Work Place Carcinogens Solar Radiation and Skin Cancer November 2013 - - PowerPoint PPT Presentation

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Work Place Carcinogens Solar Radiation and Skin Cancer November 2013 - - PowerPoint PPT Presentation

Jan 01, 2024 240 likes •687 views

Work Place Carcinogens Solar Radiation and Skin Cancer November 2013 Dr Mark Foley Overview Work place carcinogens and skin cancer Who is a risk? Screening and Self skin exam Common skin cancers Many work place hazards that

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Work Place Carcinogens Solar Radiation and Skin Cancer

November 2013 – Dr Mark Foley

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Overview

 Work place carcinogens and skin cancer  Who is a risk?  Screening and Self skin exam  Common skin cancers

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Many work place hazards that cause Skin Cancer

 Solar radiation  UV radiation from welders  Tar (coal, soot, mineral oils)  Arsenic

The Skin Clinic Marlborough

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Sun exposure is a work place carcinogen

The Skin Clinic Marlborough

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Who is at risk?

The Skin Clinic Marlborough

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The Skin Clinic Marlborough

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Who is at risk?

 Every outdoor worker

  • Especially fair skin and poor protection

The Skin Clinic Marlborough

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Office worker on lunch break

The Skin Clinic Marlborough

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Office worker on lunch break Fair skin and poor protection !

The Skin Clinic Marlborough

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Who is at risk?

 Every outdoor worker

  • Especially fair skin and poor protection
  • Sun burns and total UV exposure

 Potentially every indoor worker

  • Pattern of sun exposure – work and home
  • ? UVA

The Skin Clinic Marlborough

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Who is at risk?

 Every outdoor worker

  • Especially fair skin and poor protection
  • Sun burns and total UV exposure

 Potentially every indoor worker

  • Pattern of sun exposure – work and home
  • ? UVA

 Retired out door workers

  • Lag time from exposure to development

The Skin Clinic Marlborough

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 So every worker with poor UV

protection is at risk …..not just during their working life but a life-long risk which becomes greater in later life..

The Skin Clinic Marlborough

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Skin checks

 Every worker should be taught and

preform regular self examination

 Regular skin checks for outdoor workers,

especially those with fair skin and or poor protection.

 Clinician: Knowledge of vast variation in

skin cancer presentation.

 Check head to toe, not just sun exposed

  • skin. Ideally with dermatoscopy.

The Skin Clinic Marlborough

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The Skin Clinic Marlborough

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Why is sun exposure a work place carcinogen ?

 Chronic sun exposure

  • Sun damage – Actinic Keratosis
  • SCC
  • Lentigo maligna

The Skin Clinic Marlborough

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Why is sun exposure a work place carcinogen ?

 Chronic sun exposure

  • Sun damage – Actinic Keratosis
  • SCC
  • Lentigo maligna

 Intermittent sun exposure

  • Melanomas
  • BCC

The Skin Clinic Marlborough

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The Skin Clinic Marlborough

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Common Skin Cancers

The Skin Clinic Marlborough

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Reminder of epidermal structure

The Skin Clinic Marlborough

UVB UVA

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The Skin Clinic Marlborough

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Dermis Fat Epidermis

The Skin Clinic Marlborough

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The Skin Clinic Marlborough

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BCC

The Skin Clinic Marlborough

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Melanoma

The Skin Clinic Marlborough

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AK/SCCi/SCC

The Skin Clinic Marlborough

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BCC Melanoma AK/SCCi/SCC

The Skin Clinic Marlborough

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Where do they occur

The Skin Clinic Marlborough

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The Skin Clinic Marlborough

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The Skin Clinic Marlborough

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The Skin Clinic Marlborough

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The Skin Clinic Marlborough

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When do they occur?

 BCC’s, SCC’s and Melanoma risk all

increases with age

 Different onset ages.

The Skin Clinic Marlborough

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Melanoma – Age specific rates

The Skin Clinic Marlborough

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The Skin Clinic Marlborough

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The Skin Clinic Marlborough

Basal Cell Carcinoma Squamous Cell Carcinoma

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The Skin Clinic Marlborough

 BCC’s

  • common in under 35
  • Dramatic increased rate 35+
  • Intermittent sun exposure
  • Mainly sun exposed sites
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The Skin Clinic Marlborough

 SCC’s

  • Uncommon under 40
  • Dramatic increase in 50’s
  • Chronic sun exposure
  • Sun exposed sites
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The Skin Clinic Marlborough

 Melanoma

  • Rare under 14 yrs age
  • Dramatic increase 50’s
  • Intermittent sun exposure
  • Sun protected sites
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So Far

 UV light damages DNA, if not repaired

this is one factor in causing skin cancer

 Different age and body site profiles  Work sun exposure is a significant risk

factor.

 Long lead time from exposure to

development of sun damage and skin cancer.

The Skin Clinic Marlborough

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Solar induced DNA damage & gene suppression

 Implications for prevention

  • Minimisation of sun exposure to reduce life

time accumulation of UV radiation.

 Implications for surveillance

  • Risk extends well beyond leaving a job or

retiring

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Skin Cancers - clinical

The Skin Clinic Marlborough

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Solar Keratosis / Actinic Keratosis

 Sun damage, “sun spots”  Considered Pre-malignant

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Epidermis AK – lower 1/3 SCCi – full thickness AK SCCi

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 AK and SCCi therefore have similar

naked eye features

 Different dermatoscopy features