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Downs N, Butler H, Parisi A, Beckman-Downs M, Igoe D. Optimizing the Seasonal Shade and Ultraviolet Protection of a Suburban Playground by Utilization of the Playground Shade Index. Photochem Photobiol 2023; 99:1483-1492. [PMID: 36789633 DOI: 10.1111/php.13792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Accepted: 02/04/2023] [Indexed: 02/16/2023]
Abstract
The Playground Shade Index (PSI) is introduced as a design metric for assessing the shade and solar ultraviolet (UV) protection provided by eight different cloth weave shade structures currently utilized in public playgrounds across a regional city located in southern Queensland, Australia. The PSI, expressing the ratio of available ambient solar UV exposure relative to the UV exposure received by a shaded 184 m2 playground surface over a whole day in midsummer and midwinter, is used to determine the best design and aspect of all eight existing structures. Unlike subjective shade audits that may only consider the type of shade structure, the number and characteristics of surrounding trees, and surface materials available at a given site, the PSI considers, in addition to previous factors, the available sky fraction and the direct solar UV contribution underneath the shade structure over a full day. By considering the in situ UV protection characteristics of the shade structure, the PSI has demonstrated its value as a robust design metric. Of the eight shade structure styles examined, this research presents the most likely structure best suited for UV protection over the two solar UV extremes in summer and winter, including optimal structure aspect.
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Affiliation(s)
- Nathan Downs
- Centre for Applied Climate Science, University of Southern Queensland, Toowoomba, Australia
- School of Mathematics, Physics and Computing, University of Southern Queensland, Toowoomba, Australia
| | - Harry Butler
- Centre for Applied Climate Science, University of Southern Queensland, Toowoomba, Australia
- School of Mathematics, Physics and Computing, University of Southern Queensland, Toowoomba, Australia
| | - Alfio Parisi
- School of Mathematics, Physics and Computing, University of Southern Queensland, Toowoomba, Australia
| | - Melanie Beckman-Downs
- School of Mathematics, Physics and Computing, University of Southern Queensland, Toowoomba, Australia
| | - Damien Igoe
- School of Mathematics, Physics and Computing, University of Southern Queensland, Toowoomba, Australia
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Downs N, Raj N, Vanos J, Parisi AV, Butler H, Deo R, Igoe D, Dexter B, Beckman-Downs M, Turner J, Dekeyser S. The Playground Shade Index: A New Design Metric for Measuring Shade and Seasonal Ultraviolet Protection Characteristics of Parks and Playgrounds. Photochem Photobiol 2023; 99:1193-1207. [PMID: 36403206 DOI: 10.1111/php.13745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Accepted: 11/13/2022] [Indexed: 11/21/2022]
Abstract
Current shading strategies used to protect outdoor playgrounds from harmful solar radiation include the placement of artificial cloth weaves or permanent roofing over a playground site, planting trees in proximity to playground equipment, and using vegetation or surface texture variations to cool playground surfaces. How and where an artificial shade structure is placed or a tree is planted to maximize the shade protection over specific playground areas, requires careful assessment of local seasonal sun exposure patterns. The Playground Shade Index (PSI) is introduced here as a design metric to enable shade and solar ultraviolet exposure patterns to be derived in an outdoor space using conventional aerial views of suburban park maps. The implementation of the PSI is demonstrated by incorporating a machine learning design tool to classify the position of trees from an aerial image, thus enabling the mapping of seasonal shade and ultraviolet exposure patterns within an existing 7180 m2 parkland. This is achieved by modeling the relative position of the sun with respect to nearby buildings, shade structures, and the identified evergreen and deciduous tree species surrounding an outdoor playground.
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Affiliation(s)
- Nathan Downs
- Centre for Applied Climate Science, University of Southern Queensland, Toowoomba, Qld, Australia
- School of Mathematics, Physics and Computing, University of Southern Queensland, Toowoomba, Qld, Australia
| | - Nawin Raj
- School of Mathematics, Physics and Computing, University of Southern Queensland, Toowoomba, Qld, Australia
| | - Jennifer Vanos
- School of Sustainability, Arizona State University, Tempe, AZ
| | - Alfio V Parisi
- School of Mathematics, Physics and Computing, University of Southern Queensland, Toowoomba, Qld, Australia
| | - Harry Butler
- Centre for Applied Climate Science, University of Southern Queensland, Toowoomba, Qld, Australia
- School of Mathematics, Physics and Computing, University of Southern Queensland, Toowoomba, Qld, Australia
| | - Ravinesh Deo
- School of Mathematics, Physics and Computing, University of Southern Queensland, Toowoomba, Qld, Australia
| | - Damien Igoe
- School of Mathematics, Physics and Computing, University of Southern Queensland, Toowoomba, Qld, Australia
| | - Benjamin Dexter
- School of Mathematics, Physics and Computing, University of Southern Queensland, Toowoomba, Qld, Australia
| | - Melanie Beckman-Downs
- School of Mathematics, Physics and Computing, University of Southern Queensland, Toowoomba, Qld, Australia
| | - Joanna Turner
- School of Mathematics, Physics and Computing, University of Southern Queensland, Toowoomba, Qld, Australia
| | - Stijn Dekeyser
- School of Mathematics, Physics and Computing, University of Southern Queensland, Toowoomba, Qld, Australia
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3
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Cherian NC, Subasinghe C. Sun-Safe Zones: Investigating Integrated Shading Strategies for Children's Play Areas in Urban Parks. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:114. [PMID: 36612436 PMCID: PMC9819332 DOI: 10.3390/ijerph20010114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/05/2022] [Revised: 12/11/2022] [Accepted: 12/16/2022] [Indexed: 06/17/2023]
Abstract
Although Open Space Ratio is a critical control in the Development Approval process, there are no ultraviolet radiation (UVR) protection guidelines for urban parks. This study explores key strategies for shade provision in children's play areas in urban parks, aiming to promote sun-safe play environments against alarming skin cancer trends. The literature review identified primary issues affecting UVR exposure in public venues, and the research comprises a shade audit of Beaton Park in Dalkeith. The methods involved using virtual park modeling and Shadow Analysis simulations to generate the daily average number of hours in shade for each month. Our recommendations based on this analysis are (a) a minimum canopy cover representing 50% of the entire ground cover; (b) a minimum diameter for a shade (umbrella) of about 2.5 times the diameter of the table; and (c) an ideal umbrella height of 90 cm from the table surface. This research proposes a potential nexus between landscape design and a UVR protection framework for child-friendly Sun-safe Zones (SsZ).
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Grifoni D, Betti G, Bogi A, Bramanti L, Chiarugi A, Gozzini B, Morabito M, Picciolo F, Sabatini F, Miligi L. Protective Measures From Solar Ultraviolet Radiation for Beach Lifeguards in Tuscany (Italy): Shade and Clothing Strategies. Saf Health Work 2022; 13:421-428. [PMID: 36579014 PMCID: PMC9772484 DOI: 10.1016/j.shaw.2022.08.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 07/25/2022] [Accepted: 08/29/2022] [Indexed: 12/31/2022] Open
Abstract
Background The exposure to solar ultraviolet radiation is a significant risk factor generally underestimated by outdoor workers and employers. Several studies have pointed out that occupational solar exposure increased eye and skin diseases with a considerable impact on the lives and productivity of affected workers.The main purpose of this study was to evaluate the effectiveness against ultraviolet radiation of some measures recently undertaken for the protection of lifeguards in a coastal area of Tuscany. Methods Different shading structures (gazebos and beach umbrella) were tested during a sunny summer's day on a sandy beach by means of two radiometers; the UV protection offered by some T-shirts used by lifeguards was also tested in the laboratory with a spectrophotometer. Results The analysed shading structures strongly reduced the ultraviolet radiation by up to 90%, however a not always negligible diffuse radiation is also present in the shade, requiring further protective measures (T-shirt, sunglasses, sunscreen, etc.); the tested T-shirts showed a very good-excellent protection according to the Australian/New Zealand standard. Conclusion Results obtained in this study suggest how the adoption and dissemination of good practices, including those tested, could be particularly effective as a primary prevention for lifeguards who are subjected to very high levels of radiation for long periods.
