UV Safety Month: know the risks

With temperatures at near-record highs in Western New York this summer, many residents are headed outside to enjoy the sunshine. The U.S. Department of Health and Human Services, in conjunction with the American Academy of Ophthalmology, has declared July UV Safety Month, with a stated goal of educating the public about staying safe in the sun.

Ultraviolet, or UV, rays are the wavelengths of sunlight that can damage the skin and eyes. They can also cause skin cancer, of which there are several types, with varying degrees of severity. Those include basal cell, squamous cell, and the most invasive and, therefore, the most deadly, melanoma. Most skin cancers form on parts of the body that are most exposed to the sun or in people who have weakened immune systems.

According to the National Cancer Institute at the National Institute of Health, one in 50 men and women who are born today will be diagnosed with skin cancer during his or her lifetime, making that the most common form of cancer in the United States.

Melanoma is the most deadly form of skin cancer. As per the NCI, 44,250 men and 32,000 women, will be diagnosed with and 9,180 men and women will die of melanoma in 2012.

Another 48,000 are diagnosed with an early form of the disease that involves only the top layer of skin.

Although 42 percent of people polled by the Skin Cancer Foundation said they had been sunburned at least once within the past year, sunburn is the most common risk factor for skin cancer. One blistering sunburn during childhood or adolescence more than doubles a person’s chance of developing melanoma later in life. That same statistic applies if a person has had five or more sunburns at any age.

Two nurse practitioners at Bertrand Chaffee Hospital in Springville, Laurie Brown-Croyts and Tina Vandermeer-Gatti, weighed in on the risks of UV exposure. Both nurse practitioners, who work in the primary care center at BCH, said that their most important self-care tips were staying out of the sun between peak times, or 11 a.m. – 4 p.m., and applying sunscreen as part of a person’s daily routine.

“It’s not just a ‘going to the beach,’ thing,” said Vandermeer-Gatti. “They make lotions now with sunscreen built right in, and that’s what I always recommend to people. Make it automatic.”

“Protection has to start early. Once [sunburn has] taken place, you can’t really reverse it. Some people come in with deep burns over a large percentage of their body, and those people may need to be hospitalized. If you start to feel lightheaded, develop a fever [or] can’t keep down foods or liquids, then you might want to come in,” explained Brown-Croyts.

Sand, water, pavement, ice and snow all reflect UV rays, which can also penetrate windshields, windows and clouds. Any time spent in sunlight should be considered exposure, not just in direct rays.

“People need to be careful about their eyes,” Brown-Croyts noted. “I see a lot of cataracts. Cheap sunglasses that do not protect against UVA and UVB rays can actually make the pupils dilate, which lets in those rays even more. Make sure you buy good-quality sunglasses.”

Sunglasses that absorb UV radiation should be used. Any price point is acceptable, provided the sunglasses provide 90 – 100 percent protection against both UVA and UVB rays.

Both health care professionals stressed that sunscreen is an essential part of sun protection. In order to be effective against UV exposure, it must have a sun protection factor of at least 15, although some doctors call SPF 30 the minimum effective level.

Sunscreen should bear a “broad spectrum” label, meaning it protects against both UVA and UVB radiation and should be applied before going outside and every 30 minutes thereafter, more often, if excessive sweating or contact with water occurs.Sunscreen may be applied to infants older than 6 months, as well.

“There has been some controversy over vitamin D. A large percentage of people in the [Western New York] area are deficient,” said Vandermeer-Gatti, noting that unprotected sun exposure can be one source of the vitamin. “People should eat a proper diet and can supplement with vitamins. I would always rather people be deficient in vitamin D than treat skin cancer.

“We see a lot of overexposure on the arms, the face and the left side of the body, because, when you’re driving, that’s the side that gets exposed,” she continued.

Brown-Croyts noted that certain medications, including antibiotics, birth control and diuretics can also increase a person’s sensitivity to the sun and heat. She added that anyone with questions about their medications can call the primary care center.

Regardless of age, sun exposure or risk factors, the USDHHS recommends a full-body skin examination once a month. A home check can be performed, following what the organization calls the ABCDE’s of moles.

– Asymmetry. Normal moles are symmetrical. If one side of the mole does not match the other, it should be examined by a professional.

– Border. If the borders of the mole are ragged, blurred or irregular, the mole may be suspicious.

– Color. A mole that does not have the same color throughout or has shades of tan, brown, blue, white or red should be examined. A mole that has lightened or darkened at a different rate than other moles should also be checked.

– Diameter. Any mole that is larger than a pencil eraser should be seen by a dermatologist.

– Evolving. A mole that is evolving, which includes shrinking, growing, changing color, itching or bleeding, may be cause for concern.

In addition, any new moles that look different from the rest should also be examined more closely, even if they fail to meet the ABCDE criteria.

“If [patients] have changes in any moles they are concerned about, they should come in and have it checked out,” Brown-Croyts advised. “The sooner you can get diagnosed, the better.”

Although many local dermatologists have long waiting lists, both nurse practitioners said they would help ensure that patients with suspicious moles are seen quickly.

“If I see something I’m really concerned about, I’m going to get on the phone and get you in right away,” Vandermeer-Gatti said. “We can usually tell if something is benign or malignant, but when in doubt, I will always refer someone to a specialist.”

Both professionals warned against heatstroke or sun poisoning, especially for children and the elderly.

Most people should be drinking between eight and 12 glasses of water each day, she noted, although the required number depends on a person’s activity level.

Older individuals do not have the same thirst indicators that younger people do, so when they start to show signs of heatstroke, they may appear dizzy, confused and lethargic.

“We all need to watch out for each other,” Vandermeer-Gatti said. “Check on your elderly neighbors; make sure they’re drinking enough fluids.”

The primary care center can be reached by calling 592-8140.