American Melanoma Institute · 5 min read
How much working in the sun raises skin cancer risk, which jobs are affected, and the protections that workers and employers can put in place.
A beach vacation lasts a week. An outdoor job delivers sun 5 days a week for 30 or 40 years, often through the brightest hours of the day. That steady dose adds up to one of the largest UV exposures anyone receives.
Construction and road crews, roofers, farmers and ranch workers, grounds and garden crews, lifeguards, fishing crews, utility line workers, surveyors, and mail and package carriers all spend much of the workday under open sky.
Surroundings can raise the dose. Water, sand, snow, and concrete reflect UV back up at the face, under the brim of a hat. Thin mountain air filters out less UV than air at sea level.
Pilots and cabin crew are an unexpected addition to the list. A meta-analysis of 19 studies with more than 266,000 participants (Sanlorenzo and colleagues, JAMA Dermatology, 2015) found that both groups develop melanoma at about twice the rate of the general population. The same research team measured UV in a small aircraft cockpit and found that the windshield blocked UVB but let UVA through. Cosmic radiation and leisure-time sun may also contribute, and more data is needed to sort out the causes.
In 2023 the World Health Organization (WHO) and the International Labour Organization (ILO) published their first joint estimate of this problem. They calculated that 1.6 billion people worldwide, about 28% of everyone of working age, were exposed to solar UV on the job in 2019.
The 2 agencies attributed 18,960 deaths from nonmelanoma skin cancer in 183 countries that year to occupational sun exposure. That amounts to nearly 1 in 3 of all deaths from these cancers, and about 65% of the deaths were in men. The yearly toll had almost doubled since 2000. The review behind the estimate found that working in the sun raises a person's risk of nonmelanoma skin cancer by about 60%.
Nonmelanoma skin cancer means basal cell carcinoma and squamous cell carcinoma. Squamous cell carcinoma is the one most closely tied to total lifetime sun, and it shows up where outdoor workers get hit hardest: the scalp, ears, lower lip, back of the neck, forearms, and hands. Most cases are cured with a minor procedure when caught early. The deaths in the WHO and ILO estimate mostly reflect cancers found late.
Occupational safety specialists rank protections in order. Removing the hazard comes first, and personal gear comes last. For sun, that means starting with the schedule and with shade.
The WHO and ILO advise protective measures whenever the UV index reaches 3 or higher. The UV index is a daily forecast of sun strength, available in most weather apps. The National Institute for Occupational Safety and Health (NIOSH) recommends that employers schedule outdoor tasks for times with less sun where they can, provide shaded or indoor break areas, and train workers about the risk.
In practice, a crew might pour concrete at 6 a.m. and move shop tasks to the middle of the day. Portable canopies and shade sails over fixed work stations cut the dose without asking anyone to remember anything.
Clothing is the most reliable personal protection because it doesn't wear off. Long sleeves and long pants in a tightly woven fabric block most UV. Garments labeled with an ultraviolet protection factor (UPF) have been tested for it, and many are light and vented for hot weather.
Sunscreen fails at work mainly because it goes on once at dawn. Dermatologists recommend reapplying every 2 hours, and sooner after heavy sweating. Tying reapplication to fixed points in the day, such as the morning break and lunch, makes it a habit.
Some blood pressure pills, antibiotics, and pain relievers make skin burn faster. NIOSH lists thiazide diuretics, tetracyclines such as doxycycline, sulfa antibiotics, and NSAIDs such as ibuprofen. Workers who take these can ask their prescriber or pharmacist about sun sensitivity.
Sun is a workplace hazard in the same sense that noise and dust are. Employers who treat it that way write it into the safety plan. They supply shade, sunscreen dispensers, UPF shirts, and brims for hard hats as standard equipment.
The WHO and ILO also call for early detection programs for outdoor workers. Some employers and unions arrange skin screening days with a dermatologist.
Years of outdoor work are worth mentioning to your doctor, even if the job ended long ago. Doctors use that history, along with skin type and past skin cancers, to decide how often a full skin exam makes sense.
Between visits, look over your own skin about once a month, including the scalp, ears, and neck. The signs to report are a sore that hasn't healed in a month, a rough or scaly patch that keeps coming back, a shiny or pearly bump, a spot that bleeds easily, and any mole that is new or changing. Rough, sandpaper-like patches called actinic keratoses are common in outdoor workers. They are precancerous, and treating them lowers the chance that a squamous cell carcinoma develops.
