To the Editor
Sunscreen use is well recognized as an effective strategy for reducing risk of sunburn, photoaging, and skin cancer.1–3 The US Food and Drug Administration regulates sunscreen as an over-the-counter drug product. In some states, students’ ability to carry or use US Food and Drug Administration–regulated over-the-counter drug products of any kind while on school property is restricted, unintentionally creating barriers to adequate sun protection for students. Realizing this concern, major medical associations have called on schools to allow sunscreen use,4 and some states have passed legislation granting students the ability to carry and self-apply sunscreen while at school. We conducted a content analysis of this state legislation.
We entered the search term sunscreen into the official legislative databases of all 50 US states to identify those with laws in place related to sunscreen use in schools as of December 1, 2017. We developed a coding schema to describe and quantify the content of the state laws, and each author coded the content. Minor coding discrepancies were resolved by reviewing and discussing the exact wording of the laws.
Table I lists the laws in chronologic order based on when they were passed. Table II reflects our final coding schema and describes the content of these laws. Of the 11 states that have enacted legislation allowing students to carry and self-apply sunscreen at school, 7 passed legislation in 2017. Most laws included a definition for sunscreen, but definitions varied across states. With regard to setting, some laws spoke of schools generally, whereas others specifically mentioned public (n = 6), private (n = 3), and/or charter schools (n = 1). Some also addressed sunscreen use at school events (n = 8), at summer camps (n = 3), on school buses (n = 1), and while under the supervision of school personnel (n = 1).
Table I.
State laws regarding sunscreen use at schools listed in chronologic order
| State | Bill | Date passed |
|---|---|---|
| California | SB 1632 | August 24, 2002 |
| New York | S595A | July 31, 2013 |
| Oregon | HB 3041 | May 26, 2015 |
| Texas | SB 625 | June 19, 2015 |
| Utah | HB 288 | March 21, 2017 |
| Arizona | HB 2134 | April 26, 2017 |
| Alabama | SB 63 | May 3, 2017 |
| Washington | SB 404 | May 4, 2017 |
| Florida | HB 7069 | June 16, 2017 |
| Louisiana | HB 412 | June 22, 2017 |
| Ohio | HB 49 | June 29, 2017 |
HB, House Bill; SB, Senate Bill.
Table II.
Characteristics of state laws regarding sunscreen use in schools (N = 11 state laws)
| Characteristic | n |
|---|---|
| Includes a definition of sunscreen | |
| Yes | 7 |
| No | 4 |
| Language included in the definition of sunscreen (categories not mutually exclusive) | |
| Product is approved/regulated by the FDA for nonprescription/over-the-counter use for the purpose of limiting skin damage induced by UV light/avoiding overexposure to the sun | 4 |
| A compound topically applied to prevent sunburn | 4 |
| Not for medical treatment of an injury or illness | 2 |
| Types of schools mentioned (categories not mutually exclusive) | |
| Public schools | 6 |
| Private/nonpublic schools | 3 |
| Charter schools | 1 |
| Does not specify beyond “school” | 5 |
| Settings and scenarios specifically mentioned (categories not mutually exclusive) | |
| At school | 11 |
| At a school-sponsored, school-based, or school- related event or activity | 8 |
| Children’s camp or summer camp | 3 |
| On a school bus | 1 |
| While under the supervision of school personnel | 1 |
| Parental consent required for students to possess and self-apply sunscreen at school | |
| Yes | 1 |
| No | 2 |
| School district policies may require parental consent | 1 |
| Not specified | 7 |
| Physician’s note or prescription required for students to possess and self-apply sunscreen at school | |
| No | 8 |
| Not specified | 3 |
| Employees and volunteers allowed to assist in topical application | |
| Yes (but parental/guardian consent needed) | 6 |
| Yes (in accordance with school district policy) | 1 |
| Yes (does not mention a requirement for parental/ guardian consent) | 1 |
| Not specified | 3 |
| School personnel not required to assist students in applying sunscreen | |
| Yes | 4 |
| Not specified | 7 |
| School personnel not to be held liable/immunity from civil liability | |
| Yes | 4 |
| Not specified | 7 |
| Outdoor use of sun-protective clothing (including hats) allowed | |
| Yes | 2 |
| Not specified | 9 |
| Schools encouraged to educate students about sun safety guidelines | |
| Yes | 1 |
| Not specified | 10 |
None of the laws required a physician’s note or prescription. However, 1 required parental consent, another stated that school district policies may require parental consent, and yet another noted that the sunscreen must be supplied by a parent or guardian.
Six of the laws granted employees and volunteers permission to assist in sunscreen application with parental/guardian consent, 1 granted permission “in accordance with school district policy,” and another gave permission without mentioning additional requirements. Four of the laws specified that school personnel were not required to assist students in applying sunscreen, and another 4 included language granting school personnel immunity from civil liability in regard to adverse sequelae of application or discontinuation of sunscreen.
Two laws granted students permission to use sun-protective clothing, including hats, at school, and 1 law encouraged schools to educate students about sun safety guidelines.
Our analysis demonstrates the attention that sun-screen use in schools has gained among legislators and may guide future policy by highlighting key content and opportunities for comprehensive sun safety practices in schools. Future research could explore the impact of these laws and potential benefits of implementing them in conjunction with other school sun safety practices.5 Dermatologists can play an integral role in the guidance of future legislation by continuing to educate their patients, communities, and decision makers.
Footnotes
Conflicts of interest: None disclosed.
The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention or the National Institutes of Health.
Funding sources: None.
References
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