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Canadian Journal of Public Health

, Volume 107, Issue 4–5, pp e473–e479 | Cite as

An update to the recommended core content for sun safety messages for public education in Canada: A consensus report

  • Loraine D. Marrett
  • Maria B. H. ChuEmail author
  • John Atkinson
  • Robert Nuttall
  • Gillian Bromfield
  • Larry Hershfield
  • Cheryl F. Rosen
  • National Consensus Process on the Recommended Core Content for Sun Safety Messages in Canada
Commentary
  • 1 Downloads

Abstract

Reducing ultraviolet radiation exposure decreases the risk of skin cancer and eye damage. Between 1996 and 2006, Canadians increased their time in the sun without improving protection. National consensus on sun protection information for the public was last achieved in 1994. Public messages have since been modified inconsistently. The Ontario Sun Safety Working Group initiated a review of messages and engaged a scientific panel to draft message content. Working Group members then delivered a national consensus process, engaging a National Steering Committee, a health communications expert and representatives from 28 organizations through a workshop with pre- and post-workshop surveys. The result of the consensus process is the updated Recommended Core Content for Sun Safety Messages in Canada. Four groups of statements comprise the new content: Key Facts, Primary Recommended Protective Action Statements, Additional Recommended Protective Action Statements, and Tips for Implementing the Primary Protective Actions. Organizations are encouraged to adopt, at minimum, the Primary Recommended Protective Action Statements as the basis for public messaging. The recommended core content establishes a common understanding of what is needed for effective sun protection. The underlying expectation is that, as a key next step, content will be tailored for different subpopulations and health promotion campaigns.

Key words

Ultraviolet rays/adverse effects skin neoplasms/prevention and control eye diseases/prevention and control consensus health education Canada 

Résumé

La réduction de l’exposition aux rayons ultraviolets diminue le risque de cancer de la peau et de lésions oculaires. Entre 1996 et 2006, les Canadiens ont accru le temps qu’ils passent au soleil sans améliorer leur protection. Le dernier consensus national concernant l’information sur la protection solaire à transmettre au public date de 1994. Depuis, les messages d’intérêt public sont modifiés de façon contradictoire. L’OSSWG (Ontario Sun Safety Working Group), un organisme ontarien, a amorcé un examen de ces messages et confié à un comité scientifique le mandat d’élaborer leur contenu. Les membres de l’OSSWG ont ensuite proposé un processus de consensus national et coopéré avec un comité directeur national, une spécialiste en communication de messages sur la santé et des représentants de 28 organismes dans le cadre d’un atelier et de sondages avant et après l’atelier. Le processus de consensus a mené à la révision du contenu de base recommandé pour les messages de sécurité au soleil au Canada. Le nouveau contenu comprend quatre groupes d’énoncés: des « faits clés », des « énoncés des mesures de protection primaires recommandées », des « énoncés des mesures de protection supplémentaires recommandées » et des « conseils pour appliquer les mesures de protection primaires ». On encourage les organismes à adopter, au minimum, les « énoncés des mesures de protection primaires recommandées » à la base de leurs messages d’intérêt public. Le contenu de base recommandé établit une compréhension commune de ce qui est nécessaire à une protection solaire efficace. L’attente sous-jacente est qu’à la prochaine étape clé, on adaptera ce contenu à différentes sous-populations et à des campagnes de promotion de la santé.

Motsclés

rayons ultraviolets/effets des rayonnements tumeurs de la peau/prévention et contrôle maladies de l’œil/prévention et contrôle consensus éducation sanitaire Canada 

