Protocol for a Systematic Review on the Effectiveness of Interventions to Reduce Exposure to Occupational Solar UltraViolet Radiation (UVR) Among Outdoor Workers

Implementation of an Occupational Sun Safety Intervention: A Comparison of Two Scalability Strategies

OBJECTIVE

Two methods for scaling up an evidence-based occupational sun protection program were compared.

METHODS

Regional districts ( n = 138) in 21 state Departments of Transportation throughout the United States were randomized to receive the Go Sun Smart at Work program via in-person or digital scalability methods in 2019-2022 in 1:2 ratio. Managers completed pretest and posttest surveys and employees completed posttest surveys. Because of the COVID pandemic, only posttest measures were analyzed ( n = 255 managers; n = 1387 employees).

RESULTS

After scale-up, more employees reported training (b = 0.381, P = 0.021) and communication (b = 0.112, P = 0.049) at workplaces in in-person rather than digital strategy. There were no differences in managers' reports of sun protection training, communication, or actions by scalability method ( P > 0.05).

CONCLUSIONS

Occupational sun protection was implemented during program scale up and employees recalled training/communication more in the in-person than digital strategy.

Sun-protective behaviors and sunburn among US adults

Individuals can reduce the risk of developing skin cancer by minimizing ultraviolet sunlight exposure, though recent trends in sun-protective behaviors remain to be investigated. To evaluate sun-protective behaviors and sunburn among US adults. We analyzed data from the 2010, 2015, and 2020 National Health Interview Survey (NHIS), an annual, cross-sectional survey conducted by the US Census Bureau. Multivariable regression models were stratified by demographic variables and constructed to evaluate sun-protective behaviors and sunburn avoidance across time. From 2010 through 2020, US adults had significantly increased prevalence of seeking shade (p value, 0.003), wearing wide-brimmed hats (< 0.001), wearing long-sleeved shirts (< 0.001), using sunscreen (< 0.001), and avoiding sunburns (< 0.001) and significantly decreased prevalence of sun avoidance (< 0.001). Disparities in sun-protective behaviors also exist among different sexes, ages, education levels, and those reporting higher sun sensitivity. This cross-sectional study found that by 2020, US adults had an increased prevalence of wearing sun-protective clothing and sunscreen use, though decreased prevalence of sun avoidance. Although certain sun-protective behaviors have become more prevalent, the incidence of skin cancer continues to rise. Efforts to understand drivers of sun-protective behaviors and targeted intervention efforts are needed.

Digitally measuring solar ultraviolet radiation in outdoor workers: A study protocol for establishing the use of electronic personal dosimeters in Portugal

Introduction

The rising incidence of skin cancer over the years has made it a significant public and occupational health issue. However, skin cancer is highly preventable, mainly through reduced exposure to solar ultraviolet radiation (UVR), which can be achieved by a variety of individual and collective protective measures and interventions. The relative risk associated with different patterns of exposure to solar UVR differs for the subtypes of keratinocyte cancers (KC). Specifically, whether the exposure is intermittent or continuous, and occurs in an occupational or leisure/recreational setting. The main aim of the study using this protocol is to contribute to raising public and policy awareness on solar UVR-inflicted occupational skin cancers in Lisbon. This will be achieved by performing direct measurements of the solar UVR dose received by outdoor workers using a digital platform. Results will likely contribute to further understanding the risk estimates for keratinocyte cancer estimations in this population.

Methods

A prospective observational study will be conducted in Lisbon, Portugal. Personal electronic dosimeters (GENESIS-UV system) integrated with a digital platform will be used to assess occupational solar UVR doses of gardeners, masons, and gravediggers of the municipality of Lisbon. Two hundred and ten outdoor workers will be selected to wear the dosimeter for 1 month each, between April and October during their daily working hours. A digital web-based platform that offers private access to information through dashboard visualization will provide information for the outdoor workers and facilitate communication with the participants.

Discussion

The expected results of the overall proposal comprise the occupational solar UVR doses, expressed in standard erythemal dose (SEDs) per day of outdoor work for 7 months. Study data will provide outdoor workers with information on their personal solar UVR exposure during their working hours and an estimate of their risk of developing skin cancer. It is expected that the occupational solar UVR doses of the outdoor workers in Portugal will be above the threshold of 1 to 1.33 SED/day, due to the latitude of Lisbon and the nature of the occupations. The results prospectively should flow into the design of adequate prevention campaigns for skin cancer in outdoor workers.

Sun protection and occupation: Current developments and perspectives for prevention of occupational skin cancer

A substantial proportion of all reported occupational illnesses are constituted by skin cancer, making this disease a serious public health issue. Solar ultra-violet radiation (UVR) exposure is the most significant external factor in the development of skin cancer, for which the broad occupational category of outdoor workers has already been identified as high-risk group. Sun protection by deploying adequate technical, organizational, and person-related measures has to be understood as a functional aspect of workplace safety. To prevent skin cancers brought on by-typically cumulative-solar UVR exposure, outdoor workers must considerably lower their occupationally acquired solar UVR doses. Estimating cumulative sun exposure in outdoor workers requires consideration of the level of solar UVR exposure, the tasks to be done in the sun, and the employees' solar UVR preventive measures. Recent studies have highlighted the necessity for measures to enhance outdoor workers' sun protection behavior. In the coming decades, occupational dermatology is expected to pay increasing attention to sun protection at work. Also, the field of dermato-oncology will likely be concerned with sky-rocketing incidences of occupational skin cancers. The complete range of available alternatives should be utilized in terms of preventive actions, which seems pivotal to handle the present and future challenges in a purposeful manner. This will almost definitely only be possible if politicians' support is effectively combined with communal and individual preventive actions in order to spur long-term transformation.

Protective Measures From Solar Ultraviolet Radiation for Beach Lifeguards in Tuscany (Italy): Shade and Clothing Strategies

Background

The exposure to solar ultraviolet radiation is a significant risk factor generally underestimated by outdoor workers and employers. Several studies have pointed out that occupational solar exposure increased eye and skin diseases with a considerable impact on the lives and productivity of affected workers.The main purpose of this study was to evaluate the effectiveness against ultraviolet radiation of some measures recently undertaken for the protection of lifeguards in a coastal area of Tuscany.

Methods

Different shading structures (gazebos and beach umbrella) were tested during a sunny summer's day on a sandy beach by means of two radiometers; the UV protection offered by some T-shirts used by lifeguards was also tested in the laboratory with a spectrophotometer.

Results

The analysed shading structures strongly reduced the ultraviolet radiation by up to 90%, however a not always negligible diffuse radiation is also present in the shade, requiring further protective measures (T-shirt, sunglasses, sunscreen, etc.); the tested T-shirts showed a very good-excellent protection according to the Australian/New Zealand standard.

Conclusion

Results obtained in this study suggest how the adoption and dissemination of good practices, including those tested, could be particularly effective as a primary prevention for lifeguards who are subjected to very high levels of radiation for long periods.