Birgitta Kütting1, Hans Drexler. 1. Institute and Outpatient Clinic of Occupational, Social and Environmental Medicine, University of Erlangen- Nuremberg, Schillerstr. 25 + 29, 91054, Erlangen, Germany. birgitta.kuetting@ipasum.uni-erlangen.de
Abstract
PURPOSE: The present review is aimed at providing an overview of skin cancer with particular focus on occupational concern and giving evidence-based recommendation for effective prevention at workplace. METHODS: We performed a systematic search of literature using PubMed and the Cochrane Library. RESULTS: Outcome of preventive strategies depends either on efficacy of the strategy itself but also on acceptance and implementation of protective means among the persons at possible risk for hazardous health effects. Epidemiological studies have reported significantly more non-melanoma skin cancer in men than in women. Life-style choices and difference in immunosuppression play a major role in this gender disparity. Tumor biology of skin cancer is diverging: severe blistering sunburns corresponding to intermittent intense UV exposures are associated with an increased risk for both melanoma and basal cell carcinoma (BCC); whereas the risk of squamous cell carcinoma (SCC) and actinic keratoses (AK) is strongly associated with chronic UV exposure. Several clinical trials give evidence that long-term use of sunscreen prevents the appearance of non-melanotic skin cancer such as AK and SCC, but not of BCC. All technical and organizing measures aimed at reducing UV exposure at workplace belong to first-line prevention; however, there is much room for improvement. The efficacy of personal protection means (second-line strategy) strongly depends on the workers' compliance which is quite low at workplace. CONCLUSION: Evidence-based data confirming the benefit of sun protective strategies are scarce, general recommendations are mainly based on the avoidance of UV radiation being identified as potential risk factor for non-melanoma skin cancer in epidemiological studies. Occupational screenings should include regular interventions aimed at enhancing a clear understanding of risk factors for individuals and finally improving the acceptance and maintenance for UV-protective means at workplace.
PURPOSE: The present review is aimed at providing an overview of skin cancer with particular focus on occupational concern and giving evidence-based recommendation for effective prevention at workplace. METHODS: We performed a systematic search of literature using PubMed and the Cochrane Library. RESULTS: Outcome of preventive strategies depends either on efficacy of the strategy itself but also on acceptance and implementation of protective means among the persons at possible risk for hazardous health effects. Epidemiological studies have reported significantly more non-melanoma skin cancer in men than in women. Life-style choices and difference in immunosuppression play a major role in this gender disparity. Tumor biology of skin cancer is diverging: severe blistering sunburns corresponding to intermittent intense UV exposures are associated with an increased risk for both melanoma and basal cell carcinoma (BCC); whereas the risk of squamous cell carcinoma (SCC) and actinic keratoses (AK) is strongly associated with chronic UV exposure. Several clinical trials give evidence that long-term use of sunscreen prevents the appearance of non-melanotic skin cancer such as AK and SCC, but not of BCC. All technical and organizing measures aimed at reducing UV exposure at workplace belong to first-line prevention; however, there is much room for improvement. The efficacy of personal protection means (second-line strategy) strongly depends on the workers' compliance which is quite low at workplace. CONCLUSION: Evidence-based data confirming the benefit of sun protective strategies are scarce, general recommendations are mainly based on the avoidance of UV radiation being identified as potential risk factor for non-melanoma skin cancer in epidemiological studies. Occupational screenings should include regular interventions aimed at enhancing a clear understanding of risk factors for individuals and finally improving the acceptance and maintenance for UV-protective means at workplace.
Authors: M Radespiel-Tröger; M Meyer; A Pfahlberg; B Lausen; W Uter; O Gefeller Journal: Int Arch Occup Environ Health Date: 2008-07-23 Impact factor: 3.015
Authors: Sérgio Schalka; Denise Steiner; Flávia Naranjo Ravelli; Tatiana Steiner; Aripuanã Cobério Terena; Carolina Reato Marçon; Eloisa Leis Ayres; Flávia Alvim Sant'anna Addor; Helio Amante Miot; Humberto Ponzio; Ida Duarte; Jane Neffá; José Antônio Jabur da Cunha; Juliana Catucci Boza; Luciana de Paula Samorano; Marcelo de Paula Corrêa; Marcus Maia; Nilton Nasser; Olga Maria Rodrigues Ribeiro Leite; Otávio Sergio Lopes; Pedro Dantas Oliveira; Renata Leal Bregunci Meyer; Tânia Cestari; Vitor Manoel Silva dos Reis; Vitória Regina Pedreira de Almeida Rego Journal: An Bras Dermatol Date: 2014 Nov-Dec Impact factor: 1.896
Authors: Barbara J Walkosz; David B Buller; Peter A Andersen; Allan Wallis; Mary Klein Buller; Michael D Scott Journal: JAMA Dermatol Date: 2015-09 Impact factor: 10.282
Authors: Allan Wallis; Peter A Andersen; David B Buller; Barbara Walkosz; Lucia Lui; Mary Buller; Michael D Scott; Rob Jenkins Journal: J Public Health Manag Pract Date: 2014 Nov-Dec
Authors: Simona Surdu; Edward F Fitzgerald; Michael S Bloom; Francis P Boscoe; David O Carpenter; Richard F Haase; Eugen Gurzau; Peter Rudnai; Kvetoslava Koppova; Joëlle Févotte; Giovanni Leonardi; Marie Vahter; Walter Goessler; Rajiv Kumar; Tony Fletcher Journal: PLoS One Date: 2013-04-24 Impact factor: 3.240