New NICE guidelines on sun exposure warn ‘tanning is unsafe’

“No safe way to suntan, new NICE guidance warns,” BBC News reports. The guidelines, produced by the National Institute for Health and Care Excellence (NICE), also stresses the benefits of moderate sun exposure.

This will help prevent vitamin D deficiency; which is more common in the UK than many people realise. It is estimated that around one in five adults and older children (aged between 11 and 18) have low vitamin D status. The figure is around one in seven for younger children.

What are the risks of overexposure?

Sunlight contains ultraviolet A (UVA) and ultraviolet B (UVB) radiation, both of which can be harmful to the skin. (The guidelines do not discuss artificial sources of UV light, such as sunbeds, but these are also thought to be harmful).

Risks of overexposure to sunlight include:

  • sunburn
  • skin cancer – both the non-melanoma and melanoma types of skin cancer

Non-melanoma is a leading cause of disfigurement, with an estimated quarter of a million cases occurring each year in the UK. Melanoma is a leading cause of cancer deaths in younger adults. More than 2,000 people die every year in the UK from melanoma.

Overexposure can also cause premature ageing of the skin, which can lead to signs and symptoms, such as :

  • dryness
  • itching
  • wrinkling
  • enlarged blackheads
  • loss of skin elasticity

At-risk groups

Groups of people particularly vulnerable to overexposure include:

  • children (particularly babies) and young people
  • people who tend to burn rather than tan
  • people with lighter skin, fair or red hair, blue or green eyes, or who have lots of freckles
  • people with many moles
  • people who are immunosuppressed (that is, they have less resistance to skin problems as a result of a disease or use of particular drugs)
  • people with a personal or family history of skin cancer (even if their natural skin colour is darker than that of the family member who had cancer)
  • outdoor workers
  • those with outdoor hobbies, for example, sailing or golf
  • people who sunbathe
  • people who take holidays in sunny countries

Preventing overexposure

Avoid strong sunlight

Avoid spending long periods of time in strong sunlight. The sun is at its strongest from 11am to 3pm from March to October. It can also be very strong and have potentially damaging effects at other times. Even if it is cool or cloudy, it is possible to burn in the middle of the day in summer.

Wear suitable clothing

Skin should be protected from strong sunlight by covering up with suitable clothing, finding shade and applying sunscreen.

Suitable clothing includes:

  • a wide-brimmed hat that shades the face, neck and ears
  • a long-sleeved top
  • trousers or long skirts in close-weave fabrics that do not allow sunlight through
  • sunglasses with wraparound lenses or wide arms with the CE Mark and European Standard EN 1836:2005

Use sunscreen

When buying sunscreen, make sure it’s suitable for your skin and blocks both ultraviolet A (UVA) and ultraviolet B (UVB) radiation.

The sunscreen label should have:

  • the letters “UVA” in a circle logo and at least 4-star UVA protection
  • at least SPF15 sunscreen to protect against UVB

Most people do not apply enough sunscreen. The amount of sunscreen needed for the body of an average adult to achieve the stated sun protection factor (SPF) is around 35ml or six to eight teaspoons of lotion.

If sunscreen is applied too thinly, the amount of protection it gives is reduced. If you’re worried you might not be applying enough SPF15, you could use a stronger SPF30 sunscreen.

If you plan to be out in the sun long enough to risk burning, sunscreen needs to be applied twice:

  • 30 minutes before you go out
  • just before going out

Sunscreen should be applied to all exposed skin, including the face, neck and ears (and head if you have thinning or no hair), but a wide-brimmed hat is better.

Water-resistant sunscreen is needed if sweating or contact with water is likely.

Sunscreen needs to be reapplied liberally, frequently and according to the manufacturer’s instructions. This includes applying straight after you’ve been in water (even if it is “water-resistant”) and after towel drying, sweating or when it may have rubbed off.

Advice for babies and children

Take extra care to protect babies and children. Their skin is much more sensitive than adult skin, and repeated exposure to sunlight could lead to skin cancer developing in later life.

Children aged under six months should be kept out of direct strong sunlight.

