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Children sustain high levels of skin DNA photodamage, with a modest increase of serum 25(OH)D3, after a summer holiday in Northern Europe

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J. Narbutt, P.a. Philipsen, A. Lesiak, T. Sandberg Liljendahl, D. Segerbäck, J. Heydenreich, D. Chlebna-sokol, P. Olsen, G.i. Harrison, A. Pearson, K. Baczynska, M. Rogowski-tylman, H.c. Wulf, A.r. Young

Original languageEnglish
Pages (from-to)940-950
JournalBritish Journal of Dermatology
Volume179
Issue number4
Early online date24 Apr 2018
DOIs
Accepted/In press22 Mar 2018
E-pub ahead of print24 Apr 2018
PublishedOct 2018

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Abstract

Background
Childhood solar ultraviolet radiation (UVR) exposure increases the risk of skin cancer in adulthood, which is associated with mutations caused by UVR‐induced cyclobutane pyrimidine dimers (CPD). Solar UVR is also the main source of vitamin D, essential for healthy bone development in children.

Objectives
The impact of a 12‐day Baltic Sea (54oN) beach holiday on serum 25‐dihydroxyvitamin D (25(OH)D3) and CPD was assessed in 32 healthy Polish children (skin types I‐IV).

Methods
Blood and urine were collected, before and after the holiday, and assessed for 25(OH)D3 and excreted CPD respectively, and personal UVR exposure was measured. Diaries were used to record sunbathing, sunburn and sunscreen use. Pre‐ and post holiday skin redness and pigmentation were measured by reflectance spectroscopy.

Results
The average daily exposure UVR dose was 2.4±1.5 (SD) standard erythema doses (SED) which is borderline erythemal. The mean concentration of 25(OH)D3 increased (x1.24±0.19) from 64.7±13.3 → 79.3±18.7 nmol/L (p=1.59x10‐7). Mean CPD increased 12.62±10.0‐fold from 26.9±17.9 to 248.9±113.4 fmol/μmol creatinine (p=2.66x10‐11). Increased 25(OH)D3 was accompanied by a very much greater increase in DNA damage associated with carcinogenic potential. Overall, skin type had no significant effects on behavioural, clinical or analytical outcomes, but skin types I/II had more CPD (unadjusted p=0.0496) than skin types III/IV at the end of the holiday.

Conclusions
Careful consideration must be given to health outcomes of childhood solar exposure, and a much better understanding of the risk/benefit relationships of such exposure is required. Rigorous photoprotection is necessary for children, even in Northern Europe.

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