Indicators to support local public health to reduce the impacts of heat on health.

Heat exposure presents a significant weather-related health risk in England and Wales, and is associated with acute impacts on mortality and adverse effects on a range of clinical conditions, as well as increased healthcare costs. Most heat-related health outcomes are preventable with health protection measures such as behavioural changes, individual cooling actions, and strategies implemented at the landscape level or related to improved urban infrastructure. We review current limitations in reporting systems and propose ten indicators to monitor changes in heat exposures, vulnerabilities, heat-health outcomes, and progress on adaptation actions. These indicators can primarily inform local area decision-making in managing risks across multiple sectors such as public health, adult and social care, housing, urban planning, and education. The indicators can be used alongside information on other vulnerabilities relevant for heat and health such as underlying morbidity or housing characteristics, to prioritise the most effective adaptation actions for those who need it the most.

Impact of High Solar UV Radiant Exposures in Spring 2020 on SARS-CoV-2 Viral Inactivation in the UK†.

Potential for SARS-CoV-2 viral inactivation by solar UV radiation in outdoor spaces in the UK has been assessed. Average erythema effective and UV-A daily radiant exposures per month were higher (statistically significant, P < 0.05) in spring 2020 in comparison with spring 2015-2019 across most of the UK, while irradiance generally appeared to be in the normal expected range of 2015-2019. It was found that these higher radiant exposures may have increased the potential for SARS-CoV-2 viral inactivation outdoors in April and May 2020. Assessment of the 6-year period 2015-2020 in the UK found that for 50-60% of the year, that is most of October to March, solar UV is unlikely to have a significant (at least 90% inactivation) impact on viral inactivation outdoors. Minimum times to reach 90% and 99% inactivation in the UK are of the order of tens of minutes and of the order of hours, respectively. However, these times are best case scenarios and should be treated with caution.

Ultraviolet radiation exposure during daylight Photodynamic Therapy.

BACKGROUND: Daylight photodynamic therapy (dPDT) is an effective treatment for field-change actinic keratoses (AK), with similar efficacy to conventional PDT but lower patient pain scores. Whilst AK occur consequent to chronic solar ultraviolet (UV) exposure, paradoxically solar visible radiation is used during PDT. OBJECTIVES: To investigate the nature and levels of UV exposure, both erythemal UV and UVA, occurring during dPDT. METHODS: Four years of solar erythemally effective UV (UVE) irradiance, UVA irradiance and illuminance data were obtained from Pubic Health England for 12 locations. For a standard 2 h treatment period, the data were converted into standard erythemal doses (SEDs), UVA dose and protoporphyrin-IX (PpIX)-weighted dose from UVE irradiance, UVA irradiance and illuminance respectively. These three parameters were compared ascertaining the UV exposure received during dPDT. RESULTS: Analysis of UV exposure during dPDT showed a UK maximum average UVE exposure of 8.2 SED at Camborne (PpIX dose 23.4 J cm-2). Treatment earlier in the day reduces average UV exposure (Camborne 5.2 SED, PpIX dose 18.2 J cm-2), whilst PpIX dose achieves threshold during winter months (Camborne, November, 0.8 SED, PpIX dose 7.1 J cm-2). Cyprus and Gibraltar (with high UV exposure during dPDT) experience a maximum of 14.3 SED and 12.9 SED, with respective PpIX doses of 36.1 J cm-2 and 35.1 J cm-2, in June. UVA exposure is also presented for comparison. CONCLUSION: Therapeutically effective dPDT doses can be achieved at times of the day and year when UV exposure is minimal.

Sunglass Filter Transmission and Its Operational Effect in Solar Protection for Civilian Pilots.

