Preschool outdoor play environment may combine promotion of children´s physical activity and sun protection.:Further evidence from Southern Sweden and North Carolina

Objective.—To study the impact of preschool outdoor environments on children’s physical activity and solar ultraviolet (UV) exposure at different latitudes and countries. Methods. Outdoor environments of 11 preschools (two in Raleigh NC, USA, Lat.36¿N, nine in Malmö, Sweden, Lat.55¿N) were scored (OPEC) regarding space, vegetation, hilly terrain and level of integration between open spaces, vegetation and play structures. Free sky (%) was determined by imaging. Physical activity was measured by pedometers and solar UV-exposure by polysulphone dosimeters during 5 days in spring 2009, and individual background data gathered by questionnaires and anthropometric measurements. Global UV radiation was measured and available individual UV radiation (%) computed. Results.—In Malmö, mean step count/minute was 21.2 in preschools with high-scored environment vs. 17.6 in low-scored environments, and UV-exposure lower, 26% vs. 43% of available UV during outdoor stay. In Raleigh, step count/minute was 12.3 and UV-exposure of available UV 27% during outdoor stay. Conclusions.—Step count/minute was lower in Raleigh than in Malmö, but in Malmö children at low-scored environments ran a higher risk of sunburn than in Raleigh. Trees and shrubbery integrated in children’s playscape trigger both physical activity and sun-protective behaviour in Sweden, and previous measurements in Stockholm were confirmed. Such outdoor environment should be recommended, but the role of season and climate needs to be further explored.