Inadequate sun protection policies and practices at early childhood centres (ECCs) in New Zealand could be putting children at risk of skin cancer later in life, a new study shows.
University of Otago Wellington researchers say good practices are essential to prevent skin cancer later in life. But while many positive sun protection measures are being implemented, policies and practices frequently fall short of best practice, according to their latest study which included extensive interviews with professional development advisors working with groups of teacher-led ECCs throughout the country.
Among its findings the study showed that while sunscreen and hats were focused on in ECCs, "sun protective" hats, role modeling and protective clothing were not consistently emphasised.
Lead researcher Mary Duignan says an example is where parents might usually supply a hat, and sun-protective hats might be encouraged, but where the centre allows caps, which do not provide adequate protection.
"We found that was often the case. We also found there was inconsistent role-modelling such as staff not wearing hats while outside."
Other common issues include inconsistent management of sunscreen, ranging from systematic application at specific times, through to reliance on parents applying sunscreen before the child arrived at the centre.
Underlying reasons for the issues identified in the study included insufficient emphasis on sun protection in government early childhood regulatory and monitoring processes, and centre staff lacking access to sun protection information, Duignan says.
Better information for staff is needed, particularly to help staff confidently promote sun protection to parents, she says.
"Information about the complex relationship between sun exposure, Vitamin D levels and health is a good example – obtaining adequate Vitamin D requires a balance between sun exposure and sun protection."
Skin cancer is the most commonly diagnosed cancer in New Zealand. Our melanoma rates, along with Australia, are among the highest worldwide. Ultraviolet radiation (UVR) is a known carcinogen and in high UVR areas such as New Zealand excessive UVR exposure is estimated to cause over 90% of skin cancers.
A prolonged latency period means it can take many years to establish whether prevention programmes are effective, but evidence supports the importance of sun protection in early childhood, as excessive childhood UVR exposure increases melanoma risk later in life, Duignan says.
She notes the success of the Cancer Society of New Zealand's SunSmart Schools Accreditation Programme (SSAP) that provides accreditation to primary and intermediate schools that meet best practice sun protection criteria.
"SSAP has resulted in significant increases in the number of sun protection criteria met by schools, particularly sunscreen use, hat wearing and a requirement to play in the shade if not wearing a hat.
There is no similar New Zealand programme for early childhood services.
ECC teachers need more support to consistently implement best practice sun protection, Duignan says.
"A small investment now to support ECCs to implement best practice sun protection would likely produce long term savings in costs associated with skin cancer, and promote a healthy future for our children."
The study has been published today in the New Zealand Medical Journal.