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Thoonen K, Woodhouse S, Minto C, Blane S, Talati Z. Patterns of Sun Protection Behaviours among Australian Adolescents and Adults over a Six-Year Period. Curr Oncol 2023; 30:7178-7188. [PMID: 37623001 PMCID: PMC10453427 DOI: 10.3390/curroncol30080520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Revised: 07/17/2023] [Accepted: 07/21/2023] [Indexed: 08/26/2023] Open
Abstract
The major cause for skin cancer is the excessive and unprotected exposure to ultraviolet radiation (UVR), which can be prevented by engaging in sun protection behaviours. As longitudinal studies on both adolescents' and adults' performances of sun protection behaviours are limited, the current study aimed to investigate changes in sun protection in these population segments in Western Australia, a region with high annual UVR. During six summer seasons (2015/16 to 2020/21), cross-sectional surveys were conducted among 1806 adolescents (14 to 17 years old) and 1808 adults (18-45 years old), investigating the frequency of five sun protection behaviours (wearing clothing, applying sunscreen, wearing a hat, wearing sunglasses, and seeking shade) and sun avoidance (staying indoors). Over the six-year period, staying indoors increased in both groups. Among adolescents, a decrease in wearing clothing and sunglasses and an increase in seeking shade was demonstrated, and hat and sunscreen use remained relatively stable. Among adults, an increase in sunscreen use was shown, whereas all other sun-related behaviours remained consistent over the six-year period. The results from this study can provide directions for health communications focusing on improving sun protection behaviours among both adolescent and adult populations.
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Affiliation(s)
- Karlijn Thoonen
- Melbourne Centre for Behaviour Change, Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne 3010, Australia
| | - Sade Woodhouse
- School of Population Health, Curtin University, Perth 6845, Australia (Z.T.)
| | - Carolyn Minto
- Cancer Council Western Australia, Perth 6008, Australia;
| | - Sally Blane
- Cancer Council Western Australia, Perth 6008, Australia;
| | - Zenobia Talati
- School of Population Health, Curtin University, Perth 6845, Australia (Z.T.)
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2
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Lips P, de Jongh RT, van Schoor NM. Trends in Vitamin D Status Around the World. JBMR Plus 2021; 5:e10585. [PMID: 34950837 PMCID: PMC8674774 DOI: 10.1002/jbm4.10585] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 11/18/2021] [Accepted: 11/18/2021] [Indexed: 01/01/2023] Open
Abstract
Vitamin D status varies across all continents and countries. Vitamin D status usually is adequate in Latin America and Australia, but in contrast it is very low in the Middle East and some countries in Asia. Trends in vitamin D status, whether it improves or declines over the years, carry important messages. Trends usually are small, but can be predictors and indicators of general health. Vitamin D status has improved in the older population in the United States, and improvement relates to dairy use and vitamin D supplements. To the contrary, vitamin D status has declined in the Inuit population of Canada due to a change from a traditional fish diet to a Western diet. A large improvement was seen in Finland after mandatory fortification of dairy products was introduced. Determinants of decline are less sun exposure, increased use of sunscreen, increase of body mass index (BMI), less physical activity, and poor socioeconomic status. Determinants of increase are food fortification with vitamin D and vitamin D supplements. Food fortification can lead to a population-wide increase in vitamin D status as shown by the Finnish example. © 2021 The Authors. JBMR Plus published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research.
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Affiliation(s)
- Paul Lips
- Department of Internal Medicine, Endocrine SectionAmsterdam University Medical Centre, location VUMCAmsterdamThe Netherlands
| | - Renate T. de Jongh
- Department of Internal Medicine, Endocrine SectionAmsterdam University Medical Centre, location VUMCAmsterdamThe Netherlands
| | - Natasja M. van Schoor
- Department of Epidemiology and Data ScienceAmsterdam University Medical Centre, Vrije Universiteit Amsterdam, Amsterdam Public Health Research InstituteAmsterdamThe Netherlands
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Chen LJ, Chang YJ, Shieh CF, Yu JH, Yang MC. Relationship between practices of eye protection against solar ultraviolet radiation and cataract in a rural area. PLoS One 2021; 16:e0255136. [PMID: 34324583 PMCID: PMC8321156 DOI: 10.1371/journal.pone.0255136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Accepted: 07/09/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Cataract is a public health concern worldwide that differentially affects rural residents of outlying islands where ultraviolet radiation (UVR) may have greater penetration because of less shading. OBJECTIVES To assess the relationships between attitudes and practices of eye protection and eye diseases for residents of an offshore island of Taiwan. METHODS Questionnaire survey was administered to local residents (age > 50 years) regarding socio-demographic information, attitudes/practices of eye protection under sun exposure and eye diseases. RESULTS A total of 816 participants (response rate 90.7%, 816/900) completed the questionnaires. Mean age was 63.7 (+ 10.8) years. Among these participants, 44.4%, 15.1% and 8.3% had cataract, dry eye and glaucoma, respectively. Although 86.3% and 88.2% of participants agreed that they should avoid outdoor activities and wear glasses/broad-brimmed hats in harsh daylight, 69.4% and 48.3% of participants never/rarely used glasses or hats/umbrellas in harsh daylight, respectively. Predictors of less practices of eye protection against solar UVR included residents who were male, with lower education level, with longer residence and lack of commercial health insurance. Multivariate logistic regression revealed that practices of eye protection under sun exposure were significantly associated with less cataract, but not glaucoma or dry eye. Participants who did not wear glasses, broad-brimmed hats/use umbrellas or both in harsh sunlight (almost) every time were respectively associated with a 57% (P = 0.028), 45% (P = 0.027) or 70% (P = 0.026) increase of cataract than those who did in harsh sunlight (almost) every time. CONCLUSIONS Practices of eye protection under sun exposure is associated with lower risk of cataract.
