期刊论文详细信息
Implementation Science
Sun Safety at Work Canada: a multiple case-study protocol to develop sun safety and heat protection programs and policies for outdoor workers
D. Linn Holness1  Audrey Gardner3  Rivka Kushner2  Peter Strahlendorf3  Thomas Tenkate3  Desre M. Kramer2 
[1] St Michael’s Hospital, 30 Bond St., Toronto M5B 1W8, ON, Canada;Occupational Cancer Research Centre, Cancer Care Ontario, 3rd floor, 525 University Avenue, Toronto M5G 1X3, ON, Canada;School of Occupational and Public and Health, Ryerson University, 350 Victoria Street, Toronto M5B 2K3, ON, Canada
关键词: Occupational health and safety;    Case study design;    Implementation;    Workplace-based research;    Knowledge translation;    Solar UV;   
Others  :  1219597
DOI  :  10.1186/s13012-015-0277-2
 received in 2015-05-06, accepted in 2015-06-05,  发布年份 2015
PDF
【 摘 要 】

Background

CAREX Canada has identified solar ultraviolet radiation (UV) as the second most prominent carcinogenic exposure in Canada, and over 75 % of Canadian outdoor workers fall within the highest exposure category. Heat stress also presents an important public health issue, particularly for outdoor workers. The most serious form of heat stress is heat stroke, which can cause irreversible damage to the heart, lungs, kidneys, and liver. Although the need for sun and heat protection has been identified, there is no Canada-wide heat and sun safety program for outdoor workers. Further, no prevention programs have addressed both skin cancer prevention and heat stress in an integrated approach. The aim of this partnered study is to evaluate whether a multi-implementation, multi-evaluation approach can help develop sustainable workplace-specific programs, policies, and procedures to increase the use of UV safety and heat protection.

Methods/design

This 2-year study is a theory-driven, multi-site, non-randomized study design with a cross-case analysis of 13 workplaces across four provinces in Canada. The first phase of the study includes the development of workplace-specific programs with the support of the intensive engagement of knowledge brokers. There will be a three-points-in-time evaluation with process and impact components involving the occupational health and safety (OHS) director, management, and workers with the goal of measuring changes in workplace policies, procedures, and practices. It will use mixed methods involving semi-structured key informant interviews, focus groups, surveys, site observations, and UV dosimetry assessment. Using the findings from phase I, in phase 2, a web-based, interactive, intervention planning tool for workplaces will be developed, as will the intensive engagement of intermediaries such as industry decision-makers to link to policymakers about the importance of heat and sun safety for outdoor workers.

Discussion

Solar UV and heat are both health and safety hazards. Using an occupational health and safety risk assessment and control framework, Sun Safety at Work Canada will support workplaces to assess their exposure risks, implement control strategies that build on their existing programs, and embed the controls into their existing occupational health and safety system.

【 授权许可】

   
2015 Kramer et al.

【 预 览 】
附件列表
Files Size Format View
20150718091128123.pdf 10000KB PDF download
Fig. 11. 88KB Image download
Fig. 10. 101KB Image download
Fig. 9. 56KB Image download
Fig. 8. 208KB Image download
Fig. 7. 102KB Image download
Fig. 6. 184KB Image download
Fig. 5. 100KB Image download
Fig. 4. 79KB Image download
Fig 3. 112KB Image download
Fig. 2. 76KB Image download
Fig. 1. 106KB Image download
【 图 表 】

Fig. 1.

Fig. 2.

Fig 3.

Fig. 4.

Fig. 5.

Fig. 6.

Fig. 7.

Fig. 8.

Fig. 9.

Fig. 10.

Fig. 11.

