Comparison of Munsell® color chart assessments with primary schoolchildren's self-reported skin color
Background Skin color is related to human health outcomes, including the risks of skin cancer and vitamin D insufficiency. Self‐perceptions of skin color may influence health behaviours, including the adoption of practices protective against harmful solar ultraviolet radiation levels. Misperception...
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| Published in: | Skin research and technology Vol. 21; no. 4; pp. 459 - 465 |
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| Main Authors: | , , , |
| Format: | Journal Article |
| Language: | English |
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England
Blackwell Publishing Ltd
01.11.2015
John Wiley & Sons, Inc |
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| ISSN: | 0909-752X, 1600-0846 |
| Online Access: | Get full text |
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| Abstract | Background
Skin color is related to human health outcomes, including the risks of skin cancer and vitamin D insufficiency. Self‐perceptions of skin color may influence health behaviours, including the adoption of practices protective against harmful solar ultraviolet radiation levels. Misperception of personal risk may have negative health implications. The aim of this study is to determine whether Munsell® color chart assessments align with child self‐reported skin color.
Methods
Two‐trained investigators, with assessed color acuity, visually classified student inner upper arm constitutive skin color. The Munsell® classifications obtained were converted to Individual Typology Angle (ITA) values and respective Del Bino skin color categories after spectrocolorimeter measurements based on published values/data. As part of a written questionnaire on sun protection knowledge, attitudes, and behaviours, self‐completed in class time, students classified their end of winter skin color. Student self‐reports were compared with the ITA‐based Del Bino classifications. A total of 477 New Zealand primary students attending 27 randomly selected schools from five geographic regions. The main measures were self‐reported skin color and visually observed skin color.
Results
A monotonic association was observed between the distribution of spectrophotometer ITA scores obtained for Munsell® tiles and child self‐reports of skin color, providing some evidence for the validity of self‐report among New Zealand primary school children, although the lighter colored ITA defined groups were most numerous in this study sample. Statistically significant differences in ITA scores were found by ethnicity, self‐reported skin color, and geographic residence (P < 0.001). Certain Munsell® color tiles were frequently selected as providing a best match to skin color.
Conclusion
Assessment using Munsell® color charts was simple, inexpensive, and practical for field use and acceptable to children. The results suggest that this method may prove useful for making comparisons with other studies using visual tools to assess skin color. Alignment between the ITA distribution derived from the Munsell® assessment and child skin color self‐reports could probably be improved, particularly with the addition of another ‘light’/’white’ color category in the self‐report instrument. |
|---|---|
| AbstractList | Skin color is related to human health outcomes, including the risks of skin cancer and vitamin D insufficiency. Self-perceptions of skin color may influence health behaviours, including the adoption of practices protective against harmful solar ultraviolet radiation levels. Misperception of personal risk may have negative health implications. The aim of this study is to determine whether Munsell(®) color chart assessments align with child self-reported skin color.
Two-trained investigators, with assessed color acuity, visually classified student inner upper arm constitutive skin color. The Munsell(®) classifications obtained were converted to Individual Typology Angle (ITA) values and respective Del Bino skin color categories after spectrocolorimeter measurements based on published values/data. As part of a written questionnaire on sun protection knowledge, attitudes, and behaviours, self-completed in class time, students classified their end of winter skin color. Student self-reports were compared with the ITA-based Del Bino classifications. A total of 477 New Zealand primary students attending 27 randomly selected schools from five geographic regions. The main measures were self-reported skin color and visually observed skin color.
A monotonic association was observed between the distribution of spectrophotometer ITA scores obtained for Munsell(®) tiles and child self-reports of skin color, providing some evidence for the validity of self-report among New Zealand primary school children, although the lighter colored ITA defined groups were most numerous in this study sample. Statistically significant differences in ITA scores were found by ethnicity, self-reported skin color, and geographic residence (P < 0.001). Certain Munsell(®) color tiles were frequently selected as providing a best match to skin color.
