{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T18:42:49Z","timestamp":1777488169712,"version":"3.51.4"},"reference-count":40,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2018,12,10]],"date-time":"2018-12-10T00:00:00Z","timestamp":1544400000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>There have been many public health recommendations for avoiding UV radiation exposures. This is primarily due to concerns about skin cancer and especially melanoma, the most serious type of skin cancer. However, UV radiation is also known as the primary source of vitamin D and other compounds needed for good health. This brief commentary lists several of the many important recent studies of adverse health effects associated with low sun exposure, including some specific cancers, multiple sclerosis, diabetes, cardiovascular disease, autism, Alzheimer\u2019s disease, and age-related macular degeneration. Our conclusion is that non-burning UV exposure is a health benefit and\u2014in moderation\u2014should be recommended as such.<\/jats:p>","DOI":"10.3390\/ijerph15122794","type":"journal-article","created":{"date-parts":[[2018,12,10]],"date-time":"2018-12-10T03:36:41Z","timestamp":1544413001000},"page":"2794","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Sun Exposure Public Health Directives"],"prefix":"10.3390","volume":"15","author":[{"given":"David G.","family":"Hoel","sequence":"first","affiliation":[{"name":"Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC 29425, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Frank R.","family":"De Gruijl","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2018,12,10]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"88","DOI":"10.1001\/jamadermatol.2017.4201","article-title":"Interdisciplinary Perspectives on Sun Safety","volume":"154","author":"Geller","year":"2018","journal-title":"JAMA Dermatol."},{"key":"ref_2","unstructured":"(2018, October 29). Sun Exposure, Available online: https:\/\/www.nc.cdc.gov\/travel\/page\/sun-exposure."},{"key":"ref_3","unstructured":"(2018, October 29). Most schools can do more to help students stay sun safe, Available online: https:\/\/www.cdc.gov\/cancer\/dcpc\/research\/articles\/sun_safe_schools.htm."},{"key":"ref_4","unstructured":"(2018, October 29). Consensus Vitamin D position statement. Available online: https:\/\/www.nhs.uk\/livewell\/summerhealth\/documents\/concensus_statement%20_vitd_dec_2010.pdf."},{"key":"ref_5","unstructured":"(2018, October 29). Position statement - Sun exposure and vitamin D - risks and benefits. Available online: https:\/\/www.cancer.org.au\/policy\/Position_statement_-_Risks_and_benefits_of_sun_exposure#Key_messages_and_recommendations."},{"key":"ref_6","unstructured":"(2018, October 29). Consensus Statement on Vitamin D and Sun Exposure in New Zealand, Available online: https:\/\/www.health.govt.nz\/system\/files\/documents\/publications\/vitamind-sun-exposure.pdf."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1016\/j.ejca.2004.10.016","article-title":"Meta-analysis of risk factors for cutaneous melanoma: II. Sun exposure","volume":"41","author":"Gandini","year":"2005","journal-title":"Eur. J. Cancer"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"241","DOI":"10.1111\/j.0022-202X.2004.23551.x","article-title":"Single UVB Overexposure Stimulates Melanocyte Proliferation in Murine Skin, in Contrast to Fractionated or UVA-1 Exposure","volume":"124","author":"Jongsma","year":"2005","journal-title":"J. Investig. Dermatol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"2735","DOI":"10.1002\/ijc.28603","article-title":"Cust AE Occupational sun exposure and risk of melanoma according to anatomical site","volume":"134","author":"Vuong","year":"2014","journal-title":"Int. J. Cancer"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1087","DOI":"10.1046\/j.1523-1747.2003.12246.x","article-title":"The Influence of Painful Sunburns and Lifetime Sun Exposure on the Risk of Actinic Keratoses, Seborrheic Warts, Melanocytic nevi, Atypical Nevi, and Skin Cancer","volume":"120","author":"Kennedy","year":"2003","journal-title":"J. Investig. Dermatol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"435","DOI":"10.1177\/030089169908500603","article-title":"Risk