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Occupational Skin Cancer by Solar Ultraviolet Radiation

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Handbook of Occupational Dermatoses

Part of the book series: Updates in Clinical Dermatology ((UCD))

Abstract

Skin cancers constitute a serious public health issue in fair skinned populations globally, as they account for a substantial proportion of all reported occupational diseases, and the number of workers diagnosed with skin cancer has continuously grown in recent times. Solar ultraviolet radiation (UVR) is the most important occupational carcinogenic exposure in terms of the number of employees exposed (i.e., professional outdoor workers). Solar UVR is the leading cause of non-melanoma skin cancer. The risks of solar UVR exposure in the workplace are frequently largely ignored, and the evident future issues are contrasting against the current legal status, patient care, and compensation. The field of workplace safety includes sun protection. To avoid skin malignancies induced by UVR exposure, outdoor workers must reduce their occupationally received UVR doses sufficiently. Preventive efforts are classified into primary, secondary, and tertiary preventative measures and include technical, organizational, and person-related approaches.

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References

  1. Diepgen TL. New developments in occupational dermatology. J Dtsch Dermatol Ges. 2016;14(9):875–89. https://doi.org/10.1111/ddg.13128.

    Article  PubMed  Google Scholar 

  2. John SM, Garbe C, French LE, Takala J, Yared W, Cardone A, et al. Improved protection of outdoor workers from solar ultraviolet radiation: position statement. J Eur Acad Dermatol Venereol. 2021;35(6):1278–84. https://doi.org/10.1111/jdv.17011.

    Article  CAS  PubMed  Google Scholar 

  3. Park YJ, Kwon GH, Kim JO, Kim NK, Ryu WS, Lee KS. A retrospective study of changes in skin cancer characteristics over 11 years. Arch Craniofac Surg. 2020;21(2):87–91. https://doi.org/10.7181/acfs.2020.00024.

    Article  PubMed  PubMed Central  Google Scholar 

  4. Garbe C, Peris K, Soura E, Forsea AM, Hauschild A, Arenbergerova M, et al. The evolving field of Dermato-oncology and the role of dermatologists: position paper of the EADO, EADV and task forces, EDF, IDS, EBDV-UEMS and EORTC cutaneous lymphoma task force. J Eur Acad Dermatol Venereol. 2020;34(10):2183–97. https://doi.org/10.1111/jdv.16849.

    Article  CAS  PubMed  Google Scholar 

  5. Trakatelli M, Barkitzi K, Apap C, Majewski S, De Vries E. Skin cancer risk in outdoor workers: a European multicenter case-control study. J Eur Acad Dermatol Venereol. 2016;30(Suppl 3):5–11. https://doi.org/10.1111/jdv.13603.

    Article  PubMed  Google Scholar 

  6. Paulo MS, Adam B, Akagwu C, Akparibo I, Al-Rifai RH, Bazrafshan S, et al. WHO/ILO work-related burden of disease and injury: protocol for systematic reviews of occupational exposure to solar ultraviolet radiation and of the effect of occupational exposure to solar ultraviolet radiation on melanoma and non-melanoma skin cancer. Environ Int. 2019;126:804–15. https://doi.org/10.1016/j.envint.2018.09.039.

    Article  PubMed  Google Scholar 

  7. Boniol M, Hosseini B, Ivanov I, Náfrádi B, Neira M, Olsson A, et al. The effect of occupational exposure to solar ultraviolet radiation on malignant skin melanoma and nonmelanoma skin cancer: a systematic review and meta-analysis from the WHO/ILO joint estimates of the work-related burden of disease and injury. Geneva: World Health Organization; 2021.

    Google Scholar 

  8. Peters CE, Ge CB, Hall AL, Davies HW, Demers PA. CAREX Canada: an enhanced model for assessing occupational carcinogen exposure. Occup Environ Med. 2015;72(1):64–71. https://doi.org/10.1136/oemed-2014-102286.

    Article  PubMed  Google Scholar 

  9. McKenzie JF, El-Zaemey S, Carey RN. Prevalence of exposure to multiple occupational carcinogens among exposed workers in Australia. Occup Environ Med. 2020; https://doi.org/10.1136/oemed-2020-106629.

