A step forward for the sick: skin cancer caused by ultraviolet radiation and the injuries that precede it will be recognized as an occupational disease. The Federal Agency for Occupational Risks (Phaedrus) recently followed the proposal of the Scientific Council to include this disease in the list of occupational diseases.
What disease is it about?
Actinic keratosis is the first sign of serious skin damage from the sun. It is characterized by pinkish, scaly patches called hyperkeratotic patches. A hyperkeratosis is caused by an abnormal cornification of the skin cells. The skin thickens and feels rougher than the skin around it. These spots appear on uncovered parts of the body (baldness, face, forearms, back of the hand). Actinic keratosis is considered the most common precursor and major risk factor for the development of a cancerous lesion: invasive spinocellular carcinoma (squamous cell carcinoma).
In which cases?
There are several conditions for recognizing this type of cancer and/or injury as an occupational disease. The most important condition is that the person concerned must have worked if:
- farmer, tree nursery and fruit grower;
- gardener, horticulturist;
- lumberjack, forest worker and in nature reserves;
- fishing boat crew member;
- road worker;
- roofer;
- construction worker;
- construction worker.
This applies to the extent that these activities were mainly carried out outdoors. We can assume that these occupations lead to greater exposure to the sun’s rays.
Exposure criteria and diagnosis
Although scientific research estimates the duration of individual occupational exposure to be at least 20,000 hours during the months of May through September, this criterion is not explicitly included in the code of occupational diseases. Given the continuous scientific developments, these 20,000 hours should indeed be a guideline for Fedris, but should not be strictly applied.
Second condition: the data subject must at least six actinic keratoses on the same skin area that was exposed to the sun at the time of the diagnosis or the application to Fedris. After all, from 6 actinic keratoses there is an increased risk of developing a carcinoma. The number of actinic keratoses is also an indication of the total exposure incurred. The diagnosis of spinocellular carcinoma (squamous cell carcinoma) must be confirmed by a tissue examination. For actinic keratosis, a clinical diagnosis is sufficient, without laboratory tests.
Prevention above all
The implementation of a good skin cancer prevention strategy for outdoor workers is essential, especially the wearing of protective work clothing and the use of a sunscreen with a high protection factor. On the proposal of the Scientific Council, Fedris is working on a possible pilot project to monitor the health status of workers exposed to solar radiation. Given the long latency period (the period between exposure to solar radiation and the appearance of the first clinical effects), this could be a very interesting project.
