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Occupational Skin Cancer

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Kanerva’s Occupational Dermatology

Abstract

Occupational skin cancer can be induced due to industrial exposure to chemical carcinogens but nowadays more important due to occupational exposure to UV radiation (UVR).

Occupational skin cancer is characterized by long induction periods (years or decades), and its first manifestation is often seen many years after the occupational exposure or even when the affected individuals are not more occupationally exposed.

Important industrial chemicals are arsenic and inorganic arsenic compounds, polycyclic aromatic hydrocarbons (PAHs) with particularly high levels in brown coal tars (soft coal tars), coal tars (black coal tars), coal tar pitches, coal tar oils, and coke oven emissions and can cause basal cell carcinomas and squamous cell carcinomas.

A published systematic appraisal of the epidemiologic literature and meta-analysis clearly indicates that occupational UV-light exposure is a substantial and robust risk factor for the development of cutaneous squamous cell carcinoma (SCC).

The actually available evidence of the epidemiologic literature could also clearly show a significant risk increase for occupationally UV-exposed workers to develop basal cell carcinoma (BCC) compared to nonexposed workers.

There is enough scientific evidence that outdoor workers have an increased risk to develop work-related occupational skin cancer due to natural UVR exposure, and adequate prevention strategies have to be implemented.

The three measures that are successful and of particular importance in the prevention of nonmelanoma skin cancer in outdoor workers are the following:

  1. 1.

    Changes in behavior regarding awareness of health and disease resulting from exposure to natural UV radiation

  2. 2.

    Protection from direct UV radiation by wearing suitable clothing

  3. 3.

    Regular and correct use of appropriate sunscreens

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References

  • American Cancer Society (2006). http://www.cancer.org

  • Armstrong BK, Kricker A (1994) Cutaneous melanoma. Cancer Surv 19:219–239

    PubMed  Google Scholar 

  • Antonov D, Marx G, Elsner P (2017) Factors influencing the quality of sunscreen application in a pilot comparative study. Br J Dermatol 176:1074–1076

    Article  CAS  PubMed  Google Scholar 

  • Autier P, Boniol M, Severi G, Doré JF (2001) Quantity of sunscreen used by European students. Br J Dermatol 144:288–291

    Article  CAS  PubMed  Google Scholar 

  • Bauer A, Diepgen TL, Schmitt J (2011) Is occupational solar UV-irradiation a relevant risk factor for basal cell carcinoma? A systematic review and meta-analysis of the epidemiologic literature. Br J Dermatol 165:612–625. [Epub ahead of print]

    CAS  PubMed  Google Scholar 

  • Buettner PG, Raasch BA (1998) Incidence rates of skin cancer in Townsville, Australia. Int J Cancer 78(5):587–593

    Article  CAS  PubMed  Google Scholar 

  • Bulliard JL, Cox B (2000) Cutaneous malignant melanoma in New Zealand: trends by anatomical site, 1969–1993. Int J Epidemiol 29:416–423

    CAS  PubMed  Google Scholar 

  • Cress RD, Holly EA (1997) Incidence of cutaneous melanoma among non-Hispanic whites, Hispanics, Asians, and blacks: an analysis of California cancer registry data, 1988–93. Cancer Causes Control 8:246–252

    Article  CAS  PubMed  Google Scholar 

  • Darlington S, Williams G, Neale R et al (2003) A randomized controlled trial to assess sunscreen application and beta carotene supplementation in the prevention of solar keratoses. Arch Dermatol 139:451–455

    Article  PubMed  Google Scholar 

  • Demers AA, Nugent Z, Mihalcioiu C, Wiseman MC, Kliewer EV (2005) Trends of nonmelanoma skin cancer from 1960 through 2000 in a Canadian population. J Am Acad Dermatol 53:320–328

    Article  PubMed  Google Scholar 

  • DFG (Deutsche Forschungsgemeinschaft) (2010) List of MAK and BAT values 2010. Commission for the Investigation of Health Hazards of chemical compounds in the work area, Report No. 45. Wiley-VCH, Weinheim

