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Staying out of the midday sun

More than 40,000 new cases of skin cancer are reported each year in the UK. School nurse Pamela Millington is determined to reduce its galloping incidence. Reva Klein reports. Gone are the days when the British seaside holiday was a joke. Skegness may still be soooo bracing, but alongside the hypothermia, you could wind up with an almighty case of sunburn to bring home with you. And the repercussions of burnt skin may go far beyond the localised pain.

There is increasing evidence to show that too much sun and, in particular, sunburn in early childhood, is a major risk factor for skin cancer in adulthood. Thanks to more and more package holidays to resorts in southern Europe and the progressive thinning of the ozone layer in north-western Europe, skin cancer has become the second most common form of the disease in this country after lung cancer. Each year, more than 40,000 new cases are reported, leading to 1,800 deaths.

With the changes in the sun's intensity in this country, schools are having to take the issue of sun protection much more seriously. But what are their responsibilities when it comes to protection, particularly when children play outside in the midday sun, the time when they are at most risk of burning? And what about school trips and sports days?

School nurse Pamela Millington decided to do something about sun protection two years ago. Working for the South Devon Health Trust based in sunny Torquay, she was spurred on by the Government's Health of the Nation targets which aim to reduce the year on year increase in skin cancer by the year 2005.

Her creative thinking and energy earned her the distinction of being the only school nurse in the country to win the Crooks Pharmaceuticals Award for skin protection awareness. More importantly, it has led to each of the four primary schools in her patch adopting baseball hats and straw sun hats as part of their outdoor school uniform. She also initiated a poster design project in the junior schools from which a mobile display was created that was taken around to the casualty and outpatients departments at Torbay Hospital.

As baseball hats were not considered appropriate at the local senior schools, she worked with the headteachers on the idea of sheltered areas in the playground. While most of the schools have trees in the playground, there was little else under which to take shelter from the strong midday sun. Thanks to her campaigning, about a quarter of senior schools in the area have now made provision, with funds raised by the parent-teacher associations, for sun umbrellas under which children can sit.

Apart from the practical measures she has helped bring about, sun protection awareness work is an important focus of Pamela Millington's campaign. The fact that safety on the beach appears in the personal and social education syllabus covered during the summer term has, in her words, "helped raise awareness among the children, particularly the younger ones, of the need to wear shirts on the beach and to protect their skin with creams."

According to a research study carried out by the UK Skin Cancer Working Party, schoolteachers and early years' carers are reasonably aware of the need to protect children when they are in the sun, but they are often prevented from adopting safe practices because of institutional rules.

One PE teacher told of a hot sports day during which another teacher bought some suncream with his own money because he was worried about the children burning. When the headteacher came along, he says, "she went mad and said we weren't allowed to put anything on the children because we weren't covered legally if they were allergic to anything".

Researchers also found confusion over whether it was necessary to protect Asian and black children's skin. Said one Afro-Caribbean carer: "We do burn. People think we don't but we do. Our children aren't used to the sun and if they are suddenly out for a long time, they burn."

Back in Torquay, Pamela Millington has involved local schools in writing sun protection messages on postcards to other children, as part of the Health Education Authority's "Sun Know How" campaign. Queensway primary school is sending postcards to pen-pals at a school in Gibraltar. "If we can give the message to 200 local children and they send messages to 200 others in this country or Australia or anywhere else, it can grow into a worldwide chain letter. This is positive peer group pressure.

"We are a small country but what we often forget is that we are an island, too, with a lot of seaside towns."

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