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Influence of Skin Cancer Awareness on Sun-Protective Practices among Outdoor Workers in Nigeria

Abstract

Skin cancer is an important public health concern associated with prolonged exposure to ultraviolet (UV) radiation, particularly among individuals whose occupations require frequent or extended outdoor activities. Outdoor workers in Nigeria, including farmers, construction workers, road workers, security personnel, street vendors, traffic control personnel, and other workers who spend substantial periods under direct sunlight, may experience considerable occupational exposure to solar radiation. Prolonged and repeated exposure to UV radiation can increase the risk of skin damage and certain types of skin cancer. Skin cancer awareness provides outdoor workers with information about skin cancer, risk factors, the relationship between prolonged UV exposure and skin damage, warning signs, prevention, and the importance of early medical evaluation of suspicious skin changes. Sun-protective practices refer to behaviours adopted to reduce exposure to harmful UV radiation, including the use of protective clothing, wide-brimmed hats, sunglasses, shade-seeking, appropriate use of sunscreen, avoidance of unnecessary exposure during periods of intense sunlight, and regular observation of the skin for unusual changes. In Nigeria, limited awareness of occupational sun exposure, misconceptions about skin cancer, inadequate access to protective materials, workplace conditions, cost of sunscreen, and occupational demands may affect the adoption of appropriate sun-protective practices among outdoor workers. Effective skin cancer awareness may improve workers' knowledge of UV-related risks and encourage the adoption of appropriate protective behaviours. Against this background, this study investigates the influence of skin cancer awareness on sun-protective practices among outdoor workers in Nigeria. The study is anchored on the Health Belief Model, Social Cognitive Theory, and Knowledge-Attitude-Practice framework. The Health Belief Model explains preventive health behaviour through perceived susceptibility, perceived severity, perceived benefits, perceived barriers, and cues to action, providing a basis for understanding outdoor workers' decisions to adopt sun-protective practices. Social Cognitive Theory emphasizes the interaction between knowledge, self-efficacy, social influences, behavioural capabilities, and environmental conditions in shaping occupational health behaviour. The Knowledge-Attitude-Practice framework provides a basis for examining how improved knowledge and attitudes resulting from skin cancer awareness may influence sun-protective practices. Collectively, these theoretical perspectives provide a suitable framework for explaining how skin cancer awareness may influence sun-protective practices among outdoor workers in Nigeria. The study will adopt a quantitative quasi-experimental research design. Primary data will be collected from outdoor workers in selected urban and rural communities in Nigeria using a structured interviewer-administered questionnaire and an observational workplace checklist. A multistage sampling technique will be employed to select states, local government areas, occupational settings, workplaces, and eligible outdoor workers. Where feasible, selected workplaces or participant groups will be assigned to intervention and comparison groups. Workers in the intervention group will receive structured skin cancer awareness education covering skin cancer, UV radiation, occupational sun exposure, risk factors, warning signs, preventive measures, appropriate use of sunscreen, protective clothing, shade-seeking, scheduling of outdoor activities where practicable, and the importance of seeking professional medical evaluation for suspicious skin changes. Sun-protective practices will be assessed using indicators such as use of protective clothing, use of wide-brimmed hats, use of sunglasses, shade-seeking, appropriate sunscreen use, avoidance of unnecessary direct sunlight exposure, and routine observation of the skin for unusual changes. Descriptive statistics will be used to summarize participants' sociodemographic and occupational characteristics, skin cancer awareness, exposure to education, and sun-protective practices. Inferential statistical techniques, including chi-square tests, paired-sample tests, independent-sample tests, and logistic or multiple regression analysis, will be used to determine the influence of skin cancer awareness on sun-protective practices. Appropriate diagnostic tests will also be conducted to assess the reliability of the research instrument, model assumptions, goodness of fit, and robustness of the findings. The study is expected to find that skin cancer awareness has a significant positive influence on sun-protective practices among outdoor workers in Nigeria. Workers exposed to structured skin cancer awareness education are expected to demonstrate improved knowledge of UV-related risks and greater adoption of appropriate sun-protective behaviours. Education may increase awareness of occupational sun exposure, improve perceived susceptibility to UV-related skin damage, encourage the use of protective clothing and hats, promote shade-seeking and appropriate sunscreen use, and improve recognition of suspicious skin changes. However, awareness alone may not guarantee consistent sun protection because outdoor workers may continue to face occupational and environmental barriers such as prolonged work schedules, high temperatures, limited shade, inadequate provision of protective equipment, cost of sunscreen, and the practical demands of outdoor occupations. Consequently, skin cancer awareness is expected to be most effective when supported by workplace occupational-health policies, provision of appropriate protective equipment, accessible health information, availability of shade, and employer-supported sun-protection measures. The study is expected to contribute to the literature on skin cancer prevention, occupational health, health education, environmental health, non-communicable disease prevention, and public health in Nigeria by providing empirical evidence on the influence of skin cancer awareness on sun-protective practices among outdoor workers. The findings will provide useful information to the Federal Ministry of Health and Social Welfare, Federal Ministry of Labour and Employment, state ministries of health, occupational health authorities, primary healthcare providers, employers, labour organizations, dermatologists, public health practitioners, community health workers, development partners, and policymakers regarding strategies for reducing occupational UV exposure. The study will also provide evidence-based recommendations for strengthening occupational skin cancer education, promoting workplace sun-protection policies, improving access to protective equipment, increasing awareness of UV-related health risks, encouraging appropriate sun-protective practices, and promoting early recognition of suspicious skin changes among outdoor workers across Nigeria.

Keywords: Skin cancer awareness, sun-protective practices, outdoor workers, ultraviolet radiation, occupational health, skin cancer prevention, health education, sun exposure, non-communicable diseases, workplace health, disease prevention, public health, Nigeria.