DOI QR코드

DOI QR Code

Sun Burn Incidence and Knowledge of Greek Elementary and High School Children about Sun Protection

  • 발행 : 2015.03.09

초록

Introduction: Overexposure to sun radiation and particularly its accumulation during childhood and adolescence is a significant risk factor for skin cancer development. The sun burn is particularly important. Aim: To estimate sun burn incidence in young pupils in a coastal area of Greece. Materials and Methods: Two surveys were conducted in a school population in the same district in Greece, over different periods of time, in young people 9 to 18 years old (n=2 977). Anonymous questionnaires were completed. Levels of significance were two-tailed and statistical significance was set at p=0.05. SPSS 17.0 software was used for statistical analysis. Results: From the individual characteristics of the participants it was shown that the majority of them had dark hair and fair skin, whereas a significant percentage reported the existence of moles on face and their body (83.4% vs 68.1%). The sun burn incidence was high in adolescents and the younger pupils (41.9% vs 55.6%). The younger aged children who were living in an urban area had significantly higher rates of sun burn than those living in semi-urban areas (33.8% vs 24.8%, p=0.020). As far as the knowledge of pupils about the risks of sun radiation it was shown that the elementary school pupils had better knowledge than those at high school. Finally, those with better knowledge had the fewer sun burns (Mean 2.83 SD 0.87, p<0.001). Conclusions: The contribution of knowledge to the decrease of sun burn incidence is important as long as this is continuous. Therefore, the education should concern not only children but also teachers and parents in the context of continuous and systematic programs of health education.

