Sun Protection Habits Research Articles

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.

Sun-related behaviors, attitudes and knowledge among paralympic sailors

BackgroundOverexposure to sunlight is the main cause of skin cancer. Outdoor sports increased sun exposure times. Sun protection behaviors and attitudes are utmost importance to reduce sun exposure. AimsTo evaluate sun exposure habits, sun protection practices, and sun-related attitudes and knowledge among paralympic sailors. MethodsThis descriptive observational study analysed the answers of a validated self-reported questionnaire of habits, attitudes and knowledge related to sun exposure and skin cancer completed by 56 elite sailors with disabilities from 19 countries which taking part in 2019 Para World Sailing Championships. ResultsThree in four (76.8%) participants reported a history of sunburn in the previous season. Overall, participants showed an average for sport practice per week of 8.0 h (SD: 4.9). Participants reported a low adherence to sun protection practice, with the exception of using sunglasses (85.7%), sunscreen (83.9%) and hat (75%), having a very low rate (28.6%) of avoidance of midday sun and an inadequate sunscreen reapplication (33.9% reported “do not reapply” and 16.1% “reapply every one or 2 h”). Although 82.1% of participants reported to be worried about can get skin cancer out of the sun, they also presented excessive sun tanning attitudes (42.9% likes sunbathing and 57.1% sunbathing makes them feel well). The average score for sun-related knowledge was low (62.1 out 100 points; SD: 13.6). ConclusionsAwareness campaigns on sun risk are needed specifically directed at this target group, in order to improve their sun protection habits and reduce the rates of sunburn associated with sports practice.

Sun Exposure during Water Sports: Do Elite Athletes Adequately Protect Their Skin against Skin Cancer?

Excessive sun exposure is the main avoidable cause of skin cancer. Outdoor sports performed without adequate photoprotection are risky practices in this respect. This study examines whether elite athletes in water sports (specifically surfing, windsurfing, and sailing) take appropriate measures to protect their skin from the sun, and whether there are differences in this respect according to age, gender, or sports discipline. This study is based on a questionnaire-based health survey. World championship competitors completed a self-administered questionnaire on their sun protection and exposure habits, as well as sunburns during the last sports season. In total, 246 participants, with an age range of 16–30 years, completed the questionnaire. Of these, 49.6% used inadequate sun protection. Those who protected their skin appropriately tended to be older than those who did not (average age = 23.28 and 20.69 years, respectively; p = 0.000). There were no significant differences in sun protection habits between male and female athletes. The rate of sunburn was very high (76.7%). A high proportion (22.5%) of participants never used sunscreen. Elite athletes in water sports are at real risk of skin lesions from overexposure to the sun, associated with inadequate photoprotection practices. Campaigns to raise awareness and to promote the early detection of skin cancer should target these risk groups.

Sun protection habits among officers of municipal police in Krakow

Sun protection habits among officers of municipal police in Krakow

Use of a Clinic-Based Skin Cancer Prevention Bundle to Promote Sun-Protective Behaviors in Patients at Moderate to High Risk for Skin Cancer

ABSTRACT Background Skin cancer is the most common type of cancer in the United States, and one in five Americans will develop a skin cancer at least once during their lifetime (U.S. Cancer Statistics Working Group, 2016). Analysis of current skin cancer prevention practices in a large academic university dermatology clinic revealed a lack of skin cancer risk stratification, targeted prevention messaging, and assessment of sun-protective behavior (SPB) use. An improvement project was initiated to evaluate the impact of a skin cancer prevention bundle (SCPB) on SPB use and sunburn frequency over a 2-month period. Methods Adult clinic patients 20–65 years old, at a moderate to high risk based on Brief Skin Cancer Risk Assessment Tool scores, received an SCPB consisting of personalized Brief Skin Cancer Risk Assessment Tool risk feedback, American Academy of Dermatology skin cancer prevention recommendations, and a brief American Academy of Dermatology skin cancer prevention video. A Sun Habits Survey and an assessment of perceived skin cancer risk were performed preintervention and postintervention. Results Thirty-eight participants (92.7%) completed the project. Outcome measures showing significant difference postintervention included Sun Protection Habits Index summary scores (p &lt; .0001), sunburn frequency (p &lt; .0001), and lifetime perceived risk of skin cancer (p = .007). Individual SPB habits of limiting midday ultraviolet exposure (p = .0004) and frequency of hat use (p = .01) also showed significant increases postintervention. Conclusions and Implications Use of the clinic-based SCPB improved SPB use and reduced sunburn frequency. The SCPB is being considered for clinic-wide implementation based on the findings. Further study with a larger number of participants and ongoing postclinic implementation evaluation is recommended to confirm results and fully assess the potential of the SCPB to improve patient outcomes and reduce skin cancer risk.

