Sun safety: what are the health messages?

Solar ultraviolet radiation (UVR) is a human carcinogen. The UK and the worldwide incidence of cutaneous (skin) melanoma are rising. It is now the second most common cancer in 15-34 year-olds in the UK, increasing by 49% in 1991-2000. The UK government prioritized skin cancer in 1992 in their public health strategy The Health of the Nation, and set the target for reducing the yearly rise in skin cancer incidence by 2005. In 1998 in the Saving Lives: Our Healthier Nation strategy, targets were set to reduce the death rate from cancer, including skin cancer, by 20% by 2010. As a consequence of these targets, since the mid-1990s public health campaigns to reduce sun exposure and skin cancer incidence in the UK have used specific interventions for at-risk groups and the mass media to reach the general population. Evidence indicates a shift in knowledge, with further work required to increase change in behaviour and attitudes. An associate health problem is vitamin D deficiency, which is prevalent across certain UK population groups. The main childhood health problem associated with vitamin D deficiency is the development of rickets, with evidence indicating those at high risk are exclusively breastfed dark-skinned infants, the elderly, those with dark skin pigmentation, and certain cultural groups that cover their bodies in clothing. Adolescents are the group with the highest incidence of low vitamin D status in the UK, with children of Asian descent at higher risk than Caucasian children. Increasing the outdoor activity levels of children in winter and during the cooler hours in summer is one way of increasing safe sun exposure. It is imperative to educate the general public on the risk of vitamin D deficiency, and offer advice on safe sun exposure, dietary sources of vitamin D, and dietary supplements. More research is required on recommendations for daily vitamin D supplements to determine optimal vitamin D levels in different population groups. There also needs to be reliable and accessible evidence on the links between vitamin D deficiency and lack of sun exposure, with sun safe messages adjusted accordingly.