Policies to Promote Sun Safety and Prevent Skin Cancer

In partnership with CDC-DASH and many collaborators, NASBE has developed research-based, best practice model policy language on various school health topics that states, districts, and schools can adopt or adapt for themselves. The points they address were suggested by the CDC's scientifically rigorous school health guidelines, state and local policies, and comments from expert reviewers.

For further explanation of this model policy, see Chapter C (Part I) of Fit, Healthy, and Ready to Learn.

Note: NASBE offers its model policy language free of copyright; courtesy attribution is requested. Users will need to adapt this model policy to fit their state and local education governance structure and established policy format, particularly the phrases in italics.

1. PURPOSE AND GOALS

INTENT. The state legislature/state board/local school board is committed to preventing skin cancer, the most prevalent form of cancer, among the students and employees in its schools. Acknowledging that students spend a significant amount of time in the sun during school hours and after school in sports and recreation programs, as well as that unprotected exposure to the sun in childhood and adolescence contributes significantly to the incidence of skin cancer, the state legislature/state board/local school board intends that schools shall take measures to protect student health. All students should possess the knowledge, attitudes, and skills necessary to protect their skin from harmful sun exposure and thereby help to prevent skin cancer. The state legislature/state board/local school board further recognizes that skin cancer prevention is important for all school workers, particularly for those who spend significant portions of their day in the sun. Finally, the state legislature/state board/school board acknowledges the essential role of family and community involvement in the school sun safety program.

It is not the intent of this policy that schools eliminate physical education or other outdoor programs during or after school. Students need daily, vigorous exercise, but they also need to protect their skin from overexposure to the sun.

School leaders shall prepare, adopt, and carry out a comprehensive sun safety plan that includes:

• a sequential program of sun safety education that is integrated within both the general and health education curricula and coordinated with outdoor measures at school to prevent skin cancer. This program shall be taught by well-prepared and well-supported staff and shall be aimed at influencing students' knowledge, attitudes, and behaviors while outdoors;
• measures to promote or require student use of protective items such clothing, hats, sunglasses, sunscreen, and lip balm during all outdoor activities, including physical education, recess, and all before- and after- school activities;
• an assessment of the amount of shade on the school campus and a plan to increase this amount of shade if needed, as well as an assessment of the practicality of rescheduling outdoor activities that take place during the hours of peak sun intensity;
• education and encouragement for school staff to adopt and model sun-safe behaviors, especially staff members who spend significant amounts of their day in the sun, and specific training for school health service providers;
• strategies to involve families and the community in supporting the program; and
• an evaluation of ongoing policy development, program implementation, and program outcomes.

RATIONALE. Skin cancer is the most prevalent cancer in the United States, is linked to sun exposure in youth, and is preventable. As students spend time outdoors during physical education, recess, sports, band practice, and other school activities, schools have a responsibility to work with families and communities to protect students' future health by educating them about protecting their skin and adopting sun-safe behaviors while outdoors. School health curricula that contain developmentally appropriate, accurate information; actively engage students and give them a chance to practice and learn skills; are of sufficient duration; and include teacher training can positively affect students' health-related behaviors.

DEFINITIONS. For the purposes of this policy:

1. "Sun safety" describes a range of behaviors that include the wearing of dark, close-knit clothing that covers the arms, body, and legs; the wearing of wide brimmed (three inches or more) hats or baseball-type hats with side and back flaps added that cover the face and neck; the correct use of broad-spectrum sunscreen of at least sun protection factor (SPF) 15; using lip balm with an SPF of 15 or higher; wearing sunglasses that filter out 100 percent of ultraviolet B (UVB) and ultraviolet A (UVA) light; and, where possible and practical, seeking shade and limiting sun exposure during the hours of peak sun intensity, 10:00 AM to 4:00 PM. It also describes a school environment that offers adequate access to shaded areas.

INSTRUCTIONAL PROGRAM DESIGN. Sun safety topics shall be integrated within the sequential, coordinated health education program taught at every grade level, pre-kindergarten through grade twelve. This educational program shall focus on students' behavior when they are outdoors, be based on theories and methods proven effective by published research, and be consistent with the state's/district's health education standards/guidelines/framework. Sun safety education shall be designed to help students acquire:

• knowledge about the harmful effects of the sun and ways to protect the skin;

• sun-safe skills, including the correct use of protective clothing, hats, sunglasses, sunscreen, and lip balm, as well as seeking shade and limiting sun exposure when possible and practical, during the hours of peak sun intensity; and

• knowledge about how to assess one's sun safety habits, set goals for improvement, and achieve those goals.

