Clothing Cover Research Articles

Mummification in a forensic context: an observational study of taphonomic changes and the post-mortem interval in an indoor setting

The objective of this study was to evaluate the presence of mummification in an indoor setting, with an emphasis on the forensic perspective. A dataset of 102 forensic autopsy cases was assessed for distribution of desiccation of skin and soft tissue (i.e., subcutaneous fat and musculature) and for moist decompositional (i.e., putrefactive) changes. Further, possible correlation with the post-mortem interval (PMI) was evaluated, as well as the effects of clothing coverage of the body. The results indicated that yellow to orange parchment-like desiccated skin was found at significantly shorter PMIs than reddish brown to black leathery desiccated skin, even when soft tissue desiccation was included in the comparative analysis. Clothing appeared to have a significant decelerating effect on the extent of desiccation on the legs, but findings in regard to whole body or torso/arms were inconclusive. A large variation in PMIs was evident as regards fully desiccated skin (PMI 18–217 days), indicating difficulties in PMI estimation due to a variable repressive effect on the decompositional process per se in an indoor setting. For the specific case in forensic practice, no definite conclusion can be drawn from the observed desiccation changes to the PMI. One way forward might be creating a systematic and standardized method for describing different desiccation types, as well as other cooccurring decompositional changes and how they relate to the PMI, as a foundation for a future quantification model.

Sun-Protective Clothing Worn Regularly during Early Childhood Reduces the Number of New Melanocytic Nevi: The North Queensland Sun-Safe Clothing Cluster Randomized Controlled Trial

Numerous pigmented moles are associated with sun exposure and melanomarisk. This cluster randomized controlled trial aimed to determine if sun-protective clothing could prevent a significant proportion of the moles developing in young children (ACTRN12617000621314; Australian New Zealand Clinical Trials Registry. Twenty-five childcare centers in Townsville (19.25° S), Australia, were matched on shade provision and socioeconomic status. One center from each pair was randomized to the intervention arm and the other to the control arm. Children at 13 intervention centers wore study garments and legionnaire hats at childcare and received sun-protective swimwear and hats for home use, while children at the 12 control centers did not. The 1-35-month-old children (334 intervention; 210 control) were examined for moles at baseline (1999-2002) and were re-examined annually for up to 4 years. Both groups were similar at baseline. Children at intervention centers acquired fewer new moles overall (median 12.5 versus 16, p = 0.02; 0.46 versus 0.68 moles/month, p = 0.001) and fewer new moles on clothing-protected skin (6 vs. 8; p = 0.021 adjusted for confounding and cluster sampling) than controls. Intervention children had 24.3% fewer new moles overall (26.5 versus 35) and 31.6% (13 versus 19) fewer moles on clothing-protected skin than controls after 3.5 years. Sunlight's influence on nevogenesis is mitigated when children regularly wear UPF 30-50+ clothing covering half their body, implying that increased clothing cover reduces melanoma risk. Sun-protective clothing standards should mandate reporting of the percentage of garment coverage for childrenswear.

Examining female visual privacy as a function of window treatments

Cultural factors in Libya (and other Muslim countries) require female privacy to be maintained. Outside the home, females must wear clothing that reveals only the face and hands. When inside the home and located near windows, a similar degree of clothing cover or window treatment is required. This reduces exposure to natural daylight, with resultant reduction in health benefits of daylight. We are therefore investigating the degree to which window treatments offer sufficient privacy to permit relaxed clothing in the home. Two window treatments were tested: horizontal blinds and frosted glass, varying the free area and degree of frosting, respectively. The degree of privacy offered was operationalised by identification of the clothing level worn by a target behind the window treatment, the aim being to reduce identification to a chance level. For 0.3 s observations, only the extreme level of each treatment (horizontal blinds set to 3% free area and distortion level 20 for the frosted glass) led to chance levels of clothing identification, for both actors. For 3.0 s observations, there were significant differences in clothing identification, suggesting insufficient privacy.

