UV-protection in outdoor workers

Rationale: 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.
Objective: 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)
Study design: Controlled intervention study in outdoor workers. A single-centre study.
Study population: Outdoor workers, aged 18 years or older.

The expectation is that sunscreen use in the intervention group will increase.

T=0 (beginning of the study): questionnaire on self-reported sunscreen use, external UV-exposure measurements using a personal UV-sensor, internal UV-exposure using stratum corneum (SC) samples.

T = 6 weeks (half-way the study): external UV-exposure measurements using a personal UV-sensor, internal UV-exposure using stratum corneum (SC) samples.

T=3 months (end of the study): closing questionnaire on self-reported sunscreen use, external UV-exposure measurements using a personal UV-sensor, internal UV-exposure measurements using stratum corneum (SC) samples. Skin check for the prevalence of NMSC including AK.

Electronical monitoring of the sunscreen dispensers is continously for the duration of the study. We will provide 2-weekly posters with feedback on the sunscreens use.

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 check of body parts exposed to the sun will be performed at the end of the study.