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Measurements of the UVR Protection Provided by Hats Used at School
Abstract
The importance of protection against solar ultraviolet radiation (UVR) in childhood has lead to SunSmart policies at Australian schools, in particular primary schools, where children are encouraged and in many cases required to wear hats at school. Hat styles change regularly and the UVR protection provided by some of the hat types currently used and recommended for sun protection by the various Australian state cancer councils had not been previously evaluated. The UVR protection of the hats was measured using UVR sensitive polysulphone film badges attached to different facial sites on rotating headforms. The sun protection type hats included in this study were broad-brimmed hats, "bucket hats" and legionnaires hats. Baseball caps, which are very popular, were also included. The broad-brimmed hats and bucket hats provided the most UVR protection for the six different sites about the face and head. Legionnaires hats also provided satisfactory UVR protection, but the caps did not provide UVR protection to many of the facial sites. The highest measured UVR protection factors for facial sites other than the forehead were 8 to 10, indicating that, while some hats can be effective, they need to be used in combination with other forms of UVR protection.
... Accordingly, sun protective hat wearing is an important skin cancer primary prevention strategy which also provides increased protection against ocular UVR damage. A suitable sun protective hat provides complete protection for the scalp and an effective barrier against most direct UVR reaching the face, neck, and ears [4]. is protective coverage is more certain and sustained than that provided by sunscreen; however, sites other than the scalp remain subject to reflected UVR and may require supplementary protection. ...
... e SSAP is based on meeting 12 criteria. In summary and in addition to the two-student hat wearing criteria (1 and 2), these include that the school has to have a sun protection policy (3) about which all of the school community must be informed (4). e wearing of sun protective clothing (5) and broad spectrum sunscreen of at least SPF30 (6) is encouraged. ...
... Wearing. When outdoors during breaks, lunchtimes, excursions, or similar activities, students are required to wear a suitably sun protective hat that provides protection for the face, neck, ears, and eyes [4]. Hats were categorised and allocated a protective score based on SSAP criteria. ...
Background:
The head and neck are exposed to the highest solar ultraviolet radiation levels and experience a disproportionate skin cancer burden. Sun protective hats can provide an effective barrier. Since early life exposure contributes to skin cancer risk, the World Health Organisation recommends prevention programmes in schools. The New Zealand SunSmart Schools programme is one example. Two criteria concern wearing hat outdoors: students are required to wear a hat providing protection for the face, neck, and ears; if a suitable hat is not worn, students must play in shaded areas.
Objectives:
To investigate two internationally relevant interventions as plausible statistical predictors of hat policy strength: (1) skin cancer primary prevention programme membership, (2) use of a professional policy drafting service.
Methods:
Of 1,242 (62%) eligible schools participating in a 2017 national survey, 1,137 reported a sun protection policy and 842 were available for categorising and allocating protective scores (0-3).
Results:
In multinomial (polytomous) logistic regression models of cross-sectional association, adjusted for school characteristics, SunSmart accredited schools and those utilising a policy drafting service were independently significantly more likely than their counterparts to obtain the most protective compared to the least protective hat score (respectively, RRR 6.48: 95% CI 3.66, 11.47; 7.47: 3.67, and 15.20). For the dichotomous shade measure, similar associations were found using adjusted logistic regression (OR 3.28: 95% CI 2.11, 5.09; 2.70: 1.54, 4.74).
Conclusions:
Our findings provide support for two plausible interventions that could potentially be implemented beneficially in primary schools via established infrastructure in any jurisdiction, internationally.
... UVR overexposure can also lead to eye conditions, such as cataracts and pterygium (9,19). Research also suggests that significant UVR exposure occurs in a person's younger years, before adulthood, which often leads to long term negative health effects (1)(2)(3)8,20,21). Despite the exceedingly high prevalence of Australians living with a type of skin cancer, the mortality rate after a positive diagnosis remains relatively low (11). ...
... The requirement for the increase of UVR exposure reduction behaviours in adolescent and young adult sports competitors have been reported (7). For the tennis enthusiast, UVR exposure minimisation strategies such as wearing a hat, and clothing covering as much of the body as conditions permit alongside important UVR protection, such as applying sunscreen (21), and playing during times of lower UVR intensities before 10 am and after 4 pm have been recommended (30), though other logistical constraints can render the latter as being an impossibility. ...
... Australia's positive sun safe commitment and provide an example of organisational responsibility (3). These hats, mandated by the uniform policy (44), provide satisfactory to very good UVR protection, particularly to the head/scalp, ears, neck (21,56), and in the case of broad brim hats, the face (21). The players routinely wore caps, visors or no hat at all, which are considered to provide less UVR protection (3,21). ...
Sport is an integral and enduring part of many societies, such as Australia. Participation in outdoor sports, such as tennis, comes with a very real risk of dangerous solar ultraviolet exposure which can result in erythema (sunburn), serious conditions such as skin cancer, including melanoma, and eye conditions such as cataracts and pterygium. This study remotely assesses the effective ultraviolet exposures in response to the increased sun safety awareness at a major summertime tennis tournament in Australia. The assessment only uses publicly accessible data and information. It was found that tournament organisers have effectively adopted sun safe protocols into the uniform policy that the court officials (judges and ball kids) are mandated to follow. The combination of sun‐participant geometry and the photoprotection provided by uniforms significantly reduced the ambient ultraviolet exposure, which was recorded to be as high as 9.9 SED/hr, to just 1.0 SED/hr and 0.5 SED/hr for ball kids and judges respectively, compared to up to 2.0 SED/hr for players. Even though caution is needed against complacency with sun safety, with the need for the court officials and the players to still apply sunscreen, the court officials provided persistent visual role modelling of sun safe behaviours. This article is protected by copyright. All rights reserved.
... Hats physically cover the scalp; however, the amount of shade provided to the face and neck depends on hat style (e.g. broad-brim/visor/bucket), and how it is positioned on the head (24,25). Unlike sunscreen, clothing and hats provide a physical barrier between the skin and UVR. ...
... "girls may wear navy blue shorts or pleated skirt/skort") we analyzed the first option listed. Total BSA calculations excluded the head since shade provided by school hats varies according to the size and fit of each hat and the angle at which it is positioned on the head (25). Thus, the maximum BSA assessed was 93.4% ( Fig. 1 mean and standard deviation (SD) were used to describe the BSA covered by school uniforms. ...
... Hats described in the NQ primary school uniform guidelines we evaluated included broad-brim, bucket and legionnaire styles. Bucket-style hats with the brim sloped downward, close to the face and ears, provide similar sun protection to broad-brimmed hats but are more popular among school students (25). The way a hat is positioned on the head, how well it fits and the size of the brim determine how much skin on the head and neck is shaded from the sun since hats intercept direct UV light and do not physically cover the face or neck (25,52,53). ...
FULL TEXT http://onlinelibrary.wiley.com/journal/10.1111/(ISSN)1751-1097/earlyview
Childhood sun-exposure is linked to excessive pigmented mole development and melanoma risk. Clothing provides a physical barrier, protecting skin from ultraviolet radiation (UVR). Extending sleeves to elbow-length and shorts to knee-length has been shown to significantly reduce mole acquisition in pre-schoolers from tropical Queensland. We used publicly-available uniform images and guidelines from primary schools in Townsville (latitude 19.25°S, n=43 schools), Cairns (16.87°S, n=46), and the Atherton Tablelands (17.26°S, n=23) in tropical Australia to objectively determine the body surface proportion covered by regulation school uniforms. Uniforms of non-government, large (≥800 students), urban, educationally-advantaged schools with comprehensive sun-protection policies covered more skin than those of government schools (63.2% Vs 62.0%; p<0.001), smaller schools (63.4% Vs 62.3%; p=0.009), rural (62.7% Vs 61.9%; p=0.002), and educationally-disadvantaged schools (62.8% Vs 62.3%; p<0.001) with under-developed sun-protection policies (62.8% Vs 62.2%; p=0.002). Overall, SunSmart and non-SunSmart school uniforms covered identical body surface proportions (62.4%, p=0.084). Although wearing regulation school uniforms is mandatory at most Australian primary schools, this opportunity to improve children's sun-protection is largely over-looked. Recent evidence suggests that even encouraging minor alterations to school uniforms (e.g. slightly longer sleeves/dresses/skirts/shorts) to increase skin coverage may reduce mole acquisition and melanoma risk, especially in high-risk populations.This article is protected by copyright. All rights reserved.
... In various dosimetry studies, researchers have sought to improve the precision of human solar UV exposure assessment. These techniques included various inclined planes to simulate body posture2324252627282930313233 as well as stationary or rotating manikins343536373839404142434445464748495051 . Nevertheless, it is widely agreed that there is a need for more accurate quantification of UV radiation at representative anatomical sites of interest. ...
... In addition to experimental studies with inclined planes, a considerable amount of work have been performed by using manikins, especially upper body units. The daily UV exposure ratio to the forehead in summer in this study is higher than that measured by Gies [40,50] , Holman CD [47] , Cheese man [42] , and Airey [36] . Our data are close to those measured by Diffey [51] , but is lower than that reported by Wong et al. [41] . ...
... Our data are close to those measured by Diffey [51] , but is lower than that reported by Wong et al. [41] . The daily UV exposure ratio at the cheek in summer in this study is close to that of Gies [40] , but lower than that of Holman [47] , Diffey and Cheeseman [42, 51] , Airey [36] , and Wong et al. [41] . These discrepancies may be due to the differences in the geographical positions and measurement timings. ...
Solar ultraviolet (UV) radiation is an important environmental factor that affects human health. The understanding of diurnal variations of UV radiation at anatomical sites may be helpful in developing ways to protect humans from the harmful effects of UV radiation.
In order to characterize the diurnal variations, the UV exposure values were measured at 30 min intervals by using Solar-UV Sensors and a rotating manikin in Shenyang city of China (41 degrees 51'N, 123 degrees 27'E). Measurement data for four representative days (in each of the four seasons respectively) were analyzed.
The diurnal variations in solar UV radiation at the shoulder, the forehead and the chest were similar to those associated with a horizontal control measurement. However, the diurnal variations at the eye and the cheek exhibited bimodal distributions with two peaks in spring, summer and autumn, and a unimodal distribution in winter. The UV exposure peaks at the eye and the cheek were measured at solar elevation angles (SEA) of about 30 degrees and 40 degrees , respectively.
