User login
Spectators at baseball games may be exposed to excess solar UV radiation (UVR), which has been linked to the development of both melanoma and nonmelanoma skin cancers.1,2 Although baseball hats traditionally are worn to demonstrate team support, they also may provide some sun protection for the head and face where skin cancers are commonly found.
The importance of protecting the skin from solar UVR has led to sun-protection programs and community education as well as efforts to evaluate the impact of these programs. Major League Baseball (MLB) has partnered with the American Academy of Dermatology since 1999 to promote the importance of sun protection and raise skin cancer awareness through its Play Sun Smart program.3 A study conducted 10 years ago (N=2030) evaluated hat use in spectators at MLB games and noted that less than half of all spectators in seating sections exposed to direct sunlight wore hats.4 The purpose of the current study was to evaluate how public education about sun protection has impacted the use of hats by spectators at MLB games in 2015 compared to the prior study in 2006.
Methods
Data were collected during a 3-game series (2 day games, 1 night game) in August 2015 in New York, New York. During one of the day games, 18,000 fans received a free wide-brimmed hat. High-resolution digital photographs of seating sections were obtained using a camera with a 300-mm lens. Using the same methodology as the prior study,4 sunny and shaded seating sections were photographed during all 3 games (Figure). Photographs of each section were analyzed by an independent reviewer using a high-resolution computer screen. Spectators wearing head coverings—baseball hats, visors, or hats with circumferential brims—were defined as using hats. The number of spectators wearing hats versus not wearing hats was recorded for all identical sections of interest. Bleacher seating was analyzed separately, as spectators presumably knew in advance of the continuous direct sun exposure during day games, and a subset of young children in the bleachers (<10 years of age) also was assessed. A continuously sunny section also was evaluated at the second and sixth innings to see if hats were presumably purchased during exposure. Statistical significance was determined using χ2 tests with P<.05 indicating statistical significance.
Results
This analysis consisted of 3539 spectators. In both the sunny and shaded sections of a day game, there were more spectators wearing hats (49% and 37%, respectively)(P<.001) than in the same sections at night games (35% and 29%, respectively)(Table 1). During the day game, more spectators wore hats in the sunny section than in the adjacent shaded section (49% vs 37%; P<.001). Analysis of the same 2 sections during the night game revealed no significant differences.
Spectators sitting in the bleachers during a day game who presumably knew to anticipate direct sun exposure showed no significant differences in hat-wearing patterns versus the sunny section (44% vs 49%) but were more likely to wear hats compared to those sitting in the bleachers at the night game (44% vs 33%)(P<.001)(Table 1). There was no significant difference in the number of hats worn by spectators in the sunny section in the second inning (43%) versus the same section after continuous sun exposure at the sixth inning (44%)(Table 2). Significantly more children seated in the bleachers during the day game wore hats compared to adults in the same section (64% vs 42%; P<.001)(Table 3). During the hat giveaway day, significantly more spectators wore hats (the majority of which were the free giveaway hats) across all sections studied (P<.001)(Table 4).
Comment
More than 23 million spectators attended daytime MLB games in 2015, with millions more attending minor league and amateur events.5Although sun-protection messages tend to be well understood and received by society, many choose to ignore them.6
In partnership with the American Academy of Dermatology, the MLB’s Play Sun Smart program has promoted UVR risk awareness at sporting events since 1999.3 Those affiliated with MLB teams also receive annual skin cancer screenings in conjunction with a public education effort in May of each season. However, despite the years of sun-protection education, our study found that less than half of attendees wore hats for UVR protection. In fact, there were no significant differences noted across all of the hat-wearing parameters studied (day vs night game, sunny vs shaded section, sunny section over course of game) between the current study compared to the results from 10 years prior4 (Tables 1 and 2). For spectators in the bleacher section, even presumably knowing in advance that seating would be in the sun did not significantly increase hat-wearing behavior. Although skin cancer rates continue to rise, hat-wearing trends remain stable, revealing a concerning trend.