  10. Kauppinen T, Toikkanen J, Pedersen D, Young R, Ahrens W, Boffetta P, et al. Occupational exposure to carcinogens in the European Union. Occup Environ Med. 2000;57(1):10–8. https://doi.org/10.1136/oem.57.1.10.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  11. Loney T, Paulo MS, Modenese A, Gobba F, Tenkate T, Whiteman DC, et al. Global evidence on occupational sun exposure and keratinocyte cancers: a systematic review. Br J Dermatol. 2021;184(2):208–18. https://doi.org/10.1111/bjd.19152.

    Article  CAS  PubMed  Google Scholar 

  12. Armstrong BK, Kricker A. The epidemiology of UV induced skin cancer. J Photochem Photobiol B. 2001;63(1–3):8–18. https://doi.org/10.1016/s1011-1344(01)00198-1.

    Article  CAS  PubMed  Google Scholar 

  13. Fitzmaurice C, Abate D, Abbasi N, Abbastabar H, Abd-Allah F, Abdel-Rahman O, et al. Global, Regional, and National Cancer Incidence, mortality, years of life lost, years lived with disability, and disability-adjusted life-years for 29 cancer groups, 1990 to 2017: a systematic analysis for the global burden of disease study. JAMA Oncol. 2019;5(12):1749–68. https://doi.org/10.1001/jamaoncol.2019.2996.

    Article  PubMed  PubMed Central  Google Scholar 

  14. Modenese A, Korpinen L, Gobba F. Solar radiation exposure and outdoor work: an underestimated occupational risk. Int J Environ Res Public Health. 2018;15:10. https://doi.org/10.3390/ijerph15102063.

    Article  CAS  Google Scholar 

  15. Peters CE, Pasko E, Strahlendorf P, Holness DL, Tenkate T. Solar ultraviolet radiation exposure among outdoor workers in three Canadian Provinces. Ann Work Expo Health. 2019;63(6):679–88. https://doi.org/10.1093/annweh/wxz044.

    Article  PubMed  Google Scholar 

  16. International Commission on Non-Ionizing Radiation Protection. ICNIRP statement—protection of workers against ultraviolet radiation. Health Phys. 2010;99(1):66–87. https://doi.org/10.1097/HP.0b013e3181d85908.

    Article  CAS  Google Scholar 

  17. Gobba F, Modenese A, John SM. Skin cancer in outdoor workers exposed to solar radiation: a largely underreported occupational disease in Italy. J Eur Acad Dermatol Venereol. 2019;33(11):2068–74. https://doi.org/10.1111/jdv.15768.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  18. John SM, Trakatelli M, Ulrich C. Non-melanoma skin cancer by solar UV: the neglected occupational threat. J Eur Acad Dermatol Venereol. 2016;30(Suppl 3):3–4. https://doi.org/10.1111/jdv.13602.

    Article  PubMed  Google Scholar 

  19. Ulrich C, Salavastru C, Agner T, Bauer A, Brans R, Crepy MN, et al. The European Status Quo in legal recognition and patient-care services of occupational skin cancer. J Eur Acad Dermatol Venereol. 2016;30(Suppl 3):46–51. https://doi.org/10.1111/jdv.13609.

    Article  PubMed  Google Scholar 

  20. Wittlich M, John SM, Tiplica GS, Sălăvăstru CM, Butacu AI, Modenese A, et al. Personal solar ultraviolet radiation dosimetry in an occupational setting across Europe. J Eur Acad Dermatol Venereol. 2020;34(8):1835–41. https://doi.org/10.1111/jdv.16303.

    Article  CAS  PubMed  Google Scholar 

  21. Schmitt J, Haufe E, Trautmann F, Schulze HJ, Elsner P, Drexler H, et al. Is ultraviolet exposure acquired at work the most important risk factor for cutaneous squamous cell carcinoma? Results of the population-based case-control study FB-181. Br J Dermatol. 2018;178(2):462–72. https://doi.org/10.1111/bjd.15906.

    Article  CAS  PubMed  Google Scholar 

  22. Schmitt J, Haufe E, Trautmann F, Schulze HJ, Elsner P, Drexler H, et al. Occupational UV-exposure is a major risk factor for basal cell carcinoma: results of the population-based case-control study FB-181. J Occup Environ Med. 2018;60(1):36–43. https://doi.org/10.1097/jom.0000000000001217.