The protection of some anatomical sites such as the eye from high UV exposure should not be focused solely on the periods before and after noon, especially in the places and seasons with high SEA.
... Polysulphone dosimeters have been employed widely in the quantification of erythemal UV (1) and UVB (280-320 nm) exposures in a range of environments and during different human activities. Examples of these are the investigation of the exposures to outdoor workers (2,3), school children (4,5), exposures underwater (6), in aircraft (7), in a welding environment (8), during outdoor activities (9) and evaluation of the protection provided by hats (10,11), trees (12), stockings (13) and clothing (14). ...
... Horizontal plane. A series of glass filtered solar UV spectra for a horizontal plane were undertaken in late autumn at each of 10 respectively. The glass was placed over the input optics of a calibrated UV spectroradiometer employed to scan the solar UV spectrum between 280 and 400 nm in 0.5 nm increments. ...
... The same set-up was employed for the laminated glass. The dosimeters for both sets of glass were exposed to solar UV between 8.45 EST to 10 ...
The aims of this paper were to investigate how glass-filtered UV irradiances vary with glass thickness, lamination of the glass and the effect of solar zenith angle (SZA), and to measure the glass-filtered UV exposures to different receiving planes with a newly developed UVA dosimeter. Spectroradiometric and dosimetric techniques were employed in the experimental approach. The percentage of the glass-filtered solar UV compared to the unfiltered UV ranged from 59% to 70% and was influenced to a small extent by the glass thickness and the SZA. The laminated glass transmitted 11 to 12% and the windscreen glass transmitted 2.5-2.6%. The influence of the SZA was less for the thicker glass than it was for the thinner glass. The change in transmission was less than 14% for the SZA between 48 degrees and 71 degrees. There was negligible influence due to the SZA on the glass-transmitted UV of the laminated and windscreen glass. The influence of the glass thickness in the range of 2-6 mm on the percentage transmission was less than 16%. The influences of the glass thickness and the SZA on the glass-transmitted UV have been incorporated in the use of a UVA dosimeter for the glass-transmitted UV exposures. The UVA dosimeter was employed in the field to measure the glass-filtered UV exposures to different receiving planes. The UVA dosimeter reported has the potential for personal solar UVA exposure measurements.
... Sun exposure varies based on factors like solar zenith angle and season (Backes) [11]. Areas such as the forehead and nose receive the highest levels of radiation, followed by the lips [11,13]. Consequently, protective measures like wearing hats, sunscreen-infused clothing, lip balms with sunscreen, and regular sunscreen use are recommended [11][12][13][14]. ...
... Areas such as the forehead and nose receive the highest levels of radiation, followed by the lips [11,13]. Consequently, protective measures like wearing hats, sunscreen-infused clothing, lip balms with sunscreen, and regular sunscreen use are recommended [11][12][13][14]. ...
... According to these studies, it can be expected that wearing a hijab in hot environments can increase heat strain by interfering with convective and evaporative heat loss from the head, but this has not been scientifically verified. It might be advantageous for body temperature regulation by blocking radiant heat by using a hat or a parasol under the sun's radiation (Gies et al., 2006), but there are very rare studies on the thermo-physiological effects of wearing casual hijabs with different materials in hot environments, without strong radiation from the sun. Therefore, the present study aimed to explore the effects of hijab materials on thermophysiological responses and subjective perception of wearers during rest and exercise in hot-dry (HD) and warm-humid (WH) environments. ...
... Given that prolonged exposure to sunlight is associated with increased skin aging and heightened susceptibility to skin cancer, the adoption of hijabs could potentially serve as a protective measure for the skin. Several studies have reported the merits of employing summer hats for shielding against UV rays (Backes et al., 2018;Gies et al., 2006). While the current study scrutinized the impact of hijab materials in two hot environments, future investigations encompassing diverse hijab styles, extended exposure durations, and intense solar radiation are necessary. ...
Hijabs are predominantly worn in hot environments, but very rare studies on the thermo-physiological effects of wearing hijabs are found. We investigated the effects of wearing rayon and polyester hijabs on wearers’ physiological and subjective responses in warm-humid and hot-dry environments. Eight females (25.0 ± 2.3 y in age, 157.7 ± 4.1 cm in height, and 50.8 ± 7.5 kg in weight) participated in three conditions (No hijab, rayon hijab, and polyester hijab condition) during exercise in two thermal environments: a warm-humid (30 °C and 70%RH) and a hot-dry environment (36 °C and 30%RH), which generated an identical wet-bulb globe temperature at 27 °C. The results showed that no differences in rectal temperature were found among the three clothing conditions or the two environments, whereas auditory canal temperature was higher in the hot-dry than in the warm-humid environment ( P < 0.05) with no differences between the polyester and rayon hijab conditions. Mean skin temperature and neck temperature were higher for the polyester condition than for the rayon condition in the warm-humid environment ( P < 0.05). Sweat rate was greater for the polyester hijab condition than for the no hijab condition in the warm-humid environment ( P = 0.049). Heart rate was greater for the polyester hijab condition than for the other two conditions in the warm-humid environment ( P < 0.05). Subjects felt more thermally uncomfortable when wearing the polyester hijab than the rayon hijab in the warm-humid environment. Greater thermal burden of the polyester hijab when compared to the rayon hijab was marked in the warm-humid environment, not in the hot-dry environment.
... The solar exposure varies depending on solar zenith angle and season (Backes) [11]. The nose and forehead receive the highest radiation followed by the oral region [11,13]. Thus, protection against UV exposure such as hats, protective clothes, lipstick with sunscreen, and sunscreen is recommended [11][12][13][14]. ...
... The nose and forehead receive the highest radiation followed by the oral region [11,13]. Thus, protection against UV exposure such as hats, protective clothes, lipstick with sunscreen, and sunscreen is recommended [11][12][13][14]. ...
... 14 The few previously published studies estimating the UVR doses received by the head used individual dosimetric measurements on manikin head forms, and reported high exposure for several facial zones, with or without hat protection. 15,16 Dosimetric measurements are costly, time-consuming, context-specific, prone to behavioural bias, and, importantly, cannot distinguish direct, diffuse and reflected UVR components reaching the skin. Diffuse UVR has recently been shown to contribute substantially to the total UVR dose received, a fact probably underestimated in current prevention messages. ...
... For most facial skin zones, a wide-brimmed hat is the most effective hat style, in particular during peak summer irradiance.However, its effectiveness depends on the considered skin zone and the sun position. It should be reminded that the relative dose reduction expressed by the PPF does not indicate the amount of UVR reaching the skin or the risk associated with the dose received.Our dose estimates are in line with previous estimates of protection provided by various hats and confirmed overall the greater facial sun protection effectiveness of larger brim sizes as they provide proportionally more facial shading in particular when the sun is high (and the SZA is low).15,16,[28][29][30] During clear-sky conditions, hats with a large frontal brim provide high sun protection for the nose, but negligible protection for the ears, assuming no hair protection in the simulation model. ...
Background/Purpose
Solar ultraviolet radiation (UVR) doses received by individuals are highly influenced by behavioural and environmental factors. This study aimed at quantifying hats’ sun protection effectiveness in various exposure conditions, by predicting UVR exposure doses and their anatomical distributions.
Methods
A well‐defined three‐dimensional head morphology and four hat styles (a cap, a helmet, a middle‐ and a wide‐brimmed hat) were added to a previously published model. Midday (12:00‐14:00) and daily (08:00 ‐ 17:00) seasonal UVR doses were estimated at various facial skin zones, with and without hat‐wear, accounting for each UVR component. Protection effectiveness was calculated by the relative reduction of predicted UVR dose, expressed as a predictive protection factor (PPF).
Results
The unprotected entire face received 2.5 times higher UVR doses during a summer midday compared to a winter midday (3.3 vs. 1.3 SED) with highest doses received at the nose (6.1 SED). During a cloudless summer day, the lowest mean UVR dose is received by the entire face protected by a wide‐brimmed hat (1.7 SED). No hat reached 100% protection at any facial skin zone (PPFmax: 76%). Hats’ sun protection effectiveness varied highly with environmental conditions and were mainly limited by the high contribution of diffuse UVR, irrespective of hat style. Larger brim sizes afforded greater facial protection than smaller brim sizes except around midday when the sun position is high.
Conclusion
Consideration of diffuse and reflected UVR in sun educational messages could improve sun protection effectiveness.
This article is protected by copyright. All rights reserved.
... The brim of a hat does not necessarily cover the face and neck, but instead provides a barrier preventing UVR from reaching those sites. The level of protection depends on the hat style, with the brim of the most protective styles (broadbrim, bucket and legionnaire) offering more protection than the brim of less protective styles (caps and visors) (11). ...
... indirect coverage ¼ ðsite UVR protection factor (UPF)= direct coverage UPFÞ Â site BSA where the UPF represents the ratio of UVR with and without the hat (a higher UPF means that less UVR reaches the skin), and the direct coverage UPF represents the UPF expected in clothing items providing direct coverage. Site UPFs for each hat style (broadbrim, bucket, legionnaire, cap and visor) were obtained from Gies et al. (11). A direct coverage UPF of 30 was selected because most clothing fabrics have a UPF at or above this level (4). ...
Clothing modifies ultraviolet radiation exposure from the sun, and has an impact on skin cancer risk and the endogenous synthesis of vitamin D3 . There is no standardized method available for assessing body surface area covered by clothing, which limits generalizability between study findings. We calculated the body cover provided by 38 clothing items using diagrams of body surface area (BSA), adjusting the values to account for differences in BSA by age. Diagrams displaying each clothing item were developed and incorporated into a coverage assessment procedure (CAP). Five assessors used the CAP and Lund & Browder chart, an existing method for estimating BSA, to calculate the clothing coverage of an image sample of 100 schoolchildren. Values of clothing coverage, inter-rater reliability and assessment time were compared between CAP and Lund & Browder methods. Both methods had excellent inter-rater reliability (>0.90) and returned comparable results, though the CAP method was significantly faster in determining a person's clothing coverage. On balance, the CAP method appears to be a feasible method for calculating clothing coverage. Its use could improve comparability between sun-safety studies and aid in quantifying the health effects of ultraviolet radiation exposure. This article is protected by copyright. All rights reserved.
