Children's exposure to ultraviolet radiation - a risk profile for future skin cancers in Ireland

Abstract

Key points Why has this report been developed? Excessive exposure to ultraviolet (UV) radiation, sunburn and sunbed use in childhood are risk factors for developing skin cancer in adult life. This report presents data on these risk factors in Ireland for the first time. Data are presented principally from the Irish Health Behaviour in School-aged Children (HBSC) Study 2018 (1). This report was developed to support implementation and monitoring of the Government’s National Skin Cancer Prevention Plan 2019-2022 (2). What do we know about sunburn and sun protective behaviours in childhood? Levels of self-reported childhood sunburn in Ireland were high. Nine out of 10 schoolchildren aged 10 to 17 reported at least one experience of sunburn. Around three quarters reported sunburn within the last year. Children from more affluent families were more likely to report experiencing sunburn. Eight out of 10 schoolchildren reported wearing sunscreen and seven out of 10 reported using sunglasses on sunny days. Adoption of other sun protection measures, like covering up, wearing hats and avoiding peak UV hours, were less consistent. One in three children reported that they avoided peak UV hours and half reported wearing protective clothing to cover arms and legs when in the sun. Overall, girls were more likely to adopt sun protection behaviours but the patterns differed by gender with girls more likely to wear sunscreen, sunglasses, clothes that cover arms and legs as well as avoid peak UV hours. Boys were more likely to wear hats. What do we know about skin type and children’s attitudes to tanning? Survey data from schoolchildren in Northern Ireland shows that 58% of children find tans appealing. However, 69% of children were unable to correctly identify risks associated with tanning. Most teens in Ireland identify as Fitzpatrick skin type I or II1 indicating a significant population level genetic predisposition to future skin cancer (3). We could not source any reliable data on the use of fake tan or tanning accelerator type products. What did children say about sunbed use? Sunbed use was rare, as reported by 3% of children. The provision of sunbed services to children (aged under 18) is contrary to Irish law as outlined in the Public Health (Sunbeds) Act 2014. How might our weather be affecting risk? Six of the 10 warmest years in Ireland’s history have occurred during the childhoods of the current cohort of 18 to 20-year olds. Since 2006, for the period May to September, around two thirds of days recorded a UV index of 3 or more. During school summer holidays, June to August, around three quarters of days recorded a UV index of 3 or more. A UV index of 3 of more results in greater risk for skin damage and it is strongly advised to protect the skin. When the UV Index is over 3 the WHO recommends practicing multiple sun protection behaviors including seeking shade during midday hours, wearing on a shirt, putting on sunscreen and a hat. Climate research predicts hotter summers and more heatwaves. This may present elevating risk for UV skin damage, particularly in terms of childhood exposure during the summer school holidays. The relationship between climate change and skin damage is poorly understood. What are the priority issues for data and research? Data presented in this report could have the potential to inform the development of indicators, policy monitoring and inform risk modelling studies. The main data and research gaps identified include a lack of data on children under 10 years old and on sunburn severity, specifics on the types of sunscreens, hats and sunglasses being used, factors influencing children’s risk behaviours, and the retail and marketing of commercial sunbed use to young people in Ireland.