{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T04:53:22Z","timestamp":1790398402928,"version":"4.1.0"},"reference-count":79,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2021,4,28]],"date-time":"2021-04-28T00:00:00Z","timestamp":1619568000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:p>Exposure of outdoor workers to high levels of solar ultraviolet radiation (UVR) poses significant, well-known health risks including skin cancer and eye diseases. In South Africa, little is known about how many workers are potentially overexposed to solar UVR and what the associated impacts on their health might be. In this overview, the geography and solar UVR environment in South Africa are considered, as well as the different outdoor occupational groups likely to be affected by excessive solar UVR exposure. Sunburn, pterygium, cataract, keratinocyte cancers, and melanoma are discussed in the context of outdoor workers. Few studies in South Africa have considered these health issues and the most effective ways to reduce solar UVR exposure for those working outside. Several countries have developed policies and guidelines to support sun safety in the workplace which include training and education, in addition to the provision of personal protective equipment and managerial support. Several gaps in occupational sun protection and workplace sun safety for South Africa are identified. Legislation needs to recognize solar UVR exposure as an occupational health hazard, with sun safety guidelines and training provided for employers and employees.<\/jats:p>","DOI":"10.3389\/fpubh.2021.678680","type":"journal-article","created":{"date-parts":[[2021,4,28]],"date-time":"2021-04-28T04:30:48Z","timestamp":1619584248000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":31,"title":["Health Risks Associated With Excessive Exposure to Solar Ultraviolet Radiation Among Outdoor Workers in South Africa: An Overview"],"prefix":"10.3389","volume":"9","author":[{"given":"Caradee Y.","family":"Wright","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary","family":"Norval","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2021,4,28]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"2063","DOI":"10.3390\/ijerph15102063","article-title":"Solar radiation exposure and outdoor work: an underestimated occupational risk","volume":"15","author":"Modenese","year":"2018","journal-title":"Int. J. Environ. Res. Public Health."},{"key":"B2","volume-title":"Global Solar UV Index: a Practical Guide: A Joint Recommendation of World Health Organization, World Meteorological Organization, United Nations Environment Programme, International Commission on Non-Ionizing Radiation Protection","year":"2002"},{"key":"B3","unstructured":"General Household Survey 20192020"},{"key":"B4","unstructured":"SA Economy Shed 2,2 Million Jobs in Q2 but Unemployment Levels Drop2020"},{"key":"B5","unstructured":"A Giant Step in Agriculture Statistics"},{"key":"B6","unstructured":"Jobs in the SA formal sector up in the 3rd quarter of 20202020"},{"key":"B7","unstructured":"Forestry"},{"key":"B8","unstructured":"BrickK\n            HassonR\n          Cape TownUniversity of Cape TownValuing the Socio-Economic Contribution of Fisheries and Other Marine Uses in South Africa2016"},{"key":"B9","doi-asserted-by":"publisher","first-page":"201","DOI":"10.1111\/phpp.12451","article-title":"Photoaging and actinic keratosis in Danish outdoor and indoor workers","volume":"35","author":"Grandahl","year":"2019","journal-title":"Photodermatol Photoimmunol Photomed"},{"key":"B10","unstructured":"Number of People Employed by South Africa's Mining Industry in 2019 by Commodity"},{"key":"B11","doi-asserted-by":"publisher","first-page":"342","DOI":"10.1562\/0031-8655(2003)078<0342:msureo>2.0.co;2","article-title":"Measured solar ultraviolet radiation exposures of outdoor workers in queensland in the building and construction industry","volume":"78","author":"Gies","year":"2003","journal-title":"Photochem Photobiol"},{"key":"B12","doi-asserted-by":"publisher","first-page":"925","DOI":"10.1111\/j.1751-1097.2011.00934.x","article-title":"Occupational exposures to solar ultraviolet radiation of vineyard workers in Tuscany (Italy)","volume":"87","author":"Siani","year":"2011","journal-title":"Photochem. Photobiol."