The group developed health hazard ratings for each product based on their expert analysis of information from industry, academic, government regulatory and toxicity databases. Products were rated for overall effectiveness in sun protection based on three factors: UVB protection (using SPF ratings as the indicator of effectiveness); UVA protection (using a standard industry absorbance model to compute two standard UVA protection factors); and stability (using a customized stability database compiled from a review of industry and peer-reviewed stability studies). Only products claiming a SPF of 15 or greater were included in the review.

Key study findings

• Many high SPF sunscreens do not protect against UVA radiation.

• Many sunscreens break down quickly in the sun losing their effectiveness.

• Many sunscreens make over-the-top marketing claims that would classify the product as misbranded if FDA finalized sunscreen standards.

• U.S. regulations lag behind the world in sunscreen safety and effectiveness.

• Some sunscreens are absorbed into the blood causing safety concerns.

Overall findings indicate that 84 percent of the 823 products offer inadequate protection from the sun or contain ingredients with significant safety concerns. To be considered safe and effective, a product must block both UVA and UVB radiation, remain stable in sunlight, and contain few if any ingredients with significant known or suspected health hazards.

High SPF sunscreens (SPF of at least 30) protect only from sunburn (UVB radiation) and most lack ingredients known to protect against UVA radiation (only 12 percent protect against UVA radiation), the sun rays linked to skin damage and aging, immune system problems, and skin cancer. The FDA does not require UVA radiation protection at this time. In addition, 54 percent of products contain ingredients that are unstable alone or in combination so that ingredients break down in a matter of minutes or hours, thus letting UV radiation through to the skin.

Sunscreen regulations and guidelines
For 29 years, the FDA has failed to set mandatory sunscreen safety standards leaving companies free to make their own decision on advertising claims and product quality. Instead, FDA has drafted sunscreen standards that it urges manufacturers to follow voluntarily. Congress mandated the agency to finalize the draft sunscreen safety standards by May 2006 but the only other guideline released to date advises people to stay out of the sun from 10 a.m. to 4 p.m.

An alarming finding of the EWG report is the prevalence of misleading claims made by product manufacturers. Claims like, “all day protection,”  “waterproof,”  “chemical-free,” “blocks all harmful rays,” are not always true. As many as 51 percent of products on the market bear claims considered  “unacceptable” or   “misleading” under the FDA’s draft sunscreen safety standards.

Many sunscreens contain nano-scale ingredients that have unique, toxic properties. Top-rated (by EWG) products contain micronized and nano-scale zinc oxide and titanium dioxide which do provide strong UVA protection without penetrating healthy skin, thus minimizing consumer’s exposure. Effective UVA filters could replace nano-scale ingredients but FDA has failed to approve many of the UVA filters available in Europe and Asia with only four chemicals effective in the UVA range for use in the US. Some sunscreen ingredients are absorbed into the blood and are linked to toxic effects releasing skin-damaging free radicals. Some ingredients absorbed into the blood act like estrogen in the body potentially disrupting hormone systems. Additionally, several ingredients are strongly linked to allergic reactions.

The health impact of exposure to industrial chemical compounds is not clearly understood but the scientific literature demonstrates that we all carry in our bodies hundreds if not thousands of industrial chemicals as a result of exposure to contaminants in air, water, food, and from ingredients in everyday consumer products. Federal health standards do not require companies to test their products for safety before they are sold, including nearly all chemicals in sunscreen and other personal care products. Instead, new chemicals are approved by using computer models to predict toxicity in humans. This is particularly alarming given that studies show these pollutants cross the placenta; one recent study found an average of 200 chemicals in umbilical cord blood from 10 newborn babies!

Consumers would also be wise to keep in mind that responsible and limited exposure to sunlight can actually be beneficial for meeting the body’s need for vitamin D. A precursor to the active form of vitamin D is found in the skin. Brief and casual exposure to UV radiation converts vitamin D precursors to a metabolite that is activated first by the liver and then the kidney to the active form of vitamin D (1,25 dihydroxy vitamin D3).

UV light penetration depends on the amount of melanin in the skin, blockage of effective rays by window glass, sunscreen use and clothing type. Casual exposure to UV light seems to provide sufficient vitamin D when food sources are lacking. Vitamin D is not widespread in the food supply but the active form does exist naturally in animal products with the richest source being oily fish. It is found in small and highly variable amounts in butter, cream, eggs, and liver. Human milk and unfortified cow’s milk tend to be poor sources of vitamin D3. In the U.S., fluid milk is fortified with vitamin D as are most dried whole milk products, evaporated milk, some margarines, butter, soy milk, certain cereals and all infant formula products. Individuals who do not drink fortified milk or eat oily fish or other fortified products need brief exposure of the face, arms and hands to UV light and may be able to limit the use of sunscreens if extended durations of sunlight exposure are avoided with attention to staying inside during the hottest part of the day, 10 a.m. to 4 p.m.

The EWG recommends that the FDA set mandatory sunscreen safety standards, develop UVA standards for sunscreen, and approve new, effective, and safe sunscreens for use in the U.S.

Infants born to multivitamin users were less likely to be born preterm with a reported odds ratio of 0.29, signifying only about one-third the risk compared to non-multivitamin users. Small-for-gestational age births were also reduced in multivitamin users, with only about two-thirds the risk, a reported odds ratio of 0.64, when compared to non-multivitamin users. The study controlled for smoking, education, parity, prepregnancy body mass index (BMI), and baseline gestational age.

No difference in preterm births between 34 and 37 weeks and SGA births between the 5th and 10th percentiles was observed between the two groups. So it appears that periconceptional multivitamin use is most protective for preventing births prior to 34 weeks’ gestational age and SGA births falling below the 5th percentile.

Additionally, non-obese women who used multivitamins had about half the risk of an SGA birth below the 5th percentile (odds ratio of 0.54) when compared to non-obese women who did not use multivitamins. No difference was found in SGA births between obese women who used or did not use multivitamins in the periconceptional period. One possible explanation for the difference in non-obese women but not in obese women is that the obese women may have larger cellular and tissue stores of fat-soluble vitamins, vitamin B12, and vitamin B6 (two water soluble vitamins that are stored by the body) resulting from a higher energy intake, thus negating the effect of multivitamin supplementation. Non-obese women may have more marginal stores of certain vitamins so that supplementation in the non-obese group might contribute significantly to body vitamin levels.