Research Article
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Determination of Skin Cancer Risk Levels, Risk Perceptions, and Knowledge and Behaviors of Agricultural Workers

Year 2022, Volume: 25 Issue: 4, 268 - 273, 29.12.2022
https://doi.org/10.5152/JANHS.2022.937272

Abstract

Objective: This study was conducted to determine skin cancer risk perceptions, risk levels, and
sun protection knowledge and behaviors of agricultural workers.

Methods: The research was a descriptive type. It was made in Kumluca District, Antalya Province,
between March and July 2015. The sample included 415 individuals working in agriculture. The
data were collected by face-to-face interview method. Descriptive statistics, chi-square analysis, Mann–Whitney U-test, Kruskal–Wallis H test, and correlation analysis were used to evaluate
the data.

Results: At the end of the study, it was determined that 25.5% of agricultural workers were at
high risk, but that 50.8% did not consider themselves at risk for skin cancer. The mean knowledge score of participants was 6.40 ± 2.17, and the mean behavior score was 9.11 ± 4.92. The variables that significantly affect both knowledge and behavior mean scores are as follows: secondary
school and above education level, female gender, high risk perception, being under age of 30, and
working for less than 10 years. A weak positive relationship was found between the participants’
mean knowledge and behavior scores.


Conclusion:
Our study results showed that the skin cancer risk perception and sun protection
knowledge and behaviors of agricultural workers were low. It was determined that individuals at
young ages, with middle school education level and above, and working for less than 10 years had
higher risk perception and knowledge and behavior scores. Within the scope of these results, it
was recommended to organize training and screening programs for skin cancer and sun protection, especially for individuals with high risk levels and low knowledge, behavior, and risk perception levels.

