Literature DB >> 30679563

Relationship between ultraviolet index (UVI) and first-, second- and third-degree sunburn using the Probit methodology.

J F Sánchez-Pérez1, D Vicente-Agullo2, M Barberá2, E Castro-Rodríguez3, M Cánovas4.   

Abstract

In this paper, a relation between the ultraviolet index (UVI) as a Sun exposure time and its effects in the form of burns according to the skin type has been elaborated. Moreover, we present a new expression that relates the intensity of solar radiation and the UVI, as well as expressions to obtain the percentage of population affected both by first and second degree lllsunburn for every skin-type. The results have been adjusted and validated through experimental results taken from the bibliography. Finally, this paper presents a table where the population can easily interpret the UVI values and calculate the maximum time one can be exposed to solar radiation without getting sunburn. In addition, this article aims to raise awareness of the potential harm caused by solar radiation by indicating the percentage of population affected by different types of sunburn depending on skin-type. Moreover, ultraviolet exposure to sunlight could not just result in sunburn, but also have long-term effects on eyes, or even cause immune system disorders or melanoma. Therefore, managing risk perception with this useful table could familiarize the population with actual harm prevention.

Entities:  

Year:  2019        PMID: 30679563      PMCID: PMC6345802          DOI: 10.1038/s41598-018-36850-x

Source DB:  PubMed          Journal:  Sci Rep        ISSN: 2045-2322            Impact factor:   4.379


Introduction

Sunburn is the reddening of the skin that occurs after having been overexposed to the Sun radiation or other types of ultraviolet light, because melanin is not able to protect the skin when there is a high degree of exposure to the Sun (or a source of ultraviolet light). Melanin is the coloration (pigment) that protects the skin. Sunburn on a person with very fair skin can occur in less than 15 minutes of exposure to the Sun at noon, while a person with darker skin can tolerate the same exposure for hours[1]. Due to these differences, the World Health Organization (WHO) divided the type of skin according to its melanin levels and, therefore, its resistance to sunburn[1]. One of the main effects of solar radiation is first and, less frequently, second-degree sunburn[1]. To establish a simple methodology to inform the population of the intensity of solar radiation, the ultraviolet index (UVI) was established, a simple number that informs of the dangerousness of the sunlight as a function of the Earth’s relative position to the Sun, altitude, cloudiness, etc[2]. Sometimes, this index is difficult to interpret by the general population, since they do not perceive the danger that it could cause to their skin. Thus, in this article we propose to establish a direct relationship between this index and the different degrees of sunburn as a function of the exposure time and skin type, providing the population with a greater perception of the danger posed by solar radiation. According to WHO guidelines, UV exposure should be controlled. A moderate daily degree of this radiation is essential for the synthesis of Vitamin D through skin, liver and kidney pathway. This process is necessary for the regulation of calcium homeostasis and bone metabolism, providing a proper bone health. In addition, more recently other functions have been described, for example its regulatory role in immunity in humans, its effect on inflammation (attenuating inflammation), and its benefits for cardiovascular health and cancer. As for the latter, an insufficient exposure to this radiation can lead to deficiency or insufficiency in serum, and this may affect the immune and cardiovascular system, causing neurocognitive dysfunction, different types of cancer and diabetes mellitus inter alia, as cell composition in all these systems has Vitamin D receptors. Therefore, a well-balanced UVI exposure is mandatory for protecting skin, other organs, as well as for a proper bone health[3-7]. However, overexposure to sunlight can lead to unwanted effects such as redness, pain and swelling of the skin, as well as burns. Although the global burden of disease due to UVI exposure may be considered as low for some researchers[8,9], managing a public awareness tool would encourage Sun-protective behavior by decision making of risk perception. It would not only help to prevent sunburn as an immediate effect but also further conditions such as solar keratosis, reactivation of herpes labialis, squamous cell or basal cell carcinoma, cutaneous melanoma or cortical cataract. The UVI is a relevant communicating tool in public health, as it may increase awareness about the risks of excessive exposure to UV radiation and warn about the need to adopt preventive measures[3].

