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Cherrie JW, Cherrie MPC. Workplace exposure to UV radiation and strategies to minimize cancer risk. Br Med Bull 2022; 144:45-56. [PMID: 35973164 PMCID: PMC9744745 DOI: 10.1093/bmb/ldac019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 07/01/2022] [Accepted: 07/22/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND Workplace exposure to solar ultraviolet (UV) causes malignant melanoma and non-melanoma skin cancer. The evidence for beneficial effects of solar UV exposure in reducing the risks for other cancers is increasing. The intensity of UV radiation at the Earth's surface is dependent on latitude, but even in northern European countries exposure can be high enough for outdoor work to cause skin cancer. GROWING POINTS Awareness of the health risks and benefits of occupational solar UV exposure is poor. Actions to reduce the risk of skin cancer have been identified and employers should recognize their responsibility to actively manage these risks. There is evidence for reduced risks for breast, ovarian and colorectal cancer and possibly other cancers linked to solar UV exposure. SOURCES OF DATA This narrative review draws on published scientific articles and material designed to assist identifying strategies to protect workers from solar UV exposure. AREAS OF AGREEMENT Solar UV exposure can be harmful. Wavelengths in the UVB range are more effective in causing erythema and DNA damage. Solar UV is the main source of vitamin D for most people. Primary and secondary prevention for skin cancer can potentially eliminate these risks but the evidence for effectiveness is limited. AREAS OF CONTROVERSY Potential health benefits of UV exposure, particularly for reduced cancer risk. Determining and communicating optimal exposure to maximize health benefits. The risk of non-melanoma skin cancers may be more than doubled for some workers in temperate latitudes. AREAS TIMELY FOR DEVELOPING RESEARCH Exposure-response epidemiological studies; studies of the health benefits of occupational UV exposure; studies of the effectiveness of intervention strategies to prevent skin cancer. Use of low-cost UV sensors in workplaces.
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Affiliation(s)
- J W Cherrie
- IOM, Research Avenue North, Edinburgh EH14 4AP, UK.,Institute of Biological Chemistry, Biophysics and Bioengineering, Heriot Watt University, Edinburgh EH14 4AS, UK
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Diehl K, Thoonen K, Breitbart EW, Pfahlberg AB, Görig T. Sun Protection and Tanning Behaviors in Caregivers: Prevalence, Determinants, and Associations with Children's Behaviors. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19116876. [PMID: 35682459 PMCID: PMC9180203 DOI: 10.3390/ijerph19116876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Revised: 06/01/2022] [Accepted: 06/02/2022] [Indexed: 12/03/2022]
Abstract
The association between skin cancer and ultraviolet radiation (UVR) is well established, and sun protection behavior represents an important preventative measure. In children, caregivers play a key role in this regard. The subject of this study was threefold: whether caregivers of 1 to 11 year-old children are more likely to use sun protection measures compared to non-caregivers, whether considering oneself a role model is associated with sun protection behaviors, and whether their sun protection and risk behaviors are related to children’s behaviors. We used data from the 2020 wave of the National Cancer Aid Monitoring (NCAM) comprised of 4000 individuals (including 554 caregivers of at least one child aged 1−10 years) aged 16 to 65 years and living in Germany. Data were collected through telephone interviews between October and December 2020. No significant differences between caregivers and non-caregivers regarding sun protection and risk behaviors were identified (except tanning on vacation). In both groups, sun protection behaviors were deficient. Caregivers who considered themselves role models concerning sun safety were more likely to use sun protection measures (e.g., using sunscreen on the face: OR = 5.08, p < 0.001). In addition, caregivers’ sun protection behaviors were positively associated with children’s behaviors. Caregivers being highly protected against UVR were more likely to report the use of different measures by/in the child (mean = 4.03), compared to caregivers with medium (3.41) and low (2.97, p < 0.001) protection levels. However, we also found that caregivers’ risk behavior was associated with children’s reported risk behavior. For future prevention, it might be worth focusing on the aspect of caregivers serving as role models. A comprehensive public-health strategy is needed, including key figures such as pediatricians to prevent today’s children from developing skin cancer in later life.
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Affiliation(s)
- Katharina Diehl
- Department of Medical Informatics, Biometry and Epidemiology, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany; (A.B.P.); (T.G.)
- Correspondence:
| | - Karlijn Thoonen
- Centre for Environmental Safety and Security, National Institute for Public Health and the Environment, 3721 MA Bilthoven, The Netherlands;
| | | | - Annette B. Pfahlberg
- Department of Medical Informatics, Biometry and Epidemiology, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany; (A.B.P.); (T.G.)
| | - Tatiana Görig
- Department of Medical Informatics, Biometry and Epidemiology, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany; (A.B.P.); (T.G.)
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3
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Wright CY, Norval M. Health Risks Associated With Excessive Exposure to Solar Ultraviolet Radiation Among Outdoor Workers in South Africa: An Overview. Front Public Health 2021; 9:678680. [PMID: 33996735 PMCID: PMC8113384 DOI: 10.3389/fpubh.2021.678680] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Accepted: 03/31/2021] [Indexed: 11/13/2022] Open
Abstract
Exposure of outdoor workers to high levels of solar ultraviolet radiation (UVR) poses significant, well-known health risks including skin cancer and eye diseases. In South Africa, little is known about how many workers are potentially overexposed to solar UVR and what the associated impacts on their health might be. In this overview, the geography and solar UVR environment in South Africa are considered, as well as the different outdoor occupational groups likely to be affected by excessive solar UVR exposure. Sunburn, pterygium, cataract, keratinocyte cancers, and melanoma are discussed in the context of outdoor workers. Few studies in South Africa have considered these health issues and the most effective ways to reduce solar UVR exposure for those working outside. Several countries have developed policies and guidelines to support sun safety in the workplace which include training and education, in addition to the provision of personal protective equipment and managerial support. Several gaps in occupational sun protection and workplace sun safety for South Africa are identified. Legislation needs to recognize solar UVR exposure as an occupational health hazard, with sun safety guidelines and training provided for employers and employees.
