Sun and Safe

The Sun: The Good & the Bad BENEFITS: Heat Light Photosynthesis Outdoor environment for physical activity Production of vitamin D Happy and positive feelings HARMS: Suntan Sunburn Premature aging Freckles Liver spots Wrinkles Loss of elasticity Cataracts Suppression of immune system Actinic keratosis Skin cancer

Know Your Personal Risk Outdoor workers receive up to 8 times more UV than indoor workers and have a 60% greater risk of developing skin cancer. STRATEGY 1:

Personal Risk Equation Your risk of getting harmed from sun exposure is the sum of 3 components: Who You Are ( GENETICS) Where You Live ( ENVIRONMENT ) What You Do ( BEHAVIOR ) PERSONAL RISK FACTOR for sun damage

Personal Risk Factors GREATER RISK! GENETICS Lighter skin, hair and eyes Family history of skin cancer ENVIRONMENT High Altitude Low Latitude Sunny Climate Ground Reflection BEHAVIOR Unprotected time outdoors Especially in midday peak sun intensity hours

What’s Your Skin Type? I Always burns, never tans, sensitive to sun exposure II Burns easily, tans minimally III Burns moderately, tans gradually to light brown IV Burns minimally, always tans well to moderately brown V Rarely burns, tans profusely to dark VI Never burns, deeply pigmented, least sensitive

Genetic High Risk Factors Blond or red hair Blue, green or gray eyes Fair skin Skin that freckles and burns easily Many moles; large moles Family members with melanoma

Where Do You Live? 300+ days of sunshine each year High elevation Outdoor-oriented lifestyle Low rate of sun protection Moderate to high UV March through October (High = April to Sept)

What Do You Do? Do you stay out all day in the sun without protection? Do you sunbathe to get a tan? Do you sunburn? Do you go to a tanning salon?

STRATEGY 2: How Sun Damages The Skin At least 90% of skin cancer is caused by ultraviolet radiation.

Electromagnetic Spectrum

EPIDERMIS DERMIS SUBCUTIS Skin & UV Rays Solar UV radiation is 95% UVA & 5% UVB. UVA causes tanning, aging & skin cancer. UVB causes burning & skin cancer. Tanning beds emit 2-3 times more UVA than the sun. UVA does not produce vitamin D.

Suntans & Sunburns A suntan tells you that your skin is trying to protect itself from damaging UV rays. Suntans may give some protection from sunburn, but the skin gets damage while getting the tan, including aging from UVA rays. Cumulative sun exposure (including tanning) can lead to skin cancer. Sunburns increase risk for developing melanoma.

Skin Cancer Formation UVA and UVB rays hit the epidermis DNA in skin cells begins to break down To fend off damage, skin produces melanin, proof of DNA damage The immune system kicks into gear and tries to repair damaged cells More sun exposure hampers the repair Damaged cells can mutate into skin cancer

Skin Cancer Basal CellSquamous Cell Melanoma

STRATEGY 3: Reduce Your UV Exposure Regular UV protection can reduce skin cancer risk by 80%

3.1 Limit Time In The Sun Schedule outdoor activities around intense midday hours (10 am to 4 pm). Seek shade or go inside when you can. Shade can reduce UV by 75%. Eat lunch inside or in the shade. Use portable shade cover. Car window glass blocks UVB but not all UVA Clouds block only 20%-40% of UV

Check the UV Index Daily

Moderate to High UV Sun protection is needed when the UV Index is 3 (moderate) or higher. Also, use sun protection at high altitude in the winter months. UV increases about 5% with every 400 m gained in elevation.

3.2 Wear Cover-up Clothing Clothing can block 100% of UVA and UVB. Wear clothing that covers a large amount of your skin. Long-sleeved shirts and long pants are best. Choose fabrics with a a tight weave that allows little or no light to pass through. Darker colors absorb UV better.

What is UPF or SPF? UPF = Ultraviolet protection Factor or SPF= Sun protection Factor or The higher the UPF the more UV that’s blocked SPF is a measure of UVB protection, not a measure of UVA protection. MED: minimal erythemal dose

The Sun Safety of Hats  Choose wide-brimmed hats.  But, any hat is better than NO hat!

Wear Sunglasses The eye absorbs >99% of UV. UV rays can cause cataracts, macular degeneration, blindness & melanoma of the eye. Select and wear large sunglasses that block % of UV rays. Look for lenses that meet ANSI Z80.3. Lenses don’t have to be dark. Lenses don’t have to be expensive.

When to Wear Sunglasses During summer Around noon On the beach or boating Skiing at high altitude When using medication which may act as a photosensitiser.

3.3 Use Sunscreen Choose SPF 15 or more. Use sunscreen that blocks UVA and UVB. Apply minutes prior to sun exposure. Apply over all exposed skin. Don’t rub it in too hard – it reduces effectiveness by at least 25%. Reapply at least every two hours, or more often after swimming or sweating.

Australian Radiation Protection and Nuclear Safety Agency… “ Reapply regularly, but remember that reapplication only keeps up the protection of the first application, it doesn't give you extra protection.” “If applying sunscreen of SPF 15+ gives you 2 hours in the sun without burning, then reapplying the sunscreen after 2 hours does not protect you for another 2 hours. You have already received a sunburn dose after the first 2 hours!”

Don’t forget your lips Use lip balm with SPF 15 or higher It’s sunscreen for your lips Most lipsticks contain titanium dioxide and have about an SPF 8

Vitamin D Vitamin D sufficiency is important for overall good health. Most people can satisfy the body’s requirement for vitamin D from casual exposure to sunlight. –10-15 minutes of sun exposure twice a week to the face, arms, hands, or back without sunscreen is usually sufficient to provide adequate vitamin D. Obese, darker skinned and older people can be at risk for vitamin D deficiency, but consumption of fortified milk or orange juice will provide the necessary amount of vitamin D.

STRATEGY 4: Practice Early Detection At least 95% of skin cancer can be cured if detected early

Check Your Birthday Suit Look for changes in spots, moles or sores that don’t heal. Use the ABCD rule for moles: –A = Asymmetry: One half of the mole or birthmark doesn’t match the other. –B = Border: The edges are ragged, irregular, or poorly defined. –C = Color: The color varies from one area to another and may have differing shades of brown, black, white, red or blue. –D = Diameter: The area is larger than 6 mm (about the size of a pencil eraser) and is growing larger. Report unusual findings to your doctor. -- American Academy of Dermatology

How to perform a monthly skin check: Examine your body front and back in the mirror, then right and left sides arms raised. Bend elbows and look carefully at forearms and upper underarms and palms Look at the backs of the legs and feet; spaces between toes and sole. Examine back of neck and scalp with a hand mirror. Part hair for a closer look. Finally, check back and buttocks with a hand mirror. Consult a physician immediately if you have any doubt about a mole or changing spot on your skin.

Summary EVERYONE needs to be sun safe. Some UV exposure is healthy, but avoid sunburns and suntans Limit your unprotected time in the sun Find shade Use sunscreen with SPF 15 or higher Wear sun safe clothing, hats & eyewear Do not use tanning lamps Check your skin for changes