References

  1. 1.
    IARC Working Group on Risk of Skin Cancer and Exposure to Artificial Ultraviolet Light, International Agency for Research on Cancer (Eds.). Exposure to Artificial UV Radiation and Skin Cancer. Lyon, France: World Health Organization, International Agency for Research on Cancer, 2006.Google Scholar
  2. 2.
    Yam JCS, Kwok AKH. Ultraviolet light and ocular diseases. Int Ophthalmol 2014;34(2):383–400. PMID: 23722672. doi: 10.1007/s10792-013-9791-x.CrossRefGoogle Scholar
  3. 3.
    National Skin Cancer Prevention Committee. Exposure to and Protection from the Sun in Canada: A Report Based on the 2006 Second National Sun Survey. Toronto, ON: Canadian Partnership Against Cancer, 2010.Google Scholar
  4. 4.
    Canadian Cancer Society’s Advisory Committee on Cancer Statistics. Canadian Cancer Statistics 2015. Special Topic: Predictions of the Future Burden of Cancer in Canada. Toronto, ON: Canadian Cancer Society, 2015.Google Scholar
  5. 5.
    Mills CJ, Jackson S. Workshop report: Public education messages for reducing health risks from ultraviolet radiation. Chronic Dis Can 1995; 16(1):33–36. Available at: http://www.collectionscanada.gc.ca/webarchives/20071223122331/http://www.phac-aspc.gc.ca/publicat/cdic-mcc/16-1/d_e. html (Accessed June 1, 2015).Google Scholar
  6. 6.
    Han PKJ, Moser RP, Klein WMP. Perceived ambiguity about cancer prevention recommendations: Associations with cancer-related perceptions and behaviours in a US population survey. Health Expect 2007;10(4):321–36. PMID: 17986069. doi: 10.1111/j.1369-7625.2007.00456.x.CrossRefGoogle Scholar
  7. 7.
    Armstrong BK, Kricker A. The epidemiology of UV induced skin cancer. J Photochem Photobiol B 2001;63(1-3):8–18. PMID: 11684447. doi: 10.1016/ S1011-1344(01)00198-1.CrossRefGoogle Scholar
  8. 8.
    Fioletov VE, Kerr JB, McArthur LJB, Wardle DI, Mathews TW. Estimating UV Index climatology over Canada. J Appl Meteorol 2003;42(3):417–33. doi: 10. 1175/1520-0450(2003)042<0417:EUICOC>2.0.CO;2.CrossRefGoogle Scholar
  9. 9.
    Fioletov V, Kerr JB, Fergusson A. The UV Index: Definition, distribution and factors affecting it. Can J Public Health 2010;101(4):I5–I9. PMID: 21033538.PubMedGoogle Scholar
  10. 10.
    Sasaki H, Sakamoto Y, Schnider C, Fujita N, Hatsusaka N, Sliney DH, et al. UV-B exposure to the eye depending on solar altitude. Eye Contact Lens 2011; 37(4):191–95. PMID: 21670696. doi: 10.1097/ICL.0b013e31821fbf29.CrossRefGoogle Scholar
  11. 11.
    Kapelos G, Patterson M. Health, planning, design and shade: A critical review. J Archit Plan Res 2014;31(2):91–111.Google Scholar
  12. 12.
    Aguilera J, de Gálvez MV, Sánchez-Roldán C, Herrera-Ceballos E. New advances in protection against solar ultraviolet radiation in textiles for summer clothing. Photochem Photobiol 2014;90(5):1199–206. PMID: 24861801. doi: 10.1111/php.12292.PubMedGoogle Scholar
  13. 13.
    Ghazi S, Couteau C, Coiffard LJM. What level of protection can be obtained using sun protective clothing? Determining effectiveness using an in vitro method. Int J Pharm 2010;397(1-2):144–46. PMID: 20600730. doi: 10.1016/j. ijpharm.2010.06.022.CrossRefGoogle Scholar
  14. 14.
    Lautenschlager S, Wulf HC, Pittelkow MR. Photoprotection. Lancet 2007; 370(9586):528–37. PMID: 17693182. doi: 10.1016/S0140-6736(07)60638-2.CrossRefGoogle Scholar
  15. 15.
