Raffa Robert B, Pergolizzi Joseph V, Taylor Robert, Kitzen Jan M
University of Arizona College of Pharmacy, Tucson, Arizona.
Temple University School of Pharmacy, Philadelphia, Pennsylvania.
J Clin Pharm Ther. 2019 Feb;44(1):134-139. doi: 10.1111/jcpt.12778. Epub 2018 Nov 28.
Hawaii will ban two major ingredients of sunscreens. This article reviews the reasons and future directions. Hawaii recently enacted legislation that will ban the use of two major ingredients of the majority of commonly used sunscreens. The reason for the ban is the ingredients' putative deleterious impact on marine ecosystems, particularly coral reefs. But sunscreens also save lives by decreasing the risk of UV-induced skin cancers. We review both sides of the issue and potential implications for the healthcare system.
Coral reefs consist of organisms in delicate equilibria that are susceptible to small changes in their surroundings. Recent natural and man-made disruptions, direct or indirect, such as changes in ocean temperature and chemistry, ingress of invasive species, pathogens, pollution and deleterious fishing practices, have been blamed for the poor health, or even the outright destruction, of some coral reefs. The most popular sunscreen products contain two ingredients-oxybenzone and octinoxate-that have also been implicated in coral toxicity and will be banned. This creates a healthcare dilemma: Will the protection of coral reefs result in an increase in human skin cancers?
Concentration estimates and mechanism studies support an association-direct or indirect (via promotion of viral infection)-of sunscreens with bleaching of coral reefs. A ban on the two most common sunscreen ingredients goes into effect in Hawaii on January 1, 2021. Proponents suggest that this is a trend, just the first of many such bans worldwide; opponents warn of a dire increase in human skin cancers. As a result, alternative sunscreen compounds are being sought.
夏威夷将禁止两种主要的防晒成分。本文回顾了相关原因及未来发展方向。夏威夷最近颁布了一项立法，将禁止在大多数常用防晒霜中使用两种主要成分。禁令的原因是这些成分被认为会对海洋生态系统，尤其是珊瑚礁产生有害影响。但防晒霜也能通过降低紫外线引发皮肤癌的风险来挽救生命。我们审视了该问题的正反两面以及对医疗保健系统的潜在影响。
珊瑚礁由处于微妙平衡状态的生物组成，它们对周围环境的微小变化很敏感。近期的自然和人为干扰，无论是直接的还是间接的，如海洋温度和化学性质的变化、入侵物种的侵入、病原体、污染以及有害的捕鱼方式，都被认为是一些珊瑚礁健康状况不佳甚至彻底遭到破坏的原因。最受欢迎的防晒产品含有两种成分——氧苯酮和桂皮酸盐——它们也被认为与珊瑚毒性有关，将被禁止使用。这就造成了一个医疗保健方面的两难困境：对珊瑚礁的保护会导致人类皮肤癌病例增加吗？
浓度估算和机理研究支持防晒霜与珊瑚礁白化之间存在关联——直接关联或间接关联（通过促进病毒感染）。夏威夷将于2021年1月1日起禁止使用两种最常见的防晒成分。支持者认为这是一种趋势，只是全球众多此类禁令中的第一个；反对者则警告人类皮肤癌病例会急剧增加。因此，人们正在寻找替代的防晒化合物。
