Exposing the role of parks and recreation in sun protection.

Educating children and adults about the measures that can be taken to reduce or avoid UV exposure is important.

Gone are the days when we would send our children outside to play and get a little color in their cheeks. We know too much about the dangers of unprotected sun exposure to hazard the development of skin cancer and premature skin aging. According to Mitchell W. Sams Jr., M.D., president of the American Academy of Dermatology, sunburn is the most preventable risk factor for skin cancer including malignant melanoma, the deadliest form of skin cancer (1998). We can't change our skin type or family history, but we can alter our sunbathing habits. Parents should know that even one or two blistering sunburns can significantly increase a child's risk of developing melanoma or skin cancer later in life. Freckles aren't cute -- they're a sign of sun damage. Society's collective belief that a dark, luxurious tan equals health and beauty must be replaced with the notion that sun protection is smarter.

Skin cancer is the most common and most rapidly increasing form of cancer in the United States. "One in five Americans will develop some form of skin cancer during their lifetime," stated Darrell Rigel, M.D., a New 'fork City dermatologist and clinical professor of dermatology at New York City University. In fact, one-half of all new cancers are skin cancers. Exposure to the ultraviolet (UV) radiation of the sun is the most important fact in determining a person's risk of skin cancer. Past sunburns, sun exposure at young ages, genetics, and immune-system deficiencies may also play a part (AAD, 1998).

The three major types of skin cancer are the highly curable basal cell and squamous cell carcinomas and the more serious malignant melanoma. A total of I million new cases of basal cell and squamous cell carcinomas will be detected in 1998; approximately 41,600 new cases of malignant melanoma will also be diagnosed. In 1998 alone, skin cancer will claim the lives of nearly 9,200 people. Basal cell and squamous cell carcinomas can cause substantial illness; however, death rates from these cancers are low. If detected and treated early, these carcinomas have a cure rate of more than 95 percent. Untreated, they can cause considerable damage and disfigurement. Malignant melanoma causes more than 75 percent of all deaths from skin cancer. This disease can spread to other organs, most commonly the lungs and liver. Malignant melanoma diagnosed at an early stage can usually be cured, but melanoma diagnosed at a late stage is more likely to spread and cause death (CDC, 1998).

Who is at Risk?

Everyone is potentially at risk. Although Caucasians with lightly pigmented skin are more likely to develop skin cancer, persons of all races and ethnic backgrounds are susceptible. The only way to "make" someone safe is to provide protection. Therefore, educating children and adults about the measures that can be taken to reduce or avoid UV exposure is important (CSCPM, 1998).

Research suggests that healthy behavior patterns established in early childhood are often maintained throughout life. Parents, health care providers, schools, park and recreation programs, and community organizations can play a major role in reinforcing sun-protection behaviors (e.g., staying out of direct sunlight or planning outdoor activities for hours when UV light is less intense) and changing attitudes about exposure to the sun (i.e., the opinion that a person looks more attractive with a tan) (CDC, 1998).

The primary risk factors for skin cancer are:

* Light skin color.

* Family history of skin cancer.

* Personal history of skin cancer.

* Chronic exposure to the sun.

* History of severe sunburns early in life.

* Certain types and large numbers of moles.

* Freckles as an indicator of sun sensitivity and sun damage.

It is important to remember that a person can get sunburned while playing or watching outdoor sports, walking or running, playing on the playground, attending a day camp, or simply working or playing in the yard. People can also get sunburned while building a snowman, skiing, sledding, snowmobiling, or ice fishing. Also, remember that UV radiation is intensified as it reflects off the water, snow, or ice, and can cause skin damage even on cloudy days.

Sun Safety Practices

Sun safety practices recommended by the Centers for Disease Control and Prevention (CDC) include avoiding tans and sunburns by:

* Referring to your local weather forecast's daily UV Index when planning outdoor activities.

* Staying out of direct sunlight from 10 a.m. to 4 p.m.

* Seeking shade when playing or working outdoors.

* Wearing protective gear including sunglasses, long-sleeved shirts, and wide-brimmed hats.

* Applying sunscreen lotion with a sun protection factor (SPF) of 15 or higher.

The American Academy of Dermatology (1998) suggests the ABCs of sun safety protection:

* Stay Away from the midday sun, especially from 10 a.m. to 4 p.m., when the sun's rays are the strongest.

* To Block the sun, apply sunscreen with a sun protection factor (SPF) of at least 15 approximately 20 minutes before sun exposure. Reapply every two hours, and after swimming and sweating. Apply sunscreen beginning at six months of age.

* Cover up with a wide-brim hat or visor, tightly woven clothing, and sunglasses when outdoors.

