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George CD, Lee T, Hollestein LM, Asgari MM, Nijsten T. Global epidemiology of actinic keratosis in the general population: a systematic review and meta-analysis. Br J Dermatol 2024; 190:465-476. [PMID: 37890083 DOI: 10.1093/bjd/ljad371] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 09/11/2023] [Accepted: 09/21/2023] [Indexed: 10/29/2023]
Abstract
BACKGROUND Actinic keratosis (AK) is a common dermatological condition, and among the most common dermatological diagnoses in older populations. Although the prevalence of AK depends on demographic and environmental factors, little is known about the global context of AK. OBJECTIVES To provide a comprehensive and updated analysis of the global prevalence rate and incidence of AK in the general population through a systematic review and meta-analysis, and - through subgroup analyses - to identify high-risk phenotypes, demographic and lifestyle risk factors and regional variations in disease prevalence. METHODS A systematic search of Embase, MEDLINE, Web of Science and Google Scholar was performed on 20 May 2022. Two reviewers independently screened and assessed the quality of each study using a validated critical appraisal checklist. Epidemiological measurements (e.g. prevalence) from individual studies performed in the general population were then pooled in a random-effects meta-analysis. Subgroup analyses (i.e. population age, geographical region, occupation, sex and study quality) were conducted. RESULTS Of the 65 articles that made it through the full-text screening, 60 reported a point prevalence. A meta-analysis of these articles yielded an overall point prevalence of 14% [95% confidence interval (CI) 14-15]. In further analyses, the calculated prevalence rate varied depending on subgroup. The pooled incidence rate from the seven eligible studies analysed was 1928 per 100 000 person-years (PY; 95% CI -439 to 4294). CONCLUSIONS This comprehensive meta-analysis provides an updated global prevalence rate of AK of 14%, indicating a significant worldwide disease burden. The incidence rate of AK was found to be 1928 per 100 000 PY, emphasizing a growing public health concern. However, high heterogeneity among studies suggests that various factors influence the AK prevalence rate, necessitating further research to understand the observed differences.
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Affiliation(s)
- Christopher D George
- Erasmus MC Cancer Institute, University Medical Center Rotterdam, Department of Dermatology, Rotterdam, the Netherlands
| | - Truelian Lee
- Harvard Medical School, Department of Dermatology, Boston, MA, USA
| | - Loes M Hollestein
- Erasmus MC Cancer Institute, University Medical Center Rotterdam, Department of Dermatology, Rotterdam, the Netherlands
| | - Maryam M Asgari
- University of Colorado Anschutz Medical Campus, Department of Dermatology, Aurora, CO, USA
| | - Tamar Nijsten
- Erasmus MC Cancer Institute, University Medical Center Rotterdam, Department of Dermatology, Rotterdam, the Netherlands
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2
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Martínez AR, Pardal CV, Arjona JA, Ruiz FR, Molinero DD, Paulano MR, Subert A, Manzanedo JVG, Cambil Martín J, de Gálvez Aranda MV, López LJ, Sánchez NB, de Troya Martín M. Skin cancer prevention in extreme sports: Intervention in a 24-h race. PHOTODERMATOLOGY, PHOTOIMMUNOLOGY & PHOTOMEDICINE 2024; 40:e12940. [PMID: 38288775 DOI: 10.1111/phpp.12940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 11/15/2023] [Accepted: 11/28/2023] [Indexed: 02/01/2024]
Abstract
INTRODUCTION Excessive sun exposure and sunburns are the main preventable causes of skin cancer. The growing popularity of outdoor sports in developed countries has motivated the objective of this work to study the risk of photoexposure and the skin cancer prevention needs of athletes in an extreme race and evaluate an intervention targeted at this population. METHODS An observational study was conducted during the XXIII edition of the 101 km de Ronda race, which consisted of trail running and mountain biking categories. Environmental and personal dosimetry, monitoring of meteorological conditions, evaluation of the athletes' photoprotection and skin examination habits, a dermatological checkup, and a satisfaction questionnaire were performed. RESULTS The ultra-endurance race was carried out under adverse conditions (maximum ultraviolet index (UVI) = 9.2, temperatures above 30°C, and relative humidity >35%). The mean effective erythema dose received by race athletes (n = 11) was 2959.2 ± 404.2 J/m2 , equivalent to 29.6 standard erythema doses (SED). The CHACES questionnaire (n = 1145) showed a sunburn rate of 58% and poor protective habits: 62.9% of athletes do not usually use sunscreen and 67.2% do not self-examine their skin. Actinic keratoses (4.7%) and suspicious skin cancer lesions (4.2%) were found in dermatologic screening exams (n = 170). On the satisfaction questionnaire (n = 111), this intervention was rated as excellent (95.5%). CONCLUSION This research highlights the extreme risk of photoexposure that athletes are subjected to during ultra-endurance competitions. In the same way, it shows the need to carry out interventions aimed at the acquisition of healthy photoprotection habits and skin surveillance in this target group.
