Association Between Sunlight Exposure and Mental Health: Evidence from a Special Population Without Sunlight in Work
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Purpose: In recent years, mental health problems have become the most serious social problems worldwide. Past studies have proposed that some links exist between sunlight and mental health; however, relevant studies examining low-dose sunlight exposure populations are lacking. We conducted a study among a group of operating room nurses (ORNs) who work long hours in operating rooms and have limited sunlight exposure. We aim to add to and refine previous researches on the association between mental health and sunlight exposure in community population. Patients and Methods: A total of 787 ORNs were interviewed and analyzed. Mental health, sunlight exposure duration, sociodemographic and work-related variables, and chronic diseases were evaluated. The Kessler 10 scale (K10) was used to assess participants’ mental health status, and their sunlight exposure duration was assessed using their self-reports. Multiple linear regression analysis was adopted to examine the association between sunlight exposure and mental health. Results: The average K10 score of ORNs was 25.41. ORNs exhibit poorer mental health than other populations. Poor mental health was negatively associated with greater sunlight exposure hours per day (β=− 0.378) and sleep regularity (β=− 3.341). Poor mental health was positively associated with chronic disease (β=3.514). Conclusion: This study indicated that the positive association between sunlight exposure and mental health existed. Appropriate enhancement of sunlight exposure will be beneficial to mental health. Hospitals, related organizations and individuals should pay greater attention to ORNs’ mental health and sunlight exposure conditions. More policy recommendations as well as building structure recommendations should be proposed. Keywords: sunlight exposure, mental health, operating room nurses, ChinaKeywords:
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Vitamin D, a fat-soluble vitamin naturally present in very few foods, is synthesized when ultraviolet rays from sunlight contact the skin. Research suggests that vitamin D insufficiency may result from lack of exposure to sunlight and ultraviolet-B radiation. Individuals from geographic areas of high latitude and low sunlight exposure may be at increased risk for vitamin D deficiency. Emerging evidence supports the protective role of vitamin D in the prevention of several cancers, including breast, colon, and prostate.
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A literature review was performed to understand the possible relationship between geographic latitude and MS prevalence in the United States. If higher latitudes are associated with higher prevalence than decreased sunlight exposure and subsequent hindered vitamin D synthesis may be as well. Based on the review, these relationships seem possible.
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Endogenous vitamin D synthesis can be affected by a number of variables, including skin colour, amount of skin exposed and levels of ultraviolet radiation. The objective of this study was to assess the feasibility of using only sunlight exposure in Canada to meet the daily recommended level of vitamin D, given differences in these variables and adherence to guidelines for sun protection.Ultraviolet index data for 13 Canadian sites were obtained from Environment Canada. The sun exposure times required to synthesize 1000 IU of vitamin D in fair- and dark-skinned people who exposed either 1/4 or 1/8 of their body surface area to the sun were calculated for each hour of the year. These times were then classified according to whether the ultraviolet index was 3 or more (when sun protection is advised) or less than 3.During the fall and winter months and in the more northern sites, ultraviolet radiation levels were too low for all skin types to use sun exposure alone to obtain enough vitamin D within one time period. The required exposure time became longer when a smaller surface area was exposed. For people with darker skin, it can be difficult even in the summer to find opportunities outside of when sun protection is advised to use sunlight to obtain the recommended dose of vitamin D.Although sun exposure is an important source of vitamin D, Canadians should look to other safe sources to meet the body's vitamin D requirements throughout the year.
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The National Institute for Health and Care Excellence issued guidance on the risks and benefits of sunlight exposure earlier this year. Sunlight is needed to maintain vitamin D levels but too much exposure can damage the skin and lead to cancer. Risks of both vitamin D deficiency and skin damage depend on individual factors including age, skin colour and lifestyle, so information on sun exposure can be confusing. Practitioners therefore need to provide patient education that is both individually tailored and consistent. Aesthetic practitioners are well placed to advise patients on their risks and action to take.