of Basal and Squamous Cell Carcinoma of the Skin in Sion, Switzerland: A Case-Control Study","volume":"85","author":"Rosso","year":"1999","journal-title":"Tumori"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1447","DOI":"10.1038\/bjc.1996.275","article-title":"The multicentre south European study \u201cHelios\u201d II: Different sun exposure patterns in the aetiology of basal cell and squamous cell carcinomas of the skin","volume":"73","author":"Rosso","year":"1996","journal-title":"Brit. J. Cancer"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1016\/S1011-1344(01)00198-1","article-title":"The epidemiology of UV induced skin cancer","volume":"63","author":"Armstrong","year":"2001","journal-title":"J. Photochem. Photobiol. B"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"g1903","DOI":"10.1136\/bmj.g1903","article-title":"Vitamin D and risk of cause specific death: Systematic review and meta-analysis of observational cohort and randomised intervention studies","volume":"348","author":"Chowdury","year":"2014","journal-title":"BMJ"},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Lindqvist, P.G., Epstein, E., Nielsen, K., Landin-Olsson, M., Ingvar, C., and Olsson, H. (2016). Avoidance of sun exposure as a risk factor for major causes of death: A competing risk analysis of the Melanoma in Southern Sweden cohort. J. Int. Med.","DOI":"10.1111\/joim.12496"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1839","DOI":"10.1038\/jid.2014.27","article-title":"UVA Irradiation of Human Skin Vasodilates Arterial Vasculature and Lowers Blood Pressure Independently of Nitric Oxide Synthase","volume":"134","author":"Liu","year":"2014","journal-title":"J. Investig. Dermatol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"210","DOI":"10.1016\/j.amepre.2006.11.004","article-title":"Optimal Vitamin D Status for Colorectal Cancer Prevention","volume":"32","author":"Gorham","year":"2007","journal-title":"Am. J. Prev. Med."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"2341","DOI":"10.1158\/1055-9965.EPI-10-0264","article-title":"Serum 25(OH)D Vitamin D and Risk of Breast cancer: A Nested Case-Control Study from the French E3N Cohort","volume":"19","author":"Engel","year":"2010","journal-title":"Cancer Epidemiol. Biolmark. Prev."},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"McDonnell, S.L., Baggerly, C.A., French, C.B., Baggerly, L.L., Garland, C.F., Gorham, E.D., Hollis, B.S., Trump, D.L., and Lappe, J.M. (2018). Brest cancer risk markedly lower with serum 25-hydroxyvitamin D concentrations more than 60 ng\/mL vs less than 20 ng\/mL (150 vs 50 nmol\/L): Pooled analysis of two randomized trials and a prospective cohort. PLoS ONE, 13.","DOI":"10.1371\/journal.pone.0199265"},{"key":"ref_20","first-page":"1163","article-title":"Meta-analysis of Vitamin D Sufficiency for Improving Survival of Patients with Breast Cancer","volume":"34","author":"Mohr","year":"2014","journal-title":"Anticancer Res."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"381","DOI":"10.1373\/clinchem.2012.193003","article-title":"Low 25-Hydroxyvitamin D and Risk of Type 2 Diabetes: A Prospective Cohort Study and Metaanalysis","volume":"59","author":"Afzal","year":"2013","journal-title":"Clin. Chem."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"327","DOI":"10.1530\/EJE-14-0580","article-title":"Vitamin D status and metabolic syndrome in the elderly: The Rotterdam Study","volume":"172","author":"Vitezova","year":"2015","journal-title":"Eur. J. Endocrinol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"920","DOI":"10.1212\/WNL.0000000000000755","article-title":"Vitamin D the risk of dementia and Alzheimer disease","volume":"83","author":"Littlejohns","year":"2014","journal-title":"Neurology"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1578","DOI":"10.1212\/WNL.0000000000004489","article-title":"25-Hydroxyvitamin D deficiency and risk of MS among women in the Finnish Maternity Cohort","volume":"89","author":"Munger","year":"2017","journal-title":"Neurology"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"515","DOI":"10.1001\/jamaneurol.2015.4800","article-title":"Vitamin D Status During Pregnancy and Risk of Multiple Sclerosis in Offspring of Women in the Finnish Maternity Cohort","volume":"73","author":"Munger","year":"2016","journal-title":"JAMA Neurol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1192\/bjpo.bp.116.004077","article-title":"Gestational vitamin D deficiency and autism spectrum disorder","volume":"3","author":"Vinkhuyzen","year":"2017","journal-title":"BJPsych Open"},{"key":"ref_27","first-page":"417","article-title":"Exposure to sunshine early in life preventeddevelopment of type 1diabetes in Danish boys","volume":"19","author":"Jacobsen","year":"2016","journal-title":"J. Pediatr. Endocrinol. Metab."