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Lagacé F, Conte S, Mija LA, Moustaqim-Barrette A, Mahmood F, LeBeau J, McKenna A, Maazi M, Hanna J, Kelly ASV, Rahme E, Hrubeniuk TJ, Peláez S, Litvinov IV. A Comprehensive Analysis of Skin Cancer Concerns and Protective Practices in Manitoba, Canada, Highlights Lack of Skin Cancer Awareness and Predominance of High-Risk Sun Exposure Behaviors. Cancers (Basel) 2024; 16:3093. [PMID: 39272952 PMCID: PMC11394652 DOI: 10.3390/cancers16173093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2024] [Revised: 08/30/2024] [Accepted: 09/03/2024] [Indexed: 09/15/2024] Open
Abstract
The rapidly increasing skin cancer rates in Canada are alarming, with current data estimating that 1/3 of Canadians will be affected in their lifetime. Thus, deeper understanding of high-risk sun exposure behaviors is needed to help counter this trend. Only limited action has been taken by federal/provincial governments to reduce skin cancer incidence. A cross-sectional survey study was conducted in Manitoba, with frequency counts, means, and percentages used to encapsulate responses. Age- and gender-adjusted odds ratios were calculated using logistic regression analyses. Our study identified worrying inadequacies in sun protective behaviors and attitudes, with the threat of such high-risk behaviors amplified by a lack of skin cancer awareness. Alarming elements were noted in participants' sun exposure history (>65% reported a history of sunburns, >50% previously used a tanning bed, and >75% recently tanned for pleasure), beliefs and attitudes (>50% believe that they look better/healthier with a tan, and >40% believe that having a base tan is protective against further sun damage), and sun protection efforts (sun protective clothing was used <60% of the time, sunscreen was used by <50%, and there was a lack of knowledge about sunscreen characteristics in ~30% of respondents), in addition to significant differences being established between demographic subgroups (based on gender, age, skin phototype, income, and education attained). This study provides worrisome insight onto the grim landscape of sun protective behaviors and attitudes in Manitoba, which will inevitably translate into higher skin cancer rates and should serve as a call to action to promote targeted public health messaging in this jurisdiction and beyond.
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Affiliation(s)
- François Lagacé
- Division of Dermatology, McGill University, Montreal, QC H4A 3J1, Canada
| | - Santina Conte
- Division of Dermatology, McGill University, Montreal, QC H4A 3J1, Canada
| | - Lorena A Mija
- Faculté de médecine, Université de Montréal, Montréal, QC H3T 1J4, Canada
| | | | - Farhan Mahmood
- Division of Dermatology, McGill University, Montreal, QC H4A 3J1, Canada
| | - Jonathan LeBeau
- Faculty of Medicine, McGill University, Montreal, QC H4A3J1, Canada
| | - Alyson McKenna
- Faculté de médecine, Université de Montréal, Montréal, QC H3T 1J4, Canada
| | - Mahan Maazi
- Faculty of Medicine, University of British Columbia, Vancouver, BC V6T 1Z4, Canada
| | - Johnny Hanna
- Faculté de médecine, Université Laval, Québec, QC G1V 0A6, Canada
| | | | - Elham Rahme
- Division of Clinical Epidemiology, McGill University, Montreal, QC H4A 3J1, Canada
| | - Travis J Hrubeniuk
- Population Oncology, Cancer Care Manitoba, Winnipeg, MB R3C 2B1, Canada
- Community Health Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB R3C 2B1, Canada
| | - Sandra Peláez
- School of Kinesiology and Physical Activity Sciences, Faculty of Medicine, University of Montreal, Montreal, QC H3T 1J4, Canada
- Research Centre, Sainte-Justine University Hospital, Montreal, QC H3T 1C5, Canada
| | - Ivan V Litvinov
- Division of Dermatology, McGill University, Montreal, QC H4A 3J1, Canada
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Lagacé F, Noorah BN, Conte S, Mija LA, Chang J, Cattelan L, LeBeau J, Claveau J, Turchin I, Gulliver W, Gniadecki R, Netchiporouk E, Miller Jr. WH, Salopek TG, Rahme E, Peláez S, Litvinov IV. Assessing Skin Cancer Risk Factors, Sun Safety Behaviors and Melanoma Concern in Atlantic Canada: A Comprehensive Survey Study. Cancers (Basel) 2023; 15:3753. [PMID: 37568569 PMCID: PMC10417242 DOI: 10.3390/cancers15153753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 07/10/2023] [Accepted: 07/20/2023] [Indexed: 08/13/2023] Open
Abstract
BACKGROUND The incidence of cutaneous melanoma (CM) is increasing at an alarming rate in Canada and elsewhere around the world. Significant regional differences in CM incidence have been identified in Atlantic provinces. The goal of this study is to compare ultraviolet exposure, sun protective behaviours, level of worry and baseline CM knowledge in provinces with a high versus low incidence of CM as well, as between various demographic groups. METHODS A cross-sectional survey study was conducted in Atlantic provinces between July 2020 and August 2022. All participants aged ≥ 16 years with a completed survey were eligible. Survey responses were summarized using frequency counts, percentages, and means. Two-sided Z-tests for equality of proportions and logistic regression models were used to compare the survey results between geographic and demographic groups. RESULTS In total, 7861 participants were included (28.0% men; mean age 61.3 years; response rate 28%). Our results (gender- and age-adjusted odds ratio, 95% confidence interval) show that high-incidence provinces for CM (Prince Edward Island and Nova Scotia) had significantly more sunburns (OR 2.00, 1.72-2.31), total sun exposure (OR 2.05, 1.68-2.50), recreational sun exposure (OR 1.95, 1.61-2.35) and tans (OR 1.77, 1.53-2.05) than individuals in low-incidence provinces (Newfoundland and Labrador). However, individuals in high-incidence provinces displayed more protective behaviors: there were less tanning bed users (OR 0.82, 0.71-0.95), they checked their skin more frequently for new moles (OR 1.26, 1.06-1.51) and practiced more sun protection overall. Additional analyses are presented based on education, income, sexual orientation and gender. DISCUSSION These findings suggest that future efforts aimed at reducing the CM burden in Atlantic Canada should be tailored for target geographic and/or demographic groups. LIMITATIONS the study participants are not representative of the population in Atlantic Canada due to recruitment strategies.
