Prevalence of Sun Protection Use and Sunburn and Association of Demographic and Behaviorial Characteristics With Sunburn Among US Adults

Abstract

IMPORTANCE Monitoring sun protection and sunburn over time at the population level can provide valuable information about progress toward skin cancer prevention goals and inform future intervention efforts. OBJECTIVE To examine the prevalence of sun protection use (shade, sunscreen, and clothing) and sunburn and the association between sunburn and individual characteristics and health behaviors in the US population. DESIGN, SETTING, AND PARTICIPANTS In this cross-sectional study using a nationally representative sample of 31 162 US adults from the 2015 National Health Interview Survey-Cancer Control Supplement, household interviews of civilian, noninstitutionalized US adults were conducted throughout 2015 in person and completed on the telephone when necessary. Data analysis was performed from August 16, 2016, to September 6, 2017. MAIN OUTCOMES AND MEASURES The prevalence of sunburn and use of sun protection and their association with demographic characteristics, sun sensitivity, and health-related behaviors and conditions using multivariable logistic regression modeling. RESULTS A total of 31 162 respondents (mean [SD] age, 47.0 [0.36] years; 13 932 male [44.7%] and 17 230 female [55.3%]) were included in the analyses, with 34.2% experiencing sunburn in 2015. Sunburn prevalence was higher among younger age groups (51.2% in adults 18-29 years old; 95% CI, 48.8%-53.7%), non-Hispanic white individuals (42.5%; 95% CI, 41.2%-43.9%), and those with sun-sensitive skin (50.2%). However, sunburn was also prevalent among black (13.2%; 95% CI, 11.6%-15.1%) and Hispanic (29.7%; 95% CI, 27.6%-31.9%) individuals, demographic groups that are often considered to be at low risk of skin cancer. The most frequent sun protection behaviors were staying in the shade (37.1%; 95% CI, 36.3%-38.0%) and using sunscreen (31.5%; 95% CI, 30.7%-32.3%) followed by wearing long clothing to the ankles (28.4%; 95% CI, 27.6-29.1). Sun avoidance behaviors (seeking shade and not going in the sun) were significantly (39.5% vs 35.1%; P < .001) associated with a lower prevalence of sunburn. Those who used self-applied sunless tanning products (45.0% of users vs 36.1% of nonusers; P < .001), those who engaged in aerobic activity (37.9% of aerobic exercisers vs 32.8% of non-aerobic exercisers; P < .001), binge drinkers (45.1% of binge drinkers vs 35.0% of non-binge drinkers; P < .001), and overweight or obese individuals (37.9% of overweight or obese individuals vs 34.4% of non-overweight or obese individuals; P < .001) were more likely to experience sunburn compared with the respective comparison groups. CONCLUSIONS AND RELEVANCE Sun sensitivity was significantly associated with a higher sunburn prevalence, independent of race/ethnicity, suggesting a need to consider sun sensitivity when identifying target demographic groups for sun safety interventions. Efforts to improve vigilance and consistency with use of sun protection are needed. In addition, those who engage in physical activity, use sunless tanners, or use sunscreen for tanning purposes may re...

Primary prevention of keratinocyte carcinoma among outdoor workers, the general population and medical professionals: a systematic review updated for 2019

“…The range of the general population who reported using sunscreen when outside on sunny days ranged from 5 to 97%, with one study reporting that SPF ≥ 30 was used by 84% of members of two Illinois regional drum corps …”

“…Thirty‐nine per cent of the general population stated that they avoided sun exposure around the midday hours on sunny days, and 15–53% used shade to protect from KC …”

“…Between 4% and 99% of the general population reported protecting themselves from sun by using a hat during sun exposure …”

“…Sunscreen The range of the general population who reported using sunscreen when outside on sunny days ranged from 5 to 97%, [28][29][30][31][32][33]40,[57][58][59][60][61][62] with one study reporting that SPF ≥ 30 was used by 84% of members of two Illinois regional drum corps. 31 Among several outdoor occupational groups, 9-86% of the workers applied sunscreen during work (Fig.…”

“…49 Shade Thirty-nine per cent of the general population stated that they avoided sun exposure around the midday hours on sunny days, 28 and 15-53% used shade to protect from KC. 29,59,61,62 Seeking shade during work varied between 4 and 85% among outdoor workers from several occupational groups. 9,38,40,41,43,64,66,72 Seventy-six per cent of German outdoor workers stayed in the shade during breaks 9 and 31% of agricultural workers from Italy avoided sun exposure at midday and took breaks in shaded areas.…”