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Sarwar MS, Ramirez CN, Kuo HCD, Chou P, Wu R, Sargsyan D, Yang Y, Shannar A, Peter RM, Yin R, Wang Y, Su X, Kong AN. Triterpenoid ursolic acid regulates the environmental carcinogen benzo[a]pyrene-driven epigenetic and metabolic alterations in SKH-1 hairless mice for skin cancer interception. Carcinogenesis 2024; 45:288-299. [PMID: 38466106 PMCID: PMC11102768 DOI: 10.1093/carcin/bgae009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Revised: 01/25/2024] [Accepted: 03/09/2024] [Indexed: 03/12/2024] Open
Abstract
Polycyclic aromatic hydrocarbons (PAHs) are ubiquitous environmental carcinogens accountable to developing skin cancers. Recently, we reported that exposure to benzo[a]pyrene (B[a]P), a common PAH, causes epigenetic and metabolic alterations in the initiation, promotion and progression of non-melanoma skin cancer (NMSC). As a follow-up investigation, this study examines how dietary triterpenoid ursolic acid (UA) regulates B[a]P-driven epigenetic and metabolic pathways in SKH-1 hairless mice. Our results show UA intercepts against B[a]P-induced tumorigenesis at different stages of NMSC. Epigenomic cytosines followed by guanine residues (CpG) methyl-seq data showed UA diminished B[a]P-mediated differentially methylated regions (DMRs) profiles. Transcriptomic RNA-seq revealed UA revoked B[a]P-induced differentially expressed genes (DEGs) of skin cancer-related genes, such as leucine-rich repeat LGI family member 2 (Lgi2) and kallikrein-related peptidase 13 (Klk13), indicating UA plays a vital role in B[a]P-mediated gene regulation and its potential consequences in NMSC interception. Association analysis of DEGs and DMRs found that the mRNA expression of KLK13 gene was correlated with the promoter CpG methylation status in the early-stage comparison group, indicating UA could regulate the KLK13 by modulating its promoter methylation at an early stage of NMSC. The metabolomic study showed UA alters B[a]P-regulated cancer-associated metabolisms like thiamin metabolism, ascorbate and aldarate metabolism during the initiation phase; pyruvate, citrate and thiamin metabolism during the promotion phase; and beta-alanine and pathothenate coenzyme A (CoA) biosynthesis during the late progression phase. Taken together, UA reverses B[a]P-driven epigenetic, transcriptomic and metabolic reprogramming, potentially contributing to the overall cancer interception against B[a]P-mediated NMSC.
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Affiliation(s)
- Md Shahid Sarwar
- Department of Pharmaceutics, Ernest Mario School of Pharmacy, Rutgers, The State University of New Jersey, Piscataway, NJ 08854, USA
| | - Christina N Ramirez
- Department of Pharmaceutics, Ernest Mario School of Pharmacy, Rutgers, The State University of New Jersey, Piscataway, NJ 08854, USA
| | - Hsiao-Chen Dina Kuo
- Department of Pharmaceutics, Ernest Mario School of Pharmacy, Rutgers, The State University of New Jersey, Piscataway, NJ 08854, USA
| | - Pochung Chou
- Department of Pharmaceutics, Ernest Mario School of Pharmacy, Rutgers, The State University of New Jersey, Piscataway, NJ 08854, USA
| | - Renyi Wu
- Department of Pharmaceutics, Ernest Mario School of Pharmacy, Rutgers, The State University of New Jersey, Piscataway, NJ 08854, USA
| | - Davit Sargsyan
- Department of Pharmaceutics, Ernest Mario School of Pharmacy, Rutgers, The State University of New Jersey, Piscataway, NJ 08854, USA
| | - Yuqing Yang
- Department of Pharmaceutics, Ernest Mario School of Pharmacy, Rutgers, The State University of New Jersey, Piscataway, NJ 08854, USA
| | - Ahmad Shannar
- Department of Pharmaceutics, Ernest Mario School of Pharmacy, Rutgers, The State University of New Jersey, Piscataway, NJ 08854, USA
| | - Rebecca Mary Peter
- Department of Pharmaceutics, Ernest Mario School of Pharmacy, Rutgers, The State University of New Jersey, Piscataway, NJ 08854, USA
| | - Ran Yin
- Department of Pharmaceutics, Ernest Mario School of Pharmacy, Rutgers, The State University of New Jersey, Piscataway, NJ 08854, USA
| | - Yujue Wang
- Metabolomics Shared Resource, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ 08901, USA
| | - Xiaoyang Su
- Metabolomics Shared Resource, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ 08901, USA
| | - Ah-Ng Kong
- Department of Pharmaceutics, Ernest Mario School of Pharmacy, Rutgers, The State University of New Jersey, Piscataway, NJ 08854, USA
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Newnam R, Le-Jenkins U, Rutledge C, Cunningham C. The Association of Skin Cancer Prevention Knowledge, Sun-Protective Attitudes, and Sun-Protective Behaviors in a Navy Population. Mil Med 2024; 189:1-7. [PMID: 36208319 DOI: 10.1093/milmed/usac285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 06/02/2022] [Accepted: 09/14/2022] [Indexed: 11/13/2022] Open
Abstract
