Sun-protection Behaviors Among Active Members of the United States Lifesaving Association

BACKGROUND: Ultraviolet radiation exposure is the most prominent modifible risk factor for developing both melanoma and non-melanoma skin cancers. OBJECTIVE: We sought to elucidate sun-protective behaviors among active members of the United States Lifesaving Association (USLA), a nationwide nonprofit organization comprising beach lifeguards, and to identify positive and negative predictors of sun protective behaviors. METHODS: This was a pilot, cross-sectional survey study. All USLA lifeguards aged 18 years or older were invited to complete a 19-item survey. Data were collected anonymously at the 2018 USLA National Lifeguard Championships in Virginia Beach, Virginia. Participant characteristics and sun-protective behaviors (e.g., hat, sunglasses, protective clothing, sunscreen, and seeking shade) were surveyed. A composite score (0-10 points) was created based on sun-protective behaviors. Simple linear regression models were fit to assess the relationship between lifeguard characteristics and the sun-behavior composite score and a multiple linear regression model was used to assess their overall positive or negative effect on composite scores. RESULTS: A total of 215 USLA lifeguards completed the survey study; of these, 64.2% were male and the average age was 34.2 years. The most common sun-protective behavior was wearing sunglasses (85%), followed by applying sunscreen (65%), wearing a hat (46.7%), seeking shade (38.6%), and wearing protective clothing (34.0%). The overall average composite score was 7.5±1.9 points. In the multiple linear regression model, female sex (β=-0.85; p=0.0012), desiring a tan (β=-1.26; p=0.0008), and working more summer daytime hours (β=-0.49; p=0.049) negatively impacted composite scores. CONCLUSIONS: USLA beach lifeguards are subject to sun-exposure patterns and practiced sun-protective behaviors that potentially place them at higher risk for skin cancer.