Sun Exposure and Sun Protection Habits Among High-school Adolescents in Porto Alegre, Brazil¶

Effect of a Face-Aging Mobile App-Based Intervention on Skin Cancer Protection Behavior in Secondary Schools in Brazil: A Cluster-Randomized Clinical Trial

Question

Can a face-aging mobile app improve the skin cancer protection behavior of secondary school students?

Findings

In this cluster-randomized clinical trial of 52 school classes with 1573 Brazilian pupils, meaningful improvements were observed in sunscreen use, tanning behavior, and skin self-examinations 3 to 6 months after an intervention using a face-aging app compared with the nonintervention group.

Meaning

Face-aging apps may be useful tools to increase skin cancer protection in adolescents and thereby decrease skin cancer risk.

Importance

Because exposure to UV radiation early in life is an important risk factor for melanoma development, reducing UV exposure in children and adolescents is of paramount importance. New interventions are urgently required.

Objective

To determine the effect of the free face-aging mobile app Sunface on the skin cancer protection behavior of adolescents.

Design, Setting, and Participants

This cluster-randomized clinical trial included a single intervention and a 6-month follow-up from February 1 to November 30, 2018. Randomization was performed on the class level in 52 school classes within 8 public secondary schools (grades 9-12) in Itauna, Southeast Brazil. Data were analyzed from May 1 to October 10, 2019.

Interventions

In a classroom seminar delivered by medical students, adolescents’ selfies were altered by the app to show UV effects on their future faces and were shown in front of their class, accompanied by information about UV protection. Information about relevant parameters was collected via anonymous questionnaires before and 3 and 6 months after the intervention.

Main Outcomes and Measures

The primary end point of the study was the difference in daily sunscreen use at 6 months of follow-up. Secondary end points included the difference in daily sunscreen use at 3 months of follow-up, at least 1 skin self-examination within 6 months, and at least 1 tanning session in the preceding 30 days. All analyses were predefined and based on intention to treat. Cluster effects were taken into account.

Results

Participants included 1573 pupils (812 girls [51.6%] and 761 boys [48.4%]; mean [SD] age, 15.9 [1.3] years) from 52 school classes. Daily sunscreen use increased from 110 of 734 pupils (15.0%) to 139 of 607 (22.9%; P < .001) at the 6-month follow-up in the intervention group. The proportion of pupils performing at least 1 skin self-examination in the intervention group rose from 184 of 734 (25.1%) to 300 of 607 (49.4%; P < .001). Use of tanning decreased from 138 of 734 pupils (18.8%) to 92 of 607 (15.2%; P = .04). No significant changes were observed in the control group. The intervention was more effective for female students (number needed to treat for the primary end point: 8 for girls and 31 for boys).

Conclusions and Relevance

These findings suggest that interventions based on face-aging apps may increase skin cancer protection behavior in Brazilian adolescents. Further studies are required to maximize the effect and to investigate the generalizability of the effects.

Trial Registration

ClinicalTrials.gov Identifier: NCT03178240

Protection of the Eye from Ultraviolet Radiation Damage Among Adults in Addis Zemen Town, Northwest Ethiopia

BACKGROUND

Ultraviolet radiation is electromagnetic radiation or light having a wavelength of less than 400 nm but greater than 100 nm. Ultraviolet radiation, majorly from sunlight, can potentially damage any organ that is exposed to any part of its spectrum. Aside from the skin, the organ most susceptible to sunlight-induced damage is the eye. Ultraviolet radiation is reported to be the cause of multiple ocular problems ranging from benign conditions like pterygium and pinguecula to ocular malignancies such as basal cell carcinoma which finally leads to visual impairment and blindness. Protection practice is mandatory to avoid the burden of diseases caused by ultraviolet exposure and maximizing the protection measures implementation is important. To maximize this, it is essential to know the current practice and the associated factors affecting the usage of protective devices in the study area.

METHODS

Community-based cross-sectional study was conducted from April to May 2019 on 453 study participants. The study participants were selected through a systematic random sampling method. Data were collected using a pretested structured questionnaire. The analyzed result was summarized and presented using texts, tables and charts. A Chi-square test was applied to assess the significant association.

