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Hogan V, Hogan M, Kirwan O, Langan Walsh C, McLaughlin C, Moynihan Á, Connolly A, Walsh J, Coggins M. Sun-related knowledge and practices in Irish construction and agricultural workers. Occup Med (Lond) 2024; 74:378-385. [PMID: 38991849 DOI: 10.1093/occmed/kqae042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/13/2024] Open
Abstract
BACKGROUND Agricultural and construction workers spend much of their work time outdoors and have higher risks of developing skin cancer when compared to indoor workers. However, there is limited research on ultraviolet radiation (UVR) exposure knowledge, sun safety practices and constraints within these occupational groups in Ireland. AIMS This study aimed to examine self-reported time spent outdoors in a sample of Irish agricultural and construction workers; to describe and compare UVR exposure knowledge, safety practices and perceived constraints in both occupational groups, and to assess the association of demographic, personal and occupational factors with sun-related knowledge, practices and perceived constraints. METHODS Agricultural workers (n = 154) and construction workers (n = 467) completed a questionnaire, which measured solar UVR exposure knowledge, safety practices, and perceived constraints to sun personal protective equipment and sunscreen use in addition to demographic, personal, and workplace characteristics. Mann-Whitney and Kruskal-Wallis tests were used to examine differences in knowledge, practices and perceived constraints by these characteristics. RESULTS Both groups spend a significant proportion of their working week outdoors (25 hours per week on average). Although participation in sun safety training was high for both groups, UVR exposure knowledge and sunscreen use were low, and annual rates of reported sunburn were high. Knowledge, practices and perceived constraints also differed significantly according to demographic, personal, occupational and workplace characteristics. CONCLUSIONS In addition to training by employers and advisory groups, interventions are required to address perceived barriers that impede the uptake and usage of control measures that can lower risk.
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Affiliation(s)
- V Hogan
- Discipline of Health Promotion, School of Health Sciences, Áras Moyola, University of Galway, H91TK33, Galway, Ireland
| | - M Hogan
- School of Psychology, University of Galway, H91TK33 Galway, Ireland
| | - O Kirwan
- School of Natural Sciences & Ryan Institute, University of Galway, H91TK33 Galway, Ireland
| | - C Langan Walsh
- Discipline of Health Promotion, School of Health Sciences, Áras Moyola, University of Galway, H91TK33, Galway, Ireland
| | - C McLaughlin
- School of Natural Sciences & Ryan Institute, University of Galway, H91TK33 Galway, Ireland
| | - Á Moynihan
- School of Natural Sciences & Ryan Institute, University of Galway, H91TK33 Galway, Ireland
| | - A Connolly
- UCD Centre for Safety & Health at Work, School of Public Health, Physiotherapy, and Sports Science, University College Dublin, D04V1W8 Dublin, Ireland
| | - J Walsh
- School of Natural Sciences & Ryan Institute, University of Galway, H91TK33 Galway, Ireland
| | - M Coggins
- School of Natural Sciences & Ryan Institute, University of Galway, H91TK33 Galway, Ireland
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2
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de Boer FL, van der Molen HF, Wang JH, Raun E, Pereda J, Hwu EET, Jakasa I, Dubrac S, Rustemeyer T, Kezic S. Skin Barrier- and Immune Response-Related Biomarkers of Solar UVR Exposure Comparing Indoor and Outdoor Workers. JID INNOVATIONS 2024; 4:100280. [PMID: 38756236 PMCID: PMC11097112 DOI: 10.1016/j.xjidi.2024.100280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Revised: 03/26/2024] [Accepted: 03/31/2024] [Indexed: 05/18/2024] Open
Abstract
Outdoor workers have increased risk of developing keratinocyte cancer due to accumulated skin damage resulting from chronic and excessive exposure to UVR. This study aims to identify potential noninvasive biomarkers to assess chronic UVR exposure. We analyzed stratum corneum biomarkers collected from 2 skin locations and 2 occupational groups with contrasting solar UVR exposure: the forehead and retroauricular skin among outdoor workers and indoor workers. Using a linear mixed model adjusting for age and skin phototype, we compared biomarkers between both skin sites in indoor and outdoor workers. We measured markers of the immune response and skin barrier, including cytokines, GFs, 15-hydroxyeicosatetraenoic acid, cis- and trans-urocanic acid, and corneocyte topography, indicated by circular nano objects. Differences between the 2 skin sites were found for cis-urocanic acid, total urocanic acid, IL-1α, IL-1RA, IL-1RA/IL-1α, IL-18, 15-hydroxyeicosatetraenoic acid, CCL4, and circular nano objects. The levels of cis-urocanic acid and CCL4 also differed between indoor and outdoor workers. These findings underscore changes in both immune response and skin barrier induced by UVR. They indicate the potential utility of stratum corneum biomarkers in detecting both chronic UVR exposure in occupational setting and aiding in the development of preventive measures.
