An investigation into the ultraviolet radiation exposure of children and adolescents in Durban.
Stratospheric ozone plays an important role in absorbing ultraviolet radiation. The well-known depletion of the ozone layer has raised several concerns in terms of an expected increase in surface ultraviolet radiation. South Africa, situated in the southern mid-latitude regions, has experienced a general downward trend in total column ozone since 1979, As a result of this negative trend in total column ozone, the ultraviolet flux at the earth's surface is expected to increase. Excessive exposure to ultraviolet radiation is known to have acute and chronic effects on human health, including erythema and skin cancer. Numerous studies have acknowledged a relationship between childhood ultraviolet radiation exposure and the risk of contracting skin cancer, namely malignant melanoma, during adulthood. The aim of this study is to investigate the ultraviolet radiation dose and exposure of children and adolescents in Durban, South Africa. Polysulphone film badges were used to quantify the daily erythemal ultraviolet radiation dose of 30 individuals of varying ages and skin types, engaged in different activities, over a one-week period during summer. The results highlight the diversity of childrens' and adolescents' behavioural patterns, with behaviour being found to play an important role in determining an individual's ultraviolet radiation dose. The mean daily erythemal ultraviolet radiation dose of the children and adolescents was 1.03 MED units with a median of 0.57 MED units and a 95% range of 0.22 - 7.22 MED units. The most striking finding was that the median value was below the critical value of 1 MED unit. An explanation for the unexpectedly low erythemal ultraviolet radiation doses recorded in this study was sought in the prevailing climatic conditions. Ambient erythemal ultraviolet radiation levels recorded during the study period were high, ranging between 20.57 - 30.60 MED units. However, high temperatures (>27°C), coupled with high humidity values, may have encouraged the children and adolescents to avoid direct sunlight and find shade while outdoors. The daily erythemal ultraviolet radiation doses of the children and adolescents were also compared to the ambient erythemal ultraviolet radiation levels received on a horizontal surface by a YES UVB-l pyranometer located at the University of Natal (Durban). Children and adolescents in Durban received approximately 4.58% of the total daily ambient erythemal ultraviolet radiation incident upon a horizontal surface. This was found to be similar to a study (5 - 6%) conducted by Diffey et al. (1996) in England, as well as a study (4 - 8%) by Gies et al. (1998) in Brisbane, Australia. The personal ultraviolet radiation exposure journals of the children and adolescents were used to determine the timing of exposures, duration of exposures and nature of outdoor activities and these were then related to their daily ultraviolet radiation doses. Of all the factors considered, the nature of an individual's activity was found to have the strongest influence in determining their ultraviolet radiation dose. An activity model was derived in order to investigate the effect of activity on ultraviolet radiation dose, where three activity factors, namely swimming, walking and tennis, were calculated for a South African context and compared with those from previous international studies. It was found that the activity factors derived in this study were similar to Holman et al. (1983) and Herlihy et al. (1994) and may be used in an activity model to estimate individual erythemal ultraviolet radiation dose for a particular activity. The value of this innovative activity model lies in its ability to predict individual ultraviolet radiation dose and this may help to emphasise the importance of responsible outdoor behaviour. A mannequin was used to quantify the anatomical distribution of erythemal ultraviolet radiation under clear sky and overcast conditions. It was found that the vertex of the head and shoulders received the highest erythemal ultraviolet radiation doses under both conditions. This was then related to the erythemal ultraviolet radiation doses of the children and adolescents as recorded by the polysulphone film badges in order to identify anatomic sites susceptible to high erythemal ultraviolet radiation doses. Behaviour alternatives and ultraviolet radiation protective mechanisms were discussed and recommendations made for children and adolescents residing in Durban.