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Affiliation(s)
- Li-Ju Chen
- Department of Ophthalmology, Heping Fuyou Branch, Taipei City Hospital, Taipei, Taiwan
- University of Taipei, Taipei, Taiwan
- Institute of Health Policy and Management, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Yun-Jau Chang
- Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan
- Department of Surgery, Zhongxing branch, Taipei City Hospital, Taipei, Taiwan
| | | | - Jy-Haw Yu
- Department of Ophthalmology, Heping Fuyou Branch, Taipei City Hospital, Taipei, Taiwan
| | - Ming-Chin Yang
- Institute of Health Policy and Management, College of Public Health, National Taiwan University, Taipei, Taiwan
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Liew AYS, Cust AE. Changes in sun protection behaviours, sun exposure and shade availability among adults, children and adolescents in New South Wales, 2003-2016. Aust N Z J Public Health 2021; 45:462-468. [PMID: 34028925 DOI: 10.1111/1753-6405.13112] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2020] [Revised: 03/01/2021] [Accepted: 03/01/2021] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVE To inform skin cancer prevention policies and campaigns, we investigated changes over time in sun protection behaviours, sunburn, sun exposure and shade availability in public spaces among people living in New South Wales (NSW), Australia, between 2003 and 2016. METHODS We analysed cross-sectional data from the NSW Population Health Survey collected in 2003, 2007, 2014 and 2016, which included approximately 15,000 respondents of all ages in each year. Logistic regression models were used to analyse overall changes over time and for different age, sex and sociodemographic groups. RESULTS The use of sunscreen and protective clothing and the availability of shade increased between 2003 and 2016, but sunburn and sun exposure during peak times of ultraviolet radiation also increased. In subgroup analyses, there was no improvement in sun protection behaviours among adolescents and increases in sunburn and sun exposure were observed only among adults, particularly women and in areas with less social disadvantage. CONCLUSIONS Sun protection behaviours have improved over time among some population subgroups, but over-exposure to ultraviolet radiation remains prevalent. Implications for public health: Skin cancer prevention initiatives that specifically target adolescents and sun exposure during peak times are needed to help reduce population skin cancer risk.
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Affiliation(s)
- Andre Ying-Song Liew
- Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, New South Wales
| | - Anne E Cust
- Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW.,Melanoma Institute Australia, The University of Sydney, New South Wales
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Lacson JCA, Zamani SA, Froes LAR, Mitra N, Qian L, Doyle SH, Azizi E, Balestrini C, Bishop DT, Bruno W, Carlos-Ortega B, Cuellar F, Cust AE, Elder DE, Gerdes AM, Ghiorzo P, Grazziotin TC, Gruis NA, Hansson J, Hočevar M, Höiom V, Holland EA, Ingvar C, Landman G, Larre-Borges A, Mann GJ, Molgo M, Moredo LF, Olsson H, Out-Luiting JJ, Perić B, Pjanova D, Puig S, Salas-Alanis J, Schmid H, Wadt KAW, Newton-Bishop JA, Kanetsky PA. Birth cohort-specific trends of sun-related behaviors among individuals from an international consortium of melanoma-prone families. BMC Public Health 2021; 21:692. [PMID: 33888076 PMCID: PMC8063451 DOI: 10.1186/s12889-021-10424-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Accepted: 02/10/2021] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Individuals from melanoma-prone families have similar or reduced sun-protective behaviors compared to the general population. Studies on trends in sun-related behaviors have been temporally and geographically limited. METHODS Individuals from an international consortium of melanoma-prone families (GenoMEL) were retrospectively asked about sunscreen use, sun exposure (time spent outside), sunburns, and sunbed use at several timepoints over their lifetime. Generalized linear mixed models were used to examine the association between these outcomes and birth cohort defined by decade spans, after adjusting for covariates. RESULTS A total of 2407 participants from 547 families across 17 centers were analyzed. Sunscreen use increased across subsequent birth cohorts, and although the likelihood of sunburns increased until the 1950s birth cohort, it decreased thereafter. Average sun exposure did not change across the birth cohorts, and the likelihood of sunbed use increased in more recent birth cohorts. We generally did not find any differences in sun-related behavior when comparing melanoma cases to non-cases. Melanoma cases had increased sunscreen use, decreased sun exposure, and decreased odds of sunburn and sunbed use after melanoma diagnosis compared to before diagnosis. CONCLUSIONS Although sunscreen use has increased and the likelihood of sunburns has decreased in more recent birth cohorts, individuals in melanoma-prone families have not reduced their overall sun exposure and had an increased likelihood of sunbed use in more recent birth cohorts. These observations demonstrate partial improvements in melanoma prevention and suggest that additional intervention strategies may be needed to achieve optimal sun-protective behavior in melanoma-prone families.
