Sun exposure of indoor workers in the UK - survey on the time spent outdoors.

Assessment of ultraviolet (UV) exposure is essential for evaluation of the risks and benefits to optimise public health outcomes. The exposure depends on available environmental UV radiation and individual behaviour, and it can be obtained from dosimetry studies; however, the use of dosimeters is often not feasible for large population groups or over long periods of time. In this study, a lifestyle questionnaire has been used to obtain information on the time spent outdoors by indoor workers that could be used in combination with dosimetry studies in smaller targeted groups to quantify UV exposure for health risk/benefit analysis. 894 office and laboratory workers at the Public Health England, UK, responded to the survey. Questions addressed the time of day and the duration of time; staff were outdoors on weekdays, at weekends and during holidays. The majority of the responders spent negligible time outdoors on weekdays. Outdoor activities before and after work were constrained by the work pattern and commuting. The average time for those who go outdoors before and after commuting was 22.5 ± 16.2 min and 30.4 ± 21.4 min, respectively. Only 7% of participants regularly spent their lunch break outdoors for 21.5 ± 12.2 min and weekday exposure may contribute less than 13% of the daily available erythema dose. At the weekend, on average responders spend 5.0 ± 2.6 h outdoors over the two days: if taken around midday, it accounts for approximately 50% of available UV exposure. In winter months in the UK, November to March, the combination of very low environmental UV and low ambient temperatures results in negligible UV exposure. Holidays contributed to the majority of the annual UV exposure. In summer, 45% of responders went to destinations where the UV levels may be up to 2 times higher than in the UK; durations of overseas holidays are also longer than UK breaks. The UV dose from two weeks of holiday in extreme UV index level destinations could be comparable to a 1.5-2 summer months holiday in the UK. The survey data were validated with 6 months of dosimetry within the same cohort; very strong and strong correlation was found between the survey and measurements. This shows that a lifestyle survey can be used in combination with targeted dosimetry studies in small groups to obtain information about the time spent outdoors.

Long term variations in erythema effective solar UV at Chilton, UK, from 1991 to 2015.

In this paper erythema effective UV radiant exposure data from the PHE solar network Chilton site for the 25 year period from 1991 to 2015 are presented. The year with the highest average daily erythema effective radiant exposure was 2003 at 1577 J m-2 and the year with the lowest average daily radiant exposure was 2010 at 1149 J m-2. Overall, the average daily radiant exposure per year ranged from 5655 J m-2 to 9.98 J m-2 with the average being 1306 J m-2. A preliminary analysis of the data set is carried out. A statistically significant (p = 0.01) increase in annual radiant exposure of 4.4% per year was observed from 1991-1995. Thereafter a small decrease in annual erythema effective radiant exposure of 0.8% (p = 0.002) per year was observed from 1995-2015 with a slightly faster rate of decrease from 2000-2015 of 1.0% (p = 0.007) per year. In terms of seasonal analyses, a statistically significant increase in erythema effective UV radiant exposure of 5.1% (p = 0.02) per year in the summer during 1991-1995 has been found along with small decreases in spring and summer during 1995-2015 (-1.0%; p = 0.01 and -0.7%; p = 0.01 respectively) and 2000-2015 (-1.1%; p = 0.03 and -1.2%; p = 0.003 respectively). The data suggest that the erythema effective UV dose available for impacting public health has been decreasing in recent years.

Low-energy light bulbs, computers, tablets and the blue light hazard.

The introduction of low energy lighting and the widespread use of computer and mobile technologies have changed the exposure of human eyes to light. Occasional claims that the light sources with emissions containing blue light may cause eye damage raise concerns in the media. The aim of the study was to determine if it was appropriate to issue advice on the public health concerns. A number of sources were assessed and the exposure conditions were compared with international exposure limits, and the exposure likely to be received from staring at a blue sky. None of the sources assessed approached the exposure limits, even for extended viewing times.

'Toy' laser macular burns in children: 12-month update.

