By Christine V. Amstutz RN MN
Supervisor Health Services
Yes, sunshine always makes me smile. However, I am becoming more aware of
ultraviolet (UV) rays, the UV Index, and the fact that my suntan actually appears
after the sun’s UV rays have damaged and/or killed more skin cells. This
realization has prompted me to write about skin cancer prevention. Sunburns and
tanning during childhood especially increase a young person’s risk of developing
skin cancer as an adult. Incredibly, up to 80 % of cumulative lifetime sun
exposure can occur by age 18!
The general public is becoming increasingly aware that sunlight is the chief
cause of skin cancer. However, many of us are unaware that skin cancer is now
viewed as an epidemic by the centers for Disease Control and Prevention. One
out of every five Californians is expected to eventually get skin cancer. UV rays
also cause blistering sunburns, cataracts, premature wrinkling and a weakened
immune system. Since 2000, the federal government has officially classified solar
radiation (including UV rays) as a “known human carcinogen,” a category also
applicable to elements such as asbestos, arsenic, radon and tobacco smoke.
UV rays are a part of sunlight that is an invisible form of radiation. UV rays can
penetrate and change the structure of skin cells. It is also believed that UV rays
can cause damage to connective tissue and increase a person’s risk for
developing skin cancer. In California, UV radiation is more intense and
destructive d uring 10 a.m.-4 p.m., and when there is a cloud cover.
The UV Index was developed by the National Weather Service and
Environmental Protection Agency (EPA). It provides a forecast of the expected
risk of overexposure to UV rays and indicates the degree of caution one should
take when working, playing, or exercising outdoors. The UV Index predicts
exposure levels on a 0 -10+ scale, where 0 indicates a low risk of overexposure
and 10+ means a very high risk or overexposure. The level of danger calculated
for the basic categories of the index are for a person whose skin type burns
easily and tans minimally. For this type of person, an Index value of 5 or 6
represents a moderate possibility of UV exposure. The skin’s susceptibility to
burning can be classified on a five-point scale as outlined in the following table.
The table shows skin types and their tanning and sunburn history. People with
skin types I and II are at the highest risk for damage as a result of sun exposure.
Although the risk is lower among those with darker skin or complexion, they too
can get skin cancer.
| Skin Type |
Tanning and Sunburn History |
| I |
Always burns, never tans, sensitive to sun exposure |
| II |
Burns easily, tans minimally |
| III |
Burns moderately, tans gradually to light brown |
| IV |
Burns minimally, always tans well to moderately brown |
| V |
Rarely burns, tans profusely to dark |
| VI |
Never burns, deeply pigmented, least sensitive |
Adapting behaviors such as use of sunscreen, hats, and protective clothing is
advised for any skin type. Regardless of the type of sunscreen one chooses, it
should offer at least Sun Protection Factor (SPF) of 15. Higher numbers of SPF
indicate more protection. Sunscreens help prevent problems related to sun
exposure, such as aging skin and precancerous growths. Hats should provide
shade for all of the head and neck. Wrap around sunglasses work best because
they block UV rays from sneaking in from the side. Wearing clothing made of
tightly-woven fabric is best for protecting skin with darker colors providing more
protection than lighter colors. Interestingly enough UV rays can reflect off virtually
any surface (including sand, snow, and concrete) and can reach you in the
shade. The best advice is to protect the skin and lips by applying sunscreen and
wear protective clothing when outside.
Hopefully by following these guidelines sunshine will always make us smile.
http://www.epa.gov/pzpme/uvindex/uvover.html 
http://www.sunsafetyforkids.org
http://www.cdc.gov/cancer/nscpep/skin.htm
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