Sun Safety

Melanoma Network of Canada and Sun Safety Council

SUN SAFETY

Overexposure to the sun and other sources of ultraviolet radiation (UVR) are known to cause harm to the skin, eyes and immune system.1 About 65% of melanomas worldwide can be attributed to UVR exposure, with well over 90% among white populations.2 Exposure to UVR also increases the risk of ocular melanoma, cortical cataracts and a number of other eye conditions, while the sun’s visible light, specifically in the blue light range, increases the risk of age-related macular degeneration.3 UVR immune system effects include increased susceptibility to infection and activation of latent virus infections (e.g., herpes simplex, human papillomavirus).4

As far as we know, skin cancer represents the greatest burden of disease related to sun exposure worldwide4 and is the most common form of cancer in Canada.5 The burden of eye disease related to sun exposure has not been well quantified.6 The incidence of melanoma, the most fatal form of skin cancer, ranks sixth after prostate, breast, colorectal and lung cancers, and non-Hodgkin lymphoma. Among Canadians aged 15 to 29 and among those aged 30 to 49, it ranks fourth in frequency of diagnosis annually.7

Between 1996 and 2006, Canadians increased their time in the sun without improving protective behaviours.8 In addition, melanoma incidence rates have been increasing in Canada and are projected to continue to rise.7

Personal protective measures against sun and UVR exposure are key parts of preventing skin cancer and other conditions. A comprehensive strategy for reducing the burden of skin cancer should therefore include efforts to increase awareness of the actions individuals should take to reduce their risk. Communicating a consistent set of recommended actions that are supported by evidence is a first step in increasing the uptake of those actions.

SUN SAFETY RECOMMENDATIONS:

Ultraviolet Radiation Exposure
  • When outside and the Ultraviolet (UV) Index is 3 or higher, there is risk of harm to unprotected skin and eyes.
  • The UV Index regularly reaches 3 and higher between the peak hours of 11:00 a.m. and 3:00 p.m. (daylight savings time [DST]; 10:00 a.m. to 2:00 p.m. standard time), from March to October on sunny and cloudy days.
  • The UV Index regularly reaches 5 and higher between 11:00 a.m. and 3:00 p.m. (DST) from May to August, but rarely exceeds 10 in Canada.
  • Infants, young children and people with fair skin that burns easily are especially vulnerable to UV exposure.

Recommended Protective Actions:

  • When the UV Index forecast is 3 or higher, generally from March to October, plan outdoor activity before 11:00 a.m. and after 3:00 p.m. whenever possible for the best protection.

As a general guide, if outside for 15 minutes or more during peak hours:

  • Seek both shade AND use personal protection (hats, protective clothing, and sunglasses; and sunscreen on non-covered skin) from May to August.
  • Seek shade OR use personal protection in early spring and fall (March, April, September and October).
  • Check the weather forecast for the daily UV Index forecast (http://weather.gc.ca).
  • Protecting the skin of infants, young children and people with fair skin that tends to burn easily is especially important.
  • Ensure infants younger than six months of age are always kept out of the sun—in the shade and wearing protective clothing when outside; sunscreen may be used on infants younger than six months on small areas of skin, if adequate clothing and shade are not available.

Additional considerations:

  • Even when in water, sun protection is needed.
  • UV radiation can pass through cloud cover.
  • When around snow-covered surfaces (e.g., in the mountains), from March to November, sun protection is needed from 11:00 a.m. to 3:00 p.m. (DST). Snow reflects and intensifies UV radiation, but when the UV Index is low, intensification is minimal.
  • Environment Canada’s daily UV Index peak time forecasts are available here: http://weather.gc.ca/forecast/public_bulletins_e.html?Bulletin=fpcn49.cwao.
  • UV radiation increases with altitude, so sites at higher elevations receive more UV radiation than those closer to sea level.
  • It is important to adjust to local conditions.
Seeking Shade
  • Seek shade as a first line of defence when outside between 11:00 a.m. and 3:00 p.m. (daylight savings time) from March to October, or when the UV Index is 3 or higher.
Protective Clothing & Hats

When outside between 11:00 a.m. and 3:00 p.m. (daylight savings time) from March to October, or when the UV Index is 3 or higher:

  • Wear clothing with tightly woven fabric to cover as much skin as possible.
  • Choose hats with a wide brim all around made of tightly woven fabric. Hats should shade your face, ears and the back of your neck.
  • Use sunscreen on non-covered skin.

