 25(OH)D levels and the risk for colorectal cancer and T2DM. The meta-analytical calculation revealed a pooled relative risk (RR) of 0.62 (CI 0.56–0.70; I² = 14.7%) for colorectal cancer and an RR of 0.66 (CI 0.61–0.73; I² = 38.6%) for T2DM when comparing individuals with the highest category of 25(OH)D with those in the lowest. A dose–response analysis showed an inverse association between 25(OH)D levels and RR for both outcomes up to concentrations of about 55 ng/mL for colorectal cancer and about 65 ng/mL for T2DM. At still higher 25(OH)D levels the RR increases slightly, consistent with a U-shaped association. In conclusion, a higher 25(OH)D status is associated with a lower risk for colorectal cancer and T2DM; however, this advantage is gradually lost as levels increase beyond 50–60 ng/mL. Full article

(This article belongs to the Special Issue UV-Radiation: From Physics to Impacts)

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565 KiB

Open AccessReview

UV “Indices”—What Do They Indicate?

by Hanns Moshammer, Stana Simic and Daniela Haluza

Int. J. Environ. Res. Public Health 2016, 13(10), 1041; https://doi.org/10.3390/ijerph13101041 - 24 Oct 2016

Cited by 10 | Viewed by 5879

Abstract

Ultra-Violet (UV) radiation covers the spectrum of wavelengths from 100 to 400 nm. The potency and biological activity for a variety of endpoints differ by wavelength. For monitoring and communication purposes, different UV action spectra have been developed. These spectra use different weighting functions. The action spectrum for erythemal dose is the most widely used one. This erythemal dose per time or dose-rate has been further simplified into a “UV index”. Following this example, in our review we use the term “index” or (plural) “indices” in a more general description for all simplified single-value measures for any biologically effective UV dose, e.g., for human non-melanoma skin cancer and for previtamin D production rate. Ongoing discussion about the existence of an increased melanoma risk due to UV-A exposure underscores the uncertainties inherent in current weighting functions. Thus, we performed an online literature search to review the data basis for these indices, to understand their relevance for an individual, and to assess the applicability of the indices for a range of exposure scenarios. Even for natural (solar) UV, the spectral composition varies spatially and temporally. Artificial UV sources and personal protection introduce further variation to the spectral composition. Many biological effects are proposed for UV radiation. Only few endpoints have been studied sufficiently to estimate a reliable index. Weighting functions for chronic effects and most importantly for cancer endpoints have been developed in animal models, and often for proxy endpoints only. Epidemiological studies on biological effects of UV radiation should not only depend on single-value weighted UV dose estimates (indexes) but should strive for a more detailed description of the individual exposure. A better understanding of the adverse and beneficial effects of UV radiation by wavelength would also improve medical counseling and health communication regarding individual health-supportive behavior. Full article

(This article belongs to the Special Issue UV-Radiation: From Physics to Impacts)

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327 KiB

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Beneficial Effects of UV-Radiation: Vitamin D and beyond

by Christian Trummer, Marlene Pandis, Nicolas Verheyen, Martin R. Grübler, Martin Gaksch, Barbara Obermayer-Pietsch, Andreas Tomaschitz, Thomas R. Pieber, Stefan Pilz and Verena Schwetz

Int. J. Environ. Res. Public Health 2016, 13(10), 1028; https://doi.org/10.3390/ijerph13101028 - 19 Oct 2016

Cited by 16 | Viewed by 6529

Abstract

Aside from its well-known effects on bone and mineral metabolism, vitamin D may also play an important role in extra-skeletal processes like immunologic diseases, cancer, or cardiovascular diseases. Even though meta-analyses showed that vitamin D supplementation reduces fractures, falls, and overall mortality, its potential benefits did not find universal acclaim. Several health care authorities published Recommended Dietary Allowances (RDAs) for vitamin D, most of them ranging from 600 to 800 international units (IU) per day, corresponding to a serum level of 25-hydroxyvitamin D of at least 20 ng/mL (50 nmol/L). However, studies conducted in the general population revealed a much lower overall intake of vitamin D than the proposed RDAs. Thus, strategies to increase the vitamin D intake in the general population, e.g., food fortification or vitamin D supplementation, are needed to match the existing evidence and recommendations. Therefore, several currently ongoing projects aim to investigate the effect of vitamin D supplementation in the general population and try to establish food-based solutions to improve vitamin D status. Full article

(This article belongs to the Special Issue UV-Radiation: From Physics to Impacts)

934 KiB

Open AccessReview

Vitamin D Status and Its Consequences for Health in South Africa

by Mary Norval, Anna K. Coussens, Robert J. Wilkinson, Liza Bornman, Robyn M. Lucas and Caradee Y. Wright

Int. J. Environ. Res. Public Health 2016, 13(10), 1019; https://doi.org/10.3390/ijerph13101019 - 18 Oct 2016

Cited by 24 | Viewed by 6640

Abstract

In this review, reports were retrieved in which vitamin D status, as assessed by serum 25-hydroxyvitamin D [25(OH)D] levels, was measured in South African population groups with varied skin colours and ethnicities. Healthy children and adults were generally vitamin D-sufficient [25(OH)D level >50 nmol/L] but the majority of those aged above 65 years were deficient. A major role for exposure to solar ultraviolet radiation (UVR) in determining 25(OH)D levels was apparent, with the dietary contribution being minor. Limited data exist regarding the impact of recent changes in lifestyles on vitamin D status, such as urbanisation. With regard to disease susceptibility, 11 of 22 relevant publications indicated association between low 25(OH)D levels and disease, with deficiency most notably found in individuals with tuberculosis and HIV-1. Information on the relationship between vitamin D receptor variants and ethnicity, disease or treatment response in the South African population groups demonstrated complex interactions between genetics, epigenetics and the environment. Whether vitamin D plays an important role in protection against the range of diseases that currently constitute a large burden on the health services in South Africa requires further investigation. Only then can accurate advice be given about personal sun exposure or dietary vitamin D supplementation. Full article

(This article belongs to the Special Issue UV-Radiation: From Physics to Impacts)

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2328 KiB

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Sun Exposure and Its Effects on Human Health: Mechanisms through Which Sun Exposure Could Reduce the Risk of Developing Obesity and Cardiometabolic Dysfunction

by Naomi Fleury, Sian Geldenhuys and Shelley Gorman

Int. J. Environ. Res. Public Health 2016, 13(10), 999; https://doi.org/10.3390/ijerph13100999 - 11 Oct 2016

Cited by 33 | Viewed by 20431

Abstract

Obesity is a significant burden on global healthcare due to its high prevalence and associations with chronic health conditions. In our animal studies, ongoing exposure to low dose ultraviolet radiation (UVR, found in sunlight) reduced weight gain and the development of signs of cardiometabolic dysfunction in mice fed a high fat diet. These observations suggest that regular exposure to safe levels of sunlight could be an effective means of reducing the burden of obesity. However, there is limited knowledge around the nature of associations between sun exposure and the development of obesity and cardiometabolic dysfunction, and we do not know if sun exposure (independent of outdoor activity) affects the metabolic processes that determine obesity in humans. In addition, excessive sun exposure has strong associations with a number of negative health consequences such as skin cancer. This means it is very important to “get the balance right” to ensure that we receive benefits without increasing harm. In this review, we detail the evidence around the cardiometabolic protective effects of UVR and suggest mechanistic pathways through which UVR could be beneficial. Full article

(This article belongs to the Special Issue UV-Radiation: From Physics to Impacts)

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