SUN SAFETY: EXPOSURE, DAMAGE, AND PREVENTION

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SUN SAFETYEXPOSURE, DAMAGE, AND PREVENTION

• By Teresa PattonTraining and Staff
  DevelopmentOklahoma Dept. of Corrections

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Course Information

• Course Author Teresa Patton, Training
  Administration
• Course Issued July 3, 2007
• Course Credit 30 minutes
• ORACLE Course Code SAF199000
• Data Sources
• Photos U.S. National Library of
  Medicine/National Institutes of Health (used by
  permission)
• MayoClinic, May 2006
• abcnews, website
• Federal Trade Commission, website
• University Health Care, 2003
• American Academy of Dermatology, 2006
• VCU Massey Cancer Center, 2006
• Wikipedia, website
• Texas Cooperative Extension, website

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Performance Objectives

• At the conclusion of this course, students will
  be able to
• 1. Identify the three types of ultraviolet
  rays.
• 2. Discuss the dangers of UVA and UVB rays.
• 3. Name the two common sun-induced types of
  skin damage.
• 4. Discuss the symptoms, treatment and
  prevention of a sunburn.
• 5. Describe the danger of indoor tanning
  devices.
• 6. Understand the SPF rating on sunscreen and
  its proper use.
• 7. Discuss additional protection from the sun,
  i.e. sunglasses, hats, and sun protective
  clothing.
• 8. Explain why children need special protection
  from UV rays.
• 9. Understand the UV Index and its
  significance.
• 10. Identify the three different types of skin
  cancer and why early detection is vital.
• 11. Discuss the importance of keeping skin
  healthy.

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Sun Exposure, Damage, and Prevention

• The sun emits a warm golden cast that is very
  appealing. Many people cannot resist spending
  hours basking in its warmth especially after
  being cooped up during those winter months.
  Warmer temperatures, particularly in the summer,
  bring the time to bare the pale parts that have
  been covered all winter long.
• So heres a question Is there a price for
  having too much fun in the sun?

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Sun Exposure, Damage, and Prevention

• Yes particularly if you are spending time
  outdoors without protecting yourself from the
  suns ultraviolet radiation. Energy from the sun
  reaches the earth as visible, infrared and
  ultraviolet (UV) rays. The three types of UV
  rays are
• UVA, UVB, and UVC
• Only UVA and UVB ultraviolet rays reach the
  earths surface. The earths atmosphere absorbs
  UVC wavelengths.

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Sun Exposure, Damage, and Prevention

• What you should know about UVA and UVB rays
• UVB
• UVB rays cause a much greater risk of skin
  cancer than UVA. UVB affects the surface skin
  layer. The skin responds by releasing chemicals
  that dilate blood vessels. This causes fluid
  leakage and inflammation better known as
  sunburn.

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Sun Exposure, Damage, and Prevention

• UVA
• UVA rays also increase the damaging effects of
  UVB including skin cancer and cataracts. UVA
  penetrates into the deeper skin layers and
  damages the site where new skin cells are born.
  Wrinkles, age spots and sagging skin are the
  results of long term exposure to UVA radiation.

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Sun Exposure, Damage, and Prevention

• UVA and UVB rays react with melanin, a chemical
  that is found in most peoples skin. Melanin is
  the first defense against the sun as it absorbs
  dangerous UV rays before they do serious harm to
  your skin. The concentration of melanin differs
  among individuals and varies with skin color
  the darker your natural skin color, the more
  melanin your skin has to protect itself. Though
  skin damage can occur in any skin color, persons
  with light complexions are more susceptible.

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Sun Exposure, Damage, and Prevention

• More than likely you are familiar with two of the
  more common sun-induced types of skin damage
• sunburns and suntans
• We say skin damage because that is exactly what
  a sunburn or suntan is.

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Sunburn

• A sunburn is the skins reaction to the
  ultraviolet (UV) radiation in sunlight.
  Eventually, UV light causes the skin to burn,
  bringing pain, redness and swelling. Depending
  on the severity of the burn, the dead, damaged
  skin may peel away to make room for new skin
  cells. Although the symptoms of a sunburn may
  fade after several days, the damage to your skin
  remains.

Sunburn peeling. The dehydration of the epidermis
causes the top layer to flake off.
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Sunburn

• Sunburn photographed 2 days after a 5-hour sun
  exposure. The dark red area is sunburned. The
  normal-colored skin was covered by her suit
  during exposure.

