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Study of sunbathing habits in children and adolescents: application to the prevention of melanoma.

Excessive sun exposure in the first 15 years of life has been shown to be a determinant risk factor for melanoma. This study was conducted on a randomly selected sample of 200 adolescents (13-14 years old) and 150 children (3 years old) in Marseille (South of France). Children and adolescents were examined and interviewed (mothers answered for young children). Our results show that a large number of highly sensitive children were not identified as such by their parents and most adolescents do not realize or at least admit being highly sun sensitive. Adequate sun protection measures were used in only 63% of 3-year-olds and 38% of adolescents. With reference to their constitutional skin sensitivity and taking into account their possible use of effective sun protection measures, 33% of the children and 62% of the adolescents were highly overexposed. Only good sun protection habits of the mother were predictive of acceptable sun exposure in children. In the adolescents the predictive variables were sun protection habits of the father and sunbathing only to obtain a tan. The main reason why adolescents sunbathed was embellishment. Conversely, most mothers said that they exposed their young children to the sun for health. Many adolescents and mothers were reasonably well informed but considered the risk of sun exposure to be exaggerated by the media. These results may be important to determine the targets of future melanoma prevention campaigns.

Adolescent↗

Sun exposure and sunscreen use among sunbathers in Denmark.

Eight hundred and eight sunbathing Danes were interviewed in order to register the duration of sun exposure and sunscreen use. The mean sun exposure time, 203 min, was found to be independent of sex, age and use of sunscreen. Overall, sunscreens were used by 65%, 73% of the females and 52% of the males. The median sun protection factor used by subjects older than 10 years was 5; in the case of children 10 years or younger, it was 12. Eight per cent of the interviewed subjects used more than one factor. Fifty-seven per cent of the sunscreen users applied the sunscreen prior to arriving at the beach. The sun exposure time was not significantly different in the group of subjects using sunscreens, compared to the group of subjects not using sunscreens. This study indicates that sunscreen users may not increase their exposure to the sun.

Adult↗

[Sunbathing habits and risk of melanoma].

The increasing frequency of malignant melanoma (MM) is believed mainly to be due to the habit of sunbathing, which has an impact on the skin due to ultraviolet radiation, especially if intermittent and causing sunburn. Frequent use of tanning booths possibly increases the risk of MM but the question has not been settled. Use of sunscreens has a certain prophylactic effect on actinic keratoses, but no documented effect on MM. This does not imply that sunscreens are not advisable, but stresses the importance of correct use of sunscreens together with other sun protective measures. Primary prevention of MM is mainly a question of minimizing the impact of ultraviolet radiation (including tanning booths) on the skin: limit time in the sun, cover up with clothing, and use a sunscreen with a protection factor of at least 15.

Humans↗

A survey of sunbathing practices on three Connecticut State beaches.

In order to analyze sunbathing practices, a survey was conducted during the summer of 1995 on three Connecticut state beaches, with 1,003 interviews completed. The majority (65.8%) of respondents were women. Almost 70% of respondents were visiting the beach to get or maintain a tan. While the intended beach stay averaged four hours, only 55.7% of respondents were using sunscreen, 6.9% were sitting under shade, 12.7% were wearing hats, and 17.1% were wearing clothes other than a bathing suit. More than half (55%) of the sunscreen used had a sun protection factor of less than 15. Children were provided with greater protection than adults. The survey indicates the need for greater educational efforts to motivate protective behavior. Primary-care physicians could have an important role in these efforts.

Adolescent↗

"Sunbath polyneuritis": subacute axonal neuropathy in perazine-treated patients after intense sun exposure.

This article aims at drawing attention to the peculiar association of intense exposure to sunlight and subacute development of sensory neuropathy which was seen in 7 psychiatric patients treated with the phenothiazine derivative, perazine. Three patients additionally developed bilateral VII nerve palsy. Symptoms followed a monophasic course with almost complete remission. Routine neurophysiology suggested axonal neuropathy confirmed by sural nerve biopsy in 1 patient. A toxic origin of neuropathy is supposed, possibly induced by phenothiazine photoproducts, which may cause cell damage via lipid peroxidation.

Adult↗

The wreckage of the oil tanker 'Erika'--human health risk assessment of beach cleaning, sunbathing and swimming.

In December 1999 the oil tanker 'Erika', carrying approximately 30 tons of heavy fuel oil, wrecked before the coast of Brittany (France), polluting the local beaches and rocks over a distance of some 500 km. Also numerous birds were affected. During the first months of 2000 the coastal area and many birds were cleaned. The health risk for people involved in these cleaning activities and for tourists was evaluated with emphasis on the carcinogenic properties of this oil. The outcome indicates that the risks were limited to people who had been in bare-handed contact with the oil. Firstly they had an increased risk for developing skin irritation and dermatitis, however, these effects are in general reversible. Secondly they had an increased risk for developing skin tumours, but since the dermal contacts with the oil were of relative short duration, this risk is considered to be very limited.

Animals↗

Transtheoretical model: investigation of adolescents' sunbathing behaviour.

The incidence of malignant melanoma and non-melanoma skin cancers has increased rapidly in Sweden as well as in other western countries during the last 20 years. Adolescents are an important group in skin cancer prevention. Interventions targeting this group have been reported to affect knowledge and attitudes, but the effect on sun protection behaviour has been slight. The aim of this study was to investigate the applicability of the Transtheoretical Model (TTM) for skin cancer prevention for adolescents. A random sample of 1200 18-year-olds living in Stockholm County was selected from the national census registry. A questionnaire that included three of the major constructs of the TTM (i.e. stages of change, processes of change and decisional balance) was sent by mail. The majority of the teenagers were in the precontemplation stage for giving up intentional tanning. The relations between the stages of change and two other major constructs of the TTM, processes of change and decisional balance, were consistent with data on other health behaviours. The results may aid in developing successful skin cancer prevention programmes. The results give support for the stages of change measurement used in this study and that utilizing the TTM in skin cancer prevention may be appropriate.

Adolescent↗

Study of sunbathing in children: the preliminary evaluation of a prevention program.

AIMS AND BACKGROUND: Sunburn during childhood is associated with an increased risk for developing melanoma in an adult age. The aim of the present study was to define the validity of our educational program in order to teach the positive effects and risks of sun exposure during childhood. PATIENTS AND METHODS: We conducted a population-based, case-control study in primary schools of three towns in Northern Italy (Brescia, Bergamo and Trento) between 2001 and 2002. The study was carried out on 1945 pupils (aged 8-9 years) and included 1309 case children who received an educational program before the summer to increase awareness towards sun exposure and 636 control children who did not. Parents of case and control children were interviewed using a questionnaire about their children's skin characteristics, sun protective behavior and sunburns. The questionnaire was completed twice, before and after the summer, to verify the changes of sun exposure habits. RESULTS: A significant decrease in sunburns was demonstrated in the group of subjects who received the educational program, indicating the validity of our operative procedure (from 14.6% to 10%, P = 4 x 10(-4). CONCLUSIONS: Our educational melanoma program may be important to disseminate in a wider range of children a correct education on sun exposure during childhood.

Case-Control Studies↗

Healthcare students' attitudes to sunbathing.

The risks of exposure to the sun are now well known. But, as this study shows, nurses' education and their own attitudes and behaviour suggest they are not well prepared to convince patients and clients of the need to change behaviour.

Attitude of Health Personnel↗