Skin Cancer Prevention Behaviors Among Agricultural and Construction Workers in the United States, 2015
ORIGINAL RESEARCH — Volume 16 — February 7, 2019
Kathleen R. Ragan, MSPH1; Natasha Buchanan Lunsford, PhD1; Cheryll C. Thomas, MSPH1; Eric W. Tai, MD1; Aaron Sussell, PhD2; Dawn M. Holman, MPH1 (View author affiliations)
Suggested citation for this article: Ragan KR, Buchanan Lunsford N, Thomas CC, Tai EW, Sussell A, Holman DM. Skin Cancer Prevention Behaviors Among Agricultural and Construction Workers in the United States, 2015. Prev Chronic Dis 2019;16:180446. DOI: http://dx.doi.org/10.5888/pcd16.180446.
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Summary
What is already known on this topic?
Agricultural and construction workers (ACWs) may be at increased risk for skin cancer because of high levels of ultraviolet radiation exposure from the sun.
What is added by this report?
Agricultural workers had a higher prevalence than construction workers of almost all sun-protection behaviors. Prevalence of regular use of shade and sunscreen was lower among ACWs than national estimates.
What are the implications for public health practice?
Findings may be used to improve occupational health approaches to skin cancer risk reduction among ACWs. Employers can help reduce occupational health inequities and protect workers by creating workplaces that promote sun-safe policies, provide access to resources that facilitate sun protection, and foster workplace cultural sun-safety expectations.
Abstract
Introduction
Nearly 5 million people are treated for skin cancer each year in the United States. Agricultural and construction workers (ACWs) may be at increased risk for skin cancer because of high levels of ultraviolet radiation exposure from the sun. This is the first study that uses nationally representative data to assess sun-protection behaviors among ACWs.
Methods
We analyzed data from the 2015 National Health Interview Survey Cancer Control Supplement to examine the prevalence of sun-protection behaviors among ACWs. We calculated national, weighted, self-reported prevalence estimates. We used χ2 tests to assess differences between ACWs by industry and occupation.
Results
Most of the 2,298 agricultural and construction workers studied were male (by industry, 72.4% in agriculture and 89.3% in construction; by occupation, 66.1% in agriculture and 95.6% in construction) and non-Hispanic white. About one-third had at least 1 sunburn in the past year. The prevalence of sunscreen use and shade seeking was low and did not significantly differ among groups, ranging from 15.1% to 21.4% for sunscreen use and 24.5% to 29.1% for shade seeking. The prevalence of wearing protective clothing was significantly higher among agricultural workers than among construction workers by industry (70.9% vs 50.7%) and occupation (70.5% vs 53.0%).
Conclusion
Our findings could be used to improve occupational health approaches to reducing skin cancer risk among ACWs and to inform education and prevention initiatives addressing skin cancer. Sun-safety initiatives may include modifying work sites to increase shade and adding sun safety to workplace policies and training. Employers can help reduce occupational health inequities and protect workers by creating workplaces that facilitate sun protection.
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