Skin cancer risk perception and sun protection behavior at work, at leisure, and on sun holidays: a survey for Danish outdoor and indoor workers

Kasper Grandahl,Gunnar Hellmund Laier,Kristina Sophie Ibler,Ole Steen Mortensen

doi:10.1186/s12199-018-0736-x

Kasper Grandahl, Gunnar Hellmund Laier + Show 2 more

Open Access

https://doi.org/10.1186/s12199-018-0736-x

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Abstract

BackgroundTo prevent occupational skin cancer, it is essential that the sun-protective behavior of outdoor workers is adequate. The aim is to study the sun-protective behavior of Danish outdoor workers at work, at leisure, and on sun holiday and compare it to that of indoor workers.MethodsThis is a cross-sectional study, based on a 53-item survey completed by Danish outdoor (n = 380) and indoor workers (n = 119) in 2016–2017. Status as outdoor or indoor worker was decided based on self-report and behavioral differences were tested using (paired) t tests and multiple regression adjusted for age, sex, educational level, history of smoking, and skin type.ResultsDanish outdoor workers at work use sun protection less than they do at leisure and on sun holiday (α < .05) where their sun protection behavior is similar to that of indoor workers. The proportion of Danish outdoor workers that always/often use sun protection at work is for shade seeking around noon 4.2%, sunscreen 34.5%, wide-brimmed hat 25.3%, and long trousers and shirt with sleeves 42.4%. Of Danish outdoor workers, 49.5% do not think about the risk of occupational skin cancer and 11.8% think the risk is insignificant, 32.4% think that the use of sun protection is of low or no importance, 84.2% consider sunburn important as skin cancer risk factor still 88.9% have a history of sunburn at work, > 80.0% agree that risk of skin cancer is reduced by the use of sun protection, and only 4.0% dismiss the possibility of sun protection use at work.ConclusionsSkin cancer risk and use of sun protection at work are largely neglected in Danish outdoor workers, more so than at leisure and on sun holiday where their risk behavior resembles that of indoor workers. This indicates an untapped workplace preventive potential.

Highlights

To prevent occupational skin cancer, it is essential that the sun-protective behavior of outdoor workers is adequate
We only know that individual use of sun protection varies considerably [9, 10] and that the solar UV radiation exposure of Danish outdoor and indoor workers differs significantly at work and is the same at leisure [11, 12] whereas sun holidays are more common at higher socioeconomic status in Danes and may be more frequent in indoor workers [13]
Our results show that Danish outdoor workers use sun protection significantly more at leisure and on sun holiday than they do at work and between outdoor and indoor workers, the only significant difference in UV exposure and use of sun protection outside working hours was for the use of sunscreen at leisure

Summary

Introduction

To prevent occupational skin cancer, it is essential that the sun-protective behavior of outdoor workers is adequate. We only know that individual use of sun protection varies considerably [9, 10] and that the solar UV radiation exposure of Danish outdoor and indoor workers differs significantly at work and is the same at leisure [11, 12] whereas sun holidays are more common at higher socioeconomic status in Danes and may be more frequent in indoor workers [13]. Sun safety campaigns that targets sun protection at work could work as an effective supplement to existing campaigns that mainly targets sun protection at leisure [15] and lead to better overall use of sun protection for the 400,000 Danish outdoor workers at risk This would be analogous to the introduction of smoking ban at workplaces leading to an appropriate all-round modification of risk behavior in smoking— a WHO group 1 carcinogen [16, 17]

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