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Affiliation(s)
- Florentine L. de Boer
- Amsterdam Public Health Research Institute, Department of Public and Occupational Health, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Henk F. van der Molen
- Amsterdam Public Health Research Institute, Department of Public and Occupational Health, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Jen-Hung Wang
- Department of Health Technology, Technical University of Denmark, Kongens Lyngby, Denmark
| | - Ellen Raun
- Department of Health Technology, Technical University of Denmark, Kongens Lyngby, Denmark
| | - Jorge Pereda
- Department of Health Technology, Technical University of Denmark, Kongens Lyngby, Denmark
| | - Edwin En-Te Hwu
- Department of Health Technology, Technical University of Denmark, Kongens Lyngby, Denmark
| | - Ivone Jakasa
- Laboratory for Analytical Chemistry, Department of Chemistry and Biochemistry, Faculty of Food Technology and Biotechnology, University of Zagreb, Zagreb, Croatia
| | - Sandrine Dubrac
- Epidermal Biology Laboratory, Department of Dermatology, Venereology and Allergology, Medical University of Innsbruck, Innsbruck, Austria
| | - Thomas Rustemeyer
- Dermato-Allergology and Occupational Dermatology, Amsterdam University Medical Centers, Noord-Holland, The Netherlands
| | - Sanja Kezic
- Amsterdam Public Health Research Institute, Department of Public and Occupational Health, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, The Netherlands
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3
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Conte S, Aldien AS, Jetté S, LeBeau J, Alli S, Netchiporouk E, Lagacé F, Lefrançois P, Iannattone L, Litvinov IV. Skin Cancer Prevention across the G7, Australia and New Zealand: A Review of Legislation and Guidelines. Curr Oncol 2023; 30:6019-6040. [PMID: 37489567 PMCID: PMC10377770 DOI: 10.3390/curroncol30070450] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 06/12/2023] [Accepted: 06/17/2023] [Indexed: 07/26/2023] Open
Abstract
Incidence rates of melanoma and keratinocyte skin cancers have been on the rise globally in recent decades. While there has been a select focus on personal sun protection awareness, to our knowledge, there is a paucity of legislation in place to help support citizens' efforts to protect themselves from the harmful effects of ultraviolet radiation (UVR). Given this, we conducted a comprehensive review of legislation and guidelines pertaining to a variety of sun protection-related topics in countries of the Group of Seven (G7), Australia and New Zealand. Australia was the only country to have banned tanning beds for individuals of all ages, while other select countries have instituted bans for minors. In workplace policy, there is very little recognition of the danger of occupational UVR exposure in outdoor workers, and thus very few protective measures are in place. With regard to sports and recreation, certain dermatological/professional associations have put forward recommendations, but no legislation was brought forward by government bodies outside of Australia and New Zealand. With regard to youth, while there are various guidelines and frameworks in place across several countries, adherence remains difficult in the absence of concrete legislation and standardization of procedures. Finally, only Australia and a few select jurisdictions in the United States have implemented sales tax exemptions for sunscreen products. In light of our findings, we have made several recommendations, which we anticipate will help reduce the rates of melanoma and keratinocyte cancers in years to come. However, minimizing UVR exposure is not without risk, and we, therefore, suggest the promotion of vitamin D supplementation in conjunction with sun protective practices to limit potential harm.
