Skin cancer and welding

Recommendations From a Chinese-Language Survey of Knowledge and Prevention of Skin Cancer Among Chinese Populations Internationally: Cross-sectional Questionnaire Study

BACKGROUND

There is a paucity of studies assessing awareness and prevention of skin cancer among Chinese populations.

OBJECTIVE

The aim of the study is to compare attitudes and practices regarding skin cancer risks and prevention between Chinese Asian and North American Chinese populations and between Fitzpatrick scores.

METHODS

A cross-sectional, internet-based, 74-question survey in Chinese was conducted focusing on Han Chinese participants internationally. The survey included Likert-type scales and multiple-choice questions. All participants were required to read Chinese and self-identify as being 18 years or older and Chinese by ethnicity, nationality, or descent. Participants were recruited on the internet over a 6-month period from July 2017 through January 2018 via advertisements in Chinese on popular social media platforms: WeChat, QQ, Weibo, Facebook, and Twitter.

RESULTS

Of the 113 completed responses collected (participation rate of 65.7%), 95 (84.1%) were ethnically Han Chinese, of which 93 (96.9%) were born in China and 59 (62.1%) were female. The mean age of these 95 participants was 35.8 (SD 13.3) years; 72 (75.8%) participants were born after 1975. Few but more North American Chinese reported that Chinese Asian populations received annual skin checks (4/30, 4.2% vs 0/65, 0%; P=.009) and believed that their clinician provided adequate sun safety education (13/30, 43.3% vs 15/65, 23.1%; P=.04). Participants with higher Fitzpatrick scores less frequently received sun safety education from a clinician (4/34, 11.8% vs 22/61, 36.1%; P=.02). More participants with lower Fitzpatrick scores used sunscreen (41/61, 67.2% vs 16/34, 47.1%; P=.05), but alternative sun protection use rates are similar across groups.

CONCLUSIONS

Cultural differences and Fitzpatrick scores can affect knowledge and practices with respect to sun protection and skin cancer among social media-using Chinese Asian and North American Chinese communities based on respondent demographics. Most participants in all groups understood that people of color have some risk of skin cancer, but >30% of all groups across regions and Fitzpatrick scores are unaware of current skin protection recommendations, receive insufficient sun safety education, and do not use sunscreen. Outreach efforts may begin broadly with concerted public and private efforts to train and fund dermatologists to perform annual total body skin exams and provide more patient education. They should spark community interest through mass media and empower Chinese people to perform self-examinations and recognize risks and risk mitigation methods.

The sociological basis of the skin cancer epidemic

Given the precipitous rise in its incidence in recent decades, skin cancer has been recognized as a growing epidemic. We explore the sociological underpinnings of this epidemic, including: (1) aging of the demographic; (2) human ecologic factors (residing in areas with high ambient ultraviolet levels and a depleted ozone layer); (3) large-scale European migration to more equatorial latitudes; (4) social structures that for centuries minimized miscegenation and maximized segregation; (5) gender-based differences in sunbathing, tanning, sunscreen use, and clothing choice; (6) occupational ultraviolet exposure; (7) the complex interplay of socioeconomic status, race, and urbanization on skin cancer incidence and mortality; (8) the effects of war on skin cancer incidence; (9) cultural shifts in clothing, travel, outdoor sports, recreation, and attitudes towards being tan; and (10) the indirect effects of religion. We show that without these sociological factors, the most common type of cancer would not be nearly as common.

Wearable Light Sensors Based on Unique Features of a Natural Biochrome

Overexposure to complete solar radiation (combined ultraviolet, visible, and infrared) is correlated with several harmful biological consequences including hyperpigmentation, skin cancer, eye damage, and immune suppression. With limited effective therapeutic options available for these conditions, significant efforts have been directed toward promoting preventative habits. Recently, wearable solar radiometers have emerged as practical tools for managing personal exposure to sunlight. However, designing simple and inexpensive sensors that can measure energy across multiple spectral regions without incorporating electronic components remains challenging, largely due to inherent spectral limitations of photoresponsive indicators. In this work, we report the design, fabrication, and characterization of wearable radiation sensors that leverage an unexpected feature of a natural biochrome, xanthommatin-its innate sensitivity to both ultraviolet and visible through near-infrared radiation. We found that xanthommatin-based sensors undergo a visible shift from yellow to red in the presence of complete sunlight. This color change is driven by intrinsic photoreduction of the molecule, which we investigated using computational modeling and supplemented by radiation-driven formation of complementary reducing agents. These sensors are responsive to dermatologically relevant doses of erythemally weighted radiation, as well as cumulative doses of high-energy ultraviolet radiation used for germicidal sterilization. We incorporated these miniature sensors into pressure-activated microfluidic systems to illustrate on-demand activation of a wearable and mountable form factor. When taken together, our findings encompass an important advancement toward accessible, quantitative measurements of UVC and complete solar radiation for a variety of use cases.

