Saturday, June 6, 2015

Sun Protection and Kids in School

Spring is coming to an end soon and most schools are about to close for the summer.  This also marks the time of year when schools hold their annual field day, a celebration of fun and physical fitness.  Unfortunately, it seems that every year presents at least one story where a child is severely sun burned during the outdoor activity because of the school’s policy of no sunscreen application.

Most schools, it seems, encourages the parents to apply sunscreen on the child before they arrive.  They do not allow the child to administer their own sunscreen (at least at the elementary school level) because it’s considered the same as a controlled medication.  In short, the school district does not want to accept responsibility should a child share the lotion (sunscreen or otherwise) in case the second child could be allergic.  In some cases, such as when kids have a food allergy, the medicine (epipen in this case) is kept in the school nurse’s station and can only be administered by a trained individual.  The same apparently holds true for other medications, including lotions.  Including sunscreen.

Another reason for children getting sun burns during field day is that kids are often not allowed to wear hats.  Teaching children good manners of not wearing one’s hat indoors is a good lesson.  However, many no-hat policies were established not to teach manners, but to prevent clothing related to gang association. 

The Center for Disease Control has developed “Guidelines for School Programs to Prevent Skin Cancer.”  Within it, they recommend encouraging or requiring students to wear protective clothing, hats, and sunglasses.  They also suggest establishing a routine for sunscreen use before going outside.  Other organizations have recently encouraged smarter sun safety decisions within the schools.

I voiced my agreement to the CDC’s report last year to my wife.  While she supports sun safety as well, she, a daycare teacher, brought up a good point.  “Who’s going to apply sunscreen to the little kids?”

Teachers in daycare and elementary schools take care of many kids.  In some cases, there are teacher’s assistants.  However, many state and county governments are cutting back, so there are fewer assistants.  At my wife’s daycare, one teacher could have up to 13 children.  In elementary school, the number is double that.  Very young kids simply cannot apply sunscreen by themselves.  It would take an extended period of time for any one teacher to apply the sunscreen to 13 to 25 kids and expect to have any time left for the playground.  It’s certainly a problem which has no real easy solution.

Last year, I sent out a survey of questions to teachers.  I had hoped to analyze and present a detailed breakdown of the data, but my schedule never allowed me time.  Still, I have the data and felt I might as well present the raw data for discussion.  Here are the questions and the results.

1.      Are you a teacher?
98% responded that they were.

2.       If you are a teacher, what grade do you teach?
a)      Pre-school                  8%
b)      K thru 2nd                  34%
c)       3rd thru 5th                25%
d)      Middle School           16%
e)      High School               17%

3.       How many children are in your class?
a)      Less than 5                  1%
b)      5 to 15                         7%
c)       16 to 25                       53%
d)      More than 25               39%

4.       Do you have a teaching assistant or another adult with you in class?
a)      Yes                                 36%
b)      No                                  64%

5.       Do you feel children in your grade/age are capable of applying sunscreen by their selves?
a)      Yes                                 53%
b)      Yes, but assisted            33%
c)       No                                  14%

6.       Which statement best fits your opinion towards sunscreen application for your class?
a)      All children MUST wear sunscreen during outdoor recess
b)      Only those children whose parents request it must wear sunscreen during outdoor recess
c)       Applying sunscreen to every child takes too much time
d)      Other (most which state they simply are not allowed to apply by school rule)

7.       Do you teach sun safety in your class?
a)      Yes, it’s part of our curriculum                        3%
b)      Yes, although it’s not required teaching         63%
c)       No, it’s not allowed under our curriculum     10%
d)      No, this should not be taught in class              7%
e)      Other                                                                17% (Most stated they simply never thought of it)

8.       Many schools ask that parents order class t-shirts to wear during field trips and “Spirit Days.”  Do you feel that parents are willing to pay for class hats to wear during outdoor recess?
a)      Yes                                 52%
b)      No                                  40%
c)       Another idea             8%  (most comments suggest kids be allowed to bring their own within dress code)        

I’m not a statistician, so I can’t really provide any scientific conclusions.  It appears that there are no easy answers.  Yes, we want our children safe in the sun…but no, with regards to younger kids, the teachers simply do not have the time or assistance.  In many cases, allergies and touching (either transfer of germs or considered “inappropriate”) are a concern as well.  Perhaps there needs to be a middle ground.

In my opinion, I’d like to see sun safety added to the school’s curriculum at every age group.  There are many suggested age-specific education guidelines available…certainly the school boards can select one to cover various grades.  I’d also like to see hats be allowed for outdoor use only.  These can be school hats or a child’s personal hat.  Sunglasses should be encouraged as well.

As for sunscreen, I really don’t know.  I guess a couple more questions could have been added to the survey.

1.       What do you feel is the proper age for a child to be trusted to apply their own sunscreen? 
2.       For younger children, and considering the limitations imposed on the teachers, how do you propose sunscreen be applied to younger kids?

  Let me know your thoughts.  It’s a debate worth having.

Postscript:  My apologies for the poor formatting.  Sometimes, numbering and bullets simply don't transfer well between MS Word and this blogging software.  I'll try to make it more legible in the near future.  -Al

Monday, June 1, 2015

A Month of Facts

May has come and gone this year.  Melanoma Awareness Month 2015 is over.  But I’d like to think that the results of actions taken this month will extend well into the following months.

