Prevalence of cataract among Australian commercial airline pilots.

Because little is known about cataract in pilots, we estimated prevalence by anonymously ascertaining all commercial airline pilots diagnosed with cataract 2011-2016 using the electronic Medical Records System of the Australian Civil Aviation Safety Authority. Of 14,163 Australian male commercial pilots licensed in 2011, 1286 aged ≥60 had biennial eye examinations showing a cataract prevalence of 11.6%. Among 12,877 pilots aged <60, based on compulsory eye examinations only when first licensed, prevalence was 0.5%. There was no significant difference by ambient ultraviolet (UV) radiation levels in state of residence though lowest prevalence was seen in the low-UV state of Victoria. Most cataract in pilots ≥60 years was bilateral and of mild severity, while cataract in pilots <60 were more likely to be unilateral and of greater severity.

The increasing use of cosmetic non-ionising radiation applications - types of procedures, potential risks to consumers and regulation in Australia.

In recent years, there has been a large increase in cosmetic applications using non-ionising radiation (NIR). These applications use various types of NIR such as lasers and ultrasound for numerous cosmetic outcomes such as epilation, skin rejuvenation and tattoo removal. Cosmetic NIR procedures are marketed as a low-cost and low-risk alternative to more invasive procedures. However, treatments with these devices always result in high NIR exposure to targeted tissue in order to ensure efficacy of treatment. Consequently, there is always a risk of adverse health effects from these procedures, which may be temporary or longer lasting. Research on the health risks of cosmetic NIR applications is lacking, particularly on the extent of poor treatment application or misuse. In Australia, except for the banning of solaria, there is no national regulation for the use of NIR devices for cosmetic purposes and only three states have established regulatory controls for certain optical cosmetic applications. To mitigate the impacts of this gap in oversight, the Australian Radiation Protection and Nuclear Safety Agency has published national advice for consumers and service providers that give information on cosmetic NIR treatments and the potential risks involved.

Effectiveness, compliance and application of sunscreen for solar ultraviolet radiation protection in Australia.

Objectives and importance of study: Sunscreens are widely used, not only to prevent acute sunburn, but also for skin cancer prevention and protection against photoaging and other skin conditions related to cumulative solar ultraviolet radiation (UVR) exposure. When correctly applied, sunscreens reduce the amount of UVR reaching the skin and therefore they can reduce harmful effects of such exposures. This paper examines the benefits and risks of sunscreens, compliance requirements and how sunscreen should be used for optimal effectiveness. STUDY TYPE: Narrative review. METHODS: We reviewed evidence relating to the benefits and risks of sunscreens, sunscreen manufacturing compliance, consumer usage of sunscreen and how sunscreen should be used to be most effective. RESULTS: There is strong evidence that sunscreen is safe to use and, when applied correctly, reduces the risk of skin cancer. There is a need to address questions about the impact of sunscreen on vitamin D and its risk to the environment, as well as a need to develop sun protection factor (SPF) sunscreen testing methods that are more reproducible and ethically based. The amount of sunscreen and the way it is applied varies considerably between individuals, and this in turn markedly affects the degree and duration of protection received. Sunscreen should be used in combination with other sun protection measures that include clothing, hats, sunglasses and seeking shade. CONCLUSIONS: Regulation is essential to ensure high-quality, safe and effective sunscreen products are available to the Australian population. There is an important role for governments to put in place skin cancer prevention policies and long-term funding arrangements to build on our successful sunscreen programs so that future generations are afforded the highest level of topical protection against solar UVR.

A coherent framework for non-ionising radiation protection.

A coherent and overarching framework for health protection from non-ionising radiation (NIR) does not currently exist. Instead, many governments maintain different compliance needs targeting only some NIR exposure situations. An international framework developed by the World Health Organization would promote a globally consistent approach for the protection of people from NIR. Designed based on decades of practical experience the framework provides guidance on establishing clear national health and safety objectives and how they should be achieved. It supports multisectoral action and engagement by providing a common language and systematic approach for managing NIR. The framework should allow governments to respond to policy challenges on how to achieve effective protection of people, especially in a world that is rapidly deploying new NIR technologies. In this paper the concepts and key features are presented that underpin the framework for NIR protection, including examples of implementation.