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Affiliation(s)
- Santina Conte
- Faculty of Medicine and Health Sciences, McGill University, Montréal, QC H3G 2M1, Canada
| | - Ammar Saed Aldien
- Faculty of Medicine and Health Sciences, McGill University, Montréal, QC H3G 2M1, Canada
| | - Sébastien Jetté
- Faculty of Medicine and Health Sciences, McGill University, Montréal, QC H3G 2M1, Canada
| | - Jonathan LeBeau
- Faculty of Medicine and Health Sciences, McGill University, Montréal, QC H3G 2M1, Canada
| | - Sauliha Alli
- Faculty of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada
| | - Elena Netchiporouk
- Division of Dermatology, McGill University Health Centre, Montréal, QC H4A 3J1, Canada
| | - François Lagacé
- Division of Dermatology, McGill University Health Centre, Montréal, QC H4A 3J1, Canada
| | - Philippe Lefrançois
- Division of Dermatology, McGill University Health Centre, Montréal, QC H4A 3J1, Canada
| | - Lisa Iannattone
- Division of Dermatology, McGill University Health Centre, Montréal, QC H4A 3J1, Canada
| | - Ivan V Litvinov
- Division of Dermatology, McGill University Health Centre, Montréal, QC H4A 3J1, Canada
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4
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Slot N, Tenkate T, Forsman-Phillips L, Arrandale VH, Kalia S, Holness DL, Peters CE. Barriers and Facilitators in the Creation of a Surveillance System for Solar Radiation-Induced Skin Cancers. New Solut 2023; 33:7-24. [PMID: 37083551 DOI: 10.1177/10482911231165975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/22/2023]
Abstract
Outdoor workers are exposed to many hazards, including solar ultraviolet radiation (UVR). Identifying, reporting, analyzing and tracking the exposures or health outcomes of outdoor workers have not generally been formally considered. This article aims to summarize the best practices/strategies for creating an occupational sun exposure or skin cancer surveillance system for outdoor workers and to understand the key barriers and facilitators to the development of such a system. For the design of a successful occupational safety and health (OSH) surveillance system five occupational surveillance strategies are summarized: exposure registry, disease registry, disease screening/medical surveillance, sentinel event surveillance, and disease surveillance via data linkage. Ten key considerations are identified, including identifying a clear goal, a defined target population and stakeholder involvement, five critical barriers are highlighted including underreporting and funding, and five vital facilitators are recognized including communication/collaboration and a simple reporting process.
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Affiliation(s)
- Nicole Slot
- Cancer Epidemiology and Prevention Research, Alberta Health Services, Calgary, Alberta, Canada
| | - Thomas Tenkate
- School of Occupational and Public Health, Toronto Metropolitan University, Toronto, Ontario, Canada
| | | | - Victoria H Arrandale
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Sunil Kalia
- Dermatology and Skin Science, The University of British Columbia Faculty of Medicine, Vancouver, British Columbia, Canada
- Photomedicine Institute and Centre for Clinical Epidemiology and Evaluation, Vancouver Coastal Health Research Institute, Vancouver, BC, Canada
- Departments of Cancer Control, BC Cancer and Division of Dermatology, BC Children's Hospital, Provincial Health Services Authority, Vancouver, BC, Canada
| | - D Linn Holness
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Department of Medicine and MAP Centre for Urban Health Solutions, St. Michael's Hospital, Unity Health, Toronto, ON, Canada
| | - Cheryl E Peters
- CAREX Canada, University of British Columbia, Vancouver, British Columbia, Canada
- University of Calgary Cumming School of Medicine, Department of Community Health Sciences and Preventive Oncology, Calgary, Alberta, Canada
- BC Centre for Disease Control & BC Cancer, Vancouver, British Columbia
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5
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Tate J, Racoviță M, Cougnard-Gregoire A, Delcourt C, Harwood C, Trakatelli M. Keratinocyte carcinoma as an occupational disease. Occup Environ Med 2023; 80:237-238. [PMID: 36922015 DOI: 10.1136/oemed-2022-108784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Accepted: 02/21/2023] [Indexed: 03/17/2023]
Affiliation(s)
- Jody Tate
- Research Department, The Health Policy Partnership Ltd, London, UK
| | - Monica Racoviță
- Research Department, The Health Policy Partnership Ltd, London, UK
| | | | - Cécile Delcourt
- INSERM, Bordeaux Population Health, U1219, University of Bordeaux, Bordeaux, France
| | - Catherine Harwood
- Department of Dermatology, The Royal London Hospital, Barts Health NHS Trust, London, UK
| | - Myrto Trakatelli
- Second Department of Dermatology and Venerology, Aristotle University of Thessaloniki School of Medicine, Thessaloniki, Greece
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6
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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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7
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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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8
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Kezic S, van der Molen HF. Occupational skin cancer: measurements of ultraviolet radiation exposure bring knowledge for prevention. Br J Dermatol 2023; 188:315-316. [PMID: 36653327 DOI: 10.1093/bjd/ljac127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 12/05/2022] [Accepted: 12/08/2022] [Indexed: 01/20/2023]
Abstract
Outdoor workers are at higher risk for keratinocyte cancer. Data-base of UV-exposure generated in the Genesis-UV study will facilitate specific prevention measures and workers’ health surveillance in outdoor occupations.
