Increase Sun Protection Research Articles

Skin cancer knowledge, attitudes, beliefs, and prevention practices among beachgoers: a narrative review.

People who spend time at the beach at increased risk for ultraviolet light (UV) exposure. This review assessed skin cancer-related knowledge, attitudes, beliefs, and prevention practices among beachgoers and sunbathers at the beach. Relevant articles were search in the following electronic databases: PubMed (Medline), Cumulative Index to Nursing and Allied Health (CINAHL), ERIC, and PsycINFO. A narrative analysis of pertinent study findings was conducted. A total of 24 studies were included in this narrative review. Findings included moderate to high knowledge of sun protection as well as knowledge-based deficiencies around the type of UV light that causes sun damage, risk factors, prevention of lip damage and cancer, length of sun exposure, and risk of photoaging with increased sun protection factor value. Beachgoers and sunbathers perceive their own risk of skin cancer and skin aging as less than that of the general population. Variable sun protection behaviors were observed in this population including use of sunscreen, sunglasses, shade, hats, and protective clothing. Amongst all beachgoers and sunbathers, 21-22.8% do not use sun protection and 62% have experienced a blistering sunburn in their lives. Beachgoers would benefit from increased education on skin cancer susceptibility and the importance of sun protection strategies. Healthcare providers should provide counseling on sun protection to reduce the morbidity and mortality associated with skin cancer. Disseminating information through the media may help bring more awareness of healthy skin practices at the beach and prevent skin cancers.

Determination of Biological Activity of Hylocereus polyrhizus Methanol Extracts: Antimicrobial Activity, Probiotic-Promoting Effect, Photoprotective Activity

In our study, the biological activity of Hylocereus polyrhizus obtained from Türkiye was determined. Firstly, antimicrobial activity of methanol extracts obtained from H. polyrhizus against test microorganisms was determined by disc diffusion susceptibility assay, minimum inhibition concentration (MIC) and minimum fungicidal or bactericidal concentration (MFC or MBC) tests. Then, viable cell counting against Limosilactobacillus fermentum MA-7 using the macro-dilution method was used to determine the probiotic-promoting effect of the fruit extracts. Finally, the photo-protective activity of the extracts and extract-cream mixtures was obtained spectrophotometrically. The inhibition zone diameter of the peel extract against the test microorganisms is in the range of 9.60-12.37 mm and the fruit extract is in the range of 7.85-12.00 mm. MBC values ranged from 40 µg/µl to 80 µg/µl in peel extract and between 10 µg/µl and >80 µg/µl in the fruit extract. The inhibition zone diameters of the extracts against probiotics were determined as 6.10 -10.25 mm. As a result of the viable cell count, the viability rate of L. fermentum MA-7 increased as the fruit methanol extract concentration and time increased. The photoprotective activities of the peel and fruit extracts were determined as 13.17 and 12.26. It was determined that the extracts increased sun protection factor (SPF) value of the cream. The results indicated that H. polyrhizus extracts may have potential for use in the nutraceutical products, cosmetic and pharmaceutical industries.

Digital Interventions to Modify Skin Cancer Risk Behaviors in a National Sample of Young Adults: Randomized Controlled Trial.

Young adults engage in behaviors that place them at risk for skin cancer. Dissemination of digital health promotion interventions via social media is a potentially promising strategy to modify skin cancer risk behaviors by increasing UV radiation (UVR) protection and skin cancer examinations. This study aimed to compare 3 digital interventions designed to modify UVR exposure, sun protection, and skin cancer detection behaviors among young adults at moderate to high risk of skin cancer. This study was a hybrid type II effectiveness-implementation randomized controlled trial of 2 active interventions, a digital skin cancer risk reduction intervention (UV4.me [basic]) compared with an enhanced version (UV4.me2 [enhanced]), and an electronic pamphlet (e-pamphlet). Intervention effects were assessed over the course of a year among 1369 US young adults recruited primarily via Facebook and Instagram. Enhancements to encourage intervention engagement and behavior change included more comprehensive goal-setting activities, ongoing proactive messaging related to previously established mediators (eg, self-efficacy) of UVR exposure and protection, embedded incentives for module completion, and ongoing news and video updates. Primary outcome effects assessed via linear regression were UVR exposure and sun protection and protection habits. Secondary outcome effects assessed via logistic regression were skin self-exams, physician skin exams, sunscreen use, indoor tanning, and sunburn. The active interventions increased sun protection (basic: P=.02; enhanced: P<.001) and habitual sun protection (basic: P=.04; enhanced P=.01) compared with the e-pamphlet. The enhanced intervention increased sun protection more than the basic one. Each active intervention increased sunscreen use at the 3-month follow-up (basic: P=.03; enhanced: P=.01) and skin self-exam at 1 year (basic: P=.04; enhanced: P=.004), compared with the e-pamphlet. Other intervention effects and differences between the Basic and Enhanced Intervention effects were nonsignificant. The active interventions were effective in improving several skin cancer risk and skin cancer prevention behaviors. Compared with the basic intervention, the enhanced intervention added to the improvement in sun protection but not other behaviors. Future analyses will explore intervention engagement (eg, proportion of content reviewed). ClinicalTrials.gov NCT03313492; http://clinicaltrials.gov/ct2/show/NCT03313492.

