Incidence and public health burden of sunburn among beachgoers in the United States.

The beach environment creates many barriers to effective sun protection, putting beachgoers at risk for sunburn, a well-established risk factor for skin cancer. Our objective was to estimate incidence of sunburn among beachgoers and evaluate the relationship between sunburn incidence and sun-protective behaviors. A secondary analysis, of prospective cohorts at 12 locations within the U.S. from 2003 to 2009 (n = 75,614), were pooled to evaluate sunburn incidence 10-12 days after the beach visit. Behavioral and environmental conditions were cross-tabulated with sunburn incidence. Multivariable logistic regression was used to estimate the association between new sunburn and sun-protective behaviors. Overall, 13.1% of beachgoers reported sunburn. Those aged 13-18 years (16.5%), whites (16.0%), and those at beach locations along the Eastern Seaboard (16.1%), had the highest incidence of sunburn. For those spending ≥5 h in the sun, the use of multiple types of sun protection reduced odds of sunburn by 55% relative to those who used no sun protection (Odds Ratio = 0.45 (95% Confidence Interval:0.27-0.77)) after adjusting for skin type, age, and race. Acute health effects of sunburn tend to be mild and self-limiting, but potential long-term health consequences are more serious and costly. Efforts to encourage and support proper sun-protective behaviors, and increase access to shade, protective clothing, and sunscreen, can help prevent sunburn and reduce skin cancer risk among beachgoers.

Estimation of Skin and Ocular Damage Avoided in the United States through Implementation of the Montreal Protocol on Substances that Deplete the Ozone Layer.

Overexposure to ultraviolet (UV) radiation is a threat to human health. It can cause skin cancer and cataracts. Human-made ozone-depleting substances (ODSs) reduce the ozone concentration in the Earth's stratosphere, which acts as a protective shield from UV radiation. To protect and restore the ozone layer, the Montreal Protocol on Substances that Deplete the Ozone Layer was enacted in 1987 to phase out the production and consumption of certain ODSs and was later amended and adjusted to significantly strengthen its requirements. The United States Environmental Protection Agency (EPA) uses its Atmospheric and Health Effects Framework (AHEF) model to assess the adverse human health effects associated with stratospheric ozone depletion and the U.S. health benefits from the global implementation of the Montreal Protocol. Comparing the Montreal Protocol as amended and adjusted with a scenario of no controls on ODSs showed the prevention of an estimated 443 million cases of skin cancer and 63 million cataract cases for people born in the United States between 1890 and 2100. In addition, 2.3 million skin cancer deaths are avoided. Compared with the original 1987 Montreal Protocol, strengthening the Montreal Protocol, through its subsequent amendments and adjustments, resulted in an estimated 230 million fewer skin cancer cases, 1.3 million fewer skin cancer deaths, and 33 million fewer cataract cases.