'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 Jun;180(6):1412-1419. doi: 10.1111/bjd.17872. Epub 2019 Apr 19.

Abstract

Background: Extensive exposure to solar ultraviolet radiation (UVR) is the main risk factor for keratinocyte carcinoma (KC), making outdoor workers, including farmers, a high-risk population for KC. The use of sun protection is crucial for KC prevention but is not typically implemented by outdoor workers during their daily tasks.

Objectives: To explore the attitudes of Bavarian farmers regarding sun-protective measures in their daily work and to understand perceived barriers and unmet needs.

Methods: Farmers were recruited through the Bavarian Farmers Association in Bavaria, Southern Germany. Qualitative semi structured interviews were conducted with participants between December 2017 and March 2018. Interviews were recorded, transcribed verbatim and analysed using qualitative content analysis.

Results: Twenty farmers (11 women, nine men; nine aged 18-30 years, 11 aged > 60 years) participated. Knowledge and awareness of UVR exposure and KC, perceived individual barriers to implementing sun-protective measures, individual experiences and farm life-specific circumstances emerged as key areas influencing the perspectives of farmers regarding the primary prevention of KC. Female farmers tended to take a more positive stance on sun protection, whereas male farmers showed a lower overall interest.

Conclusions: Knowledge and awareness of KC and UVR exposure is very limited in Bavarian farmers with serious perceived barriers due to the demands of daily agricultural work. Further qualitative studies are needed to identify intervention options that can increase skin cancer awareness and that can successfully overcome real barriers to implementing sun protection.

MeSH terms

  • Adolescent
  • Adult
  • Age Factors
  • Agricultural Workers' Diseases / etiology
  • Agricultural Workers' Diseases / prevention & control*
  • Farmers / psychology*
  • Female
  • Germany
  • Health Behavior
  • Health Knowledge, Attitudes, Practice*
  • Humans
  • Male
  • Middle Aged
  • Primary Prevention*
  • Protective Clothing
  • Qualitative Research
  • Sex Factors
  • Skin / drug effects
  • Skin / radiation effects
  • Skin Neoplasms / etiology
  • Skin Neoplasms / prevention & control*
  • Sunlight / adverse effects*
  • Sunscreening Agents / administration & dosage
  • Surveys and Questionnaires
  • Young Adult

Substances

  • Sunscreening Agents