Skip to main content

Advertisement

SpringerLink
Log in

Innovative digital solution supporting sun protection and vitamin D synthesis by using satellite-based monitoring of solar radiation

  • Original Papers
  • Published:
Photochemical & Photobiological Sciences Aims and scope Submit manuscript

Abstract

Public health campaigns advise minimising UV radiation (UVR) exposure to prevent skin cancer and precancer, e.g. actinic keratosis (AK). A 3-day clinical field study, in Brazil, was performed to evaluate the mobile app Sun4Health® by siHealth Ltd. The app performs real-time monitoring of both erythemal and vitamin D-effective solar radiation doses using satellite data, enabling personalised recommendations on optimal sun exposure time and sunscreen use. When coupled to a wearable device, the app also provides body-site specific recommendations (“3D” version). 59 healthy volunteers were randomised into 3 groups, each given a different app providing: (1) ultraviolet index only (control app), (2) personalised recommendations and sun overexposure alerts (Sun4Health® app), (3) as (2) but connected via Bluetooth to a wearable device to monitor sun exposure in 3D (Sun4Health®-3D app). Participants were offered sunscreens (SPF 30 and 50) to use at their discretion. Erythema, quantified by reflectance spectroscopy, was assessed daily in the mornings and evenings on six body sites. Serum vitamin D (25(OH)D3) was measured before and after the study. Mean increase of erythema (Mexameter® units ± SD) of all exposed body sites combined over 3 days showed 55.76 ± 47.47 for group 1, 40.27 ± 37.91 for group 2 and 37.12 ± 30.69 for group 3 (p < 0.05 for all groups). Mean increase of serum 25(OH)D3 (nmol/l ± SD) showed 1.32 ± 36.49 for group 1, 6.38 ± 21.19 for group 2 and 18.68 ± 35.45 for group 3 (p > 0.05 for all groups). The results show that the Sun4Health® app is safe to use and can modify behaviour to reduce skin erythema (sunburn) yet not decreasing vitamin D status.

Graphical abstract

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7
Fig. 8
Fig. 9

Similar content being viewed by others

References

  1. Lucas, R. M., Yazar, S., Young, A. R., Norval, M., de Gruijl, F. R., Takizawa, Y., Rhodes, L. E., Sinclair, C. A., & Neale, R. E. (2019). Human health in relation to exposure to solar ultraviolet radiation under changing stratospheric ozone and climate. Photochemical & Photobiological Sciences, 18(3), 641–680. https://doi.org/10.1039/c8pp90060d

    Article  CAS  Google Scholar 

  2. Passeron, T., Bouillon, R., Callender, V., Cestari, T., Diepgen, T. L., Green, A. C., van der Pols, J. C., Bernard, B. A., Ly, F., Bernerd, F., Marrot, L., Nielsen, M., Verschoore, M., Jablonski, N. G., & Young, A. R. (2019). Sunscreen photoprotection and vitamin D status. British Journal of Dermatology, 181(5), 916–931. https://doi.org/10.1111/bjd.17992

    Article  CAS  PubMed  Google Scholar 

  3. Alfredsson, L., Armstrong, B. K., Butterfield, D. A., Chowdhury, R., de Gruijl, F. R., Feelisch, M., Garland, C. F., Hart, P. H., Hoel, D. G., Jacobsen, R., Lindqvist, P. G., Llewellyn, D. J., Tiemeier, H., Weller, R. B., & Young, A. R. (2020). Insufficient sun exposure has become a real public health problem. International Journal of Environmental Research and Public Health, 17, 14. https://doi.org/10.3390/ijerph17145014

    Article  CAS  Google Scholar 

  4. Weller, R. B., Wang, Y., He, J., Maddux, F. W., Usvyat, L., Zhang, H., Feelisch, M., & Kotanko, P. (2020). Does incident solar ultraviolet radiation lower blood pressure? Journal of the American Heart Association, 9(5), e013837. https://doi.org/10.1161/JAHA.119.013837

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  5. Harrison, G. I., & Young, A. R. (2002). Ultraviolet radiation-induced erythema in human skin. Methods, 28(1), 14–19. https://doi.org/10.1016/s1046-2023(02)00205-0

