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McKenzie C, Nahm WJ, Kearney CA, Zampella JG. Sun-protective behaviors and sunburn among US adults. Arch Dermatol Res 2023; 315:1665-1674. [PMID: 36790452 PMCID: PMC9930066 DOI: 10.1007/s00403-023-02547-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 01/17/2023] [Accepted: 01/22/2023] [Indexed: 02/16/2023]
Abstract
Individuals can reduce the risk of developing skin cancer by minimizing ultraviolet sunlight exposure, though recent trends in sun-protective behaviors remain to be investigated. To evaluate sun-protective behaviors and sunburn among US adults. We analyzed data from the 2010, 2015, and 2020 National Health Interview Survey (NHIS), an annual, cross-sectional survey conducted by the US Census Bureau. Multivariable regression models were stratified by demographic variables and constructed to evaluate sun-protective behaviors and sunburn avoidance across time. From 2010 through 2020, US adults had significantly increased prevalence of seeking shade (p value, 0.003), wearing wide-brimmed hats (< 0.001), wearing long-sleeved shirts (< 0.001), using sunscreen (< 0.001), and avoiding sunburns (< 0.001) and significantly decreased prevalence of sun avoidance (< 0.001). Disparities in sun-protective behaviors also exist among different sexes, ages, education levels, and those reporting higher sun sensitivity. This cross-sectional study found that by 2020, US adults had an increased prevalence of wearing sun-protective clothing and sunscreen use, though decreased prevalence of sun avoidance. Although certain sun-protective behaviors have become more prevalent, the incidence of skin cancer continues to rise. Efforts to understand drivers of sun-protective behaviors and targeted intervention efforts are needed.
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Affiliation(s)
- Costner McKenzie
- The Ronald O. Perelman Department of Dermatology, New York University Grossman School of Medicine, 555 Madison Ave, New York, NY, 10022, USA
| | - William J Nahm
- New York University Grossman School of Medicine, New York, NY, USA
| | | | - John G Zampella
- The Ronald O. Perelman Department of Dermatology, New York University Grossman School of Medicine, 555 Madison Ave, New York, NY, 10022, USA.
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Rydz E, Harper A, Leong B, Arrandale VH, Kalia S, Forsman-Phillips L, Holness DL, Tenkate T, Peters CE. Sun Protection Use at Work and Leisure by Outdoor Workers in Alberta, Canada. J Occup Environ Med 2021; 63:e138-e144. [PMID: 33395172 DOI: 10.1097/jom.0000000000002133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To assess the prevalence and determinants of sun protection behaviours among outdoors workers at work and leisure in Alberta, Canada. METHODS We collected outdoor workers' demographics, skin cancer risk factors, job information, and sun habits at work and leisure using self-completed questionnaires. For both settings, we compared use of specific behaviours and modelled determinants of sun protection behaviour scores. RESULTS At work, wearing a sleeved shirt (81% often/always) and hat (73%) were most prevalent, while seeking shade (12%) and applying sunscreen (36%) were least prevalent. Workers had higher sun protection scores at work than leisure. Hours spent outdoors was a strong determinant for both models. Additional leisure model predictors were eye colour, sex, skin type, and job group. CONCLUSIONS Differences in behaviours across settings were observed and should be considered when developing solar UVR exposure reduction initiatives.
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Affiliation(s)
- Ela Rydz
- CAREX Canada, Simon Fraser University, Vancouver, BC, Canada (Ms Rydz, Ms Forsman-Phillips, Dr Peters); Cancer Epidemiology and Prevention Research, Cancer Control Alberta, Alberta Health Services, Calgary, AB, Canada (Mr Harper, Mr Leong, Dr Peters); Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada (Dr Arrandale, Dr Holness); Occupational Cancer Research Centre, Ontario Health, Toronto, ON, Canada (Dr Arrandale); Department of Dermatology and Skin Science, University of British Columbia, Vancouver, BC, Canada (Dr Kalia); Photomedicine Institute and Centre for Clinical Epidemiology and Evaluation, Vancouver Coastal Health Research Institute, Vancouver, BC, Canada (Dr Kalia); Departments of Cancer Control, BC Cancer, and Division of Dermatology, BC Children's Hospital, Provincial Health Services Authority, Vancouver, BC, Canada (Dr Kalia); Department of Medicine, University of Toronto, Toronto, ON, Canada (Dr Holness); Department of Medicine and MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada (Dr Holness); School of Occupational and Public Health, Ryerson University, Toronto, ON, Canada (Dr Tenkate); Department of Oncology, Cumming School of Medicine, University of Calgary, Health Sciences Centre - Foothills Campus, Calgary, AB, Canada (Dr Peters)
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Peters CE, Tenkate T, Heer E, O'Reilly R, Kalia S, Koehoorn MW. Strategic Task and Break Timing to Reduce Ultraviolet Radiation Exposure in Outdoor Workers. Front Public Health 2020; 8:354. [PMID: 32850589 PMCID: PMC7417352 DOI: 10.3389/fpubh.2020.00354] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Accepted: 06/22/2020] [Indexed: 11/13/2022] Open
Abstract
