There was a time when one’s immediate impulse on the first sunny spring day was to get outside and enjoy it. Today, however, grim warnings from medical mandarins and cancer specialists, wholeheartedly endorsed by the sun cream industry, make people almost fear for their lives should they venture forth into the ‘dangerous’ sun at the wrong time of day or unless covered head to toe with sun factor 60.

This view, however, is only relatively recent and contrasts sharply with the very positive medical view of the benefits of sunshine earlier in the 20th century, when sunbathing and sea bathing were championed. Growing evidence now strongly shows that the earlier view was correct and that the benefits of sunlight far, far outweigh any hazards.

The medical practice of heliotherapy – exposing patients to controlled amounts of sunlight to cure or alleviate various illnesses – was accepted practice in many countries from the late 19th to mid-20th century. Dr Auguste Rollier, probably the most famous heliotherapist of his day, at his peak had 36 clinics with over 1,000 beds in Leysin, Switzerland. He used sunlight to treat diseases such as TB, rickets, smallpox, lupus vulgaris (skin tuberculosis) and wounds, a practice that had been pioneered by Danish physician Dr Niels Finsen at the turn of the 19th century, who was awarded a Nobel Prize in 1903 for his treatment of TB using ultraviolet. Rollier found that sunbathing early in the morning, in conjunction with a nutritious diet, produced the best effects.

Britain’s leading practitioner was Sir Henry Gauvain, who pioneered sunbathing at a clinic on the south coast and established Lord Mayor Treloar in Alton, Hampshire, as a leading centre for heliotherapy. But with the deaths of Gauvain in 1945 and Rollier in 1954, and the growing power of the pharmaceutical industry, heliotherapy fell into disuse. Since the ‘60s the public has been increasingly bombarded with warnings about sunbathing and the risks of skin cancer, to the almost complete exclusion of facts about the benefits of sunlight.1

Skin cancer mortality

There is no doubt that the incidence of skin cancers (see box) has increased over the past few decades and that over-exposure to the sun can cause premature ageing of the skin. However, almost all non-melanomas are curable and the number of deaths in 2001 in the whole of the UK was only 257 and 226 for men and women respectively, against over 59,000 new cases that year out of a total population of perhaps 30 million sunbathers. For the far more dangerous malignant melanoma, the totals were only 856 and 792 respectively. Set against total deaths for all cancers for 2001 of 80,035 and 74,422 respectively (Cancer Research UK), the death rates for non-melanomas and melanoma combined represent a very low percentage indeed – just 1.39 and 1.36 percent.

To judge by the Cancer Research UK’s website, the impression given is that the sun is the overwhelming, direct cause of both types. But growing evidence about factors such as diet, chlorine in water and artificial lighting – the word ‘diet’ or ‘vitamin D’ is not even mentioned on the website – tells a different story. Why, for example, is the incidence of melanoma on the Orkney and Shetland Isles, north of Scotland, 10 times that of Mediterranean islands?2

It is time to focus on alternative causes and contributing risk factors for skin cancer and to put the hazards – and benefits for many other illnesses – from solar radiation into a balanced perspective. First, let us consider the actual risk from ultraviolet radiation (UV), the main alleged threat from sunshine.

Effects of ultraviolet radiation

Ultraviolet is divided into three main frequency ranges, A, B and C (see box). Of the sunlight reaching the Earth, approximately 37 per cent is visible, 60 per cent infrared and a mere 3 per cent UV. Virtually all UVC is shielded from reaching the Earth by the ozone layer. Both UVA and UVB promote tanning and can burn but UVB is essential for the photosynthesis of vitamin D, which critically determines the uptake of calcium and other minerals, as well as many other processes.

Contrary to general belief, there is no evidence that reduction in the ozone layer, observed at the poles, has caused any increase in melanomas.3 Even a study of Punta Arenas, the largest South American city close to the Antartic ozone hole, showed no increase in health problems related to depleted ozone. In fact, UV measures were too small to have any noticeable effect.4

Eye hazard

Indeed, even the idea that UV causes cataracts, for which there is no good evidence, has lead to sunglasses that block UVA and B, when in fact exposure to these frequencies may be necessary for the eye. The eye may require the full spectrum of sunlight to stimulate pathways and organs in the brain to maintain the immune system and other functions.

The pioneering American photobiologist, Dr John Ott, offers evidence on these benefits and argues that sunglasses significantly upset and negate the eyes’ natural accommodation reflex in his classic work Health and Light (Ariel Press, Columbus, 1973). Ott reported that in research with the Wills Eye Hospital in Philadelphia he studied the pigment epithelium cells in a rabbit’s eye through different-coloured filters and observed that the colours of the filters significantly affected the biological responses within the cells themselves. Crucially, he found that these cells would divide only if low levels of UV were projected onto them. It was from this and other work that, except in conditions of high glare (water, snow or desert), he strongly recommended wearing a hat, rather than sunglasses.

American optometrist and light pioneer, Dr Jacob Liberman, in his book Light: Medicine of the Future, supports Ott’s view, suggesting that our indoor lifestyle, ‘coupled with our excessive use of sunglasses, may be blocking out the UV radiation necessary for normal cell division, thus resulting in certain degenerative eye diseases, such as macular degeneration’.5 He points out that it was research reported in the American Journal of Opthalmology in March 1982 by WT Ham and his colleagues that led a generation of eye specialists to conclude that any amount of UV is harmful to the eye. Using monkeys tied down and their eyelids pried open with lid clamps, their fully dilated pupils were exposed to beams from a 2,500-watt xenon lamp for 16 minutes. The intense light contained high levels of UV, which, quite naturally under the circumstances, caused some retinal damage. But, as Liberman points out this was highly abnormal exposure that would never happen in real life since animals’ and humans’ pupils and eyelids would naturally adjust and close to protect their eyes.

