WHY THIS IS AN ISSUE
Exposure to the sun and other sources of UVR without sufficient protection is known to cause harm to the skin and eyes.1-3 The first and second National Sun Surveys showed that between 1996 and 2006, Canadians generally increased their time in the sun without improving protective behaviours.4 At the same time, the incidence rates of melanoma, the most fatal form of skin cancer, have been increasing in Canada and are projected to continue to rise.
In addition to an increased risk of developing subsequent skin cancers, people with previous cases of skin cancer also risk developing a second primary cancer following a primary skin cancer. These include malignancies of the lung, colorectum, breast, liver, leukemias, and lymphomas.6 Both male and female rates of melanoma increase after about age 30 with higher rates in males after age 50.28
65%
It is estimated that around 65% of all melanoma cases are associated with solar and artificial ultraviolet radiation (UVR) exposure - a modifiable and preventable risk factor.29
PROTECT YOUR SKIN, PROTECT YOUR EYES.
From barbeques and ballgames to patio lunches and picking up the dry cleaning, sun exposure isn’t just something you need to think about on vacation. Protecting yourself and your family from UVR means protecting both your skin and eyes using a variety of sun avoidance and protective methods whenever you will be spending time in the sun – be it summer or winter, at home or away.
Recommendations
Whenever possible, plan outdoor activities for before 11 a.m. or after 3 p.m. between April and September when the sun’s rays are most intense.
Use sources of vitamin D that are safer than UVR exposure, e.g., dietary sources, including fortified foods, and vitamin D supplements. Intentional UVR exposure to meet vitamin D requirements is not recommended.
UV INDEX
When you’re checking the daily weather forecast, make sure you also take notice of the UV index – issued daily by Environment Canada. Knowing the UVR maximum for the day will help you plan how much sun protection is required. The higher the UV rating, the more careful you have to be when outside in the sun.
UV INDEX 1 – 2: Low
UV INDEX 3 – 5: Moderate
UV INDEX 6 – 7: High
UV INDEX 8 – 10: Very High
UV INDEX 11+: Extreme
SHADE
Shade – when combined with effective sunscreen and clothing choices – provides important protection from the sun especially when the sun’s rays are most intense between 11 a.m. and 3 p.m., depending on the time of year and location, and when the UV index is 3 or greater. On their own, hats, clothing and sunscreen are not 100% effective at preventing UVR exposure. You can also take time for periodic “shade breaks” when enjoying yourself outdoors.
Take time for periodic “shade breaks” when enjoying yourself outdoors.
Look for the following:
- Permanent structures (inside or buildings that cast a broad shadow)
- Temporary structures (large sun umbrellas or tents)
- Trees with wide spreading branches and thick leaves
Good-quality shade includes dense vegetation and covered structures that offer shade from the side, and not just overhead, to protect against scattered UVR. 12-14 As a general guide, wider and denser sources of shade provide increased SPF.13 Cloth sources of shade, such as canopies and umbrellas, should have tightly woven fabric, and additional protection (clothes, sunglasses, sunscreen) is recommended under shade to protect against scattered UVR, especially on high UV Index days.14
SUNSCREEN
Sunscreen should be used on exposed skin not covered by clothing or accessories. Consider using sunscreen for the lips (e.g., sunscreen lip balm), as well.
- Use a generous amount of sunscreen 15 (liberally apply at least 2 tablespoons to cover normally exposed areas of the body and a teaspoon to cover the face and neck, apply more if you have less clothing on).
- Reapply after swimming, strenuous exercise or toweling off.16
- Use sunscreen that says on the label:
- "Broad spectrum"
- "SPF 30" or higher
- "Water resistant"
Sunscreen comes in a variety of formulations. Find one that suits you best and apply it properly with thorough coverage. Sunscreen formulations that you find easier to apply thoroughly will be more effective.
EYE PROTECTION
For the best protection, sunglasses should fit closely and wrap around the face. Sunglasses should reflect or filter out 99 to 100% of UVR light. Many healthcare benefits cover the cost of prescription eyewear, including prescription sunglasses.
Sunglasses should reflect or filter out 99 to 100% of UVR light.
- The best UV protection is offered by close-fitting wraparound sunglasses.17
- Look for sunglasses or prescription lenses with full UVA and UVB protection. Examples of appropriate labels are "UV400" or "100% UV protection.”
- Note that contact lenses, even those with UV protection, do not provide full coverage for the eye and the skin around the eye.
CLOTHING
A range of clothing choices should be a component of comprehensive sun safety to ensure the best possible protection against harmful UVR.
- Hats should shade the head, face, ears and back of the neck with a wide brim.18
- In general, clothing provides better protection than sunscreen.19,20
- Tightly woven or UV-protective labelled clothing is recommended.21,22
UVR EXPOSURE
Overexposure to UVR is the most important cause of the three main forms of skin cancer: melanoma, basal cell carcinoma and squamous cell carcinoma.1
In addition to skin cancer, overexposure to UVR can also cause premature skin aging, eye damage, and a weakened immune system.25
SKIN TYPES
The pigmentation characteristics of your skin play a huge role in determining your risk of skin cancer. The fairer your skin is, the higher the risk.23 So it's important that you know what your skin type is and understand the risks.
NEVI (BENIGN MOLES OR FRECKLES)
Nevi are benign melanocytic tumours, also known as moles. They are strongly associated with risk for melanoma. The greater the number of nevi on a person's skin, the greater the risk of melanoma. An individual who has more than 100 common nevi or more than two atypical nevi has a five- to twenty-fold increased risk of melanoma.24
Black, very dark brown to black
Never burns, tans very easily, deeply pigmented
Brown, dark brown
Very rarely burns, tans very easily
Olive, moderate brown
Rarely burns, tans with ease to a moderate brown
Medium, white to olive
Sometimes mild burn, gradually tans to olive
White, fair
Usually burns, tans with difficulty
Light, pale white
Always burns, never tans
FAMILY HISTORY
A family history of melanoma, or having a first degree relative (like a parent or sibling) with melanoma, is associated with a two to four times increase in risk of melanoma.25-27