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Sunbathing Habits and Skin Cancer

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A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601).

Deadline for manuscript submissions: closed (30 April 2012) | Viewed by 58443

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Dr. Magnus Falk

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Guest Editor

Department of Medical and Health Sciences, Faculty of Health Sciences, Linköping University, S-581 85 Linköping, Sweden
Interests: skin cancer prevention, and affecting health behaviours, in primary care; photodermatology

Prof. Dr. Christopher David Anderson

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Guest Editor

Department of Dermatology, University Hospital, 581 85 Linköping, Sweden

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Dear Colleagues,

The evidence that sunbathing is associated to skin cancer is overwhelming. Cultural differences in the desire of a population to seek out the sun, differs, being more pronounced amongst paler populations in moderate to colder climates. Within a population sun seeking habit varies with age, gender, geographical location and the individual’s perceived risk status influencing behaviour and attitudes. As well as risk groups for skin cancer development such as sun sensitive skin type and familial or individual history of melanoma it is generally accepted that exaggerated sun exposure, most often in the form of recreational exposure such as sun bathing, should be avoided during childhood. Information about risk and methods for reducing sun exposure are keys to changing sun exposure habits and attitudes. Information campaigns need to be factual and effective. Evaluations of the outcome of preventive campaigns, whether they be directed to specific groups or to the general public, need to be performed. When total avoidance of sunlight is not possible (or desired), sunscreens and protective clothing are alternatives in the last line of defence in an activity (sunbathing) which is often enjoyed but is potentially dangerous in the long term. Moving behavioural patterns toward more controlled exposure to light including the small amounts of UV necessary to maintain adequate levels of vitamin-D, is an important public health issue.

Prof. Dr. Christopher David Anderson
Dr. Magnus Falk
Guest Editors

Keywords

Sun protection behaviour
Sun exposure habits
Skin cancer prevention
Behaviour change
Risk communication
Ultraviolet radiation
UV-protection

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Published Papers (7 papers)

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Research

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56 KiB

Open AccessArticle

Vitamin D Beliefs and Associations with Sunburns, Sun Exposure, and Sun Protection

by Bang Hyun Kim, Karen Glanz and Eric J. Nehl

Int. J. Environ. Res. Public Health 2012, 9(7), 2386-2395; https://doi.org/10.3390/ijerph9072386 - 4 Jul 2012

Cited by 8 | Viewed by 8609

Abstract

The main objective of this study was to examine certain beliefs about vitamin D and associations with sun exposure, sun protection behaviors, and sunburns. A total of 3,922 lifeguards, pool managers, and parents completed a survey in 2006 about beliefs regarding vitamin D and sun-related behaviors. Multivariate ordinal regression analyses and linear regression analysis were used to examine associations of beliefs and other variables. Results revealed that Non-Caucasian lifeguards and pool managers were less likely to agree that they needed to go out in the sun to get enough vitamin D. Lifeguards and parents who were non-Caucasian were less likely to report that sunlight helped the body to produce vitamin D. A stronger belief about the need to go out in the sun to get enough vitamin D predicted more sun exposure for lifeguards. For parents, a stronger belief that they can get enough vitamin D from foods predicted greater sun protection and a stronger belief that sunlight helps the body produce vitamin D predicted lower sun exposure. This study provides information regarding vitamin D beliefs and their association with certain sun related behaviors across different demographic groups that can inform education efforts about vitamin D and sun protection. Full article

(This article belongs to the Special Issue Sunbathing Habits and Skin Cancer)

154 KiB

Open AccessArticle

A Cluster Randomized Trial to Evaluate a Health Education Programme “Living with Sun at School”

by Hélène Sancho-Garnier, Bruno Pereira and Pierre Césarini

Int. J. Environ. Res. Public Health 2012, 9(7), 2345-2361; https://doi.org/10.3390/ijerph9072345 - 2 Jul 2012

