Sun Protection and Sunburn in Children Aged 1–10 Years in Germany: Prevalence and Determinants
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Setting
2.2. Instrument and Measures
2.2.1. Outcome Variables Used to Describe Sun Protection in Children
2.2.2. Covariates
2.3. Statistical Analyses
3. Results
4. Discussion
Limitations
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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n | %/Mean (SD) | |
---|---|---|
Children | ||
Sex | ||
Male | 258 | 46.7 |
Female | 294 | 53.1 |
Age group | ||
1–3 years | 34 | 6.1 |
4–6 years | 103 | 18.6 |
7–10 years | 417 | 75.3 |
Age in years | 554 | 7.6 (2.1) |
Skin color | ||
(Very) fair skin | 210 | 38.0 |
Medium skin | 272 | 49.2 |
(Very) brown skin | 71 | 12.8 |
Caregivers | ||
Sociodemographic characteristics | ||
Sex | ||
Male | 255 | 46.0 |
Female | 299 | 54.0 |
Age group | ||
16–25 years | 124 | 22.4 |
26–35 years | 223 | 40.3 |
36–45 years | 116 | 20.9 |
46–55 years | 56 | 10.1 |
56–65 years | 35 | 6.3 |
Age in years | 548 | 34.4 (11.4) |
Immigrant background | ||
No | 472 | 85.2 |
Yes | 82 | 14.8 |
School education | ||
Low | 74 | 15.8 |
Medium | 120 | 25.6 |
High | 274 | 58.5 |
Employment status | ||
Unemployed | 64 | 12.1 |
Part-time | 155 | 29.4 |
Full-time | 308 | 58.4 |
Area of residence | ||
North | 93 | 16.8 |
South | 179 | 32.3 |
West | 185 | 33.4 |
East | 97 | 17.5 |
Skin characteristics and tanning behaviors | ||
Skin type | ||
I | 58 | 10.5 |
II | 154 | 27.9 |
III–IV | 270 | 48.9 |
V–VI | 70 | 12.7 |
Current tanning bed use | ||
No | 530 | 95.7 |
Yes | 24 | 4.3 |
Intentional outdoor tanning | ||
never | 35 | 6.3 |
On 1 occasion | 62 | 11.2 |
On 2 occasions | 105 | 19.0 |
On 3 occasions | 352 | 63.5 |
Role model | ||
Rather disagree | 86 | 15.7 |
Rather agree | 462 | 84.3 |
Sunscreen on the Body | Sunscreen on the Face | Shirt That Covers Shoulders | Cap or Hat | Staying in the Shade | Sunglasses | |||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
% | p-Value | % | p-Value | % | p-Value | % | p-Value | % | p-Value | % | p-Value | |
Children | ||||||||||||
Sex | 0.259 | 0.822 | 0.613 | 0.829 | 0.626 | 0.138 | ||||||
Male | 75.6 | 76.7 | 70.2 | 59.3 | 47.5 | 10.1 | ||||||
Female | 79.6 | 71.6 | 72.1 | 60.2 | 45.4 | 14.3 | ||||||
Age group | 0.002 | 0.015 | 0.002 | <0.001 | <0.001 | 0.133 | ||||||
1–3 years | 94.1 | 88.2 | 85.3 | 91.2 | 85.3 | 23.5 | ||||||
4–6 years | 86.4 | 85.4 | 82.5 | 72.8 | 58.3 | 11.7 | ||||||
