Research article
Factors associated with sunburn in white children aged 6 months to 11 years

https://doi.org/10.1016/S0749-3797(00)00265-8Get rights and content

Abstract

Objective: To determine the sunburn experience and factors associated with sunburn among white children aged 6 months to 11 years.

Methods: Telephone interviews were conducted with parents and primary caretakers of children, selected by random, stratified sampling, in the contiguous United States in the summer of 1998. Information was gathered on demographic characteristics of parents and children, and children’s sunburn experience during the past year, protection from sun exposure, and hours per week spent outdoors. The proportion of children experiencing sunburn in the past year was calculated. Multivariate logistic regression analyses were conducted to determine factors associated with sunburn. Information for 1052 white children was available for the analyses.

Results: An estimated 42.6% of U.S. white children experienced one or more sunburns within the past year (95% CI 38.2–47.0). Sunburn was less common among children who ever wore hats (adjusted OR 0.59, 95% CI 0.40–0.87) and more common among children who did not always wear sunscreen (OR for using sunscreen sometimes compared with always, 2.25; 95% CI 1.31–3.86). Sunburn was also more common among children with sun-sensitive skin and older children.

Conclusions: A large proportion of U.S. white children experience sunburns. Parents and children may benefit from education about protection from sun exposure.

Introduction

Sun exposure is the primary risk factor for skin cancer.1 Evidence suggests that sun exposure leading to sunburn, including a history of sunburn at younger ages, increases the risk of melanoma1, 2, 3, 4 and basal cell carcinoma.5, 6 While squamous cell carcinomas are generally considered to be associated with chronic sun exposure, there is some evidence for an increased risk with sunburn as well.7, 8

Few estimates are available on the sunburn experience among U.S. children; 28% to 53% of children were found to have a history of sunburn9, 10 and 13% to have had a sunburn during a summer week.11 In Europe, 48% to 54% of children were found to have a history of sunburn12, 13; estimates from New Zealand and Australia range from 7% to 15% for sunburn during the past week or weekend.14, 15 While the history of sunburns may measure some level of risk for skin cancer, it also reflects lack of effective protection from sun exposure. Generally, protection from sun exposure is reported to be high for children16, 17, 18; however, it is unknown how effective protection is in preventing sunburn and ultimately decreasing the risk of skin cancer.

This study was conducted to determine the experience of sunburn and factors associated with sunburn among white U.S. children aged 6 months to 11 years. Since African-American children and children of other nonwhite races have a much lower risk of sunburn because of increased pigment in the skin and a much lower lifetime risk of skin cancer,19 the focus of this study was on white children.

Section snippets

Study population

The target population for this survey consisted of parents, guardians, or primary care-givers, such as step-, foster-, or grandparents (henceforth referred to as “parents”), of children aged 6 months to 11 years. Parents were recruited by contacting households with telephones in the contiguous United States. A household was defined as a place of residence for one or more people. After an introduction, any adult answering the telephone was asked whether or not an eligible child lived in the

Results

Of the 1052 parents, most (873, 83.1%) indicated that they were the mothers of the children, and 177 (16.9%) indicated that they were the fathers. This information was unknown for two parents. The median age of the parents was 37 years, with a range from 18 years to 93 years. The median age of the children was 6 years. There were 523 boys and 529 girls.

A total of 469 of the 1052 children experienced a sunburn within the past year. The estimated weighted proportion of U.S. white children who had

Discussion

Our results show that a large proportion of U.S. white children experienced at least one sunburn during the past year, similar to findings from Canada (45% of children sunburned during the summer).23 Our results are also within the range of findings from Europe, New Zealand, and Australia, where 29% to 61% of children had a sunburn in the previous summer.24, 25, 26 Jarret et al.27 found that 38% of British children had a sunburn during the previous year. Our results for sunburn during the past

References (31)

  • R.P Gallagher et al.

    Sunlight exposure, pigmentation factors, and risk of nonmelanocytic skin cancer. II. Squamous cell carcinoma

    Arch Dermatol

    (1995)
  • F Grodstein et al.

    A prospective study of incident squamous cell carcinoma of the skin in the Nurses’ Health Study

    J Natl Cancer Inst

    (1995)
  • L.R Maducdoc et al.

    Parents’ use of sunscreen on beach-going childrenthe burnt child dreads the fire

    Arch Dermatol

    (1992)
  • K Veil-Smith et al.

    Childhood sun exposureparental knowledge, attitudes, and behaviors

    J Health Ed

    (1997)
  • J.F Bourke et al.

    Protection of children against sunburna survey of parental practice in Leicester

    Br J Dermatol

    (1995)
  • Cited by (51)

    • Correlates of Sun Protection and Sunburn in Children of Melanoma Survivors

      2016, American Journal of Preventive Medicine
      Citation Excerpt :

      This finding may be attributed to the primary caregiver role that women often assume, but suggests a potential need for enhanced interventions for male survivors. Consistent with other studies, sunburn was more prevalent with increasing child age, and sun protection was more frequent with decreasing child age29,30 (except sunscreen use was more frequent with increasing age in this study). Survivors were not highly confident they could protect children when faced with challenges.

    • The healthytexts study: A randomized controlled trial to improve skin cancer prevention behaviors among young people

      2013, Contemporary Clinical Trials
      Citation Excerpt :

      Regular sunscreen application can reduce the incidence of melanoma by half [7]. Despite good knowledge [8], most adults do not practice adequate sun protection behaviors [9–13]. In Australia, only 33% used sunscreen outdoors during the previous weekend, 27% stayed in the shade and 18% used clothing [10].

    • Children's skin cancer prevention: A systematic review of parents' psychosocial measures

      2013, American Journal of Preventive Medicine
      Citation Excerpt :

      In a longitudinal study, attitudes about children's tans did not predict children's sunburns.42 Perceived susceptibility was positively associated with children's sun protection19,45 and negatively associated with the number of children's sunburns,12 as would be expected. Some associations were no longer significant when other variables also were considered.12,19

    View all citing articles on Scopus
    View full text