Outdoor workers are exposed daily to solar ultraviolet radiation, an important contributor in the development of non-melanoma skin cancer. This study aimed to quantify the health burden of non-melanoma skin cancers among outdoor workers in Canada.
Solar ultraviolet radiation exposure and estimates of exposure levels were applied to employment information from Canada census data to determine the exposed population in the risk exposure period (1961–2001). Risk estimates were drawn from meta-analyses selected based on quality and relevance to the current study. Population-attributable fractions were calculated using Levin’s equation and attributable cases were estimated based on incidence data reported by the Canadian Cancer Society.
In 2011, 6.31% (4556 cases) of non-melanoma skin cancer cases were estimated to be attributable to occupational exposure to solar ultraviolet radiation. The majority of these cases occurred in men in the agriculture or construction industries.
These estimates of the burden of non-melanoma skin cancer in Canada identify the need for further prevention efforts, particularly in agriculture and construction. Introducing workplace sun safety measures could be an important area for policy development.
This is a preview of subscription content, log in to check access.
Buy single article
Instant access to the full article PDF.
Price includes VAT for USA
Subscribe to journal
Immediate online access to all issues from 2019. Subscription will auto renew annually.
This is the net price. Taxes to be calculated in checkout.
Basal cell carcinoma
Job exposure matrix
Non-melanoma skin cancer
Population attributable fraction
Proportion of workers exposed
Risk exposure period
Squamous cell carcinoma
Abbas M, Kalia S (2016) Trends in non-melanoma skin cancer (basal cell carcinoma and squamous cell carcinoma) in Canada: a descriptive analysis of available data. J Cutan Med Surg 20:166–175. https://doi.org/10.1177/1203475415610106
Alfonso JH, Sandvik A, John SM (2017) Occupational skin cancer: sweeping the path to prevention. Occup Med (Lond) 67:328–330. https://doi.org/10.1093/occmed/kqw180
Apalla Z, Lallas A, Sotiriou E, Lazaridou E, Ioannides D (2017) Epidemiological trends in skin cancer. Dermatol Pract Concept 7:1–6. https://doi.org/10.5826/dpc.0702a01
Barber K, Searles GE, Vender R, Teoh H, Ashkenas J, Canadian Non-melanoma Skin Cancer Guidelines C (2015) Non-melanoma skin cancer in Canada chapter 2: primary prevention of non-melanoma skin cancer. J Cutan Med Surg 19:216–226. https://doi.org/10.1177/1203475415576465
Bauer A, Diepgen TL, Schmitt J (2011) Is occupational solar ultraviolet irradiation a relevant risk factor for basal cell carcinoma? A systematic review and meta-analysis of the epidemiological literature. Br J Dermatol 165:612–625. https://doi.org/10.1111/j.1365-2133.2011.10425.x
Canadian Cancer Society’s Advisory Committee on Cancer Statistics (2014) Canadian Cancer Statistics 2014: special topic skin cancer. Canadian Cancer Society, Toronto
Doll R, Peto R (1981) The causes of cancer: quantitative estimates of avoidable risks of cancer in the United States today. J Natl Cancer Inst 66:1191–1308
Eisemann N et al (2014) Non-melanoma skin cancer incidence and impact of skin cancer screening on incidence. J Invest Dermatol 134:43–50. https://doi.org/10.1038/jid.2013.304
Gafa L, Filippazzo MG, Tumino R, Dardanoni G, Lanzarone F, Dardanoni L (1991) Risk factors of nonmelanoma skin cancer in Ragusa, Sicily: a case-control study. Cancer Causes Control 2:395–399
Gordon R (2013) Skin cancer: an overview of epidemiology and risk factors. Semin Oncol Nurs 29:160–169. https://doi.org/10.1016/j.soncn.2013.06.002
Green A, Battistutta D, Hart V, Leslie D, Weedon D (1996) Skin cancer in a subtropical Australian population: incidence and lack of association with occupation. The Nambour Study Group. Am J Epidemiol 144:1034–1040
Guenther LC, Barber K, Searles GE, Lynde CW, Janiszewski P, Ashkenas J, Canadian Non-melanoma Skin Cancer Guidelines C (2015) Non-melanoma skin cancer in Canada chapter 1: introduction to the guidelines. J Cutan Med Surg 19:205–215. https://doi.org/10.1177/1203475415588652
Hakansson N, Floderus B, Gustavsson P, Feychting M, Hallin N (2001) Occupational sunlight exposure and cancer incidence among Swedish construction workers. Epidemiology 12:552–557
Healthier Together (2018) Be sunsbile: protecting outdoor workers. https://besunsible.healthiertogether.ca/#. Accessed 15 May 2019
Kim J et al (2018) Burden of lung cancer attributable to occupational diesel engine exhaust exposure in Canada. Occup Environ Med 75:617–622. https://doi.org/10.1136/oemed-2017-104950
Kramer DM, Tenkate T, Strahlendorf P, Kushner R, Gardner A, Holness DL (2015) Sun Safety at Work Canada: a multiple case-study protocol to develop sun safety and heat protection programs and policies for outdoor workers. Implement Sci 10:97. https://doi.org/10.1186/s13012-015-0277-2
