Outdoor workers and employers have to manage skin cancer risk. Occupational health exposures could be considered a test of mangement quality in turn.
The Bible describes the imperative to work as “by the sweat of our brow”, writes Mabila Mathebula. Cancer occurs when one cell grows independently and uncontrolled by the usual cellular mechanisms, to the detriment of the body.
There are three main types or phases of skin cancer;
 Basal Cell Carcinoma
 Squamous Cell Carcinoma
 Malignant Melanoma.
If left unattended, Malignant Melanoma can spread rapidly to other parts of the body with fatal results. Skin cancer risk could be effectively managed, since it is directly linked to sunlight and ultraviolet (UV) light exposure, as opposed to other cancers.
Dr Marianne Alexander wrote: “Sunlight in South Africa is one of the most potentially dangerous in the world”. The bulk of railway and construction work is outdoors and much time is spent bending over.
The back, particularly the shoulders, ears and the neck, are the most exposed parts of the body and should be protected. Wear a wide-brimmed hat and long-sleeved shirt with a collar.
Ultraviolent radiation still penetrate fabrics to some extent. Employees should be aware that in the four hours between 11:00 and 15:00 is when two thirds of the ultraviolent radiation of every day occurs. Siesta should apply in Africa, not Europe!
Employees exposed to the sun should use sun screen ointment. Most sun screens have a Sun Protection Factor (SPF) rating, such as SPF 5, 15, 24, 30, or even 50, and this number relates to the time required to become reddened or mildly inflamed, or the MED (Minimal Erythematic Dose).
In theory, applying a sun screen with SPF of 15, allows one to remain in the sun 15 times longer, than without protection, before becoming ‘red’.
Prevention is much better that cure. An Australian Anti-Cancer Council urges Australians to slip, slop, and slap in summer; slip on a shirt; slop on a hat and slap on some SPF 15 sun screen to avoid sunburn.
In South Africa the health authorities ask us to take C.A.R.E; Cover up; Avoid the sun from 11:00 to 15:00, Rub on sun screen; and Examine your skin regularly.
OH management indicates management quality
Employers have to plan, implement and measure programmes to raise awareness, limit exposure, manage inevitable exposure, and thus reduce skin cancer risk.
The alternative is lost productivity, occupational disease, reports, potential prosecution, and potential civil legal action.
Occupational health risks could be considered as true tests of the quality of Sheq management, corporate governance, and management in general.
OH risks are intimately linked to corporate and individual behaviour, and reflect the maturity of corporate culture. There are wide and measurable differences between a company, or a family, managed by token ‘rules’, such as ‘take care in the sun, sign here’, and by planned, consulted, socially agreed, educated, equipped, supported, measured and improved interventions.
Employers who cannot manage occuptional health risk, cannot manage safety or environmental risks either, and probably cannont manage their assets and investments either.
Skin examination should be part of our regular Sheq medical examination. As will all occupational health impacts, skin cancer risk requires sustained awareness, implementation, measurement, reporting, and integration into our management system to be effective.
One day, one week, or one month per year of ‘management’ of skin cancer risk is mere window dressing, and little better than no management at all.
• Mabila Matahebula is a senior researcher at the SA Railway Safety Regulator. He writes on Sheq issues in his private capacity as a former Sheq consultant.