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Giannangelo C, Challis MP, Siddiqui G, Edgar R, Malcolm TR, Webb CT, Drinkwater N, Vinh N, Macraild C, Counihan N, Duffy S, Wittlin S, Devine SM, Avery VM, De Koning-Ward T, Scammells P, McGowan S, Creek DJ. Chemoproteomics validates selective targeting of Plasmodium M1 alanyl aminopeptidase as an antimalarial strategy. eLife 2024; 13:RP92990. [PMID: 38976500 PMCID: PMC11230628 DOI: 10.7554/elife.92990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/10/2024] Open
Abstract
New antimalarial drug candidates that act via novel mechanisms are urgently needed to combat malaria drug resistance. Here, we describe the multi-omic chemical validation of Plasmodium M1 alanyl metalloaminopeptidase as an attractive drug target using the selective inhibitor, MIPS2673. MIPS2673 demonstrated potent inhibition of recombinant Plasmodium falciparum (PfA-M1) and Plasmodium vivax (PvA-M1) M1 metalloaminopeptidases, with selectivity over other Plasmodium and human aminopeptidases, and displayed excellent in vitro antimalarial activity with no significant host cytotoxicity. Orthogonal label-free chemoproteomic methods based on thermal stability and limited proteolysis of whole parasite lysates revealed that MIPS2673 solely targets PfA-M1 in parasites, with limited proteolysis also enabling estimation of the binding site on PfA-M1 to within ~5 Å of that determined by X-ray crystallography. Finally, functional investigation by untargeted metabolomics demonstrated that MIPS2673 inhibits the key role of PfA-M1 in haemoglobin digestion. Combined, our unbiased multi-omic target deconvolution methods confirmed the on-target activity of MIPS2673, and validated selective inhibition of M1 alanyl metalloaminopeptidase as a promising antimalarial strategy.
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Affiliation(s)
- Carlo Giannangelo
- Drug Delivery, Disposition and Dynamics, Monash Institute of Pharmaceutical Sciences, Monash UniversityParkvilleAustralia
| | - Matthew P Challis
- Drug Delivery, Disposition and Dynamics, Monash Institute of Pharmaceutical Sciences, Monash UniversityParkvilleAustralia
| | - Ghizal Siddiqui
- Drug Delivery, Disposition and Dynamics, Monash Institute of Pharmaceutical Sciences, Monash UniversityParkvilleAustralia
| | - Rebecca Edgar
- School of Medicine, Deakin UniversityGeelongAustralia
- The Institute for Mental and Physical Health and Clinical Translation, Deakin UniversityGeelongAustralia
| | - Tess R Malcolm
- Monash Biomedicine Discovery Institute and Department of Microbiology, Monash UniversityClaytonAustralia
- Centre to Impact AMR, Monash UniversityClaytonAustralia
| | - Chaille T Webb
- Monash Biomedicine Discovery Institute and Department of Microbiology, Monash UniversityClaytonAustralia
- Centre to Impact AMR, Monash UniversityClaytonAustralia
| | - Nyssa Drinkwater
- Monash Biomedicine Discovery Institute and Department of Microbiology, Monash UniversityClaytonAustralia
- Centre to Impact AMR, Monash UniversityClaytonAustralia
| | - Natalie Vinh
- Medicinal Chemistry, Monash Institute of Pharmaceutical Sciences, Monash UniversityParkvilleAustralia
| | - Christopher Macraild
- Drug Delivery, Disposition and Dynamics, Monash Institute of Pharmaceutical Sciences, Monash UniversityParkvilleAustralia
| | - Natalie Counihan
- School of Medicine, Deakin UniversityGeelongAustralia
- The Institute for Mental and Physical Health and Clinical Translation, Deakin UniversityGeelongAustralia
| | - Sandra Duffy
- Discovery Biology, Centre for Cellular Phenomics, Griffith UniversityNathanAustralia
| | - Sergio Wittlin
- Swiss Tropical and Public Health InstituteAllschwilSwitzerland
- University of BaselBaselSwitzerland
| | - Shane M Devine
- The Walter and Eliza Hall Institute of Medical ResearchParkvilleAustralia
- Department of Medical Biology, The University of MelbourneParkvilleAustralia
| | - Vicky M Avery
- Discovery Biology, Centre for Cellular Phenomics, Griffith UniversityNathanAustralia
- School of Environment and Science, Griffith UniversityNathanAustralia
| | - Tania De Koning-Ward
- School of Medicine, Deakin UniversityGeelongAustralia
- The Institute for Mental and Physical Health and Clinical Translation, Deakin UniversityGeelongAustralia
| | - Peter Scammells
- Medicinal Chemistry, Monash Institute of Pharmaceutical Sciences, Monash UniversityParkvilleAustralia
| | - Sheena McGowan
- Monash Biomedicine Discovery Institute and Department of Microbiology, Monash UniversityClaytonAustralia
- Centre to Impact AMR, Monash UniversityClaytonAustralia
| | - Darren J Creek
- Drug Delivery, Disposition and Dynamics, Monash Institute of Pharmaceutical Sciences, Monash UniversityParkvilleAustralia
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2
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Yamamoto ALC, Corrêa MDP, Torres RR, Martins FB, Godin-Beekmann S. Projected changes in ultraviolet index and UV doses over the twenty-first century: impacts of ozone and aerosols from CMIP6. Photochem Photobiol Sci 2024; 23:1279-1294. [PMID: 38762827 DOI: 10.1007/s43630-024-00594-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Accepted: 05/07/2024] [Indexed: 05/20/2024]
Abstract
This study evaluated the health-related weighted ultraviolet radiation (UVR) due to the total ozone content (TOC) and the aerosol optical depth (AOD) changes. Clear-sky Ultraviolet Index (UVI), daily doses, and exposure times for erythema induction (Dery and Tery) and vitamin D synthesis (DvitD and TvitD) were computed by a radiative transfer estimator. TOC and AOD data were provided by six Earth System Models (ESMs) from the Coupled Model Intercomparison Project Phase 6 (CMIP6). For projections, we consider four Shared Socioeconomic Pathways scenarios-SSPs (SSP1-2.6, SSP2-4.5, SSP3-7.0, and SSP5-8.5)-and two time-slices (near: 2041-2060 and far future: 2081-2100). UVR projections showed pronounced changes for the summer hemispheres in the far future. TOC increases in mid- and high latitudes of the Southern Hemisphere caused decreases in UVR at the summer solstice. However, projections did not indicate sun-safe exposure conditions in South America, Australia, and Southern Africa. On the contrary, exposure around solar noon from 10 to 20 min will still be sufficient to induce erythema in skin type III individuals throughout this century. In southern Argentina and Chile, the UVR insufficiency for vitamin D synthesis at solar noon in skin type III remains the same during this century at the winter solstice. In the Northern Hemisphere, UVI and Dery at the summer solstice should remain high (UVI ≥ 8; Dery ~ 7.0 kJ m-2) in highly populated locations. Above 45 °N, UVR levels cannot be enough to synthesize vitamin D in skin type III during the boreal winter. Our results show that climate change will affect human health through excess or lack of solar UVR availability.