Cited by 17 | Viewed by 8478

Abstract

Over-exposure to sunlight increases the risk of skin cancers, particularly when exposure occurs during childhood. School teachers can play an active role in providing an education programme that can help prevent this. “Living with the Sun,” (LWS) is a sun safety education program for school children based on a handy guide for classroom activities designed to improve children’s knowledge, but moreover to positively modify their sun safety attitudes and behaviours. The goal of our study was to determine the effectiveness of this programme by examining children’s knowledge, attitude and sun exposure behaviours prior to and after the completion of the programme. We carried out a cluster randomised trial in which the classes were randomly assigned to one of two groups; one using the LWS programme and another that didn’t, serving as the control. Data was collected before completion of the programme and an additional three times in the year after completion. The 70 participating classes (1,365 schoolchildren) were distributed throughout France. Statistical analysis confirmed that knowledge of sun risk increased significantly in the LWS classes (p < 0.001). Both groups positively changed their attitudes when considering the best sun protection, but the LWS group proved to consistently be more convinced (p = 0.04). After the summer holidays, differences between the two groups decreased throughout the year but stayed globally significant. We also observed some significant behaviour modification during the holidays. For instance, the LWS group applied sunscreen more frequently than the control group, and were more likely to wear a hat (72% versus 59%) and use a sun umbrella on the beach (75% versus 64%). Full article

(This article belongs to the Special Issue Sunbathing Habits and Skin Cancer)

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121 KiB

Open AccessArticle

Psychosocial Correlates of Sunburn among Young Adult Women

by Carolyn J. Heckman, Susan Darlow, Jessye Cohen-Filipic, Jacqueline D. Kloss, Sharon L. Manne, Teja Munshi and Clifford S. Perlis

Int. J. Environ. Res. Public Health 2012, 9(6), 2241-2251; https://doi.org/10.3390/ijerph9062241 - 18 Jun 2012

Cited by 13 | Viewed by 8447

Abstract

Skin cancer is an increasingly common disease, particularly among young adult women. Sunburn early in life is a risk factor for skin cancer. Few studies have reported on psychosocial correlates of sunburn. The current study consisted of an online survey of undergraduate women from a university in the northeastern part of the USA. A logistic regression demonstrated that young women who reported a history of four or more sunburns were significantly more likely to report fair skin, higher perceived susceptibility to skin cancer, greater perceived benefits of tanning (e.g., appearance enhancement), lower perceived control over skin protection, and more frequent sunscreen use. Sunbathing was not associated with a greater number of sunburns. These results suggest that young women who sunburn more often possess other skin cancer risk factors, are aware of their susceptibility to skin cancer, and try to use sunscreen, but feel limited control over their skin protection behavior and are not less likely to sunbathe than others. Therefore, interventions are needed to assist high risk young women in asserting more control over their sun protection behavior and perhaps improve the effectiveness of the sunscreen or other skin protection methods they do employ. Full article

(This article belongs to the Special Issue Sunbathing Habits and Skin Cancer)

140 KiB

Open AccessArticle

Patient Follow-Up After Participating in a Beach-Based Skin Cancer Screening Program

by Mary L. Greaney, Elaine Puleo, Alan C. Geller, Stephanie W. Hu, Andrew E. Werchniak, Susan DeCristofaro and Karen M. Emmons

Int. J. Environ. Res. Public Health 2012, 9(5), 1836-1845; https://doi.org/10.3390/ijerph9051836 - 10 May 2012

Cited by 4 | Viewed by 6358

Abstract

Many skin cancer screenings occur in non-traditional community settings, with the beach being an important setting due to beachgoers being at high risk for skin cancer. This study is a secondary analysis of data from a randomized trial of a skin cancer intervention in which participants (n = 312) had a full-body skin examination by a clinician and received a presumptive diagnosis (abnormal finding, no abnormal finding). Participants’ pursuit of follow-up was assessed post-intervention (n = 283). Analyses examined: (1) participant’s recall of screening results; and (2) whether cognitive and behavioral variables were associated with follow-up being as advised. Just 12% of participants (36/312) did not correctly recall the results of their skin examination. One-third (33%, 93/283) of participants’ follow-up was classified as being not as advised (recommend follow-up not pursued, unadvised follow-up pursued). Among participants whose follow-up was not as advised, 71% (66/93) did not seek recommended care. None of the measured behavioral and cognitive variables were significantly associated with recall of screening examination results or whether follow-up was as advised. Research is needed to determine what factors are associated with follow-up being as advised and to develop messages that increase receipt of advised follow-up care. Full article

(This article belongs to the Special Issue Sunbathing Habits and Skin Cancer)