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Affiliation(s)
- François Lagacé
- Division of Dermatology, Faculty of Medicine, McGill University, Montréal, QC H4A 3J1, Canada; (F.L.)
| | - Bibi Nuzha Noorah
- Faculté de Médecine, Université de Montréal, Montréal, QC H3T 1J4, Canada
| | - Santina Conte
- Department of Medicine, Faculty of Medicine and Health Sciences, McGill University, Montréal, QC H4A 3J1, Canada
| | | | - Jasmine Chang
- Department of Family Medicine, McGill University, Montréal, QC H4A 3J1, Canada
| | - Leila Cattelan
- Division of Dermatology, Faculty of Medicine, McGill University, Montréal, QC H4A 3J1, Canada; (F.L.)
| | - Jonathan LeBeau
- Department of Medicine, Faculty of Medicine and Health Sciences, McGill University, Montréal, QC H4A 3J1, Canada
| | - Joël Claveau
- Centre Hospitalier Universitaire de Québec, Hôtel-Dieu de Québec, Melanoma and Skin Cancer Clinic, Québec City, QC G1R 4H6, Canada
| | - Irina Turchin
- Division of Dermatology, Dalhousie University, Halifax, NS B3H 2Y9, Canada
| | - Wayne Gulliver
- Division of Dermatology, Department of Medicine, Memorial University of Newfoundland, St. John’s, NL A1C 5S7, Canada
| | - Robert Gniadecki
- Division of Dermatology, University of Alberta, Edmonton, AB T6G 2B7, Canada
| | - Elena Netchiporouk
- Division of Dermatology, Faculty of Medicine, McGill University, Montréal, QC H4A 3J1, Canada; (F.L.)
| | - Wilson H. Miller Jr.
- Department of Medicine and Oncology, McGill University, Montréal, QC H3T 1J4, Canada
| | - Thomas G. Salopek
- Division of Dermatology, University of Alberta, Edmonton, AB T6G 2B7, Canada
| | - Elham Rahme
- Division of Clinical Epidemiology, McGill University, Montréal, QC H3T 1J4, Canada
| | - Sandra Peláez
- École de Kinésiologie et des Sciences de L’activité Physique, Université de Montréal, Montréal, QC H3C 3J7, Canada;
| | - Ivan V. Litvinov
- Division of Dermatology, Faculty of Medicine, McGill University, Montréal, QC H4A 3J1, Canada; (F.L.)
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Wittlich M, Westerhausen S, Strehl B, Versteeg H, Stöppelmann W. The GENESIS-UV study on ultraviolet radiation exposure levels in 250 occupations to foster epidemiological and legislative efforts to combat nonmelanoma skin cancer. Br J Dermatol 2023; 188:350-360. [PMID: 36635210 DOI: 10.1093/bjd/ljac093] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 10/26/2022] [Accepted: 11/08/2022] [Indexed: 01/14/2023]
Abstract
BACKGROUND Several hundred million of the 3 billion formally employed people worldwide are at risk from high levels of solar ultraviolet radiation (UVR). Chronic light damage to the skin can lead to nonmelanoma skin cancer (NMSC), especially when irradiation is too high and is acquired for decades. However, data with uniform metrics, high resolution over time and in-depth occupational profiles are not available. OBJECTIVES To build a worldwide usable matrix of UVR exposure in occupations and to show use cases for the data. METHODS One thousand test persons were recruited to wear electronic data logger dosimeters during their working time for 7 months each. The measurements yielded 3.7 billion data points for around 48 000 days with high-quality data capture covering more than 250 occupations and 650 activities. Scientific evaluation of the data included daily and half-hourly means, geographical transfer calculations to the world, threshold exceedance quotas, transcriptome effects, and occupational disease estimates. RESULTS A compendium for global use is presented. In-depth analyses and the resulting implications for research have been elaborated to directly link exposure data to effects in the human body. Interestingly, the annual irradiances of the different occupations span a wide range of values: from about 650 to 50 standard erythemal doses, with different distributions over the months. Detailed exposure data per occupation were derived, and the risk on an occupational or activity basis assuming different exposure level quotas was quantified. This showed that, for example, in temperate latitudes, all activities with a duration of > 2 h outdoors are associated with increased NMSC risk. CONCLUSIONS We offer our work to enable sound studies on the nature of ultraviolet-induced skin cancer, dose-response relationships, intermittency of skin exposure, and derivation of limit values. Sociological studies on prevention are now possible. Practitioners may use the findings for their daily work with employees.