Assessment using Munsell(®) color charts was simple, inexpensive, and practical for field use and acceptable to children. The results suggest that this method may prove useful for making comparisons with other studies using visual tools to assess skin color. Alignment between the ITA distribution derived from the Munsell(®) assessment and child skin color self-reports could probably be improved, particularly with the addition of another 'light'/'white' color category in the self-report instrument. Background Skin color is related to human health outcomes, including the risks of skin cancer and vitamin D insufficiency. Self‐perceptions of skin color may influence health behaviours, including the adoption of practices protective against harmful solar ultraviolet radiation levels. Misperception of personal risk may have negative health implications. The aim of this study is to determine whether Munsell® color chart assessments align with child self‐reported skin color. Methods Two‐trained investigators, with assessed color acuity, visually classified student inner upper arm constitutive skin color. The Munsell® classifications obtained were converted to Individual Typology Angle (ITA) values and respective Del Bino skin color categories after spectrocolorimeter measurements based on published values/data. As part of a written questionnaire on sun protection knowledge, attitudes, and behaviours, self‐completed in class time, students classified their end of winter skin color. Student self‐reports were compared with the ITA‐based Del Bino classifications. A total of 477 New Zealand primary students attending 27 randomly selected schools from five geographic regions. The main measures were self‐reported skin color and visually observed skin color. Results A monotonic association was observed between the distribution of spectrophotometer ITA scores obtained for Munsell® tiles and child self‐reports of skin color, providing some evidence for the validity of self‐report among New Zealand primary school children, although the lighter colored ITA defined groups were most numerous in this study sample. Statistically significant differences in ITA scores were found by ethnicity, self‐reported skin color, and geographic residence (P < 0.001). Certain Munsell® color tiles were frequently selected as providing a best match to skin color. Conclusion Assessment using Munsell® color charts was simple, inexpensive, and practical for field use and acceptable to children. The results suggest that this method may prove useful for making comparisons with other studies using visual tools to assess skin color. Alignment between the ITA distribution derived from the Munsell® assessment and child skin color self‐reports could probably be improved, particularly with the addition of another ‘light’/’white’ color category in the self‐report instrument. BACKGROUNDSkin color is related to human health outcomes, including the risks of skin cancer and vitamin D insufficiency. Self-perceptions of skin color may influence health behaviours, including the adoption of practices protective against harmful solar ultraviolet radiation levels. Misperception of personal risk may have negative health implications. The aim of this study is to determine whether Munsell(®) color chart assessments align with child self-reported skin color.METHODSTwo-trained investigators, with assessed color acuity, visually classified student inner upper arm constitutive skin color. The Munsell(®) classifications obtained were converted to Individual Typology Angle (ITA) values and respective Del Bino skin color categories after spectrocolorimeter measurements based on published values/data. As part of a written questionnaire on sun protection knowledge, attitudes, and behaviours, self-completed in class time, students classified their end of winter skin color. Student self-reports were compared with the ITA-based Del Bino classifications. A total of 477 New Zealand primary students attending 27 randomly selected schools from five geographic regions. The main measures were self-reported skin color and visually observed skin color.RESULTSA monotonic association was observed between the distribution of spectrophotometer ITA scores obtained for Munsell(®) tiles and child self-reports of skin color, providing some evidence for the validity of self-report among New Zealand primary school children, although