},{"key":"B13","doi-asserted-by":"publisher","first-page":"1","DOI":"10.17159\/sajs.2015\/20140133","article-title":"Real-time measurement of outdoor worker's exposure to solar ultraviolet radiation in Pretoria, South Africa","volume":"111","author":"Makgabutlane","year":"2015","journal-title":"S. Afr. J. Sci."},{"key":"B14","volume-title":"Skin Colour, photoprotective measures, and solar ultraviolet radiation exposure of workers on a macadamia nut and avocado farm","author":"Linde","year":"2021"},{"key":"B15","doi-asserted-by":"publisher","first-page":"943","DOI":"10.1111\/php.13195","article-title":"Drivers for sun protection in black South Africans","volume":"96","author":"Diffey","year":"2020","journal-title":"Photochem. Photobiol"},{"key":"B16","first-page":"194","article-title":"Skin cancer in skin of color: an update on current facts, trends, and misconceptions","volume":"12","author":"Battie","year":"2013","journal-title":"J Drugs Dermatol."},{"key":"B17","doi-asserted-by":"publisher","first-page":"1250","DOI":"10.1111\/j.1524-4725.2005.31935","article-title":"Photoaging and nonablative photorejuvenation in ethnic skin","volume":"31","author":"Munavalli","year":"2005","journal-title":"Dermatol Surg."},{"key":"B18","first-page":"649","article-title":"The ocular dose of ultraviolet radiation to outdoor workers","volume":"29","author":"Rosenthal","year":"1988","journal-title":"Invest Ophthalmol Vis Sci"},{"key":"B19","doi-asserted-by":"publisher","first-page":"1226","DOI":"10.1111\/php.12123","article-title":"Sunburn risk among children and outdoor workers in South Africa and Reunion Island Coastal Sites","volume":"89","author":"Wright","year":"2013","journal-title":"Photochem Photobiol"},{"key":"B20","doi-asserted-by":"publisher","first-page":"5612","DOI":"10.3402\/gha.v3i0.5612","article-title":"Climate change impacts on working people (the HOTHAPS initiative): findings of the South African pilot study","volume":"3","author":"Mathee","year":"2010","journal-title":"Glob Health Action"},{"key":"B21","article-title":"Solar ultraviolet radiation: global burden of disease from solar ultraviolet radiation","volume-title":"Environmental Burden of Disease Series, No. 13.","author":"Lucas","year":"2006"},{"key":"B22","doi-asserted-by":"publisher","first-page":"719","DOI":"10.1016\/j.survophthal.2018.03.001","article-title":"Prevalence and risk factors of pterygium: a systematic review and meta-analysis","volume":"63","author":"Rezvan","year":"2018","journal-title":"Surv Ophthalmol."},{"key":"B23","first-page":"723","article-title":"The prevalence of corneal disease in the coloured community of a Karoo town","volume":"67","author":"Hill","year":"1985","journal-title":"S Afr Med J"},{"key":"B24","doi-asserted-by":"publisher","first-page":"687","DOI":"10.7196\/samj.5930","article-title":"Traditional eye medication and pterygium occurrence in Limpopo Province","volume":"102","author":"Anguria","year":"2012","journal-title":"S Afr Med J"},{"key":"B25","first-page":"232","article-title":"Pterygium in Ibadan","volume":"10","author":"Ashaye","year":"1991","journal-title":"West Afr J Med."},{"key":"B26","first-page":"802","article-title":"Ultraviolet radiation and the eye: an epidemiologic study","volume":"87","author":"Taylor","year":"1989","journal-title":"Trans Am Ophthalmol Soc"},{"key":"B27","doi-asserted-by":"publisher","first-page":"97","DOI":"10.2188\/jea.9.6sup_97","article-title":"Ocular Ultraviolet B exposure and lens opacities: a review","volume":"9","author":"West","year":"1999","journal-title":"J Epidemiol"},{"key":"B28","doi-asserted-by":"publisher","first-page":"779","DOI":"10.1111\/aos.13734","article-title":"Cataract frequency and subtypes involved in workers assessed for their solar radiation exposure: a systematic review","volume":"96","author":"Modenese","year":"2018","journal-title":"Acta Ophthalmol."