I decided to take my action by sharing a skin cancer or melanoma facts throughout the month.  Each day, I posted a specific fact about the cancer.  The only exception was on Melanoma Monday where I posted a plea to simply be aware of melanoma.  Some people doubted particular facts, but I assure you that each was quoted from a legitimate source.  In most cases, the true raw source was available from the source I cited.  For instance, I read the fact that UV radiation is a proven carcinogen, which was cited from the Skin Cancer Foundation website.  The true source listed within the site was the National Toxicology Program. Report on Carcinogens, Twelfth Edition. U.S. Department of Health and Human Services, Public Health Service, National Toxicology Program. 2011: 429-430.  It was a little hard for me to fit all that in the space provided in each fact snippet, so I simply referenced the Skin Cancer Foundation as my source.  If you doubted any of my sources, please dig a little more to find the raw source.

The most doubted, yet most shared fact was that more people develop skin cancer because of tanning than develop lung cancer because of smoking.  In case you wish to research this a bit more, the raw source was from the following: Wehner M, Chren M-M, Nameth D, et al. International prevalence of indoor tanning: a systematic review and meta-analysis. JAMA Dermatol 2014; 150(4):390-400. Doi: 10.1001/jamadermatol.2013.6896.

Anyhow, I was asked a few times to share all of the month’s fact at one time, so you’ll find the entire list and the general sources lists below.  But before I share the list, let me make a few statements. 

First of all, many of the statistics I've shared relate to cancer and death.  You can change these statistics!  You can help prevent melanoma primarily by protecting yourself from the UV rays and seeing your dermatologist regularly. If we prevent the disease, the depressing and alarming statistics would no longer exist.

Secondly, for those of you who have melanoma, the statistics I've shared apply to people in the past…they do not apply to you personally.  Statistics do not define your fight…your hope…your triumph.  You do! 

Lastly, let me share a few more statistics.  I posted 31 different facts.  These facts were read by over 325,000 people on Facebook alone.  The facts were shared on Facebook a total of over 4,800 times.  I shared the facts on Twitter and Instagram as well, so the exposure extended even further.  This has been a true example of spreading melanoma awareness.  It indeed spreads and it works.  Grassroots campaigns such as Black is the New Pink and countless others work.  Please, please, please continue to spread awareness to your friends, families and total strangers.  It makes a difference! 

Thank you to each any every person who read, liked, or shared these facts during Melanoma Awareness Month!  Also, thank you to staff member Donald at the Waterside Resort in Hilton Head Island who helped me work out some technical glitches with my tablet so that I could continue posting these facts even while I was on a family vacation!

Here are all the facts:

One out of every five Americans will get skin cancer in their lifetime.
Each year there are more new cases of skin cancer than the combined incidence of cancers of the breast, prostate, lung and colon.
The annual cost of treating skin cancers in the U.S. is estimated at $8.1 billion

The literal definition of "melanoma" is "black tumor."  Today is Melanoma Monday.  Please wear black today to help up raise awareness and to honor those touched by melanoma…past, present, and future.
About 90 percent of nonmelanoma skin cancers are associated with exposure to ultraviolet (UV) radiation from the sun.
Melanoma/skin cancer is the most underfunded of all cancers by federal and private agencies
Melanoma accounts for 5% of all skin cancers and 71% of all skin cancer deaths.
The incidence of melanoma has increased 15 times in the last 40 years. This is a more rapid increase than for any other cancer!
Cleveland Clinic
Melanoma is the most common cancer in women ages 25 to 29
Cleveland Clinic
Melanoma is the second most common cancer in women ages 30 to 34, as well as in men ages 30 to 49.
Thirty percent of all melanoma in men arises on the back
Melanoma is the fastest growing cancer in the U.S. and worldwide.
Melanoma often starts out as a mole and can be removed if caught early.
From 1970 to 2009, the incidence of melanoma increased by 800 percent among young women and 400 percent among young men.
In 2015, it is estimated that there will be 73,870 new cases of melanoma in the United States
One in 50 Americans will develop melanoma in their lifetime.
On average, one American dies from melanoma every hour.
Cancer Research UK
The average age for melanoma diagnosis is 50, compared to other cancers, which is closer to 65-70 years old.
In 2015, it is estimated that 9,940 deaths will be attributed to melanoma — 6,640 men and 3,300 women.
People under age 45 account for 25% of all melanoma cases.
10% of all people with melanoma have a family history of melanoma.
Of the seven most common cancers in the US, melanoma is the only one whose incidence is increasing.
On average, a person’s risk for melanoma doubles if he or she has had more than five sunburns.
Regular daily use of an SPF 15 or higher sunscreen reduces the risk of developing melanoma by 50 percent.
Ultraviolet radiation (UVR) is a proven human carcinogen.
More people develop skin cancer because of tanning than develop lung cancer because of smoking.
Contrary to popular belief, 80 percent of a person’s lifetime sun exposure is not acquired before age 18; only about 23 percent of lifetime exposure occurs by age 18
2011 study on solar altitude
UV eye exposure is greatest during early morning and late afternoon when the sun is lower.  Wear your sunglasses!
Cloud cover reduces UV levels, but not completely. Depending on the thickness of the cloud cover, it is possible to burn on a cloudy day, even if it does not feel warm.
Surfaces like snow, sand, pavement, and water reflect much of the UV radiation that reaches them. Because of this reflection, UV intensity can be deceptively high even in shaded areas.
My Brother Jeff
Melanoma may start on your skin, but it can spread to your lungs, brain, and other organs.  It can kill you.