Prevalence of sunburn, sun protection, and indoor tanning behaviors among Americans: Review from national surveys and case studies of 3 states

• Published in: Journal of the American Academy of Dermatology Vol. 65; no. 5; pp. S114.e1 - S114.e11
• Main Authors: Buller, David B., PhD, Cokkinides, Vilma, PhD, Hall, H. Irene, PhD, Hartman, Anne M., MS, MA, Saraiya, Mona, MD, MPH, Miller, Eric, PhD, MPH, Paddock, Lisa, MPH, Glanz, Karen, PhD, MPH
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-11-2011
• Subjects: Adolescent; Adult; adults; Aged; Behavioral Risk Factor Surveillance System; children; Dermatology; Female; Health Behavior; Health Information National Trends Survey; Humans; indoor tanning; Male; Melanoma - etiology; Melanoma - prevention & control; Middle Aged; National Health Interview Survey; Registries; skin cancer risk; Skin Neoplasms - etiology; Skin Neoplasms - prevention & control; sun protection; Sunbathing - statistics & numerical data; sunburn; Sunburn - epidemiology; Sunburn - etiology; Sunburn - prevention & control; sunscreen; Sunscreening Agents - administration & dosage; ultraviolet radiation; Ultraviolet Rays - adverse effects; United States - epidemiology; Young Adult; Youth Risk Behavior Survey; United States; skin cancer risk; NHIS; UV; sunscreen; Youth Risk Behavior Survey; CDC; YRBS; adults; Health Information National Trends Survey; SPF; sunburn; sun-protection factor; indoor tanning; National Health Interview Survey; Behavioral Risk Factor Surveillance System; sun protection; ultraviolet radiation; ACS; American Cancer Society; Centers for Disease Control and Prevention; HINTS; children; ultraviolet; BRFSS
• ISSN: 0190-9622; 1097-6787
• DOI: 10.1016/j.jaad.2011.05.033

Background Exposure to ultraviolet radiation (from solar and nonsolar sources) is a risk factor for skin cancer. Objective We sought to summarize recent estimates on sunburns, sun-protection behaviors, and indoor tanning available from national and selected statewide behavioral surveys. Methods Estimates of the prevalence of sunburn, sun-protection behaviors, and indoor tanning by US adults, adolescents, and children collected in national surveys in 1992, 2004 to 2005, and 2007 to 2009 were identified and extracted from searches of computerized databases (ie, MEDLINE and PsychINFO), reference lists, and survey World Wide Web sites. Sunburn estimates from 3 state Behavioral Risk Factors Surveillance Systems were also analyzed. Results Latest published estimates (2005) showed that 34.4% of US adults were sunburned in the past year. Incidence of sunburns was highest among men, non-Hispanic whites, young adults, and high-income groups in national surveys. About 3 in 10 adults routinely practiced sun-protection behaviors, and women and older adults took the most precautions. Among adolescents, 69% were sunburned in the previous summer and less than 40% practiced sun protection. Approximately 60% of parents applied sunscreen and a quarter used shade to protect children. Indoor tanning was prevalent among younger adults and females. Limitations Limitations include potential recall errors and social desirability in self-report measures, and lack of current data on children. Conclusion Many Americans experienced sunburns and a minority engaged in protective behaviors. Females and older adults were most vigilant about sun protection. Substantial proportions of young women and adolescents recently used indoor tanning. Future efforts should promote protective hats, clothing, and shade; motivate males and younger populations to take precautions; and convince women and adolescents to reduce indoor tanning.