Non-uniform distribution of clothing insulation as a behavioral adaptation strategy and its effect on predicted thermal sensation in hot and humid environments

Adjusting clothing insulation plays a pivotal role as human behavioral adaptation to the thermal environment. Most widely used thermal comfort models, such as the PMV model, assume that the entire body is uniformly covered by clothing. Using these models in hot and humid environments, where people often wear partially covered clothing, can cause an error in predicting the thermal sensation. The object of the present paper is to investigate the effect of the assumption of whole-body uniform clothing coverage on the error of standard thermal comfort models in hot and humid environments. Investigations were performed using a three-node thermal comfort model in the temperature range of 26C to 31C at 50% and 70% relative humidity for three different clothing levels (0.4, 0.6, and 0.8 clo). The results showed that for typical summer clothing (0.6 clo and 80% body surface coverage), ignoring the non-uniformity of clothing insulation distribution can lead to an average of 0.2-to-0.45-unit scale deviation in thermal sensation depending on ambient temperature. This effect is more evident at higher ambient temperatures and humidity. Eventually, a new model was proposed for application in hot and humid environments by considering the non-uniformity of clothing coverage. The model’s performance was evaluated against multiple sets of reported experimental data.

Quantifying the impact of heat on human physical work capacity; part III: the impact of solar radiation varies with air temperature, humidity, and clothing coverage

Heat stress decreases human physical work capacity (PWC), but the extent to which solar radiation (SOLAR) compounds this response is not well understood. This study empirically quantified how SOLAR impacts PWC in the heat, considering wide, but controlled, variations in air temperature, humidity, and clothing coverage. We also provide correction equations so PWC can be quantified outdoors using heat stress indices that do not ordinarily account for SOLAR (including the Heat Stress Index, Humidex, and Wet-Bulb Temperature). Fourteen young adult males (7 donning a work coverall, 7 with shorts and trainers) walked for 1 h at a fixed heart rate of 130 beats∙min−1, in seven combinations of air temperature (25 to 45°C) and relative humidity (20 or 80%), with and without SOLAR (800 W/m2 from solar lamps). Cumulative energy expenditure in the heat, relative to the work achieved in a cool reference condition, was used to determine PWC%. Skin temperature was the primary determinant of PWC in the heat. In dry climates with exposed skin (0.3 Clo), SOLAR caused PWC to decrease exponentially with rising air temperature, whereas work coveralls (0.9 Clo) negated this effect. In humid conditions, the SOLAR-induced reduction in PWC was consistent and linear across all levels of air temperature and clothing conditions. Wet-Bulb Globe Temperature and the Universal Thermal Climate Index represented SOLAR correctly and did not require a correction factor. For the Heat Stress Index, Humidex, and Wet-Bulb Temperature, correction factors are provided enabling forecasting of heat effects on work productivity.

Ozone Initiates Human-Derived Emission of Nanocluster Aerosols.

Nanocluster aerosols (NCAs, particles <3 nm) are important players in driving climate feedbacks and processes that impact human health. This study reports, for the first time, NCA formation when gas-phase ozone reacts with human surfaces. In an occupied climate-controlled chamber, we detected NCA only when ozone was present. NCA emissions were dependent on clothing coverage, occupant age, air temperature, and humidity. Ozone-initiated chemistry with human skin lipids (particularly their primary surface reaction products) is the key mechanism driving NCA emissions, as evidenced by positive correlations with squalene in human skin wipe samples and known gaseous products from ozonolysis of skin lipids. Oxidation by OH radicals, autoxidation reactions, and human-emitted NH3 may also play a role in NCA formation. Such chemical processes are anticipated to generate aerosols of the smallest size (1.18-1.55 nm), whereas larger clusters result from subsequent growth of the smaller aerosols. This study shows that whenever we encounter ozone indoors, where we spend most of our lives, NCAs will be produced in the air around us.