},{"key":"B29","doi-asserted-by":"publisher","first-page":"1523","DOI":"10.3390\/ijerph14121523","article-title":"Prevalence of self-reported diagnosed cataract and associated risk factors among elderly South Africans","volume":"14","author":"Phaswana-Mafuya","year":"2017","journal-title":"Int J Envir Res Public Health"},{"key":"B30","first-page":"26","article-title":"Prevalence and incidence of blindness due to age-related cataract in the rural areas of South Africa","volume":"85","author":"Cook","year":"1995","journal-title":"S Afr Med J."},{"key":"B31","doi-asserted-by":"publisher","first-page":"721","DOI":"10.1136\/bjo.72.10.721","article-title":"Prevalence and causes of blindness in the northern Transvaal","volume":"72","author":"Bucher","year":"1988","journal-title":"Br J Ophthal"},{"key":"B32","doi-asserted-by":"publisher","first-page":"e00352","DOI":"10.1016\/j.sciaf.2020.e00352","article-title":"Survey on prevalence of cataract in selected communities in Limpopo Province of South Africa","volume":"8","author":"Khoza","year":"2020","journal-title":"Scientific African"},{"key":"B33","doi-asserted-by":"publisher","first-page":"84","DOI":"10.1136\/bjo.74.2.84","article-title":"A prevalence survey of ophthalmic diseases among the Turkana tribe in north-west Kenya","volume":"74","author":"Loewenthal","year":"1990","journal-title":"Br J Ophthal."},{"key":"B34","doi-asserted-by":"publisher","first-page":"4114","DOI":"10.1167\/iovs.09-3507","article-title":"Causes of blindness and visual impairment in Nigeria: the Nigeria National Blindness and Visual Impairment Survey","volume":"50","author":"Abdull","year":"2009","journal-title":"Invest Ophthalmol Vis Sci"},{"key":"B35","doi-asserted-by":"publisher","first-page":"853","DOI":"10.1111\/j.1346-8138.1995.tb03935.x","article-title":"The epidemiology of non-melanoma skin cancer: who, why and what can we do about it","volume":"22","author":"Marks","year":"1995","journal-title":"J Dermatol."},{"key":"B36","doi-asserted-by":"publisher","first-page":"748","DOI":"10.1016\/j.jaad.2013.11.038","article-title":"Skin cancer and photoprotection in people of color: a review and recommendations for physicians and the public","volume":"70","author":"Agbai","year":"2014","journal-title":"J Am Acad Dermatol."},{"key":"B37","doi-asserted-by":"publisher","first-page":"7","DOI":"10.2188\/jea.9.6sup_7","article-title":"Sun exposure, skin cancers and related skin conditions","volume":"9","author":"Green","year":"1999","journal-title":"J Epidemiol."},{"key":"B38","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1046\/j.1365-2133.146.s61.2.x","article-title":"The epidemiology of skin cancer","volume":"146","author":"Diepgen","year":"2002","journal-title":"Br J Dermatol"},{"key":"B39","doi-asserted-by":"publisher","first-page":"262","DOI":"10.1111\/phpp.12106","article-title":"The incidence and body site of skin cancers in the population groups of South Africa","volume":"30","author":"Norval","year":"2014","journal-title":"Photodermatol Photoimmunol Photomed."},{"key":"B40","doi-asserted-by":"publisher","first-page":"291","DOI":"10.1111\/j.1365-2133.2010.10118.x","article-title":"Occupational ultraviolet light exposure increases the risk for the development of cutaneous squamous cell carcinoma: a systematic review and meta-analysis","volume":"164","author":"Schmitt","year":"2011","journal-title":"Br J Dermatol."},{"key":"B41","doi-asserted-by":"publisher","first-page":"612","DOI":"10.1111\/j.1365-2133.2011.10425.x","article-title":"Is occupational solar ultraviolet irradiation a relevant risk factor for basal cell carcinoma? A systematic review and meta-analysis of the epidemiological literature","volume":"165","author":"Bauer","year":"2011","journal-title":"Br J Dermatol."},{"key":"B42","doi-asserted-by":"publisher","DOI":"10.23736\/s0392-0488.20.06699-7","article-title":"Role of occupational and recreational sun exposure as a risk factor for keratinocytic non-melanoma skin cancers: an Italian multicentre case-control study","author":"Gallo","year":"2020","journal-title":"G Ital Dermatol Venereol."