7–10 years | 74.3 | 74.3 | 67.3 | 54.1 | 40.1 | 11.8 | ||||||
Skin color | <0.001 | <0.001 | 0.189 | <0.001 | 0.003 | 0.197 | ||||||
(Very) fair skin | 88.1 | 88.6 | 75.2 | 67.6 | 53.8 | 15.7 | ||||||
Medium skin | 76.8 | 75.4 | 69.9 | 59.6 | 44.4 | 10.3 | ||||||
(Very) brown skin | 50.7 | 50.5 | 74.8 | 38.0 | 31.0 | 11.3 | ||||||
Caregivers | ||||||||||||
Sociodemographic characteristics | ||||||||||||
Sex | 0.198 | 0.855 | 0.898 | 0.028 | 0.543 | 0.821 | ||||||
Male | 75.3 | 76.9 | 71.0 | 54.9 | 44.9 | 12.2 | ||||||
Female | 79.9 | 77.5 | 71.5 | 64.1 | 47.5 | 12.8 | ||||||
Age group | 0.435 | 0.199 | 0.024 | 0.296 | 0.146 | 0.036 | ||||||
16–25 years | 82.3 | 82.3 | 82.3 | 64.5 | 54.8 | 13.0 | ||||||
26–35 years | 77.6 | 78.9 | 69.1 | 59.2 | 41.9 | 7.6 | ||||||
36–45 years | 76.5 | 74.8 | 68.7 | 54.8 | 43.5 | 19.1 | ||||||
46–55 years | 69.6 | 67.9 | 60.7 | 67.9 | 52.7 | 16.1 | ||||||
56–65 years | 80.0 | 71.4 | 71.4 | 51.4 | 42.9 | 14.3 | ||||||
Immigrant background | 0.012 | 0.018 | 0.242 | 0.215 | 0.235 | 0.001 | ||||||
No | 79.6 | 79.0 | 72.2 | 60.9 | 47.3 | 10.6 | ||||||
Yes | 67.1 | 67.1 | 65.9 | 53.7 | 40.2 | 23.5 | ||||||
School education | 0.661 | 0.629 | 0.615 | 0.565 | 0.446 | 0.126 | ||||||
Low | 74.3 | 73.0 | 75.7 | 62.2 | 41.9 | 18.9 | ||||||
Medium | 77.5 | 75.8 | 75.0 | 63.3 | 51.3 | 13.3 | ||||||
High | 79.2 | 78.1 | 71.2 | 58.0 | 47.3 | 10.3 | ||||||
Employment status | 0.287 | 0.187 | 0.524 | 0.463 | 0.701 | 0.533 | ||||||
Unemployed | 89.8 | 68.3 | 69.8 | 65.1 | 50.8 | 8.1 | ||||||
Part-time | 78.1 | 76.8 | 74.2 | 61.9 | 44.5 | 13.5 | ||||||
Full-time | 78.9 | 78.9 | 69.2 | 57.8 | 46.4 | 12.3 | ||||||
Area of residence | 0.098 | 0.054 | 0.143 | 0.770 | 0.238 | 0.633 | ||||||
North | 81.7 | 78.5 | 68.8 | 57.0 | 52.7 | 16.1 | ||||||
South | 76.0 | 76.5 | 77.1 | 62.6 | 43.0 | 12.8 | ||||||
West | 81.6 | 82.2 | 70.3 | 60.0 | 49.2 | 11.4 | ||||||
East | 69.8 | 67.7 | 64.6 | 57.3 | 35.7 | 10.4 | ||||||
Skin characteristics and tanning behaviors | ||||||||||||
Skin type | 0.013 | 0.004 | 0.404 | 0.194 | 0.783 | 0.013 | ||||||
I | 91.2 | 86.0 | 80.7 | 71.9 | 47.4 | 19.3 | ||||||
II | 79.2 | 83.8 | 70.1 | 61.0 | 46.4 | 10.4 | ||||||
III-IV | 77.0 | 75.2 | 70.4 | 57.4 | 44.6 | 9.3 | ||||||
V-VI | 67.1 | 64.3 | 68.6 | 55.7 | 51.4 | 21.4 | ||||||
Current tanning bed use | 0.007 | 0.026 | 0.612 | 0.486 | 0.964 | 0.207 | ||||||
No | 76.7 | 76.4 | 71.5 | 59.5 | 46.3 | 12.9 | ||||||
Yes | 100.0 | 95.8 | 66.7 | 66.7 | 45.8 | 4.2 | ||||||