the lighter colored ITA defined groups were most numerous in this study sample. Statistically significant differences in ITA scores were found by ethnicity, self-reported skin color, and geographic residence (P < 0.001). Certain Munsell(®) color tiles were frequently selected as providing a best match to skin color.CONCLUSIONAssessment using Munsell(®) color charts was simple, inexpensive, and practical for field use and acceptable to children. The results suggest that this method may prove useful for making comparisons with other studies using visual tools to assess skin color. Alignment between the ITA distribution derived from the Munsell(®) assessment and child skin color self-reports could probably be improved, particularly with the addition of another 'light'/'white' color category in the self-report instrument. Background Skin color is related to human health outcomes, including the risks of skin cancer and vitamin D insufficiency. Self-perceptions of skin color may influence health behaviours, including the adoption of practices protective against harmful solar ultraviolet radiation levels. Misperception of personal risk may have negative health implications. The aim of this study is to determine whether Munsell color chart assessments align with child self-reported skin color. Methods Two-trained investigators, with assessed color acuity, visually classified student inner upper arm constitutive skin color. The Munsell classifications obtained were converted to Individual Typology Angle (ITA) values and respective Del Bino skin color categories after spectrocolorimeter measurements based on published values/data. As part of a written questionnaire on sun protection knowledge, attitudes, and behaviours, self-completed in class time, students classified their end of winter skin color. Student self-reports were compared with the ITA-based Del Bino classifications. A total of 477 New Zealand primary students attending 27 randomly selected schools from five geographic regions. The main measures were self-reported skin color and visually observed skin color. Results A monotonic association was observed between the distribution of spectrophotometer ITA scores obtained for Munsell tiles and child self-reports of skin color, providing some evidence for the validity of self-report among New Zealand primary school children, although the lighter colored ITA defined groups were most numerous in this study sample. Statistically significant differences in ITA scores were found by ethnicity, self-reported skin color, and geographic residence (P < 0.001). Certain Munsell color tiles were frequently selected as providing a best match to skin color. Conclusion Assessment using Munsell color charts was simple, inexpensive, and practical for field use and acceptable to children. The results suggest that this method may prove useful for making comparisons with other studies using visual tools to assess skin color. Alignment between the ITA distribution derived from the Munsell assessment and child skin color self-reports could probably be improved, particularly with the addition of another 'light'/'white' color category in the self-report instrument. |
| Author | Reeder, A. I. Hammond, V. A. Gray, A. R. Wright, C. Y. |
| Author_xml | – sequence: 1 givenname: C. Y. surname: Wright fullname: Wright, C. Y. email: cwright@csir.co.za organization: Climate Studies, Modelling and Environmental Health Research Group, Council for Scientific and Industrial Research, Pretoria, South Africa – sequence: 2 givenname: A. I. surname: Reeder fullname: Reeder, A. I. organization: Cancer Society of New Zealand Social and Behavioural Research Unit, Department of Preventive and Social Medicine, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand – sequence: 3 givenname: A. R. surname: Gray fullname: Gray, A. R. organization: Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand – sequence: 4 givenname: V. A. surname: Hammond fullname: Hammond, V. A. organization: Public Health South, Southern District Health Board, Dunedin, New Zealand |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/25773121$$D View this record in MEDLINE/PubMed |
