Ultraviolet Radiation (Hansard, 1 July 1992)

§ Mr. Sackville

In response to a recent request from the United Kingdom Health Departments, COMARE has now furnished advice on ultraviolet radiation (UV) and adverse health effects in the context of existing public health advice on minimising UV exposure, and the need for further research. In particular, COMARE was asked to consider its advice against a background of evidence of a raised incidence of skin cancer in the United Kingdom and recent concerns about changes in solar UV levels secondary to possible changes in the stratospheric ozone layer.

COMARE concludes that there is sufficient evidence to demonstrate that skin cancer incidence is related to exposure to UV radiation, and that risk is determined largely by patterns of exposure to existing levels of solar UV radiation, which is influenced by people's lifestyle. The committee makes a number of recommendations relating to additional public health advice on minimising exposure to natural and artificial sources of UV, and on common standards for consumer information for sunglasses and sunscreen products. The Government accept the committee's recommendations and the Health Departments are considering urgently how best to implement them. The Government note COMARE's intention to consider research needs further in the light of relevant research currently under way or planned.

The Government are grateful to COMARE for its work in this area and looks forward to receiving further advice on research needs. Following is the full text of the committee's advice:

Statement of advice from COMARE to Health Departments Health effects of ultra violet radiation

INTRODUCTION

1. The United Kingdom Health Departments have asked COMARE to consider the adverse health effects of UV radiation (UVR) in relation to existing public health advice on minimising UV exposure, and the need for further research. This has been considered against a background of:

(a) evidence of an increased incidence of all skin cancers, and in particular the increase in malignant melanoma (MM) over recent years, and
(b) whether there is a need to issue additional advice in 634 the light of the recent concerns that solar UV levels might be altered secondary to possible changes in the stratospheric ozone layer.

HEALTH EFFECTS

2. The Committee have noted with concern that there has been a 50 per cent. increase in the incidence of malignant melanoma in England and Wales (1,827 cases in 1980 rising to 2,635 cases in 1986). The much more common, although seldom fatal, forms of skin cancer which are grouped as non-melanotic skin cancers (NMSC) increased from 19,000 cases in 1980 to over 25,000 cases in 1986. We consider that this rising incidence of skin cancers constitutes a public health problem in the United Kingdom. Other health effects are known to be associated with excessive exposure to UVR, and additional research is needed in these areas.

3. We consider that there is sufficient evidence to show that skin cancer incidence is related to exposure to UV radiation and that risk is determined largely by patterns of exposure to existing levels of solar UV radiation which is influenced by people's occupation and behaviour. The risk however, varies with the degree of skin pigmentation, being greatest in the skin type with red hair and fair skin which does not tan.

CANCER REGISTRATION

4. The Committee reiterates its view that skin cancer registration procedures should be improved so that the statistics can he updated more regularly. It was recognised by the working party chaired by Professor Eva Alberman which reported last year on the national cancer registration scheme (Series MB1 No. 17) that better and more timely figures were required. Many of the working party's 17 recommendations are currently being taken forward by the cancer registries in the regional health authorities and by the NHS information management group in the Department. COMARE has previously expressed its support for this review.

SOLAR MONITORING

5. The Committee note that the National Radiological Protection Board (NRPB) set up three experimental solar UV monitoring stations in the United Kingdom in 1988, and that the instrumentation of these units has subsequently been improved. We acknowledge the value of these measurements in providing baseline data for any changes which may occur in the future. We welcome the NRPB proposal to extend this scheme to latitudes further north and south to provide a more comprehensive picture of the terrestrial solar UV levels over United Kingdom latitudes.

6. The Committee note the widespread concerns about long term stratospheric ozone depletion and support the initiatives already being taken by the signatories to the Montreal Protocol to reduce the release of ozone-depleting chemicals into the atmosphere.

7. We note that seasonal variations in solar UV levels, and short term variations due to cloud cover and local weather, are far in excess of any long term UV changes currently anticipated as a result of stratospheric ozone depletion. For this reason it would not be helpful to publish daily information on solar UVR levels; such retrospective information would be of little practical value. It should be recognised that currently the most important factor in a person's exposure to solar UVR is lifestyle and we recommend that there is a need to inform the public of the risks of excessive exposure to sunlight.

RESEARCH REQUIREMENTS

8. We consider that considerable additional scientific information on the health effects of UV is required to enable a more accurate assessment of the various aspects of health risk and to facilitate effective targeting of public health education (see 10 below). Whilst a clear association between non-melanotic skin cancer and cumulative UV exposure has been demonstrated, the relationship between UV exposure and malignant melanoma trends needs further consideration. We will consider further research needs in the light of ongoing work, in particular the work of the NRPB Advisory Group on non-ionising radiations.

635W

PUBLIC HEALTH ADVICE

9. We endorse the general content and basis of existing health advice as set out in the Health Education Authority leaflet ("Are you dying to get a suntan?"), and agree that there is a need to reinforce certain important aspects. In particular the Committee recommend that there is a need to advise about the potential longterm dangers of sunburn to children and babies, and to emphasise the need for individuals to develop a better awareness of their own skin's sensitivity to solar UVR, hearing in mind the very great variation in sensitivity which exists between different members of the population.

10. We fully endorse the Health Department's proposal to reinforce existing public health advice on UV, and to consider the specific health advice given to users of sunbeds/sunlamps and tungsten halogen lamps and recommend that this he taken forward urgently. We also support proposals to consider the application of common standards to consumer information for sunglasses and suntan products. The Committee wish to he kept fully informed of progress in these areas.