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Alli S, LeBeau J, Hasbani A, Lagacé F, Litvinov IV, Peláez S. Understanding the Perceived Relationship between Sun Exposure and Melanoma in Atlantic Canada: A Consensual Qualitative Study Highlighting a "Sunscreen Paradox". Cancers (Basel) 2023; 15:4726. [PMID: 37835419 PMCID: PMC10571640 DOI: 10.3390/cancers15194726] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2023] [Revised: 09/19/2023] [Accepted: 09/21/2023] [Indexed: 10/15/2023] Open
Abstract
Globally, cutaneous melanoma (CM) incidence is increasing, with sun exposure identified as a key modifiable risk factor. The Atlantic provinces of Canada display varied CM incidence rates: New Brunswick aligns with the national average, while Nova Scotia and Prince Edward Island exceed it, and Newfoundland and Labrador fall below this benchmark. We investigated the relationship between sun exposure and CM in these provinces. Twenty-two focus groups encompassing 95 Atlantic Canada residents were conducted and transcribed. A thematic analysis was conducted in MAXQDA using the social-ecological model as a framework. Residents of high-CM incidence provinces demonstrated greater sun exposure awareness, consulting UV indices, and using sunscreen and sun-protective clothing. However, they received greater UV exposure due to warmer climates and outdoor work and cultural activities. Conversely, those in low-incidence provinces used sunscreen and sun-protective clothing less often, engaged in occupations and hobbies affording less sun exposure, and lived in cooler climates. Our data supports a possible "sunscreen paradox", whereby increased sunscreen use is correlated with augmented sun exposure, leading to a deceptive sense of security. Public health initiatives in Atlantic Canada promoting sun safety must address this paradox while integrating community-specific behaviors and norms in order to develop tailored campaigns.
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Affiliation(s)
- Sauliha Alli
- Temerty Faculty of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada;
| | - Jonathan LeBeau
- Faculty of Medicine and Health Sciences, McGill University, Montreal, QC H3T 1C5, Canada; (J.L.); (A.H.); (F.L.)
| | - Agustina Hasbani
- Faculty of Medicine and Health Sciences, McGill University, Montreal, QC H3T 1C5, Canada; (J.L.); (A.H.); (F.L.)
| | - François Lagacé
- Faculty of Medicine and Health Sciences, McGill University, Montreal, QC H3T 1C5, Canada; (J.L.); (A.H.); (F.L.)
| | - Ivan V. Litvinov
- Faculty of Medicine and Health Sciences, McGill University, Montreal, QC H3T 1C5, Canada; (J.L.); (A.H.); (F.L.)
| | - Sandra Peláez
- School of Kinesiology and Physical Activity Sciences, Faculty of Medicine, University of Montreal, Montreal, QC H4A 3J1, Canada
- Research Centre of Sainte-Justine University Hospital, Montreal, QC H3T 1C5, Canada
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Fletcher CME, Trenerry C, Wilson C, Gunn KM. 'Being a farmer, I mostly always think there is something more important to do': A mixed methods analysis of the skin cancer detection practices of Australian farmers. Health Promot J Austr 2023. [PMID: 37611617 DOI: 10.1002/hpja.796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 08/09/2023] [Accepted: 08/09/2023] [Indexed: 08/25/2023] Open
Abstract
ISSUE ADDRESSED Farmers experience skin cancer and die from melanoma at significantly higher rates than the general Australian population. This study examined Australian farmers' engagement with self-skin examinations (SSE), participation in clinical skin examinations (CSE) by a health professional, and self-reported barriers to engagement with these important skin cancer detection practices. METHODS A cross-sectional, mixed-methods design was used. Australian farmers were recruited through an industry-based organisation representing livestock farmers. Farmers (N = 498; 22-89 years; 83.1% male) responded to a paper-based survey that included closed- and open-ended questions. RESULTS Farmers reported engagement with self-conducted SSE and routine CSE that was comparable to findings in the general population, but 29.4% of farmers reported that they had not sought a CSE as soon as possible after noticing changes to their skin. Farmers reported a range of barriers to SSE, including physical difficulties examining their skin, difficulties identifying changes in their skin, forgetfulness, and lack of motivation. Barriers to CSE included accessibility, cost, difficulties finding the right doctor, and avoidance and complacency. CONCLUSIONS There is a need to make clinical skin cancer detection more accessible to farmers, in addition to promoting self-skin examination and help-seeking behaviours within this at risk population. SO WHAT?: Novel approaches are needed to address systemic barriers faced by Australian farmers. These may include the use of teledermatology or artificial intelligence to assist with CSE. Remote training delivery methods may be also utilised to teach SSE skills to farmers who may be otherwise unable to access such opportunities.
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Affiliation(s)
- Chloe M E Fletcher
- Department of Rural Health, Allied Health and Human Performance, University of South Australia, Adelaide, South Australia, Australia
| | - Camilla Trenerry
- Freemasons Foundation Centre for Male Health and Wellbeing, The University of Adelaide, Adelaide, South Australia, Australia
- School of Psychology, The University of Adelaide, Adelaide, South Australia, Australia
| | - Carlene Wilson
- Flinders Health and Medical Research Institute, Flinders University, Adelaide, South Australia, Australia
- Olivia Newton John Cancer Wellness Research Centre, Austin Health, Melbourne, Victoria, Australia
- School of Psychology and Public Health, La Trobe University, Melbourne, Victoria, Australia
| | - Kate M Gunn
- Department of Rural Health, Allied Health and Human Performance, University of South Australia, Adelaide, South Australia, Australia
- Freemasons Foundation Centre for Male Health and Wellbeing, The University of Adelaide, Adelaide, South Australia, Australia
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Huang J, Zhang L, Shi L, Wu M, Lv T, Zhang Y, Lai Y, Tu Q, Wang X, Wang H. An epidemiological study on skin tumors of the elderly in a community in Shanghai, China. Sci Rep 2023; 13:4441. [PMID: 36932111 PMCID: PMC10023674 DOI: 10.1038/s41598-023-29012-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Accepted: 01/30/2023] [Indexed: 03/19/2023] Open
Abstract
The morbidity of skin tumors (ST) in China is a great concern as the population ages. No epidemiological survey on ST in elderly communities in China has been reported. A questionnaire survey was conducted among the residents over 60 years old in a community in Shanghai, China from May 1, 2011 to November 30, 2011. The prevalence of cutaneous tumors and associated factors were analyzed. Among 2038 valid cases, a total of 78 (3.8%, 95% CI 3.0-4.7) skin cancers (SC) were confirmed. According to the final multivariate regression analysis, age, gender and previous occupation were the significantly influential factors for SC. Actinic keratosis (AK) accounted for the largest proportion (63, 3.1%) in SC. The head and neck was the physiological site with the highest incidence of SC (64, 82.1%), and AK was the most common (55, 87.3%) in head and neck SC. The common concomitant diseases of SC were hypertension (26, 33.3%) and diabetes mellitus (9, 11.5%). Seborrheic keratosis (SK) was the most common benign skin tumor with a prevalence of 100%. Men and women developed SK in significantly different parts of the body (P < 0.0001). The incidence of ST in the elderly population in Shanghai community increased with age. ST preferred to occur in the head and neck, which might be attributed to excessive ultraviolet (UV) exposure in these areas. Therefore, early diagnosis and sun-protection education are essential interventions for ST in the elderly.
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Affiliation(s)
- Jianhua Huang
- Department of Dermatology, Huadong Hospital, Fudan University, Shanghai, China
| | - Linglin Zhang
- Institute of Photomedicine, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai, China
| | - Lei Shi
- Department of Dermatology, Huadong Hospital, Fudan University, Shanghai, China
| | - Minfeng Wu
- Department of Dermatology, Huadong Hospital, Fudan University, Shanghai, China
| | - Ting Lv
- Department of Dermatology, Huadong Hospital, Fudan University, Shanghai, China
| | - Yunfeng Zhang
- Institute of Photomedicine, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai, China
| | - Yongxian Lai
- Institute of Photomedicine, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai, China
| | - Qingfeng Tu
- Institute of Photomedicine, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai, China
| | - Xiuli Wang
- Institute of Photomedicine, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai, China.
| | - Hongwei Wang
- Department of Dermatology, Huadong Hospital, Fudan University, Shanghai, China.
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Calvache Ruales MF, Westerhausen S, Zapata Gallo HA, Strehl B, Naza Guzman SD, Versteeg H, Stöppelmann W, Wittlich M. UVR Exposure and Prevention of Street Construction Workers in Colombia and Germany. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19127259. [PMID: 35742508 PMCID: PMC9223545 DOI: 10.3390/ijerph19127259] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 06/09/2022] [Accepted: 06/11/2022] [Indexed: 12/10/2022]
Abstract
(1) Solar ultraviolet radiation (UVR) poses a major risk factor for developing skin cancer after years of chronic exposure. The irradiation is strongly dependent upon the activity or occupation carried out, but also on the climate conditions at the workplace. Knowledge of both has been tested within the occupational group of road construction workers in Colombia and Germany. (2) The GENESIS-UV measurement system has been used at both locations for consistency. A number of workers in both countries wore an electronic data logging dosimeter for several months to deliver detailed information on UVR exposure. (3) It was found that in a tropical climate, UVR exposure remains constant throughout the year, while in a temperate climate seasonal effects are visible, superimposed by behavioural aspects e.g., in springtime. The daily distribution of the radiation shows a distinct dip, especially in the Colombian data. Derived data show the high fraction of working days exceeding a threshold set by the skin type. (4) Road construction work involves high UVR exposure. In both countries, preventive measures are required to reduce the personal exposure to a minimum. Exceedance of the minimal erythema dose (MED) suggests a possible enhancing effect, especially in fair skinned people. Intercomparison of UVR exposure at workplaces is possible between countries and climate zones, emphasizing efforts for global action against skin cancer.
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Affiliation(s)
| | - Stephan Westerhausen
- Department of Ergonomics: Physical Environmental Factors, Institute for Occupational Safety and Health of the German Social Accident Insurance, D-53757 Sankt Augustin, Germany;
| | | | - Benjamin Strehl
- Department Accident Prevention: Digitalisation—Technologies, Institute for Occupational Safety and Health of the German Social Accident Insurance, D-53757 Sankt Augustin, Germany;
| | - Sergio D. Naza Guzman
- Risk Management Consultancy CGR, SURA, Cali 760046, Colombia; (M.F.C.R.); (S.D.N.G.)
| | - Helmut Versteeg
- Department Exposure and Risk Assessment, Institute for Occupational Safety and Health of the German Social Accident Insurance, D-53757 Sankt Augustin, Germany; (H.V.); (W.S.)
| | - Wiho Stöppelmann
- Department Exposure and Risk Assessment, Institute for Occupational Safety and Health of the German Social Accident Insurance, D-53757 Sankt Augustin, Germany; (H.V.); (W.S.)
| | - Marc Wittlich
- Department Accident Prevention: Digitalisation—Technologies, Institute for Occupational Safety and Health of the German Social Accident Insurance, D-53757 Sankt Augustin, Germany;
- Correspondence: ; Tel.: +49-(0)30-13001-3500
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Trenerry C, Fletcher C, Wilson C, Gunn K. "She'll Be Right, Mate": A Mixed Methods Analysis of Skin Cancer Prevention Practices among Australian Farmers-An At-Risk Group. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19052940. [PMID: 35270633 PMCID: PMC8910209 DOI: 10.3390/ijerph19052940] [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: 02/07/2022] [Revised: 02/25/2022] [Accepted: 02/27/2022] [Indexed: 11/23/2022]
Abstract
This study examined Australian farmers’ engagement with skin cancer prevention behaviours and explored what made it hard for them to be ‘SunSmart’ (barriers), and what could be done to make prevention easier (facilitators). In total, 498 farmers (83.1% male, 22–89 years, 50.8% grain, sheep, or cattle farmers) participated. The least frequently performed SunSmart behaviours (reported as never practiced during summer) were using SPF 30+ sunscreen (16.6%), wearing protective sunglasses (10.5%), and wearing protective clothing (8.6%). Greater engagement (i.e., higher scores on scale from Never to Always) with SunSmart behaviours was explained by gender (female), educational attainment (trade or technical college certificate vs. high school), personal skin cancer history, and skin sun sensitivity. Barriers reported by farmers related to personal preferences (e.g., short-sleeved rather than long-sleeved clothing), comfort, and perceived impracticality of sun protection. Farmers’ solutions included making protective clothing and sunscreen more appropriate for farm work (e.g., by making clothing more breathable). A personal health scare was the most reported motivation for skin cancer prevention. Findings highlight the need for increased access to sun-protective clothing and sunscreen that is suitable for wearing when working on farms, complemented by culturally appropriate health education messaging, to encourage more farmers to perform SunSmart behaviours.