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Affiliation(s)
| | - Carmen Vaz Pardal
- Andalusian Centre for Sports Medicine, Cádiz, Spain
- PAIDI Group: CTS-1081: Photoprotection and prevention of skin cancer (PHOTOPROTECTION), Marbella, Spain
| | | | - Francisco Rivas Ruiz
- Research Unit, Hospital Costa del Sol, Marbella, Spain
- Red de Investigación en Servicios Sanitarios en Enfermedades Crónicas (REDISSEC), Marbella, Spain
| | - Diego Doncel Molinero
- PAIDI Group: CTS-1081: Photoprotection and prevention of skin cancer (PHOTOPROTECTION), Marbella, Spain
- Hospital Costa del Sol, Marbella, Spain
| | | | - Andras Subert
- Research Unit, Hospital Costa del Sol, Marbella, Spain
| | - Jose Vicente Gutiérrez Manzanedo
- PAIDI Group: CTS-1081: Photoprotection and prevention of skin cancer (PHOTOPROTECTION), Marbella, Spain
- Department of Physical Education, Faculty of Education Sciences, University of Cádiz, Cádiz, Spain
| | - Jacobo Cambil Martín
- PAIDI Group: CTS-1081: Photoprotection and prevention of skin cancer (PHOTOPROTECTION), Marbella, Spain
- Nursing Department, Health Science Faculty, University of Granada, Granada, Spain
| | | | | | - Nuria Blázquez Sánchez
- PAIDI Group: CTS-1081: Photoprotection and prevention of skin cancer (PHOTOPROTECTION), Marbella, Spain
- Department of Dermatology, Hospital Costa del Sol, Marbella, Spain
| | - Magdalena de Troya Martín
- PAIDI Group: CTS-1081: Photoprotection and prevention of skin cancer (PHOTOPROTECTION), Marbella, Spain
- Department of Dermatology, Hospital Costa del Sol, Marbella, Spain
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Miller IJ, Stapelberg M, Rosic N, Hudson J, Coxon P, Furness J, Walsh J, Climstein M. Implementation of artificial intelligence for the detection of cutaneous melanoma within a primary care setting: prevalence and types of skin cancer in outdoor enthusiasts. PeerJ 2023; 11:e15737. [PMID: 37576493 PMCID: PMC10416769 DOI: 10.7717/peerj.15737] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 06/20/2023] [Indexed: 08/15/2023] Open
Abstract
Background There is enthusiasm for implementing artificial intelligence (AI) to assist clinicians detect skin cancer. Performance metrics of AI from dermoscopic images have been promising, with studies documenting sensitivity and specificity values equal to or superior to specialists for the detection of malignant melanomas (MM). Early detection rates would particularly benefit Australia, which has the worlds highest incidence of MM per capita. The detection of skin cancer may be delayed due to late screening or the inherent difficulty in diagnosing early skin cancers which often have a paucity of clinical features and may blend into sun damaged skin. Individuals who participate in outdoor sports and recreation experience high levels of intermittent ultraviolet radiation (UVR), which is associated with the development of skin cancer, including MM. This research aimed to assess the prevalence of skin cancer in individuals who regularly participate in activities outdoors and to report the performance parameters of a commercially available AI-powered software to assess the predictive risk of MM development. Methods Cross-sectional study design incorporating a survey, total body skin cancer screening and AI-embedded software capable of predictive scoring of queried MM. Results A total of 423 participants consisting of surfers (n = 108), swimmers (n = 60) and walkers/runners (n = 255) participated. Point prevalence for MM was highest for surfers (6.48%), followed by walkers/runners (4.3%) and swimmers (3.33%) respectively. When compared to the general Australian population, surfers had the highest odds ratio (OR) for MM (OR 119.8), followed by walkers/runners (OR 79.74), and swimmers (OR 61.61) rounded out the populations. Surfers and swimmers reported comparatively lower lifetime hours of sun exposure (5,594 and 5,686, respectively) but more significant amounts of activity within peak ultraviolet index compared with walkers/runners (9,554 h). A total of 48 suspicious pigmented lesions made up of histopathology-confirmed MM (n = 15) and benign lesions (n = 33) were identified. The performance of the AI from this clinical population was found to have a sensitivity of 53.33%, specificity of 54.44% and accuracy of 54.17%. Conclusions Rates of both keratinocyte carcinomas and MM were notably higher in aquatic and land-based enthusiasts compared to the general Australian population. These findings further highlight the clinical importance of sun-safe protection measures and regular skin screening in individuals who spend significant time outdoors. The use of AI in the early identification of MM is promising. However, the lower-than-expected performance metrics of the AI software used in this study indicated reservations should be held before recommending this particular version of this AI software as a reliable adjunct for clinicians in skin imaging diagnostics in patients with potentially sun damaged skin.
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Affiliation(s)
- Ian J. Miller
- Aquatic Based Research, Southern Cross University, Bilinga, Queensland, Australia
- Faculty of Health, Southern Cross University, Bilinga, Queensland, Australia
| | - Michael Stapelberg
- Aquatic Based Research, Southern Cross University, Bilinga, Queensland, Australia
- Faculty of Health, Southern Cross University, Bilinga, Queensland, Australia
- Specialist Suite, John Flynn Hospital, Tugun, Queensland, Australia
| | - Nedeljka Rosic
- Aquatic Based Research, Southern Cross University, Bilinga, Queensland, Australia
- Faculty of Health, Southern Cross University, Bilinga, Queensland, Australia
| | - Jeremy Hudson
- Aquatic Based Research, Southern Cross University, Bilinga, Queensland, Australia
- Faculty of Health, Southern Cross University, Bilinga, Queensland, Australia
- North Queensland Skin Centre, Townsville, Queensland, Australia
| | - Paul Coxon
- North Queensland Skin Centre, Townsville, Queensland, Australia
| | - James Furness
- Water Based Research Unit, Bond University, Robina, Queensland, Australia
| | - Joe Walsh
- Sport Science Institute, Sydney, NSW, Australia
- AI Consulting Group, Sydney, NSW, Australia
| | - Mike Climstein
- Aquatic Based Research, Southern Cross University, Bilinga, Queensland, Australia
- Faculty of Health, Southern Cross University, Bilinga, Queensland, Australia
- Water Based Research Unit, Bond University, Robina, Queensland, Australia
- Physical Activity, Lifestyle, Ageing and Wellbeing Faculty Research Group, University of Sydney, Sydney, NSW, Australia
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de Troya Martín M, Aguilar S, Aguilera-Arjona J, Rivas-Ruiz F, Rodríguez-Martínez A, de Castro-Maqueda G, Cambil-Martín J, de Gálvez-Aranda V, Blázquez-Sánchez N. Risk assessment of occupational skin cancer among outdoor workers in southern Spain: local pilot study. Occup Environ Med 2023; 80:14-20. [PMID: 36424170 DOI: 10.1136/oemed-2022-108454] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Accepted: 08/25/2022] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Overexposure to ultraviolet (UV) radiation is the main preventable cause of skin cancer. Outdoor workers, exposed to the sun for many hours throughout their working lives, are at special risk. The aim of this study is to determine occupational photoexposure and photoprotection among outdoor workers employed by a municipality in southern Spain. METHODS Cross-sectional descriptive study focusing on outdoor workers employed by the municipality of Fuengirola (in areas such as construction, gardening, urban cleaning and beach maintenance). The participants were monitored by personal dosimetry, participated in a dermatological check-up and answered a validated questionnaire (CHACES) on their habits, attitudes and knowledge related to sun exposure. RESULTS The median effective erythema dose of exposure to solar UV radiation during the working day (n=20) was 379.4 J/m2, equivalent to 3.8 standard erythema doses, almost 3 times higher than the recommended limits for an 8-hour workday. Skin examination (n=128) revealed the presence of actinic lentigines (79.7%), actinic keratoses (8.6%) and skin cancer (3.9%). The CHACES questionnaire (n=128) revealed a sunburn rate of 50.0%. Photoprotection practices were markedly deficient: only 16.7% of the survey respondents sought protection in the shade, 20.3% avoided exposure during the peak exposure hours and 33.1% applied sunscreen. CONCLUSIONS This is the first study to evaluate UV radiation exposure, occupational sun protection practices, sunburn and actinic injuries of different outdoor workers in one of the sunniest regions of Spain and underlines the need for effective interventions to protect outdoor workers' health.