    Google Scholar 

  • Diepgen TL, Drexler H (2004) Skin cancer and occupational disease. Hautarzt 55:22–27

    Article  CAS  PubMed  Google Scholar 

  • Diepgen TL, Mahler V (2002) The epidemiology of skin cancer. Br J Dermatol 146(Suppl 61):1–6

    Article  PubMed  Google Scholar 

  • Diepgen TL, Brandenburg S, Aberer W, Bauer A, Drexler H, Fartasch M, John SM, Krohn S, Palfner S, Römer W, Schuhmacher-Stock U, Elsner P (2014) Skin cancer induced by natural UV-radiation as an occupational disease – requirements for its notification and recognition. J Dtsch Dermatol Ges 12:1102–1106

    PubMed  Google Scholar 

  • Diepgen TL, Krohn S, Bauer A, Bernhard-Klimt C, Brandenburg S, Drexler H, Elsner P, Fartasch M, John SM, Kleesz P, Köllner A, Letzel ST, Merk HF, Mohr P, Münch H, Palsherm K, Pappai W, Palfner S, Römer W, Sacher J, Wehrmann W, Skudlik C, Ulrich C, Westphal F, Worm M, Zagrodnik F-D (2016) Empfehlung zur Begutachtung von arbeitsbedingten Hauterkrankungen und Hautkrebserkrankungen – Bamberger Empfehlung. Dermatol Beruf Umwelt 64:89–136

    Article  Google Scholar 

  • Diepgen TL (2016) New developments in occupational dermatology. J Dtsch Dermatol Ges 14:875–889

    PubMed  Google Scholar 

  • Drexler H, Göen T, Schaller KH (2008) Biological tolerance values: change in a paradigm concept from assessment of a single value to use of an average. Int Arch Occup Environ Health 82:139–142

    Article  PubMed  Google Scholar 

  • Drexler H, Diepgen TL, Schmitt J et al (2012) Arbeitsbedingte UV-Exposition und Malignome der Haut. Dermatol Beruf Umw 60:48–55

    Article  Google Scholar 

  • Elsner P, Diepgen TL, Schliemann S (2014) Lentigo maligna and lentigo maligna melanoma as occupational skin diseases in a forestry worker with long-standing occupational UV-exposure. J Dtsch Dermatol Ges 12:915–917

    PubMed  Google Scholar 

  • Fry A, Verne J (2003) Preventing skin cancer. BMJ 326:114–115

    Article  PubMed  PubMed Central  Google Scholar 

  • Gambichler T, Rotterdam S, Altmeyer P, Hoffmann K (2001) Protection against ultraviolet radiation by commercial summer clothing: need for standardised testing and labelling. BMC Dermatol 1:6

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Gambichler T, Laperre J, Hoffmann K (2006) The European standard for sun-protective clothing: EN 13758. J Eur Acad Dermatol Venereol 20:125–130

    Article  CAS  PubMed  Google Scholar 

  • Gandini S, Sera F, Cattaruzza MS, Pasquini P, Picconi O, Boyle P, Melchi CF (2005a) Meta-analysis of risk factors for cutaneous melanoma: II. Sun exposure. Eur J Cancer 41:45–60

    Article  PubMed  Google Scholar 

  • Gandini S, Sera F, Cattaruzza MS, Pasquini P, Abeni D, Boyle P, Melchi CF (2005b) Meta-analysis of risk factors for cutaneous melanoma: I. Common and atypical naevi. Eur J Cancer 41:28–44

    Article  PubMed  Google Scholar 

  • Gawkrodger DJ (2004) Occupational skin cancers. Occup Med 54:458–463

    Article  CAS  Google Scholar 

  • Glass AG, Hoover RN (1989) The emerging epidemic of melanoma and squamous cell skin cancer. JAMA 262:2097–2100

    Article  CAS  PubMed  Google Scholar 

  • Grandahl K, Eriksen P, Ibler KS, Bonde JP, Mortensen OS (2018) Measurements of solar ultraviolet radiation exposure at work and at leisure in Danish workers. Photochem Photobiol 94(4):807–814