Radiation Intensity and Dose

The ultraviolet index, UVI, formulated using the spectrum of erythematic action induced by UV radiation on human skin, of the CIE (Commission Internationale de l’Eclairage, acronym in French), is a simple index that informs the population of the risk of solar radiation[2].where I(λ) is the solar spectral irradiance in W/(m2·nm) and ker a constant equal to 40 m2/W. The erythema reference action spectrum coefficient, ε(λ), values are given by Madronich et al.[5]. As shown in Table 1, the ultraviolet index, UVI, a dimensionless number, can vary between 0 and 16 and it has been divided into five ranges of danger for the population according to exposure[2,10].
Table 1

UV radiation exposure categories.

UVI range ≤23–56–78–10≥11
Exposure category LowModerateHighVery highExtreme
UV radiation exposure categories. Numerous organizations inform the population about the daily values of this index. The prediction provides the maximum UV index value that matches the UV index at noon for clear skies. On cloudy days, the value of the UV index would be lower. In addition, it also sets up information of hourly values. In Spain, it can be consulted in the Agencia Estatal de Meteorología (AEMET)[11]. You can consult the UV index of any country through the website of the Finnish Meteorological Institute[12]. The intensity of ultraviolet radiation B, IUVB, in the range of 280–315 nm wavelength, and measure in W/m2, is the main component of the solution to the integral given in expression (1), since the values for this range of the erythema reference action spectrum coefficient ε(λ) nearly occupy the entire wavelength of the ultraviolet index, UVI. Thus, some authors like MacKenzie et al.[13] established the following relationship between ultraviolet index, UVI, and intensity of ultraviolet radiation B, IUVB: As it is known, solar radiation can cause skin burns after prolonged exposure. Many authors relate skin temperature with the burn-degree, which in turn depends both on exposure time and on radiant intensity. Thus, these authors, Buettner or Hardee and Lee[14,15], relate exposure time with skin temperature at different depths. However, temperature is not the correct parameter to establish the damage level, but a parameter that relates damage to exposure time (te, s) and UV radiation intensity (I, W/m2) as it is the “UV radiation dose”. Equation (3) shows the most recognized expression for the dose (D, (W/m2)4/3 s)[16,17].

Skin Types

Not all skin types react in the same way to Sun exposure. In this regard, the World Health Organization (WHO)[2] has classified phototypes or skin types into six categories according to their tolerance to solar radiation, as described in the Table 2, so that skin type I is the most sensitive and type VI is the most tolerant to UV radiation.
Table 2

Classification of skin types[2].

Skin type classificationBurns probability in the sunTans after having been in the sun
I. Melano-compromisedAlwaysSeldom
II. Melano-compromisedUsuallySometimes
III. Melano-competentSometimesUsually
IV. Melano-competentSeldomAlways
V. Melano-protectedNaturally brown skin
VI. Melano-protectedNaturally black skin
Classification of skin types[2]. One of the goals of public health is to protect the most vulnerable population groups. Given that the finding that more than 90% of non-melanoma skin cancers occur in people of skin type I and II, protection messages should be focused on people of these skin types, who tend to get burnt easily. In addition, special mention should be made of children, who are more sensitive to UV radiation. Therefore, it is understood that the development of equivalence between the UVI and the percentage of population affected by different degree sunburn will promote awareness of solar radiation among that population. Although dark-skinned people have a lower risk of cancer, they can suffer from other harmful consequences, such as burns to the eyes, solar retinopathy, photo conjunctivitis or photo keratosis. Thus, to advise on the dangers of solar radiation, several cultural and climate differences must be taken into account, namely, the population’s perception of UV radiation risks and their education[2]. Therefore, we believe that the relation between UVI and the percentage of population affected by different degree burns is a useful tool for raising awareness of solar radiation harm among the population.