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Affiliation(s)
| | - Marcelo de Paula Corrêa
- Natural Resources Institute, Federal University of Itajubá, Av. BPS, 1303, Itajubá, MG, 37500-903, Brazil
| | - Roger Rodrigues Torres
- Natural Resources Institute, Federal University of Itajubá, Av. BPS, 1303, Itajubá, MG, 37500-903, Brazil
| | - Fabrina Bolzan Martins
- Natural Resources Institute, Federal University of Itajubá, Av. BPS, 1303, Itajubá, MG, 37500-903, Brazil
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3
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Slavinsky V, Helmy J, Vroman J, Valdebran M. Solar ultraviolet radiation exposure in workers with outdoor occupations: a systematic review and call to action. Int J Dermatol 2024; 63:288-297. [PMID: 37853576 DOI: 10.1111/ijd.16877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Revised: 08/20/2023] [Accepted: 09/28/2023] [Indexed: 10/20/2023]
Abstract
Chronic solar ultraviolet radiation (sUVR) exposure leads to an increased incidence of non-melanoma skin cancer (NMSC) development, particularly when accumulated over decades. Workers in certain industries, such as construction, agriculture, postal workers, and the military, are at higher risk due to cumulative sUVR exposure in their line of work. By assessing the relationship between sUVR exposure in outdoor workers and their skin cancer risk and defining methods of prevention, clinicians can offer focused sun protection counseling to this unique population. PubMed was used to perform a literature review to address the following research questions: 1. How is ultraviolet radiation measured? 2. What is the modern utility of the ultraviolet index in modifying sun protection behaviors in outdoor industry workers? 3. What is the risk of non-melanoma skin cancer development in individuals working in outdoor occupations? 4. What is the prevalence of skin cancer among outdoor workers? 5. Is the number of nevi and solar lentigines elevated among individuals employed in outdoor occupations? The literature suggests that individuals in outdoor occupations are exposed to UV levels that often surpass safety limits for occupational UVR exposure, increasing their risk of developing skin cancer and precursor and pigmented lesions. Individuals in high-risk occupations experience significantly higher levels of sUVR exposure than their indoor worker counterparts, increasing their risk of malignant cutaneous transformation. Accordingly, these individuals must be counseled on effective solar protection methods, and employers should advocate for actionable change.
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Affiliation(s)
| | - John Helmy
- Medical University of South Carolina, Charleston, SC, USA
| | - Jenna Vroman
- Medical University of South Carolina, Charleston, SC, USA
| | - Manuel Valdebran
- Division of Pediatric Dermatology, Department of Dermatology, Medical University of South Carolina, Charleston, SC, USA
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4
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Kinoshita K, Kodera S, Hatsusaka N, Egawa R, Takizawa H, Kubo E, Sasaki H, Hirata A. Association of nuclear cataract prevalence with UV radiation and heat load in lens of older people -five city study. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023; 30:123832-123842. [PMID: 37991619 DOI: 10.1007/s11356-023-31079-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Accepted: 11/13/2023] [Indexed: 11/23/2023]
Abstract
Epidemiological studies have reported that the frequency of nuclear cataracts (NUCs) is high among the elderly and in tropical countries. Ultraviolet (UV) irradiation and lens temperature are considered as key physical contributors, although their precise quantification is difficult. The aim of this study is to investigate the association of NUC prevalence with UV irradiation and heat load. First, we assessed the lens temperature using thermodynamic modeling considering the thermophysiological response. We then conducted a multivariate linear regression analysis for the epidemiological analysis of NUC prevalence across five cities. A strong correlation was observed between NUC prevalence and the combined effects of UV irradiation and cumulative equivalent minutes at 43 °C (CEM43°C) derived from the computed lens temperature (adjusted R2 = 0.933, p < 0.0001). Heat load significantly contributed to the prevalence at 52%, surpassing the contributions of UV irradiation (31%) and the decline in DNA repair capacity in the lens (17%). These results suggested that both UV radiation and heat load are associated with NUC, with heat load contributing more. Our findings provided important implications for future interventions, particularly in the context of global warming.
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Affiliation(s)
- Kotaro Kinoshita
- Department of Electrical and Mechanical Engineering, Nagoya Institute of Technology, Gokiso-Cho, Showa-Ku, Nagoya, Aichi, 466-8555, Japan
| | - Sachiko Kodera
- Department of Electrical and Mechanical Engineering, Nagoya Institute of Technology, Gokiso-Cho, Showa-Ku, Nagoya, Aichi, 466-8555, Japan
- Center of Biomedical Physics and Information Technology, Nagoya Institute of Technology, Nagoya, Japan
| | - Natsuko Hatsusaka
- Department of Ophthalmology, Kanazawa Medical University, Ishikawa, Japan
| | - Ryusuke Egawa
- School of Engineering, Tokyo Denki University, Tokyo, Japan
| | | | - Eri Kubo
- Department of Ophthalmology, Kanazawa Medical University, Ishikawa, Japan
| | - Hiroshi Sasaki
- Department of Ophthalmology, Kanazawa Medical University, Ishikawa, Japan
| | - Akimasa Hirata
- Department of Electrical and Mechanical Engineering, Nagoya Institute of Technology, Gokiso-Cho, Showa-Ku, Nagoya, Aichi, 466-8555, Japan.
- Center of Biomedical Physics and Information Technology, Nagoya Institute of Technology, Nagoya, Japan.
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5
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Paulo MS, Symanzik C, Ádam B, Gobba F, Kezic S, van der Molen HF, Peters CE, Rocholl M, Tenkate T, John SM, Loney T, Modenese A, Wittlich M. Risk of cutaneous squamous cell carcinoma due to occupational exposure to solar ultraviolet radiation: Protocol for a systematic review and meta-analysis. PLoS One 2023; 18:e0282664. [PMID: 36867594 PMCID: PMC9983864 DOI: 10.1371/journal.pone.0282664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Accepted: 02/20/2023] [Indexed: 03/04/2023] Open
Abstract
Solar ultraviolet radiation (UVR) is the most significant occupational carcinogenic exposure in terms of the number of workers exposed (i.e., outdoor workers). Consequently, solar UVR-induced skin cancers are among the most common forms of occupational malignancies that are potentially expected globally. This systematic review is registered in PROSPERO (CRD42021295221) and aims to assess the risk of cutaneous squamous cell carcinoma (cSCC) associated to occupational solar UVR exposure. Systematic searches will be performed in three electronic literature databases (PubMed/Medline, EMBASE, and Scopus). Further references will be retrieved by a manual search (e.g., in grey literature databases, internet search engines, and organizational websites). We will include cohort studies and case-control studies. Risk of Bias assessment will be conducted separately for case-control and cohort studies. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) will be used for the certainty of assessment. In case quantitative pooling is not feasible, a narrative synthesis of results will be performed.