Sun protection knowledge and habits among street vendors of the Moshoqueque market, Chiclayo

espanolObjetivo: Determinar los conocimientos y habitos de proteccion solar en comerciantes ambulantes del mercadoMoshoqueque (Chiclayo, Lambayeque), en los meses de enero y febrero del 2020. Materiales y metodos: Estudio descriptivo y transversal. Se elaboro una ficha de recoleccion de datos. El tamano muestral fue de 362 comerciantes ambulantes. Se aplico el 95 % de confianza, el 5 % de precision y 50 % de la frecuencia esperada.Resultados: La edad promedio fue de 48,54 (DE = 11,6 anos) y la mayoria de los participantes fueron mujeres (61 %). La mediana del tiempo como comerciantes ambulantes fue 15 anos. El 92,50 % de los participantes se expone al sol por 7,6 horas al dia. En cuanto a los conocimientos, mas del 90 % reconoce que el enrojecimiento y el envejecimiento de la piel son efectos de la radiacion ultravioleta (RUV). Respecto a los habitos de proteccion solar, el 34 % nunca usa bloqueador y el 90 % no usa sombrero de ala ancha, pero si visera y sombrilla.Conclusiones: Los comerciantes conocen que el enrojecimiento y el envejecimiento son productos de la radiacion ultravioleta. Sin embargo, desconocen que el dolor de cabeza no es causado por RUV y que despues de tener una quemadura solar es necesario utilizar fotoproteccion. En cuanto a habitos de proteccion, nunca usan bloqueador, pero si visera o gorro (pero no sombreros de ala ancha). Trabajan alrededor de 7,6 h diarias, por mas de una decada. EnglishObjective: To determine the sun protection knowledge and habits among street vendors of the Moshoqueque market (Chiclayo, Lambayeque) in January and February 2020. Materials and methods: A descriptive and cross-sectional study. A data collection sheet was prepared. The sample consisted of 362 street vendors. A 95 % confidence interval, 5 % accuracy and 50 % of the expected frequency were applied. Results: The average age of the study subjects was 48.54 (SD = 11.6 years) and most of them were women (61 %). The median time as street vendors was 15 years. Ninety-two point five percent (92.5 %) were exposed to the sun 7.6 hours perday. Regarding sun protection knowledge, more than 90 % were aware that skin redness and aging are effects of ultraviolet radiation (UVR). As for their sun protection habits, 34 % never used sunscreen, 90 % did not wear wide-brimmed hats, butthey used visors and umbrellas.Conclusions: Vendors know that redness and aging are the result of UVR. However, they do not know that headache is not caused by UVR and that after sun burning it is still necessary to use sunscreen. As for their sun protection habits, theynever use sunscreen; they wear a visor or a hat (but not wide-brimmed hats). They have worked around 7.6 hours a day for more than a decade.

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.

Fair-y Tales: An analysis of children's books about sun safety.

Skin cancer prevention should ideally begin with healthy sun protection habits during childhood. Children's books can be effective tools to introduce healthy habits early in life and should be targeted toward all children regardless of skin tone. This study examined sun protection guidelines and the representation of skin tones in commercial children's books. We performed internet searches for children's books about sun protection. We compared content from these books to current sun protection guidelines from the American Academy of Dermatology (AAD). We assessed books for reading level, author profession, and skin tone representation. Seventeen books met study criteria. Of 19 factors surrounding sun protection provided by the AAD, the median number of factors mentioned within children's books was nine (range 3-13). Of the 13 books with color illustrations of people, one (7.6%) book depicted people with dark skin tones on the cover, and three (23.1%) books depicted people with dark skin tones within the story. Commercial children's books about sun protection incorporate some, but not all, of the AAD guidelines, and there is an inadequate representation of darker skin tones within and on the cover of these books.

Sun Protection Behaviour and Sunburns in Spanish Cyclists.

