Short-term UV exposure of sunbathers at a Mediterranean Sea site.

The aim of this study was to investigate whether systematic differences in solar UV exposure on a specific anatomical site (chest) exist among three groups of Italian sunbathers: healthy subjects (suntanned and non-suntanned individuals) and subjects affected by abnormally high sensitivity to solar exposure. A second aim of the study was to search for a possible relation among biological markers of individual response to UV exposure (such as skin colorimetric parameters, skin temperature and changes in free radical amounts [FR] in the blood) and photosensitivity. FR in the blood were analyzed because of their possible influence on UV carcinogenesis. Measurements of ambient doses (i.e. incident erythemally weighted irradiance on a horizontal surface over a specified period of time) and erythemally effective UV dose received by an anatomical site (here called personal dose or exposure on a specific anatomical site) were investigated. Personal doses received by the chest were determined using polysulfone dosimetry. Exposure Ratio (ER), defined as the ratio between the personal dose and the corresponding ambient dose during the same exposure period, was then calculated. Measuring of skin color in the Commission Internationale de l'Eclairage L (luminance), a (redness), b (yellowness) system and skin temperature were also carried out on the inner upper arm (nonexposed skin site) and on the chest. It was found that the median value of ER was 0.20 (min: 0.09 and max: 0.34) for suntanned individuals, it was 0.17 (min: 0.13 and max: 0.42) for non-suntanned individuals and it was 0.19 (min: 0.14 and max: 0.34) for photosensitive individuals. There were no significant differences across the groups in their median ER scores. In addition, the statistical analysis showed that L on the exposed site before exposure demonstrated consistently higher median scores after exposure in all groups. The b value after exposure was significantly lower than before exposure in all participants, while no significant differences for a were observed before or after exposure between or within the groups. Our findings suggest that photodermatoses are not significantly related to ER and to the changes in biological markers due to too short-term UV exposure.

HIV diagnoses in migrant populations in Australia-A changing epidemiology.

INTRODUCTION: We conducted a detailed analysis of trends in new HIV diagnoses in Australia by country of birth, to understand any changes in epidemiology, relationship to migration patterns and implications for public health programs. METHODS: Poisson regression analyses were performed, comparing the age-standardised HIV diagnosis rates per 100,000 estimated resident population between 2006-2010 and 2011-2015 by region of birth, with stratification by exposure (male-to-male sex, heterosexual sex-males and females). Correlation between the number of permanent and long-term arrivals was also explored using linear regression models. RESULTS: Between 2006 and 2015, there were 6,741 new HIV diagnoses attributed to male-to-male sex and 2,093 attributed to heterosexual sex, with the proportion of diagnoses attributed to male-to-male sex who were Australian-born decreasing from 72.5% to 66.5%. Compared with 2006-2010, the average annual HIV diagnosis rate per 100,000 in 2011-15 attributed to male-to-male sex was significantly higher in men born in South-East Asia (summary rate ratio (SRR) = 1.37, p = 0.001), North-East Asia (SRR = 2.18, p<0.001) and the Americas (SRR = 1.37, p = 0.025), but significantly lower as a result of heterosexual sex in men born in South-East Asia (SRR = 0.49, p = 0.002), Southern and Central Asia (SRR = 0.50, p = 0.014) and Sub-Saharan Africa (SRR = 0.39, p<0.001) and women born in South-East Asia (SRR = 0.61, p = 0.002) and Sub-Saharan Africa (SRR = 0.61, p<0.001). Positive associations were observed between the number of permanent and long-term arrivals and HIV diagnoses particularly in relation to diagnoses associated with male-to-male sex in men from North Africa and the Middle East, North Asia, Southern and Central Asia and the Americas. CONCLUSION: The epidemiology of HIV in Australia is changing, with an increase in HIV diagnosis rates attributed to male-to-male sex amongst men born in Asia and the Americas. Tailored strategies must be developed to increase access to, and uptake of, prevention, testing and treatment in this group.

Does a high UV environment ensure adequate vitamin D status?