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Affiliation(s)
- Caradee Y Wright
- Environment and Health Research Unit, South African Medical Research Council, Pretoria, South Africa.,Department of Geography, Geoinformatics and Meteorology, University of Pretoria, Pretoria, South Africa
| | - Mary Norval
- Biomedical Sciences, University of Edinburgh Medical School, Edinburgh, United Kingdom
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Linde K, Wright CY, Kapwata T, du Plessis JL. Low Use of Ocular Sun Protection among Agricultural Workers in South Africa: Need for Further Research. Photochem Photobiol 2021; 97:453-455. [PMID: 33492701 DOI: 10.1111/php.13388] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Accepted: 01/20/2021] [Indexed: 12/11/2022]
Abstract
Although ocular diseases related to solar ultraviolet radiation exposure have a high prevalence in Africa, little is known about the occupational use of ocular photoprotective measures on the continent. In a survey of South Africa farmworkers on a farm in the Limpopo Province, we analyzed factors related to ocular sun protection including use of different types of hats and sunglasses in relation to age, gender and duration of agricultural employment. Majority of participants (80%) never wore sunglasses while 23% never wore a hat when working. More male workers used measures to protect their eyes than female workers. The type of hat most worn was a cap although broad-brimmed hats provide more effective photoprotection. The need for awareness campaigns that focus on the importance of using photoprotective measures in both an agricultural and South Africa contexts was identified.
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Affiliation(s)
- Karlien Linde
- Occupational Hygiene and Health Research Initiative (OHHRI), North-West University, Potchefstroom, South Africa.,Department of Physiology and Environmental Health, University of Limpopo, Sovenga, South Africa
| | - Caradee Yael Wright
- Environmental and Health Research Unit, South African Medical Research Council (SAMRC), Pretoria, South Africa.,Department of Geography, Geoinformatics and Meteorology, University of Pretoria, Pretoria, South Africa
| | - Thandi Kapwata
- Environmental and Health Research Unit, South African Medical Research Council (SAMRC), Pretoria, South Africa.,Department of Environmental Health, Faculty of Health Sciences, University of Johannesburg, Johannesburg, South Africa
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Gallo R, Guarneri F, Corazza M, Schena D, Stingeni L, Foti C, Patruno C, Signori A, Parodi A. Role of occupational and recreational sun exposure as a risk factor for keratinocytic non-melanoma skin cancers: an Italian multicenter case-control study. Ital J Dermatol Venerol 2020; 156:692-702. [PMID: 33179876 DOI: 10.23736/s2784-8671.20.06699-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Sun exposure is the main external risk factor for keratinocytic non-melanoma skin cancer (NMSC). Outdoor workers are at increased risk, but the relationship of NMSC with occupational solar exposure is often confounded by concurrent recreational sun exposure. We compared the percentage of outdoor workers in NMSC patients versus controls without history of NMSC and assessed occupational and recreational sun exposure in both groups, evaluating also other risk factors and use of protective measures. METHODS Adult NMSC patients and controls without history of NMSC or actinic keratoses, matched for sex and age range, were recruited in the Departments of Dermatology of seven Italian University Hospitals, with a 1:2 patient/control ratio whenever possible. Data were collected using specifically designed questionnaires. RESULTS Eight hundred thirty-four patients and 1563 controls were enrolled. History of outdoor work was significantly (P=0.033) more frequent in patients. Patients were more sun exposed from outdoor leisure activities (P=0.012) and sunbathed for longer periods (P=0.13) and between 12 pm and 3.30 pm (P=0.011). Cumulative sun exposure during hobbies was similar between patients and controls in outdoor workers, higher (P<0.05) in patients among indoor workers. Patients and controls with history of outdoor work were more sun exposed at work than during leisure activities (P<0.001). Use of sunscreens by outdoor workers was very low, particularly at work (19.9%). Patients used sunscreens more than controls (P=0.002). CONCLUSIONS Occupational and recreational sun exposure are relevant risk factors for outdoor and indoor workers respectively. Sunscreens are alarmingly underused, particularly at work, and are used mainly by patients.
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Affiliation(s)
- Rosella Gallo
- Section of Dermatology, DISSAL, IRCCS Ospedale Policlinico San Martino, University of Genoa, Genoa, Italy
| | - Fabrizio Guarneri
- Section of Dermatology, Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy -
| | - Monica Corazza
- Section of Dermatology, Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - Donatella Schena
- Section of Dermatology and Venereology, Department of Medicine, University of Verona, Verona, Italy
| | - Luca Stingeni
- Section of Dermatology, Department of Medicine, University of Perugia, Perugia, Italy
| | - Caterina Foti
- Section of Dermatology, Department of Biomedical Sciences and Human Oncology, University of Bari Aldo Moro, Bari, Italy
| | - Cataldo Patruno
- Section of Dermatology, Department of Health Sciences, University of Catanzaro, Catanzaro, Italy
| | - Alessio Signori
- Section of Biostatistics, Department of Health Sciences, University of Genoa, Genoa, Italy
| | - Aurora Parodi
- Section of Dermatology, DISSAL, IRCCS Ospedale Policlinico San Martino, University of Genoa, Genoa, Italy
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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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8
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Ziehfreund S, Schuster B, Zink A. Primary prevention of keratinocyte carcinoma among outdoor workers, the general population and medical professionals: a systematic review updated for 2019. J Eur Acad Dermatol Venereol 2019; 33:1477-1495. [PMID: 30801774 DOI: 10.1111/jdv.15525] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Accepted: 01/29/2019] [Indexed: 02/07/2023]
Abstract
Worldwide 2-3 million cases of keratinocyte carcinoma (KC) are diagnosed annually. Sun-related knowledge is essential for adequate protection against solar ultraviolet radiation (UVR), the main risk factor for KC. The goal was (i) to provide an updated overview of primary prevention against KC including skin cancer-related knowledge, attitudes and sun protection behaviour (SPB) of outdoor workers, the general population and medical professionals as well as (ii) to evaluate the effectiveness and acceptability of sun protection programmes. We conducted a systematic review of articles indexed for MEDLINE on PubMed using selected MeSH terms and keywords related to the studied topic as well as an extensive hand search of publications between 1 January 2012 and 31 December 2018. We identified 51 relevant cross-sectional studies and 22 interventional studies. Sun-related knowledge and attitude showed substantial differences with some alarming results, including people who had not even heard about skin cancer before. Reported SPB varied enormously between the included studies, with none of the studies providing an overall sufficient SPB in their examined sun protection measures. However, sun protection programmes using new technologies seem to have great potential to increase sun-related knowledge and SPB. In countries worldwide, particularly in those where KC is not yet a public health issue, UVR protection should be promoted by healthcare institutions and authorities, politicians, cancer foundations and dermatologists to increase awareness as well as SPB and to decrease the worldwide burden of KC.
