Photoprotection by clothing

Comparison of three canine nose guards for reduction of ultraviolet (UVA and UVB) solar radiation

BACKGROUND

Protection from solar ultraviolet (UV) radiation is paramount for some dermatological conditions, yet there are no studies assessing UV nose guards for dogs.

OBJECTIVES

Compare the ability of three nasal guards to block solar UV radiation (UVR) from the canine nose, using two commercial products and one created by the authors.

ANIMALS

Four fabric model dogs were used in this prospective controlled trial.

MATERIALS AND METHODS

Each model had a UV dosimeter applied to the dorsal nose and anterior nasal planum. Three models had nose protectors applied: (1) a mesh hood (OutFox Field Guard, OutFox For Dogs); (2) a fabric nose shield (Nose Protector, Dog Nose Protectors); or (3) a basket muzzle with ultraviolet protection factor (UPF) 50+ fabric developed by the authors. The control had no protective device applied. All the models were placed in direct sunlight and measurements taken over nine 2 h time periods. Total cumulative UVR was analysed for each location and type of guard or control.

RESULTS

All guards provided statistically significant UV protection compared to control at all time points (p < 0.001). The basket muzzle with UPF 50+ guard was consistent in protecting the dorsal and anterior nose, blocking 94.2% and 94.3% UVR, respectively. The fabric nose protector blocked 99.2% UVR from the dorsal and 82.9% anterior. The mesh hood blocked 72.5% of UVR dorsal and 71.4% anterior.

CONCLUSIONS AND CLINICAL RELEVANCE

Two guards were superior in blocking UVR; however, the choice of UV guard in a clinical setting depends on an individual's disease location and tolerance of the device.

Sun Exposure Score and Vitamin D Levels in Moroccan Women of Childbearing Age

Sunlight exposure is an essential source of vitamin D for many humans. However, hypovitaminosis D is a global public health problem. This study aimed to develop and validate a sun exposure score (SES) and correlate it with serum 25-hydroxyvitamin D levels in women of childbearing age. One hundred and sixty women aged 18 to 45 years residing in Meknes, Morocco, were included. A questionnaire estimating the sun exposure score and blood analysis of serum 25-OHD concentration were performed. The questionnaire's reliability and construct validity were evaluated using Cronbach's alpha and factor analysis. Spearman's test was used to assess the correlation between SES and 25-OHD levels. The score's reliability and construct validity were good, with Cronbach's alpha values >0.70 and factorial saturation ranging from 0.696 to 0.948. Serum 25-OHD levels were significantly associated with the total sun exposure score, and all SES domains (Rho was 0.615 (p < 0.0001), 0.307 (p < 0.0001), 0.605 (p < 0.0001), and 0.424 (p < 0.0001) for total SES, indoor exposure domain, outdoor exposure domain, and sun protection practice domain, respectively). In addition, median 25-OHD levels increased significantly when sun exposure was changed from insufficient to sufficient (p < 0.0001). The results suggest that the sun exposure score could be used as a clinical tool to assess vitamin D levels in women of childbearing age.

The Influence of Iron Ions on Optical Brighteners and Their Application to Cotton Fabrics

The influence of iron ions at concentrations of 0.2, 0.5, and 1.0 g/L on optical brighteners of the groups stilbene and biphenyl in solution and on cotton fabric was investigated. Both groups of optical brighteners are intended for detergent formulations. The influence of iron ions was studied by absorption and fluorescence spectra in solution and by whiteness degree, identifying color differences using CIEL*a*b* coordinates and Ultraviolet Protection Factor (UPF) of cotton fabrics. The obtained results in solutions and cotton fabrics showed different behavior of optical brighteners stilbene and biphenyl in the presence of iron. Stilbene compounds with metal ions produced new species capable of absorbing in the UV-B region of the spectrum. A biphenyl compound in combination with iron had no effect on the absorption properties. Both optical brighteners were influenced by iron ions in the sense of fluorescence quenching. The influence of iron ions in single- and two-bath treatments of cotton fabrics after one cycle on whiteness degree and UPF was negligible.

