Journal Article

Effect of Sunscreen and Clothing on the Number of Melanocytic Nevi in 1,812 German Children Attending Day Care

Jürgen Bauer, Petra Büttner, Tine Sander Wiecker, Heike Luther and Claus Garbe

in American Journal of Epidemiology

Published on behalf of Johns Hopkins Bloomberg School of Public Health

Volume 161, issue 7, pages 620-627
Published in print April 2005 | ISSN: 0002-9262
Published online April 2005 | e-ISSN: 1476-6256 | DOI:
Effect of Sunscreen and Clothing on the Number of Melanocytic Nevi in 1,812 German Children Attending Day Care

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The number of melanocytic nevi is the most important risk factor for cutaneous melanoma. This 1998 cross-sectional study of 1,812 children aged 2–7 years from 78 day-care centers in Germany analyzed the protective effect of sunscreen and clothing on the number of melanocytic nevi. Total body nevi were counted, and pigmentary features were assessed. Parents underwent a standardized interview concerning their children's sun exposure and sun-protective behavior. Almost 95% of the children had used sunscreen previously. Children who used sunscreen and wore more clothing spent significantly longer periods on holidays in sunny climates (p < 0.001 and p = 0.006, respectively) and had a higher outdoor activity score at home (p < 0.001 and p = 0.012, respectively). Multivariate analysis adjusted for confounders showed no significant protective effects of applying sunscreen. Examination of the potential protective effect of clothing revealed an inverse dose-response correlation between the number of clothes worn at the beach or outdoor swimming pool and the number of melanocytic nevi (p < 0.001, adjusted for confounding). Randomized controlled trials are needed to confirm these results. Meanwhile, public education should aim to protect children primarily by sun avoidance and protective clothing, while sunscreen should also be used.

Keywords: child; clothing; health behavior; melanoma; nevus, pigmented; sunlight; sunscreening agents; CI, confidence interval; IQR, interquartile range; SPF, sun-protection factor

Journal Article.  5215 words. 

Subjects: Public Health and Epidemiology

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