Increased availability of sunscreen has led to improved sun-protective behaviors in many populations.7 In our study, the free hat giveaway had the greatest impact on hat wearing, which suggests that improved availability and access to hats can lead to an important opportunity for sun-protection programs to partner with hat manufacturers to augment their use and protective impact.
Sun avoidance during childhood and adolescence has been shown to decrease the risk for melanoma.1 Young children had the highest rate of hat usage in the current study, possibly due to parental example or dictates. Research has shown the importance of role models in promoting sun safety to young children,8,9 so perhaps use of hats by parents or MLB players contributed to the hat-wearing behavior observed in this subpopulation.
Given the limited change observed in hat-wearing behaviors over the last decade, a knowledge and behavioral gap appears to exist that may be able to be exploited to enhance future sun protection. Also, based on our findings, the MLB and other sun-protection education campaigns may wish to augment their UVR protective messages by offering hat giveaways, which appear to have a notable impact.
Acknowledgment
The authors thank Jessie Skapik, BS (New York, New York), for her independent review of the spectator photographs.
References
1. Rigel DS. Cutaneous ultraviolet exposure and its relationship to the development of skin cancer. J Am Acad Dermatol. 2008;58(5, suppl 2):S129-S132.
2. Lim HW, James WD, Rigel DS, et al. Adverse effects of ultraviolet radiation from the use of indoor tanning equipment: time to ban the tan. J Am Acad Dermatol. 2011;64:893-902.
3. Play Sun Smart. American Academy of Dermatology website. https://www.aad.org/public/spot-skin-cancer/programs/play-sun-smart. Accessed August 25, 2016.
4. Rigel AS, Lebwohl MG. Hat-wearing patterns in persons attending baseball games. J Am Acad Dermatol. 2006;54:918-919.
5. MLB attendance report - 2016. ESPN website. www.espn.go.com/mlb/attendance. Accessed May 20, 2016.
6. Turner D, Harrison SL, Buettner P, et al. Does being a “SunSmart School” influence hat-wearing compliance? an ecological study of hat-wearing rates at Australian primary schools in a region of high sun exposure [published online December 29, 2013]. Prev Med. 2014;60:107-114.
7. Dubas LE, Adams BB. Sunscreen use and availability among female collegiate athletes [published online February 3, 2012]. J Am Acad Dermatol. 2012;67:876.e1-876.e6.
8. O’Riodran DL, Geller AC, Brooks DR, et al. Sunburn reduction through parental role modeling and sunscreen vigilance. J Pediatr. 2003;142:67-72.
9. Turrisi R, Hillhouse J, Heavin S, et al. Examination of the short-term efficacy of a parent-based intervention to prevent skin cancer. J Behav Med. 2004;27:393-412.
Spectators at baseball games may be exposed to excess solar UV radiation (UVR), which has been linked to the development of both melanoma and nonmelanoma skin cancers.1,2 Although baseball hats traditionally are worn to demonstrate team support, they also may provide some sun protection for the head and face where skin cancers are commonly found.
The importance of protecting the skin from solar UVR has led to sun-protection programs and community education as well as efforts to evaluate the impact of these programs. Major League Baseball (MLB) has partnered with the American Academy of Dermatology since 1999 to promote the importance of sun protection and raise skin cancer awareness through its Play Sun Smart program.3 A study conducted 10 years ago (N=2030) evaluated hat use in spectators at MLB games and noted that less than half of all spectators in seating sections exposed to direct sunlight wore hats.4 The purpose of the current study was to evaluate how public education about sun protection has impacted the use of hats by spectators at MLB games in 2015 compared to the prior study in 2006.
Methods
Data were collected during a 3-game series (2 day games, 1 night game) in August 2015 in New York, New York. During one of the day games, 18,000 fans received a free wide-brimmed hat. High-resolution digital photographs of seating sections were obtained using a camera with a 300-mm lens. Using the same methodology as the prior study,4 sunny and shaded seating sections were photographed during all 3 games (Figure). Photographs of each section were analyzed by an independent reviewer using a high-resolution computer screen. Spectators wearing head coverings—baseball hats, visors, or hats with circumferential brims—were defined as using hats. The number of spectators wearing hats versus not wearing hats was recorded for all identical sections of interest. Bleacher seating was analyzed separately, as spectators presumably knew in advance of the continuous direct sun exposure during day games, and a subset of young children in the bleachers (<10 years of age) also was assessed. A continuously sunny section also was evaluated at the second and sixth innings to see if hats were presumably purchased during exposure. Statistical significance was determined using χ2 tests with P<.05 indicating statistical significance.