Use of Extended Cover Factor Theory in UV Protection of Woven Fabric

The paper presents an extension of existed cover factor theory more suitable for the evaluation of light penetration through a net woven fabrics structure. It also introduces a new simplified model of predicting the ultraviolet (UV) protective properties of woven fabrics assuming that the coefficient of reflection (K_R), transmission (K_T), and absorption (K_A) of constitutive yarns are known. Since usually they are not, the procedure of preparation of simulation of proper woven fabric samples without interlacing and with known constructional parameters is also presented. The procedure finishes with a fast and cheap detection of missed coefficient for any type of yarns. There are differences between theoretical and measured results, which are not particularly significant in regard to the purpose and demands of investigation.

Photoprotection by Workwear: Ultraviolet Protection Factors for Artificial Radiation from Welding Arcs

Photoprotection by clothing is one of the most effective protective measures against solar ultraviolet radiation (UVR), and the related concept of UV protection factors (UPF) for fabrics has proven itself for decades. Although immense work has been carried out regarding factors influencing textile sun protection, the idea of UPFs for artificial UVR, if necessary with different action spectra, is payed little attention. In this work, a modified UPF equation is proposed utilizing welding arcs and the ICNIRP action spectrum. These welding UPFs (wUPF) were calculated for some workwear as a function of welding power, technique and welded material. No wUPF welding power dependence existed. By means of normalized standard emission spectra, that were further clustered with regard to welding technique, it was found that the wUPF depends exclusively on the fabric’s transmittance and the ICNIRP weighting function yielding a reduced wUPF formula. Finally, a comparison of solar and welding UPFs, based on either their full or reduced equations, is discussed.

Implementation of the SunSmart program and population sun protection behaviour in Melbourne, Australia: Results from cross-sectional summer surveys from 1987 to 2017

BACKGROUND

Australia has one of the highest skin cancer rates in the world. 'SunSmart' is a multi-component, internationally recognised community-wide skin cancer prevention program implemented in Melbourne, Australia, since summer 1988-1989. Following recent reductions in melanoma rates among younger Australian cohorts, the extent of behaviour change and the potential contribution of prevention programs to this decline in melanoma rates are of interest. Sun protection is a multifaceted behaviour. Measures previously applied to monitor change over time in preventive behaviour for this population focused on individual behaviours. The omission of multiple behaviours that reduce exposure to ultraviolet radiation (UV) may have led to underestimates of behaviour change, meriting further analysis of long-term trends to contribute to this debate.

METHODS AND FINDINGS

A population-based survey was conducted in Melbourne in the summer before SunSmart commenced (1987-1988) and across summers in 3 subsequent decades (1988-2017). During summer months, residents (14-69 years) were recruited to cross-sectional weekly telephone interviews assessing their tanning attitudes, sun protection behaviour, and sunburn incidence on the weekend prior to interview. Quotas were used to ensure the sample was proportional to the population by age and sex, while younger respondents were oversampled in some years. The majority of the respondents reported their skin was susceptible to sunburn. Changes in sun protection behaviour were analysed for N = 13,285 respondents in multivariable models, cumulating surveys within decades (1987-1988: N = 1,655; 1990s: N = 5,258; 2000s: N = 3,385; 2010s: N = 2,987) and adjusting for relevant ambient weather conditions and UV levels on weekend dates. We analysed specific and composite behaviours including a novel analysis of the use of maximal sun protection, which considered those people who stayed indoors during peak UV hours together with those people well-protected when outdoors. From a low base, use of sun protection increased rapidly in the decade after SunSmart commenced. The odds of use of at least 1 sun protection behaviours on summer weekends was 3 times higher in the 1990s than pre-SunSmart (adjusted odds ratio [AOR] 3.04, 95% CI 2.52-3.68, p < 0.001). There was a smaller increase in use of maximal sun protection including shade (AOR = 1.68, 95% CI 1.44-1.97, p < 0.001). These improvements were sustained into the 2000s and continued to increase in the 2010s. Inferences about program effects are limited by the self-reported data, the absence of a control population, the cross-sectional study design, and the fact that the survey was not conducted in all years. Other potential confounders may include increasing educational attainment among respondents over time and exposure to other campaigns such as tobacco and obesity prevention.

CONCLUSIONS

With an estimated 20-year lag between sun exposure and melanoma incidence, our findings are consistent with SunSmart having contributed to the reduction in melanoma among younger cohorts.