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Affiliation(s)
- John Charles A Lacson
- Department of Cancer Epidemiology, Division of Population Science, H. Lee Moffitt Cancer Center & Research Institute, 12902 Magnolia Dr., MRC 213, Tampa, FL, 33612, USA
| | - Shawn A Zamani
- Department of Cancer Epidemiology, Division of Population Science, H. Lee Moffitt Cancer Center & Research Institute, 12902 Magnolia Dr., MRC 213, Tampa, FL, 33612, USA
- Medical Research Council - Cancer Unit, Division of Clinical Medicine, University of Cambridge, Cambridge, Cambridgeshire, UK
| | | | - Nandita Mitra
- Department of Biostatistics, Epidemiology, and Informatics, University of Pennsylvania, Philadelphia, PA, USA
| | - Lu Qian
- SWOG Statistics and Data Management Center, Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Scarlet H Doyle
- Department of Cancer Epidemiology, Division of Population Science, H. Lee Moffitt Cancer Center & Research Institute, 12902 Magnolia Dr., MRC 213, Tampa, FL, 33612, USA
| | - Esther Azizi
- Department of Dermatology, Sheba Medical Center, Tel Hashomer, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Claudia Balestrini
- Servicio de Dermatología, Hospital Dr. Sótero del Río, Santiago de Chile, Chile
| | - D Timothy Bishop
- Institute of Medical Research at St James's, University of Leeds, Leeds, UK
| | - William Bruno
- Department of Internal Medicine and Medical Specialties, University of Genoa, Genoa, Italy
| | - Blanca Carlos-Ortega
- Departamento de Ciencias Básicas, Escuela de Medicina Universidad de Monterrey, Monterrey, Mexico
| | - Francisco Cuellar
- Melanoma Unit, Dermatology Department, Hospital Clinic Barcelona, Institut de Investigacions biomediques August Pi Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain
- Consejo Nacional de Ciencia y Tecnología (CONACYT), Ciudad de México, Mexico
| | - Anne E Cust
- Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia
- Melanoma Institute Australia, The University of Sydney, Wollstonecraft, New South Wales, Australia
| | - David E Elder
- Department of Pathology and Laboratory Medicine, Hospital of the University of Pennsylvania, Philadelphia, PA, USA
| | - Anne-Marie Gerdes
- Department of Clinical Genetics, University Hospital of Copenhagen, Copenhagen, Denmark
| | - Paola Ghiorzo
- Department of Internal Medicine and Medical Specialties, University of Genoa, Genoa, Italy
- Genetics of Rare Cancers, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Thais C Grazziotin
- Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, RS, Brazil
| | - Nelleke A Gruis
- Department of Dermatology, Leiden University Medical Centre, Leiden, The Netherlands
| | - Johan Hansson
- Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden
| | - Marko Hočevar
- Institute of Oncology Ljubljana, Ljubljana, Slovenia
| | - Veronica Höiom
- Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden
| | - Elizabeth A Holland
- Westmead Institute for Medical Research, The University of Sydney, Westmead, New South Wales, Australia
| | - Christian Ingvar
- Departments of Clinical Sciences and Surgery, Lund University Hospital, Lund, Sweden
| | - Gilles Landman
- Department of Pathology, Escola Paulista de Medicina, UNIFESP, São Paulo, Brazil
- Department of Pathology, AC Camargo Cancer Center, São Paulo, Brazil
| | - Alejandra Larre-Borges
- Unidad de Lesiones Pigmentadas, Cátedra de Dermatología, Hospital de Clínicas, Universidad de la República, Montevideo, Uruguay
| | - Graham J Mann
- Melanoma Institute Australia, The University of Sydney, Wollstonecraft, New South Wales, Australia
- Westmead Institute for Medical Research, The University of Sydney, Westmead, New South Wales, Australia
- John Curtin School of Medical Research, Australian National University, Canberra, ACT, Australia
| | - Montserrat Molgo
- Pontificia Universidad Católica de Chile, Santiago de Chile, Chile
| | | | - Håkan Olsson
- Departments of Clinical Sciences and Surgery, Lund University Hospital, Lund, Sweden
| | - Jacoba J Out-Luiting
- Department of Dermatology, Leiden University Medical Centre, Leiden, The Netherlands
| | - Barbara Perić
- Institute of Oncology Ljubljana, Ljubljana, Slovenia
| | - Dace Pjanova
- Latvian Biomedical Research and Study Centre, Riga, Latvia
| | - Susana Puig
- Melanoma Unit, Dermatology Department, Hospital Clinic Barcelona, Institut de Investigacions biomediques August Pi Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain
- Centro de Investigacion Biomedica en Red de Enfermedades Raras (CIBERER), Instituto de Salud Carlos III, Barcelona, Spain
- Departament de Medicina, Universitat de Barcelona, Barcelona, Spain
| | - Julio Salas-Alanis
- Departamento de Ciencias Básicas, Escuela de Medicina Universidad de Monterrey, Monterrey, Mexico
- Dystrophic Epidermolysis Bullous Research Association Mexico, Monterrey, Mexico
| | - Helen Schmid
- Westmead Institute for Medical Research, The University of Sydney, Westmead, New South Wales, Australia
| | - Karin A W Wadt
- Department of Clinical Genetics, University Hospital of Copenhagen, Copenhagen, Denmark
| | | | - Peter A Kanetsky
- Department of Cancer Epidemiology, Division of Population Science, H. Lee Moffitt Cancer Center & Research Institute, 12902 Magnolia Dr., MRC 213, Tampa, FL, 33612, USA.
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Vornicescu C, Ungureanu L, Șenilă SC, Vesa ȘC, Cosgarea R, Baican CI, Mihu MC. Assessment of sun-related behavior and serum vitamin D in basal cell carcinoma: Preliminary results. Exp Ther Med 2020; 20:187. [PMID: 33101477 PMCID: PMC7579778 DOI: 10.3892/etm.2020.9317] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Accepted: 08/07/2020] [Indexed: 12/15/2022] Open
Abstract
Ultraviolet radiation (UV), mainly from sunlight, is the main risk factor of the most common human skin cancer, basal cell carcinoma (BCC). A positive effect of UV on the skin is its contribution to the synthesis of vitamin D, which is important in sustaining general health, but having high levels of vitamin D is considered a risk factor for BCC. However, vitamin D receptor has antagonistic effects to UV radiation in regulating Sonic Hedgehog pathway. This is a pilot study aimed at characterizing the sun-related behavior and vitamin D status of 52 BCC patients and 59 controls from our geographical area. Patients were included in 4 subgroups: Single, multiple, recurrent, and both multiple and recurrent BCCs. Patients, more than controls, had at least one sunburn in childhood and lentigines (P<0.001). Also, they spent daily, on average, more time in the sun than controls (P<0.001) (3.00-8.00 and 1.50-4.00 h respectively). Outdoor work was similar in both groups. Participants had lower vitamin D serum levels than expected. Due to the small number of cases, no statistically significant differences were found between the subgroups but some tendencies were noted. Patients with only one recurrent BCC had less sunburns than the ones who also developed tumors at multiple sites (P=0.2). Patients with multiple and recurrent tumors had slightly lower vitamin D levels compared with single BCC patients (P=0.1) although they used more vitamin D supplements after the BCC diagnosis (P=0.2). Having a diagnosis of BCC, made patients more compliant to the use of sunscreen cream, but even so, half of them still did not use it. In conclusion, more effort should be invested in sun-related education and public health actions should focus on vitamin D deficiencies.
