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JAMA Dermatology May 2018Monitoring sun protection and sunburn over time at the population level can provide valuable information about progress toward skin cancer prevention goals and inform...
IMPORTANCE
Monitoring sun protection and sunburn over time at the population level can provide valuable information about progress toward skin cancer prevention goals and inform future intervention efforts.
OBJECTIVE
To examine the prevalence of sun protection use (shade, sunscreen, and clothing) and sunburn and the association between sunburn and individual characteristics and health behaviors in the US population.
DESIGN, SETTING, AND PARTICIPANTS
In this cross-sectional study using a nationally representative sample of 31 162 US adults from the 2015 National Health Interview Survey-Cancer Control Supplement, household interviews of civilian, noninstitutionalized US adults were conducted throughout 2015 in person and completed on the telephone when necessary. Data analysis was performed from August 16, 2016, to September 6, 2017.
MAIN OUTCOMES AND MEASURES
The prevalence of sunburn and use of sun protection and their association with demographic characteristics, sun sensitivity, and health-related behaviors and conditions using multivariable logistic regression modeling.
RESULTS
A total of 31 162 respondents (mean [SD] age, 47.0 [0.36] years; 13 932 male [44.7%] and 17 230 female [55.3%]) were included in the analyses, with 34.2% experiencing sunburn in 2015. Sunburn prevalence was higher among younger age groups (51.2% in adults 18-29 years old; 95% CI, 48.8%-53.7%), non-Hispanic white individuals (42.5%; 95% CI, 41.2%-43.9%), and those with sun-sensitive skin (50.2%). However, sunburn was also prevalent among black (13.2%; 95% CI, 11.6%-15.1%) and Hispanic (29.7%; 95% CI, 27.6%-31.9%) individuals, demographic groups that are often considered to be at low risk of skin cancer. The most frequent sun protection behaviors were staying in the shade (37.1%; 95% CI, 36.3%-38.0%) and using sunscreen (31.5%; 95% CI, 30.7%-32.3%) followed by wearing long clothing to the ankles (28.4%; 95% CI, 27.6-29.1). Sun avoidance behaviors (seeking shade and not going in the sun) were significantly (39.5% vs 35.1%; P < .001) associated with a lower prevalence of sunburn. Those who used self-applied sunless tanning products (45.0% of users vs 36.1% of nonusers; P < .001), those who engaged in aerobic activity (37.9% of aerobic exercisers vs 32.8% of non-aerobic exercisers; P < .001), binge drinkers (45.1% of binge drinkers vs 35.0% of non-binge drinkers; P < .001), and overweight or obese individuals (37.9% of overweight or obese individuals vs 34.4% of non-overweight or obese individuals; P < .001) were more likely to experience sunburn compared with the respective comparison groups.
CONCLUSIONS AND RELEVANCE
Sun sensitivity was significantly associated with a higher sunburn prevalence, independent of race/ethnicity, suggesting a need to consider sun sensitivity when identifying target demographic groups for sun safety interventions. Efforts to improve vigilance and consistency with use of sun protection are needed. In addition, those who engage in physical activity, use sunless tanners, or use sunscreen for tanning purposes may require additional intervention strategies to address the unique barriers they face in staying adequately protected.
Topics: Adult; Cross-Sectional Studies; Female; Health Behavior; Humans; Male; Prevalence; Socioeconomic Factors; Sunbathing; Sunburn; Sunscreening Agents; United States; Young Adult
PubMed: 29541756
DOI: 10.1001/jamadermatol.2018.0028 -
Tidsskrift For Den Norske Laegeforening... Jan 2020
Topics: Humans; Sunburn
PubMed: 31948212
DOI: 10.4045/tidsskr.19.0795 -
Preventive Medicine May 2021Ultraviolet radiation exposure is the leading cause of skin cancer, and childhood and adolescence is a particularly susceptible life period for exposure. This systematic... (Meta-Analysis)
Meta-Analysis Review
Ultraviolet radiation exposure is the leading cause of skin cancer, and childhood and adolescence is a particularly susceptible life period for exposure. This systematic review assessed whether interventions in elementary and secondary school settings reduced sun exposure, sunburns, and development of melanocytic nevi, and improved sun-safe knowledge, attitudes and sun protection behaviors in childhood and adolescence. A systematic search up to June 2020 of MEDLINE, Embase, CINAHL, Cochrane and ProQuest databases was undertaken, for studies conducted among students in an elementary or secondary school setting that compared an intervention group with a pre-intervention or separate control group. Data were summarized using qualitative synthesis. Pooled effects from meta-analysis with random effects were also reported where appropriate. Sixty-five studies were included (22 randomized, 43 non-randomized). Most studies assessed measures of sun-safe behaviors, knowledge and attitudes (57, 48 and 33 studies, respectively), and observed improved sun protection behaviors and sun-safe knowledge, whereas few studies reduced time in the sun. About half improved participants' attitudes towards tanning desirability. Sunburns and nevus counts were less frequently assessed, but about half of these studies observed a reduction. There was substantial heterogeneity for outcomes except attitudes towards the desirability of tanning (pooled odds ratio from 6 studies: 0.81, 95% confidence interval 0.70-0.94). Key positive intervention features included: elementary school settings, interactive features or multiple components, and incorporating social norm influences. Most studies were classified at high risk of bias. In conclusion, school-based sun-related interventions had positive impacts on behaviors and attitudes among elementary and secondary school children.