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Affiliation(s)
- Daniele Grifoni
- CNR-IBE - Institute of Bioeconomy - National Research Council, Sesto Fiorentino, Italy,LaMMA Consortium, Sesto Fiorentino, Italy,Corresponding author. Institute of Bioeconomy - National Research Council, Via Madonna del Piano, 10, 50019, Sesto Fiorentino, Italy.
| | - Giulio Betti
- CNR-IBE - Institute of Bioeconomy - National Research Council, Sesto Fiorentino, Italy,LaMMA Consortium, Sesto Fiorentino, Italy
| | - Andrea Bogi
- Physical Agents Sector, Regional Public Health Laboratory, Siena, Italy
| | - Lucia Bramanti
- AUSL North West Tuscany, Hygiene and Health at Work Unit, Prevention Department, Versilia, Italy
| | - Alessandra Chiarugi
- Screening and Secondary Prevention Unit, Institut for Cancer Research, Prevention and Clinical Network (ISPRO), Florence, Italy
| | - Bernardo Gozzini
- CNR-IBE - Institute of Bioeconomy - National Research Council, Sesto Fiorentino, Italy,LaMMA Consortium, Sesto Fiorentino, Italy
| | - Marco Morabito
- CNR-IBE - Institute of Bioeconomy - National Research Council, Sesto Fiorentino, Italy
| | | | - Francesco Sabatini
- CNR-IBE - Institute of Bioeconomy - National Research Council, Sesto Fiorentino, Italy
| | - Lucia Miligi
- Environmental and Occupational Epidemiology Branch - Cancer Risk Factors and Lifestyle Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network (ISPRO), Florence, Italy
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Cimino A, McWhirter JE, Papadopoulos A. Made in the shade: A qualitative study of factors impacting shade provision at outdoor public parks. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2022; 32:2562-2574. [PMID: 34496709 DOI: 10.1080/09603123.2021.1977257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Accepted: 09/02/2021] [Indexed: 06/13/2023]
Abstract
Shade provides a variety of public health benefits; however, outdoor recreation sites often have limited shade. We conducted semi-structured interviews (n = 13) with shade stakeholders (i.e. individuals with a professional role involving shade design or provision) to gain in-depth understanding of the factors impacting shade provision at public parks. Interview transcripts were analyzed using inductive thematic analysis. Five main themes emerged: (1) attitudes toward shade at parks; (2) designing shade at parks; (3) advantages and disadvantages of natural and built shade; (4) barriers to shade at parks; and, (5) approaches to reduce shade barriers. Shade stakeholders indicated shade is important and necessary and they strive to design shade in park spaces with park user patterns in mind. However, barriers including competing interests, budget, space constraints, and maintenance and operational concerns can limit their ability to do so. Future research should determine strategies to overcome these barriers.
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Affiliation(s)
- Andrea Cimino
- Department of Population Medicine, University of Guelph, Guelph, Canada
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Dobbinson SJ, Buller DB, Chamberlain JA, Simmons J, Buller MK. Solar UV Measured under Built-Shade in Public Parks: Findings from a Randomized Trial in Denver and Melbourne. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10583. [PMID: 36078303 PMCID: PMC9518543 DOI: 10.3390/ijerph191710583] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Revised: 08/10/2022] [Accepted: 08/12/2022] [Indexed: 06/15/2023]
Abstract
Reducing exposure to ultraviolet radiation (UV) is crucial for preventing UV-induced diseases of the skin and eyes. Shade may offer significant protection from UV. More empirical research to quantify the UV protection offered from built shade is needed to guide disease prevention practices and confidence in investment in shade. This study quantified UV levels under built-shade relative to unshaded passive recreation areas (PRAs) over summer months in parks in two cities. In a randomized controlled trial, n = 1144 UV measurements were conducted at the center and periphery of PRAs in a total sample of 144 public parks as part of pretest and posttest measures of use of the PRAs by park visitors for three recruitment waves per city during 2010 to 2014. Following pretest, 36 PRAs received built-shade and 108 did not. Regression analyses modelled pre-post change in UV (Standard Erythemal Dose (SED) per 30 min) at PRAs; and environmental predictors. Mean UV at the center of built-shade PRAs decreased from pretest to posttest (x¯ = 3.39, x¯ = 0.93 SED), a change of x¯ = -3.47 SED relative to control PRAs (p < 0.001) adjusting for the covariates of ambient SED, (cosine) solar elevation and cloud cover. Clouds decreased and solar elevation increased UV levels under shade. No significant differences in UV by shade design occurred. A substantial reduction in exposure to UV can be achieved using built-shade with shade cloth designs, offering considerable protection for shade users. Supplementary sun protection is recommended for extended periods of shade use during clear sky days.
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Affiliation(s)
- Suzanne Jane Dobbinson
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne, VIC 3004, Australia
| | | | | | - Jody Simmons
- Office of the Deputy Vice-Chancellor, LaTrobe University, Melbourne, VIC 3086, Australia
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Hung M, Beazer IR, Su S, Bounsanga J, Hon ES, Lipsky MS. An Exploration of the Use and Impact of Preventive Measures on Skin Cancer. Healthcare (Basel) 2022; 10:healthcare10040743. [PMID: 35455920 PMCID: PMC9025621 DOI: 10.3390/healthcare10040743] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 04/12/2022] [Accepted: 04/13/2022] [Indexed: 12/04/2022] Open
Abstract
Background: Skin cancer is the most common form of cancer, and both clinical and epidemiological data link cumulative solar dosages and the number of sunburns to skin cancer. Each year, more than 5.4 million new cases of skin cancer are diagnosed, incurring a significant health and financial burden. Recommended preventive measures for skin cancer include the use of sunscreen, sun avoidance, and protective clothing. This study used a national database to examine the association of preventive measures with the prevalence of skin cancer, specifically analyzing the preventive measures of sunscreen use, staying in the shade, and wearing long-sleeved shirts. The second aim was to determine which characteristics, if any, correlated with using prevention measures. Methods: This study analyzed data from the National Health and Nutritional Examination Survey 2015−2016 cycle to examine the association of three preventive measures (using sunscreen, staying in the shade, and wearing long-sleeved shirts) with skin cancer. Logistic regression and chi-square tests were utilized to examine the relationship between skin cancer and these prevention methods. Results: Sunscreen use (OR = 3.752; p < 0.05) was statistically associated with a lower prevalence of skin cancer, while wearing long-sleeved shirts (OR = 6.911; p = 0.064) and staying in the shade (OR = 0.646; p = 0.481) did not emerge as factors significantly associated with a lower prevalence after controlling for gender, race/ethnicity, marital status, income, health insurance, and general health. Additionally, men and individuals of color were less likely to use sunscreen. Conclusion: Sunscreen use was associated with a lower prevalence of skin cancer, while wearing long-sleeved shirts and staying in the shade was not significantly linked to lower rates of skin cancer, suggesting that these measures may not be as effective as sunscreen for preventing skin cancer. Men and individuals of color were significantly less likely to use sunscreen. These findings can help guide future education efforts and research regarding skin cancer prevention and suggest the need to develop male-oriented programs to mitigate the gender disparity in employing sun-protection measures.
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Affiliation(s)
- Man Hung
- College of Dental Medicine, Roseman University of Health Sciences, South Jordan, UT 84095, USA; (S.S.); (M.S.L.)
- School of Medicine, University of Utah, Salt Lake City, UT 84132, USA
- Huntsman Cancer Institute, Salt Lake City, UT 84112, USA
- Correspondence:
| | - Isaac Rex Beazer
- College of Pharmacy, Roseman University of Health Sciences, South Jordan, UT 84095, USA;
| | - Sharon Su
- College of Dental Medicine, Roseman University of Health Sciences, South Jordan, UT 84095, USA; (S.S.); (M.S.L.)
| | | | - Eric S. Hon
- Department of Economics, University of Chicago, Chicago, IL 60637, USA;
| | - Martin S. Lipsky
- College of Dental Medicine, Roseman University of Health Sciences, South Jordan, UT 84095, USA; (S.S.); (M.S.L.)