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Affiliation(s)
- Corina Vornicescu
- Department of Morphological Sciences-Histology, 'Iuliu Hatieganu' University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
| | - Loredana Ungureanu
- Department of Dermatology, 'Iuliu Hatieganu' University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
| | - Simona Corina Șenilă
- Department of Dermatology, 'Iuliu Hatieganu' University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania.,Department of Dermatology, Emergency Clinical County Hospital, 400006 Cluj-Napoca, Romania
| | - Ștefan Cristian Vesa
- Department of Pharmacology, Toxicology and Clinical Pharmacology, 'Iuliu Hatieganu' University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
| | - Rodica Cosgarea
- Department of Dermatology, 'Iuliu Hatieganu' University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
| | - Corina Iulia Baican
- Department of Dermatology, 'Iuliu Hatieganu' University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania.,Department of Dermatology, Emergency Clinical County Hospital, 400006 Cluj-Napoca, Romania
| | - Mihaela Carmen Mihu
- Department of Morphological Sciences-Histology, 'Iuliu Hatieganu' University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania.,Department of Radiology, Emergency Clinical County Hospital, 400006 Cluj-Napoca, Romania
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Ziehfreund S, Krause J, Rotter M, Biedermann T, Zink A. [Primary and secondary prevention of skin cancer in rural areas : A cross-sectional study in the Bavarian Forest]. Hautarzt 2020; 71:365-373. [PMID: 32157344 DOI: 10.1007/s00105-020-04566-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Skin cancer is the most common malignancy of the fair-skinned population worldwide. To reduce skin cancer's burden primary and secondary prevention are critical. However, various studies indicate an inadequate prevention behavior among rural populations. OBJECTIVE To examine the risk and prevention behavior with respect to skin cancer and to identify subgroups in rural areas with specific need for prevention efforts. MATERIALS AND METHODS In a cross-sectional study carried out in the first quarter of 2017, patients and their accompanying persons (≥18 years) were interviewed on the subject of primary and secondary prevention in waiting rooms of nondermatological medical practices in the Bavarian Forest, Germany. Data were collected using paper-based questionnaires. Associations were calculated using logistic regression models. RESULTS In all, 880 persons (57.7% women, mean age = 49.5 years) were included in the analysis, of whom 53.6% had undergone a skin cancer screening at least once before. Sunscreen was the most frequently used sun protection measure. Male sex and being 18-34 years of age were significantly associated with not using prevention measures (depending on the measure: odds ratio [OR]: 1.4-2.4 and 1.8-3.7, respectively). In addition, not using skin cancer screening was associated with UV exposure more than 6 h daily in summer (OR: 1.8, 95%-CI [confidence interval]: 1.14-2.97). CONCLUSION Future prevention strategies should increasingly focus on young adults, on men and people with high solar UV exposition particularly, to reduce the burden of skin cancer in rural areas.
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Affiliation(s)
- Stefanie Ziehfreund
- Technische Universität München, Fakultät für Medizin, Klinik und Poliklinik für Dermatologie und Allergologie am Biederstein, Biedersteiner Str. 29, 80802, München, Deutschland.
| | - Julia Krause
- Technische Universität München, Fakultät für Medizin, Klinik und Poliklinik für Dermatologie und Allergologie am Biederstein, Biedersteiner Str. 29, 80802, München, Deutschland.,Institut für medizinische Informationsverarbeitung, Biometrie und Epidemiologie, Pettenkofer School of Public Health, Ludwig-Maximilian-Universität München, München, Deutschland
| | - Markus Rotter
- Research Unit of Molecular Epidemiology, Helmholtz Zentrum München, München, Deutschland
| | - Tilo Biedermann
- Technische Universität München, Fakultät für Medizin, Klinik und Poliklinik für Dermatologie und Allergologie am Biederstein, Biedersteiner Str. 29, 80802, München, Deutschland
| | - Alexander Zink
- Technische Universität München, Fakultät für Medizin, Klinik und Poliklinik für Dermatologie und Allergologie am Biederstein, Biedersteiner Str. 29, 80802, München, Deutschland.
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8
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Pettigrew S, Parnell A, Strickland M, Neale R, Lucas R. The Potential of Ultraviolet Radiation Meters in Secondary Schools as a Sun Protection Intervention Mechanism for Adolescents. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17041137. [PMID: 32053927 PMCID: PMC7068266 DOI: 10.3390/ijerph17041137] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Revised: 02/05/2020] [Accepted: 02/09/2020] [Indexed: 12/18/2022]
Abstract
The aim of this pilot study was to assess whether the installation of ultraviolet radiation (UVR) meters in secondary schools has the potential to improve adolescents’ sun protection-related knowledge, attitudes, and behaviours and reduce their exposure to UVR during school hours. Data were collected from students at two schools via online pre- and post-intervention surveys, measurement of sunscreen usage, polysulfone UVR exposure badges, and photographs of the schoolyards to assess hat and shade use. Several operational issues limited the quantity and quality of data that could be collected, and findings were mixed. While there were no significant changes in either self-reported or observed sun protection behaviours, there were significant improvements in UVR knowledge among students at the intervention school, and reactions to the meter were highly favourable. Students reported consulting the meter regularly and using it to make decisions about their sun protection behaviours. Overall, the study results offer some support for the use of UVR meters in areas frequented by adolescents and provide insights into the process issues that are likely to need to be addressed when attempting to trial sun protection interventions in schools.
