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Stump TK, Fastner S, Jo Y, Chipman J, Haaland B, Nagelhout ES, Wankier AP, Lensink R, Zhu A, Parsons B, Grossman D, Wu YP. Objectively-Assessed Ultraviolet Radiation Exposure and Sunburn Occurrence. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:5234. [PMID: 37047850 PMCID: PMC10094127 DOI: 10.3390/ijerph20075234] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 03/09/2023] [Accepted: 03/15/2023] [Indexed: 06/19/2023]
Abstract
Ultraviolet radiation (UVR) exposure is the primary modifiable risk factor for melanoma. Wearable UVR sensors provide a means of quantifying UVR exposure objectively and with a lower burden than self-report measures used in most research. The purpose of this study was to evaluate the relationship between detected UVR exposure and reported sunburn occurrence. In this study, a UVR monitoring device was worn by 97 parent-child dyads during waking hours for 14 days to measure instantaneous and accumulated UVR exposure. The results showed that the participants' total UVR exposure was associated with reported sunburn after adjusting for Fitzpatrick skin type and geographic location. It was observed that one standard erythemal dose (SED) increase in the participants' daily total UVR exposure was associated with reported sunburn (an odds ratio (OR) of 1.26 with a 95% CI of 1.13 and 1.41, and p < 0.001 for parents and an OR of 1.28 with a 95% CI of 1.12 and 1.47, and p < 0.001 for children). A one-SED increase in the participants' UVR exposure from 10 am to 4 pm was also associated with reported sunburn (an OR of 1.31 with a 95% CI of 1.15 and 1.49, and p < 0.001 for parents and an OR of 1.33 with a 95% CI of 1.12 and 1.59, and p = 0.001 for children). We found that elevated UVR exposure recordings measured by the UVR sensor were associated with reported sunburn occurrence. Future directions for wearable UVR sensors may include their use as an intervention tool to support in-the-moment sunburn prevention.
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Affiliation(s)
- Tammy K. Stump
- Department of Dermatology, University of Utah Health Sciences Center, Salt Lake City, UT 84132, USA
- Huntsman Cancer Institute, University of Utah, Salt Lake City, UT 84112, USA
| | - Suzanne Fastner
- Department of Dermatology, University of Utah Health Sciences Center, Salt Lake City, UT 84132, USA
- Huntsman Cancer Institute, University of Utah, Salt Lake City, UT 84112, USA
| | - Yeonjung Jo
- Department of Population Health Sciences, University of Utah, Salt Lake City, UT 84108, USA
| | - Jonathan Chipman
- Huntsman Cancer Institute, University of Utah, Salt Lake City, UT 84112, USA
- Department of Population Health Sciences, University of Utah, Salt Lake City, UT 84108, USA
| | - Benjamin Haaland
- Huntsman Cancer Institute, University of Utah, Salt Lake City, UT 84112, USA
- Department of Population Health Sciences, University of Utah, Salt Lake City, UT 84108, USA
| | - Elizabeth S. Nagelhout
- Division of Public Health, Department of Family & Preventive Medicine, University of Utah, Salt Lake City, UT 84108, USA
| | - Ali P. Wankier
- Huntsman Cancer Institute, University of Utah, Salt Lake City, UT 84112, USA
| | - Riley Lensink
- Huntsman Cancer Institute, University of Utah, Salt Lake City, UT 84112, USA
| | - Angela Zhu
- Department of Pediatrics, University of Utah, Salt Lake City, UT 84113, USA
| | - Bridget Parsons
- Huntsman Cancer Institute, University of Utah, Salt Lake City, UT 84112, USA
| | - Douglas Grossman
- Department of Dermatology, University of Utah Health Sciences Center, Salt Lake City, UT 84132, USA
- Huntsman Cancer Institute, University of Utah, Salt Lake City, UT 84112, USA
| | - Yelena P. Wu
- Department of Dermatology, University of Utah Health Sciences Center, Salt Lake City, UT 84132, USA
- Huntsman Cancer Institute, University of Utah, Salt Lake City, UT 84112, USA
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Conte S, Ghazawi FM, Le M, Nedjar H, Alakel A, Lagacé F, Mukovozov IM, Cyr J, Mourad A, Miller WH, Claveau J, Salopek TG, Netchiporouk E, Gniadecki R, Sasseville D, Rahme E, Litvinov IV. Population-Based Study Detailing Cutaneous Melanoma Incidence and Mortality Trends in Canada. Front Med (Lausanne) 2022; 9:830254. [PMID: 35308490 PMCID: PMC8927870 DOI: 10.3389/fmed.2022.830254] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Accepted: 01/31/2022] [Indexed: 12/31/2022] Open
Abstract