    Article  PubMed  Google Scholar 

  23. Bauer A, Haufe E, Heinrich L, Seidler A, Schulze HJ, Elsner P, et al. Basal cell carcinoma risk and solar UV exposure in occupationally relevant anatomic sites: do histological subtype, tumor localization and Fitzpatrick phototype play a role? A population-based case-control study. J Occup Med Toxicol. 2020;15:28. https://doi.org/10.1186/s12995-020-00279-8.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  24. Watson M, Holman DM, Maguire-Eisen M. Ultraviolet radiation exposure and its impact on skin cancer risk. Semin Oncol Nurs. 2016;32(3):241–54. https://doi.org/10.1016/j.soncn.2016.05.005.

    Article  PubMed  PubMed Central  Google Scholar 

  25. Kovačić J, Wittlich M, John SM, Macan J. Personal ultraviolet radiation dosimetry and its relationship with environmental data: a longitudinal pilot study in Croatian construction workers. J Photochem Photobiol B. 2020;207:111866. https://doi.org/10.1016/j.jphotobiol.2020.111866.

    Article  CAS  PubMed  Google Scholar 

  26. Modenese A, Gobba F, Paolucci V, John SM, Sartorelli P, Wittlich M. Occupational solar UV exposure in construction workers in Italy: results of a one-month monitoring with personal dosimeters. 2020 IEEE International Conference on Environment and Electrical Engineering and 2020 IEEE Industrial and Commercial Power Systems Europe (EEEIC/I&CPS Europe) 2020. p. 1–5.

    Google Scholar 

  27. Modenese A, Gobba F, Paolucci V, John SM, Sartorelli P, Wittlich M. A one-month monitoring of exposure to solar UV radiation of a group of construction workers in Tuscany. Energies. 2020;13(22):6035.

    Article  Google Scholar 

  28. Moldovan HR, Wittlich M, John SM, Brans R, Tiplica GS, Salavastru C, et al. Exposure to solar UV radiation in outdoor construction workers using personal dosimetry. Environ Res. 2020;181:108967. https://doi.org/10.1016/j.envres.2019.108967.

    Article  CAS  PubMed  Google Scholar 

  29. Wittlich M, Westerhausen S, Kleinespel P, Rifer G, Stöppelmann W. An approximation of occupational lifetime UVR exposure: algorithm for retrospective assessment and current measurements. J Eur Acad Dermatol Venereol. 2016;30(Suppl 3):27–33. https://doi.org/10.1111/jdv.13607.

    Article  PubMed  Google Scholar 

  30. Wittlich M, Westerhausen S, Strehl B, Schmitz M, Stöppelmann W, Versteeg H: Exposition von Beschäftigten gegenüber solarer UV-Strahlung—Ergebnisse des Projekts mit Genesis-UV. https://publikationen.dguv.de/widgets/pdf/download/article/3993 (2020). Accessed 31 December 2021.

  31. Schmitt J, Seidler A, Diepgen TL, Bauer A. Occupational ultraviolet light exposure increases the risk for the development of cutaneous squamous cell carcinoma: a systematic review and meta-analysis. Br J Dermatol. 2011;164(2):291–307. https://doi.org/10.1111/j.1365-2133.2010.10118.x.

    Article  CAS  PubMed  Google Scholar 

  32. Bauer A, Diepgen TL, Schmitt J. Is occupational solar ultraviolet irradiation a relevant risk factor for basal cell carcinoma? A systematic review and meta-analysis of the epidemiological literature. Br J Dermatol. 2011;165(3):612–25. https://doi.org/10.1111/j.1365-2133.2011.10425.x.

    Article  CAS  PubMed  Google Scholar 

  33. Breitbart EW, Choudhury K, Anders MP, Volkmer B, Greinert R, Katalinic A, et al. Benefits and risks of skin cancer screening. Oncol Res Treat. 2014;37(Suppl 3):38–47. https://doi.org/10.1159/000364887.

    Article  PubMed  Google Scholar 

  34. Skudlik C, Tiplica GS, Salavastru C, John SM. Instructions for use of the OSD notification forms. J Eur Acad Dermatol Venereol. 2017;31(Suppl 4):44–6. https://doi.org/10.1111/jdv.14320.

    Article  PubMed  Google Scholar 

  35. Carøe TK, Ebbehøj NE, Wulf HC, Agner T. Recognized occupational skin cancer in Denmark—data from the last ten years. Acta Derm Venereol. 2013;93(3):369–71. https://doi.org/10.2340/00015555-1484.