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Perez M, Abisaad JA, Rojas KD, Marchetti MA, Jaimes N. Skin Cancer: Primary, Secondary, and Tertiary Prevention. Part I. J Am Acad Dermatol 2022; 87:255-268. [DOI: 10.1016/j.jaad.2021.12.066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 12/03/2021] [Accepted: 12/15/2021] [Indexed: 10/19/2022]
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Results of a Primary Skin-Cancer-Prevention Campaign in Early Childhood on Sun-Related Knowledge and Attitudes in Southern Hungary. Cancers (Basel) 2021; 13:cancers13153873. [PMID: 34359770 PMCID: PMC8345575 DOI: 10.3390/cancers13153873] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 07/17/2021] [Accepted: 07/27/2021] [Indexed: 11/17/2022] Open
Abstract
Simple Summary Primary skin-cancer-prevention campaigns among young children are important as this is the age when individuals are developing behaviors. Our aim was to evaluate sun-protection knowledge and behavior among caregivers in daycare centers and kindergartens and to determine if educational lectures are positively influential. In daycare centers, we discovered that measures of sun protection (e.g., hat, sunscreen, and shaded areas) are more likely to be available when compared to kindergartens. Knowledge regarding sun safety has improved following our initial presentation, however, not significantly. Sun safety policies did not exist in any of the facilities, presenting an urgent need for their implementation. Abstract Avoidance of ultraviolet (UV) exposure in early childhood is important for reducing the lifetime risk of developing skin cancer. The goal of the present prospective, multicenter pilot study was to assess the sun-protection practices in kindergartens and daycare centers and to evaluate sun protection knowledge and behavior among caregivers employed in the surveyed facilities. The study consisted of two parts. A baseline questionnaire was completed by the caregivers in relation to knowledge regarding basic sun protection and sun protection practices of the participating facilities. Afterward, a thirty-minute presentation was hosted in reference to this topic. Six months following the presentation, a follow-up questionnaire was distributed among the caregivers, evaluating the attitude-related and behavioral changes towards children. A total of 153 caregivers from five daycare centers (children between 6 months and 3 years of age) and sixteen kindergartens (children between 3 and 7 years of age) willfully participated in our study. According to our results, the main source of information regarding sun protection originated from different types of media. We found that staying in shaded areas and the use of protective clothing were not frequent in the facilities. Following our presentation regarding skin types and sunscreen use, protective measures improved, but not significantly (p = 0.222). The majority (92.31%) of caregivers distributed the information throughout their environment and also to parents. Sun protection knowledge is necessary; however, motivation among caregivers and parents and involvement of children is also relevant. Hence, a continuous, repetitive educational program regarding sun-smart behavior is deemed essential.
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Haynes A, Nathan A, Maitland C, Dixon H, Nicholson A, Wakefield M, Dobbinson S. Prevalence and Correlates of Observed Sun Protection Behaviors Across Different Public Outdoor Settings in Melbourne, Australia. HEALTH EDUCATION & BEHAVIOR 2021; 49:405-414. [PMID: 34238043 DOI: 10.1177/10901981211026535] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Skin cancer prevention efforts in Australia have increasingly incorporated a focus on protection during incidental sun exposure. This complements the long-present messages promoting protection in high-risk settings and avoidance of acute intense bouts of sun exposure. Data from two waves of a cross-sectional direct observational survey was used to assess the prevalence and correlates of N = 12,083 adolescents' and adults' sun protection behavior (arm and leg cover, hat, sunglasses, and shade cover). Individuals were observed in public outdoor settings in Melbourne, Australia during peak ultraviolet (UV) times (11 a.m.-3 p.m.) on summer weekends. Settings included pools and beaches, parks and gardens, and for the first time in 2018, outdoor streets and cafés which may capture more incidental forms of sun exposure and represent another public setting where Australians commonly spend time outdoors. Females and older adults were consistently better protected than males and adolescents. Physical activity was strongly associated with low shade cover across settings. Weather was more strongly associated with sun protection at outdoor streets/cafes and parks/gardens than at pools/beaches but use of observed sun protection (particularly arm cover and covering hat) was low across settings. Continued public education about UV risk and its relation to weather and the seasons is needed to promote the routine use of multiple forms of sun protection during outdoor activities in peak UV times, especially among males and adolescents. Findings also highlight the importance of considering activity demands of public spaces in shade planning to optimize sun protection during outdoor activities in public spaces.
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Affiliation(s)
- Ashleigh Haynes
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne, VIC, Australia
| | - Andrea Nathan
- Telethon Kids Institute, Perth Children's Hospital, Nedlands, WA, Australia
| | - Clover Maitland
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne, VIC, Australia
| | - Helen Dixon
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne, VIC, Australia.,Melbourne School of Psychological Sciences, The University of Melbourne, Parkville, VIC, Australia
| | - Anna Nicholson
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne, VIC, Australia
| | - Melanie Wakefield
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne, VIC, Australia.,Melbourne School of Psychological Sciences, The University of Melbourne, Parkville, VIC, Australia
| | - Suzanne Dobbinson
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne, VIC, Australia
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Thoonen K, van Osch L, Drittij R, de Vries H, Schneider F. A Qualitative Exploration of Parental Perceptions Regarding Children's Sun Exposure, Sun Protection, and Sunburn. Front Public Health 2021; 9:596253. [PMID: 33681123 PMCID: PMC7930008 DOI: 10.3389/fpubh.2021.596253] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Accepted: 01/21/2021] [Indexed: 11/13/2022] Open
Abstract
Sun protection among children is of utmost importance since sunburn in early life is a major risk factor for skin cancer development. Because parents play a vital role in enhancing sun safety among children, this study explored parental perceptions concerning sun exposure, sun protection behaviors, and sunburn in children. Additionally, the context in which children experience sunburn in order to assist the development, optimization, and targeting of sun safety interventions for parents is revealed. A qualitative study design, using a semi-structured interview guide addressing several themes (e.g., sun exposure, sun protection, and sunburn experiences), was used. Data were collected in the Netherlands in the fall of 2019. Parents were recruited via purposive sampling at schools, youth services centers, and social media. Execution, transcription, and coding of the interviews was done by two researchers, using the qualitative analyzing program Nvivo (interrater reliability of d = 0.84). In total, 26 interviews were performed (n = 17 mothers, n = 17 daughters, aged between 4 and 11 years). Parental perceptions and recall of their child's lifetime sunburn were frequent, even though all parents reported using at least one sun protection measure during sun exposure situations and parents seemed often unaware of their child's sunburn. Moreover, parents reported an overreliance on sunscreen, often failing to adequately protect their children's skin. Water-related activities, a lack of shade, and misconceptions regarding UV-index were often related to sunburn. In addition, unexpected sun exposure or longer exposure duration than initially planned were reported as challenging situations. The majority of parents had positive perceptions regarding tanned skin for both themselves as for children. This study provides directions for skin cancer prevention efforts targeted at both parents and their children. Since a lack of knowledge regarding sufficient sun protection measures and sunburn occurrence in various situations was reported, educational efforts are warranted. Additionally, focusing on clothing, shade-seeking, and adequate sunscreen use is recommended to increase children's sun safety. By intervening in the physical environment as well (e.g., providing shady areas), sun protection barriers can be reduced. Lastly, the general positive attitude toward tanned skin evident in this study is certainly worthy of attention in future interventions.
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Affiliation(s)
- Karlijn Thoonen
- Department of Health Promotion, Care and Public Health Research Institute, Maastricht University, Maastricht, Netherlands
| | - Liesbeth van Osch
- Department of Health Promotion, Care and Public Health Research Institute, Maastricht University, Maastricht, Netherlands
| | - Rowan Drittij
- Faculty of Health, Medicine and Life Sciences, Health Sciences Master, Health Education and Promotion, Maastricht University, Maastricht, Netherlands
| | - Hein de Vries
- Department of Health Promotion, Care and Public Health Research Institute, Maastricht University, Maastricht, Netherlands
| | - Francine Schneider
- Department of Health Promotion, Care and Public Health Research Institute, Maastricht University, Maastricht, Netherlands
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12
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Tribby CP, Julian AK, Oh AY, Perna FM, Berrigan D. Associations between ultraviolet radiation, tree cover and adolescent sunburns. Int J Health Geogr 2020; 19:59. [PMID: 33317555 PMCID: PMC7734787 DOI: 10.1186/s12942-020-00253-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Accepted: 12/06/2020] [Indexed: 11/18/2022] Open
Abstract
Background Sunburn is the strongest risk factor for melanoma and non-melanoma skin cancers. Adolescent sunburns are related to higher risk of developing melanoma later in life. Little is known about the association of sunburns and shade, particularly tree cover, around adolescent homes and schools. This linkage study assessed associations of adolescent self-reported sunburns with ambient ultraviolet radiation (UV) and tree cover. Methods We analyzed a U.S. national sample of parent–child dyads (n = 1333) from the 2014 Family Life, Activity, Sun, Health, and Eating (FLASHE) study conducted by the National Cancer Institute. The outcome was adolescent sunburns reported for the previous 12 months. GIS buffers around geocoded home and school addresses were used to summarize UV and tree cover. A sensitivity analysis assessed different UV measures and tree cover buffer distances. Logistic regression models estimated the adjusted odds of any sunburns for five models: (1) no environmental variables; (2) spatial variables of latitude and longitude; (3) UV; (4) tree cover; and, (5) a combined model with UV and tree cover. Covariates included common sunburn-related items such as sun protective behaviors, socio-demographics, and latitude. Model residuals were assessed for spatial dependency and clustering. Results Overall, 44% of adolescents reported any sunburns in the previous 12 months. For the bivariate associations, lower categories of UV were associated with any reported sunburns (p-trend = 0.002). Home tree cover was not associated with any reported sunburns (p-trend = 0.08), whereas schools with lower categories of tree cover were associated with sunburns (p-trend = 0.008). The adjusted odds of any sunburns by UV tertiles, as a linear tread, was 0.89 (0.76–1.05) (p = 0.17); school tree cover was: 0.91 (0.78–1.07) (p = 0.25). Neither UV nor tree cover, in a combined model, were significant. Sensitivity analyses resulted in the optimal buffer size of 200 m for summarizing tree cover. Spatial dependence of residuals was not significant and clustering was significant for about 6% or less of the sample in each model. Conclusions We did not find significant relationships between UV or tree cover and adolescent sunburns, when adjusted by sunburn-related covariates. Better contextual data about where sunburns occurred is needed to identify environmental correlates of sunburn.