Background Cutaneous melanoma (CM) is one of the most fatal types of skin cancer. Alarmingly, increases in incidence and mortality were noted globally for this malignancy, despite increase in understanding of melanoma pathogenesis and enhanced prevention efforts. Methods Data was extracted for CM patients for provinces and territories (except Quebec) using two independent, population-based registries. Analysis was performed using both clinical and pathological characteristics: tumor morphologic classification, age, sex, anatomic site affected and place of residence. Mortality trends were assessed over a 7-year period. Results were compared to prior findings for 1992-2010. Results During 2011-2017 39,610 patients were diagnosed with CM, with 5,890 reported deaths. National crude CM incidence was 20.75 (age-standardized incidence: 14.12) cases per 100,000 individuals per year. Females accounted for 45.8% of cases and 37.1% of deaths. While CM incidence rates continue to increase in both sexes, since 2013 the CM mortality is declining. We observed important differences across the provinces/territories, where Nova Scotia, Prince Edward Island, southern Ontario/British Columbia and certain coastal communities of New Brunswick demonstrated higher CM incidence and mortality rates. The observed incidence and mortality trends for 2011-2017 validate and extend earlier observations from 1992 to 2010 for CM. Conclusion This population-based study highlights that while melanoma's incidence is increasing in Canada, mortality rates are for the first time decreasing since 2013. We detail regional distribution of this cancer highlighting communities in southern/coastal areas, as being most at risk as well as the latest trends of melanoma incidence by age, sex and anatomic site. In males, melanoma is more common on the head/trunk, while in females on the extremities. Notably, Acral Lentiginous Melanoma was the only CM subtype that was more common in females, which primarily affects hands and feet.
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Affiliation(s)
- Santina Conte
- Faculty of Medicine, McGill University, Montréal, QC, Canada
| | - Feras M Ghazawi
- Division of Dermatology, University of Ottawa, Ottawa, ON, Canada
| | - Michelle Le
- Division of Dermatology, McGill University, Montréal, QC, Canada
| | - Hacene Nedjar
- Division of Clinical Epidemiology, McGill University, Montréal, QC, Canada
| | - Akram Alakel
- Division of Dermatology, McGill University, Montréal, QC, Canada
| | - François Lagacé
- Division of Dermatology, McGill University, Montréal, QC, Canada
| | - Ilya M Mukovozov
- Department of Dermatology and Skin Science, University of British Columbia, Vancouver, BC, Canada
| | - Janelle Cyr
- Division of Dermatology, University of Toronto, Toronto, ON, Canada
| | - Ahmed Mourad
- Division of Dermatology, University of Calgary, Calgary, AB, Canada
| | - Wilson H Miller
- Department of Medicine and Oncology, McGill University Montreal, Montréal, QC, Canada
| | - Joël Claveau
- Division of Dermatology, Laval University, Quebec City, QC, Canada
| | - Thomas G Salopek
- Division of Dermatology, University of Alberta, Edmonton, AB, Canada
| | | | - Robert Gniadecki
- Division of Dermatology, University of Alberta, Edmonton, AB, Canada
| | - Denis Sasseville
- Division of Dermatology, McGill University, Montréal, QC, Canada
| | - Elham Rahme
- Division of Clinical Epidemiology, McGill University, Montréal, QC, Canada
| | - Ivan V Litvinov
- Division of Dermatology, University of Ottawa, Ottawa, ON, Canada.,Division of Dermatology, McGill University, Montréal, QC, Canada
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Henning A, J Downs N, Vanos JK. Wearable ultraviolet radiation sensors for research and personal use. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2022; 66:627-640. [PMID: 34743221 DOI: 10.1007/s00484-021-02216-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 10/06/2021] [Accepted: 10/25/2021] [Indexed: 06/13/2023]
Abstract
Skin cancers are strongly linked to personal exposure to ultraviolet (UV) radiation, yet UV exposure is also the most preventable risk factor. People are exposed to UV rays when they engage in outdoor activities, particularly exercise, which is an important health behavior. Thus, researchers and the general public have shown increasing interest in measuring UV exposure using wearable sensors during outdoor physical activity. However, minimal research exists at the intersection of UV sensors, personal exposure, adaptive behavior due to exposures, and risk of skin damage. Recent years have seen an influx of new consumer-based and research-based UV-sensing technologies with wide-ranging form factors and purposes to fill this research gap, yet a thorough review of available sensors for specific purposes does not exist. Hence, the overall goal of this state-of-the-art review is to synthesize the current academic and gray literature surrounding personal UV-sensing technologies. Peer-reviewed journal articles and "gray literature," such as working papers, manuals, and UV sensor websites, were reviewed, assessing attributes of UV wearables marketed for research use, personal use, or both. Overall, 13 wearable UV sensors are available for personal use and/or research applications. These sensors vary from electronic to photochromic, with large differences in price, data outputs, accuracy, and precision. Recommendations are provided for which sensors are most suitable for various types of research or public use. Notably, the review findings will help guide researchers in future studies assessing UV exposure during physical activity.
