At work with the CDC

A course of action on skin cancer

By Georgia Moore, MS

Do your employees work outdoors or travel from site to site on business? Do they enjoy eating lunch outside? Sunny vacations? Outdoor sports? Lots of fun, to be sure, but also potentially expensive for employers because of increased medical and other costs due to skin cancer—the most common form of cancer in the United States.

The American Cancer Society (ACS) estimates the count at more than one million cases of highly curable basal cell or squamous cell skin cancers this year. The average cost per treatment for nonmela-noma skin cancer ranges from about $500 for procedures in physician offices to more than $5,500 for treatment requiring hospitalization.

According to the ACS, the incidence of melanoma, the most deadly form of skin cancer, has increased about 3 percent per year since 1981. ACS predicts that there will be 51,400 new cases of mela-noma this year and 7,800 deaths. The direct cost of treating newly diagnosed melanoma approaches $600 million each year, 90 percent of that for treatment of advanced cases.

Risks and responses

Incidence rates are 10 times higher in whites than in other racial or ethnic groups. People who have multiple or atypical moles, a family or personal history of skin cancer or fair complexions are also at higher risk. Job exposure to certain substances that cause the skin to be sensitive to ultraviolet light—including certain dyes, coal tar and its derivatives and chlorinated hydrocarbons—also increases the likelihood of developing skin cancer.

No existing test or screening procedure for skin cancer has been shown to effectively reduce death rates, but a number of screening tests are in development. Meanwhile, prevention is the key, and the most preventable risk factor appears to be exposure to the sun's ultraviolet (UV) rays. Indeed, the Occupational Safety and Health Administration requires employers to provide protective equipment to their employees who are over-exposed to the sun's radiation on the job (rule 29 CFR 1910.132[a]).

Beyond that legal obligation, however, there are steps that businesses can take to help prevent skin cancer among employees. The cost of prevention for most businesses is minimal compared with the direct and indirect expense of diagnosis and treatment. Australia's SunSmart campaign offers some guidance:

• Reduce exposure to UV light by revising work processes or tasks that put employees at risk;

• Reengineer equipment or tools used (e.g., erect shelters for parking lot attendants or in other outdoor work or leisure areas);

• Reorganize work practices (e.g., develop a written sun protection policy, move a job to the shade and do not plan outdoor work activities during the peak UV hours of 10 a.m. to 2 p.m.);

• Provide and urge employees to use personal protective equipment, such as protective clothing (e.g., broad-brimmed hat at least 3 inches wide; long-sleeve, close-weave shirt), SPF-15 or higher sunscreen, and UV-absorbent sunglasses.

Resources

None of these steps can succeed without worker education. An educational campaign would be especially appropriate in May, which is National Melanoma/Skin Cancer Detection and Prevention Month.

The Centers for Disease Control and Prevention has a National Skin Cancer Prevention Education Program that includes the national "Choose Your Cover" campaign. Businesses can order free campaign materials to educate and encourage their employees to protect themselves from UV light.

Materials—including brochures, posters, and radio PSAs—can be viewed, downloaded, or ordered at http://www.cdc.gov/ChooseYourCover/preview.htm . TV PSAs can be previewed on the site, but must be ordered by e-mailing cancerinfo@cdc.gov. Materials may take up to several weeks to arrive.

Georgia Moore is a health communications specialist at the CDC in Atlanta. For a bibliography of the research used to prepare this article, contact the author atgbm7@cdc.gov.

 

Georgia Moore. A course of action on skin cancer. Business and Health 2001;4:40.