Risk assessment of occupational skin cancer among outdoor workers in southern Spain: local pilot study

Abstract

ObjectiveOverexposure to ultraviolet (UV) radiation is the main preventable cause of skin cancer. Outdoor workers, exposed to the sun for many hours throughout their working lives, are at special risk. The aim of this study is to determine occupational photoexposure and photoprotection among outdoor workers employed by a municipality in southern Spain.MethodsCross-sectional descriptive study focusing on outdoor workers employed by the municipality of Fuengirola (in areas such as construction, gardening, urban cleaning and beach maintenance). The participants were monitored by personal dosimetry, participated in a dermatological check-up and answered a validated questionnaire (CHACES) on their habits, attitudes and knowledge related to sun exposure.ResultsThe median effective erythema dose of exposure to solar UV radiation during the working day (n=20) was 379.4 J/m2, equivalent to 3.8 standard erythema doses, almost 3 times higher than the recommended limits for an 8-hour workday. Skin examination (n=128) revealed the presence of actinic lentigines (79.7%), actinic keratoses (8.6%) and skin cancer (3.9%). The CHACES questionnaire (n=128) revealed a sunburn rate of 50.0%. Photoprotection practices were markedly deficient: only 16.7% of the survey respondents sought protection in the shade, 20.3% avoided exposure during the peak exposure hours and 33.1% applied sunscreen.ConclusionsThis is the first study to evaluate UV radiation exposure, occupational sun protection practices, sunburn and actinic injuries of different outdoor workers in one of the sunniest regions of Spain and underlines the need for effective interventions to protect outdoor workers’ health.

Skin cancer prevention in extreme sports: Intervention in a 24‐h race

“…On the whole, these results are in line with those of other groups that are especially vulnerable due to their high sun exposure, such as outdoor workers, 33 especially lifeguards, 34 and other athletes who participate in water sports. 27 Among the latter, no greater implementation of photoprotective measures to protect against their increased exposure was observed compared to other, less exposed groups such as healthcare workers 35 or educators.…”

“…The rates obtained from the analysis of works published between 1989 and 2015 were 38.16 (95% CI, 31.72–39.97) cases of melanoma per 100,000 person‐years and 113.05 (95% CI, 89.03–137.08) cases of BCC per 100,000 person‐years 38 . Although the lesions found require histological confirmation, the percentage of suspicious lesions is slightly higher to that found in examinations performed in other at‐risk groups such as the workers and guests at Costa del Sol hotels (2.2%: six lesions in 278 individuals), 39 but lower than the rate found among workers and players at golf courses (6.7%: 23 lesions in 242 individuals) 40 and outdoor workers (6.3%: eight lesions in 128 individuals, of which five were confirmed via biopsy) 33 …”

“…38 Although the lesions found require histological confirmation, the percentage of suspicious lesions is slightly higher to that found in examinations performed in other at-risk groups such as the workers and guests at Costa del Sol hotels (2.2%: six lesions in 278 individuals), 39 but lower than the rate found among workers and players at golf courses (6.7%: 23 lesions in 242 individuals) 40 and outdoor workers (6.3%: eight lesions in 128 individuals, of which five were confirmed via biopsy). 33 The excellent score obtained on the satisfaction questionnaire conducted among athletes after the intervention, in addition to the benefits of repeating the intervention in future editions and extending it to other sports competitions, supports the positive impact of TA B L E 3 Skin monitoring habits.…”

Solar ultraviolet radiation exposure in workers with outdoor occupations: a systematic review and call to action

“…An observational cross‐sectional pilot study conducted in Spain assessed sun exposure via dosimetry measurements and sun protective behaviors of municipal workers ranging in occupation from construction and maintenance to gardeners, urban cleaning personnel, and beach cleaning and maintenance members 48 . While beach employees and afternoon shift workers recorded the highest levels of UV exposure, the values did not differ significantly between shift times or occupational sectors.…”

“…Researchers found that a one-point increase in Workplace Sun-safety Culture Score (range: 12 points) was associated with a 0.16 higher Personal Sun-Protection Score (P < 0.001), and a onepoint increase in Workplace Provision Score (range 4 points) was associated with a 0.14 higher score (P < 0.001). 34 Question 48 While beach employees and afternoon shift workers recorded the highest levels of UV exposure, the values did not differ significantly between shift times or occupational sectors. Of the 128 study participants who agreed to dermatologic check-ups, 79.7% demonstrated evidence of actinic lentigines, while 8.6% exhibited actinic keratoses.…”