COSMIC RADIATION EXPOSURE TO THE AUSTRALIAN PUBLIC.

A component of natural background radiation is exposure to galactic cosmic radiation (GCR). Annual GCR doses to the Australian public at ground levels and at altitudes of commercial domestic and international flights were estimated using the cosmic radiation dose modelling tool CARI-6. The annual population weighted average dose to Australians from GCR was estimated to be 342 µSv, of which 14.7 µSv (5%) was from domestic travel, 30.7 µSv (10%) was from international travel and 297 µSv (85%) of the dose was received at ground level. This study showed that critical population groups that are frequent flyers may exceed reference levels where additional awareness or protection should be considered. The GCR dose portion is ~25% of the total annual background radiation dose received by the Australian public.

5G mobile networks and health-a state-of-the-science review of the research into low-level RF fields above 6 GHz.

The increased use of radiofrequency (RF) fields above 6 GHz, particularly for the 5 G mobile phone network, has given rise to public concern about any possible adverse effects to human health. Public exposure to RF fields from 5 G and other sources is below the human exposure limits specified by the International Commission on Non-Ionizing Radiation Protection (ICNIRP). This state-of-the science review examined the research into the biological and health effects of RF fields above 6 GHz at exposure levels below the ICNIRP occupational limits. The review included 107 experimental studies that investigated various bioeffects including genotoxicity, cell proliferation, gene expression, cell signalling, membrane function and other effects. Reported bioeffects were generally not independently replicated and the majority of the studies employed low quality methods of exposure assessment and control. Effects due to heating from high RF energy deposition cannot be excluded from many of the results. The review also included 31 epidemiological studies that investigated exposure to radar, which uses RF fields above 6 GHz similar to 5 G. The epidemiological studies showed little evidence of health effects including cancer at different sites, effects on reproduction and other diseases. This review showed no confirmed evidence that low-level RF fields above 6 GHz such as those used by the 5 G network are hazardous to human health. Future experimental studies should improve the experimental design with particular attention to dosimetry and temperature control. Future epidemiological studies should continue to monitor long-term health effects in the population related to wireless telecommunications.

Not part of my routine: a qualitative study of use and understanding of UV forecast information and the SunSmart app.

BACKGROUND: The Ultraviolet (UV) Index provides a reliable means of monitoring the strength of UV radiation at the Earth's surface, which can be used to indicate the potential for skin damage. This qualitative study aims to examine public understanding of the UV Index among Australians who routinely use UV forecast information as well as those who do not. METHODS: Recent use of the SunSmart app (a popular mobile and tablet app that provides UV forecast information) served as a proxy for use of UV forecast information. Six focus groups were conducted with 'new users', who trialled the SunSmart app for the first time in the two weeks preceding the group discussion. In addition, 15 in-depth interviews were conducted with 'existing users', who routinely used the SunSmart app. Thematic discourse analysis was undertaken to compare views and experiences. RESULTS: Misperceptions about UV radiation were common. Participants learnt new information about UV radiation, the UV Index, and the times of the day that sun protection is recommended. Among adults who were using UV forecast information for the first time, this learning rarely translated to new behaviours; for these participants, the UV Index forecast information and recommendations were inconsistent with their own observation of the weather and subsequent judgement about their propensity to burn. Thus new users considered the UV forecast information to be overly cautious. In contrast, existing users recognised their inability to judge the UV Index level; for these participants, UV forecast information provided by the SunSmart app was incorporated into their daily routines and used to inform their sun protection behaviours. CONCLUSIONS/IMPLICATIONS: No matter how broadly UV forecast information is promoted, it is unlikely to improve sun protection behaviours across the Victorian population due to the low level of basic understanding of UV radiation. Public education strategies that correct the commonly held misperception that temperature and/or sunshine can reliably predict the potential for UV damage are required. Improved public awareness about UV radiation and how the UV Index can be used to prevent skin cancer may help Australians to develop more effective sun protection habits.

