Abstract

Skin cancer has been deemed one of the large, unmet challenges to modern medicine given that it’s the most frequently occurring and fastest growing malignant disease in terms of incidence and prevalence. Occupational solar ultraviolet radiation (UVR) exposure is a skin cancer risk factor. Outdoor workers have long exposure hours and need photoprotection against solar UVR, an IARC group 1-defined human carcinogen. In South Africa, skin cancers account for one third of all histologically-diagnosed cancers. Physiological presentation of non-melanoma skin cancers (NMSC) is most common on the head in all population groups. It is expected that occupational exposure plays a role in NMSC aetiology in South Africa, although such data are presently lacking. We aimed to estimate the number of outdoor workers potentially exposed to solar UVR in South Africa. Building on CAREX Canada methods, we used a combination of 2011 Statistics South Africa data and Canadian job prevalence assumptions. Of 51 770 560 South Africans in 2011, the working population was ~13 204 496. Estimated total working population exposed to solar UVR was 1 156 000 (8.7% of the working population). Riskiest job categories were subsistence agricultural and fishery workers and related labourers, and extraction and building trades workers and labourers in mining, construction, manufacturing and transport. Results suggest that solar UVR exposure among outdoors in South Africa may be high. More research is required to identify high-risk groups that may differ in the South African context, perform better risk assessment and inform skin cancer prevention awareness campaigns.