United States
        Environmental Protection
        Agency
Air and Radiation
6205J
EPA430-K-99-035
June 1999
www.epa.gov/sunwise
&EPA The Sun, UV, and You
        A Guide to SunWise Behavior
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                                 T
5_Ek=shile some exposure to sunlight is enjoyable, too much can be
dangerous and cause immediate effects like blistering sunburns
and long-term problems like skin cancer and cataracts.
Overexposure also causes wrinkling and aging of the skin.
Scientists are concerned that ultraviolet (UV)  radiation might even
impair the human immune system.

The U.S. Environmental Protection Agency (EPA) prepared this
booklet to help you understand the risks from overexposure to the
sun's harmful UV rays and how to  protect yourself and your loved
ones from LJV radiation.

This booklet presents the following information:

iVfS" The science behind LJV radiation and stratospheric o/onc.

py,,;3 The health risks from overexposure to LJV radiation.

oicT The steps you can take to protect yourself and your children.

lojM" What the UV Index is and how you can  use it.

>.,%' Details about EPAs SunWise School Program.
kiJ-'-i                                       o

fjf/j' Where  to get more information about the UV Index and
    ways to protect yourself from  the sun.

We hope you find this booklet useful and that you will use the
information provided to help you be SunWise!

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g-Ehe sun gives out energy over a broad spectrum of wavelengths, UV radiation,
which has a shorter wavelength than either visible blue or violet light, is responsible
for sunburn and other adverse health effects. Fortunately for life on earth, stratos-
pheric ozone screens  most harmful UV radiation. "What gets through the ozone
layer, however, can cause the following healrh problems,  particularly for people who
spend substantial time outdoors:

 »  Skin cancer and  other skin disorders
 *  Cataracts and other eye damage
 »  Immune suppression

Because of these adverse health effects, you should limit your exposure to UV radi-
ation and protect yourself when working, playing, or exercising outdoors.
Scientists have classified UV radiation into three
types: UVA, UVB, and UVC.

The stratospheric o/onc layer absorbs some but nor
all of these types of UV radiation:
        UVA
   Not absorbed by the ozone layer
        UVB
   Partially absorbed by rhe o/onc layer
        UVC
   Completely absorbed by oxygen and o/onc in the
   atmosphere

UVA and especially UVB penetrate into the skin
and eyes, and can cause rhe adverse health effects
listed above.
uvc


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The o/.onc layer absorbs most of the sun's harmful LJV rays, but its thickness varies
depending on the time of year and changing weather patterns. The ozone layer has
thinned in certain areas due to the emission of ozone-depleting chemicals.
The sun is ar its highest in the sky around noon. Ar that rime, the sun's rays have
the least distance to travel through the atmosphere, and UVB levels are at their
highest. In the early morning and lare afternoon, die sun's rays pass obliquely
through the atmosphere, and the intensity of UVB is grearly reduced. UVA levels are
not sensitive to o/onc and vary throughout the day much like visible sunlight does.
The sun's angle varies with the seasons, causing the intensity of UV rays ro vary.
UV intensity tends to be highest during the summer months.
The sun's rays are strongest at the equator where the sun is most direcrly overhead
and where UV rays must travel the least distance through  the atmosphere. O/onc
also is naturally thinner in the tropics as compared to the  mid- and high-latitudes,
so there is less o/onc to absorb the UV radiation as  it passes through the atmos-
phere. At higher latitudes the sun is lower in the sky, so UV rays must travel a
greater distance through o/onc-rich portions of the  atmosphere and in turn expose
those latitudes to less UV radiation.
UV intensity increases with altitude because there is less atmosphere to absorb the
damaging rays.
Cloud cover reduces UV levels, bur not completely. Depending on the thickness of
the cloud cover, it is possible to burn on a cloudy day even if it does not feel very
warm.