INTRODUCTION U.S. Navy service members are primarily between the ages of 18 and 30 years and often required to be outside for extended periods of time in geographical locations with increased and often unfamiliar ultraviolet indexes that collectively increase their risk for skin cancer. Skin cancer is the country's most common form of cancer, yet there is a paucity of skin cancer prevention literature, especially within the U.S. Navy. The purpose of this study was to describe skin cancer risk and skin cancer prevention "cues-to-action" and to determine if skin cancer prevention knowledge was associated with sun-protective attitudes (e.g., prevention perceptions, benefits, threats, barriers, and sun-protective behavior self-efficacy) and sun-protective behaviors (e.g., wearing long sleeve shirts and using sunscreen and not deliberately exposing skin for a tan) in a Navy population. MATERIALS AND METHODS A cross-sectional, descriptive, correlational design was utilized, and the study approval was obtained by the Naval Medical Center Portsmouth Institutional Review Board. Two-hundred twenty-nine active duty Navy service members aged 18-30 years who presented to primary care for their periodic health assessment completed the Brief Skin Cancer Risk Assessment and the Skin Cancer Survey. Descriptive statistics were utilized to assess service members' perceptions and knowledge regarding skin cancer prevention along with sociodemographic characteristics. The Spearman rank-order correlation and the Mann-Whitney U test were used to assess associations. P-values <.05 were used to determine statistical significance. RESULTS Skin cancer prevention knowledge was significantly related to sun-protective behavior self-efficacy (r = 0.218, P = .001), benefits (r = 0.271, P ≤ .001), sun protection behaviors (r = 0.152, P = .024), skin cancer risk (r = 0.256, P = .001), current frequency of high-risk sun behavior (r = 0.183, P = .006), past frequency of high-risk sun behavior (r = 0.219, P = .001), sun exposure (U = 4,813.50, P = .005), tanning bed use (U = 3,154.50, P = .031), and training (U = 4,099.50, P = .005). CONCLUSIONS Integrating skin cancer education into primary care visits (i.e., periodic health assessments) may improve Navy service members' modifiable sun-protective attitudes and behaviors and may contribute to lowering future skin cancer rates.
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Affiliation(s)
- Rachel Newnam
- Old Dominion University, Graduate School of Nursing, Norfolk, VA 23529, USA
- Naval Medical Center Portsmouth, Portsmouth, VA 23708, USA
- Naval Hospital Bremerton, Bremerton, WA 98312, USA
| | - Uyen Le-Jenkins
- Old Dominion University, Graduate School of Nursing, Norfolk, VA 23529, USA
| | - Carolyn Rutledge
- Old Dominion University, Graduate School of Nursing, Norfolk, VA 23529, USA
| | - Craig Cunningham
- Old Dominion University, Graduate School of Nursing, Norfolk, VA 23529, USA
- Naval Medical Center Portsmouth, Portsmouth, VA 23708, USA
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Teixeira FEG, de Carvalho FB, Pacheco CDO, Pimentel K, de Gomes MG, Haas SE. The Importance of Skin Health Promotion for Children: Care with Makeup Use and Skin Cancer Prevention. Asian Pac J Cancer Prev 2022; 23:3491-3499. [PMID: 36308375 PMCID: PMC9924344 DOI: 10.31557/apjcp.2022.23.10.3491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Indexed: 02/18/2023] Open
Abstract
BACKGROUND Numerous pathogenic complications affect the skin and are preventable, such as skin cancer, microbial diseases, dermal irritations, and anaphylaxis. In this context, the correct use of skin products, including sunscreens and child makeup, is important for promoting skin health and preventing adverse health conditions. OBJECTIVE This study aimed to use educational and playful activities to promote skin health for students. METHODS This project was development in a municipal elementary school (Rio Grande do Sul State, Brazil). The interventions were divided into three moments. In the first day, a questionnaire was applied to find out the students' previous knowledge about photoprotection. On the second day, an intervention lecture was held addressing issues related to photoprotection and the use of makeup. Finally, we played educational and ludic games and after, the questionnaire was reapplied. This was done to evaluate these actions' effectiveness regarding photoprotection and record their habits by applying a structured questionnaire at the beginning and end of the activities. RESULTS Students received positively and interacted significantly during all activities performed. Regarding the impact of this study, we observed that ten times more students considered using sunscreen as something important at the end of the project, as only 8.16% of participants knew what skin cancer was at the beginning of the experiment. After the educational activities, this number rose to 72.37%, and 92.86% of girls reported wearing makeup, with more than half being expired or unlabeled and only 21.6% being appropriate for child use. CONCLUSION The measures demonstrated effectively improve students' level of information regarding skin cancer prevention and indicated that inappropriate habits concerning makeup use in childhood are quite common, demonstrating the importance of educational interventions for children, since can improve your health.