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Affiliation(s)
- Camilla Trenerry
- School of Psychology, The University of Adelaide, Adelaide, SA 5000, Australia;
- Freemasons Centre for Male Health and Wellbeing, The University of Adelaide, Adelaide, SA 5000, Australia
- Flinders Health and Medical Research Institute, College of Medicine and Public Health, Flinders University, Bedford Park, SA 5042, Australia;
| | - Chloe Fletcher
- Department of Rural Health, Allied Health and Human Performance, University of South Australia, Adelaide, SA 5000, Australia;
| | - Carlene Wilson
- Flinders Health and Medical Research Institute, College of Medicine and Public Health, Flinders University, Bedford Park, SA 5042, Australia;
- Olivia Newton John Cancer Wellness Research Centre, Austin Health, Heidelberg, VIC 3084, Australia
- School of Psychology and Public Health, La Trobe University, Bundoora, VIC 3083, Australia
| | - Kate Gunn
- Freemasons Centre for Male Health and Wellbeing, The University of Adelaide, Adelaide, SA 5000, Australia
- Flinders Health and Medical Research Institute, College of Medicine and Public Health, Flinders University, Bedford Park, SA 5042, Australia;
- Department of Rural Health, Allied Health and Human Performance, University of South Australia, Adelaide, SA 5000, Australia;
- Correspondence:
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National and subnational burden of disease attributable to occupational exposure to solar ultraviolet radiation (SUVR) in Iran, 2005-2019. Int J Hyg Environ Health 2021; 240:113897. [PMID: 34861595 DOI: 10.1016/j.ijheh.2021.113897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2021] [Revised: 11/24/2021] [Accepted: 11/27/2021] [Indexed: 11/22/2022]
Abstract
Overexposure to solar ultraviolet radiation (SUVR) can cause skin and eye adverse effects for outdoor workers. In this study, the burden of disease induced by occupational exposure to SUVR and its spatiotemporal trend at national and sub-national levels in Iran, 2005-2019 were assessed. The attributable burden of disease was assessed using the following five datasets: (1) distribution of occupational exposure to SUVR, (2) total incidences and deaths of health outcomes of SUVR exposure, (3) population attributable fractions of the health outcomes of SUVR exposure, (4) age-gender distribution of outdoor workers, and (5) disability-adjusted life year (DALY) calculation constants. During 2005-2019, the attributable DALYs increased from 2442 to 2907 and the attributable DALY rate (per 100,000 workers) slightly decreased from 11.94 to 11.91. The share of YLL in the attributable burden of disease was in the range of 43%-46%. Out of nine causes, about 90% of the attributable burden of disease in 2019 was related to cataracts (29.9%), malignant skin melanoma (27.4%), squamous-cell carcinoma (18.6%), and sunburn (17.2%). During the study period, the attributable DALY rate in women increased by 60.95% (from 5.04 to 8.11) and in men decreased by 2.06% (from 13.03 to 12.76). The total attributable DALYs and DALY rate rose by age during 2005-2019. The contributions of population growth, risk-deleted DALY rates, exposure risk, and population age structure in temporal changes of the attributable burden of disease were 19.27%, 9.13%, -1.35%, and -14.8%, respectively. The three highest attributable DALY rates in 2019 were observed in South Khorasan (21.28), Chahar Mahal and Bakhtiari (17.42), and Kordestan (17.26), respectively. The preventive interventions against SUVR overexposure, regular screenings, and early treatments with an emphasis on occupations with continuous sun exposure and provinces with increasing attributable DALY rates should be considered in the occupational health action plan in the country.
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Linde K, Wright CY, du Plessis JL. Personal Solar Ultraviolet Radiation Exposure of Farmworkers: Seasonal and Anatomical Differences Suggest Prevention Measures Are Required. Ann Work Expo Health 2021; 66:41-51. [PMID: 34302333 DOI: 10.1093/annweh/wxab049] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Revised: 05/31/2021] [Accepted: 06/18/2021] [Indexed: 11/14/2022] Open
Abstract
INTRODUCTION Farmworkers are at risk of excess exposure to solar ultraviolet radiation (UVR) during their work activities, especially if they work in geographical areas with high ambient solar UVR levels such as in South Africa. Excess exposure to solar UVR may lead to several negative health effects such as certain cataracts and skin cancer. This study evaluated personal solar UVR exposure of a group of farmworkers to determine if they were at risk of health-related problems due to excess solar UVR exposure. METHODS Polysulphone film (PSF) badges were placed on the shoulder, arm, and top of the head of outdoor and indoor farmworkers on a macadamia nut and avocado farm in the Limpopo province for the duration of their daily work shift to evaluate their total daily solar UVR exposure. Sixteen days were assessed for each of the three, high solar UVR seasons, i.e. autumn, spring, and summer. RESULTS During autumn, farmworkers' arms received the highest solar UVR exposures (geometric mean (GM) = 7.8 SED, where 1 standard erythemal dose (SED) = 100 J/m2, 95% CI 6.1-9.8 SED) while the highest exposures were on the top of the head during spring (GM = 11.6 SED, 95% CI 7.3-17.4 SED) and summer (GM = 13.9, 95% CI 10.4-17.9 SED). Statistically significant differences in solar UVR exposure were found between the body sites during spring and summer but not autumn. CONCLUSIONS The relatively high daily solar UVR exposure levels of farmworkers suggest this occupational group is at risk of excess solar UVR exposure and preventive measures with awareness information to safeguard health is necessary for employers and employees.
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Affiliation(s)
- Karlien Linde
- Occupational Hygiene and Health Research Initiative (OHHRI), North-West University, Potchefstroom 2520, South Africa.,Department of Physiology and Environmental Health, University of Limpopo, Sovenga 0727, South Africa
| | - Caradee Yael Wright
- Environmental and Health Research Unit, South African Medical Research Council, Pretoria 0002, South Africa.,Department of Geography, Geoinformatics and Meteorology, University of Pretoria, Pretoria 0001, South Africa
| | - Johannes Lodewykus du Plessis
- Occupational Hygiene and Health Research Initiative (OHHRI), North-West University, Potchefstroom 2520, South Africa
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Abstract
During leisure time, people can decide if they want to expose themselves to solar ultraviolet (UV) radiation and to what extent. While working, people do not have this choice. Outdoor workers are exposed to solar UV radiation (UVR) on a daily basis. This may pose a certain health risk, which can be estimated when the personal solar UVR exposure (PE) is known. During past decades, a variety of studies were conducted to measure PE of outdoor workers and our knowledge of the PE of outdoor workers has increased remarkably. As shown by this review, studies clearly indicate that PE of most outdoor workers exceeds the internationally proposed threshold limit value, which is comparable to 1.0 to 1.3 standard erythema dose (SED), respectively, to 1.1 to 1.5 UV Index received over one hour. Besides working in a high UVR environ, monotonic workflow (limited movement, nearly static posture) is a risk factor. In such cases, PE can be higher than ambient UVR. In this review, we provide also a list of milestones, depicting the progress and the most important findings in this field during the past 45 years. However, in many respects our knowledge is still rudimentary, for several reasons. Different measuring positions have been used so that measured PE is not comparable. Few studies were designed to enable the extension of measured PE to other locations or dates. Although the importance of a proper calibration of the measuring devices in respect to the changing solar spectrum was pointed out from the beginning, this is often not performed, which leads to high uncertainties in the presented PE levels. At the end of our review, we provide some key points, which can be used to evaluate the quality of a study respectively to support the design of future studies.
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Dillane D, Balanay JAG. Comparison between EPA UV index app and UV monitor to assess risk for solar ultraviolet radiation exposure in agricultural settings in Eastern North Carolina. JOURNAL OF OCCUPATIONAL AND ENVIRONMENTAL HYGIENE 2021; 18:16-27. [PMID: 33284740 DOI: 10.1080/15459624.2020.1842880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Agricultural workers are exposed to solar ultraviolet (UV) radiation due to the significant amount of time spent working outdoors. Risk information on UV exposure from the EPA SunWise UV Index mobile app is conveniently available for timely advice on risk management, but its reliability is unknown. The purpose of this study was to determine the reliability of the EPA UV Index app in providing accurate risk information to reduce UV exposure and prevent related illnesses among agricultural workers in eastern North Carolina. UV radiation effective irradiance (UV eff ) indices were datalogged at two agricultural sites using radiometers from April-August 2019 and were assigned to risk levels (low, moderate, high, very high, extreme) based on the ACGIH® Threshold Limit Values (TLVs®). The UV index (UV app ) and its corresponding risk level were obtained using the app. Hourly UV app -based risk level assignments were time-matched to their corresponding UV eff /TLV-based risk level assignments (871 pairs) and analyzed using cross tabulation by determining the percentage of hourly UV eff /TLV-based risk levels ("gold standard") with the same hourly UV app -based risk levels, with a larger percentage indicating higher app reliability. Results showed that the app correctly identified 100% of low risk conditions, but its reliability decreased as the UV risk condition became more severe. The app correctly identified 0% of moderate, high and very high risk conditions but instead assigned 100% of them to lower risk levels (30-100% as low risk, 5-70% as moderate risk), indicating that the app was less protective in assessing UV risk. The app correctly identified 0.6% of extreme risk conditions but assigned 99.4% of them to lower risk levels (9.4% as low, 29.7% as moderate, 24.6% as high, 35.8% as very high). It is concluded that the performance of the EPA UV Index app in assessing occupational UV risk is not protective of workers particularly for high risk conditions, and that the use of the app for the assessment of risk to UV exposure in agricultural settings is not recommended.
