Sunscreen use and skin protection behaviour on the Belgian beach: a comparison 9 years later.

Public health campaigns encourage people to protect themselves against skin cancer by using sunscreens and taking other protective measures. The objective is to estimate the impact of these campaigns on the rise of awareness among the general public. This study explores the prevalence and predictors of solar protection behaviour in a sample of beachgoers and compares these results to another similar study carried out 9 years earlier (i.e. summer 2001). During the month of August 2010, a total of 408 participants (144 men and 264 women) were randomly selected on their way to the Belgian beach in the city of Ostend, Belgium. The solar protection behaviour of each participant was assessed by direct observation and an interview. The exact same questions were asked as in 2001. The general risk awareness stays the same for skin aging and skin cancer but gets higher for sunburn. When we control these results for sex, the overall higher general awareness is completely because of the higher awareness of the female subgroup. As in 2001, risk awareness is considerably higher in the female subgroup than in the male one. As in 2001, sunscreen cream was the most popular preventive behaviour in 2010 (use of sunscreen with sun protection factor 15 or higher reported by 66.4%), followed by timed sun exposure (46.8%), use of clothing and hats (36.8%) and shade (34.1%). As in summer 2001 the sunscreen use is more popular in the female population. The use of protective clothing and hats is more popular in the male group. As solar protection has become part of the beach behaviour routine, there is room for improvement for their more frequent application, the use of a higher sun protection factor (15+), timed sunbathing, more use of clothing and hats and seeking shade. The results of this study can assist in evaluating the effectiveness of present sun-protection campaigns and health education programmes.

Relevance of positive patch-test reactions to fragrance mix.

BACKGROUND: Fragrances are an important cause of allergic contact dermatitis. We presume that the traditional fragrance mix (FM) detects 70 to 80% of fragrance-allergic patients. FM has an irritant potential. Weak positive reactions may have a greater chance of being irrelevant than strong reactions. OBJECTIVE: To improve the appraisal of FM patch-test reactions, we studied the relevance of reactions of different strength. We also studied the predictive value of the following on the relevance of the initial FM patch-test results: patch-test results of a repeated FM test; results of patch tests with balsam of Peru, colophony, and ingredients of the mix; and (history of) atopic dermatitis. METHODS: One hundred thirty-eight patients who had doubtful positive (?+) or positive (+ to +++) reactions were included in the study. We determined relevance by history taking, location and course of the dermatitis, and additional patch testing. Patients were retested with FM and with each ingredient separately. RESULTS: The relevance of reactions to FM increases with the strength of the reactions. Predictors of relevance are the results of retesting with FM, the results of tests with the ingredients, and a history and/or present symptoms of atopic dermatitis. CONCLUSION: Retesting with FM and its ingredients may add to the benefit of patch testing.

Evidence-based diagnosis in patch testing.

Evidence-based medicine (EBM) is defined as the integration of the best research evidence with clinical expertise and patient values. Based on the principles of EBM, we can conclude that patch testing is cost-effective only if patients are selected on the basis of a clear-cut clinical suspicion of contact allergy and only if patients are tested with chemicals relevant to the problem (high pretest probability). Random patch testing (low pretest probability) should be discouraged. Proper pretest probability assessment can only be done in expert centres, because problem-based testing requires both a thorough knowledge of the patch-test procedure and knowledge about potential sensitizers in a specific environment.

Sunscreen use and skin protection behavior on the Belgian beach.

BACKGROUND: Public health campaigns encourage the public to protect themselves against skin cancer by using sunscreens and taking other protective measures. However, it is difficult to estimate the level of awareness among the general public. METHODS: This study explores the prevalence and predictors of solar protection behavior in a community sample of beachgoers. During the months of May, June, July and August 2001 a total of 360 participants (145 men and 215 women) were randomly selected from several Belgian beaches in and around the city of Ostend, Belgium. The solar protection behavior of each participant was assessed by direct observation and interview. RESULTS: The risk awareness percentages were 70.6% for skin cancer, 60.8% for sunburn and 25.0% for skin aging. These percentages were considerably higher in the female participant group than in the male group. Sunscreen cream was the most popular preventive behavior, especially in the female population, whereas the alternative protective measures (limited exposure during peak sun hours, the use of shade and the use of protective clothing and hats) were more popular in the male group. CONCLUSIONS: While solar protection has become part of routine beach behavior, there is room for improvement by more frequent application of sunscreen cream, the use of a higher sun protection factor (SPF) (15+), timed sunbathing, more use of clothing and hats and more seeking of shade. The results of this study can assist in evaluating the effectiveness of current sun-protection campaigns and health education programs.

Epicutaneous patch testing.

Epicutaneous patch testing is still regarded as the best method of diagnosing allergic contact dermatitis. The present patch test technique is the result of a continuous process of development and improvement since its first application in the late 19th century. During the last decades of the 20th century a lot of effort was put into standardization of materials and methods used in patch testing. Patch tests can be used to confirm a suspected allergic contact dermatitis and either to recommend avoidance of particular products or to recommend alternative products in a particular patient. The true rate of clinically relevant hypersensitivity in positive patch test reactions remains to a great extent unknown. The ideal patch test should cause as few adverse reactions as possible, but a lot of adverse reactions have been described. How-ever, it has to be noted that the overall risk-benefit equation of patch testing is in favor of the benefit, if performed correctly and with the proper indications. A careful history taking and attention to the clinical picture are key actions to facilitate the interpretation of the clinical relevance of the epicutaneous patch test results.