Sunburn caused by overexposure to ultraviolet radiation is the main cause of preventable skin cancer. This study aimed to describe the sun protection habits and rate of sunburns associated with the practice of cycling and to identify predictive factors of sunburn among cyclists. A descriptive observational study based on online surveys was conducted. Recruitment of participants was conducted through the Andalusian Cycling Federation (Spain). A questionnaire on behaviour, attitudes, and knowledge related to sun exposure was used. A bivariate analysis was carried out with sunburn episodes during the previous year as outcome variable, and a multivariate logistic regression model was built. Of the 1018 surveys returned, 87.6% were answered by men, mean age was 41.8 years (SD: 11.0), and 37.6% of the participants had phototype I or II. Sunburns during the previous year were reported by 45.6% (95% CI: 42.5-48.7) of the respondents. Sunscreen use was reported by 39.2%, and 61.0% did not examine their skin regularly despite the fact that 34 subjects (3.4%) reported a personal history of skin cancer. The multivariate logistic regression analysis showed that there was a negative correlation between episodes of sunburn and age, phototypes I-II, more than 2 h of sun exposure, and inconsistent use of sunscreen. Cyclists have high rates of sunburns and thus constitute a high-risk group for developing skin cancer. Educational interventions specifically aimed at this group of athletes would improve sun protection knowledge and practices, particularly the use of sunscreen.

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.

NEW RECREATIONAL CATEGORY ASSOCIATED WITH COMMON WART TRANSMISSION

ABSTRACT Introduction “Altinha”, a variant of beach soccer that is very popular on the beaches of Rio de Janeiro, is a recreational activity that adapts the basics of beach soccer to a game with a circular formation, with the participation of several players who mainly use the following parts of their bodies: feet, legs, head, knees and trunk. Since it is a Brazilian pursuit, the relationship between “altinha” and skin infections is poorly described. The authors report six cases of patients diagnosed with common warts, seeking to correlate the development of these lesions with participation in “altinha”. Clinical Case Six patients, young adults from Rio de Janeiro who play “altinha” on Rio’s beaches, with complaints of painless verrucous lesions, were assessed. Physical examination revealed cracked normochromic keratotic papules mainly affecting feet and legs of the dominant limb. In light of the medical history and physical examination, the diagnosis was of vulgar warts. The patients were treated with cryosurgery, obtaining satisfactory results. Discussion The sport and its outdoor environmental conditions favor transmission of the human papillomavirus due to exposure to factors such as humidity, sweating and trauma, besides direct contact with the infected skin of other players and with colonized surfaces. “Altinha” is played barefoot, and the equipment of choice is the soccer ball, which is constantly shared between players, leading to trauma caused not only by the ball, but also by the sand. Moreover, the activity demands physical exertion from participants, resulting in sweating and potential physical contact. Conclusion With the increasing popularity of “altinha” among beachgoers, dermatologists must be aware of the sun protection habits of these individuals. They must also be mindful of the need to examine their skin for related dermatosis and to warn them of the risk of infection by the human papillomavirus in this new sport. Level of Evidence IV; Case series.

Effectiveness of the SolSano Program on Sun Protection Habits, Knowledge, and Attitudes Among University Students

Background and objectiveThe SolSano (HealthySun) project is a primary school sun education program that has been running in Aragon, Spain, since 2000. In the short term, it has proven to be effective at promoting sun protection behaviors and heightening awareness in childhood. The aim of this study was to evaluate the long-term effectiveness of the SolSano program. Participants and methodsRetrospective, observational, analytical, cohort study of students at the University of Zaragoza between 2015 and 2016. The students answered a previously validated, purpose-designed, online questionnaire. We calculated descriptive statistics for all variables and performed bivariate and multivariate analyses to test for differences between students who had attended a primary school that ran the SolSano program and those who had not. ResultsData for 324 students were analyzed. Mean age was 22.9 years and 78% of the respondents were women. In total, 44% of the students had participated in the SolSano program at primary school. Half of the respondents (50.5%) had experienced 1 or 2 sunburn episodes the previous summer. Significant differences were only observed for some aspects addressed by the questionnaire between SolSano participants and nonparticipants. ConclusionsThis is the first study to evaluate the long-term effectiveness (15 years) of a primary school sun protection program. The absence of significant differences in our sample might be explained by non-continuation of the program into adolescence and the existence of sun protection campaigns outside the school.