When looking 'hot' means not feeling cold: Evidence that self-objectification inhibits feelings of being cold.

Self-objectification, the internalization of an observer's appearance-based perspective of one's body, has been theorized and demonstrated to reduce body awareness among women. In this field study, we propose self-objectification as the mechanism to explain the oft-observed phenomenon where women wearing little clothing appear unbothered by cold weather, positing that self-objectification obstructs women's feelings of cold. We surveyed women outside nightclubs on cold nights, assessed self-objectification, and asked participants to report how cold they felt. Anonymous photos were taken and coded for amount of skin exposure. We hypothesized that self-objectification would moderate the relationship between clothing coverage and reports of feeling cold. Our hypothesis was supported: women low in self-objectification showed a positive, intuitive, relationship between skin exposure and perceptions of coldness, but women more highly focused on their appearance did not feel colder when wearing less clothing. These findings offer support for the relationship between self-objectification and awareness of bodily sensations in the context of a naturalistic setting. We discuss implications of these findings, and also consider limitations, an alternative explanation, and directions for future research.

Human Emissions of Size-Resolved Fluorescent Aerosol Particles: Influence of Personal and Environmental Factors.

Human emissions of fluorescent aerosol particles (FAPs) can influence the biological burden of indoor air. Yet, quantification of FAP emissions from human beings remains limited, along with a poor understanding of the underlying emission mechanisms. To reduce the knowledge gap, we characterized human emissions of size-segregated FAPs (1-10 μm) and total particles in a climate chamber with low-background particle levels. We probed the influence of several personal factors (clothing coverage and age) and environmental parameters (level of ozone, air temperature, and relative humidity) on particle emissions from human volunteers. A material-balance model showed that the mean emission rate ranged 5.3-16 × 106 fluorescent particles per person-h (0.30-1.2 mg per person-h), with a dominant size mode within 3-5 μm. Volunteers wearing long-sleeve shirts and pants produced 40% more FAPs relative to those wearing t-shirts and shorts. Particle emissions varied across the age groups: seniors (average age 70.5 years) generated 50% fewer FAPs compared to young adults (25.0 years) and teenagers (13.8 years). While we did not observe a measurable influence of ozone (0 vs 40 ppb) on human FAP emissions, there was a strong influence of relative humidity (34 vs 62%), with FAP emissions decreasing by 30-60% at higher humidity.

Safe, mild ultraviolet-B exposure: An essential human requirement for vitamin D and other vital bodily parameter adequacy: A review.

The enigma of skin sunburning, skin ageing and skin cancer and essential vitamin D production both resulting from solar ultraviolet‐B (280‐315 nm) (UVB) exposure has long puzzled photobiologists. Advice to patients by non‐photobiological clinicians is now often to sunbathe to acquire vitamin D adequacy. However, modern work shows only mild UVB exposure is needed to maintain satisfactory levels, which have been demonstrated as very similar in summer and winter from about 25° to 70° north. Even very careful high protection factor 15 sunscreen use does not prevent adequate production, although it is slightly reduced, such that obsessive use of very protective screens of 50 + might. Dark skin pigmentation too usually at most minimally impairs production. However, confinement indoors and widespread clothing cover can, but oral supplementation overcomes any such deficiency. Thus, vitamin D adequacy needs just mild regular UVB skin exposure well under sunburning levels, unlikely to cause significant skin damage. This suggests mild UVB exposure may also be needed for other bodily requirements, which is indeed so. Thus, it also prevents the development of contact dermatitis and polymorphic light eruption through suppressing adaptive immunity. It also prevents the occurrence of multiple skin infections resulting from this suppression through stimulating innate immunity and cutaneous bacterial defensin production. Finally, blood pressure is reduced through low‐dose UVB‐induced production of the vasodilator nitric oxide (though UVA, 315‐400 nm, is more efficient). Thus, mild UVB exposure is important for several aspects of internal health, whereas high‐dose exposure is extremely detrimental to cutaneous health.