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Affiliation(s)
- Flávia Elizabete Guerra Teixeira
- Pharmacology and Pharmacometry Laboratory, Federal University of Pampa, Uruguaiana, Brazil.,Pharmaceutical Sciences Post Graduate Program, Federal University of Pampa, Uruguaiana, Brazil.
| | | | - Camila de Oliveira Pacheco
- Pharmacology and Pharmacometry Laboratory, Federal University of Pampa, Uruguaiana, Brazil.,Pharmaceutical Sciences Post Graduate Program, Federal University of Pampa, Uruguaiana, Brazil.
| | - Khayan Pimentel
- Pharmacology and Pharmacometry Laboratory, Federal University of Pampa, Uruguaiana, Brazil.
| | - Marcelo Gomes de Gomes
- Pharmacology and Pharmacometry Laboratory, Federal University of Pampa, Uruguaiana, Brazil.,Pharmaceutical Sciences Post Graduate Program, Federal University of Pampa, Uruguaiana, Brazil.
| | - Sandra Elisa Haas
- Pharmacology and Pharmacometry Laboratory, Federal University of Pampa, Uruguaiana, Brazil.,Pharmaceutical Sciences Post Graduate Program, Federal University of Pampa, Uruguaiana, Brazil. ,For Correspondence:
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Conahan LJ, Robertson S. Sun-Protective Behaviors in Patients with Melasma. J Nurse Pract 2022. [DOI: 10.1016/j.nurpra.2022.09.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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[Effects of an unconventional skin cancer prevention campaign : Impacts on the sun protection behavior of outdoor workers]. Hautarzt 2020; 71:455-462. [PMID: 32206841 DOI: 10.1007/s00105-020-04574-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND The disease burden of actinic keratoses and keratinocyte carcinoma can be reduced by primary and secondary prevention. However, these measures are often poorly received, especially among the high-risk group of outdoor workers. OBJECTIVES The aim of this follow-up study was to investigate whether an improvement in sun protection and awareness of skin changes could be observed among the study population, especially outdoor workers, one year after a prevention campaign focusing on this topic. MATERIALS AND METHODS In 2017, all participants who initially participated in a study at the Bavarian Central Agricultural Festival 2016 and agreed to participate in the follow-up study were contacted by mail and received the same questionnaire and evaluation questions regarding possible behavioral changes. RESULTS A total of 400 people took part in the follow-up study (response rate 52.8%). Of the 240 outdoor workers, 45.0% said they were more conscious of protecting themselves from the sun and 68.8% said they were more aware of skin changes. About 85.0% of outdoor workers indicated that they would consult a dermatologist earlier and 65.8% desired further prevention campaigns regarding skin cancer and sun protection. CONCLUSION Overall, the majority of participants reported that they had improved sun protection behavior and awareness of skin changes after the intervention. Based on the participants' self-disclosure, especially outdoor workers tended to use sun protection measure more frequently. These findings underline the importance of target group-oriented awareness and prevention campaigns to reduce the burden of skin cancer.
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Nahar VK, Wilkerson AH, Martin B, Boyas JF, Ford MA, Bentley JP, Johnson P, Beason KR, Black WH, Brodell RT. Sun Protection Behaviors of State Park Workers in the Southeastern USA. Ann Work Expo Health 2020; 63:521-532. [PMID: 30916316 DOI: 10.1093/annweh/wxz019] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2018] [Revised: 02/06/2019] [Accepted: 02/19/2019] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Due to the nature of their work, state park workers receive substantial exposure to sunlight, putting them at an increased risk of developing skin cancer. Increased use of sun protection behaviors can reduce this risk. OBJECTIVES Using the health belief model (HBM) as a theoretical framework, the purpose of this study was to assess factors associated with sun protection behaviors among state-park workers. METHODS In this cross-sectional study, a convenience sample of participants were recruited from 23 state parks in the Southeastern USA to complete a self-administered questionnaire based on the constructs of the HBM. RESULTS The sample comprised 310 state park workers. The majority of participants were non-Hispanic White (61.6%), male (63.5%), and were aged 39.56 (±13.97) years on average. The average duration of sun exposure during the workday was reported as 3.51 h (±1.88). Nearly 12% of the participants reported that their workplace had a sun-safety policy and ~10% reported receiving sun-safety training at their workplace. The majority of participants reported that they did not sufficiently use sun protection methods. Factors associated with sun protection behaviors included the HBM constructs of perceived benefits outweighing perceived barriers (standardized coefficient = 0.210, P = 0.001), self-efficacy (standardized coefficient = 0.333, P < 0.001), and cues to action (standardized coefficient = 0.179, P = 0.004). CONCLUSION Future research should explore the barriers to adopting and enforcing sun-safety policies in the workplace. HBM appears to be efficacious in explaining sun protection behaviors among state park workers. HBM constructs should be considered in future interventions aimed at increasing sun protection behaviors in this population.
