Is occupational solar ultraviolet irradiation a relevant risk factor for basal cell carcinoma? A systematic review and meta-analysis of the epidemiological literature
ABSTRACT The most important risk factor for basal cell carcinoma (BCC) is ultraviolet (UV) radiation. It is reasonable to assume that outdoor workers with a long history of work-related UV exposure are at increased risk of developing BCC.
To analyse systematically the epidemiological literature concerning the evidence of an association between occupational UV exposure and BCC risk in outdoor workers.
Systematic literature review of cohort studies and case-control studies providing data on occupational UV exposure and BCC occurrence. PubMed (up to 28 January 2011) was searched, supplemented by hand searching and consultation of experts in the field. The association between occupational UV exposure and BCC risk is presented as odds ratios (ORs). A random-effects meta-analysis and sensitivity analysis including meta-regression on study-specific covariates were performed.
Twenty-four relevant epidemiological studies (five cohort studies, 19 case-control studies) were identified. Twenty-three studies reported sufficient data to be included in the meta-analysis. The pooled OR for the association between outdoor work and BCC risk was 1·43 (95% confidence interval 1·23-1·66; P = 0·0001). Studies adjusting for sex (P < 0·0001) and individual nonoccupational UV exposure (P = 0·014) showed a significantly stronger association of occupational UV exposure and BCC risk. Meta-regression revealed a significant inverse relationship between occupational UV radiation exposure and BCC risk with latitude (P = 0·015).
Published epidemiological literature indicates that outdoor workers are at significantly increased risk for BCC. This finding is highly relevant for health policy to stimulate the implementation of effective prevention strategies.
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- "Entomologists are exposed to more generic field, laboratory and office exposures such as extreme temperature, traffic accidents , solar radiation, musculoskeletal and psychosocial problems, and hazards associated with other animals, such as snakes (International Labor Organization, 2012). These may lead to a range of adverse health outcomes, from direct associations, such as skin cancer from prolonged sun exposure in field work (Bauer et al., 2011; Schmitt et al., 2011), to less tangible postural and overuse problems with intensive microscopy. Despite the high theoretical risk of adverse work-related health outcomes for entomologists, no systematic review has been conducted to provide high level evidence of such a risk. "
ABSTRACT: Adverse work-related health outcomes are a significant problem worldwide. Entomologists, including arthropod breeders, are a unique occupational group exposed to potentially harmful arthropods, pesticides, and other more generic hazards. These exposures may place them at risk of a range of adverse work-related health outcomes. To determine what adverse work-related health outcomes entomologists have experienced, the incidence/prevalence of these outcomes, and what occupational management strategies have been employed by entomologists, and their effectiveness. A systematic search of eight databases was undertaken to identify studies informing the review objectives. Data pertaining to country, year, design, work-exposure, adverse work-related health outcomes, incidence/prevalence of these outcomes, and occupational management strategies were extracted, and reported descriptively. Results showed entomologists experienced work-related allergies, venom reactions, infections, infestations and delusional parasitosis. These related to exposure to insects, arachnids, chilopods and entognathans, and non-arthropod exposures, e.g. arthropod feed. Few studies reported the incidence/prevalence of such conditions, or work-related management strategies utilised by entomologists. There were no studies that specifically investigated the effectiveness of potential management strategies for entomologists as a population. Indeed, critical appraisal analysis indicated poor research quality in this area, which is a significant research gap. Entomologists are a diverse, unique occupational group, at risk of a range of adverse work-related health outcomes. This study represents the first systematic review of their work-related health risks. Future studies investigating the prevalence of adverse work-related health outcomes for entomologists, and the effectiveness of management strategies are warranted to decrease the disease burden of this otherwise understudied group. Copyright © 2015. Published by Elsevier Inc.Environmental Research 07/2015; 140:619-633. DOI:10.1016/j.envres.2015.05.025 · 3.95 Impact Factor
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ABSTRACT: Melanoma and nonmelanoma skin cancer (NMSC) are now the most common types of cancer in white populations. Both tumor entities show an increasing incidence rate worldwide but a stable or decreasing mortality rate. The rising incidence rates of NMSC are probably caused by a combination of increased sun exposure or exposure to ultraviolet (UV) light, increased outdoor activities, changes in clothing style, increased longevity, ozone depletion, genetics and in some cases, immune suppression. A dose-dependent increase in the risk of squamous cell carcinoma (SCC) of the skin was found associated with exposure to Psoralen and UVA irradiation. An intensive UV exposure in childhood and adolescence was causative for the development of basal cell carcinoma (BCC) whereas for the aetiology of SCC a chronic UV exposure in the earlier decades was accused. Cutaneous malignant melanoma is the most rapidly increasing cancer in white populations. The frequency of its occurrence is closely associated with the constitutive colour of the skin and depends on the geographical zone. The highest incidence rates have been reported from Queensland, Australia with 56 new cases per year per 100,000 for men and 43 for women. Mortality rates of melanoma show a stabilisation in the USA, Australia and also in European countries. The tumor thickness is the most important prognostic factor in primary melanoma. There is an ongoing trend towards thin melanoma since the last two decades. Epidemiological studies have confirmed the hypothesis that the majority of all melanoma cases are caused, at least in part, by excessive exposure to sunlight. In contrast to squamous cell carcinoma, melanoma risk seems not to be associated with cumulative, but intermittent exposure to sunlight. Therefore campaigns for prevention and early detection are necessary.Advances in Experimental Medicine and Biology 02/2008; 624:89-103. DOI:10.1007/978-0-387-77574-6_8 · 2.01 Impact Factor
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ABSTRACT: UV radiation is the major risk factor for the development of the main types of skin cancer, albeit with some differences. Non-melanoma skin cancers, particularly squamous cell carcinoma, are associated with cumulative UV dose, whereas malignant melanoma (MM) appears to be related to intermittent sun exposure. This seems to be confirmed by experimentally UV-induced MM, suggesting that sunburn in infancy may be an important risk factor for MM. Biomolecular studies have demonstrated that UV radiation promotes the formation of photoproducts, able to provoke UV-induced mutations, which are found in high frequency in squamous cell carcinomas. The role of UV radiation as a risk factor for MM should also be considered in relation to genetic predisposition. In subjects belonging to families with a high incidence of MM, genetic alterations, such as variants of the MC1R and CDKN2A gene mutations, associated with red hair and freckles, have been identified. UV radiation can affect the immune system, favoring the development of UV-induced skin cancer. The UV-induced immune suppression occurs by mechanisms similar to those involved in delayed skin hypersensitivity.Expert Review of Dermatology 09/2011; 6(5):445-454. DOI:10.1586/edm.11.54