Occupational Exposure to Solar Radiation at Different Latitudes and Pterygium: A Systematic Review of the Last 10 Years of Scientific Literature

Abstract

Pterygium is a chronic eye disease: among its recognized risk factors there is long-term exposure to ultraviolet (UV) radiation. The Sun is the main source of UV exposure: according to the World Health Organization, the Population Attributable Fraction of pterygium due to solar radiation (SR) is 42–74%. Outdoor work can deeply influence the eye exposure to solar UV rays, but, despite this, pterygium is currently not adequately considered as a possible occupational disease in this working category, at least in Europe. For this reason, we performed a systematic review of the scientific literature published in the last ten years (2008–2017) considering the role of outdoor work as a risk factor for pterygium, in order to give new support for the prevention of this UV related disease in workers. We identified 29 relevant papers. Our results show that pterygium prevalence highly increased with latitude and mean annual UV index, and outdoor work is one of the most relevant risk factors, as well as age and male sex, both in high risk and in moderate risk World areas considering the environmental UV levels. Accordingly, pterygium occurring in outdoor workers should be considered an occupational disease. Moreover, our findings clearly support the need of further research on more effective prevention of the occupational risk related to long-term solar radiation exposure of the eye.

Manifestações oculares em trabalhadores portuários: prevalência e fatores associados

“…(5) In addition, ocular manifestations in port workers may be related to the handling of hazardous tools, such as chainsaws, steel cables, and containers associated with environmental factors, such as temperature, humidity, wind, fumes, pollution, and light intensity which trigger clinical ocular manifestations, such as infectious processes, photokeratitis, and pterygium. (6) Similar studies reported the same ocular manifestations. (6,7) A finding related to workers exposed to open-air, wind, and sun using dangerous working tools, as the case of port workers, showed ocular symptoms, such as blurred vision, pruritus, burning, and photophobia.…”

“…(6) Similar studies reported the same ocular manifestations. (6,7) A finding related to workers exposed to open-air, wind, and sun using dangerous working tools, as the case of port workers, showed ocular symptoms, such as blurred vision, pruritus, burning, and photophobia. They resulted from foreign bodies; chemical agents, such as acids, alkaline, and detergents; and physical agents, such as acute exposure to optical radiation.…”

Adverse effect of UV radiation on eyes — a review

“…Pterygium is a degenerative lesion of the conjunctiva, which consists of fibro-vascular tissue growing into the cornea. There is strong evidence confirming the connection between chronic UVR exposure and developing a pterygium [15,16]. In the Australian study, which compromised 100 thousands of people, a strong positive correlation between UVR exposure and incidence of pterygium was proved [17].…”

“…Another study proved that the risk of pterygium was 50-380% higher in outside workers, regardless of latitude [16]. Occupational sun exposure for many hours a day and for many years is such an important risk factor, that it can be called occupational disease [16]. It is worth noticing that wearing a hat, glasses or sunglasses was negatively correlated with pterygium in outside workers [18,19].…”

“…In the Australian study, which compromised 100 thousands of people, a strong positive correlation between UVR exposure and incidence of pterygium was proved [17]. Another study proved that the risk of pterygium was 50-380% higher in outside workers, regardless of latitude [16]. Occupational sun exposure for many hours a day and for many years is such an important risk factor, that it can be called occupational disease [16].…”