Sunburned feet. The burn can cause swelling or
inflammation.
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Symptoms of a Sunburn

• Change in skin color ranging from pink to red to
  even purple
• Skin feels hot to the touch
• Pain
• Swelling
• Fluid-filled blisters that may itch and
  eventually pop or break
• Broken blisters peel to reveal even more tender
  skin beneath

Sun Fact A sunburn can occur in less than 15
minutes and can take a few days or weeks to heal
depending on the severity of the burn.
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Self-Help Treatments

• There is no cure for a sunburn except time and
  patience. Following are some suggestions to
  utilize while the body heals
• Drink plenty of water because youre probably
  dehydrated as well as sunburnt.
• Gently apply cool or cold compresses.
  Alternatively, bathe the area in cool water.
• Avoid using soap as this may irritate your
  skin.
• Dont apply butter to sunburnt skin.
• Avoid greasy substances. They seal in the
  heat and cause further damage.
• To avoid infection, do not break blisters or
  peel skin.
• There are a range of products available that
  help to soothe sunburn talk to your
  pharmacist or doctor for suggestions.
• Keep out of the sun until every last sign of
  sunburn has gone.

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Professional Treatment

• You should see your doctor or seek immediate
  professional treatment if you experience symptoms
  including
• Severe sunburn with extensive blistering and
  pain
• Sunburn over a large area
• Headache
• Nausea and vomiting
• Fever
• Dizziness or altered states of consciousness

Sun Fact Youre more likely to get sunburned
when youre relaxing and taking it easy, such as
watching outdoor sports or picnicking at the park.
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Prevention is Best

• A mild sunburn can be treated at home, but severe
  and blistered burns need prompt medical
  attention. The long term effects of repeated
  bouts of sunburn include premature wrinkling and
  increased risk of skin cancer. Once the skin
  damage occurs, it is impossible to reverse. This
  is why prevention is much better than cure.

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Suntan

• A suntan is the result of injury to the epidermis
  the top layer of your skin. A tan develops
  when UV light accelerates the production of
  melanin. Melanin is the dark pigment in the
  epidermis that gives your skin its normal color.
  The extra melanin produced to protect the deeper
  layers of your skin creates the darker color of
  a tan. A suntan is your bodys way of blocking
  out the ultraviolet rays to prevent further
  injury to the skin, but the protection only goes
  so far.

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Suntan

• Even those with darker skin types can burn with
  repeated exposures to UV light. This intense
  exposure can produce dry, rough patches,
  wrinkling, and other skin disorders. So even
  though people with darker skin can tan and
  tolerate longer periods of sun exposure without
  burning, the sun can still cause skin damage.

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Suntan

• Any tan is a sign of skin damage. Indoor tanning
  devices also give off ultraviolet rays that can
  be as harmful as those from the sun.
• There is a huge myth that tanning beds are safe.
  They are not. It doesnt matter whether you get
  radiation from the sun or a man-made source, it
  still does damage.

Sun Fact The UV radiation emitted by indoor
tanning lamps is much more intense than natural
sunlight.
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Sunless Tanners

• While some people will opt for a quick session in
  a tanning bed, others are turning to sunless
  tanning creams to get that attractive golden
  glow. Getting your tan from a cream or lotion
  designed to make the skin appear darker is one
  way to bypass exposure to UV rays and is a safe
  thing to do.
• However, sunless tanners may think this self-made
  tan offers the same amount of protection as a
  base tan would and forgo using additional
  sunscreen.
• Using a self-tanner will not stop you from
  getting a sunburn. If you want to be tan, the
  safest way is by self-tanning, but you must also
  use sunscreen protection.

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Sunscreens

• Practically everyone is susceptible to sun
  damage however, some individuals are naturally
  more at risk based upon their skin color.
  Individuals with light complexions for example
  tend to burn more rapidly than those with dark
  complexions.
• Basically, the length and intensity of exposure
  combined with your bodys inherent risk of sun
  damage will determine the level of protection you
  need.

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Sunscreens

• Sun Protection Factor (SPF) refers to a
  sunscreens ability to block harmful UVB rays.
  It does not relate to the ability of a product to
  block UVA rays. For example, with a SPF 5 rated
  sunscreen, you can theoretically stay outside in
  the sunlight fives times longer before getting a
  sunburn compared to the time required to get a
  sunburn without using the sunscreen. The higher
  the SPF number, the longer you are protected
  against sunburn damage.