From March to October in the UK, children should:

  • cover up with suitable clothing
  • spend time in the shade (particularly from 11am to 3pm)
  • wear at least SPF15 sunscreen

To ensure they get enough vitamin D, children aged under five are advised to take vitamin D supplements even if they do get out in the sun. Find out about vitamin D supplements for children.

Avoid tanning

There is no healthy way to tan. Any tan can increase your risk of developing skin cancer. Getting a tan does very little to protect your skin from the harmful effects of the sun. The idea that there is such a thing as a healthy tan is a myth.

The British Association of Dermatologists advises that people should not use sunbeds or sunlamps.

Sunbeds and lamps can be more dangerous than natural sunlight, because they use a concentrated source of ultraviolet (UV) radiation.

UV radiation can increase your risk of developing melanomas. Sunbeds and sunlamps can also cause premature skin ageing.

If you do want browner looking skin then fake tan is the way to go.

Sunlight and vitamin D

Vitamin D is essential for healthy bones, and we get most of ours from sunlight exposure.

We need vitamin D to help the body absorb calcium and phosphorus from our diet. These minerals are important for healthy bones and teeth.

A lack of vitamin D – known as vitamin D deficiency – can cause bones to become soft and weak, which can lead to bone deformities. In children, for example, a lack of vitamin D can lead to rickets. In adults, it can lead to osteomalacia, which causes bone pain and tenderness as well as muscle weakness.

Most people can make enough vitamin D from being out in the sun daily for short periods with their forearms, hands or lower legs uncovered and without sunscreen from March to October, especially from 11am to 3pm.

A short period of time in the sun means just a few minutes – about 10 to 15 minutes is enough for most lighter-skinned people – and is less than the time it takes you to start going red or burn. Exposing yourself for longer is unlikely to provide any additional benefits.

People with darker skin will need to spend longer in the sun to produce the same amount of vitamin D.

Groups of people who have little or no exposure to the sun for cultural reasons or because they are housebound or otherwise confined indoors for long periods, may be vitamin D deficient and may benefit from vitamin D supplements.

How long it takes for your skin to go red or burn varies from person to person. Cancer Research UK has a useful tool where you can find out your skin type, to see when you might be at risk of burning.

Vitamin D and pregnancy

Pregnant and breastfeeding women should take a vitamin D supplement to make sure their own needs for vitamin D are met, and their baby is born with enough stores of vitamin D for the first few months of its life.

You can get vitamin supplements containing vitamin D free of charge if you are pregnant or breastfeeding, or have a child under four years of age and qualify for the Healthy Start scheme.

Read more about vitamins and supplements in pregnancy

Links to the headlines

No safe way to suntan, new NICE guidance warns

BBC News, 9 February 2016

Don’t go out in the sun for over 10 minutes warn health chiefs: Sunseekers told there is no such thing as a healthy tan as they are urged to slap on EIGHT teaspoons of sunscreen

Daily Mail, 9 February 2016

No such thing as a safe tan, warn health officials

The Daily Telegraph, 9 February 2016

Millions of British sun-worshippers warned there is “no safe way” to get a tan

Daily Mirror, 9 February 2016

There’s no safe way to get a natural sun tan, says official health guidelines

The Independent, 9 February 2016

Further reading

National Institute for Health and Care Excellence.

Sunlight exposure: risks and benefits

February 2016

Does sunbathing really have to be bad for your health?

He also points out the danger of sunscreens that only protect against UVB rays. “Many products only bar UVB rays because these are the ones that cause sunburn,” he says. “But these allow people to stay in the sun all day, unaware of the huge dose of UVA rays they are receiving. Some doctors think that the dramatic increase in the number of skin cancer cases may be linked to the fact that so many people lie out in the sun, oblivious to the damage they are doing.”

Zinc oxide is the only ingredient that protects against the full spectrum of UV rays and some manufacturers are now including it in their products.

Sara Hiom says the best advice is to enjoy the sun sensibly: “We’re not saying you have to avoid the sun completely, just be aware of the dangers and protect your skin as carefully as you can.”

Glow it alone

If you prefer to stay out of the sun, but are still looking for a healthy summer glow, there are artificial tanning products on the market to suit all tastes and skin types. We put a few of them to the test.

For immediate results:

Clarins Sheer Bronze Tinted Self Tanning for Legs (£14.50, 125ml)

A frosty, chocolatey body cream that absorbs quickly and works almost instantly, producing a warm glow. One application survived a half-hour swim and a bath.