RESULTS

A total of 430 study subjects were participated and completed the questionnaire with a response rate of 94.92%. The mean age of the study participants was 35.3 (SD±6.68). Two hundred forty-three (56.5%) study participants were males. About 228 (53%) of participants were married, and 356 (82.8%) were Christian in religion. From the total study participants, 173 (40.23%) had good practice in protecting the eye from ultraviolet radiation damages while the remaining 59.77% had poor practice. A significant association was found between sex and protection practice of the eye from ultraviolet radiation damages.

CONCLUSION

The majority of the study participants had poor protection practice of the eye from ultraviolet radiation damages. Improving awareness and protection practice are vital to reduce the burden of ocular abnormalities due to excessive exposure to ultraviolet radiation.

Effectiveness of Educational Practices in University Students' Knowledge about Sun Protection and Its Relation to Sunlight Exposure: An Exploratory Study in a Portuguese Higher Education Institution

Nowadays, there is worldwide recognition that health and educational outcomes are inextricably linked. It is also recognized that health education comprises opportunities to improve health literacy, including the improvement of knowledge and the development of life skills to promote individual health. It is also known that the behavioral practices regarding sun exposure are an important risk factor for skin cancer. Research is needed in this area to understand the contribution of the "Education for Health" curricular unit to these issues. Our exploratory research sought to collect information about the knowledge and practices regarding sun exposure of a group of Portuguese university students who have already attended this curricular unit. The results indicate that the participants show that, notwithstanding that they have already attended this curricular unit, they do not have more literacy on skin health, do not perceive that sun exposure habits are related to skin health and do not perceive that photoprotection constitutes prevention of skin cancer. The results support the need to promote the necessary reflection and debate on the way in which health education should be taught, as well as what is taught, in order to empower students to get decision-making skills associated with the adoption of healthier attitudes and practices, thus helping to prevent skin cancer.

Knowledge and habits of sun exposure in university students: a cross-sectional study in Southern Brazil

BACKGROUND

Excessive sun exposure is the major risk factor for skin cancer. Thus, sun exposure behavior is the major focus for prevention of this disease, since it is potentially modifiable. Increasing the knowledge on sun related habits and other skin cancer risk factors is fundamental in the development of preventive programs, especially when directed to young people.

OBJECTIVES

To assess the photoprotection habits and the knowledge about skin cancer in college students.

METHODS

We conducted a cross-sectional study from Oct. 16 to Feb. 17, including 371 students from the Federal University of Santa Maria, RS, Brazil, through a self-administered questionnaire.

RESULTS

The level of knowledge about skin cancer and photoprotection was unsatisfactory in more than 10% of the students. The occurrence of sunburn was extremely high among students, and 25% reported at least one episode of second degree sunburn. Proper use of sunscreen was referred by only 34% of individuals. Students who reported having received photo education in college were associated with a more consistent use of sunscreen.

STUDY LIMITATIONS

health area represented a large part of the sample; instrument validated outside Brazil.

CONCLUSIONS

Young people are unaware of basic information about sun protection and exposure. Even among those with proper knowledge, the use of photoprotective measures is very low. The sun exposure has shown to be excessive in most of the students, which makes this population an important target for photo-educational measures.

A skin cancer prevention photoageing intervention for secondary schools in Brazil delivered by medical students: protocol for a randomised controlled trial

INTRODUCTION

The incidence of melanoma is increasing faster than any other major cancer both in Brazil and worldwide. The Southeast of Brazil has especially high incidences of melanoma, and early detection is low. Exposure to UV radiation represents a primary risk factor for developing melanoma. Increasing attractiveness is a major motivation for adolescents for tanning. A medical student-delivered intervention that harnesses the broad availability of mobile phones as well as adolescents' interest in their appearance may represent a novel method to improve skin cancer prevention.

