Skin cancer risk of Israeli workers exposed to sunlight

To assess the number and types of workers occupationally overexposed to sunlight, we interviewed a national sample of 450 employers in occupational categories involving outdoor work and 5000 of their workers. The workers were assigned to 5 overall risk levels, according to combinations of skin sensitivity to ultraviolet radiation (UVR), total weekly hours of outdoor occupational sun-exposure between 0800 and 1400, and percent of skin surface exposed during outdoor work in the summer. Based on this information it was estimated that out of a total of 379,000 Israeli workers in outdoor occupations, 167,000 (44%) are at increased risk for skin cancer (risk levels 1-3) due to occupational exposure to solar UVR. Their estimated lifetime skin cancer risk is 1.5- to 20-fold higher than that of workers at low or minimal risk levels (4-5). The characteristics of those interviewed with regard to occupation, duration of solar exposure, demographic traits, geographic location, degree of risk awareness and protective measures undertaken, provide a data base for effective intervention to reduce the hazards of occupational solar exposure in Israel. We estimate that an appropriate preventive program may reduce skin cancer in Israeli men to half its current rate.