... The manikin exposure levels presented in Table 1 clearly indicate the benefit of broad-brimmed hats when compared to the unprotected manikin headform. In a similar study conducted by Gies et al. (2006), the protective effectiveness of various hat types used by school children was studied. Gies et al. (2006) showed that broad-brimmed hats were effective at protecting wider regions of the face when compared with caps due to the hat being able to provide more facial shading. ...
... In a similar study conducted by Gies et al. (2006), the protective effectiveness of various hat types used by school children was studied. Gies et al. (2006) showed that broad-brimmed hats were effective at protecting wider regions of the face when compared with caps due to the hat being able to provide more facial shading. The results presented here indicate the expected protective benefit of broad-brimmed hats at reducing facial exposures to a variety of locations. ...
The study examines and compares the protective effectiveness of broad-brimmed hats at reducing the received solar ultraviolet facial exposure when worn by students while playing outdoor sport within a school environment. The preliminary results of a 12 month study program to investigate variation in facial exposure when playing basketball and soccer at a coastal location in South-East Queensland are presented. Facial cheek exposures were shown to be reduced significantly when broad-brimmed hats were used while playing soccer during both clear sky and overcast conditions. Maximum exposure levels received by school children were also shown to be less than those recorded by a rotating manikin headform when playing both basketball and soccer. Additional Keywords Albedo, Erythema, Skin Cancer, UV
... For people, even with perfect use of sunscreen, the recommendation is to combine sunscreen, sun avoidance and protective clothing to maximise UVR protection. [19][20][21][22] In this study, the authors sought to identify one or more nasal protective devices which could be useful in a clinical setting for dogs requiring nasal UVR protection. ...
Background
Protection from solar ultraviolet (UV) radiation is paramount for some dermatological conditions, yet there are no studies assessing UV nose guards for dogs.
Objectives
Compare the ability of three nasal guards to block solar UV radiation (UVR) from the canine nose, using two commercial products and one created by the authors.
Animals
Four fabric model dogs were used in this prospective controlled trial.
Materials and Methods
Each model had a UV dosimeter applied to the dorsal nose and anterior nasal planum. Three models had nose protectors applied: (1) a mesh hood (OutFox Field Guard, OutFox For Dogs); (2) a fabric nose shield (Nose Protector, Dog Nose Protectors); or (3) a basket muzzle with ultraviolet protection factor (UPF) 50+ fabric developed by the authors. The control had no protective device applied. All the models were placed in direct sunlight and measurements taken over nine 2 h time periods. Total cumulative UVR was analysed for each location and type of guard or control.
Results
All guards provided statistically significant UV protection compared to control at all time points (p < 0.001). The basket muzzle with UPF 50+ guard was consistent in protecting the dorsal and anterior nose, blocking 94.2% and 94.3% UVR, respectively. The fabric nose protector blocked 99.2% UVR from the dorsal and 82.9% anterior. The mesh hood blocked 72.5% of UVR dorsal and 71.4% anterior.
Conclusions and Clinical Relevance
Two guards were superior in blocking UVR; however, the choice of UV guard in a clinical setting depends on an individual's disease location and tolerance of the device.
... Sun-protective clothing, especially garments manufactured according to the Australian and New Zealand clothing standard (AS/NZ 4399:1996) with tightly woven fabrics and high ultraviolet protection factor (UPF) ratings (18) provide a physical barrier between the skin and UVR and have been shown to slow the rate of development of MN (19,20). Legionnaire, broad-brim and bucket hats protect the face, neck, and eyes better than caps and visors (21)(22)(23)(24), with bucket hats being the most commonly worn style in north Queensland schools, followed by wide-brim hats (Turner and Harrison, unpublished data). Swimming garments that incorporate longer sleeves and pants present a practical form of sun-protection since, unlike sunscreen, they do not require reapplication (25). ...
Skin cancer is the most common cancer in humans and Australia (particularly in Queensland) has the highest incidence globally. Sunlight is a known skin carcinogen and reflects off water, exacerbating the risk of sunburn. In 1988, the “SunSmart Program” was developed to promote sun-protection to Australian children. Within a decade, it evolved to include a voluntary national accreditation program for schools, known as the SunSmart Schools (SSS) Program. Additionally, in 2008, it became compulsory for primary schoolchildren attending Queensland government-funded schools to wear a shirt during all water-based activities, except when competing. We observed the proportion of student spectators from 41 Townsville (latitude 19.3°S) primary schools (65.9% SSS) wearing hats at inter-school swimming carnivals in 2009–2011 and 2015 and the proportion wearing a shirt. Overall, a median of 30.7% student spectators from each school wore a hat [max 46.2% (2009); min 18% (2015)] and 77.3% wore a shirt [max 95.8% (2009); min 74.5% (2015)], suggesting that hats are under-utilized. Students from non-government (private) schools were twice as likely as students from government schools to wear a hat (41 vs. 18.2% p = 0.003). Neither the hat nor the shirt-wearing behaviors of student spectators were significantly influenced by their school’s size (number of students), educational advantage, sun-protection policy score, or SunSmart status, indicating that other socioeconomic factors, not assessed here, may have influenced the results. Our findings suggest that the mandatory swim-shirt policy introduced in 2008 was very effective, especially initially. However, monitoring and feedback of results to schools may be needed to maintain high levels of compliance in the longer-term. Schoolchildren attending swimming carnivals should not rely on sunscreen or shade alone to protect against direct and reflected-sunlight, and need prompting to put a hat and shirt back on immediately after a race. This responsibility could be delegated to either a parent or a student prefect, if teachers are too busy to encourage and monitor sun-safety compliance among the students in their care.
... Peaked caps are a less than optimal means of protection from UV radiation, and the health workers were concerned that this might undermine messages that encourage sun protection during outdoor work. 6 Given the lack of research on the sun protection practices of farmers and other rural outdoor workers in Victoria, and in Australia more generally, the health workers approached the SunSmart program to help them to conduct a needs assessment to find out what sun protection farmers actually use, in order to assist in the development of suitable skin cancer prevention strategies. ...
Farmers and other rural outdoor workers are a high-risk group for skin cancer. This study aimed to describe the skin cancer prevention knowledge and practices of farmers and other rural outdoor workers in the Wimmera and Gippsland regions of Victoria. In total, 366 farmers and 140 other rural outdoor workers completed questionnaires at agricultural field days. Most respondents believed that they were at risk of developing skin cancer and had high levels of knowledge regarding the issue, yet farmers' prevention practices were less than optimal (particularly in terms of the low percentages reporting usually or always using sunscreen (21 %) and wearing long-sleeved shirts (20%)). A targeted campaign could focus on overcoming the barriers to using sun protection specific to the farming profession (in particular, to encourage farmers and other rural outdoor workers to wear sun protective clothing where it is practical and safe, and to incorporate sunscreen use into their daily routine).
... To protect skin and eyes from UVR, the Cancer Council Australia recommends hats that protect the face, back of the neck, eyes and ears. Broad-brimmed, bucket or legionnaire hats offer the best protection from UV radiation, providing the brim is wide enough (greater than 7.5 cm) [23]. Baseball or peaked caps and sun visors are not recommended as although they offer good protection to the nose they are relatively ineffective at protecting other facial sites such as the ears and posterior neck [24]. ...
Introduction: Few studies have described observed sun-protection behaviours. We aimed to describe the
prevalence of observed sun-protection behaviour of a high-risk population in tropical Queensland engaged in outdoor leisure activity, to act as a baseline for future comparisons and to highlight the need for further work to improve sun-protective behaviours in this high risk population.
Methods: Unobtrusive observations of clothing worn by 457 attendees at the Supercar Championship in
Townsville, Queensland, Australia were conducted in an unshaded area around solar noon, in July 2009. A
descriptive and chi-square analysis was conducted using SPSS.
Results: Caps were the most popular hat choice. Significantly more children (45.1%) than adults (27.1%) wore wide-brimmed/legionnaires/ bucket hats. Many women (35.3%), girls (26.3%), men (24.5%) and boys (18.8%) wore no hat. Significantly more females (34.3%) than males (23.9%) wore no hat.
Significantly more women (17.4%) than men (6.6%) wore full-length/ ¾-sleeves. Short-sleeve shirts were worn by 90% of men and 55% of women. A further 28% of women wore sleeveless/cap-sleeved shirts. These proportions were significantly different. More girls (27.7%) than boys (3%) wore sleeveless/cap-sleeved shirts. More boys (87.9%) than girls (61.1%) wore short-sleeves. Both these proportions were significantly different. Full-length/ ¾-sleeves were equally uncommon among boys (9.1%) and girls (11.1%).
Conclusions: Despite a widespread SunSmart campaign in Australia over the past three decades, observed sun protection behaviour at this event were not consistent with Cancer Council Australia recommendations for personal sun protection.
... Almost all sun-protection policies addressed student hat wearing while outdoors which is commendable. School hats were described as being 'SunSmart' or broad brim, bucket or legionnaire style which are considered to be 'gold standard hats' since they provide better protection to the face, head and neck regions than cap/visor styles [35,36]. Most policies stated a 'no hat, no play' rule for students and specified students without hats were to play in shaded areas. ...
Evaluate the comprehensiveness of primary school sun-protection policies in tropical North Queensland, Australia. Pre-determined
criteria were used to assess publicly available sun-protection policies from primary schools in Townsville (latitude 19.3°S;
n = 43), Cairns (16.9°S; n = 46) and the Atherton Tablelands (17.3°S; n = 23) during 2009–2012. Total scores determined policy comprehensiveness. The relationship between policy score, SunSmart status
and demographic characteristics was explored. At least 96.6% of primary schools sampled had a sun-protection policy. Although
policies of Cancer Council accredited ‘SunSmart’ schools addressed more environmental, curriculum and review-related criteria
than those of ‘non-SunSmart’ schools, the overall median score for both groups was low at 2 from a possible 12 (48.5% of SunSmart
schools [SSSs]: inter-quartile range [IQR = 2.0–9.0] versus 65.9% of non-SSSs: [IQR = 2.0–3.0], P = 0.008). Most policies addressed hat wearing, while criteria related to shade provision at outdoor events, regular policy review
and using the policy to plan outdoor events were poorly addressed. Although most primary schools in skin cancer-prone North
Queensland have written sun-protection policies, the comprehensiveness of these policies could be vastly improved. These schools
may require further support and advice to improve the comprehensive of their policies and incentives to continually implement
them to achieve and maintain exemplary sun-protection compliance.
