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Estimation of exposure durations for vitamin D production and sunburn risk in Switzerland

A Correction to this article was published on 07 May 2019

This article has been updated

Abstract

Although overexposure to solar ultraviolet radiation (UVR) is responsible for cutaneous melanoma and epithelial skin cancer and can cause negative health effects such as sunburn, a “little and often” exposure regime is often suggested to produce naturally recommended vitamin D levels, being essential for skeletal health. This study aimed to quantify solar UV doses needed to trigger 1000 International Units (IU) vitamin D doses and, at the same time, producing sunburn in Switzerland. Solar UV erythema irradiance (in mW/m2) measured at four meteorological stations in Switzerland for the period 2005–2017 were used to evaluate effective solar UV radiation producing 1000 IU vitamin D doses in skin phototype II and III individuals. Daily solar UV exposure durations (in minutes) needed to produce vitamin D with limited sunburn risk were estimated while considering mean vitamin D food intake of the Swiss population and seasonal skin coverage. In summer and spring, with 22% of uncovered skin, 1000 IU vitamin D doses are synthesized in 10–15 min of sun exposure for adults. Exposure durations between erythema risk and 1000 IU vitamin D production vary between 9 and 46 min. In winter and autumn, the recommended vitamin D production without sunburn risks often unachievable, since up to 6.5 h of sun exposure might be necessary considering 8–10% of uncovered skin surface. The vitamin D food intake only represented 10% of the recommended vitamin D production and remained unchanged throughout the year. These findings might clarify why vitamin D deficiency is common in Switzerland. Moreover, exposure durations between recommended vitamin D and increased sunburn risk might only differ by few minutes. Without additional oral vitamin D supplementation, daily doses of vitamin D (1000 IU) are not reachable in autumn and winter months in Switzerland.

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Change history

  • 07 May 2019

    In the original article, the authorship list was given as “A. Religi1, C. Backes2,3, A. Chatelan2, J.-L. Bulliard2, L. Vuilleumier4, L. Moccozet1, M. Bochud2, D. Vernez3”. This has been updated to “A. Religi*1, C. Backes*2,3, A. Chatelan2, J.-L. Bulliard2, L. Vuilleumier4, L. Moccozet1, M. Bochud 2, D. Vernez3”.

References

  1. 1.

    Moukayed M, Grant WB. Molecular link between vitamin D and cancer prevention. Nutrients. 2013;5:3993–4021.

  2. 2.

    Scott J, Lu K. Vitamin D as a therapeutic option for sunburn: clinical and biologic implications. DNA Cell Biol. 2017;36:879–82.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  3. 3.

    Bikle D. Vitamin D prevents sunburn: tips for the summer? J Invest Dermatol. 2017;137:2045–7.

    Article  CAS  Google Scholar 

  4. 4.

    Martineau AR, Jolliffe DA, Hooper RL, Greenberg L, Aloia JF, Bergman P, et al. Vitamin D supplementation to prevent acute respiratory tract infections: systematic review and meta-analysis of individual participant data. BMJ. 2017;356:i6583

  5. 5.

    Cantorna MT. Vitamin D and its role in immunology: multiple sclerosis, and inflammatory bowel disease. Prog Biophys Mol Biol. 2006;92:60–64.

    Article  CAS  Google Scholar 

  6. 6.

    Holick MF. Sunlight and vitamin D for bone health and prevention of autoimmune diseases, cancers, and cardiovascular disease. Am J Clin Nutr. 2004;80:1678S-88S.

  7. 7.

    Engelsen O, Brustad M, Aksnes L, Lund E. Daily duration of vitamin D synthesis in human skin with relation to latitude, total ozone, altitude, ground cover, aerosols and cloud thickness. Photochem Photobiol. 2005;81:1287–90.

    Article  CAS  Google Scholar 

  8. 8.

    Engelsen O. The relationship between ultraviolet radiation exposure and vitamin D status. Nutrients. 2010;2:482–95.

  9. 9.

    Webb AR. Who, what, where and when-influences on cutaneous vitamin D synthesis. Prog Biophys Mol Biol. 2006;92:17–25.

    Article  CAS  Google Scholar 

  10. 10.

    Webb A, Kline L, Holick M. Influence of season and latitude on the cutaneous synthesis of vitamin D3: exposure to winter sunlight in Boston and Edmonton will not promote vitamin D3 synthesis in human skin. J Clin Endocrinol Metab. 1988;67:373–8.

