1. IOSH No Time to Lose campaign:
‘The dangers of solar radiation – and what to do about it’
This presentation gives an overview explaining how IOSH – the Institution of Occupational Safety and Health – is tackling occupational cancer caused by solar radiation through its No Time to Lose campaign.
Dr Lesley Rushton and IOSH Vice-President Tim Eldridge

2. Occupational cancer work-related cancer
Global estimate
At least 742,000 people die every year from a
work-related cancer
– more than one death every minute.
When we launched No Time to Lose in 2014, previous figures showed that occupational cancer claimed at least 666,000 people a year.
Now, new global research estimates that at least 742,000 people are dying every year from work-related cancer. That’s more than one every minute.
The latest study – only just published – was carried out in 2015 by the ILO, Ministries in Finland and Singapore, the Workplace Safety and Health Institute in Singapore, the Finnish Institute of Occupational Health (FIOH), ICOH and EU-OSHA.
The research also found that over half of all work-related deaths in the European Union were due to occupational cancer.
Cancer caused by work is also the biggest killer in China, the Western Pacific and in Latin America.
Most alarming, is that the time lag between exposure and developing cancer can be up to 40 years – so a significant exposure today could be a death sentence in years to come.
As we all know, occupational cancers can be prevented, so we need to continue raising awareness worldwide and working together to tackle the causes.
Source: ILO, Ministries of Finland and Singapore, WSH Institute Singapore, Finnish Institute of Occupational Health (FIOH), ICOH and EU-OSHA

3. Occupational cancer
Research in Britain – first detailed study of its kind
What proportion of cancer now in Britain is caused by occupational exposure to carcinogens?
How many cancer deaths and new cancers occurring each year are caused by workplace exposures
While planning our campaign, we used the most comprehensive data available. Where research wasn’t available, we commissioned it: for example, for our phase on solar radiation exposure at work. No Time to Lose has steadily become more global and more globally recognised.
The Rushton Report of 2012 was, for Britain, a breakthrough research study commissioned by our Health and Safety Executive.
It was the only national study of this kind, but of course there are numerous other studies across the world on individual carcinogenic exposures such as solar radiation or mineral oils
It took account of lifestyle choices, such as diet and smoking, to gain a true picture and researchers found that work-related cancer is the fifth biggest cause of avoidable cancer in Britain, behind lifestyle choices.
Almost 14,000 new cases of cancer caused by work are registered each year in Britain. Of these, 4,000 are because of asbestos exposure, but 10,000 other cases are linked to exposures ranging from silica dust to diesel engine fumes.
Although this is not just about construction, there’s no getting away from the fact that a lot of the sector’s activities are implicated in these exposures.
Source: HSE ‘The burden of occupational cancer in Great Britain’, 2010, Dr Lesley Rushton

4. Occupational cancer
Research in Britain
5.3% (8.2% men, 2.3% women) of all cancers are due to occupational carcinogens
8,000 work-related cancer deaths a year
14,000 new cancer registrations each year are attributed to occupational exposure
Just under half of deaths linked to occupational cancer are in the construction industry
While planning our campaign, we used the most comprehensive data available. Where research wasn’t available, we commissioned it: for example, for our phase on solar radiation exposure at work. No Time to Lose has steadily become more global and more globally recognised.
The Rushton Report of 2012 was, for Britain, a breakthrough research study commissioned by our Health and Safety Executive.
It was the only national study of this kind, but of course there are numerous other studies across the world on individual carcinogenic exposures such as solar radiation or mineral oils
It took account of lifestyle choices, such as diet and smoking, to gain a true picture and researchers found that work-related cancer is the fifth biggest cause of avoidable cancer in Britain, behind lifestyle choices.
Almost 14,000 new cases of cancer caused by work are registered each year in Britain. Of these, 4,000 are because of asbestos exposure, but 10,000 other cases are linked to exposures ranging from silica dust to diesel engine fumes.
Although this is not just about construction, there’s no getting away from the fact that a lot of the sector’s activities are implicated in these exposures.
Source: HSE ‘The burden of occupational cancer in Great Britain’, 2010, Dr Lesley Rushton

5. Key carcinogens (100+ new cancers)
Asbestos, shift/night work, mineral oils, solar radiation, silica, diesel engine exhaust, coal tars/pitches, occupation as a painter or welder, dioxins, environmental tobacco smoke, radon, tetrachloroethylene, arsenic and strong inorganic mists
Key industries
construction, metal working, personal and household services, mining, land transport, printing/publishing, retail/hotels/restaurants, public administration/defence, farming and several manufacturing sectors.