... GSHs shade the face and neck regions better than cap or visor style hats thereby providing greater photo-protection to these areas (Downs and Parisi, 2006;Gies et al., 2006;Kimlin and Parisi, 1999). Our observations suggest that more students wear a GSH during school-hours in the cooler months than the warmer months (when UVR is higher) which is disappointing and suggests students chose to wear a hat for warmth rather than sun-protection. ...
... The ultraviolet protection factor (UPF) of glass or any other solid filter material can be determined using ink lines scribed onto both sides of the filter plate. The UPF is typically used to rate the protection of clothes, hats, shade cloths etc (Wilson and Parisi 2006;Gies et al. 2006;Toomey et al. 1995). The UPF is the ratio of the UV received by an exposed site (E) to the UV received to the same site with some form of protection in place (E p ): ...
A technique has previously been described for secondary school-aged children to make ultraviolet (UV) dosimeters from highlighter pen ink drawn onto strips of paper. This technique required digital comparison of exposed ink paper strips with unexposed ink paper strips to determine a simple calibration function relating the degree of ink fading to measured levels of UV exposure. In this article, the ink calibration process is discussed in relation to activities that can be performed by primary school-aged children. Further extension of the technique is discussed in relation to UV absorption by various transparent materials, and a simple exercise is explained that could be used by primary and secondary students to measure and calibrate UV exposures using a glass plate dosimeter.
... Chapéus com abas largas e amplas promovem a melhor proteção em relação aos demais modelos. O boné com aba frontal oferece a menor proteção, mas, infelizmente, ´ e o mais usado em função da estética ditada pela moda, principalmente entre os jovens (Gies et al., 2006). ´ Oculos com lentes escuras amplas e de boa qualidade, que impeçam o acesso da RUV ao olho em todas as direções, são essenciais na proteção dos olhos. ...
The ultraviolet radiation (UVR) can benefit and harm human health with effects like vitamin D production and skin cancer incidence, respectively. Therefore, solar exposure has become a Public Health Care (PHC) affair Recent discoveries on the UVR vs. human health relationship have challenged the PHC. ln spite of that, Brazilian actions regarding such amatter are still in the beginning. ln this work, erythemal dose measurements are presented as typical values for one of the densest Brazilian metropolitan areas. Monthly average daily values are 5806 ± 1168 J/m² (1 standard deviation, summer) and 2509 ± 346 J/m² (winter), whereas the solar exposure time Caucasians need in order to get adequate vitamin D concentration is 5 and 10 min., respectively, at noon for sunny days.
... Previous studies have assessed UV exposure at various inclined planes simulating human body posture (9)(10)(11)(12)(13)(14)(15) and with stationary or rotating manikins. (16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26) Human anatomical sites represented on manikins have included the legs, shoulders, chest, cheek, forehead, and eyes, among others. Sasaki et al. (24) and LiWen et al. (25) found that diurnal variations in solar UV radiation at the manikin eye exhibited bimodal distributions. ...
Solar ultraviolet radiation (UVR) promotes pterygium and cataract development in the human eye. When outdoors, people are subject to varying ocular UVR exposure intensity depending on time of day and orientation to the sun. To assess this variability, a manikin eye was exposed to solar UVR at 12 rotation angles relative to the sun with a solar elevation angle (SEA) ranging from 24.6° to 88.2°. At rotation angles of 0°, 30°, and 330°, the diurnal variation of ocular UVR exposure intensity showed a bimodal distribution that peaked at a SEA of about 40°, which was 3 to 4 hr both before and after noon. This timing differed from peak environmental UVR exposure intensity. At the other rotation angles, diurnal variations in ocular UV exposure exhibited unimodal curves, with maximum intensity around noon, the same as for environmental UVR. Thus, the idea that UVR exposure is most intense at midday is true for skin surfaces positioned somewhat horizontally but not for the eyes in a 60° arc with a centerline toward the sun (i.e., ranging 30° clockwise or counter-clockwise from the centerline). Maintaining certain orientations relative to the sun's position (for example, being clockwise or counter-clockwise by 30° from the sun) should effectively reduce ocular UVR exposure, especially at times when the SEA is 40°.
... However, shade structures are known to only partially block UV radiation, depending on location underneath and size of the shade apparatus and the amount of surface reflectance (18). Sun protection from hats depends on how wide the brim is and to what extent the ears, neck, and face are covered (19). The UV protection factor of clothing varies by type of garment, its fabric, weave and color, and number of washings (20). ...
In this commentary, we discuss the skin cancer epidemic in the United States and provide data to indicate that the United States public is not protecting itself from ultraviolet radiation, the primary risk factor for melanoma, and nonmelanoma skin cancer. In our opinion, skin cancer control in this country may be hindered by uncertainty about the effectiveness of sun protection strategies, inconsistent messages about the relative effectiveness of sun protection measures by federal and national organizations, and conventional research approaches that have identified few effective sun protection interventions for adults and targeted individuals for behavior change without considering the environmental context. A policy and research agenda is put forth to remedy the apparent insufficiencies in the current approach to skin cancer prevention in the United States. Cancer Epidemiol Biomarkers Prev; 1-9. ©2012 AACR.
... Baseball caps do not protect the head and face. 16 Wearing a hat with a brim that shades the eyes can reduce UV radiation to the eyes by up to 50%. 17 The brim width on hats should be at least 6 cm and provide the face, neck and ears with plenty of shade. ...
The most important risk factor in the development of skin cancer is exposure to ultraviolet (UV) radiation. Cumulative lifetime UV radiation exposure has been shown to be most important in the pathogenesis of squamous cell carcinoma, whereas intermittent high-dose UV radiation exposure in childhood and adolescence may be more important in the aetiology of basal cell carcinoma and cutaneous malignant melanoma. Using established methodology and best available estimates on UV-related mortality and morbidity, it has been estimated that annually around 1·5 million disability-adjusted life years are lost through excessive exposure to UV radiation. Skin cancer is a significant health problem and its burden is such that it causes the health system more to treat than any other forms of cancer. Prevention is the key action in managing skin cancer at a population level. Investment in prevention programmes such as SunSmart encourages protective behaviours that will reduce the human and financial costs of skin cancer.
... Despite the relationship between increasing exposure to SunSmart advertising and higher likelihood of sun-protection behavior, no direct relationship was found for sunburn. This is not completely unexpected, given there are additional factors that affect the efficacy of sun-protection behaviors in preventing sunburn; for example, correct application and re-application of sunscreen 38,39 or variable ultraviolet-radiation protection of hats 40 and shade. 41 Nonetheless, a cost-benefit analysis of the return on investment in skin cancer control programs was favorable, with an estimated investment of $AUD 0.28 per capita for a national program in Australia estimated to avoid 4300 premature deaths over 20 years and a net saving of $AUD 103 million. ...
The Australian state of Victoria has run a population-based skin cancer prevention program called SunSmart since 1988, incorporating substantial public education efforts and environmental change strategies. Trends over 15 years in behavioral risk factors for skin cancer were examined in a population exposed to the SunSmart program. Whether outcomes were associated with extent of SunSmart television advertising was then assessed.
In nine cross-sectional surveys from 1987 to 2002, 11,589 adults were interviewed by telephone about their sun exposure and sun protection during outdoor activities on summer weekends. Analyses completed in 2007 adjusted for ambient temperature and ultraviolet radiation.
Sun protection and sunburn show substantial general improvement over time, but have stalled in recent years. Use of hats and sunscreens significantly increased over time and peaked during the mid to late 1990s, compared with the pre-SunSmart baseline. The mean proportion of unprotected skin was reduced and was lowest in the summer of 1997-1998. Summer sunburn incidence declined over time and was 9.1% in 2002, almost half baseline (OR=0.53; 95% CI=0.39-0.73). Higher exposure to SunSmart advertising in the 4 weeks before the interview increased: (1) preference for no tan, (2) hat and sunscreen use, and (3) proportion of body surface protected from the sun.
The general improvement in sun-protective behaviors over time highlight that a population's sun-protective behaviors are amenable to change. Population-based prevention programs incorporating substantial television advertising campaigns into the mix of strategies may be highly effective in improving a population's sun-protective behaviors.
Spectroradiometry, radiometry, and dosimetry are employed for the measurement of ultraviolet radiation (UVR) irradiance and non‐ionizing exposure. Different types of UVR dosimeter have been developed for measuring personal and environmental UVR exposures since film dosimetry was pioneered in the 1970s. An important type of dosimeter is the thin film variant, which contains materials that undergo changes in optical absorbance when exposed to UVR. These changes can be measured at a specific wavelength using a spectrophotometer. Thin film dosimeters allow UVR exposure measurements on humans at various body sites during daily activities, as well as on plants, animals, and any sites of interest when utilized in a field environment. This review examines the properties and applications of five types of thin film UVR dosimeter that have different dynamic exposure limits and spectral responses. Polysulphone, with a spectral response approximating the human erythema action spectrum, was one of the first materials employed in thin film form for the measurement of UVR exposures up to 1 day, and up to 6 days with an extended dynamic range filter. Polyphenylene oxide has been characterized and employed for personal UVR exposure measurements up to approximately four summer days and has also been used for long‐term underwater UVR exposures. Phenothiazine and 8‐methoxypsoralen have been reported as suitable for the measurement of longer wavelength UVA exposures. Finally, polyvinyl chloride with an extended dynamic exposure range of over 3 weeks has been shown to have predominantly a spectral response in the UVB and extending up to 340 nm.
Background
Sun exposure in schools can account for a large portion of childhood sun exposure before the age of 20 years, yet legislation in the United States is lacking to properly protect children. Schools serve as a foundational resource to introduce and implement sun‐safe practices in the youth population.
Methods
Federal and state legislation relating to the access of sunscreen, sun‐protective apparel, and shade was reviewed via the website LegiScan.com .
Results
At the time of publication, only 25 states have legislation in place that addresses and allows sunscreen to be used in school, given its classification as an over‐the‐counter medication. No state has implemented legislation allowing sunglasses to be worn in school, and only two states have laws explicitly allowing hats and other sun‐protective apparel at schools. In addition, the provision of shade is addressed in four states.
