UV-protection in outdoor workers: a controlled intervention study

Skin cancer is an increasing public health burden and its incidence is
increasing in many countries with predominantly fair-skinned populations.
Non-melanoma skin cancer (NMSC) incidence is increasing, annually 2-3 million
people worldwide are diagnosed with NMSC. Occupational solar exposure
contributes greatly to the overall lifetime UV dose. Outdoor workers experience
far higher exposure levels compared to the general population. This is
reflected in an excess risk of NMSC showing up to threefold increase in outdoor
workers. This can be avoided if the appropriate measures to reduce UVR-exposure
are taken e.g. working in the shadow, use of sunscreens or UV-protective
clothing. However, sun-safety behaviour in outdoor workers is poor.

To assess the effectiveness of an intervention aiming at increase of sunscreens
use in outdoor workers. Furthermore, to assess external UV-exposure and
prevalence of NMSC including actinic keratosis (AK).

Controlled intervention study in outdoor workers. A single-centre study.

Provision of dispensers with sunscreens (SPF 50+) and regular feedback on their
use achieved by continuous electronic monitoring. Workers will wear personal
UV-sensors on their wrist providing continuous information on external
UV-exposure during the work-shift. Stratum corneum (SC) samples will be
collected at the beginning, half-way and at the end of the study, for measuring
biomarkers of the internal UV-dose. Questionnaires on sun-protecting behaviour
will be taken at the beginning and end of the study. A skin examination of body
parts exposed to the sun will be performed at the end of the study.

The burden and health risk associated with participation is negligible. The
outdoor workers will visit the researchers at the study sites three times, once
at the beginning of the study (intake and baseline), after six weeks and at the
end of the study (3 months). Each visit will take approximately 15 minutes
needed for the collection of the SC samples and, at the beginning and end of
the study, for the questionnaire. Collection of the SC will be performed by
using adhesive tapes, a minimally invasive and painless procedure, which has
often been applied in own studies and elsewhere. The provided sunscreen is
classified as cosmetics and can be obtained without prescription at the
pharmacy or drugstore.