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1171","DOI":"10.1001\/jamaophthalmol.2015.2715","article-title":"Association Between Vitamin D Status and Age-Related Macular Degeneration by Genetic Risk","volume":"133","author":"Millen","year":"2015","journal-title":"JAMA Ophthalmol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"58","DOI":"10.1016\/j.exer.2013.04.018","article-title":"Time outdoors and the prevention of myopia","volume":"114","author":"French","year":"2013","journal-title":"Exp. Eye Res."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"505","DOI":"10.1111\/j.1365-2133.2011.10699.x","article-title":"Vitamin D status in patients with chronic plaque psoriasis","volume":"166","author":"Gisondi","year":"2012","journal-title":"Br. J. Dermatol."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"3219","DOI":"10.3390\/nu7053219","article-title":"Can Skin Exposure to Sunlight Prevent Liver Inflammation?","volume":"7","author":"Gorman","year":"2015","journal-title":"Nutrients"},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"Rueter, K., Jones, A.P., Siafarikas, A., Lim, E.-M., Bear, N., Noakes, P.S., Prescott, S.L., and Palmer, D.J. (2018). Direct infant UV light exposure is associated with eczema and immune development. J. Allergy Clin. Immunol.","DOI":"10.1016\/j.jaci.2018.08.037"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"1716","DOI":"10.1016\/j.cell.2018.04.014","article-title":"Moderate UV exposure enhances learning and memory by promoting a novel glutamate biosynthetic pathway the brain","volume":"173","author":"Zhu","year":"2018","journal-title":"Cell"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"e1248325","DOI":"10.1080\/19381980.2016.1248325","article-title":"The risks and benefits of sun exposure","volume":"8","author":"Hoel","year":"2016","journal-title":"Dermato-Endocrinol."},{"key":"ref_35","unstructured":"Institute of Medicine (2010). Dietary Reference Intakes for Calcium and Vitamin D, National Academies Press. page S-11 and page 8\u20137."},{"key":"ref_36","unstructured":"(2007). MMWR Weekly Report June 1, 2007."},{"key":"ref_37","unstructured":"(2012). MMWR Weekly Report May 11, 2012."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"1009","DOI":"10.1542\/peds.109.6.1009","article-title":"Use of sunscreen, sunburning rates, and tanning bed use among more than 10,000 US children and adolescents","volume":"109","author":"Geller","year":"2002","journal-title":"Pediatrics"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"741","DOI":"10.1111\/j.1751-1097.2011.00898.x","article-title":"The vitamin D debate: Translating controlled experiments into reality of human sun exposure times","volume":"87","author":"Webb","year":"2011","journal-title":"Photochem. Photobiol."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"626","DOI":"10.1001\/archinternmed.2008.604","article-title":"Demographic differences and trends of vitamin D insufficiency in the US population, 1988\u20132004","volume":"169","author":"Ginde","year":"2009","journal-title":"Arch. Intern Med."}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/15\/12\/2794\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T15:32:28Z","timestamp":1760196748000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/15\/12\/2794"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,12,10]]},"references-count":40,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2018,12]]}},"alternative-id":["ijerph15122794"],"URL":"https:\/\/doi.org\/10.3390\/ijerph15122794","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,12,10]]}}}