Introduction

Ultraviolet radiation (UVR) is a form of electromagnetic nonionizing radiation, which has a wavelength that ranges between 100-400nm. Though there are different sources for UVR, the main source is sun exposure. UVR is subdivided based on the wavelength into UV-A, UV-B, and UV-C. Both UVA and UVB can pass to earth in different ranges [1, 2]. Even though UVR is significantly absorbed by the environment, the cumulative exposure along with other sources may produce harmful effects. A wide range of literature has been published on the health hazards of such radiation. Non-cancerous and cancerous health effects have been reported causing health and economic burden. Adverse effects of UVR on the human eye, skin, and autoimmune diseases have been well documented in the literature [3-10]. UVR is reported to be a main influential factor in cutaneous malignant melanoma, basal cell carcinoma, squamous cell carcinoma, and lip cancer [3, 4]. Location determines the risk of UVR injury, for example, the eyes, facial skin, and lips are at high risk of UVR injury. The risk of face and lips cancers was connected to outdoor time, occupation, and lifetime solar exposure [11, 12]. The solar exposure varies depending on solar zenith angle and season (Backes) [11]. The nose and forehead receive the highest radiation followed by the oral region [11, 13]. Thus, protection against UV exposure such as hats, protective clothes, lipstick with sunscreen, and sunscreen is recommended [11-14].

Lack or gap of knowledge among the public can increase the risk and decrease protection practice compliance. Proper information dissemination can not only enlighten the community but also guide them to correct UV protection. It also assists in maintaining the society members' wellbeing consequently, a significant role in life quality and economics. Studying the awareness of the community about UVR is crucial for health education. This study aimed to assess the knowledge about UVR and the effect of demographic data and photoprotection practice on awareness.

Materials and Methods

This study was conducted on adult participants. All participants in this investigation were volunteers and agreed to complete the questionnaires and consent. Each patient will answer the questionnaire independently.

All subjects will complete a two-part survey. The first part included demographical, level of education and occupation, and sun protection practice. The second part contained a questionnaire to measure participants' awareness and knowledge about UVR using three Likert scales as follows: agree, I do not agree and I do not know.

Statistical analysis

The data was collected, coded, and entered. All statistical analyses were performed using SPSS (IBM SPSS Statistics for Windows, Version 22.0. Armonk, NY: IBM Corp). The internal consistency was measured using Cronbach's alpha. Descriptive statistics were performed: frequency distribution tables, one-way ANOVA, and P-values. A P-value of equal to or less than 0.05 was considered statistically significant

Results and Discussion

A total of 708 participants completed questionnaires were received. Most of the respondents were female (70.9%). Figure 1 presents the participants’ sociodemographic data and sample characteristics. Almost half of the respondents (48.5) had sunburn ranging from mostly to rarely participants. Yet, 44.2% never use sunscreen, 54.8 never used lip balm with SPF and 78.7% never reapply lip balm with SPF (Figure 2).

The majority of respondents are aware of UVR, although just 61.9 percent of those polled were aware that it changes by geography and 55.8% by season. Most of the respondents are aware of UVR, though 61.9% of those polled were aware that it changes by geography and 55.8% by season. Almost two-thirds (67.4%) of the sample believed that covering the body can reduce skin cancer risk and 67.4% and that UVR can cause skin cancer. Four hundred eighty (67.8%) acknowledged that excessive sun exposure can cause skin wrinkles and 75% agreed that it causes skin pigmentation. More than half of the respondents (61.4) thought that avoiding afternoon sun exposure can reduce UVR risk and 80.8% that the highest UVR intensity is noon. On the other hand, only 30.9% and 35.3 % considered that excessive exposure to sun and alcohol drinking increases lip cancer risk respectively. While more than half of the sample (60.1%) stated that smoking increases lip cancer risk. When considering sunscreen cancer risk reduction 47% agreed that it reduces it for the lip and 68.2% for the skin. Most of the participants thought that UVR is very harmful (44.2%) or has some bad effects (40%).

Of sample 202 (28.5%) never used sun protection. Twenty-two percent (156) of them believed it is not needed, 6.6% (47) identified the cost as the main cause and 11% (78) stated that there is no time. The majority 42.7% (302) stated that they forget it and 17.7% (125) are using other measures. As regards to causes of using sunscreen 18.4% (130) specified that they are using it to prevent sunburn, 28.1% (199) used it as a moisturizer, 7.6% (54) to slow down skin aging, and only 8.3% (59) to prevent cancer. While 64 (9%) individuals used it because they heard it is good.

The mean awareness was 1.7269, SD= .47891.There was a significant difference in awareness between males (M = 1.9442, SD = .50174) and females (M = 1.6378, SD = .01962); t(df) = 8.076, p = 0.000. A one-way ANOVA revealed that there was a statistically significant between groups difference in education, occupation, and education at p >.05. ANOVA analysis of the impact of being affected with UVR side effects (lip peeling and dryness and sunburns) was significant at p >. 05. Adhesion to sun protection wearing significantly affected the awareness (Table 1).

Table 1. Influence of compliance with sun protection guidelines on awareness of UVR side effects

Scheffe post hoc showed that young participants age group 18-24 and 25-34 demonstrated a significantly higher awareness level of UVR harmful effect than other age groups particularly those above 45 years. Those with an educational level higher than high school were more aware of UVR especially bachelor and postgraduate degrees. A significantly higher level of awareness among students than unemployed individuals. As regard sun protection behavior, those who had poor compliance with sun protection guidelines and those who never or rarely got side effects such as sunburns showed significantly less levels of awareness of UVR hazards. In addition, significantly higher levels of awareness corresponded with participants that did not suntan (Table 2).

Table 2. The impact of tanning on awareness of UVR hazards