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Affiliation(s)
- Calvin P Tribby
- Department of Geography, University of Hong Kong, Room 1023, 10th Floor, The Jockey Club Tower Centennial Campus, Pokfulam Road, Hong Kong, Hong Kong.
| | - Anne K Julian
- Health Behaviors Research Branch, Behavioral Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, MD, USA.,Cancer Prevention Fellowship Program, Division of Cancer Prevention, National Cancer Institute, Bethesda, MD, USA
| | - April Y Oh
- Implementation Science Team, Office of the Director, Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, MD, USA
| | - Frank M Perna
- Health Behaviors Research Branch, Behavioral Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, MD, USA
| | - David Berrigan
- Health Behaviors Research Branch, Behavioral Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, MD, USA
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13
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Haynes A, Nathan A, Dixon H, Wakefield M, Dobbinson S. Sun-protective clothing and shade use in public outdoor leisure settings from 1992 to 2019: Results from cross-sectional observational surveys in Melbourne, Australia. Prev Med 2020; 139:106230. [PMID: 32768510 DOI: 10.1016/j.ypmed.2020.106230] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Revised: 06/11/2020] [Accepted: 08/02/2020] [Indexed: 10/23/2022]
Abstract
Skin cancer presents a significant public health burden in Australia. The present study aimed to supplement population-based estimates of sun protection behaviour by examining setting-specific trends in directly observed sun protection in public outdoor leisure settings. Repeated cross-sectional observational surveys of adolescents and adults were conducted on summer weekends between 11 am and 3 pm from 1992 to 2002, 2006 to 2012, and 2018 to 2019 (N = 44,979) at pools/beaches and parks/gardens within 25 km of the centre of Melbourne, Victoria. The primary outcome was a binary index representing individuals having above or below the median level of body surface covered by hat, shirt, and leg garments in each setting type. The prevalence of above-median body coverage increased between 1992 and 2002 in both settings. At pools/beaches, a slight decline in above-median body coverage between 2006 and 2019 in males and females (adjusted odds ratio, AOR = 0.96 [0.94, 0.97]; 0.94 [0.93, 0.95]) appeared to be driven by a decline in leg coverage, while arm coverage, hat, sunglasses, and shade use remained stable. At parks/gardens, a decline in above-median body coverage between 2006 and 2019 (AOR = 0.90 [0.89, 0.91]; 0.94 [0.93, 0.95]) was accompanied by small declines across other protective behaviours that varied between males and females. Patterns in protective behaviours observed in outdoor leisure settings may reflect the changing composition of individuals choosing to remain outdoors during peak UV times and highlight the importance of continued promotion and monitoring of the use of multiple measures to protect against UV damage in Australia.
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Affiliation(s)
- Ashleigh Haynes
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, 615 St Kilda Rd, Melbourne, Victoria 3004, Australia.
| | - Andrea Nathan
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, 615 St Kilda Rd, Melbourne, Victoria 3004, Australia
| | - Helen Dixon
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, 615 St Kilda Rd, Melbourne, Victoria 3004, Australia; Melbourne School of Psychological Sciences, The University of Melbourne, Parkville, Victoria, Australia
| | - Melanie Wakefield
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, 615 St Kilda Rd, Melbourne, Victoria 3004, Australia; Melbourne School of Psychological Sciences, The University of Melbourne, Parkville, Victoria, Australia
| | - Suzanne Dobbinson
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, 615 St Kilda Rd, Melbourne, Victoria 3004, Australia
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14
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Abstract
Solar ultraviolet radiation (UVR) induces the production of vitamin D (VD), but it also causes erythema and skin cancer among other diseases. The amount of UVR to get benefit and avoid harm is unknown. Some principles were proposed to provide accessible information on how to avoid overexposure to the Sun. They are (1) the Shadow Rule (SR); (2) the UV Index (UVI); and (3) the Slip, Slop, Slap, Seek, Slide (5S) steps. This work discusses these principles in the tropics, considering measurements of solar UVR, total ozone column, and cloudiness. Indeed, the SR leads to overexposures. The UVI is adequate for cloudless skies, but it does not consider radiation enhancement events by clouds. "Seek shade" in the 5S steps should be more emphasized as it is both the most efficient step in terms of avoiding direct sun and the friendliest step toward the environment. Therefore, photoprotection attitudes in the tropics should focus on the UVI and the 5S steps in addition to considering both VD sufficiency and environmental outcomes. The SR is clearly inaccurate.
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Affiliation(s)
- Abel Antônio Silva
- Instituto de Estudos Avançados (IEAv), Trevo Cel Av José Alberto Albano do Amarante 1, Putim, São José dos Campos, CEP 12.228-001, SP, Brazil
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15
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Karlsson E, Hübner IM, Haluza D, Falk M. Validation of SEPI in German-A German Translation of the Sun Exposure and Protection Index. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17176172. [PMID: 32854416 PMCID: PMC7504206 DOI: 10.3390/ijerph17176172] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Revised: 08/13/2020] [Accepted: 08/20/2020] [Indexed: 11/16/2022]
Abstract
The Sun Exposure and Protection Index (SEPI) is a brief instrument for scoring of sun exposure habits and propensity to increase sun protection, previously validated in English and in Swedish, as well as in two different outdoor sun intensity environments (Australia and Northern Europe). The aim of the present study was to study reliability and validity of a German translated version of the SEPI to be used in German-speaking populations. Data was collected at University of Flensburg and at Hamburg University of Applied Sciences from November 2018 to April 2019. Participants (n = 205) filled out the SEPI and also a selection of corresponding questions from the Austrian Vienna UV Questionnaire in German. After three weeks, the participants filled out the SEPI once again in order to assess test–retest stability. Of the 205 participants completing the baseline questionnaire, 135 participants completed it once again after three weeks. Internal consistency, by Cronbach’s alpha, for the baseline responses was 0.70 (95% C.I: 0.63–0.76) for SEPI part 1 (sun exposure habits) and 0.72 (95% C.I: 0.66–0.78) for part 2 (propensity to increase sun protection). Test–retest stability was high, with weighted Kappa >0.6 for all items but one, and the instrument correlated well with the previously validated German-language UV Skin Risk Survey Questionnaire. In conclusion, the German version of SEPI can reliably be used for mapping of individual sun exposure patterns.
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Affiliation(s)
- Elias Karlsson
- Department of Medicine, Health and Caring Sciences, Linköping University, SE-581 83 Linköping, Sweden; (E.K.); (M.F.)
| | - Inga-Marie Hübner
- Association of Dermatological Prevention [ADP], 20457 Hamburg, Germany
- Correspondence:
| | - Daniela Haluza
- Department of Environmental Health, Medical University of Vienna, 1090 Vienna, Austria;
| | - Magnus Falk
- Department of Medicine, Health and Caring Sciences, Linköping University, SE-581 83 Linköping, Sweden; (E.K.); (M.F.)
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16
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Serrano MA, Moreno JC. Spectral transmission of solar radiation by plastic and glass materials. JOURNAL OF PHOTOCHEMISTRY AND PHOTOBIOLOGY B-BIOLOGY 2020; 208:111894. [PMID: 32450467 DOI: 10.1016/j.jphotobiol.2020.111894] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Revised: 04/30/2020] [Accepted: 05/10/2020] [Indexed: 12/14/2022]
Abstract
It is well known that excessive exposure to solar ultraviolet (UV) radiation can have serious adverse effects. Many everyday materials influence the UV radiation received by humans, for example, those used in construction and on the exterior of buildings such as plastics and glass can reduce the UV exposure of persons exposed to solar radiation. In this paper we analyse the spectral transmission of solar radiation of widely used materials using the transmittance parameter. The measurements were performed on clear days, at 8 h and 12 solar hours, in July 2018 (five days) and in January 2019 (three days). The spectral transmittances of these materials and the integrated transmittances in the UVB from 300 nm, UVA, visible (VIS) and near infrared ranges (NIR) were calculated. In summer in the UVB range from 300 nm methacrylate and smoked glass have the highest transmittance values (56%) and polycarbonate present the lowest (30%). In the VIS and NIR ranges methacrylate (95%) and smoked glass (80%) have the highest transmittances and polycarbonate the lowest (45%). In general the 8 h transmittances are higher than those at 12 h and are also higher in winter than summer. For two biological functions (erythemal and DNA-damage) and for the UVB range from 300 nm, the transmittance for most materials (except fibreglass) is in the range 6-14%. The exposure times obtained show that erythemal damage could occur after long exposure to solar radiation through the materials studied, information which should be made available to the general public.
