title: Sun protective behaviour and sunburn prevalence in primary and secondary schoolchildren in western Switzerland.
abstract: OBJECTIVE
  Although solar overexposure during childhood and adolescence increases the risk of melanoma, determinants of sunburn and sun protective behaviours of Swiss children have scarcely been explored. We investigated sunburn occurrence and sun protective behaviours of schoolchildren in western Switzerland, the region with the highest incidence of melanoma in Europe.
  
  
  METHODS
  Self-reported questionnaires were administered during regular classes to pupils in 5th (primary school, n = 431), 8th and 11th grades (secondary school, n = 837) in the 18 public schools of La Chaux-de-Fonds. Descriptive statistics and multivariate logistic regression analyses were performed to assess predictors of sunburns and of three sun protective behaviours (sunscreen, shade, wear of covering clothes).
  
  
  RESULTS
  Response rate was 91%. Sunburn prevalence over the preceding year was high (60% at least one sunburn, 30% at least two, 43% at least one severe sunburn). Younger age, fair skin, regular sunscreen use, higher sun-related knowledge and preference for a tanned skin were predictors of sunburn. Sunscreen was the most used protective measure (69%), followed by seeking shade (33%) and wearing long-sleeved shirts (32%). Decline in all protective measures was observed in older pupils and those with pro-tan attitudes. The wear of covering clothes was significantly associated with sunscreen use and seeking shade. Parental encouragement favoured sunscreen use and wearing of protective clothes.
  
  
  CONCLUSIONS
  Sunscreen use as a last protective barrier against ultraviolet radiation should be better emphasised in prevention campaigns targeting children and adolescents. Multi-faceted interventions, including role models, parents and peers should help to improve children's sun protective behaviours.
authors.affiliation: Faculty of Biology and Medicine, Lausanne University, Lausanne, Switzerland.
authors.forename: Simone
authors.initials: S
authors.lastname: Ackermann
authors.affiliation: Faculty of Biology and Medicine, Lausanne University, Lausanne, Switzerland.
authors.forename: Anne
authors.initials: A
authors.lastname: Vuadens
authors.affiliation: Institute of Social and Preventive Medicine (IUMSP), Lausanne University Hospital, Switzerland.
authors.forename: Fabio
authors.initials: F
authors.lastname: Levi
authors.affiliation: Division of Chronic Diseases, Institute of Social and Preventive Medicine (IUMSP), Lausanne University Hospital, Switzerland.
authors.forename: Jean-Luc
authors.initials: JL
authors.lastname: Bulliard
mesh_terms: D000293:Adolescent; D002648:Child; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008545:Melanoma / Q000453:epidemiology / Q000517:prevention & control / Q000628:therapy; D010290:Parents / Q000193:education; D015995:Prevalence; D011481:Protective Clothing; D012574:Schools; D012878:Skin Neoplasms / Q000453:epidemiology / Q000517:prevention & control / Q000628:therapy; D013334:Students / Q000523:psychology*; D013471:Sunburn / Q000453:epidemiology* / Q000517:prevention & control; D013472:Sunlight / Q000009:adverse effects; D013473:Sunscreening Agents / Q000627:therapeutic use*; D011795:Surveys and Questionnaires; D013557:Switzerland; D014466:Ultraviolet Rays / Q000009:adverse effects
chemical_list: D013473:Sunscreening Agents