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Affiliation(s)
- S Ziehfreund
- Department of Dermatology and Allergy, Technical University of Munich, Munich, Germany
| | - B Schuster
- Department of Dermatology and Allergy, Technical University of Munich, Munich, Germany
| | - A Zink
- Department of Dermatology and Allergy, Technical University of Munich, Munich, Germany
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Schneider S, Görig T, Schilling L, Schuster A, Diehl K. [The use of sunglasses during leisure time and work : Lack of prevention of sun-induced eye damage]. Ophthalmologe 2019; 116:865-871. [PMID: 30689024 DOI: 10.1007/s00347-019-0850-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE This study aimed at collecting representative national data on the use of sunglasses on sunny summer days during leisure time or work as well as identifying population and professional groups with a pronounced lack of preventive measures to avoid sun-induced eye damage. MATERIAL AND METHODS Within the representative National Cancer Aid Monitoring, data on the use of sunglasses during leisure time was assessed among 3000 individuals aged 14-45 years in 2015, as well as on the use during outdoor work among 485 workers aged 14-45 years in 2016. Associations between the use of sunglasses and sociodemographic characteristics were assessed with the χ2-test. Additionally, descriptive and bivariate methods were used to assess connections between the use of sunglasses at work and each professional group. RESULTS While more than half of the general population normally or often wear sunglasses on a sunny summer day, only one third of outdoor workers do so. While approximately every seventh individual surveyed never wears sunglasses during leisure time, among outdoor workers it is one out of three. The use during leisure time increases with age. DISCUSSION Use of sunglasses during work could be supported by targeted information on UV-induced eye damage by ophthalmologists and company physicians with additional support from accident insurances and employers. Concerning preventive measures occupational groups such as landscapers, farmers and bricklayers who are strongly exposed to sunlight but rarely wear sunglasses are important groups.
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Affiliation(s)
- S Schneider
- Mannheimer Institut für Public Health, Sozial- und Präventivmedizin, Medizinische Fakultät Mannheim, Universität Heidelberg, Ludolf-Krehl-Str. 7-11, 68167, Mannheim, Deutschland.
| | - T Görig
- Mannheimer Institut für Public Health, Sozial- und Präventivmedizin, Medizinische Fakultät Mannheim, Universität Heidelberg, Ludolf-Krehl-Str. 7-11, 68167, Mannheim, Deutschland
| | - L Schilling
- Mannheimer Institut für Public Health, Sozial- und Präventivmedizin, Medizinische Fakultät Mannheim, Universität Heidelberg, Ludolf-Krehl-Str. 7-11, 68167, Mannheim, Deutschland
| | - A Schuster
- Augenklinik und Poliklinik, Universitätsmedizin Mainz, Johannes Gutenberg-Universität Mainz, Mainz, Deutschland
| | - K Diehl
- Mannheimer Institut für Public Health, Sozial- und Präventivmedizin, Medizinische Fakultät Mannheim, Universität Heidelberg, Ludolf-Krehl-Str. 7-11, 68167, Mannheim, Deutschland
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Moradhaseli S, Ataei P, Farhadian H, Ghofranipour F. Farmers' Preventive Behavior Analysis Against Sunlight Using the Health Belief Model: A Study from Iran. J Agromedicine 2019; 24:110-118. [PMID: 30380370 DOI: 10.1080/1059924x.2018.1541036] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Agriculture is one of the major sources of employment and income in many countries, especially in developing countries. Farmers are exposed to numerous harmful factors such as sunlight and ultraviolet radiation. These factors contribute to multiple diseases including skin cancer. The aim of this study was to analyze the farmer's preventive behavior against sunlight using the Health Belief Model (HBM). This descriptive study was conducted by survey methodology and a questionnaire. The population of the research was composed of farmers in Kermanshah Province (N = 126,900). The sample size was determined as 382 farmers using the Krejcie and Morgan table. The validity of the questionnaire was confirmed by relevant professors and experts, and the reliability was confirmed through a pilot study and the calculation of Cronbach's alpha coefficient, which was estimated at 0.70-0.83. Findings showed that the HBM structures had a significant effect on the farmer's preventive behavior, so that the perceived barriers, susceptibility, severity, benefits, self-efficacy, and cues to action have the strongest impact on the farmer's preventive behavior against sunlight. The results illustrated that components of the HBM were appropriate predictors for farmers' preventive behavior against sunlight.
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Affiliation(s)
- Somayeh Moradhaseli
- a Department of Agricultural Extension and Education, Faculty of Agriculture , Tarbiat Modares University , Tehran , Iran
| | - Pouria Ataei
- a Department of Agricultural Extension and Education, Faculty of Agriculture , Tarbiat Modares University , Tehran , Iran
| | - Homayoun Farhadian
- a Department of Agricultural Extension and Education, Faculty of Agriculture , Tarbiat Modares University , Tehran , Iran
| | - Fazlollah Ghofranipour
- b Department of Health Education, Faculty of Medical Sciences , Tarbiat Modares University , Tehran , Iran
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Cetintepe SP, McElroy B, Drummond A. Sun-related risks and risk reduction practices in Irish outdoor workers. Occup Med (Lond) 2018; 68:635-637. [DOI: 10.1093/occmed/kqy142] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- S P Cetintepe
- Division of Occupational Medicine, Department of Internal Medicine, Hacettepe University, Ankara, Turkey
- Centre for Safety and Health at Work, School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
| | - B McElroy
- Centre for Safety and Health at Work, School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
| | - A Drummond
- Centre for Safety and Health at Work, School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
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12
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Occupational UV Exposure and Sun-Protective Behaviour in German Outdoor Workers. J Occup Environ Med 2018; 60:961-967. [DOI: 10.1097/jom.0000000000001397] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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13
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Grandahl K, Ibler KS, Laier GH, Mortensen OS. Skin cancer risk perception and sun protection behavior at work, at leisure, and on sun holidays: a survey for Danish outdoor and indoor workers. Environ Health Prev Med 2018; 23:47. [PMID: 30285623 PMCID: PMC6169023 DOI: 10.1186/s12199-018-0736-x] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2018] [Accepted: 09/14/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND To prevent occupational skin cancer, it is essential that the sun-protective behavior of outdoor workers is adequate. The aim is to study the sun-protective behavior of Danish outdoor workers at work, at leisure, and on sun holiday and compare it to that of indoor workers. METHODS This is a cross-sectional study, based on a 53-item survey completed by Danish outdoor (n = 380) and indoor workers (n = 119) in 2016-2017. Status as outdoor or indoor worker was decided based on self-report and behavioral differences were tested using (paired) t tests and multiple regression adjusted for age, sex, educational level, history of smoking, and skin type. RESULTS Danish outdoor workers at work use sun protection less than they do at leisure and on sun holiday (α < .05) where their sun protection behavior is similar to that of indoor workers. The proportion of Danish outdoor workers that always/often use sun protection at work is for shade seeking around noon 4.2%, sunscreen 34.5%, wide-brimmed hat 25.3%, and long trousers and shirt with sleeves 42.4%. Of Danish outdoor workers, 49.5% do not think about the risk of occupational skin cancer and 11.8% think the risk is insignificant, 32.4% think that the use of sun protection is of low or no importance, 84.2% consider sunburn important as skin cancer risk factor still 88.9% have a history of sunburn at work, > 80.0% agree that risk of skin cancer is reduced by the use of sun protection, and only 4.0% dismiss the possibility of sun protection use at work. CONCLUSIONS Skin cancer risk and use of sun protection at work are largely neglected in Danish outdoor workers, more so than at leisure and on sun holiday where their risk behavior resembles that of indoor workers. This indicates an untapped workplace preventive potential.