    National Institute for Health and Care Excellence (NICE). Skin Cancer Prevention: Information, Resources and Environmental Changes. NICE Public Health Guidance 32, 2011. Available at: https://www.nice.org.uk/guidance/ph32/chapter/1-Recommendations#recommendation-3-information-provision-message-content (Accessed June 1, 2015).Google Scholar
  16. 16.
    Allinson S, Asmuss M, Baldermann C, Bentzen J, Buller D, Gerber N, et al. Validity and use of the UV index: Report from the UVI working group, Schloss Hohenkammer, Germany, 5–7 December 2011. Health Phys 2012;103(3):301–6. PMID: 22850235. doi: 10.1097/HP0b013e31825b581e.CrossRefGoogle Scholar
  17. 17.
    Schaefer L, Plotnikoff RC, Majumdar SR, Mollard R, Woo M, Sadman R, et al. Outdoor time is associated with physical activity, sedentary time, and cardiorespiratory fitness in youth. J Pediatr 2014;165(3):516–21. PMID: 25043155. doi: 10.1016/j.jpeds.2014.05.029.CrossRefGoogle Scholar
  18. 18.
    Pearce M, Page AS, Griffin TP, Cooper AR. Who children spend time with after school: Associations with objectively recorded indoor and outdoor physical activity. Int J Behav Nutr Phys Act 2014;11(1):45. PMID: 24679149. doi: 10. 1186/1479-5868-11-45.Google Scholar
  19. 19.
    International Agency for Research on Cancer. IARC Monographs on the Evaluation of Carcinogenic Risks to Humans. Volume 100D. A Review of Human Carcinogens. Part D: Radiation. Lyon, France: IARC Press, 2012.Google Scholar
  20. 20.
    Sliney DH. Photoprotection of the eye - UV radiation and sunglasses. J Photochem Photobiol B 2001;64(2-3):166–75. PMID: 11744403. doi: 10.1016/ S1011-1344(01)00229-9.CrossRefGoogle Scholar
  21. 21.
    Lucas RM. An epidemiological perspective of ultraviolet exposure - Public health concerns. Eye Contact Lens 2011;37(4):168–75. PMID: 21670693. doi: 10.1097/ICL.0b013e31821cb0cf.CrossRefGoogle Scholar
  22. 22.
    Cullen AP. Ozone depletion and solar ultraviolet radiation: Ocular effects, a United Nations Environment Programme perspective. Eye Contact Lens 2011; 37(4):185–90. PMID: 21670695. doi: 10.1097/ICL.0b013e318223392e.CrossRefGoogle Scholar
  23. 23.
    Fioletov VE, McArthur LJB, Mathews TW, Marrett L. On the relationship between erythemal and vitamin D action spectrum weighted ultraviolet radiation. J Photochem Photobiol B 2009;95(1):9–16. PMID: 19150601. doi: 10. 1016/j.jphotobiol.2008.11.014.CrossRefGoogle Scholar
  24. 24.
    Bodeker GE, McKenzie RL. An algorithm for inferring surface UV irradiance including cloud effects. J Appl Meteorol 1996;35(10):1860–77. doi: 10.1175/ 1520-0450(1996)035<1860:AAFISU>2.0.CO;2.CrossRefGoogle Scholar
  25. 25.
    Tarasick DW, Fioletov VE, Wardle DI, Kerr JB, McArthur LJB, McLinden CA. Climatology and trends of surface UV radiation: Survey article. Atmos-Ocean 2003;41(2):121–38. doi: 10.3137/ao.410202.CrossRefGoogle Scholar
  26. 26.
    Linos E, Keiser E, Fu T, Colditz G, Chen S, Tang JY. Hat, shade, long sleeves, or sunscreen? Rethinking US sun protection messages based on their relative effectiveness. Cancer Causes Control 2011;22(7):1067–71. PMID: 21637987. doi: 10.1007/s10552-011-9780-1.CrossRefGoogle Scholar
  27. 27.
    Kø ster B, Thorgaard C, Philip A, Clemmensen IH. Prevalence of sunburn and sun-related behaviour in the Danish population: A cross-sectional study. Scand J Public Health 2010;38(5):548–52. PMID: 20484310. doi: 10.1177/ 1403494810371250.CrossRefGoogle Scholar
  28. 28.