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Affiliation(s)
- Danielle Dillane
- Department of Public Health, Brody School of Medicine, East Carolina University, Greenville, North Carolina
| | - Jo Anne G Balanay
- Environmental Health Sciences Program, Department of Health Education and Promotion, East Carolina University, Greenville, North Carolina
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Occupational exposure: rural Australian farmers’ sun-protective behaviours. J Public Health (Oxf) 2020. [DOI: 10.1007/s10389-019-01089-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
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John SM, Garbe C, French LE, Takala J, Yared W, Cardone A, Gehring R, Spahn A, Stratigos A. Improved protection of outdoor workers from solar ultraviolet radiation: position statement. J Eur Acad Dermatol Venereol 2020; 35:1278-1284. [PMID: 33222341 DOI: 10.1111/jdv.17011] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Accepted: 10/15/2020] [Indexed: 12/26/2022]
Abstract
The vast majority of non-melanoma skin cancer (NMSC) is attributable to excessive exposure to ultraviolet radiation (UVR). Outdoor workers are exposed to an UVR dose at least 2 to 3 times higher than indoor workers and often to daily UVR doses 5 times above internationally recommended limits. The risk of UVR workplace exposure is vastly neglected, and the evident future challenges presented in this statement are contrasted with the current situation regarding legal recognition, patient care and compensation. While prevention is crucial to reduce cancer risks for outdoor workers, it is as much of relevance to better protect them through legally binding rules and regulations. Specific actions are outlined in five recommendations based on a Call to Action (table 1). The role of health professionals, including dermatologists, in this context is crucial.
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Affiliation(s)
- S M John
- EADV Task Force Occupational Skin Diseases and Dept. Dermatology, Environmental Medicine, University of Osnabrueck, Osnabrueck, Germany
| | - C Garbe
- European Association of Dermato Oncology (EADO) and Department of Dermatology, Eber, hard Karls University, Tübingen, Germany
| | - L E French
- International League of Dermatological Societies (ILDS) and Department of Dermatology, University Hospital, Ludwig-Maximilians-University of Munich, Munich, Germany
| | - J Takala
- International Commission on Occupational Health (ICOH), University of Tampere, Tampere, Finland
| | - W Yared
- European Cancer Leagues (ECL), Brussels, Belgium
| | - A Cardone
- European Cancer Patient Coalition (ECPC), Brussels, Belgium
| | - R Gehring
- Safety and Health, European Federation Building and Woodworkers (EFBWW), Brussels, Belgium
| | - A Spahn
- Agriculture Section, European Federation of Food, Agriculture and Tourism Trade Unions (EFFAT), Brussels, Belgium
| | - A Stratigos
- European Academy of Dermatology and Venereology (EADV) and Dept. Dermatology, National and Kapodistrian University of Athens, Athens, Greece
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Keratinocyte skin cancer risks for working school teachers: Scenarios and implications of the timing of scheduled duty periods in Queensland, Australia. JOURNAL OF PHOTOCHEMISTRY AND PHOTOBIOLOGY B-BIOLOGY 2020; 213:112046. [PMID: 33074139 DOI: 10.1016/j.jphotobiol.2020.112046] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Revised: 09/20/2020] [Accepted: 09/29/2020] [Indexed: 01/01/2023]
Abstract
Relative keratinocyte skin cancer risks attributable to lifetime occupational and casual sunlight exposures of working school teachers are assessed across the state of Queensland for 1578 schools. Relative risk modeling utilizing annual ultraviolet exposure assessments of teachers working in different geographic locations and exposed during periods of measured daily playground duty times for each school were made for local administrative education districts by considering traditional school opening and closing hours, and playground lunchtime schedules. State-wide, basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) relative risk estimates varied by 24% for BCC and 45% for SCC. The highest relative risk was calculated for the state's north (sunshine) coast education district which showed that risk could increase by as much as 32% for BCC and 64% for SCC due to differences in teacher duty schedules. These results highlight the importance of playground duty scheduling as a significant risk factor contributing to the overall burden of preventable keratinocyte skin cancers in Queensland.
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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: 2] [Impact Index Per Article: 0.5] [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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14
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Use of Electronic UV Dosimeters in Measuring Personal UV Exposures and Public Health Education. ATMOSPHERE 2020. [DOI: 10.3390/atmos11070744] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
The performance limits of electronic ultraviolet (EUV) dosimeters, which use AlGaN Schottky photodiodes as the ultraviolet radiation (UVR) sensing element to measure personal erythemally weighted UVR exposures, were investigated via a direct comparison with meteorological-grade reference instruments. EUV dosimeters with two types of AlGaN Schottky photodiode were compared to second-generation ‘Robertson–Berger type’ broadband erythemal radiometers. This comparison was done by calculating correction factors for the deviations of the spectral responsivity of each instrument from the CIE erythemal action spectrum and for deviations in their angular response from the ideal cosine response of flat surfaces and human skin. Correction factors were also calculated to convert the output of these instruments to vitamin D-weighted UV irradiances. These comparisons showed that EUV dosimeters can be engineered with spectral responsivities and cosine response errors approaching those of Robertson–Berger type radiometers, making them very acceptable for use in human UVR exposure and sun safety behaviour studies, provided appropriate side-by-side calibrations are performed. Examples of these calibrations and the effect of EUV dosimeter sampling rates on the calculation of received erythemal UVR doses and erythemal UVR dose rates are provided, as well as brief descriptions of their use in primary skin cancer prevention programmes, handheld meters, and public health displays.
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15
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Kovačić J, Wittlich M, John SM, Macan J. Personal ultraviolet radiation dosimetry and its relationship with environmental data: A longitudinal pilot study in Croatian construction workers. JOURNAL OF PHOTOCHEMISTRY AND PHOTOBIOLOGY B-BIOLOGY 2020; 207:111866. [DOI: 10.1016/j.jphotobiol.2020.111866] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Revised: 02/20/2020] [Accepted: 03/24/2020] [Indexed: 12/22/2022]
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16
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Modenese A, Loney T, Ruggieri FP, Tornese L, Gobba F. Sun protection habits and behaviors of a group of outdoor workers and students from the agricultural and construction sectors in north-Italy. LA MEDICINA DEL LAVORO 2020; 111:116-125. [PMID: 32352425 PMCID: PMC7810007 DOI: 10.23749/mdl.v111i2.8929] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Accepted: 02/07/2020] [Indexed: 01/14/2023]
Abstract
Background: Despite the relevant frequency of ultraviolet induced adverse health effects in workers, solar ultraviolet radiation (UVR) exposure is an occupational risk not adequately minimized in Italy. Objective: To assess the characteristics and prevalence of sun exposure habits and behaviors in a group of students and outdoor workers (OW) from the agricultural and construction sectors of a north-Italian region. Methods: Based on a previously developed standardized questionnaire, we collected full information on individual sun exposure habits at work and during leisure activities. Results: In 2018, 380 high school students and OW from the agricultural and construction sectors participated in a sun-safety campaign. More than a third (39.0%) of OW reported never using sunglasses, 52.8% never applied sunscreens at work, and a quarter never wear a UV protective hat. Considering leisure-time, students reported more frequent sunburns compared to OW: 25.0% vs. 13.8%; half (51.6%) of students and a third (36.4%) of OW reported never wearing a UV protective hat. A third (30.1%) of students and 37.2% of OW never or only seldom applied sunscreens on holidays. Discussion: The majority of OW in our study reported poor protective solar exposure habits. Young students of the construction and agricultural sectors indicated even worse sun-protective behaviors, both during apprenticeship and leisure activities. Our study highlights the low health literacy related to solar UVR in OW and apprentices. Further educational initiatives are required in Italy to improve the adoption of protective behaviors during outdoor activities.
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Affiliation(s)
- Alberto Modenese
- Dipartimento di Scienze Biomediche, Metaboliche e Neuroscienze, Università di Modena e Reggio Emilia, Modena (IT) .
| | - Tom Loney
- College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai (United Arab Emirates).
| | - Francesco Pio Ruggieri
- Dipartimento di Scienze Biomediche, Metaboliche e Neuroscienze, Università di Modena e Reggio Emilia, Modena (IT) .
| | - Lorenzo Tornese
- Dipartimento di Scienze Biomediche, Metaboliche e Neuroscienze, Università di Modena e Reggio Emilia, Modena (IT) .
| | - Fabriziomaria Gobba
- Dipartimento di Scienze Biomediche, Metaboliche e Neuroscienze, Università di Modena e Reggio Emilia, Modena (IT) .
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Blesić SM, du Preez DJ, Stratimirović DI, Ajtić JV, Ramotsehoa MC, Allen MW, Wright CY. Characterization of personal solar ultraviolet radiation exposure using detrended fluctuation analysis. ENVIRONMENTAL RESEARCH 2020; 182:108976. [PMID: 31830694 DOI: 10.1016/j.envres.2019.108976] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Revised: 11/07/2019] [Accepted: 11/28/2019] [Indexed: 06/10/2023]
Abstract
Studies of personal solar ultraviolet radiation (pUVR) exposure are important to identify populations at-risk of excess and insufficient exposure given the negative and positive health impacts, respectively, of time spent in the sun. Electronic UVR dosimeters measure personal solar UVR exposure at high frequency intervals generating large datasets. Sophisticated methods are needed to analyze these data. Previously, wavelet transform (WT) analysis was applied to high-frequency personal recordings collected by electronic UVR dosimeters. Those findings showed scaling behavior in the datasets that changed from uncorrelated to long-range correlated with increasing duration of time spent in the sun. We hypothesized that the WT slope would be influenced by the duration of time that a person spends in continuum outside. In this study, we address this hypothesis by using an experimental study approach. We aimed to corroborate this hypothesis and to characterize the extent and nature of influence time a person spends outside has on the shape of statistical functions that we used to analyze individual UVR exposure patterns. Detrended fluctuation analysis (DFA) was applied to personal sun exposure data. We analyzed sun exposure recordings from skiers (on snow) and hikers in Europe, golfers in New Zealand and outdoor workers in South Africa. Results confirmed validity of the DFA superposition rule for assessment of pUVR data and showed that pUVR scaling is determined by personal patterns of exposure on lower scales. We also showed that this dominance ends at the range of time scales comparable to the maximal duration of continuous exposure to solar UVR during the day; in this way the superposition rule can be used to quantify behavioral patterns, particularly accurate if it is determined on WT curves. These findings confirm a novel way in which large datasets of personal UVR data may be analyzed to inform messaging regarding safe sun exposure for human health.
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Affiliation(s)
- Suzana M Blesić
- Institute for Medical Research, University fo Belgrade, Belgrade, Serbia; Department of Environmental Sciences, Informatics and Statistics, Ca'Foscari University fo Venice, Venice, Italy; Center for Participatory Science, Belgrade, Serbia.
| | - D Jean du Preez
- Department of Geography, Geoinformatics and Meteorology, University of Pretoria, Pretoria, South Africa.
| | | | - Jelena V Ajtić
- Faculty of Veterinary Medicine, University of Belgrade, Serbia.
| | - M Cynthia Ramotsehoa
- Occupational Hygiene and Health Research Initiative (OHHRI), Faculty of Health Sciences, North-West University, Potchefstroom, South Africa.
| | - Martin W Allen
- MacDiarmid Institute for Advanced Materials and Nanotechnology, University of Canterbury, New Zealand.
| | - Caradee Y Wright
- Department of Geography, Geoinformatics and Meteorology, University of Pretoria, Pretoria, South Africa; Environment and Health Research Unit, South African Medical Research Council, Pretoria, South Africa.
