E016 – For the Love of Sunscreen – For the Love of Data

In this episode, data sheds some (sun)light on what Rob did wrong on a recent trip to the Caribbean and explains the terrible sunburn he has right now. Just in time for Memorial Day and Summer, we take a look at many recent findings and how they will lead us to a healthier outdoor lifestyle.

A LOT of this content came from the Environmental Working Group (EWG). Please visit their site for more great info and the source of much of this episode.

EWG recently released it’s 2017 EWG Sunscreen Guide with research and guidance on sunscreen efficacy, ingredients, and health risks. It is chock full of great information to keep you safe and dispels many misconceptions that most people hold.

Why are sun rays harmful?

UV radiation penetrates the skin and produces genetic mutations that can cause cancer
UVA
- Less intense than UVB, but 30-50x more prevalent
- Dominant tanning ray
- UVA rays penetrate deeper, suppress the immune system, cause harmful free radicals to form, and are associated with higher risk of melanoma
UVB
- UVB rays are the primary cause of sunburns and non-melanoma skin cancer.
- Most intense from 10AM-4PM April through October
- Most reflected by snow or ice
- The chemicals in sunscreen help combat UVB rays more than UVA

Why the Sun (UV Exposure) is Harmful³

New melanoma cases among American adults has tripled since the 1970s, from 7.9 per 100,000 people in 1975 to 25.2 per 100,000 in 2014 (NCI 2017)
Melanoma death rate for white American men, the highest risk group, has escalated sharply, from 2.6 deaths per 100,000 in 1975 to 4.4 in 2014
Since 2003, the rates of new melanoma cases among both men and women have been climbing by 1.7 and 1.4 percent per year, respectively, according to the federal Centers for Disease Control and Prevention (CDC 2016)
More than 3 million Americans develop skin cancer each year (ACS 2017)
Most cases involve one of two disfiguring but rarely fatal forms of skin cancer – basal and squamous cell carcinomas. Studies suggest that basal and squamous cell cancers are strongly related to UV exposure over years.
- Several researchers have found that regular sunscreen use lowers the risk of squamous cell carcinoma (Gordon 2009, van der Pols 2006) and diminishes the incidence of actinic keratosis – sun-induced skin changes that may advance to squamous cell carcinoma (Naylor 1995, Thompson 1993)
- Researchers have not found strong evidence that sunscreen use prevents basal cell carcinoma (Green 1999, Pandeya 2005, van der Pols 2006, Hunter 1990, Rosenstein 1999, Rubin 2005).
- Both UVA and UVB rays can cause melanoma, as evidenced by laboratory studies on people with extreme sun exposures. In the general population, there is a strong correlation between melanoma risk and a person’s number of sunburns, particularly those during childhood (Dennis 2010).
- The use of artificial tanning beds dramatically increases melanoma risk (Coleho 2010).
People who rely on sunscreens tend to burn, and sunburns are linked to cancer.
- When people use sunscreen properly to prevent sunburn, they often extend their time in the sun. They may prevent burns, but they end up with more cumulative exposure to UVA rays, which inflict subtler damage (Autier 2009, Lautenschlager 2007).

However, research isn’t conclusive how the link between UV exposure and sunscreen.

Scientists don’t know conclusively whether sunscreen can help prevent melanoma. There are studies on both sides that say it helps or it does not.
Several factors suggest that regular sun exposure may not be as harmful as intermittent and high-intensity sunlight. Paradoxically, outdoor workers report lower rates of melanoma than indoor workers (Radespiel-Troger 2009).
- Melanoma rates are higher among people who live in northern American cities with less year-round UV intensity than among residents of sunnier cities (Planta 2011).
- Researchers speculate that higher vitamin D levels for people with regular sun exposure may play a role in reduced melanoma risk (Godar 2011, Newton-Bishop 2011, Field 2011).
  - So DRINK MILK!
- The consensus among researchers is that the most important step people can take to reduce their melanoma risk is to avoid sunburn but not all sun exposure (Planta 2011).

What is SPF?

SPF = Sun Protection Factor
How much longer it will take for sun to redden skin than without it (i.e., SPF 15 = 15x longer for the sun to redden you.

IBISWorld, a market research company, reports that sunscreen product sales grew 2.6 percent a year between 2011 and 2016, and generated $394 million annually (IBISWorld 2016)³

Effects by Age

Baby skin is thinner and absorbs more water
Infant and toddler skin has less melanin, which protects from UV light
The older you are the thicker and more pigmented you get, which is more protective
Very few studies are done on the effects on small children
Adults older than 60 are also more sensitive to sunlight

Tanning beds are BAD!

Emit up to 12x the UVA of the sun
People who use tanning beds are 1.5-2.5x more likely to get cancer.
The risk of melanoma goes up when you use a tanning bed at any age, but the International Agency for Research on Cancer calculates that if you start using tanning beds before age 30, your risk of developing melanoma jumps by 75 percent³.

Vitamin A is a bad ingredient

Vitamin A in the form of retinyl palmitate can harm skin when combined with sunlight. Luckily its usage has been falling.

Sprays are convenient, but not the best option

Inhaling the chemicals in the spray can be bad, most people apply too light of a coat, and people miss spots. Despite this their use is on the rise, increasing 27%.