Melanoma incidence in Australian commercial pilots, 2011-2016.

OBJECTIVES: Occupational exposure to cosmic and ultraviolet radiation may increase airline pilots' risk of cutaneous melanoma. Meta-analyses of available data show a higher than average incidence of melanoma in airline pilots, but the most recent systematic review revealed that few contemporary data are available. Moreover, all relevant studies have been conducted in Northern Hemisphere populations. We therefore aimed to examine if Australian commercial pilots have a raised incidence of melanoma compared with the general population. METHODS: We examined all melanoma histologically diagnosed among Australian-licensed commercial pilots in the period 2011-2016 by manually reviewing de-identified data in the medical records system of the Australian Civil Aviation Safety Authority. We estimated age-specific incidence rates and compared these with corresponding population rates using standardised incidence ratios (SIRs) as measures of relative risk. Expected numbers were calculated by multiplying age- and calendar period-specific person-years (PYs) with corresponding rates from the entire Australian population; 95% CI were calculated assuming a Poisson distribution of the observed cases. RESULTS: In this cohort of Australian-licensed commercial pilots observed for 91 370 PYs, 114 developed a melanoma (51 invasive, 63 in situ). More than 50% of melanomas occurred on the trunk, and the predominant subtype was superficial spreading melanoma. The SIR for invasive melanoma was 1.20 (95% CI 0.89 to 1.55) and for melanoma in situ, 1.39 (95% CI 1.08 to 1.78). CONCLUSION: Australian-licensed commercial pilots have a modestly raised risk of in situ melanoma but no elevation of invasive melanoma compared with the general population.

Review of the Global Solar UV Index 2015 Workshop Report.

The Global Solar UV Index was developed as an easy-to-understand measure of the amount of biologically-effective ambient solar ultraviolet radiation (UVR) at different locations on the earth's surface. Over the past few years, questions have been raised about the global applicability of the UV Index, about the evidence base for exposure risk thresholds and related protective measures, and about whether the overall impact of the UV Index could be improved with modifications. An international workshop was organized by several organizations, including the World Health Organization, to assess if current evidence was sufficiently strong to modify the UV Index and to discuss different ways it might be improved in order to influence sun-protective behavior. While some animal research suggests there may be no threshold effect, the relative importance of sub-erythemal doses of sunlight in causing skin cancer in humans remains unknown. Evidence suggests that regular use of sunscreen can prevent skin cancer and that sunglasses are an effective method of protecting the eyes from solar UVR. The UV Index as a risk communication tool continues to be useful for raising awareness and to support sun-protection behavior. Although there was agreement that guidance on the use of the UV Index could be improved, the workshop participants identified that strong health outcome-based human evidence would be needed as the basis for a revision. For the UV Index to be relevant in as many countries as possible, it should continue to be adapted to suit local conditions.

Exposure to Radiofrequency Electromagnetic Fields From Wi-Fi in Australian Schools.

The increasing use of Wi-Fi in schools and other places has given rise to public concern that the radiofrequency (RF) electromagnetic fields from Wi-Fi have the potential to adversely affect children. The current study measured typical and peak RF levels from Wi-Fi and other sources in 23 schools in Australia. All of the RF measurements were much lower than the reference levels recommended by international guidelines for protection against established health effects. The typical and peak RF levels from Wi-Fi in locations occupied by children in the classroom were of the order of 10-4 and 10-2% of the exposure guidelines, respectively. Typical RF levels in the classroom were similar between Wi-Fi and radio but higher than other sources. In the schoolyard typical RF levels were higher for radio, TV and mobile phone base stations compared to Wi-Fi. The results of this study showed that the typical RF exposure of children from Wi-Fi at school is very low and comparable or lower to other sources in the environment.

