Sun safety knowledge, practices and attitudes in rural Australian farmers: a cross-sectional study in Western New South Wales

Abstract

Background Rates of skin cancer in Australia are amongst the highest in the world, with Western New South Wales (NSW) exhibiting very high prevalence. There is a large proportion of outdoor workers, including farmers, in Western NSW who have high levels of sun exposure and hence are at greater risk of developing skin cancer. Aims To characterise the current sun safety practices of farmers in Western NSW and explore their knowledge, attitudes and perceived barriers towards sun safety and its implementation. Methods A cross-sectional survey study was conducted using a self-directed questionnaire. Participants were recruited at field days held in Western NSW and through surveys distributed at general practices, local stores and online. Eligibility criteria were aged 18 years and over and currently working on a farm in the study region. Results Of the 144 participants, 89 (61.8%) were male with a mean age of 49 years. Knowledge of sun safety was relatively high with most questions answered correctly by greater than 80% of participants. Risk of developing skin cancer was underestimated in 58 (40.3%) participants. Of all participants, 89 (62.2%) identified one or more barriers to practicing sun safety. The most common barrier was forgetfulness in 62 (43.4%) participants. The identification of barriers was significantly associated with reduced engagement of sun safety practices (p = 0.009). Conclusions Knowledge of sun safety among farmers was high. There was, however, underestimation of risk of developing skin cancer. Addressing perceived barriers to implementing sun safety could improve sun safety practices in this cohort.

“She’ll Be Right, Mate”: A Mixed Methods Analysis of Skin Cancer Prevention Practices among Australian Farmers—An At-Risk Group

“…Consistent with previous research [ 22 , 23 , 24 ], our findings suggest that Australian farmers are not adequately engaging with skin cancer prevention behaviours. Sunscreen use was the least frequently ‘always’ employed sun protection strategy; only 6.4% of farmers reported ‘always’ wearing sunscreen during the past summer, and 51.4% reported wearing sunscreen less than half of the time.…”

“…Despite the general success of these campaigns, research examining sun-protective behaviours among farmers suggests that the messages have not adequately engaged farming populations [ 11 , 22 , 23 , 24 ]. Farmers are known to be reluctant to prioritise preventive health [ 25 , 26 ], and despite Smit-Kroner and Brumby’s [ 11 ] finding that sunscreen was the most studied, most reported, and most promoted component of the SunSmart program, a number of studies show that farmers rarely use it [ 22 , 23 , 24 , 27 ].…”

“…Despite the general success of these campaigns, research examining sun-protective behaviours among farmers suggests that the messages have not adequately engaged farming populations [ 11 , 22 , 23 , 24 ]. Farmers are known to be reluctant to prioritise preventive health [ 25 , 26 ], and despite Smit-Kroner and Brumby’s [ 11 ] finding that sunscreen was the most studied, most reported, and most promoted component of the SunSmart program, a number of studies show that farmers rarely use it [ 22 , 23 , 24 , 27 ]. Farmers in Australia and internationally report a range of barriers to sun protection that are specific to their working conditions; discomfort wearing long-sleeved clothing in the heat, and dust and dirt sticking to sunscreen [ 22 , 27 , 28 , 29 ].…”

“…Farmers are known to be reluctant to prioritise preventive health [ 25 , 26 ], and despite Smit-Kroner and Brumby’s [ 11 ] finding that sunscreen was the most studied, most reported, and most promoted component of the SunSmart program, a number of studies show that farmers rarely use it [ 22 , 23 , 24 , 27 ]. Farmers in Australia and internationally report a range of barriers to sun protection that are specific to their working conditions; discomfort wearing long-sleeved clothing in the heat, and dust and dirt sticking to sunscreen [ 22 , 27 , 28 , 29 ]. Barriers may be further compounded by underestimation of skin cancer risk [ 22 , 30 , 31 ].…”

“…Farmers in Australia and internationally report a range of barriers to sun protection that are specific to their working conditions; discomfort wearing long-sleeved clothing in the heat, and dust and dirt sticking to sunscreen [ 22 , 27 , 28 , 29 ]. Barriers may be further compounded by underestimation of skin cancer risk [ 22 , 30 , 31 ]. More research is needed to gain a better understanding of Australian farmers’ engagement with sun-protective behaviours, including the specific factors that prevent, facilitate, and motivate them to make skin cancer prevention a priority.…”