키워드

참고문헌

  1. Aalborg J, Morelli JG, Mokrohisky ST, et al (2009). Tanning increased nevus development in very-light-skinned children without red hair. Arch Dermatol, 5, 989-96.
  2. Alberg A J, Herbs RM, Genkinger JM, et al (2002). Knowledge, attitudes, and behaviors toward skin cancer in Maryland youths. J Adolesc Health, 31, 372-7. https://doi.org/10.1016/S1054-139X(02)00377-4
  3. Al-Naggar RA, Al-Naggar TH, Bobryshev YV (2011). Perceptions and opinions towards skin cancer prevention in Malaysia: a qualitative approach. Asian Pac Cancer Prev, 12, 995-9.
  4. Andsoy II, Gul A, Sahin AO, et al (2013). What Turkish nurses know and do about skin cancer and sun protective behavior. Asian Pac J Cancer Prev, 14, 7663-8. https://doi.org/10.7314/APJCP.2013.14.12.7663
  5. Armstrong BK, Kricker A (2001). The epidemiology of UV induced skin cancer. J Photochem Photobiol B, 63, 8-18. https://doi.org/10.1016/S1011-1344(01)00198-1
  6. Bandura A (1997). Self-efficacy: The exercise of control. W.H. USA: Freeman and Company Pbl.
  7. Buller DB, Buller MK, Reynolds KD (2006). A survey of sun protection policy and education in secondary schools. J Am Academy Dermatol, 54, 427-32. https://doi.org/10.1016/j.jaad.2005.11.1030
  8. Cafri G, Thompson JK, Roehrig M, et al (2008). Appearance motives to tan and not tan: Evidence for validity and reliability of a new scale. Ann Behav Med, 35, 209-20. https://doi.org/10.1007/s12160-008-9022-2
  9. Cheng S, Lian S, Hao Y, et al (2010). Sun-exposure knowledge and protection behavior in a North Chinese population: a questionnaire-based study. Photodermatol Photoimmunol Photomedicine, 26, 177-81. https://doi.org/10.1111/j.1600-0781.2010.00513.x
  10. Cokkinides V, Weinstock M, Glanz K, et al (2006). Trends in sunburns, sun protection practices, and attitudes toward sun exposure protection and tanning among us adolescents, 1998-2004. Pediatrics, 118, 853-64. https://doi.org/10.1542/peds.2005-3109
  11. Dalli D, Ogce F, Okcin FA (2004). Knowledge of the effects of sun exposure of Turkish high school students and their sun bathing habits. Asian Pac J Cancer Prev, 5, 366-9.
  12. Diaz JH, Diaz JH ( 2013). Updates for responsible sun exposure behavior and photoprotection in the south. J La State Med Soc, 165, 277-82.
  13. Duignan M, Signal L, Thomson G (2014). Good intentions, but inadequate practices - sun protection in early childhood centres, a qualitative study from New Zealand. N Z Med J, 127, 40-50.
  14. El-Khateeb EA, Lotfi RA, Abd Elaziz KM, et al 2014). Prevalences of skin diseases among primary schoolchildren in Damietta. Egypt, 53, 609-16.
  15. Ergul S, Ozeren E (2011). Sun protection behavior and individual risk factors of Turkish primary school students associated with skin cancer:a questionnaire-based study. Asian Pac J Cancer Prev, 12, 765-70.
  16. Everett Jones S, O'Malley Olsen E, Michael SL, et al (2013). Association of UV index and sunscreen use among White high school students in the United States. J Sch Health, 83, 750-6. https://doi.org/10.1111/josh.12090
  17. Garbe C, Leiter U (2009). Melanoma epidemiology and trends. Clin Dermatol, 27, 3-9. https://doi.org/10.1016/j.clindermatol.2008.09.001
  18. Gefeller O, Li J, Uter W, et al B(2014). The impact of parental knowledge and tanning attitudes on sun protection practice for young children in Germany. Int J Environ Res Public Health, 11, 4768-81. https://doi.org/10.3390/ijerph110504768
  19. Gilaberte Y, Alonso JP, Teruel MP, et al (2008). Evaluation of a health promotion intervention for skin cancer prevention is Spain: the SolSano program. Health Promot Intern, 23, 209-19. https://doi.org/10.1093/heapro/dan020
  20. Glanz K, McCarty F, Nehl EJ, et al (2009). Validity of selfreported sunscreen use by parents, children, and lifeguards. Am J Prev Med, 36, 63-9. https://doi.org/10.1016/j.amepre.2008.09.012
  21. Gritz ER, Tripp MK, Peterson SK, et al (2013). Randomized controlled trial of a sun protection intervention for children of melanoma survivors. Cancer Epidemiol Biomarkers Prev, 22, 1813-24. https://doi.org/10.1158/1055-9965.EPI-13-0249