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Wright CY, du Preez DJ, Millar DA, Norval M. The Epidemiology of Skin Cancer and Public Health Strategies for Its Prevention in Southern Africa. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17031017. [PMID: 32041101 PMCID: PMC7037230 DOI: 10.3390/ijerph17031017] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Revised: 01/22/2020] [Accepted: 01/23/2020] [Indexed: 12/24/2022]
Abstract
Skin cancer is a non-communicable disease that has been underexplored in Africa, including Southern Africa. Exposure to solar ultraviolet radiation (UVR) is an important, potentially modifiable risk factor for skin cancer. The countries which comprise Southern Africa are Botswana, Lesotho, Namibia, South Africa, and Swaziland. They differ in population size and composition and experience different levels of solar UVR. Here, the epidemiology and prevalence of skin cancer in Southern African countries are outlined. Information is provided on skin cancer prevention campaigns in these countries, and evidence sought to support recommendations for skin cancer prevention, especially for people with fair skin, or oculocutaneous albinism or HIV-AIDS who are at the greatest risk. Consideration is given to the possible impacts of climate change on skin cancer in Southern Africa and the need for adaptation and human behavioural change is emphasized.
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Affiliation(s)
- Caradee Y. Wright
- Environment and Health Research Unit, South African Medical Research Council, Pretoria 0001, South Africa;
- Department of Geography, Geoinformatics and Meteorology, University of Pretoria, Pretoria 0002, South Africa;
- Correspondence: ; Tel.: +27-12-339-8543
| | - D. Jean du Preez
- Department of Geography, Geoinformatics and Meteorology, University of Pretoria, Pretoria 0002, South Africa;
- LACy, Laboratoire de l’Atmosphère et des Cyclones (UMR 8105 CNRS, Université de La Réunion, Météo-France), 97744 Saint-Denis de La Réunion, France
| | - Danielle A. Millar
- Environment and Health Research Unit, South African Medical Research Council, Pretoria 0001, South Africa;
| | - Mary Norval
- Biomedical Sciences, University of Edinburgh Medical School, Edinburgh EH8 9AG UK;
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Walkosz BJ, Buller DB, Buller MK, Wallis A, Liu X. Senior managers' awareness of sun protection policy predicts implementation of worksite sun safety in a randomized trial. Am J Ind Med 2019; 62:893-900. [PMID: 31403221 DOI: 10.1002/ajim.23033] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Revised: 07/16/2019] [Indexed: 01/03/2023]
Abstract
BACKGROUND Outdoor workers experience chronic exposure to harmful ultraviolet radiation (UV) elevating their risk for skin cancer. METHODS A controlled randomized trial promoted the adoption of workplace sun safety policy and employee education at 98 public organizations in Colorado. A 2-year follow-up study with 68 organizations assessed the association of senior manager awareness of sun safety policies and implementation of sun safety actions. RESULTS Senior managers' awareness of existing sun safety policies, but not their personal sun protection behaviors, predicted implementation of sun safety actions including the number of sun protection messages and sun protection items in the workplace and increased communication about sun safety to employees. CONCLUSIONS Organizational adoption of sun safety policy must include efforts to broadly inform a workplace's senior management to ensure the policies are actually implemented and provide support for sun protection behaviors by outdoor workers to reduce UV exposure and skin cancer risk.
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Affiliation(s)
| | | | | | - Allan Wallis
- School of Public Affairs, University of Colorado Denver, Denver, Colorado
| | - Xia Liu
- Klein Buendel, Inc, Golden, Colorado
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20
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Occupational Exposure to Solar UV Radiation of a Group of Fishermen Working in the Italian North Adriatic Sea. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16163001. [PMID: 31434335 PMCID: PMC6719225 DOI: 10.3390/ijerph16163001] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Revised: 08/16/2019] [Accepted: 08/18/2019] [Indexed: 12/14/2022]
Abstract
Occupational solar radiation exposure is a relevant heath risk in the fishing sector. Our aim was to provide a detailed evaluation of individual UV exposure in three different fishing activities in Italy, with personal UV dosimeters and a simple formula to calculate the fraction of ambient erythemal UV dose received by the workers. The potential individual UV exposure of the fishermen was between 65 and 542 Joules/m2. The percentages of the ambient exposure were estimated between 2.5% and 65.3%. Workers’ UV exposure was mainly influenced by the characteristics of the work activity, the postures adopted, and the type of boats. Overall, our data showed that 43% of the daily measurements could result largely above the occupational limits of 1–1.3 standard erythemal dose (i.e., 100 Joules/m2) per day, in case of exposure of uncovered skin areas. Measurements of individual UV exposure are important not only to assess the risk but also to increase workers’ perception and stimulate the adoption of preventive measures to reduce solar UV risk. Furthermore, the simple method proposed, linking ambient erythemal UV dose to the workers’ exposure, can be a promising tool for a reliable assessment of the UV risk, as time series of environmental UV dose are widely available.
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Peters CE, Pasko E, Strahlendorf P, Holness DL, Tenkate T. Solar Ultraviolet Radiation Exposure among Outdoor Workers in Three Canadian Provinces. Ann Work Expo Health 2019; 63:679-688. [DOI: 10.1093/annweh/wxz044] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2018] [Revised: 04/02/2019] [Accepted: 05/13/2019] [Indexed: 01/17/2023] Open
Abstract
AbstractIntroductionSolar ultraviolet radiation (UVR) exposure places outdoor workers at risk of skin cancer and exposure is difficult to control. In response, the Sun Safety at Work Canada (SSAWC) project was undertaken (2014–2016). The purpose of this substudy was to characterize the UVR exposure levels of outdoor workers in the SSAWC project.MethodsThirteen workplaces in the provinces of British Columbia, Ontario, and Nova Scotia participated in an exposure monitoring campaign (late summer/early fall 2016). Study participants were workers from power utilities and municipalities. Participants wore a UVR measurement badge (light-sensitive polysulfone plastic) on their wrist, shoulder, or hardhat. Badge calibration and absorbance measurements were performed in the AusSun Research Lab. Personal UVR doses are presented as standard erythemal doses (SED) and compared with the internationally recommended exposure limit (1.3 SED), as well as to the total available UVR by date. Generalized linear models were used to examine determinants of solar UVR for personal UVR dose (for both SED and percent of ambient UVR). Models considered badge placement, date, province, industry, main job task, and the hours spent outdoors.ResultsMean personal UVR dose of participating workers was 6.1 SED (nearly 5× the recommended limit). Just 14% of workers experienced ‘acceptable’ levels of solar radiation; 10% were exposed at >10 times the limit. In univariate analyses, workers in Ontario had the highest levels (mean 7.3 SED), but even in the lowest exposed province (British Columbia), the mean personal UVR dose was 4.5 SED. Utility workers had double the exposure of municipal workers (10.4 and 5.5 SED, respectively). In the determinants of exposure models, the differences by province were muted, but utility line workers and those in general maintenance had higher predicted exposures. Those who wore their badge on their hardhat also had higher values of SED in the fully adjusted determinants models.ConclusionsSolar ultraviolet overexposure among outdoor workers is a concern, even in a country like Canada with relatively low ambient UVR. Implementation of sun safety programs should be supported in an effort to reduce exposure in this vulnerable group of workers.
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Affiliation(s)
- Cheryl E Peters
- Cancer Epidemiology and Prevention Research, Alberta Health Services, SW, Calgary, Alberta, Canada
- Community Health Sciences, University of Calgary Cumming School of Medicine, Hospital Drive NW Calgary, Alberta, Canada
| | - Elena Pasko
- School of Occupational and Public Health, Ryerson University, Podium building Victoria St., Toronto, Ontario, Canada
| | - Peter Strahlendorf
- School of Occupational and Public Health, Ryerson University, Podium building Victoria St., Toronto, Ontario, Canada
| | - Dorothy Linn Holness
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Division of Occupational Medicine, Department of Medicine, University of Toronto, College Cir, Toronto, Ontario, Canada
- Division of Occupational Medicine, Department of Medicine, St Michael’s Hospital, St Michael’s Hospital, Toronto, Ontario, Canada
- Centre for Urban Health Solutions, St Michael’s Hospital, Toronto, Ontario, Canada
| | - Thomas Tenkate
- School of Occupational and Public Health, Ryerson University, Podium building Victoria St., Toronto, Ontario, Canada
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Paulo MS, Adam B, Akagwu C, Akparibo I, Al-Rifai RH, Bazrafshan S, Gobba F, Green AC, Ivanov I, Kezic S, Leppink N, Loney T, Modenese A, Pega F, Peters CE, Prüss-Üstün AM, Tenkate T, Ujita Y, Wittlich M, John SM. WHO/ILO work-related burden of disease and injury: Protocol for systematic reviews of occupational exposure to solar ultraviolet radiation and of the effect of occupational exposure to solar ultraviolet radiation on melanoma and non-melanoma skin cancer. ENVIRONMENT INTERNATIONAL 2019; 126:804-815. [PMID: 30792021 DOI: 10.1016/j.envint.2018.09.039] [Citation(s) in RCA: 55] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/20/2018] [Revised: 09/20/2018] [Accepted: 09/23/2018] [Indexed: 06/09/2023]
Abstract
BACKGROUND The World Health Organization (WHO) and the International Labour Organization (ILO) are developing a joint methodology for estimating the national and global work-related burden of disease and injury (WHO/ILO joint methodology), with contributions from a large network of experts. In this paper, we present the protocol for two systematic reviews of parameters for estimating the number of deaths and disability-adjusted life years from melanoma and non-melanoma skin cancer (or keratinocyte carcinoma) from occupational exposure to solar ultraviolet radiation, to inform the development of the WHO/ILO joint methodology. OBJECTIVES We aim to systematically review studies on occupational exposure to solar ultraviolet radiation (Systematic Review 1) and systematically review and meta-analyse estimates of the effect of occupational exposure to solar ultraviolet radiation on melanoma and non-melanoma skin cancer (Systematic Review 2), applying the Navigation Guide systematic review methodology as an organizing framework and conducting both systematic reviews in tandem and in a harmonized way. DATA SOURCES Separately for Systematic Reviews 1 and 2, we will search electronic academic databases for potentially relevant records from published and unpublished studies, including Ovid Medline, PubMed, EMBASE, and Web of Science. We will also search electronic grey literature databases, Internet search engines and organizational websites; hand-search reference list of previous systematic reviews and included study records and consult additional experts. STUDY ELIGIBILITY AND CRITERIA We will include working-age (≥15 years) workers in the formal and informal economy in any WHO and/or ILO Member State, but exclude children (<15 years) and unpaid domestic workers. For Systematic Review 1, we will include quantitative studies on the prevalence of relevant levels of occupational exposure to solar ultraviolet radiation (i.e. <0.33 SED/d and ≥0.33 SED/d) and of the total working time spent outdoors, stratified by country, sex, age and industrial sector or occupation, in the years 1960 to 2018. For Systematic Review 2, we will include randomized controlled trials, cohort studies, case-control studies and other non-randomized intervention studies with an estimate of the effect of any occupational exposure to solar ultraviolet radiation (i.e., ≥0.33 SED/d) on the prevalence of, incidence of or mortality due to melanoma and non-melanoma skin cancer, compared with the theoretical minimum risk exposure level (i.e. <0.33 SED/d). STUDY APPRAISAL AND SYNTHESIS METHODS At least two review authors will independently screen titles and abstracts against the eligibility criteria at a first stage and full texts of potentially eligible records at a second stage, followed by extraction of data from qualifying studies. At least two review authors will assess the risk of bias and the quality of evidence, using the most suited tools currently available. For Systematic Review 2, if feasible, we will combine relative risks using meta-analysis. We will report results using the guidelines for accurate and transparent health estimates reporting (GATHER) for Systematic Review 1 and the preferred reporting items for systematic reviews and meta-analyses guidelines (PRISMA) for Systematic Review 2. PROSPERO REGISTRATION NUMBER CRD42018094817.