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Affiliation(s)
- Marc Wittlich
- Department 'Accident Prevention: Digitalisation - Technologies'
| | | | - Benjamin Strehl
- Department 'Accident Prevention: Digitalisation - Technologies'
| | - Helmut Versteeg
- Department 'Exposure and Risk Assessment', Institute for Occupational Safety and Health of the German Social Accident Insurance, Alte Heerstraße 111, 53757 Sankt Augustin, Germany
| | - Wiho Stöppelmann
- Department 'Exposure and Risk Assessment', Institute for Occupational Safety and Health of the German Social Accident Insurance, Alte Heerstraße 111, 53757 Sankt Augustin, Germany
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Change in Sun-Protective Behavior After Dermatologic Surgery for Skin Cancer in High-Risk Patients. Dermatol Surg 2021; 47:139-140. [DOI: 10.1097/dss.0000000000002201] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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5
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Blázquez-Sánchez N, Rivas-Ruiz F, Bueno-Fernández S, Arias-Santiago S, Fernández-Morano M, de Troya-Martín M. Validación de un cuestionario para el estudio sobre hábitos, actitudes y conocimientos en fotoprotección en la población adultojuvenil: «cuestionario CHACES». ACTAS DERMO-SIFILIOGRAFICAS 2020; 111:579-589. [DOI: 10.1016/j.ad.2020.02.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Revised: 01/20/2020] [Accepted: 02/10/2020] [Indexed: 11/27/2022] Open
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Blázquez-Sánchez N, Rivas-Ruiz F, Bueno-Fernández S, Arias-Santiago S, Fernández-Morano M, deTroya-Martín M. Validation of a Questionnaire Designed to Study Knowledge, Attitudes, and Habits Related to Sun Exposure Among Young Adults: The CHACES Questionnaire. ACTAS DERMO-SIFILIOGRAFICAS 2020. [DOI: 10.1016/j.adengl.2020.08.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Araújo FM, Carmo JAD, Cunha LD, Martins IML, Gon ADS, Caldeira AP. Development and validation of an instrument to assess the knowledge of general practitioners and pediatricians about photoprotection and solar radiation. An Bras Dermatol 2019; 94:532-541. [PMID: 31777353 PMCID: PMC6857560 DOI: 10.1016/j.abd.2019.09.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2017] [Accepted: 10/08/2018] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND The knowledge of general practitioners about photoprotection is unknown. OBJECTIVES To develop and validate an instrument to evaluate the knowledge of general practitioners and pediatricians about photoprotection, gauging the knowledge of these professionals. METHODS The study followed the steps: (1) Literature identification and item elaboration related to the theme; (2) Content validation; (3) Apparent validation; (4) Construct validation: internal consistency analysis and discriminatory analysis; (5) Reliability analysis. In Step 4, the instrument was applied to 217 general practitioners and pediatricians who worked in the host city of the study; the scores were compared with dermatologists scores. RESULTS The final instrument had 41 items and showed satisfactory internal consistency (Cronbach's alpha=0.780), satisfactory reproducibility and good test-retest reliability (good-to-excellent kappa statistic in more than 60% of items). The discriminatory analysis registered a mean score of 54.1 points for dermatologists and 31.1 points for generalists and pediatricians, from a total of 82 possible points, representing a statistically significant difference (p<0.001). Generalists and pediatricians demonstrated an understanding of the relationship between excessive sun exposure and skin cancer, but they revealed lack of technical information necessary for their professional practice. STUDY LIMITATIONS The instrument evaluates only knowledge, without evaluating the conduct of the participants. CONCLUSION The results show that the instrument has good internal consistency and good reproducibility. It could be useful in the identification of general practitioners and pediatricians knowledge gaps on the subject, for the subsequent development of training and educational strategies.
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Affiliation(s)
- Fernanda Mendes Araújo
- Department of Clinical Medicine, Dermatology, Universidade Estadual de Montes Claros, Montes Claros, MG, Brazil; Postgraduate Program in Health Sciences, Universidade Estadual de Montes Claros, Montes Claros, MG, Brazil.
| | | | - Letícia Diniz Cunha
- School of Medicine, Faculdades Integradas Pitágoras de Montes Claros, Montes Claros, MG, Brazil
| | - Igor Monteiro Lima Martins
- Postgraduate Program in Health Sciences, Universidade Estadual de Montes Claros, Montes Claros, MG, Brazil
| | - Airton Dos Santos Gon
- Department of Clinical Medicine, Dermatology, Universidade Estadual de Londrina, Londrina, PR, Brazil
| | - Antônio Prates Caldeira
- Postgraduate Program in Health Sciences, Universidade Estadual de Montes Claros, Montes Claros, MG, Brazil; Department of Pediatrics, Universidade Estadual de Montes Claros, Montes Claros, MG, Brazil
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8
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Dallazem LND, Benvegnú AM, Stramari JM, Beber AAC, Chemello RML, Beck MDO. Knowledge and habits of sun exposure in university students: a cross-sectional study in Southern Brazil. An Bras Dermatol 2019; 94:172-181. [PMID: 31090822 PMCID: PMC6486079 DOI: 10.1590/abd1806-4841.20197507] [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: 08/09/2017] [Accepted: 02/02/2018] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Excessive sun exposure is the major risk factor for skin cancer. Thus, sun exposure behavior is the major focus for prevention of this disease, since it is potentially modifiable. Increasing the knowledge on sun related habits and other skin cancer risk factors is fundamental in the development of preventive programs, especially when directed to young people. OBJECTIVES To assess the photoprotection habits and the knowledge about skin cancer in college students. METHODS We conducted a cross-sectional study from Oct. 16 to Feb. 17, including 371 students from the Federal University of Santa Maria, RS, Brazil, through a self-administered questionnaire. RESULTS The level of knowledge about skin cancer and photoprotection was unsatisfactory in more than 10% of the students. The occurrence of sunburn was extremely high among students, and 25% reported at least one episode of second degree sunburn. Proper use of sunscreen was referred by only 34% of individuals. Students who reported having received photo education in college were associated with a more consistent use of sunscreen. STUDY LIMITATIONS health area represented a large part of the sample; instrument validated outside Brazil. CONCLUSIONS Young people are unaware of basic information about sun protection and exposure. Even among those with proper knowledge, the use of photoprotective measures is very low. The sun exposure has shown to be excessive in most of the students, which makes this population an important target for photo-educational measures.
