Vidyya Medical News Servicesm
Vidyya, from the Sanskrit "vaidya," a practitioner who has come to understand the science of life.

Volume 1 Published - 14:00 UTC    08:00 EST    26-May-2000      
Issue 43 Next Update - 14:00 UTC 08:00 EST    27-May-2000      

Vidyya Home  Vidyya

Home Of Our Sponsor, Vidyya.  Vidyya. Home

Vidyya Archives  Vidyya Archives

Search Vidyya  Search Vidyya

Visit Our Library  Ex Libris

Subscribe To Our News Service  Subscriptions

All About Us  About Vidyya

Back To Vidyya Cool Tips for a Hot Season

Protect Patients From Sunburn, Stings and Food Poisoning

In the heat of the summer, nothing beats a day at the beach or the lake: The breeze is cooling, the sun feels soothing and the water refreshing. But, as pleasant as the waterfront can be, it's not without problems--from sunburn to jellyfish stings to food poisoning.

Screening the Sun

The warmth of the sun may feel good, but basking in the rays is not healthy: Sunbathing not only ages your skin, giving it wrinkles and a leathery texture, it also increases your risk of skin cancer. The types of sunlight mainly responsible for sun damage are known as ultraviolet A (or UVA) and ultraviolet B (UVB).

UVB light turns skin red fairly quickly, causing a sunburn, says Sheryl Clark, M.D., assistant professor of medicine at the Cornell Medical Center. UVB light also causes changes in skin cells that can lead to skin cancer.

UVA light, long thought to be harmless "tanning rays," also contributes to the development of skin cancer. With enough exposure, UVA rays cause sunburn. In addition, since UVA light penetrates to the dermis, or second layer of skin, it is mainly responsible for the aging effects of sunbathing.

Your first line of defense against the sun should be a sunscreen. FDA regulates sunscreens as over-the-counter drugs. Most experts recommend using a sunscreen with an SPF (sun protection factor) of 15 or more. The sun protection factor tells how much longer you can stay in the sun before burning than when you're not using a sunscreen. For example, "SPF 15" means that you can stay in the sun 15 times longer than without protection before burning.

An SPF 15 sunscreen will filter out UVB light and at least some UVA light, according to Vincent DeLeo, M.D., assistant professor and director of environmental dermatology at Columbia Presbyterian Medical Center in New York City.

FDA has approved a few products containing Parsol 1789 for screening UVA light. The agency is evaluating the UVA light protection provided by other sunscreens, including oxybenzone and titanium dioxide, two of the ingredients approved for screening UVB light. Oxybenzone screens out only part of the UVA light that reaches the Earth's surface and, therefore, its effectiveness in preventing UVA skin damage is debatable. Titanium dioxide, on the other hand, reflects all light and is probably effective in preventing UVA-induced skin damage.

For added protection, cover exposed areas with opaque clothing and wear a wide-brimmed hat to protect your head and face. (Beach umbrellas and any material you can see through do not fully protect against the sun.) Try to stay out of the sun between 10 a.m. and 2 p.m., when the rays are strongest, and reapply your sunscreen often, especially after you swim or sweat.

If you're a parent, protect your children's skin: Research indicates that one or more severe, blistering sunburns in childhood or adolescence can double the risk of melanoma (a type of skin cancer) later in life.

Light Sensitivity and Medication

Be especially careful about sun exposure if you take medication. The combination of some drugs and sunlight can decrease the time necessary to promote rashes, sunburn, premature skin aging, or more serious consequences such as cataracts, blood vessel damage, skin cancer, allergic reactions, and reduced immunity. Although exposure to the sun alone can cause all these problems, certain drugs can increase your sensitivity to light, raising the chance that these adverse reactions will occur.

Some of the medications that can cause such photosensitivity are: antihistamines, coal and tar derivatives (dandruff shampoos, for instance), oral contraceptives containing estrogens, nonsteroidal anti-inflammatory drugs (such as ibuprofen), phenothiazines (major tranquilizers and anti-nausea drugs), psoralens, sulfonamides ("sulfa" drugs, for instance), sulfonylureas (oral anti-diabetics, hypoglycemics), thiazide diuretics ("water pills"), tetracyclines, and tricyclic antidepressants.