Intentional outdoor tanning | 0.382 | 0.596 | 0.330 | 0.641 | 0.066 | 0.627 | ||||||
never | 74.3 | 74.3 | 71.4 | 65.7 | 50.0 | 14.3 | ||||||
On 1 occasion | 74.2 | 71.0 | 66.1 | 56.5 | 58.1 | 16.1 | ||||||
On 2 occasions | 83.8 | 79.0 | 78.1 | 63.8 | 37.1 | 14.3 | ||||||
On 3 occasions | 76.9 | 78.1 | 70.1 | 58.7 | 46.6 | 11.1 | ||||||
Role model | <0.001 | <0.001 | 0.276 | <0.001 | <0.001 | 0.314 | ||||||
Rather disagree | 52.3 | 57.0 | 66.3 | 37.2 | 29.1 | 9.3 | ||||||
Rather agree | 83.1 | 81.6 | 72.1 | 64.1 | 49.8 | 13.2 |
Sunscreen on the Body | Sunscreen on the Face | Shirt That Covers Shoulders | Cap or Hat | Staying in the Shade | Sunglasses | |
---|---|---|---|---|---|---|
OR (95%-CI) | OR (95%-CI) | OR (95%-CI) | OR (95%-CI) | OR (95%-CI) | OR (95%-CI) | |
Children | ||||||
Age of child | ||||||
1–3 years | Ref. | Ref. | Ref. | Ref. | ||
4–6 years | 0.51 (0.10–2.49) | 0.84 (0.28–2.47) | 0.25 (0.07–0.92) | 0.26 (0.09–0.74) | ||
7–10 years | 0.28 (0.06–1.25) | 0.39 (0.15–1.03) | 0.13 (0.04–0.44) | 0.14 (0.05–0.36) | ||
Skin color | ||||||
(Very) fair skin | Ref. | Ref. | Ref. | Ref. | ||
Medium skin | 0.45 (0.25–0.79) | 0.41 (0.23–0.72) | 0.82 (0.54–1.26) | 0.78 (0.53–1.15) | ||
(Very) brown skin | 0.19 (0.09–0.41) | 0.18 (0.09–0.37) | 0.44 (0.23–0.84) | 0.53 (0.29–0.98) | ||
Caregivers | ||||||
Sociodemographic characteristics | ||||||
Sex | ||||||
Male | Ref. | |||||
Female | 1.33 (0.92–1.91) | |||||
Age of caregiver | ||||||
16–25 years | Ref. | Ref. | Ref. | |||
26–35 years | 0.84 (0.45–1.54) | 0.53 (0.31–0.91) | 0.64 (0.40–1.03) | |||
36–45 years | 0.64 (0.32–1.25) | 0.53 (0.29–0.99) | 0.74 (0.43–1.27) | |||
46–55 years | 0.50 (0.23–1.10) | 0.36 (0.18–0.74) | 1.07 (0.55–2.12) | |||
56–65 years | 0.42 (0.17–1.07) | 0.59 (0.24–1.41) | 0.60 (0.27–1.35) | |||
Immigrant background | ||||||
No | Ref. | Ref. | Ref. | |||
Yes | 0.64 (0.35–1.15) | 0.68 (0.38–1.22) | 1.87 (0.91–3.84) | |||
School education | ||||||
Low | Ref. | |||||
Medium | 0.66 (0.29–1.49) | |||||
High | 0.51 (0.25–1.04) | |||||
Skin characteristics and tanning behaviors | ||||||
Skin type | ||||||
I | Ref. | Ref. | Ref. | Ref. | ||
II | 0.32 (0.10–1.02) | 0.84 (0.33–2.15) | 0.68 (0.33–1.37) | 0.86 (0.31–2.42) | ||
III–IV | 0.44 (0.14–1.34) | 0.70 (0.29–1.72) | 0.68 (0.34–1.38) | 0.55 (0.20–1.47) | ||
V–VI | 0.39 (0.11–1.38) | 0.61 (0.22–1.71) | 0.74 (0.32–1.72) | 1.41 (0.48–4.14) | ||
Role model | ||||||
Rather disagree | Ref. | Ref. | Ref. | Ref. | ||