References

  • 1. de Graaf L, Talibov M, Boulanger M, et al. Health of greenspace workers: morbidity and mortality data from the AGRICAN cohort. Environ Res. 2022;212(C):113375. [CrossRef]
  • 2. International Agency for Research on Cancer (IARC). Radiation volume 100 D. A study on man. Lyon: WHO Press; 2012. Available at: http://monographs.iarc.fr/ENG/Monographs/vol100D/mono100D.pdf. Accessed 26 Feb 2022.
  • 3. Rushton L, J Hutchings S. The burden of occupationally-related cutaneous malignant melanoma in Britain due to solar radiation. Br J Cancer. 2017;116(4):536-539. [CrossRef]
  • 4. World Health Organization. How common is skin cancer? Radiation: Ultraviolet Radiation (UV) and Skin Cancer; 2020. Available at: https://www.who.int/news-room/q-a-detail/radiation-ultraviolet-(uv)-radiation-and-skin-cancer#.
  • 5. World Health Organization. The Global Cancer Observatory, Turkey Globocan; 2020. Available at: https://gco.iarc.fr/today/data/factsheets/populations/792-turkey-fact-sheets.pdf.
  • 6. Baş Y, Erenler BH, Güney G, et al. Distribution of cancer cases between January 01, 2014 and December 30, 2016 in Çorum City, Turkey. Turk J Oncol. 2017;32(4):153-159.
  • 7. Togawa K, Leon ME, Lebailly P, et al. Cancer incidence in agricultural workers: findings from an international consortium of agricultural cohort studies (AGRICOH). Environ Int. 2021;157:106825. [CrossRef]
  • 8. Zhao G, Ronda E, Cea L, Pulido J, Barrio G, Regidor E. Mortality by cause of death and risk behaviors in farmers versus non-farmers: the importance of avoiding the healthy worker effect. Int Arch Occup Environ Health. 2019;92(4):599-608. [CrossRef]
  • 9. Trakatelli M, Barkitzi K, Apap C, Majewski S, De Vries ED, EPIDERM group. Skin cancer risk in outdoor workers: a European multicenter case-control study. J Eur Acad Dermatol Venereol. 2016;30(3):5-11. [CrossRef]
  • 10. Juzeniene A, Grigalavicius M, Baturaite Z, Moan J. Minimal and maximal incidence rates of skin cancer in Caucasians estimated by use of sigmoidal UV dose-incidence curves. Int J Hyg Environ Health. 2014;217(8):839-844. [CrossRef]
  • 11. McCool JP, Reeder AI, Robinson EM, Petrie KJ, Gorman DF. Outdoor workers’ perceptions of the risks of excess sun-exposure. J Occup Health. 2009;51(5):404-411. [CrossRef]
  • 12. Hammond V, Reeder AI, Gray AR, Bell ML. Are workers or their workplaces the key to occupational sun protection? Health Promot J Austr. 2008;19(2):97-101. [CrossRef]
  • 13. Kearney GD, Lea CS, Balanay J, et al. Assessment of sun safety behavior among farmers attending a regional farm show in North Carolina. J Agromedicine. 2013;18(1):65-73. [CrossRef]
  • 14. Dag S, Hisar F. Determination of knowledge and applications of workers working out in the open about skin cancer. TAF Prev Med Bull. 2016;15(6):532-536. [CrossRef]
  • 15. Reeder AI, Gray A, McCool JP. Occupational sun protection: workplace culture, equipment provision and outdoor workers’ characteristics. J Occup Health. 2013;55(2):84-97. [CrossRef]
  • 16. Robinson JD, Silk KJ, Parrott RL, Steiner C, Morris SM, Honeycutt C. Healthcare providers’ sun-protection promotion and at-risk clients’ skin-cancer-prevention outcomes. Prev Med. 2004;38(3):251-257. [CrossRef]
  • 17. Malak AT, Yildirim P, Yildiz Z, Bektas M. Effects of training about skin cancer on farmers’ knowledge level and attitudes. Asian Pac J Cancer Prev. 2011;12(1):117-120.
  • 18. Carley A, Stratman E. Skin cancer beliefs, knowledge, and prevention practices: a comparison of farmers and nonfarmers in a midwestern population. J Agromedicine. 2015;20(2):85-94. [CrossRef]
  • 19. Aygun O, Ergun A. Validity and reliability of sun protection behavior scale among Turkish adolescent population. Asian Nurs Res. 2015;9(3):235-242. [CrossRef]
  • 20. Janda M, Stoneham M, Youl P, et al. What encourages sun protection among outdoor workers from four industries? J Occup Health. 2014;56(1):62-72. [CrossRef]
  • 21. Buster KJ, You Z, Fouad M, Elmets C. Skin cancer risk perceptions: a comparison across ethnicity, age, education, gender, and income. J Am Acad Dermatol. 2012;66(5):771-779. [CrossRef]
