Randomized Trial Testing a Worksite Sun Protection Program in an Outdoor Recreation Industry

Abstract

Health communication campaigns intended to reduce chronic and severe exposure to ultraviolet radiation in sunlight and prevent skin cancer are a national priority. Outdoor workers represent an unaddressed, high-risk population. Go Sun Smart (GSS), a worksite sun safety program largely based on the diffusion-of-innovations theory, was evaluated in a pair-matched, group-randomized, pretest-posttest controlled design enrolling employees at 26 ski areas in Western North America. Employees at the intervention ski areas were more aware of GSS (odds ratio [OR] = 8.27, p < .05) and reported less sunburning (adjusted OR = 1.63, p < .05) at posttest than employees at the control areas. A dose response was evident (OR = 1.46, p < .05) with greater observed program implementation associated with fewer sunburns among employees. Program awareness per se was not predictive (p > .05) of reduced sunburning in a mediational analysis. Analyses of nonrespondents, including intent-to-treat analyses, further supported the success of GSS.

Exponentially increasing incidences of cutaneous malignant melanoma in Europe correlate with low personal annual UV doses and suggests 2 major risk factors

“…[13][14][15][16] This belief arose because outdoor workers are exposed to UV every day, unlike indoor workers, so that their skin acclimates by thickening the stratum corneum and by producing the pigment melanin (tan). However, contrary to this popular belief, outdoor workers can get numerous sunburns and can also experience blistering events [28][29][30][31] reviewed by Glanz. 32 For example, the study by Buller et al 30 found 45% of the ski area employees got sunburned and 8% received blistering sunburns.…”

“…However, contrary to this popular belief, outdoor workers can get numerous sunburns and can also experience blistering events [28][29][30][31] reviewed by Glanz. 32 For example, the study by Buller et al 30 found 45% of the ski area employees got sunburned and 8% received blistering sunburns. Another study measured alpine skiers who got 0.5-7.6 times the minimum erythemal dose (MED), or the minimum amount of UV dose needed to produce a mild sunburn, for white individuals with skin type II and 10% got more than 1 MED/h during peak exposure times.…”

“…25 UVB exposures of skin creates cutaneous vitamin D 3 production 26 that sunscreens dramatically reduce. 27 Furthermore, contrary to popular belief, outdoor workers get numerous sunburns [28][29][30][31] reviewed by Glanz.…”

Increasing Sun Protection in Winter Outdoor Recreation

“…All ski areas were National Ski Area Association (NSAA) members and had at least two aerial chairlifts. 22 See Buller et al 22 for ski-area recruitment procedures.…”

“…25 Size and location (a surrogate for climate) of ski areas were the primary matching variables; ownership structure and the proportion of female employees were also included in the matching. 22 Trained staff interviewed guests on chairlifts with a minimum run time of 4 minutes during 3-day periods (1 weekend day and 2 weekdays) to obtain pre-intervention data from January to April 2001 and post-intervention data from January to March 2002. Pairs of ski areas were visited during the same week in both years.…”