A day at the beach while on tropical vacation : sun protection practices in a high-risk setting for UV radiation exposure

Objective: To conduct an assessment of levels of UV radiation (UVR) exposure and the range of sun protection behaviors of beachgoers at a popular vacation destination.--- Design: Participants completed the sun habits survey prior to entry to the beach and completed an exit survey on leaving regarding their sun protection practices while at the beach. Ambient UVR was monitored using polysulfone dosimeters.--- Setting: A popular beach for vacationers in Honolulu, Hawaii.--- Main Outcome Measures: Sun protection practices and UVR.--- Results: Participants spent an average of 3 hours at the beach and received an estimated UVR dose of 10.4 standard erythemal doses. Latent class analysis identified 3 homogeneous classes with distinct characteristics and sun protection behaviors. Those in class 1 (unconcerned and at low risk) were at least risk of skin cancer, intended to tan, and used the least amount of sun protection. Those in class 2 (tan seekers) had the second highest risk of skin cancer, had the highest proportion of women, became sunburned easily, intended to tan, had used tanning beds in past 30 days, and had the highest proportion of sunscreen coverage and the least clothing coverage. Those in class 3 (concerned and protected) had the highest skin cancer risk, the highest proportion of clothing coverage and shade use, and were more likely to be residents of Hawaii.--- Conclusions: Beachgoers were exposed to 5 times the UVR dose required to result in erythema among unprotected fair-skinned populations. Latent class analysis was effective in identifying subgroups of beachgoers who would benefit from targeted, population-based interventions aimed at reducing skin cancer risks while enjoying outdoor leisure-time activities.