Optical performance of welding curtains and existing standards

Welding curtains and screens are intended to protect workers, other than the welder, from the effects of optical radiation generated by the welding process. The national and international standards for welding screens and curtains have different requirements. The aim is to compare the protection requirements of examples of welding curtain material and to assess compliance with the international and national standards. Spectral transmittance values (ultraviolet, visible, and infrared) of 21 samples were obtained from the records of an ISO/IES 17025 accredited test laboratory and performance/compliance was assessed according to each of the standards. In the ultraviolet, 10 samples passed and seven failed all standards. In the visible/infrared region, four samples passed and 10 failed all standards. Four samples passed the U.S. and international standards but failed the Australian/New Zealand standard in the blue-light transmittance requirement. One sample failed both the U.S. and Australian/New Zealand standards but the result for the international standard was borderline, one sample passed ISO but failed the blue-light requirements, and one failed ISO but passed the blue-light requirements. The derivations of the various requirements are not well documented. The Australia/New Zealand standard is significantly more stringent in the ultraviolet and blue-light regions. A review of the optical radiation hazards and revision of the standards are indicated. It is possible that curtains, other than those tested, that comply with the international standard might transmit hazardous levels of blue light and, conversely, adequate ultraviolet and blue-light protection is available with curtains that do not comply with the international standard.

Effect of Fish Bone Bioactive Peptides on Oxidative, Inflammatory and Pigmentation Processes Triggered by UVB Irradiation in Skin Cells

In the present study, we evaluated for the first time the photoprotective effect of fish bone bioactive peptides (FBBP) preparation isolated from silver carp (Hypophthalmichthys molitrix) discarded tissue using in vitro experimental models of skin cells exposed to ultraviolet B (UVB) irradiation and stressing agents. FBBP preparation was obtained by papain treatment of minced bones and centrifugal ultrafiltration, and the molecular weight (MW) distribution was characterized by size exclusion and reversed-phase high performance liquid chromatography (RP-HPLC). In vitro assessment of the effect of FBBP pretreatment in UVB-irradiated L929 fibroblasts and HaCaT keratinocytes revealed their cytoprotective activity. Their capacity to efficiently reduce reactive oxygen species (ROS) production and lipid peroxidation varied in a dose-dependent manner, and it was greater in fibroblasts. A decrease of proinflammatory cytokines secretion, in particular of tumor necrosis factor alpha (TNF-α), was found after FBBP pretreatment of THP-1-derived inflamed macrophages. Melanin production and tyrosinase activity investigated in UVB-irradiated Mel-Juso cells were lowered in direct relation to FBBP concentrations. FBBP fractions with high radical scavenging activity were separated by ion exchange chromatography, and two collagenic sequences were identified. All these results offer new scientific data on aquaculture fish bone-derived peptides confirming their ability to control the antioxidant, anti-inflammatory and pigmentation processes developed during UV irradiation of skin cells and recommend their use as valuable natural ingredients of photoprotective cosmeceutical products.

Telomeres in toxicology: Occupational health

The ends of chromosomes shorten at each round of cell division, and this process is thought to be affected by occupational exposures. Occupational hazards may alter telomere length homeostasis resulting in DNA damage, chromosome aberration, mutations, epigenetic alterations and inflammation. Therefore, for the protection of genetic material, nature has provided a unique nucleoprotein structure known as a telomere. Telomeres provide protection by averting an inappropriate activation of the DNA damage response (DDR) at chromosomal ends and preventing recognition of single and double strand DNA (ssDNA and dsDNA) breaks or chromosomal end-to-end fusion. Telomeres and their interacting six shelterin complex proteins in coordination act as inhibitors of DNA damage machinery by blocking DDR activation at chromosomes, thereby preventing the occurrence of genome instability, perturbed cell cycle, cellular senescence and apoptosis. However, inappropriate DNA repair may result in the inadequate distribution of genetic material during cell division, resulting in the eventual development of tumorigenesis and other pathologies. This article reviews the current literature on the association of changes in telomere length and its interacting proteins with different occupational exposures and the potential application of telomere length or changes in the regulatory proteins as potential biomarkers for exposure and health response, including recent findings and future perspectives.