  22. Hall HI, McDavid K, Jorgensen CM, et al (2001). Factors associated with sunburn in white children aged 6 months to 11 years. Am J Prev Med, 20, 9-14. https://doi.org/10.1016/S0749-3797(00)00265-8
  23. Hawryluk EB, Liang MG (2014). Pediatric melanoma, moles, and sun safety. Pediatr Clin North Am, 61, 279-91. https://doi.org/10.1016/j.pcl.2013.11.004
  24. Hoang MT, Eichenfield LF (2000). The rising incidence of melanoma in children and adolescents. Dermatol Nursing, 12, 188-92.
  25. Jones B, Oh C, Corkery E, et al (2007). Attitudes and perceptions regarding skin cancer and sun protection behaviour in an Irish population. J Eur Acad Dermatol Venereol, 21, 1097-101. https://doi.org/10.1111/j.1468-3083.2007.02209.x
  26. Kanavy HE, Gerstenblith MR (2011). Ultraviolet radiation and melanoma. Semin Cutan Med Surg, 30, 222-8.
  27. Kyle RG, Nicoll A, Forbat L, et al (2013). Adolescents' awareness of cancer risk factors and associations with healthrelated behaviours. Health Educ Res, 28, 816-27. https://doi.org/10.1093/her/cyt055
  28. Kyle RG, Macmillan I, Forbat L, et al (2014). Scottish adolescents' sun-related behaviours, tanning attitudes and associations with skin cancer awareness: a cross-sectional study. MJ Open, 4, 005137.
  29. LaBat K, De Long M, Gahring SA(2005). A longitudinal study of sun-protective attitudes and behaviors. Family Consumer Sci Res J, 33, 240-54. https://doi.org/10.1177/1077727X04272367
  30. Larsman P, Eklof M, Torner M (2012). Adolescents' risk perceptions in relation to risk behaviour with long-term health consequences; antecedents and outcomes: a literature review. Saf Sci, 50, 1740-8. https://doi.org/10.1016/j.ssci.2012.04.009
  31. Li J, Uter, W, Pfahlberg A, et al (2011). Parental perspective on sun protection for young children in Bavaria. Photodermatol Photoimmunol Photomed, 27, 196-202. https://doi.org/10.1111/j.1600-0781.2011.00598.x
  32. Li J, Uter,W, Pfahlberg A, et al (2012). comparison of patterns of sun protection during beach holidays and everyday outdoor activities in a population sample of young German children. Br J Dermatol, 166, 803-10. https://doi.org/10.1111/j.1365-2133.2012.10805.x
  33. Linabery A M, Ross J A (2008). Trends in childhood cancer incidence in the U.S. (1992-2004). Cancer, 112, 416-32. https://doi.org/10.1002/cncr.23169
  34. Livingston PM, White V, Hayman J, et al (2003). Sun exposure and sun protection behaviours among Australian adolescents: trends overtime. Prev Med, 37, 577-84. https://doi.org/10.1016/j.ypmed.2003.09.004
  35. Maksymilian Gajda, Grazyna Kaminska-Winciorek (2014). Do not let to be late: overview of reasons for melanoma delayed diagnosis. Asian Pac J Cancer Prev, 15, 3873-7. https://doi.org/10.7314/APJCP.2014.15.9.3873
  36. Malak AT, Yildirim P, Yildiz Z, et al (2013). Effects of training about skin cancer on farmers' knowledge level and attitudes. Asian Pac J Cancer Prev, 12, 117-20.
  37. Mah L, Di Giovine P, Quinn L, et al (2013). Paediatric sunburn: the experience of an Australian paediatric burns unit. J Paediatr Child Health, 49, 654-7. https://doi.org/10.1111/jpc.12268
  38. McLoone JK, Meiser B, Karatas J, et al (2014) .Perceptions of melanoma risk among Australian adolescents: barriers to sun protection and recommendations for improvement. Aust N Z J Public Health, 38, 321-5. https://doi.org/10.1111/1753-6405.12209
  39. Miles A, Waller J, Hiom S, et al (2005). Sun smart? skin cancer knowledge and preventive behaviour in a British population representative sample. Health Educ Res, 20, 579-85. https://doi.org/10.1093/her/cyh010
  40. Molgo N M, Castillo A C, Valdes FR, et al (2005). Sun exposure behaviors and knowledge. Revista Medica Chile, 133, 662-6.
  41. Nikolaou V, Stratigos AJ, Antoniou C, et al (2009). Sun exposure behavior and protection practices in a Mediterranean population: a questionnaire-based study. Photodermatol Photoimmunol Photomedicine, 25, 132-7. https://doi.org/10.1111/j.1600-0781.2009.00424.x
  42. Patruno C, Scalvenzi M, Megna M,et al (2014). Melanocytic nevi in children of southern Italy: dermoscopic, constitutional, and environmental factors. Pediatr Dermatol, 31, 38-42. https://doi.org/10.1111/pde.12119
