Sun Exposure Guidelines and Serum Vitamin D Status in Denmark: The StatusD Study

Abstract

Little is known on how vitamin D status is affected by adherence to UVB-limiting sun exposure guidelines. Our aim was to investigate the relationship between adherence to the Danish sun exposure guidelines and vitamin D status. In total, 3194 Danes (2625 adults, 569 children) were recruited among the general population, and more than 92% had blood samples taken both autumn and spring. Using linear regression, we associated serum vitamin D concentrations to questionnaire responses on: seeking shade, wearing a sunhat, wearing protective clothing or using sunscreen. The odds ratio (OR) of either low (<25 or 50 nmol/L) or adequate/high (≥50 nmol/L) vitamin D status was examined using logistic regression. For adults, those who always sought shade or wore protective clothing compared to those who did not had lower levels of vitamin D (autumn concentrations for shade: 7.2 nmol/L lower (−11.0–−3.6 nmol/L); for protective clothing: 9.9 nmol/L lower (−13.6–−6.2 nmol/L). Adherence to all four guidelines was also associated with lower vitamin D concentrations (autumn: 9.7 nmol/L lower (−14.3–−5.1 nmol/L). Use of sunscreen was associated with adequate vitamin D status, as those who always sought shade compared to those who did not had an OR (95% CI) of 1.68 (1.25–2.35) of having ≥50 nmol/L during both spring and autumn. No associations were found with wearing a sunhat, and there were no clear associations for children. In conclusion, adherence to the sun exposure guidelines on shade and protective clothing was associated with lower vitamin D status among Danish adults, but not children.

Knowledge deficit, attitude and behavior scales association to objective measures of sun exposure and sunburn in a Danish population based sample

“…sufficient UVR exposure to reach sufficient levels of Vitamin D, an area where different opinions remain [5,53,54]. …”

Skin cancer projections and cost savings 2014‐2045 of improvements to the Danish sunbed legislation of 2014

“…Furthermore, recent sunbed use was shown to increase risk of skin cancer compared to non‐recent use . The model did not include any potential positive health effects of commercial sunbed use, because there was considered to be none, like, for example, from vitamin D–related illness as vitamin D is not a general problem in the population group affected by the discussed interventions . In addition, any vitamin D supplementation needed in subgroups is available from non‐harmful sources.…”

The association between atopic dermatitis and serum 25‐hydroxyvitamin D in children: Influence of sun exposure, diet, and atopy features—A cross‐sectional study

“…Our results also show that the use of sunscreen with SPF >15 had no effect on serum 25(OH)D levels during summer months in children with AD, in agreement with the results of a Danish study that reported adequate VD status in children that used sunscreen. 36 It has been shown that the usual application of 0.8-1 mg/cm 2 of sunscreen is less than the recommended amount of 2 mg/cm 2 and that pre-vitamin D can be formed when lower amounts of SPF ≤30 sunscreen are applied due to penetration of the skin by significant amounts of UV radiation. 37…”