Effects of Solar Radiation on Human Population

The generation of skin sunburn, in its different degrees, is a significant effect of UV radiation, which generates free radicals leading to inflammation. The seriousness varies depending on the proportion of burned skin and the depth of the most severe burn. The effects caused by UV radiation in humans can be divided into two types. First, physiological effects: increased heart rate, increased transpiration or body temperature. Second, pathological effects, which are more serious and include skin burns. These burns are divided into three categories depending on the seriousness of the damage: first degree, second degree and third degree burns. First-degree sunburn produces redness, swelling, pain and superficial damage. These burns only affect the skin surface (epidermis) and cause negligible tissue damage. This kind of burn does not require medical attention, since they do not end up in blisters and their effects might be reversible in a period of 1 or 2 days. The approximate value of the dose established for the appearance of first-degree sunburn is 115 (kW/m2)4/3s, given by Sanchez-Perez et al.[18] and adjusted from the values given by Buettner and Bagster and Pitblado[19,20]. In several studies on the ultraviolet index[10,21-23], UVI, an association between skin type and maximum exposure time (in minutes) in which first-degree sunburn would appear is established (Fig. 1).
Figure 1

Relationship between exposure time for the appearance of first-degree sunburn and UV index for several skin types and 1 Minimal Erythema Dose (MED) according to DIN-5050[21,22] for clear sky days. Built from the information given by[10,21–23].

Relationship between exposure time for the appearance of first-degree sunburn and UV index for several skin types and 1 Minimal Erythema Dose (MED) according to DIN-5050[21,22] for clear sky days. Built from the information given by[10,21-23]. For skin type II and a value of 9 for UV index, using expression (2), the corresponding dose value is 113 (kW/m2)4/3s, next to value 115 (kW/m2)4/3s, given by Sanchez-Perez et al.[18] and adjusted from the experimental values given by Buettner and Bagster and Pitblado[19,20] for the beginning of first-degree burns. However, if we use expression (2) given by MacKenzie et al.[13], for the dose calculation for lower values of UV index we do not obtain an approximate value of 115 (kW/m2)4/3s. Thus, adjusting the curve for a type II to an approximate dose value of 115 (kW/m2)4/3s, Table 3, and using equation (3), we get a new expression that relates the ultraviolet index, UVI, and the intensity of ultraviolet radiation, IUV, (Fig. 2).
Table 3

Relationship between UVI and exposure time for the appearance of first-degree sunburn in skin type II according to DIN-5050. Built from the information given by[10,21–23].

UV IndexTime (min)
283
357
442
535
629
725
822
920
1018
1117
Figure 2

Relationship between UVI and intensity of ultraviolet radiation for the beginning of first-degree sunburn in skin type II.

Relationship between UVI and exposure time for the appearance of first-degree sunburn in skin type II according to DIN-5050. Built from the information given by[10,21-23]. Relationship between UVI and intensity of ultraviolet radiation for the beginning of first-degree sunburn in skin type II. The proposal for an expression that relates the ultraviolet index, UVI, and the intensity of ultraviolet radiation, IUV, is given by: This expression, which mainly includes ultraviolet B radiation, covers the wavelength from 250 nm to 400 nm, so it is closer to the UVI calculation given by expression (1) than the expression proposed by MacKenzie et al.[13], since it encompasses the variability of the erythema reference action spectrum coefficient ε(λ). Considering that each skin type has a different dose for the beginning of first-degree sunburn (Fig. 1), a dose can be established for each type using expressions (3) and (4), and the values of the UV index and exposure times in Fig. 1. The value for skin type II coincides with the value of 115 (kW/m2)4/3s given by Sanchez-Perez[18] validating the use of these expressions for solar radiation. For the rest of skin types, new dose levels are established for the initiation of first-degree burns, (Table 4).
Table 4

Beginning dose of first-degree sunburn for each skin type.

Skin type classificationDose (kW/m2)4/3s
I84.9 ± 1.67
II115 ± 1.80
III143 ± 4.57
IV195 ± 4.19

Note: The 95% confidence interval has been included in each dose.

