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How to be SunSmart - slip, slop, slap and wrap
SLIP into a shirt - and slip into some shade, especially between 11am and 4pm when the ultraviolet rays are most fierce.
SLOP on some sunscreen before going outdoors.
- Put sunscreen on any skin not covered by clothes.
- Choose a sunscreen that meets the Australian and New Zealand Standard AS/NZS2604.
- Use an SPF30+ broad-spectrum sunscreen. Wipe it on thickly at least 15 minutes before going outdoors.
- Reapply; do this 15 minutes after the first application to ensure complete coverage, and also after physical activity, swimming or towel drying.
SLAP on a hat with a brim or a cap with flaps. More people get burned on the face and neck than any other part of the body, so a good hat is important.
WRAP on a pair of sunglasses. Choose close fitting, wrap-around glasses that meet the Australian Standard AS1067.
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Skin Cancer in NZ - some facts
Skin cancer is the commonest cancer in this country.
- New Zealand has one of the highest rates of skin cancer in the world.
- There are nearly 50,000 new skin cancers a year, including 1800 new cases of melanoma.
- Over 300 people die of skin cancer a year. In 2001 244 people died of melanoma and a further 96 of non-melanoma skin cancers.
- You are most likely to be burnt on your face, neck, shoulder, and lower arm.
- The face and neck are the most common places for skin cancers particularly squamous cell carcinoma - a raised, crusty, non-healing sore, or basal cell carcinoma -a pale, red or pearly raised lump.
- New Zealanders are particularly at risk of skin cancer because of our clear skies, our outdoor lifestyle and our countries closeness to the sun.
- Our high rate of skin cancer, and melanoma in particular, is disturbing, especially given that most melanoma is preventable.
Further facts on skin cancer can be found on the Cancer Society website: www.cancernz.org.nz
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Types of skin cancers:
- Melanoma: the least common but the most serious form of skin cancer.
- Squamous cell carcinoma (SCC): easily treated if found early but can be fatal if left untreated.
- Basal cell carcinoma (BCC): the most common and least dangerous skin cancer. BCC can be serious if left untreated.
- Sun Spots (solar keratoses): people with sun spots are at greater risk of developing skin cancer.
About 1,800 new melanoma cases and about 45,000
new non-melanoma skin cancer cases are confirmed by laboratory tests each year.
There are also approximately 20,000 cases of non-melanoma skin cancer each year which are treated immediately, without health professionals ordering a laboratory test.
New skin cancers total about 67,000 a year compared to a total of 16,000 for all other new cancer registrations.
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The Costs of Skin Cancer to New Zealand
Skin cancer costs the New Zealand health system about $33 million a year. Most of this cost could be prevented, yet skin cancer prevention continues to be a low priority in national health purchasing.
Costs of treatment
The annual cost of treating skin cancers in hospital is about $14 million (in 1998/1999 dollars, excluding GST). A conservative figure for treating skin cancer outside of hospital is about $19 million. This means the total direct health system costs of skin cancer to New
Zealand amount to about $33 million every year, making skin cancer one of the most expensive cancers for the New Zealand health system.
New Zealand rates of skin cancer are similar to the rates found in the central and southern parts of Australia. More precise estimates of cost could be if there was better local information available on the prevalence of skin cancer. A number of methods were used to calculate these costs to produce the best possible information, however the figures may be conservative. In discussing these costs to the health system, it should be remembered that the greatest cost is premature death for some people.
Financial costs borne by people with skin cancer and their families are also significant. These costs include travel and accommodation to receive treatment, loss of income while receiving care, lost income due to premature death, non-medical costs during illness, and preventive purchases such as sunscreen and protective clothing. Intangible costs include stress and lost of enjoyment of life, as well as premature mortality.
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Use of estimates for evaluating preventive campaigns
New Zealand now has an 'order of magnitude' estimate of the incidence of non-melanoma skin cancers, and also of the cost of treatment of skin cancer. This new information should help with the evaluation of public health campaigns aimed at reducing the incidence of skin cancer.
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How Skin Works
To check out how skin works, what sunburn and tanning is and other skin facts check out: www.travel.howstuffworks.com/sunscreen1.htm
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The ozone layer
Ozone in the atmosphere occurs mainly in the stratosphere, at altitudes 10-30 kilometers above the Earth's surface. It forms a natural screen that absorbs most of the damaging UV radiation present in sunlight. The amount of ozone in the layer at any one time and location is subject to natural variation caused by the solar cycle (sunspots), volcanic activity and atmospheric circulation patterns. Over the past 15 years the total amount of ozone screening the Earth from UV radiation has decreased significantly, with the largest changes occurring at high latitudes. These changes cannot be explained wholly by natural factors.
Chlorine (Cl) contained in synthetic chemicals called chlorofluorocarbons (CFCs) is partly responsible for this ozone depletin. Since the 1940s CFCs have been used as, for example, refrigeration agents and propellants in aerosol sprays. They have a very long lifetime in the atmosphere. When they diffuse into the stratosphere, sunlight causes the molecules to break up, releasing Cl atoms. Cl reacts catalytically with ozone in a process which regenerates Cl, so that each atom can destroy thousands of ozone molecules. Bromine (Br) is an even more effective ozone-depleter on a per molecule basis, but its atmospheric concentration is much less than that of chlorine.