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Affiliation(s)
- Simone Pettigrew
- Food Policy Division, The George Institute for Global Health, Newtown, NSW 2042, Australia
- Correspondence: ; Tel.: +61-428-888-202
| | - Ashleigh Parnell
- Kurongkurl Katitjin, Edith Cowan University, Joondalup, WA 6050, Australia;
| | - Mark Strickland
- Cancer Prevention & Research, Cancer Council Western Australia, Subiaco, WA 6008, Australia;
| | - Rachel Neale
- Population Health Department, QIMR Berghofer Medical Research Institute, Brisbane, QLD 4006, Australia;
| | - Robyn Lucas
- National Centre for Epidemiology and Population Health, Australian National University, Canberra 2601, Australia;
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9
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Igoe DP, Amar A, Schouten P, Parisi AV, Turner J. Assessment of Biologically Effective Solar Ultraviolet Exposures for Court Staff and Competitors During a Major Australian Tennis Tournament. Photochem Photobiol 2019; 95:1461-1467. [DOI: 10.1111/php.13132] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Revised: 06/09/2019] [Accepted: 06/10/2019] [Indexed: 01/05/2023]
Affiliation(s)
- Damien P. Igoe
- Faculty of Health, Environment and Sciences University of Southern Queensland Toowoomba Qld Australia
| | - Abdurazaq Amar
- Faculty of Health, Environment and Sciences University of Southern Queensland Toowoomba Qld Australia
| | - Peter Schouten
- Faculty of Health, Environment and Sciences University of Southern Queensland Toowoomba Qld Australia
| | - Alfio V. Parisi
- Faculty of Health, Environment and Sciences University of Southern Queensland Toowoomba Qld Australia
| | - Joanna Turner
- Faculty of Health, Environment and Sciences University of Southern Queensland Toowoomba Qld Australia
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10
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Neale RE, Khan SR, Lucas RM, Waterhouse M, Whiteman DC, Olsen CM. The effect of sunscreen on vitamin D: a review. Br J Dermatol 2019; 181:907-915. [PMID: 30945275 DOI: 10.1111/bjd.17980] [Citation(s) in RCA: 53] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/01/2019] [Indexed: 01/06/2023]
Abstract
BACKGROUND Sunscreen use can prevent skin cancer, but there are concerns that it may increase the risk of vitamin D deficiency. OBJECTIVES We aimed to review the literature to investigate associations between sunscreen use and vitamin D3 or 25 hydroxyvitamin D [25(OH)D] concentration. METHODS We systematically reviewed the literature following the Meta-analysis Of Observational Studies in Epidemiology (MOOSE) guidelines. We identified manuscripts published in English between 1970 and 21 November 2017. Eligible studies were experimental [using an artificial ultraviolet radiation (UVR) source], field trials or observational studies. The results of each of the experimental studies and field trials are described in detail. Two authors extracted information from observational studies, and applied quality scoring criteria that were developed specifically for this question. These have been synthesized qualitatively. RESULTS We included four experimental studies, three field trials (two were randomized controlled trials) and 69 observational studies. In the experimental studies sunscreen use considerably abrogated the vitamin D3 or 25(OH)D production induced by exposure to artificially generated UVR. The randomized controlled field trials found no effect of daily sunscreen application, but the sunscreens used had moderate protection [sun protection factor SPF) ~16]. The observational studies mostly found no association or that self-reported sunscreen use was associated with higher 25(OH)D concentration. CONCLUSIONS There is little evidence that sunscreen decreases 25(OH)D concentration when used in real-life settings, suggesting that concerns about vitamin D should not negate skin cancer prevention advice. However, there have been no trials of the high-SPF sunscreens that are now widely recommended. What's already known about this topic? Previous experimental studies suggest that sunscreen can block vitamin D production in the skin but use artificially generated ultraviolet radiation with a spectral output unlike that seen in terrestrial sunlight. Nonsystematic reviews of observational studies suggest that use in real life does not cause vitamin D deficiency. What does this study add? This study systematically reviewed all experimental studies, field trials and observational studies for the first time. While the experimental studies support the theoretical risk that sunscreen use may affect vitamin D, the weight of evidence from field trials and observational studies suggests that the risk is low. We highlight the lack of adequate evidence regarding use of the very high sun protection factor sunscreens that are now recommended and widely used.