  • 22. Jeihooni AK, Rakhshani T. The effect of educational intervention based on health belief model and social support on promoting skin cancer preventive behaviors in a sample of Iranian farmers. J Cancer Educ. 2019;34(2):392-401. [CrossRef]
  • 23. Gaetano DE, Hodge B, Clark A, Ackerman S, Burdick P, Cook ML. Preventing skin cancer among a farming population: implementing evidence-based interventions. AAOHN J. 2009;57(1):24-31; quiz 32. [CrossRef]
  • 24. Woods CE, O’Shea E, Barrett F, Bookallil L, East L, Usher K. Occupational exposure: rural Australian farmers’ sun-protective behaviours. J Public Health (Berl.). 2020;28(6):675-684. [CrossRef]
  • 25. Susitaival P, Beckman R, Samuels SJ, Schenker MB. Self-reported dermatitis and skin cancer in California farm operators. Am J Ind Med. 2004;46(2):136-141. [CrossRef]
  • 26. Carpenter WS, Lee BC, Gunderson PD, Stueland DT. Assessment of personal protective equipment use among midwestern farmers. Am J Ind Med. 2002;42(3):236-247. [CrossRef]
  • 27. Rocholl M, Ludewig M, John SM, Bitzer EM, Wilke A. Outdoor workers’ perceptions of skin cancer risk and attitudes to sun-protective measures: a qualitative study. J Occuppational Health. 2020;62(1):1-9.
  • 28. D’Souza C, Kramadhari N, Skalkos E, Dutton T, Bailey J. Sun safety knowledge, practices and attitudes in rural Australian farmers: a cross-sectional study in western New South Wales. BMC Public Health. 2021;21(1):731. [CrossRef]
  • 29. Panahi H, Salehi L. Perspectives of paddy workers regarding the use of sunscreen: a theory-based qualitative research. Arch Public Health. 2019;77(35):35. [CrossRef]
  • 30. Zink A, Schielein M, Wildner M, Rehfuess EA. ‘Try to make good hay in the shade - it won’t work!’ A qualitative interview study on the perspectives of Bavarian farmers regarding primary prevention of skin cancer. Br J Dermatol. 2019;180(6):1412-1419. [CrossRef]
  • 31. Öncel S, Gündoğdu D. Deri kanseri risk Algısının güneşten korunma Davranışlarına etkisi: sistematik derleme. Turk Klin Public Health Nurs-Spec Top. 2017;3(1):52-60.
  • 32. Riccò M, Razio B, Poletti L, Panato C. Knowledge, attitudes, and sunsafety practices among agricultural workers in the autonomous province of Trento, North-Eastern Italy (2016). G Ital Dermatol Venereol. 2020;155(1):31-40. [CrossRef]
  • 33. Gharlipour Z, Taheri AM, Mohebi S. Effect of educational programbased protection motivation theory on preventive behaviors of skin cancer among farmers in Kashan. Int J Cancer Manag. 2019;12(3):9.
  • 34. Jones K, Parrott R, Lemieux R. Rural farmers’ exposure to radio messages about sun protection: implications for skin cancer prevention. J Radio Stud. 2001;8(2):411-424. [CrossRef]
  • 35. Kearney GD, Xu X, Balanay JA, Becker AJ. Sun safety among farmers and farmworkers: a review. J Agromedicine. 2014;19(1):53-65. [CrossRef]
  • 36. Backes C, Milon A, Koechlin A, Vernez D, Bulliard JL. Determinants of sunburn and sun protection of agricultural workers during occupational and recreational activities. J Occup Environ Med. 2017;59(11):1089-1094. [CrossRef]
  • 37. Schenker MB, Orenstein MR, Samuels SJ. Use of protective equipment among California farmers. Am J Ind Med. 2002;42(5):455-464. [CrossRef]
  • 38. Babazadeh T, Nadrian H, Banayejeddi M, Rezapour B. Determinants of skin cancer preventive behaviors among rural farmers in Iran: an application of protection motivation theory. J Cancer Educ. 2017;32(3):604-612. [CrossRef]
  • 39. Ragan KR, Buchanan Lunsford N, Thomas CC, Tai EW, Sussell A, Holman DM. Skin cancer prevention behaviors among agricultural and construction workers in the United States, 2015. Prev Chronic Dis. 2019;16(15):E15. [CrossRef]
  • 40. Trenerry C, Fletcher C, Wilson C, Gunn K. “She’ll Be Right, Mate”: a mixed methods analysis of skin cancer prevention practices among Australian farmers—an at-risk group. Int J Environ Res Public Health. 2022;19(5):2940. [CrossRef]