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Affiliation(s)
- Alyssa Henning
- School for Engineering of Matter, Transport, and Energy, Arizona State University, Tempe, AZ, USA
| | - Nathan J Downs
- School of Sciences, University of Southern Queensland, Toowoomba, Qld, Australia
| | - Jennifer K Vanos
- School of Sciences, University of Southern Queensland, Toowoomba, Qld, Australia.
- School of Sustainability, Arizona State University, 800 Cady Mall #108, Tempe, AZ, 85281, USA.
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Tsai YS, Wang DY, Chang JJ, Liang KT, Lin YH, Kuo CC, Lu SH, Wu YS, Lee LJH, Chen H, Wuu DS. Incorporation of Au Nanoparticles on ZnO/ZnS Core Shell Nanostructures for UV Light/Hydrogen Gas Dual Sensing Enhancement. MEMBRANES 2021; 11:903. [PMID: 34832131 PMCID: PMC8618099 DOI: 10.3390/membranes11110903] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/10/2021] [Revised: 11/15/2021] [Accepted: 11/17/2021] [Indexed: 11/25/2022]
Abstract
ZnO/ZnS nanocomposite-based nanostructures exhibit dual light and gas sensing capabilities. To further boost the light/dual sensing properties, gold nanoparticles (Au NPs) were incorporated into the core-shell structures. Multiple material characterizations revealed that Au NPs were successfully well spread and decorated on ZnO/ZnS nanostructures. Furthermore, our findings show that the addition of Au NPs could enhance both 365 nm UV light sensing and hydrogen gas sensing in terms of light/gas sensitivity and light/gas response time. We postulate that the optimization of gas/light dual sensing capability may result from the induced electric field and inhabitation of electron-hole recombination. Owing to their compact size, simple fabrication, and stable response, ZnO/ZnS/Au NPs-based light/gas dual sensors are promising for future extreme environmental monitoring.
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Affiliation(s)
- Yu-Sheng Tsai
- Department of Materials Science and Engineering, National Yang Ming Chiao Tung University, Hsinchu 300, Taiwan; (Y.-S.T.); (Y.S.W.)
| | - Deng-Yi Wang
- Department of Applied Materials and Optoelectronic Engineering, College of Science and Technology, National Chi Nan University, Puli 545, Taiwan; (D.-Y.W.); (J.-J.C.); (K.-T.L.); (Y.-H.L.); (C.-C.K.); (S.-H.L.); (D.-S.W.)
| | - Jia-Jie Chang
- Department of Applied Materials and Optoelectronic Engineering, College of Science and Technology, National Chi Nan University, Puli 545, Taiwan; (D.-Y.W.); (J.-J.C.); (K.-T.L.); (Y.-H.L.); (C.-C.K.); (S.-H.L.); (D.-S.W.)
| | - Keng-Tien Liang
- Department of Applied Materials and Optoelectronic Engineering, College of Science and Technology, National Chi Nan University, Puli 545, Taiwan; (D.-Y.W.); (J.-J.C.); (K.-T.L.); (Y.-H.L.); (C.-C.K.); (S.-H.L.); (D.-S.W.)
| | - Ya-Hsuan Lin
- Department of Applied Materials and Optoelectronic Engineering, College of Science and Technology, National Chi Nan University, Puli 545, Taiwan; (D.-Y.W.); (J.-J.C.); (K.-T.L.); (Y.-H.L.); (C.-C.K.); (S.-H.L.); (D.-S.W.)
| | - Chih-Chen Kuo
- Department of Applied Materials and Optoelectronic Engineering, College of Science and Technology, National Chi Nan University, Puli 545, Taiwan; (D.-Y.W.); (J.-J.C.); (K.-T.L.); (Y.-H.L.); (C.-C.K.); (S.-H.L.); (D.-S.W.)
| | - Ssu-Han Lu
- Department of Applied Materials and Optoelectronic Engineering, College of Science and Technology, National Chi Nan University, Puli 545, Taiwan; (D.-Y.W.); (J.-J.C.); (K.-T.L.); (Y.-H.L.); (C.-C.K.); (S.-H.L.); (D.-S.W.)