PURPOSE: There is increasing evidence that high-powered hand-held laser devices cause retinal injury. We present 12-month follow-up data for three patients that we previously reported with such retinal injuries. METHODS: A retrospective case series of three children with maculopathy secondary to exposure to high-power hand-held laser devices. All children underwent clinical examination and spectral domain optical coherence tomography (SD-OCT) at presentation and follow-up. Fundus-controlled microperimetry was also undertaken 12-19 months after exposure. RESULTS: Three children sustained macular injury after exposure to a high-powered hand-held laser. Acutely, they presented with a 'vitelliform-like' maculopathy with reduced vision. Over the course of follow-up, the best corrected Snellen acuity in all three patients improved to 'normal' levels (range 6/6-6/9). Long-term deficits in foveal retinal sensitivity were identified in two patients using fundus-controlled microperimetry. SD-OCT imaging showed persistent disruption of the foveal outer photoreceptor layers in all three children. CONCLUSION: Although visual acuity improved over time, deficits in microperimetry and SD-OCT persisted. All three children had retinal pigment epithelium changes, requiring follow-up for longer-term sequelae of laser injuries such as expansion of retinal atrophy and development of choroidal neovascular membranes.

Dose Estimation for a Study of Nuclear Workers in France, the United Kingdom and the United States of America: Methods for the International Nuclear Workers Study (INWORKS).

In the framework of the International Nuclear Workers Study conducted in France, the UK and the U.S. (INWORKS), updated and expanded methods were developed to convert recorded doses of ionizing radiation to estimates of organ doses or individual personal dose equivalent [H(p)(10)] for a total number of 308,297 workers, including 40,035 women. This approach accounts for differences in dosimeter response to predominant workplace energy and geometry of exposure and for the recently published ICRP report on dose coefficients for men and women separately. The overall mean annual individual personal dose equivalent, including zero doses, is 1.73 mSv [median = 0.42; interquartile range (IQR): 0.07, 1.59]. Associated individual organ doses were estimated. INWORKS includes workers who had potential for exposure to neutrons. Therefore, we analyzed neutron dosimetry data to identify workers potentially exposed to neutrons. We created a time-varying indicator for each worker, classifying them according to whether they had a positive recorded neutron dose and if so, whether their neutron dose ever exceeded 10% of their total external penetrating radiation dose. The number of workers flagged as being exposed to neutrons was 13% for the full cohort, with 15% of the cohort in France, 12% of the cohort in the UK and 14% in the U.S. We also used available information on in vivo and bioassay monitoring to identify workers with known depositions or suspected internal contaminations. As a result of this work, information is now available that will allow various types of sensitivity analyses.

[Risk of cerebrovascular disease incidence in the cohort of Mayak production association workers first employed during 1948-1958].

Incidence of cerebrovascular diseases (CVD) has been studied in a cohort of 12210 workers first employed at one of the main plants (reactors, radiochemical or plutonium) of the Mayak nuclear facility during 1948-1958 and followed up to the end of 2000. Information on external gamma doses is available for virtually all (99.9%) of these workers; the mean (+/- one standard deviation) total gamma dose was 0.91 +/- 0.95 Gy (99% percentile 3.9 Gy) for men and 0.65 +/- 0.75 Gy (99% percentile 2.99 Gy) for women. Plutonium body burden was measured only for 30.0% of workers. Amongst those monitored, the mean (+/- standard deviation) cumulative liver dose from plutonium alpha exposure was 0.40 +/- 1.15 Gy (99% percentile 5.88 Gy) for men and 0.81 +/- 4.60 Gy (99% percentile 15.95 Gy) for women 4418 cases (first diagnosis) of CVD were identified in the studied cohort. A statistically significant increasing trend in CVD incidence with total external gamma dose was revealed after adjustment for non-radiation factors and internal exposure from incorporated plutonium-239. Excess relative risk per Gy was 0.464 (95% confidence interval 0.360-0.567). Incidence of CVD was statistically significantly higher for the workers chronically exposed to external gamma rays at a dose above 1.0 Gy A statistically significant increasing trend in CVD incidence with internal liver dose from plutonium alpha exposure was observed after adjustment for non-radiation factors and external exposure. ERR per Gy was 0.155 (95% confidence interval 0.075-0.235). CVD incidence was statistically significantly higher among workers with a plutonium liver dose above 0.1 Gy, although the trend estimates differed between workers at different plants. The incidence risk estimates for external radiation are generally compatible with estimates from the study of Chernobyl clean-up workers, although the incidence data point to higher risk estimates compared to those from the Japanese A-bomb survivors.

[Mortality risk of cardiovascular diseases for occupationally exposed workers].

