A holistic approach to managing workplace exposure to solar UV
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- There are health benefits and risks associated with both too much and too little UV exposure from the sun. Managing this requires a nuanced approach. - Workers should aim to get some sun exposure daily in summer to maintain sufficient vitamin D levels, while avoiding sunburn and limiting exposure to minimize skin cancer risk. - Employers can help by monitoring personal UV exposure and vitamin D levels, providing shade and protective equipment, and using behavioral interventions like phone messages to influence positive sun safety habits.
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A holistic approach to managing workplace exposure to solar UV
- 1. A holistic approach to managing workplace exposure to solar UV John Cherrie
- 2. Summary… • Solar UV causes skin cancer • Too little UV exposure can cause health issues –Reduced vitamin D synthesis –Increased risk of breast, ovarian and colorectal cancer • Managing health risks requires a nuanced approach • Workplace behaviour management – Targeted sun-safety messages to the mobile phones • Increased use of real-time UV monitors • Biomonitoring for vitamin D to ensure sufficient UV exposure
- 3. Ultra-violet light… Don’t penetrate the ozone layer Cause of skin reddening and sunburn, tends to damage the skin's more superficial epidermal layers Penetrates the skin more deeply than UVB, play a major part in skin ageing (photoaging)
- 4. Measurement of UV exposure… • Accurate fixed location measurements with a radiometer • Personal exposure – Polysulphone film (PSF) – Electronic detectors • Measurement frequency weighted to erythemal action spectrum • Expressed as Standard Erythemal Dose (1 SED = 100 J/m2) • The ICNIRP guideline corresponds to between 1.0 and 1.33 SED per day
- 5. Use of personal UV monitors… • Employers should measure worker UV exposure to better manage risk • Best to locate monitor on the upper arm
- 6. Use of personal UV monitors… • Employers should measure worker UV exposure to better manage risk • Best to locate monitor on the upper arm
- 7. Skin cancer… • The main cause of skin cancers is UV radiation • Malignant melanoma • Non-melanoma skin cancer (NMSC) – Squamous cell carcinoma (SCC) – Basal cell carcinoma (BCC) Malignant melanoma
- 8. Melanoma and other skin cancer deaths per million persons Source: WHO 2012
- 9. NMSC exposure-response… Schmitt et al. Br J Dermatol 2018;178:e161–1. Schmitt et al. J Occup Environ Med 2018;60:36– 43.
- 10. Insufficient UV exposure… • Recent epidemiology has shown: – Vitamin D supplements do not reduce cancer risks – Good evidence for reduced risks for breast, ovarian and colorectal cancer and possibly other cancers linked to solar UV exposure – The reduced risks are not due to greater vitamin D (measured as 25(OH)D in blood), i.e. some other pathway must be responsible • Plus, there are other impacts on bone and psychological health Cherrie JW and Cherrie M. (2022)Workplace exposure to UV radiation and strategies to minimise cancer risk. British Medical Bulletin.
- 11. Advice about control… • Wear long-sleeved top and long trousers • Wear a hat with a brim or a flap that covers the ears and neck • If possible, keep in the shade • Use sunscreen with a high protection factor https://www.hse.gov.uk/skin/employ/sunprotect.htm https://www.cancercouncil.com.au/cancer-prevention/sun-protection/workplaces-and-sun-protection/
- 12. Balance… Too much UV, e.g. causes sun burn, skin cancer Too little UV, e.g. creates vitamin D insufficiency, probably increases risk for some cancers
- 13. Targeted sun-safety messages… • We have trialed using daily messages to the cell phones of construction workers … supported with a smartphone app • We had limited success.. – Knowledge of sun safety increased – The interventions had a significant positive effect on desirable behaviours for Vitamin D and sun safety – No effect on UV exposure – The desire for a sun-tan was strong
- 14. Importance of worker psychological profile… • Most workers were initially in the Contemplation stage and by the end they had progressed to the Preparation stage • Stage of change predicted consumption of Vitamin D supplements but not UV exposure
- 15. Importance of worker psychological profile… • Theory of Planned Behaviour (TPB)… – Questionnaire – Model explained 49% of the variance in expressed sun- safety behaviour
- 16. A more holistic approach to sun safety… • Employers need to take ownership of the problem – Providing health protection and health promotion • All workers should be encouraged to get sun exposure to ensure they have sufficient vitamin D, year around – The necessary duration of exposure varies by skin colour • Workers should be encouraged to avoid sunburn
- 17. Biomonitoring for vitamin D… • Monitor serum vitamin D at the end of Summer (September) to ensure that workers reach around 80.5 nmol/l to maintain 25(OH)D over 25 nmol/l levels through the winter • At least 30-min sun exposure around midday (fair skin) to around 90-min (brown skin) • Indoor workers should go outdoors
- 18. Summary… • There are health benefits and harms from UV exposure • All workers should have some sun exposure every day during summer – Serum vitamin D is a good biomarker of exposure • No worker should suffer sunburn – Exposure should be restricted to minimize skin cancer risk • Attitudes, norms and perceived ability to act determine behaviour and exposure • Phone messages can be used to influence worker behaviour
- 19. Thanks… The research was funded by IOSH and was undertaken collaboratively by the IOM and Heriot Watt University This presentation has been designed using resources from PoweredTemplate.com Nioi A, Wendelboe-Nelson C, Cowan S, Cherrie M, Rashid S, Cowie H, et al. Nudging construction workers towards better sun-safety behaviour: summary of the evidence for practitioners. Policy and Practice in Health and Safety. 2020;18(1):25-33. Cherrie JW, Nioi A,Wendelboe-Nelson C, Cowan S, Cherrie M, Rashid S, et al. Exposure to Solar UV During Outdoor ConstructionWork in Britain. AnnWork Expo Health. 2021;65(2):176-82. Lansdown TC, Cowan S, Nioi A, Cowie H, Wendelboe-Nelson C, Rashid S, et al. Vitamin D and UV exposure in construction workers-a randomized control trial using text messaging to promote positive behaviours. J Public Health. 2019;116(4):536-8. Cherrie JW andCherrie M. (2022)Workplace exposure to UV radiation and strategies to minimise cancer risk. British Medical Bulletin.
Editor's Notes
- Holistic in the sense of combining Health protection and health promotion. And in brining together exposure science, including new uses of sensors, and occupational psychology
- Make the point that we should be using sensors more
- Make the point that we should be using sensors more
- Yin-yang Health protection and health promotion, combined
- Pre-contemplation: lack of awareness of risk Contemplation: considering making behavioural changes Preparation: getting ready to take actual steps to change behaviour Action: changing behaviour to mediate risks Maintenance: ensure ongoing behavioural change
- • Attitudes are the degree of favourableness and unfavourableness of an individual’s feeling towards performing a particular behaviour. • Subjective Norms (SNs) are the individual’s perception of the likelihood that the group or individuals may approve or disapprove of performing the given behaviour. • Perceived Behavioural Control (PBC) is an individual’s perception of the ease or difficulty in performing the behaviour of interest. At pre-intervention, the three predictors accounted for 49% of the variance in the expressed Behavioural Intention, and the overall model significantly predicted Intentions to take sun protective measures (F(3,57) = 18.48, p<0.0001). All three predictors made significant contributions. In decreasing order from strongest to weakest, these were SNs, Attitudes and PCBs