Farm Safety Camp Manual

Sun Sense

Goal: Campers will acquire sun safe habits in childhood to reduce the risk of adulthood skin cancer

Objectives:
Campers will be able to

1. Recognize at least three risk factors for skin cancer.
2. Explain that there are types of skin cancer
3. List early warning signs (ABCD?s ) of skin cancer.
4. Identify at least three areas of skin cancer prevention.
5. Perform prevention activities and relate to prevention information

Who's at Risk?

1. To engage their interest, begin with these questions:
   Do you like to go to the beach?
   Do you play or work outdoors?
   Do you try to get a tan?
   Do you or anyone you know use a tanning bed?
   Have you ever had a sunburn that developed blisters?
   If your answer was yes to any of the questions, you or someone you know is at risk for skin cancer.
   
   
2. Risk factors

• Skin type--All skin types and ethnic groups are at risk if the necessary preventive measures are not taken. People with fair skin or skin that burns or freckles easily are at a significant increased risk.
• History of getting blistered as a child. Just one incident of blistering as a child greatly increases the chances of developing skin cancer later by as much as 75%.
• Prior skin cancers.
• Working or playing outdoors.
• Family History
• Geographic location. The sun in Georgia is more intense than in some other areas of the U.S.
• Age--skin becomes more delicate and susceptible with aging.
• Medications may increase sensitivity to the sun.
• Tanning beds or sun lamps increase the risk of skin cancer much like exposure to the sun, but they may be more dangerous than the sun. Exposure to tanning beds increases chances for squamous cell carcinoma by 2.5 times and the likelihood of developing basal cell carcinoma by 1.5 times.

NOTE:
90% of all skin cancers can be attributed to the sun.
50% of lifetime exposure to ultra violet light occurs during childhood and adolescence.

Skin Cancer

Materials needed:
Pictures showing ABCD?s (available online at www.skincare.org)
Body map (available from Skin Cancer Foundation at www.skincare.org and Mary Kay cosmetics).

Types of Skin Cancer

• Basal Cell--appears as small fleshy bump usually on sun exposed areas. Grows slowly and does not spread to other body areas but can cause deep damage.
• Squamous cell--appears as red, scaly rough patches usually on sun exposed areas. Will increase in size and can spread to other body areas.
• Melanoma--Appears as an asymmetrical, irregular shaped area with mixed shades of tan, brown or black. It will spread rapidly to other areas of the body. This is the most deadly type of skin cancer. 1 in 5 will die. Affects both light and dark skinned people.

The students need to understand that there are types of skin cancer and melanoma is the most serious type.

What to Look For
The ABCD?s of Skin Cancer serve as a general guide or warning that a health care provider should be consulted:

A= Asymmetry; A line drawn through the middle of the lesion will not create matching halves. The halves are not alike or even.
B= Border; The border or edge is uneven or has an irregular shape.
C= Color; Varying shades of brown, black, red ,or tan in a single lesion or suspicious mole.
D= Diameter; Normal moles are about the size of a pencil eraser or smaller. Any growth or change in size or shape of moles, freckles, or skin markings should be examined by your physician.

Have campers repeat the ABCD's .

PREVENTION INFORMATION

This information is based on the "Georgia's Got Youth Covered" Training Manual. Jointly produced by Georgia Department of Human Resources, The University of Georgia, and the Centers for Disease Control and Prevention Cooperative Agreement Number U56/CCU411051

Prevention Information
Materials needed:
Examples of sunscreen
Long Mirror Hand Mirror
Examples of several types of hats
Body Map Handout, Definition Handout, Post test
Pencils

Sunscreen:

