Sun is the primary cause of skin cancer, and that means that construction laborers, who work outside most of the time, are at high risk for this disease. However, because their risk of accidental death and injury on the job is not only higher, but also more immediate, the dangers of skin cancer in this industry have often been neglected.

But no longer. In response to concerns raised by a local union representing highway workers in the sun-drenched desert of Nevada, the Laborers' Health and Safety Fund of North America (LHSFNA) has succeeded in motivating members of the Laborers' International Union of North America (LIUNA) to protect themselves against this common and potentially deadly disease.

Construction work is dangerous. It has the third highest death rate from injuries of all American industries.  Within construction, the death rate for laborers is more than three times the average for the entire industry.  It is hardly surprising that laborers do not always see the risk of skin cancer as a top priority.  However, in 1995, the Conference to Develop a National Skin Cancer Agenda specifically identified outdoor workers as a high-risk group worthy of targeting. They experience twice the number of nonmelanoma skin cancers (basal cell carcinomas and squamous cell carcinomas ) as indoor workers.

LHSFNA, a labor-management fund, was created in 1988 to foster better health behaviors among laborers and their families, and to reduce workplace injury and illness.  Taking note of the number of skin cancers among laborers, the LHSFNA developed a skin cancer awareness program that focuses on incidence, causes, and risk factors as well as detection, prevention and treatment. It offers a training package, Sun Sense: Skin Cancer Control for Laborers. The issue of skin cancer is also raised in tool-box talks — brief jobsite meetings — and safety meetings which are routine on unionized construction jobs.

Several years ago, the Fund began providing cloth flaps that can be secured to a cap or a hardhat to protect the back of the neck, and the response was overwhelming. The Fund distributes 10,000 of them a year. "The men are not ‘lotion-oriented' and will not take the trouble to buy bottles of sunscreen at the store," reported one LHSFNA staffer. A small, unscientific survey of laborers found that only 10 percent used sunscreen on a regular basis, significantly lower than the national average.  Still, when the Fund introduced laborers to sunscreen by distributing small individual packets at the Sun Sense classes and through local union halls, these were snapped up. Soon, there was a deluge of requests for sunscreen for training centers, membership meetings, health fairs, member picnics and even charity golf tournaments. In 2002, 25,000 packets of SPF 30 sunscreen were distributed. Wall dispensers are mounted at the training centers, and laborers are encouraged to apply lotion before their simulated outdoor work training sessions.

"I never thought a laborer would pay any attention to sunscreen. Boy, was I ever wrong about that," said Clint Taylor, Training Director for a laborers' training center in Mt. Sterling, IL. "The older guys understand because they've heard the stories and seen the evidence. They know it's important to talk about this, especially to younger guys who think they're invincible."

If the overwhelming and ever increasing demand for skin protection products and educational materials is any indication, the union's program is a success. According to many Sun Sense instructors, after each time a class is taught, a union member approaches to ask advice.  Kelly Lapping, director of the Laborer's training center for the Washington DC area, sat in on a Sun Sense class during a health fair.  Afterward, he approached the instructor about some moles, and she advised him to see a dermatologist.  "The moles were atypical," Lapping says.  "I consider myself lucky.  Now, I get check-ups on a regular basis and encourage my trainees to take advantage of cancer screening opportunities."

Learn how to perform a skin self-examination here.