Detection of radioxenon in Darwin, Australia following the Fukushima Dai-ichi nuclear power plant accident.

A series of (133)Xe detections in April 2011 made at the Comprehensive Nuclear-Test-Ban Treaty Organisation (CTBTO) International Monitoring System noble gas station in Darwin, Australia, were analysed to determine the most likely source location. Forward and backwards atmospheric transport modelling simulations using FLEXPART were conducted. It was shown that the most likely source location was the Fukushima Dai-ichi nuclear power plant accident. Other potential sources in the southern hemisphere were analysed, including the Australian Nuclear Science and Technology Organisation (ANSTO) radiopharmaceutical facility, but it was shown that sources originating from these locations were highly unlikely to be the source of the observed (133)Xe Darwin detections.

The influence on the radioxenon background during the temporary suspension of operations of three major medical isotope production facilities in the Northern Hemisphere and during the start-up of another facility in the Southern Hemisphere.

Medical isotope production facilities (MIPF) have recently been identified to emit the major part of the environmental radioxenon measured at many globally distributed monitoring sites deployed to strengthen the radionuclide component of the Comprehensive Nuclear-Test-Ban Treaty (CTBT) verification regime. Efforts to raise a global radioxenon emission inventory revealed that the yearly global total emission from MIPF's is around 15 times higher than the total radioxenon emission from nuclear power plants (NPP's). Given that situation, from mid 2008 until early 2009 two out of the ordinary hemisphere-specific events occured: 1) In the Northern hemisphere, a joint temporary suspension of operations of the three largest MIPF's made it possible to quantify the effects of the emissions related to NPP's. The average activity concentrations of (133)Xe measured at a monitoring station close to Freiburg, Germany, went down significantly from 4.5 +/- 0.5 mBq/m(3) to 1.1 +/- 0.1 mBq/m(3) and in Stockholm, Sweden, from 2.0 +/- 0.4 mBq/m(3) to 1.05 +/- 0.15 mBq/m(3). 2) In the Southern hemisphere the only radioxenon-emitting MIPF in Australia started up test production in late November 2008. During eight test runs, up to 6.2 +/- 0.2 mBq/m(3) of (133)Xe was measured at the station in Melbourne, 700 km south-west from the facility, where no radioxenon had been observed before, originating from the isotopic production process. This paper clearly confirms the hypothesis that medical isotope production facility are at present the major emitters of radioxenon to the atmosphere. Suspension of operations of these facilities indicates the scale of their normal contribution to the European radioxenon background, which decreased two to four fold. This also gives a unique opportunity to detect and investigate the influence of other local and long distance sources on the radioxenon background. Finally the opposing effect was studied: the contribution of the start-up of a renewed radiopharmaceutical facility to the build up of a radioxenon background across Australia and the Southern hemisphere.

Evaluation of radioxenon releases in Australia using atmospheric dispersion modelling tools.

The origin of a series of atmospheric radioxenon events detected at the Comprehensive Test Ban Treaty Organisation (CTBTO) International Monitoring System site in Melbourne, Australia, between November 2008 and February 2009 was investigated. Backward tracking analyses indicated that the events were consistent with releases associated with hot commission testing of the Australian Nuclear Science Technology Organisation (ANSTO) radiopharmaceutical production facility in Sydney, Australia. Forward dispersion analyses were used to estimate release magnitudes and transport times. The estimated (133)Xe release magnitude of the largest event (between 0.2 and 34 TBq over a 2 d window), was in close agreement with the stack emission releases estimated by the facility for this time period (between 0.5 and 2 TBq). Modelling of irradiation conditions and theoretical radioxenon emission rates were undertaken and provided further evidence that the Melbourne detections originated from this radiopharmaceutical production facility. These findings do not have public health implications. This is the first comprehensive study of atmospheric radioxenon measurements and releases in Australia.