6. Spotlight on skin cancer caused by solar radiation exposure at work
I’m now going to give you an overview of skin cancer caused by solar radiation exposure at work and how IOSH is raising awareness of this significant health issue.
Spotlight on skin cancer caused by solar radiation exposure at work

7. Skin cancer
Global estimate
Around 2 to 3 million non- melanoma skin cancers and 132,000 melanoma skin cancers occur globally each year.
Skin cancer – Global estimate NB: These are not occupational:
Skin cancer is the most common cancer in the world. (3 different common types: basal cell carcinoma (75%) rarely spreads; squamous cell carcinoma (20%) can spread; malignant melanoma 5th most common cancer in Britain. Can spread if not caught early.
The World Health Organization (WHO) estimates that between 2 million and 3 million non-melanoma skin cancers and 132,000 melanoma skin cancers occur globally each year.
Occupational exposure to solar radiation:
From an occupational perspective, it’s difficult to achieve accurate estimates of people exposed to solar radiation at work – only one or two countries have estimated exposure levels.
In Germany, it’s been estimated that 2.5 million to 3 million outdoor workers are exposed.
In Great Britain, it’s estimated that 5.5 million people have been exposed to solar radiation through their work – in the service industries, construction sector, manufacturing and agriculture.
Source: World Health Organization (WHO)

8. Trends in Melanoma for Britain (Cancer Research UK)
Approx 15,400 new cases of melanoma diagnosed each year (42/day) and 2400 deaths (6/day)

9. Trends in Non-Melanoma Skin Cancer for Britain (CRUK)
Approx 140,000 (370+/day) new NMSC cases per year, 950 deaths per year (2/day).

10. IOSH research on work-related sun exposure in Britain
Imperial College London
In a year, malignant melanoma caused by solar radiation exposure at work claims around 50 lives and there are at least 240 new cases.
Around 40 per cent of malignant melanoma cases involve construction workers.
The majority affected are men.
IOSH research on work-related sun exposure in Britain
Imperial College London
The findings:
According to research by Imperial College London which was commissioned by IOSH into work-related sun exposure in Britain, malignant melanoma (the more serious form of skin cancer) kills nearly 50 people each year and there are at least 240 new cases.
The research highlighted that 42 per cent of malignant melanoma cancer cases involve construction workers – other key sectors include agriculture, public administration/defence and land transport.
The majority affected are men, and just under half those diagnosed with malignant melanoma linked to occupational exposures are under 65.

11. Attributable Proportion (%) Attributable Registrations
Burden of melanoma and non-melanoma skin cancer (NMSC) from solar radiation at work
Attributable Proportion (%)
Attributable Deaths
Attributable Registrations
Melanoma
NMSC
Men
3.2%
3.6% 39 10
184
1312
Women
0.9%
0.7% 7 2 56
229
Total
2.0%
2.4% 46 12
239
1541
Due to the varying risk estimates reported for melanoma, and the difficulty separating the contribution of occupational versus non-occupational exposures, no risk estimate was carried out for melanoma.
*Totals are the product sums and are not therefore equal to the sums of the separate estimates of attributable fraction, deaths and registrations for each agent. The difference is especially notable where the constituent AFs are large.
Mineral oils: Production; used as lubricant by metal workers, machinists, engineers; printing industry (ink formulation); used in cosmetics, medicinal and pharmaceutical preparations
Solar radiation: outdoor workers
Coal tars and pitches: Production of refined chemicals and coal tar products (patent fuel); coke production; coal gasification; aluminium production; foundries; road paving and construction (roofers and slaters).
For Great Britain in 2005, there were 292 total deaths in men aged 25+ and 209 in women aged 25+ from NMSC; in 2004 there were 36,380 total registrations for NMSC in men aged 25+ and 30,840 in women aged 25+. Estimation has not been carried out for arsenic because of lack of epidemiological evidence of an increased risk in GB.
The estimated total (male and female) attributable fractions, deaths and registrations for NMSC related to occupational exposure is 4.50% (95% Confidence Interval (CI)= ), which equates to 23 (95%CI=4-50) attributable deaths and 2862 (95%CI= ) attributable registrations. Results for individual carcinogenic agents for which the attributable fraction was determined are as follows:
Mineral oils: The estimated total (male and female) attributable fraction for NMSC associated with occupational exposure to mineral oils is 1.42% (95%CI= ), which equates to 7 (95%CI=0-36) attributable deaths and 902 (95%CI= ) attributable registrations.
PAH coal tars and pitches: The estimated total (male and female) attributable fraction for NMSC associated with occupational exposure PAH coal tars and pitches is 0.76% (95%CI= ), which equates to 4 (95%CI=1-9) attributable deaths and 475 (95%CI=80-1,080) attributable registrations.
Solar radiation: The estimated total (male and female) attributable fraction for NMSC associated with occupational exposure to solar radiation is 2.41% (95%CI= ), which equates to 12 (95%CI=6-19) attributable deaths and 1,541 (95%CI=735-2,419) attributable registrations.

