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Prevention
Prevention is the key to reducing the proliferation
of skin cancer. Understanding the proper steps to prevention is
critical to ensure the best protective measures are taken. Being
sun smart is important at all ages and it is especially critical
to instill these practices at an early age. Not only will you help
ensure the safety of your young ones, but help to spread the understanding
and importance of sun safety.
Infants & Toddlers Sun Safety
Keeping infants and young children out of the sun
as much as possible is very important during the first year of a
child’s life. Research shows that skin damage more than doubles
from the age of 6 months to 18 months.* An infant or toddler’s
skin is very sensitive and is still in the process of developing,
which makes them more susceptible to sun damage. A bad burn in a
small infant can be very serious and have lifelong consequences.
Regular use of sunscreen with an SPF of 15+ during the first 18
years of life can tremendously reduce the risk of skin cancer. However,
before the age of three, sunscreen does not provide adequate protection
for developing skin and the best protection is to keep sun exposure
to a minimum.*
Infants (Less Than 6 Months)
Infants less than 6 months should be kept out of
direct sunlight. However, when adequate clothing and shade are not
available, parents may apply a minimal amount of sunscreen to small
areas, such as the infant's face and the back of the hands. Choose
a waterproof product that is moisturizing (not alcohol-based) and
has a sun protection factor (SPF) of 15 or higher.
Cover Up
Unprotected baby skin can sunburn in 10 minutes or less. Therefore,
covering up is an essential part to protecting your infant.
- Cover up your baby's supersensitive skin with
a sun hat, long-sleeved shirt and long pants.
- Dark, thick fabrics provide better protection,
but may overheat your baby in the summer.
- In the water, put a t-shirt on your baby. After
getting out, a dry shirt should be used, as wet fabrics decrease
the ability to protect against harmful rays.
- Once your baby is 6 months old, use a sunscreen
with a SPF of at least 15.
- Limit baby’s sun exposure as much as possible
during the hours of 10 a.m. and 4 p.m., when the sun is at its
strongest. SEEK SHADE!
- Keep sunscreen, shirts, hats and umbrellas handy
so you are always prepared to be outside and protect your baby.
- For a newborn, a carriage with a hood is preferable
to an upright stroller. With an infant or toddler, use a canopy
stroller or get an attachment.
- Beware of surfaces that reflect the sun. Sand,
snow, concrete and water can reflect as much as half the sun's
rays onto your child's skin. Merely sitting in the shade or under
an umbrella does not guarantee protection. You still need to cover-up
with protective clothing.
- Cover up on cloudy days. The sun's rays can
be as strong on cloudy, hazy days as they are on sunny days.
- Remember that sunscreen provides protection,
but does not mean that you are able to stay in the sun for a longer
period of time.
- Set the example - don't forget to cover up and
use sunscreen yourself!
*Information taken from the Massachusetts Melanoma
Foundation
Toddlers/Pre Schoolers
Helpful hits to using sun safety with toddlers
and pre schoolers:
- Play connect the dots! Place dots of sunscreen
on children's bodies and have them connect the dots by rubbing
in the sunscreen.
- Have children apply the sunscreen themselves.
- Give children lots of praise and positive reinforcement.
- Give children a sticker every time they put
on sunscreen.
- Some children enjoy putting sunscreen on when
it's treated like make-up.
- Let children put sunscreen on you.
- Make the application of sunscreen a regular
part of their morning routine.
- Brush teeth, put on sunscreen, get dressed,
brush hair, eat breakfast, etc.
- Sing a nursery rhyme while applying sunscreen.
- Ask the children where you should put the sunscreen.
Let them squeeze the bottle. Give them some control.
- Make it fun!
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Child Sun Safety
Childhood sunburns can increase your child’s
risk of developing skin cancer as an adult. Even a suntan is harmful
to children. Tanning is an outward sign to internal skin damage.
Research shows that much of the damage to skin is done in the first
18 years of life. Protecting skin and eyes during the first 18 years
can reduce the risk of some types of skin cancer by up to 78%. Melanoma
is a cancer of younger people and can start as early as adolescence.
Youth and Skin Cancer
- 50% of lifetime exposure to UV light occurs
during childhood and adolescence
- It can take less than 10 minutes for a child’s
skin to burn
- Severe childhood sunburns are at an increased
risk for skin cancer
- Being sun safe is the first step to reduce the
chances of getting skin cancer later in life
- A person born today is twice as likely to develop
malignant melanoma compared to someone born only a decade ago
and 12 times more likely as someone born 50 years ago.