The role of community pharmacists in primary and secondary prevention of skin cancer: an evaluation of a Flemish skin cancer prevention campaign

BackgroundSkin cancer is a leading form of cancer in Belgium. Prevention of skin cancer by community pharmacists can play a role in increasing awareness and promoting sun protection. However, which persons could be reached by community pharmacists for skin cancer awareness in Belgium and whether this increased awareness is associated with increased sun protection and early detection remains unclear.MethodsDemographics of approached persons in Flemish community pharmacies during the months of May-June 2022 and the content of the skin cancer counseling were retrieved from the pharmacy database. Sunscreen purchases and dermatologist visits were evaluated up to 180 days after the skin cancer counseling.ResultsCommunity pharmacists provided skin cancer counseling to a broad population of visitors (n = 822, 69% females, median age of 59 years Q1-Q3: 44–71 years). During the campaign, 822 visitors received a leaflet with skin cancer prevalence and sunscreen importance. On top of that, 335 visitors (41%) received additional counseling: skin type sensitivity was checked for 198 visitors (24%), typical characteristics of melanoma were discussed with 100 visitors (12%) and 37 visitors (5%) were referred to a physician for further information or concerns regarding a skin spot. Overall, one out of three visitors purchased sunscreen on the day of the counseling (33%, increasing up to 38% after 180 days). Among people under 20 years, this was even higher (51%). Additional counseling increased the likelihood of a dermatologist visit within 180 days (OR = 1.80; 95%CI: 1.12–2.88).ConclusionsBy providing skin cancer counseling in Belgian community pharmacies, a broad range of citizens was reached and triggered to purchase sunscreen, often on the same day as the counseling. Notably, young people were likely to purchase sunscreen. Citizens receiving additional counseling were more likely to visit a dermatologist within 180 days.

Attitudes, Behaviors, and Risks of Sun Protection to Prevent Skin Cancer Amongst Children, Adolescents, and Adults.

Skin cancer is the most common cancer diagnosis worldwide. Many factors are involved in the development of skin cancers, but ultraviolet (UV) light exposure is the most modifiable. Our lifetime cumulative UV exposure may be a result of poor sun protection practices in childhood and adolescence. Modifying the attitudes and behaviors of children can be done in the classroom, at recreational activities, and at home. A review of the literature was conducted using Embase and PubMed to examine the relationship between attitudes and behaviors as they relate to sun protection strategies. Well-developed, standardized sun protection educational programs are needed to instruct children and adolescents. Individualized counseling from physicians or online programs is needed to help parents increase sun-safe standards for their children. Many young women utilize indoor tanning beds frequently, but many instructional programs increased their tanning bed usage. Time should be allotted at schools, sports practices, camps, and other outdoor activities for sunscreen reapplication. Many parents and children report the media is their primary source of information about sun safety. Media outlets may positively change attitudes and behaviors when reporting about sun safety. Parents and children need individualized programs or counseling to reduce ultraviolet (UV) exposure and increase sun protection. At-risk populations need tailored instruction, but few strategies have worked to decrease UV exposure.