【 参考文献 】
  • [1]World Health Organization. Skin cancers: how common is skin cancer. In: Ultraviolet radiation and the INTERSUN Programme; 2013. http://www.who.int/uv/faq/skincancer/en/index1.html. Accessed 29 March 2015.
  • [2]Canadian Cancer Society’s Advisory Committee on Cancer Statistics, Canadian Cancer Statistics 2014, Canadian Cancer Society, Editor 2014: Toronto. http://www.cancer.ca/~/media/cancer.ca/CW/cancer%20information/cancer%20101/Canadian%20cancer%20statistics/Canadian-Cancer-Statistics-2014-EN.pdf. Accessed 29 March 2015.
  • [3]Krueger H, Williams D, Chomiak M, Trenaman L. The economic burden of skin cancer in Canada: current and projected (final report). Toronto, Canada: Canadian Partnership Against Cancer; 2010. http://www.krueger.ca/downloads/skincancer.pdf. Accessed 29 March 2015.
  • [4]Adam-Poupart A, Lebreche F, Smargiassi A, Duguay P, Busque M-A, Gagne C et al.. Climate change and occupational health and safety in a temperate climate: potential impacts and research priorities in Quebec, Canada. Ind Health. 2013; 51:68-78.
  • [5]Elwood JM. Who gets skin cancer: individual risk factors. In: Prevention of skin cancer. Hill DJ, Elwood JM, English DR, editors. Kluwer Academic, Dordrecht; 2004: p.3-20.
  • [6]Staples M, Elwood M, Burton RC, Williams JL, Marks R, Giles GG. Non-melanoma skin cancer in Australia: the 2002 national survey and trends since 1985. Med J Aust. 2006; 184(1):6-10.
  • [7]Milon A, Bulliard J-L, Vuilleumier L, Danuser B, Vernez D. Estimating the contribution of occupational solar ultraviolet exposure to skin cancer. Br J Dermatol. 2014; 170:157-64.
  • [8]European Agency for Safety and Health at Work, Brun E. New and emerging risks in occupational health and safety. Luxembourg: European Agency for Safety and Health at Work; 2009. https://osha.europa.eu/en/publications/reports/TE3008390ENC_chemical_risks. Accessed 29 March 2015.
  • [9]Holman CDJ, Gibson IM, Stephenson M, Armstrong BK. Ultraviolet irradiation of human body sites in relation to occupation and outdoor activity: field studies using personal UVR dosimeters. Clin Exp Dermatol. 1983; 8:269-77.
  • [10]Gies P, Wright J. Measured solar ultraviolet radiation exposures of outdoor workers in Queensland in the building and construction industry. Photochem Photobiol. 2003; 78(4):342-8.
  • [11]Solar radiation-occupational estimate. 2012.
  • [12]Marrett LD, Pichora EC, Costa ML. Work-time sun behaviours among Canadian outdoor workers: results from the 2006 National Sun Survey. Can J Public Health. 2010; 101(4):119-22.
  • [13]Safe Work Australia. National hazard exposure worker surveillance: exposure to direct sunlight and the provision of sun exposure controls in Australian workplaces. Canberra: Commonwealth of Australia; 2010. http://www.safeworkaustralia.gov.au/sites/SWA/about/Publications/Documents/310/NationalHazardExposureWorkerSurveillance_Exposure_DirectSunlight_Provision_SunExposureControls_AustralianWorkplaces_2010_PDF.pdf. Accessed 29 March 2015.
  • [14]Peters CE, Nicol AM, Demers PA. Prevalence of exposure to solar ultraviolet radiation (UVR) on the job in Canada. Can J Public Health. 2012; 103(3):223-6.
  • [15]World Health Organization, INTERSUN: the global UV project: a guide and compendium. Geneva: World Health Organization; 2003. http://www.who.int/uv/publications/en/Intersunguide.pdf. Accessed 29 March 2015.
  • [16]Fioletov V, Kerr JV, Fergusson A. The UV index: definition, distribution and factors affecting it. Can J Public Health. 2010; 101(4):I5-9.
  • [17]Vecchia P, Hietanen M, Stuck B, van Deventer E, Niu S. Protecting workers from ultraviolet radiation. International Commission on Non-Ionizing Radiation Protection, Germany; 2007.
  • [18]Australian Radiation Protection and Nuclear Safety Agency. Radiation protection standard: occupational exposure to ultraviolet radiation. In Radiation Protection Series; 2006. http://www.arpansa.gov.au/pubs/rps/rps12.pdf. Accessed 29 March 2015.
  • [19]Australian Radiation Protection and Nuclear Safety Agency. Management plan for sun protection: supplementary Information. April 2010. http://www.arpansa.gov.au/pubs/rps/rps12_Supplementary_Information_Sun_Protection.pdf. Accessed 29 March 2015.