    Article  CAS  PubMed  Google Scholar 

  • Green A (1992) Changing patterns in incidence of non-melanoma skin cancer. Epithelial Cell Biol 1:47–51

    Article  CAS  PubMed  Google Scholar 

  • Green A, Williams G, Neale R et al (1999) Daily sunscreen application and betacarotene supplementation in prevention of basal-cell and squamous-cell carcinomas of the skin: a randomised controlled trial. Lancet 354(9180):723–729

    Article  CAS  PubMed  Google Scholar 

  • Greim H (ed) (2005) Arsenic and its inorganic compounds. The MAK-collection Part I: MAK value documentations, vol 21. DFG, Deutsche Forschungsgemeinschaft. Wiley-VCH, Weinheim

    Google Scholar 

  • Halpern AC, Kopp LJ (2005) Awareness, knowledge and attitudes to non-melanoma skin cancer and actinic keratosis among the general public. Int J Dermatol 44:107–111

    Article  PubMed  Google Scholar 

  • Hemminki K, Dong C (2000) Subsequent cancers after in situ and invasive squamous cell carcinoma of the skin. Arch Dermatol 136:647–651

    Article  CAS  PubMed  Google Scholar 

  • IARC, Cancer IAfRo (1992) Solar and ultraviolet radiation, vol 55. International Agency for Research on Cancer, Lyon

    Google Scholar 

  • Johnson K, Davy L, Boyett T, Weathers L, Roetzheim RG (2001) Sun protection practices for children: knowledge, attitudes, and parent behaviors. Arch Pediatr Adolesc Med 155(8):891–896

    Article  CAS  PubMed  Google Scholar 

  • Kim SM, Oh BH, Lee YW, Choe YB, Ahn KJ (2010) The relation between the amount of sunscreen applied and the sun protection factor in Asian skin. J Am Acad Dermatol 62:218–222

    Article  PubMed  Google Scholar 

  • Knuschke P, Unverricht I, Ott G, Janssen M (2007) Personenbezogene Messung der UV-Exposition von Arbeitnehmern im Freien. Schriftenreihe der Bundesanstalt für Arbeitsschutz und Arbeitsmedizin, Forschung, F 1777, Dortmund/Berlin/Dresden. ISBN 978-3-88261-060-4

    Google Scholar 

  • Knuschke P, Janßen M, Ott G (2008) Referenzbasis solarer UV-Expositionen zur Bewertung der Expositionslevel in der Bevölkerung und an Arbeitsplätzen im Freien. In: Kaase H, Serick F (eds) Licht und Gesundheit, Berlin, pp 24–29. ISBN 3-9807635-0-3

    Google Scholar 

  • Kowal-Verna A, Criswell BK (2005) Burn scar neoplasms: a literature review and statistical analysis. Burns 31:403–413

    Article  Google Scholar 

  • Laperre J, Gambichler T (2001) Determination of the ultraviolet protection factor of textile materials: measurement precision. Photodermatol Photoimmunol Photomed 17(5):223–229

    Article  CAS  PubMed  Google Scholar 

  • Lear JT, Smith AG, Strange RC, Fryer AA (2000) Detoxifying enzyme genotypes and susceptibility to cutaneous malignancy. Br J Dermatol 142:8–15

    Article  CAS  PubMed  Google Scholar 

  • Letzel S, Drexler H (1998) Occupationally related tumors in tar refinery workers. J Am Acad Dermatol 39:712–720

    Article  CAS  PubMed  Google Scholar 

  • Lindelof B, Sigurgeirsson B, Gabel H et al (2000) Incidence of skin cancer in 5356 patients following organ transplantation. Br J Dermatol 143:513–519

    CAS  PubMed  Google Scholar 

  • MacKie RM (2004) Awareness, knowledge and attitudes to basal cell carcinoma and actinic keratoses among the general public within Europe. J Eur Acad Dermatol Venereol 18:552–555

    Article  CAS  PubMed  Google Scholar 

  • Madan V, Lear JT, Szeimies RM (2010) Non-melanoma skin cancer. Lancet 375:673–685

