Protecting outdoor workers from the sun

Australia has the highest rate of skin cancer in the world. It is estimated that 1 in 2 people who spend their life in this country will develop skin cancer. Every year in Australia, 8240 new cases of melanoma are diagnosed and 1000 people die from the disease. Approximately 374,000 new cases of non-melanoma skin cancer (NMSC) - basal cell carcinoma and squamous cell carcinoma - are diagnosed, resulting in 360 deaths.

The link between skin cancer and ultraviolet radiation (UVR) has been clearly established and by reducing exposure to UVR almost all skin cancers are preventable. The workplace is an important source of exposure to ultraviolet radiation for outdoor workers who are at high risk of getting skin cancer because of their high exposure to UVR over extended periods of time. Nearly all skin cancers (including melanoma) can be cured if detected and treated early. However, prevention is better than cure. Treatment for both melanoma and NMSC can require surgery and follow-up treatment such as radiation therapy and result in permanent scarring. Practising sun-safe behaviours can prevent skin cancer from occurring in the first place. Cumulative or long-term exposure to UVR as experienced by outdoor workers has been shown to play a key role in developing skin cancer. However, risk for skin cancer is also strongly associated with intense intermittent exposure as often experienced by indoor workers on weekends and holiday. The overall cost of skin cancer to the community is estimated at over 300 million dollars including absenteeism costs of over 50 million dollars. Individuals may have considerable personal costs for treatment over a course of time. UVR cannot be seen or felt. It comes from the sun and there are three types:

• UVA: transmits freely through the earth's atmosphere.
• UVB: 15 per cent of UVB transmits through the earth's atmosphere. The other 85 per cent is absorbed by ozone.
• UVC: is completely absorbed by ozone and does not reach the earth's surface.

UVA and UVB both contribute to sunburn, skin ageing, eye damage and skin cancer. The Occupational Health and Safety Act 2000 states that employers have a duty of care towards their employees. This means that employers are responsible for ensuring the health and safety of all employees. Exposure to UVR has been recognised as an occupational health and safety hazard and employees who work outside must be protected from its harmful effects. Workplaces that employ outdoor workers have a responsibility under the Act to develop and implement a sun protection policy and provide ongoing training to support it.

The key components of a sun protection policy can include:

• Providing and maintain appropriate clothing and equipment to protect outdoor workers form the sun.
• Setting up systems of work to reduce the amount of time workers spend in the sun.
• Providing information, training and supervision in consultation with employees regarding prevention and early detection of skin cancer.

Both employers and employees have a duty of care to maintain a safe working environment. Employers are responsible for implementing measures to protect employees from recognised hazards at work and employees are responsible for cooperating with sun protection measures put in place by the employer. All workplaces that employ outdoor workers should develop a skin protection policy to control worker exposure to UVR. The following steps can help make the policy and its implementation a success:

• Compile information on the number of workers in the organisation, current workplace practices and procedures in similar industries. Prepare information on the current Act and the workplace's duty of care to employees.
• Conduct a risk assessment of the working environment. Consider climatic conditions, availability of shade and clothing requirements of all employees.
• Form a committee or working party comprising staff who represent a wide cross section of the organisation, including employees, management and union representation, to plan, develop and implement the policy.
• Establish channels for consultation and communication with staff. By providing staff with the means to discuss concerns and give suggestions the likelihood of compliance increases.
• Incorporate changes to support the policy - such as individuals wearing protective clothing and organisations rescheduling work times or adjusting work environments to ensure there is adequate provision of shade.
• Establish means to monitor and evaluate the policy to ensure it meets workplace and employee needs. Keep a written record of what has been undertaken and the results of all actions and activities.

One of the most effective strategies to reduce exposure to UVR is to review work areas and practices to minimise UV exposure during the peak time, that is 10 am - 2 pm (11 am - 3 pm daylight saving time). Workers should be encouraged to start early in the day - 7 am or earlier where possible, use peak UVR times to complete indoor tasks and to rotate indoor and outdoor work so that outdoor work is shared during peak UVR times.

