Malignant neoplasms of the skin

Abstract

Malignant neoplasms of the skin comprise a group of cancers which are often less commonly considered occupational in origin than many other types of cancers related to workplace exposures, such as mesothelioma, lung or bladder cancer. One reason for this is that skin neoplasms are very common in the community and the main causal exposure, sunlight, is ubiquitous. Therefore, occupational risk factors may not be recognised when a case of skin cancer is diagnosed unless a full occupational history is taken. There are three main types of skin cancer (basal cell carcinoma, squamous cell carcinoma and malignant melanoma), and all may be contributed to by occupational exposures. While the global burden of disease estimates suggest that the incidence of malignant neoplasms of the skin appears to be rising, this may be due to better diagnostic techniques, as well as greater exposure to sunlight and occupational carcinogens. The most common chemical skin carcinogens are mineral oils, inorganic arsenic and polycyclic aromatic hydrocarbons. While the main physical hazard causing skin neoplasms is ultraviolet light exposure at work, the pattern of exposure differs for the three main types of skin neoplasms. There is also some evidence that ionising radiation exposure at work may also play a role. While there are many available measures to protect workers from ultraviolet light and chemical skin carcinogens, research has shown that actual use is very variable. An increasing body of intervention studies investigating the use of sun protection measures among workers is identifying those measures found to be more acceptable to the workers and more effective in reducing skin exposure, but more research is needed in this area.