Levin ML (1953) The occurrence of lung cancer in man. Acta Unio Int Contra Cancrum 9:531–541
Madan V, Lear JT, Szeimies RM (2010) Non-melanoma skin cancer. Lancet 375:673–685. https://doi.org/10.1016/S0140-6736(09)61196-X
Marks R, Jolley D, Dorevitch AP, Selwood TS (1989) The incidence of non-melanocytic skin cancers in an Australian population: results of a five-year prospective study. Med J Aust 150:475–478
Mofidi A et al (2018) The economic burden of occupational non-melanoma skin cancer due to solar radiation. J Occup Environ Hyg 15:481–491. https://doi.org/10.1080/15459624.2018.1447118
Nurminen M, Karjalainen A (2001) Epidemiologic estimate of the proportion of fatalities related to occupational factors in Finland. Scand J Work Environ Health 27:161–213
Peters CE, Nicol AM, Demers PA (2012) Prevalence of exposure to solar ultraviolet radiation (UVR) on the job in Canada. Can J Public Health 103:223–226
Peters CE, Ge CB, Hall AL, Davies HW, Demers PA (2015) CAREX Canada: an enhanced model for assessing occupational carcinogen exposure. Occup Environ Med 72:64–71. https://doi.org/10.1136/oemed-2014-102286
Peters CE, Demers PA, Kalia S, Nicol AM, Koehoorn MW (2016) Levels of occupational exposure to solar ultraviolet radiation in Vancouver, Canada. Ann Occup Hyg 60:825–835. https://doi.org/10.1093/annhyg/mew037
Pukkala E, Saarni H (1996) Cancer incidence among Finnish seafarers, 1967–92. Cancer Causes Control 7:231–239
Radespiel-Troger M, Meyer M, Pfahlberg A, Lausen B, Uter W, Gefeller O (2009) Outdoor work and skin cancer incidence: a registry-based study in Bavaria. Int Arch Occup Environ Health 82:357–363. https://doi.org/10.1007/s00420-008-0342-0
Rosen L (2013) An intuitive approach to understanding the attributable fraction of disease due to a risk factor: the case of smoking. Int J Environ Res Public Health 10:2932–2943. https://doi.org/10.3390/ijerph10072932
Rushton L et al (2012) Occupational cancer burden in Great Britain. Br J Cancer 107(Suppl 1):S3–S7. https://doi.org/10.1038/bjc.2012.112
Samarasinghe V, Madan V (2012) Nonmelanoma skin cancer. J Cutan Aesthet Surg 5:3–10. https://doi.org/10.4103/0974-2077.94323
Schmitt J, Seidler A, Diepgen TL, Bauer A (2011) Occupational ultraviolet light exposure increases the risk for the development of cutaneous squamous cell carcinoma: a systematic review and meta-analysis. Br J Dermatol 164:291–307. https://doi.org/10.1111/j.1365-2133.2010.10118.x
Schmitt J et al (2018a) Is ultraviolet exposure acquired at work the most important risk factor for cutaneous squamous cell carcinoma? Results of the population-based case-control study FB-181. Br J Dermatol 178:462–472. https://doi.org/10.1111/bjd.15906
Schmitt J et al (2018b) Occupational UV-exposure is a major risk factor for basal cell carcinoma: results of the population-based case-control study FB-181. J Occup Environ Med 60:36–43. https://doi.org/10.1097/jom.0000000000001217
Sun Safety at Work (2018) Sun safety at work: enhancing sun safety in Canadian workplaces. https://sunsafetyatwork.ca/. Accessed 15 May 2019
Surdu S et al (2013) Occupational exposure to ultraviolet radiation and risk of non-melanoma skin cancer in a multinational European study. PLoS One 8:e62359. https://doi.org/10.1371/journal.pone.0062359
Vishvakarman D, Wong JC (2003) Description of the use of a risk estimation model to assess the increased risk of non-melanoma skin cancer among outdoor workers in Central Queensland, Australia. Photodermatol Photoimmunol Photomed 19:81–88
Vuong K, McGeechan K, Armstrong BK, Investigators A, Investigators GEM, Cust AE (2014) Occupational sun exposure and risk of melanoma according to anatomical site. Int J Cancer 134:2735–2741. https://doi.org/10.1002/ijc.28603
Wheless L, Black J, Alberg AJ (2010) Nonmelanoma skin cancer and the risk of second primary cancers: a systematic review. Cancer Epidemiol Biomark Prev 19:1686–1695. https://doi.org/10.1158/1055-9965.EPI-10-0243
Young C, Rushton L, British Occupational Cancer Burden Study G (2012) Occupational cancer in Britain. Skin cancer. Br J Cancer 107(Suppl 1):S71–S75. https://doi.org/10.1038/bjc.2012.120
The Burden of Occupational Cancer Research presented in this report was funded by the Canadian Cancer Society Multi-Sector Team Grant in Prevention Research (#701285). Occupational carcinogen exposure estimates were provided by CAREX Canada, which is funded by the Canadian Partnership against Cancer.
Conflict of interest
The authors declare that they have no conflict of interest.
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
About this article
Cite this article
Peters, C.E., Kim, J., Song, C. et al. Burden of non-melanoma skin cancer attributable to occupational sun exposure in Canada. Int Arch Occup Environ Health 92, 1151–1157 (2019). https://doi.org/10.1007/s00420-019-01454-z
- Occupational health
- Skin cancer
- Solar radiation