[Uses and risks of sunlight on the skin].
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Heliotherapy↗
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Sunbed use in Swedish urban adolescents related to behavioral characteristics.
BACKGROUND: Sunbed use among Swedish adolescents has not been extensively studied, nor has the social learning process associated with it. The purpose of this study was to explore Swedish adolescents' sunbed use in relation to sex, age, smoking, perceived physical attractiveness, attitudes to artificial and natural UV exposure, psychosomatic symptoms, and risk knowledge. METHODS: In the spring of 1993, 60 school classes comprising 1,502 students ages 14-19 were randomly selected to answer a questionnaire concerning sunbed use and sunbathing habits, smoking, perceived physical attractiveness, psychosomatic symptoms, and need for information about and knowledge of the risks of UV exposure. RESULTS: Of 1,252 respondents, 57% had used sunbeds (females 70%, males 44%) > or = four times during the previous year. A marked increase (P < 0.001) in both sunbed use and smoking was detected between the 8th and the 9th grade (at ages 14-15). Sunbed use was also significantly correlated with sex, age, excessive tanning in natural sunlight, and low perceived physical attractiveness. The need for information on risks of high UV exposure was greatest among the best informed students and among students with high UV exposure (sunbed use, excessive tanning in natural sunlight). CONCLUSIONS: It seems doubtful whether further information on UV risks would result in altered behavior among highly exposed students, who seem receptive to information and have good knowledge. For a better understanding of the mechanisms underlying the association between sunbed use, smoking, and self-esteem, more in-depth, qualitative studies are required.
Adolescent↗
Summer sun exposure: knowledge, attitudes, and behaviors of Midwest adolescents.
BACKGROUND: Extensive print, radio, and television coverage about the dangers of sun exposure and benefits of sun protection occurred over the past decade. Illinois teen knowledge and attitudes about sun exposure/protection, sun-exposure/protection behavior, and information sources were determined by a summer telephone survey. METHODS: Telephone interviews with 658 teenagers between ages 11 and 19 included African-American, Asian, Hispanic, Native American, and white teenagers. RESULTS: Teens knew that too much sun was harmful as it caused skin cancer and sunburn. Sunburn was mentioned more often by those with skin types that burned easily and tanned poorly (I,II) (P < 0.001), was better known to girls than to boys (P < 0.001), and was recognized more by those with higher socioeconomic status (P < 0.001) but was not associated with age. Widely held sun exposure attitudes were socializing with friends and feeling better when outdoors. On weekdays, boys averaged 5.3 hr (SD, 1.65 hr) outside compared with 3.9 hr (SD, 0.75 hr) for girls (P < 0.001). Teenage boys were more likely to obtain occupational sun exposure, and girls sunbathed. Subjects with skin types I and II reported an average of 3.3 sunburns in the past year. During unprotected sun exposure, extensive numbers of teens with moderate-risk skin type experienced at least 1 sunburn per year. Indoor tanning use was more prevalent among older girls and those with skin types I and II. Sunscreen use was associated with water recreational activities (swimming, water sports, and going to the beach) by girls slightly more than by boys (P < 0.001). Hat-wearing was more common among boys than among girls. CONCLUSIONS: Teen knowledge that excessive sun exposure causes skin cancer and sunburns and that wearing sunscreens and hats were sun-protective methods did not enable sun protection that prevented burning. This is particularly troublesome because severe sunburns in youth are associated with an increased risk of melanoma. Existing teen sunscreen use could be broadened by educating teens to use adequate quantities of sunscreen prior to daily sun exposure to prevent painful burns. Messages to teens that emphasize the short-term consequence of painful sunburns because of inadequate protection during outdoor occupational and non-water-related recreational exposure would increase the relevance of the message and may enable behavioral change. Parents and physicians need to be included in messages that are directed to teens and to become part of their education. Parents could ensure an adequate sunscreen supply for daily use by the family, encourage teens not to deliberately tan, and serve as role models for the use of protective clothing.
Adolescent↗
Melanoma control in the United States: current status.
Screening and education for melanoma/skin cancer are receiving increasing worldwide attention. In an attempt to improve melanoma control in the United States, where incidence and mortality rates continue to increase, the American Academy of Dermatology (AAD) has provided free skin cancer screenings to more than 600,000 Americans and prevention messages to millions more. This chapter reviews and summarizes ongoing melanoma control activities in the United States, including prevention, education, and early detection/screening. We also address outcome measures in melanoma control and suggest that the unique external and visible nature of skin cancer blurs the distinction between screening and education. Measuring and evaluating the benefits of international melanoma control activities presents many challenging tasks. Future collaborative work must include complementary strategies in melanoma/skin cancer prevention, education, and screening to combat the worldwide increase in melanoma incidence and mortality.
