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Insufficient sun exposure has become a real public health problem

Insufficient sun exposure has become a real public health problem
Insufficient sun exposure has become a real public health problem

This article aims to alert the medical community and public health authorities to accumulating evidence on health benefits from sun exposure, which suggests that insufficient sun exposure is a significant public health problem. Studies in the past decade indicate that insufficient sun exposure may be responsible for 340,000 deaths in the United States and 480,000 deaths in Europe per year, and an increased incidence of breast cancer, colorectal cancer, hypertension, cardiovascular disease, metabolic syndrome, multiple sclerosis, Alzheimer's disease, autism, asthma, type 1 diabetes and myopia. Vitamin D has long been considered the principal mediator of beneficial effects of sun exposure. However, oral vitamin D supplementation has not been convincingly shown to prevent the above conditions; thus, serum 25(OH)D as an indicator of vitamin D status may be a proxy for and not a mediator of beneficial effects of sun exposure. New candidate mechanisms include the release of nitric oxide from the skin and direct effects of ultraviolet radiation (UVR) on peripheral blood cells. Collectively, this evidence indicates it would be wise for people living outside the tropics to ensure they expose their skin sufficiently to the sun. To minimize the harms of excessive sun exposure, great care must be taken to avoid sunburn, and sun exposure during high ambient UVR seasons should be obtained incrementally at not more than 5-30 min a day (depending on skin type and UV index), in season-appropriate clothing and with eyes closed or protected by sunglasses that filter UVR.

Europe, Humans, Public Health, Sunburn, Sunlight, Ultraviolet Rays, Vitamin D, Vitamin D Deficiency
1660-4601
Alfredsson, Lars
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Armstrong, Bruce K
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Butterfield, D Allan
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Chowdhury, Rajiv
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de Gruijl, Frank R
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Feelisch, Martin
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Garland, Cedric F
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Hart, Prue H
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Hoel, David G
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Jacobsen, Ramune
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Lindqvist, Pelle G
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Llewellyn, David J
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Tiemeier, Henning
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Weller, Richard B
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Young, Antony R
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Alfredsson, Lars
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Armstrong, Bruce K
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Butterfield, D Allan
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Chowdhury, Rajiv
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de Gruijl, Frank R
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Feelisch, Martin
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Garland, Cedric F
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Hart, Prue H
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Hoel, David G
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Jacobsen, Ramune
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Lindqvist, Pelle G
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Llewellyn, David J
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Tiemeier, Henning
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Weller, Richard B
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Young, Antony R
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Alfredsson, Lars, Armstrong, Bruce K, Butterfield, D Allan, Chowdhury, Rajiv, de Gruijl, Frank R, Feelisch, Martin, Garland, Cedric F, Hart, Prue H, Hoel, David G, Jacobsen, Ramune, Lindqvist, Pelle G, Llewellyn, David J, Tiemeier, Henning, Weller, Richard B and Young, Antony R (2020) Insufficient sun exposure has become a real public health problem. International Journal of Environmental Research and Public Health, 17 (14), [5014]. (doi:10.3390/ijerph17145014).

Record type: Review

Abstract

This article aims to alert the medical community and public health authorities to accumulating evidence on health benefits from sun exposure, which suggests that insufficient sun exposure is a significant public health problem. Studies in the past decade indicate that insufficient sun exposure may be responsible for 340,000 deaths in the United States and 480,000 deaths in Europe per year, and an increased incidence of breast cancer, colorectal cancer, hypertension, cardiovascular disease, metabolic syndrome, multiple sclerosis, Alzheimer's disease, autism, asthma, type 1 diabetes and myopia. Vitamin D has long been considered the principal mediator of beneficial effects of sun exposure. However, oral vitamin D supplementation has not been convincingly shown to prevent the above conditions; thus, serum 25(OH)D as an indicator of vitamin D status may be a proxy for and not a mediator of beneficial effects of sun exposure. New candidate mechanisms include the release of nitric oxide from the skin and direct effects of ultraviolet radiation (UVR) on peripheral blood cells. Collectively, this evidence indicates it would be wise for people living outside the tropics to ensure they expose their skin sufficiently to the sun. To minimize the harms of excessive sun exposure, great care must be taken to avoid sunburn, and sun exposure during high ambient UVR seasons should be obtained incrementally at not more than 5-30 min a day (depending on skin type and UV index), in season-appropriate clothing and with eyes closed or protected by sunglasses that filter UVR.

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Accepted/In Press date: 4 July 2020
Published date: 13 July 2020
Keywords: Europe, Humans, Public Health, Sunburn, Sunlight, Ultraviolet Rays, Vitamin D, Vitamin D Deficiency

Identifiers

Local EPrints ID: 457804
URI: http://eprints.soton.ac.uk/id/eprint/457804
ISSN: 1660-4601
PURE UUID: d53fc0f7-ed09-4b2f-a508-0d33107b2854
ORCID for Martin Feelisch: ORCID iD orcid.org/0000-0003-2320-1158

Catalogue record

Date deposited: 16 Jun 2022 17:05
Last modified: 03 Sep 2022 01:48

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Contributors

Author: Lars Alfredsson
Author: Bruce K Armstrong
Author: D Allan Butterfield
Author: Rajiv Chowdhury
Author: Frank R de Gruijl
Author: Martin Feelisch ORCID iD
Author: Cedric F Garland
Author: Prue H Hart
Author: David G Hoel
Author: Ramune Jacobsen
Author: Pelle G Lindqvist
Author: David J Llewellyn
Author: Henning Tiemeier
Author: Richard B Weller
Author: Antony R Young

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