Ultraviolet Radiation Exposure: Some Observations and Considerations, Focusing on Some Italian Experiences, on Cancer Risk, and Primary Prevention

Solar ultraviolet radiation may cause acute and chronic health effects on the skin, eyes, and also on the immune system. Actinic keratosis, non-melanoma skin cancers, and malignant melanoma are the main long-term adverse skin effects. In the white population, the most common type of cancer worldwide is skin cancer, and the incidence of this cancer has increased during the last decades. The most important risk factor responsible for this trend seems to be Ultraviolet Radiation (UVR). IARC has classified UVR as being carcinogenic to humans. UV radiation exposure is ubiquitous; to study skin cancer risk, it is important to take into account the fact that UV exposure may occur both for occupational activities but also during vacation or recreational activities. Furthermore, exposure to artificial UVR such as those emitted by artificial devices, classified by IARC as carcinogenic to humans, is also to be considered. Due to the prominent role of UVR, primary prevention of skin cancer is very suitable, because when following specific rules this risk factor can be reduced. The incidence rate of skin cancer is higher in people with fair skin. Outdoor workers exposed to solar UVR are at risk of developing skin cancer, particularly non-melanoma skin cancers, and welders exposed to artificial UVR are at risk of developing ocular melanoma. A specific project on solar UVR risk in outdoor workers in Tuscany, Italy, has shown that outdoor workers had an unsatisfactory sun protection behaviour. The project demonstrates the complexity of studying UVR exposure and recommended the need for prevention programs. Risk increases with increasing ambient solar radiation and with unsafe behaviours in the sun or when using artificial UVR (e.g., sunbeds). Effective prevention strategies have to be adopted both for the outdoor workers and for the general population exposed to UVR. A standardized program of proven efficacy, such as that implemented in Australia, should also be implemented in other countries. All these strategies could contribute to the aim of decreasing the morbidity and mortality of cancers associated with this exposure. The aim of this paper is to provide an overview of UVR exposure risk, particularly occupational risk, and to give some elements to understand the complexity of the relation between UVR exposure and cancer risk, as well as to outline primary prevention measures, focusing also on Italian experiences that could be useful for providing additional elements of knowledge on this topic.

Epidemiology and Risk Factors of Melanoma

The incidence of melanoma continues to increase worldwide. In the United States, melanoma is the fifth most common cancer in men and the sixth most common cancer in women. The risk factors contributing to melanoma have largely remained unchanged, but there is a new focus on modifiable risk factors including sun exposure and ultraviolet light. A large public initiative supported by the Centers for Disease Control focuses on educating the public on the risks of sun exposure and indoor tanning. Early detection and resection of melanoma lesions is necessary to prevent metastasis and reduce medical costs.

Skin cancer in outdoor workers exposed to solar radiation: a largely underreported occupational disease in Italy

Background

Solar UV radiation (sUVR) is one of the main carcinogen exposures in occupational settings, and UV‐induced skin cancers are the most frequent tumours in fair‐skinned individuals worldwide.

Objectives

According to this premise, we should expect a high number of occupational skin cancers reported to the national workers’ compensation authorities each year, also considering that the incidence of skin cancers has been constantly increased in recent years

Methods

We examined the data on reported non‐melanoma skin cancers (NMSC) and actinic keratoses (AK) to the Italian National Workers Compensation Authority (INAIL) from 2012 to 2017, and we compared the number of reported skin cancers for outdoor workers with the expected numbers, obtained from currently available NMSC incidence rates for the Italian population applied to the occupational sUVR‐exposed workers estimated with the CAREX methodology in Italy in 2005.

Results

The cases of NMSC reported each year to INAIL in Italy are 34 per year on average, while for AK the mean number of reported cases is of only 15/year. We estimated a number of expected NMSC cases in Italy for solar UV‐exposed workers ranging between 432 and 983, representing a proportion between reported vs. expected skin cancers of only 3.5–6.2%.

Conclusions

Our study clearly shows that occupational skin cancers in Italy are largely underreported, and, accordingly, urgent initiatives should be taken to raise appropriate awareness to the problem of occupational sUVR‐induced skin cancers, so that adequate preventive measures can be implemented rapidly.

Ignition of Welding Arc and UV Actinic Hazard Evaluation

Welding arcs emit strong ultraviolet (UV) radiation, which could pose serious health risks for skin and eyes. According to Directive 2006/25/EC, UV hazard evaluation has to be performed in the working environment. The measurement of welding arc ignition radiation is a difficult task. This article describes the effort made to determine actinic radiant exposure levels during welding arc ignition in the controlled environment of a welding laboratory. A new method of UV actinic hazard evaluation from welding arc ignition radiation using a CCD spectroradiometer combined with a photometer is presented. The hazard of UV emitted in pulsed metal active gas welding (MAG-P) of construction steel is described. The duration of ignition peak in the study was in the range of 9–15 ms. The actinic radiant exposure during arc ignition over aversion response time was in the range of 0.26–1.12 J/m2. The daily exposure time can easily exceed the permissible exposure time obtained in our study, i.e., 13–34 s, which means that UV radiation form MAG-P arc welding is hazardous for workers in the vicinity of the welding arc. The measurement method presented in the article enables determination of radiant exposure of arc ignition radiation.