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Affiliation(s)
| | - Sierra Aguilar
- Occupational Risk Prevention Service, Fuengirola City Council, Fuengirola, Spain
| | - José Aguilera-Arjona
- Photobiological Dermatology Laboratory, Medical Research Centre, Department of Medicine and Dermatology, University of Malaga, Malaga, Spain
| | | | | | - Guillermo de Castro-Maqueda
- Physical Education Department, Education Science Faculty, University of Cadiz, Cadiz, Spain.,Nursing Department, Health Science Faculty, University of Granada, Granada, Spain
| | - Jacobo Cambil-Martín
- Nursing Department, Health Science Faculty, University of Granada, Granada, Spain
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5
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Gutiérrez-Manzanedo JV, Vaz Pardal C, Blázquez-Sánchez N, De Gálvez MV, Aguilera-Arjona J, González-Montesinos JL, Rivas Ruiz F, De Troya-Martín M. Ultraviolet exposure of competitors during a Tokyo Olympic Sailing Regatta Test Event. PHOTODERMATOLOGY, PHOTOIMMUNOLOGY & PHOTOMEDICINE 2022. [PMID: 36208003 DOI: 10.1111/phpp.12839] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Accepted: 10/04/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Overexposure to sunlight is the main cause of skin cancer. Photoprotection practices and sunburn play a crucial role in skin cancer prevention. OBJECTIVES This study aimed to quantify the risk of sun exposure and to evaluate photoprotection practices in Spanish sailors during Olympic competitions. METHODS Solar daily ultraviolet (UV) radiation cycle, personal UV dosimetry, photoprotection practices and sunburn checking were followed during three consecutive days of competition among sailors from the Spanish Olympic Sailing Team during a Tokyo Olympic Regatta Test Event. RESULTS A total of 13 sailors (7 women), with mean age of 27.6 ± 4.7 years and sports experience of 17.7 ± 5.4 years, were studied. The most common phototypes were type III (53.8%) and type II (38.5%). The rate of sunburn checked was high (46.2%). The mean daily personal UV exposure received was 761.0 ± 263.6 J/m2 , 3.0 ± 1.1 minimal erythemal dose and 7.6 ± 2.6 standard erythemal dose, seven times greater than the maximum permissible UV light exposure values for an 8 h working day. The use of a T-shirt was the most common practice (94.2%), followed by the use of shade (50.2%), hat/cap (44.0%), sunglasses (26.1%) and sunscreen (11.8%). CONCLUSIONS Olympic sailor's studies presented high levels of UV radiation received, high rate of sunburn and insufficient adherence to sun-protective behaviours (especially, to use of sunscreen) to prevent sunburn, the main cause of skin cancer. Sport Federations should develop educational campaigns addressing sun-related exposure habits and photoprotection behaviours to reduce the risk of skin cancer among these athletes.
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Affiliation(s)
| | | | | | - Maria Victoria De Gálvez
- Department of Dermatology and Medicine, Photobiological Dermatology Laboratory Medical Research Centre, Faculty of Medicine, University of Málaga, Málaga, Spain
| | - José Aguilera-Arjona
- Department of Dermatology and Medicine, Photobiological Dermatology Laboratory Medical Research Centre, Faculty of Medicine, University of Málaga, Málaga, Spain
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6
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Fernandez-Ruiz J, Montero-Vilchez T, Buendia-Eisman A, Arias-Santiago S. Knowledge, Behaviour and Attitudes Related to Sun Exposure in Sportspeople: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph191610175. [PMID: 36011808 PMCID: PMC9407896 DOI: 10.3390/ijerph191610175] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 08/11/2022] [Accepted: 08/11/2022] [Indexed: 05/20/2023]
Abstract
People who practice outdoor sports have an increased risk of skin cancer as they are exposed to high doses of ultraviolet (UV) radiation. Recent studies have shown that in many athletes, sun protection behaviours are inadequate, with the risk that this entails. The aim of this review is to collect the information published to date about the knowledge, attitudes and habits of athletes in relation to sun exposure and its risks. A systematic review was conducted using PubMed and Embase with the search algorithm "(skin cancer OR melanoma) AND (exercise OR sport OR athletes)". All studies analysing the knowledge, attitudes and habits of photoprotection in athletes were included. A total of 2,365 publications were found, of which 23 were selected, including a total of 10,445 sportspeople. The majority of participants declared their voluntary intention to tan and stated that the sun made them feel better, although they also showed concern about possible damage associated with UV radiation. In most studies, less than half of the participants made adequate use of photoprotective measures. In general, most athletes had a high level of knowledge regarding the risk of skin cancer associated with sun exposure. In conclusion, most athletes are aware of the risks associated with UV radiation but do not make adequate use of photoprotective cream. New training programs on photoprotection could help improve athletes' photoprotective behaviour, reducing the incidence of skin cancer and precancerous lesions in this population.
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Affiliation(s)
- Jonatan Fernandez-Ruiz
- Dermatology Department, Faculty of Medicine, University of Granada, 18071 Granada, Spain
| | - Trinidad Montero-Vilchez
- Department of Dermatology, Hospital Universitario Virgen de las Nieves, 18012 Granada, Spain
- Instituto de Investigación Biosanitaria de Granada (ibs.GRANADA), 18012 Granada, Spain
- Correspondence: ; Tel.: +34-958-023-422
| | - Agustin Buendia-Eisman
- Dermatology Department, Faculty of Medicine, University of Granada, 18071 Granada, Spain
- Department of Dermatology, Hospital Universitario Virgen de las Nieves, 18012 Granada, Spain
| | - Salvador Arias-Santiago
- Dermatology Department, Faculty of Medicine, University of Granada, 18071 Granada, Spain
- Department of Dermatology, Hospital Universitario Virgen de las Nieves, 18012 Granada, Spain
- Instituto de Investigación Biosanitaria de Granada (ibs.GRANADA), 18012 Granada, Spain
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Doncel Molinero D, Ruiz Paulano M, Rivas Ruiz F, Blázquez Sánchez N, de Gálvez Aranda MV, de Castro Maqueda G, de Troya Martín M. Sun Protection Behaviour and Sunburns in Spanish Cyclists. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2022; 37:957-964. [PMID: 33108803 DOI: 10.1007/s13187-020-01906-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/19/2020] [Indexed: 06/11/2023]
Abstract
Sunburn caused by overexposure to ultraviolet radiation is the main cause of preventable skin cancer. This study aimed to describe the sun protection habits and rate of sunburns associated with the practice of cycling and to identify predictive factors of sunburn among cyclists. A descriptive observational study based on online surveys was conducted. Recruitment of participants was conducted through the Andalusian Cycling Federation (Spain). A questionnaire on behaviour, attitudes, and knowledge related to sun exposure was used. A bivariate analysis was carried out with sunburn episodes during the previous year as outcome variable, and a multivariate logistic regression model was built. Of the 1018 surveys returned, 87.6% were answered by men, mean age was 41.8 years (SD: 11.0), and 37.6% of the participants had phototype I or II. Sunburns during the previous year were reported by 45.6% (95% CI: 42.5-48.7) of the respondents. Sunscreen use was reported by 39.2%, and 61.0% did not examine their skin regularly despite the fact that 34 subjects (3.4%) reported a personal history of skin cancer. The multivariate logistic regression analysis showed that there was a negative correlation between episodes of sunburn and age, phototypes I-II, more than 2 h of sun exposure, and inconsistent use of sunscreen. Cyclists have high rates of sunburns and thus constitute a high-risk group for developing skin cancer. Educational interventions specifically aimed at this group of athletes would improve sun protection knowledge and practices, particularly the use of sunscreen.