    Article  CAS  PubMed  Google Scholar 

  6. Fajuyigbe, D., & Young, A. R. (2016). The impact of skin colour on human photobiological responses. Pigment Cell & Melanoma Research, 29(6), 607–618. https://doi.org/10.1111/pcmr.12511

    Article  CAS  Google Scholar 

  7. Fajuyigbe, D., Lwin, S. M., Diffey, B. L., Baker, R., Tobin, D. J., Sarkany, R. P. E., & Young, A. R. (2018). Melanin distribution in human epidermis affords localized protection against DNA photodamage and concurs with skin cancer incidence difference in extreme phototypes. The FASEB Journal, 32(7), 3700–3706. https://doi.org/10.1096/fj.201701472R

    Article  CAS  PubMed  Google Scholar 

  8. Young, A. R., Morgan, K. A., Ho, T. W., Ojimba, N., Harrison, G. I., Lawrence, K. P., Jakharia-Shah, N., Wulf, H. C., Cruickshank, J. K., & Philipsen, P. A. (2019). Melanin has a small inhibitory effect on cutaneous vitamin D synthesis: A comparison of extreme phenotypes. The Journal of Investigative Dermatology. https://doi.org/10.1016/j.jid.2019.11.019

    Article  PubMed  Google Scholar 

  9. Young, A. R., Claveau, J., & Rossi, A. B. (2017). Ultraviolet radiation and the skin: Photobiology and sunscreen photoprotection. Journal of the American Academy of Dermatology, 76(31), S100–S109. https://doi.org/10.1016/j.jaad.2016.09.038

    Article  CAS  PubMed  Google Scholar 

  10. Narbutt, J., Philipsen, P. A., Harrison, G. I., Morgan, K. A., Lawrence, K. P., Baczynska, K. A., Grys, K., Rogowski-Tylman, M., Olejniczak-Staruch, I., Tewari, A., Bell, M., O’Connor, C., Wulf, H. C., Lesiak, A., & Young, A. R. (2019). Sunscreen applied at >/= 2 mg cm(-2) during a sunny holiday prevents erythema, a biomarker of ultraviolet radiation-induced DNA damage and suppression of acquired immunity. British Journal of Dermatology, 180(3), 604–614. https://doi.org/10.1111/bjd.17277

    Article  CAS  PubMed  Google Scholar 

  11. Young, A. R., Narbutt, J., Harrison, G. I., Lawrence, K. P., Bell, M., O’Connor, C., Olsen, P., Grys, K., Baczynska, K. A., Rogowski-Tylman, M., Wulf, H. C., Lesiak, A., & Philipsen, P. A. (2019). Optimal sunscreen use, during a sun holiday with a very high ultraviolet index, allows vitamin D synthesis without sunburn. British Journal of Dermatology, 181(5), 1052–1062. https://doi.org/10.1111/bjd.17888

    Article  CAS  PubMed  Google Scholar 

  12. Neale, R. E., Khan, S. R., Lucas, R. M., Waterhouse, M., Whiteman, D. C., & Olsen, C. M. (2019). The effect of sunscreen on vitamin D: A review. British Journal of Dermatology, 181(5), 907–915. https://doi.org/10.1111/bjd.17980

    Article  CAS  PubMed  Google Scholar 

  13. Schalka, S., Steiner, D., Ravelli, F. N., Steiner, T., Terena, A. C., Marcon, C. R., Ayres, E. L., Addor, F. A., Miot, H. A., Ponzio, H., Duarte, I., Neffa, J., Cunha, J. A., Boza, J. C., Samorano Lde, P., Correa Mde, P., Maia, M., Nasser, N., Leite, O. M., … Brazilian Society of D. (2014). Brazilian consensus on photoprotection. Anais Brasileiros de Dermatologia, 89(6 Suppl 1), 1–74. https://doi.org/10.1590/abd1806-4841.20143971