More details

  • Choose synthetic fabrics or polyester blends, or look for clothing labels with a high ultraviolet protection factor (UPF) number.
  • Lightweight, loose-fitting UV protective clothing can keep you cooler than bare skin in hot weather.
  • Baseball hats do not provide enough protection, covering only the scalp and shading only a small part of the face.
  • Don’t risk developing skin cancer while trying to keep active. When you participate in outdoor sport, cover up as much as possible.
  • If you work outdoors, consider UV protective clothing designed specifically for outdoor workers, which may also keep you cooler.
Eye Protection

Sunglasses that completely shield the eyes protect against a number of eye diseases.

  • Wear close-fitting, wraparound sunglasses or sunglasses with side shields, even if you wear contact lenses, when outside from 11:00 a.m. to 3:00 p.m. (daylight savings time), from March to October.
  • Wear sunglasses any time you are in highly reflective environments, such as on snow, water or sand.

More details

  • For effective protection, sunglasses should provide coverage from direct and indirect sunlight.
  • Brown-tinted sunglasses generally provide better protection than other tint colours.
  • Prescription sunglasses and sunglasses that fit over your regular non-treated prescription glasses are available.
  • Most modern, non-tinted prescription glasses are treated to provide ultraviolet (UV) protection.
  • In situations where you can’t wear sunglasses, use either prescription or non-prescription (plano) ultraviolet absorbing contact lenses.
Sunscreens

Sunscreens must have a sun protection factor (SPF) of 30 or higher, be broad spectrum and water resistant, and applied with a generous layer on all exposed skin to work effectively.

  • Sunscreens should be used on exposed skin not covered by protective clothing, which offers more effective skin protection.
  • Use a generous amount of sunscreen. Reapply sunscreen based on activity level, immediately after swimming, towelling off or sweating heavily.
  • When choosing a sunscreen, look for one that is:
  • Broad spectrum, protects against ultraviolet A (UVA) and ultraviolet B (UVB)
  • SPF 30 or higher
  • Water resistant

More details:

  • Applying sunscreen about 15 minutes before going outside helps your skin to absorb it before exposure, but once outside, it’s not too late to apply.
  • Health Canada recommends reapplying sunscreen every two hours.
  • Sunscreens come in a variety of formulations. Find one that suits you best.
  • In Canada, all sunscreens have passed a review by Health Canada and are given a drug identification number (DIN).
  • Reviews of studies of a number of common sunscreen ingredients have not shown that those ingredients, including oxybenzone (benzophenone-3), pose health risks.
Tanning Equipment & Tanning Beds

There is no such thing as a safe or healthy tan. Exposure to ultraviolet A (UVA) and UVB radiation from tanning equipment can cause sunburn and eye damage, as well as increase the risk of skin cancer and other UV-related negative health effects.

More details

  • A “base tan” provides little to no protection against sunburn. Any tan or change in skin colour is a sign of skin damage.
  • Tanning is not a safe source of vitamin D. The best way to maintain a healthy level of vitamin D is through taking a vitamin D supplement and including D-rich food sources, such as milk or milk alternatives, such as fortified soy and almond beverages, in your diet.
Vitamin D

There are safer ways to maintain healthy vitamin D levels than through ultraviolet (UV) exposure.

For bone health, seek sources of vitamin D that are safer than UV exposure:

  • Take a daily vitamin D supplement of 400 to 1,000 international units (IU) to ensure that you maintain healthy vitamin D levels all year round.
  • Include in your diet:
    • Naturally-occurring food sources of vitamin D, such as egg yolk, as well as salmon, tuna, mackerel and other fatty fish
    • Milk, fortified milk alternatives, such as soy and almond beverages, and margarine provide a major source of vitamin D.
  • Tanning beds are not a safe source of vitamin D.

WHAT DOES THE EVIDENCE SAY

References:

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