Sun Fact To get maximum protection from your
sunscreen, apply at least one large handful about
30 minutes before you go outside. Reapply after
swimming, toweling dry or participating in any
vigorous activity that causes heavy perspiration.
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Sunscreens

• The actual length of protection will vary for
  each individual given the same SPF rating. For
  instance, if Jack tends to burn in 10 minutes
  with a SPF of 15, then the sunscreen will provide
  up to 150 minutes of sun protection. However, if
  Jill usually burns in 20 minutes and applies
  the same SPF product, Jill is protected for 300
  minutes.

It may not be fair, but its true Were not
all equal under the sun!
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Sun Protective Clothing

• Another way to protect skin from the harmful
  effects of the sun is to wear sun-protective
  clothing. These fabrics differ from typical
  summer fabrics in several ways they generally
  have a tighter weave or knit and are usually
  darker in color. Sun-protective clothes have a
  label listing the garments Ultraviolet
  Protection Factor (UPF) value, that is, the level
  of protection the garment provides from the suns
  UV rays. The higher the UPF, the higher the
  protection from the suns UV rays.
• The UPF rating indicates how much of the suns UV
  radiation is absorbed by the fabric. For
  example, a fabric with a UPF rating of 20 only
  allows 1/20th of the suns UV radiation to pass
  through it. This means that this fabric will
  reduce your skins UV radiation exposure by 20
  times where its protected by the fabric.
• A garment should not be labeled sun-protective
  or UV-protective if its UPF is less than 15.
  Sun-protective clothing may lose its
  effectiveness if its too tight or stretched out,
  damp or wet, and if it has been washed or worn
  repeatedly.

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Sunglasses

• As you apply sunscreen to protect your skin,
  dont forget sunglasses to protect your eyes.
  The same harmful rays that damage skin can also
  increase your risk of developing eye problems,
  such as cataracts a clouding of the eyes lens
  that develops over years.
• In the short-term, people who spend long hours on
  the beach or in the snow without adequate eye
  protection can develop photokeratitis, reversible
  sunburn of the cornea. This painful condition
  can result in temporary loss of vision. When
  sunlight reflects off of snow, sand and water, it
  further increases exposure to UV radiation.
• Everyone is at risk for eye damage from the sun
  year-round. The risk is greatest from about
  1000 a.m. to 400 p.m.

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Sunglasses

• Your glasses should block both UVA and UVB rays.
  Do not assume that you get more UV protection
  from pricier sunglasses or glasses with a darker
  tint. Look for a label that specifically states
  that the glasses offer 99 percent to 100 percent
  UV protection.
• Sunglasses should be dark enough to reduce glare,
  but not dark enough to distort colors and affect
  the recognition of traffic signals. Tint is
  mainly a matter of personal preference. For best
  color perception, Prevent Blindness America
  recommends lenses that are neutral gray, amber,
  brown or green. People who wear contact lenses
  that offer UV protection should still wear
  sunglasses.

Sun Fact Some people choose sunglasses that wrap
all the way around the temples to block light
from entering from the sides of sunglasses. A
hat with a three-inch brim can help block
sunlight from overhead.
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Special Protection for Children

• Estimates are that 50 to 80 percent of an
  individuals lifetime sun exposure occurs by the
  age of 18.
• It is critical to apply sunscreens with a minimum
  SPF15 to childrens skin about 30 minutes before
  they go outdoors. Reapply sunscreens after they
  swim, towel off or play hard.
• Infants six months and younger should be kept out
  of direct sunlight altogether. Sunscreens may
  irritate baby skin, and infants developing eyes
  are particularly vulnerable to sunlight.

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Special Protection for Children

• Begin NOW to teach your children to follow the
  ABCs for Fun in the Sun
• A AWAY Stay away from the sun in the middle of
  the day.
• B BLOCK Use SPF15 or higher sunscreen.
• C COVER UP Wear a T-shirt and a hat.

Sun Fact Children, as well as adults, should
avoid the midday sun and its intense rays.
Schedule outdoor time before 1000 a.m. and after
400 p.m. (daylight savings time 900 a.m. to
300 p.m.).
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UV Index

• In response to the increasing incidence of skin
  cancer, cataracts and other effects from exposure
  to the suns harmful rays, the National Weather
  Service, the U.S. Environmental Protection Agency
  and the Centers for Disease Control and
  Prevention collaborated on a sun-awareness
  information program. As a result of this
  collaboration, the National Meteorological Center
  of the National Weather Service developed the UV
  Index.
• The index is a next-day forecast that estimates
  the amount of UV radiation that will reach the
  earths surface providing important information
  to help you prevent overexposure to the suns
  rays. The index also includes the effects of
  cloud cover on the anticipated UV exposure level
  for the next day.