Conclusions
With a significant portion of sun exposure occurring at schools, state and federal legislation must address sun protection for students, opening the door for expanded access and additional research related to skin cancer prevention.
Objetivo: describir los conocimientos, las prácticas y la prevalencia de uso de medidas de protección adecuadas frente a la radiación ultravioleta (RUV) en una muestra de habitantes de Bogotá D.C., Colombia (2013-2018). Método: estudio de corte transversal a partir de encuestas realizadas por la Secretaría Distrital de Salud (SDS) en diferentes sectores de Bogotá. Se entrevistaron transeúntes de áreas públicas de concentración masiva en las 20 localidades de Bogotá, los cuales fueron incluidos de forma secuencial y por conveniencia. Se estudiaron aspectos sociodemográficos, fenotípicos, antecedente de interés, conocimientos y prácticas relacionadas con la exposición a la RUV. Resultados: se analizaron 8.420 encuestas, donde el 66 % (n: 5.560) eran sujetos de género femenino, con una mediana de edad de 38 años. La mayoría de los encuestados se ubicaron en los estratos socioeconómicos del I al III (95,6 %; n: 8.051). El 27 % declaró una ocupación laboral al aire libre (n: 2.268) y el 50 % reportaron exponerse a la RUV los siete días de la semana (n: 4.255). El 70 % de los participantes (n: 5.870) reconoció que la RUV es un factor de riesgo de cáncer de piel, pero tan sólo el 20,8 % (n: 1.753)reportó prácticas adecuadas de protección. Conclusiones: a pesar del alto nivel de conocimiento frente a los riesgos de la RUV existe un bajo porcentaje de uso de medidas de protección en esta muestra de habitantes de Bogotá. Se deben reforzar las estrategias que conduzcan a incrementar la protección frente a la RUV en este grupo poblacional.
Solar radiation can readily influence the physiology of the scalp skin, the hair follicle, and the physical properties of the hair shaft.
This research presents a novel methodology for deriving the total daily broadband solar UVA (320-400 nm) received by school teachers during their working day from Ozone Monitoring Instrument (OMI) satellite solar noon UVA irradiance measurements for a Queensland sub-tropical site (27.5o S, 152o E). Daily UVA exposures are weighted to the anatomical human cheek (anterior infra-orbital region) for teachers wearing, and not wearing broad-brimmed hats. The method utilizes the OMI UVA irradiance data collected daily at high temporal resolution over 2005 to 2016 to derive the total daily UVA exposure to a horizontal plane. These horizontal plane exposures are scaled by factors to take into account the timing of outdoor activity. The relationship between exposures to a horizontal plane and those to a vertical plane and the protection provided by a broad-brimmed hat were assessed to evaluate the total daily UVA exposures to the cheek for classroom and physical education teaching staff expected to be outside at different periods of the day. The developed method enables the total daily UVA exposure to specific anatomical sites to be evaluated from the satellite solar noon irradiance at locations that do not have access to surface-based instrumentation capable of recording in the solar UVA waveband.
In this study, ocular biologically effective exposure to solar ultraviolet radiation (UVBE) is investigated with six kinds of sun protective measures (spectacle lenses, sunglasses, cap, bonnet, straw hat, and under parasol). Ocular UV exposure measurements were performed on manikins during the summer period in Shenyang city (41.64° N, 123.50° E, 66 m a.s.l.), China. The measurements include the ocular UV exposure of an unprotected eye and the ambient UV as a control concurrently. Based on the relative spectral weighting factors of the International Commission on Non‐Ionizing Radiation Protection (ICNIRP), the ocular biologically effective UV is calculated and compared with the 8‐hour exposure limits of ICNIRP (30J m‐2).
The UV index (UVI) of the measurement days is 0‐8, and the 8‐hour (8:00‐16:00 China Standard Time, CST) cumulated UVBE of the unprotected eye is 452.0 J m‐2. The 8‐hour cumulated UVBE of the eye with spectacle lenses, sunglasses, cap, bonnet, straw hat, and under parasol, are 364.2 J m‐2, 69.1 J m‐2, 51.4 J m‐2, 49.0 J m‐2, 56.8 J m‐2 and 110.2 J m‐2, respectively. Importantly, it should be noted that the eye could be exposed to risk despite protective measures. The 8‐hour cumulated UVBE of the eye with protection is ca 1.6‐15.1 times the exposure limit, respectively. As indicated in the present study, during summer months, high exposure to the sun for more than 30 minutes without eye protection and more than 1‐hour with eye protection is not advisable. The protection measures could effectively reduce the UVBE reaching the eye, yet, there is still a high degree of risk when compared with the ICNIRP 8‐hour exposure limits.
Good sun‐safety practice includes wearing sun‐protective hats that must meet defined photoprotective criteria such as the 2017 Australian/New Zealand standard (AS/NZS 4399:2017). This study investigated the availability of sun‐safe hats during a three‐day cross‐sectional survey in November 2019 by visiting every shop in a single large multi‐store shopping complex in Australia. Hats were categorised according to whether the target customer was an adult or child prior to the assessment of design suitability for sun safety according to the standard. Of the 260 shops in the study shopping centre, 30 (12 %) sold hats. Of the 524 hats examined in the study, 69 % of all commercially available hats for adults and children did not meet the standard. Of the 9 % of hats that had swing tags claiming an Ultraviolet Protection Factor of 50 (UPF‐50), about half were not sun safe. Further research is needed to investigate the possibility of whether sun‐safety hat standards should be given to retailers of hats for display, or whether manufacturers could be required to put warning labels on all hats that do not meet sun‐safety hat standards.
This research has been taken up to develop eco-friendlyKhadi fabric having UV protective action meanwhile concerned with the extraction of dye using Eucalyptus globulus dye at various dyeing concentrations. Optimal results were achieved by dyeing at 90°C-100°Cfor 90 minutes using the pre-mordanting method with different mordants i.e. Punica granatum, Phyllanthus Emblica, Terminalia belliricaandAcacia catechu. The evaluation of dyed samples in terms of ultraviolet radiation ( UPF) and colour fastness to washing, rubbing and sunlight was done. The results of colour fastness to washing and rubbing showed good to very good and colour fastness to light showed good to moderate results. The data, which is obtained, showed that the mordanted samples have high dye uptake with excellent UPF values.
The International Commission on Non-Ionizing Radiation Protection (ICNIRP) produced guidelines on exposure to ultraviolet radiation (UVR) in 2004. The 2004 ICNIRP guidelines list exposure limits for all of the different wavelengths of UVR that provide protection for both the skin and the eyes from acute effects of exposure. There are now numerous countries around the world that have in place requirements regarding basic legal requirements for occupational safety and health in workplaces and require the employer to do an assessment of risks in the workplace and design preventative measures and procedures. Numerous countries around the world have had existing sunscreen standards for many years. Australia introduced the world's first standard on sun-protective clothing in 1996. This standard covers both recreational wear and clothing for occupational purposes. Solaria have been a worldwide health issue for a considerable time, as shown by the evidence from numerous research studies that link solaria to melanoma induction in solaria users.
This chapter deals with programs that are in place to influence behavior: to alert people to actual dangers of non-ionizing radiation (NIR) and appropriate measures that can be taken to reduce the chance of injury or illness. These programs can in the form of formal or informal training, both for occupational groups and the general public. The chapter is in three parts: ultraviolet (UV) radiation, laser safety, and radio frequency (RF). In the case of UV, the concern is as much the general public as with the occupational group most at risk: the outdoor worker. Hazards arising from the use of lasers present inherent risks to the safety of operators and bystanders. The process of risk assessments is the first step in developing a preventative surveillance program to assist in maintaining a safe working environment where lasers are used. One of the cornerstones of this programs designed to monitor safety is accident and incident reporting.
Skin cancer is the most common cancer in humans and Australia (particularly in Queensland) has the highest incidence globally. Sunlight is a known skin carcinogen and reflects off water, exacerbating the risk of sunburn. In 1988, the “SunSmart Program” was developed to promote sun-protection to Australian children. Within a decade, it evolved to include a voluntary national accreditation program for schools, known as the SunSmart Schools (SSS) Program. Additionally, in 2008, it became compulsory for primary schoolchildren attending Queensland government-funded schools to wear a shirt during all water-based activities, except when competing. We observed the proportion of student spectators from 41 Townsville (latitude 19.3°S) primary schools (65.9% SSS) wearing hats at inter-school swimming carnivals in 2009-2011 and 2015 and the proportion wearing a shirt. Overall, a median of 30.7% student spectators from each school wore a hat (max 46.2% [2009]; min 18% [2015]) and 77.3% wore a shirt (max 95.8% [2009]; min 74.5% [2015]), suggesting that hats are under-utilized. Students from non-government (private) schools were twice as likely as students from government schools to wear a hat (41% vs 18.2% p=0.003). Neither the hat nor the shirt-wearing behaviors of student spectators were significantly influenced by their school’s size (number of students), educational advantage, sun-protection policy score or SunSmart status, indicating that other socio-economic factors, not assessed here, may have influenced the results. Our findings suggest that the mandatory swim-shirt policy introduced in 2008 was very effective, especially initially. However, monitoring and feedback of results to schools may be needed to maintain high levels of compliance in the longer-term. Schoolchildren attending swimming carnivals should not rely on sunscreen or shade alone to protect against direct and reflected-sunlight, and need prompting to put a hat and shirt back on immediately after a race. This responsibility could be delegated to either a parent or a student prefect, if teachers are too busy to encourage and monitor sun-safety compliance among the students in their care.
This case report describes a patient who used a baseball cap for scalp photoprotection.Baseball caps are commonly worn in the United States, in part for photoprotection. Public health efforts to prevent skin cancers recommend wide-brimmed hats over baseball caps owing to caps’ incomplete coverage for face, neck, and ears; however, to our knowledge, their relative efficacy for scalp photoprotection has not been investigated. We report a case of focal chronic photodamage and actinic keratoses on a patient’s alopecic scalp despite his adherence to baseball cap use for photoprotection.