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Affiliation(s)
- R E Neale
- Population Health Department, QIMR Berghofer Medical Research Institute, 300 Herston Rd, Herston, QLD, 4006, Australia
| | - S R Khan
- Population Health Department, QIMR Berghofer Medical Research Institute, 300 Herston Rd, Herston, QLD, 4006, Australia
| | - R M Lucas
- National Centre for Epidemiology and Population Health, Australian National University, Australia
| | - M Waterhouse
- Population Health Department, QIMR Berghofer Medical Research Institute, 300 Herston Rd, Herston, QLD, 4006, Australia
| | - D C Whiteman
- Population Health Department, QIMR Berghofer Medical Research Institute, 300 Herston Rd, Herston, QLD, 4006, Australia
| | - C M Olsen
- Population Health Department, QIMR Berghofer Medical Research Institute, 300 Herston Rd, Herston, QLD, 4006, Australia
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Sideris E, Thomas SJ. Patients' sun practices, perceptions of skin cancer and their risk of skin cancer in rural Australia. Health Promot J Austr 2019; 31:84-92. [PMID: 30980690 DOI: 10.1002/hpja.253] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2018] [Accepted: 04/09/2019] [Indexed: 11/11/2022] Open
Abstract
ISSUE ADDRESSED Skin cancer affects nearly one in three Australians. As a preventable disease there have been many public awareness campaigns targeting skin cancer knowledge and sun protection in Australia in the last 30 years to increase knowledge of the disease and how to prevent it. Despite higher incidence and mortality of skin cancer in regional Australia and adults over 65 years though, little research exists examining this high-risk population's skin cancer knowledge and sun behaviours, with most previous research conducted in urban Australia or overseas. This study aimed to examine adults' skin cancer knowledge, sun behaviours and demographic factors in a regional Australian town. METHODS Cross-sectional study design was utilised. Adult patients of a Mudgee General Practice (n = 179, 18-89 years) completed a survey based on their skin cancer knowledge and sun behaviours. Chi-squared tests were used to analyse responses. RESULTS Poor non-melanoma skin cancer awareness, risky sun behaviours and inadequate sun protection behaviours were found. Males and those at greatest current risk of skin cancer in Australia, those over 60 years, had the poorest skin cancer knowledge and were least likely to recognise skin cancer or use some sun protection measures. CONCLUSIONS Greater non-melanoma skin cancer and sun protection education and research is needed, particularly targeting older and male Australians. SO WHAT?: The findings suggest rural men and older Australians would benefit from more targeted campaigns and education to increase their skin cancer awareness and use of sun protection in order to minimise future skin cancer.
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Affiliation(s)
- Emily Sideris
- RACGP, North Sydney, NSW, Australia.,Graduate Medicine, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, NSW, Australia
| | - Susan J Thomas
- Graduate Medicine, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, NSW, Australia
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12
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Baykal Selcuk L, Aksu Arica D, Ates E, Yayli S, Bahadir S. Sun-protective behaviours of Turkish young adults. PHOTODERMATOLOGY, PHOTOIMMUNOLOGY & PHOTOMEDICINE 2019; 35:178-186. [PMID: 30648287 DOI: 10.1111/phpp.12450] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/27/2018] [Revised: 12/11/2018] [Accepted: 12/23/2018] [Indexed: 01/12/2023]
Abstract
BACKGROUND The prevalence of skin cancers, including melanoma, has increased significantly in the past five decades. The main environmental factor implicated in their development is excessive sun exposure. Data on sun-protective behaviours in the Turkish population are very limited. OBJECTIVES We aim to assess sun protection behaviours and the prevalence of exposure through broad participation among a young adult population in a national university in Turkey. METHODS A multiple-choice questionnaire including 27 questions to evaluate sun protection behaviours was sent to e-mail addresses of all undergraduates. From 40 000 undergraduates, 17 769 of them were included in the study, with a response rate of 44.4%. RESULTS Sunscreen usage was the most preferred sun protection method, used by 64% of the study population, followed by the use of sunglasses (60%), tending to remain in the shade (49%), the use of a hat (34%) and wearing long-sleeved clothing (23%). Forty-four percentage of the students used at least two methods, whereas 7% did not use any sun protection method. The prevalence rates of the use of sunscreen, sunglasses, wearing long-sleeved clothing and preferring to remain in the shade in the summer were all significantly higher among women. In addition, the prevalence rates of the use of sunscreen and preferring to remain in the shade were higher among students in the faculty of medicine. CONCLUSION We found that when compared to the countries with the highest incidences of skin cancer, such as Australia and the United States, young adults in Turkey are protecting themselves more from the sun. This rate was even higher among women and faculty of medicine undergrads.
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Affiliation(s)
- Leyla Baykal Selcuk
- Department of Dermatology, School of Medicine, Karadeniz Techinical University, Trabzon, Turkey
| | - Deniz Aksu Arica
- Department of Dermatology, School of Medicine, Karadeniz Techinical University, Trabzon, Turkey
| | - Elif Ates
- Department of Family Medicine, School of Medicine, Karadeniz Techinical University, Trabzon, Turkey
| | - Savaş Yayli
- Department of Dermatology, School of Medicine, Karadeniz Techinical University, Trabzon, Turkey
| | - Sevgi Bahadir
- Department of Dermatology, School of Medicine, Karadeniz Techinical University, Trabzon, Turkey
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13
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Verhagen R, O'Malley E, Smedes F, Mueller JF, Kaserzon S. Calibration parameters for the passive sampling of organic UV filters by silicone; diffusion coefficients and silicone-water partition coefficients. CHEMOSPHERE 2019; 223:731-737. [PMID: 30807940 DOI: 10.1016/j.chemosphere.2019.02.077] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/15/2018] [Revised: 02/08/2019] [Accepted: 02/12/2019] [Indexed: 06/09/2023]
Abstract
In recent years, organic ultraviolet filters (UVFs) received considerable attention as a group of emerging contaminants, including in Australia where the use of UVFs is particularly relevant. Passive sampling using polymers has become widely used for routine monitoring of chemicals in the aquatic environment. Application of passive samplers for monitoring chemicals in the water relies on calibration data such as chemical's polymer-water partition coefficient (Kpw) and diffusion coefficients in the sampling material (Dp), for understanding uptake and kinetic limitations. In the present study, Kpw and Dp for nine UVFs were estimated. Kpw values were determined in different water - polymer partition experiments where (1) a given mass of chemicals was dosed into the water and (2) into the polymer. Diffusion coefficients were determined using the stacking method. The estimated log Kpw and log Dp ranged from 2.9 to 6.4 L kg-1 and -11.1 to -10.5 m2s-1, respectively. The sufficient high Dp allows application of kinetic models that only consider water boundary-controlled uptake for converting silicone sampler uptake into an aqueous phase concentration using the presented Kpw.