Tarımda Çalışanların Deri Kanseri Risk Düzeyleri, Risk Algıları, Bilgi ve Davranışlarının Belirlenmesi

Year 2022, Volume: 25 Issue: 4, 268 - 273, 29.12.2022
https://doi.org/10.5152/JANHS.2022.937272

Abstract

Amaç: Bu çalışma, tarımda çalışanların deri kanseri risk algıları, risk düzeyleri, güneşten korunma
bilgi ve davranışlarını belirlemek amacıyla yapılmıştır.

Yöntemler: Araştırma tanımlayıcı tiptedir. Mart-Temmuz 2015 tarihleri arasında Antalya İli
Kumluca İlçe merkezinde yapılmıştır. Örnekleme, tarımda çalışan 415 birey alınmıştır. Veriler yüz
yüze görüşme yöntemi ile toplanmıştır. Verilerin değerlendirilmesinde; tanımlayıcı istatistikler,
Ki-kare Analizi, Mann Whitney U testi, Kruskal Wallis-H testi, Korelasyon Analizi kullanılmıştır.

Bulgular: Araştırma sonunda tarımda çalışanların %25,5’inin yüksek risk düzeyinde olduğu, fakat
%50,8’inin kendisini deri kanseri için riskli görmediği belirlenmiştir. Katılımcıların bilgi puan
ortalaması 6,40 ± 2,17, davranış puan ortalaması 9,11 ± 4,92’dir. Hem bilgi hem de davranış puan
ortalamalarını anlamlı düzeyde etkileyen değişkenler; ortaokul ve üzeri eğitim seviyesi, kadın cinsiyeti, yüksek risk algısı, 30 yaş altında ve 10 yıldan az süredir çalışıyor olmaktır. Katılımcıların bilgi
ve davranış puan ortalamaları arasında pozitif yönde zayıf bir ilişki bulunmuştur.


Sonuç:
Çalışma sonuçları tarım çalışanlarının risk algısı, güneşten korunma bilgi ve davranışlarının
düşük düzeyde olduğunu göstermiştir. Genç yaşta, ortaokul ve üzerinde eğitim seviyesinde
ve 10 yıldan az süredir çalışıyor olanların, hem risk algılarının hem de bilgi ve davranış puan
ortalamalarının daha yüksek olduğu belirlenmiştir. Bu sonuçlar kapsamında özellikle risk düzeyi yüksek, bilgi, davranış ve risk algı düzeyleri düşük bireylere yönelik, deri kanseri ve güneşten korunma eğitim ve tarama programlarının düzenlenmesi önerilmiştir.