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Affiliation(s)
- Marília Silva Paulo
- CHRC, NOVA Medical School, Faculdade de Ciências Médicas, NMS, FCM, Universidade Nova de Lisboa, Lisbon, Portugal
- Institute of Public Health, College of Medicine & Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Cara Symanzik
- Department of Dermatology, Environmental Medicine, and Health Theory, Osnabrück University, Institute for Interdisciplinary Dermatological Prevention and Rehabilitation (iDerm) at Osnabrück University, Osnabrück, Germany
| | - Balázs Ádam
- Institute of Public Health, College of Medicine & Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Fabriziomaria Gobba
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena & Reggio Emilia, Modena, Italy
| | - Sanja Kezic
- Amsterdam UMC, Department of Occupational and Public Health, University of Amsterdam, Amsterdam, The Netherlands
| | - Henk F. van der Molen
- Amsterdam UMC, Department of Occupational and Public Health, University of Amsterdam, Amsterdam, The Netherlands
| | - Cheryl E. Peters
- BC Centre for Disease Control, Vancouver, Canada
- BC Cancer, Vancouver, Canada
- University of British Columbia, Vancouver, Canada
| | - Marc Rocholl
- Department of Dermatology, Environmental Medicine, and Health Theory, Osnabrück University, Institute for Interdisciplinary Dermatological Prevention and Rehabilitation (iDerm) at Osnabrück University, Osnabrück, Germany
| | - Thomas Tenkate
- School of Occupational and Public Health, Toronto Metropolitan University, Toronto, Ontario, Canada
| | - Swen Malte John
- Department of Dermatology, Environmental Medicine, and Health Theory, Osnabrück University, Institute for Interdisciplinary Dermatological Prevention and Rehabilitation (iDerm) at Osnabrück University, Osnabrück, Germany
| | - Tom Loney
- College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
| | - Alberto Modenese
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena & Reggio Emilia, Modena, Italy
| | - Marc Wittlich
- Institute for Occupational Safety and Health of the German Social Accidents Insurance (IFA), Sankt Augustin, Germany
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Photoprotection in occupational dermatology. Photochem Photobiol Sci 2023:10.1007/s43630-023-00385-6. [PMID: 36853496 DOI: 10.1007/s43630-023-00385-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Accepted: 01/30/2023] [Indexed: 03/01/2023]
Abstract
Skin cancer has become a substantial matter of public health and in the workplace, accounting for a significant share of all reported occupational diseases. The most important external factor in the development of skin cancer is exposure to solar ultraviolet radiation. Outdoor workers have already been identified as a high-risk category. The need for interventions to improve the sun protection behavior of outdoor workers has recently been understood. Outdoor workers' risk perceptions and attitudes toward sun protection methods are likely to influence practical sun protection behavior at work, and despite the fact that many workers have expressed interest in improving their sun protection behavior, outdoor workers' unique needs are still neglected. Occupational dermatology is predicted to become more concerned with photoprotection in the decades ahead. Preventive action against the rapidly increasing number skin cancer cases is in great demand around the globe. In terms of preventive measures, the full range of available options should be used as needed to address the current difficulties in a goal-oriented way. This will almost certainly only be achievable if preventative efforts on a collective and individual level are successfully paired with support from policymakers to inspire long-term change.
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7
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Wittlich M, Westerhausen S, Strehl B, Versteeg H, Stöppelmann W. The GENESIS-UV study on ultraviolet radiation exposure levels in 250 occupations to foster epidemiological and legislative efforts to combat nonmelanoma skin cancer. Br J Dermatol 2023; 188:350-360. [PMID: 36635210 DOI: 10.1093/bjd/ljac093] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 10/26/2022] [Accepted: 11/08/2022] [Indexed: 01/14/2023]
Abstract
BACKGROUND Several hundred million of the 3 billion formally employed people worldwide are at risk from high levels of solar ultraviolet radiation (UVR). Chronic light damage to the skin can lead to nonmelanoma skin cancer (NMSC), especially when irradiation is too high and is acquired for decades. However, data with uniform metrics, high resolution over time and in-depth occupational profiles are not available. OBJECTIVES To build a worldwide usable matrix of UVR exposure in occupations and to show use cases for the data. METHODS One thousand test persons were recruited to wear electronic data logger dosimeters during their working time for 7 months each. The measurements yielded 3.7 billion data points for around 48 000 days with high-quality data capture covering more than 250 occupations and 650 activities. Scientific evaluation of the data included daily and half-hourly means, geographical transfer calculations to the world, threshold exceedance quotas, transcriptome effects, and occupational disease estimates. RESULTS A compendium for global use is presented. In-depth analyses and the resulting implications for research have been elaborated to directly link exposure data to effects in the human body. Interestingly, the annual irradiances of the different occupations span a wide range of values: from about 650 to 50 standard erythemal doses, with different distributions over the months. Detailed exposure data per occupation were derived, and the risk on an occupational or activity basis assuming different exposure level quotas was quantified. This showed that, for example, in temperate latitudes, all activities with a duration of > 2 h outdoors are associated with increased NMSC risk. CONCLUSIONS We offer our work to enable sound studies on the nature of ultraviolet-induced skin cancer, dose-response relationships, intermittency of skin exposure, and derivation of limit values. Sociological studies on prevention are now possible. Practitioners may use the findings for their daily work with employees.
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Affiliation(s)
- Marc Wittlich
- Department 'Accident Prevention: Digitalisation - Technologies'
| | | | - Benjamin Strehl
- Department 'Accident Prevention: Digitalisation - Technologies'
| | - Helmut Versteeg
- Department 'Exposure and Risk Assessment', Institute for Occupational Safety and Health of the German Social Accident Insurance, Alte Heerstraße 111, 53757 Sankt Augustin, Germany
| | - Wiho Stöppelmann
- Department 'Exposure and Risk Assessment', Institute for Occupational Safety and Health of the German Social Accident Insurance, Alte Heerstraße 111, 53757 Sankt Augustin, Germany
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8
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Symanzik C, John SM. Sun protection and occupation: Current developments and perspectives for prevention of occupational skin cancer. Front Public Health 2022; 10:1110158. [PMID: 36620257 PMCID: PMC9816330 DOI: 10.3389/fpubh.2022.1110158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Accepted: 12/12/2022] [Indexed: 12/24/2022] Open
Abstract
A substantial proportion of all reported occupational illnesses are constituted by skin cancer, making this disease a serious public health issue. Solar ultra-violet radiation (UVR) exposure is the most significant external factor in the development of skin cancer, for which the broad occupational category of outdoor workers has already been identified as high-risk group. Sun protection by deploying adequate technical, organizational, and person-related measures has to be understood as a functional aspect of workplace safety. To prevent skin cancers brought on by-typically cumulative-solar UVR exposure, outdoor workers must considerably lower their occupationally acquired solar UVR doses. Estimating cumulative sun exposure in outdoor workers requires consideration of the level of solar UVR exposure, the tasks to be done in the sun, and the employees' solar UVR preventive measures. Recent studies have highlighted the necessity for measures to enhance outdoor workers' sun protection behavior. In the coming decades, occupational dermatology is expected to pay increasing attention to sun protection at work. Also, the field of dermato-oncology will likely be concerned with sky-rocketing incidences of occupational skin cancers. The complete range of available alternatives should be utilized in terms of preventive actions, which seems pivotal to handle the present and future challenges in a purposeful manner. This will almost definitely only be possible if politicians' support is effectively combined with communal and individual preventive actions in order to spur long-term transformation.
