A narrative review of occupational solar ultraviolet radiation in Britain and skin cancer

Background Occupational exposure to solar ultraviolet (UV) is known to cause malignant melanoma (MM) and non-melanoma skin cancer (NMSC). However, knowledge of the causal associations has developed erratically.Aims This review aims to identify when it was accepted that workplace solar UV exposure could cause skin cancer and when it was recognized that there was a risk for outdoor workers in Britain, identifying the steps employers should have taken to protect their workers.Methods Informative reviews, published since 1974, were located through a systematic literature search. These were used to chart changes in summative knowledge of the role of occupational solar UV exposure in causing skin cancer. An assessment was made of the identified hazards of skin cancer and the recognition of risks for outdoor workers in Britain.Results From at least 1975, it has been accepted that occupational solar UV exposure could cause squamous cell carcinoma, and from around 2011 for MM and basal cell carcinoma. From 2004, repeated sunburn at work was identified as a likely cause of MM. From 1999, it was accepted that occupational solar UV exposure causes NMSC amongst British workers, and from 2012 there was limited evidence for an MM risk for outdoor workers in northern European countries.Conclusions Skin cancer risks for British outdoor workers should be actively managed and they should have health surveillance. Outdoor workers who have skin cancer should be eligible for compensation. Solar ultraviolet exposure is not generally taken seriously by British employers, employee organizations or regulators. Scientific knowledge of the occupational skin cancer hazards and risks for outdoor workers in Britain has changed over the last 50 years. Still, it is now accepted that workplace exposures can cause all the main types of skin cancer. It is time to implement strict sun safety risk-management measures in outdoor workplaces, including appropriate health surveillance.