  • [20]Australian Government: Canberra. Australian Safety and Compensation Council. Guidance note for the protection of workers from the ultraviolet radiation in sunlight; 2008. http://www.safeworkaustralia.gov.au/sites/swa/about/publications/Documents/306/GuidanceNote_ProtectionOfWorkers_UltravioletRadiationInSunlight_2008_PDF.pdf. Accessed 29 March 2015.
  • [21]Cancer Council Victoria. Skin cancer and outdoor work: a guide for employers; 2009. http://www.cancer.org.au/content/pdf/PreventingCancer/BeSunsmart/Skincanceroutdoorworkbooklet.pdf. Accessed 29 March 2015.
  • [22]Girgis A, Sanson-Fisher RW, Watson A. A workplace intervention for increasing outdoor workers’ use of solar protection. Am J Public Health. 1994; 84(1):77-81.
  • [23]Shoveller JA, Lovato CY, Peters L, Rivers JK. Canadian national survey on sun exposure and protective behaviours: outdoor workers. Can J Public Health. 2000; 91(1):34-5.
  • [24]Stepanski BM, Mayer JA. Solar protection behaviors among outdoor workers. J Occup Environ Med. 1998; 40(1):43-8.
  • [25]Kearney GD, Lea CS, Balanay J, Wu Q, Bethel JW, Von Hollen H et al.. Assessment of sun safety behavior among farmers attending a regional farm show in North Carolina. J Agromedicine. 2013; 18:65-73.
  • [26]Duffey SA, Choi SH, Hollern R, Ronis DL. Factors associated with risk sun exposure behaviors among operating engineers. Am J Ind Med. 2012; 55:786-92.
  • [27]Nahar VK, Ford MA, Hallam JS, Bass MA, Hutcheson A, Vice MA. Skin cancer knowledge, beliefs, self-efficacy, and preventative behaviors among North Mississippi landscapers. Dermatol Res Pract. 2013.
  • [28]Carey RN, Glass DC, Peters S, Reid A, Benke G, Driscoll TR, Fritschi L. Occupational exposure to solar radiation in Australia: who is exposed and what protection do they use? Aust N Z J Public Health. 2014; 38(1):54-9.
  • [29]Borland RM, Hocking B, Godhin GA. The impact of a skin cancer control education package for outdoor workers. Med J Aust. 1991; 154:686-8.
  • [30]Lewis EC, Mayer JA, Slymen D. Postal workers’ occupational and leisure time sun safety behaviors (United States). Cancer Causes Control. 2006; 17:181-6.
  • [31]Pichon LC, Mayer JA, Slymen DJ, Elder JP, Lewis EC, Galindo GR. Ethnoracial differences among outdoor workers in key sun-safety behaviors. Am J Prev Med. 2005; 28(4):374-8.
  • [32]Salas R, Mayer JA, Hoerster KD. Sun-protective behaviors of Californian farm workers. J Occup Environ Med. 2005; 47:1244-9.
  • [33]National Sun Safety Committee, Primary Prevention Action Group, Canadian Strategy for Cancer Control. Strategic directions for the primary prevention of skin cancer in Canada. January 2006. http://www.saskcancer.ca/Strategic%20Directions. Accessed 29 March 2015.
  • [34]Ontario Sun Safety Working Group. Insight on cancer: sun exposure and protective behaviours in Ontario. An Ontario report based on the 2006 second national sun survey. Canadian Cancer Society, Ontario Division; Toronto; 2010. https://www.cancercare.on.ca/common/pages/UserFile.aspx?fileId=87528. Accessed 29 March 2015.
  • [35]Ministry of Labour. Health and safety guidelines: heat stress. 2008; Revised June 2014. http://www.labour.gov.on.ca/english/hs/pubs/gl_heat.php. Accessed 29 March 2015.
  • [36]Morioka I, Miyai N, Miyashita K. Hot environment and health problems of outdoor workers at a construction site. Ind Health. 2006; 44:474-80.
  • [37]Stoecklin-Marios M, Hennessy-Burt T, Mitchell D, Schenker M. Heat-related illness knowledge and practices among California hired farm workers in the MICASA study. Ind Health. 2013; 51:47-55.
  • [38]Sinclair WH, Brownsberger JC. Wearing long pants while working outdoors in the tropics does not yield higher body temperatures. Aust N Z J Public Health. 2013; 37(1):70-5.
  • [39]de Vries E, Arnold M, Altsitsiadis E, Trakatelli M, Hinrichs B, Stockfleth E. Potential impact of interventions resulting in reduced exposure to ultraviolet (UV) radiation (UVA and UVB) on skin cancer incidence in four European countries, 2010–2050. Br J Dermatol. 2012; 167 Suppl 2:53-62.
