Lifeguards' Sun Protection Habits and Sunburns Association With Sun-Safe Environments and Skin Cancer Prevention Program Participation

Objective: To examine associations among outdoor pool environments, social norms, pool policies, and participation in a sun safety program with lifeguards' sun protection habits and sunburn. Design: Cross-sectional survey. Setting: Outdoor swimming pools across the United States. Participants: Lifeguards and aquatic instructors at pools participating in the Pool Cool skin cancer prevention program in 2001 (N = 699) and 2002 (N = 987). Main Outcome Measures: Sun protection habits and number of sunburns. Results: Social norms supporting sun safety were associated with more sun protection habits (95% confidence intervals [CIs], 0.18-0.28 in 2001 and 0.17-0.26 in 2002), as were pool policies supporting sun safety (95% CI, 0.02-0.07 in 2001 and 0.002-0.04 in 2002). There was a trend toward fewer sunburns as social norms, pool policies, and participation in the Pool Cool program increased, but results differed across the 2 years. In 2001, lower social norms scores and pool policy scores were associated with more reported sunburns. In 2002, teaching Pool Cool sun safety lessons was associated with fewer sunburns. Conclusion: The pool environment is related to sun safety behaviors of outdoor pool staff, with social norms showing the strongest association.