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Affiliation(s)
- Marilia Silva Paulo
- Institute of Public Health, College of Medicine & Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates; Global Health and Tropical Medicine, Instituto de Higiene e Medicina Tropical, Universidade Nova de Lisboa, Lisbon, Portugal.
| | - Balazs Adam
- Institute of Public Health, College of Medicine & Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates; Division of Occupational Health, Department of Preventive Medicine, Faculty of Public Health, University of Debrecen, Debrecen, Hungary.
| | - Cyril Akagwu
- Defence Health Maintenance Limited, Ministry of Defence, Nigeria
| | - Issaka Akparibo
- Division of Aerospace Medicine, Wright State University, OH, USA.
| | - Rami H Al-Rifai
- Institute of Public Health, College of Medicine & Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates.
| | | | - Fabriziomaria Gobba
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena & Reggio Emilia, Italy.
| | - Adele C Green
- QIMR Berghofer Medical Research Institute, Royal Brisbane Hospital, QLD 4029, Australia; CRUK Manchester Institute, University of Manchester, Manchester, UK.
| | - Ivan Ivanov
- Department of Public Health, Environmental and Social Determinants of Health, World Health Organization, Geneva, Switzerland.
| | - Sanja Kezic
- Amsterdam UMC, University of Amsterdam, Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam, Netherlands.
| | - Nancy Leppink
- Labour Administration, Labour Inspection and Occupational Safety and Health Branch, International Labour Organization, Geneva, Switzerland.
| | - Tom Loney
- Institute of Public Health, College of Medicine & Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates; College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates.
| | - Alberto Modenese
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena & Reggio Emilia, Italy.
| | - Frank Pega
- Department of Public Health, Environmental and Social Determinants of Health, World Health Organization, Geneva, Switzerland.
| | - Cheryl E Peters
- Alberta Health Services & University of Calgary Calgary, Canada; CAREX Canada, Simon Fraser University, Vancouver, Canada.
| | - Annette M Prüss-Üstün
- Department of Public Health, Environmental and Social Determinants of Health, World Health Organization, Geneva, Switzerland.
| | - Thomas Tenkate
- Ryerson University, School of Occupational & Public Health, Canada.
| | - Yuka Ujita
- Labour Administration, Labour Inspection and Occupational Safety and Health Branch, International Labour Organization, Geneva, Switzerland.
| | - Marc Wittlich
- Institute for Occupational Safety and Health, German Social Accident Insurance (IFA), Sankt Augustin, Germany.
| | - Swen M John
- Department of Dermatology, Environmental Medicine and Health Theory, University of Osnabrück, Osnabrück, Germany; Institute for Interdisciplinary Dermatological Prevention and Rehabilitation (iDerm) at the University of Osnabrück, Lower-Saxonian Institute of Occupational Dermatology, Osnabrück, Germany.
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Buller DB, Walkosz BJ, Buller MK, Wallis A, Andersen PA, Scott MD, Meenan RT, Cutter GR. Implementation of Occupational Sun Safety at a 2-Year Follow-Up in a Randomized Trial: Comparison of Sun Safe Workplaces Policy Intervention to Attention Control. Am J Health Promot 2018; 33:683-697. [PMID: 30477333 DOI: 10.1177/0890117118814398] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
PURPOSE Implementation of employer sun safety actions was assessed in a 2-year follow-up to an occupational sun protection policy intervention. DESIGN Two-year follow-up assessment in a randomized pretest-posttest controlled design. SETTING Local government organizations with workers in public safety, public works, and parks and recreation. PARTICIPANTS Sixty-three local government organizations (participation = 64%) and 330 frontline supervisors and 1454 workers. INTERVENTION Sun Safe Workplaces (SSW) intervention promoting occupational sun safety policy and education. MEASURES Observations of SSW messages and sun safety items and surveys on organizations' communication and actions on sun safety. ANALYSIS Comparison between SSW and control groups was conducted using regression models and adjusted for clustering where appropriate, with α criterion set at P = .05 (2-tailed). RESULTS At intervention worksites, more SSW messages ( P < .001) and sun safety items ( P = .025) were observed; more frontline supervisors reported organizations provided free/reduced price sunscreen ( P = .005) and communicated about sun safety ( P < .001); and more workers recalled receiving sun safety messages ( P < .001) and sun safety training ( P <.001) compared to control organizations. Implementation was greater at larger than smaller intervention organizations for wide-brimmed hats ( P = .009), long work pants ( P = .017), and shade structures ( P = .036). Older workers received the most written messages ( P = .015). CONCLUSIONS Sun Safe Workplaces appeared to produce actions by organizations to support employee sun safety. Large organizations may have processes, communication channels, and slack resources to achieve more implementation.
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Affiliation(s)
| | | | | | - Allan Wallis
- 2 School of Public Affairs, University of Colorado Denver, Denver, CO, USA
| | - Peter A Andersen
- 3 School of Communication, San Diego State University, San Diego, CA, USA
| | | | - Richard T Meenan
- 5 Kaiser Permanente, Center for Health Research, Portland, OR, USA
| | - Gary R Cutter
- 6 Department of Biostatistics, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA
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Schilling L, Schneider S, Görig T, Spengler M, Greinert R, Breitbart EW, Diehl K. "Lost in the sun"-The key role of perceived workplace support for sun-protective behavior in outdoor workers. Am J Ind Med 2018; 61:929-938. [PMID: 30175492 DOI: 10.1002/ajim.22905] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/20/2018] [Indexed: 11/10/2022]
Abstract
BACKGROUND Previous studies show that workplace support for sun-protective behaviors plays an important role in the actual sun-protective behavior of outdoor workers. Therefore, our aim was to examine perceived workplace support (organizational and social support) in relation to different sun-protective behaviors. METHODS A Germany-wide sample of outdoor workers (n = 485) was surveyed via telephone. We analyzed associations of workplace support with sun-protective behaviors, sociodemographic, and occupational characteristics, occupational sun exposure, and concerns about sun. RESULTS A large number of outdoor workers perceived no workplace support for sun protection (eg, 17.8% agreed that sun protection is enforced at their workplace). We found that those who do not get any support are less likely to show sun-protective behaviors. CONCLUSIONS A starting point for a better organizational support is the implementation of mandatory sun protection policies in the workplace. Social support for protection against solar UV exposure can be promoted through safety training and education.
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Affiliation(s)
- Laura Schilling
- Mannheim Institute of Public Health, Social and Preventive Medicine (MIPH), Medical Faculty Mannheim; Heidelberg University; Mannheim Germany
| | - Sven Schneider
- Mannheim Institute of Public Health, Social and Preventive Medicine (MIPH), Medical Faculty Mannheim; Heidelberg University; Mannheim Germany
| | - Tatiana Görig
- Mannheim Institute of Public Health, Social and Preventive Medicine (MIPH), Medical Faculty Mannheim; Heidelberg University; Mannheim Germany
| | - Maria Spengler
- Mannheim Institute of Public Health, Social and Preventive Medicine (MIPH), Medical Faculty Mannheim; Heidelberg University; Mannheim Germany
| | - Rüdiger Greinert
- Association of Dermatological Prevention (ADP); Hamburg Germany
- Centre of Dermatology; Elbe Clinics; Buxtehude Germany
| | | | - Katharina Diehl
- Mannheim Institute of Public Health, Social and Preventive Medicine (MIPH), Medical Faculty Mannheim; Heidelberg University; Mannheim Germany
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Nkogatse MM, Ramotsehoa MC, Eloff FC, Wright CY. Solar Ultraviolet Radiation Exposure and Sun Protection Behaviors and Knowledge Among a High-Risk and Overlooked Group of Outdoor Workers in South Africa. Photochem Photobiol 2018; 95:439-445. [PMID: 30183090 DOI: 10.1111/php.13008] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2018] [Accepted: 08/24/2018] [Indexed: 11/30/2022]
Abstract
The exposure of outdoor car guards to solar ultraviolet radiation (UVR), the majority with deeply pigmented skin, to solar UVR was measured for five consecutive days during early spring (September 2017) in South Africa using electronic UVR dosimeters attached to the upper arm of each participant. The exposure of the nape of the neck, forehead, nose, cheek and hand was extrapolated from the measurements. The onsite ambient solar UVR on a flat, horizontal, unshaded surface was measured concurrently. The sun-related knowledge, behavior and attitudes of the car guards were evaluated using questionnaires. Total personal daily solar UVR exposure as a percentage of the ambient solar UVR exposure was 24%. The exposure of car guards on several body sites was in excess of the occupational threshold limit value. Sleeved shirts and hats were the most commonly used sun protection measures (worn by 70% and 80%, respectively). Considering the high levels of solar UVR reported on most days throughout the year in South Africa, more studies quantifying the personal exposure of outdoor workers in both the informal and formal sectors are necessary.
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Affiliation(s)
- Mahlako Malesele Nkogatse
- Occupational Hygiene and Health Research Initiative (OHHRI), Faculty of Health Sciences, North-West University, Potchefstroom, South Africa
| | - Motsehoa Cynthia Ramotsehoa
- Occupational Hygiene and Health Research Initiative (OHHRI), Faculty of Health Sciences, North-West University, Potchefstroom, South Africa
| | - Frederick Christofel Eloff
- Occupational Hygiene and Health Research Initiative (OHHRI), Faculty of Health Sciences, North-West University, Potchefstroom, 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, Gauteng
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Modenese A, Korpinen L, Gobba F. Solar Radiation Exposure and Outdoor Work: An Underestimated Occupational Risk. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:E2063. [PMID: 30241306 PMCID: PMC6209927 DOI: 10.3390/ijerph15102063] [Citation(s) in RCA: 75] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Revised: 09/17/2018] [Accepted: 09/18/2018] [Indexed: 12/22/2022]
Abstract
A considerably high number of outdoor workers worldwide are constantly exposed for the majority of their working life to solar radiation (SR); this exposure is known to induce various adverse health effects, mainly related to its ultraviolet (UV) component. The skin and the eye are the principal target organs for both acute and long-term exposure. Actinic keratosis, non-melanoma skin cancers, and malignant melanoma are the main long-term adverse skin effects, whereas in the eye pterygium, cataracts, and according to an increasing body of evidence, macular degeneration may be induced. Despite this, SR exposure risk is currently undervalued, if not neglected, as an occupational risk factor for outdoor workers. SR exposure is influenced by various environmental and individual factors, and occupation is one of the most relevant. For a better understanding of this risk and for the development of more effective prevention strategies, one of the main problems is the lack of available and adequate methods to estimate SR worker exposure, especially long-term exposure. The main aims of this review were to provide a comprehensive overview of SR exposure risk of outdoor workers, including the UV exposure levels and the main methods recently proposed for short-term and cumulative exposure, and to provide an update of knowledge on the main adverse eye and skin effects. Finally, we also outline here preventive interventions to reduce occupational risk.
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Affiliation(s)
- Alberto Modenese
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena & Reggio Emilia, 41124 Modena, Italy.
| | - Leena Korpinen
- Clinical Physiology and Neurophysiology Unit, The North Karelia Central Hospital, 80210 Joensuu, Finland.
| | - Fabriziomaria Gobba
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena & Reggio Emilia, 41124 Modena, Italy.
