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Thirty years ago, the Global Solar UV Index (UVI) has been introduced as a health promotion instrument to improve sun protection. We assessed systematically global levels of awareness and use of the UVI as a prerequisite for the preventive effectiveness of this public health tool. We conducted a comprehensive literature search across 10 databases, including PubMed, Scopus and Web of Science Core Collection, as well as clinical trial registries and gray literature databases. The risk of bias of studies was evaluated using the Joanna Briggs Institute checklist for prevalence studies. In addition to narrative and descriptive analysis, we performed meta‐analyses with geographical subgroup analyses to statistically summarize the results. In total, we identified 40 publications from 39 different studies across multiple global regions. However, the number of studies in the analyses varies depending on the outcome. The results, especially the awareness of the UVI, were largely dependent on the specific geographical location of the studies. While the prevalence of awareness of the UVI is high among Australian populations, there is considerable variability in levels of awareness across other global regions. At the same time, the use of the UVI is at a low level across all regions, demonstrating the need for enhanced dissemination of knowledge about the perils associated with ultraviolet radiation and the advantages of using the UVI. [ABSTRACT FROM AUTHOR]

According to the World Health Organization and partner organizations, no protection against ultraviolet (UV) radiation is required on days with "low" values (i.e., values <3) of the Global Solar Ultraviolet Index (UVI). Erythemal irradiance (Eer) data of such days were analyzed to evaluate this claim. Measurements from 9 stations of the German solar UV monitoring network from 2007 to 2016 yielded 14,431 daily Eer time series of low UVI days. Erythemal doses for certain fixed time intervals—acquired from measurements on horizontal planes—were compared with the average minimal erythemal dose (MED) of skin phototype II. Doses from days with rounded UVI values of 0 were insufficient to induce erythema and even on days with rounded UVI values of 1 doses exceeding 1 MED of skin type II could only be acquired under very specific circumstances of prolonged exposure. Conversely, sun exposure on days with rounded UVI values of 2 can indeed provide doses sufficient to induce erythema in skin type II after two hours around noon. In conclusion, our analyses do not support the claim of harmlessness currently associated with the entire low UVI exposure category in public guidance on interpretation of the UVI. [ABSTRACT FROM AUTHOR]

Background No observed event is a special, but not uncommon, result in patch test studies. The interpretation of such findings depends critically on the sample size (n) of the investigation, and is statistically addressed by the use of confidence intervals ( CIs). Objective To define the statistically correct method of calculating a CI with a confidence level of 1 − α, where α denotes the tolerated statistical error probability, for an observed prevalence of 0%. Methods A literature survey and evaluation of the statistical methods was conducted. The popular statistical software packages spss™ and sas™ were examined with regard to the methods implemented, and the results obtained, for estimating such CIs in this special case. Results The evaluation identified [0; 1 − α1/n], which is well approximated by [0; 3/n] for α = 0.05, as an appropriate method to compute a CI with a confidence level of 1 − α. The resulting CI is an exact one, and more efficient than standard solutions. Popular statistical software such as spss™ and sas™ offers only various inefficient or even invalid procedures, but does not include this method. Conclusions It is easy to calculate a CI for an observed prevalence of 0% obtained in some studies. Such a CI facilitates the interpretation of such a finding, as it puts the observed zero result into adequate statistical perspective. [ABSTRACT FROM AUTHOR]

Background: Exposure to ultraviolet (UV) radiation is the most important modifiable risk factor for skin cancer. Parents are responsible for sun protection of their young children and thus their knowledge and attitudes should be assessed. Methods: A survey that included 2619 children aged 3-6 years (response: 64.7%) was performed in Erlangen during 2001/2002. Parents' attitude, knowledge and behavior regarding sun protection were ascertained by using a self-administered questionnaire. Demographic and photosensitivity data of the children were recorded, along with the UV radiation-related outcomes. Results: Most parents correctly recognized the risk factors of skin cancer, except the intermittent and intensive sun exposure. Nevertheless, most parents also agreed with statements regarding sun- and tanning related beauty and well-being. The overwhelming majority of parents stressed the necessity of sun protection for their children; however, 50% of the children experienced some form of solar radiation injury during the preceding summer. Children eagerly pursued outdoor activities, especially boys compared with girls (P<0.01). A gender difference was also apparent, with boys showing more willingness to wear hats than girls (P<0.01). Conclusion: The relatively high level of knowledge was in contrast to a prevalent attitude of regarding sunlight as enhancing health and well-being. This may hamper UV radiation avoidance strategies. Thus, future campaigns should not only address preventive knowledge but also focus on associated attitudes to effectively modify the behavior. [ABSTRACT FROM AUTHOR]

