title: Use of sunglasses in public outdoor recreation settings in Honolulu, Hawaii.
abstract: OBJECTIVE
  Approximately, 20.5 million Americans (17.2%) older than 40 years have a cataract in at least one eye, and rates are expected to rise to over 30 million by 2020. Wearing sunglasses, especially early in life, may reduce the risk of cataracts. Meanwhile, little is known about the prevalence of wearing sunglasses in the United States, especially in areas with high ultraviolet radiation. The objective of this study was to assess the prevalence and predictors of wearing sunglasses in public outdoor recreation settings.
  
  
  METHODS
  Systematic observations were made at beaches, parks and outdoor public swimming pools in Honolulu, Hawaii on sunny days between November 2005 and June 2007. Observations were conducted independently by two trained observers between 10:00 am and 4:00 pm. During each observation period, each individual in the area was coded for gender, age category, clothing coverage, shade use, and use of sunglasses.
  
  
  RESULTS
  A total of 5171 people were observed by two independent observers, and the inter-rater reliability use of sunglasses was excellent (Cohen kappa = 0.83). Overall, 33.0% of people wore sunglasses. chi analysis revealed that significantly more people (p < 0.001) wore sunglasses at swimming pools (35.1%) and parks (34.8%) compared to beaches (30.4%). Adults (41.6%) were more likely to wear sunglasses than children (12.3%; p < 0.001). Gender was not significantly associated (p = 0.3) with the use of sunglasses (males = 32.7%; females = 33.3%). Those wearing hats were significantly more likely (p < 0.001) to wear sunglasses (46.6%) than those with bare heads (28.4%).
  
  
  CONCLUSIONS
  Direct observation in public outdoor recreation settings revealed that only one third of the population wore sunglasses. Further research should examine the use of sunglasses in other locations and investigate the effectiveness of interventions that promote the wearing of sunglasses in settings with risk for ultraviolet radiation exposure.
authors.affiliation: Office of Public Health Studies, University of Hawaii at Manoa, Honolulu, Hawaii 96822, USA. jmaddock@hawaii.edu
authors.forename: Jay E
authors.initials: JE
authors.lastname: Maddock
authors.forename: David L
authors.initials: DL
authors.lastname: O'Riordan
authors.forename: Taryn
authors.initials: T
authors.lastname: Lee
authors.forename: Joni A
authors.initials: JA
authors.lastname: Mayer
authors.forename: Thomas L
authors.initials: TL
authors.lastname: McKenzie
mesh_terms: D000328:Adult; D002648:Child; D005126:Eye Burns / Q000453:epidemiology / Q000517:prevention & control*; D005135:Eye Protective Devices / Q000706:statistics & numerical data*; D005260:Female; D005500:Follow-Up Studies; D006254:Hawaii / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008297:Male; D015588:Observer Variation; D011998:Recreation; D012189:Retrospective Studies; D013471:Sunburn / Q000453:epidemiology / Q000517:prevention & control*; D014466:Ultraviolet Rays / Q000009:adverse effects*