References

  • 1. de Graaf L, Talibov M, Boulanger M, et al. Health of greenspace workers: morbidity and mortality data from the AGRICAN cohort. Environ Res. 2022;212(C):113375. [CrossRef]
  • 2. International Agency for Research on Cancer (IARC). Radiation volume 100 D. A study on man. Lyon: WHO Press; 2012. Available at: http://monographs.iarc.fr/ENG/Monographs/vol100D/mono100D.pdf. Accessed 26 Feb 2022.
  • 3. Rushton L, J Hutchings S. The burden of occupationally-related cutaneous malignant melanoma in Britain due to solar radiation. Br J Cancer. 2017;116(4):536-539. [CrossRef]
  • 4. World Health Organization. How common is skin cancer? Radiation: Ultraviolet Radiation (UV) and Skin Cancer; 2020. Available at: https://www.who.int/news-room/q-a-detail/radiation-ultraviolet-(uv)-radiation-and-skin-cancer#.
  • 5. World Health Organization. The Global Cancer Observatory, Turkey Globocan; 2020. Available at: https://gco.iarc.fr/today/data/factsheets/populations/792-turkey-fact-sheets.pdf.
  • 6. Baş Y, Erenler BH, Güney G, et al. Distribution of cancer cases between January 01, 2014 and December 30, 2016 in Çorum City, Turkey. Turk J Oncol. 2017;32(4):153-159.
  • 7. Togawa K, Leon ME, Lebailly P, et al. Cancer incidence in agricultural workers: findings from an international consortium of agricultural cohort studies (AGRICOH). Environ Int. 2021;157:106825. [CrossRef]
  • 8. Zhao G, Ronda E, Cea L, Pulido J, Barrio G, Regidor E. Mortality by cause of death and risk behaviors in farmers versus non-farmers: the importance of avoiding the healthy worker effect. Int Arch Occup Environ Health. 2019;92(4):599-608. [CrossRef]
  • 9. Trakatelli M, Barkitzi K, Apap C, Majewski S, De Vries ED, EPIDERM group. Skin cancer risk in outdoor workers: a European multicenter case-control study. J Eur Acad Dermatol Venereol. 2016;30(3):5-11. [CrossRef]
  • 10. Juzeniene A, Grigalavicius M, Baturaite Z, Moan J. Minimal and maximal incidence rates of skin cancer in Caucasians estimated by use of sigmoidal UV dose-incidence curves. Int J Hyg Environ Health. 2014;217(8):839-844. [CrossRef]
  • 11. McCool JP, Reeder AI, Robinson EM, Petrie KJ, Gorman DF. Outdoor workers’ perceptions of the risks of excess sun-exposure. J Occup Health. 2009;51(5):404-411. [CrossRef]
  • 12. Hammond V, Reeder AI, Gray AR, Bell ML. Are workers or their workplaces the key to occupational sun protection? Health Promot J Austr. 2008;19(2):97-101. [CrossRef]
  • 13. Kearney GD, Lea CS, Balanay J, et al. Assessment of sun safety behavior among farmers attending a regional farm show in North Carolina. J Agromedicine. 2013;18(1):65-73. [CrossRef]
  • 14. Dag S, Hisar F. Determination of knowledge and applications of workers working out in the open about skin cancer. TAF Prev Med Bull. 2016;15(6):532-536. [CrossRef]
  • 15. Reeder AI, Gray A, McCool JP. Occupational sun protection: workplace culture, equipment provision and outdoor workers’ characteristics. J Occup Health. 2013;55(2):84-97. [CrossRef]
  • 16. Robinson JD, Silk KJ, Parrott RL, Steiner C, Morris SM, Honeycutt C. Healthcare providers’ sun-protection promotion and at-risk clients’ skin-cancer-prevention outcomes. Prev Med. 2004;38(3):251-257. [CrossRef]
  • 17. Malak AT, Yildirim P, Yildiz Z, Bektas M. Effects of training about skin cancer on farmers’ knowledge level and attitudes. Asian Pac J Cancer Prev. 2011;12(1):117-120.
  • 18. Carley A, Stratman E. Skin cancer beliefs, knowledge, and prevention practices: a comparison of farmers and nonfarmers in a midwestern population. J Agromedicine. 2015;20(2):85-94. [CrossRef]
  • 19. Aygun O, Ergun A. Validity and reliability of sun protection behavior scale among Turkish adolescent population. Asian Nurs Res. 2015;9(3):235-242. [CrossRef]
  • 20. Janda M, Stoneham M, Youl P, et al. What encourages sun protection among outdoor workers from four industries? J Occup Health. 2014;56(1):62-72. [CrossRef]
  • 21. Buster KJ, You Z, Fouad M, Elmets C. Skin cancer risk perceptions: a comparison across ethnicity, age, education, gender, and income. J Am Acad Dermatol. 2012;66(5):771-779. [CrossRef]
  • 22. Jeihooni AK, Rakhshani T. The effect of educational intervention based on health belief model and social support on promoting skin cancer preventive behaviors in a sample of Iranian farmers. J Cancer Educ. 2019;34(2):392-401. [CrossRef]