* Keep infants less than six months of age out of direct sunlight and in the Shade. Use an umbrella over the stroller.

Each of these recommendations implies the wise use of sun protection practices in active outdoor living and playing.

Strategies in Parks and Recreation

Over the past several years, there has been much discussion about the benefits of parks and recreation to the quality of life of all Americans. Because so many of these benefits are directly related to an active lifestyle in the outdoors, it is natural that those charged with the provision of these activities and opportunities should be committed to some basic strategies for sun protection and safety.

Strategy #1: Include sun-protection training at all in-service training and staff development programs. The basics of sun-protection training can be taught in less than 30 minutes. Training should be provided for all full-time, part-time, and seasonal employees, as well as direct service volunteers. This training should provide employees and volunteers with an understanding of how and why sun-protection activities can be implemented within their program services. Individual agencies and programs should adapt training according to their needs and standards.

Strategy #2: Include sun-protection education in all appropriate program offerings. All park and recreation programs with the potential for sun exposure should provide basic sun-protection education to their clientele. This education program needs to inform patrons of the potential hazards of sun exposure as well as the simple, yet appropriate, means to adequate sun protection. Program leaders should model correct sun-protection practices in each of their activities.

Strategy #3: Initiate policies requiring sun-protection standards in program and service offerings. Agencies and programs should initiate policies requiring sun-protection standards and practices to be implemented within the agency and its program offerings. Such policies should address having sun screen in first-aid kits and coaches' packets; making sun screen available in concession stands, club houses, and aquatics areas; providing shade in team, spectator, aquatic, playground, and camping areas; providing UV Index information in activity areas with intense sun exposure; and requiring appropriate clothing during high sun-exposure activities. The risk management plan for each agency should include a policy regarding appropriate sun-protection measures.

Strategy #4: Model appropriate sun-protection standards and behaviors in program and service offerings. Agency staff at all levels should display correct sun-protection practices during all appropriate activities. Staff should also encourage program participants to follow acceptable sun-protection practices while involved in program offerings. Tournament scheduling should avoid "middle of the day" games whenever possible. When not possible, appropriate sun-safety measures should be encouraged of both participants and spectators. Aquatics areas, playgrounds, and day camps should have UV Index information readily available to participants and staff.

Strategy #5: Include sun-protection standards in all future program and facility development. Sun-protection measures should become a part of all strategic planning initiatives within each agency and program. Professionals and other individuals with a direct responsibility for the prevention and treatment of sun-related diseases within each community should be invited to provide input for all future initiatives.

Safe Fun in the Sun

Is recreation about fun in the sun? Absolutely! Is recreation about safety in the sun? Yes! As we continue to provide the American public with health benefits, let's add to the list the prevention of potential life-threatening cancer and related skin diseases from sun exposure. Is the task that difficult? Not really. Is the task important? Remember: one in five Americans will develop skin cancer during his or her lifetime.

References

American Academy of Dermatology. 1998. "Skin Cancer Risks Increase for Americans." New York. 29 April.

Centers for Disease Control and Prevention. 1998. "National Skin Cancer Prevention Education Program At-A-Glance." Atlanta.

Coalition for Skin Cancer Prevention in Maryland. 1998. "The Adventures of SunGuard Man." Baltimore.

Sams Jr., M.D., W. Mitchell. 1998. "Families Frying Together: Sunbathing Habits of Parents and Children." fathermag.com. 29 January.

RELATED ARTICLE: Tips for Kids

* Limit outdoor activities between 10 a.m. and 4 p.m., when the sun's rays are strongest. Don't forget that there is reflective light in the shade.

* Babies less than six months old should spend very little time in the sun. If they are exposed to the sun, they should wear protective clothing, including a hat with a brim that shades their face and sunglasses that filter harmful UV rays.

* Babies and children older than six months should always wear a broad-spectrum sunscreen with an SPF of at Least 15. Sunscreen should be applied 30 minutes before children go outside and reapplied every two to three hours when they are in the sun or water, even if the Label says the product is waterproof. And be sure not to forget the nose, Lips, ears, and backs of hands and feet!

RELATED ARTICLE: Did you Know ...

* Half of all new cancers are skin cancers?

* Six out of seven skin cancer deaths are from malignant melanoma?

* Approximately 1 million new cases of skin cancer will be diagnosed in the United States this year?

* Some 1,200 people will die of basal cell or squamous cell carcinoma this year?

* The incidence of malignant melanoma doubted among white mates between 1973 and '91?

* Melanoma is more common than any other non-skin cancer among people between the ages of 25 and 29?