Protection from sun exposure in US white children ages 6 months to 11 years

Hall, H. Irene; Jorgensen, Cynthia M.; McDavid, Kathleen; Kraft, Joan Marie; Breslow, Rosalind A.

doi:10.1016/s0033-3549(04)50057-2

Cited by 52 publications

(19 citation statements)

References 17 publications

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“…39 Sunscreen is the main form of protection used by the population. [40][41][42][43] Sunscreens reduce the intensity of UVR affecting the epidermis, thus preventing erythema and sunburn. Many sunscreen agents approved by the US Food and Drug Administration are organic chemicals that absorb various wavelengths of UVR, primarily in the UVB range; many are also effective in the UVA range.…”

Section: Preventionmentioning

confidence: 99%

Ultraviolet Radiation: A Hazard to Children and Adolescents

Balk¹,

Binns²,

Brumberg³

et al. 2011

Pediatrics

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Ultraviolet radiation (UVR) causes the 3 major forms of skin cancer: basal cell carcinoma; squamous cell carcinoma; and cutaneous malignant melanoma. Public awareness of the risk is not optimal, overall compliance with sun protection is inconsistent, and melanoma rates continue to rise. The risk of skin cancer increases when people overexpose themselves to sun and intentionally expose themselves to artificial sources of UVR. Yet, people continue to sunburn, and teenagers and adults alike remain frequent visitors to tanning parlors. Pediatricians should provide advice about UVR exposure during healthsupervision visits and at other relevant times. Advice includes avoiding sunburning, wearing clothing and hats, timing activities (when possible) before or after periods of peak sun exposure, wearing protective sunglasses, and applying and reapplying sunscreen. Advice should be framed in the context of promoting outdoor physical activity. Adolescents should be strongly discouraged from visiting tanning parlors. Sun exposure and vitamin D status are intertwined. Cutaneous vitamin D production requires sunlight exposure, and many factors, such as skin pigmentation, season, and time of day, complicate efficiency of cutaneous vitamin D production that results from sun exposure. Adequate vitamin D is needed for bone health. Accumulating information suggests a beneficial influence of vitamin D on many health conditions. Although vitamin D is available through the diet, supplements, and incidental sun exposure, many children have low vitamin D concentrations. Ensuring vitamin D adequacy while promoting sun-protection strategies will require renewed attention to children's use of dietary and supplemental vitamin D. Pediatrics 2011;127:588-597 BACKGROUND Sunlight sustains life on earth. The sun provides warmth, is needed for photosynthesis, drives biorhythms, and promotes feelings of wellbeing, and sunlight is essential for vitamin D synthesis in skin.The sun emits ultraviolet ("above violet") radiation (UVR) waves that range from 200 to 400 nm. UVB (290 -320 nm) and UVA (320 -400 nm) rays penetrate the atmosphere and have the greatest biological significance. Solar radiation that reaches the earth's surface comprises approximately 95% UVA and 5% UVB rays. 1 Sand, snow, concrete, and water can reflect up to 85% of sunlight, thus intensifying exposure. 2 UVR can penetrate to a depth of 60 cm in water and result in significant exposure. UVA rays are relatively constant throughout the day and the year. UVB rays have greater intensity in summer than in winter, at midday than in morning or late afternoon, in

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Section: Preventionmentioning

confidence: 99%

Ultraviolet Radiation: A Hazard to Children and Adolescents

Balk¹,

Binns²,

Brumberg³

et al. 2011

Pediatrics

View full text Add to dashboard Cite

show abstract

“…When used properly, sunscreen can prevent sunburn (3,4), nonmelanocytic (5), and melanocytic (6-;8) skin cancers. Sunscreens have become very popular for the prevention of sun damage, and are often the method of choice for people who are trying to reduce their UV radiation exposure and its effects (9,10).…”