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Affiliation(s)
| | - Manuel Ruiz Paulano
- Area of Dermatology, Costa del Sol Health Agency, 29603, Marbella- Malaga, Spain
| | - Francisco Rivas Ruiz
- Area of Dermatology, Costa del Sol Health Agency, 29603, Marbella- Malaga, Spain
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Photoprotection in Outdoor Sports: A Review of the Literature and Recommendations to Reduce Risk Among Athletes. Dermatol Ther (Heidelb) 2022; 12:329-343. [PMID: 35099755 PMCID: PMC8850489 DOI: 10.1007/s13555-021-00671-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Indexed: 01/04/2023] Open
Abstract
Solar exposure, for long hours and often at peak times with limited shade available, predisposes athletes to episodic sunburn and chronic damage, causing increased risk of precancerous lesions and skin cancer. Environmental factors and training intensity affect risk. Clothing provides good protection, but changing established “uniforms” may not be possible for reasons of practicality, safety, or simply custom. Although physical activity should be encouraged for its physical and mental benefits, risk of skin damage should be minimised. We review existing behaviours, skin cancer risk, and campaigns in the sporting population and highlight key recommendations to help sun protection practices become engrained in sports practice.
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9
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Gálvez MVD, Aguilera J, Leal M, Sánchez-Roldán C, Herrera-Ceballos E. Sunscreens effectiveness are not altered by concomitant use of moisturizing creams: An ultraviolet reflectance photography study. PHOTODERMATOLOGY PHOTOIMMUNOLOGY & PHOTOMEDICINE 2021; 38:250-258. [PMID: 34674316 DOI: 10.1111/phpp.12745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 09/03/2021] [Accepted: 10/06/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Sunscreens are widely used to protect the skin against the harmful effects of solar radiation. It is not known whether solar protection factor of a sunscreen is altered by the concomitant use of other cosmetic products. OBJECTIVES The aim of this study was to analyze changes in the protective effect of different commercial and ISO standards sunscreens with high SPF applied shortly before and after application of non-sunscreens galenic formulas type moisturizing creams. METHODS ISO 24444:2019 standard sunscreens, which claimed SPF 16 and 63, as well as 4 different claimed SPF 50 and 50+ commercial sunscreens were prepared and applied in different sequential order to the back of 25 volunteers and compared with different commercial moisturizing formulas. Ultraviolet (UV) reflectance photography followed by image analysis was used to compare untreated skin and skin treated with moisturizing creams alone and combined with sunscreens. RESULTS The UV reflectance analysis showed no significant changes of the skin color reflectance treated with moisturizing cream compared with untreated skin. Application of the sunscreen formulations were associated with a 35% - 70% decrease in color related to the in vivo expected SPF, indicating significant UV absorption for all sunscreen formulas. All standard and commercial sunscreens showed no significant differences in UV reflection color level when combined with the different moisturizing creams applied before or after the sunscreen. CONCLUSIONS Effectiveness of low- and high-protection sunscreens were not altered by the concomitant use of a moisturizing creams applied shortly before and after the sunscreens.
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Affiliation(s)
- María Victoria de Gálvez
- Photobiological Dermatology Laboratory, Medical Research Center, Department of Dermatology and Medicine, Faculty of Medicine, University of Malaga, Málaga, Spain
| | - José Aguilera
- Photobiological Dermatology Laboratory, Medical Research Center, Department of Dermatology and Medicine, Faculty of Medicine, University of Malaga, Málaga, Spain
| | - María Leal
- Photobiological Dermatology Laboratory, Medical Research Center, Department of Dermatology and Medicine, Faculty of Medicine, University of Malaga, Málaga, Spain
| | - Cristina Sánchez-Roldán
- Photobiological Dermatology Laboratory, Medical Research Center, Department of Dermatology and Medicine, Faculty of Medicine, University of Malaga, Málaga, Spain
| | - Enrique Herrera-Ceballos
- Photobiological Dermatology Laboratory, Medical Research Center, Department of Dermatology and Medicine, Faculty of Medicine, University of Malaga, Málaga, Spain.,Dermatology Service, Universitary Clinical Hospital Virgen de la Victoria, Málaga, Spain
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10
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Attitudes and Behaviors That Impact Skin Cancer Risk among Men. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18199989. [PMID: 34639288 PMCID: PMC8508125 DOI: 10.3390/ijerph18199989] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/28/2021] [Revised: 09/16/2021] [Accepted: 09/18/2021] [Indexed: 01/04/2023]
Abstract
Despite substantially higher skin cancer risks, little research has investigated men’s attitudes about skin cancer and how those attitudes relate to their risks of developing skin cancer. This study aims to close the gap in research, regarding men’s perceptions and behaviors about skin cancer, sun exposure, and tanning. This study utilized a cross-sectional survey of 705 men recruited from Amazon Mechanical Turk (MTurk), reporting attitudes and behaviors towards sun exposure, tanning, and sun protection. While the majority of men reported large daily outdoor activities, that their skin frequently burns with sun exposure, and riskier perceptions of tanning, only a minority reported daily use of sunscreen or most other sun protective behaviors. More sun protection methods were associated with more frequent use of sunscreen and less positive tanning perceptions. Men consistently engaged in high-risk behaviors for developing skin cancer, but they did not engage highly in protective behaviors to mitigate their risk. The findings can help improve clinical and public health interventions to lower men’s risk of skin cancer with strong messages about sunscreen use and sun protective methods.