Background: Contact allergy (CA) to topical corticosteroids (CS) is relatively rare; however, current data from Germany are not available. Furthermore, valid risk assessment needs to take into account of the actual exposure to CS in the population. Patients and Methods: The reaction profile of 9 CS included in a “CS test battery” of the German Contact Dermatitis Research Group (DKG) in patients seen in German clinics belonging to the Information Network of Departments of Dermatology (IVDK; ) between 01/1995 and 12/2004 was analyzed. Applying the “Clinical Epidemiology/Drug Utilization Research” approach, annual incidences of CA to CS in Germany were extrapolated. These estimates were used as numerator for a relative incidence (RI) estimate which used exposure in terms of “defined daily doses” (DDD) to the respective CS as denominator, the latter information collected by the AOK Research Institute (WIdO). Results: On average, 7.4% of all patients were patch tested with the CS series, mostly yielding < 1% positive reactions. Exceptions included hydrocortisone 17-butyrate (1.5%), amcinonide (1.6%) and budesonide (2.6%). With a RI of 10.7, 23.6 and 4.9 per 100 000 DDD, respectively, the three CS mentioned classify as moderate topical drug allergens. Clobetasol 17-propionate and triamcinolone acetonide both yielded a RI of 1.4/100 000 DDD, indicating low sensitization risk. For hydrocortisone, betamethasone, prednisolone and dexamethasone (RI < 1/100 000 DDD) the risk of sensitization appears minute. Conclusions: The results support and extend previous evidence on the CA risk of CS, adding to a therapeutic index and risk assessment. [ABSTRACT FROM AUTHOR]

To support the decision as to whether erythematous patch test reactions to allergens are irritant or allergic, sodium lauryl sulfate (SLS, 0·5% in water) has been added to the standard patch tests since July 1996 in the Dortmund Department of Dermatology. Data on 1600 patients patch tested up until June 2001, as well as standardized data on ambient temperature and humidity obtained by the German Meteorological Service, were included in a logistic regression analysis taking age, sex and atopy as potential confounders into account. The pattern of association was heterogeneous: while doubtful reactions to nickel sulfate were significantly associated with dry/cold weather conditions, but not with SLS reactivity, the opposite was observed for lanolin alcohol, benzocaine and Myroxylon pereirae resin (balsam of Peru). Doubtful reactions to other allergens, namely formaldehyde, fragrance mix or p-phenylenediamine, were associated with both factors. For several other allergens of the standard series, no distinct, significant pattern could be discerned. In conclusion, meteorological conditions and SLS reactivity independently contribute information on individual irritability at the time of patch testing, and both should be considered. [ABSTRACT FROM AUTHOR]

Examines on the association between size of test chamber and patch test reaction. Interpretation of data on 495 patients; Analysis on the statistical aspects of this study; Difference on the reaction pattern between fragrance mix and wool wax alcohols.

The level of knowledge and awareness of skin cancer risks in parents of young children is largely unknown. The Erlangen Kindergarten study, which enrolled 3,129 parents of 3- to 6-year-old children in southern Germany, addressed this. The population-based survey found an overall high level of knowledge about skin cancer risks and strong support for the necessity of sun protection but identified two areas (role of intermittent sun exposure, sun protection on cloudy summer days) offering a target for improvement in future public health campaigns. [ABSTRACT FROM AUTHOR]

Presents a letter to the editor on reproducibility of patch test readings.