Previously submitted to: JMIR Dermatology (no longer under consideration since Oct 07, 2020)
Date Submitted: Aug 31, 2020
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Sunburn Frequency and Risk and Protective Factors: A Cross-Sectional Survey
ABSTRACT
Background:
Primary prevention of skin cancer is at the forefront of public health as morbidity and economic burden of this malignancy continue to grow. There are limited data on effective interventions to reduce sunburn frequency and modifiable risk factors.
Objective:
To determine an association between (1) demographic characteristics and outdoor sunburn frequency and (2) sunburn frequency and sun-related behaviors.
Methods:
Of the 23,430 surveys sent out, 4,883 participants reported sunburn-related data in the National Cancer Institute Health Information National Trends Survey (HINTS) 5 Cycle 3, a nationally representative, cross-sectional household survey. Association between frequency of sunburns within the last 12 months and demographic, risk, and protective factors were examined using Rao-Scott chi-square test. When assessing demographic factors, potential confounding was addressed using multivariable analysis.
Results:
In multivariable models, respondents more likely to report any sunburn were younger than 35 (ages 35-64 Odds Ratio (OR) (95% Confidence Interval CI): 0.43 (0.30-0.61); ages 65+ OR (95% CI): 0.12 (0.07-0.16)) and non-Hispanic white ethnicity (Non-Hispanic Black or Other OR (95% CI): 0.19 (0.13-0.30); Hispanic OR (95% CI): 0.48 (0.32-0.72)). Respondents with higher income were more likely to report any sunburn (OR (95% CI): 2.58 (1.78-3.76)), but less likely to sunburn frequently (OR (95% CI): 0.26 (0.12-0.56)). Females were less likely to report frequent sunburns than males (OR (95% CI): 0.56 (0.34-0.94)). Engagement in sporting events (P =.04), outdoor events (P=.04), and day-to-day activities (P<.001) during the most recent sunburn was more commonly reported by those with frequent sunburns as compared with those with infrequent sunburns while no difference was found in protective factors or alcohol use.
Conclusions:
Public health interventions to prevent sunburns should target specific higher risk demographics during time spent outdoors, sporting events, and other day-to-day activities. Further insight into risk and protective behaviors for those who did not burn for comparison could be useful to further guide public health interventions.
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