Vorbeugung gesundheitlicher Schäden durch die Sonne – Verhältnisprävention in der Stadt und auf dem Land: Grundsatzpapier des UV-Schutz-Bündnisses

Sun Exposure of Preschoolers, Parental Sun Protection Behavior, and Sun Protection Measures at Preschool in Bavaria-Comparison of Two Cross-Sectional Studies of 2010/11 and 2018/19

INTRODUCTION

Children's skin is particularly susceptible to the carcinogenic effects of ultraviolet radiation. Young children are dependent on sun protection measures taken by parents and other caregivers.

OBJECTIVES

The aim of the study is to evaluate parental sun protection behavior and sun protection measures at preschool at two points in time (2010/11 and 2018/19) in Bavaria and to test for a secular trend.

METHODS

Two cross-sectional surveys were carried out. For each survey, more than 4,000 parents of preschoolers completed a self-administered questionnaire about parental sun protection behavior and sun protection measures at preschool. To identify possible associations between parental sun protection behavior and sociodemographic characteristics, logistic regression analysis was carried out.

RESULTS

In the survey of 2018/19, six out of eight sun protection measures are adequately applied by over two-thirds of the parents. Two out of eight sun protection measures are adequately applied by less than one-third of the parents. Those two measures are aligning sun protection to actual UV index and preschoolers wearing sunglasses. The comparison of the study population of the survey of 2010/11 and of 2018/19 shows an improvement in parental sun protection behavior for seven out of eight sun protection measures. In both surveys more than 80% of parents state that preschool staff ensures preschoolers wear sun hats and sunscreen outside on sunny days.

CONCLUSIONS

Future campaigns should focus on the use of sunglasses and promote the UV index, as these sun protection measures are used very little.

[Shaded places for skin cancer prevention in kindergartens and schools]

BACKGROUND

Excessive UV radiation from the sun may lead to skin cancer, the most common type of cancer in Germany. Therefore, among other things, the World Health Organization recommends seeking shade during the midday hours from a UV index of 3 (3 to 5 = "moderate"). However, this important preventive measure can only be taken if sufficient shaded areas are available. The aim of the study is to record shaded areas in kindergartens and schools nationwide.

METHODS

An epidemiological cross-sectional study with two samples was carried out. Management of kindergartens and schools were surveyed using online questionnaires about the provision of shading measures at their educational institution from May to August 2020 and from April to July 2021, respectively. The primary outcome was to record the presence of various structural shading measures in the outdoor area of their educational institutions. The secondary outcome was to estimate the size of the shaded exterior area.

RESULTS

From the nationwide population, 1042 kindergartens (1.9%) and 713 schools (2.3%) participated. Compared to schools, kindergartens had sun protection measures in the outdoor area significantly more often (99% vs. 82%; p < 0.001) and were able to shade a significantly larger outdoor area (43% vs. 26%; p < 0.001). Assuming a minimum required shaded outdoor area of 1 m2 per person, 45% of the schools and 10% of the kindergartens did not have sufficient shaded outdoor areas (p < 0.001).

CONCLUSION

Almost every fifth school in Germany had no shaded places in the outdoor area. Against the background of climatic changes, an urgent high need for improvements seems obvious.

[The UV Protection Alliance in Germany-Purpose and goals]

Despite the serious health consequences of UV radiation, protection against UV radiation is even now still not a matter of course. The population has a largely realistic view of UV radiation-related health risks but this does not seem to instigate a change in personal risk assessments and towards an adequate UV protection behavior. This is not least due to the partly contradictory statements and recommendations regarding the positive and negative health effects, also from the scientific community. A harmonization as well as a collation of the statements and activities of individual players in UV protection related to the prevention of UV-related diseases gives the key messages the necessary strength to make UV protection a matter of course in society. To this end, the UV Protection Alliance was initiated by the Federal Office for Radiation Protection (BfS). This article reports on the UV Protection Alliance, presents the partners in the Alliance, the goals of the UV Protection Alliance, previous results of work by the Alliance and actions and interventions of the Alliance partners. The public impact of the UV Protection Alliance is explained and an outlook is given on future tasks of the Alliance.

[Behavioral and structural prevention of skin cancer : Implementation and effectiveness]

BACKGROUND

Ultraviolet radiation (UV)-induced malignancies, especially skin cancer, have continued to increase for decades. The main cause is natural and artificial UV radiation. The affected persons and the health care system are heavily burdened. The situation threatens to worsen, as climate change could lead to an increase in UV radiation exposure of the population and, thus, the risk of UV-related cancer in Germany as well. The prevention of UV-related diseases is, therefore, a health and radiation protection objective that needs to be considered.

OBJECTIVE

Necessary and appropriate prevention measures for the precaution of UV-related cancer are presented.

MATERIALS AND METHODS

The currently recommended and applied primary behavioral and structural preventive measures and potential, prevention-related relief for the health care system are examined and summarized.

RESULTS

Numerous behavioral and structural preventive measures are already being applied. Sustainably designed, multicomponent and personalized behavioral preventive measures in combination with structural prevention modules are effective and have a high economic and health-related benefit. The use of modern media and multimedia measures is recommended.

CONCLUSION

Structural prevention measures in addition to behavioral measures enable a reduction of the cancer risk caused by UV radiation. The aim must be to establish these measures nationwide for the entire population.

[UV radiation in Germany: influences of ozone depletion and climate change and measures to protect the population]

Ultraviolet radiation (UV radiation) can lead to numerous skin and eye diseases, both immediately and later in life. The most serious consequence is skin cancer. The risk of skin cancer increases, among other things, with increasing UV irradiance and/or with increasing outdoor exposure times. Due to the fact that UV radiation is carcinogenic, protection of the population against harmful UV exposure is an important radiation protection and health objective.In Germany, ozone depletion and climate change can also influence the UV irradiance and outdoor exposure times to such an extent that the UV exposure of the population and thus the skin cancer risk can increase. This is why protection against harmful UV exposure is even more important. Since ozone depletion and climate change can further increase the UV exposure of humans, protection against high UV exposure is even more important. A country's adaptation strategies to the health consequences of ozone depletion and climate change should therefore also include strategies to reduce UV exposure.In this review, the health effects of UV radiation and the risk factors for UV-related skin cancer are first presented. The measurement of UV irradiance and exposure in Germany is explained. The effects of ozone depletion and climate change on UV exposure are then described and measures to protect the population are presented.