METHODS AND ANALYSIS

We developed a free mobile app (Sunface), which will be implemented in at least 30 secondary school classes, each with 21 students (at least 30 classes with 21 students for control) in February 2018 in Southeast Brazil via a novel method called mirroring. In a 45 min classroom seminar, the students' altered three-dimensional selfies on tablets are 'mirrored' via a projector in front of their entire class, showing the effects of unprotected UV exposure on their future faces. External block randomisation via computer is performed on the class level with a 1:1 allocation. Sociodemographic data, as well as skin type, ancestry, UV protection behaviour and its predictors are measured via a paper-pencil questionnaire before as well as at 3 and 6 months postintervention. The primary end point is the group difference in the 30-day prevalence of daily sunscreen use at a 6-month follow-up. Secondary end points include (1) the difference in daily sunscreen use at a 3-month follow-up, (2) if a self-skin examination in accordance with the ABCDE rule was performed within the 6-month follow-up and (3) the number of tanning sessions.

ETHICS AND DISSEMINATION

Ethical approval was obtained from the ethics committee of the University of Itauna. Results will be disseminated at conferences and in peer-reviewed journals.

TRIAL REGISTRATION NUMBER

NCT03178240; Pre-results.

Melanoma risk: adolescent females' perspectives on skin protection pre/post-viewing a ultraviolet photoaged photograph of their own facial sun damage

Suntanning increases skin cancer risk and prematurely ages skin. Photoageing photography is an effective means of increasing adult ultraviolet radiation (UVR) awareness and skin-protection practices. While adults' largely positive suntanning-deterrence responses to photoageing photography are well-documented, comparatively little is known about the deterrence effectiveness of photoageing photography with adolescents. To help fill this knowledge gap, in-depth interviews were collected from 10 adolescent females and were subsequently subjected to interpretive phenomenological analysis. The emergent central theme - Having a tan and looking good in the short-term is okay, however, in the longer-term you can end up looking far worse… but still a tan is worth it - and its component subthemes reveal that the adolescent female's desire for a suntan is largely appearance driven. While photoaged photography is effective in increasing their awareness of the skin damage that UVR exposure causes, it does not alter their suntanning intentions. The analysis also revealed that one of the major barriers to adolescent females' adoption of skin-protective behaviours is their belief in their own invincibility. Hence, skin-protection interventions that lessen the aura of invincibility around adolescent females' understanding of their risk for developing skin cancers are vital to reducing the incidence of malignant melanoma.

Photoprotection in specific populations: Children and people of color

Improved education on appropriate photoprotection in children is vital. Photoprotection for these individuals should include seeking shade, the use of physical agents (clothing, hat, sunglasses), and application of sunscreens on exposed areas. Avoidance of the use of tanning beds is an important component of education for teenagers. Ultraviolet radiation exposure induces DNA damage and photoaging in all skin types, including people of color. The extent of such damage is inversely related to constitutive skin pigmentation. Therefore, personalized photoprotection recommendations concerning skin cancer risk factors, desired treatment outcomes, health needs (eg, vitamin D), and photoaging based on the needs and preferences of the patient are essential. It is clear that additional research is needed on optimal levels of protection against ultraviolet radiation for people of color.

Outdoor Exposure to Solar Ultraviolet Radiation and Legislation in Brazil

The total ozone column of 265 ± 11 Dobson Units in the tropical-equatorial zones and 283 ± 16 Dobson Units in the subtropics of Brazil are among the lowest on Earth, and as a result, the prevalence of skin cancer due to solar ultraviolet radiation is among the highest. Daily erythemal doses in Brazil can be over 7,500 J m. Erythemal dose rates on cloudless days of winter and summer are typically about 0.147 W m and 0.332 W m, respectively. However, radiation enhancement events yielded by clouds have been reported with erythemal dose rates of 0.486 W m. Daily doses of the diffuse component of erythemal radiation have been determined with values of 5,053 J m and diffuse erythemal dose rates of 0.312 W m. Unfortunately, Brazilians still behave in ways that lead to overexposure to the sun. The annual personal ultraviolet radiation ambient dose among Brazilian youths can be about 5.3%. Skin cancer in Brazil is prevalent, with annual rates of 31.6% (non-melanoma) and 1.0% (melanoma). Governmental and non-governmental initiatives have been taken to increase public awareness of photoprotection behaviors. Resolution #56 by the Agência Nacional de Vigilância Sanitária has banned tanning devices in Brazil. In addition, Projects of Law (PL), like PL 3730/2004, propose that the Sistema Único de Saúde should distribute sunscreen to members of the public, while PL 4027/2012 proposes that employers should provide outdoor workers with sunscreen during professional outdoor activities. Similar laws have already been passed in some municipalities. These are presented and discussed in this study.

