Skin Cancer and Ultraviolet Radiation
Australia and New Zealand have the highest rate of skin cancer in the world and at least 2 in 3 Australians will be diagnosed with skin cancer before the age of 703. Queensland has a higher rate of skin cancers compared to Tasmania3.
Sun exposure is well established as the major cause of skin cancer in Australia. It is the ultraviolet (UV) radiation component of sunlight which is harmful. Not only can it cause skin cancer, it can also cause eye damage. Skin damage will only be covered in this article.
The level of UV radiation is not directly related to temperature or brightness of sunlight which means that harm can still occur on cool or cloudy days during peak UV periods3. Intermittent exposure to solar UV radiation can be harmful.
Although the main source of UV radiation is solar, UV radiation also is generated from phototherapy, solariums, fluorescent, neon and halogen lighting, industrial arc welding, UV radiation lamps, “black lights”, germicidal UV radiation lamps and UV lasers.
Solar UV radiation is composed of three wavelengths: UVA, UVB and UVC. All UVC and most UVB radiation is absorbed by the atmosphere, all UVA and approximately 10 percent of UVB radiation reaches the earth’s surface. Both UVA and UVB are known causes of skin cancer.
Solar UV radiation:
- Can cause damage to living organisms
- Is carcinogenic to humans
- Cannot be seen or felt
- Does not depend on temperature
- Can be high even on cool and cloudy days
- Can pass through clouds
- Can pass through loosely woven material
- Can bounce off reflective surfaces like metal, concrete, water and snow, and
- Is the best natural source of vitamin D which in small amounts is essential for good health2.
Types of UV Radiation Exposure
Workers who spend all or part of the day working outdoors are at risk of skin cancer1. Some types of exposure risks are not obvious and can include vehicle drivers like taxi, bus, truck, delivery and courier services1, or in the airline industry including pilots and cabin crew. Physical education teachers who may be exposed intermittently to the sun during the day can also be at risk.
The accumulated exposure creates a risk to workers’ health and safety1.
Adverse Effects of Solar UV Radiation
Short term exposure to the sun can result in sunburn3. This can include reddening of the skin, blistering, swelling and later, peeling of the skin. For untanned skin, exposed to the summer sun between 10:00 and 14:00 (or 11:00 and 15:00 with daylight saving), the effects will be:
- 11-12 minutes of sun exposure results in mild sunburn
- 30 minutes of sun exposure results in appreciable discomfort
- 60 minutes of sun exposure results in peeling and blistering
- 120 minutes of sun exposure results in permanent damage1, 3.
Long term exposure to the sun can result in premature skin ageing and skin cancers.
Types of Skin Cancers in Australia
There are three main types of skin cancers in Australia:
- Basal cell carcinoma (BCC) – most common but least dangerous
- Squamous cell carcinoma (SCC) – less common but more dangerous than BCC. Caused by continuous exposure to UV radiation in outdoor occupations
- Melanoma – least common but most dangerous. Often starts as a spot or freckle and changes colour and thickness or shape over months. Melanomas can spread to internal organs and cause death if not detected and removed promptly3.
Who has Health and Safety Responsibility?
Persons conducting a business or undertaking (PCBU) are required to manage the risks of sun-related disease and injury, including:
- Working indoors (where possible)
- Working outside only during the mornings, afternoons and evenings, avoiding midday
- Providing shade and shelter, and
- Using sun protective clothing, hats, sunglasses and sunscreen2.
Workers are also required to comply with instructions given by their employer for reasons of health and safety and take reasonable precautions to protect themselves and others at work3.
How to Manage the Risks
Managing risks associated with exposure to solar UV radiation should follow a systematic process of:
- Identifying hazards – find out what could cause harm
- Assessing the risks if necessary – understand the nature of the harm that could be caused by the hazard, how serious the harm could be and the likelihood of it happening
- Controlling risks – implement the most effective control measures that are reasonably practicable in the circumstances and
- Reviewing control measures to ensure they are working as planned.
UV Radiation Control Measures
Once the level of UV radiation risk in the workplace has been identifies, control measures can be implemented. Some control measures are more effective than others therefore a combination of control measures should be to provide the best solution to minimise the risk to the lowest level reasonably practicable. The Hierarchy of Control can be used to control the identified risks:
- Elimination – carry out the work indoors to eliminate the risk of solar UV radiation exposure. This is the best protection2.
- Minimisation:
- Substitution – carry out the work during the early morning and late afternoon when UV radiation exposure is lower
- Isolation – separate the hazard or hazardous work practice from people
- Engineering – installation of a sunshade or use of natural shade
- Administrative – rotating jobs and varying tasks
- Personal protective equipment – lowest order control measure and should only be considered when other higher order control measures are not reasonably practicable or to increase protection from the hazard. This includes sun protective work clothing, sun protective hats, sunglasses and sunscreen1,3.
Personal Protective Equipment
Case should be taken to not create a secondary hazard to the worker. E.g. loose clothing near outdoor machinery.
- Clothing – select appropriate clothing that has UPF (ultraviolet protection factor) rating of 50+ and allows sweat evaporation, long sleeves and long trousers where appropriate/practicable
- Hats – provide shade the bigger the brim
- Sunscreens – a high SPF broad-spectrum sunscreen that provides protection against UVA and UVB that is appropriate for skin type and working conditions
- A hat and sunscreen together is preferable, than sunscreen alone
- Lip protection – protection with SPF 30+ sunscreen or lipstick
- Eye protection – determine either over-riding health or safety concerns and select the appropriate eye protection3.
SunSmart UV Alert
The Bureau of Meteorology issues the SunSmart UV alert which is based on the UV index, when the UV Index is forecast to reach three or above. This can be accessed via:
- myuv.com.au
- a smart phone application and a widget for your website at https://www.sunsmart.com.au/tools/interactive-tools/free-sunsmart-app
- television, radio and newspapers
- the Bureau of Meteorology website at bom.gov.au/uv
- the Australian Radiation Protection and Nuclear Safety Agency (ARPANSA) website at www.arpansa.gov.au1.
Health Surveillance
Employers should consider providing regular skin checks at skin clinics for works who are exposed to solar UV radiation and provide information on how workers can check their own skin.
Having regular skin checks to detect skin cancer is not an alternative to using sun protection control measures.
Tips on how to carry out a self-check include:
- Checking your whole body including the soles of your feet, between your toes, your armpits, ears, eyelids, under your fingernails and scalp
- Using a hand held mirror or have someone help you check areas you cannot see like your back, back of your neck and legs
- Looking for a new spot or a spot that is different from the ones around it
- Looking for a sore that does not heal, and
- Looking for a spot or mole that has changed in size, shape or colour2.
For all enquiries about our Health Surveillance services
Next Steps
Providing a sun safe workplace is important for the health and safety of workers. However, being able to provide skin cancer checks to workers through their employer is a great way to look after individuals and identify any issues early.
If you would like to know more about MAX’s Skin Cancer Check service, please contact our friendly team on support@injurynet.com.au or speak to your program manager.
References
- Guide on exposure to solar ultraviolet radiation – national guidance. Safework Australia 2019
- Working outside – Working in the sun | Safe Work Australia
- Guidance note for the protection of workers from the ultraviolet radiation in sunlight. Australian Safety and Compensation Council (ASCC) 2008