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Affiliation(s)
- Cara Symanzik
- Institute for Interdisciplinary Dermatological Prevention and Rehabilitation (iDerm), Osnabrück University, Osnabrück, Germany,Department of Dermatology, Environmental Medicine and Health Theory, Institute for Health Research and Education (IGB), Faculty of Human Sciences, Osnabrück University, Osnabrück, Germany,*Correspondence: Cara Symanzik ✉
| | - Swen Malte John
- Institute for Interdisciplinary Dermatological Prevention and Rehabilitation (iDerm), Osnabrück University, Osnabrück, Germany,Department of Dermatology, Environmental Medicine and Health Theory, Institute for Health Research and Education (IGB), Faculty of Human Sciences, Osnabrück University, Osnabrück, Germany
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9
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Cherrie JW, Cherrie MPC. Workplace exposure to UV radiation and strategies to minimize cancer risk. Br Med Bull 2022; 144:45-56. [PMID: 35973164 PMCID: PMC9744745 DOI: 10.1093/bmb/ldac019] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 07/01/2022] [Accepted: 07/22/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND Workplace exposure to solar ultraviolet (UV) causes malignant melanoma and non-melanoma skin cancer. The evidence for beneficial effects of solar UV exposure in reducing the risks for other cancers is increasing. The intensity of UV radiation at the Earth's surface is dependent on latitude, but even in northern European countries exposure can be high enough for outdoor work to cause skin cancer. GROWING POINTS Awareness of the health risks and benefits of occupational solar UV exposure is poor. Actions to reduce the risk of skin cancer have been identified and employers should recognize their responsibility to actively manage these risks. There is evidence for reduced risks for breast, ovarian and colorectal cancer and possibly other cancers linked to solar UV exposure. SOURCES OF DATA This narrative review draws on published scientific articles and material designed to assist identifying strategies to protect workers from solar UV exposure. AREAS OF AGREEMENT Solar UV exposure can be harmful. Wavelengths in the UVB range are more effective in causing erythema and DNA damage. Solar UV is the main source of vitamin D for most people. Primary and secondary prevention for skin cancer can potentially eliminate these risks but the evidence for effectiveness is limited. AREAS OF CONTROVERSY Potential health benefits of UV exposure, particularly for reduced cancer risk. Determining and communicating optimal exposure to maximize health benefits. The risk of non-melanoma skin cancers may be more than doubled for some workers in temperate latitudes. AREAS TIMELY FOR DEVELOPING RESEARCH Exposure-response epidemiological studies; studies of the health benefits of occupational UV exposure; studies of the effectiveness of intervention strategies to prevent skin cancer. Use of low-cost UV sensors in workplaces.
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Affiliation(s)
- J W Cherrie
- IOM, Research Avenue North, Edinburgh EH14 4AP, UK.,Institute of Biological Chemistry, Biophysics and Bioengineering, Heriot Watt University, Edinburgh EH14 4AS, UK
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Grifoni D, Betti G, Bogi A, Bramanti L, Chiarugi A, Gozzini B, Morabito M, Picciolo F, Sabatini F, Miligi L. Protective Measures From Solar Ultraviolet Radiation for Beach Lifeguards in Tuscany (Italy): Shade and Clothing Strategies. Saf Health Work 2022; 13:421-428. [PMID: 36579014 PMCID: PMC9772484 DOI: 10.1016/j.shaw.2022.08.009] [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: 05/11/2022] [Revised: 07/25/2022] [Accepted: 08/29/2022] [Indexed: 12/31/2022] Open
Abstract
Background The exposure to solar ultraviolet radiation is a significant risk factor generally underestimated by outdoor workers and employers. Several studies have pointed out that occupational solar exposure increased eye and skin diseases with a considerable impact on the lives and productivity of affected workers.The main purpose of this study was to evaluate the effectiveness against ultraviolet radiation of some measures recently undertaken for the protection of lifeguards in a coastal area of Tuscany. Methods Different shading structures (gazebos and beach umbrella) were tested during a sunny summer's day on a sandy beach by means of two radiometers; the UV protection offered by some T-shirts used by lifeguards was also tested in the laboratory with a spectrophotometer. Results The analysed shading structures strongly reduced the ultraviolet radiation by up to 90%, however a not always negligible diffuse radiation is also present in the shade, requiring further protective measures (T-shirt, sunglasses, sunscreen, etc.); the tested T-shirts showed a very good-excellent protection according to the Australian/New Zealand standard. Conclusion Results obtained in this study suggest how the adoption and dissemination of good practices, including those tested, could be particularly effective as a primary prevention for lifeguards who are subjected to very high levels of radiation for long periods.
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Affiliation(s)
- Daniele Grifoni
- CNR-IBE - Institute of Bioeconomy - National Research Council, Sesto Fiorentino, Italy,LaMMA Consortium, Sesto Fiorentino, Italy,Corresponding author. Institute of Bioeconomy - National Research Council, Via Madonna del Piano, 10, 50019, Sesto Fiorentino, Italy.