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| Cites_doi | 10.1158/1055-9965.EPI-09-1300 10.1067/mjd.2000.103807 10.1136/bjo.86.12.1408 10.1111/j.0909-725X.2006.00167.x 10.1001/jamadermatol.2013.6101 10.1562/2006-08-22-RA-1010 10.1054/bjps.2001.3581 10.1111/j.1600-0749.2006.00338.x 10.1111/j.1600-0846.2008.00306.x 10.1016/j.jaad.2004.03.051 10.1093/ije/dyn017 10.1111/bjd.12529 10.1016/0738-081X(95)00069-R 10.1158/1055-9965.EPI-14-0269 10.1111/j.1467-2494.1991.tb00561.x 10.1016/j.jaad.2005.12.041 10.1001/archderm.1988.01670060015008 |
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| Keywords | primary schoolchildren Munsell® color charts skin color |
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| References | Reeder AI, Hammond VA, Gray AR. Questionnaire items to assess skin color and erythemal sensitivity: reliability, validity, and "the dark shift". Cancer Epidemiol Biomarkers Prev 2010; 19: 1167-1173. Eilers S, Bach DQ, Gaber R, Blatt H, Guevara Y, Nitsche K, Kundu RV, Robinson J. Accuracy of self-report in assessing Fitzpatrick skin phototypes I through VI. JAMA Dermatol 2013; 149: 1289-1294. Sanclemente G, Zapata J-F, Garcia J-J, Gaviria A, Gómes L-F, Barrera M. Lack of correlation between minimal erythema dose and skin phototype in a colombian scholar population. Skin Res Technol 2008; 14: 403-409. GretbagMacbeth. Munsell soil color charts. Revised washable ed. New Windsor, NY: GretbagMacbeth, 2000. Reeder AI, Iosua E, Gray AR, Hammond VA. Validity and reliability of the Munsell® soil color charts for assessing human skin color. Cancer Epidemiol Biomarkers Prev 2014; 23: 2041-2047. Henseler H, Cheong V, Weiler-Mithoff EM, MacKay IR, Webster MHC. The use of Munsell colour charts in nipple-areola tattooing. Br J Plast Surg 2001; 54: 358-360. Fitzpatrick TB. The validity and practicality of sun-reactive skin types I through VI. Arch Dermatol 1988; 124: 869-871. Taylor S, Westerhof W, Im S, Lim J. Noninvasive techniques for the evaluation of skin color. J Am Acad Dermatol 2006; 54: S282-S290. Gibson IM. Measurement of skin colour in-vivo. J Soc Cosmet Chem 1971; 22: 725-740. Holman CDJ, Armstrong BK. Pigmentary traits, ethnic origin, benign nevi, and family history as risk factors for cutaneous malignant melanoma. J Natl Cancer Inst 1984; 72: 257-266. Kinnear PRSA. New Farnsworth-Munsell 100 hue test norms of 587 normal observers for each year of age 5-22 and for age decades 30-70. Br J Opthalmol 2002; 86: 1408-1411. Choe YB, Jang SJ, Jo SJ, Ahn KJ, Young JI. The difference between constitute and facultative skin color does not reflect skin phototype in Asian skin. Skin Res Technol 2006; 12: 68-72. Reisfeld PL. Blue in the skin. J Am Acad Dermatol 2000; 42: 597-605. Del Bino S, Sok J, Bessac E, Bernerd F. Relationship between skin response to ultraviolet exposure and skin color type. Pigment Cell Res 2006; 19: 606-614. Del Bino S, Bernerd F. Variations in skin colour and the biological consequences of ultraviolet radiation exposure. Br J Dermatol 2013; 169(Suppl. 3): 33-40. Chan JL, Ehrlich A, Lawrence RC, Moshell AN, Turner ML, Kimball AB. Assessing the role of race in quantitative measures of skin pigmentation and clinical assessments of photosensitivity. J Am Acad Dermatol 2005; 52: 609-615. Lucas RM, McMichael AJ, Armstrong BK, Smith WT. Estimating the global disease burden due to ultraviolet radiation exposure. Int J Epidemiol 2008; 37: 654-667. Chardon A, Cretois I, Hourseau C. Skin colour typology and suntanning pathways. Int J Cosm Sc 1991; 13: 191-208. Wright C, Reeder A, Bodeker G, Gray A, Cox B. Solar UVR exposure, concurrent activities and sun-protective practices among primary schoolchildren. Photochem Photobiol 2007; 83: 749-758. Andreassi L, Flori L. Practical applications of cutaneous colorimetry. Clin Dermatol 1995; 13: 369-373. 1984; 72 1971; 22 2006; 12 2010; 19 2000 1991; 13 2002; 86 2006; 54 2013; 149 1995; 13 2000; 42 2008; 14 2008; 37 1988; 124 2005; 52 2013; 169 2006; 19 2007; 83 2014; 23 2001; 54 e_1_2_10_12_1 e_1_2_10_9_1 e_1_2_10_13_1 e_1_2_10_21_1 e_1_2_10_11_1 e_1_2_10_20_1 GretbagMacbeth (e_1_2_10_10_1) 2000 Holman CDJ (e_1_2_10_15_1) 1984; 72 Gibson IM (e_1_2_10_8_1) 1971; 22 e_1_2_10_2_1 e_1_2_10_4_1 e_1_2_10_18_1 e_1_2_10_3_1 e_1_2_10_19_1 e_1_2_10_6_1 e_1_2_10_16_1 e_1_2_10_5_1 e_1_2_10_17_1 e_1_2_10_14_1 e_1_2_10_7_1 |