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Affiliation(s)
- María-Antonia Serrano
- Centre for Biomaterials and Tissue Engineering, Universitat Politècnica de València, Camino de Vera, s/n, 46022 Valencia, Spain..
| | - Juan Carlos Moreno
- Departamento de Física Aplicada, Universitat Politècnica de València, Valencia, Spain.
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17
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Are Environmental Interventions Targeting Skin Cancer Prevention among Children and Adolescents Effective? A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17020529. [PMID: 31947667 PMCID: PMC7013813 DOI: 10.3390/ijerph17020529] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Revised: 12/20/2019] [Accepted: 12/24/2019] [Indexed: 11/17/2022]
Abstract
Skin cancer, which is increasing exceedingly worldwide, is substantially preventable by reducing unprotected exposure to ultraviolet radiation (UVR). Several comprehensive interventions targeting sun protection behaviors among children and adolescents in various outdoor settings have been developed; however, there is a lack of insight on stand-alone effectiveness of environmental elements. To compose future skin cancer prevention interventions optimally, identification of effective environmental components is necessary. Hence, an extensive systematic literature search was conducted, using four scientific databases and one academic search engine. Seven relevant studies were evaluated based on stand-alone effects of various types of environmental sun safety interventions on socio-cognitive determinants, sun protection behaviors, UVR exposure, and incidence of sunburns and nevi. Free provision of sunscreen was most often the environmental component of interest, however showing inconsistent results in terms of effectiveness. Evidence regarding shade provision on shade-seeking behavior was most apparent. Even though more research is necessary to consolidate the findings, this review accentuates the promising role of environmental components in skin cancer prevention interventions and provides directions for future multi-component sun safety interventions targeted at children and adolescents in various outdoor settings.
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18
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Tribby CP, Perna FM, Berrigan D. Walking and Sun Protective Behaviors: Cross-Sectional Associations of Beneficial Health Factors. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E2361. [PMID: 31277315 PMCID: PMC6651436 DOI: 10.3390/ijerph16132361] [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] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Revised: 06/27/2019] [Accepted: 06/29/2019] [Indexed: 01/04/2023]
Abstract
Sun protective behaviors and physical activity have the potential to reduce cancer risk. Walking is the most common type of physical activity in the United States, but it is unclear whether sun protective behaviors differ by categories of walking, such as leisure versus transportation walking. We examined whether sun protective behaviors varied by category or duration of walking in the 2015 National Health Interview Survey (N = 26,632), age ≥ 18 years. We used logistic regression to estimate sunscreen use, sun avoidance, and sun protective clothing use by four categories of walking (no reported walking, transportation only, leisure only, or walking for both) and separately for walking duration for the general population and sun-sensitive individuals. Prevalence of sunscreen use varied across walking categories and the odds of use were higher with longer walking duration for transportation and leisure compared to those who reported no walking. Sun avoidance varied across walking categories and the odds of avoidance were lower with longer duration leisure but not transportation walking. Sun protective clothing varied across walking categories and the odds of use were higher for longer duration transportation, but not leisure walking. Data on the concurrence of walking and sun protection is needed to further understand the relationship between these health behaviors. By examining leisure and transportation walking, we found variations in sun protective behaviors that may provide important insight into strategies to increase sun protection while promoting physical activity.
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Affiliation(s)
- Calvin P Tribby
- Cancer Prevention Fellowship Program, Division of Cancer Prevention, National Cancer Institute, Bethesda, MD 20892, USA.
- Health Behaviors Research Branch, Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, MD 20892, USA.
| | - Frank M Perna
- Health Behaviors Research Branch, Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, MD 20892, USA
| | - David Berrigan
- Health Behaviors Research Branch, Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, MD 20892, USA
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19
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Heckman CJ. Public Parks and Shady Areas in Times of Climate Change, Urban Sprawl, and Obesity. Am J Public Health 2019; 107:1856-1858. [PMID: 29116832 DOI: 10.2105/ajph.2017.304140] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Carolyn J Heckman
- Carolyn J. Heckman is an associate professor in the Cancer Prevention and Control Program at Fox Chase Cancer Center in Philadelphia, PA
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20
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Holman DM, Ding H, Freeman M, Shoemaker ML. Association Between Sun Protection Behaviors and Sunburn Among U.S. Older Adults. THE GERONTOLOGIST 2019; 59:S17-S27. [PMID: 31100136 PMCID: PMC6681447 DOI: 10.1093/geront/gny173] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2018] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Skin cancer incidence rates are highest among U.S. older adults. However, little is known about sun protection behaviors and sunburn among adults aged 65 years and older. RESEARCH DESIGN AND METHODS We used data from the 2015 National Health Interview Survey to examine the association between sun protection behaviors (sun avoidance, wearing protective clothing, and sunscreen use) and likelihood of having experienced sunburn in the past year. RESULTS Just over one in ten older adults (13.2%) had experienced sunburn in the past year; sunburn prevalence was nearly twice as high (20.4%) among sun-sensitive older adults. Men, ages 65-69 years, non-Hispanic whites, and those with skin that burns or freckles after repeated sun exposure were more likely to have been sunburned in the past year compared with the respective comparison groups. The only sun protection behavior significantly associated with sunburn was sunscreen use. None of the sun protection behaviors were significantly associated with a decreased risk of sunburn. DISCUSSION AND IMPLICATIONS The prevalence of sunburn among older adults suggests opportunities to reduce skin cancer risk within this demographic group by preventing overexposure to the sun. The lack of reduced sunburn risk among those who regularly used sun protection may be related to inadequate or inconsistent use of sun protection or the way the sun protection behaviors were measured. Multi-sector approaches to facilitate sun-safety among older adults are warranted and could include targeted efforts focused on those most likely to get sunburned, including men and those with sun-sensitive skin.
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Affiliation(s)
- Dawn M. Holman
- Centers for Disease Control and Prevention, Division of Cancer Prevention and Control, Atlanta, Georgia
| | - Helen Ding
- DB Consulting Group Inc., Atlanta, Georgia
| | - MaryBeth Freeman
- Centers for Disease Control and Prevention, Division of Cancer Prevention and Control, Atlanta, Georgia
| | - Meredith L. Shoemaker
- Centers for Disease Control and Prevention, Division of Cancer Prevention and Control, Atlanta, Georgia
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21
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Lucas RM, Yazar S, Young AR, Norval M, de Gruijl FR, Takizawa Y, Rhodes LE, Sinclair CA, Neale RE. Human health in relation to exposure to solar ultraviolet radiation under changing stratospheric ozone and climate. Photochem Photobiol Sci 2019; 18:641-680. [PMID: 30810559 DOI: 10.1039/c8pp90060d] [Citation(s) in RCA: 99] [Impact Index Per Article: 19.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
The Montreal Protocol has limited increases in the UV-B (280-315 nm) radiation reaching the Earth's surface as a result of depletion of stratospheric ozone. Nevertheless, the incidence of skin cancers continues to increase in most light-skinned populations, probably due mainly to risky sun exposure behaviour. In locations with strong sun protection programs of long duration, incidence is now reducing in younger age groups. Changes in the epidemiology of UV-induced eye diseases are less clear, due to a lack of data. Exposure to UV radiation plays a role in the development of cataracts, pterygium and possibly age-related macular degeneration; these are major causes of visual impairment world-wide. Photodermatoses and phototoxic reactions to drugs are not uncommon; management of the latter includes recognition of the risks by the prescribing physician. Exposure to UV radiation has benefits for health through the production of vitamin D in the skin and modulation of immune function. The latter has benefits for skin diseases such as psoriasis and possibly for systemic autoimmune diseases such as multiple sclerosis. The health risks of sun exposure can be mitigated through appropriate sun protection, such as clothing with both good UV-blocking characteristics and adequate skin coverage, sunglasses, shade, and sunscreen. New sunscreen preparations provide protection against a broader spectrum of solar radiation, but it is not clear that this has benefits for health. Gaps in knowledge make it difficult to derive evidence-based sun protection advice that balances the risks and benefits of sun exposure.