    Article  PubMed  Google Scholar 

  36. Federal Ministry of Justice and for Consumer Protection: German "Ordinance on Preventive Occupational Health Care (ArbMedVV)". http://www.gesetze-im-internet.de/englisch_arbmedvv/index.html, 2019. Accessed 31 December 2021.

  37. World Health Organization: WHO Website. Classifications. ICD. https://www.who.int/classifications/icd/en/, 2021. Accessed 31 December 2021.

  38. International Agency for Research on Cancer of the World Health Organization: IARC Handbooks of Cancer Prevention—Preamble for Primary Prevention. https://handbooks.iarc.fr/docs/HB-Preamble-Primary-Prevention.pdf, 2019. Accessed 21 October 2021.

  39. Alfonso JH, Bauer A, Bensefa-Colas L, Boman A, Bubas M, Constandt L, et al. Minimum standards on prevention, diagnosis and treatment of occupational and work-related skin diseases in Europe—position paper of the COST Action StanDerm (TD 1206). J Eur Acad Dermatol Venereol. 2017;31(Suppl 4):31–43. https://doi.org/10.1111/jdv.14319.

    Article  CAS  PubMed  Google Scholar 

  40. Reinau D, Weiss M, Meier CR, Diepgen TL, Surber C. Outdoor workers' sun-related knowledge, attitudes and protective behaviours: a systematic review of cross-sectional and interventional studies. Br J Dermatol. 2013;168(5):928–40. https://doi.org/10.1111/bjd.12160.

    Article  CAS  PubMed  Google Scholar 

  41. Tenkate T, Strahlendorf P. Sun safety at work: a management systems approach to occupational sun safety. Toronto: Ryerson University; 2020.

    Google Scholar 

  42. Rocholl M, Weinert P, Bielfeldt S, Laing S, Wilhelm KP, Ulrich C, et al. New methods for assessing secondary performance attributes of sunscreens suitable for professional outdoor work. J Occup Med Toxicol. 2021;16(1):25. https://doi.org/10.1186/s12995-021-00314-2.

    Article  PubMed  PubMed Central  Google Scholar 

  43. Schmalwieser AW, Casale GR, Colosimo A, Schmalwieser SS, Siani AM. Review on occupational personal solar UV exposure measurements. Atmos. 2021;12(2):142. https://doi.org/10.3390/atmos12020142.

    Article  Google Scholar 

  44. Rocholl M, Ludewig M, John SM, Bitzer EM, Wilke A. Outdoor workers' perceptions of skin cancer risk and attitudes to sun-protective measures: a qualitative study. J Occup Health. 2020;62(1):e12083. https://doi.org/10.1002/1348-9585.12083.

    Article  PubMed  Google Scholar 

  45. Ludewig M, Rocholl M, John SM, Wilke A. Secondary prevention of UV-induced skin cancer: development and pilot testing of an educational patient counseling approach for individual sun protection as standard procedure of patient care. Int Arch Occup Environ Health. 2020;93(6):765–77. https://doi.org/10.1007/s00420-020-01532-7.

    Article  PubMed  PubMed Central  Google Scholar 

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Author information

Authors and Affiliations

  1. Institute for Interdisciplinary Dermatological Prevention and Rehabilitation (iDerm) and Department of Dermatology, Environmental Medicine and Health Theory at Osnabrück University, Osnabrück, Germany

    Cara Symanzik & Swen Malte John

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  1. Cara Symanzik
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  2. Swen Malte John
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Editors and Affiliations

  1. Department of Dermatology, Universitat Autònoma and Universitat Pompeu Fabra de Barcelona, Barcelona, Spain

    Ana M. Giménez-Arnau

  2. Department of Dermatology, UCSF Medical Center, San Francisco, CA, USA

    Howard I. Maibach

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Symanzik, C., John, S.M. (2023). Occupational Skin Cancer by Solar Ultraviolet Radiation. In: Giménez-Arnau, A.M., Maibach, H.I. (eds) Handbook of Occupational Dermatoses. Updates in Clinical Dermatology. Springer, Cham. https://doi.org/10.1007/978-3-031-22727-1_5

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  • DOI: https://doi.org/10.1007/978-3-031-22727-1_5

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