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Affiliation(s)
- Lia Natália Diehl Dallazem
- Program of Post-Graduation in Health Sciences,
Universidade Federal de Santa Maria, Santa Maria (RS), Brazil
| | - Ana Maria Benvegnú
- Discipline of Dermatology, Universidade Federal de Santa
Maria, Santa Maria (RS), Brazil
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Stratigos AJ, Fargnoli MC, De Nicolo A, Peris K, Puig S, Soura E, Menin C, Calista D, Ghiorzo P, Mandala M, Massi D, Rodolfo M, Del Regno L, Stefanaki I, Gogas H, Bataille V, Tucker MA, Whiteman D, Nagore E, Landi MT. MelaNostrum: a consensus questionnaire of standardized epidemiologic and clinical variables for melanoma risk assessment by the melanostrum consortium. J Eur Acad Dermatol Venereol 2018; 32:2134-2141. [PMID: 30098061 DOI: 10.1111/jdv.15208] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2018] [Accepted: 07/12/2018] [Indexed: 12/20/2022]
Abstract
BACKGROUND Many melanoma observational studies have been carried out across different countries and geographic areas using heterogeneous assessments of epidemiologic risk factors and clinical variables. AIM To develop a consensus questionnaire to standardize epidemiologic and clinical data collection for melanoma risk assessment. METHODS We used a stepwise strategy that included: compilation of variables from case-control datasets collected at various centres of the MelaNostrum Consortium; integration of variables from published case-control studies; consensus discussion of the collected items by MelaNostrum members; revision by independent experts; addition of online tools and image-based charts; questionnaire testing across centres and generation of a final draft. RESULTS We developed a core consensus questionnaire (MelanoQ) that includes four separate sections: A. general and demographic data; B. phenotypic and ultraviolet radiation exposure risk factors and lifestyle habits; C. clinical examination, medical and family history; and D. diagnostic data on melanoma (cases only). Accompanying online tools, informative tables, and image-based charts aid standardization. Different subsections of the questionnaire are designed for self-administration, patient interviews performed by a physician or study nurse, and data collection from medical records. CONCLUSIONS The MelanoQ questionnaire is a useful tool for the collection and standardization of epidemiologic and clinical data across different studies, centres, cultures and languages. This will expedite ongoing efforts to compile high-quality data for pooled analyses or meta-analyses and offer a solid base for the design of clinical, epidemiologic and translational studies on melanoma.
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Affiliation(s)
- Alexander J Stratigos
- First Department of Dermatology, National and Kapodistrian University of Athens School of Medicine, Andreas Sygros Hospital, Athens, Greece
| | | | - Arcangela De Nicolo
- Cancer Genomics Program, Veneto Institute of Oncology IOV - IRCCS, Padua, Italy
| | - Ketty Peris
- Institute of Dermatology, Catholic University, Rome, Italy
| | - Susana Puig
- Dermatology Department, Melanoma Unit, Hospital Clinic de Barcelona, Universitat de Barcelona, Barcelona, Spain.,Instituto de Investigacion Biomedica August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Barcelona, Spain
| | - Efthymia Soura
- First Department of Dermatology, National and Kapodistrian University of Athens School of Medicine, Andreas Sygros Hospital, Athens, Greece
| | - Chiara Menin
- Immunology and Diagnostic Molecular Oncology Unit, Veneto Institute of Oncology IOV - IRCCS, Padua, Italy
| | - Donato Calista
- Dermatology Unit, Maurizio Bufalini Hospital, Cesena, Italy
| | - Paola Ghiorzo
- Department of Internal Medicine and Medical Specialties, University of Genoa and Genetics of Rare Cancers, University Hospital Policlinico San Martino-IRCCS, Genoa, Italy
| | - Mario Mandala
- Unit of Melanoma, Department of Oncology and Hematology, Papa Giovanni XXIII Cancer Center Hospital, Bergamo, Italy
| | - Daniela Massi
- Department of Surgery and Translational Medicine, University of Florence, Florence, Italy
| | - Monica Rodolfo
- Immunotherapy Unit, Department of Experimental Oncology and Molecular Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | | | - Irene Stefanaki
- First Department of Dermatology, National and Kapodistrian University of Athens School of Medicine, Andreas Sygros Hospital, Athens, Greece
| | - Helen Gogas
- Department of Internal Medicine, Laikon Hospital, National and Kapodistrian University of Athens School of Medicine, Athens, Greece
| | - Veronique Bataille
- Department of Twin Research and Genetic Epidemiology, Kings College, London, UK
| | - Margaret A Tucker
- Human Genetics Program, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - David Whiteman
- Population Health Department, QIMR Berghofer Medical Research Institute, Brisbane, Qld, Australia
| | - Eduardo Nagore
- Department of Dermatology, Instituto Valenciano de Oncología, València, Spain
| | - Maria Teresa Landi
- Human Genetics Program, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
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Emmerson AJB, Dockery KE, Mughal MZ, Roberts SA, Tower CL, Berry JL. Vitamin D status of White pregnant women and infants at birth and 4 months in North West England: A cohort study. MATERNAL AND CHILD NUTRITION 2017; 14. [PMID: 28421711 DOI: 10.1111/mcn.12453] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/15/2016] [Revised: 03/01/2017] [Accepted: 03/01/2017] [Indexed: 11/29/2022]
Abstract
The prevalence of vitamin D deficiency in pregnant white-skinned women (WSW) and their infants has not been investigated at northern latitudes in a developed county. A 2-year observational cohort study was undertaken in the North West of England to determine 25-hydroxyvitamin D (25OHD) levels in WSW and their infants during pregnancy and 4 months postdelivery and to explore factors associated with these levels. Nutritional and lifestyle questionnaires were completed and 25OHD levels measured at 28 weeks and 4 months postdelivery. Twenty-seven percent and 7% of WSW had insufficient and deficient levels of 25OHD during pregnancy and 48% and 11% four months postdelivery. WSW with Fitzpatrick skin-type I (FST I) have significantly lower 25OHD than other skin types after controlling for time spent outside and vitamin D intake. Twenty-four percent and 13% of infants had insufficient and deficient 25OHD levels at 4 months. Unsupplemented breast-fed infants have the highest level of insufficiency (67%) compared with formula-fed infants (2%). Factors associated with infant serum 25OHD levels at 4 months included breast feeding, supplementation, and time outside. WSW have a high prevalence of insufficiency and deficiency during pregnancy which doubles 4 months after birth. Breast-fed infants of WSW are rarely considered at risk of vitamin D insufficiency but have high rates compared with formula-fed infants. This is the first study to show the finding that FST I WSW have significantly lower levels of 25OHD than those with FST II-IV (difference adjusted for diet and time outside 14 (95%CI 7-21) nmol/L).