The program shall be developmentally appropriate, active, engaging, and taught in lessons that emphasize the positive benefits of sun safety. The program shall engage families as partners in their children's education.

The school health council shall assess all sun safety curricula and materials for accuracy, completeness, balance, and consistency with the state's/district's educational goals and standards.

STAFF QUALIFICATIONS. Staff responsible for sun safety education shall be well prepared and regularly participate in professional development activities to effectively deliver the sun safety educational program as planned. Preparation and professional development activities shall provide basic knowledge of skin cancer prevention, combined with skill practice in program-specific activities and instructional techniques and strategies designed to promote sound, consistent behaviors to protect the skin from sun damage.

EDUCATIONAL REINFORCEMENT. Sun safety education shall be closely coordinated with other sun safety efforts, such as projects to increase the amount of shade on the school campus. In addition, sun safety concepts shall be integrated into subject areas such as science, geography, and mathematics.

3. OUTDOOR ACTIVITIES AND THE SCHOOL ENVIRONMENT

PROGRAM REQUIREMENTS. Districts/schools shall create, implement, and monitor a plan to address sun safety outdoors that considers measures such as protective clothing, hats, sunglasses, sunscreen, lip balm, and access to shaded areas on the school campus. This plan shall contain the following elements:

• ways to encourage students to wear sunglasses and protective clothing while outdoors;
• provisions that allow or require students to wear hats that protect the face, neck, and ears whenever they are outside. As head lice can be spread by sharing hats, this plan must include an educational component for students and families about the importance of not sharing hats. Specific hats that the districts/schools determine are gang related or inappropriate may be prohibited;
• an enumeration of ways, such as working with families and the community, to ensure that students have access to and use a SPF 15 (or higher) broad-spectrum, water-resistant sunscreen or lotion and lip balm;
• ways to encourage or allow students to apply sunscreen and lip balm before school and before outdoor activities. This plan shall consider the issue of sunscreen sensitivities and allergies; and
• ways to encourage students to seek shaded areas for outdoor activities and limit sun exposure, when possible and practical, during the hours of peak sun intensity. This plan may consider a review of student outdoor activities that take place during the hours of peak sun exposure, but it shall not include any suspension or scaling back of physical education programs.

In addition, all new school construction or renovation projects shall include a plan to provide shade for areas where students and staff congregate, such as playgrounds, sports fields, lunch areas, and waiting areas.

Finally, materials developed by businesses that promote protective items such as sunscreen, shirts, or hats shall take into account other district/school policies regarding commercial messages.

4. SUN SAFETY FOR SCHOOL STAFF

PROGRAM REQUIREMENTS. All districts/schools shall develop a work site sun safety policy and plan to assure that all school staff, particularly those who work outside most of the time, are adequately educated about sun safety, which includes the following topics:

• the harmful and beneficial effects of the sun;
• the relationship between unprotected skin exposure to the sun and skin cancer, as well as premature aging and wrinkling of the skin;
• ways to protect the skin, including the proper use of protective clothing, hats, sunglasses, sunscreen, and lip balm, as well as limiting sun exposure, when possible and practical, during the times of peak sun intensity; and
• the importance of modeling sun-safe behaviors for students.

School nurses and other school health workers shall have sufficient preservice training and participate in ongoing professional development activities to support the sun safety program and effectively counsel students.

5. FAMILY AND COMMUNITY INVOLVEMENT

PROGRAM REQUIREMENTS. All districts/schools shall develop a plan to work with families and the community to support and supplement sun safety efforts at the school. This plan shall describe how families shall be provided with information about:

• the causes of skin cancer and the ways that it can be prevented;
• the school sun safety program;
• sunscreen sensitivity and allergies;
• the importance of children wearing hats to prevent overexposure to the sun, but not sharing hats, which can spread head lice;
• ways that families can reinforce the school-based sun safety program with activities at home; and
• ways that families can become involved with and support the sun safety school program.

School instructional staff shall collaborate with agencies and groups conducting sun safety education and activities in the community to send consistent messages to students and their families. Guest speakers invited to address students shall receive appropriate orientation to the relevant policies of the school/district.