Sun exposure and 25-hydroxyvitamin D3 levels in a community sample: Quantifying the association with electronic dosimeters.

There is uncertainty about the amount of sun exposure required to increase low blood 25-hydroxyvitamin D (25(OH)D3) levels, a possible disease risk factor. The study aimed to quantify the association between sun exposure and serum 25(OH)D3 concentrations in a multiethnic community sample (n=502) living in Auckland (37°S) and Dunedin (46°S), New Zealand, aged 18-85 years. They wore electronic ultraviolet dosimeters between March and November (autumn, winter and spring) for 8 weeks to record their sun exposure. This was converted to standard erythemal doses (SEDs), corrected for clothing to generate equivalent full-body exposures, SEDEFB. Blood samples were collected at the end of weeks 4 and 8 to measure 25(OH)D3. Median weekly SEDEFB was 0.33 during weeks 1-4 and 0.34 during weeks 5-8. Weekly exposures <0.5 SEDEFB during weeks 5-8 were associated with decreasing 25(OH)D3 concentrations at the end of week 8. There was a non-linear association between sun exposure and 25(OH)D3, with most of the increase in 25(OH)D3 being at exposures <2 SEDEFB per week. This finding suggests that vitamin D status is increased by regular small sun exposures (<2 SEDEFB per week), and that greater exposures result in only small additional increases in 25(OH)D3.

Factors associated with photoprotection by body clothing coverage, particularly in non-summer months, among a New Zealand community sample.

Clothing coverage is important for reducing skin cancer risk, but may also influence vitamin D sufficiency, so associated plausible predictors require investigation. Volunteers (18 to 85 years), with approximately equal numbers by sex and four ethnicity groups, were recruited in cities from two latitude bands: Auckland (36.9°S) and Dunedin (45.9°S). Baseline questionnaire, anthropometric and spectrophotometer skin colour data were collected and weather data obtained. Percent body coverage was calculated from eight week diary records. Potential independent predictors (unadjusted p < 0.25) were included in adjusted models. Participants (n = 506: Auckland n = 334, Dunedin n = 172; mean age 48.4 years) were 62.7% female and had a median body clothing coverage of 81.6% (IQR 9.3%). Dunedin was cooler, less windy and had lower UVI levels than Auckland. From the fully adjusted model, increased coverage occurred in non-summer months (despite adjusting for weather), among Dunedin residents and Asians (compared to Europeans), during the middle of the day, with a dose response effect observed for greater age. Reduced coverage was associated with Pacific ethnicity and greater time spent outdoors. Additionally, higher temperatures were associated with reduced coverage, whereas increased cloud cover and wind speed were associated with increased coverage. Although the only potentially modifiable factors associated with clothing coverage were the time period and time spent outdoors, knowledge of these and other associated factors is useful for the framing and targeting of health promotion messages to potentially influence clothing coverage, facilitate erythema avoidance and maintain vitamin D sufficiency.

Proposal for a modification of the UVI risk scale.

The standardisation of UV information to the public through the UV Index (UVI) has been hugely beneficial since its endorsement by multiple international agencies more than 10 years ago. It has now gained widespread acceptance, and UVI values are available throughout the world from satellite instruments, ground-based measurements, and from forecasts based on model calculations. These have been useful for atmospheric scientists, health professionals (skin and eye specialists), and the general public. But the descriptors and health messages associated with the UVI scale are targeted towards European skin types and UV regimes, and are not directly applicable to the population living closer to the equator, especially for those in the high-altitude Altiplano region of South America. This document arose from discussions at the Latin American Society of Photobiology and Photomedicine's Congress, which was held in Arequipa, Peru, in November 2013. A major outcome of the meeting was the Arequipa Accord, which is intended as a unifying document to ensure co-ordination of UV and health research decisions in Latin America. A plank of that agreement was the need to tailor the UVI scale to make it more relevant to the region and its population. Here we make some suggestions to improve the international applicability of the UVI scale.

A critical assessment of two types of personal UV dosimeters.

Doses of erythemally weighted irradiances derived from polysulphone (PS) and electronic ultraviolet (EUV) dosimeters have been compared with measurements obtained using a reference spectroradiometer. PS dosimeters showed mean absolute deviations of 26% with a maximum deviation of 44%, the calibrated EUV dosimeters showed mean absolute deviations of 15% (maximum 33%) around noon during several test days in the northern hemisphere autumn. In the case of EUV dosimeters, measurements with various cut-off filters showed that part of the deviation from the CIE erythema action spectrum was due to a small, but significant sensitivity to visible radiation that varies between devices and which may be avoided by careful preselection. Usually the method of calibrating UV sensors by direct comparison to a reference instrument leads to reliable results. However, in some circumstances the quality of measurements made with simple sensors may be over-estimated. In the extreme case, a simple pyranometer can be used as a UV instrument, providing acceptable results for cloudless skies, but very poor results under cloudy conditions. It is concluded that while UV dosimeters are useful for their design purpose, namely to estimate personal UV exposures, they should not be regarded as an inexpensive replacement for meteorological grade instruments.

UV radiation: balancing risks and benefits.

We use action spectra published by the International Commission on Illumination to examine diurnal, seasonal and latitudinal variations in erythemally weighted (sunburning) UV-a health risk, and vitamin D-weighted UV-a health benefit. Vitamin D-weighted UV is more strongly dependent on ozone and solar zenith angle. Consequently, its diurnal, seasonal and geographic variability is more pronounced than for erythemally weighted UV. We then investigate relationships between the two quantities. An algorithm is developed and used to relate vitamin D production to the widely used UV index, to help the public to optimize their exposure to UV radiation. In the summer at noon, there should at mid-latitudes be sufficient UV to photosynthesize optimal vitamin D in approximately 1 min for full body exposure, whereas skin damage occurs after approximately 15 min. Further, while it should be possible to photosynthesize vitamin D in the winter at mid-latitudes, the amount of skin that must be exposed is larger than from the hands and face alone. This raises the question of whether the action spectrum for vitamin D production is correct, since studies have reported that production of vitamin D is not possible in the winter at mid-latitudes.