April 1998

Skin cancer is the most common form of cancer in the United States, accounting for more than one million new cases each year. The principal cause is excessive and long-term exposure to the sun. Farmers, by nature of their occupation, are exposed to excessive amounts of sun and are at a high risk of developing skin cancer. The majority of skin cancers occur on areas of the body chronically exposed to sunlight, namely the face and neck. Wearing a wide-brimmed hat can decrease the risk of skin cancer by protecting the face and neck from sun exposure.

Operation Hat Check was an initiative designed by the National Farm Medicine Center to promote farmers' use of sunsafe hats. The objective of Operation Hat Check was to encourage farmers to trade in their baseball caps, which offer minimal protection from the sun, for a free wide-brimmed hat that provides more sun protection for the face and neck.

Operation Hat Check was initiated at the 1997 Wisconsin Farm Progress Days in Manitowoc County. Each year this event attracts an estimated 150,000 visitors to a large farm site that includes three days of field demonstrations, product exhibits, entertainment, and socialization for a primarily rural population. A total of 250 wide-brimmed hats were offered in trade each day. Participants were asked to complete a one-page form in conjunction with the hat exchange and asked if they would be willing to complete a short mailed survey regarding the hat in three months. Those who agreed to participate, were sent a mailed survey three months later to ascertain their use of the wide-brimmed hat when they were out in the sun for 15 minutes or more.

A total of 426 people participated in Operation Hat Check. Males comprised 66% of the sample and 68% of the sample were 40 years of age or older. Fifty-seven percent of the sample were currently farming or retired farmers and 64% had never worn a wide-brimmed hat in the past.

Eighty-six percent of the sample (n=366) agreed to complete a mailed survey in three months. A total of 281 surveys were returned for a response rate of 77%. Thirty-nine percent of the participants reported wearing the hat more than 50% of the time when they were out in the sun for more than 15 minutes and less than 6% reported that they had not worn the wide-brimmed at all in the past three months. Nineteen percent of the participants reported purchasing another sunsafe hat as a result of their participation in Operation Hat Check.

There was some association between age and the percentage of time the hat was worn, with those reporting greatest use of the hat being somewhat older. Also, persons who reported wearing a wide-brimmed hat in the past were more likely to report greater use of the hat. However, there was no difference in percentage of time the hat was worn based on gender or occupation.

Operation Hat Check reached a population at increased risk for skin cancer as the majority of participants were current or retired farmers, were male, and were over 40 years of age. Although follow-up was based on self-report only, the participants reported an increased use of wide-brimmed hats when compared to baseline.

For more information contact:
National Farm Medicine Center
1000 North Oak Avenue
Marshfield, WI 54449-5790
Telephone: 715-387-9298
Email: nfmcsh@mcrf.mfldclin.edu