Section: Introductionmentioning

confidence: 99%

A Noninvasive Objective Measure of Sunscreen Use and Reapplication

Lunde

Urschitz

Glanz

2005

Cancer Epidemiology, Biomarkers &Amp; Prevention

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Objectives: To study whether a noninvasive swabbing technique can detect sunscreen use for up to 6 hours, and whether the technique can detect reapplication of sunscreen. Methods: Thirty volunteer office workers were randomly assigned to have one of a variety of sunscreens applied using recommended application techniques, and half were randomly assigned to have sunscreen reapplied after 3 hours. Alcohol-based swabs were used to obtain a sample from participants' arm at 20 minutes, and hourly from 1 to 6 hours post-application. Absorption readings were analyzed using an UV-visible spectrophotometer. Results: The swabbing technique was consistently able to distinguish the sunscreen from control swabs for up to 6 hours. The absorption readings between 20 minutes and 6 hours were significantly higher than control swabs. There were no differences between the group that had sunscreen reapplied and the group that did not. Conclusion: The sunscreen swabbing technique is an effective noninvasive method for detecting a variety of sunscreen products in adults over a 6-hour period. No differences in absorption readings were found with sunscreen reapplication. This procedure will be a useful adjunct to other objective measures of sun protection and UV radiation exposure, resulting in a more accurate picture of the sun protection habits of individuals. (Cancer Epidemiol Biomarkers Prev 2005;14(3):722 -6)

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“…Sunscreens are widely used to protect children from harmful effects of sunlight, [38][39][40] and marketing suggests a ''safe suntan.'' 41 The most important problem analyzing the protective or harmful effects of sunscreen use is the positive correlation identified previously of higher sun protection factors with increased sun exposure [42][43][44] as well as with sunburn.…”

Section: Discussionmentioning

confidence: 99%

Interventional study in 1,232 young German children to prevent the development of melanocytic nevi failed to change sun exposure and sun protective behavior

et al. 2005

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Sunscreens have been proposed as protective measures to inhibit the development of melanocytic nevi in childhood and to decrease the long term risk for cutaneous melanoma development. Our present study investigates the influence of sunscreen use and education on the number of incident melanocytic nevi. A total of 1,812 children in 78 public nursery schools in 2 German cities were randomized to 3 study arms: (i) parents were informed on study purpose and sun protection measures only at an initial educational meeting; (ii) parents received educational material 3 times yearly; and (iii) education and 800 ml free broad spectrum sunscreens with sun protection factor 25 provided on a yearly basis. Final assessment after 3 years follow-up included 1,232 children (68%). Changes of sun protection habits including sunscreen use were sparse, without any differences attributable to the intervention efforts. As a consequence, there were no significant differences between the 3 study arms for the main outcome measure, the number of incident melanocytic nevi. Analysis of the sunscreen use in the entire cohort irrespective of our study arms did not show any impact on incident nevus numbers in bivariate or multivariate analysis. In conclusion, intervention with educational letters and free sunscreens seemingly had no additional effect on sun-protection for German children. High prevalence of sunscreen use at study commencement, social desirability, and inadequate application of sunscreens might have partially covered their effect. ' 2005 Wiley-Liss, Inc.Key words: melanocytic nevi; prevention and control; child; sunscreens; intervention studies Exposure to ultraviolet light in childhood as well as in adulthood is the central environmental risk factor for cutaneous melanoma (CM).1-4 The use of sunscreen is intended to avoid sunburn as well as to reduce the risk of CM. Numerous case-control studies focusing on the effect of sunscreen use and the risk of CM reported contradicting results reaching from a reduced risk, 5-8 an unchanged risk, 9 to an increased risk in persons using sunscreen.10-17 Most of these case-control studies were hospitalbased, might not have been controlled comprehensively for exposure to sunlight and skin type and were most likely influenced by recall bias, as they involved melanoma patients. Meta-analyses of studies published recently on the relationship of sunscreen use and the risk of CM could not find any association. 18-21The number of melanocytic nevi (MN) is known to be the strongest risk factor for CM. Nevi are precursor lesions of a substantial proportion of 20-60% of CM. 22 Humans develop MN from an early age onward and numerous studies have investigated the development of MN in children. 1,[23][24][25][26][27][28][29][30] Studying sunscreen use in children and its relationship to MN should be less influenced by recall bias. Thus far, however, investigations of sun protective behavior in children have not shown conclusive evidence for either a protective or harmful effect of sunscreen. [31][32][33][...

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Protection from sun exposure in US white children ages 6 months to 11 years

Abstract: Parents report that a large proportion of white children is protected from sun exposure by one or more methods. Health care providers and educators might encourage the use of all methods of protection, not just sunscreen use, and educate older children to protect themselves from the sun.

Cited by 52 publications

References 17 publications

Ultraviolet Radiation: A Hazard to Children and Adolescents

Ultraviolet Radiation: A Hazard to Children and Adolescents

A Noninvasive Objective Measure of Sunscreen Use and Reapplication

Interventional study in 1,232 young German children to prevent the development of melanocytic nevi failed to change sun exposure and sun protective behavior

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