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UV Index Exposure Categories
Index Values Exposure Categories
0 - 2 Minimal An index reading of 0 to 2 means minimal danger from the suns UV rays for the average person.
3 - 4 Low An index reading of 3 to 4 means you may be at risk of skin damage from the suns rays many people can experience a sunburn in 45 minutes.
5 - 6 Moderate An index reading of 5 to 6 means you may be at some measurable risk of skin damage due to the sun many people can experience a burn in only 30 minutes.
7 - 9 High An index reading of 7 to 9 means you may be at high risk of harm from unprotected exposure to the sun may people can burn in under 15 minutes.
10 Very High An index reading of 10 and above means you are at maximum risk of harm from unprotected sun exposure many people burn in as little as 10 minutes without protection.
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UV Index

• Do not rely upon temperature as an indication of
  sun UV intensity. The index can change everyday,
  just as the temperature does. You can find the
  UV index in a local paper, your weather channel
  or on the internet.
• Sun protection should be practiced year round, in
  all seasons, and even on cloudy days.

Sun Fact Snow skiers are at particular risk
considering that ultraviolet radiation increases
4 to 5 percent with every 1000 feet above sea
level.
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Skin Cancer

• Skin cancer is a malignant growth on the skin.
  It is the fastest growing cancer in the United
  States and in the USA represents the most
  commonly diagnosed malignancy, exceeding lung,
  breast, colorectal and prostate cancer. In the
  US, over 1 million people will be diagnosed with
  skin cancer in 2007.
• There are three types of skin cancer
• basal cell
• squamous
• malignant melanoma

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Basal Cell Skin Cancer

• Basal cell skin cancer can cause
  disfigurement.
• Flesh-colored, red or black, round bump with
  apearly border, develops into ulcerating sore.

Basal cell is the most common skin cancer and 85
occur in the head and neck region. Basal cell
carcinomas enlarge slowly and steadily and can
invade neighboring tissue, like the eye, but they
usually do not spread to distant parts of the
body (metastasize). It is fairly easy to treat
when detected early.
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Squamous Skin Cancer

• Squamous skin cancer Can be life-threatening.Thi
  ckened, red, scaly bump or wart-like
  growth,develops into a raised, crusted sore.

Squamous skin cancer is the second most common
form of skin cancer.  When identified early and
treated promptly, the future is bright.  However,
if overlooked, they are harder to treat and can
cause disfigurement.  While 96 to 97 percent of
SCCs are localized, the small percentage of
remaining cases can spread to other parts of the
body, and the results are often fatal.
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Melanoma Skin Cancer

• Melanoma Skin Cancer Potentially Deadly
• Look for changes in COLOR - new color, black,
  brown, red, blue or white.

Malignant melanoma is the least common skin
cancer. If it is recognized and treated early,
it is nearly 100 percent curable.  But if it is
not, the cancer can advance and spread to other
parts of the body, where it becomes hard to treat
and can be fatal, accounting for 75 of the total
number of skin cancer deaths.
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Early Detection

• Physician examinations and frequent
  self-examinations are essential for early
  detection of skin cancer.
• The self-exam should be done with the aid of
  bright lights and two mirrors a hand held and a
  full length. Undress completely. Look
  systematically from head to toe and make sure
  that you do not miss any areas. Do it the same
  way every time.

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Early Detection

• Take a close look at all moles because this is
  where melanoma begins. The following, known as
  the ABCDs, are warning signs of potentially
  cancerous moles
• A Asymmetry. Common moles are usually
  symmetric. Draw an imaginary line though the
  center of the mole. If one side is noticeably
  different from the other, the mole is asymmetric
  and may be a problem.
• B Border. An irregular border that seems
  notched or indistinct is a warning sign.
• C Color. Common moles are usually one color.
  Multiple hues or colors is a warning sign.
• D Diameter. A diameter great than 6 mm is a
  warning sign.

See examples on the next slide
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Early Detection
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Moles

• Normal mole round or oval, even color.Many
  moles - increased risk of melanoma skin cancer.

