Protection from Sun Exposure in US White Children Ages 6 Months to 11 Years

Abstract

Objectives.

To estimate the prevalence of protection from sun exposure among US white children ages 6 months to 11 years.

Methods.

During the summer of 1998, using telephone directory lists supplemented by random-digit dialing, the authors surveyed parents living in the contiguous United States. They calculated weighted prevalence estimates for protection methods and conducted logistic regression analyses to determine parent and child characteristics predictive of protection behaviors.

Results.

Parents of 1,055 white children were interviewed. Children spent a median of 20 hours per week outdoors during the summer, of which 10 hours were at school. Sunscreen (61.8%, 95% confidence interval [CI] 57%, 66%) and shade (26.5%, 95% CI 22%, 31%) were the most frequently reported protection methods. Parents reported higher rates of protection for younger children and children who sunburn easily.

Conclusions.

Parents report that a large proportion of white children is protected from sun exposure by one or more methods. Health care providers and educators might encourage the use of all methods of protection, not just sunscreen use, and educate older children to protect themselves from the sun.

References

American Cancer Society. Cancer facts & figures—2000. Atlanta: American Cancer Society; 2000. Pub. No. 5008.00.

Miller

Weinstock

. Nonmelanoma skin cancer in the United States: incidence. J Am Acad Dermatol 1994; 30:774–8.

Armstrong

English

. Cutaneous malignant melanoma. In: Schottenfeld

Fraumeni

Jr , editors. Cancer epidemiology and prevention. 2nd ed. New York: Oxford University Press; 1996. p. 1282–1312.

Scotto

Fears

Kraemer

Fraumeni

. Nonmelanoma skin cancer. In: Schottenfeld

Fraumeni

Jr , editors. Cancer epidemiology and prevention. 2nd ed. New York: Oxford University Press; 1996. p. 1313–1330.

Weinstock

Colditz

Willett

Stampfer

Bronstein

Mihm

Jr Speizer

. Nonfamilial cutaneous melanoma incidence in women associated with sun exposure before 20 years of age. Pediatrics 1989; 84:199–204.

Elwood

Gallagher

. Sun exposure and the epidemiology of melanoma. In: Gallagher

Elwood

, editors. Epidemiological aspects of cutaneous malignant melanoma. Boston: Kluwer Academic Publishers; 1994. p. 15–66.

Robinson

Rigel

Amonette

. Sun-protection behaviors used by adults for their children—United States, 1997. MMWR Morb Mortal Wkly Rep 1998; 47:480–2.

Buller

Callister

Reichert

. Skin cancer prevention by parents of young children: health information sources, skin cancer knowledge, and sun-protection practices. Oncol Nurs Forum 1995; 22:1559–66.

Olson

Dietrich

Sox

Stevens

Winchell

Ahles

. Solar protection of children at the beach. Pediatrics 1997; 99:1–5 [cited 1997 Jun 2]. Available from: URL: http://www.pediatrics.org/cgi/content/full/99/6/e1

10.

Maducdoc

Wagner

. Parents' use of sunscreen on beach-going children: the burnt child dreads the fire. Arch Dermatol 1992; 128:628–9.

11.

Fotz

. Parental knowledge and practices of skin cancer prevention: a pilot study. J Pediatr Health Care 1993; 7:220–5.

12.

Vail-Smith

Watson

Felts

Parrillo

Knight

Hughes

. Childhood sun exposure: parental knowledge, attitudes, and behaviors. J Health Educ 1997; 28:149–55.

13.

Centers for Disease Control and Prevention (US). Assessment of public health education needs for CDC's national skin cancer prevention education program. Final report. Atlanta (GA): Centers for Disease Control and Prevention; 1998.

14.

Greenland

. Introduction to regression models. In: Rothman

Greenland

, editors. Modern epidemiology. 2nd ed. Philadelphia (PA): Lippincott-Raven Publishers; 1998. p. 359–99.

15.

Shah

Barnwell

Bieler

. SUDAAN user's manual: software for analysis of correlated data. Release 6.40. Research Triangle Park (NC): Research Triangle Institute; 1995.

16.

Stern

Weinstock

Baker

. Risk reduction of nonmelanoma skin cancer with childhood sunscreen use. Arch Dermatol 1986; 122:537–45.

17.

Diffey

Gibson

Haylock

McKinlay

. Outdoor ultraviolet exposure of children and adolescents. Br J Dermatol 1996; 134:1030–4.

18.

Ries

LAG

Kosary

Hankey

Miller

Clegg

Edwards

, editors. SEER cancer statistics review, 1973–1996. Bethesda (MD): National Cancer Institute (US); 1999.

19.

Grin

Pennoyer

Lehrich

Grant-Kels

. Sun exposure of young children while at day care. Pediatr Dermatol 1994; 11:304–9.

20.

Autier

. The case for sunscreens revisited [letter]. Arch Dermatol 1998; 134:509–10.

21.

Naylor

. The case for sunscreen revisited: in reply [letter]. Arch Dermatol 1998; 134:510–11.

22.

Mayer

Sallis

Eckhardt

Creech

Johnston

Elder

Lui

. Assessing children's ultraviolet radiation exposure: the use of parental recall via telephone interviews. Am J Public Health 1997; 87:1046–9.

23.

Pion

Kopf

Hughes

Wetton

Collins

Bishop

. Teaching children about skin cancer: the draw-and-write technique as an evaluation tool. Pediatr Dermatol 1997; 14:6–12.

24.

Zinman

Schwartz

Gordon

Fitzpatrick

Cam-Field

. Predictors of sunscreen use in childhood. Arch Pediatr Adolesc Med 1995; 149:804–7.

25.

Grob

Guglielmina

Gouvernet

Zarour

Noe

Bonerandi

. Study of sunbathing habits in children and adolescents: application to the prevention of melanoma. Dermatology 1993; 186:94–8.

26.

National Center for Chronic Disease Prevention and Health Promotion (US). Unrealized prevention opportunities: reducing the health and economic burden of chronic disease. Atlanta (GA): Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion; 1998.

27.

Rosenberg

Mayer

Eckhardt

. Skin cancer prevention education: a national survey of YMCAs. J Community Health 1997; 22:373–85.

28.

Hall

Rogers

. Sun protection behaviors among African Americans. Ethn Dis 1999; 9:126–31.

29.

Reagan

Aaronson

Pinkleton

Ramo

. Differentiating telephone surveys from telemarketing to increase response rates. Commun Res Rep 1995; 12:170–7.

30.

Kristal

White

Davis

Corycell

Raghunathan

Kinne

Lin

. Effects of enhanced calling efforts on response rates, estimates of health behavior, and costs in a telephone health survey using random-digit dialing. Public Health Rep 1993; 106:372–9.

31.

Groves

. The future of telephone survey research. Presented at 16th Annual Behavioral Risk Factor Surveillance System Conference; 1999 May; Minneapolis, MN.