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Affiliation(s)
- Vinayak K Nahar
- Center for Animal and Human Health in Appalachia, College of Veterinary Medicine, DeBusk College of Osteopathic Medicine, and School of Mathematics and Sciences, Lincoln Memorial University, Harrogate, TN, USA.,Department of Dermatology, School of Medicine, University of Mississippi Medical Center, Jackson, MS, USA
| | - Amanda H Wilkerson
- Department of Health and Exercise Science, College of Arts and Sciences, University of Oklahoma, Norman, OK, USA
| | - Brian Martin
- DeBusk College of Osteopathic Medicine, Harrogate, TN, USA
| | - Javier F Boyas
- School of Social Work, University of Georgia, Athens, GA, USA
| | - Mary A Ford
- Department of Health, Exercise Science, and Recreation Management, School of Applied Sciences, University of Mississippi, University, MS, USA
| | - John P Bentley
- Department of Pharmacy Administration, School of Pharmacy, University of Mississippi, University, MS, USA
| | - Paul Johnson
- Department of Management, School of Business Administration, University of Mississippi, University, MS, USA
| | - Kim R Beason
- Department of Health, Exercise Science, and Recreation Management, School of Applied Sciences, University of Mississippi, University, MS, USA
| | - William H Black
- Department of Dermatology, School of Medicine, University of Mississippi Medical Center, Jackson, MS, USA
| | - Robert T Brodell
- Department of Dermatology, School of Medicine, University of Mississippi Medical Center, Jackson, MS, USA
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Ziehfreund S, Schuster B, Zink A. Primary prevention of keratinocyte carcinoma among outdoor workers, the general population and medical professionals: a systematic review updated for 2019. J Eur Acad Dermatol Venereol 2019; 33:1477-1495. [PMID: 30801774 DOI: 10.1111/jdv.15525] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Accepted: 01/29/2019] [Indexed: 02/07/2023]
Abstract
Worldwide 2-3 million cases of keratinocyte carcinoma (KC) are diagnosed annually. Sun-related knowledge is essential for adequate protection against solar ultraviolet radiation (UVR), the main risk factor for KC. The goal was (i) to provide an updated overview of primary prevention against KC including skin cancer-related knowledge, attitudes and sun protection behaviour (SPB) of outdoor workers, the general population and medical professionals as well as (ii) to evaluate the effectiveness and acceptability of sun protection programmes. We conducted a systematic review of articles indexed for MEDLINE on PubMed using selected MeSH terms and keywords related to the studied topic as well as an extensive hand search of publications between 1 January 2012 and 31 December 2018. We identified 51 relevant cross-sectional studies and 22 interventional studies. Sun-related knowledge and attitude showed substantial differences with some alarming results, including people who had not even heard about skin cancer before. Reported SPB varied enormously between the included studies, with none of the studies providing an overall sufficient SPB in their examined sun protection measures. However, sun protection programmes using new technologies seem to have great potential to increase sun-related knowledge and SPB. In countries worldwide, particularly in those where KC is not yet a public health issue, UVR protection should be promoted by healthcare institutions and authorities, politicians, cancer foundations and dermatologists to increase awareness as well as SPB and to decrease the worldwide burden of KC.
