Cancer Association of South Africa (CANSA) Fact Sheet on Being SunSmart with Infants,Toddlers and Children

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Cancer Assciatin f Suth Africa (CANSA) Fact Sheet n Being SunSmart with Infants,Tddlers and Children Intrductin Just ne blistering sunburn in childhd r adlescence mre than dubles a persn's chances f develping melanma later in life. The sun expsure pattern believed t result in melanma is that f brief, intense expsure - a blistering sunburn - rather than years f tanning. Parents shuld d their best t prevent their children frm getting sunburned at any age. Parents and guardians need t be extra vigilant abut sun prtectin fr their infants and tddlers at all times. [Picture Credit: Sunburn] Sun Expsure Prtectin fr Infants 0 t 6 Mnths Infants under 6 mnths f age shuld be kept ut f the sun. Special care shuld be taken frm 10:00 until 15:00 when the Ultravilet (UV) radiatin levels f the sun are at their mst intense. If yur baby is yunger than 6 mnths, make sure t keep him/her ut f direct sunlight. Prtect the baby frm sun expsure, whether direct r reflected ultravilet (UV) radiatin. UV radiatin tends t reflect f certain surfaces, e.g. water, cement, tiles, sand r similar surfaces. Children shuld always be dressed in apprpriate prtective clthing (preferably made frm material with a UP indicatin f ultravilet prtectin ability), a hat with a brim and sunglasses. Parents shuld als ensure that they d nt get verheated. Avid the applicatin f sunscreen n infants under the age f 6 mnths. Sunscreens are designed fr use by children and adults. The skin f Babies and infants are less mature and als have a higher surface-area t bdy-weight rati. This means that an infant's expsure t the chemicals in sunscreens may be much greater, increasing the risk f side effects frm the applicatin f sunscreen. Researched and Authred by Prf Michael C Herbst [D Litt et Phil (Health Studies); D N Ed; M Art et Scien; B A Cur; Dip Occupatinal Health; Dip Genetic Cunselling; Dip Audimetry and Nise Measurement; Diagnstic Radigrapher;] Reviewed by Dr Caradee Wright, Envirnment and Health Research Unit, Suth African Medical Research Cuncil. Apprved by Ms Elize Jubert, Chief Executive Officer [BA Scial Wrk (cum laude); MA Scial Wrk] June 2018 Page 1

Here are sme things t keep in mind every summer when utside with infants: Keep the infant in the shade Cnsult a paediatrician (preferably a dermatlgist) befre using any sunscreen n infants. If used at all, ne shuld nt assume that the infant is well prtected Prvide the child with a hat made f sufficiently thick material f gd ultravilet prtectin factr (UPF) quality. The hat shuld prvide sufficient shade at all times and prvide prtectin fr the whle face, ears and neck. The same applies t clthing which shuld cver and prtect the sensitive skin f infants. [Picture Credit: Well Prtected Infant] With the slightest indicatin that an infant is becming sunburned, remve the infant frm the sun immediately and apply cld cmpresses t the affected areas. Seek medical assistance if necessary r in dubt. Sun Expsure Prtectin fr Babies 6 t 12 Mnths Use liberal amunts f sunscreen n babies and infants f 6 mnths r lder. This shuld be applied apprximately 20 minutes befre taking them int direct sunlight. Limit sun expsure especially between 10:00 t 15:00 [Picture Credit: Children in the Sun] Always chse a brad-spectrum sunscreen with an sun prtectin factr (SPF) f at least 15 preferably SPF 30 Sunscreen shuld be generusly applied - and reapplied at least every tw hurs - mre ften if the baby is spending time in the water Always first test the sunscreen n a small area f the baby r tddler s skin t check fr any skin reactins Babies and children with naturally darker skin tnes shuld als have their face and eyes prtected frm ver expsure t UV rays Sun Expsure Prtectin fr Tddlers and Pre-Schl Kids Aim t minimise direct sun expsure time between 10:00 and 15:00. [Picture Credit: By with Hat] Make use f a cmbinatin f sun prtectin measures: Clthe children with cl, lse fitting clthes and wraps made frm densely wven fabrics with a gd ultravilet prtectin factr (UPF) rating. If pssible, chse fabrics that are at least UPF15 (gd prtectin), but preferably Researched and Authred by Prf Michael C Herbst [D Litt et Phil (Health Studies); D N Ed; M Art et Scien; B A Cur; Dip Occupatinal Health; Dip Genetic Cunselling; Dip Audimetry and Nise Measurement; Diagnstic Radigrapher;] Reviewed by Dr Caradee Wright, Envirnment and Health Research Unit, Suth African Medical Research Cuncil. Apprved by Ms Elize Jubert, Chief Executive Officer [BA Scial Wrk (cum laude); MA Scial Wrk] June 2018 Page 2

