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Updated: Jun 24, 2026

Minimal Erythema Dose (MED) Testing
Published on: May 28, 2013
Characteristics of swimming pools with high rates of objectively measured sunscreen use
Tom Elliott1, Karen Glanz, Eric J Nehl
1Rollins School of Public Health, Emory University, Atlanta, Georgia 30322, USA. tsellio@sph.emory.edu
Background:
A combination of verbal reports, observations, and physical assessments can improve understanding of prevention programs.
Objective:
Skin swabbing techniques were used to detect the presence of sunscreen as part of a sun protection measurement study at 16 swimming pools. Three pools demonstrated much higher sunscreen use (>95%) than the others (47.1%). This paper compares these three pools to the other 13 to examine whether they have common features and if different sources of data can help interpret the findings.
Methods:
Data were collected from skin swabs detecting the presence of sunscreen; observations of participants; observations of pool environments; and surveys.
Results:
Pool observations showed a higher use of shade structures, sun safety signs, and other supporting items at the three high-sunscreen use pools. These three pools had significantly more year-round and long-term employees than did the other 13 pools.
Limitations:
Sunscreen characteristics could not be determined using the swabbing technique. Publicity about the study, or the weather, may have influenced behaviors at the pools.
Conclusions:
Supportive environments were associated with consistent high levels of sunscreen use. This study also confirms the importance of using multiple data sources to interpret findings.
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