Harrison, Simone L., Buettner, Petra G., and Nowak, Madeleine J. (2023) Sun-Protective Clothing Worn Regularly during Early Childhood Reduces the Number of New Melanocytic Nevi: The North Queensland Sun-Safe Clothing Cluster Randomized Controlled Trial. Cancers, 15 (6). 1762.

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Abstract

Numerous pigmented moles are associated with sun exposure and melanoma risk. This cluster randomized controlled trial aimed to determine if sun-protective clothing could prevent a significant proportion of the moles developing in young children (ACTRN12617000621314; Australian New Zealand Clinical Trials Registry). Twenty-five childcare centers in Townsville (19.25◦S), Australia, were matched on shade provision and socioeconomic status. One center from each pair was randomized to the intervention arm and the other to the control arm. Children at 13 intervention centers wore study garments and legionnaire hats at childcare and received sun-protective swimwear and hats for home use, while children at the 12 control centers did not. The 1–35-month-old children (334 intervention; 210 control) were examined for moles at baseline (1999–2002) and were re-examined annually for up to 4 years. Both groups were similar at baseline. Children at intervention centers acquired fewer new moles overall (median 12.5 versus 16, p = 0.02; 0.46 versus 0.68 moles/month, p = 0.001) and fewer new moles on clothing-protected skin (6 vs. 8; p = 0.021 adjusted for confounding and cluster sampling) than controls. Intervention children had 24.3% fewer new moles overall (26.5 versus 35) and 31.6% (13 versus 19) fewer moles on clothing-protected skin than controls after 3.5 years. Sunlight’s influence on nevogenesis is mitigated when children regularly wear UPF 30-50+ clothing covering half their body, implying that increased clothing cover reduces melanoma risk. Sun-protective clothing standards should mandate reporting of the percentage of garment coverage for childrenswear.

Item ID:	77907
Item Type:	Article (Research - C1)
ISSN:	2072-6694
Keywords:	clothing; sun protection; melanocytic nevus; ultraviolet protection factor (UPF); melanoma; skin cancer; garment; ultraviolet radiation; dermatology; children
Copyright Information:	© 2023 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
Funders:	National Health and Medical Research Council of Australia (NHMRC), Queensland Health, Vera W. Parkes Bequest to James Cook University
Projects and Grants:	NHMRC ID 9937577
Date Deposited:	21 Mar 2023 00:18
FoR Codes:	42 HEALTH SCIENCES > 4202 Epidemiology > 420201 Behavioural epidemiology @ 100%
SEO Codes:	20 HEALTH > 2004 Public health (excl. specific population health) > 200401 Behaviour and health @ 100%
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