    Article  PubMed  PubMed Central  Google Scholar 

  14. SACN. (2016). Vitamin D and Health. Scientific Advisory Committee on Nutrition.

  15. Dowdy, J. C., Sayre, R. M., & Holick, M. F. (2010). Holick’s rule and vitamin D from sunlight. Journal of Steroid Biochemistry and Molecular Biology, 121(1–2), 328–330. https://doi.org/10.1016/j.jsbmb.2010.04.002

    Article  CAS  PubMed  Google Scholar 

  16. Bogh, M. K., Schmedes, A. V., Philipsen, P. A., Thieden, E., & Wulf, H. C. (2011). Interdependence between body surface area and ultraviolet B dose in vitamin D production: A randomized controlled trial. British Journal of Dermatology, 164(1), 163–169. https://doi.org/10.1111/j.1365-2133.2010.10082.x

    Article  CAS  PubMed  Google Scholar 

  17. Neville, J. J., Palmieri, T., & Young, A. R. (2021). Physical determinants of vitamin D photosynthesis: A review. JBMR Plus, 5(1), e10460. https://doi.org/10.1002/jbm4.10460

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  18. MacLaughlin, J., & Holick, M. F. (1985). Aging decreases the capacity of human skin to produce vitamin D3. The Journal of Clinical Investigation, 76(4), 1536–1538. https://doi.org/10.1172/JCI112134

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  19. van Dijk, A., den Outer, P., van Kranen, H., & Slaper, H. (2016). The action spectrum for vitamin D3: Initial skin reaction and prolonged exposure. Photochemical & Photobiological Sciences, 15(7), 896–909. https://doi.org/10.1039/c6pp00034g

    Article  Google Scholar 

  20. CIE. (2006). Action spectrum for the production of previtamin D3 in human skin. Austria.

    Google Scholar 

  21. Young, A. R., Morgan, K. A., Harrison, G. I., Lawrence, K. P., Petersen, B., Wulf, H. C., & Philipsen, P. A. (2021). A revised action spectrum for vitamin D synthesis by suberythemal UV radiation exposure in humans in vivo. Proceedings of the National Academy of Sciences U S A, 118, 40. https://doi.org/10.1073/pnas.2015867118

    Article  CAS  Google Scholar 

  22. Morelli, M., Masini, A., Simeone, E., & Khazova, M. (2016). Validation and in vivo assessment of an innovative satellite-based solar UV dosimeter for a mobile app dedicated to skin health. Photochemical & Photobiological Sciences, 15(9), 1170–1175. https://doi.org/10.1039/c6pp00129g

    Article  CAS  Google Scholar 

  23. Morelli, M., Michelozzi, B., Simeone, E., & Khazova, M. (2021). Validation of a satellite-based solar UV-A radiation dosimeter for mobile healthcare applications. Journal of Atmospheric and Solar-Terrestrial Physics, 215, 105529. https://doi.org/10.1016/j.jastp.2020.105529

    Article  Google Scholar 

  24. McLellan, L. J., Morelli, M., Simeone, E., Khazova, M., Ibbotson, S. H., & Eadie, E. (2020). SmartPDT(R): Smartphone enabled real-time dosimetry via satellite observation for daylight photodynamic therapy. Photodiagnosis and Photodynamic Therapy, 31, 101914. https://doi.org/10.1016/j.pdpdt.2020.101914

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  25. CIE. (1998). Erythema reference action spectrum and standard erythema dose. Commission Internationale de l’Eclairage, Vienna, Austria.

  26. Photonet National Managed Clinical Network—Treatment Protocols. (2020). https://www.photonet.scot.nhs.uk/professionals-area/standards-and-protocols/.