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Özalp B, Calavul A, Taşkan S, Yıldırım M. The Demographics of Patients with Skin Cancer who Underwent Surgery in Diyarbakır and Performed Surgical Techniques. DICLE MEDICAL JOURNAL 2018. [DOI: 10.5798/dicletip.424981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Beck N, Balanay JAG, Johnson T. Assessment of occupational exposure to heat stress and solar ultraviolet radiation among groundskeepers in an eastern North Carolina university setting. JOURNAL OF OCCUPATIONAL AND ENVIRONMENTAL HYGIENE 2018; 15:105-116. [PMID: 29090983 DOI: 10.1080/15459624.2017.1392530] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Groundskeepers spend most of the year working outdoors, exposing them to heat and solar ultraviolet (UV) radiation and increasing their risk to related adverse health effects. Various studies on heat and UV exposures in different occupations have been published, but those on groundskeepers are rare. The purpose of this study was to assess the exposure to heat stress and solar UV radiation among groundskeepers in an eastern North Carolina university setting. Wet bulb globe temperature (WBGT) index using a heat stress monitor and UV effective irradiance (UVeff) index using a digital UV meter were recorded in various work areas three times a day (morning, noon, afternoon) and during three seasons (spring, summer, fall). Data analysis was conducted using descriptive statistics, analysis of variance (ANOVA), Tukey Honestly Significant Difference (HSD), and Pearson Correlation tests. The mean (±SD) WBGT index was the highest in the afternoon (25.4 ± 5.0°C), summer (27.8 ± 3.1°C), and July (29.0 ± 2.6°C); the mean UVeff index was the highest at noon, summer and June (0.0116 ± 0.0061, 0.0101 ± 0.0081, and 0.0114 ± 0.0089 mW/cm2, respectively). Differences in the mean WBGT and UVeff indices within the time periods of day, seasons and months were significant (P < 0.01). The overall correlation between WBGT and UV indices was moderate (r = 0.42, P < 0.01) but lack of correlation was found during different times of the day during the fall and summer seasons. The largest percentages of WBGT indices exceeding the American Conference of Governmental Industrial Hygienists (ACGIH) threshold limit values (TLVs) for different workloads were found in the afternoon (11.3-40.7%), summer (14.6-56%), and July (28.8-76.3%). The mean UVeff for noon (0.0116 mW/cm2) and afternoon (0.0100 mW/cm2) exceeded the TLV for 30-min exposure. This study shows that groundskeepers are potentially exposed to excessive heat stress and UV radiation, and are at risk to developing heat- and UV-related illnesses. The study findings will be beneficial in implementing recommended control measures to prevent heat stress and UV exposure among groundskeepers and other similar outdoor workers.
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Affiliation(s)
- Nicole Beck
- a Environmental Health Sciences Program, Department of Health Education and Promotion , East Carolina University , Greenville , North Carolina
| | - Jo Anne G Balanay
- a Environmental Health Sciences Program, Department of Health Education and Promotion , East Carolina University , Greenville , North Carolina
| | - Terri Johnson
- b Department of Statistics , University of California Los Angeles , Los Angeles , California
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Predictors of Sun Protective Behaviors among Latino Day Laborers. J Skin Cancer 2018; 2018:3454309. [PMID: 29623223 PMCID: PMC5829325 DOI: 10.1155/2018/3454309] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2017] [Revised: 11/22/2017] [Accepted: 12/17/2017] [Indexed: 12/04/2022] Open
Abstract
Objectives Despite the substantial solar ultraviolet radiation experienced by Latino day laborers, little attention has been given to factors that are associated with sun protective behaviors. The purpose of this study was to examine psychological and nonpsychological predictors of sun protective behaviors among Latino day laborers. Methods This cross-sectional study included a nonrandom sample of 137 Latino day laborers recruited from Mississippi and Illinois. Participants completed a self-report survey instrument, available in English and Spanish, on sun protective behaviors. Results Multivariate regression results showed that sun protective behaviors were significantly greater among Latino day laborers: (a) who had greater perceptions that their supervisor also engaged in sun protective behaviors (β = 0.25, p ≤ 0.01); (b) who reported higher levels of health literacy (β = 0.23, p ≤ 0.001); (c) who have greater knowledge of skin cancer risk factors (β = 0.21, p ≤ 0.01); and (d) who have skin tone that was self-perceived to be more prone to sunburns (β = 0.19, p ≤ 0.01). Conclusions Latino day laborers possess marginal levels of skin cancer knowledge and engage minimally in sun protective behaviors. Skin cancer prevention interventions are warranted for this high-risk group, particularly in the locations in which Latino day laborers work.
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Gage R, Leung W, Stanley J, Reeder A, Barr M, Chambers T, Smith M, Signal L. Clothing Protection from Ultraviolet Radiation: A New Method for Assessment. Photochem Photobiol 2017; 93:1513-1518. [PMID: 28608526 DOI: 10.1111/php.12803] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2017] [Accepted: 05/24/2017] [Indexed: 11/29/2022]
Abstract
Clothing modifies ultraviolet radiation (UVR) exposure from the sun and has an impact on skin cancer risk and the endogenous synthesis of vitamin D. There is no standardized method available for assessing body surface area (BSA) covered by clothing, which limits generalizability between study findings. We calculated the body cover provided by 38 clothing items using diagrams of BSA, adjusting the values to account for differences in BSA by age. Diagrams displaying each clothing item were developed and incorporated into a coverage assessment procedure (CAP). Five assessors used the CAP and Lund & Browder chart, an existing method for estimating BSA, to calculate the clothing coverage of an image sample of 100 schoolchildren. Values of clothing coverage, inter-rater reliability and assessment time were compared between CAP and Lund & Browder methods. Both methods had excellent inter-rater reliability (>0.90) and returned comparable results, although the CAP method was significantly faster in determining a person's clothing coverage. On balance, the CAP method appears to be a feasible method for calculating clothing coverage. Its use could improve comparability between sun-safety studies and aid in quantifying the health effects of UVR exposure.
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Affiliation(s)
- Ryan Gage
- University of Otago, Wellington, New Zealand
| | - William Leung
- University of Otago, Wellington, New Zealand.,University of Auckland, Auckland, New Zealand
| | | | - Anthony Reeder
- Cancer Society Social & Behavioural Research Unit, University of Otago School of Medicine, Dunedin, New Zealand
| | | | | | - Moira Smith
- University of Otago, Wellington, New Zealand
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Dobbinson S, Niven P, Buller D, Allen M, Gies P, Warne C. Comparing Handheld Meters and Electronic Dosimeters for Measuring Ultraviolet Levels under Shade and in the Sun. Photochem Photobiol 2016; 92:208-14. [PMID: 26575187 DOI: 10.1111/php.12551] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2015] [Accepted: 09/22/2015] [Indexed: 01/07/2023]
Abstract
This study aimed to compare the validity, reliability and practicality of alternative portable methods for measuring erythemal UVR levels in passive recreation areas in public parks. UVR levels were measured for point in time comparisons between Solarmeter 6.5 handheld meters and time-stamped electronic dosimeters in a large central park in Melbourne, Australia. Observations were made at 20 locations in the park by two research assistants under two conditions: (1) matched shade (2) contrasting shade-no shade. Comparisons were also made with scientific instruments on the UVR monitoring station rooftop and by remotely selecting UV records and forecasts on cloud-free dates of park observations. There was good agreement between the portable UVR instruments in the park setting as confirmed via Bland Altman plots, while the dosimeter appeared less sensitive to change in shade conditions. The rooftop measurements showed that the Solarmeter 6.5 UVR readings were comparable to those of the adjacent rooftop instruments. The practicalities of using the dosimeters and Solarmeters for behavioral studies are discussed. These findings provide a basis for use of the Solarmeter 6.5 to measure changes in UVR levels due to different environmental conditions with relative accuracy for intervention studies in outdoor settings.
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Affiliation(s)
| | | | | | - Martin Allen
- Department of Electrical and Computer Engineering, College of Engineering, University of Canterbury, Christchurch, New Zealand
| | - Peter Gies
- Australian Radiation Protection and Nuclear Safety Agency, Government of Australia, Melbourne, VIC, Australia
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Hault K, Rönsch H, Beissert S, Knuschke P, Bauer A. Knowledge of outdoor workers on the effects of natural UV radiation and methods of protection against exposure. J Eur Acad Dermatol Venereol 2016; 30 Suppl 3:34-7. [PMID: 26995021 DOI: 10.1111/jdv.13631] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/21/2016] [Indexed: 12/31/2022]
Abstract
The most important but influenceable risk factor in the development of skin cancer is the unprotected exposure to solar ultraviolet (UV) radiation. In order to assure adequate and effective protection against UV exposure, a level of knowledge about solar radiation and its effects is required. The objective of this study was to assess the knowledge of workers in outdoor professions on the effects of natural UV radiation and methods of protection against exposure. Forty outdoor workers were given a standardized questionnaire designed to ascertain their level of knowledge. The majority of participants knew exposure to solar radiation can be detrimental depending on exposure time. Eighty-three percentage recognized that people working regularly in an outdoor environment may be at risk due to high exposure. Long-sleeved clothing plus headgear and sunscreen containing sun-protecting substances were deemed adequate methods of protection by 83% and 85% respectively. Seventy percentage of the outdoor workers were familiar with the definition of the sun protection factor (SPF), yet only 25% correctly identified the amount of sunscreen needed to achieve the SPF as indicated on the product. A mere 8% of participants knew that symptoms of a sunburn first became apparent 3 h after sun exposure and only 18% were able to accurately gauge the amount of time they could spend in the sun before developing one. Although 30% had heard of the ultraviolet index (UVI), only 13% understood that protecting your skin using additional measures is recommended as of UVI 3. Overall, 30% of the outdoor workers thought themselves sufficiently protected against the harmful effects of the sun. While the participants of this study had a basic fundamental understanding of the effects of solar radiation and methods of protection against exposure, there remains an urgent need for further clarification across all demographic groups.
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Affiliation(s)
- K Hault
- Department of Dermatology, University Hospital Carl Gustav Carus, Technical University of Dresden, Dresden, Germany
| | - H Rönsch
- Department of Dermatology, University Hospital Carl Gustav Carus, Technical University of Dresden, Dresden, Germany
| | - S Beissert
- Department of Dermatology, University Hospital Carl Gustav Carus, Technical University of Dresden, Dresden, Germany
| | - P Knuschke
- Department of Dermatology, University Hospital Carl Gustav Carus, Technical University of Dresden, Dresden, Germany
| | - A Bauer
- Department of Dermatology, University Hospital Carl Gustav Carus, Technical University of Dresden, Dresden, Germany
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Peters CE, Demers PA, Kalia S, Nicol AM, Koehoorn MW. Levels of Occupational Exposure to Solar Ultraviolet Radiation in Vancouver, Canada. ANNALS OF OCCUPATIONAL HYGIENE 2016; 60:825-35. [PMID: 27279636 DOI: 10.1093/annhyg/mew037] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/21/2015] [Accepted: 05/17/2016] [Indexed: 12/30/2022]
Abstract
INTRODUCTION Outdoor workers are at high risk of exposure to solar ultraviolet radiation (UVR), a known human carcinogen. In Canada, no objective measures of UVR exposure are available for occupational settings. METHODS The Outdoor Workers Project collected UVR exposure data among outdoor workers in Vancouver, Canada during the summer of 2013. Objective measures of exposure were taken for one week using calibrated electronic UVR dosimeters. Additional data was collected from workers on skin cancer risk factors, family history of skin cancer, and job type; as well as meteorological data for sampling days. Marginal models were constructed to examine the worker, job and meteorological determinants of UVR exposure levels, as measured in standard erythemal dose (SED). RESULTS Seventy-eight workers were recruited, of which 73 had at least 1 day of measured UVR exposure for this analysis. Participants were mostly male, young and Caucasian. Mean exposure (corrected for repeated measures) was 1.08 SED. Exposure measures were highly variable even in the same workplace, ranging from 0.01 SED to 19.2 SED. Younger age, working in land-based construction, and sunnier weather forecasts led to higher levels of UVR exposure. CONCLUSIONS Exposure levels capable of causing sunburn were common in this study of outdoor workers, in a location not typically associated with high sun exposure.