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Affiliation(s)
- Anthoney J B Emmerson
- Departments of Newborn Intensive Care, and Obstetrics, St Mary's Hospital, & Manchester Health Sciences Centre, Central Manchester Foundation Trust, Manchester, UK
| | - Karen Elizabeth Dockery
- Departments of Newborn Intensive Care, and Obstetrics, St Mary's Hospital, & Manchester Health Sciences Centre, Central Manchester Foundation Trust, Manchester, UK
| | - M Z Mughal
- Vitamin D Research Group, University of Manchester, Manchester, UK
| | | | - Clare Louise Tower
- Departments of Newborn Intensive Care, and Obstetrics, St Mary's Hospital, & Manchester Health Sciences Centre, Central Manchester Foundation Trust, Manchester, UK
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11
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Wu S, Cho E, Li WQ, Weinstock MA, Han J, Qureshi AA. History of Severe Sunburn and Risk of Skin Cancer Among Women and Men in 2 Prospective Cohort Studies. Am J Epidemiol 2016; 183:824-33. [PMID: 27045074 DOI: 10.1093/aje/kwv282] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2015] [Accepted: 10/12/2015] [Indexed: 12/20/2022] Open
Abstract
Few studies have assessed the relationship between sunburn and risk of different skin cancers (melanoma, squamous cell carcinoma (SCC), and basal cell carcinoma (BCC)) in prospective studies simultaneously, and little is known about the association of severe sunburns at different body sites with skin cancer risk. We used data on 87,166 women in the Nurses' Health Study (1982-2010) and 32,959 men in the Health Professionals Follow-up Study (1992-2010) to investigate skin cancer risk associated with history of severe sunburns at different body sites (face/arms, trunk, and lower limbs). After adjustment for other risk factors, overall baseline history of severe sunburn was more apparently associated with risk of melanoma than with risk of SCC and BCC in men (multivariable-adjusted hazard ratios were 2.41 (95% confidence interval (CI): 1.32, 4.41) for melanoma, 1.48 (95% CI: 1.08, 2.03) for SCC, and 1.18 (95% CI: 1.06, 1.32) for BCC) but not in women. Sunburn on the trunk appeared to be more closely associated with melanoma risk, but not risk of SCC and BCC, when compared with sunburns at other body sites (face/arms and lower limbs). These differences were more apparent in men than in women. Pending further investigation, our findings add novel insights to the existing literature on sunburn history and skin cancer risk.
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12
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Rosario M, Li F, Wypij D, Roberts AL, Corliss HL, Charlton BM, Frazier AL, Austin SB. Disparities by Sexual Orientation in Frequent Engagement in Cancer-Related Risk Behaviors: A 12-Year Follow-Up. Am J Public Health 2016; 106:698-706. [PMID: 26794176 DOI: 10.2105/ajph.2015.302977] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
OBJECTIVES We examined sexual-orientation disparities in frequent engagement in cancer-related risk indicators of tobacco, alcohol, diet and physical activity, ultraviolet radiation, and sexually transmitted infections (STIs). METHODS We used longitudinal data from the national Growing Up Today Study (1999-2010). Of the analytic sample (n = 9958), 1.8% were lesbian or gay (LG), 1.6% bisexual (BI), 12.1% mostly heterosexual (MH), and 84.5% completely heterosexual (CH). RESULTS More sexual minorities (LGs, BIs, and MHs) than CHs frequently engaged in multiple cancer-related risk behaviors (33%, 29%, 28%, and 19%, respectively). Sexual-minority young women, especially BI and MH, more frequently engaged over time in substance use and diet and physical activity risk than CH women. More young gay than CH men frequently engaged over time in vomiting for weight control (odds ratio [OR] = 3.2; 95% confidence interval [CI] = 1.1, 9.4), being physically inactive (OR = 1.7; 95% CI = 1.2, 2.4), and using tanning booths (OR = 4.7; 95% CI = 3.0, 7.4), and had a higher prevalence of ever having an STI (OR = 3.5; 95% CI = 2.0, 6.4). Individual analyses were generally comparable to the group-level analyses. CONCLUSIONS Young sexual minorities are at risk for cancer through frequent exposure to cancer-related risk behaviors over time. Long-term, longitudinal studies and surveillance data are essential and warranted to track frequent engagement in the risk behaviors and cancer-related morbidity and mortality.
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Affiliation(s)
- Margaret Rosario
- Margaret Rosario is with Department of Psychology, City University of New York-City College and Graduate Center, New York, NY. Fei Li and David Wypij are with Department of Biostatistics, Harvard T. H. Chan School of Public Health (HSPH), Boston, MA. David Wypij, Brittany M. Charlton, A. Lindsay Frazier, and S. Bryn Austin are with Department of Pediatrics, Harvard Medical School (HMS), Boston. David Wypij is also with Department of Cardiology, Boston's Children's Hospital, Boston. Andrea L. Roberts is with Department of Social and Behavioral Sciences, HSPH. Heather L. Corliss is with Division of Health Promotion and Behavioral Science at San Diego State University, San Diego, CA. Brittany M. Charlton and S. Bryn Austin are also with Division of Adolescent and Young Adult Medicine, Boston Children's Hospital. A. Lindsay Frazier is also with Dana-Farber Cancer Institute, Boston, and Department of Epidemiology, HSPH. A. Lindsay Frazier and S. Bryn Austin are also with Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, HMS
| | - Fei Li
- Margaret Rosario is with Department of Psychology, City University of New York-City College and Graduate Center, New York, NY. Fei Li and David Wypij are with Department of Biostatistics, Harvard T. H. Chan School of Public Health (HSPH), Boston, MA. David Wypij, Brittany M. Charlton, A. Lindsay Frazier, and S. Bryn Austin are with Department of Pediatrics, Harvard Medical School (HMS), Boston. David Wypij is also with Department of Cardiology, Boston's Children's Hospital, Boston. Andrea L. Roberts is with Department of Social and Behavioral Sciences, HSPH. Heather L. Corliss is with Division of Health Promotion and Behavioral Science at San Diego State University, San Diego, CA. Brittany M. Charlton and S. Bryn Austin are also with Division of Adolescent and Young Adult Medicine, Boston Children's Hospital. A. Lindsay Frazier is also with Dana-Farber Cancer Institute, Boston, and Department of Epidemiology, HSPH. A. Lindsay Frazier and S. Bryn Austin are also with Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, HMS
