As early as 1775, an English physician, Sir Percivall Pott, reported a high incidence of skin sores on men working as chimney sweeps. He maintained that the sores were caused by coal soot in their clothes. This may be the first case of skin cancer appearing in a medical publication.
Skin cancer is the out-of-control growth of abnormal cells in the epidermis, the outermost skin layer, caused by unrepaired DNA damage that triggers mutations. These mutations lead the skin cells to multiply rapidly and form malignant tumors. The main types of skin cancer are basal cell carcinoma, squamous cell carcinoma, melanoma, and Merkel cell carcinoma. (Recently, Jimmy Buffet died from Merkel cell carcinoma.)
Sun exposure is the main occupational risk factor for skin cancer. Employees who work outdoors are the most vulnerable to developing skin cancer. Also, occupations, such as firefighters, petrochemical workers, asphalters, or roofers, have on-the-job exposures that increase their risk for skin cancer.
Firefighters face a host of dangers on the job and skin cancer is one of the hazards. Studies have found that there is an increased risk of melanoma in firefighters due to exposures to chemicals and soot. It is recommended that they use wipes to get the soot off their face, washing their gear as soon as they get back, and shower. In 2022, the International Agency for Research on Cancer reclassified the occupation of being a firefighter to the highest hazard category as a group one carcinogen.
Pilots and flight attendants, when at altitude, are exposed to increased radiation and data suggests that they may carry unique risks regarding skin cancer. In a 2018 study, flight attendants were found to have higher incidences of cancer than members of the general population, including melanoma and non-melanoma skin cancer. Among pilots, a JAMA meta-analysis found that pilots have approximately twice the incidence of melanoma compared with the general population.
Petroleum is the origin of many complex mixtures such as gasoline and diesel fuel and is used to produce plastics, textiles, pesticides, cosmetics, paints, and insulating materials. Workers in the petroleum industry are exposed to a variety of known or potentially harmful substances and have an increased risk to melanoma.
Being exposed to large amounts of arsenic increases the risk of developing skin cancer. Arsenic is an element found naturally in well water in some areas. It is also used in making some pesticides and is used in copper or lead smelting, wood treating, and glass manufacturing. Workers exposed to coal tar, paraffin, and certain types of petroleum products may also have an increased risk of skin cancer.
Employers who have workers who work outdoors should be provided with protective clothing and sun screen. These employees and those who are exposed to chemicals that have a link to skin cancer should be educated about possible links to skin cancer. In consultation with a medical professional, regular dermatological examinations for these employees should be added to a medical monitoring program.