Topics: Adolescent; Child; Health Knowledge, Attitudes, Practice; Humans; Schools; Skin Neoplasms; Sunbathing; Sunburn; Ultraviolet Rays
PubMed: 33609617
DOI: 10.1016/j.ypmed.2021.106459 -
Pediatric Dermatology May 2017Skin cancer incidence has been increasing in U.S. Hispanics over several decades and the postdiagnosis outcomes are worse for Hispanics than for non-Hispanic whites....
BACKGROUND/OBJECTIVES
Skin cancer incidence has been increasing in U.S. Hispanics over several decades and the postdiagnosis outcomes are worse for Hispanics than for non-Hispanic whites. Parents are influential in children's health preventive behaviors, but little is known about parental factors associated with children's skin cancer-related behaviors in the U.S. Hispanic population. The present study examined parental and child correlates of skin cancer-related behaviors (sunburns, sunbathing, sun-protective clothing use, and sunscreen use) of children of Hispanic parents.
METHODS
This survey study included a population-based sample of 360 U.S. Hispanic parents (44.8% male) who had a child 14 years of age or younger. Measures included parental reports of parent and child demographic characteristics, parent skin cancer knowledge and linguistic acculturation, and parent and child skin cancer-related behaviors.
RESULTS
Approximately 28% of children and 31.9% of parents experienced at least one sunburn in the past year and approximately 29% of children and 36.7% of parents were reported to sunbathe. Moderate use of sun-protective clothing and sunscreen was reported for parents and their children. Child sun-protective clothing use and sunscreen use, sunburns, and sunbathing were associated with the corresponding behaviors of their parents.
CONCLUSIONS
Future research should consider the role of acculturation and perceived risk in the sun protection behaviors of U.S. Hispanic children, particularly in those who report a fair skin type. Hispanic parents should be included in interventions targeting their children's skin cancer-related behaviors, and it is suggested that such interventions could also encourage parents to improve their own behaviors.
Topics: Acculturation; Adolescent; Adult; Aged; Aged, 80 and over; Child; Child, Preschool; Female; Health Behavior; Health Knowledge, Attitudes, Practice; Health Surveys; Hispanic or Latino; Humans; Infant; Male; Middle Aged; Parents; Protective Clothing; Skin Neoplasms; Sunbathing; Sunburn; Sunscreening Agents; Young Adult
PubMed: 28523887
DOI: 10.1111/pde.13136 -
Health Promotion Journal of Australia :... Sep 2020This study explores the experiences of adults aged 18 years and older who received an unintended sunburn while wearing sunscreen and examines why the application of...
ISSUE ADDRESSED
This study explores the experiences of adults aged 18 years and older who received an unintended sunburn while wearing sunscreen and examines why the application of sunscreen as a sun protection measure did not work as intended.
METHODS
Qualitative content analysis was conducted on 11 interviews with people living in Australia who had received an unintended sunburn. Data were collected from July 2017 to January 2018. Twelve participants took part in individual semi-structured interviews either face-to-face or over the telephone, and 11 participants met the eligibility criteria and were included for analysis.
RESULTS
The themes that emerged included experience of disbelief after sunburn; sunburn after water-based activity; inaccurate sunscreen application; sunscreen acceptability and trust; discomfort in application, opportunistic sun exposure; aesthetically motivated behaviour; normative beliefs; and lack of awareness of recent sun safety campaigns.
CONCLUSION
Participants perceived themselves as well protected from sun exposure and were surprised they received a sunburn. We found that participants did not reapply sunscreen often enough, especially before and during water activities and overestimated the amount of time they could be safely exposed to the sun. SO WHAT?: The findings of this study suggest a greater need for sun protection education on how to effectively use and apply sunscreen to avoid sunburn and skin cancer.
SUMMARY
This study explores the experiences of adults aged 18 years and older who received an unintended sunburn while wearing sunscreen and examines why the application of sunscreen as a sun protection measure did not work as intended. Qualitative content analysis was conducted on 11 interviews with people living in Australia who had received an unintended sunburn.
