Ref. :  000024096
Date :  2006-07-25
Language :  French
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Conséquences de la surexposition au rayonnement UV solaire pour la santé

Author :  OMS / WHO


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Un nouveau rapport de l'OMS montre la répartition des maladies provoquées par le rayonnement UV
| GENEVA -- Un nouveau rapport de l'Organisation mondiale de la Santé (OMS) indique que le rayonnement ultraviolet solaire entraîne une charge de morbidité considérable dans le monde, notamment certains cancers. Quelques mesures de prévention simples permettraient d'éviter une grande part de la morbidité et de la mortalité associées aux UV.

Le rapport, Global Burden of Disease of Solar Ultraviolet Radiation (Charge mondiale de la morbidité due au rayonnement ultraviolet solaire), estime à 60 000 le nombre des décès dus chaque année à une surexposition au rayonnement UV. Sur ces 60 000 décès, 48 000 ont pour cause des mélanomes malins et 12 000 des carcinomes cutanés.

Au total, plus de 1,5 millions d'années de vie ajustées sur l'incapacité (DALY), une mesure des capacités perdues à cause de la maladie ou de la mort par rapport au fonctionnement normal de l'être humain, sont perdues chaque année en raison de la surexposition au rayonnement UV. La conséquence la plus grave en est le mélanome malin, pour lequel le taux de guérison n'est élevé que s'il est dépisté à un stade précoce. On estime que plus de 90 % de la charge mondiale des mélanomes et des autres cancers cutanés sont imputables à l'exposition au rayonnement UV.

Ce nouveau rapport de l'OMS est le premier examen systématique de la charge mondiale de morbidité entraînée par le rayonnement UV. Il étudie neuf événements indésirables pour la santé résultant de la surexposition au rayonnement UV. Les trois premiers, à l'origine de la plus grosse charge de morbidité, sont les mélanomes malins et les autres cancers cutanés se développant dans différentes couches cellulaires de la peau (carcinome spinocellulaire, carcinome basocellulaire). Par ailleurs, le rayonnement UV provoque des érythèmes solaires, le photovieillissement cutané, des cataractes corticales (opacités du cristallin), des ptérygions (une excroissance de chair à la surface de l'œil), des réactivations de l'herpès labial (bouton de fièvre) et le carcinome spinocellulaire de l'œil, une maladie très rare.

« Cette évaluation globale des risques sanitaires associés au rayonnement UV fournit une base solide à l'action de la santé publique. Nous avons tous besoin de soleil, mais l'excès peut être dangereux, voire mortel. Heureusement, de simples mesures de prévention permettent d'éviter presque totalement les maladies provoquées par les UV, comme les mélanomes malins, les cancers cutanés et les cataractes », nous dit le Dr Maria Neira, Directeur à l'OMS de Santé publique et environnement.

Le rapport note que le rayonnement UV a aussi des effets bénéfiques, principalement la synthèse de vitamine D lors de l'exposition de la peau aux UVB (à courte longueur d'onde). Présente en quantité suffisante, la vitamine D évite le développement de maladies osseuses comme le rachitisme, l'ostéomalacie et l'ostéoporose. On étudie en outre la possibilité que les UV aient aussi un effet bénéfique pour certains cancers et troubles de l'immunité.

L'OMS fait observer que, dans la plupart des cas, l'exposition minimale ordinaire au rayonnement UV suffit à maintenir la vitamine D à des niveaux qui permettent d'éviter tous ces problèmes de santé. La surexposition au rayonnement solaire est bien plus dangereuse.

Comme le rappelle l'OMS, quelques mesures de sécurité, faciles à mettre en œuvre, permettraient d'éviter une grande partie des cancers et des décès imputables au rayonnement UV :

* Limiter la durée de l'exposition en milieu de journée
* Profiter intelligemment de l'ombre, c'est-à-dire s'y réfugier quand le rayonnement UV est le plus intense
* Porter des vêtements et accessoires de protection, sans oublier chapeaux et lunettes de soleil
* Appliquer une crème solaire à large spectre avec un facteur de protection d'au moins 15
* Eviter les lampes et les salons de bronzage, que l'OMS recommande de proscrire totalement pour les jeunes de moins de 18 ans
* Connaître l'indice UV : quand on prévoit un niveau de rayonnement de 3 (modéré) ou plus, il faut prendre des mesures pour se protéger du soleil
* Protéger les enfants du soleil

Parallèlement au lancement de ce nouveau rapport, l'OMS et l'Organisation mondiale du tourisme (OMT) unissent leurs forces pour multiplier les actions visant à informer le grand public et à renforcer les mesures pour prévenir les maladies évitables. Par le biais de l'OMT, l'OMS distribuera à tous les ministères nationaux en charge du tourisme des informations, parmi lesquelles son nouveau dépliant sur les pratiques à adopter pour l'exposition au soleil.


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