Imagine if … we were serious about preventing skin cancer!
Principal and Owner of Sun Protection Facilitator GmbH
The 16th Sun Protection Conference in London 2023 provided ideas on how this could happen. Indeed, the phrase “Imagine if…” was the title of the final talk of this year’s two-day event, given by Prof. Paul Matts, Vice President of Research and Development at P&G in the UK and new head of the organizing committee. Paul Matts emphasized that his comments and thoughts in his presentation are his own and do not necessarily reflect those of P&G (email@example.com):
A minority will develop skin cancer.
And… 100% of humans look older, less healthy and less attractive than they should because of chronic UVR exposure.
Imagine if… :
1. …we labeled sunscreens with the same rigorous simplicity as we do other deadly human hazards…
2. …we developed and implemented progressive tax models that made sunscreens significantly cheaper without penalizing the poorest consumers…
3. …we would develop and implement strategies to make sunscreen available to the public for free, at times and places where human traffic and UV exposure are highest…
4…we came together to consider and meet the needs of those for whom sun protection is a vital necessity…
o We all just talked more between sunshine conferences….
Paul Matts said he started with a total of eleven “Imagine if…” statements, but then cut it down to four for his talk. For this column, we’ll take a closer look at the first of his statement, particularly the analogy to seatbelts in cars. Most of the presentations from the Sun Protection Conference are now available for purchase 1.
Here is a brief summary of the other three “Imagine if…” statements, including a short commentary. The second statement targets the often high cost of sunscreen. Paul Matts compared the situation to Amy Callaghan’s campaign to abolish the “tampon tax”, which is very well known in the UK. It turned out that consumers benefited very little from this move after the abolition of this tax. When it comes to sunscreen, many consumers now seem to be turning to homemade sunscreen to limit their costs. This is a worrying development. On the other hand, providing affordable sunscreens is a goal cited in the recent US National Academy of Science report 2. Andrew Birnie, a dermatologist and co-founder of an explicitly affordable sunscreen brand (ALTRUIST), was also a speaker at the conference 3. In addition, affordable sunscreens are now available in supermarkets and drugstores in almost every country.
The third statement from Imagine-if… refers to the placement of sunscreen dispensers in public parks, schools, on the beach, etc.. Paul Matts showed examples. Apparently, the Netherlands is particularly active. We know that it all starts with education at home and should continue at school into teenage years. The decline in skin cancer cases among the younger population in Australia shows that such measures are paying off.
The fourth statement from Imagine-if… refers to particularly vulnerable groups in society who do not only have fair skin. People with albinism (PwA) are one such group (Figure 1). They need the best possible sun protection. BASF first became involved with the Regional Dermatological Training Center (RDTC) in Moshi, Tanzania, as a raw material supplier to help them produce the appropriate sunscreen for their PwA program 4. Attempts to send finished sunscreen products have not proven to be sustainable.
Analogy sunscreen – 3-point safety belt
The first Imagine-if… statement is about labeling, i.e. the stark simplicity applied to other deadly human safety hazards…. as a stark contrast to what is currently happening in the area of sunscreen. Paul Matts looked in great detail at seatbelts in cars, which became compulsory in the UK 40 years ago. The key message was that the label is not visible to the driver and passengers, i.e. there is no need, and it would be quite confusing if seatbelts in cars were labeled as strong, very strong or ultra-strong, for example. That would make no sense at all. We expect safety devices to work when they are needed. I don’t know anyone for whom the seatbelt is a selling point for a car.
I can’t show you the slides of Paul Matts’ talk, but I can offer you an excerpt of the slides I showed in my talk at the London Sun Safety Conference in 2011, twelve years ago. I was a bit of a cry in the wilderness then, but I am pleased that the person in charge of this year’s conference has worked out the same example as an analogy (Figures 2-7).
The 3-point safety belt was invented by VOLVO and first introduced in Sweden (1963). It took quite a while for the various countries to adopt this new safety measure and make the use of the belt compulsory. The first country was Sweden, Germany (West) introduced it in 1975 (Figure 3) and Germany (East) in 1980. Switzerland in 1981 and the United Kingdom in 1983. In Germany, the compliance rate rose from 60% to over 90% when a fine was introduced in 1984. People had all sorts of excuses for not complying (Figure 6). In Switzerland, the controversy was best documented as a referendum was held in 1980 on the introduction of compulsory helmet and seatbelt use (Figure 7).
In general, a distinction must be made between open/public labeling and hidden labeling/specification. The speakers repeatedly referred to the latter as “back office”. This is a good term, but should not be confused with a lack of transparency. Very interested consumers need to be able to trace the performance of a seatbelt back to its specifications in order to hold car manufacturers and authorities accountable in case of questions or malfunctions. Today, such information can be simultaneously available and hidden thanks to a barcode 5.
The most important message to take away from the London Sun Protection Conference was that we should finally get serious about skin cancer prevention. This will probably require some sort of global harmonization of regulations. John Staton gave an insight into the latest developments in Australia: Sun protection – fighting the sun or fighting ourselves? e.g. the distinction between primary and secondary sun protection plays an important role, and Gerald Renner shared with us his opinion on the future of regulatory renewal: cosmetics vs. pharmaceuticals vs. medical devices… what has worked so far and what will work in the future?
National Academy of Science (NAS) Review of Fate, Exposure, and Effects of Sunscreens in Aquatic Environments and Implications for Sunscreen Usage and Human Health, Washington (DC): National Academies Press (US); 2022 Aug 9. Available from: https://pubmed.ncbi.nlm.nih.gov/36479751/↩︎
Uli Osterwalder studied Chemical Engineering at ETH Zurich, Switzerland and at the University of Houston in Houston, Texas. He joined Ciba-Geigy in Basel in 1979 where he first developed a Phosgene Generator in central process development. Later he developed his leadership skills in Project Management and Process Analytics. At Ciba Specialty Chemicals Uli Osterwalder helped establish new business development in Fabric Care and Personal Care. After the acquisition by BASF SE he became Senior Marketing Manager and Scientific Adviser in Sun Care in Ludwigshafen and Duesseldorf.
2016 he came back to Basel, working for DSM as senior Senior Scientific Adviser suncare for two years. 2018 he started his own company, Sun Protection Facilitator GmbH and is committed to contribute to further improvements in sun protection. Uli Osterwalder works for ISO on the development of new UV protection assessment methods and is now chairing the technical committee ISO TC/217 (Cosmetics). He is author and co-author of numerous scientific articles and book chapters on sun protection.
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