Beginning dose of first-degree sunburn for each skin type. Note: The 95% confidence interval has been included in each dose. Second-degree burns affect the epidermis (outer-layer) and the dermis (underlying layer of the skin), causing blisters, pain, swelling and redness. Contrary to first-degree burns, in this kind of burns a medical treatment is required to heal the damaged area[24]. Using data collected by Stoll and Greene[25] and Metha et al.[26], a value of dose is established for the beginning of second-degree burns of 250 (kW/m2)4/3s. Third-degree burns affect the deep hypodermis, dermis and epidermis, causing skin carbonization or a translucent white color, with coagulated and visible vessels under the skin surface. The healing of these burns occurs slowly due to tissue destruction. Consequently, people with these types of burns are more vulnerable to infections[24].

Probit Equations to Determine Solar Effects

Probit equations[27] relate the percentage of population affected by a certain damage level (e.g., first-, second- or third-degree sunburn) and solar radiation. The dimensionless number Probit (Y) and its interpretation allow calculating the population percentage affected by this radiation, Sánchez-Pérez et al.[18] and TNO (1989)[16]: In the case of first-degree sunburn, an adjustment must be made depending on the skin type. Given that the value of population affected by first-degree sunburn is 1%, Y = 2.67, and using the values given in Table 4, for each skin type the following expressions are proposed: The expressions given by Sánchez-Pérez et al.[18] and TNO[16] are maintained for the calculation of the rest of the affected population percentage, that is, second- and third-degree burns. For the interpretation of the Probit value, the Probit tables can be used, which establish a relation between Probit number and the percentage of population affected[16,18,27-32] or the following equation[27-32]:where R is the percentage of affected population and valid for a percentage range between 5 and 95%, that is, valid for Probit values between 3.36 and 6.64. The interpretation of the results obtained from the previous equations is done through the corrected tables for doses and Probit given by Sanchez-Perez et al.[18], thus determining the percentage of people affected by the different degrees of burns.

Relationship Between UVI and Percentage of Population Affected by Each Type of Burn

Following the proceeding established by Sanchez-Perez et al.[18] for the calculation of percentages of affected population using the Probit equations and expressions (2) and (3), the following table (Table 5) is established, which relates the percentage of population affected for each UVI, exposure time and skin type.
Table 5

Relationship between UVI and percentage of population affected by each burn type. Different expressions for each type of skin in first-degree burns.

UVIExposition time (minutes)Dose (kW/m2)4/3sSkin typeFirst-degree burns (%)Second-degree burns (%)Third-degree burns (%)
62595.12I200
II000
III000
IV000
30114.14I600
II100
III000
IV000
35133.16I1600
II300
III000
IV000
40152.18I2800
II700
III100
IV000
45171.21I4000
II1300
III300
IV000
50190.23I5300
II2100
III700
IV000
55209.25I6300
II3100
III1100
IV100
60228.28I7200
II4100
III1800
IV300
72088.48I100
II000
III000
IV000
25110.60I600
II000
III000
IV000
30132.72I1500
II200
III000
IV000
35154.84I3000
II700
III100
IV000
40176.96I4400
II1500
III400
IV000
45199.08I5800
II2600
III900
IV100
50221.20I6900
II3700
III1600
IV200
55243.32I7810
II4710
III2310
IV410
60265.44I8420
II5520
III3120
IV620
820101.32I300
II000
III000
IV000
25126.65I1200
II200
III000
IV000
30151.98I2800
II700
III100
IV000
35177.31I4500
II1600
III400
IV000
40202.64I6000
II2800
III1000
IV100
45227.97I7200
II4000
III1800
IV300
50253.30I8110
II5110
III2710
IV510
55278.63I8730
II6030
III3530
IV730
60303.96I8850
II6750
III4350
IV1150
920114.58I700
II100
III000
IV000
25143.23I2200
II400
III100
IV000
30171.87I4100
II1300
III400
IV000
35200.52I5900
II2700
III900
IV100
40229.16I7300
II4100
III1900
IV300
45257.81I8310
II5310
III2910
IV610
50286.45I8830
II6330
III3830
IV930
55315.10I8860
II7060
III4660
IV1460
60343.74I86110
II72110
III51110
IV16110
1020128.24I1300
II200
III000
IV000
25160.30I3400
II900
III200
IV000
30192.36I5400
II2300
III700
IV000
35224.42I7100
II3900
III1700
IV200
40256.48I8210
II5310
III2910
IV610
45288.53I8740
II6340
III3840
IV840
50320.59I8870
II7070
III4770
IV1470
55352.65I85120
II74120
III53120
IV19120
60384.71I79190
II73190
III56190
IV21190
1120142.27I2200
II400
III000
IV000
25177.83I4500
II1600
III400
IV000
30213.40I6500
II3300
III1300
IV200
35248.97I8100
II5000
III2700
IV500
40284.55I8730
II6230
III3830
IV930
45320.10I8870
II7070
III4770
IV1470
50355.67I84130
II73130
III52130
IV19130
55391.24I79190
II72190
III56190
IV23190
60426.80I70.4290
II66290
III54290
IV23290
Relationship between UVI and percentage of population affected by each burn type. Different expressions for each type of skin in first-degree burns. From Table 5 it can be concluded that the results for the first-degree sunburn are in accordance with reality. However, for the second degree there is a high percentage of affected population for types of skin, which are more resistant to burns, such as Type III and IV. This is because only the values given by Stoll and Greene[25] and Metha et al.[26] for the initiation of second-degree burns are irrespective of skin type. In order to distinguish the start of second degree burns for each skin type, experimental results obtained by Stoll and Greene[25] and Metha et al.[26], who do not distinguish the type of skin, are adjusted using the experimental data of first degree burns, which do distinguish skin type. Thus, it is proposed that set the start of second-degree burns up 250 (kW/m2)4/3s[18], for skin type II, and the start of second-degree burns for the rest of skins type is adjusted with the data of each skin type of first-degree burns. Therefore, the values of Table 6 can be obtained.
Table 6