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Affiliation(s)
- Kasper Grandahl
- The Department of Occupational Medicine, Copenhagen University Holbaek, Gl. Ringstedvej 4B, 4300 Holbaek, Denmark
| | | | | | - Ole Steen Mortensen
- The Department of Occupational Medicine, Copenhagen University Holbaek, Gl. Ringstedvej 4B, 4300 Holbaek, Denmark
- Section of Social Medicine, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
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Almeida MCDS, Barros VG, Baptista PCP, Silva A. Factors associated with use of personal proactive equipment among community health agents in a coastal municipality in northern São Paulo, Brazil. Rev Bras Med Trab 2018; 16:346-352. [PMID: 32270095 DOI: 10.5327/z1679443520180134] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2017] [Accepted: 08/27/2018] [Indexed: 11/05/2022] Open
Abstract
Background Community health agents (CHAs) are a part of Family Health Strategy multidisciplinary teams, and their function is to develop individual and collective health promotion, recovery and preventive actions, including household visits. Their work exposes CHAs to hazards in the work environment, therefore, using personal protective equipment (PPE) is essential. Aims To draw the sociodemographic and occupational profile of CHAs and investigate associations with use of PPE. Methods Cross-sectional quantitative study performed with 137 CHAs in a coastal municipality in the north of the state of São Paulo, Brazil. We applied a questionnaire for sociodemographic and occupational data. The data were subjected to descriptive and inferential analysis, with significance level of 5%. Results 94.16% of the participants were female, and their average age 34.80 years old. Their average time in the job was 3.18 years. The means of transport most often used to commute was bicycles. 94.16% of the participants reported daily use of some type of PPE, which included: sunscreen (88.32%), closed footwear (53.28%), hats (8.0%), sunglasses (6.57%) and raincoats (3.65%). We found significant association between use of PPE and longer time in the job, and between wearing closed footwear and older age and longer time in the job. Conclusion The results point to the need of interventions to promote use of PPE.
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Affiliation(s)
| | | | | | - Arlete Silva
- School of Nursing, Universidade de São Paulo - São Paulo (SP), Brazil
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Szewczyk M, Pazdrowski J, Golusiński P, Dańczak-Pazdrowska A, Pawlaczyk M, Sygut J, Marszałek A, Golusiński W. Outdoor work as a risk factor for high-grade cutaneous squamous cell carcinoma of the head and neck. Postepy Dermatol Alergol 2018; 35:408-412. [PMID: 30206456 PMCID: PMC6130134 DOI: 10.5114/ada.2018.75841] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2017] [Accepted: 07/12/2017] [Indexed: 11/28/2022] Open
Abstract
INTRODUCTION While it is clear that individuals with outdoor occupations are at a significantly greater risk of developing cutaneous squamous cell carcinoma (cSCC), no previous studies have investigated the potential association between the tumour grade and occupation in this patient population. AIM To assess occupation as a risk factor for the development of high-grade cSCC. Secondarily, to determine the association between the tumour grade and other clinical characteristics. MATERIAL AND METHODS Retrospective analysis of 256 patients treated for head and neck cSCC at our institution in 2007-2016. The following patient characteristics and variables were assessed: age; sex; tumour location and grade; profession; and education level. A univariate analysis was performed to assess the association between each study variable and grade 3 tumour differentiation. RESULTS The following variables were significantly associated (p < 0.05) with grade 3 (G3) cSCC tumours: outdoor work vs. indoor work; primary school vs. high school education; and age. Additionally, patients with low-grade (G1) tumours were significantly younger (mean age: 72) than patients with high-grade (G3) tumours (mean age: 79) (p = 0.046). CONCLUSIONS To our knowledge, this is the first study to assess the variables associated with the tumour grade among outdoor workers. These findings suggest that outdoor workers who develop cSCC are at a greater risk of developing more aggressive cancers. These findings provide additional support for classifying cSCC as an occupational disease. Early education about the dangers of sun exposure during the first years of school is essential to minimize the risks of developing high-grade skin cancer.