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Affiliation(s)
- S Ziehfreund
- Department of Dermatology and Allergy, Technical University of Munich, Munich, Germany
| | - B Schuster
- Department of Dermatology and Allergy, Technical University of Munich, Munich, Germany
| | - A Zink
- Department of Dermatology and Allergy, Technical University of Munich, Munich, Germany
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Moeini B, Ezati E, Barati M, Rezapur-Shahkolai F, Mohammad Gholi Mezerji N, Afshari M. Skin Cancer Preventive Behaviors in Iranian Farmers: Applying Protection Motivation Theory. Workplace Health Saf 2018; 67:231-240. [PMID: 30305002 DOI: 10.1177/2165079918796850] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Farmers are among the most common work groups at risk of skin cancer. The protection motivation theory has been widely accepted as a framework for predicting health related behaviors. This study was conducted to determine the role of factors preventing skin cancer among farmers in Eslamabad-e Gharb district, Iran, using the protection motivation theory. In this descriptive study, 280 farmers living in this district were studied from May to June 2017. Using cluster random sampling methods, health houses where farmers received health care were selected. Each farmer within the selected health house was then enrolled into the study using simple random sampling. Data were collected by interview using an author-developed questionnaire. The questionnaire ascertained demographic information and constructs of the protection motivation theory. Almost half of the farmers had a history of sunburn (56.4%). With regard to prevention, a small proportion reported using sunscreen (8.6%), hats (3.2%), gloves 3.9%, sunglasses 4.6%, and protective clothing 15.4%. The results of regression analyses showed that with one unit of increase in the scores of self-efficacy to adopt prevention behavior and perceived protection motivation resulted in an increase in the mean score of the "protective" behavior by 0.26 and 0.20, respectively. Working conditions among farmers place them at great risk and skin cancer prevention is essential. Intervention and prevention programs should fully identify the determinants of skin cancer prevention in farmers; in addition, the identified effective factors must be taken into account when designing and implementing appropriate interventions.
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Grandahl K, Ibler KS, Laier GH, Mortensen OS. Skin cancer risk perception and sun protection behavior at work, at leisure, and on sun holidays: a survey for Danish outdoor and indoor workers. Environ Health Prev Med 2018; 23:47. [PMID: 30285623 PMCID: PMC6169023 DOI: 10.1186/s12199-018-0736-x] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2018] [Accepted: 09/14/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND To prevent occupational skin cancer, it is essential that the sun-protective behavior of outdoor workers is adequate. The aim is to study the sun-protective behavior of Danish outdoor workers at work, at leisure, and on sun holiday and compare it to that of indoor workers. METHODS This is a cross-sectional study, based on a 53-item survey completed by Danish outdoor (n = 380) and indoor workers (n = 119) in 2016-2017. Status as outdoor or indoor worker was decided based on self-report and behavioral differences were tested using (paired) t tests and multiple regression adjusted for age, sex, educational level, history of smoking, and skin type. RESULTS Danish outdoor workers at work use sun protection less than they do at leisure and on sun holiday (α < .05) where their sun protection behavior is similar to that of indoor workers. The proportion of Danish outdoor workers that always/often use sun protection at work is for shade seeking around noon 4.2%, sunscreen 34.5%, wide-brimmed hat 25.3%, and long trousers and shirt with sleeves 42.4%. Of Danish outdoor workers, 49.5% do not think about the risk of occupational skin cancer and 11.8% think the risk is insignificant, 32.4% think that the use of sun protection is of low or no importance, 84.2% consider sunburn important as skin cancer risk factor still 88.9% have a history of sunburn at work, > 80.0% agree that risk of skin cancer is reduced by the use of sun protection, and only 4.0% dismiss the possibility of sun protection use at work. CONCLUSIONS Skin cancer risk and use of sun protection at work are largely neglected in Danish outdoor workers, more so than at leisure and on sun holiday where their risk behavior resembles that of indoor workers. This indicates an untapped workplace preventive potential.
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Affiliation(s)
- Kasper Grandahl
- The Department of Occupational Medicine, Copenhagen University Holbaek, Gl. Ringstedvej 4B, 4300 Holbaek, Denmark
| | | | | | - Ole Steen Mortensen
- The Department of Occupational Medicine, Copenhagen University Holbaek, Gl. Ringstedvej 4B, 4300 Holbaek, Denmark
- Section of Social Medicine, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
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Szewczyk M, Pazdrowski J, Golusiński P, Dańczak-Pazdrowska A, Pawlaczyk M, Sygut J, Marszałek A, Golusiński W. Outdoor work as a risk factor for high-grade cutaneous squamous cell carcinoma of the head and neck. Postepy Dermatol Alergol 2018; 35:408-412. [PMID: 30206456 PMCID: PMC6130134 DOI: 10.5114/ada.2018.75841] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2017] [Accepted: 07/12/2017] [Indexed: 11/28/2022] Open
Abstract
INTRODUCTION While it is clear that individuals with outdoor occupations are at a significantly greater risk of developing cutaneous squamous cell carcinoma (cSCC), no previous studies have investigated the potential association between the tumour grade and occupation in this patient population. AIM To assess occupation as a risk factor for the development of high-grade cSCC. Secondarily, to determine the association between the tumour grade and other clinical characteristics. MATERIAL AND METHODS Retrospective analysis of 256 patients treated for head and neck cSCC at our institution in 2007-2016. The following patient characteristics and variables were assessed: age; sex; tumour location and grade; profession; and education level. A univariate analysis was performed to assess the association between each study variable and grade 3 tumour differentiation. RESULTS The following variables were significantly associated (p < 0.05) with grade 3 (G3) cSCC tumours: outdoor work vs. indoor work; primary school vs. high school education; and age. Additionally, patients with low-grade (G1) tumours were significantly younger (mean age: 72) than patients with high-grade (G3) tumours (mean age: 79) (p = 0.046). CONCLUSIONS To our knowledge, this is the first study to assess the variables associated with the tumour grade among outdoor workers. These findings suggest that outdoor workers who develop cSCC are at a greater risk of developing more aggressive cancers. These findings provide additional support for classifying cSCC as an occupational disease. Early education about the dangers of sun exposure during the first years of school is essential to minimize the risks of developing high-grade skin cancer.