},{"key":"B43","doi-asserted-by":"publisher","first-page":"56","DOI":"10.1016\/j.canep.2017.10.007","article-title":"Distribution of cancer mortality rates by province in South Africa","volume":"51","author":"Made","year":"2017","journal-title":"Cancer Epidemiol."},{"key":"B44","first-page":"65","article-title":"Melanoma in black South Africans","volume":"180","author":"Hudson","year":"1995","journal-title":"J Am Coll Surg."},{"key":"B45","doi-asserted-by":"publisher","first-page":"1056","DOI":"10.1111\/bjd.19010","article-title":"Trends in malignant melanoma mortality in 31 countries from 1985 to 2015","volume":"183","author":"Yang","year":"2020","journal-title":"Br J Dermatol."},{"key":"B46","doi-asserted-by":"publisher","first-page":"246","DOI":"10.7196\/SAMJ.2019.v109i4.13565","article-title":"The incidence of melanoma in South Africa: an exploratory analysis of National Cancer Registry data from 2005 to 2013 with a specific focus on melanoma in black Africans","volume":"109","author":"Tod","year":"2019","journal-title":"S Afr Med J"},{"key":"B47","doi-asserted-by":"publisher","first-page":"249","DOI":"10.1016\/S0190-9622(79)70018-1","article-title":"Photoprotection by melanin\u2014a comparison of black and Caucasian skin","volume":"1","author":"Kaidbey","year":"1979","journal-title":"J Am Acad Dermatol"},{"key":"B48","unstructured":"Mortality and Causes of Death in South Africa, 2016: Findings From Death Notification"},{"key":"B49","doi-asserted-by":"publisher","first-page":"396","DOI":"10.1159\/000500663","article-title":"Trends in melanoma mortality in the population groups of South Africa","volume":"235","author":"Wright","year":"2019","journal-title":"Dermatology"},{"key":"B50","doi-asserted-by":"publisher","first-page":"147","DOI":"10.1016\/j.canep.2017.04.004","article-title":"Sun exposure and skin cancer, and the puzzle of cutaneous melanoma: A perspective on Fears et al. Mathematical models of age and ultraviolet effects on the incidence of skin cancer among whites in the United States. American Journal of Epidemiology 1977; 105: 420\u2013427","volume":"48","author":"Armstrong","year":"2017","journal-title":"Cancer Epidemiol."},{"key":"B51","doi-asserted-by":"publisher","first-page":"213","DOI":"10.1001\/jamadermatol.2020.4616","article-title":"UV Exposure and the risk of cutaneous melanoma in skin of color: a systematic review","volume":"157","author":"Lopes","year":"2021","journal-title":"JAMA Dermatol."},{"key":"B52","doi-asserted-by":"publisher","first-page":"672","DOI":"10.1111\/bjd.19379","article-title":"Occupation and cutaneous melanoma: a 45-year historical cohort study of 14\u00b79 million people in five Nordic countries","volume":"184","author":"Alfonso","year":"2020","journal-title":"Br J Dermatol."},{"key":"B53","unstructured":"p. 14Ultraviolet Radiation as a Hazard in the Workplace2003"},{"key":"B54","doi-asserted-by":"publisher","first-page":"22","DOI":"10.1186\/1476-069X-6-22","article-title":"Reducing ultraviolet radiation exposure among outdoor workers: state of the evidence and recommendations","volume":"6","author":"Glanz","year":"2007","journal-title":"Environ Health"},{"key":"B55","unstructured":"p. 1110World Health OrganizationProtecting Workers from Ultraviolet Radiation2007"},{"key":"B56","doi-asserted-by":"publisher","first-page":"928","DOI":"10.1111\/bjd.12160","article-title":"Outdoor workers' sun-related knowledge, attitudes and protective behaviours: a systematic review of cross-sectional and interventional studies","volume":"168","author":"Reinau","year":"2013","journal-title":"Br J Dermatol."},{"key":"B57","doi-asserted-by":"publisher","first-page":"453","DOI":"10.1111\/php.13388","article-title":"Low use of ocular sun protection among agricultural workers in South Africa: need for further research","volume":"97","author":"Linde","year":"2021","journal-title":"Photochem Photobiol"},{"key":"B58","doi-asserted-by":"publisher","first-page":"37","DOI":"10.3390\/atmos11010037","article-title":"Perceptions of occupational heat, sun exposure, and health risk prevention: a qualitative study of forestry workers in South Africa","volume":"11","author":"Rother","year":"2020","journal-title":"Atmosphere"},{"key":"B59","doi-asserted-by":"publisher","first-page":"1142","DOI":"10.3390\/ijerph14101142","article-title":"Sun exposure, sun-related symptoms, and sun protection practices in an African informal traditional medicines market","volume":"14","author":"Wright","year":"2017","journal-title":"Int J Environ Res Public Health"},{"key":"B60","doi-asserted-by":"publisher","first-page":"34","DOI":"10.1111\/jdv.13631","article-title":"Knowledge of outdoor workers on the effects of natural UV radiation and methods of protection against exposure","volume":"30","author":"Hault","year":"2016","journal-title":"J Eur Acad Dermatol Venereol."