UPF50 (excellent prtectin). Always use a brad spectrum sunscreen with a SPF f at least 15 but preferably a SPF 30. Pay special attentin t the bridge f the nse, the back f the neck as well as earlbes. Prvide children with brad-brimmed hats. Try t btain a bucket r leginnaire style hat because it will adequately prtect the child s face, neck and ears. [Picture Credit: Sunglasses] Prvide children with sunglasses. Lk fr sunglasses that are labelled at least UV400 and are clse fitting and f wrap-arund style Sun Expsure Prtectin fr Schl Kids and Adlescents Every child shuld have access t prper sun prtectin at schl. Accrding t the Wrld Health Organizatin (WHO) excess slar UV radiatin expsure during schl years cntributes significantly t ttal lifetime sun expsure. In Suth Africa, sunlight is mst intense between 10:00 and 15:00, when learners are ften utdrs fr recess and ther schl r after-schl activities. It is during these times that children need t be prtected against UV radiatin. Prper sun prtectin in childhd can drastically reduce the risk f develping skin cancer as an adult. Regardless f age and skin clur, every child shuld be taught abut sun prtectin Children shuld be taught t seek shade whenever pssible. If pssible, children shuld be taught t seek shade under a tree r an UPF umbrella When pssible, lng-sleeved shirts and lng pants and skirts can prvide prtectin frm UV rays. Give the child a hat that will prvide shade fr the face, scalp, ears, and neck. Prvide children with gd quality UVB400 sunglasses. Let children apply sunscreen f 15 30 SPF. D nt frget t pay special attentin t prtect ears, nse, lips, and the tps f feet. Incidence f Skin Cancer in Infants, Tddlers and Children Accrding t the Natinal Cancer Registry (2014) the fllwing cases f skin cancer were diagnsed in infants, tddlers and children: Type f Skin Cancer: 2014 All Bys 0 t 4 All Bys 5 t 9 All Bys 10 t 14 All Bys 15 t 19 Basal Cell Carcinma 1 2 1 1 Squamus Cell Carcinma 3 1 2 2 Malignant Melanma 1 1 1 7 Researched and Authred by Prf Michael C Herbst [D Litt et Phil (Health Studies); D N Ed; M Art et Scien; B A Cur; Dip Occupatinal Health; Dip Genetic Cunselling; Dip Audimetry and Nise Measurement; Diagnstic Radigrapher;] Reviewed by Dr Caradee Wright, Envirnment and Health Research Unit, Suth African Medical Research Cuncil. Apprved by Ms Elize Jubert, Chief Executive Officer [BA Scial Wrk (cum laude); MA Scial Wrk] June 2018 Page 3

Type f Skin Cancer: 2014 0 t 4 5 t 9 10 t 14 15 t 19 Basal Cell Carcinma 0 1 3 3 Squamus Cell Carcinma 1 0 3 1 Malignant Melanma 0 0 4 6 Medical Disclaimer This Fact Sheet is intended t prvide general infrmatin nly and, as such, shuld nt be cnsidered as a substitute fr advice, medically r therwise, cvering any specific situatin. Users shuld seek apprpriate advice befre taking r refraining frm taking any actin in reliance n any infrmatin cntained in this Fact Sheet. S far as permissible by law, the Cancer Assciatin f Suth Africa (CANSA) des nt accept any liability t any persn (r his/her dependants/estate/heirs) relating t the use f any infrmatin cntained in this Fact Sheet. Whilst the Cancer Assciatin f Suth Africa (CANSA) has taken every precautin in cmpiling this Fact Sheet, neither it, nr any cntributr(s) t this Fact Sheet can be held respnsible fr any actin (r the lack theref) taken by any persn r rganisatin wherever they shall be based, as a result, direct r therwise, f infrmatin cntained in, r accessed thrugh, this Fact Sheet. Surces and References Cnsulted r Utilised By with Hat https://www.ggle.c.za/search?q=infant+with+brad+brimmed+hat&surce=lnms&tbm=isch&sa=x&ei=s- OzU9SnIqmQ7AbO3YGgAw&ved=0CAYQ_AUAQ&biw=1517&bih=714&dpr=0.9#facrc=_&imgdii=_&imgrc=KyjLCcdSMUX OM%253A%3BKqcUEggiTVAM%3Bhttp%253A%252F%252Fwww.sungrubbies.cm%252FWeb%252520images%252FAdv enture-hat-kid-cp.jpg%3bhttp%253a%252f%252fwww.sungrubbies.cm%252fprduct_departments_html%252fsun- Hats-Dept.htm%3B142%3B147 Cancer Cuncil Australia http://wiki.cancer.rg.au/preventin/psitin_statement_-_sun_prtectin_and_infants_(0-12_mnths) Centers fr Disease Cntrl and Prtectin http://www.cdc.gv/cancer/skin/basic_inf/children.htm Children in the Sun https://www.ggle.c.za/search?q=sun+prtectin+6+t+12+mnths&surce=lnms&tbm=isch&sa=x&ei=3- WzU5bXAcqV7AbwqGABQ&ved=0CAYQ_AUAQ&biw=1517&bih=714&dpr=0.9#facrc=_&imgdii=KuCQjhb- DzKiM%3A%3B3C51VW7y2CQerM%3BKuCQjhb-DzKiM%3A&imgrc=KuCQjhb-DzKiM%253A%3B5rP- QFD0CzpCPM%3Bhttp%253A%252F%252F4.bp.blgspt.cm%252F-uG5G5zy346I%252FUb-uDMhGY- I%252FAAAAAAAACrY%252Fjqv1INMQehE%252Fs1600%252Fmayfavs4.jpg%3Bhttp%253A%252F%252Fhusefburke.blg spt.cm%252f2013%252f06%252fmay-mmmy-and-baby-favrites.html%3b1206%3b1600 Harvard Medical Schl http://www.health.harvard.edu/healthbeat/tw-keys-t-strng-bnes-calcium-and-vitamin-d Kids Health http://kidshealth.rg/en/parents/sun-safety.html Researched and Authred by Prf Michael C Herbst [D Litt et Phil (Health Studies); D N Ed; M Art et Scien; B A Cur; Dip Occupatinal Health; Dip Genetic Cunselling; Dip Audimetry and Nise Measurement; Diagnstic Radigrapher;] Reviewed by Dr Caradee Wright, Envirnment and Health Research Unit, Suth African Medical Research Cuncil. Apprved by Ms Elize Jubert, Chief Executive Officer [BA Scial Wrk (cum laude); MA Scial Wrk] June 2018 Page 4