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Affiliation(s)
- Cheryl E Peters
- .School of Population and Public Health, University of British Columbia, 2nd Floor, 2206 East Mall, Vancouver, BC V6T1Z3, Canada; .Department of Health Sciences, Carleton University, 5411 - Herzberg Laboratories, 1125 Colonel By Drive, Ottawa, ON K1S5B6, Canada;
| | - Paul A Demers
- .Occupational Cancer Research Centre, Cancer Care Ontario, 3rd Floor, 525 University Ave, Toronto, ON M5G2L3, Canada; .Dalla Lana School of Public Health, University of Toronto Toronto, ON, Canada
| | - Sunil Kalia
- .Department of Dermatology and Skin Science, Faculty of Medicine, University of British Columbia, 835 West 10th Avenue, Vancouver, BC V5Z 4E8, Canada
| | - Anne-Marie Nicol
- .Faculty of Health Sciences, Simon Fraser University, Blusson Hall 11516, 8888 University Drive, Burnaby, BC V5A1S6, Canada
| | - Mieke W Koehoorn
- .School of Population and Public Health, University of British Columbia, 2nd Floor, 2206 East Mall, Vancouver, BC V6T1Z3, Canada
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Solar ultraviolet and the occupational radiant exposure of Queensland school teachers: A comparative study between teaching classifications and behavior patterns. JOURNAL OF PHOTOCHEMISTRY AND PHOTOBIOLOGY B-BIOLOGY 2016; 158:105-12. [DOI: 10.1016/j.jphotobiol.2016.02.018] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/04/2015] [Accepted: 02/22/2016] [Indexed: 01/28/2023]
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Modenese A, Farnetani F, Andreoli A, Pellacani G, Gobba F. Questionnaire-based evaluation of occupational and non-occupational solar radiation exposure in a sample of Italian patients treated for actinic keratosis and other non-melanoma skin cancers. J Eur Acad Dermatol Venereol 2016; 30 Suppl 3:21-6. [DOI: 10.1111/jdv.13606] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/21/2016] [Indexed: 11/29/2022]
Affiliation(s)
- A. Modenese
- Chair of Occupational Medicine; University of Modena and Reggio Emilia; Modena Italy
| | - F. Farnetani
- Chair of Dermatology; University of Modena and Reggio Emilia; Modena Italy
| | - A. Andreoli
- Chair of Occupational Medicine; University of Modena and Reggio Emilia; Modena Italy
| | - G. Pellacani
- Chair of Dermatology; University of Modena and Reggio Emilia; Modena Italy
| | - F. Gobba
- Chair of Occupational Medicine; University of Modena and Reggio Emilia; Modena Italy
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Reeder AI, Gray AR, Liley JB, Scragg RKR, McKenzie RL, Stewart AW. Factors associated with photoprotection by body clothing coverage, particularly in non-summer months, among a New Zealand community sample. Photochem Photobiol Sci 2016; 15:389-97. [PMID: 26888562 DOI: 10.1039/c5pp00431d] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Clothing coverage is important for reducing skin cancer risk, but may also influence vitamin D sufficiency, so associated plausible predictors require investigation. Volunteers (18 to 85 years), with approximately equal numbers by sex and four ethnicity groups, were recruited in cities from two latitude bands: Auckland (36.9°S) and Dunedin (45.9°S). Baseline questionnaire, anthropometric and spectrophotometer skin colour data were collected and weather data obtained. Percent body coverage was calculated from eight week diary records. Potential independent predictors (unadjusted p < 0.25) were included in adjusted models. Participants (n = 506: Auckland n = 334, Dunedin n = 172; mean age 48.4 years) were 62.7% female and had a median body clothing coverage of 81.6% (IQR 9.3%). Dunedin was cooler, less windy and had lower UVI levels than Auckland. From the fully adjusted model, increased coverage occurred in non-summer months (despite adjusting for weather), among Dunedin residents and Asians (compared to Europeans), during the middle of the day, with a dose response effect observed for greater age. Reduced coverage was associated with Pacific ethnicity and greater time spent outdoors. Additionally, higher temperatures were associated with reduced coverage, whereas increased cloud cover and wind speed were associated with increased coverage. Although the only potentially modifiable factors associated with clothing coverage were the time period and time spent outdoors, knowledge of these and other associated factors is useful for the framing and targeting of health promotion messages to potentially influence clothing coverage, facilitate erythema avoidance and maintain vitamin D sufficiency.
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Affiliation(s)
- Anthony I Reeder
- Cancer Society of New Zealand Social & Behavioural Research Unit, Department of Preventive & Social Medicine, University of Otago Medical School, P.O. Box 56, Dunedin 9054, New Zealand.
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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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Day AK, Stapleton JL, Natale-Pereira AM, Goydos JS, Coups EJ. Occupational sunscreen use among US Hispanic outdoor workers. BMC Res Notes 2015; 8:578. [PMID: 26477041 PMCID: PMC4609133 DOI: 10.1186/s13104-015-1558-1] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2015] [Accepted: 10/05/2015] [Indexed: 12/02/2022] Open
Abstract
Background Occupational ultraviolet radiation (UVR) exposure is a risk factor for skin cancer, and Hispanic individuals are over-represented in a number of outdoor occupations (e.g., farming, landscaping). This study examined predictors of occupational sunscreen use in a group of US Hispanic adults who work outdoors. Results A population-based sample of outdoor workers (n = 149, 85 % male) completed survey measures regarding their demographics, melanoma risk, perceived skin cancer risk, skin cancer knowledge, and their occupational sunscreen use. Sixty-nine percent of the sample reported never or rarely wearing sunscreen while working outdoors. Being female (p = .02), having a higher level of education (p = .03), and residing at a higher latitude (p = .04) were associated with more frequent sunscreen use. Conclusions This study highlights the importance of interventions to promote sun protection behaviors among US Hispanic outdoor workers, and identifies potential intervention targets.
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Affiliation(s)
- Ashley K Day
- Rutgers Cancer Institute of New Jersey, Rutgers, The State University of New Jersey, 195 Little Albany Street, New Brunswick, NJ, 08901, USA. .,School of Psychology, University of Adelaide, North Tce Campus, Adelaide, SA, 5005, Australia.
| | - Jerod L Stapleton
- Rutgers Cancer Institute of New Jersey, Rutgers, The State University of New Jersey, 195 Little Albany Street, New Brunswick, NJ, 08901, USA. .,Department of Medicine, Rutgers Robert Wood Johnson Medical School, 125 Paterson Street, New Brunswick, NJ, 08901, USA. .,Department of Health Education and Behavioral Science, Rutgers School of Public Health, 683 Hoes Lane West, Piscataway, NJ, 08854, USA.
| | - Ana M Natale-Pereira
- Department of Medicine, Rutgers New Jersey Medical School, 185 South Orange Avenue, Newark, NJ, 07103, USA.
| | - James S Goydos
- Rutgers Cancer Institute of New Jersey, Rutgers, The State University of New Jersey, 195 Little Albany Street, New Brunswick, NJ, 08901, USA. .,Department of Surgery, Rutgers Robert Wood Johnson Medical School, 125 Paterson Street, New Brunswick, NJ, 08901, USA.
| | - Elliot J Coups
- Rutgers Cancer Institute of New Jersey, Rutgers, The State University of New Jersey, 195 Little Albany Street, New Brunswick, NJ, 08901, USA. .,Department of Medicine, Rutgers Robert Wood Johnson Medical School, 125 Paterson Street, New Brunswick, NJ, 08901, USA. .,Department of Health Education and Behavioral Science, Rutgers School of Public Health, 683 Hoes Lane West, Piscataway, NJ, 08854, USA.
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Giménez VB, Ysasi GG, Moreno JC, Serrano MA. Maximum Incident Erythemally Effective UV Exposure Received by Construction Workers, in Valencia, Spain. Photochem Photobiol 2015; 91:1505-9. [PMID: 26346996 DOI: 10.1111/php.12530] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2015] [Accepted: 08/10/2015] [Indexed: 11/30/2022]
Abstract
This article analyzes the influence of Ultraviolet Erythematic Radiation (UVER) dose received by construction workers in Valencia highlighting the upper limit of the dose received for a worker in different periods of a year. Building construction usually implies workers to stand for several hours outdoors while working until roof top is finished. In Valencia, construction carried out near the coastline has been very intense in the last few years with the construction of a great amount of summer flats. This article focuses on the maximum values UVER can reach in different seasons of the year for cities with similar latitude to Valencia (39°28'N, 0°22'W), as an important way of warning construction workers about the necessity of taking preventive actions. Viospor dosimeters placed on a mannequin have been used in this study. The measurements took place between 2012 December and 2013 July.
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Affiliation(s)
- Vicente Blanca Giménez
- Instituto de Ingeniería Energética, Universitat Politècnica de València, Valencia, España
| | - Gonzalo Gurrea Ysasi
- Instituto de Ingeniería Energética, Universitat Politècnica de València, Valencia, España
| | - Juan Carlos Moreno
- Instituto de Ingeniería Energética, Universitat Politècnica de València, Valencia, España
| | - María Antonia Serrano
- Instituto de Ingeniería Energética, Universitat Politècnica de València, Valencia, España
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Smit-Kroner C, Brumby S. Farmers sun exposure, skin protection and public health campaigns: An Australian perspective. Prev Med Rep 2015; 2:602-7. [PMID: 26844126 PMCID: PMC4721376 DOI: 10.1016/j.pmedr.2015.07.004] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Non-melanoma skin cancer is a common and costly cancer in agricultural populations. Prevention and early detection are an effective way to decrease the burden of disease and associated costs. To examine sun exposure and skin protection practices in agricultural workers and farmers a thematic review of the literature between 1983 and 2014 was undertaken. Comparison between studies was complicated by differences in study design, definitions of skin protection, and analytic methods used. Farmers are the most exposed to harmful ultraviolet (UV) radiation of all outdoor workers and the level of reported skin protection by farmers is suboptimal. Years of public health campaigns have failed to adequately address farmers' specific needs. Increased rates of skin cancer and subsequent higher costs are expected. Estimates of sun exposure and skin protection practice indicate that protective clothing is the most promising avenue to improve on farmers' skin protection. Early detection needs to be part of public health campaigns. This review explores the quantitative data about Australian farmers and their skin protective behaviours. We investigate what the documented measurable effect of the public health campaign Slip!Slop!Slap! has had on agricultural workers and farmers and make recommendations for future focus.