Text message reminders for improving sun protection habits: A systematic review

Excessive exposure to ultraviolet radiation increases the risk of skin cancer and other conditions. SMS text reminders may be a useful tool to improve sun protection habits due to its massive reach, low cost, and accessibility. To perform a systematic review of randomized controlled trials (RCTs) that evaluated the effects of SMS text reminders in promoting sun protection habits. We performed a systematic search in PubMed, Central Cochrane Library, and Scopus; following the PRISMA recommendations to perform systematic reviews. We included RCTs published up to December 2018, which evaluated the benefits and harms of SMS text reminders to improve sun protection habits. Random-effects meta-analyses were performed whenever possible. The certainty of the evidence was assessed for RCTs estimates using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) methodology. The study protocol was registered in PROSPERO (CRD42018091661). Five RCTs were included in this review. When pooled, the studies found no effect of SMS text reminders in "sunburn anytime during follow-up" (two studies, risk ratio: 0.93; 95% confidence interval: 0.83-1.05). Contradictory results were obtained for sunscreen use (three RCTs) and sun protection habits (two RCTs), however, they could not be meta-analyzed because outcomes were measured differently across studies. The certainty of the evidence was very low for these three outcomes according to GRADE methodology. RCTs that assessed effects of SMS text reminders did not find a significant benefit on objective outcomes, such as having a sunburn, sunscreen use and composite score of sun protection habits. Since certainty of the evidence was very low, future high-quality studies are needed to reach a conclusion regarding the balance of desirable and undesirable outcomes. PROSPERO (CRD42018091661).

Effect of a Skin Self-monitoring Smartphone Application on Time to Physician Consultation Among Patients With Possible Melanoma

Melanoma is among the most lethal skin cancers; it has become the fifth most common cancer in the United Kingdom, and incidence rates are rising. Population approaches to reducing incidence have focused on mass media campaigns to promote earlier presentation and potentially improve melanoma outcomes; however, interventions using smartphone applications targeting those with the greatest risk could promote earlier presentation to health care professionals for individuals with new or changing skin lesions. To study the effect of a commercially available skin self-monitoring (SSM) smartphone application among individuals with increased risk of melanoma on their decision to seek help for changing skin lesions. This phase 2 randomized clinical trial was conducted in 12 family practices in Eastern England between 2016 and 2017. A total of 238 participants, aged 18 to 75 years and with an increased risk of melanoma, were identified using a real-time melanoma risk assessment tool in family practice waiting rooms. Analysis was intention to treat. Participants were observed for 12 months, and data analysis was conducted from January to August 2018. The intervention and control groups received a consultation with standard written advice on sun protection and skin cancer detection. The intervention group had an SSM application loaded on their smartphone and received instructions for use and monthly self-monitoring reminders. The coprimary outcomes were skin consultation rates with family practice physicians and patient intervals, measured as the time between noticing a skin change and consulting with a family practice clinician. Follow-up questionnaires were sent at 6 and 12 months, and consultation rates were extracted from family practice records. Secondary outcomes included skin self-examination benefits and barriers, self-efficacy for consulting without delay, perceived melanoma risk, sun protection habits, and potential harms. A total of 238 patients were randomized (median [interquartile range] age, 55 [43-65] years, 131 [55.0%] women, 227 [95.4%] white British; 119 [50.0%] randomized to the intervention group). Overall, 51 participants (21.4%) had consultations regarding skin changes during the 12 months of follow-up, and 157 participants (66.0%) responded to at least 1 follow-up questionnaire. There were no significant differences in skin consultation rates (adjusted risk ratio, 0.96; 95% CI, 0.56 to 1.66; P = .89), measures of SSM (adjusted mean difference, 0.08; 95% CI, -0.83 to 1.00; P = .86), or psychological harm (eg, Melanoma Worry Scale: adjusted mean difference, -0.12; 95% CI, -0.56 to 0.31; P = .58). In this study, recruitment, retention, and initial delivery of the intervention were feasible, and this research provided no evidence of harm from the SSM smartphone application. However, no evidence of benefit on skin self-examination or health care consulting was found, and there is no reason at this stage to recommend its implementation in this population at increased risk of melanoma. isrctn.org Identifier: ISRCTN16061621.