    Article  CAS  Google Scholar 

  11. 11.

    Armstrong B, Kricker A. The epidemiology of UV induced skin cancer. J Photochem Photobiol B. 2001;63:8–18.

    Article  CAS  Google Scholar 

  12. 12.

    DGE, OGE and SGE, Referenzwerte für die Nährstoffzufuhr. 1. Auflage. Deutsche Gesellschaft für Ernährung, Deutsche Gesellschaft für Ernährung, Schweizerische Gesellschaft für Ernährungsforschung, Schweizerische Vereinigung für Ernährung, Bonn: Umschau Braus GmbH, 2017.

  13. 13.

    OSAV. Office fédéral de la sécurité alimentaire et des affaires vétérinaires, Recommendations concernant la vitamine D. 2017.

  14. 14.

    Zehnder D, Bland R, Williams M, McNinch R, Howie A, Stewart P, et al. Extrarenal expression of 25-hydroxyvitamin d(3)-1 alpha-hydroxylase. J Clin Endocrinol Metab. 2001;86:888–94.

    CAS  PubMed  Google Scholar 

  15. 15.

    Fioletov VE, McArthur LJ, Mathews TW, Marret L. On the relationship between erythemal and vitamin D action spectrum weighted ultraviolet radiation. J Photochem Photobiol B. 2009;95:9–16.

    Article  CAS  Google Scholar 

  16. 16.

    Moan J, Porojnicu AC, Dahlback A, Setlow RB. Addressing the health benefits and risks, involving vitamin D or skin cancer, of increased sun exposure. Proc Natl Acad Sci USA. 2008;105:668–73.

    Article  Google Scholar 

  17. 17.

    Webb AR, Engelsen O. Ultraviolet exposure scenarios: risks of erythema from recommendations on cutaneous vitamin D synthesis. Sunlight, Vitamin D and Skin Cancer. Adv Exp Med Biol. 2008;72–85.

  18. 18.

    Romanhole RC, Ataide JA, Moriel P, Mazzola PG. Update on ultraviolet A and B radiation generated by the sun and artificial lamps and their effects on skin. Int J Cosmet Sci. 2015; 37:366–70.

  19. 19.

    Guerra K, Crane J. Cancer, Skin, Prevention. Treasure Island (FL): StatPearls Publishing; 2018.

    Google Scholar 

  20. 20.

    Madronich S, Mckenzie R, Bjorn LaCM. Changes in biologically active ultraviolet radiation reaching the Earth’s surface. J Photochem Photobiol. 1998;46:5–19.

    Article  CAS  Google Scholar 

  21. 21.

    HF DeLuca. History of the discovery of vitamin D and its active metabolites. Bonekey Rep. 2014;3:479.

  22. 22.

    Guessous I, Dudler V, Glatz N, Theler J-M, Zoller O, Paccaud F, Bochud M. Vitamin D levels and associated factors: a population-based study in Switzerland. Swiss Med Wkly. 2012:142. https://doi.org/10.4414/smw.2012.13719.

  23. 23.

    Richard A, Rohrmann S, Quack Lötscher K. Prevalence of vitamin D deficiency and its associations with skin color in pregnant women in the first trimester in a sample from Switzerland. Nutrients. 2017;9:260.

    Article  PubMed  PubMed Central  Google Scholar 

  24. 24.

    Diffey BL. Is casual exposure to summer sunlight effective at maintaining adequate vitamin D status?. Photodermatol Photoimmunol Photomed. 2010;26:172–6.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  25. 25.

    Webb A, Kift R, Berry J, Rhodes L. The vitamin D debate: translating controlled experiments into reality for human sun exposure times. Photochem Photobiol. 2011;87:741–5.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  26. 26.

    Biesalski H, Köhrle J, Schürmann K. Vitamine, Mineralstoffe und Spurenelemente. Stuttgart: Thieme; 2002.

    Google Scholar 

  27. 27.

    McKenzie R, Liley J, Bjorn L. UV radiation: balancing risks and benefits. Photochem Photobiol. 2009;85:88–98.

    Article  CAS  Google Scholar 

  28. 28.

    Schrempf M, Thuns N, Lange K, Seckmeyer G. Impact of orientation on the vitamin D weighted exposure of a human in an urban environment. Int J Environ Res Public Health. Health. 2017;14:920

    Article  CAS  Google Scholar 

  29. 29.

