Sun Exposure and Sun Protection Habits Among High-school Adolescents in Porto Alegre, Brazil¶

Who Are the Nonusers of Sunscreen, and What Are Their Reasons? Development of a New Item Set

Sunscreen use is an important aspect of sun protective behavior. Previous studies revealed deficits in sunscreen use. Our aim was to quantify sunscreen use in a nationwide representative study in Germany as well as to develop and test an item battery on reasons for none use of sunscreen. We analyzed data of the National Cancer Aid Monitoring (NCAM; wave 4; n = 3000, aged 14-45). To describe those who only use sunscreen rarely or never, we used chi² statistics and logistic regression analysis. In addition, we utilized a newly developed item battery on barriers to sunscreen use. Here, we used Cronbach's alpha to investigate reliability. In total, 20.7% reported using sunscreen rarely or never. Infrequent or none use of sunscreen was associated with male sex, immigrant background, none or rare sunbathing in summer, and current or past use of sunbeds. Participants with higher skin cancer risk (e.g., pale skin) were less likely to use sunscreen infrequently or never. The major reasons for not using sunscreen were inconvenience and no perceived need for applying sunscreen. Overall, internal consistency of the item battery on potential barriers to sunscreen use was very good (Cronbach's alpha = 0.865). We found deficits in sunscreen use especially in sunbed users, men, and individuals with immigrant background. Our results give important implications for future prevention and health promotion campaigns on sunscreen use.

Attractiveness as a motive for tanning: Results of representative nationwide survey in Germany

BACKGROUND

In previous research, enhancing attractiveness is reported to be an important aspect of tanning motivation. Our aim was to analyze attractiveness as a reason for tanning in a large representative sample in relation to sociodemographic characteristics, perceived risks of ultraviolet radiation (UVR), and exposure to natural and artificial UVR.

METHODS

We analyzed data from 3000 participants (14-45 years) in the German representative National Cancer Aid Monitoring (wave 3). Attractiveness was measured using the General Attractiveness Subscale of the Physical Appearance Reasons for Tanning Scale. Associations were analyzed using chi-square tests and logistic regression analyses.

RESULTS

Attractiveness played a larger role for participants aged 18-35, those with an immigrant background, medium educational level, and not in a relationship. Significant associations were also identified with a low risk perception of UVR. For sunbathing, the highest OR (9.96, P < .001) was found for high scores on General Attractiveness Subscale, whereas risk perception of UVR was not related to sunbathing in multivariate analyses. For sunbed use, risk perception also only played a minor role as a preventing factor, while higher associations could be identified for age (OR_{18-25 years}  = 8.21, P < .001) and attractiveness (OR = 3.55, P < .001).

CONCLUSION

Our study showed that people who tan to enhance their attractiveness are more likely to perceive fewer risks of UVR and to show higher UVR exposure behavior and are therefore at greater risk of developing skin cancer. Measures for prevention of UVR-related skin damage should therefore focus more on reducing the positive perception of a tanned appearance instead of only emphasizing the risks of UVR.

Assessment of sun-related behaviour, knowledge and attitudes among nursing students

BACKGROUND

As future healthcare professionals, nursing students will play an important role in social training and promoting healthy behaviours including protection against sunlight. However, few studies to date have focused on their knowledge and attitudes regarding sun-related behaviour.

OBJECTIVE

To evaluate the level of knowledge, attitudes and practices about sun protection and skin cancer among nursing students.

METHODS

This cross-sectional study included 200 all year nursing students from University of Vigo, located in the Vigo, Ourense and Pontevedra campus. Participants completed a validated, self-reported questionnaire with 38 questions regarding their demographic characteristics, sun-related behaviour, knowledge and attitudes.

RESULTS

Approximately 87% of students reported experiencing sunburn last summer and 57% stated that they had sunbathed more than 15 days. Participants showed low level of sun protection behaviours, with the exception of using sunscreen (86%) and wearing sunglasses (72.5%). Knowledge about skin cancer and sun protection was considered high (rate of correct responses 87.7%, 6.14 out of 7). Moreover, positive tanning attitudes were high in the sample overall. Nursing students awarded a high value to tanned skin and showed misconceptions about sun exposure.

CONCLUSION

Although most of the students were aware of the side effects of sun exposure, their behaviours and attitudes were unsatisfactory. A high level of knowledge may not be predictive of positive practices and adequate attitudes, even among future healthcare professionals. Further guidance and educational campaigns are utmost important, particularly in a group that will be directly involved in prevention and early diagnosis of skin cancer.

[Behaviors related to sunlight exposure versus protection in a random population sample from 15 Brazilian State capitals and the Federal District, 2002-2003]

This article examines region-specific relations between prevalence of protection against sunlight and socio-demographic and behavioral variables in Brazil. Data were derived from a cross-sectional population-based random sample. Information on sunlight exposure was available for a total of 16,999 individuals 15 years and older. Comparing the North and South of Brazil, crude differences between women and men in the use of "sunscreen" and "protective headwear" were +10.9% (95%CI: 7.1; 14.6) and -11.6% (95%CI: -17.0; -6.3) in the North and +21.3% (95%CI: 17.7; 24.9) and -16.0% (95%CI: -20.2; -12.5) in the South. Adjusted differences by selected variables confirmed that women use more sunscreen protection and less headwear protection as compared to men in both the North and South, but the difference was not homogeneous by region (interaction term p value < 0.05).

Seasonal Erythemal UV Doses in Belo Horizonte, Brazil

The ultraviolet radiation (UVR) emitted by the Sun causes many effects on the biosphere. On human beings they vary from the benefit of vitamin D synthesis to the harm of skin cancer induction. The biological dose depends on the effect, the exposure time to the Sun and the amount of UVR received. In this work we show that the measured incidence of erythemal dose (ED) in Belo Horizonte (19.92 degrees S, 43.94 degrees W, 858 m a.s.l., Brazil) for a cloudless day can vary from 7503 to 2926 J m(-2) in the summer-winter seasonal variation. In addition, supposing a linear relationship between the ED and the geophysical parameters of solar zenith angle cosine (cos(SZA)), column ozone and reflectivity from the ozone monitoring instrument overpass measurements, a model for the forecast of UVR incidence on a monthly-based period is developed. From this an annual ED of 1,451,099 J m(-2) is obtained.

Photoprotection in adolescence

Physical changes and the establishment of personal values are characteristics of adolescence. Despite being well informed regarding sun protection and the skin cancer risks related to sun exposure, teenagers usually make little use of sunscreens and remain out in the sun for long periods. Besides the social appeal and the impression that a nice tan provides a healthy appearance, the tendency to deny long-term risks seems to influence sun exposure behaviors in this life period. Due to the strong relation between skin cancer and sun exposure in childhood and adolescence, it is important to encourage the adoption of photoprotection measures early in life. Adolescents have difficulty accepting guidance through official educational messages, and very few of them follow family recommendations. Celebrities, fashion, and the entertainment industry exert a greater influence on their choices. Thus, it is fundamental to incorporate photoprotection counseling into the medical routine, in an adolescent-driven way. This article reviews peculiarities of sun protection in adolescence and discusses the type of advice to be given to patients in this age group.