  • 23. Gaetano DE, Hodge B, Clark A, Ackerman S, Burdick P, Cook ML. Preventing skin cancer among a farming population: implementing evidence-based interventions. AAOHN J. 2009;57(1):24-31; quiz 32. [CrossRef]
  • 24. Woods CE, O’Shea E, Barrett F, Bookallil L, East L, Usher K. Occupational exposure: rural Australian farmers’ sun-protective behaviours. J Public Health (Berl.). 2020;28(6):675-684. [CrossRef]
  • 25. Susitaival P, Beckman R, Samuels SJ, Schenker MB. Self-reported dermatitis and skin cancer in California farm operators. Am J Ind Med. 2004;46(2):136-141. [CrossRef]
  • 26. Carpenter WS, Lee BC, Gunderson PD, Stueland DT. Assessment of personal protective equipment use among midwestern farmers. Am J Ind Med. 2002;42(3):236-247. [CrossRef]
  • 27. Rocholl M, Ludewig M, John SM, Bitzer EM, Wilke A. Outdoor workers’ perceptions of skin cancer risk and attitudes to sun-protective measures: a qualitative study. J Occuppational Health. 2020;62(1):1-9.
  • 28. D’Souza C, Kramadhari N, Skalkos E, Dutton T, Bailey J. Sun safety knowledge, practices and attitudes in rural Australian farmers: a cross-sectional study in western New South Wales. BMC Public Health. 2021;21(1):731. [CrossRef]
  • 29. Panahi H, Salehi L. Perspectives of paddy workers regarding the use of sunscreen: a theory-based qualitative research. Arch Public Health. 2019;77(35):35. [CrossRef]
  • 30. Zink A, Schielein M, Wildner M, Rehfuess EA. ‘Try to make good hay in the shade - it won’t work!’ A qualitative interview study on the perspectives of Bavarian farmers regarding primary prevention of skin cancer. Br J Dermatol. 2019;180(6):1412-1419. [CrossRef]
  • 31. Öncel S, Gündoğdu D. Deri kanseri risk Algısının güneşten korunma Davranışlarına etkisi: sistematik derleme. Turk Klin Public Health Nurs-Spec Top. 2017;3(1):52-60.
  • 32. Riccò M, Razio B, Poletti L, Panato C. Knowledge, attitudes, and sunsafety practices among agricultural workers in the autonomous province of Trento, North-Eastern Italy (2016). G Ital Dermatol Venereol. 2020;155(1):31-40. [CrossRef]
  • 33. Gharlipour Z, Taheri AM, Mohebi S. Effect of educational programbased protection motivation theory on preventive behaviors of skin cancer among farmers in Kashan. Int J Cancer Manag. 2019;12(3):9.
  • 34. Jones K, Parrott R, Lemieux R. Rural farmers’ exposure to radio messages about sun protection: implications for skin cancer prevention. J Radio Stud. 2001;8(2):411-424. [CrossRef]
  • 35. Kearney GD, Xu X, Balanay JA, Becker AJ. Sun safety among farmers and farmworkers: a review. J Agromedicine. 2014;19(1):53-65. [CrossRef]
  • 36. Backes C, Milon A, Koechlin A, Vernez D, Bulliard JL. Determinants of sunburn and sun protection of agricultural workers during occupational and recreational activities. J Occup Environ Med. 2017;59(11):1089-1094. [CrossRef]
  • 37. Schenker MB, Orenstein MR, Samuels SJ. Use of protective equipment among California farmers. Am J Ind Med. 2002;42(5):455-464. [CrossRef]
  • 38. Babazadeh T, Nadrian H, Banayejeddi M, Rezapour B. Determinants of skin cancer preventive behaviors among rural farmers in Iran: an application of protection motivation theory. J Cancer Educ. 2017;32(3):604-612. [CrossRef]
  • 39. Ragan KR, Buchanan Lunsford N, Thomas CC, Tai EW, Sussell A, Holman DM. Skin cancer prevention behaviors among agricultural and construction workers in the United States, 2015. Prev Chronic Dis. 2019;16(15):E15. [CrossRef]
  • 40. Trenerry C, Fletcher C, Wilson C, Gunn K. “She’ll Be Right, Mate”: a mixed methods analysis of skin cancer prevention practices among Australian farmers—an at-risk group. Int J Environ Res Public Health. 2022;19(5):2940. [CrossRef]
There are 40 citations in total.

Details

Primary Language Turkish
Subjects Nursing, Health Care Administration
Journal Section Research Articles
Authors

Dilek Ayaz 0000-0002-0878-4802

Selma Öncel 0000-0002-1882-1793

Publication Date December 29, 2022
Published in Issue Year 2022 Volume: 25 Issue: 4

Cite

AMA Ayaz D, Öncel S. Tarımda Çalışanların Deri Kanseri Risk Düzeyleri, Risk Algıları, Bilgi ve Davranışlarının Belirlenmesi. Journal of Nursology. December 2022;25(4):268-273. doi:10.5152/JANHS.2022.937272

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