Background: Women are adopting skin-lightening practices worldwide in an attempt to enhance their skin tone. The reasons and beliefs behind such practices vary from culture to culture. Scarce data are available for this phenomenon among Saudi women. We carried out this study to determine the practices, reasons, and correlates of skin-lightening practices among women in the northern region of Saudi Arabia. Method: Using nonprobability convenient sampling, an analytical cross-sectional study was carried out among women attending two multispecialty hospitals in the Al-Jouf region. A prevalidated, self-administered questionnaire containing 35 items about demographic characteristics, skin-lightening practices, knowledge of skinlightening products (SLPs), reasons, and perceptions about lighter skin tone was used to collect data. Results: Among 605 sampled women, usage of skin-lightening practices was found in 382 participants (63.1%). All participants had relatively lighter skin. Skin type and education affected skin-lightening practices significantly (P values = 0.002 and 0.012, respectively). The prevalent reason for using SLPs was cosmetic (66%). Onethird of users faced side effects from these products. The SLP users believed that lighter skin tone plays a role in self-esteem, perception of beauty, social class, marriage, and employment opportunities (P values < 0.01) as compared to nonusers. Media was found to influence the use of SLPs (P values < 0.001). Conclusion: Skin-lightening practices are prevalent among Saudi women. Such practices are reinforced by a belief that fairer skin is associated with beauty, self-esteem, and financial and social advantages. A public health educational campaign is needed to decrease the usage of SLPs. K E Y W O R D S media influence, mercury products for skin lightening, perceptions about beauty, reasons behind skin-lightening practices, skin-lightening practices, skin-lightening products How to cite this article: Alrayyes SF, Alrayyes SF, Farooq Dar U. Skin-lightening practices behind the veil: An epidemiological study among Saudi women.

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Background Health care workers (HCWs) involved in day-to-day care and other healthcare activities play a significant role in biomedical waste (BMW) management. The World Health Organization stated some of the causes for the failure of BMW management, namely, lack of awareness of the health hazards related to BMW and inadequate trained HCWs in BMW management. The present study assessed knowledge, attitude, and practice (KAP) towards BMW management among the HCWs in northern Saudi Arabia. Methodology The present study assessed KAP through a self-administered and validated questionnaire. Using a multistage probability sampling method, 384 HCWs from different healthcare facilities participated in this survey. We performed binomial logistic regression analysis to find association between KAP subscales and sociodemographic characteristics. Spearman’s correlation test was performed to find the strength and direction of correlation (rho) between KAP scores. Results Of the population studied, high knowledge, attitude, and practice scores were found in 47.1%, 65.1%, and 49.5% of the HCWs, respectively. The present study found that knowledge score was significantly higher among the age group from 30 to 39 years (ref: age less than 30 years: AOR = 2.25, 95% CI [1.05–4.85], p = 0.04) and non- Saudi nationals (ref: Saudi: AOR = 2.84, 95% CI [1.63–4.94], p < 0.001) The attitude score towards BMW management was significantly lower among the HCWs working in tertiary care settings (ref: PHC: AOR = 0.38, 95% CI [0.12–0.69], p = 0.01). Regarding the practice score, the male categories had a significantly higher score (ref: female: AOR = 1.82, 95% CI [1.19 –2.99], p = 0.02), while pharmacist (ref: physicians: AOR = 0.39, 95% CI [0.18–0.58], p = 0.02) and lab technicians (ref: physicians: AOR = 0.31, 95% CI [0.11–0.53], p = 0.02) had a significant lower practice score. The test results revealed a weak positive correlation of knowledge with the attitude scores (rho = 0.249, p = 0.001), and a moderately strong positive correlation was found between attitude and practice scores (rho = 0.432, p = 0.001). Conclusion This study suggests that a regular training program for the HCWs on BMW management is necessary through symposiums, role play, interactive lectures, and other feasible training methods. Furthermore, a multicentric prospective exploratory study is to be conducted in other regions of the KSA to understand the region-specific training needs of HCWs.

Health care workers (HCWs) working in different health care facilities are exposed to many hazards, especially during the COVID-19 pandemic. This questionnaire-based cross-sectional study aimed to assess the prevalence, pattern, and risk factors of occupational health hazards faced by 438 randomly selected HCWs from northern Saudi Arabia. The HCWs are commonly exposed to needle stick injuries (34.5%) under the biological hazards category; and work-related stress (69.6%) under the non-biological hazards categories. The significant associated factors were work setting (ref: Primary Health Center: Adjusted OR (AOR) = 2.81, 95%CI = 1.21–4.59, p = 0.017), smoking status (ref.: non-smoker: AOR = 1.73, 95%CI = 1.03–2.91, p = 0.039), and mean sleeping duration per day (AOR = 1.22, 95%CI = 1.04–1.43, p = 0.014) for biological, and smoking status (ref: non-smoker: AOR = 2.16, 95%CI = 1.09–3.29, p = 0.028), and mean sleeping duration per day (AOR = 1.35, 95%CI = 1.07–1.70, p = 0.013) for non-biological categories. This study revealed several risk factors and occupational health hazards that HCWs are exposed to during their work time. Periodic training and follow-up assessments regarding bio-safety measures for the HCWs should be implemented. Finally, future explorative studies are warranted on the feasibility of implementing rotation-based postings for the HCWs in different health care settings.

Objectives: To determine the prevalence of imposter syndrome (IS) among Saudi adults and its association with burnout. Methods: Using non-probability convenience sampling, we carried out a cross-sectional analytical study among adults in Northern Saudi Arabia. Data collection toll was a self-administered questionnaire containing young imposter scale (YIS), Maslach burnout inventory (MBI) and depression, anxiety, and stress scale 21 (DASS 21). These 3 scales are valid and reliable measurement tools for measuring IS, burnout, and psychological morbidity. Results: In the study sample (n=384), imposterism was present among 222 adults (57.8%). Moderate and severe symptoms of depression were present in 217 (56.5%), symptoms of stress in 210 (54.7%), and symptoms of anxiety in 126 (32.8%). Burnout was measured in 3 domains of depersonalization, emotion exhaustion, and personal accomplishments. High degree of depersonalization was found in 221 (57.6%), higher emotional exhaustion in 246 (64.1%) while lower personal accomplishment was present in 126 (32.8%). We found statistical association between IS and gender ( p <0.01), depression ( p <0.001) stress ( p <0.001) and all 3 domains of burnout ( p <0.01). Imposter syndrome was not found associated with anxiety ( p =0.97). Young imposter scale score was associated with all the 3 domains of burnout even after controlling for depression, anxiety, and stress. Conclusion: Imposter syndrome is frequent among Saudi adults and associated with all 3 burnout domains. Mental health domains like burnout, depression, stress, and anxiety were found associated with IS.