For the evening:

Shiseido Brilliant Bronze Quick Self-Tanning Gel (£18, 150ml)

Ideal for the body, but perhaps a little strong for the face – this gel slides easily on to the skin and dries instantly.

For overnight effect:

St Tropez Whipped Bronze Mousse (£30, 8oz)

For the best results, leave this darkly tinted mousse on overnight. The skin begins to look mottled about five days later, and you’ll need to reapply.

For a pale tan:

Susan Molyneux Auto Bronze spray (£16.55, 200ml)

Although one application won’t make a drastic difference to your skin colour, it replaces those bluish-white wintry tones with a healthy, golden glow.

For the beach:

Decléor Hydrating Self-Tanning Spray SPF8 (£20, 150ml)

Also available as a milk, this spray is easy to use and smells delicious. Overnight, it developed into a deep, natural tan, although some colour came off after showering.

For mature skin:

Carita Tinted Cream for Face SPF8 (£56.50, 50ml)

At first, it stings a little and can leave the skin feeling greasy, but a day later it feels soft, and the tan should relax into a natural colour.

For sensitive skin:

Fake Bake Sunless Self-Tanning Lotion (£21.95, 170ml)

Unlike other products, this chocolatey cream shouldn’t aggravate skin problems or cause itching, but it can cling slightly to dry patches. The colour is paler than it promises, so you may need to reapply after a day or two.

10 Amazing Health Benefits of Sun Exposure

It is not just plants that absorb and metabolize sunlight. Human beings do it too. However, the relationship between sun exposure and health in humans isn’t as straightforward as we might want it to be. Genes are a factor of how humans metabolize sunlight; as is skin type. For instance, people with pale skin that burns easily in the sun are likely to get skin cancer if exposed to too much sun. The timing and duration of exposure is also a crucial factor when it comes to how our bodies metabolize sunlight.

That being said, a number of scientists suggest that the health benefits of moderate sun exposure may in fact outweigh the risks. Researchers from the University of Edinburgh in the UK, for example, specifically point out that the heart-health benefits of sun exposure far outweigh the risk of developing skin cancer. Here are ten huge health benefits of moderate sun exposure you absolutely should know about.

1. Sun exposure lowers blood pressure.

In a landmark study, a group of researchers at the University of Edinburgh found that a compound called nitric oxide that helps lower blood pressure is released into the blood vessels as soon as sunlight touches the skin. This finding was important because until then it was thought that sunlight’s only health benefits to humans was to stimulate production of vitamin D. Richard Weller, Senior Lecturer in Dermatology, and colleagues, however, found that sun exposure can not only improve health, but also prolong life. That’s because the benefits of lower blood pressure include cutting risk of heart attacks and strokes. These benefits, says, Weller “far outweigh the risk of getting skin cancer.”

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2. Sun exposure improves bone health.

It is a well known fact that vitamin D stimulates the absorption of bone-strengthening calcium and phosphorus in the body. However, emerging research also indicates there is a direct correlation between bone density and vitamin D3. Vitamin D3 is a fat-soluble vitamin formed during the process of Vitamin D manufacture when sunlight hits the skin. It regulates calcium absorption. When you have higher levels of vitamin D3 in your blood, you are at a lower risk of suffering fractures of virtually all types. On the other hand, lower levels of vitamin D3 in the blood are associated with higher rate of all types of fractures. This is why sun exposure is especially important for bone health in older adults.

3. Sun exposure improves brain function.

Aside from promoting bone health and regulating vital calcium levels, scientists have now linked vitamin D with a number of functions throughout the body, including the functioning of the brain. One study led by neuroscientist David Llewellyn of the University of Cambridge, assessed vitamin D levels in more than 1,700 men and women from England, aged 65 or older and found that cognitive function reduced the lower the subjects’ vitamin D levels were. However, more studies have found sunlight could help spur nerve cell growth in the hippocampus, which is the part of the brain responsible for forming, organizing and storing of memories.