Results
This analysis consisted of 3539 spectators. In both the sunny and shaded sections of a day game, there were more spectators wearing hats (49% and 37%, respectively)(P<.001) than in the same sections at night games (35% and 29%, respectively)(Table 1). During the day game, more spectators wore hats in the sunny section than in the adjacent shaded section (49% vs 37%; P<.001). Analysis of the same 2 sections during the night game revealed no significant differences.
Spectators sitting in the bleachers during a day game who presumably knew to anticipate direct sun exposure showed no significant differences in hat-wearing patterns versus the sunny section (44% vs 49%) but were more likely to wear hats compared to those sitting in the bleachers at the night game (44% vs 33%)(P<.001)(Table 1). There was no significant difference in the number of hats worn by spectators in the sunny section in the second inning (43%) versus the same section after continuous sun exposure at the sixth inning (44%)(Table 2). Significantly more children seated in the bleachers during the day game wore hats compared to adults in the same section (64% vs 42%; P<.001)(Table 3). During the hat giveaway day, significantly more spectators wore hats (the majority of which were the free giveaway hats) across all sections studied (P<.001)(Table 4).
Comment
More than 23 million spectators attended daytime MLB games in 2015, with millions more attending minor league and amateur events.5Although sun-protection messages tend to be well understood and received by society, many choose to ignore them.6
In partnership with the American Academy of Dermatology, the MLB’s Play Sun Smart program has promoted UVR risk awareness at sporting events since 1999.3 Those affiliated with MLB teams also receive annual skin cancer screenings in conjunction with a public education effort in May of each season. However, despite the years of sun-protection education, our study found that less than half of attendees wore hats for UVR protection. In fact, there were no significant differences noted across all of the hat-wearing parameters studied (day vs night game, sunny vs shaded section, sunny section over course of game) between the current study compared to the results from 10 years prior4 (Tables 1 and 2). For spectators in the bleacher section, even presumably knowing in advance that seating would be in the sun did not significantly increase hat-wearing behavior. Although skin cancer rates continue to rise, hat-wearing trends remain stable, revealing a concerning trend.
Increased availability of sunscreen has led to improved sun-protective behaviors in many populations.7 In our study, the free hat giveaway had the greatest impact on hat wearing, which suggests that improved availability and access to hats can lead to an important opportunity for sun-protection programs to partner with hat manufacturers to augment their use and protective impact.
Sun avoidance during childhood and adolescence has been shown to decrease the risk for melanoma.1 Young children had the highest rate of hat usage in the current study, possibly due to parental example or dictates. Research has shown the importance of role models in promoting sun safety to young children,8,9 so perhaps use of hats by parents or MLB players contributed to the hat-wearing behavior observed in this subpopulation.
Given the limited change observed in hat-wearing behaviors over the last decade, a knowledge and behavioral gap appears to exist that may be able to be exploited to enhance future sun protection. Also, based on our findings, the MLB and other sun-protection education campaigns may wish to augment their UVR protective messages by offering hat giveaways, which appear to have a notable impact.
Acknowledgment
The authors thank Jessie Skapik, BS (New York, New York), for her independent review of the spectator photographs.
Spectators at baseball games may be exposed to excess solar UV radiation (UVR), which has been linked to the development of both melanoma and nonmelanoma skin cancers.1,2 Although baseball hats traditionally are worn to demonstrate team support, they also may provide some sun protection for the head and face where skin cancers are commonly found.
