Sun exposure patterns of urban, suburban, and rural children: a dosimetry and diary study of 150 children

Background: Sun exposure is the main etiology of skin cancer. Differences in skin cancer incidence have been observed between rural and urban populations. Objectives: As sun exposure begins in childhood, we examined summer UVR exposure doses and sun behavior in children resident in urban, suburban, and rural areas. Methods: Personal, electronic UVR dosimeters and sun behavior diaries were used during a summer (3.5 months) by 150 children (4–19 years of age) resident in urban, suburban, and rural areas. Results: On school/kindergarten days rural children spent more time outdoors and received higher UVR doses than urban and suburban children (rural: median 2.3 h per day, median 0.9 SED per day, urban: median 1.3 h per day, median 0.3 SED per day, suburban: median 1.5 h per day, median 0.4 SED per day) (p ≤ 0.007). Urban and suburban children exhibited a more intermittent sun exposure pattern than rural children. Differences in UVR exposure doses were from high exposure days (e.g. beach days) outside Denmark. Suburban children had a total UVR exposure similar to rural children (suburban: median 109.4 SED, rural: median 103.1 SED), with days spent abroad contributing greatly to the total UVR exposure dose (total UVR on days spent abroad: suburban: median 48.0 SED, rural: median 8.0 SED). Conclusions: Differences in sun exposure patterns exist between children from different areas and may be the background for higher skin cancer incidences in urban populations.