Rather agree | 3.64 (2.13–6.22) | 2.74 (1.60–4.72) | 2.69 (1.61–4.49) | 2.31 (1.35–3.93) | ||
n | 546 | 546 | 553 | 546 | 546 | 465 |
Sum Score of Protection Measures (1) | Use of ≥ 4 Protection Measures (2) | ||||
---|---|---|---|---|---|
Bivariate Analysis | Multiple Logistic Regression | ||||
Mean (SD) | p-Value | % | p-Value | OR (95%-CI) | |
Children | |||||
Sex | 0.494 | 0.484 | |||
Male | 2.87 (1.23) | 50.7 | |||
Female | 2.94 (1.32) | 53.4 | |||
Age of child | <0.001 | <0.001 | |||
1–3 years | 3.70 (1.94) | 90.0 | Ref. | ||
4–6 years | 3.33 (1.07) | 65.8 | 0.20 (0.06–0.75) | ||
7–10 years | 2.75 (1.29) | 45.9 | 0.11 (0.03–0.38) | ||
Skin color | <0.001 | <0.001 | |||
(Very) fair skin | 3.33 (1.10) | 63.2 | Ref. | ||
Medium skin | 2.85 (1.21) | 50.9 | 0.74 (0.48–1.14) | ||
(Very) brown skin | 2.04 (1.44) | 26.9 | 0.37 (0.19–0.74) | ||
Caregivers | |||||
Sociodemographic characteristics | |||||
Sex | 0.052 | 0.241 | |||
Male | 2.85 (1.26) | 49.8 | |||
Female | 2.97 (1.29) | 54.4 | |||
Age of caregiver | 0.001 | 0.002 | |||
16–25 years | 3.25 (1.15) | 65.1 | Ref. | ||
26–35 years | 2.83 (1.22) | 47.9 | 0.50 (0.30–0.83) | ||
36–45 years | 2.70 (1.55) | 44.0 | 0.54 (0.30–0.97) | ||
46–55 years | 2.80 (1.23) | 54.7 | 0.69 (0.34–1.41) | ||
56–65 years | 2.82 (1.25) | 46.7 | 0.41 (0.18–0.94) | ||
Immigrant background | 0.026 | 0.005 | |||
No | 2.96 (1.23) | 54.6 | |||
Yes | 2.66 (1.46) | 40.0 | |||
School education | 0.461 | 0.591 | |||
Low | 2.98 (1.37) | 56.4 | |||
Medium | 2.92 (1.30) | 55.4 | |||
High | 2.98 (1.25) | 51.5 | |||
Employment status | 0.430 | 0.554 | |||
Unemployed | 2.70 (1.31) | 45.7 | |||
Part-time | 2.90 (1.28) | 51.7 | |||
Full-time | 2.98 (1.24) | 52.8 | |||
Area of residence | <0.001 | 0.002 | |||
North | 3.01 (1.25) | 55.5 | |||
South | 3.06 (1.14) | 53.4 | |||
West | 2.99 (1.24) | 57.5 | |||
East | 2.42 (1.45) | 36.4 | |||
Skin characteristics and tanning behaviors | |||||
Skin type | 0.005 | 0.027 | |||
I | 3.49 (1.05) | 68.7 | Ref. | ||
II | 3.04 (1.12) | 52.5 | 0.47 (0.23–0.97) | ||
III–IV | 2.89 (1.26) | 50.6 | 0.57 (0.28–1.16) | ||
V–VI | 2.70 (1.51) | 45.6 | 0.56 (0.24–1.32) | ||
Current tanning bed use | 0.304 | 0.864 | |||
No | 2.90 (1.29) | 52.1 | |||
Yes | 3.17 (0.84) | 53.8 | |||
Intentional outdoor tanning | 0.011 | 0.352 | |||
never | 3.08 (1.41) | 59.5 | |||
On 1 occasion | 2.95 (1.32) | 57.3 | |||
On 2 occasions | 3.23 (1.16) | 55.4 | |||
On 3 occasions | 2.81 (1.28) | 49.5 | |||
