Chronic-sun cancers put twist on work hazard

When his doctor found pre-cancerous skin lesions on one side of his face but not the other, a Halifax transit driver figured he knew the cause: while on the job, his left side is exposed to sunlight through the bus window.

An appeal panel has agreed, ruling that the driver is eligible for workers compensation because his chronic sun exposure constitutes a workplace injury. The decision late last month is just the latest over the last several years to compensate outdoor employees who develop skin cancer.

A cruise-ship captain, police officer and letter carrier are among those who have successfully fought for payments to compensate apparently sun-triggered cancer.

The rulings put a new twist on the concept of workplace hazard, usually associated with more tangible risks like dangerous physical tasks or toxic chemicals.

One dermatologist warns the trend could have major consequences, given that skin cancers are the most common type of the disease, with about 75,000 new cases of non-melanoma skin cancer diagnosed annually in Canada and 4,200 of melanoma.

“This is potentially a very concerning thing for government and insurance, because there are lots of [military] people who serve our great nation and lots of people who work outdoors,” said Dr. Ben Barankin, who is based in Toronto. “If everybody starts blaming skin cancer on the outdoor exposure, it’s going to get very ugly ... This could bankrupt government and insurance.”

He said he recently wrote a report for lawyers handling the case of a late Second World War navy veteran who had skin cancer and whose wife is claiming a military pension on his behalf, arguing that his endless hours on the deck of warships likely was a cause of the disease.

Dr. Barankin notes, though, that little was known about the sun/cancer connection in the 1940s, and questions generally how much workplace sun exposure has to do with people getting sick.

It is certainly clear that exposure to sunlight is a major factor for developing the disease — along with inherited attributes like skin type — and outdoor workers are subject to as much as 10 times the sun as indoor employees, according to World Health Organization figures.

A German study published last year found that people who toil outside were up to three times more likely than others to contract strains of the cancer that cause relatively few deaths. It showed no difference in the rate of the much more deadly melanoma.

Regardless, workers compensation boards have quietly come to accept claims for sunlight-linked cancer over the last 10 years, so long as a dermatologist or oncologist can testify that the employee’s outside work may have brought on the disease, said Gary Newhouse, a Toronto lawyer specializing in workers-compensation claims.

The B.C. workers compensation agency, for instance, has provided payments to six people for sunlight-caused skin cancer since 2002, including a gardener, plasterer and boomboat operator.

The policy is not widely known, though, said Mr. Newhouse.

“Probably many people who get skin cancer and might be eligible would never think of applying,” said Mr. Newhouse. “If anything, it’s under-claimed.”

Dr. Barankin said it is often unclear whether work is a factor, especially since childhood, when cells are still developing, is the most critical time period for skin cancer growth. As well, some malignancies can take 20 to 30 years to develop after the damage is done.

“Someone who gets their skin cancer at 50, is it because they were truck driving for the previous 10 years or because they were sun burning as kid? We really can’t say,” he argued. “The courts should be very careful. There’s no cause and effect.”

The Nova Scotia bus driver, whose name was not released, was diagnosed with actinic keratosis — lesions that can turn into carcinoma — mostly on the left side of his face and temple.

The employee said he spent a lot of time outdoors as a child but had worked 22 years driving buses, 17 of them on the day shift, and that he sat with his left side less than a foot from the window.

The appeal board decision cited data suggesting that 80% of the skin cancer risk comes from sunlight exposure during childhood. Nevertheless, it concluded that it was “just as likely as not” the driver’s work contributed to his illness and said he was eligible for compensation.

tblackwell@nationalpost.com