Real-Time UV Measurement With a Sun Protection System for Warning Young Adults About Sunburn: Prospective Cohort Study

Abstract

Background Melanoma is attributable to predisposing phenotypical factors, such as skin that easily sunburns and unprotected exposure to carcinogenic UV radiation. Reducing the proportion of young adults who get sunburned may reduce the incidence of melanoma, a deadly form of skin cancer. Advances in technology have enabled the delivery of real-time UV light exposure and content-relevant health interventions. Objective This study aims to examine the feasibility of young adults performing the following tasks daily: wearing a UV dosimeter, receiving text messages and real-time UV-B doses on their smartphone, and responding to daily web-based surveys about sunburn and sun protection. Methods Young adults aged 18-39 years (n=42) were recruited in the United States in June 2020 via social media. Participants received the UV Guard sun protection system, which consisted of a UV dosimeter and a smartphone app. During 3 consecutive periods, intervention intensity increased as follows: real-time UV-B dose; UV-B dose and daily behavioral facilitation text messages; and UV-B dose, goal setting, and daily text messages to support self-efficacy and self-regulation. Data were self-reported through daily web-based surveys for 28 days, and UV-B doses were transmitted to cloud-based storage. Results Patients’ median age was 22 years (IQR 20, 29), and all patients had sun-sensitive skin. Sunburns were experienced during the study by fewer subjects (n=18) than those in the preceding 28 days (n=30). In July and August, the face was the most commonly sunburned area among 13 body locations; 52% (22/42) of sunburns occurred before the study and 45% (19/42) occurred during the study. The mean daily UV-B dose decreased during the 3 periods; however, this was not statistically significant. Young adults were most often exercising outdoors from 2 to 6 PM, walking from 10 AM to 6 PM, and relaxing from noon to 2 PM. Sunburn was most often experienced during exercise (odds ratio [OR] 5.65, 95% CI 1.60-6.10) and relaxation (OR 3.69, 95% CI 1.03-4.67) relative to those that did not exercise or relax in each category. The self-reported exit survey indicated that participants felt that they spent less time outdoors this summer compared to the last summer because of the COVID-19 pandemic and work. In addition, 38% (16/42) of the participants changed their use of sun protection based on their app-reported UV exposure, and 48% (20/42) shifted the time they went outside to periods with less-intense UV exposure. A total of 79% (33/42) of the participants were willing to continue using the UV Guard system outside of a research setting. Conclusions In this proof-of-concept research, young adults demonstrated that they used the UV Guard system; however, optimization was needed. Although some sun protection behaviors changed, sunburn was not prevented in all participants, especially during outdoor exercise. Trial Registration ClinicalTrials.gov NCT03344796; http://clinicaltrials.gov/ct2/show/NCT03344796

Stratospheric ozone, UV radiation, and climate interactions

“…They can be engineered to have a spectral responsivity and a directional response approaching those of research-grade radiometers measuring erythemal irradiance [ 284 ]. The time resolution and ability to interface wirelessly with smartphones allows feedback to users, and has supported research on how such information can influence sun exposure amongst melanoma survivors [ 348 ], dockworkers and fishermen [ 349 ], or young adults in general [ 350 ]. In a small study of outdoor workers in Romania, dosimeters measured up to 6 SEDs per day and led the authors to suggest that UV dosimeters should be compulsory for outdoor workers, similar to personal dosimetry for ionizing radiation in relevant professions [ 351 ].…”

A UVR-sensor wearable device intervention to reduce sun exposure in melanoma survivors: Results from a randomized controlled trial

“…avoiding peak sun), which may have contributed to a lack of change in the summary measure and in these individual behaviors. In a 2021 prospective cohort study among young adults using a UV-dosimeter and messaging and goal-setting app, reductions in chest and shoulder sunburns and a trend towards fewer scalp sunburns over a 28-day period were observed, and wearing protective clothing was the most common goal reported [27]. It is possible that wearing t-shirts and hats are easily achievable sun protection measures among young cancer-free adults who may be likely to wear little protective clothing otherwise.…”

Etiologies of Melanoma Development and Prevention Measures: A Review of the Current Evidence

“…One example involved the use of UV sensors in conjunction with a smartphone to provide real-time feedback regarding UV dosage. These sensors have been shown to modulate wearers’ behavior in regard to UV exposure, with a resulting decrease in the average UV dosage received per day [ 86 , 87 ]. Application-based monitoring systems could also prove to be efficacious for increasing sunscreen usage, especially among individuals at high risk for melanoma.…”