*Information taken from the National Coalition for
Skin Cancer Prevention www.sunsafety.org
Teach Children Sun Safe Habits
Children learn healthy habits best at a young age. Therefore, it
is important to begin protecting your children from the beginning
and teaching them the importance of sun safety. With sun damage
accumulating over a person’s lifespan, beginning sun safety
habits at a young age should be a priority.
- Maximize protection between the hours of 10 a.m.
to 4 p.m.
- Wear sun protective clothing including long
sleeved shirts and pants made of tightly woven fabric.
- Wear a wide-brimmed hat that protects head,
face, ears and neck. If a baseball cap is worn, make sure to use
sunscreen on ears and neck.
- Wear UV-protective sunglasses with 99%-100%
UV absorption.
- Seek SHADE. During peak sun hours (10-4pm) seek
shade. Shadow rule- if your shadow is shorter than you, the sun’s
rays are at their strongest and you should seek shade.
- Encourage children to play in shaded areas, especially
during peak sun hours.
- Use a sunscreen of SPF 15+ and apply a generous
amount (about a palmful) and apply 30 minutes before going outside.
- Reapply Sunscreen every 90 minutes or after swimming,
towel drying or perspiring, even if the label says the product
is waterproof. Don’t forget the lips and ears- both areas
can burn just as easily!
- Strongly discourage the
use of tanning beds.
* Information taken from the Massachusetts Melanoma
Foundation www.massmelanoma.org
and American Cancer Society www.cancer.org
Teach Your Children the Meaning of SHADE
Sunglasses. Always wear sunglasses
with UV ray protection
Hats. Always wear a wide brim hat made from a close
weave fabric
Always wear protective clothing, long sleeved shirts
and pants
During the peak sun hours of 10 - 4 reduce exposure
to the sun -stay in the shade
Every 90 minutes reapply sun block with at least
a SPF of 15
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Adult Sun Safety
Skin Cancer and Melanoma Facts
- Cancer of the skin is the most common form of
all cancer accounting for more than 50% of all cancers.
- More than 1 million cases of nonmelanoma skin
cancer are found in this country each year.
- During 2005, the American Cancer Society estimates
that about 59,600 new melanomas will be diagnosed in the United
States.
- About 79 percent of the new skin cancer cases
will be basal cell carcinoma, 15 percent will be squamous cell
carcinoma, and 5 percent will be invasive melanoma. The other
1 percent will represent rare types of skin cancer, such as Merkel
cell carcinoma, adnexal carcinoma(s), dermatofibroma fibrosarcoma
protuberans, etc.
- Both basal cell carcinoma and squamous cell
carcinoma have a better than 95 percent cure rate if detected
and treated early.
- There will be about 105,750 new cases of melanoma
in 2005 – 46,170 in situ (noninvasive) and 59,580 invasive
(33,580 men and 26,000 women).* This is a 10 percent increase
in new cases of melanoma from 2004. In 2005, at current rates
1 in 34 Americans have a lifetime risk of developing melanoma
and 1 in 62 Americans have a lifetime risk of developing invasive
melanoma.
- The American Cancer Society estimates there will
be about 10,590 deaths from skin cancer in 2005- 7,770 from melanoma
and 2,820 from other skin cancers.
- One American dies of melanoma almost every hour
(every 68 minutes). In 2005, 7,770 deaths will be attributed to
melanoma – 4,910 men and 2,860 women.* Older Caucasian males
have the highest mortality rates from melanoma.
- The incidence of melanoma more than tripled among
Caucasians between 1980 and 2003.
- More than 73 percent of skin cancer deaths are
from melanoma.
- Melanoma is more common than any non-skin cancer
among women between 25 and 29 years old.
- Invasive melanoma is the fifth most common cancer
in men and the sixth most common cancer in women.
- 1 in 5 Americans will develop some form of skin
cancer during their lifetime.
- Five or more sunburns double your risk of developing
skin cancer.
* Information taken from the American Cancer Society
www.cancer.org
and American Academy of Dermatology www.aad.org
Why Skin Cancer Rates Are Rising
- Increased leisure time devoted to outdoor activities.
- Decrease in coverage of clothing worn.
- Nation population migration to sunnier states.
- Decreasing amounts of stratospheric ozone that
partially protects the earth’s surface from receiving cancer-producing
UV radiation.