Topics: Adult; Australia; Health Behavior; Humans; Skin Neoplasms; Sunburn; Sunscreening Agents
PubMed: 31631453
DOI: 10.1002/hpja.301 -
International Journal of Molecular... Sep 2018Skin color diversity is the most variable and noticeable phenotypic trait in humans resulting from constitutive pigmentation variability. This paper will review the... (Review)
Review
Skin color diversity is the most variable and noticeable phenotypic trait in humans resulting from constitutive pigmentation variability. This paper will review the characterization of skin pigmentation diversity with a focus on the most recent data on the genetic basis of skin pigmentation, and the various methodologies for skin color assessment. Then, melanocyte activity and amount, type and distribution of melanins, which are the main drivers for skin pigmentation, are described. Paracrine regulators of melanocyte microenvironment are also discussed. Skin response to sun exposure is also highly dependent on color diversity. Thus, sensitivity to solar wavelengths is examined in terms of acute effects such as sunburn/erythema or induced-pigmentation but also long-term consequences such as skin cancers, photoageing and pigmentary disorders. More pronounced sun-sensitivity in lighter or darker skin types depending on the detrimental effects and involved wavelengths is reviewed.
Topics: Animals; Erythema; Genetic Predisposition to Disease; Humans; Melanins; Phenotype; Pigmentation Disorders; Polymorphism, Single Nucleotide; Skin Diseases; Skin Neoplasms; Skin Pigmentation; Sunburn; Ultraviolet Rays
PubMed: 30205563
DOI: 10.3390/ijms19092668 -
Journal of Physical Activity & Health Sep 2021Physical activity is associated with greater odds of sunburn in adults, increasing harmful sun exposure and skin cancer risk. The authors sought to investigate parallel...
BACKGROUND
Physical activity is associated with greater odds of sunburn in adults, increasing harmful sun exposure and skin cancer risk. The authors sought to investigate parallel associations between sunburn and physical activity among US high school students.
METHODS
The authors examined pooled cross-sectional data from the 2015 and 2017 Youth Risk Behavior Survey. A nationally representative sample of 21,894 US high school students who responded to the sunburn question was included.
RESULTS
Prevalence of sunburn was 56.6% between 2015 and 2017. Sunburn prevalence was higher in physically active students (88.3%; 95% confidence interval [CI], 86.7%-90.0%; P < .0001) and student athletes (63.0%; 95% CI, 59.4%-66.7%; P < .0001). Among male students who were vigorously physically active (≥5 d) or on ≥3 teams, the odds of sunburn were 2.33 (95% CI, 1.81-3.00; P < .0001) and 2.52 (95% CI, 1.96-3.23; P < .0001), respectively. Among female students who were vigorously physically active (≥5 d) or on ≥3 teams, the odds of sunburn were 1.65 (95% CI, 1.36-2.02; P < .0001) and 2.92 (95% CI, 2.07-4.13; P < .0001), respectively.
CONCLUSIONS
Many US high school students are affected by sunburn, and the odds of sunburn are elevated during physical activity and team sports participation. Efforts are needed to improve sun safety regulations, education, and resources for youth during school and physical activity.
Topics: Adolescent; Adult; Cross-Sectional Studies; Exercise; Female; Humans; Male; Prevalence; Schools; Students; Sunburn
PubMed: 34186506
DOI: 10.1123/jpah.2020-0711 -
BMC Public Health Jul 2016Excessive sun exposure and sunburn increase individuals' risk of skin cancer. It is especially important to prevent sunburn in childhood due to the higher relative risk...
BACKGROUND
Excessive sun exposure and sunburn increase individuals' risk of skin cancer. It is especially important to prevent sunburn in childhood due to the higher relative risk of skin cancer across the life span compared to risk associated with sunburn episodes experienced later in life. This study examined demographic and attitudinal factors associated with engagement in a range of sun protection behaviours (wearing a hat, wearing protective clothing, staying in the shade, and staying indoors during the middle of the day) and the frequency of sunburn among Western Australian adolescents to provide insights of relevance for future sun protection campaigns.
METHODS
Cross-sectional telephone surveys were conducted annually with Western Australians between 2005/06 and 2014/15. The results from 4150 adolescents aged 14-17 years were used to conduct a path analysis of factors predicting various sun protection behaviours and sunburn.
RESULTS
Significant primary predictors of the sun protection behaviours included in the study were skin type (sun sensitivity), gender, tanning-related attitudes and behaviours, and perceived relevance of public service advertisements that advocate sun protection. Of the four sun protection behaviours investigated, staying in the shade and staying indoors during the middle of the day were associated with a lower frequency of sunburn.
CONCLUSION
There is a particular need to target sun protection messages at adolescent males who are less likely to engage in the most effective sun protection behaviours and demonstrate an increased propensity to experience sunburn. The results suggest that such future sun protection messages should include a focus on the importance of staying in the shade or indoors during periods of high UV radiation to increase awareness of the efficacy of these methods of avoiding skin cancer.
