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      Outdoor workers’ perceptions of skin cancer risk and attitudes to sun‐protective measures: A qualitative study

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          Abstract

          Objectives

          Since January 2015, squamous cell carcinoma or multiple actinic keratosis of the skin caused by natural ultraviolet irradiation (UVR) is recognized as occupational disease in Germany. Interventions which improve the sun protection behavior of outdoor workers are urgently needed. When developing preventive interventions, the attitudes of target groups need to be taken into consideration. Therefore, outdoor workers’ perceptions and attitudes were investigated.

          Methods

          Seven guided, problem‐centered qualitative interviews with healthy male outdoor workers were conducted. A qualitative content analysis was used to analyze the data.

          Results

          We found an underestimation of the perceived skin cancer risk in the seven outdoor workers and heterogeneous attitudes toward the usage of sun‐protective measures. Participants stated that the feasibility of technical sun‐protective measures depends on the size of the working area. While using a headgear seemed common, none of the participants stated using additional neck protection. Wearing long‐sleeved shirts and long trousers were considered problematic. The interviews revealed important requirements for sun‐protective clothes, especially in terms of different materials. Although the usage of sunscreen was common, our interviewees seemed to apply it wrongly.

          Conclusion

          Risk perceptions of outdoor workers and their attitudes toward sun protection measures may influence the factual UV protection behavior in the workplace. Structures to facilitate the implementation of technical and organizational sun‐protective measures seem to be necessary. Educational interventions and clear instructions which are tailored to the individual needs and attitudes of outdoor workers are required to improve the UV protection behavior and to avoid common mistakes.

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          Most cited references45

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          A systematic review of worldwide incidence of nonmelanoma skin cancer.

            Nonmelanoma skin cancer (NMSC) is the most common cancer affecting white-skinned individuals and the incidence is increasing worldwide. This systematic review brings together 75 studies conducted over the past half century to look at geographical variations and trends worldwide in NMSC, and specifically incidence data are compared with recent U.K. cancer registry data. Following the development of a comprehensive search strategy, an assessment tool was adapted to look at the methodological quality of the eligible studies. Most of the studies focused on white populations in Europe, the U.S.A. and Australia; however, limited data were available for other skin types in regions such as Africa. Worldwide the incidence for NMSC varies widely with the highest rates in Australia [>1000/100, 000 person-years for basal cell carcinoma (BCC)] and the lowest rates in parts of Africa (< 1/100, 000 person-years for BCC). The average incidence rates in England were 76·21/100, 000 person-years and 22·65/100, 000 person-years for BCC and squamous cell carcinoma (SCC), respectively, with highest rates in the South-West of England (121·29/100, 000 person-years for BCC and 33·02/100, 000 person-years for SCC) and lowest rates by far in London (0·24/100, 000 person-years for BCC and 14·98/100, 000 person-years for SCC). The incidence rates in the U.K. appear to be increasing at a greater rate when compared with the rest of Europe. NMSC is an increasing problem for health care services worldwide. This review highlights a requirement for prevention studies in this area and the issues surrounding incomplete NMSC registration. Registration standards of NMSC should be improved to the level of other invasive disease. © 2012 The Authors. BJD © 2012 British Association of Dermatologists.
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            Is Open Access

            Qualitative Content Analysis

            The article describes an approach of systematic, rule guided qualitative text analysis, which tries to preserve some methodological strengths of quantitative content analysis and widen them to a concept of qualitative procedure. First the development of content analysis is delineated and the basic principles are explained (units of analysis, step models, working with categories, validity and reliability). Then the central procedures of qualitative content analysis, inductive development of categories and deductive application of categories, are worked out. The possibilities of computer programs in supporting those qualitative steps of analysis are shown and the possibilities and limits of the approach are discussed. URN: urn:nbn:de:0114-fqs0002204 Forum Qualitative Sozialforschung / Forum: Qualitative Social Research, Vol 1, No 2 (2000): Qualitative Methods in Various Disciplines I: Psychology
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              Reaching the parts other methods cannot reach: an introduction to qualitative methods in health and health services research.

              C Pope, N Mays (1995)
              Qualitative research methods have a long history in the social sciences and deserve to be an essential component in health and health services research. Qualitative and quantitative approaches to research tend to be portrayed as antithetical; the aim of this series of papers is to show the value of a range of qualitative techniques and how they can complement quantitative research.
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                Author and article information

                Contributors
                mrocholl@uni-osnabrueck.de
                Journal
                J Occup Health
                J Occup Health
                10.1002/(ISSN)1348-9585
                JOH2
                Journal of Occupational Health
                John Wiley and Sons Inc. (Hoboken )
                1341-9145
                1348-9585
                02 September 2019
                Jan-Dec 2020
                : 62
                : 1 ( doiID: 10.1002/joh2.v62.1 )
                : e12083
                Affiliations
                [ 1 ] Department of Dermatology, Environmental Medicine and Health Theory Institute for Health Research and Education University of Osnabrück Osnabrück Germany
                [ 2 ] Institute for Interdisciplinary Dermatological Prevention and Rehabilitation at the University of Osnabrück Osnabrück Germany
                [ 3 ] Public Health and Health Education University of Education Freiburg Freiburg im Breisgau Germany
                Author notes
                [*] [* ] Correspondence

                Marc Rocholl, Am Finkenhügel 7a, 49076 Osnabrück, Germany.

                Email: mrocholl@ 123456uni-osnabrueck.de

                Author information
                https://orcid.org/0000-0002-6584-0161
                https://orcid.org/0000-0003-1214-1399
                Article
                JOH212083
                10.1002/1348-9585.12083
                6970388
                31478315
                1b77c40d-181a-4b64-8dd5-816896de91f9
                © 2019 The Authors. Journal of Occupational Health published by John Wiley & Sons Australia, Ltd on behalf of The Japan Society for Occupational Health

                This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

                History
                : 12 March 2019
                : 11 July 2019
                : 13 August 2019
                Page count
                Figures: 0, Tables: 3, Pages: 9, Words: 6602
                Categories
                Original Article
                Original Articles
                Custom metadata
                2.0
                January/December 2020
                Converter:WILEY_ML3GV2_TO_JATSPMC version:5.7.5 mode:remove_FC converted:20.01.2020

                attitude,germany,occupational health,qualitative research,sunscreening agents

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