Sunburn in children and adolescents: associations with parents' behaviour and attitudes.

AIMS: Sunburn in childhood is a known risk factor for melanoma and non-melanoma skin cancer. Based on a theoretical model, we tested the hypothesis that parental attitudes and behaviour are related to the risk of sunburn in their children. METHODS: We analysed the association between behaviour in the sun and attitudes related to tanning among Danish parents and their children's risk for sunburn by logistic regression. Gender, educational level, and skin type of the responding parent were included as confounders and analyses were stratified for child age. RESULTS: In children aged 7-12 and 13-17 years, the risk of sunburn increased when parents had experienced sunburn themselves, and also for 13-17 year olds if parents had a very positive attitude towards tanned skin. We found no association between parental attitudes and behaviour and the risk of sunburn in children aged 0-6 years. CONCLUSIONS: Interventions to influence the attitudes and behaviour of parents could reduce their children's risk for excessive sun exposure and thereby their risk for melanoma and non-melanoma skin cancer. The results encourage preventive campaigns to focus on changing parental attitudes towards tanned skin and sun behaviour.

Determinants of sunbed use in a population of Danish adolescents.

In Denmark, melanoma is the most common type of cancer in individuals aged 15-34 years. Ultraviolet radiation from sunbeds is a risk factor for melanoma. Knowledge of the characteristics of sunbed users is important in the development and implementation of prevention strategies of sunbed use. The objective of this study was to examine sunbed use and its association with smoking, parental socioeconomic status (SES), friends' attitudes towards artificial tanning, and school environment among adolescents aged 14-18 years at continuation schools in Denmark. We conducted a survey among adolescents in Danish continuation schools in 2011. We examined sunbed use and its association with age, smoking, friends' attitudes towards artificial tanning, parental SES, and shared environment of the continuation school, using logistic regression. Within the past 12 months, 38% of the pupils had used a sunbed (70% girls and 28% boys). There was no difference in sunbed use according to age. Smoking and friends' positive attitudes towards, and higher use of sunbeds were associated with increased use of sunbeds. High SES of mothers' was associated with lower odds for sunbed use among girls. The association of school environment with sunbed use was modest compared with the other variables. Adolescents in continuation schools report a higher use of sunbeds than Danish adolescents as such. Educational interventions should be targeted at preteens, as sunbed use is common in 14-year-olds. Special educational tools are tested in the continuation school environment and may prove effective in this population.

Influential factors for sun policy implementation in Danish kindergartens.

BACKGROUND: In 2007, the Danish Cancer Society and the Tryg Fonden launched a campaign to prevent skin cancer and melanoma. As a part of this intervention programme, the Danish Cancer Society prepared a ''sun policy'', which recommends how children in Danish kindergartens can be protected from the sun. AIMS: The aim of this study was to determine the factors that influence a decision to implement the sun policy in Danish kindergartens. METHODS: We conducted a comparative qualitative study. Data were collected at semi-structured interviews with the principals of five kindergartens with a sun policy and five without. RESULTS: The key factor in making a decision is the priority given to the sun policy by the principal, which in turn depends on the principal's perception of his or her resources. Further factors are the principal's attitude toward parental responsibility and media focus on sun protection. CONCLUSIONS: Principals must be convinced of the importance of a written sun policy. A mailed reminder containing arguments about its importance to accompany the draft sun policy might reinforce the formulation and implementation of sun policies nationwide.

Vacations to sunny destinations, sunburn, and intention to tan: a cross-sectional study in Denmark, 2007-2009.

BACKGROUND: Denmark has experienced an increase in melanoma incidence since the 1960s. Exposure to ultraviolet radiation is the main preventable cause of this cancer. We examined current travel to, and sun-related behaviour of Danes at, sunny destinations in relation to their risk for sunburn. METHOD: A population-based sample of 11,158 respondents aged 15-59 years completed three questionnaires in 2007-2009 that included items on exposure to ultraviolet radiation. Using logistic regression analysis we examined the relations between sunny vacations, sun-related behaviour, demographic factors and risk for sunburn. RESULTS: During 2007-2009, 44.8-45.8% of the respondents travelled to a sunny destination at least once a year; 24% became sunburnt, and 69% tanned intentionally. The odds ratio for sunburn in general for people who went on a sunny vacation as compared with those who did not was 1.6 (1.5-1.7). Sunscreen use (1.9; 1.4-2.6) and intentional tanning (3.4; 2.8-4.1) were positively associated with sunburn on vacation. CONCLUSIONS: Taking a vacation in a sunny place is a risk factor for sunburn, especially for young people. The recommendation for sunscreen use should be re-evaluated, as intention to tan is the most important factor in sunburn on vacation and should be targeted more strategically.

Prevalence of sunburn and sun-related behaviour in the Danish population: a cross-sectional study.

BACKGROUND: In Denmark, the incidence of melanoma has been increasing since the 1960s. Intermittent exposure to ultraviolet radiation and a history of sunburn and sunbed use are known risk factors. We describe the association between use of protective measures, sun-related behaviour and experience of sunburn in the Danish population three months after the start of the campaign. METHOD: A population-based sample of 3,499 persons aged 15-59 years completed a questionnaire that included items on exposure to ultraviolet radiation. We examined the relations between sunburn and sun-related behaviour by logistic regression analysis. RESULTS: Within the previous 12 months, 35% of the study population had experienced sunburn. Sunburn became less frequent with age (odds ratio (OR) 4.44; 15-19 vs. 50-59) and skin type (OR 2.57; I vs. III). Sunburn was negatively associated with shade and clothing and positively with use of sunscreens. We found no significant difference in sunscreen use between intentional tanners who experienced sunburn and those who did not. A larger fraction of unintentional tanners with sunburn than those who were not sunburnt had used sunscreen. Sunscreen was used to prolong the time spent in the sun by 66% of sunburnt people; however, we found no association between duration of sun exposure and sunscreen use. CONCLUSIONS: Future campaigns to reduce the prevalence of sunburn in the Danish population must especially target young persons and intentional tanning, and they should emphasize that sunscreen cannot be used to extend the time spent in the sun and that shade and clothing provide the best protection against sunburn.

Sunbed use in the Danish population in 2007: a cross-sectional study.

BACKGROUND: In Denmark, the incidence of all types of skin cancer, including malignant melanoma, has been increasing since the 1960s. Exposure to ultraviolet (UV) radiation is the main preventable cause of skin cancer. We describe current sunbed use in the Danish population. METHODS: A population-based sample of 3437 persons aged 15-59 years completed a questionnaire that included items on artificial and natural exposure to UV. We examined relations between sunbed use, outdoor tanning, knowledge about associated health risks and demographic factors with logistic regression analysis. RESULTS: Within the past 12 months, 29% of all Danes aged 15-59 had used a sunbed, including 59% females aged 15-19, even though knowledge about the relation between exposure to UV and cancer was more frequent in this group. A larger proportion of persons aged 15-18 had first used a sunbed before the age of 14 than older groups. Single males, frequent outdoor sunbathers, persons who experienced sunburns and less educated persons were more likely to use sunbeds. CONCLUSIONS: Future campaigns to reduce the Danes sunbed use should target initiation by young people and the high prevalence among them. The results suggest a legislative solution, with a minimum age of 18 years for indoor tanning.