The importance of protecting the skin from solar UVR has led to sun-protection programs and community education as well as efforts to evaluate the impact of these programs. Major League Baseball (MLB) has partnered with the American Academy of Dermatology since 1999 to promote the importance of sun protection and raise skin cancer awareness through its Play Sun Smart program.3 A study conducted 10 years ago (N=2030) evaluated hat use in spectators at MLB games and noted that less than half of all spectators in seating sections exposed to direct sunlight wore hats.4 The purpose of the current study was to evaluate how public education about sun protection has impacted the use of hats by spectators at MLB games in 2015 compared to the prior study in 2006.
Methods
Data were collected during a 3-game series (2 day games, 1 night game) in August 2015 in New York, New York. During one of the day games, 18,000 fans received a free wide-brimmed hat. High-resolution digital photographs of seating sections were obtained using a camera with a 300-mm lens. Using the same methodology as the prior study,4 sunny and shaded seating sections were photographed during all 3 games (Figure). Photographs of each section were analyzed by an independent reviewer using a high-resolution computer screen. Spectators wearing head coverings—baseball hats, visors, or hats with circumferential brims—were defined as using hats. The number of spectators wearing hats versus not wearing hats was recorded for all identical sections of interest. Bleacher seating was analyzed separately, as spectators presumably knew in advance of the continuous direct sun exposure during day games, and a subset of young children in the bleachers (<10 years of age) also was assessed. A continuously sunny section also was evaluated at the second and sixth innings to see if hats were presumably purchased during exposure. Statistical significance was determined using χ2 tests with P<.05 indicating statistical significance.
Results
This analysis consisted of 3539 spectators. In both the sunny and shaded sections of a day game, there were more spectators wearing hats (49% and 37%, respectively)(P<.001) than in the same sections at night games (35% and 29%, respectively)(Table 1). During the day game, more spectators wore hats in the sunny section than in the adjacent shaded section (49% vs 37%; P<.001). Analysis of the same 2 sections during the night game revealed no significant differences.
Spectators sitting in the bleachers during a day game who presumably knew to anticipate direct sun exposure showed no significant differences in hat-wearing patterns versus the sunny section (44% vs 49%) but were more likely to wear hats compared to those sitting in the bleachers at the night game (44% vs 33%)(P<.001)(Table 1). There was no significant difference in the number of hats worn by spectators in the sunny section in the second inning (43%) versus the same section after continuous sun exposure at the sixth inning (44%)(Table 2). Significantly more children seated in the bleachers during the day game wore hats compared to adults in the same section (64% vs 42%; P<.001)(Table 3). During the hat giveaway day, significantly more spectators wore hats (the majority of which were the free giveaway hats) across all sections studied (P<.001)(Table 4).
Comment
More than 23 million spectators attended daytime MLB games in 2015, with millions more attending minor league and amateur events.5Although sun-protection messages tend to be well understood and received by society, many choose to ignore them.6
In partnership with the American Academy of Dermatology, the MLB’s Play Sun Smart program has promoted UVR risk awareness at sporting events since 1999.3 Those affiliated with MLB teams also receive annual skin cancer screenings in conjunction with a public education effort in May of each season. However, despite the years of sun-protection education, our study found that less than half of attendees wore hats for UVR protection. In fact, there were no significant differences noted across all of the hat-wearing parameters studied (day vs night game, sunny vs shaded section, sunny section over course of game) between the current study compared to the results from 10 years prior4 (Tables 1 and 2). For spectators in the bleacher section, even presumably knowing in advance that seating would be in the sun did not significantly increase hat-wearing behavior. Although skin cancer rates continue to rise, hat-wearing trends remain stable, revealing a concerning trend.
Increased availability of sunscreen has led to improved sun-protective behaviors in many populations.7 In our study, the free hat giveaway had the greatest impact on hat wearing, which suggests that improved availability and access to hats can lead to an important opportunity for sun-protection programs to partner with hat manufacturers to augment their use and protective impact.
Sun avoidance during childhood and adolescence has been shown to decrease the risk for melanoma.1 Young children had the highest rate of hat usage in the current study, possibly due to parental example or dictates. Research has shown the importance of role models in promoting sun safety to young children,8,9 so perhaps use of hats by parents or MLB players contributed to the hat-wearing behavior observed in this subpopulation.