    Bränström R, Kasparian NA, Chang Y, Affleck P, Tibben A, Aspinwall LG, et al. Predictors of sun protection behaviors and severe sunburn in an international online study. Cancer Epidemiol Biomarkers Prev 2010;19(9):2199–210. PMID: 20643826. doi: 10.1158/1055-9965.EPI-10-0196.CrossRefGoogle Scholar
  29. 29.
    Health Canada. Sunscreen Monograph - Version 2.0, 2013. Available at: http://webprod.hc-sc.gc.ca/nhpid-bdipsn/atReq.do?atid=sunscreen-ecransolaire&lang=eng (Accessed May 29, 2015).Google Scholar
  30. 30.
    Moloney FJ, Collins S, Murphy GM. Sunscreens: Safety, efficacy and appropriate use. Am J Clin Dermatol 2002;3(3):185–91. PMID: 11978139. doi: 10.2165/00128071-200203030-00005.CrossRefGoogle Scholar
  31. 31.
    Diffey B. Sunscreens: Expectation and realization. Photodermatol Photoimmunol Photomed 2009;25(5):233–36. PMID: 19747240. doi: 10.1111/j.1600-0781.2009.00459.x.CrossRefGoogle Scholar
  32. 32.
    Beyer DM, Faurschou A, Philipsen PA, Haedersdal M, Wulf HC. Sun protection factor persistence on human skin during a day without physical activity or ultraviolet exposure. Photodermatol Photoimmunol Photomed 2010; 26(1):22–27. PMID: 20070835. doi: 10.1111/j.1600-0781.2009.00479.x.CrossRefGoogle Scholar
  33. 33.
    Bodekaer M, Faurschou A, Philipsen PA, Wulf HC. Sun protection factor persistence during a day with physical activity and bathing. Photodermatol Photoimmunol Photomed 2008;24(6):296–300. PMID: 19000186. doi: 10.1111/ j.1600-0781.2008.00379.x.CrossRefGoogle Scholar
  34. 34.
    Usher-Smith JA, Emery J, Kassianos AP, Walter FM. Risk prediction models for melanoma: A systematic review. Cancer Epidemiol Biomarkers Prev 2014; 23(8):1450–63. PMID: 24895414. doi: 10.1158/1055-9965.EPI-14-0295.CrossRefGoogle Scholar
  35. 35.
    Gandini S, Autier P, Boniol M. Reviews on sun exposure and artificial light and melanoma. Prog Biophys Mol Biol 2011;107(3):362–66. PMID: 21958910. doi: 10.1016/j.pbiomolbio.2011.09.011.CrossRefGoogle Scholar
  36. 36.
    World Health Organization. The Known Health Effects of UV. Available at: http://www.who.int/uv/faq/uvhealtfac/en/ (Accessed May 29, 2015).
  37. 37.
    Fannin TE, Grosvenor T. Clinical Optics. Boston, MA: Butterworths, 1987.Google Scholar
  38. 38.
    Health Canada. Vitamin D and Calcium: Updated Dietary Reference Intakes, 2013. Available at: http://www.hc-sc.gc.ca/fn-an/nutrition/vitamin/vita-d-eng.php (Accessed July 23, 2014).Google Scholar

Copyright information

© The Canadian Public Health Association 2016

Authors and Affiliations

  • Loraine D. Marrett
    • 1
    • 2
  • Maria B. H. Chu
    • 1
    Email author
  • John Atkinson
    • 3
  • Robert Nuttall
    • 4
  • Gillian Bromfield
    • 5
  • Larry Hershfield
    • 2
    • 6
  • Cheryl F. Rosen
    • 7
    • 8
  • National Consensus Process on the Recommended Core Content for Sun Safety Messages in Canada
  1. 1.Cancer Care OntarioTorontoCanada
  2. 2.Dalla Lana School of Public HealthUniversity of TorontoTorontoCanada
  3. 3.Canadian Cancer SocietyOntario DivisionTorontoCanada
  4. 4.Canadian Cancer SocietyNational OfficeTorontoCanada
  5. 5.Cancer Care OntarioTorontoCanada
  6. 6.Larry Hershfield & Associates, Ltd.TorontoCanada
  7. 7.Division of Dermatology, Toronto Western HospitalUniversity Health Network Hospitals, and Mount Sinai HospitalTorontoCanada
  8. 8.Department of MedicineUniversity of TorontoTorontoCanada

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