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Affiliation(s)
- Mateusz Szewczyk
- Department of Head and Neck Surgery, Poznan University of Medical Sciences, The Greater Poland Cancer Centre, Poznan, Poland
| | - Jakub Pazdrowski
- Department of Head and Neck Surgery, Poznan University of Medical Sciences, The Greater Poland Cancer Centre, Poznan, Poland
| | - Paweł Golusiński
- Department of Head and Neck Surgery, Poznan University of Medical Sciences, The Greater Poland Cancer Centre, Poznan, Poland
- Department of Biology and Environmental Studies, Poznan University of Medical Sciences, Poznan, Poland
| | | | - Mariola Pawlaczyk
- Department of Gerontology and Geriatric Medicine, Poznan University of Medical Sciences, Poznan, Poland
| | - Jacek Sygut
- Department of Cancer Pathology and Prophylaxis, Poznan University of Medical Sciences, The Greater Poland Cancer Centre, Poznan, Poland
| | - Andrzej Marszałek
- Department of Cancer Pathology and Prophylaxis, Poznan University of Medical Sciences, The Greater Poland Cancer Centre, Poznan, Poland
| | - Wojciech Golusiński
- Department of Head and Neck Surgery, Poznan University of Medical Sciences, The Greater Poland Cancer Centre, Poznan, Poland
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Sureda A, Capó X, Busquets-Cortés C, Tejada S. Acute exposure to sunscreen containing titanium induces an adaptive response and oxidative stress in Mytillus galloprovincialis. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2018; 149:58-63. [PMID: 29154135 DOI: 10.1016/j.ecoenv.2017.11.014] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/30/2017] [Revised: 11/06/2017] [Accepted: 11/08/2017] [Indexed: 06/07/2023]
Abstract
The use of sunscreens to protect against ultraviolet radiation exposure progressively increases as result of a greater awareness of the people and the greater arrival of tourists. The components of these creams can end up in the waters affecting coastal species. Mediterranean mussels (Mytillus galloprovincialis) were subjected to an acute exposure of a sunscreen with TiO2 in their composition during 24h. The low and medium concentrations used in the assays contained a concentration of TiO2 in the range of values found in coastal waters of the Balearic Islands. Titanium and metallothionein concentrations were progressively increasing in gills with the sunscreen concentration in a dose-dependent manner. The activities of the antioxidant enzymes and the detoxification glutathione s-transferase evidenced a hormetic shape response with increased activities at lower sunscreen concentrations, a response that was abolished at the highest concentration. In accordance with these enzyme activities, the levels of malondialdehyde, as a marker of lipid peroxidation, were significantly elevated by the higher sunscreen concentrations. Acetylcholinesterase activity maintained control activities except for the highest sunscreen concentration, where a significant decrease was evidenced. In conclusion, the treatment of mussels with a sunscreen containing TiO2 in the range of Balearic coastal waters induces an adaptive response that is overcome by the highest concentration. Follow-up biomonitoring studies are necessary to control the concentration of sunscreen compound in coastal waters such as titanium since they can induce oxidative stress to affected organisms.