Pigmented naevi and sun protection behaviour among primary and secondary school students in an Eastern Hungarian city

BACKGROUND

The most important risk factors for malignant melanoma are skin type I or II, large number of atypical naevi and a history of sunburn in childhood and adolescence.

METHODS

A cross-sectional study was performed to assess skin type, number of pigmented lesions and sun protection behaviour in 1157 12- to 19-year-old Hungarian students at 20 primary and secondary schools in Debrecen, Hungary. After receiving dermatological training, 18 school doctors examined the students' skin. A questionnaire was completed by the students with the assistance of their parents about sun protection, sunburns and the use of sunbed. Data from 612 questionnaires were evaluated.

RESULTS

Based on the doctors' evaluation, most of the pupils were classified as having skin type II and majority of them had 5-20 naevi, particularly on the trunk. Based on the student's response, 5.2% purposely sunbathed daily, 10.1% did not use any form of sun protection, 32.2% wore sun-protective clothing and 65.7% applied sunscreen generally. 6.9% used sunbed, and 74.0% previously experienced serious sunburn at least once. Indoor tanning statistically correlated with the number of melanocytic naevi.

CONCLUSION

A high prevalence of sunburn was reported by the students and some of them did not apply any sun protection methods but used sunbed at a critical age for developing melanoma at a later time. These data highlight the importance of educating children and parents about appropriate sun protection.

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.

Risk factors for squamous cell carcinoma, a study by the National Dermatology Centre of Colombia

INTRODUCTION

Nonmelanoma skin cancer is the most common malignancy in white individuals. The risk factors for squamous cell carcinoma, which belongs to the family of nonmelanoma skin cancers, have not been studied in Colombia.

OBJECTIVE

To determine the risk factors for squamous cell carcinoma in patients at a national referral center for skin diseases in Colombia.

MATERIAL AND METHODS

We conducted a case-control study that evaluated sociodemographic, epidemiological, and clinical factors among 332 individuals. Risk was calculated as odds ratio (ORs) using the multivariate conditional logistic regression analysis method.

RESULTS

The following risk factors were identified: family history of skin cancer (OR, 6.55; 95% CI, 1.4-28.9), living in a rural area after the age of 30 years (OR, 3.13; 95% CI, 1.3-7.2), a lifetime working outdoors (OR, 2.98; 95% CI, 1.5-5.7), smoking more than 10 cigarettes a day (OR, 2.96; 95% CI, 1.3-6.5), actinic conjunctivitis (OR, 2.68; 95% CI, 1.2-5.9), poikiloderma of Civatte (OR, 3.29; 95% CI, 1.7-6.1), numerous facial actinic keratoses (OR, 9.23; 95% CI, 4.9-17.1), and numerous freckles (OR, 3.68; 95% CI, 1.3-10.1).

CONCLUSIONS

We have documented clinical characteristics and personal history factors that should guide the physician in making decisions on the preventive and follow-up measures to be adopted for individuals at risk of squamous cell carcinoma. These findings may help guide policy for controlling the disease using local information.

Considerations on photoprotection and skin disorders

Excessive exposure to solar or artificial sources of UV radiation is deleterious to the skin and can cause or worsen several diseases. Detrimental effects of UV radiation exert an important role in the development of skin cancers, cause alterations on the immune response, and act as a trigger or aggravating factor for pigmentary disorders. A group of measures, including education, change of habits, use of physical barriers and sunscreens constitutes a significant part of the treatment of many skin disorders and are valuable preventive tools. This article summarizes the relevant studies addressing these issues, emphasizing the many aspects of photoprotection.