- Tanning is falsely viewed as healthy.
- General aging of the population.
* Information taken from the Skin Cancer Prevention
Program
Protection is Vital
Proper sun protection is the most important thing we can do to protect
ourselves from skin cancer. Up to 90% of all skin cancers are caused
by exposure to the sun’s harmful ultraviolet (UV) rays.
While skin cancers are almost always curable when detected and treated
early, the surest line of defense is to prevent them in the first
place. Here are some sun-safety habits that should be part of everyone’s
daily healthcare:
Limit Time in Sun
- Avoid unnecessary sun exposure, especially during
the sun’s peak hours (10am to 4pm).
- Keep track of time spent in sunlight and do
not stay in an unshaded spot for a long stretch of time.
Seek the Shade
- Always seek the shade.
- Be aware that sunlight bounces off reflective
surfaces and can reach you even under an umbrella or tree.
Cover Up
- Cover up with clothing. Wear long-sleeved shirts
and long pants. Tightly woven fabrics and dark colors, such as
deep blue and black or bright colors such as orange and red offer
the best protection. Change than to then if you can see light
through fabrics, then the material is not protecting against harmful
UV rays. Water also reduces fabrics ability to protect against
UV
rays.
- Wear a broad-brimmed hat, which protects head,
face, ears and neck. A 3-4 inch brim that extends around the hat
is best. If opting for a baseball cap or visor, be sure to use
sunscreen as the lower face, neck and ears are left exposed.
- Wear UV-blocking sunglasses that wraparound
or have large frames. Eyelids and the sensitive skin around your
eyes are common sites for skin cancer and sun-induced aging. The
use of sunglasses also helps reduce the risk of cataracts later
in life.
Use Sunscreen
- Wear a broad-spectrum sunscreen with a sun protection
factor (SPF) of 15 or higher.
- Use sunscreen that blocks both UVA and UVB rays.
- Apply generously to all exposed skin. The average
adult should use approximately one ounce of sunscreen per application.
Not using the proper amount will reduce the product’s SPF
and protection received.
- Be sure to cover often-missed spots- lips, ears,
around eyes, neck, scalp, hands and feet.
- Choose products that suit your skin and activity
level. Sunscreens come in lotion, gel, spray, cream and stick
forms. Also products are available in water resistant, sweat proof,
sport proof, fragrance-free, hypoallergenic or in sensitive skin
formulas.
Avoid Tans
- Avoid tanning parlors and artificial tanning
devices. The UV radiation emitted by indoor tanning lamps is many
times more damaging than natural sunlight.
- Tanning is the skins response to the sun’s
damaging rays.
Examine Your Skin
- Examine your skin from head to toe every month.
- Have a professional skin examination annually.
* Some information taken from the Skin Cancer Foundation
www.skincancer.org
Sunless Tanning
For those people who wish to have a “healthy-looking”
tan, there are alternatives. For instance, we recommend sunless
tanning products to our patients because it allows them to achieve
an instant, natural-looking tan without streaking or orange color.
This product is all-natural and has a pleasant odor and in no way
contributes to increasing the risk of developing skin cancers.
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Outdoor
Workers
Melanoma
[From the 2004 Burden of Skin Diseases prepared
by the Lewin Group Inc. for the Society for Investigative Dermatology
and the American Academy of Dermatology Association]
The most well-known form of skin cancer, melanoma,
is also the most aggressive and deadly. In 2004, 7,900 of the approximately
55,000 individuals newly diagnosed with melanoma will die of their
disease. In addition to its high mortality rate, melanoma is now
the second leading cause of lost productive work years due to cancer.
Melanoma causes abnormal proliferation of specialized
cells in the skin, eyes, and hair that produce the pigment melanin.
According to the American Cancer Society (ACS), early diagnosis
is the most important factor in successful treatment and ACS recommends
annual skin examinations for everyone over the age of 40 and every
three years for individuals between the ages of 20 and 40. A clear
relationship between increased sun exposure and risk of melanoma
has been established. Therefore, preventive efforts to reduce the
incidence of the disease focus on increasing application of sunscreens
and protective clothing when outdoors, eliminating the use of tanning
beds, and reducing sun exposure between the hours of 10am and 4pm
(when UV rays are harshest). In addition to environmental factors,
genetic factors contribute to risk for developing melanoma.
