Introduction Outdoor workers are exposed to a variety of hazards, including solar ultraviolet radiation (UVR). Identifying, reporting, analyzing, and tracking the exposures or health outcomes of outdoor workers specifically have not generally been considered in a formalized way.

Objectives Our objective was to identify the key characteristics and the barriers and facilitators of occupational surveillance systems in order to make recommendations for a system for outdoor workers that includes consideration of sun exposure and skin cancer.

Methods A traditional literature review (peer-reviewed and grey literature) was performed using search terms relevant for surveillance, outdoor workers, and best practices. Additionally, 22 qualitative key informant interviews were conducted with a variety of experts. The audio recorded interviews were transcribed verbatim and coded for broad themes and specific barriers and facilitators using NVivo 12.

Results The literature review found no occupational surveillance programs focused solely on outdoor workers. Five occupational surveillance strategies were summarized to obtain a better understanding of occupational surveillance systems and how they might be applied to keratinocyte carcinoma (KC) or solar UVR exposure in outdoor workers. The key informant interviews revealed ten key considerations for the design of a surveillance system, including identifying a clear goal, a defined target population and stakeholder involvement. Additionally, five critical barriers including underreporting and funding, and five vital facilitators including communication/collaboration and a simple reporting process were identified.

Conclusion Our study demonstrated that barriers and facilitators to an occupational surveillance system for outdoor workers exist and thoughtful design and implementation are key. Some specific suggestions for a successful occupational surveillance program for outdoor workers include the recognition of KC as an occupational disease, designing and implementing a notification/data collection mechanism for KC, continuing to build primary prevention initiatives, educating workers/employers on the risks of skin cancer and other outdoor hazards, and investing long-term into surveillance.