title: Changes in the pattern of sun exposure and sun protection in young children from tropical Australia.
abstract: BACKGROUND
  Australia has one of the highest rates of skin cancer globally. Lifetime risk is associated with childhood sun exposure.
  
  
  OBJECTIVE
  We sought to investigate whether skin cancer prevention programs have resulted in improvements in sun-exposure and sun-protection behavior among young children in tropical Australia.
  
  
  METHODS
  Two cohorts of 12-to 35-month-old children from Townsville, Australia, were compared: cohort 1 was recruited from hospital birth records (1991) and cohort 2 was recruited via local child-care centers (1999-2002). Children's phenotypic characteristics were assessed. Parents completed questionnaires detailing children's demographic characteristics, and sun-exposure and sun-protective practices.
  
  
  RESULTS
  Although 1-year-old children from cohort 2 spent more time in the sun than those from cohort 1 (median 2.2 vs 2.8 h/d; P = .002), a higher proportion almost always wore sunscreen and a swim-shirt year round. Although more 1-year-old children in cohort 2 had experienced a sunburn (35.5% vs 51.2%; P = .007), both cohort 2 age groups experienced fewer hours of sun exposure to the back of the trunk (P < .001), were less likely to have been sunburned on the back/shoulders (age 1 year 34.8% vs 10.1% and age 2 years 52% vs 10.1%; P < .001), and acquired fewer melanocytic nevi at these sites (P < .001).
  
  
  CONCLUSIONS
  There was potential for socially desirable responses (information bias).
  
  
  CONCLUSIONS
  Although duration of sun exposure in early childhood did not decrease during an 8-year period, reported use of personal sun protection did. The observed increase in popularity of swim-shirts and sunscreen between cohorts coincided with the development of significantly fewer melanocytic nevi in these children.
authors.affiliation: Skin Cancer Research Group, School of Public Health, Tropical Medicine and Rehabilitation Sciences, James Cook University, Townsville, Queensland, Australia.
authors.forename: Annika
authors.initials: A
authors.lastname: Smith
authors.forename: Simone
authors.initials: S
authors.lastname: Harrison
authors.forename: Madeleine
authors.initials: M
authors.lastname: Nowak
authors.forename: Petra
authors.initials: P
authors.lastname: Buettner
authors.forename: Robert
authors.initials: R
authors.lastname: Maclennan
mesh_terms: D001315:Australia / Q000453:epidemiology; D002656:Child Day Care Centers / Q000706:statistics & numerical data; D002675:Child, Preschool; D003020:Clothing; D015331:Cohort Studies; D004781:Environmental Exposure / Q000009:adverse effects / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D015999:Multivariate Analysis; D009508:Nevus, Pigmented / Q000453:epidemiology* / Q000517:prevention & control*; D010290:Parents; D012307:Risk Factors; D012878:Skin Neoplasms / Q000453:epidemiology* / Q000517:prevention & control*; D013472:Sunlight / Q000009:adverse effects*; D013473:Sunscreening Agents / Q000008:administration & dosage; D011795:Surveys and Questionnaires
chemical_list: D013473:Sunscreening Agents