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Affiliation(s)
- Sanja Kezic
- Amsterdam UMC, University of Amsterdam, Public and Occupational Health, Amsterdam Public Health Research Institute, and Netherlands Center for Occupational Diseases, Amsterdam, the Netherlands
| | - Henk F van der Molen
- Amsterdam UMC, University of Amsterdam, Public and Occupational Health, Amsterdam Public Health Research Institute, and Netherlands Center for Occupational Diseases, Amsterdam, the Netherlands
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9
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de Troya Martín M, Aguilar S, Aguilera-Arjona J, Rivas-Ruiz F, Rodríguez-Martínez A, de Castro-Maqueda G, Cambil-Martín J, de Gálvez-Aranda V, Blázquez-Sánchez N. Risk assessment of occupational skin cancer among outdoor workers in southern Spain: local pilot study. Occup Environ Med 2023; 80:14-20. [PMID: 36424170 DOI: 10.1136/oemed-2022-108454] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Accepted: 08/25/2022] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Overexposure to ultraviolet (UV) radiation is the main preventable cause of skin cancer. Outdoor workers, exposed to the sun for many hours throughout their working lives, are at special risk. The aim of this study is to determine occupational photoexposure and photoprotection among outdoor workers employed by a municipality in southern Spain. METHODS Cross-sectional descriptive study focusing on outdoor workers employed by the municipality of Fuengirola (in areas such as construction, gardening, urban cleaning and beach maintenance). The participants were monitored by personal dosimetry, participated in a dermatological check-up and answered a validated questionnaire (CHACES) on their habits, attitudes and knowledge related to sun exposure. RESULTS The median effective erythema dose of exposure to solar UV radiation during the working day (n=20) was 379.4 J/m2, equivalent to 3.8 standard erythema doses, almost 3 times higher than the recommended limits for an 8-hour workday. Skin examination (n=128) revealed the presence of actinic lentigines (79.7%), actinic keratoses (8.6%) and skin cancer (3.9%). The CHACES questionnaire (n=128) revealed a sunburn rate of 50.0%. Photoprotection practices were markedly deficient: only 16.7% of the survey respondents sought protection in the shade, 20.3% avoided exposure during the peak exposure hours and 33.1% applied sunscreen. CONCLUSIONS This is the first study to evaluate UV radiation exposure, occupational sun protection practices, sunburn and actinic injuries of different outdoor workers in one of the sunniest regions of Spain and underlines the need for effective interventions to protect outdoor workers' health.