Sun-protection habits and knowledge of patients with vitiligo

Vitiligo is a common chronic depigmentation disease. Patients are generally advised to protect themselves from the sun. One hundred fifty-three patients diagnosed with vitiligo and 106 healthy volunteers with no additional dermatological disease were included in the study. We evaluated the sun-protection habits of patients with vitiligo and controls, and also assessed their knowledge and attitudes toward sun exposure. Rates of sunscreen use, high-factor sunscreen use, and remaining in the shade were significantly higher among patients (p = 0.004, p = 0.028, p = 0.040). We found significantly higher rates of modifying vacation habits, high sun-protection factors (SPF) sunscreen use, and preferring to remain in the shade among patients using phototherapy (p = 0.016, p = 0.019, p = 0.028). We showed higher rates of modification of vacation habits, wearing sunglasses, and remaining in the shade among patients with longer disease durations (p = 0.026, p = 0.001, and p = 0.017). We determined higher rates of sunscreen use, high-SPF sunscreen use, and tendencies to remain in the shade in vitiligo patients compared to the general population. We also determined that disease duration and treatment with phototherapy alters sun-protection habits, but the presence of generalized disease and lesions in visible areas such as the face does not alter patients' habits.

Sun protection habits and behaviors of a group of outdoor workers and students from the agricultural and construction sectors in north-Italy.

Background:Despite the relevant frequency of ultraviolet induced adverse health effects in workers, solar ultraviolet radiation (UVR) exposure is an occupational risk not adequately minimized in Italy.Objective:To assess the characteristics and prevalence of sun exposure habits and behaviors in a group of students and outdoor workers (OW) from the agricultural and construction sectors of a north-Italian region.Methods:Based on a previously developed standardized questionnaire, we collected full information on individual sun exposure habits at work and during leisure activities.Results:In 2018, 380 high school students and OW from the agricultural and construction sectors participated in a sun-safety campaign. More than a third (39.0%) of OW reported never using sunglasses, 52.8% never applied sunscreens at work, and a quarter never wear a UV protective hat. Considering leisure-time, students reported more frequent sunburns compared to OW: 25.0% vs. 13.8%; half (51.6%) of students and a third (36.4%) of OW reported never wearing a UV protective hat. A third (30.1%) of students and 37.2% of OW never or only seldom applied sunscreens on holidays.Discussion:The majority of OW in our study reported poor protective solar exposure habits. Young students of the construction and agricultural sectors indicated even worse sun-protective behaviors, both during apprenticeship and leisure activities. Our study highlights the low health literacy related to solar UVR in OW and apprentices. Further educational initiatives are required in Italy to improve the adoption of protective behaviors during outdoor activities.

Awareness, knowledge, and attitude toward nonmelanoma skin cancer and actinic keratosis among the general population of western Saudi Arabia.

Background:This study evaluated the levels of awareness, knowledge, and attitude, including sun-protection habits, toward basal cell carcinoma and actinic keratosis among the Saudi population.Materials and Methods:A cross-sectional study was conducted among the general population of Jeddah, Saudi Arabia using a 12-item survey concerning the knowledge and awareness of basal cell carcinoma and actinic keratosis, as well as associated preventive measures. A Chi-square test was used to determine associations among variables.Results:The majority of participants were unaware of basal cell carcinoma and actinic keratosis (80.7%), while 8.6% were aware of both, and 9.8% and 1% were aware of only basal cell carcinoma or actinic keratosis, respectively. The majority of participants who were educated up to high school level had no knowledge of either condition (96%, P < 0.0001). Among participants with high levels of awareness of basal cell carcinoma and actinic keratosis, medical practitioners were identified as the main source of information (72.5%, P < 0.0001, and 70.6%, P < 0.0001, respectively). The majority of participants whose knowledge of the relationship between sun exposure and skin cancer was insufficient also lacked sufficient awareness of either basal cell carcinoma or actinic keratosis (92.6%, P < 0.0001). The majority of participants (62.8%) declared using sunscreen “rarely”.Conclusion:This study showed a low level of knowledge about the risks associated with sun exposure and suitable protection methods, with only a small fraction of participants declaring a regular use of sunscreen. Public education campaigns are required to increase the awareness of cancer risks and protection methods among the Saudi population.

Sun-protection and sun-exposure habits among sailors: results of the 2018 world's largest sailing race Barcolana' skin cancer prevention campaign.

