Recommendations and advice How to prevent malignant skin tumours In 1995, the Danish National Board of Health published the report How to prevent malignant skin tumours ("Forebyggelse af maligne tumorer i huden"). The report s conclusions and recommendations are still valid for the preventive work in this field: In most cases, skin cancer develops because people are exposed to excessive ultraviolet radiation from the sun due to changed patterns of behaviour. Children and adults should therefore restrict the amount of time they spend in the sun in order to avoid periodical intense exposure (with or without sunburn) and to reduce the overall ultraviolet radiation to which the skin is exposed in the course of a person s life. Children and young people in particular should take extra care, both because their behaviour in relation to the sun places them at a special risk, and because the risk of undesirable long-term effects increases with the number of years of being exposed to the risk. You should avoid spending time in the sun between 12 noon and 3 pm as this is when about half the potentially damaging radiation occurs. Shade, clothing and hats offer the best protection.
Sunscreen may be used when other protection is not possible. Factor 15 sunscreen is recommended. Your skin type has a bearing on how well your body tolerates sunshine. People born with sensitive skin types should take extra care and ensure they reduce the time they allow unprotected skin to be exposed to the sun. In particular, people whose skin quickly reddens should stay out of the sun. Such people, who often have pale skins, are at greater risk of all types of sun damage, including skin cancer. Increased pigmentation normally requires exposure to ultraviolet radiation. Consequently, you cannot achieve a tan without subjecting yourself to a certain risk. Using sunbeds increases the total ultraviolet radiation dose which a person receives, and therefore contributes to the risk of long-term skin damage, including skin cancer.
Children and the sun By following some simple advice, parents can protect their children against sunburn and generally being exposed to excessive sunshine. Protecting children is easy: Do not allow children to stay outdoors unprotected from the sunshine Very young children who cannot walk or crawl should never spend time outdoors in direct sunshine It is particularly important to protect children against the sun when they are outdoors between 12 noon and 3 pm Shade is good. Create it yourself by using a parasol Light summer clothes and a small hat offer good protection for children playing outdoors in the sunshine When very young children do not spend time in the sun, it is seldom necessary to use sunscreen. To protect the skin against reflected sunlight from the sea or white sand, you can apply sunscreen to the cheeks, nose and the backs of hands If a child needs sunscreen, make sure to apply it thoroughly before he or she goes out into the sun Slightly older children require a high factor sunscreen. Remember that sunscreen quickly loses its effect, for example after a swim Children below 12 years of age are advised not to use sunscreen as it contains the substance 4-methylbenzylidene camphor (4-MBC) In the past, the Board has recommended using sunscreens with physical filters for very young children. However, knowing what we do to-
day, there is no reason to recommend physical filters in favour of others. People at special risk in the heat Everyone can suffer from dehydration and in the worst case heatstroke, but some people are more susceptible than others. This concerns: Babies and children up to 4 years of age are particularly sensitive to high temperatures. Take care that the child is not too hot when sleeping, for example by undressing and uncovering the child. Make sure the child has plenty to drink. The elderly and the infirm do not always feel thirsty even though they lack fluids, and the body is not always able to sense and react to temperature increases, so it can be difficult to drink enough. You should be aware that placing a glass of water in front of someone is not always sufficient it may well be necessary to remind them and make sure they drink it. It is a good idea to put a bottle or jug of water corresponding to one day s consumption in the fridge. This makes it easier to keep an eye on how much the elderly person is drinking. Overweight people tend to retain heat more than people with a normal body weight. People who exert themselves through work or exercise in hot and humid conditions. Pregnant women. People with cardiovascular disease and pulmonary disease. People taking certain types of drugs with so-called anticholinergenic effects are particularly vulnerable as the drugs
block the nerve stimulation of the sweat glands. Several antidepressant and antipsychotic drugs as well as certain antihistamines have an anticholinergenic effect. Caution should also be exercised during treatment with beta blockers, which inhibit skin blood flow, and diuretics which exacerbate dehydration. Heatstroke Heatstroke is a condition where the body overheats within a relatively short space of time. Heatstroke occurs due to failed thermoregulation. This means that the body temperature increases while the body s ability to sweat fails, the result being that the body is unable to cool down. Heatstroke can cause death or chronic handicap unless it is treated quickly. Symptoms Extremely high body temperature. When the body temperature exceeds 41 C, the situation is critical. Body temperatures in excess of 42 C will often lead to cell damage to the brain, liver, kidneys and skeletal musculature as well as haemorrhaging. Red, hot and dry skin, i.e. reduced or non-existent sweat production. Reduced urine production, increasingly dark orange in colour, i.e. an indication of fluid/salt deficiency. Fast and strong pulse. Increasing malaise, weakness, headache and dizziness. Disorientation, fainting, confusion, unconsciousness and cramps.
Treatment Heatstroke victims must be immediately placed in the shade and preferably in cool surroundings. In serious cases, cooling must be ensured by fanning, showering with cool water, or by placing the victim in a bath of cool water while the skin is massaged to increase blood circulation. In such cases, the victim should be taken to hospital as quickly as possible as oxygen treatment and an intravenous drip are often necessary and also possibly medication.