Skin cancer dangerous risk for construction industry

Dr. Thomas Lynch is certified by the American Board of Dermatology. He practices in Springfield.

Members of the construction industry are particularly susceptible to skin cancer because of their frequent and prolonged exposure to sunlight. Sunlight (ultraviolet A & B) is the primary cause of skin cancer. Simply put, there are more sun-related non-melanoma skin cancers diagnosed annually in the United States than the sum total of all other cancers anywhere in the body. Therefore, I wish to briefly discuss risk factors, prevention, recognition and treatment of these very common tumors.

Risk factors

Skin cancer is predominantly a disease of fair-skinned people. Those at highest risk are of Celtic origin (i.e. fair skinned, blue eyed, Scots-Irish-English) and those out in the sun a lot. Welcome to the Ozarks!

The biologic effects of ultraviolet light (sun exposure) are cumulative. They start in our infancy and are manifested as early as the teens as mottling (freckling) and premature wrinkling.

Prevention

A large number of skin cancers can be prevented by judicious and daily use of sunscreens in the range of 15 to 45 sun protection factor. The more effective sunscreens on the market today contain Parsol (avobenzone) and/or titanium dioxide. These sunscreens are widely available.

It is important they be used daily and all year long. On a cloudy day in the winter, the measured radiation reaching exposed skin is only reduced 50 percent. Sunscreens should be applied before leaving for work or recreation and reapplied during the noon hour if frequent sweating and subsequent wiping of the exposed skin occurs. Sunscreen is better applied at the bathroom mirror in the morning as opposed to from the lunch pail or golf bag.

If stinging of the eyes is a frequent complaint, alcohol-based sunscreen or physical block such as titanium dioxide-based sunscreens are better tolerated.

Light colored clothing transmits ultraviolet light as opposed to dark clothing which converts the ultraviolet radiant energy to heat. Therefore, light colored clothing is not an effective sunscreen. A wet white T-shirt is essentially no sunscreen.

There is, however, a wonderful new product called Sunguard. This is made by the Rit dye company and is available in the laundry detergent section of grocery stores. It is a powder which, when added to the wash, imparts a No. 30 sunscreen factor into light-colored garments. It is good for 20 washes. Please become familiar with this product. It is one that should be used by virtually all fair-skinned people in this country.

Recognition

The following signs and symptoms of skin cancer are important: rapid growth, color change and bleeding, particularly spontaneous bleeding (i.e. a bloody scab that forms, heals and then reforms several days to weeks later) is cancer until proven otherwise. Tenderness, pain, itching and chronic irritation are also factors, but to a lesser degree.

Any "mole" which shows asymmetry, notched borders, irregular colors (specifically deep blue to black with red and white tinges), enlarging diameter and elevation are also suspicious. These changes are sometimes indicative of malignant melanoma, a more aggressive skin cancer than the non-melanoma cancers (basal cell and squamous cell carcinoma).

Malignant melanoma is the leading new cancer diagnosis in Caucasians in this country (ages 25-29), and is second in incidence to breast cancers in females age 30-34. The average age of death from melanoma is 41. It is very important that patients be aware of this and inspect their skin periodically for these clinical signs of malignancy. If the above changes are noted, please contact your personal physician and/or dermatologist for evaluation.

Treatment

Treatment, of course, is based upon timely and appropriate diagnosis. The treatments of skin cancers are readily available and well-tolerated, and in cases of early diagnosis, quite simple. It should be appreciated, however, that the longer the delay in diagnosis, the more aggressive the tumor and the more involved the treatment. Skin cancers can be treated by surgical excision, curettage and desiccation (scraping and burning), X-ray therapy and Mohs surgery. Mohs surgery is usually reserved for the more complicated cases.

The aforementioned facts are certainly applicable to those in the construction industry because of their frequent and prolonged exposure to sunlight. It is not our intention as dermatologists to limit sun exposure recreationally and occupationally, but to encourage protected sun exposure by the judicious use of sunscreens. We all enjoy the Ozarks. However, intentional sunbathing and tanning beds definitely increase the risk of malignancy.

By knowing risk factors, preventative measures, signs and symptoms of skin cancer, and available treatment, we can reduce the frequency and severity of our most common cancer.