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Affiliation(s)
- Rory Verhagen
- Queensland Alliance for Environmental Health Science (QAEHS), The University of Queensland, 20 Cornwall street, Woolloongabba, Queensland 4102, Australia.
| | - Elissa O'Malley
- Queensland Alliance for Environmental Health Science (QAEHS), The University of Queensland, 20 Cornwall street, Woolloongabba, Queensland 4102, Australia
| | - Foppe Smedes
- Masaryk University, Faculty of Science, Research Centre for Toxic Compounds in the Environment (RECETOX), Kamenice 753/5, 625 00, Brno, Czech Republic
| | - Jochen F Mueller
- Queensland Alliance for Environmental Health Science (QAEHS), The University of Queensland, 20 Cornwall street, Woolloongabba, Queensland 4102, Australia
| | - Sarit Kaserzon
- Queensland Alliance for Environmental Health Science (QAEHS), The University of Queensland, 20 Cornwall street, Woolloongabba, Queensland 4102, Australia
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Vuong K, Armstrong BK, McGeechan K, Cust AE. Personalized melanoma risk assessments and tailored prevention advice: a pragmatic randomized controlled trial in Australian general practice. Fam Pract 2019; 36:237-246. [PMID: 29800131 DOI: 10.1093/fampra/cmy040] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Personalized risk assessments using prediction models that incorporate several melanoma risk factors may promote melanoma-prevention behaviours. OBJECTIVES To evaluate the effect on short-term melanoma-prevention behaviours of web-based, real-time, model-generated personalized melanoma risk information and tailored prevention advice, and its feasibility and clinician acceptability. METHODS Between February and April 2016, in an open randomized controlled trial across four general medical practices in New South Wales, Australia, 272 patients were randomly allocated to receive (i) real-time model-generated personalized melanoma risk assessment and tailored melanoma-prevention advice or (ii) generic melanoma-prevention advice. We measured self-reported melanoma-prevention behaviours at baseline and 6 weeks and the intervention's feasibility and acceptability. RESULTS Follow-up questionnaires were completed by 185 patients at 6 weeks: 174 assessed as average risk and 11 as high or very high risk. There were no statistically significant differences between intervention and control patients in sun protection, sun exposure or early diagnosis behaviours. When stratified by melanoma risk, average risk patients in the intervention group appeared to show greater sun protection at 6 weeks (mean difference = 0.23, on a scale of 1-5; 95% confidence interval: 0.01 to 0.45; P = 0.04) than patients in the control group; the P value for interaction between intervention and risk category was 0.10. There was favourable feedback from patients and general practitioners. CONCLUSIONS Web-based delivery in general practice of real-time, model-generated personalized melanoma risk prediction and tailored melanoma-prevention advice is feasible and acceptable. An apparent increase in sun protection behaviour in average risk patients warrants further evaluation in different risk groups.
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Affiliation(s)
- Kylie Vuong
- Cancer Epidemiology and Prevention Research, Sydney School of Public Health, The University of Sydney, Sydney, Australia.,School of Public Health and Community Medicine, The University of New South Wales, Sydney, Australia
| | - Bruce K Armstrong
- Cancer Epidemiology and Prevention Research, Sydney School of Public Health, The University of Sydney, Sydney, Australia
| | | | - Anne E Cust
- Cancer Epidemiology and Prevention Research, Sydney School of Public Health, The University of Sydney, Sydney, Australia.,Melanoma Institute Australia, The University of Sydney, Sydney, Australia
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15
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Støle HS, Nilsen LTN, Joranger P. Beliefs, attitudes and perceptions to sun-tanning behaviour in the Norwegian population: a cross-sectional study using the health belief model. BMC Public Health 2019; 19:206. [PMID: 30777037 PMCID: PMC6380037 DOI: 10.1186/s12889-019-6503-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2018] [Accepted: 02/01/2019] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND Norway has one of the highest incidences of melanoma in the world. It has been suggested that the majority of all skin cancers could be prevented by changes related to sun-tanning behaviour. This study explores the sun-tanning behaviour of the Norwegian population using a modified Health Belief Model (HBM). Increased knowledge about beliefs, attitudes and sun-tanning behaviour can provide information which may be useful for future sun protection interventions. METHODS In 2017, 1004 members of the Norwegian population completed cross-sectional online surveys. People who seek the sun for tanning purposes was the eligibility criterion for this study, reducing the study population to 569. With the aid of the constructs from the HBM, predictive factors explaining sun-tanning behaviour were determined using multivariate linear regression adjusted for demographics (gender, age, education and income). Furthermore, the predictor variables, empowerment and benefits of tanning, were added to the model. RESULTS Five of the constructs in the modified HBM showed significant correlation with sun-tanning behaviour using bivariate analysis. The strongest correlation was perceived barriers of sun protection (0.42), with the next strongest being the benefits of tanning (0.30). The modified model explained 31% of the variation in sun-tanning behaviour using multivariate analysis. Significant predictors from the HBM to sun-tanning behaviour were perceived barriers to sun protection (Beta = 0.36, p < 0.001) and the severity of melanoma (Beta = - 0.20, p < 0.001). In addition, empowerment (Beta = 0.05, p = 0.05) and the benefits of tanning (Beta = 0.28, p < 0.001) proved to be variables with significant effect on sun-tanning behaviour. The demographic factors age, education and income were also associated with sun-tanning behaviour (p < 0.05). CONCLUSION Based on the results of this study, several factors in the modified HBM had a significant impact on Norwegians' sun-tanning behaviour. The results indicate that future sun protection interventions should focus on reducing barriers in relation to sun protection behaviour, as well as emphasizing the severity of adverse tanning behaviour and melanoma. Efforts to alter the perceptions of the beneficial factors of tanning behaviour can also be appropriate in health promotion campaigns and interventions. Finally, implementing empowerment strategies could have a positive effect on promoting healthy sun-tanning behaviour.