    Article  CAS  PubMed  Google Scholar 

  • Mofidi A, Tompa E, Spencer J, Kalcevich C, Peters CE, Kim J, Song C, Mortazavi SB, Demers PA (2018) The economic burden of occupational non-melanoma skin cancer due to solar radiation. J Occup Environ Hyg 15(6):481–491

    Article  PubMed  Google Scholar 

  • Moloney FJ, Comber H, Conlon PJ et al (2006) The role of immunosuppression in the pathogenesis of basal cell carcinoma. Br J Dermatol 154:790–791

    Article  CAS  PubMed  Google Scholar 

  • Muzic JG, Schmitt AR, Wright AC, Alniemi DT, Zubair AS, Olazagasti Lourido JM, Sosa Seda IM, Weaver AL, Baum CL (2017) Incidence and trends of basal cell carcinoma and cutaneous squamous cell carcinoma: a population-based study in Olmsted County, Minnesota, 2000 to 2010. Mayo Clin Proc 92(6):890–898

    Article  PubMed  PubMed Central  Google Scholar 

  • Naldi L, Diepgen TL (2007) The epidemiology of skin cancer. In: Lim HW, Hönigsmann H, Hawk JLM (eds) Photodermatology. Informa Healthcare, New York

    Google Scholar 

  • Naylor MF, Boyd A, Smith DW, Cameron GS, Hubbard D, Neldner KH (2004) High sun protection factor sunscreens in the suppression of actinic neoplasia. Arch Dermatol 131:170–175

    Article  Google Scholar 

  • Neale R, Williams G, Green A (2002) Application patterns among participants randomized to daily sunscreen use in a skin cancer prevention trial. Arch Dermatol 138:1319–1325

    Article  PubMed  Google Scholar 

  • Oberyszyn TM (2008) Non-melanoma skin cancer: importance of gender, immunosuppressive status and vitamin D. Cancer Lett 261(2):127–136

    Article  CAS  PubMed  Google Scholar 

  • Pandeya N, Olsen CM, Whiteman DC (2017) The incidence and multiplicity rates of keratinocyte cancers in Australia. Med J Aust 207(8):339–343

    Article  PubMed  Google Scholar 

  • Parkin DM, Whelan SL, Ferlay J, Storm H (2005) Cancer incidence in five continents. IARC cancer base no. 7, vol I–VIII. IARC, Lyon

    Google Scholar 

  • Ramirez CC, Federman DG, Kirsner RS (2005) Skin cancer as an occupational disease: the effect of ultraviolet and other forms of radiation. Int J Dermatol 44:95–100

    Article  PubMed  Google Scholar 

  • Ridley AJ, Whiteside JR, McMillan TJ, Allinson SL (2009) Cellular and sub-cellular responses to UVA in relation to carcinogenesis. Int J Radiat Biol 85:177–195

    Article  CAS  PubMed  Google Scholar 

  • Röwert-Huber J, Patel MJ, Forschner T, Ulrich C, Eberle J, Kerl H, Sterry W, Stockfleth E (2007) Actinic keratosis is an early in situ squamous cell carcinoma: a proposal for reclassification. Br J Dermatol 156(Suppl 3):8–12

    Article  PubMed  Google Scholar 

  • Rünger TM (2007) How different wavelengths of the ultraviolet spectrum contribute to skin carcinogenesis: the role of cellular damage responses. J Invest Dermatol 127:2103–2105

    Article  PubMed  CAS  Google Scholar 

  • Ruppert L, Ofenloch R, Surber C, Diepgen TL (2016) Occupational risk factors for skin cancer and the availability of sun protection measures at German outdoor workplaces. Int Arch Occup Environ Health 89:1009–1015

    Article  CAS  PubMed  Google Scholar 

  • Saladi RN, Persaud AN (2005) The causes of skin cancer: a comprehensive review. Drugs Today (Barc) 41:37–53

    Article  CAS  Google Scholar 

  • Schmitt J, Seidler A, Diepgen TL, Bauer A (2011) Occupational UV-light exposure increases the risk for the development of cutaneous squamous cell carcinoma: a systematic review and meta-analysis. Br J Dermatol 164:291–307