Sunscreen Application, Safety, and Sun Protection: The Evidence

Recently in Canada, there has been an effort to create consistent messaging about sun safety as there is a lack of up-to-date evidence-based guidelines regarding sun-protection measures. This review aimed to provide updated, evidence-based recommendations on sunscreen application, safety, and sun protection regarding the following topics for which there is clinical uncertainty: physical barriers, sunscreen properties, sunscreen application, and risk-benefit analysis.

Public Health Messages Associated with Low UV Index Values Need Reconsideration

Overexposure to ultraviolet (UV) radiation is the main modifiable risk factor for skin cancer. The Global Solar Ultraviolet Index (UVI) was introduced as a tool to visualize the intensity of UV radiation on a certain day, which should enable and encourage people to take appropriate protective measures. The ‘low’ exposure category of the UVI, defined by a rounded UVI value of 0, 1 or 2, was linked to the health message ‘No protection required’ by the World Health Organization and partner organizations. However, published evidence corroborating this advice is not available. To evaluate the erythemal risk of low UVI days, we analyzed 14,431 daily time series of ambient erythemal irradiance data measured at nine stations of the German solar UV monitoring network during the years 2007–2016. We analyzed the proportion of days in the sample for which ambient erythemal doses calculated for various time intervals exceed average minimal erythemal doses (MEDs) of the Fitzpatrick skin phototypes I–VI to assess the potential for erythema arising from sun exposure on days with low UVI values. Additionally, we calculated for each day the minimum exposure duration needed to receive one MED. Our results indicate that on days with a UVI value of 0, risk of erythema is indeed negligible. Conversely, the abovementioned health message appears misleading when melano-compromised individuals (skin type I and II) spend more than 1.5 hours outdoors on days with a UVI value of 2. Under rare circumstances of prolonged exposure, MEDs of the two most sensitive skin types can also be exceeded even on days with a UVI value of 1. Hence, current WHO guidance for sun protection on days with low UVI values needs reconsideration.

Evaluation of vitamin D plasma levels after mild exposure to the sun with photoprotection

BACKGROUND

Most of the organism's vitamin D (VD) is obtained through the cutaneous synthesis after exposure to the sun's UVB radiation. Sunscreens are indicated for the prevention of actinic damage to the skin, however, there are few clinical trials assessing the synthesis of cutaneous VD in real-life situations of sun exposure with ordinary clothing and usual photoprotection.

OBJECTIVES

To evaluate the synthesis of VD with suberythemal sun exposure in healthy adults using topical photoprotection (SPF 30).

METHODS

Quasi-experimental study, conducted at Rio de Janeiro (Brazil), during winter, with 95 healthy adults who had 25-OH-VD checked twice, 24 hours apart, and were exposed to the sun (UVB=20 mJ/cm2), according to a randomized grouping: SC - use of SPF 30 on the face, neck and chest (n=64), NO - no sunscreens (n=10), CO - confined from sun exposure for 24h (n=21). The groups were matched according to the propensity score related to gender, age, phototype, body mass index, glycosylated hemoglobin and baseline levels of VD. The outcome evaluated was the variation (ΔVD) in serum level of 25-OH-VD (ng/ml) between the groups.

RESULTS

A statistically significant difference was identified between CO and SC groups [median (p25-p75)]: ΔVD =1.4 (-0.3-3.6) vs. 5.5 (4.8-6.6); p<0.01. There was no difference between SC and NO groups: 5.4 (3.1-6.1) vs. 4.1 (2.5-6.0); p=0.17.

STUDY LIMITATIONS

Laboratory analysis technique (chemiluminescence) with great variability, loss of food intake standardatization, unbalanced groups.

CONCLUSIONS

Suberythemal sun exposure with sunscreen (SPF 30) provides similar vitamin D serum variation than without photoprotection in healthy adults.

Comparison of UV protection properties of cotton fabrics treated with aqueous and methanolic extracts of Solanum nigrum and Amaranthus viridis plants

Harmful effects of ultraviolet rays and protection against them have been long discussed. Numerous synthetic dyes, finishes, UV absorbers, and optical brightening agents are present in the market for decades for achieving UV protection through textiles. However, due to environmental impacts of these chemical agents, textile industry is looking for alternatives. In this regard, some natural dyes and plant extracts have shown promising results. However, use of colorless plant extracts as UV protective finishes is still rare. In this study, ultraviolet protection factor (UPF) rating of bleached cotton fabric has been improved by the application of plant extracts with minimal change in fabric's color. For this purpose, two medicinal plants, that is, Solanum nigrum and Amaranthus viridis were selected and bleached cotton fabric was treated with their methanolic and aqueous extracts. Fabrics treated with both extracts exhibited excellent UPF ratings.