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HUhe ozone layer forms a thin shield in the stratosphere, protecting life on earth
from rhc sun's harmful LJV rays.  In the 1980s, scientists began accumulating evi-
dence that the ozone layer was being depleted. Depletion of the ozone layer can
result in increased UV radiation  reaching the earth's surface, which can lead to a
greater chance of overexposure to UV radiation and consequent health effects
including skin cancer, cataracts, and immune suppression.
Ozone is a naturally occurring gas that is found in two layers in the atmosphere. In the
layer surrounding the earths surface—the troposphere—ground-level or "bad" o/onc is
an air pollutant that damages human health and vegetation and is a key ingredient of
urban smog. The troposphere extends up to the stratosphere, which is where the "good"
ozone protects life on earth by absorbing some of the suns ultraviolet rays. Stratospheric
o/onc is most concentrated between 6 to 30 miles above the earth's surface.
O/onc is formed when oxygen molecules absorb LJV radiation and split apart into two
oxygen atoms  (O), which combine with other oxygen molecules (Cb) to form ozone
molecules (O;-;).  O/onc also is broken apart as it absorbs LJV radiation. In this way,
UV radiation helps sustain the natural balance of o/onc in the stratosphere, while
ozone in turn absorbs UV radiation, protecting life on earth from harmful radiation.
Until recently, chlorofluorocarbons (CFCs) were used wide-  -^
ly in industry and elsewhere as refrigerants, insulating
foams, and solvents. They           ll _=_•=._  =
migrate into the upper         ^= 1=a"'=" ~ JT^pi.z.
atmosphere after use,  carried  by                  "    1
air currents into the stratosphere. This                 ilr  saf"
process can take as long as 5 to 10 years.                          = <=
These chemicals absorb UV radiation, break apart,         .      ^"^E!
and react with ozone, taking one oxygen atom away and form-

                                    "',  4

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ing highly reactive chlorine monox-
ide. Chlorine monoxide in turn
breaks down ©3 again by pulling
     a single oxygen atom, creating
two O2 molecules, and allowing the
chlorine to move freely to another
ozone molecule. In this way, each
chlorine atom acts as a catalyst,
repeatedly combining with and
breaking apart as many as 100,000
ozone molecules during  its stratos-
pheric life.

Other compounds also damage the
o/onc layer in much the same way
as do CFCs. These ozone-depleting
substances include pesticides such  as
methyl bromide, halons  used in fire
extinguishers, and methyl chloro-
form used in industrial processes.


irfiffifc
 ^*  '""' «
Countries around the world have
recognized the threats posed by
o/onc depletion and have respond-
ed by adopting the Montreal
Protocol on Substances That
Deplete the Ozone Layer. Parties to
this treaty, including the  United States, are phasing out the production and use of
ozone-depleting substances.
Current studies predict that CFC levels in the atmosphere should peak by around
2000 and should fall to pre-1980 levels by about 2050. As international control
measures reduce the release of CFCs and other o/onc-dcplcting substances, natural
atmospheric processes will repair the ozone layer. Until that time, we can expect
increased levels of UV radiation at the earth's surface. These increased UV radiation
levels can lead to a greater chance of overexposure to UV radiation and the conse-
quent health effects.

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  J mcricans love the sun and spend a great deal of time outside—working, play-
ing, exercising—often in clothing that exposes a lot of skin to the sun. Most people
are now aware that too much sun has been linked to skin cancer. However, few
know the degree of risk posed by overexposure, and fewer are aware that the risks
go beyond skin cancer. Recent medical  research  has shown that overexposure to the
sun's UV radiation can contribute to serious health problems. Each year, tor exam-
ple, more than  1 million cases of skin cancer are diagnosed in the United States,
and one person dies every hour from melanoma or nonmelanoma skin cancer.
This section provides a quick overview  of the  major problems linked to excess UV
exposure: skin cancer (i.e., melanoma, basal cell  carcinoma, and squamous cell car-
cinoma); other skin problems; cataracts and other eye damage; and immune system
suppression. Understanding these risks  and taking a few sensible precautions
described in this booklet will  help you to enjoy the sun while lowering your
chances of sun-related health  problems  later in life.
Overexposure to UV radiation poses the risk of serious health effects for everyone,
but not everyone is equally at risk. For example, you may be at greater risk of con-
tracting skin cancer if your skin always burns, or burns easily, and it you have
blond or red hair, or blue, green, or gray eyes. Other factors indicating an increased
risk of skin cancer  include: a history of blistering sunburns in early  childhood, usu-
ally from acute sun overexposure; the presence of many moles; or a  family history
of skin cancer. Also, people who work or otherwise spend a large amount of time
outdoors (i.e., chronic exposure to the sun) may be at higher risk of health effects.
It's a good idea to remember that anyone can contract skin cancer, and that all peo-
ple, no matter what skin type, are equally at risk of eye damage.
Melanoma, the most serious form of skin cancer, also is one of the fastest growing
types of cancer in the United States, Many scientists believe there might be a link
between childhood sunburns and malignant melanoma later in life. Melanoma
cases in this country have more than doubled in the past 2 decades; according to

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the American Cancer Society, about 44,200 new cases of melanoma and 7,300
deaths are currently reported each year.