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Affiliation(s)
- R M Lucas
- National Centre for Epidemiology and Population Health, Research School of Population Health, Australian National University, Canberra, Australia. and Centre for Ophthalmology and Visual Science, University of Western Australia, Perth, Australia
| | - S Yazar
- Centre for Ophthalmology and Visual Science, University of Western Australia, Perth, Australia and MRC Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, UK
| | | | - M Norval
- Biomedical Sciences, University of Edinburgh Medical School, Edinburgh, Scotland, UK
| | - F R de Gruijl
- Department of Dermatology, Leiden University Medical Centre, Leiden, The Netherlands
| | - Y Takizawa
- Akita University School of Medicine, National Institute for Minamata Disease, Nakadai, Itabashiku, Tokyo, Japan
| | - L E Rhodes
- Centre for Dermatology Research, School of Biological Sciences, Faculty of Biology, Medicine, and Health, The University of Manchester and Salford Royal NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
| | | | - R E Neale
- QIMR Berghofer Institute of Medical Research, Herston, Brisbane, Australia and School of Public Health, University of Queensland, Australia
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22
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Holman DM, Kapelos GT, Shoemaker M, Watson M. Shade as an Environmental Design Tool for Skin Cancer Prevention. Am J Public Health 2018; 108:1607-1612. [PMID: 30359104 PMCID: PMC6236749 DOI: 10.2105/ajph.2018.304700] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/03/2018] [Indexed: 01/10/2023]
Abstract
Little work has been done to explore the use of shade for skin cancer prevention in the context of the built environment. In an effort to address this gap and draw attention to the intersection between architectural and public health practice, we reviewed research on shade design, use, and policies published from January 1, 1996, through December 31, 2017. Our findings indicate that various features influence the sun-protective effects of shade, including the materials, size, shape, and position of the shade structure; the characteristics of the surrounding area; and weather conditions. Limited research suggests that shade provision in outdoor spaces may increase shade use. Shade audit and design tools are available to inform shade planning efforts. Shade policies to date have mostly been setting specific, and information on the implementation and effects of such policies is limited. Integrating shade planning into community design, planning, and architecture may have a substantial impact and will require a multidisciplinary approach.
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Affiliation(s)
- Dawn M Holman
- Dawn M. Holman, Meredith Shoemaker, and Meg Watson are with the Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA. George Thomas Kapelos is with the Department of Architectural Science, Ryerson University, Toronto Ontario, Canada
| | - George Thomas Kapelos
- Dawn M. Holman, Meredith Shoemaker, and Meg Watson are with the Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA. George Thomas Kapelos is with the Department of Architectural Science, Ryerson University, Toronto Ontario, Canada
| | - Meredith Shoemaker
- Dawn M. Holman, Meredith Shoemaker, and Meg Watson are with the Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA. George Thomas Kapelos is with the Department of Architectural Science, Ryerson University, Toronto Ontario, Canada
| | - Meg Watson
- Dawn M. Holman, Meredith Shoemaker, and Meg Watson are with the Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA. George Thomas Kapelos is with the Department of Architectural Science, Ryerson University, Toronto Ontario, Canada
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23
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Shedding Light on the Shade: How Nurseries Protect Their Children from Ultraviolet Radiation. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15091793. [PMID: 30134509 PMCID: PMC6163746 DOI: 10.3390/ijerph15091793] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/28/2018] [Revised: 08/11/2018] [Accepted: 08/14/2018] [Indexed: 11/26/2022]
Abstract
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.
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24
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Turner J, Parisi AV. Ultraviolet Radiation Albedo and Reflectance in Review: The Influence to Ultraviolet Exposure in Occupational Settings. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:E1507. [PMID: 30018236 PMCID: PMC6069363 DOI: 10.3390/ijerph15071507] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/22/2018] [Revised: 07/13/2018] [Accepted: 07/13/2018] [Indexed: 11/29/2022]
Abstract
Ultraviolet (UV) albedo and UV reflectance are defined, compared and contrasted, to explain their roles and place in studies focusing on UV radiation and exposure measurements, in the context of localised albedo measurement and human UV exposure studies. This review recommends that the term UV albedo be used when investigating natural horizontal surfaces when the albedo is not known to change significantly over time. The term UV reflectance should be mostly used for non-natural surfaces and non-horizontal measurements and will change with respect to the geometry of the irradiances reflected and received, and due to the intrinsic nature of the surface itself. UV albedo measurements made in the literature have been compiled, in both broadband and spectral UV albedo measurements. Broadband measurements have been tabulated and spectral UV measurements have been displayed visually. The methodology of measurements is briefly discussed. Finally, studies that consider how high albedo or reflectance sites influence UV exposure are reviewed. It was concluded that there is currently no known relationship between the albedo or reflectance of a surface and the resulting influence it has on individual UV exposure. This presents an opportunity for researchers to continue exploring the influence of reflective UV surfaces.
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Affiliation(s)
- Joanna Turner
- Faculty of Health Engineering and Sciences, University of Southern Queensland, Toowoomba 4350, Australia.
| | - Alfio V Parisi
- Faculty of Health Engineering and Sciences, University of Southern Queensland, Toowoomba 4350, Australia.
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25
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Taber JM, Dickerman BA, Okhovat JP, Geller AC, Dwyer LA, Hartman AM, Perna FM. Skin cancer interventions across the cancer control continuum: Review of technology, environment, and theory. Prev Med 2018; 111:451-458. [PMID: 29277407 PMCID: PMC5949070 DOI: 10.1016/j.ypmed.2017.12.019] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2017] [Revised: 11/11/2017] [Accepted: 12/19/2017] [Indexed: 12/12/2022]
Abstract
The National Cancer Institute's Skin Cancer Intervention across the Cancer Control Continuum model was developed to summarize research and identify gaps concerning skin cancer interventions. We conducted a mapping review to characterize whether behavioral interventions addressing skin cancer prevention and control from 2000 to 2015 included (1) technology, (2) environmental manipulations (policy and/or built environment), and (3) a theoretical basis. We included 86 studies with a randomized controlled or quasi-experimental design that targeted behavioral intervention in skin cancer for children and/or adults; seven of these were dissemination or implementation studies. Of the interventions described in the remaining 79 articles, 57 promoted only prevention behaviors (e.g., ultraviolet radiation protection), five promoted only detection (e.g., skin examinations), 10 promoted both prevention and detection, and seven focused on survivorship. Of the 79 non-dissemination studies, two-thirds used some type of technology (n=52; 65.8%). Technology specific to skin cancer was infrequently used: UVR photography was used in 15.2% of studies (n=12), reflectance spectroscopy was used in 12.7% (n=10), and dermatoscopes (n=1) and dosimeters (n=2) were each used in less than 3%. Ten studies (12.7%) targeted the built environment. Fifty-two (65.8%) of the studies included theory-based interventions. The most common theories were Social Cognitive Theory (n=20; 25.3%), Health Belief Model (n=17; 21.5%), and the Theory of Planned Behavior/Reasoned Action (n=12; 15.2%). Results suggest that skin cancer specific technology and environmental manipulations are underutilized in skin cancer behavioral interventions. We discuss implications of these results for researchers developing skin cancer behavioral interventions.
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Affiliation(s)
- Jennifer M Taber
- Behavioral Research Program, National Cancer Institute, United States.
| | | | | | - Alan C Geller
- Harvard TH Chan School of Public Health, United States
| | | | - Anne M Hartman
- Behavioral Research Program, National Cancer Institute, United States
| | - Frank M Perna
- Behavioral Research Program, National Cancer Institute, United States
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26
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McNoe BM, Reeder AI, de Lange MP. SunSmart schools: a New Zealand skin cancer primary prevention intervention blueprint for primary school settings. Br J Dermatol 2018; 179:963-964. [PMID: 29654698 DOI: 10.1111/bjd.16670] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- B M McNoe
- Cancer Society Social and Behavioural Research Unit, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
| | - A I Reeder
- Cancer Society Social and Behavioural Research Unit, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
| | - M P de Lange
- Department of Preventive and Social Medicine, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
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27
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Abstract
Solar protection is an important public health issue because solar UV exposure can cause acute and chronic damage to the skin. Seeking shade is a convenient and commonly practiced sun avoidance measure. Shade works by physically shielding the skin from direct UV rays; however UV rays can also reach the skin from other angles. It is not clear how protective the widely-used shade structures like umbrellas and walls are under actual use conditions. In this study, a sky view model was applied to systematically assess the influence of different factors to umbrellas and walls, including the transmission of the shade materials, the reflectivity of the ground or the wall, diffused UV to total UV irradiance ratios, shade geometry, a person's positions and orientations in the shade. We measured the sunburn protection factor (SPF) with a calibrated UV meter at different positions in the shades of an umbrella at different times of the day and compared the measurement results with the modeling. We found that shade structures like umbrellas and walls are more effective when the ratios of diffused UV to total UV irradiance are smaller (mid-day). The effectiveness increases with more coverage, less surface reflectance, and more centralized positions in the shade. The SPF value for a typical umbrella is probably between 3 and 7 in real-life. The low sun protection level offered by a typical shade highlights the importance of educating the public about how to properly protect the skin from the sun and the importance of applying a combination of sun protection measures during extended sun exposures.
