lesson learnt using timeresolved personal electronic UV dosimetry RAD 2012 The first International Conference on Radiation and Dosimetry in Various Fields of Research April 26 9th 2012 ID: 415894
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Slide1
1
Sun exposure patterns; lesson learnt using time-resolved personal electronic UV dosimetry
RAD 2012
The first International Conference on Radiation and Dosimetry in Various Fields of Research
,
April 26 9th, 2012
Elisabeth Thieden MSc, DMSc
Bispebjerg Hospital, Department of Dermatology
Copenhagen University, DenmarkSlide2
2
The aim of the study was to assess objectively the UVR exposure pattern
Sun exposure behaviour
Indoor and outdoor work?
Workdays, Days off,
Holidays in and out of DenmarkOutdoor sports?Risk behaviour in the sun?Sunbed use?
Age, Sex and Skin Type?
Sunburn as acute side-effect?
Sunscreen as sun protection?Slide3
3
UVR dosimeter: SunSavermeasures time-stamped UVR doses in standard erythema doses, SED = 100 J/m
2
at 298 nmSlide4
4
Sun diary shows sun behaviour
SunSaver on
On/Off work
In DK or abroad
Sunbathing
Exposing upper body RISK BEHAVIOR
At the beach
Sunscreen + SPF no.
SunburnedSlide5
5
Population sampleSubgroups of the Danish population
Sun-years
Age-Span (Years of age, range) 96 Children (4-15)
30 Adolescents (16-10)
121
Indoor workers (21-64)
Expected high UVR dose:
53
Sun worshippers (21-63)
37
Golfers (27-68)
70
Gardeners (25-60)
407 Total Sun-years included
1 Sun-Year = 1 subject in 1 summer-half-year
Slide6
6
UVR dose in Denmark 56ºN in SED (100 J/m2 at 298 nm)
Paper III
Ambient
% of Ambient Received on SunSaver in DK
per
month
median
on
workdays
median
on
days off
median
In southern
Europe
median
April
3
68
2.1
5
.3
40.9 May5913.55.7 7.9 June6033.14.4 11.9 July6112.97.3 34.5 August4422.34.9 34.1 Sept.2671.42.7 12.7 October980.40.3 4.8
Non parametric statistic has been used. The results are given as
median
values and either range or Inter Quartile RangeSlide7
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UVR per Sun-year in SED to the wrist based on 39068 days (119 days per Sun-year)
Sun
years
SED
per
Day
Median
SED
per
year
Median
% of
Ambient UVR
Median
Total
346
1.0
173
(17-980)
5.1
Children
68
0.91474.1Adolescents221.0 189 4.7Indoor workers 1110.71324.0Sun worshippers491.0 1816.1Golfers311.2 2177.5Gardeners651.3 2246.6Thieden et al, Arch Dermatol. 2004;140:197-203Slide8
8
SunSaver measure- ments in DK Year
2000
Subject no.
SED/day
A person day
Thieden et al,
Arch Dermatol. 2004;140:197-203Slide9
9
UV exposure, sex and age
Males
n=164
Median (range)
Females
n=182
Median (range)
UVR/year in SED
177
(20-840)
170
(17-554)
< 20 year of age
120
(20-633)
178
(69-540)
Risk (Days)
9
(0-46)
17(0-93)Days with sunscreen SPF 1 (0-117) 8 (0-130)Sunburns (No.) 0 (0-4) 1(0-6)Thieden et al, Arch Dermatol. 2005;141:967-973Slide10
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25% of Lifetime UVR before 20 years of age as expected
n
SED per year
Median (95%-range)
%
Measured
%
Expected
Children
≥1 & <13
year
45
149
(23-523)
14.6
15.8
Teenagers
≥13 & <20 year
35
185
* (71-634)10.69.2Adults≥20 & <77 year84161 (36-663)74.975.0Thieden et al. JID 2005;123:1147-50Slide11
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% of measured UVR (median):Work/Day off +/- Risk behaviour
Thieden et al:
Arch Dermatol. 2004;140:197-203
Work
-
R
+
R
Day off
-
R
+
R
Total
(median % Days)
17
(48)
1.5
(1)
27
(37)
36
(9)
Children 131.3 21 51 Adolescents11 2.1 19 68Indoor workers 17 0.533 36Sun worshippers9 2.9 22 60Golfers13 0 49 33Gardeners51 4.2 25 9Slide12
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UVR dose: 12:00 –15:00
Indoor breaks at noon lower UVR dose
Thieden et al. BJD 2005;153:795-801Slide13
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Daily variation in ambient UVR Summer, Spring and Winter
Reduce UVR dose with 50% by avoiding the sun 3 hours at noonSlide14
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Sunburn, the acute side effect of UV
% Sun-years with
Median days with
Thieden et al
Arch Dermatol.