Melanoma can spread to other parts of the body quickly, but when detected in its
cadiest stages it is almost always curable. If not caught early, melanoma is often fatal.
Melanoma begins as an uncontrolled growth of pigment-producing cells in the
skin. This growth leads to the formation of dark-pigmcntcd malignant moles or
tumors, called melanomas. Melanomas can appear suddenly without warning but
also can develop from or  near a mole. For this reason, it is important to know the
location and appearance of moles on the body so any change will be noticed.
Melanomas are found most frequently on the upper backs of men and women, and
the legs of women, but can occur anywhere on  the body. Be aware  of any unusual
skin condition, especially a change in the size or color of a mole or other darkly or
irregularly pigmented growth or spot; scaliness, oo/ing, bleeding, or change in the
appearance of a bump or nodule; spread of pigment from the border into sur-
rounding skin; and change in sensation  including itchiness, tenderness, or pain.
Unlike melanoma, nonmelanoma skin cancers are rarely fatal. Nevertheless, they
should not be taken lightly. Untreated, they can spread and cause more serious
health problems. An estimated 1  million Americans will develop nonmelanoma
skin cancers this year, while 1,900 will die from the disease.
There are two primary types of nonmelanoma skin cancers:
      Cell Carcinomas are tumors of the skin that usually appear as small, fleshy
bumps or nodules on the head and neck but can occur on other skin areas as well.
It is the most common skin cancer found among fair-skinned people. Basal cell car-
cinoma does not grow quickly and rarely spreads to other parts  of the body. It can,
however, penetrate below the skin to the bone and cause  considerable local damage.
Squamous Cell Carcinomas are tumors that might appear as nodules or as red,
scaly patches. The second most common skin cancer found in fair-skinned people,
squamous cell carcinoma is rarely found  in darker-skinned people. This cancer can
develop into large masses, and unlike basal cell  carcinoma, it can spread to other
parts of the body.


These two nonmelanoma skin cancers have  cure rates as high as 95 percent if
detected and treated early. The key is to watch for signs and  to detect the cancer in
its early stages.

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Basal cell carcinoma tumors usually appear as slowly growing, raised, translucent,
pearly nodules that,  if untreated, mighr crust, discharge pus, and sometimes bleed.
Squamous cell carcinomas usually are raised, red or pink scaly nodules, or wart-like
growths that form pus in the center. They typically develop on the edge of the cars,
the face, lips, mouth, hands, and other exposed areas of the body
These sun-induced skin growths occur on body areas exposed to the sun. The face,
hands, forearms, and the ''V" of the neck are especially susceptible to this type of
blemish. They are premalignant, but if left untreated, actinic keratoses can become
malignant. Look for raised, reddish, rough-textured growths. See a dermatologist
promptly  if you notice these growths.
Chronic exposure to the sun causes changes in the skin called actinic (or solar) degen-
eration. Over time, the skin becomes thick, wrinkled, and leathery. Since it occurs
gradually often manifesting itself many years after the majority of a persons exposure
to the sun,  this condition is often regarded as unavoidable, a normal part of growing
older. With proper protection from UV radiation, however, premature aging of the
skin can be substantially avoided.
Cataracts are a form of eye damage, a loss of transparency in the lens that clouds
vision. Left untreated, cataracts can rob people of vision. Research has shown that
UV radiation increases the likelihood of certain cataracts. Although curable with
modern eye surgery, cataracts diminish the eyesight of millions of Americans and
necessitate billions of dollars of eye surgery each year. Other kinds of eye damage
include: pterygium (tissue growth on the white of the eye that can  block vision), skin
cancer around the eyes, and degeneration of the macula (the part of the retina near
the center, where  visual perception is  most acute). All of these problems could be
lessened with proper eye protection from UV radiation.

Scientists have found that sunburn can alter the distribution and function of disease-
fighting white blood cells in humans for up to 24 hours after exposure to the sun.
Repeated exposure to UV radiation might cause more long-lasting damage to the
body's immune system. Mild sunburns can suppress immune functions in people of
all skin types.
                                    \8

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   Protecting yourself from overexposure to UV radiation is simple if you take the
   precautions listed below.
10 aft
               The sun's UV rays are strongest between 10 a.m. and 4 p.m. To the
               extent you can, limit exposure to the sun during these hours.
               The UV Index provides important information to help you plan your
               outdoor activities in ways that prevent overexposure to the sun's rays.
               Developed by the National Weather Service (NWS) and EPA, the UV
               Index is issued daily in selected cities across the United States.
                                  That        99 to 100 P
               Sunglasses that provide 99 to 100 percent UVA and UVB protection
               will greatly reduce sun exposure that can lead to cataracts and other
               eye damage. Check the label when buying sunglasses.
               A hat with a wide brim offers good sun protection for your eyes, ears,
               face, and the back of your neck—areas particularly prone to overexpo-
               sure to the sun.