    Seckmeyer G, Schrempf M, Wieczorek A, Riechelmann S, Graw K, Seckmeyer S, et al. A novel method to calculate solar UV exposure relevant to vitamin D production in humans. Photochem Photobiol. 2013;89:974–83.

    Article  CAS  Google Scholar 

  30. 30.

    CIE. Commission International de l’Eclairage, Rationalizing nomenclature for UV doses and effects on humans. 2014.

  31. 31.

    Godar D, Pope S, Grant W, Holick M. Solar UV doses of adult Americans and vitamin D(3) production. Dermatoendocrinol. 2011;3:243–50.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  32. 32.

    Bulliard JL, De Weck D, Bordoni FTA, Levi F. Detailed site distribution of melanoma and sunlight exposure: aetiological patterns from a Swiss series. Ann Oncol. 2017;18:789–94.

    Article  Google Scholar 

  33. 33.

    Chatelan A, Beer-Borst S, Randriamiharisoa A, Pasquier J, Blanco JM, Siegenthaler S, et al. Major differences in diet across three linguistic regions of Switzerland: Results from the First National Nutrition Survey menuCH. Nutrients. 2017;9:1163.

    Article  PubMed  PubMed Central  Google Scholar 

  34. 34.

    Thompson J, Fioletov V, Marrett L, Rosen C, Weinstock M. Vitamin D at the expense of skin cancer protection: is it worth the risk?. J Invest Dermatol. 2016;136:2104–5.

    Article  CAS  Google Scholar 

  35. 35.

    Serrano M, Canada J, Moreno J, Gurrea G. Solar ultraviolet doses and vitamin D in a northern mid-latitude. Sci Total Environ. 2017;574:744–50.

    Article  CAS  Google Scholar 

  36. 36.

    M Holick, Evolution, biologic functions, and recommended dietary allowances for vitamin D. In Vitamin D, Totowa, NJ: Humana Press, 1999, p.1–16.

  37. 37.

    Dubuisson C, Lioret S, Touvier M, Dufour A, Calamassi-Tran, Volatier JL, et al. Trends in food and nutritional intakes of French adults from 1999 to 2007: results from the INCA surveys. Br J Nutr. 2010;103:1035–48.

    Article  CAS  Google Scholar 

  38. 38.

    Bochud M, Chatelan A, Blanco JM, Beer-Borst SM. Anthropometric characteristics and indicators of eating and physical activity behaviors in the Swiss adult population: results from menuCH 2014–2015. Report on behalf of the Federal Office of Public Health and the Food Safety and Veterinary Office, 2017.

  39. 39.

    Olds W, McKinley A, Moore M, Kimlin M. In vitro model of vitamin D3 (cholecalciferol) synthesis by UV radiation: dose-response relationships. J Photochem Photobiol B. 2008;93:88–93.

    Article  CAS  Google Scholar 

  40. 40.

    Pludowski P, Holick M, Grant W, Konstantynowicz J, Mascarenhas M, Haq A, et al. Vitamin D supplementation guidelines. J Steroid Biochem Mol Biol. 2018;175:125–35.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  41. 41.

    Holick MF. Vitamin D deficiency. N Engl J Med. 2007;357:266–81.

    Article  CAS  Google Scholar 

  42. 42.

    Bischoff-Ferrari HA, Giovannucci E, Willett WC, Dietrich T, Dawson-Hughes B. Estimation of optimal serum concentrations of 25-hydroxyvitamin D for multiple health outcomes. Am J Clin Nutr. 2006;84.1:18–28.

    Article  Google Scholar 

  43. 43.

    D Wolpowitz and G B, Clarifying the vitamin D controversy: The health benefits of supplementation by diet versus sunshine, vol. Skin Aging, Berlin, Heidelberg: Springer, 2006. 81–102.

  44. 44.

    Ross A, Manson J, Abrams A, Aloia J, Brannon P, Clinton S. et al. The 2011 report on dietary reference intakes for calcium and vitamin D from the Institute of Medicine: what clinicians need to know. J Clin Endocrinol Metab. 2011;96:53–58.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  45. 45.

    McDonnell S, Baggerly C, French C, Baggerly L, Garland C, Gorham E, et al. Breast cancer risk markedly lower with serum 25-hydroxyvitamin D concentrations ≥60 vs <20ng/ml (150 vs 50 nmol/L): Pooled analysis of two randomized trials and a prospective cohort. PloS ONE. 2018;13:e0199265.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  46. 46.