| | - Giulio Betti
- CNR-IBE - Institute of Bioeconomy - National Research Council, Sesto Fiorentino, Italy,LaMMA Consortium, Sesto Fiorentino, Italy
| | - Andrea Bogi
- Physical Agents Sector, Regional Public Health Laboratory, Siena, Italy
| | - Lucia Bramanti
- AUSL North West Tuscany, Hygiene and Health at Work Unit, Prevention Department, Versilia, Italy
| | - Alessandra Chiarugi
- Screening and Secondary Prevention Unit, Institut for Cancer Research, Prevention and Clinical Network (ISPRO), Florence, Italy
| | - Bernardo Gozzini
- CNR-IBE - Institute of Bioeconomy - National Research Council, Sesto Fiorentino, Italy,LaMMA Consortium, Sesto Fiorentino, Italy
| | - Marco Morabito
- CNR-IBE - Institute of Bioeconomy - National Research Council, Sesto Fiorentino, Italy
| | | | - Francesco Sabatini
- CNR-IBE - Institute of Bioeconomy - National Research Council, Sesto Fiorentino, Italy
| | - Lucia Miligi
- Environmental and Occupational Epidemiology Branch - Cancer Risk Factors and Lifestyle Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network (ISPRO), Florence, Italy
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11
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Calvache Ruales MF, Westerhausen S, Zapata Gallo HA, Strehl B, Naza Guzman SD, Versteeg H, Stöppelmann W, Wittlich M. UVR Exposure and Prevention of Street Construction Workers in Colombia and Germany. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19127259. [PMID: 35742508 PMCID: PMC9223545 DOI: 10.3390/ijerph19127259] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 06/09/2022] [Accepted: 06/11/2022] [Indexed: 12/10/2022]
Abstract
(1) Solar ultraviolet radiation (UVR) poses a major risk factor for developing skin cancer after years of chronic exposure. The irradiation is strongly dependent upon the activity or occupation carried out, but also on the climate conditions at the workplace. Knowledge of both has been tested within the occupational group of road construction workers in Colombia and Germany. (2) The GENESIS-UV measurement system has been used at both locations for consistency. A number of workers in both countries wore an electronic data logging dosimeter for several months to deliver detailed information on UVR exposure. (3) It was found that in a tropical climate, UVR exposure remains constant throughout the year, while in a temperate climate seasonal effects are visible, superimposed by behavioural aspects e.g., in springtime. The daily distribution of the radiation shows a distinct dip, especially in the Colombian data. Derived data show the high fraction of working days exceeding a threshold set by the skin type. (4) Road construction work involves high UVR exposure. In both countries, preventive measures are required to reduce the personal exposure to a minimum. Exceedance of the minimal erythema dose (MED) suggests a possible enhancing effect, especially in fair skinned people. Intercomparison of UVR exposure at workplaces is possible between countries and climate zones, emphasizing efforts for global action against skin cancer.
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Affiliation(s)
| | - Stephan Westerhausen
- Department of Ergonomics: Physical Environmental Factors, Institute for Occupational Safety and Health of the German Social Accident Insurance, D-53757 Sankt Augustin, Germany;
| | | | - Benjamin Strehl
- Department Accident Prevention: Digitalisation—Technologies, Institute for Occupational Safety and Health of the German Social Accident Insurance, D-53757 Sankt Augustin, Germany;
| | - Sergio D. Naza Guzman
- Risk Management Consultancy CGR, SURA, Cali 760046, Colombia; (M.F.C.R.); (S.D.N.G.)
| | - Helmut Versteeg
- Department Exposure and Risk Assessment, Institute for Occupational Safety and Health of the German Social Accident Insurance, D-53757 Sankt Augustin, Germany; (H.V.); (W.S.)
| | - Wiho Stöppelmann
- Department Exposure and Risk Assessment, Institute for Occupational Safety and Health of the German Social Accident Insurance, D-53757 Sankt Augustin, Germany; (H.V.); (W.S.)
| | - Marc Wittlich
- Department Accident Prevention: Digitalisation—Technologies, Institute for Occupational Safety and Health of the German Social Accident Insurance, D-53757 Sankt Augustin, Germany;
- Correspondence: ; Tel.: +49-(0)30-13001-3500
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12
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National and subnational burden of disease attributable to occupational exposure to solar ultraviolet radiation (SUVR) in Iran, 2005-2019. Int J Hyg Environ Health 2021; 240:113897. [PMID: 34861595 DOI: 10.1016/j.ijheh.2021.113897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2021] [Revised: 11/24/2021] [Accepted: 11/27/2021] [Indexed: 11/22/2022]
Abstract
Overexposure to solar ultraviolet radiation (SUVR) can cause skin and eye adverse effects for outdoor workers. In this study, the burden of disease induced by occupational exposure to SUVR and its spatiotemporal trend at national and sub-national levels in Iran, 2005-2019 were assessed. The attributable burden of disease was assessed using the following five datasets: (1) distribution of occupational exposure to SUVR, (2) total incidences and deaths of health outcomes of SUVR exposure, (3) population attributable fractions of the health outcomes of SUVR exposure, (4) age-gender distribution of outdoor workers, and (5) disability-adjusted life year (DALY) calculation constants. During 2005-2019, the attributable DALYs increased from 2442 to 2907 and the attributable DALY rate (per 100,000 workers) slightly decreased from 11.94 to 11.91. The share of YLL in the attributable burden of disease was in the range of 43%-46%. Out of nine causes, about 90% of the attributable burden of disease in 2019 was related to cataracts (29.9%), malignant skin melanoma (27.4%), squamous-cell carcinoma (18.6%), and sunburn (17.2%). During the study period, the attributable DALY rate in women increased by 60.95% (from 5.04 to 8.11) and in men decreased by 2.06% (from 13.03 to 12.76). The total attributable DALYs and DALY rate rose by age during 2005-2019. The contributions of population growth, risk-deleted DALY rates, exposure risk, and population age structure in temporal changes of the attributable burden of disease were 19.27%, 9.13%, -1.35%, and -14.8%, respectively. The three highest attributable DALY rates in 2019 were observed in South Khorasan (21.28), Chahar Mahal and Bakhtiari (17.42), and Kordestan (17.26), respectively. The preventive interventions against SUVR overexposure, regular screenings, and early treatments with an emphasis on occupations with continuous sun exposure and provinces with increasing attributable DALY rates should be considered in the occupational health action plan in the country.
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13
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Soueid L, Triguero-Mas M, Dalmau A, Barrera-Gómez J, Alonso L, Basagaña X, Thieden E, Wulf HC, Diffey B, Young AR, Nieuwenhuijsen M, Dadvand P. Estimating personal solar ultraviolet radiation exposure through time spent outdoors, ambient levels and modelling approaches. Br J Dermatol 2021; 186:266-273. [PMID: 34403140 DOI: 10.1111/bjd.20703] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/13/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Evidence on validation of surrogates applied to evaluate the personal exposure levels of solar ultraviolet radiation (UVR) in epidemiological studies is scarce. OBJECTIVES To determine and compare the validity of three approaches, including (i) ambient UVR levels, (ii) time spent outdoors, and (iii) a modelling approach integrating the aforementioned parameters, to estimate personal UVR exposure over a period of six months among indoor and outdoor workers and in different seasons (summer/winter). METHODS This validation study was part of the EU ICEPURE project and was performed between July 2010 and January 2011 in a convenience sample of indoor and outdoor workers in Catalunya - Spain. We developed linear regression models to quantify the variation in the objectively measured personal UVR exposure that could be explained, separately, by the ambient UVR, time spent outdoors, and modelled UVR levels. RESULTS Our 39 participants - mostly male and with a median age of 35 years- presented a median daily objectively measured UVR of 0.37 standard erythemal doses (SEDs). The UVR dose was statistically significantly higher in summer and for outdoor workers. The modelled personal UVR exposure and self-reported time spent outdoors could reasonably predict the variation in the objectively measured personal UVR levels (R2 = (0.75, 0.79)), whereas ambient UVR was a poor predictor (R2 =0.21). No notable differences were found between seasons or occupation. CONCLUSIONS Time outdoors and our modelling approach were reliable predictors and of value to be applied in epidemiological studies of the health effects of current exposure to UVR.
