Marilia Silva Paulo1, Balazs Adam2, Cyril Akagwu3, Issaka Akparibo4, Rami H Al-Rifai5, Sholeh Bazrafshan6, Fabriziomaria Gobba7, Adele C Green8, Ivan Ivanov9, Sanja Kezic10, Nancy Leppink11, Tom Loney12, Alberto Modenese13, Frank Pega14, Cheryl E Peters15, Annette M Prüss-Üstün16, Thomas Tenkate17, Yuka Ujita18, Marc Wittlich19, Swen M John20. 1. Institute of Public Health, College of Medicine & Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates; Global Health and Tropical Medicine, Instituto de Higiene e Medicina Tropical, Universidade Nova de Lisboa, Lisbon, Portugal. Electronic address: mariliap@uaeu.ac.ae. 2. Institute of Public Health, College of Medicine & Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates; Division of Occupational Health, Department of Preventive Medicine, Faculty of Public Health, University of Debrecen, Debrecen, Hungary. Electronic address: adam.balazs@sph.unideb.hu. 3. Defence Health Maintenance Limited, Ministry of Defence, Nigeria. 4. Division of Aerospace Medicine, Wright State University, OH, USA. Electronic address: akparibo.2@wright.edu. 5. Institute of Public Health, College of Medicine & Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates. Electronic address: rrifai@uaeu.ac.ae. 6. Division of Aerospace Medicine, Wright State University, OH, USA. Electronic address: bazrafshankondori.2@wright.edu. 7. Department of Biomedical, Metabolic and Neural Sciences, University of Modena & Reggio Emilia, Italy. Electronic address: fabriziomaria.gobba@unimore.it. 8. QIMR Berghofer Medical Research Institute, Royal Brisbane Hospital, QLD 4029, Australia; CRUK Manchester Institute, University of Manchester, Manchester, UK. Electronic address: adele.green@qimrberghofer.edu.au. 9. Department of Public Health, Environmental and Social Determinants of Health, World Health Organization, Geneva, Switzerland. Electronic address: ivanovi@who.int. 10. Amsterdam UMC, University of Amsterdam, Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam, Netherlands. Electronic address: s.kezic@amc.nl. 11. Labour Administration, Labour Inspection and Occupational Safety and Health Branch, International Labour Organization, Geneva, Switzerland. Electronic address: leppink@ilo.org. 12. Institute of Public Health, College of Medicine & Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates; College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates. Electronic address: tom.loney@mbru.ac.ae. 13. Department of Biomedical, Metabolic and Neural Sciences, University of Modena & Reggio Emilia, Italy. Electronic address: alberto.modenese@unimore.it. 14. Department of Public Health, Environmental and Social Determinants of Health, World Health Organization, Geneva, Switzerland. Electronic address: pegaf@who.int. 15. Alberta Health Services & University of Calgary Calgary, Canada; CAREX Canada, Simon Fraser University, Vancouver, Canada. Electronic address: Cheryl.peters@ahs.ca. 16. Department of Public Health, Environmental and Social Determinants of Health, World Health Organization, Geneva, Switzerland. Electronic address: pruessa@who.int. 17. Ryerson University, School of Occupational & Public Health, Canada. Electronic address: thomas.tenkate@ryerson.ca. 18. Labour Administration, Labour Inspection and Occupational Safety and Health Branch, International Labour Organization, Geneva, Switzerland. Electronic address: ujita@ilo.org. 19. Institute for Occupational Safety and Health, German Social Accident Insurance (IFA), Sankt Augustin, Germany. Electronic address: marc.wittlich@dguv.de. 20. Department of Dermatology, Environmental Medicine and Health Theory, University of Osnabrück, Osnabrück, Germany; Institute for Interdisciplinary Dermatological Prevention and Rehabilitation (iDerm) at the University of Osnabrück, Lower-Saxonian Institute of Occupational Dermatology, Osnabrück, Germany. Electronic address: sjohn@uos.de.