| | - David Wypij
- Margaret Rosario is with Department of Psychology, City University of New York-City College and Graduate Center, New York, NY. Fei Li and David Wypij are with Department of Biostatistics, Harvard T. H. Chan School of Public Health (HSPH), Boston, MA. David Wypij, Brittany M. Charlton, A. Lindsay Frazier, and S. Bryn Austin are with Department of Pediatrics, Harvard Medical School (HMS), Boston. David Wypij is also with Department of Cardiology, Boston's Children's Hospital, Boston. Andrea L. Roberts is with Department of Social and Behavioral Sciences, HSPH. Heather L. Corliss is with Division of Health Promotion and Behavioral Science at San Diego State University, San Diego, CA. Brittany M. Charlton and S. Bryn Austin are also with Division of Adolescent and Young Adult Medicine, Boston Children's Hospital. A. Lindsay Frazier is also with Dana-Farber Cancer Institute, Boston, and Department of Epidemiology, HSPH. A. Lindsay Frazier and S. Bryn Austin are also with Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, HMS
| | - Andrea L Roberts
- Margaret Rosario is with Department of Psychology, City University of New York-City College and Graduate Center, New York, NY. Fei Li and David Wypij are with Department of Biostatistics, Harvard T. H. Chan School of Public Health (HSPH), Boston, MA. David Wypij, Brittany M. Charlton, A. Lindsay Frazier, and S. Bryn Austin are with Department of Pediatrics, Harvard Medical School (HMS), Boston. David Wypij is also with Department of Cardiology, Boston's Children's Hospital, Boston. Andrea L. Roberts is with Department of Social and Behavioral Sciences, HSPH. Heather L. Corliss is with Division of Health Promotion and Behavioral Science at San Diego State University, San Diego, CA. Brittany M. Charlton and S. Bryn Austin are also with Division of Adolescent and Young Adult Medicine, Boston Children's Hospital. A. Lindsay Frazier is also with Dana-Farber Cancer Institute, Boston, and Department of Epidemiology, HSPH. A. Lindsay Frazier and S. Bryn Austin are also with Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, HMS
| | - Heather L Corliss
- Margaret Rosario is with Department of Psychology, City University of New York-City College and Graduate Center, New York, NY. Fei Li and David Wypij are with Department of Biostatistics, Harvard T. H. Chan School of Public Health (HSPH), Boston, MA. David Wypij, Brittany M. Charlton, A. Lindsay Frazier, and S. Bryn Austin are with Department of Pediatrics, Harvard Medical School (HMS), Boston. David Wypij is also with Department of Cardiology, Boston's Children's Hospital, Boston. Andrea L. Roberts is with Department of Social and Behavioral Sciences, HSPH. Heather L. Corliss is with Division of Health Promotion and Behavioral Science at San Diego State University, San Diego, CA. Brittany M. Charlton and S. Bryn Austin are also with Division of Adolescent and Young Adult Medicine, Boston Children's Hospital. A. Lindsay Frazier is also with Dana-Farber Cancer Institute, Boston, and Department of Epidemiology, HSPH. A. Lindsay Frazier and S. Bryn Austin are also with Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, HMS
| | - Brittany M Charlton
- Margaret Rosario is with Department of Psychology, City University of New York-City College and Graduate Center, New York, NY. Fei Li and David Wypij are with Department of Biostatistics, Harvard T. H. Chan School of Public Health (HSPH), Boston, MA. David Wypij, Brittany M. Charlton, A. Lindsay Frazier, and S. Bryn Austin are with Department of Pediatrics, Harvard Medical School (HMS), Boston. David Wypij is also with Department of Cardiology, Boston's Children's Hospital, Boston. Andrea L. Roberts is with Department of Social and Behavioral Sciences, HSPH. Heather L. Corliss is with Division of Health Promotion and Behavioral Science at San Diego State University, San Diego, CA. Brittany M. Charlton and S. Bryn Austin are also with Division of Adolescent and Young Adult Medicine, Boston Children's Hospital. A. Lindsay Frazier is also with Dana-Farber Cancer Institute, Boston, and Department of Epidemiology, HSPH. A. Lindsay Frazier and S. Bryn Austin are also with Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, HMS
| | - A Lindsay Frazier
- Margaret Rosario is with Department of Psychology, City University of New York-City College and Graduate Center, New York, NY. Fei Li and David Wypij are with Department of Biostatistics, Harvard T. H. Chan School of Public Health (HSPH), Boston, MA. David Wypij, Brittany M. Charlton, A. Lindsay Frazier, and S. Bryn Austin are with Department of Pediatrics, Harvard Medical School (HMS), Boston. David Wypij is also with Department of Cardiology, Boston's Children's Hospital, Boston. Andrea L. Roberts is with Department of Social and Behavioral Sciences, HSPH. Heather L. Corliss is with Division of Health Promotion and Behavioral Science at San Diego State University, San Diego, CA. Brittany M. Charlton and S. Bryn Austin are also with Division of Adolescent and Young Adult Medicine, Boston Children's Hospital. A. Lindsay Frazier is also with Dana-Farber Cancer Institute, Boston, and Department of Epidemiology, HSPH. A. Lindsay Frazier and S. Bryn Austin are also with Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, HMS
| | - S Bryn Austin
- Margaret Rosario is with Department of Psychology, City University of New York-City College and Graduate Center, New York, NY. Fei Li and David Wypij are with Department of Biostatistics, Harvard T. H. Chan School of Public Health (HSPH), Boston, MA. David Wypij, Brittany M. Charlton, A. Lindsay Frazier, and S. Bryn Austin are with Department of Pediatrics, Harvard Medical School (HMS), Boston. David Wypij is also with Department of Cardiology, Boston's Children's Hospital, Boston. Andrea L. Roberts is with Department of Social and Behavioral Sciences, HSPH. Heather L. Corliss is with Division of Health Promotion and Behavioral Science at San Diego State University, San Diego, CA. Brittany M. Charlton and S. Bryn Austin are also with Division of Adolescent and Young Adult Medicine, Boston Children's Hospital. A. Lindsay Frazier is also with Dana-Farber Cancer Institute, Boston, and Department of Epidemiology, HSPH. A. Lindsay Frazier and S. Bryn Austin are also with Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, HMS
