What are the five sun protection and child care essentials to protect children and staff at your service from the effects of UV radiation?

Introduction

This short guide is both for employers of outdoor workers and the employees themselves on sun protection. These include construction workers, farmers, agricultural and horticultural workers, fishermen, gardeners, postal workers, council workers, refuse collectors and couriers. The guide provides useful information on the topic of skin cancers which are much more common in outdoor workers than those who work indoors. It also outlines measures that employers should have in place to protect their employees. 

Skin Cancer

Cancer is a disease of the body cells. The cells do not behave as normal and keep on growing to form a primary tumour. If a cancer is malignant, the cells can break away from the body part where they form and be carried by the bloodstream or lymph vessels elsewhere and form a secondary tumour.

Skin cancer is caused by abnormal growth of the cells nearest the skin, squamous, basal and melanocytes (see Fig.1). Squamous and basal cells form non melanoma skin cancer while melanocytes cells which give the skin its pigment or colour form melanoma skin cancer. Basal cell cancers (BCC) are more strongly related to acute sun burn events in childhood and intermittent adult exposure while squamous cell cancer (SCC) is mostly a result of chronic long term occupational sun exposure.

Fig. 1

Cases of Skin Cancer

Unfortunately the annual rates of both melanoma and non-melanoma skin cancers (NMSC) are increasing steadily in Ireland. There are over 1000 cases of melanoma and almost 12,000 cases of non-melanoma annually.

Between 2015 and 2045, it is predicted that the number of cases of melanoma per year among males will increase to 1,678 (+207%), and for females to 1,400 (+140%). The number of people diagnosed with NMSC over the same time period is predicted to increase to 16,623 (+177%) for males and 13,503 (+189%) for females1.

Causes of Skin Cancer

The main cause of skin cancer is ultraviolet (UV) light from the sun. Sun exposure is the best natural source of Vitamin D and is important for good general health. We can all enjoy the outdoors but we just need to think about how we protect our skin when outside. Outdoor workers are at higher risk than other workers.

Outdoor workers

Outdoor workers such as people working in construction may be particularly at risk in heatwaves from high outdoor temperatures as well as from UV exposure.  The harmful effects from the sun, like sunburn and skin cancer, come from UV radiation. If you work outdoors, you might be exposed to 2-3 times more UV radiation from the sun than someone who works indoors, putting you at high risk of skin cancer.

You need to keep hydrated by drinking plenty of fluids. You also need to protect your skin from the sun. If you spend all or part of the day regularly working outdoors, you can reduce your risk of skin cancer by protecting your skin (by being SunSmart). The general advice is to keep out the sun especially if outdoors between 11am to 3pm when UV rays are at their strongest. If possible, schedule outdoor work before 11am or after 3pm.

However, if you have to go outdoors to work, protect your skin by using shade, wear clothing that covers the skin, a wide brimmed hat, sunglasses and sunscreen of 30+ for adults.

Employer Protective Measures

Employers need to make sure that their workers can keep hydrated easily and can protect their skin from UV radiation damage.

There are a range of protective measures as follows:

• If possible, plan outdoor work in sunny weather to limit duration and intensity of employee exposure to direct sunlight (11am to 3pm sun rays are most intense)
• Limit duration of exposure if possible when UV index is high (3 or above), do indoor work if possible
• Provide shade if possible, or if that is not possible, there should be shade for breaks
• Give information to employees about dangers of sun exposure
• Ensure workers have easy access to safe drinking water. Workers should have enough time to hydrate – as the outdoor temperature rises the frequency of water breaks should go up
• Inform employees about the Sun Smart code
• Educate and encourage employees to self-check skin for signs of skin cancer
• Check UV index, if 3 or above greater risk www.met.ie/uv-index
• Ensure breaks are taken out of direct sunlight
• Encourage employees to cover up, keep clothing on with sleeves down, collars up and wear clothing with high ultraviolet protection factor (UPF), 15 or more, wear wide-brimmed hat
• Ensure employees do not strip off clothing when it is sunny
• Provide sunscreen, SPF of at least 30+ with a high UVA protection and water resistance. Reapply regularly.
• Provide sun glasses, wraparound are best.

Sun Smart Code

Please make it easy for workers to follow the SunSmart code messages - 5 Ss:

1. Slip on clothing that covers your skin, such as long sleeves, collared t-shirts.
2. Slop on sunscreen on exposed areas. Use sunscreen SPF minimum 30 or higher. Apply 20 minutes before going outside and re-apply every two hours – more often if perspiring.
3. Slap on a wide-brimmed hat.
4. Seek shade - especially if outdoors between 11am and 3pm when UV rays are at their strongest. If possible, schedule outdoor work before 11am or after 3pm.
5. Slide on wraparound sunglasses to protect your eyes. 

Reference

1 National Cancer Registry. Cancer incidence projections for Ireland 2020-2045. Cork: National Cancer Registry; 2019

Useful Sites

• Irish Cancer Society at www.cancer.ie
• Skinmama courtesy of the EU Health Program skinmama.eu/
• HSE Sunsmart https://www.hse.ie/sunsmart  

Useful Resources

• SunSmart audit tool for skin cancer prevention in outdoor workers
• SunSmart framework for skin cancer prevention in outdoor workers
• SunSmart sample terms of reference for skin cancer prevention group
• SunSmart Survey for skin cancer prevention in outdoor workers
• Tools and resources for skin cancer prevention in outdoor workers
• Outdoor Workers and UV risks - Be SunSmart - YouTube

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