High SPFs are deceiving²

Correctly applied SPF 50 blocks 98% of UVB rays; SPF 100 blocks 99%
The higher the SPF, the more UVB it blocks, but the less UVA it blocks
The way sunscreens are measured may not reflect real world conditions
- In lab measurements, small changes in light can change an SPF 100 sunscreens rating to SPF 37
People spend more time in the sun when they wear a higher SPF
Higher doses of ingredients may be harmful when absorbed into the skin
If you don’t apply enough, or misapply, an SPF 100 sunscreen’s actual rating could be as low as SPF 3.2. T-Shirts are SPF 5.
Most countries cap advertisements at 50+ (Europe, Japan, Canada, etc.); Australia caps at 30

European Sunscreens > American Sunscreens?

Several European companies have developed chemicals that are better at blocking UVA, but these have not yet been approved by the FDA. Europe also requires that the advertised SPF (which is its UVB rating) be no more than 3x the UVA rating.

Tips to Stay Safe in the Sun

Know how intense the sun is

Check a site like http://sunburnmap.com/

Know your ingredients and pick the right SPF

Know what protects you best. Check if a sunscreen’s claims are accurate, and check how harmful the ingredients may be at http://wsw.ewg.org/sunscreen/

FDA-Approved Sunscreens		Side Effects
Active Ingredient/UV Filter Name	Range Covered
	UVA1: 340-400 nm
	UVA2: 320-340 nm
	UVB: 290-320 nm
Chemical Absorbers:
Aminobenzoic acid (PABA)	UVB
Avobenzone	UVA1	Relatively high skin allergen
Cinoxate	UVB
Dioxybenzone	UVB, UVA2
Ecamsule (Mexoryl SX)	UVA2
Ensulizole (Phenylbenzimiazole Sulfonic Acid)	UVB
Homosalate	UVB	Slight skin penetration; disrupts some hormones
Meradimate (Menthyl Anthranilate)	UVA2
Octocrylene	UVB	Relatively high allergen
Octinoxate (Octyl Methoxycinnamate)	UVB	Slight skin penetration; acts like hormone in body; moderate allergen
Octisalate ( Octyl Salicylate)	UVB
Oxybenzone	UVB, UVA2	Penetrates skin significantly; acts like estrogen in the body; relatively high allergen
Padimate O	UVB
Sulisobenzone	UVB, UVA2
Trolamine Salicylate	UVB
Physical Filters:
Titanium Dioxide	UVB, UVA2	Inhalation concerns
Zinc Oxide	UVB,UVA2, UVA1	Inhalation concerns

Table From http://www.skincancer.org/prevention/uva-and-uvb

Follow these tips

Seek the shade, especially between 10 AM and 4 PM.
Do not burn.
Avoid tanning and UV tanning booths.
Cover up with clothing, including a broad-brimmed hat and UV-blocking sunglasses.
Use a broad spectrum (UVA/UVB) sunscreen with an SPF of 15 or higher every day. For extended outdoor activity, use a water-resistant, broad spectrum (UVA/UVB) sunscreen with an SPF of 30 or higher.
Apply 1 ounce (2 tablespoons) of sunscreen to your entire body 30 minutes before going outside. Reapply every two hours, or immediately after swimming or excessive sweating.
Keep newborns out of the sun. Sunscreens should be used on babies over the age of six months.
Examine your skin head-to-toe every month.
See your physician every year for a professional skin exam.
Don’t forget to sunscreen your lips

Most tips From http://www.skincancer.org/prevention/uva-and-uvb

At a glance, do these things:

Other places to protect yourself

Car windows block a lot of UVB, but not UVA
- Two studies found significantly more melanoma on the left side of the body/face, suggesting long exposure in cars puts you at more risk
- Car windshields block a lot of UVB and UVA because of the plastic in the middle (around SPF 50); side windows do not do so well (around SPF 16)
- Transparent window films block out almost 100% of both UVA and UVB
Skip the sunroof and convertible
Check office windows and skylights to see if they are glass or plastic and if they are treated with a UV film

Tips if you get a Sunburn¹⁷

Take frequent cool baths or showers to help relieve the pain. As soon as you get out of the bathtub or shower, gently pat yourself dry, but leave a little water on your skin. Then, apply a moisturizer to help trap the water in your skin. This can help ease the dryness.
Use a moisturizer that contains aloe vera or soy to help soothe sunburned skin. If a particular area feels especially uncomfortable, you may want to apply a hydrocortisone cream that you can buy without a prescription. Do not treat sunburn with “-caine” products (such as benzocaine), as these may irritate the skin or cause an allergic reaction.
Consider taking aspirin or ibuprofen to help reduce any swelling, redness and discomfort.
Drink extra water. A sunburn draws fluid to the skin’s surface and away from the rest of the body. Drinking extra water when you are sunburned helps prevent dehydration.
If your skin blisters, allow the blisters to heal. Blistering skin means you have a second-degree sunburn. You should not pop the blisters, as blisters form to help your skin heal and protect you from infection.
Take extra care to protect sunburned skin while it heals. Wear clothing that covers your skin when outdoors. Tightly-woven fabrics work best. When you hold the fabric up to a bright light, you shouldn’t see any light coming through.

Tips from https://www.aad.org/public/skin-hair-nails/injured-skin/treating-sunburn

Music

“Wear Sunscreen Commencement Speech” by Mike Harper, KNVE

Sources

Podcast: Play in new window | Download

Tips to Stay Safe in the Sun

Tips if you get a Sunburn17

Music

Sources

Tips if you get a Sunburn¹⁷