Indoor Versus Outdoor: Does Occupational Sunlight Exposure Increase Melanoma Risk? A Systematic Review

Maduka, Richard C.; Kojima, Tai; Gonsai, Radha; DeWalt, Nick; Chetty, Ashwin; Brackett, Alexandria; Olino, Kelly; Schneider, Eric B.; Ahuja, Vanita

doi:10.1016/j.jss.2022.10.025

Cited by 3 publications

(2 citation statements)

References 28 publications

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“…Outdoor workers have no increase in melanoma incidence compared to indoor workers. [50] Multiple studies have correlated higher vitamin D levels -a biomarker for chronic sun exposure-with reduced melanoma mortality. [51] Evidence suggests that patients with melanoma have an increased but low risk of melanoma mortality and live longer than people in the general population.…”

Section: Discussionmentioning

confidence: 99%

Higher ultraviolet light exposure is associated with lower mortality: an analysis of data from the UK Biobank cohort study

Stevenson

Clemens

Pairo-Castineira

et al. 2023

Preprint

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ObjectiveTo examine to what extent UV exposure is associated with all-cause and cause-specific mortality.DesignProspective population-based study.SettingUK Biobank.Participants376,729 participants with white ancestry and no missing data. Two UV exposures were assessed: sun-seeking behaviour (categorised as less active versus more active) and home latitude.Main outcome measuresAll-cause, cardiovascular disease (CVD), cancer and non-CVD/non-cancer mortality. Risk of residual confounding was examined using three negative control outcomes.ResultsThe median follow-up was 12.7 years. Participants with more active sun-seeking behaviour were at a lower risk of all-cause mortality (HR=0.86; 95% confidence interval (CI) 0.80 to 0.93), CVD mortality (HR=0.81; 95% CI 0.68 to 0.95) and cancer mortality (HR=0.86; 95% CI 0.77 to 0.95) compared to participants with less active sun-seeking behaviours, adjusted for demographic, socioeconomic, behavioural and clinical confounders. More active sun seekers had around 50 extra days of survival. Participants whose home latitude was 300km farther south were also at a lower risk of all-cause mortality (HR=0.94; 95% CI 0.92 to 0.96), CVD mortality (HR=0.91; 95% CI 0.86 to 0.95) and cancer mortality (HR=0.93; 95% CI 0.90 to 0.96), adjusted for demographic, socioeconomic, behavioural and clinical confounders. Participants whose home latitude was 300km farther south had around 16 extra days of survival. Sun-seeking behaviour was not associated with two of the three negative controls and home latitude was not associated with any of the negative controls.ConclusionsGreater behavioural and higher geographically related UV exposures were associated with a lower risk of all-cause, CVD and cancer mortality. This study adds to growing evidence that the benefits of UV exposure may outweigh the risks in low sunlight countries. Tailoring public health advice to both the benefits and hazards of UV exposure may reduce the burden of disease and increase life expectancy in low sunlight countries.

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Section: Discussionmentioning

confidence: 99%

Higher ultraviolet light exposure is associated with lower mortality: an analysis of data from the UK Biobank cohort study

Stevenson

Clemens

Pairo-Castineira

et al. 2023

Preprint

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“…Factors found to contribute to higher melanoma incidence rates were high socioeconomic status, as well as technical, transport, military, and public safety workers with potential skin exposure to carcinogens [39]. In addition, one systematic review did not report differences between outdoor versus indoor workers with regard to cutaneous melanoma development [40]. Depending on the country and its geographic latitude, it is likely that a combination of factors (UV index, Fitzpatrick skin phototype, occupational behavior, hobbies, vacation patterns, etc.)…”

Section: Occupational Healthmentioning

confidence: 99%

Skin Cancer Prevention across the G7, Australia and New Zealand: A Review of Legislation and Guidelines

Conte,

Aldien,

Jetté

et al. 2023

Current Oncology

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Incidence rates of melanoma and keratinocyte skin cancers have been on the rise globally in recent decades. While there has been a select focus on personal sun protection awareness, to our knowledge, there is a paucity of legislation in place to help support citizens’ efforts to protect themselves from the harmful effects of ultraviolet radiation (UVR). Given this, we conducted a comprehensive review of legislation and guidelines pertaining to a variety of sun protection-related topics in countries of the Group of Seven (G7), Australia and New Zealand. Australia was the only country to have banned tanning beds for individuals of all ages, while other select countries have instituted bans for minors. In workplace policy, there is very little recognition of the danger of occupational UVR exposure in outdoor workers, and thus very few protective measures are in place. With regard to sports and recreation, certain dermatological/professional associations have put forward recommendations, but no legislation was brought forward by government bodies outside of Australia and New Zealand. With regard to youth, while there are various guidelines and frameworks in place across several countries, adherence remains difficult in the absence of concrete legislation and standardization of procedures. Finally, only Australia and a few select jurisdictions in the United States have implemented sales tax exemptions for sunscreen products. In light of our findings, we have made several recommendations, which we anticipate will help reduce the rates of melanoma and keratinocyte cancers in years to come. However, minimizing UVR exposure is not without risk, and we, therefore, suggest the promotion of vitamin D supplementation in conjunction with sun protective practices to limit potential harm.

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Higher ultraviolet light exposure is associated with lower mortality: An analysis of data from the UK biobank cohort study

Stevenson,

Clemens,

Pairo-Castineira

et al. 2024

Health & Place

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Indoor Versus Outdoor: Does Occupational Sunlight Exposure Increase Melanoma Risk? A Systematic Review

Cited by 3 publications

References 28 publications

Higher ultraviolet light exposure is associated with lower mortality: an analysis of data from the UK Biobank cohort study

Higher ultraviolet light exposure is associated with lower mortality: an analysis of data from the UK Biobank cohort study

Skin Cancer Prevention across the G7, Australia and New Zealand: A Review of Legislation and Guidelines

Higher ultraviolet light exposure is associated with lower mortality: An analysis of data from the UK biobank cohort study

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