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11
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Weikert AE, Pagoto SL, Handley E, Courtney JB, Brunke-Reese D, Conroy DE. Golfers' Interest in Multilevel Sun-Protection Strategies. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18147253. [PMID: 34299704 PMCID: PMC8305060 DOI: 10.3390/ijerph18147253] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 07/02/2021] [Accepted: 07/04/2021] [Indexed: 01/03/2023]
Abstract
Active adults accumulate more ultraviolet (UV) radiation exposure and are at greater risk of skin cancer than inactive adults. Golf is a popular sport that increases UV exposure because it is played outdoors in daylight. This study evaluated adult golfers’ interest in multilevel sun-protection strategies and characterized differences in interest as a function of golfer characteristics. Adult golfers (N = 347) completed a web survey to rate their interest in 20 sun-protection strategies. We estimated descriptive statistics and evaluated differences in interest as a function of demographics, perceived risk, sun-protective behavior, and golf exposure. Golfers reported the greatest interest in environmental supports for sun protection, but these ratings were driven by golfers who already perceived golf as a risk behavior and used sunscreen diligently. Vulnerable golfers—those with a golf-related sunburn in the past year or who spend more time golfing—expressed interest in a broader range of intervention components, including education, family support, and text messages. Multilevel skin cancer prevention interventions are needed for golfers. Intervention components of interest involved support and reminders, which suggests they are open to sun-safety behaviors but need help executing them.
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Affiliation(s)
- Amanda E. Weikert
- Department of Kinesiology, The Pennsylvania State University, University Park, PA 16802, USA; (A.E.W.); (J.B.C.); (D.B.-R.)
| | - Sherry L. Pagoto
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT 06269, USA;
| | - Eric Handley
- Golf Teaching and Research Center, The Pennsylvania State University, University Park, PA 16082, USA;
| | - Jimikaye B. Courtney
- Department of Kinesiology, The Pennsylvania State University, University Park, PA 16802, USA; (A.E.W.); (J.B.C.); (D.B.-R.)
| | - Deborah Brunke-Reese
- Department of Kinesiology, The Pennsylvania State University, University Park, PA 16802, USA; (A.E.W.); (J.B.C.); (D.B.-R.)
| | - David E. Conroy
- Department of Kinesiology, The Pennsylvania State University, University Park, PA 16802, USA; (A.E.W.); (J.B.C.); (D.B.-R.)
- Department of Preventive Medicine, Northwestern University, Chicago, IL 60611, USA
- Correspondence: ; Tel.: +1-814-863-3451
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de Troya Martín M, Blázquez Sánchez N, García Harana C, Alarcón Leiva MC, Aguilera Arjona J, Rivas Ruiz F, de Gálvez Aranda MV. "Beach Lifeguards' Sun Exposure and Sun Protection in Spain". Saf Health Work 2021; 12:244-248. [PMID: 34178403 PMCID: PMC8209343 DOI: 10.1016/j.shaw.2020.10.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Revised: 07/01/2020] [Accepted: 10/06/2020] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Sunburn is the main avoidable cause of skin cancer. Beach lifeguards spend many hours exposed to the effects of solar radiation during their work day, precisely at times of the year when levels of solar irradiation are highest. The aim of this study is to quantify the risk to beach lifeguards of sun exposure. METHODS A descriptive cross-sectional study was carried out in the Western Costa del Sol, southern Spain, during the summer of 2018. The research subjects were recruited during a skin cancer prevention course for beach lifeguards. All participants were invited to complete a questionnaire on their habits, attitudes, and knowledge related to sun exposure. In addition, ten were specially monitored using personal dosimeters for three consecutive days, and the results were recorded in a photoprotection diary. A descriptive analysis (mean and standard deviation for the quantitative variables) was performed, and inter-group differences were evaluated using the Mann-Whitney U test. RESULTS Two hundred fifteen lifeguards completed the questionnaire, and 109 met the criteria for inclusion in this analysis. The mean age was 23.8 years (SD: 5.1), 78.0% were male, 71.5% were phototype III or IV (Fitzpatrick's phototype), and 77.1% had experienced at least one painful sunburn during the previous summer. The mean daily personal ultraviolet exposure per day, the minimal erythema dose, and the standard erythema dose, in J/m2, were 634.7 [standard deviation (SD): 356.2], 2.5 (SD: 1.4) and 6.35 (SD: 3.6), respectively. CONCLUSION Beach lifeguards receive very high doses of solar radiation during the work day and experience correspondingly high rates of sunburn. Intervention strategies to modify their sun exposure behavior and working environment are necessary to reduce the risk of skin cancer for these workers and to promote early diagnosis of the disease.
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Affiliation(s)
| | | | - Cristina García Harana
- Dermatology Department, Hospital Costal Del Sol, Marbella, Spain
- Medicine Department, University of Málaga, Spain
| | | | | | - Francisco Rivas Ruiz
- Research Unit, Hospital Costal Del Sol, Marbella, Spain
- Research Network of Health Services in Chronic Diseases (REDISSEC), Spain
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Courtney J, Handley E, Pagoto S, Russell M, Conroy DE. Alcohol Use as a Function of Physical Activity and Golfing Motives in a National Sample of United States Golfers. Nutrients 2021; 13:1856. [PMID: 34072398 PMCID: PMC8229716 DOI: 10.3390/nu13061856] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Accepted: 05/27/2021] [Indexed: 02/07/2023] Open
Abstract
Alcohol and physical inactivity are risk factors for a variety of cancer types. However, alcohol use often co-occurs with physical activity (PA), which could mitigate the cancer-prevention benefits of PA. Alcohol is integrated into the culture of one of the most popular physical activities for adults in the United States (U.S.), golf. This study examined how alcohol use was associated with total PA, golf-specific PA, and motives for golfing in a national sample of golfers in the U.S. Adult golfers (n = 338; 51% male, 81% White, 46 ± 14.4 years) self-reported alcohol use, golfing behavior and motives, and PA. Most (84%) golfers consumed alcohol, averaging 7.91 servings/week. Golf participation, including days/week, holes/week, and practice hours/week, was not associated with alcohol use. Golfers with stronger social motives were 60% more likely to consume alcohol. Weekly walking (incident risk ratio (IRR) = 7.30), moderate-to-vigorous PA (MVPA; IRR = 5.04), and total PA (IRR = 4.14) were associated with more alcohol servings/week. Golfers' alcohol use may be higher than the general adult population in the U.S. and contributes 775 extra kilocalories/week, a surplus that may offset PA-related energy expenditure and cancer-protective effects. Alcohol use interventions targeting golfers may facilitate weight loss and reduce cancer risk, especially for golfers motivated by social status.