12. Major industry sectors for Melanoma
Attributable Deaths
Attributable Registrations
Melanoma
NMSC
Agriculture and hunting 11 1 55
116
Construction 21 7
101
841
Land transport 4 6
Public administration and defence 5 2 26
240

14. IOSH research on work-related sun exposure in the UK construction sector
The University of Nottingham
Awareness around solar radiation risks is generally poor
59 per cent of construction workers reported having sunburn at least once in the last year
40 per cent thought there was no need to wear sunscreen on a cloudy day
Both workers and managers didn't see sun safety as an important issue because of the UK climate
IOSH research on work-related sun exposure in the UK construction sector
The University of Nottingham
The findings:
Research commissioned by IOSH from Nottingham University into work-related sun exposure in the UK construction sector found that awareness around solar radiation risks is generally poor – two thirds of workers outside for an average of nearly seven hours a day thought they were not at risk, or didn’t know whether they were or not.
59 per cent of construction workers reported having sunburn at least once in the last year.
Just over 40 per cent thought there was no need to wear sunscreen on a cloudy day. Most didn’t use measures to protect themselves against sun exposure.
Both workers and managers didn’t see sun safety as an important issue – mainly because of a misperception that the UK climate doesn’t pose a great risk of skin cancer.

15. People who could be at risk
Construction workers
Dock and maritime worker
Engineers
Farmworkers and other rural workers
Police officers
Decorators
Postal workers
Rail or road workers
Refuse and recycling collectors
Sports persons
Traffic and parking workers
People who could be at risk
A number of trades are at risk of exposure to solar radiation, from construction and road workers to farmworkers and postal workers.

16. A construction worker received high‑level occupational UV exposure most of the working day, except during lunch hour, accumulating to 5.1 SED. A postal service worker was exposed intermittently around noon and in the afternoon, preceded by no exposure forenoon when packing mail, accumulating to 1.6 SED. A crane fitter was exposed only during lunch hour, accumulating to 0.7 SED. (standard erythema (skin reddening) doses per hour (SED/h)

17. Controlling solar radiation exposure
Assess the risks of exposure
Do any employees work regularly outside?
Are workers exposed to higher levels of solar radiation for significant periods?
Are workers unprotected from the effects of solar radiation?
How to prevent solar radiation exposure
90 percent of all skin cancer deaths could be prevented if people controlled their UV exposure.
You can control UV exposure by assessing the risks of exposure.
Do any employees work regularly outside?
Are workers exposed to higher levels of solar radiation for significant periods?
Are workers unprotected from the effects of solar radiation?

18. What is solar radiation?
Solar radiation is composed of many different wavelengths – ultraviolet, visible, and infrared.
The main cause of sunburn and skin cancer is exposure to the ultraviolet radiation (UV).
Unlike visible light, UV isn’t just composed of one type of wavelength. It’s actually composed of UVA, UVB and UVC. UVC is the most harmful form of UV light but fortunately that is stopped by the upper atmosphere and it is UVB and UVA that penetrate down to the earth’s surface and that’s the UV that gives us sunburn and skin cancer.
You can’t feel exposure to UV and the warmth that you feel on a sunny day is actually the infrared radiation.