Shedding Light on the Shade: How Nurseries Protect Their Children from Ultraviolet Radiation

Minimizing exposure to ultraviolet radiation (UVR) is strongly recommended as the most important primary prevention measure regarding skin cancer. The responsibility for adequate sun protection of young children lies with their parents and external caregivers. Since a high proportion of 3- to 6-year-old children in Germany attend nurseries, the practice of sun protection in this setting was assessed. A survey was conducted in 246 nurseries in southern Germany during spring and summer of 2014 and 2015. Shade coverage in the outdoor area of the nursery was assessed by study team members and UVR protective behavior of staff was assessed by an interview with the directors. On average, 52% of the entire outdoor area and 65% of the children’s outdoor play area were covered by shade, with a significant difference between nurseries of different sizes, pointing to a better shade coverage in larger nurseries. The daily outdoor stay was not regularly scheduled before or after peak sun intensity hours around noon to avoid intense UVR exposure. General sun protection rules were present in the majority of the nurseries and addressed predominantly wearing sunhats and applying sunscreen. Our findings show that current sun protection recommendations for children are only partially met in nurseries and indicate a lower level of sun protection in small institutions. Especially, avoidance of excessive exposure to UVR around noon and the importance of shade provision over play structures needs to be emphasized in future information campaigns.

Photoprotection in adolescents: what they know and how they behave

BACKGROUND

The greatest sun exposure occurs until adolescence and this is the only factor involved in photocarcinogenesis subject to modification with photoprotection.

OBJECTIVE

The objective of this study was to evaluate the habits and knowledge of adolescents regarding photoprotection.

METHOD

Cross-sectional study that included 512 students from primary and high school. Data were collected by questionnaires with questions about habits and knowledge on sun protection. For data analysis, Pearson's Chi-square test and Yates test were applied, with 5% level of significance.

RESULTS

We evaluated 512 students, with a mean age of 14 years old. The teenagers agreed that ultraviolet rays cause skin cancer and aging (96% and 70%, respectively). Knowledge about the occurrence of burns even on cloudy days was recorded in 68% of cases, as well as the need for photoprotection for sports in 72%. The source of information about sun protection were by parents in 55%. In 70% was observed previous occurrence of sunburn, the daily use of sunscreens was found in 15% and 67% used only at the beach. of sunscreens with SPF higher than 30 was reported by 70% of students and 57% reported going to the beach between 10h and 16h. In 68% of cases it was registered insufficient sun protection, attributed, in 57% of the time to forgetfulness.

STUDY LIMITATIONS

The sample refers to two schools of Curitiba (PR), Brazil.

CONCLUSION

Teenagers know the risks of sun exposure, but they do not adopt the practices for adequate protection.

Clothing Protection from Ultraviolet Radiation: A New Method for Assessment

Clothing modifies ultraviolet radiation (UVR) exposure from the sun and has an impact on skin cancer risk and the endogenous synthesis of vitamin D. There is no standardized method available for assessing body surface area (BSA) covered by clothing, which limits generalizability between study findings. We calculated the body cover provided by 38 clothing items using diagrams of BSA, adjusting the values to account for differences in BSA by age. Diagrams displaying each clothing item were developed and incorporated into a coverage assessment procedure (CAP). Five assessors used the CAP and Lund & Browder chart, an existing method for estimating BSA, to calculate the clothing coverage of an image sample of 100 schoolchildren. Values of clothing coverage, inter-rater reliability and assessment time were compared between CAP and Lund & Browder methods. Both methods had excellent inter-rater reliability (>0.90) and returned comparable results, although the CAP method was significantly faster in determining a person's clothing coverage. On balance, the CAP method appears to be a feasible method for calculating clothing coverage. Its use could improve comparability between sun-safety studies and aid in quantifying the health effects of UVR exposure.

Brazilian consensus on photoprotection

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.

The influence of the environment and clothing on human exposure to ultraviolet light

Objection

The aim of this study is to determine the effect of clothing and the environment on human exposure to ultraviolet light.