  27. Petersen, B., & Wulf, H. C. (2014). Application of sunscreen–theory and reality. Photodermatology, Photoimmunology and Photomedicine, 30(2–3), 96–101. https://doi.org/10.1111/phpp.12099

    Article  PubMed  Google Scholar 

  28. Acker, S., Hloucha, M., & Osterwalder, U. (2014). The easy wasy to make a sunscreen. SOFW Journal, 140, 24–30.

    Google Scholar 

  29. Bieliauskiene, G., Holm-Schou, A. S., Philipsen, P. A., Murphy, G. M., Sboukis, D., Schwarz, T., Young, A. R., & Wulf, H. C. (2020). Measurements of sun sensitivity in five European countries confirm the relative nature of Fitzpatrick skin phototype scale. Photodermatology, Photoimmunology and Photomedicine, 36(3), 179–184. https://doi.org/10.1111/phpp.12529

    Article  PubMed  Google Scholar 

  30. WHO. (2017). Radiation: The ultraviolet (UV) index. https://www.who.int/news-room/q-a-detail/radiation-the-ultraviolet-(uv)-index.

  31. Whiteman, D. C., Neale, R. E., Aitken, J., Gordon, L., Green, A. C., Janda, M., Olsen, C. M., Soyer, H. P., & Sunscreen Summit Policy, G. (2019). When to apply sunscreen: A consensus statement for Australia and New Zealand. Australian and New Zealand Journal of Public Health, 43(2), 171–175. https://doi.org/10.1111/1753-6405.12873

    Article  PubMed  Google Scholar 

  32. Lehmann, M., Pfahlberg, A. B., Sandmann, H., Uter, W., & Gefeller, O. (2019). Public health messages associated with low UV index values need reconsideration. International Journal of Environmental Research and Public Health, 16, 12. https://doi.org/10.3390/ijerph16122067

    Article  Google Scholar 

  33. McKenzie, R. L., & Lucas, R. M. (2018). Reassessing impacts of extended daily exposure to low level solar UV radiation. Science and Reports, 8(1), 13805. https://doi.org/10.1038/s41598-018-32056-3

    Article  CAS  Google Scholar 

  34. Sheehan, J. M., Potten, C. S., & Young, A. R. (1998). Tanning in human skin types II and III offers modest photoprotection against erythema. Photochemistry and Photobiology, 68(4), 588–592.

    Article  CAS  PubMed  Google Scholar 

  35. Sheehan, J. M., Cragg, N., Chadwick, C. A., Potten, C. S., & Young, A. R. (2002). Repeated ultraviolet exposure affords the same protection against DNA photodamage and erythema in human skin types II and IV but is associated with faster DNA repair in skin type IV. The Journal of Investigative Dermatology, 118(5), 825–829. https://doi.org/10.1046/j.1523-1747.2002.01681.x

    Article  CAS  PubMed  Google Scholar 

  36. Datta, P., Philipsen, P. A., Olsen, P., Petersen, B., Johansen, P., Morling, N., & Wulf, H. C. (2016). Major inter-personal variation in the increase and maximal level of 25-hydroxy vitamin D induced by UVB. Photochemical & Photobiological Sciences, 15(4), 536–545. https://doi.org/10.1039/c5pp00462d

    Article  CAS  Google Scholar 

  37. Manousaki, D., Mitchell, R., Dudding, T., Haworth, S., Harroud, A., Forgetta, V., Shah, R. L., Luan, J., Langenberg, C., Timpson, N. J., & Richards, J. B. (2020). Genome-wide association study for vitamin D levels reveals 69 independent loci. American Journal of Human Genetics, 106(3), 327–337. https://doi.org/10.1016/j.ajhg.2020.01.017

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  38. Leao, L., Rodrigues, B. C., Dias, P. T. P., Gehrke, B., Souza, T., Hirose, C. K., & Freire, M. D. C. (2021). Vitamin D status and prevalence of hypovitaminosis D in different genders throughout life stages: A Brazilian cross-sectional study. Clinics (São Paulo, Brazil), 76, e2571. https://doi.org/10.6061/clinics/2021/e2571

    Article  Google Scholar 

  39. Bogh, M. K., Schmedes, A. V., Philipsen, P. A., Thieden, E., & Wulf, H. C. (2010). Vitamin D production after UVB exposure depends on baseline vitamin D and total cholesterol but not on skin pigmentation. The Journal of Investigative Dermatology, 130(2), 546–553. https://doi.org/10.1038/jid.2009.323

