Outdoor work and skin cancer incidence: a registry-based study in Bavaria
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To analyse the association between occupational ultraviolet (UV) light exposure and skin cancer (basal cell carcinoma, BCC; squamous cell carcinoma, SCC; cutaneous malignant melanoma, CMM) based on data from the Bavarian population-based cancer registry.
The population-based cancer registry of Bavaria (Germany) provided data on incident cases of BCC, SCC, and CMM, respectively, during the period 2001 until 2005. Eleven Bavarian districts with complete skin cancer registration were included in this analysis based on 2,156,336 person years. Cases were assigned to “indoor”, “mixed indoor/outdoor”, and “outdoor” exposure categories according to their job title. We computed age-specific and age-adjusted incidence rates of BCC (n = 1,641), SCC (n = 499), and CMM (n = 454) by work type, and the relative risk (RR) of skin cancer occurrence for “outdoor” and “mixed indoor/outdoor” workers, respectively, compared to “indoor” workers.
The risk of BCC was substantially elevated in male (RR, 2.9; 95% CI, 2.2–3.9) and female (RR, 2.7; 95% CI, 1.8–4.1) outdoor workers compared to male and female indoor workers, respectively. We also found an elevated risk of similar magnitude for SCC in male (RR, 2.5; 95% CI, 1.4–4.7) and female (RR, 3.6; 95% CI, 1.6–8.1) outdoor workers compared to male and female indoor workers, respectively. CMM risk was not significantly associated with outdoor work.
Our study confirms previous reports on the increased risk of BCC and SCC in outdoor workers compared to indoor workers.
KeywordsCancer Skin Incidence Risk Outdoor work Ultraviolet light Occupation
The authors wish to express their gratitude towards all Bavarian patients, doctors, dentists, regional cancer registries, and towards the confidentiality office of the Bavarian cancer registry for providing and processing the cancer notifications that were used as the basis for this study.
- Aragon T (2006) Epitools: epidemiology tools. University of California Berkeley Center for Infectious Disease Preparedness, Berkeley. http://cran.r-project.org/. Accessed 30 Nov 2007
- Association of Population-Based Cancer Registries in Germany (2006) Cancer in Germany, 5th edn. Association of Population-Based Cancer Registries in Germany, Saarbrücken. http://www.ekr.med.uni-erlangen.de/GEKID/Doc/kid2006_english.pdf. Accessed 30 Nov 2007
- Bavarian State Office of Statistics (2004) Microcensus 2004. Bavarian State Office of Statistics, Munich (in German)Google Scholar
- Carstensen B, Plummer M, Läärä E et al (2006) Epi: a package for statistical analysis in epidemiology. Department of Biostatistics, University of Copenhagen, Copenhagen. http://cran.r-project.org/. Accessed 30 Nov 2007
- dos Santos Silva I (1999) Cancer epidemiology: principles and methods. International Agency for Research on Cancer, Lyon, p 82Google Scholar
- Fritz A, Percy C, Jack A et al (eds) (2000) International classification of diseases for oncology, 3rd edn. WHO, GenevaGoogle Scholar
- Gass R, Bopp M (2005) Mortality from malignant melanoma: epidemiological trends in Switzerland. Schweiz Rundsch Med Prax 94:1295–1300 (in German)Google Scholar
- Naldi L, Altieri A, Imberti GL et al (2005) Sun exposure, phenotypic characteristics, and cutaneous malignant melanoma. An analysis according to different clinico-pathological variants and anatomic locations (Italy). Cancer Causes Control 16:893–899. doi: 10.1007/s10552-005-2300-4 PubMedCrossRefGoogle Scholar
- Rothman KJ, Greenland S (1998) Modern epidemiology, 2nd edn. Lippincott-Raven, PhiladelphiaGoogle Scholar
- Seidler A, Husmann G, Nübling M et al (2006) Occupations involving UV exposure and skin cancer: epidemiologic data of the Rhineland-Palatinate Cancer Registry. Zentralblatt Arbeitsmedizin Arbeitsschutz Ergon 56:78–90 (in German)Google Scholar
- Sobin LH, Wittekind C (eds) (2002) TNM classification of malignant tumours, 6th edn. Wiley, New YorkGoogle Scholar
- Statistisches Bundesamt (ed) (1992) Klassifizierung der Berufe, systematisches und alphabetisches Verzeichnis der Berufsbenennungen, Ausgabe 1992. Verlag Metzler Poeschel, Stuttgart (in German)Google Scholar
- The Danish Board of National Health (2001) Cancer Incidence in Denmark 1997. The Danish Board of National Health, CopenhagenGoogle Scholar
- Walther U, Kron M, Sander S et al (2004) Risk and protective factors for sporadic basal cell carcinoma: results of a two-centre case–control study in southern Germany. Clinical actinic elastosis may be a protective factor. Br J Dermatol 151:170–178. doi: 10.1111/j.1365-2133.2004.06030.x PubMedCrossRefGoogle Scholar
- World Health Organisation (1992) International statistical classification of disease and related health problems, 10th revision, vol 1. WHO, GenevaGoogle Scholar