Sun exposure and sun protective behaviours in Portugal: results from the first National Health Examination Survey (INSEF 2015)
- 10 Downloads
Sunlight exposure is responsible for a large number of dermatological diseases. The purpose of this study was to estimate the prevalence of hazardous sun exposure and adherence to sun protective behaviours and its associated factors in adults from the Portuguese population.
A total of 4,797 participants aged between 25 and 74 years old answered the sun exposure module of the National Health Examination Survey questionnaire, which was performed in 2015. Hazardous sun exposure and sun protective behaviours were assessed for a typical summer day during leisure time. Descriptive statistics and Poisson regression were used to examine associations between hazardous sun exposure and adherence to sun protective behaviours with population characteristics.
Among the 4,797 participants, prevalence of hazardous sun exposure was 76.4 and 67.4% among men and women, respectively. It was mainly associated with younger age, lower education level and practice of regular physical activity. The prevalence of nonadherence to sun protective behaviours was 38.6 and 22.3%, among men and women, respectively. Education and income were inversely associated with adherence to sun protective behaviours. Individuals residing in regions displaying higher UV indexes had higher prevalence of sun protective practices.
The prevalence of hazardous sun exposure and nonadherence to sun protective behaviours is considerable in the Portuguese population. The association between these indicators and sociodemographic factors in the population, reinforces the importance of developing sun protection messages directed at specific target audiences.
KeywordsINSEF Epidemiology Portugal Sun exposure UV radiation Sun protection
The National Health Examination Survey (INSEF) was developed as part of the project “Improvement of epidemiological health information to support public health decision and management in Portugal. Towards reduced inequalities, improved health and bilateral cooperation”, funded by the Public Health Initiatives Program, within the European Economic Area Financial Mechanism (EEA Grants) 2009–2014, and by the Portuguese Government.
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflicts of interest.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. This study was approved by the ethical committee of the National Health Institute Doutor Ricardo Jorge and by the ethical committees of the Portuguese Regional Health Administrations and of the ethical committees of the Regional Health Secretariats of the Autonomous Regions of Madeira and Azores.
Informed consent was obtained from all individual participants involved in the study.
- Bränström R, Kasparian NA, Chang Y-M, Affleck P, Tibben A, Aspinwall LG, Azizi E, Baron-Epel O, Battistuzzi L, Bergman W, Bruno W, Chan M, Cuellar F, Dębniak T, Pjanova D, Ertmański S, Figl A, Gonzalez M, Hayward NK, Hocevar M, Kanetsky PA, Leachman SA, Heisele O, Palmer J, Peric B, Puig S, Schadendorf D, Gruis NA, Newton-Bishop J, Brandberg Y (2010) Predictors of sun protection behaviours and severe sunburn in an international on-line study. Cancer Epidemiol Biomark Prev 19:2199–2210. https://doi.org/10.1158/1055-9965.EPI-10-0196 CrossRefGoogle Scholar
- Direção-Geral da Saúde Cuidados a ter com a exposição solar. https://www.dgs.pt/saude-ambiental-calor/exposicao-solar.aspx. Accessed 15 Jan 2019
- Elwood JM, Diffey BL (1993) A consideration of ambient solar ultraviolet radiation in the interpretation of studies of the aetiology of melanoma. Melanoma Res 3:113–122Google Scholar
- English DR, Armstrong BK, Kricker A, Winter MG, Heenan PJ, Randell PL (1998) Demographic characteristics, pigmentary and cutaneous risk factors for squamous cell carcinoma of the skin: a case-control study. Int J Cancer 76:628–634. https://doi.org/10.1002/(SICI)1097-0215(19980529)76:5<628::AID-IJC3>3.0.CO;2-S CrossRefGoogle Scholar
- Fitzpatrick TB (1988) The validity and practicality of sun-reactive skin types I through VI. Arch Dermatol 124:869. https://doi.org/10.1001/archderm.1988.01670060015008 CrossRefGoogle Scholar
- Harris PA, Taylor R, Thielke R, Payne J, Gonzalez N, Conde JG (2009) Research electronic data capture (REDCap): a metadata-driven methodology and workflow process for providing translational research informatics support. J Biomed Inform 42:377–381. https://doi.org/10.1016/j.jbi.2008.08.010 CrossRefGoogle Scholar
- Holick MF (2016) Biological effects of sunlight, ultraviolet radiation, visible light, infrared radiation and vitamin D for health. Anticancer Res 36:1345–1356Google Scholar
- International Agency for Cancer Research (2018) Cancer today. http://gco.iarc.fr/today/online-analysis-map?v=2018&mode=population&mode_population=continents&population=900&populations=900&key=asr&sex=0&cancer=16&type=0&statistic=5&prevalence=0&population_group=0&ages_group%5B%5D=0&ages_group%5B%5D=17&nb_items=5&grou. Accessed August 2019
- Leiter U, Eigentler T, Garbe C (2014) Epidemiology of skin cancer. Adv Exp Med Biol 810:120–140Google Scholar
- Nunes B, Barreto M, Gil AP, Kislaya I, Namorado S, Antunes L, Gaio V, Santos AJ, Rodrigues AP, Santos J, Roquette R, Alves-Alves C, Castilho E, Cordeiro E, Dinis A, Prokopenko T, Silva AC, Vargas P, Lyshol H, Dias CM (2018) The first Portuguese National Health Examination Survey (2015): design, planning and implementation. J Public Health (Bangkok), pp 1–7. https://doi.org/10.1093/pubmed/fdy150
- Organisation for Economic Co-operation and Development OECD (20190 Project on Income Distribution and Poverty. https://www.oecd.org/social/income-distribution-database.htm#targetText=To%20benchmark%20and%20monitor%20income,after%20taxes%20and%20transfers%2C%20etc.. Accessed August 2019
- Pereira Duquia R, Maria Baptista Menezes A, Larangeira de Almeida H Jr, Fossati Reichert F, da Silva dos Santos I, Lanzetta Haack R, Lessa Horta B (2013) Prevalence of sun exposure and its associated factors in southern Brazil: a population-based study [Prevalência e fatores associados à exposição solar no sul do Brasil: um estudo de base populacional]. An Bras Dermatol 88:554–561. https://doi.org/10.1590/abd1806-4841.20132122 CrossRefGoogle Scholar
- Pinault L, Fioletov V (2017) Sun exposure, sun protection and sunburn among Canadian adults. Health Rep 28:12–19Google Scholar
- Ribeiro C, Relvas A, Costa V, Costa M (2017) Proteção solar: conhecimentos e hábitos na população pediátrica. Nascer Crescer vol 26 n.1 pp 31–35Google Scholar
- Rodriges Â, Fernandes-Machado S, Neves Alves M, de Paula CM, Correia O, Césarini P (2014) Proteção solar em crianças e jovens portugueses: um estudo transversal. Psicol saúde doenças 15:828–841Google Scholar
- StataCorp (2017) Stata statistical software: release 15. StataCorp, College StationGoogle Scholar
- World Health Organization (2019) World Health Organization Sun protection. In: UV Expo. https://www.who.int/uv/sun_protection/en/. Accessed August 2019
- World Health Organization, World Meteorological Organization, United Nations Environment Programme, International Commission on Non-Ionizing Radiation (2002) Global solar UV index: a practical guide. WHO, GenevaGoogle Scholar