Incidence and public health burden of sunburn among beachgoers in the United States

Is sunscreen alone effective at preventing sunburn on a high-solar beach vacation: A modeling study?

Beach holidays in areas of strong sunlight are popular and sunscreen is often the primary means of photoprotection favored by many people. The object of this study was to estimate how effective sunscreen is in preventing sunburn under high ultraviolet (UV) levels. We used a computational model to determine how the quantity, frequency, substantivity, and labeled SPF of applied sunscreens impact on the predicted erythemal response in unacclimatized skin over the course of a 7-day holiday in a high-solar environment. Our results indicated that sunscreen on its own may be insufficient to prevent sunburn in white skin on a sun-seeking holiday that combines prolonged exposure with high UV levels. Nevertheless, sunscreens have a valuable role to play on a beach holiday especially if an SPF30 or higher is chosen, the product is applied liberally and uniformly, application is started early into the sun exposure period and repeated at 2-hourly intervals throughout the day, and the product binds well to the skin. The main limitation of our investigation is that it is not an observational study but rather a computational model and while all models are wrong, some, including this one, are useful.

Understanding the Perceived Relationship between Sun Exposure and Melanoma in Atlantic Canada: A Consensual Qualitative Study Highlighting a "Sunscreen Paradox"

Globally, cutaneous melanoma (CM) incidence is increasing, with sun exposure identified as a key modifiable risk factor. The Atlantic provinces of Canada display varied CM incidence rates: New Brunswick aligns with the national average, while Nova Scotia and Prince Edward Island exceed it, and Newfoundland and Labrador fall below this benchmark. We investigated the relationship between sun exposure and CM in these provinces. Twenty-two focus groups encompassing 95 Atlantic Canada residents were conducted and transcribed. A thematic analysis was conducted in MAXQDA using the social-ecological model as a framework. Residents of high-CM incidence provinces demonstrated greater sun exposure awareness, consulting UV indices, and using sunscreen and sun-protective clothing. However, they received greater UV exposure due to warmer climates and outdoor work and cultural activities. Conversely, those in low-incidence provinces used sunscreen and sun-protective clothing less often, engaged in occupations and hobbies affording less sun exposure, and lived in cooler climates. Our data supports a possible "sunscreen paradox", whereby increased sunscreen use is correlated with augmented sun exposure, leading to a deceptive sense of security. Public health initiatives in Atlantic Canada promoting sun safety must address this paradox while integrating community-specific behaviors and norms in order to develop tailored campaigns.

Syndromic Surveillance of Health Effects Due to Summer Sun Overexposure: Construction of an Indicator Based on Drug Sales in Pharmacies-Preliminary Study within the PRISME Project

INTRODUCTION

Solar radiation is classified as a known human carcinogen. In France, people frequently ask local pharmacies to dispense products for sunburns. In the PRISME project, studying this use can be a specific and sensitive way to assess these overexposures.

OBJECTIVE

This study aims to construct an indicator for monitoring healthcare consumption in pharmacies after overexposure to solar UV.

METHODS

The study, conducted between July and August 2019, covered a sample of pharmacies located in coastal communities of southern France. A list of products for sunburn was defined. When one of the products on this list was sold, the customer was asked to fill out a questionnaire to determine whether the purchase was related to UV overexposure. A positive predictive value (PPV) per active ingredient was calculated.

RESULTS

Overall, nine pharmacies participated in the study, and 288 questionnaires were collected. The majority of products purchased were for women (60.7%), for people aged 15 and over (78.1%), and for people not living in the department (68.9%). The most frequently purchased products were our trolamine-containing products which accounted for 53% of sales. With the exception of three products, all PPVs were greater than 0.8.

CONCLUSION

The high PPV confirms the suitability of the product selection as an indicator for monitoring healthcare consumption related to solar UV overexposure. Two indicators (one sensitive and one specific) were selected to maximise the chances of identifying UV-related remedies.

Modeling acute and cumulative erythemal sun exposure on vulnerable body sites during beach vacations utilizing behavior-encoded 3D body models

Vacationers in a high-solar-intensity beach setting put themselves at risk of ultraviolet radiation (UV) over-exposure that can lead to acute and chronic health consequences including erythema, photoaging, and skin cancer. There is a current gap in existing dosimetry work on capturing detailed time-resolved anatomical distributions of UV exposure in the beach vacation setting. In this study, a radiative transfer model of the solar conditions of Tampa Bay, St. Petersburg, Florida, USA (27.8°N, 82.8°W) is combined with an in silico three-dimensional body model and data on typical beach vacation behaviors to calculate acute and cumulative body-site-specific UV exposure risk during a beach vacation. The resulting cumulative UV exposure calculated for a typical mix of clothing choices, settings, and activities during a week-long (7-day) beach vacation is 172.2 standard erythemal doses (SED) at the forearm, which is comparable with the average total annual UV exposure of European and North American residents and consistent with existing dosimetry studies. This model further estimates that vacationers choosing to spend a full day exclusively in the beach or pool setting can experience UV exposure in excess of 50 SED a day at multiple body sites. Such exposure indicates that significant sun protective measures would be required to prevent sunburn across all skin types in this setting. This work clarifies the significant role that beach vacations play in UV exposure and corresponding acute and cumulative health risks and highlights the importance of behavioral choices (including clothing, activity and photoprotection) as crucial factors in differentiating personal solar exposure risks.

Sunburns among beachgoers in the northern coast of Peru: frequency and factors associated

Background

Overexposure to ultraviolet (UV) radiation has increased skin cancer incidence and the risk of sunburns, especially during the summer months.

Objective

Identify the frequency and factors associated with sunburns in a sample of beachgoers in the northern coast of Peru.

Methods

We conducted a secondary data analysis of a previous study that assessed the awareness, behavior and attitudes concerning sun exposure among beachgoers. We included adults between 18 and 59 years who went to a beach in northern Peru during summer (March 2018). Three generalized linear models of the Poisson family were constructed to evaluate the factors associated with having had at least one sunburn last summer. All regression models reported the adjusted prevalence ratio (aPR) with their respective 95% confidence interval (95% CI).

Results

Of a total of 402 participants, 225 (56.0%) had one to five sunburns and 25 (6.2%) had six or more. Beachgoers who were 1–15 days (aPR: 1.16, 95% CI [1.05–1.27]) or more than 15 days (aPR: 1.22, 95% CI [1.09–1.36]) exposed to the sun on the beach had a higher frequency of at least one sunburn. The non-regular wearing of a hat or cap also increased the frequency of sunburns (aPR: 1.06, 95% CI [1.01–1.12]). In contrast, those who had Skin Phototype III (aPR: 0.94, 95% CI [0.88–0.99]) or IV (aPR: 0.69, 95% CI [0.63–0.75]) had a lower frequency of sunburns.

Conclusion

Three out of five beachgoers had one or more sunburns in the last summer. The factors associated with a higher frequency were the time of sun exposure at the beach and the non-regular use of a hat or cap. Type III–IV skin phototypes were associated with a lower sunburn frequency.