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Affiliation(s)
- L Soueid
- Barcelona Institute of Global Health (ISGlobal), Barcelona, Spain.,Universitat Pompeu Fabra (UPF), Barcelona, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | - M Triguero-Mas
- Barcelona Institute of Global Health (ISGlobal), Barcelona, Spain.,Universitat Pompeu Fabra (UPF), Barcelona, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain.,Universitat Autònoma de Barcelona, Barcelona, Spain.,Lab for Urban Environmental Justice and Sustainability, Barcelona, Spain.,Institute of Environmental Science and Technology, ICTA-UAB), Barcelona, Spain.,Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
| | - A Dalmau
- Barcelona Institute of Global Health (ISGlobal), Barcelona, Spain.,Universitat Pompeu Fabra (UPF), Barcelona, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain.,Agència de Qualitat i Avaluació Sanitàries de Catalunya (AQuAS), Barcelona, Spain
| | - J Barrera-Gómez
- Barcelona Institute of Global Health (ISGlobal), Barcelona, Spain.,Universitat Pompeu Fabra (UPF), Barcelona, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | - L Alonso
- Barcelona Institute of Global Health (ISGlobal), Barcelona, Spain.,Universitat Pompeu Fabra (UPF), Barcelona, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | - X Basagaña
- Barcelona Institute of Global Health (ISGlobal), Barcelona, Spain.,Universitat Pompeu Fabra (UPF), Barcelona, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | - E Thieden
- Department of Dermatology, Bispebjerg Hospital, Copenhagen, Denmark
| | - H C Wulf
- Department of Dermatology, Bispebjerg Hospital, Copenhagen, Denmark
| | - B Diffey
- Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, England, UK
| | - A R Young
- King's College London, St John´s Institute of Dermatology, London, United Kingdom
| | - M Nieuwenhuijsen
- Barcelona Institute of Global Health (ISGlobal), Barcelona, Spain.,Universitat Pompeu Fabra (UPF), Barcelona, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | - P Dadvand
- Barcelona Institute of Global Health (ISGlobal), Barcelona, Spain.,Universitat Pompeu Fabra (UPF), Barcelona, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
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14
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Rocholl M, Weinert P, Bielfeldt S, Laing S, Wilhelm KP, Ulrich C, John SM. New methods for assessing secondary performance attributes of sunscreens suitable for professional outdoor work. J Occup Med Toxicol 2021; 16:25. [PMID: 34225747 PMCID: PMC8256554 DOI: 10.1186/s12995-021-00314-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Accepted: 06/23/2021] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Outdoor workers (OW) are highly exposed to solar ultraviolet radiation (UVR) and thus at increased risk for developing skin cancer. An essential part of an overall strategy to reduce workplace UVR-exposure to OW's skin is the usage of sunscreens. However, compliance with regular sunscreen usage seems to be low, as products are usually designed for recreational sun exposure and thus do not meet the requirements of physically active OW. To date, no standardized test procedures assess the suitability of sunscreens for professional use. The aim of this pilot study was to develop standardized methods of testing secondary performance attributes (PA) to represent real-life working conditions of outdoor work. METHODS Ten sunscreen products, carefully selected after a detailed market survey of all relevant producers available on the German market, were evaluated regarding their suitability for professional outdoor work on 24 healthy volunteers in a newly designed test procedure. In addition to three standardized efficacy characteristics, i.e., sun protection factor, water-resistance, and UVA protection, we evaluated each PA involving parameters typically associated with outdoor workplaces. RESULTS We developed standardized methods for objectifying the suitability of sunscreen products for professional outdoor work. The test procedures used are well feasible and appropriate for testing the PA because they represent practical working conditions in detail - although the degree of discriminability of single test methods varied. The claimed sun protection factor (SPF) of the products was confirmed; bio-stability of the SPF after physical activity was achieved in most cases. While most products hardly irritate the eyes and are quickly absorbed, the evaluation of the subjective skin feeling and non-slip grip is inconsistent. CONCLUSIONS In this pilot study, for the first time secondary PA are defined and examined. Although further objectification of the PA assessment as well as the establishment of minimum standards should be sought, the new methods could already complement the so far mandatory labels and in this way provide a significant impetus for the current scientific and political focus on the improvement of occupational health in highly UVR-exposed OW.
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Affiliation(s)
- Marc Rocholl
- Institute for Health Research and Education, Department of Dermatology, Environmental Medicine and Health Theory, University of Osnabrück, Am Finkenhügel 7a, 49076, Osnabrück, Germany. .,Institute for Interdisciplinary Dermatological Prevention and Rehabilitation (iDerm) at the University of Osnabrück, Am Finkenhügel 7a, 49076, Osnabrück, Germany.
| | - Patricia Weinert
- Institute for Interdisciplinary Dermatological Prevention and Rehabilitation (iDerm) at the University of Osnabrück, Am Finkenhügel 7a, 49076, Osnabrück, Germany
| | - Stephan Bielfeldt
- proDERM Institute of Applied Dermatological Research GmbH, Kiebitzweg 2, 22869, Schenefeld, Hamburg, Germany
| | - Sabrina Laing
- proDERM Institute of Applied Dermatological Research GmbH, Kiebitzweg 2, 22869, Schenefeld, Hamburg, Germany
| | - Klaus Peter Wilhelm
- proDERM Institute of Applied Dermatological Research GmbH, Kiebitzweg 2, 22869, Schenefeld, Hamburg, Germany
| | - Claas Ulrich
- Department of Dermatology and Allergy, Skin Cancer Center, Charité-Universitätsmedizin, Charitéplatz 1, 10117, Berlin, Germany
| | - Swen Malte John
- Institute for Health Research and Education, Department of Dermatology, Environmental Medicine and Health Theory, University of Osnabrück, Am Finkenhügel 7a, 49076, Osnabrück, Germany.,Institute for Interdisciplinary Dermatological Prevention and Rehabilitation (iDerm) at the University of Osnabrück, Am Finkenhügel 7a, 49076, Osnabrück, Germany
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15
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Abstract
During leisure time, people can decide if they want to expose themselves to solar ultraviolet (UV) radiation and to what extent. While working, people do not have this choice. Outdoor workers are exposed to solar UV radiation (UVR) on a daily basis. This may pose a certain health risk, which can be estimated when the personal solar UVR exposure (PE) is known. During past decades, a variety of studies were conducted to measure PE of outdoor workers and our knowledge of the PE of outdoor workers has increased remarkably. As shown by this review, studies clearly indicate that PE of most outdoor workers exceeds the internationally proposed threshold limit value, which is comparable to 1.0 to 1.3 standard erythema dose (SED), respectively, to 1.1 to 1.5 UV Index received over one hour. Besides working in a high UVR environ, monotonic workflow (limited movement, nearly static posture) is a risk factor. In such cases, PE can be higher than ambient UVR. In this review, we provide also a list of milestones, depicting the progress and the most important findings in this field during the past 45 years. However, in many respects our knowledge is still rudimentary, for several reasons. Different measuring positions have been used so that measured PE is not comparable. Few studies were designed to enable the extension of measured PE to other locations or dates. Although the importance of a proper calibration of the measuring devices in respect to the changing solar spectrum was pointed out from the beginning, this is often not performed, which leads to high uncertainties in the presented PE levels. At the end of our review, we provide some key points, which can be used to evaluate the quality of a study respectively to support the design of future studies.