| | - Yewchung Sermon Wu
- Department of Materials Science and Engineering, National Yang Ming Chiao Tung University, Hsinchu 300, Taiwan; (Y.-S.T.); (Y.S.W.)
| | - Lukas Jyuhn-Hsiarn Lee
- National Institute of Environmental Health Sciences, National Health Research Institutes, Miaoli 350, Taiwan
- Stroke Center, Departments of Neurology, Environmental and Occupational Medicine, National Taiwan University Hospital, Taipei 100, Taiwan
- Institute of Environmental and Occupational Health Sciences, College of Public Health, National Taiwan University, Taipei 100, Taiwan
- Research Center for Environmental Medicine, Ph.D. Program of Environmental and Occupational Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan
| | - Hsiang Chen
- Department of Applied Materials and Optoelectronic Engineering, College of Science and Technology, National Chi Nan University, Puli 545, Taiwan; (D.-Y.W.); (J.-J.C.); (K.-T.L.); (Y.-H.L.); (C.-C.K.); (S.-H.L.); (D.-S.W.)
| | - Dong-Sing Wuu
- Department of Applied Materials and Optoelectronic Engineering, College of Science and Technology, National Chi Nan University, Puli 545, Taiwan; (D.-Y.W.); (J.-J.C.); (K.-T.L.); (Y.-H.L.); (C.-C.K.); (S.-H.L.); (D.-S.W.)
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Parsons BG, Nagelhout ES, Wankier AP, Hu N, Lensink R, Zhu A, Nottingham K, Grossman D, Jensen JD, Wu YP. Reactivity to UV Radiation Exposure Monitoring Using Personal Exposure Devices for Skin Cancer Prevention: Longitudinal Observational Study. JMIR Mhealth Uhealth 2021; 9:e29694. [PMID: 34581683 PMCID: PMC8512190 DOI: 10.2196/29694] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 06/23/2021] [Accepted: 08/03/2021] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Emerging UV radiation (UVR) monitoring devices may present an opportunity to integrate such technology into skin cancer prevention interventions. However, little is known about the effects of using a wearable UVR monitor on adults' and children's sun protection-related behaviors and attitudes (eg, cancer worry and perceived risk). Understanding the potential role of reactivity and seasonal effects will help inform the use of objective monitors in the context of skin cancer prevention research, including intervention studies. OBJECTIVE The aim of this study is to examine the potential reactivity associated with a wearable personal UVR monitor, specifically the effects associated with reported sun-protective behaviors and skin cancer-related attitudes, which are often the targets of skin cancer preventive interventions. METHODS Child-parent dyads (n=97 dyads) were asked to wear a UVR monitoring device during waking hours for 2 weeks. Participants were asked to sync the device daily with a smartphone app that stored the UVR exposure data. Participants were blinded to their UVR exposure data during the 2-week period; thus, the smartphone app provided no feedback to the participants on their UVR exposure. Participants completed self-report questionnaires assessing sun-protective behaviors, sunburn, tanning, skin self-examination, skin cancer-related knowledge, perceived risk, cancer worry, response efficacy, and intentions to change behaviors over the 2-week period. Linear regressions were conducted to investigate changes in the outcomes over time and to account for the role of the season of study participation. RESULTS Regression results revealed that there was a significant decrease over time for several sun protection outcomes in children, including time spent outdoors on weekends (P=.02) and weekdays (P=.008), sunscreen use (P=.03), reapplication (P<.001), and unintentional tanning (P<.001). There were no significant changes over time in children's and parents' UVR exposure, sunburn occurrence, or sun protection attitudes. Season of participation was associated with several outcomes, including lower sunscreen use (P<.001), reapplication (P<.001), sunburns (P=.01), intentions to change sun-protective behaviors (P=.02), and intentional (P=.008) and unintentional tanning (P=.01) for participants who participated in the fall versus the summer. CONCLUSIONS The findings from this study suggest that daily use of a UVR monitoring device over a 2-week period may result in changes in certain sun-protective behaviors. These results highlight the importance of identifying and addressing potential reactivity to UVR monitoring devices, especially in the context of skin cancer preventive intervention research. Ultimately, objectively assessed UVR exposure could be integrated into the outcome assessment for future testing of skin cancer prevention interventions.
