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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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: Climate change and solar ultraviolet radiation may affect vaccine-preventable infectious diseases (VPID), the human immune response process and the immunization service delivery system. We systematically reviewed the scientific literature and identified 37 relevant publications. Our study shows that climate variability and ultraviolet radiation may potentially affect VPID and the immunization delivery system through modulating vector reproduction and vaccination effectiveness, possibly influencing human immune response systems to the vaccination, and disturbing immunization service delivery. Further research is needed to determine these affects on climate-sensitive VPID and on human immune response to common vaccines. Such research will facilitate the development and delivery of optimal vaccination programs for target populations, to meet the goal of disease control and elimination.Expert Review of Vaccines 12/2014; DOI:10.1586/14760584.2014.990387 · 4.22 Impact Factor
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ABSTRACT: Brazil is a country of continental dimensions with a large heterogeneity of climates and massive mixing of the population. Almost the entire national territory is located between the Equator and the Tropic of Capricorn, and the Earth axial tilt to the south certainly makes Brazil one of the countries of the world with greater extent of land in proximity to the sun. The Brazilian coastline, where most of its population lives, is more than 8,500 km long. Due to geographic characteristics and cultural trends, Brazilians are among the peoples with the highest annual exposure to the sun. Epidemiological data show a continuing increase in the incidence of non-melanoma and melanoma skin cancers. Photoprotection can be understood as a set of measures aimed at reducing sun exposure and at preventing the development of acute and chronic actinic damage. Due to the peculiarities of Brazilian territory and culture, it would not be advisable to replicate the concepts of photoprotection from other developed countries, places with completely different climates and populations. Thus the Brazilian Society of Dermatology has developed the Brazilian Consensus on Photoprotection, the first official document on photoprotection developed in Brazil for Brazilians, with recommendations on matters involving photoprotection.