Outdoor Workers at Higher Risk for Skin Cancers

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It’s a fact of life for those who work outside consistently, occupational or otherwise, have an elevated risk of skin cancer. Recent studies have shown that there is a much higher risk for squamous cell carcinoma, and other forms of non-melanoma skin cancer (NMSC), for outdoor workers.

Unfortunately, skin cancer, due to long-term UV exposure at the work place is not often considered an occupational disease. This is because there is confounding evidence from leisure activities (sunbathing, swimming etc.) which also contribute to the problem of skin cancer.

Outdoor workers should take steps to recognize NMSCs, such as squamous cell carcinomas (SCC) and basal cell carcinomas (BCC). Workers should also be aware of pre cancerous lesions such as actinic keratosis; reddish brown scaly areas, usually a few millimeters wide and rough to the touch.

If not checked and treated, these can become SCCs. The most common spots are found are the back of the hands, forearms, face, and the scalp. Squamous cell carcinomas usually develop after years of cumulative UV exposure around 40 years of age and older. The older one becomes, and with continued excess sun exposure, the higher the risk.

The negative effects of UV radiation depend on the type of radiation, the intensity, and the duration of exposure. Exposure is thought of as the cumulative continuous, intermittent, and mixed exposure to UVA and UVB radiation.

In a series of 16 studies, typical outdoor workers (construction workers, farmers, sailors etc.) were compared to groups that generally worked indoors. The studies concluded that the risk of SCC is about twice as much for those outdoor workers, than their indoor counterparts. An analysis of 24 similar studies revealed that outdoor workers were 43% more likely to develop BCC as well.

There are various ways of addressing this issue, besides just the effective use of sunscreen, long sleeves, and hats. If you are an employer or employee that works outdoors, you may want to talk to your company about opportunities for the use of awnings, educational programs regrading sun protection, and planning work schedules to reduce time spent in the midday sun when UV radiation is most intense.

Sunscreens do not provide complete UV protection, and you should never mislead an employee into ignoring the importance of proper clothing in the work place. Annual skin exams for outdoor workers is also an opportunity to identify skin cancers early and educate them on sun protective options.

BE ON THE LOOK OUT! The sooner these conditions are found, the sooner they can be treated!

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Actinic keratosis are usually seen on sun exposed areas: hands, arms, face, ears, neck and scalp. They are rough small patches that can progress to squamous cell carcinomas.
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A large ulcerated squamous cell carcinoma surrounded by several actinic keratoses.
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Squamous cell carcinomas can have different appearances. Any new changing lesion, especially on sun exposed areas should be evaluated by a medical professional.
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Basal cell carcinomas are usually described as pearly, but can become ulcerated. Some are pink, scaly, then start to bleed or ulcerate.

 

Diepgen, T.l., M. Fartasch, H. Drexler, and J. Schmitt. “The Relationship Between Occupational Sun Exposure and Non-Melanoma Skin Cancer” Deutches Arzteblatt International 109 (2012): 715-720. 26 June 2015

Diepgen, T.l., M. Fartasch, H. Drexler, and J. Schmitt. “Occupational Skin Cancer Induced by Ultraviolet Radiation and Its Prevention.” British Journal of Dermatology 167 (2012): 76-84. Web. 26 June 2015.

Photos:

http://www.aocd.org/?page=BasalCellCarcinoma

http://www.americanskin.org/resource/scc.php

http://diseasespictures.com/actinic-keratosis/

http://www.express.co.uk/life-style/health/572223/50-outdoor-workers-dying-skin-cancer-Britain-each-year

http://www.dermatology.ucsf.edu/skincancer/General/types/squamous_cell.aspx

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