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Affiliation(s)
- Hao Ou-Yang
- Johnson and Johnson Consumer Inc., Skillman, NJ 08558, USA.
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Buller DB, English DR, Buller MK, Simmons J, Chamberlain JA, Wakefield M, Dobbinson S. Shade Sails and Passive Recreation in Public Parks of Melbourne and Denver: A Randomized Intervention. Am J Public Health 2017; 107:1869-1875. [PMID: 29048958 DOI: 10.2105/ajph.2017.304071] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
OBJECTIVES To test whether shade sails will increase the use of passive recreation areas (PRAs). METHODS We conducted a stratified randomized pretest-posttest controlled design study in Melbourne, Australia, and Denver, Colorado, in 2010 to 2014. We randomized a sample of 144 public parks with 2 PRAs in full sun in a 1:3 ratio to treatment or control. Shade sails were built at 1 PRA per treatment park. The outcome was any use of the study PRA (n = 576 pretest and n = 576 posttest observations; 100% follow-up). RESULTS Compared with control PRAs (adjusted probability of use: pretest = 0.14, posttest = 0.17), use of treatment PRAs (pretest = 0.10, posttest = 0.32) was higher at posttest (odds ratio [OR] = 3.91; 95% confidence interval [CI] = 1.71, 8.94). Shade increased use of PRAs in Denver (control: pretest = 0.18, posttest = 0.19; treatment: pretest = 0.16, posttest = 0.47) more than Melbourne (control: pretest = 0.11, posttest = 0.14; shaded: pretest = 0.06, posttest = 0.19; OR = 2.98; 95% CI = 1.09, 8.14). CONCLUSIONS Public investment in shade is warranted for skin cancer prevention and may be especially useful in the United States. TRIAL REGISTRATION Clinicaltrials.gov identifier NCT02971709.
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Affiliation(s)
- David B Buller
- David B. Buller and Mary Klein Buller are with Klein Buendel, Inc., Golden, CO. Dallas R. English is with the Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia. Jody Simmons, Melanie Wakefield, and Suzanne Dobbinson are with the Centre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne. James A. Chamberlain is with the Cancer Epidemiology Centre, Cancer Council Victoria
| | - Dallas R English
- David B. Buller and Mary Klein Buller are with Klein Buendel, Inc., Golden, CO. Dallas R. English is with the Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia. Jody Simmons, Melanie Wakefield, and Suzanne Dobbinson are with the Centre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne. James A. Chamberlain is with the Cancer Epidemiology Centre, Cancer Council Victoria
| | - Mary Klein Buller
- David B. Buller and Mary Klein Buller are with Klein Buendel, Inc., Golden, CO. Dallas R. English is with the Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia. Jody Simmons, Melanie Wakefield, and Suzanne Dobbinson are with the Centre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne. James A. Chamberlain is with the Cancer Epidemiology Centre, Cancer Council Victoria
| | - Jody Simmons
- David B. Buller and Mary Klein Buller are with Klein Buendel, Inc., Golden, CO. Dallas R. English is with the Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia. Jody Simmons, Melanie Wakefield, and Suzanne Dobbinson are with the Centre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne. James A. Chamberlain is with the Cancer Epidemiology Centre, Cancer Council Victoria
| | - James A Chamberlain
- David B. Buller and Mary Klein Buller are with Klein Buendel, Inc., Golden, CO. Dallas R. English is with the Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia. Jody Simmons, Melanie Wakefield, and Suzanne Dobbinson are with the Centre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne. James A. Chamberlain is with the Cancer Epidemiology Centre, Cancer Council Victoria
| | - Melanie Wakefield
- David B. Buller and Mary Klein Buller are with Klein Buendel, Inc., Golden, CO. Dallas R. English is with the Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia. Jody Simmons, Melanie Wakefield, and Suzanne Dobbinson are with the Centre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne. James A. Chamberlain is with the Cancer Epidemiology Centre, Cancer Council Victoria
| | - Suzanne Dobbinson
- David B. Buller and Mary Klein Buller are with Klein Buendel, Inc., Golden, CO. Dallas R. English is with the Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia. Jody Simmons, Melanie Wakefield, and Suzanne Dobbinson are with the Centre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne. James A. Chamberlain is with the Cancer Epidemiology Centre, Cancer Council Victoria
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Perna FM, Dwyer LA, Tesauro G, Taber JM, Norton WE, Hartman AM, Geller AC. Research on Skin Cancer-Related Behaviors and Outcomes in the NIH Grant Portfolio, 2000-2014: Skin Cancer Intervention Across the Cancer Control Continuum (SCI-3C). JAMA Dermatol 2017; 153:398-405. [PMID: 28329179 PMCID: PMC5817496 DOI: 10.1001/jamadermatol.2016.6216] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2016] [Accepted: 12/26/2016] [Indexed: 11/14/2022]
Abstract
Importance The Surgeon General's Call to Action to Prevent Skin Cancer broadly identified research gaps, but specific objectives are needed to further behavioral intervention research. Objective To review National Institute of Health (NIH) grants targeting skin cancer-related behaviors and relevant outcomes. Design, Setting, and Participants A portfolio analysis of the title, abstract, specific aims, and research plans of identified grant applications from 2000 to 2014 targeting skin cancer-related behaviors or testing behavioral intervention effects on cancer-relevant outcomes along the cancer continuum. Main Outcomes and Measures Funding trends were compared along the cancer control continuum, with respect to investigator demographics and use of theory, technology, policy, and changes to environmental surroundings (built environment). Results A total of 112 submitted applications met inclusion criteria; of these, 40 (35.7%) were funded, and 31 of the 40 were interventions. Comparing the 40 funded grants with the 72 unfunded grants, the overall success rates did not differ significantly between male (33.3%) and female (37.3%) investigators, nor did the frequency of R01 awards (36.7% and 28.1%, respectively). Among intervention awards, most (24 of 31) addressed prevention. Fewer awards targeted detection alone or in conjunction with prevention (3) or cancer survivorship (4), and no grant addressed emotional sequelae or adherence behavior related to diagnosis or treatment. Fewer than half of funded grants aimed for clinically related targets (eg, sunburn reduction). Use of theory and technology occurred in more than 75% of grants. However, the full capability of proposed technology was infrequently used, and rarely did constructs of the proposed behavior change theory clearly and comprehensively drive the intervention approach. Policy or environmental manipulation was present in all dissemination grants but was rarely used elsewhere, and 19.4% included policy implementation and 25.8% proposed changes in built environment. Conclusions and Relevance Grant success rate in skin cancer-related behavioral science compares favorably to the overall NIH grant success rate (approximately 18%), and the success rate of male and female investigators was not statistically different. However, gaps exist in behavioral research addressing all points of the skin cancer control continuum, measuring interventions that hit clinically related targets, and leveraging technology, theory, and environmental manipulation to optimize intervention approach.
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Affiliation(s)
| | | | | | | | | | | | - Alan C. Geller
- Harvard T. H. Chan School of Public Health, Boston, Massachusetts
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Walkosz BJ, Scott MD, Buller DB, Andersen PA, Beck L, Cutter GR. Prevalence of Sun Protection at Outdoor Recreation and Leisure Venues at Resorts in North America. AMERICAN JOURNAL OF HEALTH EDUCATION 2017; 48:90-99. [PMID: 29147456 DOI: 10.1080/19325037.2016.1271755] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Background Exposure to solar ultra violet radiation (UVR) is a primary risk factor for skin cancer. Vacationers often fail to protect themselves from harmful UVR. Purpose The study assessed the sun protection practices of resort guests in various outdoor leisure and recreation venues during warm-weather seasons. Method 41 North American resorts were enrolled in a quasi-experimental randomized controlled trial. Adult guests were observed (n=4091) and surveyed (n=3694) in a cross sectional sample. Data collection was conducted in recreation and leisure venues with outdoors commons/reception areas acting as the comparison condition. Results The mean percent of vacationers at pools and beaches were more likely (p < 0.001) to wear sunscreen than in commons areas but less likely (p < 0.001) to wear cover-up clothing or use shade. In both samples, the combined sun protection scores were higher in commons areas compared to all venues except for outdoor dining (p < 0.001). Discussion Sun safety was suboptimal in all venues and was potentially mitigated by venue type. Translation to Health Education Practice Approaches are needed to encourage vacationers to practice comprehensive sun protection and to work with resorts to construct built environments that facilitate rather than act as barriers to sun safety.
