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Research Magazine > ARCHIVE > Summer 97 > Article

The Big Coverup
by Paul Karr

Morgan Smith raises Angus cattle near the south-central Georgia town of Douglas. He spends most of his work and recreational hours outdoors, he said, and never gave much thought to the discolored patch of skin on one of his shoulders.

Then Roxanne Parrott, a UGA associate professor of speech communication, showed up one night at a local cattlemen's meeting with some graphic photographs - and some serious talk about sun exposure and skin cancer.

"After that meeting I got concerned," said Smith, 30. "I know a lot of people who've had these cancers, but I didn't know how serious they could be. I went to a doctor and had that patch removed and checked. It sure helped me feel better knowing I didn't have a problem."

Smith was lucky: His patch was benign. But along with his relief came a new resolve. He has since begun wearing long-sleeved shirts, long pants and a special hat that covers his ears and neck while out in the fields. It wouldn't have happened but for a four-year project to protect Georgia's farm families from sunburn and skin cancer.

"She puts [skin cancer education] on the level where the average farmer can understand it," Smith said of Parrott. "I just wish that more people could hear her program. I got a lot out of it and I believe everyone who sees and hears what happens to [skin cancer victims] would."

"Farmers are very independent people," said Parrott, who coordinates the program's outreach initiative. "This is one of those cases where people have to do things every day that may not be ideal for their health. Our job here has been to give them better health information."

Parrott, a former Arizona resident and skin cancer patient herself, had become accustomed to ranchers and farmers wearing wide-brimmed cowboy hats to keep the sun off their heads in the intense Southwestern sun.

When she arrived in Georgia, however, she was surprised by the lack of protection farmers used. Many Georgians, she noticed, wore little or no protection on their heads, arms and chests while in the fields - especially during the midday hours, when harmful ultraviolet (UV) radiation is most intense. The rate of skin cancer among Georgia farmers, it turned out, was demonstrably higher than normal.

Working with the head of Georgia's cancer control program, Parrott created a study of 450 families in several agricultural south Georgia counties. The work began with a questionnaire whose findings surprised the team.

Although a little less than half the farmers in Parrott's survey claimed they wore wide-brimmed hats, sunscreen or long-sleeved shirts, in practice almost none were observed to wear such hats or shirts. One in four did not wear sunglasses; one in seven even wore shorts.

A number of farmers also admitted they used "udder balm" - a product that soothes chapped udders on livestock - for sun protection because the label indicated it protected against sun. (In fact, the balm does not block any UV radiation; it is a moisturizer.)

After sifting through those eye-popping results, Parrott's team came up with an action plan aimed at changing the farmers' skin protection habits. As a population, Georgia farmers are becoming, on average, an older group every year; the members of Parrott's study group averaged 52 years of age. If the researchers were going to change such deeply entrenched habits, they decided they would need to target social situations where farmers would feel most comfortable receiving warnings and advice.

Keeping that in mind, the group's educational work has included some conventional and not-so-conventional efforts.

Parrott obtained special dark blue and red baseball caps with bandannas stitched to their backs - the colors and designs were carefully selected by consulting farmers to appeal to their fellow farmers - which protect ears and necks from sunburn.

"Farmers tend to wear free baseball caps from farm suppliers or feed and seed companies," Parrott said. "So we went after that preference."

The specially designed caps were distributed to feed merchants and county agricultural extension service agents. Farmers who participated in Parrott's survey also each received a coupon good for a hat; later observations demonstrated that, indeed, farmers who received the coupons were more likely to pick up the hats than other farmers.

The group taught extension agents, agricultural workers and rural health-care providers about the myths and realities of sun protection (see Sun Facts). That information then was passed on to farmers, along with free samples of more than 10 different brands of sunscreen.

"The biggest barrier has been with the sunscreen," Parrott said, "because when the farmers sweat and work, dirt and pesticides stick to it. And then their skin breaks out." How to address that? "We let sunscreen manufacturers know about this problem, and promoted brands that were more absorbent and less sticky."

In feed and seed stores, multicolored brochures also were set out to broadcast the same sorts of messages. Migrant workers were even given sun-protection theme coloring books that proved enormously popular among both children and parents.

"This training program has been picked up by 4-H and other farm organizations," Parrott said. At press time, 18 states also had adapted some version of it.

Sun exposure diaries were distributed to the farmers. The diaries, designed to be as simple and convenient as possible, recorded what farmers wear at certain times of the day.

Special long-sleeved shirts were given to farmers. Composed of polyester and a little cotton, the shirts are four to six times more effective than cotton T-shirts at blocking UV radiation.

The group created a sun safety class to serve as part of the Abraham Baldwin College's annual farm safety camp in Tifton, Ga. The summer camp traditionally has focused mostly on tractor rollovers, care working with machinery and the like, but Parrott's program turned out to be astonishingly popular. The offers to sample 12 kinds of free sunscreen and 12 different hats, as well as a show of gruesome photographs of skin cancer victims, all drew big crowds.

Parrott's team now is collecting data to determine whether the education program is making any difference in outdoor behavior. While it's too early to say anything conclusive, field surveys seem to hold encouraging news.

"We feel like we have had good success rates. Farmers seem to be responding to these messages," Parrott said. "I really believe that skin cancer has not had enough effort or research money put into it even though, unlike with many cancers, we know what causes it and how to prevent it."

And with Parrott's educational program now serving as a national model, the message is beginning to get across.


Each person's need for sunscreen is different, depending on skin type and duration of time spent in the sun. Dermatologists and cancer specialists use the following formula to determine what sun protection factor (SPF) a person needs:

1. Calculate how many minutes your unprotected skin normally takes to redden slightly in the midday sun.
2. Figure out how many total minutes you will be spending in the sun.
3. Divide the number of minutes you will spend in the sun by the number of minutes in which you redden. That's how much SPF you need in your sunscreen.
No matter what the SPF, remember to reapply sunscreen every four hours (or every hour if you get wet).


Sunscreen takes 20 to 30 minutes to begin working - even if it's applied outdoors.
A denim shirt has an SPF of 1,700, but a cotton T-shirt has an SPF of just 8.
Suntans don't protect any better than pale skin against skin cancer.
African-American skin has an SPF of only 4.
Darker clothes and hats block more dangerous UV rays than light-colored ones.
Shade trees, umbrellas and being in water don't significantly protect skin from UV rays.
Sunscreen must be reapplied every four hours - and every hour when wet.
Lips are especially vulnerable to sunburn so use special lip sunscreens.
Just one blistering sunburn before the age of 20 doubles the risk of skin cancer for the rest of one's life.
The sun's radiation has strengthened in recent years as the Earth's protective atmospheric ozone layer has thinned.
Sunburn damage is permanent.

For more information, access http://www.ph.dhr.state.ga.us, or e-mail Roxanne Parrott at rparrott@uga.cc.uga.edu.

Paul Karr is a prize-winning journalist and essayist whose works have appeared in Sports Illustrated, the San Francisco Examiner-Chronicle and other publications.


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 The best protection from UV radiation is to keep the sun from actually getting to your skin. A long sleeved denim shirt does that very well and protects better than sunscreen with an SPF 40.