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Affiliation(s)
- Mateusz Szewczyk
- Department of Head and Neck Surgery, Poznan University of Medical Sciences, The Greater Poland Cancer Centre, Poznan, Poland
| | - Jakub Pazdrowski
- Department of Head and Neck Surgery, Poznan University of Medical Sciences, The Greater Poland Cancer Centre, Poznan, Poland
| | - Paweł Golusiński
- Department of Head and Neck Surgery, Poznan University of Medical Sciences, The Greater Poland Cancer Centre, Poznan, Poland
- Department of Biology and Environmental Studies, Poznan University of Medical Sciences, Poznan, Poland
| | | | - Mariola Pawlaczyk
- Department of Gerontology and Geriatric Medicine, Poznan University of Medical Sciences, Poznan, Poland
| | - Jacek Sygut
- Department of Cancer Pathology and Prophylaxis, Poznan University of Medical Sciences, The Greater Poland Cancer Centre, Poznan, Poland
| | - Andrzej Marszałek
- Department of Cancer Pathology and Prophylaxis, Poznan University of Medical Sciences, The Greater Poland Cancer Centre, Poznan, Poland
| | - Wojciech Golusiński
- Department of Head and Neck Surgery, Poznan University of Medical Sciences, The Greater Poland Cancer Centre, Poznan, Poland
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16
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Zink A, Thomé F, Schielein M, Spinner CD, Biedermann T, Tizek L. Primary and secondary prevention of skin cancer in mountain guides: attitude and motivation for or against participation. J Eur Acad Dermatol Venereol 2018; 32:2153-2161. [PMID: 29846981 DOI: 10.1111/jdv.15095] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Accepted: 05/14/2018] [Indexed: 12/13/2022]
Abstract
BACKGROUND Outdoor professionals such as mountain guides are at a substantial risk of developing non-melanoma skin cancer (NMSC) due to solar ultraviolet radiation (UVR) exposure. Despite major recent primary prevention efforts, studies on secondary skin cancer prevention efforts are limited and corresponding data on outdoor workers scarce. OBJECTIVE To assess the sun protective behaviour and individual motivations for or against skin cancer screening examinations in the German mountain guide population to aid in the development of effective awareness and prevention strategies. METHODS A cross-sectional study among all registered mountain guides in Germany was conducted using a 35-item online questionnaire on primary and secondary prevention of NMSC as well as perceived barriers for prevention. RESULTS A total of 145 mountain guides participated in the study in January 2017. Of these, 86.2% reported using sunscreen often or always, 62.1% with a sun protection factor (SPF) of 30-50% and 60.7% had undergone dermatological examination by a medical professional. The most common reasons for using secondary prevention efforts were hope of an early diagnosis (77.3%), fear of skin cancer (73.9%) and the intention to be aware of one's own health (70.5%). The main reasons for not doing so were absence of conspicuous skin conditions (63.2%) and feeling healthy (59.6%). CONCLUSION Awareness of prevention strategies recommended by the scientific community is low among affected occupationally high-risk mountain guide populations. Understanding the specific needs of this high-risk group is essential for the development of sustainable awareness and prevention strategies.
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Affiliation(s)
- A Zink
- Department of Dermatology and Allergy, Technical University of Munich, Munich, Germany.,Institute for Medical Informatics, Biometry and Epidemiology (IBE), Ludwig-Maximilians-University, Munich, Germany
| | - F Thomé
- Department of Dermatology and Allergy, Technical University of Munich, Munich, Germany
| | - M Schielein
- Department of Dermatology and Allergy, Technical University of Munich, Munich, Germany.,Institute for Medical Informatics, Biometry and Epidemiology (IBE), Ludwig-Maximilians-University, Munich, Germany
| | - C D Spinner
- Department of Medicine II, Technical University of Munich, Munich, Germany
| | - T Biedermann
- Department of Dermatology and Allergy, Technical University of Munich, Munich, Germany
| | - L Tizek
- Department of Dermatology and Allergy, Technical University of Munich, Munich, Germany.,Institute for Medical Informatics, Biometry and Epidemiology (IBE), Ludwig-Maximilians-University, Munich, Germany
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17
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Görig T, Diehl K, Greinert R, Breitbart EW, Schneider S. Prevalence of sun-protective behaviour and intentional sun tanning in German adolescents and adults: results of a nationwide telephone survey. J Eur Acad Dermatol Venereol 2017; 32:225-235. [PMID: 28573745 DOI: 10.1111/jdv.14376] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2016] [Accepted: 05/08/2017] [Indexed: 12/17/2022]
Abstract
BACKGROUND The incidence rate of melanoma in the Caucasian population is rising worldwide. One of the major environmental risk factors for melanoma is the exposure to ultraviolet (UV) radiation. To prevent skin damage caused by UV exposure, several organizations recommend wearing protective clothing, staying in the shade, avoiding the outdoors during midday and using sunscreen. OBJECTIVE To provide representative data on factors associated with sun-protective behaviours and intentional sun exposure during summertime in the German population. METHODS A population-based sample of 3000 German residents aged 14-45 years (response: 32.1%) was interviewed via telephone from October to December 2015. Survey participants provided data on the use of recommended sun-protective measures on a sunny summer day and their intentional sun exposure during summertime. Data were weighted by age, sex, educational level and federal state to ensure the national representativeness of the sample. RESULTS Wearing long-sleeved clothes was the most frequently reported protective measure (53.9%), while wearing headgear was the least common (17.9%). Significantly lower frequencies of almost all recommended sun-protective measures were identified for males, participants between 14 and 25 years, those with an immigrant background and those with low levels of education. Using sun protection was positively associated with female gender (OR = 1.62), higher levels of education (ORhigh = 1.27), sunburn during childhood (OR = 1.33) and paying attention to healthy nutrition (OR = 1.64; all P < 0.05). Sun tanning behaviour was associated with female gender (OR = 1.42), younger age, lower level of education, sunbed use (OR = 5.24) and smoking status (OR = 1.50; all P < 0.001). CONCLUSION As individual sun-protective measures are easy to implement and provide effective protection against high-risk UV exposure, campaigns on skin cancer prevention in Germany should put a stronger focus on young adults, men, less educated individuals and those with immigration background.
