title: A graded work site intervention program to improve sun protection and skin cancer awareness in outdoor workers in Israel.
abstract: OBJECTIVE
  A graded worksite intervention program to improve sun protection and skin cancer awareness of outdoor workers was implemented and evaluated longitudinally over a period of 20 months.
  
  
  METHODS
  Outdoor male workers (144/213 recruits) from geographically separated units of the Israel National Water Company were allocated to complete (n = 37), partial (n = 72) or minimal (n = 35) intervention groups. Subsequent to the assignment and training of local safety officers, an educational and medical screening package was provided to the corresponding groups either once, or repeatedly a year later. Personal sun protective gear was provided upon repeated intervention. Outcome measures were evaluated through self-response questionnaires administered prior to the first intervention pulse, and 8 months after the first and second interventions.
  
  
  RESULTS
  A 15-61% improvement in sun-protection habits was noted in the entire study population 8 months after initialization, compared to no sunscreen use, 20% sun-exposed skin area and highest mean occupational exposure dose of 1.68 MED/day at pre-test. An even greater use of sunscreen was evident 1 year later in the complete and partial intervention groups, + 80% and + 52%, respectively. The baseline rate of self-examination of the skin in the same two groups (49%) increased significantly at post-test (+ 71% and + 53%, respectively).
  
  
  CONCLUSIONS
  This integrated intervention program led to significantly improved sun protection and skin cancer awareness. Repeated intervention combined with the supply of sun-protective gear contributed to an even greater impact.
authors.affiliation: Department of Dermatology, The Chaim Sheba Medical Center, Tel Hashomer, Israel. esaz1@post.tau.ac.il
authors.forename: E
authors.initials: E
authors.lastname: Azizi
authors.forename: P
authors.initials: P
authors.lastname: Flint
authors.forename: S
authors.initials: S
authors.lastname: Sadetzki
authors.forename: A
authors.initials: A
authors.lastname: Solomon
authors.forename: Y
authors.initials: Y
authors.lastname: Lerman
authors.forename: G
authors.initials: G
authors.lastname: Harari
authors.forename: F
authors.initials: F
authors.lastname: Pavlotsky
authors.forename: A
authors.initials: A
authors.lastname: Kushelevsky
authors.forename: R
authors.initials: R
authors.lastname: Glesinger
authors.forename: E
authors.initials: E
authors.lastname: Shani
authors.forename: L
authors.initials: L
authors.lastname: Rosenberg
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D016009:Chi-Square Distribution; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007557:Israel; D008297:Male; D016273:Occupational Exposure / Q000517:prevention & control*; D016272:Occupational Health; D011322:Primary Prevention / Q000379:methods; D011481:Protective Clothing / Q000706:statistics & numerical data; D011835:Radiation Protection / Q000379:methods; D012044:Regression Analysis; D012878:Skin Neoplasms / Q000209:etiology / Q000517:prevention & control*; D013472:Sunlight / Q000009:adverse effects*; D013473:Sunscreening Agents / Q000627:therapeutic use
chemical_list: D013473:Sunscreening Agents