Abstract
BACKGROUND: The World Health Organization (WHO) and the International Labour Organization (ILO) are developing a joint methodology for estimating the national and global work-related burden of disease and injury (WHO/ILO joint methodology), with contributions from a large network of experts. In this paper, we present the protocol for two systematic reviews of parameters for estimating the number of deaths and disability-adjusted life years from melanoma and non-melanoma skin cancer (or keratinocyte carcinoma) from occupational exposure to solar ultraviolet radiation, to inform the development of the WHO/ILO joint methodology. OBJECTIVES: We aim to systematically review studies on occupational exposure to solar ultraviolet radiation (Systematic Review 1) and systematically review and meta-analyse estimates of the effect of occupational exposure to solar ultraviolet radiation on melanoma and non-melanoma skin cancer (Systematic Review 2), applying the Navigation Guide systematic review methodology as an organizing framework and conducting both systematic reviews in tandem and in a harmonized way. DATA SOURCES: Separately for Systematic Reviews 1 and 2, we will search electronic academic databases for potentially relevant records from published and unpublished studies, including Ovid Medline, PubMed, EMBASE, and Web of Science. We will also search electronic grey literature databases, Internet search engines and organizational websites; hand-search reference list of previous systematic reviews and included study records and consult additional experts. STUDY ELIGIBILITY AND CRITERIA: We will include working-age (≥15 years) workers in the formal and informal economy in any WHO and/or ILO Member State, but exclude children (<15 years) and unpaid domestic workers. For Systematic Review 1, we will include quantitative studies on the prevalence of relevant levels of occupational exposure to solar ultraviolet radiation (i.e. <0.33 SED/d and ≥0.33 SED/d) and of the total working time spent outdoors, stratified by country, sex, age and industrial sector or occupation, in the years 1960 to 2018. For Systematic Review 2, we will include randomized controlled trials, cohort studies, case-control studies and other non-randomized intervention studies with an estimate of the effect of any occupational exposure to solar ultraviolet radiation (i.e., ≥0.33 SED/d) on the prevalence of, incidence of or mortality due to melanoma and non-melanoma skin cancer, compared with the theoretical minimum risk exposure level (i.e. <0.33 SED/d). STUDY APPRAISAL AND SYNTHESIS METHODS: At least two review authors will independently screen titles and abstracts against the eligibility criteria at a first stage and full texts of potentially eligible records at a second stage, followed by extraction of data from qualifying studies. At least two review authors will assess the risk of bias and the quality of evidence, using the most suited tools currently available. For Systematic Review 2, if feasible, we will combine relative risks using meta-analysis. We will report results using the guidelines for accurate and transparent health estimates reporting (GATHER) for Systematic Review 1 and the preferred reporting items for systematic reviews and meta-analyses guidelines (PRISMA) for Systematic Review 2. PROSPERO REGISTRATION NUMBER: CRD42018094817.
BACKGROUND: The World Health Organization (WHO) and the International Labour Organization (ILO) are developing a joint methodology for estimating the national and global work-related burden of disease and injury (WHO/ILO joint methodology), with contributions from a large network of experts. In this paper, we present the protocol for two systematic reviews of parameters for estimating the number of deaths and disability-adjusted life years from melanoma and non-melanoma skin cancer (or keratinocyte carcinoma) from occupational exposure to solar ultraviolet radiation, to inform the development of the WHO/ILO joint methodology. OBJECTIVES: We aim to systematically review studies on occupational exposure to solar ultraviolet radiation (Systematic Review 1) and systematically review and meta-analyse estimates of the effect of occupational exposure to solar ultraviolet radiation on melanoma and non-melanoma skin cancer (Systematic Review 2), applying the Navigation Guide systematic review methodology as an organizing framework and conducting both systematic reviews in tandem and in a harmonized way. DATA SOURCES: Separately for Systematic Reviews 1 and 2, we will search electronic academic databases for potentially relevant records from published and unpublished studies, including Ovid Medline, PubMed, EMBASE, and Web of Science. We will also search electronic grey literature databases, Internet search engines and organizational websites; hand-search reference list of previous systematic reviews and included study records and consult additional experts. STUDY ELIGIBILITY AND CRITERIA: We will include working-age (≥15 years) workers in the formal and informal economy in any WHO and/or ILO Member State, but exclude children (<15 years) and unpaid domestic workers. For Systematic Review 1, we will include quantitative studies on the prevalence of relevant levels of occupational exposure to solar ultraviolet radiation (i.e. <0.33 SED/d and ≥0.33 SED/d) and of the total working time spent outdoors, stratified by country, sex, age and industrial sector or occupation, in the years 1960 to 2018. For Systematic Review 2, we will include randomized controlled trials, cohort studies, case-control studies and other non-randomized intervention studies with an estimate of the effect of any occupational exposure to solar ultraviolet radiation (i.e., ≥0.33 SED/d) on the prevalence of, incidence of or mortality due to melanoma and non-melanoma skin cancer, compared with the theoretical minimum risk exposure level (i.e. <0.33 SED/d). STUDY APPRAISAL AND SYNTHESIS METHODS: At least two review authors will independently screen titles and abstracts against the eligibility criteria at a first stage and full texts of potentially eligible records at a second stage, followed by extraction of data from qualifying studies. At least two review authors will assess the risk of bias and the quality of evidence, using the most suited tools currently available. For Systematic Review 2, if feasible, we will combine relative risks using meta-analysis. We will report results using the guidelines for accurate and transparent health estimates reporting (GATHER) for Systematic Review 1 and the preferred reporting items for systematic reviews and meta-analyses guidelines (PRISMA) for Systematic Review 2. PROSPERO REGISTRATION NUMBER: CRD42018094817.
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