title: Sun-seeking behavior to increase cutaneous vitamin D synthesis: when prevention messages conflict.
abstract: OBJECTIVE
  The public has long been encouraged to engage in sun-safe practices to minimize exposure to sunlight, the major cause of nonmelanoma skin cancer. More recently, some have advocated unprotected sun exposure to increase cutaneous synthesis of vitamin D as a way to promote health. We assessed the net result of these conflicting messages.
  
  
  METHODS
  In a cross-sectional survey in 2007, questionnaires were mailed to participants of an ongoing cohort study in Washington County, Maryland. The study population consisted of 8,027 adults (55% response rate).
  
  
  RESULTS
  Thirty percent of respondents were aware that unprotected sun exposure increased endogenous vitamin D levels. Among those who were aware of this benefit, 42% reported going out into the sun to increase vitamin D levels. Sun-seeking to increase vitamin D production did not significantly differ according to self-reported personal history of skin cancer, but was significantly higher among women, older age groups, those with less education, and vitamin D supplement users.
  
  
  CONCLUSIONS
  A substantial proportion of respondents reported sun-seeking behavior expressly to increase endogenous vitamin D levels. The message about sun exposure and vitamin D is reaching the general public; however, this finding poses challenges to skin cancer prevention efforts.
authors.affiliation: Comstock Center for Public Health Research and Prevention, Washington County, MD, USA.
authors.forename: Sandra L
authors.initials: SL
authors.lastname: Clipp
authors.forename: Alyce
authors.initials: A
authors.lastname: Burke
authors.forename: Judith
authors.initials: J
authors.lastname: Hoffman-Bolton
authors.forename: Rhoda
authors.initials: R
authors.lastname: Alani
authors.forename: Nanette J
authors.initials: NJ
authors.lastname: Liégeois
authors.forename: Anthony J
authors.initials: AJ
authors.lastname: Alberg
mesh_terms: D000328:Adult; D000368:Aged; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005260:Female; D015438:Health Behavior; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D012867:Skin / Q000378:metabolism*; D012878:Skin Neoplasms / Q000517:prevention & control*; D016082:Solar System; D014807:Vitamin D / Q000096:biosynthesis*
chemical_list: D014807:Vitamin D