Adult↗
Quests for cures: a history of tourism for climate and health.
This paper creates a framework for the study of the history of tourism for climate and health. It traces the ways in which people have both moved away from detrimental health conditions and towards places thought to provide climatic cures. It brings to light the complex issues that have affected the course of the tourist trade. In this way it helps to explain that the modern geographical distribution of the highly fashionable resort areas of the world owe a great deal to past and present interpretations of the Hippocratic Corpus.
Americas↗
Predictors of sunbathing and sunscreen use in college undergraduates.
Sunbathing and sunscreen use, as well as related intentions, attitudes, beliefs, and knowledge, were assessed in 90 Southern Appalachian undergraduates. A large majority (75%) reported sunbathing, with more than half reporting sun lamp use. A slight majority (56.7%) reported some use of sunscreen. Subjects reporting an intention to tan spent more time sunbathing, both outside and under a sun lamp. Individuals reporting a sun protection intention had lighter tans and spent less time sunbathing. Sunbathing was predicted by perceptions of sunbathing as relaxing, while sun lamp use was predicted by more positive views of suntans. Sunscreen use was predicted by more positive sun protection attitudes and less negative sunscreen attitudes.
Adult↗
Sun protection behaviors and stages of change for the primary prevention of skin cancers among beachgoers in southeastern New England.
Sun exposure is the most important avoidable cause of skin cancers. We report characteristics of a representative sample (N = 2,324) of beachgoers in Southeastern New England during the summer of 1995. This sample was not employing adequate sun protection behaviors (83% did not often avoid the sun during midday and only 45% often used sunscreen). Important demographic and skin cancer risk factor differences in sun protective behaviors and stages of change for sun protection were found, especially differences based on age, gender, and degree of sun sensitivity. Consistent with previous research, increased age, female gender, and greater sun sensitivity were each independently associated with more sun protective behaviors. These findings underscore the need for interventions targeting high-risk populations, such as those receiving high-intensity sun exposures at the beach.
Adolescent↗
High prevalence of chronic venous disease in hospital employees.
OBJECTIVES: Chronic venous disease (CVD), which comprises primary/idiopathic abnormalities of the venous system, and secondary sequels after deep venous thrombosis are major health issues in Western countries. The present study was conducted to prove the hypothesis that the development of CVD might be triggered by exogenous, occupational risk factors. METHODS: We determined the prevalence and social relationship of CVD in a wide cross-section of hospital employees (n = 209; medical doctors and nurses, medical technician assistants, secretaries, scientific staff, cleaners and utility workers) without predocumented CVD. Prevalence, known endogenous risk factors for CVD and occupational and environmental risk factors (family history of venous disease, history of deep venous thrombosis, current oral contraceptive therapy, obesity, regular participation in sports or frequent use of saunas or sun-baths, and long periods of standing during work) were investigated. The restriction in quality of life due to symptoms of CVD was also evaluated. CVD was classified according to the CEAP criteria. RESULTS: CVD was present in a total of 70 employees (34%), predominantly in women. Standing at work was a predisposing factor. We found the highest prevalence of CVD in utility workers and cleaners and the lowest prevalence in medical technician assistants, secretaries and scientific staff. CONCLUSION: The study demonstrated that within a representative cross-section of hospital employees in a University hospital the prevalence of CVD was highest in women, especially in those working in a standing position or under conditions of high temperature and humidity. The results warrant regular evaluation of risk factors with subsequent primary prophylaxis of CVD.
Adult↗
[Behavior of sunbed users in Switzerland].
OBJECTIVES: A constant rise in the number of skin cancer cases has been observed during the last few years. An important reason for this trend is that exposure of the population to UV radiation is higher. Although natural UV radiation is the major source, exposure due to use of sunbeds must be considered from the point of view of prevention. METHODS: 151 sunbed users in Bern and Basel were questioned on their reasons for visiting a solarium, their behaviour when using a sunbed and their awareness of risks resulting from UV radiation. RESULTS: It was shown that young women are the most frequent sunbed users. Also, sunbeds are often used regularly, not only for cosmetic reasons but also from a desire for relaxing and well-being in the warmth and light. Although most of the persons questioned were aware of certain health risks resulting from UV radiation, this knowledge hardly influenced their behaviour. Thus, more than half the people questioned use sunbeds longer and more often than advised by international recommendations. CONCLUSIONS: In view of a continuing increase in the number of skin cancer cases the improvement of preventive strategies for sunbed users is of major importance. Another urgent requirement is informing the public and increasing the general awareness of possible adverse health effects caused by UV radiation.