4. Sun exposure eases mild depression.

Sunlight deprivation can cause a condition called seasonal affective disorder (SAD). SAD is a form of depression common in the winter months. It is also common in people who work long hours in office buildings and hardly get out for some sun. Moderate sun exposure, however, increases levels of natural antidepressants in the brain that can actually help relieve this and other forms of mild depression. That’s because on sunny days the brain produces more serotonin, a mood-lifting chemical, than on darker days.

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5. Sun exposure improves sleep quality.

When sunlight hits our eyes, a message is sent to the pineal gland in the brain and production of melatonin (a hormone that makes us drowsy and helps us sleep) is shut down until the sun goes down again. Your body gets a clear signal that it’s no longer night and this helps to maintain a normal circadian rhythm. When it gets dark outside, your body gets the signal again and you feel tired and drowsy at bedtime. Low levels of melatonin production at night due to overproduction during the day has been linked to poor sleep quality, especially in older adults. Ditch the sunglasses early in the morning when you wake up if possible so your body gets the message that it is day and triggers the pineal gland to stop releasing melatonin.

6. Sun exposure lessens Alzheimer’s symptoms.

Clinical research has shown Alzheimer’s patients who are exposed to the sun throughout the day from 9 a.m. to 6 p.m. followed by darkness at night score better on mental exams and improve some aspects of the disease. For example, one study published in the Journal of the American Medical Association found that Alzheimer’s patients exposed to bright light had fewer symptoms of depression, nighttime wakefulness, agitation and lost less function than those exposed to dim daytime lighting. The researchers attributed these improvements to more regular circadian rhythms.

7. Sun exposure heals some skin disorders.

Sunlight promotes healing of skin disorders, such as acne, psoriasis, eczema, jaundice and other fungal skin infections. In one study, for example, a four-week outdoor sunbathing therapy was successfully used to significantly clear symptoms of psoriasis in 84% of subjects. While sun exposure has a therapeutic effect on the skin and sunlight has been successfully used to treat skin disorders, this alternative treatment method should be done under medical supervision to prevent negative side-effects of UV radiation and to ensure the benefits outweigh the risks.

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8. Sun exposure boosts growth in children.

This benefit is especially true for infants. Studies reveal the amount of sun exposure in the first few months of a baby’s life has an effect on how tall the child grows. Many cultures around the world recognize this fact and expose children to mild sun to boost growth and height.

9. Sun exposure enhances the immune system.

Sun exposure can help suppress an overactive immune system, which could explain why sunlight is used to treat autoimmune diseases like psoriasis. And since white blood cells increase with sun exposure and they play a key role in fighting diseases and defending the body against infection, moderate sun exposure is very helpful for your immune system.

10. Sun exposure reduces risk of certain cancers.

Vitamin D deficiency increases your risk of many cancers, especially breast and colon cancer. However, eating whole foods and getting some sun can send breast cancer into remission. This connection was first made by Drs. Frank and Cedric Garland from the University of California who observed that the incidence of colon cancer was nearly three times higher in New York than in New Mexico. Subsequent studies have since shown vitamin D supplementation produce a dramatic 60% drop in risk of developing any form of cancer. This confirms the benefits of vitamin D and sun exposure in reducing risk of cancer.

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Bottom line:

Sunshine does have its benefits, but it’s still the number one cause of skin cancer. Experts recommend no more than 15 to 20 minutes of direct sunlight daily for a healthy adult. After that, apply sunscreen with a minimum Sun Protection Factor (SPF) of 30. Remember skin color, where you live and how much skin you expose to the sun affect how much vitamin D you can produce.

Featured photo credit: Luci Correia via flickr.com

Most of us love being outside in the summertime. Sunshine not only makes everything look better, it makes us feel good too.

But ultraviolet (UV) rays in the sunlight can damage the cells in your body.

You should do everything you can to avoid getting burnt by the sun.

This is because over time small amounts of sunburn damage can build up, which may lead to the development of skin cancer or melanoma.

Tanning and your skin

Tanning is a natural process. Your skin creates the brown-coloured pigment called melanin to protect it against the harmful UV rays in sunlight. This means even the lightest suntan is evidence of skin damage.

While a tan is your body’s way of protecting itself against UV rays, if the damaged skin cells can’t repair themselves, they can become cancerous. You should be particularly careful in spring when your skin is pale.

