Occupational sun protection: workplace culture, equipment provision and outdoor workers' characteristics.

OBJECTIVES The aim of this study was to describe outdoor workers' sun-protective practices, workplace sun-safety culture and sun-protective equipment provision; investigate the association of demographic, personal and occupational factors with sun-protective practices; and identify potential strategies for improving workers' sun protection. METHODS The present study used a clustered survey design with randomly identified employers in nine occupations. Employees provided questionnaire measures of demographics, personal characteristics (skin type, skin cancer risk perceptions, tanning attitudes, sun-exposure knowledge), personal occupational sun protection practices (exposure reduction, use of sun-protective clothing, sunscreen and shade), workplace sun-protective equipment provision and perceived workplace sun-safety culture. Summative scores were calculated for attitudes, knowledge, workplace provision and culture. A multivariable model was built with worker and workplace variables as plausible predictors of personal sun protection. RESULTS In this study, 1,061 workers (69% participation) from 112 workplaces provided sufficient information for analysis. Sex, age, prioritized ethnicity, education and risk perception differed significantly between occupational groups (p<0.001), as did workers' sun-protective practices and workplace sun-protection equipment provision and supportive culture. After adjustment, each one-point increase in Workplace Sun-safety Culture 2013Score (range 12 points) was associated with a 0.16 higher Personal Sun-Protection Score (p<0.001), and each one-point increase in Workplace Provision Score (range 4 points) was associated with a 0.14 higher score (p<0.001). Sun Protection Score was significantly associated with skin response to sun exposure (p<0.001), female sex (p=0.021), tanning attitudes (p=0.022) and occupation (p=0.049), but not ethnicity, age education, knowledge or skin cancer risk perception. CONCLUSIONS Protective equipment provision and sun-protective workplace culture are promising components for the development of comprehensive programmes to improve outdoor workers' sun-protective practices.