"Bronzers" and Tanning Pills

Products called "bronzers" are promoted as a way to get tan without the sun. These products contain FDA-approved additives (such as dihydroxyacetone) that interact with protein on the skin's surface to produce a color when applied to the skin, according to John Bailey, Ph.D., acting director of the division of colors and cosmetics in FDA's Center for Food Safety and Applied Nutrition. Though bronzers can give your skin a golden color, they do not provide any protection against the sun. Also, they can be difficult to apply; thus, your "tan" may be uneven, and the chemicals in the bronzers may react differently on various areas of your body, producing a tan of many shades.

Other products that contain cosmetic color additives also claim to give you a tan. So-called "tanning pills" that contain, for instance, canthaxanthin, beta carotene, and related color additives produce a tan by imparting a color to the skin, says Bailey. The color varies with each individual, ranging from tan to orange or even pink. Although canthaxanthin and beta carotene are approved by FDA for use as food colors, their use as tanning agents is not approved. "To induce a tan, you have to consume them in high amounts. And at high amounts there are problems," says Bailey. At least one company submitted an application for the approval of canthaxanthin-containing pills as a tanning agent, but withdrew the application when side effects, such as the deposition of crystals in the eye, were discovered.

Tanning accelerators, lotions promoted to stimulate the body's own tanning process, usually contain the amino acid tyrosine. But, says Bailey, "The credible scientific information that we have suggests that they don't work."

Soothing the Burn

If despite all precautions you burn, there are a number of topical analgesics--with ingredients such as benzocaine, lidocaine, camphor, phenol, and menthol--on the market that will temporarily soothe the pain of a mild burn.

Moisturizers such as cocoa butter and petrolatum can help relieve the dryness when burned skin begins to peel. If you have a severe sunburn or if your skin is blistered, however, see a doctor for medical treatment.

The Sting of the Deep

Jellyfish, stingrays, and other creatures are a fact of life in the ocean. To avoid getting stung by aquatic life, stay out of infested waters (look for warning signs and flags posted by lifeguards) and, if possible, look where you step or walk when you're in the water.

If you're stung by a jellyfish or stingray, the American Red Cross advises you to rub the area with sand and soak it in saltwater. If necessary, get a pail of saltwater and immerse the affected area in it, says Geoffrey Doughlin, M.D., chairman of Emergency Medicine at Jamaica Hospital in New York. A saltwater bath will stop the stinging cells of a jellyfish from firing; vinegar, if you have access to it, will do the same. Don't rinse the area with tap water, warns Dr. Doughlin. The change in salt concentration can cause the stinging cells to release more venom. After a thorough saltwater soaking, make a paste of water and baking soda or meat tenderizer, and apply it to the wound.

There are no over-the-counter drugs approved specifically for the relief of jellyfish stings. FDA is reviewing a proposed monograph of ingredients in over-the-counter external analgesics, according to Audrey Love, a microbiologist in the division of OTC drug evaluation. So far, she says, no data have been submitted to indicate that these ingredients can relieve jellyfish stings.

Most of the time, jellyfish and stingray stings cause only a local reaction--for instance, stinging, redness and burning that lasts anywhere from a few minutes to a few hours. However, their stings--as well as the stings of other marine life--can also cause a more generalized reaction and, rarely, result in death. In such severe cases, doctors may prescribe antibiotics, antihistamines or, in very severe cases, steroids. If you begin to feel weak, nauseated or hot after being stung, seek emergency treatment immediately. In addition, get medical help for any sting that results in blisters, as well as for stings on the face or neck; reactions in these areas can be particularly severe.

Shellfish Safety

One common summer treat is shellfish, freshly caught from local waters. But, warns Felicia Busch, R.D., a spokeswoman for the American Dietetic Association, unless you're certain that the shellfish were harvested from clean waters, you may be risking food poisoning.

