by Janice Clark Young, EDD, CHES, and Brenda S. Goodwin, MS
The risk of skin cancer begins with a child’s first exposure to sunlight. The sun’s ultraviolet (UV) radiation damages the skin, eyes, and immune system1, and the effects are cumulative. Although light-skinned people are the most susceptible to skin cancer, everyone is vulnerable and should be vigilant about sun safety.
Sun protection should begin at birth, since establishing healthy routines in childhood can foster positive lifelong preventive habits.2 Sun safety is especially important for young people because multiple sunburns (in fact, just one blistering sunburn) during childhood and adolescence more than double the risk of melanoma in the future.3
The World Health Organization (WHO) notes, “UV radiation exposure during the school years contributes significantly to total lifetime sun exposure.”1 During a child’s typical weekday, six to nine hours are spent at school. Sunlight is most intense between 10 AM and 4 PM, when students are often outdoors for recess and other school or after-school activities. Many school grounds lack the adequately shaded areas needed to limit UV exposure.
Shade can be provided by solid roof structures, gazebos, awnings, shade cloth, and natural shade, such as thickly leaved trees.4 However, these partial shade methods still allow some UV exposure (even on gray days, since UV rays pass through clouds, rain, and fog), so more sun protection strategies are needed. Children must be instructed to “protect themselves when outdoors by using shade, clothing, hats and sunscreen (in that order of priority),” an article in Health Education Research advises.5 Teachers, coaches, and staff should model sun protection behaviors during outdoor activities. Rescheduling these activities to avoid midday exposure is also especially important, since some schools prohibit wearing caps, hats, and sunglasses on school property due to the association with gang activities and/or drug use.6
Professional development for school staff should address sun safety policies, practices, and teaching strategies.1 Teachers can take advantage of the many free, age-appropriate sun protection curricula or lessons. K-8 classroom materials are available through the SunWise School Program (www.epa.gov/sunwise), as are lessons from the Sun Safety Activity Guide (www.nsc.org). For grades K-12, the Melanoma Foundation (www.melanomafoundation.com) offers SunSmart America, and the Shade Foundation (www.shadefoundation.org) provides the Sun Safe School Guide. Many US school districts lack written sun safety policies. This plus misunderstanding and lack of knowledge of UV radiation risks contributes to children’s poor sun protection practices.7 Certain existing policies define sunscreen as “medicine,” require parental/ medical permission for its application, or prohibit teachers/aides from applying it to children.6 A revised sun protection policy might recommend that parents 1) include sunscreen in students’ supply kits; and 2) sign permission slips allowing their children to apply sunscreen before going outside. Permission slips would be kept in the students’ permanent school health records.6 Suggestions for creating a policy, as well as a sample policy, are available at www.sunsafetyforkids.org/schoolpolicy/.
Community members, businesses, and organizations can assist in sun protection efforts by 1) serving on school sun safety committees; 2) donating money to buy trees/shrubs and shade structures; 3) planting trees or installing shade structures on school grounds; and 4) making sunscreen available for school/ recreation use. Additionally, in some states, grassroots advocacy is needed to pass laws allowing the legal distribution of sunscreen and the use of hats in schools and community recreation programs.
It behooves all adults to become positive role models who practice and promote sun protection behaviors.2 School personnel and parents can be instrumental in establishing these lifelong healthy behaviors.
Dr. Young is an Associate Professor in the Department of Health and Exercise Sciences at Truman State University, Kirksville, MO.
Brenda Goodwin is an Instructor in the Department of Health, Physical Education and Recreation at Missouri State University, Springfield, MO.
- World Health Organization. (2003). Sun protection and schools: How to make a difference [Electronic version]. Retrieved on 11/25/09, from http://www.who.int/uv/ publications/en/sunprotschools.pdf
- Young, JC (2000). Sun safety survey of preschools and day care centers. American Journal of Health Studies; 16(2):71.
- Gilchrest, BA, Eller MS, Geller AC, and Yaar M. New England Journal of Medicine 1999 (April 29). 340(17);1341-1348.
- Centers for Disease Control and Prevention. (2002). Shade planning for America’s schools. Retrieved from the internet on 11/23/09, from http://www.cdc.gov/cancer/ skin/pdf/shade_planning.pdf
- Giles-Corti B, English DR, Costa C, Milne E, Cross D, and Johnston R. Creating SunSmart schools. Health Education Research 2004; 19(1):98-109.
- Glanz K, Saraiya M, and Wechsler H. Guidelines for school programs to prevent skin cancer. Morbidity and Mortality Weekly Report 2002 (April 26); 51(RR04); 1-16.
- Dadlani C and Orlow SJ. Planning for a brighter future: A review of sun protection and barriers to behavioral change in children and adolescents. Dermatology Online Journal (2008 Sept.); 14(9). Retrieved from the internet on 11/16/09 from http:// dermatology.cdlib.org/149/commentaries/sunprotection/dadlani.html
- Centers for Disease Control and Prevention. (n.d). Sun safety at schools: What you can do. Retrieved from the internet on 11/23/09, from http://www.cdc.gov/cancer/ skin/pdf/sunsafety_v0908.pdf