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Affiliation(s)
| | - Sierra Aguilar
- Occupational Risk Prevention Service, Fuengirola City Council, Fuengirola, Spain
| | - José Aguilera-Arjona
- Photobiological Dermatology Laboratory, Medical Research Centre, Department of Medicine and Dermatology, University of Malaga, Malaga, Spain
| | | | | | - Guillermo de Castro-Maqueda
- Physical Education Department, Education Science Faculty, University of Cadiz, Cadiz, Spain.,Nursing Department, Health Science Faculty, University of Granada, Granada, Spain
| | - Jacobo Cambil-Martín
- Nursing Department, Health Science Faculty, University of Granada, Granada, Spain
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10
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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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11
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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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12
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Gutiérrez-Manzanedo JV, Vaz Pardal C, Blázquez-Sánchez N, De Gálvez MV, Aguilera-Arjona J, González-Montesinos JL, Rivas Ruiz F, De Troya-Martín M. Ultraviolet exposure of competitors during a Tokyo Olympic Sailing Regatta Test Event. PHOTODERMATOLOGY, PHOTOIMMUNOLOGY & PHOTOMEDICINE 2022. [PMID: 36208003 DOI: 10.1111/phpp.12839] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Accepted: 10/04/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Overexposure to sunlight is the main cause of skin cancer. Photoprotection practices and sunburn play a crucial role in skin cancer prevention. OBJECTIVES This study aimed to quantify the risk of sun exposure and to evaluate photoprotection practices in Spanish sailors during Olympic competitions. METHODS Solar daily ultraviolet (UV) radiation cycle, personal UV dosimetry, photoprotection practices and sunburn checking were followed during three consecutive days of competition among sailors from the Spanish Olympic Sailing Team during a Tokyo Olympic Regatta Test Event. RESULTS A total of 13 sailors (7 women), with mean age of 27.6 ± 4.7 years and sports experience of 17.7 ± 5.4 years, were studied. The most common phototypes were type III (53.8%) and type II (38.5%). The rate of sunburn checked was high (46.2%). The mean daily personal UV exposure received was 761.0 ± 263.6 J/m2 , 3.0 ± 1.1 minimal erythemal dose and 7.6 ± 2.6 standard erythemal dose, seven times greater than the maximum permissible UV light exposure values for an 8 h working day. The use of a T-shirt was the most common practice (94.2%), followed by the use of shade (50.2%), hat/cap (44.0%), sunglasses (26.1%) and sunscreen (11.8%). CONCLUSIONS Olympic sailor's studies presented high levels of UV radiation received, high rate of sunburn and insufficient adherence to sun-protective behaviours (especially, to use of sunscreen) to prevent sunburn, the main cause of skin cancer. Sport Federations should develop educational campaigns addressing sun-related exposure habits and photoprotection behaviours to reduce the risk of skin cancer among these athletes.
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Affiliation(s)
| | | | | | - Maria Victoria De Gálvez
- Department of Dermatology and Medicine, Photobiological Dermatology Laboratory Medical Research Centre, Faculty of Medicine, University of Málaga, Málaga, Spain
| | - José Aguilera-Arjona
- Department of Dermatology and Medicine, Photobiological Dermatology Laboratory Medical Research Centre, Faculty of Medicine, University of Málaga, Málaga, Spain
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Boothby-Shoemaker WT, Mohammad TF, Ozog DM, Lim HW. Photoprotection by clothing: A review. PHOTODERMATOLOGY, PHOTOIMMUNOLOGY & PHOTOMEDICINE 2022; 38:478-488. [PMID: 35073443 DOI: 10.1111/phpp.12776] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 12/19/2021] [Accepted: 01/13/2022] [Indexed: 12/18/2022]
Abstract
Clothing is recognized by leading health agencies as a primary method to protect against the harmful effects of photodamage caused by ultraviolet (UV) radiation and visible light. The photoprotective capacity of clothing is commonly measured as the ultraviolet protective factor (UPF). While the technology driving photoprotective clothing has been well-established, there continues to be efforts to discover new materials to improve the UPF of clothing. Here, we show increased Google searches for photoprotective clothing over the last decade, suggesting a high level of public interest in photoprotective clothing. In addition, we investigate the frequency of UPF-graded photoprotective clothing sold by large retail stores featured in Fortune 1000. We review factors that alter the UPF of clothing and describe emerging textile technologies used to increase clothing's photoprotective capacity. Finally, we compare how photoprotective clothing is regulated among different countries, the importance of photoprotective clothing in occupational health, and research in visible light and clothing photoprotection.