Under the National Shellfish Sanitation Program, a collaborative federal-state program that FDA administers, the government tests the water in harvesting areas for contamination from, for instance, bacteria caused by the dumping of raw sewage. If the water is highly contaminated, those harvesting areas are closed. As a result, though shellfish sold off the back of a pickup truck at the beach may seem fresh, there's a chance it may have been harvested from contaminated waters. To protect yourself, ask to see either a shipping tag or the shipping number of the shellfish--all shellfish caught in approved waters must carry such a number. If you plan to go shellfishing yourself, call your state fisheries department beforehand to find out which waters are safe for harvesting, says Busch.

No matter where you buy your shellfish, handle them correctly to head off food poisoning: Store your catch in an ice-filled cooler, head for home as soon as possible, and refrigerate the fish immediately. Cook the fish thoroughly; raw shellfish carry the greatest risk of food poisoning. Shellfish steamed for only a minute or two can also pass on a variety of food-borne illnesses: gastroenteritis, hepatitis, cholera, and other serious diseases.

Your safest choices are dishes in which the shellfish is cooked for a long time at a high temperature, as baked scallops are, for instance. Finally, since raw shellfish probably contains some bacteria, it should be avoided by pregnant women, infants and young children, the elderly, and people with a compromised immune system or a blood, stomach or liver disorder.

You can also avoid food-borne illnesses by taking a few precautions on all your summer outings: Keep hot foods hot and cold foods cold. Prepare and refrigerate cold foods in advance so that they're cold before you put them in the cooler. In your cooler, keep food separate by wrapping items in plastic bags or wrap. Once you're at the beach or park, place your cooler in the shade. For hot food, don't partially cook a food at home, take it to your outing, and finish the cooking: This encourages the growth of bacteria. Cook all food thoroughly and store it properly. Finally, always keep utensils and containers for raw food separate from ones for cooked food.

Though sun and water and food can pose special problems just when you're trying to forget yours, a little knowledge and planning can help make your summertime a safer season.

The Right Shades

It's important to protect your eyes from ultraviolet radiation in the summer--and all year round. Ultraviolet light increases the risk of cataracts, so it pays to wear sunglasses that protect against the rays when you're out in the sun.

FDA defines a sunglass as a spectacle lens that protects the human eye from bright sunlight. The agency has proposed a revised voluntary standard for sunglasses. Summarized, the characteristics recommended by this standard include:

  • Sunglasses must block 99 percent of UVB. A UVB-blocking sunglass is adequate to protect the eyes in moderately bright sunlight, such as is found in low-altitude, urban areas in temperate to northern latitudes.
  • A UV-blocking sunglass blocks 99 percent of both UVA and UVB. A UV-blocking sunglass is adequate to protect human eyes in intensely bright sunlight, such as is found in low-elevation snow fields and non-equatorial beaches.
  • Such sunglasses should block 60 to 90 percent of visible light to adequately reduce glare and increase visual comfort. Adequate traffic signal recognition should be provided by these sunglasses.
  • To be adequate to protect the eyes during prolonged daily use in extremely bright sunlight, such as is found in high-elevation snow fields and equatorial sand beaches, a UV-blocking sunglass should block 92 to 97 percent of visible light and have side-shields (or be goggles). Side-shields are needed in extremely bright sunlight to prevent reflected UV and visible light from entering the eye. These sunglasses have poor traffic signal recognition properties and may produce severe loss of visibility in dim light.
  • Sunglasses should not be used at night, in tunnels, or in similar dim environments.
  • The only medical claims allowed on sunglasses are that they may prevent cataracts and photokeratitis.
  • All sunglass lenses must pass FDA's safety test for breakage.
  • Consumers should check the label or ask the retailer to determine if the sunglasses being purchased are adequate for their use conditions.

Vidyya. Home |  Ex Libris |  Vidyya  | 
Subscription Information |  About Vidyya |  Vidyya Archives | 

Editor: Susan K. Boyer, RN
© Vidyya. All rights reserved.