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Affiliation(s)
- Jimikaye Courtney
- College of Health and Human Development, Pennsylvania State University, University Park, PA 16802, USA; (E.H.); (M.R.); (D.E.C.)
| | - Eric Handley
- College of Health and Human Development, Pennsylvania State University, University Park, PA 16802, USA; (E.H.); (M.R.); (D.E.C.)
| | - Sherry Pagoto
- Institute for Collaboration in Health, Interventions, and Policy, University of Connecticut, Storrs, CT 06269, USA;
| | - Michael Russell
- College of Health and Human Development, Pennsylvania State University, University Park, PA 16802, USA; (E.H.); (M.R.); (D.E.C.)
| | - David E. Conroy
- College of Health and Human Development, Pennsylvania State University, University Park, PA 16802, USA; (E.H.); (M.R.); (D.E.C.)
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García-Malinis AJ, Gracia-Cazaña T, Zazo M, Aguilera J, Rivas-Ruiz F, de Troya Martín M, Gilaberte Y. Sun Protection Behaviors and Knowledge in Mountain Marathon Runners and Risk Factors for Sunburn. ACTAS DERMO-SIFILIOGRAFICAS 2021. [DOI: 10.1016/j.adengl.2020.11.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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García-Malinis AJ, Gracia-Cazaña T, Zazo M, Aguilera J, Rivas-Ruiz F, de Troya Martín M, Gilaberte Y. Sun Protection Behaviors and Knowledge in Mountain Marathon Runners and Risk Factors for Sunburn. ACTAS DERMO-SIFILIOGRAFICAS 2020; 112:159-166. [PMID: 33197435 DOI: 10.1016/j.ad.2020.11.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 10/22/2020] [Accepted: 11/02/2020] [Indexed: 10/23/2022] Open
Abstract
BACKGROUND AND OBJECTIVES The incidence of skin cancer in our society is growing at an alarming rate due to overexposure to solar UV radiation in recreational and occupational settings. The aim of this study was to evaluate sun exposure and protection attitudes, behaviors, and knowledge among mountain ultramarathon runners and to assess risk factors for sunburn in this population. MATERIAL AND METHODS Cross-sectional survey of runners who participated in the «Gran Trail Aneto-Posets» race in Aragon, Spain. Using a validated questionnaire, we collected data on sociodemographic characteristics, running experience, sunburn in the previous summer, and sun exposure and protection behaviors. We calculated descriptive statistics and performed bivariate and multivariate analyses of associations using history of sunburn as the primary outcome. Statistical significance was set at a p level of less than 0.05. RESULTS We surveyed 657 runners (72.1% men) with a mean age of 39.71 years; 45.1% reported sunburn in the past year. The most common protective measures used were sunglasses (74.7%), sunscreen (sun protection factor ≥ 15) (61.9%), a hat (52.2%), and other protective clothing (7.4%). Risk factors for sunburn were younger age, low Fitzpatrick skin type (I and II), running for three or more hours a day, and staying in the shade as a protective measure. By contrast, protective factors were use of sunscreen and seeking shade rather than sun at midday (p < 0.001). CONCLUSIONS Sunburn is common among long-distance mountain runners, despite what appears to be adequate sun protection knowledge and behaviors. Targeted strategies are needed to improve sun protection behaviors among mountain runners.
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Affiliation(s)
| | | | - Miguel Zazo
- Servicio de Urgencias, Hospital San Jorge, Huesca, España
| | - José Aguilera
- Departamento de Dermatología, Facultad de Medicina de Málaga, Málaga, España
| | - Francisco Rivas-Ruiz
- Unidad de Investigación, Agencia Sanitaria Costa del Sol, REDISSEC, Málaga, España
| | | | - Yolanda Gilaberte
- Servicio de Dermatología, Hospital Universitario Miguel Servet, Zaragoza, España
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Snyder A, Valdebran M, Terrero D, Amber KT, Kelly KM. Solar Ultraviolet Exposure in Individuals Who Perform Outdoor Sport Activities. SPORTS MEDICINE - OPEN 2020; 6:42. [PMID: 32880767 PMCID: PMC7471243 DOI: 10.1186/s40798-020-00272-9] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Accepted: 08/13/2020] [Indexed: 12/18/2022]
Abstract
BACKGROUND Skin cancer is the most common cancer in the USA. Therefore, it is important to review the contribution of ultraviolet radiation (UVR) exposure to skin cancer in individuals with the highest risk. Documenting the relationship between outdoor sports solar ultraviolet exposure and their risk of skin cancer along with appropriate risk mitigation strategies can help inform clinicians of practical information for counseling sun protective behaviors in this population. METHODS We conducted a review of the current evidence using PubMed to answer the following research questions: (1) How is ultraviolet radiation measured? (2) What is the modern utility of the ultraviolet index in modifying recreational sun protection behaviors? (3) What is the risk of developing skin cancer for outdoor sport participants? (4) What is the prevalence of skin cancer in sport participants? and (5) Is the number of nevi and solar lentigines elevated in outdoor sport participants? RESULTS Based on the literature, individuals who practice outdoor sport-related activities receive high ultraviolet radiation exposure, have a high risk for skin cancer, have a high prevalence for pigmented lesions, and may benefit from electronic sun protection educational interventions. CONCLUSIONS Individuals who practice outdoor sports experience substantially higher ultraviolet radiation exposure, routinely exceed the recommended exposure limits, and are at a higher risk of developing skin cancer. Therefore, those who are frequently engaged in outdoor leisure activities should be coached about efficient sun protective practices and relevant mobile technologies that may facilitate adherence.
