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      Human health in relation to exposure to solar ultraviolet radiation under changing stratospheric ozone and climate

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          Abstract

          The Montreal Protocol has limited increases in the UV-B (280–315 nm) radiation reaching the Earth's surface as a result of depletion of stratospheric ozone. Exposure to UV-B radiation has both risks and benefits for human health.

          Abstract

          The Montreal Protocol has limited increases in the UV-B (280–315 nm) radiation reaching the Earth's surface as a result of depletion of stratospheric ozone. Nevertheless, the incidence of skin cancers continues to increase in most light-skinned populations, probably due mainly to risky sun exposure behaviour. In locations with strong sun protection programs of long duration, incidence is now reducing in younger age groups. Changes in the epidemiology of UV-induced eye diseases are less clear, due to a lack of data. Exposure to UV radiation plays a role in the development of cataracts, pterygium and possibly age-related macular degeneration; these are major causes of visual impairment world-wide. Photodermatoses and phototoxic reactions to drugs are not uncommon; management of the latter includes recognition of the risks by the prescribing physician. Exposure to UV radiation has benefits for health through the production of vitamin D in the skin and modulation of immune function. The latter has benefits for skin diseases such as psoriasis and possibly for systemic autoimmune diseases such as multiple sclerosis. The health risks of sun exposure can be mitigated through appropriate sun protection, such as clothing with both good UV-blocking characteristics and adequate skin coverage, sunglasses, shade, and sunscreen. New sunscreen preparations provide protection against a broader spectrum of solar radiation, but it is not clear that this has benefits for health. Gaps in knowledge make it difficult to derive evidence-based sun protection advice that balances the risks and benefits of sun exposure.

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          Most cited references295

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          Effect of Time Spent Outdoors at School on the Development of Myopia Among Children in China: A Randomized Clinical Trial.

          Myopia has reached epidemic levels in parts of East and Southeast Asia. However, there is no effective intervention to prevent the development of myopia.
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            Ultraviolet-radiation-induced inflammation promotes angiotropism and metastasis in melanoma.

            Intermittent intense ultraviolet (UV) exposure represents an important aetiological factor in the development of malignant melanoma. The ability of UV radiation to cause tumour-initiating DNA mutations in melanocytes is now firmly established, but how the microenvironmental effects of UV radiation influence melanoma pathogenesis is not fully understood. Here we report that repetitive UV exposure of primary cutaneous melanomas in a genetically engineered mouse model promotes metastatic progression, independent of its tumour-initiating effects. UV irradiation enhanced the expansion of tumour cells along abluminal blood vessel surfaces and increased the number of lung metastases. This effect depended on the recruitment and activation of neutrophils, initiated by the release of high mobility group box 1 (HMGB1) from UV-damaged epidermal keratinocytes and driven by Toll-like receptor 4 (TLR4). The UV-induced neutrophilic inflammatory response stimulated angiogenesis and promoted the ability of melanoma cells to migrate towards endothelial cells and use selective motility cues on their surfaces. Our results not only reveal how UV irradiation of epidermal keratinocytes is sensed by the innate immune system, but also show that the resulting inflammatory response catalyses reciprocal melanoma-endothelial cell interactions leading to perivascular invasion, a phenomenon originally described as angiotropism in human melanomas by histopathologists. Angiotropism represents a hitherto underappreciated mechanism of metastasis that also increases the likelihood of intravasation and haematogenous dissemination. Consistent with our findings, ulcerated primary human melanomas with abundant neutrophils and reactive angiogenesis frequently show angiotropism and a high risk for metastases. Our work indicates that targeting the inflammation-induced phenotypic plasticity of melanoma cells and their association with endothelial cells represent rational strategies to specifically interfere with metastatic progression.
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              International trends in the incidence of malignant melanoma 1953-2008--are recent generations at higher or lower risk?

              The incidence of cutaneous malignant melanoma has steadily increased over the past 50 years in predominately fair-skinned populations. This increase is reported to have leveled off recently in several Northern and Western European countries, Australia, New Zealand and in North America. We studied the global patterns and time trends in incidence of melanoma by country and sex, with a focus on and age- and cohort-specific variations. We analyzed the incidence data from 39 population-based cancer registries, examining all-ages and age-truncated standardized incidence rates of melanoma, estimating the annual percentage change and incidence rate ratios from age-period-cohort models. Incidence rates of melanoma continue to rise in most European countries (primarily Southern and Eastern Europe), whereas in Australia, New Zealand, the U.S., Canada, Israel and Norway, rates have become rather stable in recent years. Indications of a stabilization or decreasing trend were observed mainly in the youngest age group (25-44 years). Rates have been rising steadily in generations born up to the end of the 1940s, followed by a stabilization or decline in rates for more recently born cohorts in Australia, New Zealand, the U.S., Canada and Norway. In addition to the birth cohort effect, there was a suggestion of a period-related influence on melanoma trends in certain populations. Although our findings provide support that primary and secondary prevention can halt and reverse the observed increasing burden of melanoma, they also indicate that those prevention measures require further endorsement in many countries. Copyright © 2012 UICC.
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                Author and article information

                Journal
                PPSHCB
                Photochemical & Photobiological Sciences
                Photochem. Photobiol. Sci.
                Royal Society of Chemistry (RSC)
                1474-905X
                1474-9092
                March 13 2019
                2019
                : 18
                : 3
                : 641-680
                Affiliations
                [1 ]National Centre for Epidemiology and Population Health
                [2 ]Research School of Population Health
                [3 ]Australian National University
                [4 ]Canberra
                [5 ]Australia
                [6 ]Centre for Ophthalmology and Visual Science
                [7 ]University of Western Australia
                [8 ]Perth
                [9 ]MRC Institute of Genetics and Molecular Medicine
                [10 ]King's College London
                [11 ]London
                [12 ]UK
                [13 ]Biomedical Sciences
                [14 ]University of Edinburgh Medical School
                [15 ]Edinburgh
                [16 ]Department of Dermatology
                [17 ]Leiden University Medical Centre
                [18 ]Leiden
                [19 ]The Netherlands
                [20 ]Akita University School of Medicine
                [21 ]National Institute for Minamata Disease
                [22 ]Tokyo
                [23 ]Japan
                [24 ]Centre for Dermatology Research
                [25 ]School of Biological Sciences
                [26 ]Faculty of Biology, Medicine, and Health
                [27 ]The University of Manchester and Salford Royal NHS Foundation Trust
                [28 ]Manchester Academic Health Science Centre
                [29 ]Cancer Council Victoria
                [30 ]Melbourne
                [31 ]QIMR Berghofer Institute of Medical Research
                [32 ]Brisbane
                [33 ]School of Public Health
                [34 ]University of Queensland
                Article
                10.1039/C8PP90060D
                30810559
                e81e4ef7-a7bb-4133-8395-b0661370fddb
                © 2019

                http://rsc.li/journals-terms-of-use

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