    Article  CAS  PubMed  Google Scholar 

  • Stockfleth E, Ulrich C, Meyer T, Christophers E (2002) Epithelial malignancies in organ transplant patients: clinical presentation and new methods of treatment. Recent Results Cancer Res 160:251–258

    Article  CAS  PubMed  Google Scholar 

  • Stoff B, Salisbury C, Parker D, O’Reilly Zwald F (2010) Dermatopathology of skin cancer in solid organ transplant recipients. Transplant Rev 24:172–189

    Article  Google Scholar 

  • Thieden E, Philipsen PA, Heydenreich J, Wulf HC (2004) UV radiation exposure related to age, sex, occupation, and sun behavior based on time-stamped personal dosimeter readings. Arch Dermatol 140:197–203

    Article  PubMed  Google Scholar 

  • Thompson SC, Jolley D, Marks R (1993) Reduction of solar keratoses by regular sunscreen use. N Engl J Med 329:1147–1151

    Article  CAS  PubMed  Google Scholar 

  • Thorn M, Bergstrom R, Adami HO, Ringborg U (1990) Trends in the incidence of malignant melanoma in Sweden, by anatomic site, 1960–1984. Am J Epidemiol 132:1066–1077

    Article  CAS  PubMed  Google Scholar 

  • Ulrich C, Jurgensen JS, Degen A et al (2009) Prevention of non-melanoma skin cancer in organ transplant patients by regular use of a sunscreen: a 24 months, prospective, case-control study. Br J Dermatol 161(Suppl 3):78–84

    Article  PubMed  Google Scholar 

  • Walther U, Kron M, Sander S, Sebastian G, Sander R, Peter RU, Meurer M, Krähn G, Kaskel P (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

    Article  CAS  PubMed  Google Scholar 

  • Wang H, Diepgen TL (2006) The epidemiology of basal cell and squamous cell carcinoma. In: Reichrath J (ed) Molecular mechanisms of basal cell and squamous cell carcinomas. Springer, New York, pp S.1–S.9

    Google Scholar 

  • Wittlich M, Westerhausen S, Kleinespel P et al (2016) An approximation of occupational lifetime UVR exposure: algorithm for retrospective assessment and current measurements. J Eur Acad Dermatol Venereol 30(Suppl 3):27–33

    Article  PubMed  Google Scholar 

  • Wulf HC, Stender IM, Lock-Andersen J (1997) Sunscreens used at the beach do not protect against erythema: a new definition of SPF is proposed. Photodermatol Photoimmunol Photomed 13:129–132

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Social Medicine, Occupational and Environmental Dermatology, University Heidelberg, Heidelberg, Germany

    Thomas L. Diepgen

  2. Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, Friedrich-Alexander-University, Erlangen-Nürnberg, Erlangen, Germany

    Hans Drexler

Authors
  1. Thomas L. Diepgen
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  2. Hans Drexler
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Correspondence to Thomas L. Diepgen .

Editor information

Editors and Affiliations

  1. Department of Dermatology, Environmental Medicine and Health Theory, University of Osnabrück, Osnabrück, Germany

    Swen Malte John

  2. National Allergy Research Centre, Department of Dermatology and Allergy, Herlev-Gentofte University Hospital, Hellerup, Hellerup, Denmark

    Jeanne Duus Johansen

  3. Department of Dermatology and Allergology, VU University Medical Center, Amsterdam, The Netherlands

    Thomas Rustemeyer

  4. Department of Dermatology, University Hospital Jena, Jena, Germany

    Peter Elsner

  5. Department of Dermatology, University of California, San Francisco, CA, USA

    Howard I. Maibach

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Diepgen, T.L., Drexler, H. (2020). Occupational Skin Cancer. In: John, S., Johansen, J., Rustemeyer, T., Elsner, P., Maibach, H. (eds) Kanerva’s Occupational Dermatology. Springer, Cham. https://doi.org/10.1007/978-3-319-68617-2_10

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  • DOI: https://doi.org/10.1007/978-3-319-68617-2_10

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