[Considerations on photoprotection and skin disorders]

Excessive exposure to solar or artificial sources of UV radiation is deleterious to the skin and can cause or worsen several diseases. Detrimental effects of UV radiation exert an important role in the development of skin cancers, cause alterations on the immune response, and act as a trigger or aggravating factor for pigmentary disorders. A group of measures, including education, change of habits, use of physical barriers and sunscreens constitutes a significant part of the treatment of many skin disorders and are valuable preventive tools. This article summarizes the relevant studies addressing these issues, emphasizing the many aspects of photoprotection.

Assessment of knowledge of skin cancer prevention and its relation with sun exposure and photo protection amongst gym academy members on the south of Santa Catarina, Brazil

BACKGROUND

Skin cancer is the most frequent neoplasia in several parts of the world and also in Brazil. There is evidence of an increase in morbidity and mortality from skin cancer. Although the incidence of skin cancer is increasing, it is estimated that 45% of all preventable cancers worldwide are skin neoplasias. Several studies have emphasized the need for campaigns to encourage sun protection.

OBJECTIVE

To assess the knowledge about skin cancer prevention and its association with sun exposure and photo protection in gym members.

METHODS

We conducted a cross-sectional, descriptive and quantitative study during January to July 2009, including gym members of both sexes in the city of Criciuma. A self-administered questionnaire was used. The statistical analysis was conducted in a descriptive way in regards to the absolute and relative frequencies of the variables under study.

RESULTS

Of the 317 questionnaires studied, 62% were from women and 38% from men. Skin types II and III predominated, and the average age was 27.6 years. 94.3% of the participants reported that they had heard about the risks of sun exposure, mostly in terms of skin cancer risk (80.8%). Most participants, especially women, reported some form of sun protective measure.

CONCLUSION

The population studied, similar to that in other regions of Brazil and the world, is aware of the risks of excessive sun exposure and skin cancer prevention, but has not yet incorporated appropriate sun protection measures into their daily habits.

Knowledge, attitudes and practices about sun exposure and photoprotection in outpatients attending dermatology clinics at four hospitals in Lima, Peru

BACKGROUND

To establish the knowledge, about sun exposure and photoprotection in outpatients treated at the dermatology clinics in four hospitals in Lima, Peru.

MATERIAL AND METHODS

A cross-sectional study was conducted involving a sample of 364 patients selected using a systematic random sampling process in the four participating hospitals. The selected patients were interviewed to determine their knowledge, behavior and practices in relation to sun exposure and photoprotection. The chi-square test was used to identify any significant differences between knowledge and practices.

RESULTS

The mean age of the patients in this sample was 45.1 ± 21.4 years. Of the 364 patients, 55.9% were women and 54.8% had skin phototype IV. The principal risks related to sun exposure were skin cancer (80.5%) and sunburn (77.8%). Knowledge regarding sun protection was more evident in individuals with university/college education (p<0.001). In addition, 78.9% of the individuals reported that they knew about photo-protectors and 52.3% stated that they used them regularly. In general, women were more knowledgeable regarding sun protection (p=0.001). Of the total number of users of photoprotection, 38.4% used these products daily, while 61.6% used them only occasionally. The use of photo-protectors differed significantly in accordance with the individual's education level (p<0.001). In the majority of cases there was a statistically significant difference between knowledge and practice with respect to solar protection.

CONCLUSIONS

The level of awareness of the outpatients treated at the dermatology clinics in these four hospitals in Lima, Peru about the risks of sun exposure is acceptable; however, a large proportion fail to incorporate regular solar protection as a practice in their daily life.

Knowledge, attitude, and performance of students toward skin cancer in Yazd, 2009

BACKGROUND

Cancer is increasingly recognized as a major and growing health concern in the Eastern Mediterranean Region (EMR), and skin cancers are the most prevalent cancers. The purpose of this study was to evaluate the knowledge, attitude, and performance of university students regarding skin cancer.

METHODS

This cross-sectional study included 230 samples selected randomly from the students of Yazd universities. The reliability of the questionnaire was certified by specialists, validated by a pilot study, and confirmed by Alpha Cronbachs test (α = 0.8). SPSS software was used for data entry, manipulation, and analysis.