    Article  CAS  PubMed  Google Scholar 

  40. Pereira, L. A., Luz, F. B., Carneiro, C., Xavier, A. L. R., Kanaan, S., & Miot, H. A. (2019). Evaluation of vitamin D plasma levels after mild exposure to the sun with photoprotection. Anais Brasileiros de Dermatologia, 94(1), 56–61. https://doi.org/10.1590/abd1806-4841.20198070

    Article  PubMed  PubMed Central  Google Scholar 

  41. Kockott, D., Herzog, B., Reichrath, J., Keane, K., & Holick, M. F. (2016). New approach to develop optimized sunscreens that enable cutaneous vitamin D formation with minimal erythema risk. PLoS ONE, 11(1), e0145509. https://doi.org/10.1371/journal.pone.0145509

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  42. Tewari, A., Lahmann, C., Sarkany, R., Bergemann, J., & Young, A. R. (2012). Human erythema and matrix metalloproteinase-1 mRNA induction, in vivo, share an action spectrum which suggests common chromophores. Photochemical & Photobiological Sciences, 11(1), 216–223. https://doi.org/10.1039/c1pp05243h

    Article  CAS  Google Scholar 

Download references

Acknowledgements

The clinical field study (No. RBR-2MF6QG) was registered on 20th May 2020 with Registro Brasileiro de Ensaios Clínicos (ReBEC) which is a Brazilian database for clinical trials, with ethical approval EN19-0771-01 received by the Brazilian Ministry of Health (Comissão Nacional de Ética em Pesquisa—CONEP). The study was co-funded by siHealth, by BASF and by the European Space Agency (contract no. 4000120541/17/NL/US). The authors ARY, SS, MM and ES have been the Co-Investigators of the clinical study. The authors are grateful to the technical team of siHealth that developed the Sun4Health® apps used in the study as well as to Markus Schwind and Anja Suckert from BASF for their support. The siHealth’s Sun4Health® app is distributed as “Sun3P” (“Sun3P-3D” in its 3D version) and commercialised by BASF in the Personal Care market for providing personalised products. Special thanks to the Santos district of the Brazilian Society of Dermatology, represented by the president, Dr Tatiana Chioro Fernandes, and the students from the dermatology league of the medical schools UNILUS (Lusíadas University of Santos, Brazil) and UNIMES (Metropolitan University of Santos, Brazil) for their valuable collaboration in organising and monitoring the volunteers during the days of the study.

Author information

Authors and Affiliations

  1. St John’s Institute of Dermatology, King’s College London, London, UK

    Antony R. Young

  2. Department of Dermatology, Medcin Clinical Research Center, Osasco, SP, Brazil

    Sérgio Schalka

  3. siHealth Ltd, Harwell Campus, Didcot, Oxfordshire, UK

    Rowan C. Temple, Emilio Simeone & Marco Morelli

  4. BASF Grenzach GmbH, Grenzach-Wyhlen, Germany

    Myriam Sohn

  5. BASF Personal Care and Nutrition GmbH, Düsseldorf, Germany

    Christina Kohlmann

Authors
  1. Antony R. Young
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Sérgio Schalka
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Rowan C. Temple
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Emilio Simeone
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Myriam Sohn
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Christina Kohlmann
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Marco Morelli
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Marco Morelli.

Ethics declarations

Conflict of interest

ARY received a consultancy fee paid by siHealth and BASF, including his travel and accommodation costs. SS is the Clinical Director of Medcin, that received a consultancy fee paid by siHealth and BASF for the logistic organisation and clinical supervision. ES, MM and RCT are respectively the CEO, the CTO and the Head of Technology Innovation of siHealth. CK and MS are employees of BASF, that provided the study sunscreens.

Additional information

The original online version of this article was revised: Figure 3b and c were exchanged.

Rights and permissions

Springer Nature or its licensor holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Young, A.R., Schalka, S., Temple, R.C. et al. Innovative digital solution supporting sun protection and vitamin D synthesis by using satellite-based monitoring of solar radiation. Photochem Photobiol Sci 21, 1853–1868 (2022). https://doi.org/10.1007/s43630-022-00263-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s43630-022-00263-7

Keywords

Search

Navigation