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Affiliation(s)
- Bridget G Parsons
- Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, United States
| | | | - Ali P Wankier
- Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, United States
| | - Nan Hu
- Department of Biostatistics, Robert Stempel College of Public Health & Social Work, Florida International University, Miami, FL, United States
| | - Riley Lensink
- Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, United States
| | - Angela Zhu
- Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, United States
| | - Katy Nottingham
- Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, United States
| | - Douglas Grossman
- Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, United States
| | - Jakob D Jensen
- Department of Communication, University of Utah, Salt Lake City, UT, United States
| | - Yelena P Wu
- Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, United States.,Department of Dermatology, University of Utah, Salt Lake City, UT, United States
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Attitudes and Behaviors That Impact Skin Cancer Risk among Men. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18199989. [PMID: 34639288 PMCID: PMC8508125 DOI: 10.3390/ijerph18199989] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/28/2021] [Revised: 09/16/2021] [Accepted: 09/18/2021] [Indexed: 01/04/2023]
Abstract
Despite substantially higher skin cancer risks, little research has investigated men’s attitudes about skin cancer and how those attitudes relate to their risks of developing skin cancer. This study aims to close the gap in research, regarding men’s perceptions and behaviors about skin cancer, sun exposure, and tanning. This study utilized a cross-sectional survey of 705 men recruited from Amazon Mechanical Turk (MTurk), reporting attitudes and behaviors towards sun exposure, tanning, and sun protection. While the majority of men reported large daily outdoor activities, that their skin frequently burns with sun exposure, and riskier perceptions of tanning, only a minority reported daily use of sunscreen or most other sun protective behaviors. More sun protection methods were associated with more frequent use of sunscreen and less positive tanning perceptions. Men consistently engaged in high-risk behaviors for developing skin cancer, but they did not engage highly in protective behaviors to mitigate their risk. The findings can help improve clinical and public health interventions to lower men’s risk of skin cancer with strong messages about sunscreen use and sun protective methods.
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Horsham C, Ford H, Herbert J, Wall A, Walpole S, Hacker E. Assessing Sunscreen Protection Using UV Photography: Descriptive Study. JMIR DERMATOLOGY 2021; 4:e24653. [PMID: 37632801 PMCID: PMC10501517 DOI: 10.2196/24653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 04/07/2021] [Accepted: 04/09/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Photography using a UV transmitting filter allows UV light to pass and can be used to illuminate UV blocking lotions such as sunscreens. OBJECTIVE The aim of this study is to compare currently available UV photography cameras and assess whether these devices can be used as visualization tools for adequate coverage of sun protection lotions. METHODS This study was conducted in 3 parts: in phase 1, 3 different UV cameras were tested; in phase 2, we explored whether UV photography could work on a range of sun protection products; and in phase 3, a UV webcam was developed and was field-tested in a beach setting. In phase 1, volunteers were recruited, and researchers applied 3 sun protection products (ranging from sun protection factor [SPF] 15 to 50+) to the participants' faces and arms. UV photography was performed using 3 UV cameras, and the subsequent images were compared. In phase 2, volunteers were recruited and asked to apply their own SPF products to their faces in their usual manner. UV photographs were collected in the morning and afternoon to assess whether the coverage remained over time. Qualitative interviews were conducted to assess the participants' level of satisfaction with the UV image. In phase 3, a small portable UV webcam was designed using a plug-and-play approach to enable the viewing of UV images on a larger screen. The developed webcam was deployed at a public beach setting for use by the public for 7 days. RESULTS The 3 UV camera systems tested during phase 1 identified the application of a range of sun protection lotions of SPF 15 to 50+. The sensitivity of the UV camera devices was shown to be adequate, with SPF-containing products applied at concentrations of 2 and 1 mg/cm2 clearly visible and SPF-containing products applied at a concentration of 0.4 mg/cm2 having lower levels of coverage. Participants in phase 2 reported high satisfaction with the UV photography images, with 83% (29/35) of participants likely to use UV photography in the future. During phase 2, it was noted that many participants used tinted SPF-containing cosmetics, and several tinted products were further tested. However, it was observed that UV photography could not identify the areas missed for all tinted products. During phase 3, the electrical components of the UV webcam remained operational, and the camera was used 233 times by the public during field-testing. CONCLUSIONS In this study, we found that UV photography could identify the areas missed by sun protection lotions with chemical filters, and participants were engaged with personalized feedback. TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry (ANZCTR) ACTRN12619000975190; http://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=377089 ; Australian New Zealand Clinical Trials Registry (ANZCTR) ACTRN12619000145101; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=376672.
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Affiliation(s)
- Caitlin Horsham
- School of Public Health and Social Work, Queensland University of Technology, Brisbane, Australia
| | - Helen Ford
- School of Public Health and Social Work, Queensland University of Technology, Brisbane, Australia
| | | | | | - Sebastian Walpole
- Genetics & Population Health Division, QIMR Berghofer, Brisbane, Australia
| | - Elke Hacker
- School of Public Health and Social Work, Queensland University of Technology, Brisbane, Australia
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