  • [40]Canadian Partnership Against Cancer, Chappell H, Kerner J, Parker C. Literature review of evidence-based strategies and practices in promoting skin cancer prevention, Canadian Partnership Against Cancer. Toronto: Canadian Health Research Collection; 2009. Accessed 29 March 2015.
  • [41]Saraiya M, Glanz K, Briss PA, Nichols P, White C, Das D et al.. Interventions to prevent skin cancer by reducing exposure to ultraviolet radiation: a systematic review. Am J Prev Med. 2004; 27(5):422-66.
  • [42]Community Preventive Services Task Force, 2012 Annual Report to Congress. Community Preventive Services Task Force, Washington, D.C. 2012. http://www.thecommunityguide.org/annualreport/2012-congress-report-full.pdf. Accessed 29 March 2015.
  • [43]Community Preventive Services Task Force: Guide to Community Preventive Services. Preventing skin cancer: interventions in outdoor occupational settings. August 2013. http://thecommunityguide.org/cancer/skin/education-policy/outdooroccupations.html. Accessed 29 March 2015.
  • [44]Glanz K, Buller DB, Saraiya M. Reducing ultraviolet radiation exposure among outdoor workers: state of the evidence and recommendations. Environ Health. 2007; 6(22):1-11.
  • [45]Kutting B, Drexler H. UV-induced skin cancer at workplace and evidence-based prevention. Int Arch Occup Environ Health. 2010; 83:843-54.
  • [46]Horsham C, Auster J, Sendall MC, Stoneham M, Youl P, Crane P et al.. Interventions to decrease skin cancer risk in outdoor workers. Update to a 2007 systematic review. BMC Res Notes. 2014; 7:10. BioMed Central Full Text
  • [47]Reinau D, Weiss M, Meier CR, Diepgen TL, Surber C. Outdoor workers’ sun-related knowledge, attitudes and protective behaviours: a systematic review of cross-sectional and interventional studies. Br J Dermatol. 2013; 168:928-40.
  • [48]Hale AR, Guldenmund FW, van Loenout PLCH, Oh JIH. Evaluating safety management and culture interventions to improve safety: effective intervention strategies. Safety Sci. 2010; 48:1026-35.
  • [49]Reeder AI, Gray A, McCool JP. Occupational sun protection: workplace culture, equipment provision and outdoor workers’ characteristics. J Occup Health. 2013; 55:84-97.
  • [50]Geller AC, Glanz K, Shigaki D, Isnec MR, Sun T, Maddock J. Impact of skin cancer prevention on outdoor aquatics staff: the Pool Cool program in Hawaii and Massachusetts. Prev Med. 2001; 33(3):155-61.
  • [51]Hanrahan PF, Hersey P, Watson AB, Callaghan TM. The effect of an educational brochure on knowledge and early detection of melanoma. Aust N Z J Public Health. 1995; 19(3):270-4.
  • [52]Buller DB, Andersen PA, Walkosz BJ, Scott MD, Cutter GR, Dignan MB et al.. Randomised trial testing a worksite sun protection program in an outdoor recreation industry. Health Educ Behav. 2005; 32(4):514-35.
  • [53]Mayer JA, Slymen DJ, Clapp EJ, Pichon LC, Eckhardt L, Eichenfield LF et al.. Promoting sun safety among US Postal Service letter carriers: impact of a 2-year intervention. Am J Public Health. 2007; 97(3):559-65.
  • [54]Glanz K, Maddock JE, Lew RA, Murakami-Akatsuka L. A randomized trial of the Hawaii SunSmart program's impact on outdoor recreation staff. J Am Acad Dermatol. 2001; 44(6):973-8.
  • [55]Mayer JA, Slymen DJ, Clapp E, Pichon L, Elder J, Sallis J et al.. Long-term maintenance of a successful occupational sun safety initiative. Arch Dermatol. 2009; 145(1):88-9.
  • [56]Oh SS, Mayer JA, Lewis E, Slymen D, Sallis J, Elder J et al.. Validating outdoor workers’ self-report of sun protection. Prev Med. 2004; 39:798-803.
  • [57]Andersen PA, Buller D, Walkosz B, Maloy J, Scott M, Cutter G, Dignan M. Testing a theory-based health communication program: a replication of Go Sun Smart in outdoor winter recreation. J Health Commun. 2009; 14:346-65.
  • [58]Buller DB, Andersen P, Walkosz B, Scott M, Cutter G, Dignan M, Kane I, Zhang X. Enhancing industry-based dissemination of an occupational sun protection program with theory-based strategies employing personal contact. Am J Health Prom. 2012; 26(6):356-65.
  • [59]Buller DB, Andersen P, Walkosz B, Scott M, Maloy J, Dignan M, Cutter G. Compliance with sunscreen advice in a survey of adults engaged in outdoor winter recreation at high-elevation ski areas. J Am Acad Dermatol. 2012; 66:63-70.