232 KiB

Open AccessArticle

Relationships of Sun-Protection Habit Strength with Sunscreen Use During Outdoor Sport and Physical Activity

by Sheleigh Lawler, Liane McDermott, David O’Riordan, Kym Spathonis, Elizabeth Eakin, Evie Leslie, Cindy Gallois, Nadine Berndt and Neville Owen

Int. J. Environ. Res. Public Health 2012, 9(3), 916-923; https://doi.org/10.3390/ijerph9030916 - 15 Mar 2012

Cited by 13 | Viewed by 9496

Abstract

The objective of this cross-sectional questionnaire study was to assess associations of a self-report index of sun protection habit strength with sunscreen use in sporting environments and outdoor physical activity. Participants (n = 234) in field hockey, soccer, tennis and surf sports in Queensland, Australia, completed a self-administered survey on sun protection during organized sport, and during general outdoor physical activity during 2005/2006. The sun protection habit strength index was dichotomized into two categories. Multinomial logistic regression analyses assessed the associations of low versus high sun protection habit strength with three categories of sunscreen use (no or rare use; inadequate use; and adequate use). Compared to participants with low sun protection habit strength, those with high sun protection habit strength had significantly greater odds of any sunscreen use during organized sport and during general outdoor physical activity. This association was strongest for adequate sunscreen use in both settings. In conclusion, this study suggests that the measure of sun protection habit strength is a potentially useful assessment tool for future sun protection studies. Full article

(This article belongs to the Special Issue Sunbathing Habits and Skin Cancer)

764 KiB

Open AccessArticle

The Skin Ivory Spot. A Possible Indicator for Skinfield Photo-Carcinogenesis in Recreational Sunbed Addicts

by Pascale Quatresooz, Claudine Piérard-Franchimont and Gérald E. Piérard

Int. J. Environ. Res. Public Health 2012, 9(2), 362-369; https://doi.org/10.3390/ijerph9020362 - 25 Jan 2012

Cited by 5 | Viewed by 6267

Abstract

Introduction: For a decade or so, artificial sources of restricted light wavelengths, particularly sunbeds, have progressively gained popularity among adolescents and young adults. Warnings were raised focusing on the risk of accelerated photoaging and photocarcinogenesis. The ULEV (ultraviolet light-enhanced visualization) method is a convenient noninvasive way identifying subtle pigmentary changes presenting as a mottled subclinical melanoderma (MSM). Of note, rare spotty amelanotic macules presenting as skin ivory spots (SIS) was reported on any part of the body. Subjects and method: This work is the first attempt at evaluating the changes in the MSM and SIS spots developed on the skin of 33 phototype III young women designated as avid users involved in frequent exposures to sunshine and sunbeds for lifestyle purposes for a duration of at least 120 months. Results: MSM was markedly heterogeneous and was distinctly obvious in the majority of adepts of frequent natural and artificial photoexposures. SIS was particularly developed in subjects presenting with severe MSM patterns. Discussion: MSM and SIS are more severe in subjects frequently exposed to sunbeds and sun exposures. These signs possibly represent a risk marker for field photocarcinogenesis. Full article

(This article belongs to the Special Issue Sunbathing Habits and Skin Cancer)

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Review

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109 KiB

Open AccessReview

Gain-Framed Messages Do Not Motivate Sun Protection: A Meta-Analytic Review of Randomized Trials Comparing Gain-Framed and Loss-Framed Appeals for Promoting Skin Cancer Prevention

by Daniel J. O’Keefe and Daisy Wu

Int. J. Environ. Res. Public Health 2012, 9(6), 2121-2133; https://doi.org/10.3390/ijerph9062121 - 5 Jun 2012

Cited by 49 | Viewed by 9676

Abstract

Persuading people to undertake actions to prevent skin cancer is an important public health challenge. A number of studies have compared the effectiveness of gain-framed and loss-framed appeals in this domain, often expecting gain-framed appeals to be more persuasive. A meta-analytic review (k = 33, N = 4,168), however, finds no significant difference in the persuasiveness of gain- and loss-framed appeals for encouraging skin cancer prevention. This conclusion is unaffected by differences in the specific protective action advocated or by differences in the kind of outcomes invoked. But the results offer an intimation that men might be more susceptible to framing variations in this domain—with loss-framed appeals potentially having a persuasive advantage. Full article

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