May Clinic http://www.mayclinic.rg/healthy-living/infant-and-tddler-health/expert-answers/baby-sunscreen/faq-20058159 http://www.mayclinic.rg/healthy-living/adult-health/in-depth/sunless-tanning/art-20046803 http://www.mayclinic.rg/healthy-lifestyle/infant-and-tddler-health/expert-answers/baby-sunscreen/faq-20058159 NHS http://www.nhs.uk/chq/pages/852.aspx?categryid=87 NIH Medline Plus http://www.nlm.nih.gv/medlineplus/magazine/issues/winter11/articles/winter11pg12.html Skin Cancer Fundatin http://www.skincancer.rg/preventin/sun-prtectin/children/sun-safety-tips-fr-infants-babies-and-tddlers http://www.skincancer.rg/get-invlved/schls/prtectin-frm Sunburn https://www.ggle.c.za/search?q=sunburn+infants+and+tddlers&surce=lnms&tbm=isch&sa=x&ei=bqyu5idjevb7ab EYCgCg&ved=0CAYQ_AUAQ&biw=1517&bih=714&dpr=0.9#facrc=_&imgdii=_&imgrc=jsyVbqZHJ8abIM%253A%3BKn0sT zwtyaz7mm%3bhttp%253a%252f%252fhmeremedieshealth.cm%252fwpcntent%252fuplads%252fsunburn_kid.jpg%3bhttp%253a%252f%252fwww.ttz2teens.c.uk%252farticles%252fsunse nse.htm%3b500%3b300 Sunglasses https://www.ggle.c.za/search?q=wrap+arund+sunglasses+children&surce=lnms&tbm=isch&sa=x&ei=yu6zu7ednoq v7abc64hgdq&ved=0cayq_auaq&biw=1517&bih=666&dpr=0.9#facrc=_&imgdii=_&imgrc=gs63ekvrzyjh3m%253a%3 BRpfAigZCf0_- EM%3Bhttp%253A%252F%252Fblg.realkidshades.cm%252Ffiles%252F2011%252F12%252Fmfs_desc_pic1.jpg%3Bhttp% 253A%252F%252Fblg.realkidshades.cm%252Funcategrized%252Fhurray-it-is-vacatin-week%252F%3B330%3B245 SunSmart http://www.sunsmart.cm.au/cmmunities/parents US Fd and Drug Administratin http://www.fda.gv/frcnsumers/cnsumerupdates/ucm309136.htm http://www.fda.gv/radiatin-emittingprducts/radiatinemittingprductsandprcedures/tanning/ucm116434.htm Well Prtected Infant https://www.ggle.c.za/search?q=infant+with+brad+brimmed+hat&surce=lnms&tbm=isch&sa=x&ei=aewzu8qwn6x C7Aap8YDBQ&sqi=2&ved=0CAYQ_AUAQ&biw=1517&bih=714&dpr=0.9#facrc=_&imgdii=_&imgrc=tZR9v_SRWAplsM%2 53A%3Be72nu9hD433mOM%3Bhttp%253A%252F%252Fmedia-cacheec0.pinimg.cm%252F736x%252Fba%252Fa2%252F10%252Fbaa2105644681f7cb352bede7600a026.jpg%3Bhttp%253A%2 52F%252Fwww.pinterest.cm%252Fpin%252F389491067746347608%252F%3B570%3B763 Wrld Health Organizatin http://www.wh.int/mediacentre/factsheets/fs287/en/ Researched and Authred by Prf Michael C Herbst [D Litt et Phil (Health Studies); D N Ed; M Art et Scien; B A Cur; Dip Occupatinal Health; Dip Genetic Cunselling; Dip Audimetry and Nise Measurement; Diagnstic Radigrapher;] Reviewed by Dr Caradee Wright, Envirnment and Health Research Unit, Suth African Medical Research Cuncil. Apprved by Ms Elize Jubert, Chief Executive Officer [BA Scial Wrk (cum laude); MA Scial Wrk] June 2018 Page 5