Expert consensus on the use of sunscreen agents: Indian perspective

<p class="abstract">Sunscreens have been widely known to play an integral part in photoprotection. Both physical and chemical sunscreens have been extensively used for prevention and management of several conditions induced by ultraviolet rays such as sunburn, photoaging, skin cancer, and phototoxic reactions. Currently, sunscreens are available in different formulations like creams, lotions, gels, sticks, and sprays. Forty experts in the field of clinical dermatology participated in the expert group meetings organized via teleconference webinar to discuss definitions, diagnoses, and management. Current evidence on the use of sunscreen agents along with clinical experience of experts was discussed. The application of an adequate amount of sunscreen with an appropriate sun protection factor is imperative, and must be in accordance to skin type and exposure pattern of an individual. As part of a complete sun protection regimen, the judicious use of sunscreens must be combined with avoidance of midday sun exposure and protective clothing. There is an undeniable need to improve public education and awareness regarding use of sunscreens. This review article provides a consensus clinical viewpoint of expert dermatologists on effective use of sunscreens to assist in clinical decision-making for healthcare professionals.</p>

1459Socioeconomic position influence on the early-life individual exposome in the Italian NINFEA birth cohort

Background Early exposure to unhealthy lifestyles and environmental risk factors is known to affect health throughout the life-course. There is also evidence that the exposure patterns are influenced by the socioeconomic position (SEP). Methods We use the data of the Turin participants of the Italian NINFEA birth cohort (n∼2500) to study how family SEP drives the early life exposome. SEP at birth is measured through the EHII (Equivalized Household Income Indicator), while the exposome includes urban environment, diet and lifestyle exposures measured during infancy. We use standard regression models to evaluate the effect of EHII on each exposome variable accounting for multiple comparison and potential confounders (Drivers-Exposome Wide Association Study – DExWAS) and the hierarchical clustering on the principal components approach to identify groups with similar exposure pattern. Results The DExWAS show that low EHII is associated with lower consumption of fruit and vegetables, lower levels of NO2, building and facilities densities, traffic, walkability and connectivity index, higher land-use diversity index, and higher exposure to pets. The hierarchical cluster analysis identifies three groups, with subjects belonging to the cluster characterized by higher level of urban environment risk factors and a healthier diet having a higher mean EHII. Conclusions These SEP-early life exposome analyses will be replicated in several European birth cohorts participating in the H2020 ATHLETE and LifeCycle projects. Key messages In the Italian city of Turin children from low SEP family are exposed to higher levels of environmental risk factors and unhealthy lifestyles during infancy.

Design of Refractive/Diffractive Hybrid Projection Lens for DMD-Based Maskless Lithography

The projection lens is the core component of DMD-based maskless lithography and its imaging quality directly affects the transferal of exposure pattern. Based on the traditional projection lens system, we have designed diffractive optical element (DOE) and aspheric surfaces to optimize the refractive/diffractive hybrid projection lens system to improve its imaging quality. We found that the best effect is obtained when DOE is very close to the front lens group before the diaphragm of the hybrid system. Compared with the traditional projection lens system, this hybrid projection lens system has lower wave aberration with the help of DOE, and higher image quality owing to the modulation transfer function (MTF) value being improved. Finally, a hybrid projection lens system with working distance of 29.07 mm, image Space NA of 0.45, and total length of 196.97 mm is designed. We found that the maximum distortion and field curvature are 1.36 × 10−5% and 0.91 μm, respectively.

Phthalate Exposure Pattern in Breast Milk within a Six-Month Postpartum Time in Southern Taiwan

Di-(2-ethylhexyl) phthalate (DEHP), a common plasticizer, has been detected in breast milk in many countries; however, whether phthalate metabolite concentration and the detection rate in breast milk change postpartum is still unknown. We measured phthalate metabolite concentrations in breast milk in the first 6 months postpartum in women enrolled in the E-Da hospital from January to July 2017. A total of 56 breastfeeding mothers and 66 samples were included in this study. We analyzed the samples’ concentration of eight phthalate metabolites using liquid chromatography mass spectrometry. The concentration of mono-2-ethylhexyl phthalate (MEHP) was significantly higher in the first month, and then decreased over time. The detection rate of ono-isobutyl phthalate (MiBP) and mono-n-butyl phthalate (MBP) was low in the first month and then increased over time. Compared with a previous study published in 2011, the levels of MEHP and MiBP in breast milk were much lower in the present study, suggesting an increased awareness of the health risks of phthalate exposure after a food scandal occurred in Taiwan. This study provides information for evaluating newborns’ exposure to different kinds of phthalate through human milk in the postpartum period.

A comparison of thyroidal protection by iodine and perchlorate against radioiodine exposure in Caucasians and Japanese