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Affiliation(s)
- T Görig
- Mannheim Institute of Public Health, Social and Preventive Medicine, Heidelberg University, Mannheim, Germany
| | - K Diehl
- Mannheim Institute of Public Health, Social and Preventive Medicine, Heidelberg University, Mannheim, Germany
| | - R Greinert
- Association of Dermatological Prevention, Hamburg, Germany.,Center of Dermatology, Elbe Clinics, Buxtehude, Germany
| | - E W Breitbart
- Association of Dermatological Prevention, Hamburg, Germany
| | - S Schneider
- Mannheim Institute of Public Health, Social and Preventive Medicine, Heidelberg University, Mannheim, Germany
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Zink A, Wurstbauer D, Rotter M, Wildner M, Biedermann T. Do outdoor workers know their risk of NMSC? Perceptions, beliefs and preventive behaviour among farmers, roofers and gardeners. J Eur Acad Dermatol Venereol 2017; 31:1649-1654. [PMID: 28414878 DOI: 10.1111/jdv.14281] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2017] [Accepted: 03/28/2017] [Indexed: 11/28/2022]
Abstract
BACKGROUND Non-melanoma skin cancer (NMSC) was officially recognized in 2015 as an occupational disease for outdoor workers in Germany. Together with the enormous socioeconomic impact of NMSC, this has led to the continuous demand of evidence-based prevention. However, studies assessing the perceptions and beliefs along with risk behaviour of outdoor workers as an essential prerequisite for prevention are rare. OBJECTIVE To assess perceptions, beliefs, barriers, risk and preventive behaviours towards non-melanoma skin cancer among different outdoor groups as a basis for the development of sustainable prevention programmes. PATIENTS AND METHODS Cross-sectional study among outdoor workers of three different occupational groups (farmer, gardener, roofer) using a 20-question online survey on NMSC awareness, risk and preventive behaviours. RESULTS Between March and April 2016, 353 outdoor workers participated in the study. Of these, 153 (43.4%) reported never to use sunscreen during work. Wearing headgear and long pants were the most common sun protection measures. Poor use of sunscreen was more likely in males and farmers. A low perceived skin cancer risk was significantly associated with poor use of sunscreen, long-sleeved shirts, sunglasses and headgear. CONCLUSIONS Despite great evidence on NMSC risk in outdoor professions throughout the literature, high-risk groups in fact are not yet aware of the topic. Sustainable target group-oriented awareness prevention programmes are needed to lower the immense burden of NMSC.
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Affiliation(s)
- A Zink
- Department of Dermatology and Allergy, Technical University of Munich, Munich, Germany
| | - D Wurstbauer
- Department of Dermatology and Allergy, Technical University of Munich, Munich, Germany
| | - M Rotter
- Research Unit of Molecular Epidemiology (AME), Helmholtz Zentrum München, Munich, Germany
| | - M Wildner
- Bayerisches Landesamt für Gesundheit und Lebensmittelsicherheit (LGL), Munich, Germany
| | - T Biedermann
- Department of Dermatology and Allergy, Technical University of Munich, Munich, Germany
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Sena JS, Girão RJS, Carvalho SMFD, Tavares RM, Fonseca FLA, Silva PBA, Barbosa MCFP. Occupational skin cancer: Systematic review. Rev Assoc Med Bras (1992) 2017; 62:280-6. [PMID: 27310554 DOI: 10.1590/1806-9282.62.03.280] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2014] [Accepted: 05/25/2015] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE To analyze the epidemiological profile, risk factors in the workplace environment and prevention methods for professionals at risk of skin cancer. METHOD A systematic review of articles on occupational skin cancer, published in the Lilacs, Scielo, Medline and Cochrane Library from January 1st, 2008, to December 31st, 2013, was performed. The search included the following terms: "neoplasias cutâneas" (DeCS), "exposição ocupacional" (DeCS), "epidemiologia" (DeCS) as well as the keyword "prevenção", and their equivalents in English. RESULTS After analyzing the titles and summaries of articles, the search strategy resulted in 83 references, of which 22 articles met the eligibility criteria. DISCUSSION We found that sun exposure is the main occupational risk factor for skin cancer, causing outdoor workers to be the most vulnerable to developing occupational skin cancer. Professionals with low levels of education and European descent are at increased risk of developing this cancer. CONCLUSION Outdoor workers are more vulnerable to developing occupational skin cancer, estimating that professionals with low level of education and European descent are at increased risk of developing this cancer. Therefore, companies need to invest more in the health of workers by providing protective equipment and thus preventing occupational skin cancer.
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Affiliation(s)
- Jéssica Suellen Sena
- Faculdade Integral Diferencial, Faculdade Integral Diferencial, Teresina PI , Brazil, Medical Student, Faculdade Integral Diferencial (Facid/DeVry), Teresina, PI, Brazil
| | - Régio José Santiago Girão
- DeVry University, DeVry, Facid, Teresina PI , Brazil, MSc in Health Sciences from Faculdade de Medicina do ABC (FMABC). Dermatology Lecturer of the Facid/DeVry, Teresina, PI, Brazil
| | - Sionara Melo Figueiredo de Carvalho
- Universidade Federal do Ceará, Universidade Federal do Ceará, Fortaleza PI , Brazil, MSc in Health Sciences from FMABC. Oncology Lecturer of the Universidade Federal do Ceará (UFC), Fortaleza, PI, Brazil
| | - Rosielly Melo Tavares
- Faculdade Integral Diferencial, Faculdade Integral Diferencial, Teresina PI , Brazil, Medical Student, Faculdade Integral Diferencial (Facid/DeVry), Teresina, PI, Brazil
| | - Fernando Luiz Affonso Fonseca
- Universidade Federal de São Paulo, Universidade Federal de São Paulo, Santo André SP , Brazil, Post-doctoral from Instituto Israelita de Ensino e Pesquisa Albert Einstein and the Roche Center for Medical Genomics. Adjunct Professor III, Universidade Federal de São Paulo, and Lecturer of Pharmaceutical Sciences and Environmental Health Management, FMABC, Santo André, SP, Brazil
| | - Patrícia Barros Aquino Silva
- Faculdade Integral Diferencial, Faculdade Integral Diferencial, Teresina PI , Brazil, Medical Student, Faculdade Integral Diferencial (Facid/DeVry), Teresina, PI, Brazil
| | - Maria Clara Fortes Portela Barbosa
- Faculdade Integral Diferencial, Faculdade Integral Diferencial, Teresina PI , Brazil, Medical Student, Faculdade Integral Diferencial (Facid/DeVry), Teresina, PI, Brazil
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20
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Maguire E, Spurr A. Implementation of Ultraviolet Radiation Safety Measures for Outdoor Workers. J Cutan Med Surg 2016; 21:117-124. [PMID: 27940497 DOI: 10.1177/1203475416683389] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Ultraviolet radiation (UVR) poses a major risk for outdoor workers, putting them at greater risk for skin cancer. In the general population, the incidence of both melanoma and nonmelanoma skin cancers is increasing. It is estimated that 90% of skin cancers in Canada are directly attributable to UVR exposure, making this cancer largely preventable with the appropriate precautions. A scoping review was conducted on the barriers and facilitators to UVR safety in outdoor workers to elucidate why these precautions are not in use currently. We discuss these results according to the Hierarchy of Controls as a means to outline effective and feasible prevention strategies for outdoor workers. In doing so, this review may be used to inform the design of future workplace interventions for UVR safety in outdoor workers to decrease the risk of skin cancer in this vulnerable population.
