Survey Of Beachgoers' Tanning Habits Should Help Interventions To Prevent Skin Cancer

A study published in the November issue of Archives of
Dermatology seeks to determine which beachgoers would benefit
from targeted interventions to reduce skin cancer risk by identifying
sun-protection practices and risk profiles.



In the past 30 years, the Unites States has seen a rapid increase in
the incidence of skin cancer and death due to outdoor exposure to
ultraviolet radiation (UVR). Experts have been instructing people to
engage in practices that reduce the risk of skin cancer such as
limiting time
spent in the sun, using sunscreen and wearing protective clothing.
Author David L. O'Riordan, Ph.D. (University of Queensland, Brisbane,
Australia) and colleagues write that, "Adults and adolescents
are particularly at risk for intense, episodic
sun exposure while on vacation or in 'high-risk' environments such as
beaches."



Studying the relationship between levels of UVR exposure and sun
protection behavior of vacationers, O'Riordan and colleagues conducted
a study at a popular beach in Honolulu,
Hawaii. Between February and March 2004, 88
participants completed two surveys: a sun habits survey before entering
the beach, and an exit survey upon leaving the beach that asked about
sun protection
practices while at the beach. The researchers also tracked UVR levels
every day.



Spending about three hours at the beach, on average, participants were
exposed to levels of UVR
equal to five times the amount required to burn unprotected
fair-skinned people. The researchers also note that 70% of the
participants intended to tan at the beach even though 40% reported
having had a sunburn in the last 2 days. Nearly 23% of
participants indicated that they had been to a tanning salon in the
past 30 days.



O'Riordan and colleagues defined three distinct groups of people based
on sun protection behaviors:


Class 1 consisted of unconcerned and lower risk
individuals. They used the least amount of sunscreen and shade and a
small amount of clothing. The group came to the beach with the
intention of tanning and had the fewest members with a high risk of
skin cancer.
Class 2 consisted of tan seekers, but ones who sunburn
easily. This group used the most sunscreen coverage
and the least clothing coverage. They also reported the most tanning
salon use.
Class 3 consisted of those who were concerned about UVR and
took precautionary measures. This group had the most clothing coverage
and shade use, as well as the smallest proportion of people who
intended to tan.



"Findings from
this study indicate that the beach is an ideal setting to initiate a
program aimed at promoting sun-safe practices while enjoying the many
activities that a day at the beach has to offer," write the authors.
"Collaborative efforts
with key stakeholders such as local government, the tourist industry,
local business and community representatives should examine a broad
range of strategies - not just targeting individual behavior change,
but
also the environment - to promote the reduction of intense UVR
exposures
among beachgoers."



The researchers conclude that: "Specific strategies
should target the subsets of the beach-going population (particularly
those in group 2 - the tan seekers) that intend to tan and sunburn
repeatedly, taking into account their relevant personal attributes and
behavior patterns. A balance should be provided between messages that
focus on the immediate detrimental effects (photoaging, soreness) as
well as the long-term detrimental health effects (skin cancer) of
excessive UVR exposure, all the time balancing the health interests of
the public with the needs of local industry."



Sherry L.
Pagoto, Ph.D., and Joel Hillhouse, Ph.D. (University of
Massachusetts Medical School, Worcester, Mass.) write in an
accompanying editorial that this taxonomy of tanning subtypes should
improve our
ability to choose appropriate health interventions. They write:



"The advantages of the development of a tanning
typology will not be fully realized until brief assessments that can
accurately classify patients are developed and empirically verified. We
believe that the latent class analysis used by O'Riordan et al to
identify and define their subtypes is an important step in this
process. Such assessments, together with messages tailored to each
subtype, will give clinicians a way to identify those patients in
greatest need as well as the most effective messages to deliver to
specific patients. Given the time constraints of the typical
patient-clinician interaction, such systems may very well maximize the
efficiency of delivering UV safety information. Public health skin
cancer prevention programs may also benefit from the improved accuracy
of risk identification as well as the ability to tailor messages to
various tanning subtypes, perhaps using interactive online intervention
programs."



A Day at the Beach While on Tropical Vacation: Sun Protection
Practices in a High-Risk Setting for UV Radiation Exposure

David L. O'Riordan; Alana D. Steffen; Kevin B. Lunde; Peter
Gies

Archives of Dermatology (2008). 144[11]:
pp. 1449 - 1455.

Click
Here to View Abstract



Written by: Peter M Crosta