1. SUN SAFETY Notes taken from Project Safety Teacher’s Guide, 2001

2. The Skin Made up of dermis and epidermis Made up of dermis and epidermis Dermis: deepest layer of skin, contains blood and lymphatic vessels Dermis: deepest layer of skin, contains blood and lymphatic vessels Epidermis: outer later of skin, made up of basal cells (at the base of this layer), squamous cells (flat cells) and melanocytes (produce melanin which produces a pigment/tan) Epidermis: outer later of skin, made up of basal cells (at the base of this layer), squamous cells (flat cells) and melanocytes (produce melanin which produces a pigment/tan) You shed your skin cells, the entire outer layer of skin (epidermis) is replaced every 15-30 days. You shed your skin cells, the entire outer layer of skin (epidermis) is replaced every 15-30 days.

3. Skin Cancer 3 kinds of skin cancer 3 kinds of skin cancer Basal cell carcinoma: most common type, starts in basal cells, slow growing, seldom spreads, do not leave untreated, treated by cutting the cancer out of the body, or freezing and scrapping off body. Basal cell carcinoma: most common type, starts in basal cells, slow growing, seldom spreads, do not leave untreated, treated by cutting the cancer out of the body, or freezing and scrapping off body. Squamous cell carcinoma: second most common type, starts in squamous cells, starts as a nodule or red patch, may metastasize if untreated, treated by cutting the cancer out of the body, or freezing and scrapping off body. Squamous cell carcinoma: second most common type, starts in squamous cells, starts as a nodule or red patch, may metastasize if untreated, treated by cutting the cancer out of the body, or freezing and scrapping off body. Melanoma: most deadly type of skin cancer, starts in melanocytes, blistering sunburns before the age of 18 increase chances of getting melanoma, at greater risk for getting melanomas in future, even after treated. Treated by surgery to cut out of body, early detection is critical. Mostly likely to show up on soles of feet, hands, under fingernails and toenails, in mouth. Melanoma: most deadly type of skin cancer, starts in melanocytes, blistering sunburns before the age of 18 increase chances of getting melanoma, at greater risk for getting melanomas in future, even after treated. Treated by surgery to cut out of body, early detection is critical. Mostly likely to show up on soles of feet, hands, under fingernails and toenails, in mouth.

4. Increased Incidence 1 in 5 people in the US will develop skin cancer in their lifetime, 1 in 3 people who live in the sunbelt. 1 in 5 people in the US will develop skin cancer in their lifetime, 1 in 3 people who live in the sunbelt. Sunbelt: states that lie below 37°N latitude, 16 states Sunbelt: states that lie below 37°N latitude, 16 states Australia: 2 out of 3 people develop melanoma Australia: 2 out of 3 people develop melanoma Most cases are in north Australia (closer to equator) Most cases are in north Australia (closer to equator) Hole in ozone layer above Australia, UV rays are not screened out as well. Hole in ozone layer above Australia, UV rays are not screened out as well. Not too many cases in Asian countries, even though they are near the equator, because pale/fair skin is considered a criterion for beauty. Not too many cases in Asian countries, even though they are near the equator, because pale/fair skin is considered a criterion for beauty. Increase in cases in the NW: many outdoor activities, high altitude, cloudy so people don’t wear sunscreen. Increase in cases in the NW: many outdoor activities, high altitude, cloudy so people don’t wear sunscreen.

5. Tans, UV rays & Tanning Beds What is a tan: melanocytes react to sun exposure by releasing melanin (pigment) because melanin absorbs UV rays. A tan is a sign of skin damage. What is a tan: melanocytes react to sun exposure by releasing melanin (pigment) because melanin absorbs UV rays. A tan is a sign of skin damage. UVC rays cannot reach earth UVC rays cannot reach earth UVB rays, less reach earth, they cause blistering sunburns, impair immune system UVB rays, less reach earth, they cause blistering sunburns, impair immune system UVA rays cause premature aging of skin, eye damage and impair immune system. Penetrate skin more deeply than UVB, damage cells in epidermis and dermis UVA rays cause premature aging of skin, eye damage and impair immune system. Penetrate skin more deeply than UVB, damage cells in epidermis and dermis Tanning beds use UVA rays since they go deeper into the skin. Long term tanning bed users are 8 times more likely to get melanoma. Tanning beds use UVA rays since they go deeper into the skin. Long term tanning bed users are 8 times more likely to get melanoma.