Parametric human modelling to determine body surface area covered by sun-protective clothing

Solar ultraviolet radiation (UVR) is the main environmental risk-factor for cancer of the skin. Sun-protective clothing provides a physical barrier that reduces the UVR dose reaching the skin and European and Australian standards for sun-protective clothing set minimum clothing coverage requirements. Body Surface Area Coverage by clothing (BSAC) is calculated by means of indirect or direct methods, which are laborious and do not support computer-based apparel design. To support the sun-safe specification and design of garments, parametric digital human models and protective clothing mesh covering the minimum Body Surface Area specified in AS/NZS 4399:2017, were created making use of MakeHuman v1.1.1 and Blender software. The Whole Body Surface Area (WBSA) and the BSAC were calculated employing code developed in Blender. Thus, different groups of subjects were analysed to explore BSAC. The method assists in the evaluation of exposed body areas in a wider spectrum of different occupations. Practitioner summary: Sun-protective clothing provides a physical barrier that reduces the UVR dose reaching the skin’s surface. Body Surface Area Coverage (BSAC) by clothing is an important determinant of the sun protective capabilities of a garment. In this study, BSAC is calculated using parametric digital human modelling. Abbreviation: UVR: (Solar) ultraviolet radiation; DHM: digital human modeling; BSA: body surface area; BSAC: body surface area coverage (by clothing); BSANC: body surface area not covered (by clothing); WBSA: whole body surface area; BCC: basal cell carcinoma; SCC: squamous cell carcinoma; UPF: ultraviolet protection factor; GPF: garment protection factor

Effects of clothing ease and body postures on the air gap and clothing coverage

PurposeThe purpose of this paper is to determine the effects of clothing ease and body postures on the size and distribution of the air gap as well as the body coverage with the clothing.Design/methodology/approachVisual and quantitative analyses were conducted using a 3D body scanner and Geomagic Software. The air gap size and clothing area factor (fcl) in three test coverall and seven selected postures were calculated and compared.FindingsThe results indicated that both the clothing ease and body postures had a strong effect on the air gap and clothing coverage, especially the more complex the postures, the wider the range of influence. Nevertheless, these effects varied over body regions, being stronger at the lower body than the upper body. The air gap size at the left side of the body was generally larger than the right side. It was also found that the clothing coverage was linearly correlated with the air gap size and could be employed as an indicator to evaluate clothing protective capabilities.Practical implicationsThe findings suggested that greater attention should be paid to the protection and flexibility at the lower body and asymmetrical distribution of the air gap should be considered in the future air gap modeling.Originality/valueThe outcomes provided useful information to improve the protective clothing and develop more realistic air gap models to simulate the heat and mass transfer.

Thermal comfort in high altitude Himalayan residential houses in Darjeeling, India – An adaptive approach

The study of thermal comfort in buildings is required to maintain a stable and comfortable condition of the indoor environment. The climate chamber study used to determine thermal comfort is mathematically reproducible and robust, but exaggerative and hence is energy inefficient, whereas the adaptive model-based field survey method is exhaustive and bioclimatic specific. Although, several field survey-based thermal comfort studies have been reported from India, these studies were conducted mostly either in hot and humid or composite climatic condition, and very few research has been reported from cold climatic region, which lies mostly along the high altitudinal Himalayan region. In this paper, the results of field survey-based thermal comfort studies in residential houses of highly altitudinal Darjeeling Himalayan region in eastern India are presented. The study found that female subjects showed a lesser clothing cover but portrayed a higher discomfort with lower thermal sensation and higher comfort temperature. The comfort temperature as determined in this study did not comply with the ASHRAE standard 55 graphical method, and hence new comfort zone for regions with similar cold climate is proposed.

Frequency and genetic diversity of Blastocystis subtypes among patients attending to health centers in Mazandaran, northern Iran.