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Affiliation(s)
- Wyatt T Boothby-Shoemaker
- Photomedicine and Photobiology Unit, Henry Ford Health System, Detroit, Michigan, USA.,Michigan State University College of Human Medicine, East Lansing, Michigan, USA
| | - Tasneem F Mohammad
- Photomedicine and Photobiology Unit, Henry Ford Health System, Detroit, Michigan, USA
| | - David M Ozog
- Photomedicine and Photobiology Unit, Henry Ford Health System, Detroit, Michigan, USA
| | - Henry W Lim
- Photomedicine and Photobiology Unit, Henry Ford Health System, Detroit, Michigan, USA
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Ring J. Dermatology and venereology - highlights in research and patient care in 2021. J Eur Acad Dermatol Venereol 2021; 36:8-10. [PMID: 34897828 DOI: 10.1111/jdv.17822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- J Ring
- Department Dermatology and Allergy Biederstein, Technical University Munich, Munich, Germany
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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: 4] [Impact Index Per Article: 1.3] [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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Posch C. Ageing research: rethinking primary prevention of skin cancer. J Eur Acad Dermatol Venereol 2021; 35:2216-2218. [PMID: 34647667 DOI: 10.1111/jdv.17660] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Accepted: 09/13/2021] [Indexed: 12/12/2022]
Affiliation(s)
- C Posch
- Department of Dermatology and Allergy, School of Medicine, German Cancer Consortium (DKTK), Technical University of Munich, Munich, Germany.,Faculty of Medicine, Sigmund Freud University Vienna, Vienna, Austria
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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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De Castro-Maqueda G, Lagares Franco C, Gutiérrez-Manzanedo JV, Gobba F, Blázquez Sánchez N, De Troya-Martin M. What Sun Protection Practices Should Be Adopted by Trainee Teachers to Reduce the Risk of Skin Cancer and Other Adverse Outcomes? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:E529. [PMID: 33435239 PMCID: PMC7826784 DOI: 10.3390/ijerph18020529] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Revised: 01/03/2021] [Accepted: 01/04/2021] [Indexed: 01/13/2023]
Abstract
Excessive sun exposure and insufficient protection are the main risk factors for the onset of melanoma and non-melanoma skin cancer (the most common types of cancer suffered by fair-skinned populations) and other adverse effects on the skin and eyes. Epidemiological data highlight the scant awareness of this risk among young people and the high rates of sunburn often recorded among this population. The main aim of the present study is to examine sun exposure and protection behavior by university students. A cross-sectional questionnaire-based study was undertaken to investigate sun exposure and protection practices among students of education sciences at a university in southern Spain. The data obtained were used to perform a descriptive, comparative analysis, by groups and by gender, of photoprotection and skin self-examination practices. The reliability and validity of the questionnaire were both tested. Of the 315 students who completed the questionnaire, 74.6% had suffered at least one sunburn during the previous year. Few made frequent use of sunscreen or protective clothing and 89.5% did not self-examine their skin. The metric properties of the questionnaire revealed its excellent reliability and validity. Among the Spanish university students considered, there was little awareness of the risk of excessive sun exposure, self-protection was insufficient, the potential exposure to dangerous levels of ultraviolet radiation was high, and most had suffered one or more sunburns in the last year. Intervention strategies should be implemented to highlight the risks involved and the need for more appropriate sun protection practices. Information campaigns should be conducted in this respect so that, when these students become teachers, they will have adequate knowledge of the risks involved and of the benefits of addressing this problem effectively, and will ultimately transfer these health education competences to their own students.
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Affiliation(s)
- Guillermo De Castro-Maqueda
- Department of Physical Education, Faculty of Education Sciences and University of Cádiz, 11519 Cádiz, Spain;
| | | | - José V. Gutiérrez-Manzanedo
- Department of Physical Education, Faculty of Education Sciences and University of Cádiz, 11519 Cádiz, Spain;
| | - Fabriziomaria Gobba
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 41121 Modena, Italy;
| | - Nuria Blázquez Sánchez
- Dermatology Department, Costa del Sol Hospital, 29603 Marbella, Spain; (N.B.S.); (M.D.T.-M.)
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