6. Myths about tanning “Tanning indoors is safer than tanning in the sun.” Indoor tanning and tanning outside are both dangerous. Although tanning beds operate on a timer, the exposure to ultraviolet (UV) rays can vary based on the age and type of light bulbs. You can still get a burn from tanning indoors, and even a tan indicates damage to your skin. Tanning beds cause about 1,800 injuries requiring visits to the emergency room every year. “I can use a tanning bed to get a base tan, which will protect me from getting a sunburn.” A tan is a response to injury: skin cells respond to damage from UV rays by producing more pigment. Banning Tanning California, Illinois, Nevada, Oregon, Texas, and Vermont have banned the use of tanning beds by minors. Brazil and one state in Australia (New South Wales) have banned the use of tanning beds. The United Kingdom, Germany, Scotland, France, several Australian states, and several Canadian provinces have banned indoor tanning for people younger than age 18.

7. Risk Factors The main risk factor for developing cancer is exposure to UV radiation The main risk factor for developing cancer is exposure to UV radiation Avoidable risk factors Avoidable risk factors Sun exposure, especially before the age of 18 Sun exposure, especially before the age of 18 Unavoidable risk factors Unavoidable risk factors Family history Family history Geographic location Geographic location Tendency to freckle or burn Tendency to freckle or burn Hair and skin type Hair and skin type Skin Types Skin Types Type 1 – always burns, never tans, red or blonde hair, freckles Type 1 – always burns, never tans, red or blonde hair, freckles Type II – skin burns easily, tans little. Fair skinned. Type II – skin burns easily, tans little. Fair skinned. Type III-Skin burns occasionally, gradually tans. Type III-Skin burns occasionally, gradually tans. Type IV – minimal burning, always tans. Light to medium skin pigmentation. Type IV – minimal burning, always tans. Light to medium skin pigmentation. Type V – seldom burns, always tans. Medium to heavy pigmentation. Type V – seldom burns, always tans. Medium to heavy pigmentation. Type VI – seldom burns, tans darkly. Heavy pigmentation. Type VI – seldom burns, tans darkly. Heavy pigmentation.

8. ABCDEs of Melanoma Melanoma lesions often originate from existing moles. Follow the patter of ABCDEs when looking at the characteristics of moles. Melanoma lesions often originate from existing moles. Follow the patter of ABCDEs when looking at the characteristics of moles. A symmetry – if the lesions were folded in half, the side would not match. A symmetry – if the lesions were folded in half, the side would not match. B order irregularity – these lesions have jagged, scalloped, notched or blurred edges, rather than a smooth continuous line. B order irregularity – these lesions have jagged, scalloped, notched or blurred edges, rather than a smooth continuous line. C olor variation – 2 or more different colors C olor variation – 2 or more different colors D iameter – any sudden or continuing growth in size of mole, concern for lesions with a diameter of 6mm or larger (size of a pencil eraser) D iameter – any sudden or continuing growth in size of mole, concern for lesions with a diameter of 6mm or larger (size of a pencil eraser) E volution – has this mole changed over time E volution – has this mole changed over time

9. Sun Exposure Avoid sun exposure between 10am-4pm, that is when the UV rays are more direct. Avoid sun exposure between 10am-4pm, that is when the UV rays are more direct. Wear sunscreen and protective clothing when outside Wear sunscreen and protective clothing when outside Try to find shade when outside Try to find shade when outside You can get a sun burn on a cloudy day You can get a sun burn on a cloudy day Wear sunglasses with lenses that filter out UVA and UVB rays Wear sunglasses with lenses that filter out UVA and UVB rays Some medications make you more sensitive to the sun Some medications make you more sensitive to the sun Look out for reflective surfaces as they can reflect UV radiation back to you: Look out for reflective surfaces as they can reflect UV radiation back to you: Concrete 10-15% Concrete 10-15% Water – 100% Water – 100% Asphalt – 7-8% Asphalt – 7-8% Grass 3-5% Grass 3-5% Sand 15-30% Sand 15-30% Snow 85% Snow 85%

10. S un P rotection F actor Apply sunscreen 20 minutes before you go in the sun, SPF 15+ Apply sunscreen 20 minutes before you go in the sun, SPF 15+ Reapply after swimming and sweating, or toweling off Reapply after swimming and sweating, or toweling off SPF is the amount of time the sunscreen will protect you, use the equation: time it takes for your skin to turn red in the sun X the SPF number = minutes of protection. SPF is the amount of time the sunscreen will protect you, use the equation: time it takes for your skin to turn red in the sun X the SPF number = minutes of protection. Example 5 (min) X 15 (SPF) = 75 (minutes of protection) Example 5 (min) X 15 (SPF) = 75 (minutes of protection) Wear clothes that protect you, and always wear a hat Wear clothes that protect you, and always wear a hat Cotton shirt – SPF 7 Cotton shirt – SPF 7 Cotton/polyester shirt – SPF 15 Cotton/polyester shirt – SPF 15 Denim jeans – SPF 95-100 Denim jeans – SPF 95-100 Polyester/lycra surf shirt – SPF 35 Polyester/lycra surf shirt – SPF 35