},{"key":"B61","unstructured":"Industrial Hygiene Field Operations ManualChapter 11 \u2013 Ultraviolet Radiation2019"},{"key":"B62","doi-asserted-by":"publisher","first-page":"e12083","DOI":"10.1002\/1348-9585.12083","article-title":"Outdoor workers' perceptions of skin cancer risk and attitudes to sun-protective measures: a qualitative study","volume":"62","author":"Rocholl","year":"2020","journal-title":"J Occup Health"},{"key":"B63","unstructured":"ICNIRP statement: principles for non-ionizing radiation protection47782Health Phys1182020"},{"key":"B64","unstructured":"ARPANSANew Resource to Protect Outdoor Workers2019"},{"key":"B65","doi-asserted-by":"publisher","first-page":"87","DOI":"10.1111\/j.1753-6405.2008.00173.x","article-title":"Occupational exposure to ultraviolet radiation \u2013 not a standard for all","volume":"32","author":"Tenkate","year":"2008","journal-title":"Aust N Z J Public Health"},{"key":"B66","unstructured":"Occupational Health and Safety Act2004"},{"key":"B67","unstructured":"AustraliaSun Protection for Outdoor Workers2017"},{"key":"B68","unstructured":"CanadaCanadian Health and Safety Regulations2021"},{"key":"B69","doi-asserted-by":"publisher","first-page":"10","DOI":"10.5130\/AJCEB.v2i2.2896","article-title":"Outdoor workers and sun protection: knowledge and behaviour","volume":"2","author":"Cioffi","year":"2012","journal-title":"Austral J Construction Econ Build"},{"key":"B70","doi-asserted-by":"publisher","first-page":"84","DOI":"10.1539\/joh.12-0182-OA","article-title":"Occupational sun protection: workplace culture, equipment provision and outdoor workers' characteristics","volume":"55","author":"Reeder","year":"2013","journal-title":"J Occup Health"},{"key":"B71","first-page":"333","article-title":"Risk assessment: an opportunity to change health and safety performance","volume":"98","author":"Foster","year":"1998","journal-title":"J SA Inst Mining Metallurgy"},{"key":"B72","doi-asserted-by":"publisher","first-page":"1212","DOI":"10.1177\/0960327115600370","article-title":"Hazards identified and the need for health risk assessment in the South African mining industry","author":"Utembe","year":""},{"key":"B73","unstructured":"South African Occupational Health and Safety Amendment Act (No. 181 of 1993)"},{"key":"B74","unstructured":"MelbourneNational Skin CommitteeSkin cancer and outdoor work: A Work Health and Safety Guide2007"},{"key":"B75","unstructured":"Sun Protection for Outdoor Workers"},{"key":"B76","unstructured":"ARPANSANew Resource to Protect Outdoor Workers2019"},{"key":"B77","unstructured":"Overview: Working in Outdoor and Indoor Heat Environments"},{"key":"B78","unstructured":"The Guide to Community Preventive ServicesSkin Cancer: Interventions in Outdoor Occupational Settings2014"},{"key":"B79","unstructured":"South AfricaNational Climate Change and Health Adaptation Plan 2014-20192014"}],"container-title":["Frontiers in Public Health"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2021.678680\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,4,28]],"date-time":"2021-04-28T04:31:27Z","timestamp":1619584287000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2021.678680\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,4,28]]},"references-count":79,"alternative-id":["10.3389\/fpubh.2021.678680"],"URL":"https:\/\/doi.org\/10.3389\/fpubh.2021.678680","relation":{},"ISSN":["2296-2565"],"issn-type":[{"value":"2296-2565","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,4,28]]},"article-number":"678680"}}