Since the late 1970s an ozone "hole" has formed over Antarctica during early spring, caused by the special meteorological conditions of the cold atmosphere which make CFCs much more destructive. At this time, more than half of the ozone over Antarctica can be destroyed. This hole cannot shift over New Zealand, but it is thought to contribute to global ozone changes because the ozone recovery in Antarctica during the late spring/early summer dilutes the available total ozone. Evidence of ozone destruction has also been observed recently over the Arctic.
Based on the Montreal Protocol, regulations to minimise future ozone depletion are now in effect. As a result, it is predicted that the amount of chlorine in the stratosphere will peak just before the end of this century. Because CFCs last so long it will be several decades before Cl reverts to pre-ozone depletion levels.
Further information can be found on the NIWA website:
www.niwa.cri.nz/services/uvozone/
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What is MED? (Minimal Erythemal Dose)
When you go into the sun, your skin will takes a certain amount of time to burn. This interval is your personal Minimal Erythemal Dose (MED).
For more information check out :
www.meteo.lcd.lu/meteo_lcd/papers/uv/uvi/uvi_01.html
An SPF, or sun protective factor, simply indicates how many times your MED you can be exposed to UV rays without burning: If your MED is 10 minutes and you're wearing SPF 20, you're protected for 200 minutes or if your MED is 15 minutes and you happen to be wearing SPF 20, you will be protected for 300 minutes.
So, how do they decide what SPF a sunscreen is?
Scientists select pale skinned people to experiment on. A device that pumps out UV is aimed at a small space on the subjects skin – this establishes their MED (Minimal Erythemal Dose) or individual burn time. They do exactly the same thing again, but this time the scientist will put sunscreen on the subject to see how long it takes with protection.
So… if a sunscreen is rated SPF 20 it should be able to prevent a person with a MED of 10 from burning for 200 minutes. This is how a sunscreen achieves their SPF rating!
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Shade
Shade is one of the most convenient forms of sun protection. Seek shade when UV rays are the most intense, but keep in mind that shade structures such as trees, umbrellas or canopies do not offer complete sun protection so always wear sun protection.
Further information can be found on the NZ Cancer website:
www.cancernz.org.nz
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NZ Cancer Control Strategy
About 16,000 New Zealanders develop cancer annually, it kills about 7,500 people each year and this number is growing.
The overall purposes of the New Zealand Cancer Control Strategy are to reduce the incidence and impact of cancer and reduce inequalities with respect to cancer.
The New Zealand Cancer Control Strategy is the first phase in the development and implementation of a comprehensive and co-ordinated programme to control cancer in New Zealand. The strategy includes purposes, principles and goals to guide existing and future actions to control cancer.
It also includes objectives and broad areas for action. The next phase will involve identifying priorities for action, planning implementation, and defining processes to manage, monitor and review implementation.
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Ministry of Health Cancer Register
The New Zealand Cancer Registry is a population-based register of all primary malignant diseases diagnosed in New Zealand, excluding squamous cell and basal cell skin cancers. Data is used in research, and in monitoring and evaluating cancer screening programmes.
The NZCR was set up in 1948 primarily using information sent by public hospitals to the NMDS. The Cancer Registry Act 1993 and Cancer Registry Regulations 1994 were introduced to increase reporting of primary cancers in New Zealand. Since the Cancer Registry Regulations 1994 came into effect, laboratory test results have been collected and the data quality and completeness have significantly improved.
For more information look at the New Zealand Health Information Service website: www.nzhis.govt.nz
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Maori and Skin Cancer
Do Maori need to be concerned about getting skin cancer?
Yes. Historically melanoma has mainly been an issue for New Zealanders of European origin, as the risk is much less among people with naturally darker skin colour.1 Although melanoma is not currently a significant health issue for Maori it should not be overlooked.
Recent survey results indicate that self-defined Maori include a full range of skin types and a sizable proportion with a tendency to sunburn.2 Also, many Maori reported considerable occupational sun exposure during a normal working day, and although this may not increase the risk of melanoma it may increase the risk of other types of skin cancer among those with fairer skin types.3 It is important, too, that caregivers ensure adequate protection for children with fair skin.
1. Parkin DM, Muir CS, Whelan SL. Et al. (Editors) Cancer incidence in five continents. International Agency for Research on Cancer Scientific Publication No. 120. Lyon: IARC, 1992.
2. Reeder A.I. Results from the Maori respondents included in a national survey of awareness, understanding & response to sun protection messages in media weather reports. Social & Behavioural Research in Cancer Group, Department of Preventive and Social Medicine, Dunedin School of Medicine, 31 March 2001.
3. English DR, Armstrong BK, Kricker A and Fleming C. Sunlight and cancer. Cancer Causes and Control, 1997: 8:271-283.
What are the registered rates of melanoma for Maori?
In 1999, there were only 12 Maori, but 1,472 non-Maori registrations for melanoma.1 The age-standardised registration rate for non-Maori was around 10 times higher than that for Maori, which is 3.1 per 100,000. For some registrations, however, no ethnicity has been reported. These cases are excluded so both the number of cases and the registration rate may be understated.
1. New Zealand Health Information Service. Cancer: New registrations and deaths, 1999. Wellington: Ministry of Health, 2002.
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