Topics: Adolescent; Adolescent Behavior; Cross-Sectional Studies; Female; Health Knowledge, Attitudes, Practice; Humans; Incidence; Male; Protective Clothing; Skin Neoplasms; Sunbathing; Sunburn; Sunscreening Agents; Telephone; Western Australia
PubMed: 27411518
DOI: 10.1186/s12889-016-3197-4 -
JAMA Dermatology May 2017Indoor tanning and sunburns, particularly during adolescence and young adulthood, increase the risk of developing skin cancer.
IMPORTANCE
Indoor tanning and sunburns, particularly during adolescence and young adulthood, increase the risk of developing skin cancer.
OBJECTIVE
To examine the trends in the prevalence of indoor tanning and the association between indoor tanning and sunburn among US high school students.
DESIGN, SETTING, AND PARTICIPANTS
This study pooled and examined cross-sectional data from the 2009, 2011, 2013, and 2015 national Youth Risk Behavior Survey. During 2009, 2011, 2013, and 2015, the overall response rates were 71%, 71%, 68%, and 60%, respectively, and unweighted sample sizes were 16 410, 15 425, 13 538, and 15 624, respectively. It included nationally representative samples of US high school students. Data were collected during the spring semester (January to June) in each survey cycle beginning February 9, 2009, through June 18, 2015.
MAIN OUTCOMES AND MEASURES
Prevalence of indoor tanning in the past year from 2009 to 2015 and its association with sunburn in 2015.
RESULTS
Among high school students in the United States, the prevalence of indoor tanning decreased from 15.6% (95% CI, 13.7%-17.6%) in 2009 to 7.3% (95% CI, 6.0%-8.9%) in 2015. Decreases in indoor tanning were found among male (from 6.7% in 2009 to 4.0% in 2015) and female (from 25.4 % in 2009 to 10.6 % in 2015) students overall, non-Hispanic white (from 21.1 % in 2009 to 9.4% in 2015) and Hispanic (from 8.2% in 2009 to 4.7% in 2015) students overall, and all age groups. Among non-Hispanic white female students, the prevalence decreased from 37.4% (95% CI, 33.6%-41.4%) in 2009 to 15.2% (95% CI, 11.7%-19.5%) in 2015. In 2015, indoor tanning was associated with sunburn in the adjusted model: 82.3% (95% CI, 77.9%-86.0%) of indoor tanners had at least 1 sunburn during the preceding year compared with 53.7% (95% CI, 48.9%-58.4%) of those who did not engage in indoor tanning (P < .001).
CONCLUSIONS AND RELEVANCE
Despite declines in the prevalence of indoor tanning from 2009 to 2015 among high school students nationwide, indoor tanning remains commonplace among certain subgroups, especially non-Hispanic white female students. Three-quarters of those who engaged in indoor tanning had experienced at least 1 sunburn. Efforts by the public health and medical communities are needed to further reduce the prevalence of indoor tanning and sunburn and thus prevent future cases of skin cancer.
Topics: Adolescent; Adolescent Behavior; Cross-Sectional Studies; Female; Health Surveys; Humans; Male; Prevalence; Risk-Taking; Sex Factors; Students; Sunbathing; Sunburn; United States
PubMed: 28257531
DOI: 10.1001/jamadermatol.2016.6273 -
International Journal of Dermatology Mar 2024Exposure to solar ultraviolet radiation (UVR) is associated with several cutaneous adverse effects. However, to the best of our knowledge, in South Africa there are no... (Review)
Review
Exposure to solar ultraviolet radiation (UVR) is associated with several cutaneous adverse effects. However, to the best of our knowledge, in South Africa there are no formal guidelines on sun protection. A group of South African dermatologists and researchers convened over the course of 1 year to deliberate on integrated advice for sun protection among the multi-ethnic South African population. For people with light skin and those with genetic skin disorders (e.g., oculocutaneous albinism), sun protection was identified as critical to prevent sunburn, skin cancer, and photoaging. The evidence is less clear for people with medium and darker skin types, especially the latter, in whom melanin may confer a degree of protection against some parts of the solar spectrum. Recent studies have demonstrated that visible light can cause pigmentary changes in individuals with darker skin types in particular. Sun protection for people of all skin colors is beneficial to protect against photoaging and ocular damage. Herein sun protection advice is suggested for South Africans of all skin colors to reduce morbidity and mortality from sun exposure, particularly relating to skin cancer. Several knowledge gaps are identified as future research priorities.
Topics: Humans; Ultraviolet Rays; South Africa; Sunlight; Sunburn; Skin Neoplasms; Sunscreening Agents
PubMed: 38124402
DOI: 10.1111/ijd.16980