19. UV penetration UV penetration
UVA penetrates the skin deeper into the dermis and can cause damage to the cells in the skin and give rise to skin cancer. It also damages the cells of the dermis causing premature ageing.
UVB only penetrates the epidermis layer, the upper layer of the skin, and can cause more damage to the DNA in that skin layer and potentially gives rise to more skin cancer than UVA. However, exposure to both do cause problems and generate skin cancer after prolonged exposure.

20. UV index
UV index
The UV index helps people understand the extent of UV exposure.
Weather forecasts in many countries include a projection of the UV index to guide public sun exposure.
The index ranges from one to eleven. One and two are considered low levels and it is reasonably safe for people to be outside for prolonged periods of time.
Three to five are moderate levels of UV exposure. People should take care during the midday and cover up.
Six to seven on the index is considered to be high exposure. People should look for shade during the midday hours, cover up and wear sunscreen.
Very high levels are in the range of eight to ten. People should spend time in the shade between 10am and 3pm which is when UV levels are at the highest. They should also cover up and use sunscreen.
The index eleven is an extreme exposure and people should avoid being outside in midday hours.

21. Prevention Avoid Check the UV index Avoid exposure during midday
Work rotation
Work in the shade
Take breaks in the shade
Raise awareness of solar radiation issues with workers
Cover up
Wear sunglasses
Wear sun protection
Check your skin
Drink plenty of water
Prevention
You can prevent UV exposure by:
Avoiding it
Checking the UV index to see what sort of exposure there is on that day
Avoiding exposure during midday
Working in rotation
Working in the shade
Taking breaks in the shade
Raising awareness of solar radiation issues with workers, using toolbox talks or training sessions
Covering up with clothing
Wearing sunglasses to stop UV exposure to the eye and making sure they are certified as being UV protection
Wearing sun protection
Checking your skin for signs of UV damage
Drinking plenty of water on warmer days to avoid dehydration

22. Mark Story Video https://youtu.be/alRqaZt4ZZM
Note: This slide includes a film, therefore, please make sure you have access to speakers and that your computer’s volume is turned up.
My Story: Mark Carter
Mark Carter was exposed to solar radiation when he joined the Merchant Navy at the age of 17. At 42, Mark was diagnosed with malignant melanoma. The cancer was treated, but thirteen and a half years later it returned, and sadly Mark passed away in 2014.

23. No Time to Lose: campaign on occupational cancer
I’ll now give an overview on occupational cancer and IOSH’s No Time to Lose campaign.

24. The No Time to Lose campaign aims to:
raise awareness of a significant health issue facing employees
offer businesses free practical, original materials to help them deliver effective prevention programmes
suggest solutions to tackle the problem
The No Time to Lose campaign on occupational cancer aims to do several things.
The main point of this campaign is to raise awareness. Work-based carcinogens are largely under the radar and we need to raise their profile if we want to see more action to control them.
Responsible businesses are doing a lot of what is required, but they need to do more, so we’re developing free resources to help them.
We’ve created an action plan to provide solutions to address the issue – for example, working with policy-makers globally to promote policies to raise awareness and encourage cutting exposure to carcinogens at work. The work we’re doing with our supporters worldwide drives this forward.
Whether you’re an employer or employee, industry body or policy-maker, safety and health professional or occupational hygienist, we all have a part to play if we want to call time on work-caused cancers.  We can beat occupational cancer if we work together to control the exposure risks.

25. The four phases
We have launched four phases of the No Time to Lose campaign. These are diesel engine exhaust emissions, solar radiation, silica dust, and asbestos.

26. Free practical materials
We worked with supportive businesses to develop free practical resources to help manage carcinogens in the workplace.
On the campaign website everyone can download free materials to help manage diesel fumes, solar radiation, silica dust and asbestos at work. You’ll find everything from factsheets, posters and leaflets, to films, presentations, infographics, and case studies.