    McDonnell SL, Baggerly KA, Baggerly CA, Aliano JL, French CB, Baggerly LL, et al. Maternal 25(OH)D concentrations ≥40ng/mL associated with 60% lower preterm birth risk among general obstetrical patients at an urban medical center. PLoS ONE. 2017;12:e0180483.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  47. 47.

    McDonnell SL, Baggerly C, French CB, Baggerly LL, Garland CF, Gorham ED, et al. Serum 25-hydroxyvitamin D concentrations≥40ng/ml are associated with >65% lower cancer risk: pooled analysis of randomized trial and prospective cohort study. PLoS ONE. 2016;11:e0152441.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  48. 48.

    Fitzpatrick TB. Soleil et peau [Sun and skin]. Journal de Médecine Esthétique (in French). 33–34, 1975.

  49. 49.

    Andreassi L, Casini L, Simoni S, Bartalini P, Fimiani M. Measurement of cutaneous colour and assessment of skin type. Photodermatol Photoimmunol Photomed. 1990;7:20–24.

    CAS  PubMed  Google Scholar 

  50. 50.

    Geller A, Jablonski N, Pagoto S, Hay J, Hillhouse J, Buller D, et al. Interdisciplinary Perspectives on Sun Safety. JAMA Dermatol. 2018;154:88–92. 1

    Article  PubMed  PubMed Central  Google Scholar 

  51. 51.

    Wulf H, Philipsen P, Ravnbak M. Minimal erythema dose and minimal melanogenesis dose relate better to objectively measured skin type than to Fitzpatricks skin type. Photodermatol Photoimmunol Photomed. 2010;26:280–4.

    Article  Google Scholar 

  52. 52.

    Ravnbak M. Objective determination of Fitzpatrick skin type. Dan Med Bull. 2010;57:B4153.

    PubMed  Google Scholar 

  53. 53.

    Sheehan J, Potten C, Young A. Tanning in human skin types II and III offers modest photoprotection against erythema. Photochem Photobiol. 1998;68:588–92.

    Article  CAS  Google Scholar 

  54. 54.

    Coelho S, Yin L, Smuda C, Mahns A, Kolbe L, Hearing V. Photobiological implications of melanin photoprotection after UVB-induced tanning of human skin but not UVA-induced tanning. Pigment Cell Melanoma Res. 2015;28:210–6.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  55. 55.

    Stahl W, Sies H. Photoprotection by dietary carotenoids: concept, mechanisms, evidence and future development. Mol Nutr Food Res. 2012;56:287–95.

    Article  CAS  Google Scholar 

  56. 56.

    Stahl W, Heinrich U, Aust O, Tronnier H, Sies H. Lycopene-rich products and dietary photoprotection. Photochem Photobiol Sci. 2006;5:238–42.

    Article  CAS  Google Scholar 

  57. 57.

    Alaluf S, Heinrich U, Stahl W, Tronnier H, Wiseman S. Dietary carotenoids contribute to normal human skin color and UV photosensitivity. J Nutr. 2002;132:399–403.

    Article  CAS  Google Scholar 

  58. 58.

    Black H, Rhodes L. The potential of omega-3 fatty acids in the prevention of non-melanoma skin cancer. Cancer Detect Prev. 2006;30:224–32.

  59. 59.

    Guo J, Lovegrove JA, Givens DI. 25(OH)D3-enriched or fortified foods are more efficient at tackling inadequate vitamin D status than vitamin D3. Proc Nutr Soc. 2018;77:282–91.

    Article  CAS  Google Scholar 

  60. 60.

    Holick M. Vitamin D: A millenium perspective. J Cell Biochem. 2003;88:296–307.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

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Acknowledgements

This work was supported by the Swiss National Science Foundation (SNF) grant CR23I3_152803. Herewith we would like to thank the Federal Department of Home Affairs (FDHA), the Federal Food Safety and Veterinary Office (FSVO), Division Risk Assessment for having provided the Swiss Nutrition Survey (menuCH) data. Further, we are grateful to M. A. Serrano from the Solar Radiation Research Group of the Universitat Politècnica de València for her fruitful and constructive comments.

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Religi, A., Backes, C., Chatelan, A. et al. Estimation of exposure durations for vitamin D production and sunburn risk in Switzerland. J Expo Sci Environ Epidemiol 29, 742–752 (2019). https://doi.org/10.1038/s41370-019-0137-2

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