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Affiliation(s)
- Erin Maguire
- 1 Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Alison Spurr
- 1 Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
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Abstract
BACKGROUND Postal delivery workers spend a large proportion of their work time outdoors, placing them at increased risk of skin cancer. To date, no studies have examined occupational sun safety knowledge and practice within this group in the UK. AIMS To describe the occupational sun safety knowledge and practice of UK postal delivery workers and to investigate the association of demographic, personal and occupational factors with knowledge and practice in order to identify potential strategies for improving sun safety in this occupational group. METHODS Postal delivery workers completed a questionnaire that collected data on occupational sun safety knowledge and practice in addition to demographic, personal and workplace characteristics. One-way analysis of variances were applied to assess differences in knowledge and practice by these characteristics. RESULTS A total of 1153 postal delivery workers completed the questionnaire, a 60% response rate. Thirty-three per cent reported receiving sun safety training within the previous 12 months. The majority of respondents reported correct knowledge on three of the six domains and good practice on four of the six behavioural domains. However, only one-fifth of respondents reported wearing sunglasses and ensuring a plentiful intake of water. Knowledge and practice differed significantly according to demographic, personal and workplace characteristics. CONCLUSIONS There is a need to raise the profile of occupational skin cancer in this occupational group and to increase the priority given to occupational sun safety policies alongside targeted and tailored interventions, the effect of which can be evaluated.
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Affiliation(s)
- J Houdmont
- Division of Psychiatry and Applied Psychology, School of Medicine, University of Nottingham, Yang Fujia Building, Jubilee Campus, Wollaton Road, Nottingham NG8 1BB, UK,
| | - S Davis
- Royal Mail Group, 185 Farringdon Road, London EC1A 1AA, UK
| | - A Griffiths
- Institute of Mental Health, School of Medicine, University of Nottingham , Innovation Park, Triumph Road, Nottingham NG7 2TU, UK
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Occupational risk factors for skin cancer and the availability of sun protection measures at German outdoor workplaces. Int Arch Occup Environ Health 2016; 89:1009-15. [DOI: 10.1007/s00420-016-1138-2] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2015] [Accepted: 04/27/2016] [Indexed: 12/15/2022]
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Peters CE, Koehoorn MW, Demers PA, Nicol AM, Kalia S. Outdoor Workers' Use of Sun Protection at Work and Leisure. Saf Health Work 2016; 7:208-12. [PMID: 27630789 PMCID: PMC5011087 DOI: 10.1016/j.shaw.2016.01.006] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2015] [Revised: 01/18/2016] [Accepted: 01/27/2016] [Indexed: 11/19/2022] Open
Abstract
Background Outdoor workers are at risk of high ultraviolet radiation exposure, and may have difficulty using sun protection. The objectives were to determine the prevalence of sun protection behaviors in a sample of outdoor construction workers, and to assess which factors predict better sun protection practices. Methods Participants were recruited via construction unions. Workers answered a questionnaire on demographics, skin cancer risk, sun protection behaviors, and job. Sun protection behavior scores (from questions on sunscreen use, sleeved shirt, hat, shade seeking, sunglasses) were calculated by converting Likert-scale answers to scores from 0 to 4, and taking the mean (separately for work and leisure). Determinants of sun protection behavior scores were examined for work and leisure using generalized linear models. Results Seventy-seven workers had complete questionnaire data (participation 98%). Sun protection behaviors used most often were hats (79% often/always) and sleeved shirts (82% often/always); least prevalent were shade-seeking (8% often/always) and sunscreen (29% often/always). For both work and leisure scores, the strongest predictor was skin type, with fairer-skinned individuals having higher sun protection behavior scores. Workers had higher scores at work than on weekends. Workplaces that required hats and sleeved shirts for safety purposes had higher protection behavior scores. Conclusion This high-participation rate cohort helps characterize sun protection behaviors among outdoor workers. Workers practiced better sun protection at work than on weekends, suggesting that workplace policies supportive of sun protection could be useful for skin cancer prevention in the construction industry.
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Affiliation(s)
- Cheryl E Peters
- School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
| | - Mieke W Koehoorn
- School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
| | - Paul A Demers
- Occupational Cancer Research Centre, Cancer Care Ontario, Toronto, ON, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Anne-Marie Nicol
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada
| | - Sunil Kalia
- Dermatology and Skin Science, University of British Columbia, Vancouver, BC, Canada
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Almeida MCDS, Baptista PCP, Silva A. Workloads and strain process in Community Health Agents. Rev Esc Enferm USP 2016; 50:95-103. [DOI: 10.1590/s0080-623420160000100013] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
ABSTRACT OBJECTIVE To identify the workloads present in the work activities of community health agents (CHAs) and the resulting strain processes. METHOD A descriptive, exploratory, cross-sectional and quantitative study conducted with 137 CHAs. Data were collected through a questionnaire and interview guided by the health surveillance software called SIMOSTE (Health Monitoring System of Nursing Workers), following the ethical codes of the current law. RESULTS In total, were identified 140 workloads involved in 122 strain processes, represented by the occurrence of health problems of the CHAs. The mechanical (55.00%) and biological (16.43%) loads stood out. The most common strain processes were the external causes of morbidity and mortality (62.31%) and diseases of the musculoskeletal system and connective tissue (10.66%). CONCLUSION From the identified overloads, it became evident that all workloads are present in the work process of CHAs, highlighting the mechanical load, represented mainly by external causes of morbidity and mortality that are related to occupational accidents.