This study assesses the Vitamin D status of 126 healthy free-living adults aged 18-87 years, in southeast Queensland, Australia (27 degrees S) at the end of the 2006 winter. Participants provided blood samples for analysis of 25(OH)D (the measure of an individual's Vitamin D status), PTH, Calcium, Phosphate, and Albumin, completed a questionnaire on sun-protective/sun-exposure behaviours, and were assessed for phenotypic characteristics such as skin/hair/eye colour and BMI. We found that 10.2% of the participants had serum 25(OH)D levels below 25 nmol/l (considered deficient) and a further 32.3% had levels between 25 nmol/l and 50 nmol/l (considered insufficient). Our results show that low levels of 25(OH)D can occur in a substantial proportion of the population at the end of winter, even in a sunny climate. 25(OH)D levels were higher amongst those who spent more time in the sun and lower among obese participants (BMI>30) than those who were not obese (BMI<30). 25(OH)D levels were also lower in participants who had black hair, dark/olive skin, or brown eyes, when compared with participants who had brown or fair hair, fair skin, or blue/green eyes. No associations were found between 25(OH)D status and age, gender, smoking status, or the use of sunscreen.

Symptom prevalence and clustering of symptoms in people living with chronic hepatitis C infection.

Quality of life has been shown to be poor among people living with chronic hepatitis C. However, it is not clear how this relates to the presence of symptoms and their severity. The aim of this study was to describe the typology of a broad array of symptoms that were attributed to hepatitis C virus (HCV) infection. Phase 1 used qualitative methods to identify symptoms. In Phase 2, 188 treatment-naïve people living with HCV participated in a quantitative survey. The most prevalent symptom was physical tiredness (86%) followed by irritability (75%), depression (70%), mental tiredness (70%), and abdominal pain (68%). Temporal clustering of symptoms was reported in 62% of participants. Principal components analysis identified four symptom clusters: neuropsychiatric (mental tiredness, poor concentration, forgetfulness, depression, irritability, physical tiredness, and sleep problems); gastrointestinal (day sweats, nausea, food intolerance, night sweats, abdominal pain, poor appetite, and diarrhea); algesic (joint pain, muscle pain, and general body pain); and dysesthetic (noise sensitivity, light sensitivity, skin problems, and headaches). These data demonstrate that symptoms are prevalent in treatment-naïve people with HCV and support the hypothesis that symptom clustering occurs.

Epidemiology of gonorrhoea notifications in Australia, 2007-12.

UNLABELLED: Background An increase in the notification rate of gonorrhoea was observed in the national surveillance system. In Australia, gonorrhoea is relatively rare, apart from among some populations of Aboriginal people and men who have sex with men. METHODS: Data about gonorrhoea cases reported between 2007 and 2012 from all Australian jurisdictions were extracted from the National Notifiable Diseases Surveillance System. Analyses were undertaken of the time trends in counts and rates, according to jurisdiction, gender, Aboriginal and Torres Strait Islander status, diagnosis method and sexual orientation. RESULTS: The largest increase in notifications between 2007 and 2012 was observed in both men and women in New South Wales (2.9- and 3.7-fold greater in 2012 than 2007, respectively) and Victoria (2.4- and 2.7-fold greater in 2012 than 2007, respectively), men in the Australian Capital Territory and women in Queensland. The highest notification rates remained in Indigenous people in the Northern Territory and Western Australia, and particularly in women, although rates may have decreased over the study period. Changes in age and sex distribution, antimicrobial resistance and patterns of exposure and acquisition were negligible. CONCLUSIONS: There is an ongoing gonorrhoea epidemic affecting Aboriginal and Torres Strait Islander people in Australia, but the increases in notifications have occurred primarily in non-Aboriginal populations in the larger jurisdictions. Interpretation of these surveillance data, especially in relation to changes in population subgroups, would be enhanced by laboratory testing data. Further efforts are needed to decrease infection rates in populations at highest risk.

Occupational exposures to solar ultraviolet radiation of vineyard workers in Tuscany (Italy).

A study to quantify the UV exposure of vineyard workers was carried out using polysulphone dosimetry. The study took place in Tuscany (Italy) involving 32 vineyard workers, covering three different stages of the vine's growth. The level of personal exposure expressed as a function on the available ambient UV radiation was determined. We also assessed skin reflectance parameters, pre and post exposure. It was found that during spring backs received between 53% and 87% of ambient exposure and arms between 30% and 60%. During summer, the workers received on the back between 36% and 77% of ambient exposure and between 19% and 43% of ambient exposure on the arm. The comparison with the occupational UV exposure limit showed that all subjects received UV exposures in excess of the limit. The exposure of back of neck exceeded 10 SED (assumed as a threshold level of sun-adapted skin for Mediterranean subjects) in spring, which means that in the case of non sun-adapted skin and without sun protection, erythema can be induced in this targeted population. The cumulative exposure was also estimated under specific assumptions of UV exposure giving values in some cases higher than previous studies.