RESULTS

The students studied had medium knowledge level related to skin cancer. Their attitude towards skin cancer was relatively good. The performance level of the population under study was moderate. Non-medical students had more poor knowledge, attitude, and performance than medical students. Overall results show a significant relationship between knowledge, attitude, and performance level of the population under study.

CONCLUSION

Skin cancers are the most common form of cancers in our state, but my students do not have appropriate knowledge and performance levels about this disease. It is therefore proposed that related information should be given to them during continuous and regular educational programs.

[Risk factors for basal cell carcinoma: a study from the national dermatology center of Colombia]

BACKGROUND

Colombia is home to one of the areas with the highest levels of exposure to UV radiation in the world, namely, the Andes Mountains, which stretch along the equator. Recent studies have reported an increase in the incidence of basal cell carcinoma in Colombia, but the risk factors associated with the development of this disease have not been studied.

OBJECTIVE

To determine the risk factors for basal cell carcinoma in patients from the National Dermatology Center of Colombia.

MATERIAL AND METHODS

We performed a case-control study involving 406 individuals, and analyzed sociodemographic, epidemiological, and clinical factors using multiple logistic regression.

RESULTS

The following risk factors were identified: skin phototypes I to III (odds ratio [OR], 15.4), family history of skin cancer (OR, 5.8), past history of actinic keratosis (OR, 3.3), continued residence in a rural area after the age of 30 years (OR, 2.96), practice of outdoor sports (OR, 2.67), history of 10 or more episodes of sunburn (OR, 2.3), actinic conjunctivitis (OR, 2.26), and failure to use a hat in childhood (OR, 2.11).

CONCLUSIONS

Different factors specific to Colombia increase the risk of basal cell carcinoma. In particular, the association with phototype III could partly explain the increase in incidence detected in this country. Preventive programs should target the risk groups detected and highlight the importance of basing decisions on local evidence.

Health disparities among different ethnic and racial middle and high school students in sun exposure beliefs and knowledge

Racial and ethnic differences may influence sun protection behavior. Adolescent students were administered a sun protection questionnaire and educational program. White people had the greatest pretest knowledge which resulted in the highest score, and blacks and Hispanics scored lower. White people who found tanned individuals attractive had greater score improvements. All groups improved after intervention.

Fotoproteção e exercício físico

As medidas de fotoproteção são divulgadas como procedimentos essenciais na prevenção de doenças cutâneas e manutenção da saúde e beleza. Os exercícios físicos regulares também são indicados para alcançar o estilo de vida saudável; no entanto, a prática esportiva expõe a maior radiação solar. O objetivo deste artigo é revisar as medidas fotoprotetoras na prevenção dos danos causados pelo Sol na pele dos desportistas. Abordam-se o histórico da fotoproteção, o espectro eletromagnético, os efeitos das radiações e os riscos de exposição durante as atividades físicas. Implementar estratégias, como a escolha do horário, local, roupas e acessórios, complementados pelo uso de filtros solares, minimizam os riscos decorrentes das radiações ultravioletas A e B (UVA e UVB) durante a prática esportiva ao ar livre. Dentre os produtos disponíveis no mercado, devem-se preferir aqueles que ofereçam segurança, ampla proteção, boa cosmética, estabilidade química em diferentes condições de calor e umidade, fotoestabilidade e baixo custo. O atleta deve ser orientado pelos profissionais da área da saúde sobre os riscos inerentes às suas atividades cotidianas e esportivas. O autoexame de pele é parte essencial na prevenção dos problemas dermatológicos, pois auxilia na detecção precoce. O futuro da fotoproteção no esporte está no investimento em medidas educativas desde a infância, reduzindo assim os danos solares cumulativos. A exposição solar deve ocorrer de modo cauteloso e com o mínimo de sequelas, mediante comportamento de fotoproteção, para proporcionar melhor qualidade de vida.