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Abstract
OBJECTIVE Sustainability of prevention programs is a public health goal. METHODS The effectiveness of Go Sun Smart, an occupational skin cancer prevention program, was evaluated 5 to 7 years out from the conclusion of a controlled randomized dissemination trial that compared an enhanced versus basic dissemination strategy at 53 ski areas enrolled in the trial. RESULTS Employees (n = 2940) at ski areas in the enhanced condition reported fewer sunburns but did not differ from employees in the basic condition on other sun-protection measures. Significant differences for all sun-protection practices were identified at ski areas that displayed nine or more Go Sun Smart materials or a combined total of nine or more Go Sun Smart and other sun safety messages. CONCLUSIONS Exposure to prevention messages is an important determinant of program effectiveness and potentially of program sustainability.
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Kramer DM, Tenkate T, Strahlendorf P, Kushner R, Gardner A, Holness DL. Sun Safety at Work Canada: a multiple case-study protocol to develop sun safety and heat protection programs and policies for outdoor workers. Implement Sci 2015; 10:97. [PMID: 26159710 PMCID: PMC4702388 DOI: 10.1186/s13012-015-0277-2] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2015] [Accepted: 06/05/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND CAREX Canada has identified solar ultraviolet radiation (UV) as the second most prominent carcinogenic exposure in Canada, and over 75 % of Canadian outdoor workers fall within the highest exposure category. Heat stress also presents an important public health issue, particularly for outdoor workers. The most serious form of heat stress is heat stroke, which can cause irreversible damage to the heart, lungs, kidneys, and liver. Although the need for sun and heat protection has been identified, there is no Canada-wide heat and sun safety program for outdoor workers. Further, no prevention programs have addressed both skin cancer prevention and heat stress in an integrated approach. The aim of this partnered study is to evaluate whether a multi-implementation, multi-evaluation approach can help develop sustainable workplace-specific programs, policies, and procedures to increase the use of UV safety and heat protection. METHODS/DESIGN This 2-year study is a theory-driven, multi-site, non-randomized study design with a cross-case analysis of 13 workplaces across four provinces in Canada. The first phase of the study includes the development of workplace-specific programs with the support of the intensive engagement of knowledge brokers. There will be a three-points-in-time evaluation with process and impact components involving the occupational health and safety (OHS) director, management, and workers with the goal of measuring changes in workplace policies, procedures, and practices. It will use mixed methods involving semi-structured key informant interviews, focus groups, surveys, site observations, and UV dosimetry assessment. Using the findings from phase I, in phase 2, a web-based, interactive, intervention planning tool for workplaces will be developed, as will the intensive engagement of intermediaries such as industry decision-makers to link to policymakers about the importance of heat and sun safety for outdoor workers. DISCUSSION Solar UV and heat are both health and safety hazards. Using an occupational health and safety risk assessment and control framework, Sun Safety at Work Canada will support workplaces to assess their exposure risks, implement control strategies that build on their existing programs, and embed the controls into their existing occupational health and safety system.
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Affiliation(s)
- Desre M Kramer
- Occupational Cancer Research Centre, Cancer Care Ontario, 3rd floor, 525 University Avenue, Toronto, ON, M5G 1X3, Canada.
| | - Thomas Tenkate
- School of Occupational and Public and Health, Ryerson University, 350 Victoria Street, Toronto, ON, M5B 2K3, Canada
| | - Peter Strahlendorf
- School of Occupational and Public and Health, Ryerson University, 350 Victoria Street, Toronto, ON, M5B 2K3, Canada
| | - Rivka Kushner
- Occupational Cancer Research Centre, Cancer Care Ontario, 3rd floor, 525 University Avenue, Toronto, ON, M5G 1X3, Canada
| | - Audrey Gardner
- School of Occupational and Public and Health, Ryerson University, 350 Victoria Street, Toronto, ON, M5B 2K3, Canada
| | - D Linn Holness
- St Michael's Hospital, 30 Bond St., Toronto, ON, M5B 1W8, Canada
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Schalka S, Steiner D, Ravelli FN, Steiner T, Terena AC, Marçon CR, Ayres EL, Addor FAS, Miot HA, Ponzio H, Duarte I, Neffá J, Cunha JAJD, Boza JC, Samorano LDP, Corrêa MDP, Maia M, Nasser N, Leite OMRR, Lopes OS, Oliveira PD, Meyer RLB, Cestari T, Reis VMSD, Rego VRPDA. Brazilian consensus on photoprotection. An Bras Dermatol 2015; 89:1-74. [PMID: 25761256 PMCID: PMC4365470 DOI: 10.1590/abd1806-4841.20143971] [Citation(s) in RCA: 65] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2014] [Accepted: 10/28/2014] [Indexed: 12/14/2022] Open
Abstract
Brazil is a country of continental dimensions with a large heterogeneity of climates
and massive mixing of the population. Almost the entire national territory is located
between the Equator and the Tropic of Capricorn, and the Earth axial tilt to the
south certainly makes Brazil one of the countries of the world with greater extent of
land in proximity to the sun. The Brazilian coastline, where most of its population
lives, is more than 8,500 km long. Due to geographic characteristics and cultural
trends, Brazilians are among the peoples with the highest annual exposure to the sun.
Epidemiological data show a continuing increase in the incidence of non-melanoma and
melanoma skin cancers. Photoprotection can be understood as a set of measures aimed
at reducing sun exposure and at preventing the development of acute and chronic
actinic damage. Due to the peculiarities of Brazilian territory and culture, it would
not be advisable to replicate the concepts of photoprotection from other developed
countries, places with completely different climates and populations. Thus the
Brazilian Society of Dermatology has developed the Brazilian Consensus on
Photoprotection, the first official document on photoprotection developed in Brazil
for Brazilians, with recommendations on matters involving photoprotection.
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Affiliation(s)
- Sérgio Schalka
- Photobiology Department, Sociedade Brasileira de Dermatologia, São Paulo, SP, Brazil
| | | | | | | | | | | | - Eloisa Leis Ayres
- Center of Dermatology Prof. Rene Garrido Neves, City Health Foundation, Rio de Janeiro, RJ, Brazil
| | | | | | - Humberto Ponzio
- Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Ida Duarte
- Charity Hospital, Santa Casa de Misericórdia, São Paulo, SP, Brazil
| | - Jane Neffá
- Fluminense Federal University, Niterói, RJ, Brazil
| | | | | | | | | | - Marcus Maia
- Charity Hospital, Santa Casa de Misericórdia, São Paulo, SP, Brazil
| | - Nilton Nasser
- Federal University of Santa Catarina, Blumenau, SC, Brazil
| | | | | | | | | | | | | | | | | |
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