Validation of the Sun Exposure and Protection Index (SEPI) in Greek: An Instrument for Measuring Children’s Sun Protection Propensity

Skin cancer, the most common type of cancer worldwide, has been linked to overexposure to ultraviolet radiation (UVR) without protection. As skin cancer is a preventable type of cancer, there is a pressing need to adopt health-promoting behaviors early in life. The Sun Exposure and Protection Index (SEPI) is an instrument for evaluating adults’ sun exposure habits and the propensity to increase sun protection with widely accepted validity and reliability in Swedish, English, and German. The present study aims to validate SEPI with children in Greek. Data was collected from 127 primary school students in Cyprus who completed the instrument twice within two weeks. Internal consistency calculated by Cronbach’s alpha was 0.69 for all 13 items included in SEPI. A statistically significant (p &lt; 0.01) strong and positive correlation coefficient (Pearson’s r = 0.63) was measured between the total scores for parts 1 and 2. Test–retest stability was high and significant (ρ &gt; 0.5, p &lt; 0.01) for all items but one. In conclusion, the Greek version of SEPI demonstrates reasonable internal consistency, as Cronbach’s alpha is at a relatively acceptable level. It can be used for evaluating prevention interventions assessing sun exposure habits, and the propensity to increase sun protection among primary school students.

Factors Associated With Sun Protection Behaviors Among Childhood Cancer Survivors.

Childhood cancer survivors (CCS) are at increased risk of developing skin cancer. Engaging in sun-protective behaviors may ameliorate that risk, but prior work shows that survivors engage in suboptimal levels of sun-protective behaviors. Guided by the Health Belief Model (HBM), this study evaluated factors associated with sun-protective behavior among CCS. This is a secondary analysis of a survey study of 94 adult survivors of childhood cancer recruited from a long-term follow-up clinic. Participants reported their sun protection habits, skin type/sensitivity, barriers to sun protection, and perceived severity and susceptibility of getting skin cancer. Descriptive statistics were used to describe the prevalence of sun protection behaviors and hierarchical linear regression was used to evaluate predictors of sun protection behavior following the HBM. On average, CCS engaged in moderate levels of sun-protective behaviors ( M =2.53; SD=0.59). Hierarchical linear regression indicated that fair skin type ( P =0.02) and higher perceived susceptibility relative to noncancer survivors ( P =0.02) were associated with increased sun protection behaviors. Perceived barriers to sun protection were marginally significant ( P =0.09), whereas other constructs from the HBM did not contribute significantly to the model. Although CCS are at increased risk of developing skin cancer, they engage in suboptimal levels of sun protection behaviors. Findings suggest that interventions to educate survivors about their unique risk of skin cancer and effective prevention behaviors are needed.

340 Benzene in sunscreen: Do sensationalizing dermatology reports have a lasting effect on google trends and reddit engagement?

Skin cancer is the most common form of cancer and has continued to rise in the past decade. Sunscreen has been shown to decrease the risk of developing melanoma by 50%, and squamous cell carcinoma by 40%. Australia has a robust sun-safety program which was implemented in 1988 and has shown to be effective in increasing sun protection behaviors and a decline in melanoma incidence. Behavior change is hard and complex and important for dermatologists to understand to help modify a patient's sun protective behaviors.

Knowledge, attitudes and practices of the general puplic toward the harmful effects of sun exposure and protection

Background; Excessive unprotected sun exposure is a significant risk factor for skin damage and skin cancers. In recent decades, the incidence of skin cancer has increased dramatically worldwide, reaching epidemic proportions. Sun protection is a key primary preventive strategy against skin cancer and skin damage induced by sun exposure. Aim and objectives; was to determine the knowledge, attitudes and behaviors of individuals on the harmful effects of the sun and protection ways. Subjects and methods; this study was a cross-sectional study conducted on 104 males and 316 females who attended Menoufia university dermatology clinic and some of the employments (physicians , nurses and officers)in the Menoufia university hospitals and some of the students. Result; the mean age of the studied participant was 31.30±7.55 and the majority of them were females (75.2%). There were significant bad sun habits and lower sun protection behavior (indicated by increasing SEPI part I score which was 10.22±3.63). Also, there was significant decreasing propensity to increase sun protection (indicated by increasing SEPI score part II) in males than females, unmarried than married persons, with low levels of education in the studied participants.