Methods

The ultraviolet (ultraviolet A and ultraviolet B) light intensity was measured, and air quality parameters were recorded in 2014 in Beijing, China. Three types of clothing (white polyester cloth, pure cotton white T-shirt, and pure cotton black T-shirt) were individually placed on a mannequin. The ultraviolet (ultraviolet A and ultraviolet B) light intensities were measured above and beneath each article of clothing, and the percentage of ultraviolet light transmission through the clothing was calculated.

Results

(1) The ultraviolet light transmission was significantly higher through white cloth than through black cloth; the transmission was significantly higher through polyester cloth than through cotton. (2) The weather significantly influenced ultraviolet light transmission through white polyester cloth; transmission was highest on clear days and lowest on overcast days (ultraviolet A: P=0.000; ultraviolet B: P=0.008). (3) Air quality parameters (air quality index and particulate matter 2.5 and 10) were inversely related to the ultraviolet light intensity that reached the earth’s surface. Ultraviolet B transmission through white polyester cloth was greater under conditions of low air pollution compared with high air pollution.

Conclusion

Clothing color and material and different types of weather affected ultraviolet light transmission; for one particular cloth, the transmission decreased with increasing air pollution.

In vitro assessment of ultraviolet protection of coloured cotton knitted fabrics with different structures under stretched and wet conditions

Clothing provides intrinsic ultraviolet (UV) protection that can be improved by colouration. However, the daily wearing condition can undermine the UV protection of coloured clothing wherein garments are stretched by body movement and/or wetted by perspiration of wearers. Knitwear is an indispensable clothing in summer, but its UV protection against wearing conditions lacks extensive study especially in a fabric structural approach. This article aimed at narrowing the research gap by focusing on the UV protection against stretch and wetness provided by various knitted fabric constructions incorporating the knit, tuck and miss stitches. The results show that the black knitted fabrics exhibit a significant reduction in the UV protection factor by 53% on average at a 10% stretch level. Knitted fabrics with miss stitches retained good UV protection even when the fabrics were stretched by 20% of its original dimensions.

The consequences of UV-induced immunosuppression for human health

Exposure to UV radiation can cause suppression of specific immune responses. The pathways leading to the down-regulation are complex, starting from the absorption of UV photons by chromophores in the skin and ending with local and systemic changes in immune mediators, the generation of T and B regulatory cells and inhibition of effector and memory T cell activation. The consequences for human health are thought to be both beneficial and adverse. The former are illustrated by protection against polymorphic light eruption, and possible protection against T cell-mediated autoimmune diseases and asthma. The latter are illustrated by skin cancer, cutaneous lupus erythematosus and infectious diseases including vaccination. Many outstanding questions remain in this rapidly developing and controversial area, not least what advice to give the general public regarding their sun exposure. While considerable advances have been made in the development of strategies that preserve the health benefits of sunlight exposure and decrease its detrimental effects, further research is required before optimal levels of protection are achieved.