27. Free practical resources to tackle solar radiation exposure
We’ve developed free resources to help manage solar radiation exposure at work. On the No Time to Lose website you’ll find more materials including toolbox talks, films, case studies and more…

28. There’s ‘No Time to Lose’ get involved today
I’ll now give an overview on IOSH’s No Time to Lose campaign.

29. Support the campaign – join over 300 organisations
Over 290 organisations worldwide are already supporting No Time to Lose
Organisations can support the campaign by providing a few sentences to reflect their commitments to taking action to prevent occupational cancers.
All our supporters have offered to spread the word via their communication channels.
We also provide supporter packs to help communicate campaign messages.

30. Pledge to take action – join 116 leading businesses
1. Assess the risks
2. Develop and deliver a prevention strategy
3. Brief managers
4. Engage employees
5. Demand the same standards from their supply chain
6. Report progress
Pledge to take action
A central part of what we have done involves urging businesses to pledge to take action. The pledge is a six point action plan which involves businesses committing to:
Assessing the risks
Developing and delivering a prevention strategy
Briefing managers
Engaging employees
Demanding the same standards of their supply chain
Reporting on progress made
Currently, 116 leading businesses around the world have now signed up to the campaign pledge. They have been recognised for their significant commitment to tackling carcinogens at work on our campaign website, in communications and with a No Time to Lose certificate.

31. Royal Mail Story https://youtu.be/j8-t50gNoKc
Note: This slide includes a film, therefore, please make sure you have access to speakers and that your computer’s volume is turned up.
Royal Mail Group film
This film shows how IOSH No Time to Lose campaign pledge signatory Royal Mail Group put in place a sun safety strategy to protect its employees from solar radiation exposure.

32. Campaign highlights
Through good partnership work with many organisations worldwide, the practical changes and workplace improvements our pledge signatories are putting in place, and high profile advocacy by our supporters, No Time to Lose is raising awareness and beginning to make positive impacts worldwide.
So far:
Media coverage has reached over 67 million people
6 million social media impressions have been generated
120,000 visitors have explored the campaign website
95,000 resources have been downloaded
Campaign films have been viewed 38,000 times
20,000 campaign packs have been distributed
300 organisations have formally supported the campaign and 116 businesses have signed up to our pledge – through them, work-related carcinogens have been highlighted to more than half a million employees worldwide
And we won the Chartered Institute of Public Relations ‘Mark of Excellence’ Award 2018 in the best international campaign category
To keep up to date with the latest news, please follow the campaign on Twitter.

33. New No Time to Lose website
Please visit our new No Time to Lose campaign website to find out more and get free resources to tackle occupational cancer – go to

34. IOSH supports European campaign –
‘Healthy Workplaces Manage Dangerous Substances’
IOSH is also supporting a Europe-wide campaign to highlight the importance of managing dangerous substances at work to help prevent ill health.
Cancer, respiratory illnesses and skin diseases are some of the health issues caused by exposure to hazardous substances at work. These include chemicals such as paints, glues and disinfectants; carcinogens including asbestos, diesel engine exhaust emissions and silica dust; and natural materials like grain dust and crude oil.
Many workers are exposed to these substances at work. In Europe, almost 80,000 people die a year from cancer caused by carcinogenic exposure at work.
The ‘Healthy Workplaces Manage Dangerous Substances’ campaign, organised by the European Agency for Safety and Health at Work (EU-OSHA), is working to tackle this issue and aims to:
raise awareness of the risks from dangerous substances in the workplace
promote a culture of prevention to eliminate or effectively manage risks
improve understanding of the risks associated with carcinogens
target vulnerable workers, for example, young people and migrant workers
provide information on policy developments and relevant legislation.
You can get involved in the campaign by:
downloading the campaign resources to help raise awareness
entering the ‘Healthy Workplaces Good Practice Awards’, which recognise innovative approaches to the issues associated with managing dangerous substances
joining an IOSH networking event to hear a presentation on preventing carcinogenic exposure at work
raising awareness in your workplace during the ‘European Week for Safety and Health at Work’ in October.
To find out more about the campaign, visit

35.
To find out more about the campaign and to get involved, please visit