| References_xml | – reference: Fitzpatrick TB. The validity and practicality of sun-reactive skin types I through VI. Arch Dermatol 1988; 124: 869-871. – reference: Eilers S, Bach DQ, Gaber R, Blatt H, Guevara Y, Nitsche K, Kundu RV, Robinson J. Accuracy of self-report in assessing Fitzpatrick skin phototypes I through VI. JAMA Dermatol 2013; 149: 1289-1294. – reference: Reeder AI, Iosua E, Gray AR, Hammond VA. Validity and reliability of the Munsell® soil color charts for assessing human skin color. Cancer Epidemiol Biomarkers Prev 2014; 23: 2041-2047. – reference: Gibson IM. Measurement of skin colour in-vivo. J Soc Cosmet Chem 1971; 22: 725-740. – reference: Wright C, Reeder A, Bodeker G, Gray A, Cox B. Solar UVR exposure, concurrent activities and sun-protective practices among primary schoolchildren. Photochem Photobiol 2007; 83: 749-758. – reference: Sanclemente G, Zapata J-F, Garcia J-J, Gaviria A, Gómes L-F, Barrera M. Lack of correlation between minimal erythema dose and skin phototype in a colombian scholar population. Skin Res Technol 2008; 14: 403-409. – reference: Holman CDJ, Armstrong BK. Pigmentary traits, ethnic origin, benign nevi, and family history as risk factors for cutaneous malignant melanoma. J Natl Cancer Inst 1984; 72: 257-266. – reference: Choe YB, Jang SJ, Jo SJ, Ahn KJ, Young JI. The difference between constitute and facultative skin color does not reflect skin phototype in Asian skin. Skin Res Technol 2006; 12: 68-72. – reference: GretbagMacbeth. Munsell soil color charts. Revised washable ed. New Windsor, NY: GretbagMacbeth, 2000. – reference: Del Bino S, Sok J, Bessac E, Bernerd F. Relationship between skin response to ultraviolet exposure and skin color type. Pigment Cell Res 2006; 19: 606-614. – reference: Del Bino S, Bernerd F. Variations in skin colour and the biological consequences of ultraviolet radiation exposure. Br J Dermatol 2013; 169(Suppl. 3): 33-40. – reference: Taylor S, Westerhof W, Im S, Lim J. Noninvasive techniques for the evaluation of skin color. J Am Acad Dermatol 2006; 54: S282-S290. – reference: Reeder AI, Hammond VA, Gray AR. Questionnaire items to assess skin color and erythemal sensitivity: reliability, validity, and "the dark shift". Cancer Epidemiol Biomarkers Prev 2010; 19: 1167-1173. – reference: Chardon A, Cretois I, Hourseau C. Skin colour typology and suntanning pathways. Int J Cosm Sc 1991; 13: 191-208. – reference: Kinnear PRSA. New Farnsworth-Munsell 100 hue test norms of 587 normal observers for each year of age 5-22 and for age decades 30-70. Br J Opthalmol 2002; 86: 1408-1411. – reference: Lucas RM, McMichael AJ, Armstrong BK, Smith WT. Estimating the global disease burden due to ultraviolet radiation exposure. Int J Epidemiol 2008; 37: 654-667. – reference: Reisfeld PL. Blue in the skin. J Am Acad Dermatol 2000; 42: 597-605. – reference: Chan JL, Ehrlich A, Lawrence RC, Moshell AN, Turner ML, Kimball AB. Assessing the role of race in quantitative measures of skin pigmentation and clinical assessments of photosensitivity. J Am Acad Dermatol 2005; 52: 609-615. – reference: Henseler H, Cheong V, Weiler-Mithoff EM, MacKay IR, Webster MHC. The use of Munsell colour charts in nipple-areola tattooing. Br J Plast Surg 2001; 54: 358-360. – reference: Andreassi L, Flori L. Practical applications of cutaneous colorimetry. 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Skin color is related to human health outcomes, including the risks of skin cancer and vitamin D insufficiency. Self‐perceptions of skin color may... Skin color is related to human health outcomes, including the risks of skin cancer and vitamin D insufficiency. Self-perceptions of skin color may influence... Background Skin color is related to human health outcomes, including the risks of skin cancer and vitamin D insufficiency. Self-perceptions of skin color may... BACKGROUNDSkin color is related to human health outcomes, including the risks of skin cancer and vitamin D insufficiency. Self-perceptions of skin color may... |
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| SubjectTerms | Child Color Perception - physiology Color Perception Tests - methods Color Perception Tests - standards Colorimetry - methods Colorimetry - standards Diagnostic Self Evaluation Female Humans Male Munsell® color charts New Zealand Observer Variation Physical Examination primary schoolchildren Reference Values Reproducibility of Results Self Report Sensitivity and Specificity skin color Skin Pigmentation - physiology |
| Title | Comparison of Munsell® color chart assessments with primary schoolchildren's self-reported skin color |
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