Blastocystis hominis is a common intestinal protozoan with global distribution. The prevalence of B. hominis is extremely diverse in different countries. Molecular studies show that there is a great deal of genetic variation in the Blastocystis parasite isolated from humans and animals. Therefore, this study was conducted to determine B. hominis genotypes in patients attending to health centers of Sari, Mazandaran Province, north of Iran. 420 fecal specimens were collected from individuals in health centers of Sari from April to December 2017. The samples were examined by direct methods, parasite test (formalin ether) and Giemsa staining. In order to determine the genotypes of Blastocystis parasite, all positive samples in direct methods were tested by PCR using SSU rDNA gene. Eventually, seven positive molecular samples were sequenced and recorded in the gene bank. The phylogenetic analysis was done by drawing a gene tree using the neighbor-joining procedure. B. hominis was detected in 60 stool specimens by microscopic method. All these 60 samples were positive by PCR and the bands 310bp were observed. According to the phylogenetic tree, it was revealed that B. hominis isolates of Mazandaran Province are more similar to subtype ST3 (ST type) that reported in Khorramabad in Lorestan Province (West of Iran). The present study showed that, like most studies, ST3 is the dominant genotype of protozoan in Sari. Improvement of public health awareness, relative improvement in environmental health, urban wastewater treatment, proper clothing coverage and the use of gloves during dealing with livestock and the use of domestic water treatment devices can reduce the Blastocystis infection in this area.

Optimal sunscreen use, during a sun holiday with a very high ultraviolet index, allows vitamin D synthesis without sunburn.

SummaryBackgroundSunlight contains ultraviolet (UV)A and UVB radiation. UVB is essential for vitamin D synthesis but is the main cause of sunburn and skin cancer. Sunscreen use is advocated to reduce the sun's adverse effects but may compromise vitamin D status.ObjectivesTo assess the ability of two intervention sunscreens to inhibit vitamin D synthesis during a week‐long sun holiday.MethodsThe impact of sunscreens on vitamin D status was studied during a 1‐week sun holiday in Tenerife (28° N). Comparisons were made between two formulations, each with a sun protection factor (SPF) of 15. The UVA‐protection factor (PF) was low in one case and high in the other. Healthy Polish volunteers (n = 20 per group) were given the sunscreens and advised on the correct application. Comparisons were also made with discretionary sunscreen use (n = 22) and nonholiday groups (51·8° N, n = 17). Sunscreen use in the intervention groups was measured. Behaviour, UV radiation exposure, clothing cover and sunburn were monitored. Serum 25‐hydroxyvitamin D3 [25(OH)D3] was assessed by high‐performance liquid chromatography–tandem mass spectrometry.ResultsUse of intervention sunscreens was the same (P = 0·60), and both equally inhibited sunburn, which was present in the discretionary use group. There was an increase (P < 0·001) in mean ± SD 25(OH)D3 (28·0 ± 16·5 nmol L−1) in the discretionary use group. The high and low UVA‐PF sunscreen groups showed statistically significant increases (P < 0·001) of 19·0 ± 14·2 and 13·0 ± 11·4 nmol L−1 25(OH)D3, respectively with P = 0·022 for difference between the intervention sunscreens. The nonholiday group showed a fall (P = 0·08) of 2·5 ± 5·6 nmol L−1 25(OH)D3.ConclusionsSunscreens may be used to prevent sunburn yet allow vitamin D synthesis. A high UVA‐PF sunscreen enables significantly higher vitamin D synthesis than a low UVA‐PF sunscreen because the former, by default, transmits more UVB than the latter. What's already known about this topic? Action spectra (wavelength dependence) for erythema and the cutaneous formation of vitamin D overlap considerably in the ultraviolet (UV)B region.Theoretically, sunscreens that inhibit erythema should also inhibit vitamin D synthesis.To date, studies on the inhibitory effects of sunscreens on vitamin D synthesis have given conflicting results, possibly, in part, because people typically apply sunscreen suboptimally.Many studies have design flaws. What does this study add? Sunscreens (sun protection factor, SPF 15) applied at sufficient thickness to inhibit sunburn during a week‐long holiday with a very high UV index still allow a highly significant improvement of serum 25‐hydroxyvitamin D3 concentration.An SPF 15 formulation with high UVA protection enables better vitamin D synthesis than a low UVA protection product. The former allows more UVB transmission.

