Self-reported sun exposure is commonly used in research, but how well this represents actual sun exposure is poorly understood. From February to July 2011, a volunteer sample (n = 47) of older adults (≥45 years) in Canberra, Australia, answered brief questions on time outdoors (weekdays and weekends) and natural skin color. They subsequently maintained a sun diary and wore an ultraviolet radiation (UVR) digital dosimeter for 7 days. Melanin density was estimated using reflectance spectrophotometry; lifetime sun damage was assessed using silicone casts of the back of the hand; and serum 25-hydroxyvitamin D (25(OH)D) concentration was assayed. Questionnaire-reported time outdoors correlated significantly with diary-recorded time outdoors (Spearman correlation r(s) = 0.66; 95% CI 0.46, 0.80; P < 0.001) and UVR dosimeter dose (r(s ) = 0.46; 95% CI 0.18, 0.68; P = 0.003), but not 25(OH)D concentration (r(s) = 0.24; 95% CI -0.05, 0.50; P = 0.10). Questionnaire-reported untanned skin color correlated significantly with measured melanin density at the inner upper arm (r(s) = 0.49; 95% CI 0.24, 0.68; P < 0.001). In a multiple linear regression model, statistically significant predictors of 25(OH)D concentration were self-reported frequency of physical activity, skin color and recent osteoporosis treatment (R(2) = 0.54). In this study, brief questionnaire items provided valid rankings of sun exposure and skin color, and enabled the development of a predictive model for 25(OH)D concentration.

BackgroundAdults living in the sunny Australian climate are at high risk of skin cancer, but vitamin D deficiency (defined here as a serum 25-hydroxyvitamin D (25(OH)D) concentration of less than 50 nmol/L) is also common. Vitamin D deficiency may be a risk factor for a range of diseases. However, the optimal strategies to achieve and maintain vitamin D adequacy (sun exposure, vitamin D supplementation or both), and whether sun exposure itself has benefits over and above initiating synthesis of vitamin D, remain unclear.The Sun Exposure and Vitamin D Supplementation (SEDS) Study aims to compare the effectiveness of sun exposure and vitamin D supplementation for the management of vitamin D insufficiency, and to test whether these management strategies differentially affect markers of immune and cardio-metabolic function.Methods/DesignThe SEDS Study is a multi-centre, randomised controlled trial of two different daily doses of vitamin D supplementation, and placebo, in conjunction with guidance on two different patterns of sun exposure. Participants recruited from across Australia are aged 18–64 years and have a recent vitamin D test result showing a serum 25(OH)D level of 40–60 nmol/L.DiscussionThis paper discusses the rationale behind the study design, and considers the challenges but necessity of data collection within a non-institutionalised adult population, in order to address the study aims. We also discuss the challenges of participant recruitment and retention, ongoing engagement of referring medical practitioners and address issues of compliance and participant retention.Trial registrationAustralia New Zealand Clinical Trials Registry: ACTRN12613000290796 Registered 14 March 2013.

Vitamin D deficiency is more common in Northeast-Asian immigrants to western countries than in the local population; prevalence equalizes as immigrants adopt the host country's culture. In a community-based study of 100 Northeast-Asian immigrants in Canberra, Australia, we examined predictors of vitamin D status, its association with indicators of acculturation (English language use; time since migration) and mediators of that association. Participants completed a sun and physical activity diary and wore an electronic ultraviolet radiation (UVR) dosimeter for 7 days. Skin colour was measured by reflectance spectrophotometry. Serum concentrations of 25-hydroxyvitamin D (25(OH)D) and cardio-metabolic biomarkers were measured on fasting blood. In a multiple linear regression model, predictors for 25(OH)D concentration were season of blood collection, vitamin D supplementation, UVR exposure, body mass index, physical activity and having private health insurance (R(2) = 0.57). Greater acculturation was associated with lower risk of vitamin D deficiency (de-seasonalized 25(OH)D level <50 nmol L(-1)) (Adjusted Odds Ratio (AOR): 0.22 [95%CI 0.04-0.96]); this association was statistically mediated by physical activity and time outdoors. Vitamin D deficiency was associated with higher total cholesterol levels (>5.0 mmol L(-1)) (AOR: 7.48 [95%CI 1.51-37.0]). Targeted public health approaches are required to manage the high prevalence of vitamin D deficiency in migrants retaining a traditional lifestyle.

Monitoring ambient solar UVR levels provides information on how much there is in both real time and historically. Quality assurance of ambient measurements of solar UVR is critical to ensuring accuracy and stability and this can be achieved by regular intercomparisons of spectral measurement systems with those of other organizations. In October and November of 2013 a solar UVR spectroradiometer from Public Health England (PHE) was brought to Melbourne for a campaign of intercomparisons with a new Bentham spectrometer of Australian Radiation Protection and Nuclear Safety Agency (ARPANSA) and one at the Australian Bureau of Meteorology (BOM), supported by New Zealand's National Institute for Water and Atmosphere (NIWA). Given all three spectroradiometers have calibrations that are traceable to various national standards, the intercomparison provides a chance to determine measurement uncertainties and traceability that support UV measurement networks in Australia, New Zealand and the UK. UV Index measurements from all three systems were compared and ratios determined for clear sky conditions when the scans from each instrument were within 2 min of each other. While wavelengths below 305 nm showed substantial differences between the PHE unit and the two other systems, overall the intercomparison results were encouraging, with mean differences in measured UV Index between the BOM/NIWA and those of PHE and ARPANSA of <0.1% and 7.5%, respectively.

During August 2011 stratospheric ozone over much of Southern Australia dropped to very low levels (approximately 265 Dobson Units) for over a week above major population centers. The weather during this low ozone period was mostly clear and sunny, resulting in measured solar ultraviolet radiation (UVR) levels up to 40% higher than normal, with UV Index > 3 despite being winter. Satellite ozone measurements and meteorological assimilated data indicate that the event was likely due in large part to the anomalous southward movement over Australia of ozone-poor air in the lower stratosphere originating from tropical latitudes. At the time, a study measuring the UVR exposures of outdoor workers in Victoria was underway and a number of the workers recorded substantial UVR exposures and were sunburnt. Given the cities and populations involved (approximately 10 million people), it is likely that many people could have been exposed to anomalously high levels of solar UVR for that time of year, with resultant higher UVR exposures and sunburns to unacclimatized skin (often a problem transitioning from low winter to higher spring UVR levels). Reporting procedures have been modified to utilize ozone forecasts to warn the public of anomalously high UVR levels in the future.