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16
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Vuilleumier L, Harris T, Nenes A, Backes C, Vernez D. Developing a UV climatology for public health purposes using satellite data. ENVIRONMENT INTERNATIONAL 2021; 146:106177. [PMID: 33189989 DOI: 10.1016/j.envint.2020.106177] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Revised: 09/30/2020] [Accepted: 09/30/2020] [Indexed: 06/11/2023]
Abstract
The effects of solar ultraviolet (UV) radiation on life on Earth differ greatly. While overexposure to UV rays is harmful, small amounts of exposure are necessary for the synthesis of Vitamin D and good health. To optimize individual exposure to solar UV, it is therefore crucial to use UV data sources representative for entire populations and realistically accounting for various influencing factors. A UV climatology for Switzerland based on satellite data has been developed to provide risk estimates at population level. An algorithm generating ground-based radiation estimate has been transformed from the visible to the UV wavelength domain by adapting both a clear-sky radiation transfer model and a cloud modification factor model using satellite imagery. The algorithm allows the computation of global UV erythemal irradiance at a spatial resolution of 1.5 - 2 km and an hourly temporal resolution over fifteen years. A validation, conducted with measurements from three meteorological stations over ten years, showed that the expanded uncertainty for low hourly UVI values (UVI < 3) is about ± 0.3, while for high hourly UVI values (UVI > 6) it can go up to ± 1.5. In clear-sky situation, the uncertainty is in the range of 10-15%. The climatology developed allows to visualise potential UV exposure at regional and national scale. National prevention intervention could use new strategies to better focus on populations at risk and better tailor available researches. The UV climatology allows a high versatility in adapting the data extraction to the goal of studies using it. Further tailored data extraction and analysis will be necessary to exploit this climatology in a wide range of environmental and occupational health applications. Its development was focused on Switzerland, but the techniques used can be extended globally.
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Affiliation(s)
- Laurent Vuilleumier
- Federal Office of Meteorology and Climatology (MeteoSwiss), Payerne, Switzerland.
| | - Todd Harris
- Laboratory of Atmospheric Processes and their Impacts, School of Architecture, Civil and Environmental Engineering, Swiss Institute of Technology, Lausanne, Switzerland.
| | - Athanasios Nenes
- Laboratory of Atmospheric Processes and their Impacts, School of Architecture, Civil and Environmental Engineering, Swiss Institute of Technology, Lausanne, Switzerland; Institute of Chemical Engineering Sciences, Foundation for Research and Technology Hellas, Patras, Greece.
| | - Claudine Backes
- Center for Public Health and Primary Care Medicine (Unisanté), University of Lausanne, Switzerland.
| | - David Vernez
- Center for Public Health and Primary Care Medicine (Unisanté), University of Lausanne, Switzerland.
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John SM, Garbe C, French LE, Takala J, Yared W, Cardone A, Gehring R, Spahn A, Stratigos A. Improved protection of outdoor workers from solar ultraviolet radiation: position statement. J Eur Acad Dermatol Venereol 2020; 35:1278-1284. [PMID: 33222341 DOI: 10.1111/jdv.17011] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Accepted: 10/15/2020] [Indexed: 12/26/2022]
Abstract
The vast majority of non-melanoma skin cancer (NMSC) is attributable to excessive exposure to ultraviolet radiation (UVR). Outdoor workers are exposed to an UVR dose at least 2 to 3 times higher than indoor workers and often to daily UVR doses 5 times above internationally recommended limits. The risk of UVR workplace exposure is vastly neglected, and the evident future challenges presented in this statement are contrasted with the current situation regarding legal recognition, patient care and compensation. While prevention is crucial to reduce cancer risks for outdoor workers, it is as much of relevance to better protect them through legally binding rules and regulations. Specific actions are outlined in five recommendations based on a Call to Action (table 1). The role of health professionals, including dermatologists, in this context is crucial.
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Affiliation(s)
- S M John
- EADV Task Force Occupational Skin Diseases and Dept. Dermatology, Environmental Medicine, University of Osnabrueck, Osnabrueck, Germany
| | - C Garbe
- European Association of Dermato Oncology (EADO) and Department of Dermatology, Eber, hard Karls University, Tübingen, Germany
| | - L E French
- International League of Dermatological Societies (ILDS) and Department of Dermatology, University Hospital, Ludwig-Maximilians-University of Munich, Munich, Germany
| | - J Takala
- International Commission on Occupational Health (ICOH), University of Tampere, Tampere, Finland
| | - W Yared
- European Cancer Leagues (ECL), Brussels, Belgium
| | - A Cardone
- European Cancer Patient Coalition (ECPC), Brussels, Belgium
| | - R Gehring
- Safety and Health, European Federation Building and Woodworkers (EFBWW), Brussels, Belgium
| | - A Spahn
- Agriculture Section, European Federation of Food, Agriculture and Tourism Trade Unions (EFFAT), Brussels, Belgium
| | - A Stratigos
- European Academy of Dermatology and Venereology (EADV) and Dept. Dermatology, National and Kapodistrian University of Athens, Athens, Greece
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18
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Rydz E, Harper A, Leong B, Arrandale VH, Kalia S, Forsman-Phillips L, Holness DL, Tenkate T, Peters CE. Solar ultraviolet radiation exposure among outdoor workers in Alberta, Canada. ENVIRONMENTAL RESEARCH 2020; 189:109902. [PMID: 32980002 DOI: 10.1016/j.envres.2020.109902] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 06/29/2020] [Accepted: 06/30/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Outdoor workers are at risk of prolonged and high solar ultraviolet radiation (UVR) exposure, which is known to cause skin cancer. The objectives of this study were to characterize the UVR exposure levels of outdoor workers in Alberta, Canada, and to investigate what factors may contribute to their exposure. METHODS This study collected objective solar UVR measurements from outdoor workers primarily in Alberta during the summer of 2019. Workers were recruited via the management or health and safety teams from building trade unions and employers. Calibrated, electronic UVR dosimeters were worn by workers on their hardhats, wrists, or lapels for five working days. Data on workers' demographics, jobs, sun protection behaviors, and personal risk factors were collected using questionnaires, and meteorological data for each sampling day were noted. Mean daily exposure measured as the standard erythemal dose (SED) was calculated and compared to the international occupational exposure limit guideline (1.3 SED). Marginal models were developed to evaluate potential determinants of occupational solar UVR exposure. RESULTS In total, 883 measurements were collected from 179 workers. On average, workerswere exposed to 1.93 SED (range: 0.03-16.63 SED) per day. Just under half of workers (45%) were exposed to levels exceeding the international exposure limit guideline. In the bivariate analyses, landscape and maintenance workers, as well as trade and recreation workers, had the highest levels of exposure (average: 2.64 and 1.84 SED, respectively). Regional variations were observed, with the "other" cities/regions (outside of Edmonton and Calgary) experiencing the highest average levels (2.60 SED). Workers who placed the dosimeters on their hardhats experienced higher levels compared to the other groups. Exposure was highest on sunny and mixed days. Education, trade, city, dosimeter placement, forecast, hair colour, and number of hours outside were included in the final exposure model, of which trade, dosimeter placement, forecast, and number of hours outside at work were statistically significant. CONCLUSIONS Exposure to elevated solar UVR levels is common among outdoor workers in Alberta. The study findings can help inform future monitoring studies and exposure reduction initiatives aimed at protecting workers.