A comprehensive approach to evaluating and classifying sun-protective clothing

Summary Excessive exposure to sunlight causes skin cancer, the most common cancer in humans. An estimated 80% of melanoma (the most deadly form of skin cancer) cases in Australia could be prevented by reducing sun exposure. Clothing provides a protective barrier that reduces the amount of solar ultraviolet radiation (UVR) reaching the skin. In 1996, Australia pioneered a relative ranking of the sun-protective capabilities of clothing based on the transmission of UVR through fabric, known as the Ultraviolet Protection Factor (UPF). UPF garment swing tags were introduced as part of this original standard (AS/NZS 4399:1996) which was widely adopted by industry. However, it did not consider the body surface area (BSA) covered by garments. Minimum body coverage requirements for the torso and limbs were added to some standards (e.g. European Union, 2003; Australian/New Zealand, 2017) but not others (e.g. USA). In light of recent evidence showing that clothing coverage is important in preventing some of the pigmented moles that develop in childhood (important risk-factor for melanoma), it is imperative that sun-protective clothing rating schemes consider BSA coverage of the garment, in addition to fabric UPF. We developed a new index for rating sun-protective clothing, “the Garment Protection Factor (GPF)” that incorporates both of these important factors. BSA coverage is determined based on the number of lines visible on a clothed versus an unclothed mannequin. GPF increases with BSA coverage of the garment and fabric UPF over 3 categories: GPF 0 to &amp;lt; 3 indicates the garments ‘meets’ minimum standards; 3 to &amp;lt; 6 indicates ‘good’ sun-protection; and GPF ≥ 6 indicates ‘excellent’ protection. Adoption of this rating scheme should provide an incentive for manufacturers to design sun-protective garments that exceed the minimum standard for BSA coverage and fabric UPF, and provide consumers with adequate information on which to base their choice, with positive implications for skin cancer prevention.

Sun Protection Among New Zealand Primary School Children.

Schools are an important setting for raising skin cancer prevention awareness and encouraging sun protection. We assessed the clothes worn and shade used by 1,278 children in eight schools in the Wellington region of New Zealand. These children were photographed for the Kids'Cam project between September 2014 and March 2015 during school lunch breaks. Children's mean clothing coverage (expressed as a percentage of body area covered) was calculated. Data on school sun-safety policies were obtained via telephone. Mean total body clothing coverage was 70.3% (95% confidence interval = 66.3%, 73.8%). Body regions with the lowest mean coverage were the head (15.4% coverage), neck (36.1% coverage), lower arms (46.1% coverage), hands (5.3% coverage), and calves (30.1% coverage). Children from schools with hats as part of the school uniform were significantly more likely to wear a hat (52.2%) than children from schools without a school hat (2.7%). Most children (78.4%) were not under the cover of shade. Our findings suggest that New Zealand children are not sufficiently protected from the sun at school. Schools should consider comprehensive approaches to improve sun protection, such as the provision of school hats, sun-protective uniforms, and the construction of effective shade.

Clothing Protection from Ultraviolet Radiation: A New Method for Assessment.

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

Cutaneous squamous cell carcinoma: an epidemiological review.

