Occupational Skin Cancer: Outdoor Workers’ number one enemy

Outdoor workers are at least twice as likely to contract skin cancer from exposure to the sun than indoor workers. Brian Johnson finds out why

From L-R, EFBWW’S Rolf Gehring, Osnabrück University’s Dr Marc Wittlich, Jens Gieske MEP, the WHO’s Dr Emilie van Deventer, EADV President Prof Luca Borradori, Nessa Childers MEP, Alojz Peterle MEP, EADV’s Prof Swen Malte John | Photo credit: BR&U/ Jan Van de Vel

By Brian Johnson

Brian Johnson is Managing Editor of The Parliament Magazine

26 Jun 2017

Occupational skin cancer is costing EU governments more than €500m a year and is now considered to be the number one enemy of Europe’s outdoor workers.

That was the stark message delivered at the launch of an interactive exhibition in the European Parliament highlighting ultraviolet (UV) solar radiation induced skin cancer as an occupational disease. Participants at the event in the European Parliament, organised by the European Academy of Dermatology and Venereology, (EADV) were told that Europe’s estimated 14.5 million outdoor workers are mostly unaware that they are twice as likely to contract non-melanoma skin cancer as indoor workers.

Opening the event last week, EADV President Professor Luca Borradori said the exhibition provided an opportunity to increase awareness among EU policymakers of the dangers that Europe’s outdoor workers face from UV exposure from the sun.

“Sun exposure is the key factor in developing skin cancer,” said Borradori, adding that, “outdoor workers have at least a twofold increased risk of contracting non-melanoma skin cancer,” making it their “number one enemy”.

Skin cancer occurs when damaged skin cells, caused by UV radiation, triggers cell mutation and rapid cell multiplication. “Action is needed to prevent the risk of developing cancer, but little has been done to protect outdoor workers,” said Borradori.


“Despite strong evidence that outdoor workers exposed to high levels of UV radiation from the sun, develop a much higher incidence of non-melanoma skin cancer, this link has not yet not been translated into a common European or national standard on UV prevention. Most EU member states have no legislation to protect outdoor workers from UV radiation.”

Borradori encouraged EU policymakers to support EADV’s global call to action to raise awareness on the issue.

EADV are asking for improvements to the legislative framework to protect outdoor workers more effectively, official recognition of UV induced non-melanoma skin cancers as occupational diseases, the development of tools to measure workplace exposure, the creation of an evidence base as well as multi-stakeholder collaboration to promote sun-safe working practices and education on the simple and cheap techniques of sun-safe behaviour and prevention of skin cancer.

“This exhibition is a reminder that we all need to fight together on preventing skin cancer,” said Borradori.

Jens Gieseke, the MEP host for the exhibition, applauded EADV for its innovative approach in highlighting the issue saying he couldn’t recall attending an event that had so much “incredible interactivity and value to participants.”

With free skin cancer screenings, spot checks with dermatologists, UV scanners, sun damage camera and, on-demand medical experts and outdoor workers providing expertise and experiences, EADV aim to encourage people to take a hands-on approach to the three-day exhibition. “I want to encourage everyone to get involved in the exhibition,” said Gieseke.

“We must inform ourselves, help raise awareness and take away a renewed commitment to contribute as much as possible to skin cancer prevention. Treating occupational skin cancer across Europe costs more than €500m a year. This is a cost that could largely be avoided if appropriate prevention measures were taken.

“With healthcare systems across Europe under significant economic pressures, health economic arguments support the call for action on the prevention of occupational skin cancer - the most frequent occupational cancer - in Europe. Skin cancer may be outdoor workers number one enemy, but together we are going to beat it.”

Nessa Childers, a vice-president of the European Parliament’s all-party MEPs Against Cancer (MAC) group welcomed the initiative arguing that “classifying non-melanoma skin cancers as occupational diseases would go a long way to remedying the situation for outdoor workers”.

She acknowledged that member states’ health systems were under stress, but said, “I like to think we could see a decrease in occupational skin cancer due to preventative measures. However, awareness raising differs between member states.”

The EU “needs to ensure a baseline, and the sharing of best practice,” she added.

Childers’ MAC colleague Alojz Peterle said, “Educating people on sun-safe behaviour is the most cost effective tool against skin cancer.”

Peterle told participants that improving the legislative framework was crucial and reiterated that exposure to UV solar radiation, “is the most common carcinogenic exposure in the EU, yet most outdoor workers are still unaware of the risks of working under the sun. But there are often simple and affordable solutions at hand to help avoid this preventable form of cancer.

“It is our duty to make this House an advocate for the safety of outdoor workers. More awareness means more action and that means less cancer. We can do a lot.” .

Peterle, the MAC President closed saying, “It’s essential that we highlight the importance of prevention. Promoting and educating people on the simple and cost-effective techniques of sun-safe behaviour and the prevention of skin cancer are a good way to start the summer.”

Other speakers included Dr Emilie van Deventer, from the WHO’s Radiation Programme who said, “the risk factors of UV radiation are well known and the science is very clear: UV radiation is a carcinogen. Outdoor workers need and deserve protection from UV radiation, just as the they need protection from other carcinogens such as asbestos.”

Event Moderator Professor Swen Malte John of Osnabrück university, said it was time that UV radiation from the sun was treated like any other occupational hazard.

“Outdoor workers have at least a twofold increased risk of contracting non-melanoma skin cancer making it their number one enemy” EADV President Professor Luca Borradori

“The WHO have classed UV as a Group 1 carcinogen alongside substances such as Plutonium, Arsenic and Asbestos,” said John. “We want legislation to protect outdoor workers against the carcinogen UV in the same way as they are protected against all other carcinogens”.

Solar UV radiation was controversially omitted from the scope of the EU’s recent directive on the protection of workers from risks associated with exposure to occupational carcinogens. An omission that John, the chair of EADV’s media & PR committee, argued allowed UV-induced skin cancers to go virtually unnoticed and unreported across the EU.

“UV radiation from the sun is physically invisible: In several EU member states, UV is also invisible as an occupational disease. The directive is missing on solar UV even though UV induced skin cancer is the most frequently reported occupational cancer in Germany”

Further comment came from Dr Marc Wittlich, from the institute for occupational safety and health at the German Social Accident Insurance, who outlined the results of his three-year research programme.

Focussing on measuring occupational exposure to UV radiation, “Reliable measurement data is the best starting point for prevention of UV exposure,” said Wittlich, adding, “this golden standard was lacking until today.”

Almost 1000 volunteers eventually delivered more than three billion datasets covering more than 85,000 days of measurement.

“We gained a lot of knowledge on the exposure of workers, not only with respect to their jobs, but more precisely on their distinct occupational activities”.

“Notably,” revealed Wittlich,” even in a country with a moderate latitude such as Germany, UV exposure can be as high as 581 sunburn doses a year in fair skinned people – about twice of what was previously thought.”

“We will also take a closer look at leisure time exposure to finally arrive at a holistic approach for preventing UV exposure,” he concluded.

Rolf Gehring, from the European Federation of Building and Woodworkers, said that for anyone to do their job properly, they needed the right tools and the right level of knowledge and understanding.

“Education on protection from the sun should,” he said,“ start in the kindergartens not just when [learning] apprenticeships.”

He argued that UV radiation should be included in the European schedule of occupational diseases, and in the directive on the protection of workers. The European Parliament should organise a public hearing on what to do about the issue

“At European level, we need to improve the legal framework on occupational exposure to UV radiation, and ensure that UV induced skin cancer is recognised as an occupational disease.”

Find out more about the EADV Skin Cancer: Safe Work Under the Sun Campaign