Observed use of sunglasses in public outdoor settings around Melbourne, Australia: 1993 to 2002

Abstract

Background.

Wearing sunglasses may reduce the risk of cataract and of skin cancer in the periorbital area. Understanding predictors of sunglasses use may help identify groups with lower usage patterns.

Methods.

An annual observational field survey of teenagers and adults at leisure at outdoor venues around Melbourne, Australia was conducted between 11 am and 3 pm on mainly sunny, summer weekends (n = 42,207). The serial cross-sectional survey assessed sun protection behaviors, including use of sunglasses from 1993 to 2002, and other variables hypothesized to predict sun-related behavior (sex, age, SES, activity level and setting, size of social group, and weather conditions). Predictors of use of sunglasses were assessed using multivariate logistic regression.

Results.

36.2% of those observed wore sunglasses, and this increased only slightly over the years. Sunglasses use was most common among those observed on sunny days, in no or partial shade, in parks/gardens and at pools/beaches, less active people and people on their own or in pairs, people observed in higher socio-economic areas, females, people 20–50 years of age, and people wearing head and clothes cover.

Conclusion.

Sunglasses use should be encouraged among the population in general and especially among golfers, tennis players, teenagers, males, and people in lower SES areas.

Introduction

Cataract is the leading cause of blindness and visual impairment worldwide (Thylefors et al., 1995). Sunlight exposure (particularly UV-B exposure) appears to be an important risk factor for cataract (McCarty and Taylor, 2002, World Health Organization, 1994, English et al., 1997). Sunglasses can provide an effective method of reducing ocular solar UV exposure (Gies et al., 1998). This should be beneficial in relation to cataract prevention and prevention of skin cancer in the periorbital area.

Australia has extreme levels of solar UV radiation (Lemus-Deschamps et al., 1999). It was the first country to introduce mandatory standards for sunglasses in the 1980s; UVR protection provided by sunglasses has increased substantially since then (Gies et al., 1998). In Victoria, Australia, skin cancer prevention campaigns have recommended use of sunglasses as part of sun protection since the 1980s (Montague et al., 2001).

Published reports on use of sunglasses during peak UV periods are relatively rare in the literature and have tended to be one-off observational surveys conducted in a single setting (e.g. Robinson and Rademaker, 1998, Threlfall, 1992, Whiteman et al., 1994, Zitser et al., 1996), one-off self-report surveys (Lee et al., 1994, Cokkinides et al., 2001, Richards et al., 2001), or cross-sectional self-report surveys conducted over a number of years (Dobbinson et al., 2002, Dobbinson, 2004, Livingston et al., 2003, Tamir et al., 2002). Use of sunglasses varies widely across studies, from as low as 28% to as high as 63%. It is unclear to what extent variations in sunglasses use observed in different studies are attributable to differences in the settings in which the studies were conducted, variations in the demographic characteristics of those surveyed, varying weather conditions, or to other differences in the methods of the respective studies. Few studies make detailed descriptions of predictors of use of sunglasses since they have generally not focused on use of sunglasses as their primary outcome. Among the predictors of use of sunglasses that have been presented are age (Dobbinson et al., 2002, Lee et al., 1994, Robinson and Rademaker, 1998), sex (Cokkinides et al., 2001, Dobbinson et al., 2002, Lee et al., 1994, Livingston et al., 2003, Richards et al., 2001, Robinson and Rademaker, 1998, Threlfall, 1992, Zitser et al., 1996), and clothes cover (Threlfall, 1992).

The aim of this study was to describe differences in use of sunglasses related to environmental factors and individual factors, and to examine cross-sectional trends in use of sunglasses among teenagers and adults at leisure in public, outdoor places around Melbourne, Australia between 1993 and 2002.