Restructuring the workday to reduce occupational exposure to solar ultraviolet radiation (UVR)

BACKGROUND AND AIM: Messaging about sun avoidance strategies is often not practical for outdoor workers. The objective of this study was to use personal monitoring data to determine when peak UVR exposure occurs for outdoor workers, estimate how much UVR could be reduced by altering the timing of shady tasks or breaks during peak exposure times, and compare these to peak periods of ambient UVR. The aim was to provide evidence-based sun avoidance recommendations for outdoor workers in British Columbia, Canada. METHODS: UVR exposure data [standard erythemal dose (SED)] were collected during the 2013 summer months in Vancouver, using personal electronic dosimeters. Mixed-effect models were used to estimate the 60-, 30-, and 15-min time intervals at which maximum exposure occurred for the months of July and August. Ambient UVR was also collected using data from the nearest Brewer spectrophotometer station and parallel analyses were conducted. RESULTS:There were 73 workers and 321 participant-days available for analysis. Models indicated that periods of maximum exposure for 15-, 30-, and 60-min intervals began at 12:28 pm, 12:17 pm, and 11:52 am, respectively, for sunny days in July. These periods were similar in August. The median exposure during these time periods and the potential for reducing UVR was 0.03 SED (2.8% potential daily exposure reduction), 0.09 SED (7.1%), and 0.18 SED (15.9%), respectively. However, there was a large range in exposure estimates as some workers experienced up to 84.8% of their exposure in the peak 60-min interval. CONCLUSIONS:Skin cancer prevention messaging does not include practical messages for outdoor workers. Providing workers with information on the timing of peak UVR can help to modify work tasks for the the greatest reductions in exposure. Prevention measures including shady breaks, increased sun protection, and task reorganization during these peak times are recommended to reduce UVR exposure among those at highest risk. KEYWORDS: Occupational exposure, solar radiation, outdoor workers, ultraviolet radiation, prevention

Optimizing Texting Interventions for Melanoma Prevention and Early Detection: A Latin Square Crossover RCT

Text messaging is an effective way to reach large populations with health promotion support. This study aims to establish the optimal text messaging intervention to achieve behavior change in young adults at risk of skin cancer. Latin square crossover RCT. Participants were women and men aged 18-40 years living in Queensland, Australia who owned a smartphone and had ≥2 skin cancer risk factors. Participants were enrolled from December 2018 to February 2019 and completed an eligibility survey. Eligible participants were randomized to 4 different text message interventions using a Latin square design with varying personalization, interactivity, and message frequency (February 2019‒July 2019). Each intervention lasted for 1 month; between interventions, participants had a 1-week washout period in which they completed an online questionnaire. Participants completed a 6-month follow-up online survey in January 2020. Measures included self-reported sun protection habits and sunburns. A total of 277 (71.2% response rate) participants completed the 6-month follow-up. The sun protection habits index was significantly higher in all the 4 text messaging interventions (p<0.01 for each intervention) than at baseline, with similar sun protection habits improvements among all interventions (p=0.27). Sunburn rates decreased significantly over time (p<0.01 each intervention), with all the 4 interventions achieving reductions in sunburn rates during the intervention periods (p=0.78). Overall, the sunburn rates decreased from 40.3% at baseline to 7.0% at the end of the intervention, and at 6-month follow-up, it remained significantly below baseline levels at 23.5% (p<0.01). Regular text messaging interventions result in significantly increased sun protection and decreased sunburn in young adults. This study is registered at the Australian and New Zealand Clinical Trials Registry ACTRN12618001299291.

249 Increased susceptibility to sunburn occurs during the first three years of hydrochlorothiazide use: Results from the National Health and Nutrition Examination Survey, 2009-2018

Hydrochlorothiazide (HCTZ) has been associated with increased photosensitivity and development of non-melanoma skin cancer. Given the Food and Drug Administration’s recommendation of increased sun protection in patients taking HCTZ, we investigated the relationship between HCTZ use, photoprotection behaviors, and sunburn using the National Health and Nutrition Examination Survey (NHANES). We combined NHANES data from 2009-2018 (931 taking HCTZ, 18148 not taking HCTZ) and used multiple logistic regression to calculate adjusted odds ratios (aOR) of staying in shade, wearing long sleeves, and using sunscreen. We used quasi-Poisson regression with linear spline to model incidence rate ratios (IRR) of sunburns in the past year associated with duration of HCTZ use. Models were adjusted for survey cycle, sex, age, race/ethnicity, education level, income to poverty ratio, history of skin cancer, and time spent outdoors. We controlled for photoprotection behaviors when examining sunburn as the outcome. Current HCTZ use was not associated with change in odds of frequently staying in shade (aOR 1.11, CI 0.93 – 1.32, P=0.253), wearing long sleeves (aOR 1.38, CI 0.99 – 1.91, P=0.063), or using sunscreen (aOR 1.11, CI 0.89 – 1.39, P=0.363). Among participants who took HCTZ for 3 years or less, each additional year of HCTZ use was associated with a 38% increase in incidence rate of sunburns in the past year (IRR 1.38, CI 1.12 – 1.70, p=0.004). Among participants who took HCTZ for more than 3 years, no statistically significant association between duration of HCTZ use and incidence rate of sunburns was found (IRR 0.98, CI 0.93 – 1.04, p=0.526). In summary, we found areas for improvement in sun protection among patients taking HCTZ and increased susceptibility to sunburn during the first 3 years of HCTZ use. Education on photoprotection methods, especially with initiation of HCTZ, is important in this population to prevent photodamage and the development of skin cancer.