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Affiliation(s)
- Ela Rydz
- CAREX Canada, Simon Fraser University, Vancouver, BC, Canada
| | - Andrew Harper
- Cancer Epidemiology and Prevention Research, CancerControl Alberta, Alberta Health Services, Calgary, AB, Canada
| | - Brandon Leong
- Cancer Epidemiology and Prevention Research, CancerControl Alberta, Alberta Health Services, Calgary, AB, Canada
| | - Victoria H Arrandale
- Occupational Cancer Research Centre, Cancer Care Ontario, Toronto, ON, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Sunil Kalia
- Department of Dermatology and Skin Science, University of British Columbia, Vancouver, BC, Canada; Photomedicine Institute and Centre for Clinical Epidemiology and Evaluation, Vancouver Coastal Health Research Institute, Vancouver, BC, Canada; Department of Cancer Control, BC Cancer, and Division of Dermatology, BC Children's Hospital, Provincial Health Services Authority, Vancouver, BC, Canada
| | | | - Dorothy Linn Holness
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada; Department of Medicine, University of Toronto, Toronto, ON, Canada; Department of Medicine and MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada
| | - Thomas Tenkate
- School of Occupational and Public Health, Ryerson University, Toronto, ON, Canada
| | - Cheryl E Peters
- CAREX Canada, Simon Fraser University, Vancouver, BC, Canada; Cancer Epidemiology and Prevention Research, CancerControl Alberta, Alberta Health Services, Calgary, AB, Canada; Department of Oncology, Cumming School of Medicine, University of Calgary, Health Sciences Centre - Foothills Campus, Calgary, AB, Canada.
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19
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Butacu AI, Wittlich M, John SM, Zurac S, Dascalu M, Moldovan H, Tiplica GS. Is Occupational Skin Cancer More Aggressive than Sporadic Skin Cancer? MAEDICA 2020; 15:155-161. [PMID: 32952678 PMCID: PMC7482692 DOI: 10.26574/maedica.2020.15.2.155] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Background: Non-melanoma skin cancer (NMSC) represents the most frequently diagnosed cancer in humans. Occupational solar UV radiation exposure is associated with a higher-risk of developing NMSC, but still Romania does not acknowledge this affliction as an occupational disease. The study aims to determine if occupationally-induced NMSC is associated with more aggressive clinical and histopathological features compared to sporadic NMSC. Material and methods: A retrospective, analytical, comparative study was conducted during 2017-2019 in a University Department of Dermato-venereology in Bucharest, Romania, with focus on patients presenting with NMSC who underwent surgical excision of lesions followed by histopathological examination, classified as outdoor or indoor workers. High-risk clinical and histopathological characteristics were analysed and correlated with outdoor UV exposure. Outcomes: The study included 51 consecutive patients diagnosed with NMSC, of which 25 outdoor workers (OW) and 26 controls as indoor workers with no occupational UV exposure background. OW presented with 21 BCC and four SCC, while controls with 22 BCC and four SCC. Males were predominant in both groups and most patients came from urban environment. The mean age value was lower for the OW group compared to controls. OW had a 4.66 times higher risk of developing NMSC with aggressive location and size χ² (1, N=51) = 6.246, p=0.013, OR=4.66 (95% CI: 1.34, 16.23) and a 24-fold risk of developing NMSC with clinically poorly defined margins χ² (1, N=51) = 21.697, p<0.001, OR=24.44 (95% CI: 5.38,110.92). The risk of developing a high-risk histopathological subtype was 15 times greater for OW χ² (1, N=51) = 13.814, p<0.001, OR=15.27 (95% CI: 2.94,79.08). Moderate to severe desmoplastic reaction was 8.57 more frequent in controls χ² (1, N=51) = 12.244, p=0.001, OR=8.57 (95% CI: 2.42, 30.30). Grades 2 and 3 of actinic elastosis were significantly associated with outdoor work (χ² (1, N=51) = 33.382, p<0.001, OR=131.25 (95% CI: 13.60, 1266.37). The presence of ulceration and pigment association of tumors on the histopathological report were not significantly associated with outdoor working. Conclusion: 1. Occupational NMSC in Romania is associated with high-risk clinical features; 2. Poorly defined borders is a significant clinical high-risk factor associated with occupational UV exposure in NMSC; 3. High-risk histopathological subtypes are more frequently encountered in outdoor workers diagnosed with NMSC compared to indoor workers with no occupational UV exposure background; 4. Occupational NMSC is associated with significantly higher grades of desmoplastic reaction and of actinic elastosis compared to indoor workers.
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Affiliation(s)
- Alexandra-Irina Butacu
- Dermatology Reseach Unit, Colentina Clinical Hospital, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
| | - Marc Wittlich
- Institute for Occupational Safety and Health of the German Social Accident Insurance, Sankt Augustin, Germany
| | - Swen Malte John
- Department of Dermatology, Environmental Medicine and Health Theory, University of Osnabrück, Osnabrück, Germany
| | - Sabina Zurac
- Department of Pathology, Colentina Clinical Hospital, Bucharest, Romania
| | - Mihai Dascalu
- "Politehnica" University, Faculty of Automatic Control and Computers, Bucharest, Romania
| | - Horatiu Moldovan
- University of Medicine, Pharmacy, Science & Technology of Targu-Mures, Department of Occupational Medicine, Targu Mures, Romania
| | - George-Sorin Tiplica
- 2nd Department of Dermatology, Colentina Clinical Hospital, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
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