The safest protection from ultraviolet (UV) radiation exposure is offered by textiles including various apparels, accessories such as hats and shade structures such as umbrellas. Their protectiveness depends on fabric composition, (natural, artificial or synthetic fibres), fabric construction (porosity, weight and thickness) and dyeing (natural or synthetic dyes, dye concentration, UV-absorbing properties, etc.). In this study the UV-protection properties were investigated on fabrics made of vegetable fibres (cotton, flax, hemp and ramie), with different construction parameters (drapery and apparel fabrics), dyed with some of the most common natural dyes. The effect of a tannins-based mordant (the galls of Quercus infectoria) on UV-protection capacity was also tested. UV radiation transmittance of fabrics was measured by two methods: one based on the utilisation of a spectrophotometer equipped with an integrating sphere (in vitro test), and the other based on outdoor measurements taken by a spectroradiometer. Transmittance measurements were used to calculate the Ultraviolet Protection Factor (UPF). Our results revealed that thick and dense (cover factor, CF > 94%) drapery fabrics made of vegetable fibres usually showed good UV-protection levels even if undyed. The use of the tannins-based mordant increased, even without dyeing, the UV-protection level up to the very good and/or excellent protection categories when fabric construction was suitable. Dyeing did not further increase the protection level. Lighter fabrics, usually used for apparel, even showed high UV-protection level after just dyeing, provided that CF was above 94%. Taking into account the high concentrations of dyes used in the present work and the utilisation of mordants containing tannins, slight differences in UV-protection capacity were detected among natural dyes tested and between the two different methods of transmittance measurement. However, UV-protection category defined from outdoor measurements was often higher than that calculated by the in vitro test, indicating an underestimation of the actual protection level of tested fabrics assessed by the latter.
Intense, intermittent exposure, the kind of exposure associated with attending an amusement park for example, is correlated with the development of basal cell carcinoma and melanoma. The goals of this study were to assess the use of the station by visitors and to identify opportunities to increase the utilization of the sunscreen station.
The study was a descriptive observational study of attendees at an amusement park in Pennsylvania. The study included a paper survey and observation of the station for frequency of use.
The station was very infrequently used; observation showed that 0.9% (8/879) of attendees in proximity used the station. There were numerous suggestions from attendees about increased utilization by improved station signage and locations as well as station advertising. Surveys were collected from 283 attendees and 59% (n=165) had used sunscreen on the day of the study and 29% (n=81) reported typical sunscreen use as 'Never' or 'Rarely' used. Once visitors were made aware of the station 76% (201/263) reported that they would utilize it.
This study showed that sunscreen use at an amusement park can be improved, especially among men and young adults. Therefore, men and younger visitors need to be purposefully encouraged in advertising and marketing the sunscreen stations.
ABSTRACT Polysulphone dosimeters ,have been employed ,to measure ,the erythemally ,effective UV exposure to the vertex, nose, cheek, chin and side facial sites of 45 volunteer high school students from Hervey Bay, Australia (25.3,. Facial exposure relative to the ,received ambient ,UV increased ,to the ,nose at higher ,(winter) Solar Zenith Angles (SZA) compared,with lower (summer) SZA ranges for both protected and unprotected students. The protection offered by the ,broad-brimmed ,hats was reduced significantly to the lower chin facial site at the higher SZA range, indicating that the style of hat used offers best protection in summer ,to the ,upper facial regions at most risk of receiving ,a high ,exposure
The safest protection from ultraviolet (UV) radiation exposure is offered by textiles including various apparels, accessories such as hats and shade structures such as umbrellas. Their protectiveness depends on fabric composition, (natural, artificial or synthetic fibres), fabric construction (porosity, weight and thickness) and dyeing (natural or synthetic dyes, dye concentration, UV-absorbing properties, etc.). In this study the UV-protection properties were investigated on fabrics made of vegetable fibres (cotton, flax, hemp and ramie), with different construction parameters (drapery and apparel fabrics), dyed with some of the most common natural dyes. The effect of a tannins-based mordant (the galls of Quercus infectoria) on UV-protection capacity was also tested. UV radiation transmittance of fabrics was measured by two methods: one based on the utilisation of a spectrophotometer equipped with an integrating sphere (in vitro test), and the other based on outdoor measurements taken by a spectroradiometer. Transmittance measurements were used to calculate the Ultraviolet Protection Factor (UPF).
Farmers and other rural outdoor workers are a high-risk group for skin cancer. This study aimed to describe the skin cancer prevention knowledge and practices of farmers and other rural outdoor workers in the Wimmera and Gippsland regions of Victoria. In total, 366 farmers and 140 other rural outdoor workers completed questionnaires at agricultural field days. Most respondents believed that they were at risk of
developing skin cancer and had high levels of knowledge regarding the issue, yet farmers’ prevention practices were less than optimal (particularly in terms of the low percentages reporting usually or always using sunscreen (21%) and wearing long-sleeved shirts (20%)).
A targeted campaign could focus on overcoming the barriers to using sun protection specific to the farming profession (in particular, to encourage farmers and other rural outdoor workers to wear sun protective clothing where it is practical and safe, and to incorporate
sunscreen use into their daily routine).
Reducing people's exposure to ultraviolet radiation is the primary strategy for skin cancer prevention.
We sought to provide comprehensive national data on preventive behaviors and risk assessment for Australia.
A national survey was conducted in summer 2003-2004. In 8 weekly cross-sectional surveys, adults and adolescents were interviewed about their sun protection and sunburn on the previous summer weekend. Adjustments were made for specific weather and ultraviolet radiation conditions relevant to time and location.
Adolescents were relatively homogeneous in their low compliance with sun protection (significantly less use of hats, covering clothing, shade, and sunglasses than adults) on weekends, and consequently were more likely to be sunburned than adults (25% compared with 18%; odds ratio=1.80, P<.001). Temperature was a significant predictor of sun-protective behaviors and a strong determinant of sunburn, as was ultraviolet radiation for adults' sunburn. Using shade, spending less time outdoors, and, for adults, wearing clothing covering were associated with reduced odds of sunburn.
The study relied on self-reported behaviors and sunburn.
Further improvement in Australians' sun-protective behaviors is needed.
Polysulfone (PS) dosimeters have been employed to measure the erythemally effective UV exposure to the vertex, nose, cheek, chin and side facial sites of 45 volunteer high school students from Hervey Bay, Australia (25.3 degrees S 152.9 degrees E). The results of a series of 1 h outdoor sport trials (basketball and soccer) found the mean student facial exposure, determined as the arithmetic average of facial site exposures of unprotected students (no hat) to protected students (hat), varied from 140 +/- 82 J m(-2) (1sigma) to 99 +/- 33 J m(-2) (1sigma), respectively. All hourly student facial exposures recorded over the study period were found to exceed the National Health and Medical Research Council's adopted safe daily limit of 30 J m(-2). Facial exposure relative to the received ambient UV increased to the nose at higher (winter) solar zenith angles (SZAs) compared with lower (summer) SZA ranges for both protected and unprotected students. The protection offered by the broad-brimmed hats was reduced significantly to the lower chin facial site at the higher SZA range, indicating that the style of hat used offers best protection in summer to the upper facial regions at most risk of receiving a high exposure when no hat protection is used. Variations to specific student facial exposure sites were measured between both basketball and soccer players. Variation in student facial exposure was further examined with respect to cloud cover and comparisons to manikin headform measurements were also made. The study results indicate that hats alone are not adequate forms of sun protection in a school environment. Schools aiming to achieve acceptable safe limits of facial exposure may need to further consider the effectiveness of hat protection with increasing SZA, cloud cover and head position relative to the sun that is specific to the scheduled outdoor activity.
The SunWise School Program is a school-based sun safety education program that was developed by the US Environmental Protection Agency and aims to teach children how to protect themselves from overexposure to the sun. The objectives of this study were to assess the health benefits of the SunWise School Program and use economic analysis to determine the program's net benefits and cost-effectiveness.
Standard cost/benefit and cost-effectiveness analysis methods were used. Intervention costs were measured as program costs estimated to be incurred by the US government, which funds SunWise, using 3 funding scenarios. Health outcomes were measured as skin cancer cases and premature mortalities averted and quality-adjusted life-years saved. These health outcomes were modeled using an effectiveness evaluation of SunWise based on pretest and posttest surveys administered to students who participated in the program and the Environmental Protection Agency's peer-reviewed Atmospheric and Health Effects Framework model. Costs averted were measured as direct medical costs and costs of productivity losses averted as a result of SunWise. Net benefits were measured as the difference between costs averted and program costs.
Economic analysis indicated that if the SunWise School Program continues through 2015 at current funding levels, then it should avert >50 premature deaths, nearly 11,000 skin cancer cases, and 960 quality-adjusted life-years (undiscounted) among its participants. For every dollar invested in SunWise, between approximately 4 in medical care costs and productivity losses are saved, depending on the funding scenario.
From a cost/benefit and cost-effectiveness perspective, it is worthwhile to educate children about sun safety; small to modest behavioral impacts may result in significant reductions in skin cancer incidence and mortality.
SunSmart is a programme of the Anti-Cancer Council of Victoria. It is an evidence-based health promotion programme where decisions
about the form and content of the programme are influenced by available evidence and community consultation processes. A systematic
evaluation and research strategy is in place to ensure that as much information as possible is available on process, impact
and outcomes. Over the past 19 years the Anti-Cancer Council of Victoria has made a substantial impact in Victoria in relation
to sun protection. It is one of the very few campaigns that has been able to demonstrate substantial changes not only in behaviour
and attitudes but also in the downturn of skin cancer rates. Substantial sustainable changes have also occurred in the physical
landscape as public authorities and commercial operators design their environment to be as sun protective as possible. This
paper focuses on the key strategies that have encouraged positive change in the behaviour and attitudes of the Victorian population
and the research that has documented the outcomes.
Quantifying individual exposure to ultraviolet radiation (UVR) is critical to understanding the etiology of a number of diseases including nonmelanotic and melanotic skin cancers. Measurements of personal exposure to solar UVR were made in Hobart, Tasmania in February (summer) 1991 for six different outdoor activities using UVR-sensitive polysulfone (PS) film attached at seven anatomical sites. Concurrent behavioral and environmental observations were also made. To date many studies have relied on subject recall to quantify past solar UVR exposures. To gain insight into the accuracy of subject recall the measured UVR exposures received by different subjects using the PS film were compared to those calculated from personal diaries and ambient solar UVB levels from a monitoring station. In general, when UVR exposure activities took place under close supervision, good correlations were obtained between the PS badges and the ambient measurements/diaries approach. Ultraviolet radiation exposures for the field study involving 94 subjects engaged in a number of outdoor activities are presented.
