Sun Protection Behaviours and Photosensitivity in Japanese Children: Toyama Adjunct Study of Japan Environment and Children’s Study (JECS)
DOI:
https://doi.org/10.2340/actadv.v106.adv-2026-0397Keywords:
Pediatrics, sun protection, photosensitivity disorders, photosensitivity, sunscreen, Photodermatology, Erythropoietic protoporphyriaAbstract
Children have up to three3 times the annual sun exposure of adults. This cross-sectional study evaluated sun protection behaviorbehaviour, related factors, and the incidence of photosensitivity in Japanese children. A self-administered questionnaire administered to mothers of second2nd-grade children as part of the Toyama Adjunct Study of the Japan Environment and Children’s Study was used and analyzedanalysed (n=1,691). The results showed that 67.5 % of children always or sometimes used sunscreen when going out for a long time, while 73.2 % used at least one method of sun protection when swimming in an outdoor pool. BehaviorsBehaviours related to sun exposure were related to the sex of the child, Fitzpatrick skin phototype, skin symptoms after sun exposure, annual household income, father’s highest educational level, and maternal age. The incidence of photosensitivity disorders was 0.5 %. Diagnoses included polymorphous light eruptions in 4 (50%) and solar urticaria in 2 (25%). However, 5.9 % of children had skin symptoms after sun exposure, but were undiagnosed. In general, photosensitivity is rarely encountered in pediatricpaediatric patients; in this study, we determined its prevalence in children in Japan. Six factors appeared to be relevant to behaviorsbehaviours related to sun exposure. Further investigation is required to confirm these findings.
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References
Cestari T, Buster K.
Photoprotection in specific populations: cChildren and people of color. J Am Acad Dermatol 2017; 76: S110–S121. DOI: https://doi.org/10.1016/j.jaad.2016.09.039
Burnett ME, Hu JY, Wang SQ. Sunscreens: obtaining adequate photoprotection. Dermatol Ther 2012; 25: 244–251. DOI: https://doi.org/10.1111/j.1529-8019.2012.01503.x
Thoonen K, Osch L van, Vries H de, Jongen S, Schneider F. Are environmental interventions targeting skin cancer prevention among children and adolescents effectiveEnvironmental Interventions Targeting Skin Cancer Prevention among Children and Adolescents Effective? A systematic reviewSystematic Review. Int J Environ Res Public Health 2020; 17: 529. DOI: https://doi.org/10.3390/ijerph17020529
ten Berge O, Sigurdsson V, Bruijnzeel-Koomen CAFM, van Weelden H, Pasmans SGMA. Photosensitivity testing in children. J Am Acad Dermatol 2010; 63: 1019–1025. DOI: https://doi.org/10.1016/j.jaad.2009.12.032
Horkay I, Emri G, Varga V, Simics E, Remenyik E. Photosensitivity skin disorders in childhood. Photodermatol Photoimmunol Photomed 2008; 24: 56–60. DOI: https://doi.org/10.1111/j.1600-0781.2008.00341.x
Kawamoto T, Nitta H, Murata K, Toda E, Tsukamoto N, Hasegawa M, et al. Rationale and study design of the Japan Environment and Children’s Study environment and children’s study (JECS). BMC Public Health 2014; 14: 25. DOI: https://doi.org/10.1186/1471-2458-14-25
Michikawa T, Nitta H, Nakayama SF, Yamazaki S, Isobe T, Tamura K, et al. Baseline profile of participantsProfile of Participants in the Japan Environment and Children’s Study (JECS). J Epidemiol 2018; 28: 99–104. DOI: https://doi.org/10.2188/jea.JE20170018
Morita A, Lim HW, Passeron T, Goh CL, Kang HY, Ly F, et al. Attitudes and behaviors regarding sun exposure in Japan compared to Europe and North America. J Dermatol 2024; 51: 1004–1009. DOI: https://doi.org/10.1111/1346-8138.17217
Nouri N, Iravani P, Abtahi-Naeini B. Sun protection behaviors among children aged 6-18 years old, the role of socioeconomic factors: A cross-sectional study. Health Sci Rep 2023; 6: e1727. DOI: https://doi.org/10.1002/hsr2.1727
Moshki M, Karimy M, Asl HR, Mojadam M, Araban M. Predictors of sun protection behavior in high school students of Ahvaz: a cross-sectional study. Int J Adolesc Med Health 2020; 32: 20180006. DOI: https://doi.org/10.1515/ijamh-2018-0006
Fitzpatrick TB. The validity and practicality of sun-reactive skin types I through VI. Arch Dermatol 1988; 124: 869–871. DOI: https://doi.org/10.1001/archderm.1988.01670060015008
Ullman LE, Nasir-Moin M, Hoffman V, Ghadersohi S, Swartzman I, de Weever M, et al. Sunscreen use and affordability attitudes based on ethnicity, socioeconomic status, and Fitzpatrick skin type. Arch Dermatol Res 2024; 316: 266. DOI: https://doi.org/10.1007/s00403-024-02997-z
Janjani H, Nedjat S, Yunesian M, Nasseri S, Haghighat Doost F, Nabizadeh R. Sun exposure and health safety practices of high school students in an urban population of Iran. BMC Public Health 2019; 19: 1736. DOI: https://doi.org/10.1186/s12889-019-8100-7
Taheri F, Salehpour M, Taheri AR. Survey of knowledge, attitude, and practice of female high school students regarding sun protectionKnowledge, Attitude, and Practice of Female High School Students Regarding Sun Protection in Birjand, Iran. Mod Care J 2022; 19: e122395. DOI: https://doi.org/10.5812/modernc-122395
Chantorn R, Lim HW, Shwayder TA. Photosensitivity disorders in children: part I. J Am Acad Dermatol 2012; 67: 1093. DOI: https://doi.org/10.1016/j.jaad.2012.07.033
Frain-Bell W. Idiopathic photodermatoses. In: Frain-Bell W, editor. Cutaneous photobiology. Oxford: Oxford University Press; 1985: p. 51–55.
Ferguson J. Polymorphic light eruption and actinic prurigo. Curr Probl Dermatol 1990; 2: 127–147. DOI: https://doi.org/10.1016/S1040-0486(10)80001-8
Jansén CT. Photosensitivity in childhood. Acta Derm Venereol Suppl 1981; 95: 54–57.
Mizawa M, Makino T, Nakano H, Sawamura D, Shimizu T. Incomplete erythropoietic protoporphyria caused by a splice site modulator homozygous IVS3-48C polymorphism in the ferrochelatase gene. Br J Dermatol 2016; 174: 172–175. DOI: https://doi.org/10.1111/bjd.14078
Mizawa M, Makino T, Nakano H, Sawamura D, Shimizu T. Erythropoietic pProtoporphyria in a Japanese pPopulation. Acta Derm Venereol 2019; 99: 634–639. DOI: https://doi.org/10.2340/00015555-3184
Mizawa M, Hara H, Makino T, Shimizu T. Clinical, genetic, and epidemiological findings of erythropoietic protoporphyria in Japan. Photomed Photobiol 2023; 43, 44: 7–16.
Nakano H, Nakano A, Toyomaki Y, Ohashi S, Harada K, Moritsugu R, et al. Novel ferrochelatase mutations in Japanese patients with erythropoietic protoporphyria: high frequency of the splice site modulator IVS3-48C polymorphism in the Japanese population. J Invest Dermatol 2006; 126: 2717–2719. DOI: https://doi.org/10.1038/sj.jid.5700456
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