OHS Regulation requires an employer to provide personal protective equipment and the equipment which is provided must be appropriate for the person and control the risk for that person. Employees should be provided with an adequate supply and replacement of suitable protective clothing and equipment. Both the design and the type of fabric used in the garment are important in maximising the sun protection it offers:

• Clothing should be loose fitting and cover as much skin as possible.
• Fabric should be a tight, close weave. Purpose-made protective work clothing is available made from fabric with a UPF rating of 40, 45, 50 or 50+. The higher the UPF the better. As a guide, employees should be provided with a minimum of:
  1. Three sets of clothing.
  2. One pair of sunglasses in accordance with the Australian Standard AS 1067.
  3. One broad brimmed hat or equivalent.

Clothing should be replaced on a wear and tear basis. Frequent laundering will eventually reduce the UPF level of fabric and should be taken into account when considering replacing clothing. When selecting clothing, other hazards must be taken into account.

Employees who work outdoors are required to wear the following clothing and personal protective equipment at all times such as:

• Shirts with long or three-quarter length sleeves and collars to protect the arms and neck.
• Shirts made from a close weave, lightweight, breathable fabric that are loose fitting to allow for air circulation and comfort.
• Shirts with high visibility are recommended to replace standard shirts and safety vests.
• Loose-fitting trousers or long skirts. If shorts are worn they should come to the knee.
• Workers should choose what type of trousers they prefer, for example, lightweight or heavyweight trousers - belt type or tracksuit style.
• A broad brimmed hat should be worn at all times. The brim should measure no less than 8-10 cm in width.
• If hard hats are to be worn, brim attachments with neck flaps should be attached.
• Hats should be comfortable and made of a close weave material. Hats that have a gauze or mesh section are not suitable, as UV rays will penetrate.
• Sunglasses that screen out at least 95 per cent of ultra violet light and comply with Australian Standards AS 1067 are to be provided to all outdoor workers.
• If safety sunglasses are required then they need to comply with AS 1337 and 1338.
• Sunglasses and safety glasses should be glare-resistant, lightweight, comfortable and fit closely to the face. Wrap-around sunglasses offer the best protection.
• Clip-ons are available for people with prescription glasses. Clear lens glasses, which offer UV protection, are also available.
• In selecting eye protection, other hazards must be taken into account such as infection control procedures, chemicals, grinders, gases.
• Each employee should have an individual set of glasses.
• Sunscreen does not offer 100 per cent protection and should always be used in conjunction with other protective measures such as clothing, hats and sunglasses.
• Sunscreen must be easily accessible for all employees. It should be stored in a cool place and should not be used past its expiry date.
• Sunscreen should be labelled broad-spectrum to filter out UVA and UVB. UVA and UVB are known to damage the skin and present a risk for skin cancer.
• Sunscreen should have a sun protection factor (SPF 30+). Sunscreen with an SPF 30+ filters out at least 96.7 per cent of UVR.
• Sunscreen should be applied generously to all areas of exposed skin at least 20 minutes before going outside. It is recommended that an average size adult use one teaspoon of product on each limb. Half a teaspoon should be applied to the face and neck - including ears and back of neck.
• Sunscreen should be labelled water-resistant and reapplied every 2 hours.
• Lips should be protected with a lip balm containing SPF30+.

Ensure that workers have access to shade at any time of the day, and especially during peak UVR times. Shade can be permanent or portable and can be erected and adapted to suit different types of equipment and work sites.

• Use the shade of existing buildings and other structures at the work site.
• Natural shade such as trees and shrubs may also provide cover.
• Put up fabrics such as canvas, sailcloth, awning, PVC coated polyester or umbrella fabric, or use ready-made canopies. These fabrics are generally tightly woven and have an all-weather coating.
• Heavy textile covers block out most light, giving up to 99 per cent ultraviolet protection from direct sunlight.
• Different colours and fabric densities provide different levels of protection.
• Provide quick and easy portable shade for small numbers of people.
• Check the UPF of tents and umbrella fabrics before buying them.
• Be aware that the more open the shelter is, the more ultraviolet radiation gets in. The provision of shade will not provide total protection from UVR.

It is recommended that outdoor workers adopt personal protective measures such as the wearing of hats, protective clothing and sunscreen in addition to using shade.

Training and education for all employees, supervisors and mangers is essential before the policy is introduced. Training should include an explanation of the policy and provide workers with an understanding of what control measures are planned and what will be expected of them in the workplace.