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Zhu GA, Raber I, Sakshuwong S, Li S, Li AS, Tan C, Chang ALS. Estimation of individual cumulative ultraviolet exposure using a geographically-adjusted, openly-accessible tool. BMC DERMATOLOGY 2016; 16:1. [PMID: 26790927 PMCID: PMC4721109 DOI: 10.1186/s12895-016-0038-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/18/2015] [Accepted: 01/06/2016] [Indexed: 12/22/2022]
Abstract
Background Estimates of an individual’s cumulative ultraviolet (UV) radiation exposure can be useful since ultraviolet radiation exposure increases skin cancer risk, but a comprehensive tool that is practical for use in the clinic does not currently exist. The objective of this study is to develop a geographically-adjusted tool to systematically estimate an individual’s self-reported cumulative UV radiation exposure, investigate the association of these estimates with skin cancer diagnosis, and assess test reliability. Methods A 12-item online questionnaire from validated survey items for UV exposure and skin cancer was administered to online volunteers across the United States and results cross-referenced with UV radiation indices. Cumulative UV exposure scores (CUES) were calculated and correlated with personal history of skin cancer in a case–control design. Reliability was assessed in a separate convenience sample. Results 1,118 responses were included in the overall sample; the mean age of respondents was 46 (standard deviation 15, range 18 – 81) and 150 (13 %) reported a history of skin cancer. In bivariate analysis of 1:2 age-matched cases (n = 149) and controls (n = 298), skin cancer cases were associated with (1) greater CUES prior to first skin cancer diagnosis than controls without skin cancer history (242,074 vs. 205,379, p = 0.003) and (2) less engagement in UV protective behaviors (p < 0.01). In a multivariate analysis of age-matched data, individuals with CUES in the lowest quartile were less likely to develop skin cancer compared to those in the highest quartile. In reliability testing among 19 volunteers, the 2-week intra-class correlation coefficient for CUES was 0.94. We have provided the programming code for this tool as well as the tool itself via open access. Conclusions CUES is a useable and comprehensive tool to better estimate lifetime ultraviolet exposure, so that individuals with higher levels of exposure may be identified for counseling on photo-protective measures. Electronic supplementary material The online version of this article (doi:10.1186/s12895-016-0038-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Gefei A Zhu
- Department of Dermatology, Stanford University School of Medicine, 450 Broadway St., Redwood City, CA, 94063, USA.
| | - Inbar Raber
- Department of Dermatology, Stanford University School of Medicine, 450 Broadway St., Redwood City, CA, 94063, USA.
| | | | - Shufeng Li
- Department of Dermatology, Stanford University School of Medicine, 450 Broadway St., Redwood City, CA, 94063, USA.
| | - Angela S Li
- Department of Dermatology, Stanford University School of Medicine, 450 Broadway St., Redwood City, CA, 94063, USA.
| | - Caroline Tan
- Department of Dermatology, Stanford University School of Medicine, 450 Broadway St., Redwood City, CA, 94063, USA.
| | - Anne Lynn S Chang
- Department of Dermatology, Stanford University School of Medicine, 450 Broadway St., Redwood City, CA, 94063, USA.
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Shahnam A, Samarawickrema I, Ali S. Sun-protection practices among undergraduates at an Australian University. Australas J Dermatol 2015; 58:93-98. [PMID: 26344847 DOI: 10.1111/ajd.12388] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2015] [Accepted: 08/02/2015] [Indexed: 11/27/2022]
Abstract
BACKGROUND/OBJECTIVES To assess the sun-protection practices of undergraduates at the Australian National University. METHODS We sent emails with links to the questionnaire on the use of five sun-protection practices in the last fortnight of the summer to 3341 randomly selected students aged 18-24 years in this cross-sectional study. The response rate was 19% and 507 students met the inclusion criteria. RESULTS The sample consisted of 338 female and 169 male students with a mean age of 20.5 years (SD ± 1.9). Any method of sun protection was used always or often by 32% of respondents. The commonest method used was shade (58%) while the least common was wearing a hat (8%). Domestic students (44%) used sunglasses more than the international students (23%, P < 0.05) and female students used sunscreen (48%) and sunglasses (37%) more than male students (33% and 23% respectively) (P < 0.05). In the 22-24-year-old age group non-medical students (54%) used sunglasses more than the medical students (36%, P < 0.05). CONCLUSIONS Only a third of the sample practiced any method of sun protection and there were significant differences in the practices between subgroups, suggesting they were at an increased risk of sun damage.
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Affiliation(s)
- Adel Shahnam
- Medical School, Australian National University, Canberra, Australian Capital Territory, Australia
| | - Indira Samarawickrema
- National Centre for Epidemiology and Population Health and Research School of Population Health, Australian National University, Canberra, Australian Capital Territory, Australia
| | - Sayed Ali
- Canberra Hospital, Canberra, Australian Capital Territory, Australia
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15
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Schalka S, Steiner D, Ravelli FN, Steiner T, Terena AC, Marçon CR, Ayres EL, Addor FAS, Miot HA, Ponzio H, Duarte I, Neffá J, Cunha JAJD, Boza JC, Samorano LDP, Corrêa MDP, Maia M, Nasser N, Leite OMRR, Lopes OS, Oliveira PD, Meyer RLB, Cestari T, Reis VMSD, Rego VRPDA. Brazilian consensus on photoprotection. An Bras Dermatol 2015; 89:1-74. [PMID: 25761256 PMCID: PMC4365470 DOI: 10.1590/abd1806-4841.20143971] [Citation(s) in RCA: 65] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2014] [Accepted: 10/28/2014] [Indexed: 12/14/2022] Open
Abstract
Brazil is a country of continental dimensions with a large heterogeneity of climates
and massive mixing of the population. Almost the entire national territory is located
between the Equator and the Tropic of Capricorn, and the Earth axial tilt to the
south certainly makes Brazil one of the countries of the world with greater extent of
land in proximity to the sun. The Brazilian coastline, where most of its population
lives, is more than 8,500 km long. Due to geographic characteristics and cultural
trends, Brazilians are among the peoples with the highest annual exposure to the sun.