Cutaneous squamous cell carcinoma (SCC) is a common cancer in white populations and its disease burden is often substantially underestimated. SCC occurs more often in men than women and increases dramatically with age; those affected often develop multiple primaries over time, which increases the burden. The main external cause is solar ultraviolet radiation (UVR), with immunosuppression being the other established risk factor, shown by the high SCC rates in organ transplant recipients. Sunbed use and certain genetic disorders and medical conditions are also associated with SCC, while associations with human papillomavirus infection and high bodyweight are not established. The presence of actinic keratoses (AKs) on sun-damaged skin is one of the strongest predictors of SCC in unaffected people and a very small proportion of AKs are SCC precursors, although the true rate of malignant transformation of AKs is unknown. The mainstay of SCC prevention is protection of the skin from undue sun exposure by use of clothing cover and sunscreen during summer or in sunny places. Educational, behavioural and multicomponent interventions directed at individuals ranging from parents of newborns, to school children and adolescents, to outdoor workers, have repeatedly been shown to be effective in improving sun-protective behaviours. Health policies can facilitate SCC prevention by setting standards for relevant behaviours to reduce UVR exposure, for example, by legislated restriction of the tanning industry. Skin cancer prevention initiatives are generally highly cost-effective and public investment should be encouraged to control the growing public health problems caused by SCC.

Factors associated with photoprotection by body clothing coverage, particularly in non-summer months, among a New Zealand community sample.

Clothing coverage is important for reducing skin cancer risk, but may also influence vitamin D sufficiency, so associated plausible predictors require investigation. Volunteers (18 to 85 years), with approximately equal numbers by sex and four ethnicity groups, were recruited in cities from two latitude bands: Auckland (36.9°S) and Dunedin (45.9°S). Baseline questionnaire, anthropometric and spectrophotometer skin colour data were collected and weather data obtained. Percent body coverage was calculated from eight week diary records. Potential independent predictors (unadjusted p < 0.25) were included in adjusted models. Participants (n = 506: Auckland n = 334, Dunedin n = 172; mean age 48.4 years) were 62.7% female and had a median body clothing coverage of 81.6% (IQR 9.3%). Dunedin was cooler, less windy and had lower UVI levels than Auckland. From the fully adjusted model, increased coverage occurred in non-summer months (despite adjusting for weather), among Dunedin residents and Asians (compared to Europeans), during the middle of the day, with a dose response effect observed for greater age. Reduced coverage was associated with Pacific ethnicity and greater time spent outdoors. Additionally, higher temperatures were associated with reduced coverage, whereas increased cloud cover and wind speed were associated with increased coverage. Although the only potentially modifiable factors associated with clothing coverage were the time period and time spent outdoors, knowledge of these and other associated factors is useful for the framing and targeting of health promotion messages to potentially influence clothing coverage, facilitate erythema avoidance and maintain vitamin D sufficiency.

Environmental variables associated with vacationers' sun protection at warm weather resorts in North America

BackgroundVacationing at sunny, warm weather locations is a risk factor for excessive solar ultraviolet (UV) radiation exposure and skin cancer. ObjectivesThis study examined the association of environmental variables related to UV levels with vacationers' sun protection. MethodsVacationers at 41 summer resorts in 17 states and 1 Canadian Province were interviewed (n=3531) and observed (N=4347) during 2012 and 2013. Clothing coverage, sunglasses, and shade use were observed. Use of sunscreen and sunburns were self-reported. Environmental information was recorded by research staff or acquired from ground stations and the weather service. ResultsTemperature was positively associated with sun protection behaviors; however clothing coverage was negatively associated with temperature. Cloud cover was negatively associated with sun protection, with the exception of clothing coverage which was positively associated with it. Elevation showed a mixed pattern of associations with vacationer's sun protection. Latitude of a resort was negatively associated with most sun protection behaviors, such that sun protection increased at more southerly resorts. Similarly, the farther south a vacationer traveled to the resort, the less sun protection they employed. The UV index showed a weak, positive relationship with some sun protection behaviors even when controlling for temperature. ConclusionsVacationers appeared aware that UV is higher at southern latitudes and may learn UV is intense when living in southern regions. However, many used temperature, an unreliable cue, to judge UV intensity and seemed to adjust clothing for warmth not UV protection. Efforts are needed to help individuals make more accurate sun safety decisions.