title: Lifeguards' sun protection habits and sunburns: association with sun-safe environments and skin cancer prevention program participation.
abstract: OBJECTIVE
  To examine associations among outdoor pool environments, social norms, pool policies, and participation in a sun safety program with lifeguards' sun protection habits and sunburn.
  
  
  METHODS
  Cross-sectional survey.
  
  
  METHODS
  Outdoor swimming pools across the United States.
  
  
  METHODS
  Lifeguards and aquatic instructors at pools participating in the Pool Cool skin cancer prevention program in 2001 (N = 699) and 2002 (N = 987).
  
  
  METHODS
  Sun protection habits and number of sunburns.
  
  
  RESULTS
  Social norms supporting sun safety were associated with more sun protection habits (95% confidence intervals [CIs], 0.18-0.28 in 2001 and 0.17-0.26 in 2002), as were pool policies supporting sun safety (95% CI, 0.02-0.07 in 2001 and 0.002-0.04 in 2002). There was a trend toward fewer sunburns as social norms, pool policies, and participation in the Pool Cool program increased, but results differed across the 2 years. In 2001, lower social norms scores and pool policy scores were associated with more reported sunburns. In 2002, teaching Pool Cool sun safety lessons was associated with fewer sunburns.
  
  
  CONCLUSIONS
  The pool environment is related to sun safety behaviors of outdoor pool staff, with social norms showing the strongest association.
authors.affiliation: Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, 1518 Clifton Rd, NE, Room 521, Atlanta, GA 30307, USA. dmhall@sph.emory.edu
authors.forename: Dawn M
authors.initials: DM
authors.lastname: Hall
authors.forename: Frances
authors.initials: F
authors.lastname: McCarty
authors.forename: Tom
authors.initials: T
authors.lastname: Elliott
authors.forename: Karen
authors.initials: K
authors.lastname: Glanz
mesh_terms: D000293:Adolescent; D003430:Cross-Sectional Studies; D005260:Female; D006184:Habits; D006266:Health Education; D007722:Health Knowledge, Attitudes, Practice; D006282:Health Personnel / Q000523:psychology*; D006306:Health Surveys; D006801:Humans; D008297:Male; D016273:Occupational Exposure / Q000517:prevention & control*; D012878:Skin Neoplasms / Q000209:etiology / Q000517:prevention & control*; D013471:Sunburn / Q000517:prevention & control; D013472:Sunlight / Q000009:adverse effects; D013550:Swimming; D055815:Young Adult