Results of the risk analysis of mortality from ischemic heart disease (IHD) in the cohort of Mayak nuclear workers (18763 individuals) first employed in 1948-1972, with follow-up to 31.12.2005, were summarized. The mortality risk of IHD in the cohort of Mayak workers depended on the non-radiation factors such as gender, age, calendar period, smoking, alcohol consumption, arterial hypertension, body mass index. There was no statistically significant relationship between mortality from 1HD and total external dose. The risk of mortality from IHD was significantly higher for workers exposed to the total absorbed dose to liver > 0.025 Gy from internal alpha-radiation. There was a significantly increasing trend (ERR/Gy) of the IHD mortality with the total absorbed dose to liver from internal alpha-radiation due to incorporated plutonium. However, there was a decreasing trend of ERR/Gy with restriction of the follow-up to Ozyorsk and adjustment for the external dose.

Safety of light emitting diodes in toys.

Light emitting diodes (LEDs) are increasingly being used in toys. An assessment methodology is described for determining the accessible emission limits for the optical radiation from the toys, which takes account of expected use and reasonably foreseeable misuse of toys. Where data are available, it may be possible to assess the toy from the data sheet alone. If this information is not available, a simple measurement protocol is proposed.

Occupational UVR skin protection by make-up.

New legislation has been introduced in the Member States of the European Union, covering worker exposure to artificial optical radiation. Use of make-up could reduce the ultraviolet hazard level and provide additional protection for skin against UV radiation (UVR). This is particularly important in entertainment and filming where intentional exposure of the actors and presenters to the very intense light sources may be required for extended periods of time. This document presents the assessment of UVR protection of make-up used in entertainment and demonstrates that the protection level varies considerably for different luminaires and application techniques. An important practical implication of this finding is that make-up alone cannot be considered as a reliable protection measure against skin exposure to actinic UV.

Assessment of personal exposures to optical radiation in large entertainment venues.

Workplace exposure to optical radiation from artificial sources is regulated in Europe under the Artificial Optical Radiation Directive 2006/25/EC implemented in the UK as The Control of Artificial Optical Radiation at Work Regulations 2010. The entertainment environment often presents an extremely complex situation for the assessment of occupational exposures. Multiple illumination sources, continuously changing illumination conditions and people moving during performances add further complexity to the assessment. This document proposes a methodology for assessing the risks arising from exposure to optical radiation and presents detailed case studies of practical assessment for two large entertainment venues.

Temporal variation of erythemally effective UVB/UVA ratio at Chilton, UK.

An analysis of the temporal variation in the erythemally weighted UVB/UVA irradiance ratio using spectral data collected from a monitoring site in Chilton, UK (51°N) for the 5-y period from 2004 to 2008 is presented. The variation in the diurnal ratio was found to be bell-shaped, with minima on average 1 h after sunrise and before sunset. The minima were found to be indicative of the point at which UVB becomes undetectable by the spectroradiometer and therefore the outer boundary of useful data. A potential flaw entailed in the erythemal weighting of low-level spectral UV data is described. The peak daily ratio value was found to have a bell-shaped distribution over the course of a year with a maximum in July rather than at the summer solstice-a result explained by the ozone cycle. The peak daily ratio was found to vary by a factor of 4 over the course of the year; this range of variation was also found to occur over a single day in the summer.

Cerebrovascular diseases in the cohort of workers first employed at Mayak PA in 1948-1958.

The incidence of and mortality from cerebrovascular diseases (CVD) have been studied in a cohort of 12,210 workers first employed at one of the main plants of the Mayak nuclear facility during 1948-1958 and followed up to 31 December 2000. Information on external γ-ray doses is available for virtually all of these workers (99.9%); the mean total γ-ray dose (± SD) was 0.91 ± 0.95 Gy (99th percentile 3.9 Gy) for men and 0.65 ± 0.75 Gy (99th percentile 2.99 Gy) for women. In contrast, plutonium body burden was measured only for 30.0% of workers; among those monitored, the mean cumulative liver dose from plutonium α-particle exposure (± SD) was 0.40 ± 1.15 Gy (99th percentile 5.88 Gy) for men and 0.81 ± 4.60 Gy (99th percentile 15.95 Gy) for women. A total of 4418 cases of CVD, including 665 cases of stroke, and 753 deaths from CVD, including 404 deaths from stroke, were identified in the study cohort. Having adjusted for non-radiation factors, there were statistically significant increasing trends in CVD incidence but not mortality with both total external γ-ray dose and internal liver dose. Much of the evidence for increased incidence in relation to external dose arose for workers with cumulative doses above 1 Gy. Although the dose response is consistent with linearity, the statistical power to detect non-linearity at external doses below 1 Gy was low. CVD incidence was statistically significantly higher among workers with a plutonium liver dose above 0.1 Gy. There was a statistically significant increasing trend in incidence with increasing internal dose, even after adjusting for external dose, although the trend estimates differed between workers at different plants. The risk estimates for external radiation are generally compatible with those from other large occupational studies, although the incidence data point to higher risk estimates compared to those from the Japanese A-bomb survivors.