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Affiliation(s)
- Alan Snyder
- College of Graduate Studies, Medical University of South Carolina, Charleston, SC, USA.
| | - Manuel Valdebran
- Division of Pediatric Dermatology, Department of Dermatology, Medical University of South Carolina, Charleston, SC, USA
| | - David Terrero
- College of Pharmacy and Pharmaceutical Sciences, University of Toledo, Toledo, OH, USA
| | - Kyle T Amber
- Department of Dermatology, University of Illinois at Chicago, Chicago, IL, USA
| | - Kristen M Kelly
- Department of Dermatology, University of California, Irvine, Irvine, CA, USA
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Duarte A, Mota I, Campo M, Correia O. Skin Cancer and UV Literacy - Outdoor Workers Study. ACTAS DERMO-SIFILIOGRAFICAS 2020. [DOI: 10.1016/j.adengl.2018.10.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Cáncer de piel y alfabetización sobre UV: estudio en trabajadores al aire libre. ACTAS DERMO-SIFILIOGRAFICAS 2020; 111:531-533. [DOI: 10.1016/j.ad.2018.10.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2018] [Revised: 10/24/2018] [Accepted: 10/28/2018] [Indexed: 11/18/2022] Open
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García-Montero P, Blázquez-Sánchez N, Rivas-Ruíz F, Millán-Cayetano JF, Fernández-Canedo I, de Troya-Martín M. Preventing Skin Cancer Among Staff and Guests at Seaside Hotels. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2020; 35:501-508. [PMID: 30756322 DOI: 10.1007/s13187-019-01488-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Beach users and outdoor workers in resort areas are major risk groups for skin cancer, and therefore seaside hotels constitute a strategic area in which to conduct awareness-raising campaigns and interventions. The main aim of the present study is to describe habits, attitudes and knowledge related to sun exposure, the sunburn events experienced and potentially malignant skin lesions observed among hotel staff and guests recruited during a skin cancer prevention campaign at seaside hotels in the western Costa del Sol (southern Spain). This descriptive cross-sectional study was conducted at four seaside hotels in the western Costa del Sol. An 8-day awareness-raising campaign on skin cancer was conducted for hotel guests and staff, who were invited to complete a questionnaire about their habits, attitudes and knowledge regarding photoprotection, and to receive a comprehensive skin examination. The questionnaire on habits, attitudes and knowledge related to sun exposure was completed by 542 participants. The most common photoprotection practice was the use of sunglasses (79.3%). Potentially dangerous lesions were identified in 39 persons (14%). In addition, 94.0% reported having gained new knowledge, 89.6% had changed their attitudes towards sun tanning and 94.7% intended to improve their photoprotection practices in the future. Seaside hotels are an optimal scenario for conducting studies aimed at skin cancer prevention and reduction. Further studies should be carried out in other geographical areas to confirm our results, to evaluate the costs and benefits of such interventions and determine their long-term impact on health.
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Affiliation(s)
- Pablo García-Montero
- Dermatology Department, Hospital Costa del Sol, Autovía A7 - Km 187, Marbella, Málaga, Spain.
| | - Nuria Blázquez-Sánchez
- Dermatology Department, Hospital Costa del Sol, Autovía A7 - Km 187, Marbella, Málaga, Spain
| | - Francisco Rivas-Ruíz
- Research Unit, Hospital Costa del Sol, Marbella, Spain
- Health Services Research on Chronic Patients Network (REDISSEC), Madrid, Spain
| | | | - Inés Fernández-Canedo
- Dermatology Department, Hospital Costa del Sol, Autovía A7 - Km 187, Marbella, Málaga, Spain
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Mir JF, Estrada-Campmany M, Heredia A, Rodríguez-Caba C, Alcalde M, Espinosa N, Monnier J, Pérez-Anker J, Yélamos O, Puig S, Bosch N, Malvehy J. Role of community pharmacists in skin cancer screening: A descriptive study of skin cancer risk factors prevalence and photoprotection habits in Barcelona, Catalonia, Spain. Pharm Pract (Granada) 2019; 17:1455. [PMID: 31592287 PMCID: PMC6763307 DOI: 10.18549/pharmpract.2019.3.1455] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2019] [Accepted: 07/28/2019] [Indexed: 01/05/2023] Open
Abstract
Background: Skin cancer incidence is increasing alarmingly, despite current efforts
trying to improve its early detection. Community pharmacists have proven
success in implementing screening protocols for a number of diseases because
of their skills and easy access. Objective: To evaluate the prevalence of skin cancer risk factors and the
photoprotection habits with a questionnaire in community pharmacy users. Methods: A research group consisting of pharmacists and dermatologists conducted a
descriptive cross-sectional study to assess photoprotection habits and skin
cancer risk factors by using a validated questionnaire in 218 community
pharmacies in Barcelona from May 23rd to June 13th
2016. All participants received health education on photoprotection and skin
cancer prevention. Patients with ≥1 skin cancer risk factor were
referred to their physician, as they needed further screening of skin
cancer. Results: A total of 5,530 participants were evaluated. Of those, only 20.2%
participants had received a total body skin examination for skin cancer
screening in the past by a physician and 57.1% reported using a SPF
50+ sunscreen. 53.9% participants presented ≥1 skin cancer
risk factor: 11.8% participants reported having skin cancer familial
history and 6.2% reported skin cancer personal history; pharmacists
found ≥10 melanocytic nevi in 43.8% participants and
chronically sun-damaged skin in 21.4%. Lesions suspicious for
melanoma were reported in 10.9% of the participants and urgent
dermatological evaluation was recommended. Conclusions: Pharmacists can detect people with skin cancer risk factors amongst their
users. This intervention can be considered in multidisciplinary strategies
of skin cancer screening.
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Affiliation(s)
- Joan F Mir
- Consultant Pharmacist in Research and Projects Area. Barcelona Pharmacists Association (COFB). Barcelona (Spain).
| | - Maria Estrada-Campmany
- Consultant Pharmacist in Research and Projects Area. Barcelona Pharmacists Association (COFB). Barcelona (Spain).
| | - Anna Heredia
- Professional Relations Manager. Barcelona Pharmacists Association (COFB). Barcelona (Spain).
| | - Cristina Rodríguez-Caba
- Head of Department of Continuous Professional Development. Barcelona Pharmacists Association (COFB). Barcelona (Spain).
| | - Marta Alcalde
- Community Pharmacist. Dermopharmacy and Medical Devices Area. Barcelona Pharmacists Association (COFB). Barcelona (Spain).
| | - Natalia Espinosa
- Dermatologist. Melanoma Unit, Dermatology Department, IDIBAPS-Hospital Clinic. Barcelona (Spain).
| | - Jilliana Monnier
- Dermatologist. Melanoma Unit, Dermatology Department, IDIBAPS-Hospital Clinic. Barcelona (Spain).
| | - Javiera Pérez-Anker
- Dermatologist. Melanoma Unit, Dermatology Department, IDIBAPS-Hospital Clinic. Barcelona (Spain).
| | - Oriol Yélamos
- Dermatologist. Melanoma Unit, Dermatology Department, IDIBAPS-Hospital Clinic. Barcelona (Spain).
| | - Susana Puig
- Dermatologist. Melanoma Unit, Dermatology Department, IDIBAPS-Hospital Clinic. Barcelona; & Biomedical Research Networking Centers Consortium, Institute of Health Carlos III (CIBER-ISCIII). Barcelona (Spain).
| | - Núria Bosch
- Community Pharmacist. Dermopharmacy and Medical Devices Area. Barcelona Pharmacists Association (COFB). Barcelona (Spain).
| | - Josep Malvehy
- Dermatologist. Melanoma Unit, Dermatology Department, Hospital Clínic de Barcelona. Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS).Centro de Investigación Biomédica en Red (CIBER), Instituto Carlos III, Barcelona (Spain).