2005;141:482-488
Sun-burn
≥3
Sun-
burns
Sun-burn
Risk +SPF
Risk -SPF
Total
59
16
1
3
7
Children
50
12
0.5
58Adolescent64322710Indoor workers6620136Sun worshippers71271137Golfers4510007Gardeners5221
0
4Slide15
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A typical sunburn Day in Denmark
A
Day off (91%)
Risk behaviour (79%)
(Sunbathing or exposing shoulders)May, June, July (90%)A median of 6.4 hours outdoors, hereof 2.8-3.0 hours between 12:00-15:00
Ambient UVR above 25 SED
No sunburns on workdays
without
risk behaviourSlide16
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Winter vs. Summer UVR exposurefor 19 indoor workers in DK
Winter
Oct.-March
Summer
April-Sep.
Ambient UVR dose in
SED
394
3363
Personal UVR dose in DK
3.1
133
% of ambient UVR in DK
0.8
3.4
% Days with 0 SED
77
19
Minuts/day with UVR>0 SED
10
120
2.6% during solar exposure in winter in DK, 75.6% in summer and 21.8% from holidays outside Denmark and in sunbeds
Winter UVR exposure:
Sun holidays 4.3 SED/day Sunbed 3 SED/sessionSlide17
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44 (13%) used sunbeds
Mean: 5 sessions
Max: 23 sessions
Mean: 2.4 SED/sessionMax: 11.5 SED/session Vs. non-users
More risk days:20 days vs. 12 days(p<.001)
Higher annual UVR:
203 SED vs. 168 SED
(p=.03)
Sunbed use is an indicator of high solar UV exposure
Thieden et al 2005.
Arch Dermatol. 2005;141:967-973Slide18
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When you take off your clothes -you get a high UV dose !Ways to reduce the UVR exposure dose, I
f people still want to stay in the sun:
Concentrate on sun exposure reduction and sun protection on “days off work” with risk behaviour.
Reduce time with risk behaviour at high UVR intensity, or do risk behaviour at times when UVR intensity is lower. Take small breaks indoors or in the shade if sunbathing during high UVR intensity.
Plan breaks and meetings indoors at UVR peak hours.Postpone sun holidays to August or September when ambient UVR is reduced compared to June and July.
Apply sunscreen on
all
days with risk behaviour or during long lasting outdoor activities.
Learn proper use of sunscreen.
Avoid sunbed use, as it adds to the cumulative UVR dose.
Slide19
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ICEPUREThe Impact of Climatic and Environmental factors on Personal Ultraviolet Radiation Exposure and human health
,
1 (coordinator) King’s College London, (KCL), UK
2 Bispebjerg Hospital (BBH), Denmark
3 Medical University of Lodz, (MUL), Poland
4 Karolinska Institute, (KI), Sweden
5 Center for Research on Environmental Epidemiology,
(CREAL), Spain
6 University of Veterinary Medicine, Vienna, (UVM), Austria
7 Health Protection Agency, (HPA), United Kingdom
8 Danish Meteorological Institute, (DMI), Denmark
ENV.2008.1.2.5 Grant agreement no.:227020Slide20
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Summary of objectives1 Measurement of personal UVR exposure in different
work and leisure environments in Europe.
2 Validation of existing UVR estimates in epidemiological studies
3 Correlation of personal UVR exposure with satellite and ground
station data
(UVR, albedo, aerosol, cloud cover)4 Combination of personal, satellite and ground station UVR data
and radiative transfer modelling to develop a UVR exposure model
that will ultimately be used together with climate models to predict
future UVR exposure levels.
5 Determination of the beneficial and harmful biological effects
of UVR, and critical dose levels, in relation to personal UVR
exposure including Vitamin D synthesis, DNA damage and
immunosuppression.
6 Review of the current health risks of UVR exposure and
assessment of the impact of the using personal UVR data on
existing exposure relationships, and where possible, determine
critical levels of exposure.Slide21
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Population field studiesFarmers families in 4 countries
Country
Coordinates
Farmers
Spouses
Children
Total
Denmark
56
°N
12°E
44
44
64
152
Spain
41
°N 2°E
20
19
17
56
Poland52°N 21°E301960109Austria48°N 16°E35313299Slide22
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Population field studiesLeisure studies of 1 week
Activity
Place
Coordi-nates
DK
Danes
ES
Span-
iards
AT
Austrian
PL
Polish
Winter sun vacation
Tenerife
28
°N 16°W
25
20
Ski vacation
Austria
47
°N 13°E
2627Childrens’ campPoland54°N 19°E32Winter sun vacation with immunosuppres.Tenerife28°N 16°W
22 17 CSlide23
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Pictures from sun vacation studySlide24
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Acknowledgements
Hans Christian Wulf, MD, prof. DSc
Peter Philipsen, MSc (Eng), PhD
Jane Sandby-Møller, MD, PhD
Jakob Heydenreich, MSc (Eng) Gillian Murphy, MD, DublinAntony R. Young, Prof. KCL, UK and the rest of
The ICEPURE groupAll the volunteers in the studies
European Community Environment and Climate 1994-1998 Work Programme, contract no. ENV-CT97-0556
Seventh Framework programme, Theme ENV.2008.1.2.5 Grant agreement no.:227020