Epidemiology
Melanoma is one of the few skin conditions with
comprehensive epidemiology statistics available in a nationally
representative dataset. For this study, the NCI SEER database was
used to estimate the incidence, prevalence, and mortality rates
for melanoma, stratified by age and gender. According to the most
recently available SEER data, adjusted to the 2004 US population,
55,100 individuals were diagnosed with melanoma and there were 7,920
deaths due to this cancer in 2004. Furthermore, its reported incidence
has increased 690% from 1950 to 2001, and the overall mortality
rate has increased 165% during the same period. The overall crude
prevalence rate for all ages and both sexes is roughly 240 per 100,000
individuals. When this rate is applied to the 2004 US population,
the overall prevalence of melanoma is 718,000 individuals.
Among all cancers in the US, the reported incidence
of cutaneous melanoma ranks fifth among men and seventh among women.
Melanoma is the most commonly diagnosed cancer among women ages
20-29. Individuals at highest risk for melanoma include those with
fair skin, red or blonde hair, and those who are often and continuously
exposed to sunlight (such as lifeguards and landscapers), who had
multiple blistering sunburns as a child or adolescent, and/or with
a family history of the disease.
Direct Costs
The estimated 2004 total direct cost associated
with treatment of melanoma was $291 million. This includes $213
million in costs for care provided in hospital inpatient and outpatient
departments, physicians’ offices, and emergency rooms. There
were 603,800 physician office visits due to melanoma, according
to data from the National Ambulatory Medical Survey, making this
the primary site of care for individuals with this condition. There
were 57,000 visits made to hospital outpatient department and 6,000
visits made to emergency rooms for melanoma.
Inpatient hospital stays where melanoma was listed
as one of the diagnoses totaled 10,400, with nearly half of these
visits listing melanoma as the primary diagnosis. Of those cases
where melanoma was listed as the primary diagnosis, the average
length of stay was 3.6 days, according to the NIS. Hospital inpatient
costs for melanoma amounted to $35.4 million.
Indirect Costs
The indirect costs associated with melanoma are
particularly high, at an estimated $2.9 billion in annual lost productivity
alone. The majority of this lost productivity is due to forgone
future earnings due to premature death, since as many as 45% of
melanoma deaths occur prior to retirement age. Due to its high incidence
in younger individuals, melanoma is the second largest cause of
lost productive years for all types of cancer. The average net present
value of foregone future earnings is approximately $364,000.
Outdoor workers have a higher risk of skin cancer
than in any other field of work. This is due to the fact that much
of the work done is between 10-4 where the sun rays are at the strongest.
In addition, much of the work done happens in the spring and summer
months where UV radiation is higher as well. Therefore, it is important
that outdoor workers take precautions to protecting their skin and
being safe. Steps listed above for adults should be taken, in addition
to some other helpful hints listed below.
Know the Intensity of UV Rays
UV Radiation is more intense under certain time frames or conditions.
Such as:
- From 10 a.m. to 4 p.m.
- When there is a lack of thick cloud cover
- From mid-spring through mid-fall
- At higher altitudes
- Reflective surfaces, such as water and glass
can direct additional UV rays toward people.
Employers
- Crew supervisors should model sun protective
behaviors
- Utilize a skin cancer prevention “buddy
system” to reinforce and support commitment to practice
sun safety
- Skin cancer prevention education materials should
be taken home by employees to encourage their children
- Employees should use a hand mirror to perform
a self skin examination every one to three months
Suggested Guidelines for Outdoor Work or
Recreation
1. For outdoor labor occurring on sunny days,
especially between 10 a.m. to 4 p.m., staff is encouraged to:
- Work in shaded areas where practical
- Wear full-body coverage clothing, including:
full-brimmed hats, long-sleeve shirts and full-length pants
made of tightly woven fabric that is lightweight.
- Wear full-spectrum sunglasses- that protect
from UVA and UVB rays.
- Apply SPF of 15+ at least 30 minutes before
going outside.
- Use lip balm that has a SPF of at least 15.
2. Sun Protection training and materials should
be provided to staff encouraging them to practice sun safety while
either on the job or engaging in any outdoor pastimes.
3. These guidelines should be communicated and reinforced to employees
through verbal reminders, posters, signs, pamphlets, notice, payroll
stuffers, newsletter, and meetings.
*Guidelines taken from Sun Safety Kit provided by
Skin Cancer Prevention Program
Read the Laborers' Health and Safety Fund article
on "The
Real Face of Skin Cancer".
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