Glycerol‐Filled Silicone Adhesive Patches with Excellent Sun Protection

AbstractNumerous medical conditions such as cancer, eczema, moles, and burns may leave patients with increased sensitivity to UV light. A UV‐protective patch that provides a healing environment for sensitive or broken skin is therefore developed from two‐phase glycerol‐silicone adhesives. The adhesives are prepared using a simple processing method in which high shear forces mix glycerol and silicone prepolymers that are subsequently cured to form a stable, free‐standing adhesive containing inherent discrete glycerol droplets. These materials are excellent candidates for wound care adhesives, since glycerol increases the silicone adhesives’ water absorption while providing low peel forces and gentle adherence to the skin. Adhesives show increased sun protection properties with increasing glycerol content. When TiO2, a well‐known ingredient in sunscreen products, is added to the glycerol‐filled silicone adhesives, the sun protection factor reached SPF 100 without compromising the mechanical or peel strength properties. Further, the sun protective properties of the TiO2‐filled glycerol‐silicone adhesives prove to be stable when exposed to 80% relative humidity for 20 h to simulate performance during typical usage.

Sun Protection Behavior Following Skin Cancer Resection and Reconstruction.

Increased exposure to ultraviolet radiation (UVR) is associated with an increased risk of nonmelanoma skin cancer. Cutaneous surgery can be negatively influenced by UVR, causing delayed wound healing, hyperpigmentation of the scar, and an increased incidence of additional skin cancers. By changing sun protection behavior, these risks can be limited. Therefore, this study evaluates changes in patients' sun protective behavior after Mohs micrographic surgery (MMS). Patients undergoing MMS between December 2017 and November 2019 were included. Patients were asked to complete the FACE-Q Skin Cancer - Sun Protection Behavior checklist before and 3 months and 1 year post-surgery. A total of 125 patients completed the pre-operative and 3-months post-operative checklists, and 89 (71.2%) completed the 1-year post-operative checklist. Reported sun protective behaviors increased post-surgery at all time points (p < 0.001). Patients with a prior history of facial skin cancer demonstrated a larger increase in sun protection behaviors after surgery than patients without a history of facial skin cancer (p = 0.04). Patients with defects located on the ear or scalp demonstrated a lesser increase in sun protection behaviors than patients with defects located in more conspicuous areas as the face (p = 0.02). Our study demonstrates a change in sun protection behavior, with an increase in sun protection behavior over time in patients after MMS. However, more improvement is possible. Targeted counseling can increase sun protection behavior in patients without a history of facial skin cancer and patients with skin cancer located on the ears or scalp.

Novel sunprotection interventions to prevent skin cancer: A randomized study targeting Danes going on vacation to destinations with high UV index.

BackgroundIn Denmark, 16,500 cases of melanoma and keratinocyte cancers were registered in 2015, of which 90% could have been avoided by behavioral changes. We aimed to test novel interventions in a randomized design. The interventions targeted Danes going on vacation to high UVI destinations aiming to decrease sunburn by increasing use of sun protection to prevent skin cancer in the Danish population.MethodsWe report a randomized behavioral intervention during May-Dec 2018 with 1548 Danish adults on vacation in 2018 for a period of 1–3 weeks. The study population was population-based and aged 18–65 years. We tested two protection routines against minimal intervention control group (2-by2-factorial design): 1) Avoidance of the sun during peak hours and shade, use of the UV-index and planning of indoor/outdoor activity respectively and, 2) Coverage by increasing use of the hat advice and increasing sunscreen amount by application routine. Outcome was use of protection and sunburn.ResultsThere were no differences in sunburn prevalence between intervention and control groups. Protection routine 1 and 2 both increased the overall protection score compared to non-users. Protection routine 1 increased the reported use of shade and decreased time exposed in the sun. Protection routine 2 increased the use of hat and sunscreen amount.ConclusionSimple measures can help avoid the majority of one of the most widespread cancers worldwide. Vacations to high UVI destinations is a major influence on the annual Danish UV-exposure. We influenced travelers to protect themselves better and to increase sun protection behavior.

