Skin Cancer Prevention in Agricultural Workers: A Review of Sun Safety Practices and Intervention Strategies...

Agricultural workers face significantly higher ultraviolet radiation (UVR) exposure than indoor workers, increasing their skin cancer risk. This systematic review evaluates peer-reviewed literature from 2013 to 2024 on sun safety behaviors and interventions among agricultural workers.

Following PRISMA guidelines, a search was conducted across PubMed, SCOPUS, Cochrane Library, Web of Science, Agricola, and EBSCO using MeSH terms and keywords including "farmworker," "sun safety," "skin cancer," and "interventions." Eligible studies were full-text manuscripts published in English between February 1, 2013, and May 15, 2024. A total of 166 manuscripts were identified, with 84 remaining after duplicate removal. Two independent reviewers screened the abstracts and full texts, resulting in 38 manuscripts. Eight additional manuscripts were added after reference review.

Of the 46 included studies, 39 (84.8%) were primary and seven (15.2%) were secondary studies. While five of the primary studies were intervention-focused, 34 were primarily descriptive. Geographically, 71.7% of studies investigated populations outside the U.S. while 17.4% focused on U.S. farmers. Knowledge levels and attitudes about sun protection varied significantly. Sun protection behaviors also varied widely, with hats and long pants being more commonly used methods, although regional and cultural differences were evident. In terms of intervention-based studies, multicomponent strategies, like workplace-specific action plans, highlighted the effectiveness of tailoring interventions to workplace culture and environmental needs.

Research on sun safety interventions for agricultural workers remains limited. As a one-size-fits-all approach is ineffective, future research should prioritize designing and evaluating tailored, workplace-driven interventions in collaboration with employees.