Sun Safe Workplaces: Assessment of Benefits and Costs of a Policy Intervention

Workers in the United States spend large amounts of time on the job, making the workplace a
key venue for preventive health programs. A workplace risk that has received limited
attention is solar ultraviolet radiation (UVR). Unprotected exposure to solar UVR of outdoor
workers can produce both an immediate acute harm (i.e., severe sunburn) and long-term skin
damage that can elevate the risk of developing skin cancers. Preventing skin cancer is a
priority due to its high prevalence; tendency to recur; association with other cancers; and
lost productivity ($66.9 billion in losses were attributed to melanoma-related mortality from
1990-2008). Sun Safe Workplaces (SSW) is a comprehensive occupational sun safety education
and policy intervention that was tested by Klein Buendel, Inc.'s (KB) research team in a
randomized control trial with 98 cities, counties, and special districts in Colorado.
Posttesting was completed in November 2013. The SSW intervention focused on three sectors in
the organizations: public works, public safety, and parks and recreation. Half of the
employers received the SSW intervention, with the remaining employers in the control
condition receiving basic sun safety information. Preliminary analyses indicate that 80% of
employers in the SSW intervention condition provided sun safety education to employees and
36% adopted formal sun protection policies. No control organizations reported policy
adoption. KB will conduct a two-year follow-up study on the benefits of the SSW intervention
(i.e., increasing employees' sun protection) and return on investment (ROI; benefits relative
to intervention costs). Employee behavior was not assessed in the current SSW trial because
it was uncertain whether the SSW intervention would result in uptake of education and policy
and thus have the potential to influence their sun protection practices. The proposed
two-year follow-up of the 98 organizations in the SSW trial will include: (1) surveys with
employees (n=10,787) and front line supervisors (n=767) to assess employees' sun protection
practices and workplace actions to support employee sun safety; (2) on-site observations of
sun protection actions by the employers (e.g., posters, sunscreen, shade structures); and (3)
tracking of the costs of implementing the SSW intervention and induced employer costs. The
proposed analyses will compare the sun protection practices of employees a) between
workplaces that received the SSW intervention and controls and b) among workplaces that
provided education and adopted policy, provided education only, and control workplaces.
Analyses will determine if the extent of sun protection actions by employers influences
employees' sun safety practices. The economic evaluation will estimate the ROI (i.e.,
comparison of the estimated program benefits to combined cost elements). The proposed study
is significant and innovative because it provides critical information applicable to a wide
range of industrial sectors with outdoor workers on a workplace risk that has received scant
attention. Determining the effectiveness and ROI of prevention programs is essential for
national and local resource investment.

Inclusion Criteria:

- Participation in the prior Sun Safe Workplaces: A Campaign on Sun Protection Policies
for Outdoor Workers.

- A local government organization with employees who worked outdoors in at least one of
the following service areas: public works, public safety, and parks and recreation,

- Having a full time executive

- Having a population of at least 3000 residents

- Being employed at a participating local government organization as a manager or
employee?

- Being employed at a participating local government organization in a job requiring
outdoor work at least part of the time.

Exclusion Criteria:

- Organization had participated in the authors' previous occupational sun protection
project.