Fotoexposição e fatores de risco para câncer da pele: uma avaliação de hábitos e conhecimentos entre estudantes universitários

FUNDAMENTOS: O câncer da pele é a neoplasia mais frequente no Brasil. Compreender as atitudes que influenciam a proteção e a exposição aos raios solares é extremamente importante para sua prevenção. OBJETIVOS: Avaliar hábitos de fotoexposição e fotoproteção, bem como conhecimento de fatores de risco para câncer da pele, tendo por fim delinear os padrões de comportamento dos jovens perante os efeitos solares. MÉTODOS: Distribuíram-se questionários autoaplicativos a 368 universitários, na faixa etária dos 20 anos, dos cursos de Medicina, Educação Física, Direito e Comunicação Social de instituição de ensino privada em Taguatinga (DF). RESULTADOS: O uso diário de fotoprotetor foi significativamente maior entre as mulheres. A prática de bronzeamento artificial foi baixa (3,5%), referida apenas por mulheres. O uso de filtro solar com fator de proteção maior do que 15 ou igual a 15 foi referido por 278 estudantes. De modo geral, mais de 90% dos estudantes acreditam na associação entre radiação ultravioleta e câncer da pele. Apesar disso, apenas 43,5% acreditam na genética como fator de risco. Entre os que rejeitam a hipótese do fator de risco genético para carcinogênese cutânea, 86,2% são acadêmicos das Ciências Humanas (Direito e Comunicação Social). CONCLUSÃO: Esses dados permitem orientar medidas nos níveis individual e coletivo, colaborando para a prevenção de lesões cutâneas.

Knowledge, attitude and performance study of secondary school teachers of Yazd city regarding skin cancer

BACKGROUND

The cancers are a major health problem and skin cancers are the most prevalent cancers. It is clear that teachers play an important role in the health education of students and their families.

OBJECTIVE

This study was done to determine the knowledge, attitude and performance levels of teachers in Yazd city regarding skin cancer in order to plan programs for increasing their respective levels. Methods Samples of this cross sectional study selected randomly from the schools of Yazd. The data were collected by completion of questionnaire. anova, Kruskal-Wallis, T-test and Pearson Correlations statistical tests were used for analysis.

RESULTS

Of the total, 170 were men and 270 were women with a mean age of 37.98 +/- 6.28 years. The mean knowledge, attitude and performance score of the teachers respectively was 24.17 +/- -5.27, 28.09 +/- -5.79 and 6.34 +/- -3.42. The knowledge levels were significantly related to the attitude (P = 0.05) and performance levels (P = 0.01). There was an inverse relation between age and performance levels (P = 0.01). The performance levels of women were better than men (P = 0.001). The field of study and education of the teachers was related to the knowledge (P = 0.001) and attitude levels (P = 0.02).

CONCLUSION

Skin cancers are the most common form of cancers in our state, but my teachers do not have appropriate knowledge and performance levels about this disease. It is therefore proposed that related information should be given to them during continuous and regular educational programs.

[Sunburn in young people: population-based study in Southern Brazil]

OBJECTIVE

To assess the prevalence and risk factors for sunburn in young people.

METHODS

Population-based cross-sectional study using a multiple-stage sampling carried out with people living in the urban area of Pelotas, Southern Brazil, between October and December 2005. Data was collected from interviews with 1.604 subjects using a standardized pre-coded questionnaire about their family and another questionnaire applied to those aged between ten and 29 years for assessing the occurrence of sunburn episodes. Sunburn was defined as skin burning after sun exposure. Chi-square test with Yates' correction was used to compare proportions and Poisson regression with design effect control and robust adjustment of variance was applied in the multivariate analysis.

RESULTS

Of those aged between 10 and 29 years, 1,412 reported sun exposure in the last summer. Losses and refusals were 5.5%. A total of 48.7% of the interviewees reported sunburn in the last year. The following variables were associated with sunburn in the multivariate analysis: white skin (PR=1.41; 95% CI: 1.12;1.79); higher skin sensitivity to sun exposure (PR=1.84; 95% CI: 1.64;2.06); age between 15 and 19 years (PR=1.30; 95% CI: 1.12;1.50); belonging to the higher quartile of income (PR=1.20; 95% CI: 1.01;1.42); and irregular use of sunscreens (PR=1.23; 95% CI: 1.08;1.42).

CONCLUSIONS

The prevalence of sunburn in the population studied was high mainly among white young people with higher skin sensitivity, higher income and who used sunscreens irregularly. Sun exposure during safe times and with adequate protection should be promoted.