Berufliche UV-Belastung und Hautkrebs

Probing Different Approaches in Ultraviolet Radiation Personal Dosimetry - Ball Sports and Visiting Parks

Solar ultraviolet radiation (UVR) continues to be a decisive influencing factor for skin health. Besides acute damage (e.g. erythema), chronic light damage is of particular relevance. Skin cancer can develop on the basis of this light damage. Knowledge about irradiation is crucial for the choice of preventive measures, but has so far been incomplete in many occupational and leisure activities. Often a methodological problem in study design is the cause. Here we report on the clarification of two issues. First, further values are to be determined on the way to a comprehensive exposure register of leisure-related activities. Furthermore, it is to be determined to what extent the measurement setting can have an influence on the measurement campaigns. For long-term measurements, football referees were equipped with dosimeters over several months, selective measurements during visits to parks were carried out by on-site recruitment of test persons. It turned out that the choice of method also depends on the expected compliance of the test persons. Long-term measurements of specific activities such as playing football are particularly suitable for observing the course of UV exposure over the year and generating resilient mean values. Point measurements such as visits to parks can also do this if there are enough such events spread over the year. However, they are particularly suitable for such on-site campaigns, as they may be combined with awareness campaigns of the issue of skin cancer. They also allow many measurements to be taken at the same time in one place. Both playing football and visiting parks are associated with high levels of radiation, so specific prevention concepts need to be developed. We were able to determine that the sunburn dose for light skin types was reached or exceeded for both of the investigated activities.

Occupational skin cancer due to UV-irradiation--Analyses of notified cases as "virtually-certain" occupational disease in Germany between 2005 and 2011

BACKGROUND

UV-induced skin cancer is not yet included in the German ordinance on occupational diseases and can only be notified and recognized acknowledged as "virtually-certain" occupational disease. The objective of the study was to analyze notified and acknowledged cases of occupational skin cancer due to UV-irradiation in Germany between 2005 and 2011.

PATIENTS AND METHODS

All notified cases of occupational skin cancer due to UV-irradiation have been analyzed which have been registered by the German Statutory accident insurance as of May 2012 were analyzed. The data analyze was descriptive stratified annually for presenting time trends.Data analysis was descriptive, stratified by year to defect time trends.

RESULTS

Notified cases have increased annually with a total of 548 registered cases of occupational skin cancer induced by UV-irradiation between 2005 and 2011, and 74 recognized acknowledged cases. In 56 cases the procedure was not yet finished. Squamous cell carcinoma (SCC) and in-situ squamous cell carcinoma (actinic keratosis, Bowen's disease) were most frequent and have been the most frequentlyobserved in 333 notified cases. and between 15.6 % and 24.9 % have been recognizedof cases with SCC and actinic keratosis were recognized, respectively. 184 patients with basal cell carcinoma were notified but only 6.5 % recognized acknowledged and only 3 cases with exclusive basal cell carcinoma. Out of 50 notified patients with Mmelanoma only one was recognizedacknowledged.

CONCLUSIONS

The results are in good agreement with the proposal of the German Minister of labor to establish UV-induced skin cancer as a new occupational disease.

The relationship between occupational sun exposure and non-melanoma skin cancer: clinical basics, epidemiology, occupational disease evaluation, and prevention

BACKGROUND

The cumulative effect of solar ultraviolet (UV) radiation is responsible for the worldwide increase in non-melanoma skin cancer, a category that includes squamous cell carcinoma and its precursors (the actinic keratoses) as well as basal-cell carcinoma. Non-melanoma skin cancer is the most common type of cancer in areas of the world with a light-skinned population. The occupational exposure to UV radiation is high in many outdoor occupations; recent studies suggest that persons working in such occupations are more likely to develop non-melanoma skin cancer.

METHODS

On the basis of a selective review of the literature, we present the current state of knowledge about occupational and non-occupational UV exposure and the findings of meta-analyses on the association of outdoor activity with non-melanoma skin cancer. We also give an overview of the current recommendations for prevention and for medicolegal assessment.

RESULTS

Recent meta-analyses have consistently documented a significantly higher risk of squamous cell carcinoma of the skin among persons who work outdoors (odds ratio [OR] 1.77, 95% confidence interval [CI] 1.40-2.22, p<0.001). There is also evidence for an elevated risk of basal-cell carcinoma (OR 1.43, 95% CI 1.23-1.66, p = 0.0001), but the effect is of lesser magnitude and the study findings are not as uniform.

CONCLUSION

The association of occupational exposure to solar UV radiation with squamous cell carcinoma, including actinic keratosis, has been conclusively demonstrated. It follows that, in Germany, suspected non-melanoma skin cancer in persons with high occupational exposure to UV radiation should be reported as an occupational disease under § 9, paragraph 2 of the Seventh Book of the German Social Code (Sozialgesetzbuch, SGB VII). Preventive measures are urgently needed for persons with high occupational exposure to UV radiation.