Evaluation of health promotion interventions aimed at behavioural or environmental change involves assessing change that occurs as a result of the program. Direct observational methods can be used for this purpose and this paper describes three such methods that we pilot tested for use in a 5-year intervention study aimed at reducing sun exposure in primary school children. (1) Monitoring 'No hat, no play' policies. This method involved video taping children in selected school play areas during lunch time and analysing the content of the videos to assess the proportion of children wearing various types of hats. (2) Assessing shade provision in the playground. This method involved taking aerial photographs of each school and using them to estimate the proportion of shade in play areas available to children at lunchtime. (3) Shade use. This involved children wearing polysulphone film badges to measure the amount of UV-B exposure they received during one lunch period, relative to the total possible dose registered on index badges. Each method was implemented successfully, and we demonstrated that the video and aerial photography methods produced highly reproducible results and that all three methods were feasible. These three methods will be used in our intervention study to assess longitudinal change in schools' sun-protection policy and practice.
To reduce ultraviolet radiation (UVR) exposure during childhood, shade structures are being erected in primary schools to provide areas where children can more safely undertake outdoor activities. This study to evaluate the effectiveness of existing and purpose built shade structures in providing solar UVR protection was carried out on 29 such structures in 10 schools in New Zealand. Measurements of the direct and scattered solar UVR doses within the central region of the shade structures were made during the school lunch break period using UVR-sensitive polysulfone film badges. These measurements indicate that many of the structures had UVR protection factors (PF) of 4-8, which was sufficient to provide protection during the school lunch hour. However, of the 29 structures examined, only six would meet the suggested requirements of UVR PF greater than 15 required to provide all-day protection.
Broadband field measurements were conducted beneath three different‐sized public shade structures, small, medium and large, during winter in the Southern Hemisphere. These measurements were compared with the diffuse UV to quantify the relationship of the UV under and around the shade structures to the diffuse UV. For the shade structures, a relationship between the diffuse UV and the UV in the shade has been provided for clear skies and solar zenith angles (SZA) of 49–76°. This allows the prediction of the UV in the shade of these structures if the diffuse UV is known. The ultraviolet protection factors for the three shade structures ranged from 1.5 to 5.4 for decreasing SZA. For the greater SZA of 70–76°, the erythemal UV in the shade was 65%, 59% and 51% of that in full sun for the small, medium and large structures, respectively. For the smaller SZA of 50–53° the erythemal UV in the shade was 35%, 41% and 18% for the small, medium and large shade structures, respectively. From this research it can be concluded that the UV radiation levels in the shade in winter could cause erythema and other sun‐related disorders.
It has been widely accepted since early in the 20th Century that sun exposure is a cause of BCC and SCC in humans [1]. That human melanoma is also caused by sun exposure was not suggested until the early 1950s, and is still not accepted by some, or the relationship is described as controversial or complex [2,3]. Nevertheless, an expert working group of the International Agency for Research on Cancer concluded, in 1992, “There is sufficient evidence in humans for the carcinogenicity of solar radiation. Solar radiation causes cutaneous malignant melanoma and non-melanocytic skin cancer” [4].
Erythemal action spectra have been the subject of experimental and theoretical interest for over 50 years. Despite all of these studies, or perhaps because of the diversification of the published data resulting from them, no one action spectrum has been universally adopted. In response to a request by Division 6 of the Commission on Illumination (CIE) for the formulation of a reference action spectrum for adoption by the CIE, members of Technical Committee 2 propose the following: 1. The reference action spectrum for erythema should be that shown in figure 1 (proposed action spectrum). 2. The data contained in the action spectrum should be used only as spectral weighting factors to indicate the approximate relative erythemal efficacy of a light source (between 250 and 400 nm).
Evaluation of health promotion interventions aimed at behavioural or environmental change involves assessing change that occurs as a result of the program. Direct observational methods can be used for this purpose and this paper describes three such methods that we pilot tested for use in a 5-year intervention study aimed at reducing sun exposure in primary school children. (1) Monitoring ‘No hat, no play’ policies. This method involved video taping children in selected school play areas during lunch time and analysing the content of the videos to assess the proportion of children wearing various types of hats. (2) Assessing shade provision in the playground. This method involved taking aerial photographs of each school and using them to estimate the proportion of shade in play areas available to children at lunchtime. (3) Shade use. This involved children wearing polysulphone film badges to measure the amount of UV-B exposure they received during one lunch period, relative to the total possible dose registered on index badges. Each method was implemented successfully, and we demonstrated that the video and aerial photography methods produced highly reproducible results and that all three methods were feasible. These three methods will be used in our inter
Abstract Quantifying individual exposure to ultraviolet radiation (UVR) is critical to understanding the etiology of a number of diseases including nonmelanotic and melanotic skin cancers. Measurements of personal exposure to solar UVR were made in Hobart, Tasmania in February (summer) 1991 for six different outdoor activities using UVR-sensitive polysulfone (PS) film attached at seven anatomical sites. Concurrent behavioral and environmental observations were also made. To date many studies have relied on subject recall to quantify past solar UVR exposures. To gain insight into the accuracy of subject recall the measured UVR exposures received by different subjects using the PS film were compared to those calculated from personal diaries and ambient solar UVB levels from a monitoring station. In general, when UVR exposure activities took place under close supervision, good correlations were obtained between the PS badges and the ambient measurements/diaries approach. Ultraviolet radiation exposures for the field study involving 94 subjects engaged in a number of outdoor activities are presented.
Broadband field measurements were conducted beneath three different-sized public shade structures, small, medium and large, during winter in the Southern Hemisphere. These measurements were compared with the diffuse UV to quantify the relationship of the UV under and around the shade structures to the diffuse UV. For the shade structures, a relationship between the diffuse UV and the UV in the shade has been provided for clear skies and solar zenith angles (SZA) of 49–76°. This allows the prediction of the UV in the shade of these structures if the diffuse UV is known. The ultraviolet protection factors for the three shade structures ranged from 1.5 to 5.4 for decreasing SZA. For the greater SZA of 70–76°, the erythemal UV in the shade was 65%, 59% and 51% of that in full sun for the small, medium and large structures, respectively. For the smaller SZA of 50–53° the erythemal UV in the shade was 35%, 41% and 18% for the small, medium and large shade structures, respectively. From this research it can be concluded that the UV radiation levels in the shade in winter could cause erythema and other sun-related disorders.
Australia has the highest rates of skin cancer in the world, with malignant melanoma rates in Western Australia second only to the state of Queensland. The Cancer Foundation of Western Australia has been actively involved in skin cancer control programmes for almost 20 years. The evaluation of skin cancer campaigns run by the Foundation over the past 5 years, including evaluation data from the summer 1998/99 campaign, is reported. Secondly, the reduction of age standardised rates of melanoma now being witnessed in Western Australia are reported. From these data arises the question - is it too early to claim that public health measures have contributed to this recent reduction in melanoma rates in Western Australia? Finally, a summary is presented of lessons learned about the historical process of conducting skin cancer control programmes. While there is debate about the specific impact in terms of skin cancer incidence rates, there is no doubt our programmes have changed the way Australians perceive, and behave, in the sun.
Sunscreens are in widespread use as a form of skin protection against solar ultraviolet radiation. Previous studies provide
some data to show that the amount of sunscreen applied is less than manufacturers' recommendations, although studies have
often used indirect measurement techniques. This study comprised 50 volunteers who applied a standard aqueous cream as a hypoallergenic
analogue for sunscreen to one of their forearms. Two novel methods of directly measuring forearm area were used, based on
a mathematical model and the use of a helically wrapped cloth belt. Application amounts ranged from 0.05 mg.cm-2 to 8.38 mg.cm-2. The distribution was heavily skewed, with a modal value in the range 0.5-1.0 mg.cm-2. Of the volunteers 69% applied less than the generally accepted quantity of 2.0 mg.cm-2, with 61% applying less than 1.5 mg.cm-2, and 37% applying less than 1.0 mg.cm-2. The study confirms previous findings that most sunscreen application is not sufficient to achieve the stated sun protection
factor. The use of higher factor sunscreens, a reassessment of the definition of sun protection factors and/or further public
education campaigns are warranted.
WHILE evaluating the weathering characteristics of the plastics polysulphone and polyphenylene oxide (PPO) we found that they both darkened when exposed to ultraviolet radiation1. We realised the potential of these polymers as monitors for ultraviolet radiation and are developing them for this use. PPO is now being used to monitor continuously solar ultraviolet radiation at forty sites throughout the world2. We are developing polysulphone as a possible personnel dosimeter to measure exposure of the skin to ultraviolet radiation. Two requirements for any ultraviolet dosimeter are: (1) that the wavelength response of the dosimeter should be similar to the erythemal action spectrum of human skin, and (2) that the dosimeter should have a monotonic response as the ultraviolet dose increases. The results presented here indicate that polysulphone might well satisfy these criteria.
The sun protection factor (SPF) is a ratio that estimates the protective efficacy of a sunscreen against sunburn. The generally accepted methods used to determine the SPF of a sunscreen require that the formulation be applied in a thickness of 1.5 mg/cm2 (Deutsches Institut für Normung) or 2 mg/cm2 (US Food and Drug Administration). The applied thickness of a sunscreen is important for the degree of photoprotection. Forty-two volunteers on a beach applied their own sunscreen all over the body. The amount of the applied sunscreen was on average 0.5 mg/cm2. This indicates that the labelled SPF is probably considerably higher than the obtained degree of protection against sunburn.
The degree of sun protection provided by various styles of hat at different anatomical sites on the head was measured using model headforms and ultraviolet-sensitive film badges. It was found that hats with a small brim, such as the flat cap favoured by elderly male photosensitive patients, provided negligible protection at all sites apart from the vertex and forehead. Peaked baseball-style caps offer good protection to the nose but are relatively ineffective at other sites on the face. Hats with a wide (greater than 7.5 cm) brim are necessary in order to provide reasonable protection factors (greater than 3) around the nose and cheeks.