Adolescent↗
[Sun protection during holidays].
Ultraviolet radiation is causally involved in induction of skin cancer, premature skin aging and photodermatoses. The longing of our western society for a "healthy tanning" as well as the unbroken trend to spend the holidays in sunny regions lead to the fact that human skin is increasingly exposed to ultraviolet radiation and its detrimental effects. Because of the socio-political importance of the vacation period as the "most beautiful and most important time of the year", effective prevention of these unwanted UV effects has an enormous importance to the general population. In this article the most important methods for effective sun protection are critically discussed.
Adult↗
[Could balneology and medical climatology have more than historic importance in the therapy of chronic diseases?].
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Balneology↗
Prevalence and correlates of sun protection and skin self-examination practices among cutaneous malignant melanoma survivors.
Little is known about the level of engagement and correlates of sun protection and skin self-exam among individuals diagnosed with melanoma. Participants (N = 229) completed measures of skin self-exam and sun protection practice and knowledge and attitudes. Approximately eighty-four percent of patients reported engaging in skin self-examination at least once in the past year. Engagement in sun protection practices was moderate. Self-exam practice was associated with gender, physician recommendation about self-exam, and perceived benefits and barriers of self-exam. Sun protection was associated with gender, age, medical status and health care access, physician recommendation, knowledge, and a number of psychological factors. Behavioral interventions to improve skin surveillance and sun protection may benefit from an emphasis on physician education regarding self-exam and sun protection, education regarding the efficacy of sunscreen and the risks associated with sunbathing, reducing perceived barriers to self-exam and sun protection, and reducing reliance on social influences on sun protection practices.
Adult↗
Basal cell carcinoma arising in a split skin graft.
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Basal Cell Carcinoma↗
Recreational use of Psoralens to fortify skin tanning.
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Adult↗
Exposure to the sun and sunbeds and the risk of cutaneous melanoma in the UK: a case-control study.
Migration, latitude and case-control studies have clearly established a link between melanoma and sun exposure. This case-control study of melanoma was set up to examine the role of sun exposure and sunbeds in the pathogenesis of melanoma in the United Kingdom (UK), a country with low levels of ultraviolet radiation. The study included 413 cases and 416 controls. More than 10 severe sunburns compared with less than 10 sunburns was associated with an Odds Ratio (OR) of 1.98 (95% Confidence Interval (CI) 1.02-3.86) (P=0.04) when adjusted for age, gender and skin type. Sunburns before the age of 15 years were not associated with melanoma once adjustments for age, gender and skin were made. 31% of women and 16% of the men had used sunbeds. Sunbed users were younger than non-users (40 years versus 51 years, P<0.0001). Ever use of sunbeds gave an adjusted OR of 1.19 (95% CI 0.84-1.68) (P=0.33). The risk of melanoma did not increase with increasing hours or years of sunbed exposure. The risk associated with sunbed use was only significant for young individuals with fair skin for whom there was a significant OR of 2.66 (95% CI 1.66-6.09) (P=0.02) after adjustment for the sun exposure variables. Outdoor occupation and residence in hot countries were not associated with an increased risk of melanoma. The only significant associations in this study were with 10 or more sunburns and the use of a sunbed in young subjects with fair skin. Sunbed use is now becoming more prevalent in Caucasian populations and the results of this study suggest that sunbed usage may moderately affect individuals with sun-sensitive skin types. However, the magnitude of melanoma risk in association with natural and artificial sun exposure is small compared with phenotypic risk factors such as skin type and naevus counts. However, it is possible that the mean lag time of 7 years between exposure to sunbed and melanoma in this study may have led to an under-estimation of the long-term melanoma risk.
Adolescent↗
The importance of assessing the readiness to change sun-protection behaviours: a population-based study.
The purpose of this study was to collect information that may be valuable in developing successful skin cancer prevention programmes. A random sample of 6000 adolescents and 4000 adults answered a questionnaire about sun-related issues. The response rate was 68%. Using sunscreen was the main sun-protection behaviour measured. Approximately 40% of adolescents and 30% of adults did not use any sun-protection strategy other than sunscreen. Readiness to change sun-protection behaviour was measured by assessing the stages of change modified from the Transtheoretical Model (TTM). Half of the participants were in the precontemplation stage of giving up sunbathing and avoiding the sun between 11 a.m. and 3 p.m. Attitude had the strongest association with being in the action/maintenance stages for all sun protection behaviours. A large proportion of participants were not ready to change their sun-protection behaviours, which highlights the importance of including motivational strategies when attempting to change sun-protection behaviours.
Adolescent↗