Increasing topical sunscreen use in German outdoor workers: results of a non-randomised controlled intervention study
In brief
Sunscreen use reached 84% among outdoor workers after workplace intervention
After six months, 83.5% of workers offered sunscreen and brief education reported using it at least sometimes, up from 54.7% at baseline; use in the control group was 52.3%. Sunburn reports fell more in the intervention group, but the difference in change was not statistically significant, and the non-randomised design limits conclusions about cause and effect.
- Journal
- BMC public health (Q1)
- Published
- 23 September 2026
- Study design
- Randomized controlled trial
- Evidence level
- Level 1, High (CEBM 1b)
- Authors
- Anja Dick, Michaela Ludewig, Christoph Skudlik, Ivone Jakasa, Sanja Kezic, Florentine de Boer, et al.
- PMID
- 42773431
- DOI
- 10.1186/s12889-026-29422-6
Why clinicians should know about it
- Picked for Dermatology (top studies of the week, 27 September 2026): Intervention increased sunscreen use among outdoor workers
Abstract
BACKGROUND: Occupational exposure to solar ultraviolet radiation (UVR) is a major environmental risk factor for skin cancer. Outdoor workers accumulate high lifetime UVR exposure and therefore face an increased risk of developing actinic keratoses and skin cancer. Despite established recommendations for sun protection, adherence among outdoor workers remains low. Improving access to sunscreen and providing targeted health education may help reduce barriers to sun-protective behaviour among outdoor workers. Therefore, this study evaluated the effectiveness of a workplace intervention designed to increase sunscreen use among outdoor workers. METHODS: A non-randomised controlled intervention study was conducted among outdoor workers in Germany during one sun-exposure season (April-September 2025). Participants were assigned to either an intervention group or a control group. The intervention consisted of facilitated access to different sunscreen products combined with a brief structured health education on UVR risks and correct sunscreen use. Sunscreen use and sunburn occurrence were assessed using a questionnaire at baseline (T0), after three months (T1), and after six months (T2). The primary outcome was the proportion of workers reporting sunscreen use at least "sometimes". Longitudinal changes were analysed using generalised linear mixed models. RESULTS: A total of 234 outdoor workers were enrolled, with 117 participants in each group. After six months, 97 participants in the intervention group and 86 in the control group completed the study. At baseline, 54.7% of participants in both groups reported sunscreen use in general at least sometimes. At T2, this proportion increased to 83.5% in the intervention group compared with 52.3% in the control group. The number of reported sunburns decreased over time in both groups, with a stronger reduction observed in the intervention group; however, the group × time interaction did not reach statistical significance. CONCLUSIONS: A simple workplace intervention consisting of facilitated sunscreen provision and brief health education was associated with a substantial increase in sunscreen use over the six-month follow-up period. This low-threshold approach represents a feasible and scalable strategy for occupational skin cancer prevention. TRIAL REGISTRATION: The study was approved by the Ethics Committee of Osnabrück University and registered in the German Clinical Trials Register (DRKS00035178; registration date: 10 October 2024).
Abstract as published, via PubMed.
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