Given the limited change observed in hat-wearing behaviors over the last decade, a knowledge and behavioral gap appears to exist that may be able to be exploited to enhance future sun protection. Also, based on our findings, the MLB and other sun-protection education campaigns may wish to augment their UVR protective messages by offering hat giveaways, which appear to have a notable impact.
Acknowledgment
The authors thank Jessie Skapik, BS (New York, New York), for her independent review of the spectator photographs.
References
1. Rigel DS. Cutaneous ultraviolet exposure and its relationship to the development of skin cancer. J Am Acad Dermatol. 2008;58(5, suppl 2):S129-S132.
2. Lim HW, James WD, Rigel DS, et al. Adverse effects of ultraviolet radiation from the use of indoor tanning equipment: time to ban the tan. J Am Acad Dermatol. 2011;64:893-902.
3. Play Sun Smart. American Academy of Dermatology website. https://www.aad.org/public/spot-skin-cancer/programs/play-sun-smart. Accessed August 25, 2016.
4. Rigel AS, Lebwohl MG. Hat-wearing patterns in persons attending baseball games. J Am Acad Dermatol. 2006;54:918-919.
5. MLB attendance report - 2016. ESPN website. www.espn.go.com/mlb/attendance. Accessed May 20, 2016.
6. Turner D, Harrison SL, Buettner P, et al. Does being a “SunSmart School” influence hat-wearing compliance? an ecological study of hat-wearing rates at Australian primary schools in a region of high sun exposure [published online December 29, 2013]. Prev Med. 2014;60:107-114.
7. Dubas LE, Adams BB. Sunscreen use and availability among female collegiate athletes [published online February 3, 2012]. J Am Acad Dermatol. 2012;67:876.e1-876.e6.
8. O’Riodran DL, Geller AC, Brooks DR, et al. Sunburn reduction through parental role modeling and sunscreen vigilance. J Pediatr. 2003;142:67-72.
9. Turrisi R, Hillhouse J, Heavin S, et al. Examination of the short-term efficacy of a parent-based intervention to prevent skin cancer. J Behav Med. 2004;27:393-412.
References
1. Rigel DS. Cutaneous ultraviolet exposure and its relationship to the development of skin cancer. J Am Acad Dermatol. 2008;58(5, suppl 2):S129-S132.
2. Lim HW, James WD, Rigel DS, et al. Adverse effects of ultraviolet radiation from the use of indoor tanning equipment: time to ban the tan. J Am Acad Dermatol. 2011;64:893-902.
3. Play Sun Smart. American Academy of Dermatology website. https://www.aad.org/public/spot-skin-cancer/programs/play-sun-smart. Accessed August 25, 2016.
4. Rigel AS, Lebwohl MG. Hat-wearing patterns in persons attending baseball games. J Am Acad Dermatol. 2006;54:918-919.
5. MLB attendance report - 2016. ESPN website. www.espn.go.com/mlb/attendance. Accessed May 20, 2016.
6. Turner D, Harrison SL, Buettner P, et al. Does being a “SunSmart School” influence hat-wearing compliance? an ecological study of hat-wearing rates at Australian primary schools in a region of high sun exposure [published online December 29, 2013]. Prev Med. 2014;60:107-114.
7. Dubas LE, Adams BB. Sunscreen use and availability among female collegiate athletes [published online February 3, 2012]. J Am Acad Dermatol. 2012;67:876.e1-876.e6.
8. O’Riodran DL, Geller AC, Brooks DR, et al. Sunburn reduction through parental role modeling and sunscreen vigilance. J Pediatr. 2003;142:67-72.
9. Turrisi R, Hillhouse J, Heavin S, et al. Examination of the short-term efficacy of a parent-based intervention to prevent skin cancer. J Behav Med. 2004;27:393-412.
Practice Points
- With less than half of attendees wearing hats to Major League Baseball games, there has been limited change in hat-wearing behavior over the last decade, possibly due to a knowledge or behavioral gap.
- Improved availability and access to hats can lead to improved sun-protective behaviors.