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Affiliation(s)
- Antoni Sureda
- Research Group in Community Nutrition and Oxidative Stress, Department of Fundamental Biology and Health Sciences, University of Balearic Islands, Ctra. Valldemossa, km 7,5, Ed. Guillem Colom, 07122 Balearic Islands, Spain; CIBEROBN (Fisiopatología de la Obesidad y la Nutrición CB12/03/30038), Instituto de Salud Carlos III, Balearic Islands, Spain.
| | - Xavier Capó
- Research Group in Community Nutrition and Oxidative Stress, Department of Fundamental Biology and Health Sciences, University of Balearic Islands, Ctra. Valldemossa, km 7,5, Ed. Guillem Colom, 07122 Balearic Islands, Spain
| | - Carla Busquets-Cortés
- Research Group in Community Nutrition and Oxidative Stress, Department of Fundamental Biology and Health Sciences, University of Balearic Islands, Ctra. Valldemossa, km 7,5, Ed. Guillem Colom, 07122 Balearic Islands, Spain
| | - Silvia Tejada
- Laboratory of Neurophysiology, Department of Biology, University of Balearic Islands, Ctra. Valldemossa, km 7,5, Ed. Guillem Colom, 07122 Balearic Islands, Spain
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Predictors of Sun Protective Behaviors among Latino Day Laborers. J Skin Cancer 2018; 2018:3454309. [PMID: 29623223 PMCID: PMC5829325 DOI: 10.1155/2018/3454309] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2017] [Revised: 11/22/2017] [Accepted: 12/17/2017] [Indexed: 12/04/2022] Open
Abstract
Objectives Despite the substantial solar ultraviolet radiation experienced by Latino day laborers, little attention has been given to factors that are associated with sun protective behaviors. The purpose of this study was to examine psychological and nonpsychological predictors of sun protective behaviors among Latino day laborers. Methods This cross-sectional study included a nonrandom sample of 137 Latino day laborers recruited from Mississippi and Illinois. Participants completed a self-report survey instrument, available in English and Spanish, on sun protective behaviors. Results Multivariate regression results showed that sun protective behaviors were significantly greater among Latino day laborers: (a) who had greater perceptions that their supervisor also engaged in sun protective behaviors (β = 0.25, p ≤ 0.01); (b) who reported higher levels of health literacy (β = 0.23, p ≤ 0.001); (c) who have greater knowledge of skin cancer risk factors (β = 0.21, p ≤ 0.01); and (d) who have skin tone that was self-perceived to be more prone to sunburns (β = 0.19, p ≤ 0.01). Conclusions Latino day laborers possess marginal levels of skin cancer knowledge and engage minimally in sun protective behaviors. Skin cancer prevention interventions are warranted for this high-risk group, particularly in the locations in which Latino day laborers work.
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Zink A, Wurstbauer D, Rotter M, Wildner M, Biedermann T. Do outdoor workers know their risk of NMSC? Perceptions, beliefs and preventive behaviour among farmers, roofers and gardeners. J Eur Acad Dermatol Venereol 2017; 31:1649-1654. [PMID: 28414878 DOI: 10.1111/jdv.14281] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2017] [Accepted: 03/28/2017] [Indexed: 11/28/2022]
Abstract
BACKGROUND Non-melanoma skin cancer (NMSC) was officially recognized in 2015 as an occupational disease for outdoor workers in Germany. Together with the enormous socioeconomic impact of NMSC, this has led to the continuous demand of evidence-based prevention. However, studies assessing the perceptions and beliefs along with risk behaviour of outdoor workers as an essential prerequisite for prevention are rare. OBJECTIVE To assess perceptions, beliefs, barriers, risk and preventive behaviours towards non-melanoma skin cancer among different outdoor groups as a basis for the development of sustainable prevention programmes. PATIENTS AND METHODS Cross-sectional study among outdoor workers of three different occupational groups (farmer, gardener, roofer) using a 20-question online survey on NMSC awareness, risk and preventive behaviours. RESULTS Between March and April 2016, 353 outdoor workers participated in the study. Of these, 153 (43.4%) reported never to use sunscreen during work. Wearing headgear and long pants were the most common sun protection measures. Poor use of sunscreen was more likely in males and farmers. A low perceived skin cancer risk was significantly associated with poor use of sunscreen, long-sleeved shirts, sunglasses and headgear. CONCLUSIONS Despite great evidence on NMSC risk in outdoor professions throughout the literature, high-risk groups in fact are not yet aware of the topic. Sustainable target group-oriented awareness prevention programmes are needed to lower the immense burden of NMSC.
