Workers Exposed to Sunlight at High Risk of Deadly Skin Cancer

2023-11-08

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GENEVA —A new study by the World Health Organization and International Labour Organization finds nearly 1 in 3 deaths from non-melanoma skin cancer are caused by working in the sun.

"We know that around the world, 1.6 billion workers are exposed to solar ultraviolet radiation globally. Depending on where you live, you will have more or less protection," said Maria Neira, director of the WHO department of environment, climate change and health.

"The number of those deaths from occupational non-melanoma skin cancer burden has doubled over the last 20 years and, of course, unfortunately, we can expect to see many cases in the future. It takes a number of years to develop a cancer," she said.

The joint study issued Wednesday provides data for 183 countries and produces the first comprehensive global picture of the extent of this growing occupational health problem. Authors of the study say governments can use their data to identify unsafe workplaces and design policies to protect workers from the harmful effects of the sun's rays.

According to the joint estimates, 1 in 4 of the 1.6 billion people of working age was exposed to UV radiation while working outdoors in 2019 and nearly 19,000 died from non-melanoma skin cancer.

"We pooled a large number of case control studies, epidemiological evidence in three regions of the world, 90,000 people, and found there was a 60% increased risk" of developing non-melanoma skin cancer among working people exposed to solar UV radiation, said Frank Pega, a technical officer in the WHO department of environment, climate change and health, and the report's lead author.

"It is not only a question of life and death," he said, "but actually skin cancer is extremely disabling. Skin cancer poses a lot of lesions on your skin and your face, and your arms and is highly visible. It is a really big burden for people - half a million lives lost every year to this horrible risk factor."

The report says occupational exposure to solar ultraviolet radiation is estimated to have decreased by almost one-third between 2000 and 2019. However, it noted that during this same period, "there has been an 88% increase in non-melanoma skin cancer deaths and a 77% increase in non-melanoma skin cancer" due to occupational ultraviolet radiation.

Pega said that these large work-related occupational skin cancer deaths were very unusual in that they were almost equally distributed around the world.

"Skin cancer normally is concentrated in high income countries, in the European and North American regions and in Australasia. But this burden is different. It actually affects low and middle-income countries.

"So, it is really a global health issue, and it actually is equally present in Africa as it is in Europe, North America and Southeast Asia," he said. "So that is very new and that is something that we have to think about."

The WHO and ILO are calling for action to mitigate this serious workplace hazard.

"There are effective solutions to protect workers from the sun's harmful rays, and prevent their deadly effects," said Tedros Adhanom Ghebreyesus, WHO director-general.

Echoing the WHO chief's sentiments, Joaquim Pintado Nunes, head of the ILO's Labor Administration, inspection and occupation safety and health branch, said, "We know that preventing death from this kind of exposure is quite cost effective and does not require much."

"For example, organizing work in a way to avoid workers to be exposed and working under the sun at given hours of the day, providing shade for the workers, hydrating also the workers while they work, providing clothing that will also cover the skin to protect it from the sun," he said. "I would say with a very minor investment, this impressive number of 19,000 deaths could, as a matter of fact, be prevented."

While agreeing with the substance of these measures, Pega observed that a large category of workers is cut out of these protections because of inequalities baked into the system.

"We cannot forget informal economy workers," he said. "These are 61% of all workers globally and they are likely much more commonly to be outdoor workers. So, they will be most affected, and often not have any protections from employers because they do not have one or actually any protections from labor, labor laws or labor institutions because there is no employer to work with."

WHO and ILO warn these deaths will continue to increase unless governments, employers, and workers' representatives cooperate to enact life-saving policies that will protect workers from the sun's harmful rays.