Serial Cross-Sectional Observations of Sun-Protective Behaviors at an Annual Outdoor Motorsport Event in Tropical Queensland, Australia.

Skin cancer, the most prevalent cancer in Caucasians residing at low latitudes, can primarily be prevented by avoiding overexposure to sunlight. Serial cross-sectional observations were conducted at an outdoor motorsport event held in Townsville, Queensland each July (Southern winter) to determine whether sun-protection habits changed over time. Most (71.1%) of the 1337 attendees observed (97.6% lightly pigmented skin, 64.0% male) wore a hat (any style shading the face), while few (18.5%) wore three-quarter or full-length sleeves. While hat-wearing rates (any style) were similar in 2009 (326, 72.6%) and 2013 (625, 70.4%), the use of sun-protective styles (wide-brimmed/bucket/legionnaires) decreased from 29.2% to 18.6% over the same period, primarily because the use of sun-protective hats halved (from 28.7% to 14.0%) among females, while decreasing from 29.4% to 21.1% in males. Although relatively few individuals wore sun-protective (three-quarter-length or full-length) sleeves regardless of year (OR = 0.117, P < 0.0001), encouragingly, the use of sun-protective sleeves more than doubled between 2009 (10.5%) and 2013 (22.5%). Interestingly females, albeit the minority, at this sporting event were less likely to wear a hat (OR = 0.473, P < 0.0001) than males. These findings highlight the need for continued momentum toward skin cancer primary prevention through sun protection with a dedicated focus on outdoor sporting settings.

Parametric human modelling to determine body surface area covered by sun-protective clothing.

Solar ultraviolet radiation (UVR) is the main environmental risk-factor for cancer of the skin. Sun-protective clothing provides a physical barrier that reduces the UVR dose reaching the skin and European and Australian standards for sun-protective clothing set minimum clothing coverage requirements. Body Surface Area Coverage by clothing (BSAC) is calculated by means of indirect or direct methods, which are laborious and do not support computer-based apparel design. To support the sun-safe specification and design of garments, parametric digital human models and protective clothing mesh covering the minimum Body Surface Area specified in AS/NZS 4399:2017, were created making use of MakeHuman v1.1.1 and Blender software. The Whole Body Surface Area (WBSA) and the BSAC were calculated employing code developed in Blender. Thus, different groups of subjects were analysed to explore BSAC. The method assists in the evaluation of exposed body areas in a wider spectrum of different occupations. Practitioner summary: Sun-protective clothing provides a physical barrier that reduces the UVR dose reaching the skin's surface. Body Surface Area Coverage (BSAC) by clothing is an important determinant of the sun protective capabilities of a garment. In this study, BSAC is calculated using parametric digital human modelling. Abbreviation: UVR: (Solar) ultraviolet radiation; DHM: digital human modeling; BSA: body surface area; BSAC: body surface area coverage (by clothing); BSANC: body surface area not covered (by clothing); WBSA: whole body surface area; BCC: basal cell carcinoma; SCC: squamous cell carcinoma; UPF: ultraviolet protection factor; GPF: garment protection factor.

Sun-Protective Behaviors of Student Spectators at Inter-school Swimming Carnivals in a Tropical Region Experiencing High Ambient Solar Ultraviolet Radiation.

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.

Melanocytic nevi in a Brazilian community of predominantly Dutch descent (1999-2007).

BACKGROUNDS: Epidemiological studies have shown a significant relationship between melanocytic nevi and cutaneous melanoma. OBJECTIVE: To evaluate the development of melanocytic nevi in the pupils of a school composed primarily of children of Dutch descent and to assess the effect of environmental factors on these individuals whose phenotypic characteristics were similar to those of their ancestors. METHODS: In 1999 a cohort study was initiated to count the number of melanocytic nevi in 282 pupils of 3 to 17 years of age, 53.9% of whom were boys. Five years later a repeat exam was conducted in 148 students of 8 to 22 years of age, 49.3% of whom were males. The association between the age, skin phototype, eye color, hair color and ethnic group of the pupils and their parents and the presence of melanocytic nevi was analyzed at the beginning and at the end of the study. RESULTS: There was a significant increase in cases of melanocytic nevi and dysplastic nevi at the follow-up examination. The number of melanocytic nevi was greater in boys than in girls in both covered and exposed areas of skin. Likelihood analysis calculated using the odds ratio showed that boys were more likely to develop melanocytic nevi than girls and that the children of non-mixed and mixed race with lighter hair were more likely to develop melanocytic nevi than those of other ethnic groups and those with dark hair. Children with skin phototype I were more likely to develop melanocytic nevi in covered areas of skin compared to those with skin types II or III. CONCLUSIONS: These data show that individuals of Dutch descent were more likely to develop melanocytic nevi than individuals of other ethnic origins.