Beginning dose of second-degree burns for each skin type.

Skin type classificationFirst-degree burns dose (kW/m2)4/3sSecond-degree burns dose (kW/m2)4/3s
I84.9 ± 1.67220 ± 1.67
II115 ± 1.80250 ± 1.80
III143 ± 4.57279 ± 4.57
IV195 ± 4.19330 ± 4.19

Note: The 95% confidence interval has been included in each dose.

Beginning dose of second-degree burns for each skin type. Note: The 95% confidence interval has been included in each dose. These values are in the range of those given by different authors for the initiation of second-degree burns, 236–390 (kW/m2)4/3s, without specifying the skin type[16,18,20,33]. Thus, the following expressions of Probit equations can be proposed adjusting the value of 1% population affected by second-degree burns, Y = 2.67, for each type of skin using the values given in Table 6. Therefore, using the above expressions, Table 5 can be rewritten in the following table (Table 7).
Table 7

Relationship between UVI and percentage of population affected by each burn type. Different expressions for each skin type in first- and second-degree burns.

UVIExposition time (minutes)Dose (kW/m2)4/3sSkin typeFirst-degree burns (%)Second-degree burns (%)Third-degree burns (%)
62595.12I200
II000
III000
IV000
30114.14I600
II100
III000
IV000
35133.16I1600
II300
III000
IV000
40152.18I2800
II700
III100
IV000
45171.21I4000
II1300
III300
IV000
50190.23I5300
II2100
III700
IV000
55209.25I6300
II3100
III1100
IV100
60228.28I7110
II4100
III1800
IV300
72088.48I100
II000
III000
IV000
25110.60I600
II000
III000
IV000
30132.72I1500
II200
III000
IV000
35154.84I3000
II700
III100
IV000
40176.96I4400
II1500
III400
IV000
45199.08I5800
II2600
III900
IV100
50221.20I6810
II3700
III1600
IV200
55243.32I7720
II4710
III2400
IV500
60265.44I8330
II5520
III3300
IV800
820101.32I300
II000
III000
IV000
25126.65I1200
II200
III000
IV000
30151.98I2800
II700
III100
IV000
35177.31I4500
II1600
III400
IV000
40202.64I6000
II2800
III1000
IV100
45227.97I7110
II4000
III1800
IV300
50253.30I8020
II5110
III2800
IV600
55278.63I8550
II6030
III3710
IV1000
60303.96I8490
II6750
III4620
IV1600
920114.58I700
II100
III000
IV000
25143.23I2200
II400
III100
IV000
30171.87I4100
II1300
III400
IV000
35200.52I5900
II2700
III900
IV100
40229.16I7210
II4100
III1900
IV300
45257.81I8130
II5310
III3000
IV700
50286.45I8560
II6330
III4010
IV1100
55315.10I84100
II7060
III5020
IV2000
60343.74I81160
II72110
III5840
IV2610
1020128.24I1300
II200
III000
IV000
25160.30I3400
II900
III200
IV000
30192.36I5400
II2300
III700
IV000
35224.42I7010
II3900
III1700
IV200
40256.48I8030
II5310
III3000
IV700
45288.53I8560
II6340
III4110
IV1200
50320.59I83120
II7070
III5220
IV2100
55352.65I79180
II74120
III6050
IV3010
60384.71I72260
II73190
III6780
IV3730
1120142.27I2200
II400
III000
IV000
25177.83I4500
II1600
III400
IV000
30213.40I6500
II3300
III1300
IV200
35248.97I7920
II5000
III2700
IV500
40284.55I8460
II6230
III4010
IV1200
45320.10I84110
II7070
III5420
IV2100
50355.67I78190
II73130
III6050
IV3110
55391.24I70280
II72190
III6690
IV3930
60426.80I62.4370
II66290
III68150
IV4660