We determined the cumulative exposure of 3 body sites to ultraviolet radiation from sunlight for 126 children observed from 1-3 d during a variety of common recreational activities at a girl scout camp, baseball camp and community baseball field. Median arm exposure to children playing baseball at a camp ranged from 27.6% to 33.2% of the possible ambient exposure. These exposures are similar to adult exposures reported for comparable activities. Median exposure to the arm at the girl scout camp during mixed activities ranged from 9.0% to 26.5% of possible ambient exposure. At the girl scout camp, exposure both within and between activity groups varied substantially and were more variable than the baseball players' exposure. Arm exposure was greater than cheek and forehead exposure for all subject groups, with an arm-to-cheek exposure ratio ranging from 1.7 to 2.3. For organized sports, such as baseball, it may be possible to assign a single exposure estimate for use in epidemiologic studies or risk estimates. However, for less uniform outdoor activities, wide variability in exposure makes it more difficult to predict an individual's exposure.
Childhood exposure to ultraviolet (UV) radiation in sunlight may be an important risk factor for later development of skin diseases. We quantified the UVB radiant exposure on the wrist and face of children performing mixed outdoor activities at a summer camp. Polysulfone film badges were attached directly to the skin for several hours and simultaneously were used to measure ambient UVB levels. The results for the ratio of site-specific exposure to ambient exposure indicate a high degree of intersubject variability, a parity of samples taken in right and left positions, and a significantly higher exposure on the wrist compared with the face. The technique was well accepted by the subjects but some badges could not be read because of loss or damage. Measurement of exposure ratios in additional settings as well as data on childhood activity patterns are needed for an overall assessment of childhood exposure.
An Australia-wide survey in 1985 recorded the highest rates of medically treated non-melanocytic skin cancer (NMSC) ever reported. We report the findings of a repeat survey conducted in 1990. This second survey confirmed the differences, by age, sex, body site, latitude, country of birth and skin reaction to strong sunlight, that were observed in 1985. Over the 5-year period certain changes were noted: the incidence of NMSCs increased by 19%, of basal-cell carcinomas (BCC) by 11% and of squamous-cell carcinomas (SCC) by 51%. With advancing age, men and women differed in their incidence, and this difference was greater for SCC than for BCC. Log-linear modelling, however, failed to detect either a cohort or a survey effect between the 2 surveys. The proportional distribution of BCCs and SCCs by body site indicated an increase in BCCs on the trunk in both men and women, and half the proportion of SCCs on the head and neck in women as compared with men. The latitudinal gradients observed in 1985 were even stronger in 1990; the population living north of 37 degrees S experienced a 30% increase in the incidence of treated NMSC between 1985 and 1990, while the population living south of 37 degrees S had a 25% decrease. The implications of these findings for cancer-control initiatives are discussed.
The weekday and weekend outdoor ultraviolet exposure of young people from primary and secondary schools in three geographically distinct regions of England was determined over a 3-month period in summer. Ultraviolet exposure was measured using personal film badges worn by each young person, and time spent outdoors, in hourly intervals, assessed using exposure records. In each area a class of 9-10-year-old children from a primary school and a class of 14-15-year-old adolescents from a secondary school took part, giving a total of 180 subjects. We found that primary school children received higher outdoor ultraviolet exposure than young people in secondary schools, and geographical differences in exposure could not be accounted for solely by differences in ambient ultraviolet. There was little difference between the exposure of males and females. Children and adolescents did not behave as homogeneous groups with regard to exposure.
The ultraviolet radiation (UVR) exposures of primary school children in Brisbane, Toowoomba and Mackay (latitudes 27 degrees 30', 27 degrees 33' and 21 degrees 15' south, respectively) were assessed over a period of 2 weeks at each location using UVR-sensitive polysulfone (PS) film badges attached at the shoulder. The students filled in questionnaires on their time spent outdoors for each day of the study. These data in conjunction with the ambient UVR measured by a detector/datalogger unit at each site were used to correlate the calculated exposures with those measured using the PS badges. Overall, the questionnaires indicated that the males spent more time outdoors and had higher measured UVR exposures than females. For both boys and girls at each location, there was a strong correlation between the mean measured UVR exposure and the ambient solar UVR at that location.
"Kidskin" is an intervention study involving children at 33 primary schools in Perth, Western Australia. This study includes measurement of changes in implementation of schools' sun protection policies. This paper reports on measurement of observable aspects of sun protection.
Hat use was assessed from videos of children in the playground. Shade use was measured using UVR-sensitive polysulfone badges worn by a random sample of children. Shade provision was measured from aerial photographs of the schools. Principals were surveyed about school policies and practices.
Eighty-seven percent of children wore a hat during lunch time at school, although only 14% wore the most protective styles of hats. The mean proportion of ambient UVR exposure received by Year 1 children was 15.5%; children spent less time in the sun on sunnier days. On average, 14.5% of the playground was shaded; this was not associated with children's sun exposure. Correlations between these results and the principals' estimates were poor.
Children should be encouraged to wear more protective styles of hats and to avoid sun exposure, even on less sunny days during spring and summer. Principals' estimates of shade provision and children's sun protection behavior at school are of little value.
There is persuasive evidence that each of the three main types of skin cancer, basal cell carcinoma (BCC), squamous cell carcinoma (SCC) and melanoma, is caused by sun exposure. The incidence rate of each is higher in fairer skinned, sun-sensitive rather than darker skinned, less sun-sensitive people; risk increases with increasing ambient solar radiation; the highest densities are on the most sun exposed parts of the body and the lowest on the least exposed; and they are associated in individuals with total (mainly SCC), occupational (mainly SCC) and non-occupational or recreational sun exposure (mainly melanoma and BCC) and a history of sunburn and presence of benign sun damage in the skin. That UV radiation specifically causes these skin cancers depends on indirect inferences from the action spectrum of solar radiation for skin cancer from studies in animals and the action spectrum for dipyrimidine dimers and evidence that presumed causative mutations for skin cancer arise most commonly at dipyrimidine sites. Sun protection is essential if skin cancer incidence is to be reduced. The epidemiological data suggest that in implementing sun protection an increase in intermittency of exposure should be avoided, that sun protection will have the greatest impact if achieved as early as possible in life and that it will probably have an impact later in life, especially in those who had high childhood exposure to solar radiation.
Broadband field measurements were conducted beneath three different-sized public shade structures, small, medium and large, during winter in the Southern Hemisphere. These measurements were compared with the diffuse UV to quantify the relationship of the UV under and around the shade structures to the diffuse UV. For the shade structures, a relationship between the diffuse UV and the UV in the shade has been provided for clear skies and solar zenith angles (SZA) of 49-76 degrees. This allows the prediction of the UV in the shade of these structures if the diffuse UV is known. The ultraviolet protection factors for the three shade structures ranged from 1.5 to 5.4 for decreasing SZA. For the greater SZA of 70-76 degrees, the erythemal UV in the shade was 65%, 59% and 51% of that in full sun for the small, medium and large structures, respectively. For the smaller SZA of 50-53 degrees the erythemal UV in the shade was 35%, 41% and 18% for the small, medium and large shade structures, respectively. From this research it can be concluded that the UV radiation levels in the shade in winter could cause erythema and other sun-related disorders.
The risk to outdoor workers of exposure to solar ultraviolet radiation (UVR) has been known for some time, particularly in the building and construction industry, where workers often use little in the way of protection against solar UVR. In recent years there have been attempts by authorities in Australia and in Queensland in particular, where UVR levels in spring and summer are very high to extreme, to instigate and to encourage the use of personal UVR protection by outdoor workers. To quantify UVR exposure of building and construction industry workers involved in typical outdoor work, a study was conducted using UVR-sensitive polysulphone film badges. The results indicated that the doses were significant, often well in excess of recommended exposure limits. The measured exposures varied between trades. Data on the use of personal UVR-protective equipment and the skin type of workers were also collected. Many of the workers had skin types that were sensitive to UVR and showed signs of sunburn. In summary, the study found that at-risk individuals were exposed to extreme levels of UVR, in most cases without adequate and appropriate sun protection.
The 2002 revision of the UV index (UVI) issued by the World Health Organisation (WHO), the World Meteorological Office (WMO), the United Nations Environment Programme (UNEP) and the International Commission on Non-Ionizing Radiation Protection (ICNIRP) (World Health Organization [2002] Global Solar UV Index: A Practical Guide. WHO, Geneva) was motivated by the need to further standardize the use and presentation of the UVI. Awareness of the hazards of solar UV radiation (UVR) is generally high in Australia, but more effective use of the UVI will assist in promoting further changes to the population's sun exposure behavior. UVI levels for a number of cities around Australia as measured by the Australian Radiation Protection and Nuclear Safety Agency (ARPANSA), covering the time period 1996-2000, are presented. Also shown are UVI forecasts from the Australian Bureau of Meteorology (BOM). Agreement between the BOM data and the measurements varies depending on the location but is within 2 UVI units approximately 75% of the time. UVI levels are supplied to the media, and in summer values in excess of 12-14 are regularly recorded, although the more northerly locations occasionally reach 16 and 17. The factors affecting the solar UVR environment and the measured UVI are also discussed and compared against measurements from the UK.
Simple dosage guide for sunscreens will help users Sun protection with hats
- S Taylor
- B L Diffey
Taylor, S. and B. L. Diffey (2002) Simple dosage guide for sunscreens will help users. Br. Med. J. 324, 1526. Diffey, B. L. and J. Cheeseman (1992) Sun protection with hats. Br. J. Dermatol. 127, 1&12.
How sun exposure causes skin cancer: an epidemiological perspective An assessment of the adequacy of sunscreen usage
- B K Armstrong
- G C Hart
- A L Wright
- R G Cameron
Armstrong, B. K. (2004) How sun exposure causes skin cancer: an epidemiological perspective. In Prevention of Skin Cancer (Edited by D. Hill, M. Elwood and D. English), pp. 89-116. Kluwer Academic Publishers, Netherlands. Hart, G. C., A. L. Wright and R. G. Cameron (2000) An assessment of the adequacy of sunscreen usage. Proceedings of the International Workshop on UV Exposure, Measurement & Protection Oxford, 18-20 October 1999. Radiat. Prot. Dosim. 91, 275-278.
A reference action spectrum for ultraviolet induced erythema in human skin.
- CIE Research Note