               Staying under cover is one of the best ways to protect yourself from
               the sun.
                             >f ft
                                   •as
               Tightly-woven, loose-fitting, and full-length clothes are best for pro-
               tection of exposed skin.

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                          a
             A sunscreen with a sun protection factor (SPF) of at least 15
             blocks most harmful UV radiation. Apply sunscreen liberally
             and rcapply every 2 hours when working, playing, or exercising
             outdoors. Even waterproof sunscreen     come off when you
             towel off sweat or water. Consult your physician about sunscreen
             use on children under 6 months of age. Also use lip  balm of
             SPF 15.
             The light source from sunbeds and sunlamps damages the skin
             and unprotected eyes. It's a good idea to avoid  artificial sources of
             UV light.
The                   the                                     of UV
                                on a § to 10+      in the
             Oto2
             3 to 4
             5 to 6
             7 to 9
             10+
Minimal
Low
Moderate
High
Very High
While             precautions                                  to adopt
the safeguards recommended above when the UV Index predicts exposure levels
of moderate or higher.
Some medications cause serious sun sensitivity, as do some        such as
lupus erythematosus. The UV Index is not intended for use by seriously sun-
sensitive individuals. Consult your doctor about additional precautions you
might need to take.
                                  •JO

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   uv
    he National Weather Service uses a computer model to calculate the next day's
UV levels for selected cities across the United Stares. The model takes into account
a number effectors including the amount of ozone and clouds overhead,  latitude,
elevation, and rime of year.

To compute the UV Index forecast, rhe model first calculates a UV dose rate, or
amount of UV radiation to which a person will be exposed at the next day's solar
noon (when rhe sun  is highest in rhe sky) under "clear sky" (no clouds) conditions.

The UV dose  rates obtained from the model are then adjusted for the effects of ele-
vation and cloud cover at specific locations. Higher elevations will increase the UV
dose rare because rhere is less atmosphere to absorb and scatter UV rays. Greater
cloud cover will tend to reduce the UV dose rate because clouds screen out some—
bur not all—UV rays.

The resulring value is rhe nexr day's UV Index forecast. The UV forecasts  for select-
ed locations are provided daily on a 0 to 10+ scale, where 0 indicates a minimal
likely level of exposure to UV rays and 10+ means a very high level of exposure.

For more information about rhe UV Index, or for daily forecasts, please consulr
.
                                     -11

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^jlthough many of the suns harmful effects do not appear until later in life,
recent medical research has shown that it is very important to protect children and
young adults from overexposure to UV radiation. The majority of most people's
sun exposure occurs before age 1 8, and studies increasingly suggest a link between
early exposure and skin cancer as an adult.
Take special care with children, since they tend to spend more time outdoors than
adults and can burn more easily. The precautions described in this booklet can help
ensure that the children around you avoid UV-related health problems, both now
and later in life. Started early and followed consistently, each of these steps will
become an accepted habit, as easy as fastening seatbelts every time you drive the car.
In response to the serious public-health threat posed by overexposure to UV radia-
tion, EPA is working with schools and communities across the nation to launch the
SunWise School Program. SunWise teaches children in elementary school and their
caregivers how to protect themselves from overexposure to the sun. Educating chil-
dren about sun safety is the key to reducing the risk of future UV-related health
problems.
Participating schools will sponsor activities that raise children's awareness of the
largely preventable health risks from UV radiation and teach simple steps to avoid
overexposure. Such activities might include:
  *   Cross-curricular classroom lessons.
  *   Reporting the UV Index and UV  ground data on the SunWise Internet
     Learning Site.
  *   Infrastructure enhancements (e.g., policy changes and shade structures).
  *   Community partnerships.
  »   Schoolwide sun safety activities,
  *   Train-the-trainer video.
For additional information about the SunWise School Program, please contact EPA's
Stratospheric O/onc Information Hotline at 800 296-1996 or visit the programs
Web site at , ,

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    o learn more about the UV Index and how to protect yourself
from ovcrcxposurc to the sun's UV rays, call EPA's Stratospheric
Ozone Information Hotline at 800 296-1996 or visit our Web site
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