  • [60]Buller DB, Walkosz B, Andersen P, Scott M, Dignan M, Cutter G, Zhang X, Kane I. Sustainability of the dissemination of an occupational sun protection program in a randomized trial. Health Educ Behav. 2012; 39(4):498-502.
  • [61]Walkosz BJ, Buller D, Andersen P, Scott M, Dignan M, Cutter G, Maloy J. Increasing sun protection in winter outdoor recreation: a theory-based health communication program. Am J Prev Med. 2008; 34(6):502-9.
  • [62]Escofferey C, Glanz K, Hall D, Elliot T. A multi-method process evaluation for a skin cancer prevention diffusion trial. Eval Health Prof. 2009; 32(2):184-203.
  • [63]Glanz K, Steffen A, Elliot T, O’riordan DL. Diffusion of an effective skin cancer prevention program: design, theoretical foundations, and first-year implementation. Health Psychol. 2005; 24(5):477-87.
  • [64]Hall DM, McCarthy F, Elliot T, Glanz K. Lifeguards’ sun protection habits and sunburns. Arch Dermatol. 2009; 145(2):139-44.
  • [65]Hiemstra M, Glanz K, Nehl E. Changes in sunburn and tanning attitudes among lifeguards over a summer season. J Am Acad Dermatol. 2012; 66(3):430-7.
  • [66]Rabin BA, Elliot T, Deshpande A, Brownson R, Glanz K. Individual and setting level predictors of the implementation of a skin cancer prevention program: a multilevel analysis. Implement Sci. 2010; 5(40):1-13.
  • [67]Rye S, Janda M, Stoneham M, Crane P, Sendall M, Youl P, Tenkate T, Baldwin L, Perina H, Finch L, Kimlin M. Changes in outdoor workers’ sun-related attitudes, beliefs, and behaviors. J Occup Environ Med. 2014; 56(9):e62-72.
  • [68]Janda M, Stoneham M, Youl P, Crane P, Sendall MC, Tenkate T, Kimlin M. What encourages sun protection among outdoor workers from four industries? J Occup Health. 2014; 56:62-72.
  • [69]Creswell JW. Research design: qualitative, quantitative, and mixed methods approaches. 2nd ed. Sage Publications, Thousand Oaks; 2003.
  • [70]Kramer DM, Cole DC. Sustained, intensive engagement to promote health and safety knowledge transfer to and utilization by workplaces. Sci Commun. 2003; 25(1):56-82.
  • [71]Kramer D, Cole D, Leithwood K. Doing knowledge transfer: engaging management and labor with research on employee health and safety. Bull Sci Technol Soc. 2004; 24:316-30.
  • [72]Allen P, Sequeira S, Jacob RR, Hino AA, Stamatakis KA, Harris JK, Brownson RC. Promoting state health department evidence-based cancer and chronic disease prevention: a multi-phase dissemination study with a cluster randomized trial component. Implement Sci. 2013; 8(1):141. BioMed Central Full Text
  • [73]Harris JR, Cheadle A, Hannon PA, Forehand M, Licheillo P, Mahoney S, et al. A framework for disseminating evidence-based health promotion practices. Prev Chronic Dis. 2012;9.
  • [74]Kramer DM, Wells R, Carlan N, Aversa T, Bigelow P, Dixon S, McMillan K. Did you have an impact? A theory-based method for planning and evaluation knowledge-transfer and exchange activities in occupational health and safety. Int J Occup Safety Ergonomics. 2013; 19–1:41-62.
  • [75]Prochaska JM, Prochaska JO, Levesque DA. A transtheoretical approach to changing organizations. Adm Policy Mental Health. 2001; 28(4):247-61.
  • [76]Shea CM, Jacobs SR, Esserman DA, Bruce K, Weiner BJ. Organizational readiness implementing change: a psychometric assessment of a new measure. Implement Sci. 2014; 9:7. BioMed Central Full Text
  • [77]Weiner B. A theory of organizational readiness for change. Implement Sci. 2009; 4:6. BioMed Central Full Text
  • [78]Dobbins M, Robeson P, Ciliska D, Hanna S, Cameron R, O’Mara L et al.. A description of a knowledge broker role implemented as part of a randomized controlled trial evaluating three knowledge translation strategies. Implement Sci. 2009; 4:23. BioMed Central Full Text
  • [79]Meyer M. The rise of the knowledge broker. Sci Commun. 2010; 32(1):118-27.
  • [80]Greenhalgh T, Robert G, Macfarlane F, Bate P, Kyriakidou O. Diffusion of innovations in service organizations: systematic review and recommendations. Milbank Q. 2004; 82(4):581-629.
  • [81]Yin R. Case study research: design and methods. 5th ed. Sage, Thousand Oaks, CA; 2014.
  文献评价指标  
  下载次数:21次 浏览次数:7次