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Affiliation(s)
- Barbara J Walkosz
- Senior Scientist, Klein Buendel, Inc., 1667 Cole Boulevard, Suite 225, Golden, CO 80401
| | - Michael D Scott
- Professor Emeritus at California State University and President Mikonics, Inc., 40 B Old Road South, Santa Fe, NM 87540
| | - David B Buller
- Senior Scientist and Director of Research, Klein Buendel, Inc., 1667 Cole Boulevard, Suite 225, Golden, CO 80401
| | - Peter A Andersen
- Professor Emeritus, School of Communication, San Diego State University, 5500 Campanile Drive, San Diego, CA 92182
| | - Larry Beck
- Professor, L. Robert Payne School of Hospitality and Tourism Management, Room PSFA 445, San Diego State University, San Diego, CA 92182
| | - Gary R Cutter
- Professor, Department of Biostatistics, School of Public Health, RPHB 401B, University of Alabama, 1720 2Avenue South, Birmingham, AL 35294
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Dobbinson S, Niven P, Buller D, Allen M, Gies P, Warne C. Comparing Handheld Meters and Electronic Dosimeters for Measuring Ultraviolet Levels under Shade and in the Sun. Photochem Photobiol 2016; 92:208-14. [PMID: 26575187 DOI: 10.1111/php.12551] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2015] [Accepted: 09/22/2015] [Indexed: 01/07/2023]
Abstract
This study aimed to compare the validity, reliability and practicality of alternative portable methods for measuring erythemal UVR levels in passive recreation areas in public parks. UVR levels were measured for point in time comparisons between Solarmeter 6.5 handheld meters and time-stamped electronic dosimeters in a large central park in Melbourne, Australia. Observations were made at 20 locations in the park by two research assistants under two conditions: (1) matched shade (2) contrasting shade-no shade. Comparisons were also made with scientific instruments on the UVR monitoring station rooftop and by remotely selecting UV records and forecasts on cloud-free dates of park observations. There was good agreement between the portable UVR instruments in the park setting as confirmed via Bland Altman plots, while the dosimeter appeared less sensitive to change in shade conditions. The rooftop measurements showed that the Solarmeter 6.5 UVR readings were comparable to those of the adjacent rooftop instruments. The practicalities of using the dosimeters and Solarmeters for behavioral studies are discussed. These findings provide a basis for use of the Solarmeter 6.5 to measure changes in UVR levels due to different environmental conditions with relative accuracy for intervention studies in outdoor settings.
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Affiliation(s)
| | | | | | - Martin Allen
- Department of Electrical and Computer Engineering, College of Engineering, University of Canterbury, Christchurch, New Zealand
| | - Peter Gies
- Australian Radiation Protection and Nuclear Safety Agency, Government of Australia, Melbourne, VIC, Australia
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Harrison SL, Garzón-Chavez DR, Nikles CJ. Sun protection policies of Australian primary schools in a region of high sun exposure. HEALTH EDUCATION RESEARCH 2016; 31:416-428. [PMID: 27093982 DOI: 10.1093/her/cyw020] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/17/2014] [Accepted: 03/17/2016] [Indexed: 06/05/2023]
Abstract
Queensland, Australia has the highest rates of skin cancer globally. Predetermined criteria were used to score the comprehensiveness of sun protection policies (SPP) of primary schools across Queensland. SPP were sought for schools in 10 regions (latitude range 16.3°S-28.1°S) from 2011 to 2014. Of the 723 schools sampled, 90.9% had a written SPP available publicly. Total SPP scores were low {mean 3.6 [95% CI: 3.4-3.9]; median 2 [interquartile range (IQR) 2, 4]}, with only 3.2% of schools achieving the maximum score of 12. Median SPP scores were higher in Northern and Central Queensland [both 2 (IQR 2, 6) and (IQR 2, 5), respectively] than in Southern Queensland [2 (IQR 2, 3); P = 0.004]. Clothing and hat-wearing were addressed in most policies (96% and 89%) while few schools used their SPP to plan outdoor events (5.2%) or reschedule activities to minimize sun exposure (11.7%). The SunSmart Schools program has been operating in Queensland for 17 years, and while most primary schools now have a written SPP, most are not comprehensive. Incentive-based approaches (5-star-rating award scheme and grants) may assist in addressing this issue, to reduce sun exposure of students and teachers. These data provide a baseline from which improvements in the comprehensiveness of school SPPs can be evaluated.
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Affiliation(s)
- S L Harrison
- JCU Skin Cancer Research Unit, College of Public Health, Medical & Veterinary Sciences, Room Eg-083 Ground Floor, The Townsville Hospital Education Wing, James Cook University, Townsville, QLD 4811, Australia The Anton Breinl Research Centre for Health Systems Strengthening, Australian Institute of Tropical Health and Medicine (AITHM), James Cook University, Townsville, QLD 4811, Australia
| | - D R Garzón-Chavez
- JCU Skin Cancer Research Unit, College of Public Health, Medical & Veterinary Sciences, Room Eg-083 Ground Floor, The Townsville Hospital Education Wing, James Cook University, Townsville, QLD 4811, Australia
| | - C J Nikles
- JCU Skin Cancer Research Unit, College of Public Health, Medical & Veterinary Sciences, Room Eg-083 Ground Floor, The Townsville Hospital Education Wing, James Cook University, Townsville, QLD 4811, Australia
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Krzyścin JW, Guzikowski J, Rajewska-Więch B. Optimal vitamin D3 daily intake of 2000IU inferred from modeled solar exposure of ancestral humans in Northern Tanzania. JOURNAL OF PHOTOCHEMISTRY AND PHOTOBIOLOGY B-BIOLOGY 2016; 159:101-5. [PMID: 27043260 DOI: 10.1016/j.jphotobiol.2016.03.029] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/18/2015] [Revised: 03/04/2016] [Accepted: 03/21/2016] [Indexed: 01/30/2023]
Abstract
Recently, high serum 25-hydroxyvitamin D concentration (~110nmol/L) was found in the Hadza tribe still keeping ancient hunter-gather life style. This level could serve as optimal vitamin D level that was built during millennia of human evolution. The personal vitamin D3 effective solar exposures of the Hadza adults are estimated using radiative model simulations with input from the satellite observations over lake Eyasi (3.7°S, 35.0°E). The calculations are carried out assuming the Hadza typical clothing habits and specific scenarios of the out-door activity comprising early morning and late afternoon working time in sun and prolonged midday siesta in the shade. The modeled doses received by the Hadza are converted to the vitamin D3 effective daily doses pertaining to the lighter skinned persons. We propose a novel formula to get adequate vitamin D level - exposure of 1/3 MED around local noon to 1/3 part of the whole body during warm sub-period of the year in the low- and mid-latitude regions. Such daily solar exposure is equivalent to ~2000IU of vitamin D3 taken orally. For many contemporary humans with limited out-door activity habit achieving such daily norm requires vitamin D3 supplementation of 2000IU throughout the whole year.
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Affiliation(s)
- Janusz W Krzyścin
- Institute of Geophysics, Polish Academy of Sciences, Warsaw, Poland.
| | - Jakub Guzikowski
- Institute of Geophysics, Polish Academy of Sciences, Warsaw, Poland
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Lucas RM, Norval M, Wright CY. Solar ultraviolet radiation in Africa: a systematic review and critical evaluation of the health risks and use of photoprotection. Photochem Photobiol Sci 2016; 15:10-23. [DOI: 10.1039/c5pp00419e] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
The majority of the African continent experiences high solar UVB radiation throughout the year. The adverse consequences of this on the health of populations living in Africa are reviewed.
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Affiliation(s)
- Robyn M. Lucas
- National Centre for Epidemiology and Population Health
- The Australia National University
- Canberra
- Australia
| | - Mary Norval
- Biomedical Sciences
- University of Edinburgh
- Edinburgh
- UK
| | - Caradee Y. Wright
- South African Medical Research Council and University of Pretoria
- Pretoria
- South Africa
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35
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Logue ME, Zlotoff BJ. Reflections on smart phones, tablets, and ultraviolet (UV) light: Should we worry?: An observational study. J Am Acad Dermatol 2015; 73:526-8. [PMID: 26282803 DOI: 10.1016/j.jaad.2015.06.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2015] [Revised: 06/10/2015] [Accepted: 06/12/2015] [Indexed: 11/17/2022]
Affiliation(s)
- Mary E Logue
- School of Medicine, University of New Mexico, Albuquerque, New Mexico.
| | - Barrett J Zlotoff
- Department of Dermatology, University of New Mexico, Albuquerque, New Mexico
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36
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Silva AA. The diffuse component of erythemal ultraviolet radiation. Photochem Photobiol Sci 2015; 14:1941-51. [DOI: 10.1039/c5pp00131e] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
The diffuse (Dif) component of ultraviolet radiation (UVR) plays an important role in the daily exposure of humans to solar radiation.
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