Occupational Exposure to Ultraviolet Radiation and Risk of Non-Melanoma Skin Cancer in a Multinational European Study

Abstract

BackgroundStudies suggest that ambient sunlight plays an important role in the pathogenesis of non-melanoma skin cancers (NMSC). However, there is ongoing controversy regarding the relevance of occupational exposure to natural and artificial ultraviolet radiation (UV) radiation.ObjectivesWe investigated potential associations between natural and artificial UV radiation exposure at work with NMSC in a case-control study conducted in Hungary, Romania, and Slovakia.MethodsOccupational exposures were classified by expert assessment for 527 controls and 618 NMSC cases (515 basal cell carcinoma, BCC). Covariate information was collected via interview and multiple logistic regression models were used to assess associations between UV exposure and NMSC.ResultsLifetime prevalence of occupational exposure in the participants was 13% for natural UV radiation and 7% for artificial UV radiation. Significant negative associations between occupational exposure to natural UV radiation and NMSC were detected for all who had ever been exposed (odds ratio (OR) 0.47, 95% confidence interval (CI) 0.27–0.80); similar results were detected using a semi-quantitative metric of cumulative exposure. The effects were modified by skin complexion, with significantly decreased risks of BCC among participants with light skin complexion. No associations were observed in relation to occupational artificial UV radiation exposure.ConclusionsThe protective effect of occupational exposure to natural UV radiation was unexpected, but limited to light-skinned people, suggesting adequate sun-protection behaviors. Further investigations focusing on variations in the individual genetic susceptibility and potential interactions with environmental and other relevant factors are planned.

Farmers develop more aggressive histologic subtypes of basal cell carcinoma. Experience from a Tertiary Hospital in Northern Greece

“…Our findings are in accordance with previous studies reporting an increased risk of developing BCC among farmers . In our study, farm workers made up an unexpectedly high percentage (35.3%) among patients attending our hospital for BCC, compared to available literature data reporting a rate of 23% . This can be partially explained by the fact that our hospital is a referral centre of a wide agricultural region in Northern Greece.…”

“…Recently published meta‐analyses have consistently documented a significantly higher risk of cutaneous squamous cell carcinoma (SCC) among outdoor workers . On the other hand, even though there is also cumulative evidence for an elevated risk of BCC, there is some degree of discordance among the results reported by individual occupational studies . Analytically, Bauer et al .…”

Melanoma risk prediction models

“…Similar results could be seen in other studies that emphasize importance of occupational UV exposure dominantly for non-melanoma skin cancers (NMSC) [30][31][32][33] . This causal relation between chronic UV exposure and NMSC coincides with our results where more NMSC was detected in controls where occupational UV exposure was dominant.…”

The Sustainability of an Occupational Skin Cancer Prevention Program

“…(2, 5, 9, 10, 12, 13, 21–27) They also spend considerable time outdoors off the job, further elevating their risk. Because outdoor workers often do not take adequate precautions to protect themselves from UV, (6, 8, 15, 18, 26, 28, 29) targeted prevention efforts are critical.…”