Radioactive iodine released in nuclear accidents may accumulate in the thyroid and by irradiation enhances the risk of cancer. Radioiodine uptake into the gland can be inhibited by large doses of stable iodine or perchlorate. Nutritional iodine daily intake may impact thyroid physiology, so that radiological doses absorbed by the thyroid as well as thyroid blocking efficacy may differ in Japanese with a very rich iodine diet compared to Caucasians. Based on established biokinetic–dosimetric models for the thyroid, we derived the parameters for Caucasians and Japanese to quantitatively compare the effects of radioiodine exposure and the protective efficacy of thyroid blocking by stable iodine at the officially recommended dosages (100 mg in Germany, 76 mg in Japan) or perchlorate. The maximum transport capacity for iodine uptake into the thyroid is lower in Japanese compared to Caucasians. For the same radioiodine exposure pattern, the radiological equivalent thyroid dose is substantially lower in Japanese in the absence of thyroid blocking treatments. In the case of acute radioiodine exposure, stable iodine is less potent in Japanese (ED50 = 41.6 mg) than in Caucasians (ED50 = 2.7 mg) and confers less thyroid protection at the recommended dosages because of a delayed responsiveness to iodine saturation of the gland (Wolff–Chaikoff effect). Perchlorate (ED50 = 10 mg in Caucasians) at a dose of 1000 mg has roughly the same thyroid blocking effect as 100 mg iodine in Caucasians, whereas it confers a much better protection than 76 mg iodine in Japanese. For prolonged exposures, a single dose of iodine offer substantially lower protection than after acute radioiodine exposure in both groups. Repetitive daily iodine administrations improve efficacy without reaching levels after acute radioiodine exposure and achieve only slightly better protection in Japanese than in Caucasians. However, in the case of continuous radioiodine exposure, daily doses of 1000 mg perchlorate achieve a high protective efficacy in Caucasians as well as Japanese (> 0.98). In Caucasians, iodine (100 mg) and perchlorate (1000 mg) at the recommended dosages seem alternatives in case of acute radioiodine exposure, whereas perchlorate has a higher protective efficacy in the case of longer lasting radioiodine exposures. In Japanese, considering protective efficacy, preference should be given to perchlorate in acute as well as prolonged radioiodine exposure scenarios.

Effects of Prometryn Exposure Scenarios on Microcystis aeruginosa Growth and Water Qualities in Incubator Experiments

Although multiple herbicide exposures are more prospective to occur in water, many previous studies were carried out as single herbicide exposure. To investigate the toxic effect of prometryn on cyanobacteria and water qualities, single and double prometryn exposures (at different growth phases) on Microcystis aeruginosa growth and concentrations of nutrients were compared after a 44-day experiment. Results indicated that under single exposure, maximum inhibition rates were 4.7–12.0% higher than those under double exposures. Correspondingly, the maximum Microcystis aeruginosa densities and growth rates under single exposure were 10.3–21.1% and 19.5–37.7% lower than those under double exposures (p < 0.05), respectively. These findings revealed that repeated prometryn exposures resulted in a reduction in biological effects, because the time of application and the concentration injected during the first application were both significant factors in the biological effects of prometryn. Prometryn exposure scenarios did not have a significant effect on nutrient or nutrient consumption concentrations (p > 0.05). In general, the pattern of nutrient limitation showed a shift from phosphorus to nitrogen limitation. The quantified relationships between Microcystis aeruginosa growth rates and consumed nutrients were studied. Based on the above findings, we believe that a high-dose and single prometryn exposure is a more effective exposure pattern for limiting cyanobacteria growth.

A Potential Health Risk to Occupational User from Exposure to Biocidal Active Chemicals

Biocidal active chemicals have potential health risks associated with exposure to retail biocide products such as disinfectants for COVID-19. Reliable exposure assessment was investigated to understand the exposure pattern of biocidal products used by occupational workers in their place of occupation, multi-use facilities, and general facilities. The interview–survey approach was taken to obtain the database about several subcategories of twelve occupational groups, the use pattern, and the exposure information of non-human hygiene disinfectant and insecticide products in workplaces. Furthermore, we investigated valuable exposure factors, e.g., the patterns of use, exposure routes, and quantifying potential hazardous chemical intake, on biocidal active ingredients. We focused on biocidal active-ingredient exposure from products used by twelve occupational worker groups. The 685 non-human hygiene disinfectants and 763 insecticides identified contained 152 and 97 different active-ingredient chemicals, respectively. The toxicity values and clinical health effects of total twelve ingredient chemicals were determined through a brief overview of toxicity studies aimed at estimating human health risks. To estimate actual exposure amounts divided by twelve occupational groups, the time spent to apply the products was investigated from the beginning to end of the product use. This study investigated the exposure assessment of occupational exposure to biocidal products used in workplaces, multi-use facilities, and general facilities. Furthermore, this study provides valuable information on occupational exposure that may be useful to conduct accurate exposure assessment and to manage products used for quarantine in general facilities.

Exploring Evaluation Variables for Low-Cost Particulate Matter Monitors to Assess Occupational Exposure

(1) Background: Small, lightweight, low-cost optical particulate matter (PM) monitors are becoming popular in the field of occupational exposure monitoring, because these devices allow for real-time static measurements to be collected at multiple locations throughout a work site as well as being used as wearables providing personal exposure estimates. Prior to deployment, devices should be evaluated to optimize and quantify measurement accuracy. However, this can turn out to be difficult, as no standardized methods are yet available and different deployments may require different evaluation procedures. To gain insight in the relevance of different variables that may affect the monitor readings, six PM monitors were selected based on current availability and evaluated in the laboratory; (2) Methods: Existing strategies that were judged appropriate for the evaluation of PM monitors were reviewed and seven evaluation variables were selected, namely the type of dust, within- and between-device variations, nature of the power supply, temperature, relative humidity, and exposure pattern (peak and constant). Each variable was tested and analyzed individually and, if found to affect the readings significantly, included in a final correction model specific to each monitor. Finally, the accuracy for each monitor after correction was calculated; (3) Results: The reference materials and exposure patterns were found to be main factors needing correction for most monitors. One PM monitor was found to be sufficiently accurate at concentrations up to 2000 µg/m3 PM2.5, with other monitors appropriate at lower concentrations. The average accuracy increased by up to three-fold compared to when the correction model did not include evaluation variables; (4) Conclusions: Laboratory evaluation and readings correction can greatly increase the accuracy of PM monitors and set boundaries for appropriate use. However, this requires identifying the relevant evaluation variables, which are heavily reliant on how the monitors are used in the workplace. This, together with the lack of current consensus on standardized procedures, shows the need for harmonized PM monitor evaluation methods for occupational exposure monitoring.