A tan doesn’t guarantee that you will avoid skin cancer later on in life. Sun exposure is a key factor in skin cancer, and the number of cases has doubled over the last few decades.

How can you avoid sun damage?

Children

Small children usually love the sun and want to stay outside far longer than adults.

But they are very sensitive to the sun’s rays.

Keep kids out of the sun for the hottest parts of the day and protect them with a high SPF (30+).

You can protect your skin by following a few basic rules for your skin type.

Choose one statement from the list below that best describes your skin type. Imagine you are sunbathing in spring for the first time, without wearing any sunscreen.

  • Skin type 1: I always burn, I never tan.
  • Skin type 2: if I spend an hour in the sun I feel slightly burnt the next day. After seven days I have a slight tan.
  • Skin type 3: if I spend an hour in the sun I feel slightly burnt the next day. After seven days I am moderately tanned.
  • Skin type 4: I never feel burnt after spending an hour in the sun. After seven days I am very tanned.

Medicines

Certain medicines can cause hypersensitivity to the sun’s rays and cause severe eczema from sunbathing.

Consult your GP before sunbathing if you are taking any medication.

All skin types should stay out of the sun at the hottest times of the day (11am to 3pm).

Having pale skin that doesn’t tan, red hair and freckles puts you in the highest risk category for sunburn and long-term sun damage. Over exposure can cause skin cancers many years later – so cover up and be safe now!

Skin type 1

Avoid sunbathing and make sure you cover arms and legs with long shirts etc when out in the summer sun.

You will not get a tan – any attempts will only cause skin damage, which may later develop into cancer.

Fine pale skin does not age as quickly as other skin types. Your tanned friends will get wrinkles long before you do.

Skin type 2

Sunscreen myth 1

‘Sunscreen gives 100 per cent protection.’

Even the highest SPF sunscreen with maximum UVA stars can’t block out all the sun’s harmful rays.

This is why you should stay in the shade or cover up when the sun is at its strongest (11am to 3pm).

Don’t try to tan and take extra care in the sun.

Use a sunscreen with a high protection factor (SPF 30) during the peak of the summer season.

Don’t use a sunscreen with an SPF lower than 15.

Skin types 3

You should wear a sunscreen with a high sun protection factor (SPF 20+).

Don’t be tempted to use a sunscreen with an SPF lower than 15, even if you rarely burn.

You are still at risk of developing skin cancer and should take care in the sun.

Sunscreen myth 2

Think you can lower the SPF factor when you start to tan? Think again.

A tan is a sign that the skin is already damaged, so don’t add to this by reducing your protection.

Skin type 4

Even though your chances of developing skin cancer are less than those of people with skin type 1, 2 or 3, the sun can still damage your skin and cause wrinkles.

You should use a sunscreen with an SPF of 15.

What you need to know about SPF

  • There are two systems for specifying a sunscreen’s protection. American SPF numbers are double the SPF numbers on European products. An American SPF 20 sunscreen is the same as SPF 10 in Europe. Check which system is being used when you buy, and ask if you are in doubt.
  • SPF is a laboratory measure of effectiveness. The European SPF system is based on the time a person with pale skin can remain in the sun without getting red and tender. This is usually 20 minutes in spring.
  • If an SPF 8 sunscreen was applied, this would mean you could stay out in the spring sun for 8 x 20 minutes (160 minutes) without getting burnt.
  • In practice, we don’t know how quickly we burn, while factors such as sweat, water and application reduce sunscreen’s effectiveness, so you shouldn’t try to use this calculation as a guide.

Application, application

Good advice

  • On a cloudy day 30 to 50 per cent of the sun’s UV rays reach your skin, so it’s still possible to burn.
  • You may not feel the sun’s rays if it’s windy, but they still cause damage.
  • Brief intensive sunbathing is harmful, eg all day in the sun for one week. It may contribute to skin cancer developing.
  • On hot days use a hat and cover up arms and legs with loose-fitting clothes.
  • Vitamin D is essential for good bone health, and up to 90 per cent of our requirements are probably gained through the effects of sunlight. The complete facts and figures about how much is needed to prevent severe diseases, such as rickets, is not absolutely clear. But the current advice is that 10 to 15 minutes exposure to the summer sun 2 to 3 times a week should be sufficient to keep us healthy without taking any risks. Testing for vitamin D levels is commonly undertaken by GP’s and hospital consultants if there are any concerns about low levels in people who have to avoid even minimal contact for health reasons such as previous skin cancer or photosensitivity problems. Supplements containing vitamin D can be prescribed if needed.