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Toro-Huamanchumo CJ, Burgos-Muñoz SJ, Vargas-Tineo LM, Perez-Fernandez J, Vargas-Tineo OW, Burgos-Muñoz RM, Zentner-Guevara JA, Bada C. Awareness, behavior and attitudes concerning sun exposure among beachgoers in the northern coast of Peru. PeerJ 2019; 7:e6189. [PMID: 30671297 PMCID: PMC6338095 DOI: 10.7717/peerj.6189] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Accepted: 11/30/2018] [Indexed: 11/21/2022] Open
Abstract
Background Skin cancer incidence has increased over the last years, becoming a major public health problem. Objective To describe the awareness, behavior and attitudes concerning sun exposure among beachgoers in the northern coast of Peru. Methods We conducted a cross-sectional study in the Pimentel beach, Peru. The “Beach Questionnaire” was used and we surveyed all the beachgoers from 8 a.m. to 4 p.m. and from March 5 to March 19. For the statistical analysis, sun exposure habits, sunburns history, knowledge, attitudes and practices were crossed with sex using the chi2 test. Results We surveyed 410 beachgoers, the most frequent phototype was type III (40.5%). Only the 13.66% of the respondents correctly answered the seven knowledge questions related to sun exposure and skin cancer. Men more frequently agreed that “when they are tanned their clothes looks nicer” (p = 0.048). Likewise, regarding the questions “Sunbathing is relaxing” and “Sunbathing improves my mood”, men agreed or totally agreed with more frequency than women (63.64% vs. 46.15%, p < 0.001; and 61.36% vs 49.15%, p = 0.014, respectively). Regarding sun protection practices, women more frequently used sunshade (p = 0.001) and sunscreen (SPF ≥ 15) (p < 0.001) when compared to the male group. Conclusion Sun exposure is a potentially preventable risk factor for skin cancer. Thus, awareness of the risks of UVR overexposure and adequate sun-protective behaviors and attitudes are essential. Our results, however, are not as favorable as expected. Public health efforts should encourage sun-safety precautions and intervention campaigns should be carried out in recreational settings, such as the beaches.
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Affiliation(s)
- Carlos J Toro-Huamanchumo
- Universidad de San Martín de Porres, Facultad de Medicina, Centro de Investigación en Epidemiología Clínica y Medicina Basada en Evidencias, Lima, Peru
| | | | | | | | | | | | | | - Carlos Bada
- School of Medicine, Universidad de San Martín de Porres, Lima, Peru.,Clínica San Judas Tadeo, Lima, Peru
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kelati A, Baybay H, Atassi M, Elfakir S, Gallouj S, Meziane M, Mernissi FZ. Skin cancer knowledge and attitudes in the region of Fez, Morocco: a cross-sectional study. BMC DERMATOLOGY 2017; 17:2. [PMID: 28212650 PMCID: PMC5316218 DOI: 10.1186/s12895-017-0055-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/01/2017] [Accepted: 02/15/2017] [Indexed: 11/18/2022]
Abstract
BACKGROUND The prevalence of skin cancers is constantly increasing in Morocco, and they have gradually become more aggressive due to a significant delay in the diagnosis. Our aim was to assess the levels of awareness and the influencing factors related to skin cancer knowledge in Morocco. METHODS This cross-sectional study was carried out in Morocco through the medium of a validated questionnaire, which contained several items - demographics, skin cancer knowledge and attitudes towards skin cancer patients- during a period of 1 year (2014). RESULTS Out of the 700 participants enrolled in the study, 17.9% had never heard of skin cancer, 32.5% had a low score of skin cancer knowledge, 66.7% had a moderate score, and only 0.85% had a high score of skin cancer knowledge. Further, 15.1% of the participants were under the assumption that this cancer is contagious. The sun was the most incriminated risk factor in skin cancer occurrence by 74.3% of the participants, and 57.9% of them believed that prevention is important through using various means of photoprotection. After univariate and multivariate analysis, the influencing factors related to the skin cancer knowledge in Morocco were: the socioeconomic status (P = 0.003, OR = 7. 3) and the educational level (p < 0.001, OR = 20. 9). CONCLUSIONS Due to the lack of knowledge or the underestimation of skin cancer in our study population, efforts are needed to promote skin cancer surveillance behaviors in Morocco.
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Affiliation(s)
- Awatef kelati
- Department of dermatology, University Hospital Hassan II, 202 Hay Mohamadi, Fez, Morocco
| | - Hanane Baybay
- Department of dermatology, University Hospital Hassan II, 202 Hay Mohamadi, Fez, Morocco
| | - Mariam Atassi
- Department of clinical epidemiology and scientific research, University Hospital Hassan II, Fez, Morocco
| | - Samira Elfakir
- Department of clinical epidemiology and scientific research, University Hospital Hassan II, Fez, Morocco
| | - Salim Gallouj
- Department of dermatology, University Hospital Hassan II, 202 Hay Mohamadi, Fez, Morocco
| | - Mariame Meziane
- Department of dermatology, University Hospital Hassan II, 202 Hay Mohamadi, Fez, Morocco
| | - Fatima Zahra Mernissi
- Department of dermatology, University Hospital Hassan II, 202 Hay Mohamadi, Fez, Morocco
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Maguire E, Spurr A. Implementation of Ultraviolet Radiation Safety Measures for Outdoor Workers. J Cutan Med Surg 2016; 21:117-124. [PMID: 27940497 DOI: 10.1177/1203475416683389] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Ultraviolet radiation (UVR) poses a major risk for outdoor workers, putting them at greater risk for skin cancer. In the general population, the incidence of both melanoma and nonmelanoma skin cancers is increasing. It is estimated that 90% of skin cancers in Canada are directly attributable to UVR exposure, making this cancer largely preventable with the appropriate precautions. A scoping review was conducted on the barriers and facilitators to UVR safety in outdoor workers to elucidate why these precautions are not in use currently. We discuss these results according to the Hierarchy of Controls as a means to outline effective and feasible prevention strategies for outdoor workers. In doing so, this review may be used to inform the design of future workplace interventions for UVR safety in outdoor workers to decrease the risk of skin cancer in this vulnerable population.
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Affiliation(s)
- Erin Maguire
- 1 Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Alison Spurr
- 1 Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
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