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Affiliation(s)
- Christel Smit-Kroner
- National Centre for Farmer Health, Deakin University, School of Medicine, Box 283, Hamilton, VIC 3300, Australia
| | - Susan Brumby
- National Centre for Farmer Health, Deakin University, School of Medicine, Box 283, Hamilton, VIC 3300, Australia
- Western District Health Service, 20 Foster Street, Hamilton, VIC 3300, Australia
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Bodekær M, Petersen B, Thieden E, Philipsen PA, Heydenreich J, Olsen P, Wulf HC. UVR exposure and vitamin D in a rural population. A study of outdoor working farmers, their spouses and children. Photochem Photobiol Sci 2015; 13:1598-606. [PMID: 25248029 DOI: 10.1039/c4pp00188e] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
BACKGROUND Living and working in the countryside may result in excessive UVR exposure, with increased risk of skin cancer. Some sun exposure is, however, recommended, since vitamin D production is UVB-dependent. OBJECTIVES To examine UVR exposure and vitamin D levels in a rural population of outdoor working male farmers, their indoor working spouses and their children, expected to receive high UVR exposure. METHODS Prospective, cohort study. During the summer 2009 daily, personal UVR exposure and sun behaviour were recorded by dosimetry and diaries (17 403 days). Vitamin D was measured at the end of summer and the following winter. RESULTS Risk behaviour (= exposure of shoulders/upper body to the sun), beach days, sunscreen use and sunburns were infrequent. Farmers and boys had the highest daily UVR exposure (both 1.5 SED per day), likewise on work days. On non-work days the UVR exposure was even higher (up to 2.0 SED per day). Farmers, girls and boys had a higher chronic UVR exposure than the spouses, who had more intermittent high UVR exposure. Vitamin D levels did not differ between family members. At the end of summer 16% of the participants were vitamin D insufficient, the following winter, 61%. Some UVR exposure variables correlated positively, but weakly, with vitamin D levels. CONCLUSIONS UVR exposure was generally high among this study population, however, vitamin D levels still dropped below the recommended level during winter for most participants. Differences in UVR exposure between the groups did not result in differences in vitamin D levels.
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Affiliation(s)
- M Bodekær
- Department of Dermatology, Bispebjerg Hospital, Copenhagen, Denmark.
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Janda M, Stoneham M, Youl P, Crane P, Sendall MC, Tenkate T, Kimlin M. What Encourages Sun Protection among Outdoor Workers from Four Industries? J Occup Health 2014; 56:62-72. [DOI: 10.1539/joh.13-0179-oa] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Monika Janda
- School of Public Health and Social Work, Institute of Health and Biomedical Innovation, Queensland University of TechnologyAustralia
| | - Melissa Stoneham
- Public Health Advocacy Institute of Western Australia, Faculty of Health SciencesCurtin UniversityAustralia
| | | | - Phil Crane
- School of Public Health and Social Work, Institute of Health and Biomedical Innovation, Queensland University of TechnologyAustralia
| | - Marguerite C Sendall
- School of Public Health and Social Work, Institute of Health and Biomedical Innovation, Queensland University of TechnologyAustralia
| | - Thomas Tenkate
- School of Occupational and Public Health, Ryerson UniversityCanada
| | - Michael Kimlin
- School of Public Health and Social Work, Institute of Health and Biomedical Innovation, Queensland University of TechnologyAustralia
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Serrano MA, Cañada J, Moreno JC, Gurrea G. Occupational UV exposure of environmental agents in Valencia, Spain. Photochem Photobiol 2014; 90:911-8. [PMID: 24494834 DOI: 10.1111/php.12252] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2013] [Accepted: 01/23/2014] [Indexed: 11/28/2022]
Abstract
Excessive exposure to ultraviolet radiation (UVR) is considered the most important environmental risk factor in the development of melanoma and skin cancer. Outdoor workers are among those with the highest risk from exposure to solar UVR, as their daily activities constantly expose them to this radiation source. A study was carried out in Valencia, Spain, in summer 2012 and involved a group of 11 workers for a period of six 2-day recordings. Sensitive spore-film filter-type personal dosimeters (VioSpor) were used to measure erythemal UVR received by environmental agents in the course of their daily work. Median 2-day UV exposure was 6.2 standard erythema dose (SED), with 1 SED defined as effective 100 J m(-2) when weighted with the Commission Internationale de L'Eclairage's (CIE) erythemal response function. These workers were found to receive a median of 8.3% total daily ambient ultraviolet erythemal radiation. Comparison with the occupational UV exposure limit showed that the subjects had received an erythemal UV dose in excess of occupational guidelines, indicating that protective measures against this risk are highly advisable.
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Affiliation(s)
- María-Antonia Serrano
- Instituto de Ingeniería Energética, Universitat Politècnica de València, Valencia, España
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46
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Parisi AV, Turnbull DJ. Shade provision for UV minimization: a review. Photochem Photobiol 2014; 90:479-90. [PMID: 24417678 DOI: 10.1111/php.12237] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2013] [Accepted: 01/05/2014] [Indexed: 11/26/2022]
Abstract
Minimizing exposure to ultraviolet (UV) radiation is an essential component of skin cancer prevention. Providing and using natural and built shade is an effective protection measure against harmful UV. This article describes the factors that must be addressed to ensure quality, effective, well-designed shade and recommends best practice approaches to improving the protection factor (PF) of shade structures. It identifies examples of interventions to increase shade availability and use, and examples of effective shade based on measured protection factors or measured reductions in UV exposures. Finally, this article considers examples of best practice for undertaking shade audits. The article is based on refereed articles and reviews, reports, conference papers and shade practice and policies from reports and on web sites. Articles for the Australian setting are considered first, followed by those in an international setting.
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Milon A, Bulliard JL, Vuilleumier L, Danuser B, Vernez D. Estimating the contribution of occupational solar ultraviolet exposure to skin cancer. Br J Dermatol 2014; 170:157-64. [DOI: 10.1111/bjd.12604] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/21/2013] [Indexed: 11/30/2022]
Affiliation(s)
- A. Milon
- Institute of Work and Health (IST); University of Lausanne and Geneva; Route de la Corniche 2, 1066 Epalinges, Lausanne Switzerland
| | - J.-L. Bulliard
- Cancer Epidemiology Unit; University Institute of Social and Preventive Medicine (IUMSP); Centre Hospitalier Universitaire Vaudois and University of Lausanne; 10 route de la Corniche 1010 Lausanne Switzerland
| | - L. Vuilleumier
- Federal Office of Meteorology and Climatology (MeteoSwiss); chemin de l'Aérologie; 1530 Payerne Switzerland
| | - B. Danuser
- Institute of Work and Health (IST); University of Lausanne and Geneva; Route de la Corniche 2, 1066 Epalinges, Lausanne Switzerland
| | - D. Vernez
- Institute of Work and Health (IST); University of Lausanne and Geneva; Route de la Corniche 2, 1066 Epalinges, Lausanne Switzerland
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Horsham C, Auster J, Sendall MC, Stoneham M, Youl P, Crane P, Tenkate T, Janda M, Kimlin M. Interventions to decrease skin cancer risk in outdoor workers: update to a 2007 systematic review. BMC Res Notes 2014; 7:10. [PMID: 24397996 PMCID: PMC4028889 DOI: 10.1186/1756-0500-7-10] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2013] [Accepted: 12/16/2013] [Indexed: 11/10/2022] Open
Abstract
Background Outdoor workers are at high risk of harmful ultraviolet radiation exposure and are identified as an at risk group for the development of skin cancer. This systematic evidence based review provides an update to a previous review published in 2007 about interventions for the prevention of skin cancer in outdoor workers. Results This review includes interventions published between 2007-2012 and presents findings about sun protection behaviours and/or objective measures of skin cancer risk. Six papers met inclusion criteria and were included in the review. Large studies with extended follow-up times demonstrated the efficacy of educational and multi-component interventions to increase sun protection, with some higher use of personal protective equipment such as sunscreen. However, there is less evidence for the effectiveness of policy or specific intervention components. Conclusions Further research aimed at improving overall attitudes towards sun protection in outdoor workers is needed to provide an overarching framework.
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Affiliation(s)
| | | | | | | | | | | | | | - Monika Janda
- School of Public Health and Social Work, Institute of Health and Biomedical Innovation, Queensland University of Technology, Victoria Park Road, Kelvin Grove 4059, Queensland, Australia.
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Serrano MA, Cañada J, Moreno JC. Solar UV exposure in construction workers in Valencia, Spain. JOURNAL OF EXPOSURE SCIENCE & ENVIRONMENTAL EPIDEMIOLOGY 2013; 23:525-530. [PMID: 22739681 DOI: 10.1038/jes.2012.58] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/27/2012] [Accepted: 03/29/2012] [Indexed: 06/01/2023]
Abstract
Exposure to ultraviolet radiation (UVR) has long been recognized as the most important environmental risk factor for melanoma and skin cancer. Outdoor workers are among the groups most at risk from exposure to solar UVR in their daily activities. Sensitive spore-film filter-type personal dosimeters (VioSpor) were used to measure the biologically effective UVR received by construction workers in the course of their daily work. The study took place in Valencia, Spain, in July 2010 and involved a group of eight workers for a period of 5 days. The median UV exposure was 6.11 standard erythema dose (SED) per day, with 1 SED defined as effective 100 J/m(2) when weighted with the Commission Internationale de L'Eeclairage erythemal response function. These workers were found to receive a median of 13.9% of total daily ambient ultraviolet erythemal radiation (UVER). Comparison with the occupational UVR exposure limit showed that the subjects had received UVER exposure in excess of occupational guidelines, indicating that protective measures against this risk are highly advisable.
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Affiliation(s)
- María-Antonia Serrano
- Instituto de Ingeniería Energética, Universitat Politècnica de València, 46022 Valencia, España.
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Wright CY, Brogniez C, Ncongwane KP, Sivakumar V, Coetzee G, Metzger JM, Auriol F, Deroo C, Sauvage B. Sunburn Risk Among Children and Outdoor Workers in South Africa and Reunion Island Coastal Sites. Photochem Photobiol 2013; 89:1226-33. [DOI: 10.1111/php.12123] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2013] [Accepted: 06/20/2013] [Indexed: 11/30/2022]
Affiliation(s)
- Caradee Y. Wright
- Climate Studies; Modelling and Environmental Health Research Group; Council for Scientific and Industrial Research; Pretoria; South Africa
| | - Colette Brogniez
- Laboratoire d'Optique Atmosphérique; Sciences et Technologies; CNRS/INSU; Université Lille 1; Villeneuve d'Ascq Cedex; France
| | | | | | | | - Jean-Marc Metzger
- UMS 3365 - OSU Réunion; Université de La Réunion; Saint Denis Cedex 09 La Réunion; France
| | - Frédérique Auriol
- Laboratoire d'Optique Atmosphérique; Sciences et Technologies; CNRS/INSU; Université Lille 1; Villeneuve d'Ascq Cedex; France
| | - Christine Deroo
- Laboratoire d'Optique Atmosphérique; Sciences et Technologies; CNRS/INSU; Université Lille 1; Villeneuve d'Ascq Cedex; France
| | - Béatrice Sauvage
- Laboratoire d'Optique Atmosphérique; Sciences et Technologies; CNRS/INSU; Université Lille 1; Villeneuve d'Ascq Cedex; France
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