Epidemiological data show a continuing increase in the incidence of non-melanoma and
melanoma skin cancers. Photoprotection can be understood as a set of measures aimed
at reducing sun exposure and at preventing the development of acute and chronic
actinic damage. Due to the peculiarities of Brazilian territory and culture, it would
not be advisable to replicate the concepts of photoprotection from other developed
countries, places with completely different climates and populations. Thus the
Brazilian Society of Dermatology has developed the Brazilian Consensus on
Photoprotection, the first official document on photoprotection developed in Brazil
for Brazilians, with recommendations on matters involving photoprotection.
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Affiliation(s)
- Sérgio Schalka
- Photobiology Department, Sociedade Brasileira de Dermatologia, São Paulo, SP, Brazil
| | | | | | | | | | | | - Eloisa Leis Ayres
- Center of Dermatology Prof. Rene Garrido Neves, City Health Foundation, Rio de Janeiro, RJ, Brazil
| | | | | | - Humberto Ponzio
- Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Ida Duarte
- Charity Hospital, Santa Casa de Misericórdia, São Paulo, SP, Brazil
| | - Jane Neffá
- Fluminense Federal University, Niterói, RJ, Brazil
| | | | | | | | | | - Marcus Maia
- Charity Hospital, Santa Casa de Misericórdia, São Paulo, SP, Brazil
| | - Nilton Nasser
- Federal University of Santa Catarina, Blumenau, SC, Brazil
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Fernández-Morano T, de Troya-Martín M, Rivas-Ruiz F, Blázquez-Sánchez N, Buendía-Eisman A. Sensitivity to change of the Beach Questionnaire to behaviour, attitudes and knowledge related to sun exposure: quasi-experimental before-after study. BMC Public Health 2015; 15:60. [PMID: 25636540 PMCID: PMC4314809 DOI: 10.1186/s12889-015-1415-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2014] [Accepted: 01/14/2015] [Indexed: 11/11/2022] Open
Abstract
Background Health questionnaires must present accredited measurement properties such as validity, reliability and sensitivity to change, the latter being essential for interventions to be planned and for evaluating their effectiveness. The aim of this study was to evaluate the sensitivity to change of a Beach Questionnaire. Methods Quasi-experimental before-after study carried out in 2011, for a study population of adolescents attending schools in the Costa del Sol. First, the questionnaire was administered to the adolescents, after which a multicomponent educational intervention was carried out; finally, three months later, the same questionnaire was re-administered to the same adolescents. Changes were assessed in the categories of each item, using the McNemar test, and the changes in the scores, standardised to a range of 0–100, using the Student t test for paired samples, and including the mean of the differences and the 95% confidence interval. The level of statistical significance was set at p < 0.05. Results 228 adolescents, aged 14–17 years, and 55.3% were girls. Statistically significant changes were observed in sunburn experiences, exposure to the sun at mid-day and attitudes to sun exposure and suncreams. For the seven items related to knowledge about sun exposure, a higher rate of correct answers was observed. The analysis of changes, within the standardised range, revealed a significant improvement in the scores for sun exposure habits (MD 4.33; CI 95% 2.2-6.5), attitudes to sun exposure (MD 2.22; CI 95% 1.2-3.2) and knowledge (MD 9.10; CI 95% 7.1-11.1), but not in those for sun-protection practices (MD 0.23; CI 95% -1.2-1.7). Conclusions The Beach Questionnaire on behaviour, attitudes and knowledge related to sun exposure is the first such instrument in Spanish language to provide sufficient sensitivity to change. It constitutes a useful tool for epidemiologic research into photoprotection and for skin cancer prevention programmes.
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Affiliation(s)
- Teresa Fernández-Morano
- Doctoral student at the University of Granada, Granada, Spain`. .,Dermatology Department, Costa del Sol Hospital, Marbella, Spain.
| | - Magdalena de Troya-Martín
- Dermatology Department, Costa del Sol Hospital, Marbella, Spain. .,Red de Investigación en Servicios de Salud en Enfermedades Crónicas-Redissec, Granada, Spain.
| | - Francisco Rivas-Ruiz
- Red de Investigación en Servicios de Salud en Enfermedades Crónicas-Redissec, Granada, Spain. .,Research Department Costa del Sol Hospital, Marbella, Spain.
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Kirby JS, Hansen TJ, Sabella C, Sisti AJ, Fields M. Summertime scorcher: assessing and promoting sunscreen protection in an amusement park setting. PHOTODERMATOLOGY PHOTOIMMUNOLOGY & PHOTOMEDICINE 2014; 30:195-201. [PMID: 24417478 DOI: 10.1111/phpp.12110] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/20/2013] [Indexed: 11/27/2022]
Abstract
BACKGROUND/PURPOSE Intense, intermittent exposure, the kind of exposure associated with attending an amusement park for example, is correlated with the development of basal cell carcinoma and melanoma. The goals of this study were to assess the use of the station by visitors and to identify opportunities to increase the utilization of the sunscreen station. METHODS The study was a descriptive observational study of attendees at an amusement park in Pennsylvania. The study included a paper survey and observation of the station for frequency of use. RESULTS The station was very infrequently used; observation showed that 0.9% (8/879) of attendees in proximity used the station. There were numerous suggestions from attendees about increased utilization by improved station signage and locations as well as station advertising. Surveys were collected from 283 attendees and 59% (n=165) had used sunscreen on the day of the study and 29% (n=81) reported typical sunscreen use as 'Never' or 'Rarely' used. Once visitors were made aware of the station, 76% (201/263) reported that they would utilize it. CONCLUSION This study showed that sunscreen use at an amusement park can be improved, especially among men and young adults. Therefore, men and younger visitors need to be purposefully encouraged in advertising and marketing the sunscreen stations.
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Affiliation(s)
- Joslyn S Kirby
- Penn State Milton S. Hershey Medical Center, Hershey, PA, USA
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