Objectives: Public health messaging about sun avoidance strategies is often not practical for outdoor workers. The objective of this study was to use personal monitoring data to determine when peak UVR exposure occurs for outdoor workers, estimate how much UVR could be reduced by altering the timing of shady tasks or breaks during peak exposure times, and descriptively compare these to peak periods of ambient UVR. Ultimately, we aim to provide evidence-based sun avoidance recommendations for outdoor workers in British Columbia, Canada. Methods: UVR exposure data [standard erythemal dose (SED)] were collected during the 2013 summer months in Vancouver, using personal electronic dosimeters that sampled once per minute for an average of 4.4 working days (range: 1-7 days). Mixed-effect models were used to estimate the 60-, 30-, and 15-min time intervals at which maximum exposure occurred for the months of July and August. Using these time intervals, UVR exposure during peak periods was summarized as SED and as a percentage of the total daily exposure. Ambient UVR was also collected using data from the nearest Brewer spectrophotometer station and parallel analyses were conducted. Results: There were 73 workers and 321 participant-days available for analysis. Models indicated that periods of maximum exposure for 15-, 30-, and 60-min intervals began at 12:28, 12:17 pm, and 11:52 am, respectively, for sunny days in July. These periods were similar in August. The median exposure during these time periods and the potential for reducing UVR was 0.03 SED (2.8% potential daily exposure reduction), 0.09 SED (7.1%), and 0.18 SED (15.9%), respectively. However, there was a large range in exposure estimates as some workers experienced up to 84.8% of their exposure in the peak 60-min interval. Conclusion: Skin cancer prevention messaging does not include practical messages for outdoor workers and providing times of peak UVR help to identify times when the greatest reductions in exposure can occur. Prevention measures including shady breaks, increased sun protection, and task reorganization during these peak times are recommended during these peak times to reduce UVR exposure among those at highest risk.
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Affiliation(s)
- Cheryl E Peters
- Cancer Epidemiology and Prevention Research, Alberta Health Services, Calgary, AB, Canada.,Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Thomas Tenkate
- School of Occupational and Public Health, Ryerson University, Toronto, ON, Canada
| | - Emily Heer
- Cancer Epidemiology and Prevention Research, Alberta Health Services, Calgary, AB, Canada
| | - Rachel O'Reilly
- Cancer Epidemiology and Prevention Research, Alberta Health Services, Calgary, AB, Canada
| | - Sunil Kalia
- Department of Dermatology and Skin Science, University of British Columbia, Vancouver, BC, Canada
| | - Mieke W Koehoorn
- School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
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Houdmont J, Randall R, Cheyne A, Davis S, Evans H, Faichney J. UK Postal Delivery Workers' Occupational Sun Safety: Using Behavior Change Theories to Identify Intervention Pathways. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16193712. [PMID: 31581620 PMCID: PMC6801953 DOI: 10.3390/ijerph16193712] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Revised: 09/23/2019] [Accepted: 09/28/2019] [Indexed: 11/16/2022]
Abstract
Postal delivery workers have substantial sun exposure. In the United Kingdom (UK) a high proportion of workers possesses a sun sensitive skin type. This population is at elevated risk for skin cancer, yet uptake of sun safety practices is low. Studies are needed to identify the underlying factors that contribute to the uptake of occupational sun safety practices that may be targeted during behavior change interventions. This study integrated the Theory of Planned Behavior (TPB) and the Transtheoretical Model's stages of change (SoC) as guiding frameworks to identify underlying beliefs that influence UK postal delivery workers' uptake of occupational sun safety practices. Thirty-four workers participated in semi-structured interviews that used the SoC to establish current receptiveness to and adoption of two sun safety practices (using sunscreen of at least sun protection factor (SPF) 30 on exposed skin and wearing a wide-brimmed hat when working outdoors in the summer). Beliefs underlying current practices were elicited in accordance with the TPB and stratified by the SoC. For sunscreen use and wearing a wide-brimmed hat, 64% and 3% of participants were in the action or maintenance SoC, respectively. Behavioral and control beliefs differed by SoC, with those in the earlier stages more likely than those in the latter stages to report negative attitudes to, and difficulty enacting, sun safety practices. Normative beliefs concerning the views of colleagues and employers towards sunscreen were relatively consistent across the SoC. This study highlights the need for tailored and targeted behavior change interventions. The SoC-stratified accounts of the influence of TPB components on behavior provide a basis for bespoke interventions that reflect inter-individual and inter-practice differences in their working mechanisms.
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Affiliation(s)
- Jonathan Houdmont
- Centre for Organizational Health and Development, School of Medicine, University of Nottingham, B Floor, Yang Fujia Building, Jubilee Campus, Wollaton Road, Nottingham NG8 1BB, UK.
| | - Raymond Randall
- Management School, University of Sheffield and Loughborough University, Sheffield, S10 1FL, UK.
| | - Alistair Cheyne
- ESSCA School of Management and School of Business and Economics, Loughborough University, Loughborough, LE11 3TU, UK.
| | | | - Hannah Evans
- Management School, University of Sheffield and Loughborough University, Sheffield, S10 1FL, UK.
| | - Joanne Faichney
- Centre for Organizational Health and Development, School of Medicine, University of Nottingham, B Floor, Yang Fujia Building, Jubilee Campus, Wollaton Road, Nottingham NG8 1BB, UK.
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