Sunburn related to UV radiation exposure, age, sex, occupation, and sun bed use based on time-stamped personal dosimetry and sun behavior diaries

Objective: To assess when sunburn occurs and who experiences sunburn by personal UV dosimetry and diaries. Design: Open prospective observational study. Setting: University hospital. Participants: A convenience sample of 340 Danish volunteers: children, adolescents, indoor workers, sun worshippers, golfers, and gardeners (age range, 4-68 years). Main Outcome Measures: Subjects recorded sun-burn and sun-exposure behavior in diaries and carried personal, electronic, wristwatch UV radiation (UVR) dosimeters that measured time-stamped UVR doses continuously for a median of 119 days covering 346 sun-years (1 sun-year equals I subject participating during I summer half-year). Results: Atypical sunburn day was a day off work (91%; odds ratio, 4.1) with risk behavior (sunbathing/ exposing shoulders) (79%; odds ratio, 15.9) in May, June, or July (90%) for 6.4 exposure hours (interquartile range, 5-7.7 hours), of which 2.8 hours fell between noon and 3 Pm. Subjects had a median of I sunburn per sun-year; adolescents, sun worshippers, and indoor workers had more than children, golfers, and gardeners (P<.05). Sunburn peaked at age 20 years, and female subjects had more sunburns than male subjects (P<.01). Skin type IV had fewer sunburns than types I through III (P<.01). Sunburned persons had more risk-behavior days and lower skin type (P<.01) than nonsunburned persons. The median UVR doses received were significantly higher on sunburn days than on nonsunburn days with risk behavior (P<.01). There was a significant correlation between sunburn size and severity; sunburn and sunscreen use; and sunburn and sun-bed use (P<.01 for all 3 comparisons). Conclusions: Sunburn was highly correlated with risk behavior. Reduction of risk-behavior days and/or exposure hours around noon can reduce sunburn. Sunburn was not found during breaks on normal full-time indoor work or school days.