Reducing ultraviolet radiation exposure among outdoor workers: State of the evidence and recommendations

<p>Abstract</p> <p>Objective</p> <p>Outdoor workers have high levels of exposure to ultraviolet radiation and the associated increased risk of skin cancer. This paper describes a review of: 1) descriptive data about outdoor workers' sun exposure and protection and related knowledge, attitudes, and policies and 2) evidence about the effectiveness of skin cancer prevention interventions in outdoor workplaces.</p> <p>Data sources</p> <p>Systematic evidence-based review.</p> <p>Data synthesis</p> <p>We found variable preventive practices, with men more likely to wear hats and protective clothing and women more likely to use sunscreen. Few data document education and prevention policies.</p> <p>Conclusion</p> <p>Reports of interventions to promote sun-safe practices and environments provide encouraging results, but yield insufficient evidence to recommend current strategies as effective. Additional efforts should focus on increasing sun protection policies and education programs in workplaces and evaluating whether they improve the health behavior of outdoor workers.</p

Evaluation of the North American Guidelines for Children's Agricultural Tasks using a case series of injuries

Objective: To evaluate the potential for the North American Guidelines for Children's Agricultural Tasks (NAGCAT) to prevent the occurrence of pediatric farm injuries. This evaluation focuses upon farm injuries experienced when children were engaged in farm work. Design: Novel outcome evaluation involving primary review of three retrospective case series. Setting: Fatal, hospitalized, and restricted activity injuries from the United States and Canada. Subjects: Nine hundred and thirty four pediatric farm injury cases. Methods: The applicability of NAGCAT to each case was rated. For injuries where NAGCAT were applicable, recurrent injury patterns were described and the potential for NAGCAT to prevent their occurrence was assessed. Results: A total of 283 (30.3%) cases involved children engaged in farm work. There was an applicable NAGCAT guideline in 64.9% of the work related cases. Leading individual guidelines applicable to the injury events were: (1) working with large animals; (2) driving a farm tractor; and (3) farm work with an all-terrain vehicle. In the judgment of the research team, 59.6% of these injuries were totally preventable if the principles espoused by NAGCAT had been applied. Conclusions: NAGCAT are a set of consensus guidelines aimed at the prevention of pediatric farm injuries. The findings suggest that NAGCAT, if applied, would be efficacious in preventing many of the most serious injuries experienced by children engaged in farm work. However, work related injuries represent only a modest portion of pediatric farm injuries. This new information assists in the refinement of NAGCAT as an injury control resource and puts its potential efficacy into context

Pediatric farm injuries involving non-working children injured by a farm work hazard: five priorities for primary prevention

Objectives: To describe pediatric farm injuries experienced by children who were not engaged in farm work, but were injured by a farm work hazard and to identify priorities for primary prevention. Design: Secondary analysis of data from a novel evaluation of an injury control resource using a retrospective case series. Data sources: Fatal, hospitalized, and restricted activity farm injuries from Canada and the United States. Subjects: Three hundred and seventy known non-work childhood injuries from a larger case series of 934 injury events covering the full spectrum of pediatric farm injuries. Methods: Recurrent injury patterns were described by child demographics, external cause of injury, and associated child activities. Factors contributing to pediatric farm injury were described. New priorities for primary prevention were identified. Results: The children involved were mainly resident members of farm families and 233/370 (63.0%) of the children were under the age of 7 years. Leading mechanisms of injury varied by data source but included: bystander and passenger runovers (fatalities); drowning (fatalities); machinery entanglements (hospitalizations); falls from heights (hospitalizations); and animal trauma (hospitalizations, restricted activity injuries). Common activities leading to injury included playing in the worksite (all data sources); being a bystander to or extra rider on farm machinery (all data sources); recreational horseback riding (restricted activity injuries). Five priorities for prevention programs are proposed. Conclusions: Substantial proportions of pediatric farm injuries are experienced by children who are not engaged in farm work. These injuries occur because farm children are often exposed to an occupational worksite with known hazards. Study findings could lead to more refined and focused pediatric farm injury prevention initiatives