The human health effects of ozone depletion and interactions with climate change

Depletion of the stratospheric ozone layer has led to increased solar UV-B radiation (280-315 nm) at the surface of the Earth. This change is likely to have had an impact on human exposure to UV-B radiation with consequential detrimental and beneficial effects on health, although behavioural changes in society over the past 60 years or so with regard to sun exposure are of considerable importance. The present report concentrates on information published since our previous report in 2007. The adverse effects of UV radiation are primarily on the eye and the skin. While solar UV radiation is a recognised risk factor for some types of cataract and for pterygium, the evidence is less strong, although increasing, for ocular melanoma, and is equivocal at present for age-related macular degeneration. For the skin, the most common harmful outcome is skin cancer, including melanoma and the non-melanoma skin cancers, basal cell carcinoma and squamous cell carcinoma. The incidence of all three of these tumours has risen significantly over the past five decades, particularly in people with fair skin, and is projected to continue to increase, thus posing a significant world-wide health burden. Overexposure to the sun is the major identified environmental risk factor in skin cancer, in association with various genetic risk factors and immune effects. Suppression of some aspects of immunity follows exposure to UV radiation and the consequences of this modulation for the immune control of infectious diseases, for vaccination and for tumours, are additional concerns. In a common sun allergy (polymorphic light eruption), there is an imbalance in the immune response to UV radiation, resulting in a sun-evoked rash. The major health benefit of exposure to solar UV-B radiation is the production of vitamin D. Vitamin D plays a crucial role in bone metabolism and is also implicated in protection against a wide range of diseases. Although there is some evidence supporting protective effects for a range of internal cancers, this is not yet conclusive, but strongest for colorectal cancer, at present. A role for vitamin D in protection against several autoimmune diseases has been studied, with the most convincing results to date for multiple sclerosis. Vitamin D is starting to be assessed for its protective properties against several infectious and coronary diseases. Current methods for protecting the eye and the skin from the adverse effects of solar UV radiation are evaluated, including seeking shade, wearing protective clothing and sunglasses, and using sunscreens. Newer possibilities are considered such as creams that repair UV-induced DNA damage, and substances applied topically to the skin or eaten in the diet that protect against some of the detrimental effects of sun exposure. It is difficult to provide easily understandable public health messages regarding "safe" sun exposure, so that the positive effects of vitamin D production are balanced against the negative effects of excessive exposure. The international response to ozone depletion has included the development and deployment of replacement technologies and chemicals. To date, limited evidence suggests that substitutes for the ozone-depleting substances do not have significant effects on human health. In addition to stratospheric ozone depletion, climate change is predicted to affect human health, and potential interactions between these two parameters are considered. These include altering the risk of developing skin tumours, infectious diseases and various skin diseases, in addition to altering the efficiency by which pathogenic microorganisms are inactivated in the environment.

Solar radiation induced skin damage: review of protective and preventive options

PURPOSE

Solar energy has a number of short- and long-term detrimental effects on skin that can result in several skin disorders. The aim of this review is to summarise current knowledge on endogenous systems within the skin for protection from solar radiation and present research findings to date, on the exogenous options for such skin photoprotection.

RESULTS

Endogenous systems for protection from solar radiation include melanin synthesis, epidermal thickening and an antioxidant network. Existing lesions are eliminated via repair mechanisms. Cells with irreparable damage undergo apoptosis. Excessive and chronic sun exposure however can overwhelm these mechanisms leading to photoaging and the development of cutaneous malignancies. Therefore exogenous means are a necessity. Exogenous protection includes sun avoidance, use of photoprotective clothing and sufficient application of broad-spectrum sunscreens as presently the best way to protect the skin. However other strategies that may enhance currently used means of protection are being investigated. These are often based on the endogenous protective response to solar light such as compounds that stimulate pigmentation, antioxidant enzymes, DNA repair enzymes, non-enzymatic antioxidants.

CONCLUSION

More research is needed to confirm the effectiveness of new alternatives to photoprotection such as use of DNA repair and antioxidant enzymes and plant polyphenols and to find an efficient way for their delivery to the skin. New approaches to the prevention of skin damage are important especially for specific groups of people such as (young) children, photosensitive people and patients on immunosuppressive therapy. Changes in public awareness on the subject too must be made.

Evaluation of sun awareness with an emphasis on ultraviolet protection by clothing: a survey of adults in Western Germany

BACKGROUND

Little is known about the sun habits of the population in Germany.

OBJECTIVE

We aimed to assess the sun awareness and notion on ultraviolet (UV) radiation protection by fabrics in adult subjects from North Rhine-Westphalia in Germany.

METHODS

During regular skin cancer screening campaigns, 1206 subjects completed and returned a structured questionnaire on constitutional parameters and the respondents' sun habits.

RESULTS

Staying in the shade and the use of high-factor sunscreens are the most commonly performed sun-protective measures reported by the respondents. Males and lower-educated people use clothing in conjunction with sunscreens more infrequently. Most respondents, particularly females, know that sun protection provided by clothing is variable. However, the elderly more frequently consider sun protection by clothing as excellent. Notably, more than two-thirds of the respondents would prefer clothing with a labelled ultraviolet protection factor. The respondents of this survey mainly considered baby wear, children wear, and leisure wear for sun-protective clothing, whereby light-weighted, breathable, natural fabrics preferably made of cotton and linen were the most frequently reported protective textiles.

CONCLUSIONS

Given the lack of epidemiological observations on people's sun habits and protection in Germany, the present relatively large survey provides useful information and implications for counselling in sun protection and marketing of UV-protective clothing.