Cardiovascular diseases in the cohort of workers first employed at Mayak PA in 1948-1958.

Incidence of and mortality from cardiovascular diseases have been studied in a cohort of 12,210 workers first employed at one of the main plants of the Mayak nuclear facility during 1948-1958 and followed up to 31 December 2000. Information on external gamma-ray doses is available for virtually all of these workers (99.9%); the mean total gamma-ray dose (+/-SD) was 0.91 +/- 0.95 Gy (99% percentile 3.9 Gy) for men and 0.65 +/- 0.75 Gy (99% percentile 2.99 Gy) for women. In contrast, plutonium body burden was measured for only 30.0% of workers; among those monitored, the mean cumulative liver dose from plutonium alpha exposure (+/- SD) was 0.40 +/- 1.15 Gy (99% percentile 5.88 Gy) for men and 0.81 +/- 4.60 Gy (99% percentile 15.95 Gy) for women. A total of 3751 cases of ischemic heart disease (IHD), including 683 cases of acute myocardial infarction (AMI), and 1495 IHD deaths, including 338 AMI deaths, were identified in the study cohort during the follow-up period. Having adjusted for non-radiation factors, there were statistically significant increasing trends with both total external gamma-ray dose and internal liver dose in IHD incidence. The trend with internal dose was weaker and was not statistically significant after adjusting for external dose, whereas the external dose trend was little changed after adjusting for internal dose. The trend with external dose in IHD mortality was not statistically significantly greater than zero but was consistent with the corresponding trend in IHD incidence. The estimated trend in IHD mortality with internal dose was lower and was not statistically significant once adjustment was made for external dose. There was a statistically significantly increasing trend in AMI incidence but not AMI incidence with external dose. The risk estimates for IHD in relation to external radiation are generally compatible with those from other large occupational studies and the Japanese A-bomb survivors.

Mortality and cancer incidence following occupational radiation exposure: third analysis of the National Registry for Radiation Workers.

Mortality and cancer incidence were studied in the National Registry for Radiation Workers in, relative to earlier analyses, an enlarged cohort of 174 541 persons, with longer follow-up (to 2001) and, for the first time, cancer registration data. SMRs for all causes and all malignant neoplasms were 81 and 84 respectively, demonstrating a 'healthy worker effect'. Within the cohort, mortality and incidence from both leukaemia excluding CLL and the grouping of all malignant neoplasms excluding leukaemia increased to a statistically significant extent with increasing radiation dose. Estimates of the trend in risk with dose were similar to those for the Japanese A-bomb survivors, with 90% confidence intervals that excluded both risks more than 2-3 times greater than the A-bomb values and no raised risk. Some evidence of an increasing trend with dose in mortality from all circulatory diseases may, at least partly, be due to confounding by smoking. This analysis provides the most precise estimates to date of mortality and cancer risks following occupational radiation exposure and strengthens the evidence for raised risks from these exposures. The cancer risk estimates are consistent with values used to set radiation protection standards.

Cancer in the offspring of female radiation workers: a record linkage study.

This study uses record linkage between the National Registry of Childhood Tumours (NRCT) and the National Registry for Radiation Workers to re-assess our earlier finding that the offspring of women radiation workers exposed to ionising radiation before the child's conception may be at an increased risk of childhood cancer. An additional 16,964 childhood cancer patients taken from the NRCT, together with the same number of matched controls, are included. Pooled analyses, based on the new and original datasets, include 52,612 cases and their matched controls. Relative risks (RRs) for maternal employment as a radiation worker, maternal exposure or not during the relevant pregnancy and pattern of employment relative to conception and diagnosis dates were calculated.The new data provide no evidence of an increased risk of childhood cancer associated with maternal preconception radiation work and thus do not support our earlier finding of a raised risk in the offspring of female radiation workers. Considering the pooled data, a weak association was found between maternal radiation work during pregnancy and childhood cancer in offspring although the evidence is limited by the small numbers of linked cases and controls.