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Affiliation(s)
- Hanne Stavenes Støle
- Department of Nursing and Health Promotion, OsloMet – Oslo Metropolitan University, Postboks 4, St. Olavs plass, 0130 Oslo, Norway
| | - Lill Tove Norvang Nilsen
- Department of Radiation Applications, Norwegian Radiation Protection Authority, Grini næringspark 13, 1361 Østerås, Norway
| | - Pål Joranger
- Department of Nursing and Health Promotion, OsloMet – Oslo Metropolitan University, Postboks 4, St. Olavs plass, 0130 Oslo, Norway
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Prevalence and predictors of vitamin D deficiency in a nationally representative sample of adults participating in the 2011-2013 Australian Health Survey. Br J Nutr 2019; 121:894-904. [PMID: 30674358 DOI: 10.1017/s0007114519000151] [Citation(s) in RCA: 50] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Vitamin D deficiency is recognised as a public health problem globally, and a high prevalence of deficiency has previously been reported in Australia. This study details the prevalence of vitamin D deficiency in a nationally representative sample of Australian adults aged ≥25 years, using an internationally standardised method to measure serum 25-hydroxyvitamin D (25(OH)D) concentrations and identifies demographic and lifestyle factors associated with vitamin D deficiency. We used data from the 2011-2013 Australian Health Survey (n 5034 with complete information on potential predictors and serum 25(OH)D concentrations). Serum 25(OH)D concentrations were measured by a liquid chromatography-tandem MS that is certified to the reference measurement procedures developed by the National Institute of Standards and Technology, Ghent University and the US Centers for Disease Control and Prevention. Vitamin D deficiency and insufficiency were defined as serum 25(OH)D concentrations <50 nmol/l and 50 to <75 nmol/l, respectively. Overall, 20 % of participants (19 % men; 21 % women) were classified as vitamin D deficient, with a further 43 % classified as insufficient (45 % men; 42 % women). Independent predictors of vitamin D deficiency included being born in a country other than Australia or the main English-speaking countries, residing in southern (higher latitude) states of Australia, being assessed during winter or spring, being obese, smoking (women only), having low physical activity levels and not taking vitamin D or Ca supplements. Given our increasingly indoor lifestyles, there is a need to develop and promote strategies to maintain adequate vitamin D status through safe sun exposure and dietary approaches.
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Rajatanavin N, Kanokrungsee S, Aekplakorn W. Vitamin D status in Thai dermatologists and working-age Thai population. J Dermatol 2018; 46:206-212. [PMID: 30592077 DOI: 10.1111/1346-8138.14742] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2018] [Accepted: 11/13/2018] [Indexed: 02/02/2023]
Abstract
This study aimed to determine the prevalence of vitamin D insufficiency among Thai dermatologists compared with the general working-age population in Bangkok. A cross-sectional study was conducted in healthy Thai physicians who had at least 1 years' experience in dermatology practise and a subsample of the general Thai population from the Fourth National Health Survey. Serum 25-hydroxyvitamin D (25[OH]D), a combination of 25(OH)D2 and 25(OH)D3, levels in both groups were measured using liquid chromatography coupled with mass spectrometry. The majority of dermatologists were of Fitzpatrick skin type III (n = 61, 61.3%) or IV (n = 32, 33.3%). The mean serum 25(OH)D and 25(OH)D3 levels were 18.9 and 18.2 ng/mL, respectively, whereas the corresponding levels in the general population were 26.5 and 25.8 ng/mL. None of the dermatologist had serum 25(OH)D sufficiency (>30 ng/mL), 38 (38.78%) had vitamin D insufficiency (20-30 ng/mL) and 60 (61.22%) had vitamin D deficiency (<20 ng/mL). The frequency of vitamin D deficiency in dermatologists was significantly higher than in the general population (61.2% vs 19.2%, P < 0.001). Ninety percent of dermatologists used sunscreen daily and spent time mostly indoors. Dermatologists used physical sun-protection more than half of the time when outdoors, for example, a book or paper as a sunshade (70.3%), an umbrella (48.4%), a long-sleeved shirt (20.4%) or a hat (9.7%). In conclusion, dermatologists showed a remarkably high prevalence of vitamin D deficiency which may be due to inadequate exposure to sunlight, regular use of sunscreen and practicing various sun-protection activities.
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Affiliation(s)
- Natta Rajatanavin
- Division of Dermatology, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Silada Kanokrungsee
- Division of Dermatology, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Wichai Aekplakorn
- Department of Community Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
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Jongenelis M, Pettigrew S, Strickland M, Minto C, Slevin T. The relationship between skin checking and sun protection behaviours: implications for skin cancer prevention campaigns. Public Health 2018; 155:55-58. [DOI: 10.1016/j.puhe.2017.11.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2017] [Revised: 10/12/2017] [Accepted: 11/20/2017] [Indexed: 11/30/2022]
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Predictors of sun protection behaviours and sunburn among Australian adolescents. BMC Public Health 2016; 16:565. [PMID: 27411518 PMCID: PMC4944266 DOI: 10.1186/s12889-016-3197-4] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2015] [Accepted: 06/07/2016] [Indexed: 01/14/2023] Open
Abstract
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.
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