INTRODUCTION: The ocular effects of excess solar radiation exposure are well documented. Recent evidence suggests that ocular ultraviolet radiation (UVR) exposure to professional pilots may fall outside international guideline limits unless eye protection is used. Nonprescription sunglasses should be manufactured to meet either international or national standards. The mean increase in UVR and blue light hazards at altitude has been quantified and the aim of this research was to assess the effectiveness of typical pilot sunglasses in reducing UVR and blue light hazard exposure in flight. METHOD: A series of sunglass filter transmittance measurements were taken from personal sunglasses (N = 20) used by pilots together with a series of new sunglasses (N = 18). RESULTS: All nonprescription sunglasses measured conformed to international standards for UVR transmittance and offered sufficient UVR protection for pilots. There was no difference between right and left lenses or between new and used sunglasses. All sunglasses offered sufficient attenuation to counter the mean increase in blue light exposure that pilots experience at altitude, although used sunglasses with scratched lenses were marginally less effective. One pair of prescription sunglasses offered insufficient UVR attenuation for some flights, but would have met requirements of international and national standards for UV-A transmittance. This was likely due to insufficient UVR blocking properties of the lens material. CONCLUSIONS: Lenses manufactured to minimally comply with standards for UVR transmittance could result in excess UVR exposure to a pilot based on in-flight irradiance data; an additional requirement of less than 10% transmittance at 380 nm is recommended.

Occupational Ocular UV Exposure in Civilian Aircrew.

INTRODUCTION: Ultraviolet radiation (UVR) increases with altitude; however, there are a number of other factors which may influence ocular exposure during flight. The aim of this study was to assess ocular UVR exposure of pilots in airline and off-shore helicopter operations on different aircraft types and to compare with exposure in a typical office environment. METHOD: In-flight data were captured on equipment including a CCD array spectroradiometer on five return sector European airline flights and one transatlantic flight from London Gatwick in addition to four helicopter flights from Aberdeen Dyce airport. Further data were collected in an office environment from three workstations during summer and winter months. RESULTS: A wide variation in ocular UVA dose was found during flights. The main factor influencing exposure was the UVR transmission of the windshield, which fell into two distinct profile types. In an aircraft with good UVA blocking properties, ocular exposure was found to be equivalent to office exposure and did not exceed international guideline limits regardless of external conditions or flight time. Most aircraft assessed had poor UVA blocking windshields which resulted in an ocular exposure to the unprotected eye in excess of international guideline limits (up to between 4.5 to 6.5 times greater during one flight). No significant UVB dose was found. DISCUSSION: Pilots should be warned of the potential high UVA exposure during flight and advised on the use of sunglasses. A windshield labeling system would allow the pilot to tailor their eye protection practices to that particular aircraft.

Estimating Sun Exposure of Children in Day Care Nurseries in South Oxfordshire, UK.

Exposure to ultraviolet radiation and sunburn during childhood and adolescence is linked to increased risks of melanoma and basal cell carcinoma later in life. Infants and toddlers are thought to be unusually vulnerable to UVR because of lower levels of melanin, a thinner stratum corneum and a higher surface area/body mass ratio. The aim of this study was to assess variations in the available erythema effective radiant doses to young children in day care nurseries in South Oxfordshire, UK over 7 years between 2008 and 2014. The data were analyzed in three distinct seasons according to a series of realistic exposure scenarios taking into account nursery routines. The results indicate the time of year when high doses are to be expected and provide strong support for arguments in favor of raising public awareness of sun protection earlier in the year.

Measurements of pilots' occupational solar UV exposure.

It is known that ultraviolet radiation (UVR) increases by 10-12% every 1000 m altitude; UVR at the 10 000 m of typical cruise altitude for commercial aircraft may be 2-3 times higher than at ground level. Information on the levels of solar UV exposures is essential for the assessment of the occupational risk of pilots developing sun-related eye disorders and skin cancers. The aim of the study was to investigate how UV hazard exposures can be measured during flights so that the occupational dose can be ascertained and compared with international guidance. This article describes the development of instrumentation for automated time-stamped spectral measurements which were collected using bespoke automation software. The software enables the advanced acquisition techniques of automated dark signal capture and multiband integration control optimizing the dynamic performance of the spectrometer over the full spectral range. The equipment was successfully tested in a number of aircraft and helicopter flights during 2012-2013 and illustrated in this article on an example of a Gatwick-Alicante flight.