Optical radiation emissions from compact fluorescent lamps.

There is a drive to energy efficiency to mitigate climate change. To meet this challenge, the UK Government has proposed phasing out incandescent lamps by the end of 2011 and replacing them with energy efficient fluorescent lighting, including compact fluorescent lamps (CFLs) with integrated ballasts. This paper presents a summary of an assessment conducted by the Health Protection Agency in March 2008 to evaluate the optical radiation emissions of CFLs currently available in the UK consumer market. The study concluded that the UV emissions from a significant percentage of the tested CFLs with single envelopes may result in foreseeable overexposure of the skin when these lamps are used in desk or task lighting applications. The optical output of all tested CFLs, in addition to high-frequency modulation, had a 100-Hz envelope with modulation in excess of 15%. This degree of modulation may be linked to a number of adverse effects.

Studies of occupational radiation exposure and health: experience from the UK National Registry for Radiation Workers.

Studies of persons exposed to radiation in the course of their work are directly relevant to the task of estimating the health risks of protracted radiation exposures. However, such investigations are not always easy to undertake, and not all studies are equally informative. Considerable care is required, therefore, in order to be able to draw reliable inferences from studies of radiation workers. This paper highlights some important aspects concerning the design, conduct and interpretation of such investigations, with reference to experience gained from a large long-term study of radiation workers in the United Kingdom (the National Registry for Radiation Workers, NRRW). Key findings from the NRRW are summarised, together with a brief description of a recent international study and of work in progress.

Assessment of sun protection for children's summer 2005 clothing collection.

Overexposure to solar ultraviolet radiation (UVR) in childhood is considered to be a critical factor for developing skin cancer in later life. Clothing may offer a simple and effective means of protection against overexposure to the sun, but its use has often been underrated in public opinion. The Health Protection Agency, in close collaboration with a number of UK retailers, conducted a study to evaluate the UVR protection characteristics of the summer 2005 collection of children's clothing for outdoor activity. The current paper presents a summary of the assessment and the effects of stretching and wetting on the Ultraviolet Protection Factor (UPF) rating of children's clothing. The results demonstrate the need for better public guidance in sun protection of children and more comprehensive evaluation procedures for sun protection provided by clothing.

Radiation and chemical degradation of UVR protection characteristics of fabrics.

Clothing can provide substantial protection against solar ultraviolet radiation (UVR) and quantifying the amount of protection can have useful applications to recreational, occupational and medical situations. However, exposure of fabrics to sunlight and sea water can alter their physical and chemical properties, resulting in a change of UVR attenuation characteristics. The objective of the current study was to evaluate the effects of environmental degradation of fabrics on their UVR protection characteristics. The methodologies applied in this study can be used also for the assessment of protective clothing against occupational exposure.

COX-1 and COX-2 expression in stage I and II invasive cervical carcinoma: relationship to disease relapse and long-term survival.

COX-1 and COX-2 are members of the cyclooxygenase (COX) family, which influence tumor invasion and apoptosis. The objective of the study was to assess the relationship between COX-1 and COX-2 expression in early-stage disease and subsequent disease relapse and long-term survival. Women with FIGO stage I and II cervical carcinoma, younger than 50 years, treated between 1981 and 1990 were included. COX-1 and COX-2 expressions in the tumors were assessed by immunohistochemistry. COX-1 and COX-2 were expressed in 61% (17/28) and 57% (16/28) of tumors, respectively. COX-1 nonexpressers showed an improved overall survival compared to expressers (log-rank test, P= 0.09). There was no significant difference in the overall survival in COX-2 nonexpressers compared to expressers (P= 0.6). Out of eight women with disease relapse, COX-1 or COX-2 expression was noted in six of eight tumors, and both were expressed in five of eight tumors. Our preliminary data suggest an adverse prognosis with COX-1 expression in early-stage cervical carcinoma and a trend toward COX-1 expression in disease relapse. The association between COX-2 expression and a worse prognosis was not proven in this study.