Nevos melanocíticos numa comunidade de origem predominantemente holandesa no Brasil (1999-2007) / Melanocytic nevi in a Brazilian community of predominantly Dutch descent (1999-2007)

FUNDAMENTOS: Estudos epidemiológicos têm demonstrado relação significativa entre nevos melanocíticos e melanoma cutâneo. OBJETIVO: Acompanhar o desenvolvimento de nevos melanocíticos nos alunos de uma escola composta, majoritariamente, por descendentes de holandeses e a influência do meio ambiente sobre esses indivíduos com características fenotípicas semelhantes às de seus antepassados. MÉTODOS: Em 1999, iniciou-se estudo coorte para contagem de nevos melanocíticos nos 282 alunos entre três e 17 anos, sendo 53,9 por cento meninos. Após cinco anos, realizou-se novo exame em 148 alunos entre oito e 22 anos, dos quais 49,3 por cento eram meninos. Analisou-se a relação da idade, sexo, fotótipo, cor dos olhos, cor dos cabelos e etnia dos alunos e dos pais com a presença de nevos melanocíticos no início e no final do estudo. RESULTADOS: Houve aumento significativo de nevos melanocíticos e nevos displásicos no reexame. Os meninos tiveram mais nevos melanocíticos (áreas cobertas e expostas) do que as meninas. A análise de probabilidade para razão de risco revelou que os meninos têm mais chance de desenvolver nevos melanocíticos do que as meninas, assim como os de etnia não miscigenada e miscigenada e com cabelos claros têm mais que os alunos de outras etnias e com cabelos escuros. Os que apresentam fotótipo I são mais propensos a desenvolver nevos melanocíticos nas áreas cobertas do que os que têm fotótipos II e III. CONCLUSÕES: Os dados demonstram que os indivíduos de etnia holandesa tiveram maior probabilidade de desenvolver nevos melanocíticos do que os outros grupos étnicos.

BACKGROUNDS: Epidemiological studies have shown a significant relationship between melanocytic nevi and cutaneous melanoma. OBJECTIVE: To evaluate the development of melanocytic nevi in the pupils of a school composed primarily of children of Dutch descent and to assess the effect of environmental factors on these individuals whose phenotypic characteristics were similar to those of their ancestors. METHODS: In 1999 a cohort study was initiated to count the number of melanocytic nevi in 282 pupils of 3 to 17 years of age, 53.9 percent of whom were boys. Five years later a repeat exam was conducted in 148 students of 8 to 22 years of age, 49.3 percent of whom were males. The association between the age, skin phototype, eye color, hair color and ethnic group of the pupils and their parents and the presence of melanocytic nevi was analyzed at the beginning and at the end of the study. RESULTS: There was a significant increase in cases of melanocytic nevi and dysplastic nevi at the follow-up examination. The number of melanocytic nevi was greater in boys than in girls in both covered and exposed areas of skin. Likelihood analysis calculated using the odds ratio showed that boys were more likely to develop melanocytic nevi than girls and that the children of non-mixed and mixed race with lighter hair were more likely to develop melanocytic nevi than those of other ethnic groups and those with dark hair. Children with skin phototype I were more likely to develop melanocytic nevi in covered areas of skin compared to those with skin types II or III. CONCLUSIONS: These data show that individuals of Dutch descent were more likely to develop melanocytic nevi than individuals of other ethnic origins.

Sun exposure and the incidence of melanocytic nevi in young Australian children.

The number of melanocytic nevi (MN) is an important risk factor for cutaneous melanoma. The present study further investigated the relationship between sun exposure, the incidence of MN, and the prevalence of large acquired MN (>or=5 mm). A cohort of 479 preschool children born in Townsville, Australia was examined for MN in 1991 and a year later. Sun exposure was assessed by questionnaire. The erythemally effective dose of solar UV radiation was estimated from questionnaire data combined with local UV biometry. Almost all (97.7%) children had acquired new MN (median, 12), with a median incidence rate of 11.0 per year (interquartile range, 7.0-16.5). Total number of hours of sun exposure during follow-up (P = 0.034) and tendency to burn (P = 0.028) were independent risk factors for MN incidence. Sunburn experience during follow-up failed to reach significance when adjusted for tendency to burn. Lifetime number of sunburns (P < 0.001) and the severity of sunburns experienced during follow-up (P < 0.001) were significantly related to the presence of large acquired MN at follow-up. Reducing the total number of hours of sun exposure is particularly relevant in sun-sensitive children and may restrain the development of MN, whereas avoiding sunburn in young children might prevent large MN, subsequently reducing the risk of melanoma.