"Though malignant melanoma may be rare, moles are very common and sunbathing very popular: there is therefore enormous scope for the sort of scaremongering that is dignified as health education and public information."

SIRC – Media Watch 03-09-99

Seasonal disorder – practising safe sun.

As the summer draws to a close, it seems a good point to reflect upon the by now well established scare of the season – the dangers of sun exposure. Back in June, the government was delighted with the media's response to their new concept in public safety, the 'Solar UV Index'. Adopted by terrestrial and satellite TV channels, the broadsheets and tabloids alike the UV index was bandied around with the nonchalant regularity of the weather forecast.

The campaign, aggressively marketed by the Health Education Authority and the Cancer Research Campaign, is the latest in a long line of promotions that effectively played on the anxieties of the 'worried well'. [see eg: "No more good air days" ] The idea behind the solar UV index is that people first identify their skin type, according to certain specifics laid down by the scheme, and then calculate the period of safe exposure based upon the index figure of the day released in media weather bulletins. This latest crusade sought primarily to target children and was supported by its own web site and policed by beach-based 'mole-watch' patrols. Like its precursors – Australia's 'slip, slap, slop' slogans and Britain's 'sun know how' campaigns – the solar UV index calculations were prompted by a perceived risk of malignant melanoma.

As Dr Michael Fitzpatrick points out in Living Marxism: "in fact these are a relatively rare type of skin cancer, and the one least related to sunlight. Around 90 percent of skin cancers in Britain are either basal cell or squamous-cell carcinomas: both are highly correlated with sun exposure and are commonest around the head, neck and arms, where the skin is most likely to burn. Malignant melanomas account for less than 10 percent of skin cancers, around 4000 cases a year in Britain (or about one case every 10 years for the average GP)."

Two Newcastle University professors, Sam Shuster, emeritus professor of dermatology and Professor Jonathan Rees caused outrage back in August 1997 when they suggested to the Times that "The melanoma story is largely made up. The evidence for ultraviolet light as the main cause is not there." Furthermore, the professors accused their academic colleagues of making a living out of perpetuating the skin cancer scare.

We have been constantly reminded of the dangers of exposure to the sun and that as responsible individuals we should reduce the time we spend in it, cover up, stay in the shade and wear appropriate factor sunscreens. Does this then remove the risks to our health? Apparently not. According to a study, published in the US Journal of the National Cancer Institute the "use of higher SPF sunscreen seems to increase the duration of recreational sun exposure".

Ironically, it appears that people who wear higher factor sunscreens tend to remain out in the sun much longer, precisely because they feel protected from the risk of sunburn. After all that is what they presumably are designed to do, but the promise that sunscreens somehow eliminate all risk is obviously flawed. The fact that you may slap factor 50 onto every exposed inch of your body obviously does not make sunbathing in the middle of the Sahara for twelve hours a day a particularly sensible course of action. The public however has been led to believe both by the manufacturers and the health professionals that these products would offer a certain degree of protection, but now it would appear that they might actually be hazardous.

Once again mixed messages are abundant. Dr John Knowland, a biochemist at Oxford University, has recently offered another hypothesis as to why skin cancer rates continue to be on the increase. Commenting to the BBC he said: "The important thing to remember is that a sunscreen that absorbs energy cannot actually destroy that energy, it has to do something with it. The concern that some people have is that they can convert the light energy into chemical energy, which is potentially damaging."

For a truly safe summer maybe we should simply replace the living room lights with high watt spot lamps, lay on the floor and dream about foreign climes. Sorry, you can't do that either. Doctors from USA and Finland have suggested that the prevalence of artificial light in modern Western society may in part account for breast cancer rates being five times those of the developing world. Their theory is that artificial light may disrupt the regulation of melatonin, a hormone that may spur the development of breast cancer. In addition to this, shutting sunlight out altogether has recently been seen to present other hazards. Concerns were raised in the BMJ in May after a child was reported with vitamin deficiency, which was linked to the use of high factor sunscreens. An editorial in the New England Journal of Medicine entitled "Rickets Today -- Children Still Need Milk and Sunshine" advocated a traditional approach to children's health "Wherever children live, they should follow Grandma's advice: "Drink up your milk, and go play outside.""

So is it safe to sunbathe? The BBC asked the same question in an Internet poll and received some significant variations of opinion that mirrored the conflicting nature of health advice on the subject. A group of researchers from Bristol University argued, in an article in the British Medical Journal, that the benefits from sun-bathing may outweigh the risk of skin cancer and were subsequently accused of undermining years of public health campaigns by the HEA, who suggested that their conclusions were based on faulty research. Talking to BBC Breakfast News back in July one of the report's authors, Dr David Gunnell, sought to defend their findings "What we have said is we need to carefully balance up the benefits and disbenefits of sunlight exposure". While certainly being alarming, the fact that the dangers of sun exposure should prove to be such a well-publicised 'risk' is hardly surprising. As Dr Fitzpatrick is quick to point out, the methods employed to perpetuate this scare are all too familiar: "Though malignant melanoma may be rare, moles are very common and sunbathing very popular: there is therefore enormous scope for the sort of scaremongering that is dignified as health education and public information. The threat to children is always a particularly welcome angle for health promotion activists, for whom encouraging parental guilt is a key strategic device."

If all that wasn't enough to keep you in the shade, the advent of the first total eclipse visible in Britain for 52 years on August 11 at 11:11 am apparently presented us with another significant threat. Chief medical officer, Professor Liam Donaldson, issued official guidelines telling people not to look at the sun directly and suggested that the only truly safe way of viewing the eclipse was with either a pinhole camera or by staying inside and watching the whole spectacular event on the television. "The events are going to last a couple of hours and it can take just a split second when the full force of the sun's rays play on the back of the eye to permanently damage it, and possibly cause blindness," he said. "It can affect everyone, particularly children, so I would urge great caution. So we would say, enjoy the atmosphere, enjoy the eclipse but don't take any chances."

While Professor Donaldson was right to urge caution he may be guilty of a tendency to over compensate. Scientists have been using special filters to safely monitor the sun during eclipses for over twenty years so to suggest that these devices were somehow not appropriate does seem rather alarmist. Furthermore, in various avenues of the media we were warned that reduced lighting might cause an increase in crime, the eclipse may be harmful to our pets and even that driving during the event could be dangerous! As luck would have it technological advances at this late stage of the twentieth century have successfully managed to equip all road going vehicles with headlights, last time I looked, but such nonsense was still deemed newsworthy by some.

Professor Ralph Chew, an eye safety expert was quoted in the Times as saying: "In all my years working in this field, I have never encountered the degree of hysteria and loud-mouthing that has come out of Britain in the past six months." These types of claims seemed to reflect the misinterpretation that sunlight during an eclipse was more harmful that at any other time. As Emily Winterburn, assistant astronomy officer at the Royal Observatory in Greenwich, said: "You do not stare straight at the sun on a sunny day (with or without governmental advice), and similarly it will both hurt and damage your eyes to stare straight at the sun during the eclipse – except at totality, when the sun is less bright than the full moon." There we have it. Simple, practical and straightforward advice. Did we really need constant health warnings accompanying every mention of the eclipse in the press and national television? I wasn't around to witness the eclipse of 1927 and I very much doubt I will be here for the next one. If I am that fortunate, I don't intend to experience that one via television either.