Relationship between UVI and percentage of population affected by each burn type. Different expressions for each skin type in first- and second-degree burns. The results obtained are more in line with reality, both for first and second-degree burns, since a distinction is made between the different types of skin and its resistance to sunburn. Therefore this information is relevant for preventing further potential conditions on a sporadic occurrence (photokeratosis, photo conjunctivitis or solar retinopathy) or more severe skin affections such as melanoma or non-melanoma skin cancer (squamous cell carcinoma or basal cell carcinoma)[34]. To facilitate its handling, Table 7 could be included in a mobile application, where users could see the probability of suffering burns through their location and the choice of their skin types, and depending on their exposure time to UV radiation.

Conclusions

In this paper a relation between the ultraviolet index (UVI), exposure time to the Sun and its effects in the form of burns according to the skin type has been elaborated. In addition, we have presented a new expression that relates the intensity of solar radiation and the UVI. Also, we include expressions to obtain the percentage of population affected both by first and second degree burns by distinguishing the type of skin. The results have been adjusted and validated through experimental results obtained in the bibliography. Finally, as a main conclusion, this article presents a table where the population can easily interpret the UVI values and obtain the maximum exposure time they can be exposed to solar radiation without getting any sunburn depending on their skin type. In addition, this article aims to raise awareness of the danger of solar radiation by indicating the percentage of population affected by different types of burns and skins. In addition, apart from sunburn, the excessive exposure to UVR can lead to chronic sun-induced skin damage, including photoaging, skin cancer and ocular disorders. It is generally accepted that in order to be effective in raising awareness, the UVI messaging must be accurate and compelling by communicating relevant risks to population. In other words, this messaging contributes to mitigating hazards by creating risk perception around potential skin damage. Moreover, recent changes in population habits (the practice of outdoor leisure activities and changes in clothing) along with increasing temperatures have led to longer exposure to UV radiation, with consequent risks for the population, making the adoption of preventive measures of very high importance[8]. As a conclusion, Table 7 could be included in the mobile application where users through their location and the choice of their skin types could see the probability of suffering burns depending on the exposure time to UV radiation.
  11 in total

1.  Relationship between pain and tissue damage due to thermal radiation.

Authors:  A M STOLL; L C GREENE
Journal:  J Appl Physiol       Date:  1959-05       Impact factor: 3.531

2.  Relationship between UVB and erythemally weighted radiation.

Authors:  Richard McKenzie; Dan Smale; Michael Kotkamp
Journal:  Photochem Photobiol Sci       Date:  2004-01-28       Impact factor: 3.982

3.  Estimating the global disease burden due to ultraviolet radiation exposure.

Authors:  Robyn M Lucas; Anthony J McMichael; Bruce K Armstrong; Wayne T Smith
Journal:  Int J Epidemiol       Date:  2008-02-14       Impact factor: 7.196

4.  Effects of extreme heat and cold on human skin. II. Surface temperature, pain and heat conductivity in experiments with radiant heat.