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Affiliation(s)
- A Zink
- Department of Dermatology and Allergy, Technical University of Munich, Munich, Germany
| | - D Wurstbauer
- Department of Dermatology and Allergy, Technical University of Munich, Munich, Germany
| | - M Rotter
- Research Unit of Molecular Epidemiology (AME), Helmholtz Zentrum München, Munich, Germany
| | - M Wildner
- Bayerisches Landesamt für Gesundheit und Lebensmittelsicherheit (LGL), Munich, Germany
| | - T Biedermann
- Department of Dermatology and Allergy, Technical University of Munich, Munich, Germany
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Maguire E, Spurr A. Implementation of Ultraviolet Radiation Safety Measures for Outdoor Workers. J Cutan Med Surg 2016; 21:117-124. [PMID: 27940497 DOI: 10.1177/1203475416683389] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Ultraviolet radiation (UVR) poses a major risk for outdoor workers, putting them at greater risk for skin cancer. In the general population, the incidence of both melanoma and nonmelanoma skin cancers is increasing. It is estimated that 90% of skin cancers in Canada are directly attributable to UVR exposure, making this cancer largely preventable with the appropriate precautions. A scoping review was conducted on the barriers and facilitators to UVR safety in outdoor workers to elucidate why these precautions are not in use currently. We discuss these results according to the Hierarchy of Controls as a means to outline effective and feasible prevention strategies for outdoor workers. In doing so, this review may be used to inform the design of future workplace interventions for UVR safety in outdoor workers to decrease the risk of skin cancer in this vulnerable population.
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Affiliation(s)
- Erin Maguire
- 1 Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Alison Spurr
- 1 Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
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Santiago-Rivas M, Schnur JB, Jandorf L. Sun Protection Belief Clusters: Analysis of Amazon Mechanical Turk Data. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2016; 31:673-678. [PMID: 26194777 PMCID: PMC4723289 DOI: 10.1007/s13187-015-0882-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/18/2023]
Abstract
This study aimed (i) to determine whether people could be differentiated on the basis of their sun protection belief profiles and individual characteristics and (ii) explore the use of a crowdsourcing web service for the assessment of sun protection beliefs. A sample of 500 adults completed an online survey of sun protection belief items using Amazon Mechanical Turk. A two-phased cluster analysis (i.e., hierarchical and non-hierarchical K-means) was utilized to determine clusters of sun protection barriers and facilitators. Results yielded three distinct clusters of sun protection barriers and three distinct clusters of sun protection facilitators. Significant associations between gender, age, sun sensitivity, and cluster membership were identified. Results also showed an association between barrier and facilitator cluster membership. The results of this study provided a potential alternative approach to developing future sun protection promotion initiatives in the population. Findings add to our knowledge regarding individuals who support, oppose, or are ambivalent toward sun protection and inform intervention research by identifying distinct subtypes that may best benefit from (or have a higher need for) skin cancer prevention efforts.
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Affiliation(s)
- Marimer Santiago-Rivas
- Department of Oncological Sciences, Icahn School of Medicine at Mount Sinai, Medical Institute, 1425 Madison Ave, Suite 3-50, One Gustave L. Levy Place, Box 1130, New York, NY, 10029, USA.
| | - Julie B Schnur
- Department of Oncological Sciences, Icahn School of Medicine at Mount Sinai, Medical Institute, 1425 Madison Ave, Suite 3-50, One Gustave L. Levy Place, Box 1130, New York, NY, 10029, USA
| | - Lina Jandorf
- Department of Oncological Sciences, Icahn School of Medicine at Mount Sinai, Medical Institute, 1425 Madison Ave, Suite 3-50, One Gustave L. Levy Place, Box 1130, New York, NY, 10029, USA
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Skin Protection Behaviors among Young Male Latino Day Laborers: An Exploratory Study Using a Social Cognitive Approach. Dermatol Res Pract 2016; 2016:1479637. [PMID: 27019656 PMCID: PMC4785254 DOI: 10.1155/2016/1479637] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2015] [Revised: 11/26/2015] [Accepted: 12/06/2015] [Indexed: 11/17/2022] Open
Abstract
Latino Day Laborers (LDLs) are employed in occupations where multiple work hazards exist. One such hazard is the overexposure to solar ultraviolet radiation for continuous periods of time. Regular sun exposure can put individuals at increased risk of developing skin cancers, especially without adequate protection. The purpose of this cross-sectional exploratory study was to use a social cognitive framework to assess skin protective behaviors among LDLs. A community-based nonrandom and purposive sample of LDLs was recruited in two states: Mississippi and Illinois. The study sample consisted of 137 male participants, of which the majority were of Mexican ancestry (72%). The average age was 35.40 (SD = 9.89) years. Results demonstrated that a substantial number of LDLs do not adequately practice sun protection behaviors on a regular basis. The skin cancer knowledge scores were very modest. The most frequently indicated barriers towards sun protection were “inconvenient,” “forget to use,” and “not being able to reapply sunscreen.” Overall, LDLs had moderate confidence in their abilities to adopt successful sun protection strategies. This study underscores the need for intervention programs aimed at LDLs to reduce extended time in the sun and increase use of sun protective measures when working outdoors.
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