Watch for these changes in moles
Atypical mole mix of browns, smudged border,
often bigger than 6 mm (the size of a pencil
eraser). increased risk of melanoma skin cancer
Sun Fact Forty to 50 percent of Americans who
live to the age of 65 will have skin cancer at
least once.
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Keep Your Skin Healthy

• All people, regardless of age, should take the
  necessary steps to protect their skin. For the
  most complete sun protection, use all three of
  the previously discussed methods
• Avoid the sun during high-intensity hours.
  Reduce the time you spend outdoors during the
  hours of 1000 a.m. to 400 p.m.
• Wear protective clothing. Cover your skin with
  clothing such as long-sleeved shirts, long pants
  and wide-brimmed hats. Dont forget
  sunglasses.
• Use sunscreen. Apply sunscreen liberally 30
  minutes before going outdoors so that your skin
  has time to absorb the sunscreen. Re-apply
  according to the directions on the label
  usually about every hour.

Sun Fact Some medications can make skin more
susceptible to sun damage.
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Conclusion

• The majority of skin cancers are preventable.
  Taking basic precautions can significantly reduce
  the health effects of chronic sun exposure.
• Preventing sun-related skin damage must start
  early in age and continue throughout your
  lifetime.

Sun Fact Your skin has a memory. This means that
your skin remembers the damage that is done to it
over time, which can result in skin cancer later
in life, premature wrinkling, etc.
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Course Review

• Self-Test

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Course ReviewSelf-Test

• Question 1
• Is there a price for having too much fun in the
  sun?

Yes particularly if you are spending time
outdoors without protecting yourself from the
suns ultraviolet radiation.
Click for answer
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Course ReviewSelf-Test

• Question 2 True or False
• Melanin is the first defense against the sun as
  it absorbs dangerous UV rays before they do
  serious harm to your skin.

True
Click for answer
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Course ReviewSelf-Test

• Question 3 True or False
• Two of the more common sun-induced types of skin
  damage are sunburns and suntans.

True
Click for answer
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Course ReviewSelf-Test

• Question 4 True or False
• A sunburn can occur in about 30 minutes time of
  being outdoors unprotected.

False. A sunburn can occur in less than 15
minutes and can take a few day or weeks to heal
depending on the severity of the burn.
Click for answer
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Course ReviewSelf-Test

• Question 5 True or False
• A suntan is your bodys way of blocking out the
  ultraviolet rays to prevent further injury to the
  skin.

True. But the protection only goes so far.
Click for answer
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Course ReviewSelf-Test

• Question 6 True or False
• To get maximum protection from your sunscreen,
  apply at least one large handful about 10 minutes
  before you go outside.

False. Sunscreen should be applied about 30
minutes before venturing outside.
Click for answer
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Course ReviewSelf-Test

• Question 7 True or False
• Everyone is at risk for eye damage from the sun
  year-round.

True
Click for answer
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Course ReviewSelf-Test

• Question 8 True or False
• Infants six months and younger should be kept out
  of direct sunlight.

True. Sunscreens may irritate baby skin, and
infants developing eyes are particularly
vulnerable to sunlight.
Click for answer
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Course ReviewSelf-Test

• Question 9 True or False
• The weather temperature is a reliable indication
  of the suns UV intensity.

False. The suns UV index can change everyday,
just as the temperature does.
Click for answer
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Course ReviewSelf-Test

• Question 10 True or False
• Skin cancer is the fastest growing cancer in the
  United States.

True
Click for answer
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Course ReviewSelf-Test

• Question 11 True or False
• The three types of skin cancer are basal cell,
  squamous, and malignant melanoma.

True
Click for answer
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Course ReviewSelf-Test

• Question 12
• Of the three types of skin cancer basal cell,
  squamous, and malignant melanoma which accounts
  for 75 of the total number of skin cancer deaths?

malignant melanoma
Click for answer
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Course ReviewSelf-Test

• Question 13 True or False
• For the most complete sun protection avoid the
  sun during high-intensity hours, wear protective
  clothing, and use sunscreen.

True
Click for answer
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Course ReviewSelf-Test

• Question 14 True or False
• Periodic self-examinations are essential for
  early detection of skin cancer.

False. Frequent self-examinations and physician
examinations are essential for early detection of
skin cancer.
Click for answer
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Course ReviewSelf-Test

• Question 15 True or False
• The majority of skin cancers are preventable.

True
Click for answer
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Resources

• If you would like to learn more about skin cancer
  or skin damage, visit your family doctor,
  dermatologist, or contact the following
• Cancer Information Services (CIS)
• 1-800-4-CANCER
• http//cis.nci.nih.gov
• American Cancer Society (ACS)
• 1-800-ACS-2345
• www.cancer.org
• American Academy of Dermatology
• www.aad.org