UVR-sensor wearable device intervention to improve sun behaviors and reduce sunburns in melanoma survivors: study protocol of a parallel-group randomized controlled trial

BackgroundIndividuals who have been diagnosed with melanoma have more than a 9-fold increased risk of developing another melanoma. Ultraviolet radiation (UVR) exposure following a melanoma diagnosis can be modified to reduce risk of a new melanoma diagnosis. Yet research shows that many melanoma survivors do not report optimal sun protection practices. The objective of this study is to evaluate the effectiveness of a UVR-sensor wearable device to improve sun protection behaviors and reduce sunburns in a randomized controlled trial (RCT) in melanoma survivors.MethodsWe will conduct an RCT among 368 melanoma survivors in two waves (Summer 2020, Summer 2021). This approach allows for adequate recruitment of the required sample and potential improvements to recruitment, compliance, and retention strategies between waves. The intervention includes an informational brochure about sun protection behaviors and a commercially available UVR-sensor wearable device (Shade), which accurately measures UVR. The device, along with its associated mobile application, measures and stores UVR exposure. As UVR exposure accumulates, the device provides notifications to increase sun protection action. Survivors in the control group receive the device and a separate mobile application that does not provide notifications or summary UVR exposure data. Participants will be asked to wear the device for 12 weeks. They will complete surveys about their sun behaviors at study entry, every 4 weeks during the intervention, and 1 year later. At the end of the intervention period, intervention and control groups will be compared for differences in a summary measure of sun protection habits and experience of a sunburn. We will also measure self-reported physical activity, depression, and anxiety to examine potential unintended negative consequences of the intervention.DiscussionThe study intervention will be completed Fall 2021, with anticipated results available in 2022. If this intervention improves sun protection behaviors in melanoma survivors, these findings would support expanding the use of this technology with other populations at high risk for melanoma.Trial registrationClinicalTrials.gov NCT03927742. Registered on April 15, 2019.

The Impact of Increasing Sun Protection Counseling and Skin Cancer Screening.

Skin cancer is the most common cancer in the United States. Skin cancer is a broad term that includes squamous cell carcinoma, basal cell carcinoma, and melanoma. Melanoma is the most concerning of the three types of skin cancer and is the focus of this project. The projected number of individuals impacted by a new diagnosis of melanoma in 2020 is a staggering 100,350 coupled with an estimated 6,850 patients dying from melanoma each year. In Wisconsin, it is estimated there will be 2,190 new cases of melanoma, and 150 deaths in 2020. Expanding patient's knowledge about the risk and benefits of skin cancer screenings, techniques, and characteristics will enhance understanding of the significance of skin cancer. The purpose of this study was to assess current skin cancer knowledge and raise awareness by providing education regarding skin cancer risks and statistics among manufacturing employees in Wisconsin. A quality improvement procedure took place as employees of a Midwestern global manufacturer were educated about self-skin screens, skin cancer risks, and the importance of sun protective behaviors. Pre- and post-education surveys were distributed and obtained. A total of 16 individuals participated in the study, and the results were clinically significant. Providing education about skin cancer risks and sun protection behaviors improved employee's knowledge base by 50%. Although individuals identified skin cancer as an area of high concern, few reported knowing how to prevent skin cancer and the risks for skin cancer before being provided the related education. Therefore, it is evident, even with this small group that simple skin cancer counseling offers great benefit in helping increase knowledge among those educated about skin cancer risk factors and sun protective behaviors.

Testing Wearable UV Sensors to Improve Sun Protection in Young Adults at an Outdoor Festival: Field Study.