  43. Reynolds KD, Buller DB, Yaroch A L, et al (2006). Mediation of a middle school skin cancer prevention program. Health Psychology, 25, 616-25. https://doi.org/10.1037/0278-6133.25.5.616
  44. Williams AL, Grogan S, Clark-Carter D, et al (2013). Appearance-based interventions to reduce ultraviolet exposure and/or increase sun protection intentions and behaviours: A systematic review and meta-analyses. Br J Health Psychol, 18, 182-217. https://doi.org/10.1111/j.2044-8287.2012.02089.x
  45. Wright C, Reeder AI, Gray A, et al (2008). Child sun protection: sun-related attitudes mediate the association between children's knowledge and behaviours. J Paediatrics Child Health, 44, 692-8. https://doi.org/10.1111/j.1440-1754.2008.01408.x
  46. Pustisek N, Sikanic-Dugic N, Hirsl-Hecej V, et al (2010). Acute skin sun damage in children and its consequences in adults. Coll Antropol, 34, 233-7.
  47. Ramazzotti V, Cercato MC, Terrenato I, et al (2011). Skin cancer risk factors in childhood: findings of a survey conducted within Italian areas with a different incidence of melanoma. Epidemiol Prev, 35, 82-8.
  48. Reinau D, Meier CR, Gerber N, et al (2014). Evaluation of a sun safety education programme for primary school students in Switzerland. Eur J Cancer Prev, 23, 303-9. https://doi.org/10.1097/CEJ.0000000000000040
  49. Saraiya M, Glanz K, Briss PA, et al (2004). Interventions to prevent skin cancer by reducing exposure to ultraviolet radiation: a systematic review. Am J Prev Med, 27, 422-6.
  50. Saridi M, Toska A, Rekleiti M, et al (2012). Sun-protection habits of primary students in a coastal area of Greece. J Skin Cancer, 2012, 629652.
  51. Saridi Ma, Rekleiti M, Toska A, et al (2014). Skin cancer prevention and sun protection habits in children. epidemiology I - Theory, Res Practice, 1st Edition , Concept Press Ltd.
  52. Saridi MIb, Rekleiti MD, Toska AG, et al (2014a). Assessing a sun protection program aimed at Greek elementary school students for malign melanoma prevention. Asian Pac J Cancer Prev, 15, 5009-18. https://doi.org/10.7314/APJCP.2014.15.12.5009
  53. Saridi Mc, Toska A, Rekleiti M, et al (2014). An educational intervention in primary school students regarding sun protection: a pilot study. Primary Health Care, 4,1.
  54. Savona MR, Jacobsen MD, James R, et al (2005). Ultraviolet radiation and the risks of cutaneous malignant melanoma and non-melanoma skin cancer: perceptions and behaviours of Danish and American adolescents. Eur J Cancer Prev, 14, 57-62. https://doi.org/10.1097/00008469-200502000-00008
  55. Suppa M, Cazzaniga S, Fargnoli MC, et al (2013). Knowledge, perceptions and behaviours about skin cancer and sun protection among secondary school students from Central Italy. J Eur Acad Dermatol Venereol, 27, 571-9. https://doi.org/10.1111/j.1468-3083.2012.04484.x
  56. Tripp MK, Vernon SW, Gritz ER, et al (2013). Children's skin cancer prevention: a systematic review of parents' psychosocial measures. Am J Prev Med, 44, 265-73. https://doi.org/10.1016/j.amepre.2012.10.027
  57. Volkov A, Dobbinson S, Wakefield M, et al (2013). Seven-year trends in sun protection and sunburn among Australian adolescents and adults. Aust N Z J Public Health, 37, 63-9. https://doi.org/10.1111/1753-6405.12012
  58. Wong JR, Harris JK, Rodriguez-Galindo C, et al (2013). Andersson C, Engardt M (2010). European ozone in a future climate: Importance of changes in dry deposition and isoprene emissions. J Geophysical Res: Atmospheres, 115.
  59. World Health Organization (2003). Sun protection and schools: how to make a difference. Geneva.
  60. Wright C, Reeder AI, Gray A, et al (2008). Child sun protection: sun-related attitudes mediate the association between children's knowledge and behaviours. J Paediatrics Child Health, 44, 692-8. https://doi.org/10.1111/j.1440-1754.2008.01408.x
  61. Zerefos CS (2002). Long-term ozone and UV variations at Thessaloniki, Greece. Physics Chemistry Earth, 27, 455-60. https://doi.org/10.1016/S1474-7065(02)00026-8