Abstract
Consideration of the implications of solar UV exposure on public health during extreme temperature events is important due to their increasing frequency as a result of climate change. In this paper public health impacts of solar UV exposure, both positive and negative, during extreme hot and cold weather in England in 2018 were assessed by analysing environmental variations in UV and temperature. Consideration was given to people’s likely behaviour, the current alert system and public health advice. During a period of severe cold weather in February-March 2018 UV daily doses were around 25–50% lower than the long-term average (1991–2017); however, this would not impact on sunburn risk or the benefit of vitamin D production. In spring 2018 unseasonably high temperatures coincided with high UV daily doses (40–75% above long-term average) on significant days: the London Marathon (22 April) and UK May Day Bank Holiday weekend, which includes a public holiday on the Monday (5–7 May). People were likely to have intermittent excess solar UV exposure on unacclimatised skin, causing sunburn and potentially increasing the risk of skin cancers. No alerts were raised for these events since they occurred outside the alerting period. During a heat-wave in summer 2018 the environmental availability of UV was high—on average of 25% above the long-term average. The public health implications are complex and highly dependent on behaviour and sociodemographic variables such as skin colour. For all three periods Pearson’s correlation analysis showed a statistically significant (p<0.05) positive correlation between maximum daily temperature and erythema-effective UV daily dose. Public health advice may be improved by taking account of both temperature and UV and their implications for behaviour. A health impact-based alert system would be of benefit throughout the year, particularly in spring and summer.
Highlights
It is known that climate change is resulting in increased frequency of hot weather episodes [1,2,3,4]
It can be used as an approximation for some health effects that are dependent on the shortest terrestrial UV-B wavelengths including cutaneous vitamin D generation and increased risk of skin cancers [47, 48]. ese health impacts are dependent on dose [20, 49]. e particular units chosen for this analysis are standard erythemal dose (SED) which is 100 Jm− 2 erythema effective UV irradiance. e dose required to produce sunburn is dependent on skin type; 2 SED is likely to elicit erythema in a very sensitive skin type (Fitzpatrick skin type I), whereas higher skin types (Fitzpatrick skin type V or VI) may require 20 SED to develop erythema [19, 50]
In order to protect the public from harm to health from cold and hot weather, England has two frameworks in place—the Cold Weather Plan for England [62] and Heat Wave Plan for England [63]. ese are supported by an alert system, delivered by the UK Met Office in partnership with Public Health England (PHE), which raises cold weather alerts (CWA) and heat-wave alerts (HWA) based on temperature thresholds
Summary
It is known that climate change is resulting in increased frequency of hot weather episodes [1,2,3,4]. Ese periods of extreme temperatures are likely to significantly impact public health [6,7,8,9,10,11,12,13,14]; little has been said regarding how these events may be affecting people’s exposure to solar UV radiation. Exposure to solar UV-B benefits vitamin D production and bone health [21, 22]; there is emerging evidence of the role of UVA in cardiovascular health [15, 18, 23,24,25,26,27,28,29,30,31,32], and there are suggestions that solar UV exposure reduces the risk of some cancers and other causes of death [18, 33,34,35]. Too little as well as too much exposure to the sun and to solar UV in particular
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