Epidemiologic data suggest an increased risk of melanoma (MM) and non-melanoma skin cancer (NMSC) in persons with intense recreational sun-exposure such as marathon runners or surfers. Up to data little is known about the sun-exposure habits, sun-protection behaviours and risk factors for MM and NMSC among sailors. The objective of this prospective, cross-sectional study was to investigate the sun-exposure and sun-protective habits and risk factors for skin cancer among sailors attending the 50° edition of Barcolana, the largest sailing race in of the world, which took place in October 2018 in Trieste, Italy as an integrative component of a public sun-prevention campaign. The study consisted of 2 parts: (i) a self-administered questionnaire focusing on sun-exposure and protective habits and (ii) a free skin examination carried out by volunteer dermatologists. Participation was optional and anonymous, and open to visitors and sailors attending the event. Overall, 431 (52.4%) sailors and 391 (47.6%) visitors responded to the questionnaire, while a total of 437 individuals including 189 (43.3%) sailors and 248 (56.6%) visitors participated in the skin examination group. The majority of sailors reported a past history of severe sunburns (20.2%), applied sunscreen never (14.4%) to sometimes (45.7%) or only once daily (59%) on the face (55%) and shoulders (26%). Moreover, 14% of sailors had a personal history of non-melanoma skin cancer (NMSC). During the dermatological examination, suspicious lesions for skin cancer (including MM and NMSC) were identified in 37% of the sailors. Our findings support the need to develop and promote primary and secondary prevention strategies to improve the sun-exposure and sun-protective habits among sailors.

Sun Protection Habits and Sun Exposure of Physical Education Teachers in the South of Spain.

The high prevalence and increasing incidence of skin cancer (SC) is a significant public health problem. We can address its main risk factor, which is incident and accumulated solar radiation, and its damages by disseminating knowledge and promoting changes in habits and attitudes toward the sun. The influence of teachers in the education of young people is crucial. Physical education teachers (PET) spend the majority of their time outdoors, thereby exposing themselves to solar radiation daily and greatly increasing the risk of SC. We carried out a case-control study matching for age and gender through surveys about photoexposure and photoprotection habits on a sample of 200 teachers (100 PET and 100 non-PET) on South of Spain. The results confirmed that there is a significant difference in sun exposure during the workday; PET group showed higher exposure (P<0.01). We ascertained that photoprotection habits are deficient across the population. These data contribute to the understanding of the danger associated with poor sun protection among teachers (primary and secondary school teachers) and its mitigation. It is also worth noting that future prevention campaigns will be necessary for the subsequent correct transmission of the habits to students.

Not part of my routine: a qualitative study of use and understanding of UV forecast information and the SunSmart app

BackgroundThe Ultraviolet (UV) Index provides a reliable means of monitoring the strength of UV radiation at the Earth’s surface, which can be used to indicate the potential for skin damage. This qualitative study aims to examine public understanding of the UV Index among Australians who routinely use UV forecast information as well as those who do not.MethodsRecent use of the SunSmart app (a popular mobile and tablet app that provides UV forecast information) served as a proxy for use of UV forecast information. Six focus groups were conducted with ‘new users’, who trialled the SunSmart app for the first time in the two weeks preceding the group discussion. In addition, 15 in-depth interviews were conducted with ‘existing users’, who routinely used the SunSmart app. Thematic discourse analysis was undertaken to compare views and experiences.ResultsMisperceptions about UV radiation were common. Participants learnt new information about UV radiation, the UV Index, and the times of the day that sun protection is recommended. Among adults who were using UV forecast information for the first time, this learning rarely translated to new behaviours; for these participants, the UV Index forecast information and recommendations were inconsistent with their own observation of the weather and subsequent judgement about their propensity to burn. Thus new users considered the UV forecast information to be overly cautious. In contrast, existing users recognised their inability to judge the UV Index level; for these participants, UV forecast information provided by the SunSmart app was incorporated into their daily routines and used to inform their sun protection behaviours.Conclusions/implicationsNo matter how broadly UV forecast information is promoted, it is unlikely to improve sun protection behaviours across the Victorian population due to the low level of basic understanding of UV radiation. Public education strategies that correct the commonly held misperception that temperature and/or sunshine can reliably predict the potential for UV damage are required. Improved public awareness about UV radiation and how the UV Index can be used to prevent skin cancer may help Australians to develop more effective sun protection habits.