Role model | <0.001 | <0.001 | |||
Rather disagree | 2.16 (1.27) | 24.3 | Ref. | ||
Rather agree | 3.08 (1.26) | 58.3 | 4.33 (2.45–7.67) | ||
n | 543 |
Bivariate Analysis | Multiple Logistic Regression | ||
---|---|---|---|
% | p-Value | OR (95%-CI) | |
Children | |||
Sex | 0.860 | ||
Male | 21.5 | ||
Female | 22.1 | ||
Age of child | 0.035 | ||
1–3 years | 5.9 | Ref. | |
4–6 years | 18.6 | 3.53 (0.76–16.29) | |
7–10 years | 23.9 | 4.81 (1.12–20.59) | |
Skin color | 0.462 | ||
(Very) fair skin | 24.4 | ||
Medium skin | 20.7 | ||
(Very) brown skin | 18.3 | ||
Caregivers | |||
Sociodemographic characteristics | |||
Sex | 0.080 | ||
Male | 25.1 | ||
Female | 18.9 | ||
Age of caregiver | 0.670 | ||
16–25 years | 22.6 | ||
26–35 years | 20.2 | ||
36–45 years | 21.7 | ||
46–55 years | 20.4 | ||
56–65 years | 31.4 | ||
Immigrant background | 0.967 | ||
No | 21.7 | ||
Yes | 22.0 | ||
School education | 0.038 | ||
Low | 32.9 | Ref. | |
Medium | 18.3 | 0.45 (0.23–0.89) | |
High | 20.1 | 0.51 (0.29–0.91) | |
Employment status | 0.570 | ||
Unemployed | 16.1 | ||
Part-time | 22.6 | ||
Full-time | 21.2 | ||
Area of residence | 0.220 | ||
North | 26.9 | ||
South | 22.5 | ||
West | 22.3 | ||
East | 14.6 | ||
Skin characteristics and tanning behaviors | |||
Skin type | 0.847 | ||
I | 22.8 | ||
II | 24.2 | ||
III–IV | 20.7 | ||
V–VI | 20.3 | ||
Current tanning bed use | 0.603 | ||
No | 22.0 | ||
Yes | 17.4 | ||
Intentional outdoor tanning | 0.903 | ||
never | 11.8 | ||
On 1 occasion | 12.9 | ||
On 2 occasions | 21.2 | ||
On 3 occasions | 24.5 | ||
Role model | 0.321 | ||
Rather disagree | 25.9 | ||
Rather agree | 21.0 | ||
n | 466 |
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Görig, T.; Södel, C.; Pfahlberg, A.B.; Gefeller, O.; Breitbart, E.W.; Diehl, K. Sun Protection and Sunburn in Children Aged 1–10 Years in Germany: Prevalence and Determinants. Children 2021, 8, 668. https://doi.org/10.3390/children8080668
Görig T, Södel C, Pfahlberg AB, Gefeller O, Breitbart EW, Diehl K. Sun Protection and Sunburn in Children Aged 1–10 Years in Germany: Prevalence and Determinants. Children. 2021; 8(8):668. https://doi.org/10.3390/children8080668
Chicago/Turabian StyleGörig, Tatiana, Corinna Södel, Annette B. Pfahlberg, Olaf Gefeller, Eckhard W. Breitbart, and Katharina Diehl. 2021. "Sun Protection and Sunburn in Children Aged 1–10 Years in Germany: Prevalence and Determinants" Children 8, no. 8: 668. https://doi.org/10.3390/children8080668