BackgroundAustralia and New Zealand have the highest skin cancer incidence rates worldwide, and sun exposure is the main risk factor for developing skin cancer. Sun exposure during childhood and adolescence is a critical factor in developing skin cancer later in life.ObjectiveThis study aims to test the effectiveness of wearable UV sensors to increase sun protection habits (SPH) and prevent sunburn in adolescents.MethodsDuring the weeklong school leavers outdoor festival (November 2019) at the Gold Coast, Australia, registered attendees aged 15-19 years were recruited into the field study. Participants were provided with a wearable UV sensor and free sunscreen. The primary outcome was sun exposure practices using the SPH index. Secondary outcomes were self-reported sunburns, sunscreen use, and satisfaction with the wearable UV sensor.ResultsA total of 663 participants were enrolled in the study, and complete data were available for 188 participants (188/663, 28.4% response rate). Participants provided with a wearable UV sensor significantly improved their use of sunglasses (P=.004) and sunscreen use both on the face (P<.001) and on other parts of the body (P=.005). However, the use of long-sleeve shirts (P<.001) and the use of a hat (P<.001) decreased. During the study period, 31.4% (59/188) of the participants reported receiving one or more sunburns. Satisfaction with the wearable UV sensor was high, with 73.4% (138/188) of participants reporting the UV sensor was helpful to remind them to use sun protection.ConclusionsDevices that target health behaviors when outdoors, such as wearable UV sensors, may improve use of sunscreen and sunglasses in adolescents.

Validation of SEPI in German-A German Translation of the Sun Exposure and Protection Index.

The Sun Exposure and Protection Index (SEPI) is a brief instrument for scoring of sun exposure habits and propensity to increase sun protection, previously validated in English and in Swedish, as well as in two different outdoor sun intensity environments (Australia and Northern Europe). The aim of the present study was to study reliability and validity of a German translated version of the SEPI to be used in German-speaking populations. Data was collected at University of Flensburg and at Hamburg University of Applied Sciences from November 2018 to April 2019. Participants (n = 205) filled out the SEPI and also a selection of corresponding questions from the Austrian Vienna UV Questionnaire in German. After three weeks, the participants filled out the SEPI once again in order to assess test–retest stability. Of the 205 participants completing the baseline questionnaire, 135 participants completed it once again after three weeks. Internal consistency, by Cronbach’s alpha, for the baseline responses was 0.70 (95% C.I: 0.63–0.76) for SEPI part 1 (sun exposure habits) and 0.72 (95% C.I: 0.66–0.78) for part 2 (propensity to increase sun protection). Test–retest stability was high, with weighted Kappa >0.6 for all items but one, and the instrument correlated well with the previously validated German-language UV Skin Risk Survey Questionnaire. In conclusion, the German version of SEPI can reliably be used for mapping of individual sun exposure patterns.

Strategic Task and Break Timing to Reduce Ultraviolet Radiation Exposure in Outdoor Workers.

Objectives: Public health messaging about sun avoidance strategies is often not practical for outdoor workers. The objective of this study was to use personal monitoring data to determine when peak UVR exposure occurs for outdoor workers, estimate how much UVR could be reduced by altering the timing of shady tasks or breaks during peak exposure times, and descriptively compare these to peak periods of ambient UVR. Ultimately, we aim to provide evidence-based sun avoidance recommendations for outdoor workers in British Columbia, Canada.Methods: UVR exposure data [standard erythemal dose (SED)] were collected during the 2013 summer months in Vancouver, using personal electronic dosimeters that sampled once per minute for an average of 4.4 working days (range: 1–7 days). Mixed-effect models were used to estimate the 60-, 30-, and 15-min time intervals at which maximum exposure occurred for the months of July and August. Using these time intervals, UVR exposure during peak periods was summarized as SED and as a percentage of the total daily exposure. Ambient UVR was also collected using data from the nearest Brewer spectrophotometer station and parallel analyses were conducted.Results: There were 73 workers and 321 participant-days available for analysis. Models indicated that periods of maximum exposure for 15-, 30-, and 60-min intervals began at 12:28, 12:17 pm, and 11:52 am, respectively, for sunny days in July. These periods were similar in August. The median exposure during these time periods and the potential for reducing UVR was 0.03 SED (2.8% potential daily exposure reduction), 0.09 SED (7.1%), and 0.18 SED (15.9%), respectively. However, there was a large range in exposure estimates as some workers experienced up to 84.8% of their exposure in the peak 60-min interval.Conclusion: Skin cancer prevention messaging does not include practical messages for outdoor workers and providing times of peak UVR help to identify times when the greatest reductions in exposure can occur. Prevention measures including shady breaks, increased sun protection, and task reorganization during these peak times are recommended during these peak times to reduce UVR exposure among those at highest risk.