Evidence indicates that the increase in cataracts in sunny parts of the world may be due to other factors, including malnutrition (diarrhoea can lead to severe demineralization), smoking, pollution and poor diet. For example, a diet rich in unsaturated fats and their oxidized products has been linked to the risk of UVB triggering increased cataract formation,6 whereas those who eat a more balanced diet, supplemented with vitamins C and E, appear not to get cataracts, even with prolonged exposure to the sun.7 However, both Ott and Liberman condemn the use of sunlamps, which produce UVA and can cause skin cancer, including melanoma.8

Occupational exposure

A further argument against the idea that simple exposure to UV rays causes cancer is observation of people constantly exposed to them. Melanomas seldom occur in outdoor workers. A study of the risk in US Navy personnel between 1974 and 1984 found a higher incidence among sailors who had indoor jobs than those working outside. Those working both indoors and outdoors showed most protection, with a rate 24 percent below the US national average.9

Findings like these support other studies that indicate that while severe sunburn may trigger melanoma, regular sunbathing may actually prevent it.10 Indeed, evidence indicates that regular, moderate sunbathing can actually reduce its risk. The fact that melanomas can occur on the palms of the hands and soles of the feet indicate that UV is only one of a number of possible causes and possibly not even the most significant. Although melanoma has been rising among pale-skinned populations worldwide, there has been no corresponding rise among dark-skinned people, who have only one-tenth to one-third the incidence. Their skin’s much-increased melanin level does protect them but they also tend to spend much more time outdoors in much higher levels of UV. Dr Damien Downing points out that melanin, the pigment that helps protect the deeper layers of the skin, also protects against free radical damage from sunlight. The skin also uses sunlight to kill bacteria. ‘It seems that even without ultraviolet light, skin lipids will take up some oxygen from the air and use it to kill bacteria. However, this effect is much more intense under UV.’11

It seems that ultraviolet may not be the total scourge so many ‘authorities’ portray it to be and that we need to look at other risk factors, not least the substances they urge us to rub all over ourselves for protection.

Sunscreens – help or hazard?

Some commercial sunscreens, which are meant to protect the skin, have certainly been suspected of promoting skin cancers (see box).

Researchers have found that high levels of oxybenzone, used extensively in high-factor creams, can be absorbed into the body. As this particular chemical has had few studies on its possible toxic effects, what this is doing to your body is anyone’s guess. The Lancet article recommended that sun creams should not be applied on large areas of the body repeatedly over an extended period of time.12

Other research has found that children who use a lot of cream and oil are more likely to get freckles and thus may be at higher risk of developing melanoma.13

There are now some 1,140 drugs that are known to cause photosensitization, with possibility of interacting with other sunscreen chemicals rubbed into the skin.

Finally, a poor diet laden with fats and processed foods may be crucial in predisposing a person to sunburn or worse. American nutritionist Dr Zane Kime, in his book Sunlight Could Save Your Life, stated:
‘… sunbathing is dangerous for those who are on a standard, high-fat American diet or do not get an abundance of vegetables, whole grains and fresh fruits.’14

Indeed, the heliotherapists of the last century placed great emphasis on diet to maximize the sun’s benefits. Rollier insisted that nourishing meals were an integral part of treatment, suggesting that well-nourished skin responds better to sunlight than skin deficient in minerals.

Beneficial effects of sunlight

Countering the ill-informed warnings and scaremongering of vested interests, there is evidence that a number of other factors are important in causing or predisposing someone to skin cancer besides exposure to the sun.

In part two these will be investigated further, together with the mass of evidence supporting the sun’s beneficial effects in promoting health and reducing disease, including many cancers, especially breast, colon, ovary and prostate, as well as reducing or combating diabetes; MS; heart disease and high blood pressure; osteoporosis; psoriasis; SAD and even tooth decay.

The early heliotherapists found that gradual, daily exposure to the sun, coupled with a nutritious diet, could cure many illnesses and promote robust health. Research is now proving them correct thus rejecting the unbalanced negative propaganda; it is leading us back to our senses to the appreciation that sunshine is an essential nutrient and sensible sunbathing is overwhelmingly good for you.

References
1. Dr Richard Hobday (ra.hobday@virgin.net) has charted the development and decline of heliotherapy, and the new evidence for the benefits of sunshine on a range of illnesses, with its implications for building and hospital design, in his highly recommended book, The Healing Sun (Findhorn Press, 1999).
2. Science 1991;254:114-5.
3. British Journal of Cancer research 1992; 65: 916-21.
4. American Journal of Public Health 1995;85(4):546-50.
5. Light: Medicine of the Future, Bear & Co, Santa Fe, New Mexico, 1991, p150.
6. Can Research 1985;45:6254-9.
7. Ophthalmol 1998;105:1836; Am J Clin Nutr 1997;66:911-16.
8. American Journal of Epidimeology 1994;140:691-9.
9. Arch Environmental Health 1990;45(5):261-7.
10. Lancet 1982;2:290-3.
11. Day Light Robbery, Arrow Books, 1981, out of print.
12. Lancet 1997;350:863-4.
13. J Nat Can Inst 1998;90:1873-80.
14. World Health Publications, Penryn, Calif, 1980.
15. BMJ 1996;312:1612-13. Also see BMJ 1979;3 Nov:1144.

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Simon Best produces the quarterly news report Electromagnetic Hazard & Therapy, and mans a live Helpline (0906 4010237 premium rate). For details, send an sae to: 9 Nine Acres, Midhurst, W Sussex GU29 9EP or see www.em-hazard-therapy.com .

This article is updated and expanded from a previous one appearing in What Doctors Don’t Tell You, July 2001 (www.wddty.co.uk).

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© Caduceus, 2003.