In June 2005 the SunSmart Partnership (Cancer Society of NZ and the Health Sponsorship Council) convened a meeting of experts and key stakeholders to discuss the risks and benefits of sun exposure in NZ. A Position Statement was developed as a result of discussions at the meeting, a summary of which appears below. Access the full text at http://www.sunsmart.co.nz/sunvitamind.asp
Summary of Position Statement
- In most situations, sun protection to prevent skin cancer and sun damage to the skin is required during times when the ultraviolet index (UVI) is raised.
When the UVI is higher than or equal to 3, sensible sun protection behaviour is warranted and is unlikely to put people at risk of vitamin D deficiency.
When the UVI is low (1 or 2) no sun protection is required.
- During the summer months most people should be able to achieve adequate vitamin D (blood 25-hydroxyvitamin D) levels through incidental outdoor UV exposure outside peak UV times (Peak UV times in NZ are 11.00AM – 4.00PM during daylight savings months).
As an example, someone who burns easily in the sun (skin type 1 or 2) may only need 5 minutes of daily summer sun exposure before 11am and after 4pm (to the face, hands and forearms) to achieve adequate vitamin D levels whereas someone who tans more easily or has darker skin (skin type 5 or 6) will need more time e.g., up to 20 minutes.
Deliberate exposure at peak UV times is not recommended as this increases the risk of skin cancer, eye damage, and photo aging.
During winter, particularly in southern New Zealand, where UV radiation levels are dramatically lower, vitamin D status may drop below adequate levels. Additional measures to achieve adequate vitamin D status may be required particularly for those at risk of vitamin D deficiency. Summer levels of vitamin D influence winter levels of vitamin D because body stores decline in winter.
- Certain people are at high risk of skin cancer. They include individuals who have had skin cancer, have received an organ transplant or are highly sun sensitive (photosentive).
People at high risk need to have more rigorous sun protection practices and therefore should discuss their vitamin D requirements with their medical practitioner to determine if dietary supplementation rather than sun exposure is recommended.
- Some groups in the community are at increased risk of vitamin D deficiency. These include the elderly, babies of vitamin D deficient mothers, people who are housebound or are in institutional care, people with darker skin types and those who cover their skin for religious or cultural reasons.
For people with a higher risk of vitamin D deficiency, status should be discussed with their medical practitioner.
There needs to be an appropriate response from the health sector – including policy, research, and primary care to respond to this increased risk.
- People who have darker skin (skin types 5 and 6) are at higher risk of vitamin D insufficiency and at lower risk of skin cancer.
This may have implications for the health of Maori, Asian and Pacific communities, especially those living further south.
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