GroundCover™ Issue: 108 | Author: Melissa Branagh-McConachy
Five minutes is all it takes to prepare to work safely outdoors in the sun. Yet although the ‘slip, slop, slap’ catchcry has become part of the Australian vernacular, the incidence of skin cancer continues to climb, with rates in regional areas significantly higher than those in cities and farm workers branded a high-risk group
Victorian grain grower Karl Price: "You usuallly hear of older farmers developing skin cancer after years of cumulative exposure, but I'm proof that young people can also be affected."
PHOTO: Karla Northcott
Squamous cell carcinoma
Basal cell carcinoma
Cancer Council Australia is urging grain growers to allocate five minutes each morning to sun protection in response to research that shows outdoor workers receive up to 10 times more ultraviolet (UV) radiation than indoor workers.
Australia’s peak non-government cancer control organisation has reported that 74 per cent of agricultural workers are exposed to direct sunlight for an average of 5.7 hours during their work day.
It has been estimated that each year about 200 melanomas and 34,000 non-melanoma skin cancers are caused by occupational exposures in Australia, with exposure to UV over a long period putting growers at a higher-than-average risk of squamous cell carcinoma (SCC) and basal cell carcinoma (BCC).
The statistics paint a serious picture. Despite being an almost entirely preventable disease, the latest World Health Organization data confirmed Australia has one of the highest levels of skin cancer in the world, with two-thirds of Australians developing skin cancer before the age of 70 and almost 1900 dying from the disease each year.
Cancer Council Victoria SunSmart manager Jen Makin says all skin types can be permanently and irreversibly damaged by overexposure to UV radiation, and that the risks of skin cancer increase with unprotected exposure.
“Regular check-ups can ensure early detection, but some cancers can grow or change rapidly – within weeks,” she says. “We encourage self-monitoring and urge partners to check hidden areas. Anything different or unusual should be reported to a GP immediately.”
In addition to the health implications, Ms Makin says skin cancer can present significant financial and personal costs for growers. “Melanoma usually requires surgery, radiotherapy or chemotherapy, which may mean time away for treatment,” she says. “Five minutes in the morning can prevent five months or more off the farm.”
Employers also have an obligation to reduce the risks and protect farm workers from ongoing exposure to UV radiation under Australian occupational health and safety legislation.
Professor Scott Kitchener, medical director of Queensland Rural Medical Education and professor of rural health at Queensland’s Griffith University, says it is not common for growers to become sunburnt because it compromises their ability to work. However, he told the recent GRDC-sponsored National Centre for Farmer Health conference in Hamilton, Victoria, that cumulative sun exposure is a major risk.
“Farmers tend to be susceptible to non-melanoma skin cancers – SCCs and BCCs – but we know squamous and basal cell carcinomas are also risk factors for melanoma,” he said.
“If we target skin cancers in their early stages, we get much better health outcomes, but anecdotally farmers don’t go to the doctor regularly. I therefore encourage trainee doctors and registrars to do checks and discuss skin cancer opportunistically when farmers come in.”
Sun protection on the farm
Ultraviolet (UV) radiation, not heat, causes skin cancer. Check daily sun protection times and base outdoor work schedules on this information (available as a free widget and as a SunSmart app). Personal protective equipment (PPE) and clothing includes:
- long pants and shirts with a collar in lightweight fabrics that carry a UV protection factor (UPF) 50+ swing tag;
- hats with a broad brim, bucket hats with a deep crown and an angled brim or legionnaire-style hats with a neck flap provide the best protection. Buy hats with a UPF
- 50+ rating;
- close-fitting, wraparound sunglasses with polarised lenses and an eye protection factor (EPF) of 9 or 10; and
- sun protection factor (SPF) 30+, broad-spectrum, water-resistant sunscreen applied every two hours. Protect lips with a SPF 30+ lip balm.
SOURCE: Cancer Council Australia
What to look for
- Check your whole body (including scalp, soles of feet, between toes, armpits, ears, eyelids and under fingernails).
- Use a mirror or ask someone to check your back, and the back of your neck and legs.
- Look for new spots.
- Look for any sore that does not heal.
- Look for spots or moles that have changed size, shape or colour.
- Nodular melanoma
- Basal cell carcinoma
- Squamous cell carcinoma
"It can happen to anyone"
Cavendish grower Karl Price has vivid memories of his 35th birthday for all the wrong reasons. What should have been a family celebration at his farm in Victoria’s south-west turned into a Melbourne hospital stay.
Just three weeks earlier, the father of four was diagnosed with stage-3 melanoma and was booked to undergo surgery at Peter MacCallum Cancer Centre.
Shocked by the diagnosis, Karl says there were no warnings and claims he always took precautions – which he says indicate “this can happen to anyone”.
“I’d had quite a few moles removed, but none had shown signs of melanoma,” he says. “I rarely got sunburnt, always wore sunscreen, sunglasses and a big hat, and I didn’t walk around in a singlet and shorts.”
A month of intravenous therapy and debilitating headaches preceded a year-long drug treatment program, with side effects including extreme tiredness and mood swings.
“I slept for 18 hours a day and couldn’t work,” Karl says.
With a 1000-hectare cropping and sheep property to manage and regular contract work, Karl’s absence meant hiring extra labour to help his father and another full-time worker look after the day-to-day running of the farm.
Now 37, Karl’s energy levels have returned to normal but he says the ordeal has “changed the way we do things”.
“I was stressed – I was sick, had a young family and wanted to stay on the farm so we had to make changes,” he says. “We installed a full canopy on the four-wheeler and covered the sheep yards and race. I now do any maintenance in the shed, check the UV reading daily and if levels climb above 11, I don’t work outside.
“The overcast days are the most dangerous. UV levels often hit 3 on cloudy days but many people don’t realise they should be wearing hats and sunscreen in those conditions.”
Karl’s message to other growers is straightforward. “Protect yourself and if you notice something different, see a doctor,” he says.
“You usually hear of older farmers developing skin cancer after years of cumulative exposure, but I’m proof that young people can also be affected.”
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