Authors:  K BUETTNER
Journal:  J Appl Physiol       Date:  1951-06       Impact factor: 3.531

5.  Effects of extreme heat and cold on human skin. I. Analysis of temperature changes caused by different kinds of heat application.

Authors:  K BUETTNER
Journal:  J Appl Physiol       Date:  1951-06       Impact factor: 3.531

6.  Vitamin D as a Therapeutic Option for Sunburn: Clinical and Biologic Implications.

Authors:  Jeffrey F Scott; Kurt Q Lu
Journal:  DNA Cell Biol       Date:  2017-10-24       Impact factor: 3.311

Review 7.  Vitamin D effects on musculoskeletal health, immunity, autoimmunity, cardiovascular disease, cancer, fertility, pregnancy, dementia and mortality-a review of recent evidence.

Authors:  Pawel Pludowski; Michael F Holick; Stefan Pilz; Carol L Wagner; Bruce W Hollis; William B Grant; Yehuda Shoenfeld; Elisabeth Lerchbaum; David J Llewellyn; Katharina Kienreich; Maya Soni
Journal:  Autoimmun Rev       Date:  2013-03-28       Impact factor: 9.754

8.  Oral Vitamin D Rapidly Attenuates Inflammation from Sunburn: An Interventional Study.

Authors:  Jeffrey F Scott; Lopa M Das; Sayeeda Ahsanuddin; Yuqi Qiu; Amy M Binko; Zachary P Traylor; Sara M Debanne; Kevin D Cooper; Rebecca Boxer; Kurt Q Lu
Journal:  J Invest Dermatol       Date:  2017-05-30       Impact factor: 8.551

9.  Consequence analysis to determine damage to buildings from vapour cloud explosions using characteristic curves.

Authors:  Fernando Díaz Alonso; Enrique González Ferradás; Juan Francisco Sánchez Pérez; Agustín Miñana Aznar; José Ruiz Gimeno; Marta Doval Miñarro
Journal:  J Hazard Mater       Date:  2008-02-16       Impact factor: 10.588

Review 10.  Vitamin D Prevents Sunburn: Tips for the Summer?

Authors:  Daniel D Bikle
Journal:  J Invest Dermatol       Date:  2017-10       Impact factor: 8.551

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  4 in total

1.  The incidence of skin melanoma in Gran Canaria (Canary Islands, Spain) is lower than expected in Southern Europe despite high-risk environmental conditions: an island-wide cross-sectional study.

Authors:  Mercè Grau-Pérez; Gregorio Carretero; Pablo Almeida; Elena Castro-González; María Del Pilar de-la-Rosa-Del-Rey; Jesús María González-Martín; Leopoldo Borrego
Journal:  Cancer Causes Control       Date:  2021-03-01       Impact factor: 2.506

2.  Trends in Cancers of the Skin: Insights from a Three-year Observational Cohort in Manhattan Beach, California.

Authors:  Lawrence S Moy; Jacob M Hands; Paul K Shitabata
Journal:  J Clin Aesthet Dermatol       Date:  2022-01

3.  Solar UV Radiation in the Tropics: Human Exposure at Reunion Island (21° S, 55° E) during Summer Outdoor Activities.

Authors:  Jean-Maurice Cadet; Hassan Bencherif; Nicolas Cadet; Kévin Lamy; Thierry Portafaix; Matthias Belus; Colette Brogniez; Frédérique Auriol; Jean-Marc Metzger; Caradee Y Wright
Journal:  Int J Environ Res Public Health       Date:  2020-11-03       Impact factor: 3.390

4.  UV Index Does Not Predict Ocular Ultraviolet Exposure.

Authors:  Natsuko Hatsusaka; Yusuke Seki; Norihiro Mita; Yuki Ukai; Hisanori Miyashita; Eri Kubo; David Sliney; Hiroshi Sasaki
Journal:  Transl Vis Sci Technol       Date:  2021-06-01       Impact factor: 3.283

  4 in total

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