1. Explanation of SPF--skin protection factor. SPF represents how much longer you are able to stay in the sun without burning. Average skin can be exposed to sunlight about 10 minutes before burning. Very pale people should use 5 minutes as their guide and black or Hispanics 15-20 minutes. A sunscreen with an SPF of 15 would protect average skin for 150 minutes against sunburn (10 minutes x 15 SPF). SPF15 is the minimum recommended.
2. To be effective sunscreens should be applied 20-30 minutes before going into the sun and reapplied at intervals that concur with your skin type. If swimming or sweating you may need to apply more frequently.
3. Choose an SPF number of 15 or higher. SPF numbers cannot be added together if more than one sunscreen is applied (Example: A sunscreen with an SPF of 5 and another with an SPF of 10 does not = SPF 15. The numbers do not add to one another). The sunscreen should also be a broad spectrum sunscreen (filters out long and short UVA and UVB rays). So when shopping for your sunscreen, it's a good idea to look for a broad-spectrum sunscreen with an SPF of at least 15.
4. Remember that sunscreen has a shelf life. Sunscreens 2 or 3 years old will not. Provide adequate protection. Most authorities recommend purchasing new sunscreen every year.
5. Due to the intensity of the sun in Georgia, sunscreen should be worn year round.
6. Sunscreen should be reapplied regularly if spending an extended amount of time in the sun. Perspiration, humidity, wind and water may dissipate the sunscreen quickly.

Protective Clothing:

• Tightly woven hats with a 4 inch brim (all the way around the hat) are recommended to protect the head, ears, neck and face. Baseball caps are NOT recommended since they expose ears and neck.
• Loose fitting, long-sleeved shirts and pants, made of tightly woven fabric are good barriers against sun exposure. A frequently recommended fabric is denim.
• UV protective sunglasses should also be worn to protect eyes and tissue around eyes.

Exposure:

1. Avoid peak hours of sun exposure which include the hours between 10:30 A.M. and 3:00 P.M.
2. Cloudy days still allow ultra violet rays through to the earth?s surface, thus allowing sunburn.

Skin Self Exams:

1. Explain skin exam procedure--begin at head and work your way down including scalp and between toes. (Description available at www.cancer.org and www.skincancer.org ) Show how to look at your back using hand mirror while standing with back to long mirror.
2. Skin exams should be performed monthly.
3. Chart any existing moles and seek immediate medical attention if any are suspicious.
4. Review body map monthly and note any changes.

Skin Cancer Prevention Activities

Evaluating Different kinds of Sunscreen. The purpose is to find one that campers will use. Purchase at least 5 different brands of sunscreen. Place these at different stations around the room and divide the campers into small groups. Have them try at least one kind of sunscreen. Lead discussion on things they like or do not like about this sunscreen.

Too thick or not thick enough
Too thin or not thin enough
Easy or difficult to spread
Smells pleasant or not
Not too sticky
Not too greasy
Provides good protection

Will you use this to protect your skin?
I don?t want to use skin protection.
Why not? Explain reasons for developing prevention habits as a child.

Hat Evaluation
Have a variety of hats available. Usually no more than about 6 types/styles works well. May have more than one of each kind to place at different stations around the room. These should be different kinds of tightly woven wide brimmed hats that they may try on. A baseball cap should be used to point out how little protection it provides to the neck and ears.
Purpose: With peers watching find a hat that would be worn by the camper to prevent sun exposure.

Body Map
Pass out blank diagrams of a person (front and back). These maps can be as simple as stick figures. Have each camper mark a diagram to indicate the location of moles on his/her body. Demonstrate looking at entire back of body using long mirror and hand mirror.
Reinforce monthly exams and charting new moles.
Use and discuss a handout on Conducting a Skin Self Exam (www.cancer.org.).

Post Test for Sun Sense

1. There are three types of skin cancer.

True or False

2. Circle the correct ABCD?s of skin cancer.

Asymmetry	Blood	Active	Content
Border	Basal	Cell	Disc
Diameter	Color	Cool	Bright

3. How long should sunscreen be applied before going out into the sun?

A: 5-10 minutes
B: 20-30 minutes
C: Immediately

4. When are the peak hours of sun exposure to avoid?

A. 9:00 A.M. to 12:00 P.M.
B. 10:30 A.M. to 3:00 P.M.
C. 3:00 P.M. to 5:00 P.M.

Answers:
1. True
2. Asymmetry, Border, Color, & Diameter
3. B
4. B

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