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Excessive exposure to sunlight during early childhood increases the risk of developing skin cancer. Self-administered questionnaires exploring sun-protection knowledge, practices and policy were mailed to the directors/coordinators/senior teachers of all known early childhood services in Queensland, Australia, in 2002 (n = 1383; 56.5% response). Most (73.7%) services had a written sun-protection policy (SPP). However, 40.6% of pre-schools and kindergartens had not developed a written SPP. Most directors had moderate knowledge about sun-protection (median score: 7/12 [IQR 6, 8]), but few understood the UV index, the sun-protection factor rating for sunscreens or the association between childhood sun-exposure, mole development and melanoma. Pre-school teachers had lower knowledge scores than directors of long day care centers and other services (P = 0.0005). Staff members reportedly wore sun-protective hats, clothing and sunglasses more often than children. However, sunscreen use was higher among children than staff. Directors' knowledge scores predicted reported hat, clothing, sunscreen and shade utilization among children. Remoteness impacted negatively on director's knowledge (P = 0.043) and written SPP development (P = 0.0005). Higher composite sun-protection scores were reported for children and staff from services with written sun-protection policies. SPP development and increased sun-protection knowledge of directors may improve reported sun-protective behaviors of children and staff of early childhood services.

Baseline survey of sun-protection knowledge, practices and policy in early childhood settings in Queensland, Australia