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Sir, I read with interest, an article by Patwardhan et al.[1] published in your journal. It is commendable to note that the authors have put in effort to validate questionnaire to estimate sunlight exposure and then correlate the same with vitamin D status. But authors mention 'Nevertheless, the association of UV exposure with serum 25(OH)D concentrations in Asian adults from tropical climates like India, where angle and latitude are favourable for receiving optimal sunlight, has to the best of our knowledge not been reported so far' which is far from truth. A study from south Indian city, Tirupati (latitude 13.40° N and longitude 77.2° E) using in vitro ampoule model with precursors of vitamin D (7-dehydrocholesterol) when exposed to sunlight demonstrated best conversion to active vitamin D between 11 A.M. to 2 P.M. clearly proving the efficacy of sunlight in vitamin D synthesis. The median percentage conversion of 7-dehydrocholesterol to pre-vitamin D3 and its photoproducts and percentage of pre-vitamin D3 and vitamin D3 was shown to be 11.5% and 10.2% respectively at a solar zenith angle of 36.8° and at 12:30 P.M.[2] Vitamin D surveys from rural south India (Tirupati) by Harinarayan et al.,[3] have similarly demonstrated higher vitamin D levels in agricultural workers who are exposed to long hours of sunlight as part of their work compared to urban dwellers (~24 ng/mL vs 19 ng/mL) establishing positive correlation between exposure to UV rays from sun and serum vitamin D levels. In another study from north India,[4] authors compared serum 25(OH) D and bioavailable 25(OH) D in males with varying durations of sun-exposure between indoor and outdoor environments in Delhi during August–September. They demonstrated that serum 25(OH)D increases by 2.03 ng/mL per hour of sun-exposure (95% confidence interval 1.77–2.28; P < 0.001). Also they found that outdoor workers with prolonged sun-exposure were vitamin D-sufficient, with higher serum bioavailable 25(OH) D than the indoor workers during summer. Studies from Pune (latitude 18.31° N and longitude 73.55° E) involving current authors,[5] themselves have shown that toddlers (of course not adults in this case) exposed to sunlight (playing outside) for more than 30 min a day exposing more than 40% of their body surface area have a normal vitamin D status (males: 91.6 nmol/L and females: 67.7 nmol/L) which was three times more compared with the toddlers who were indoors for most part of the day (males: 32 nmol/L and females: 21.1 nmol/L.[5] A similar association is proven across India in adolescent school children aged 10–15 years by Marwaha et al.[6] In a dose–response study by Mark et al.,[7] healthy adults of South Asian ethnicity (n = 60; 20–60 years old) while wearing casual clothes that revealed a 35% skin area were exposed to ultraviolet rays equivalent to 15–90 min unshaded noontime summer sunlight at 53.5° N (Manchester, United Kingdom), three times/week for 6 weeks. They demonstrated that participants who received exposures equivalent to 45 min unshaded sunlight (n = 33) attained a mean (±SD) rise in 25(OH) D concentration of 8.7 ± 5.7 ng/mL (95% CI: 6.8, 10.6 ng/mL; P < 0.001), and 94% of subjects achieved concentrations >10 ng/mL proving an association between sunlight exposure and vitamin D status. I think the association between sunlight exposure and vitamin D synthesis is well established in south Asians especially Indians. Hence, author's claim of novelty of data presented with regards to this association is not true and is ill-founded. Financial support and sponsorship None. Conflicts of interest There are no conflicts of interest.
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Background/purpose: The advice that an adequate vitamin D status can be achieved by short, casual exposure to summer sunlight is ubiquitous. This review will examine the value of this advice. Methods: The results of experimental studies on changes in serum 25-hydroxyvitamin D [25(OH)D] concentrations following ultraviolet exposure are interpreted in the context of human exposure to sunlight. Results: It is shown that current advice about modest sun exposure during the summer months does little in the way of boosting overall 25(OH)D levels, while sufficient sun exposure that could achieve a worthwhile benefit would compromise skin health. Conclusions: Failure to understand the nature of human exposure to sunlight has led to misguided advice concerning the sun exposure necessary for an adequate vitamin D status.
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The purpose of this study is to compare by chromametric analysis the changes seen in normal skin and solar lentigos after exposure to sunlight. The color measurements were made with a Minolta CR200 chromameter and expressed in the L*a*b* system, which allows a color to be quantified according to 3 axes: white-black (L*), red-green (a*) and yellow-blue (b*). In order to better assess the sensitivity of physiological mechanisms involved in this pigmentation, we chose the weakest conditions of sunlight: the first series of measurements were made at the end of the winter (March) on areas rarely exposed for several months, and the second measurement was made 2 months later before the first intense summer solar exposure. Solar lentigos underwent a significant change in pigmentation, with a darkening of these lesions and an increase in the red and yellow color components. The pigmentation of healthy skin adjacent to these lentigos remained unchanged.
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Objective To analyze a topographic distribution of cutaneous basal cell carcinoma (BCC) and clinicopathological differences of disease with regards to the extent of sunlight exposure. Methods A total of 1,065 BCC cases from 815 patients were investigated. The topographic regions of the body affected were merged into the sun-protected, intermittently sun-exposed, and permanently sun-exposed sites. Results BCCs occurred most commonly in the permanently sun-exposed sites (63.8%), followed by intermittently sun-exposed sites (30.8%), and sun-protected sites (5.4%). There was higher proportion of the men in the parts of the body intermittently exposed to sunlight and vice versa, higher percentage of the women in the sun-protected, as well as, in the permanently sun-exposed parts. There was a statistically significant trend towards an increased age with rising extent of sunlight exposure. Superficial BCC correlated positively with the intermittently sun-exposed sites and negatively with the permanently sun-exposed sites. Nodular BCC was related to the permanently sun-exposed sites and negatively with the intermittently sun-exposed sites. Infiltrative BCC was linked to permanently sun-exposed sites, while it was completely absent in the body regions, the skin of which was usually protected from UVR. A proportion of BCCs with aggressive growth phenotype positively correlated with rising extent of sunlight exposure. Conclusion Considerable clinicopathological variations in BCCs depending on locations and corresponding solar exposure levels were confirmed. With respect to the body sites, from which the lesions arise, this neoplasia may have distinct etiopathogenesis and biology. Probably, different patterns of sun exposure are independent risk factors for certain histological BCC subtypes and hence prognosis of this malignancy.
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