If you want to avoid wrinkles and skin damage, the best protection is to stay in the shade.

When out and about, a high SPF sunscreen offers protection, but its action will be limited if you skimp on application and forget to reapply.

To get the most out of your sunscreen, follow these tips.

  • Choose a ‘broad spectrum’ sunscreen. This means it provides UVA and UVB protection. It should have an SPF of at least 15 and at least four UVA stars.
  • Apply sun lotion 30 minutes before you go out.
  • Use a thick layer of cream to get the SPF protection indicated on the bottle. Even if you use a high SPF, you will burn if you miss bits and don’t reapply frequently.
  • The effect of sunscreen reduces after one to two hours in the sun – so make sure you apply more often than this.
  • SPF 50 does not offer significantly more protection than a sunscreen with SPF 30. For this reason in Australia and America the highest SPF factor you will find is 30+.
  • Swimming makes the skin more sensitive to the sun. Use a water-resistant lotion and always reapply sunscreen after swimming.
  • Sweating dissipates sunscreen. If you sweat in the sun or you’re taking part in any physical activity outdoors, make sure you reapply the lotion or use a cream that isn’t absorbed by the skin. Look for products containing titanium dioxide or zinc oxide.
  • Certain perfumes and creams can cause hypersensitivity to the sun’s rays. To be safe, avoid wearing any products other than sunscreen when exposed to the sun.

What are the warning signs that you’ve been out too long?

  • Heat – your skin feels warm to the touch, even when you try to cool it with water.
  • Reddening.
  • Soreness.

The reddening can be hard to see at first but gradually becomes more obvious.

You can test for this reddening:

  • press your thumb against your skin
  • lifting it will reveal a white area
  • if this turns red again quickly, you have spent too long in the sun.

What can be done to relieve sunburn?

  • Cool the sunburnt area in tepid water for 30 minutes to one hour.
  • Apply a pain-relieving gel, calamine lotion or other soothing lotion. Ask your pharmacist for advice on products you can buy without a prescription.
  • Take extra care when cooling children’s burns.

Contact a doctor if:

  • the skin becomes excessively red and painful
  • blisters or a rash form and cover a large area
  • the skin is broken and weeping
  • a small child or infant has sunburn.

Other people also read:

What’s in a sunscreen: find out why skin tans.

Pregnancy and travel: vaccinations and medicines.

Vitamins and minerals: what do they do?

Allergy: does hypersensitivity occur frequently?

Based on a text by Dr Eric Olesen, GP

Last updated 14.08.2016

Jeni Worden GP

Chris Fortuna

Melanoma is now the most common (and deadliest) form of cancer in women ages 25 to 29, according to the Skin Cancer Foundation. In addition, any significant sun damage you’ll rack up in your lifetime will happen by your mid-20s.

Getting adequate protection has become trickier too. Many sunscreens only protect against UVB (or burning) rays because it was thought that those were the only beams that caused cancer. However, there’s new evidence that UVA rays, which age the skin but don’t burn you, are carcinogenic too, says dermatologist Nick Lowe, author of Away with Wrinkles.

Listen closely to this: “A sunscreen that doesn’t protect against UVA rays can be worse than none at all, because it allows you to stay in the sun all day without burning, but you’re still damaging your DNA,” says Sheldon Pinnell, M.D., professor emeritus of dermatology at Duke University Medical Center. Your best defense is a sunscreen (minimum SPF 15) with zinc oxide, titanium dioxide or avobenzone (also called Parsol 1789); it will likely be labeled as full- or broad-spectrum or indicate UVA and UVB protection. It’s also good to choose a block laced with antioxidants like vitamins C or E or green tea. They help your sunscreen do its job by fighting off free radicals generated by UV light.

PS: Don’t think tanning beds are safer. They’re even worse than the sun because they expose you to huge levels of UVA. “In my opinion, tanning beds are second only to smoking as a public-health concern,” says Dr. Lowe.

Health benefits of sunbathing

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