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Bauer A, Haufe E, Heinrich L, Seidler A, Schulze HJ, Elsner P, Drexler H, Letzel S, John SM, Fartasch M, Brüning T, Dugas-Breit S, Gina M, Weistenhöfer W, Bachmann K, Bruhn I, Lang BM, Brans R, Allam JP, Grobe W, Westerhausen S, Knuschke P, Wittlich M, Diepgen TL, Schmitt J. Basal cell carcinoma risk and solar UV exposure in occupationally relevant anatomic sites: do histological subtype, tumor localization and Fitzpatrick phototype play a role? A population-based case-control study. J Occup Med Toxicol 2020; 15:28. [PMID: 32944060 PMCID: PMC7488106 DOI: 10.1186/s12995-020-00279-8] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2019] [Accepted: 08/12/2020] [Indexed: 01/13/2023] Open
Abstract
Background A two-fold risk increase to develop basal cell carcinoma was seen in outdoor workers exposed to high solar UV radiation compared to controls. However, there is an ongoing discussion whether histopathological subtype, tumor localization and Fitzpatrick phototype may influence the risk estimates. Objectives To evaluate the influence of histological subtype, tumor localization and Fitzpatrick phototype on the risk to develop basal cell carcinoma in highly UV-exposed cases and controls compared to those with moderate or low solar UV exposure. Methods Six hundred forty-three participants suffering from incident basal cell carcinoma in commonly sun-exposed anatomic sites (capillitium, face, lip, neck, dorsum of the hands, forearms outside, décolleté) of a population-based, case-control, multicenter study performed from 2013 to 2015 in Germany were matched to controls without skin cancer. Multivariate logistic regression analysis was conducted stratified for histological subtype, phototype 1/2 and 3/4. Dose-response curves adjusted for age, age2, sex, phototype and non-occupational UV exposure were calculated. Results Participants with high versus no (OR 2.08; 95% CI 1.24–3.50; p = 0.006) or versus moderate (OR 2.05; 95% CI 1.15–3.65; p = 0.015) occupational UV exposure showed a more than two-fold significantly increased risk to develop BCC in commonly UV-exposed body sites. Multivariate regression analysis did not show an influence of phototype or histological subtype on risk estimates. The restriction of the analysis to BCC cases in commonly sun-exposed body sites did not influence the risk estimates. The occupational UV dosage leading to a 2-fold increased basal cell carcinoma risk was 6126 standard erythema doses. Conclusion The risk to develop basal cell carcinoma in highly occupationally UV-exposed skin was doubled consistently, independent of histological subtype, tumor localization and Fitzpatrick phototype.
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Affiliation(s)
- A Bauer
- Department of Dermatology, University AllergyCentre, Medical Faculty Carl Gustav Carus, Technical University Dresden, Fetscherstr 74, D-01307 Dresden, Germany
| | - E Haufe
- Centre of Evidence-based Healthcare, University Hospital and Medical Faculty Carl Gustav Carus, Technical University Dresden, Dresden, Germany
| | - L Heinrich
- Centre of Evidence-based Healthcare, University Hospital and Medical Faculty Carl Gustav Carus, Technical University Dresden, Dresden, Germany
| | - A Seidler
- Institute and Policlinic for Occupational and Social Medicine, Faculty of Medicine Carl Gustav Carus, Dresden, Germany.,Institute and Outpatient Clinics of Occupational and Social Medicine, Medical Faculty Carl Gustav Carus, Technical University Dresden, Dresden, Germany
| | - H J Schulze
- Department of Dermatology, Dermatological Radiotherapy and Dermatohistopathology, Special Clinics Hornheide, Münster, Germany
| | - P Elsner
- Department of Dermatology, University Hospital Jena, Jena, Germany
| | - H Drexler
- Institute and Outpatient Clinic of Occupational, Social and Environmental Medicine, Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen, Germany
| | - S Letzel
- Institute of Occupational, Social and Environmental Medicine, University Medical Centre, Johannes-Gutenberg University Mainz, Mainz, Germany
| | - S M John
- Department of Dermatology, Environmental Medicine and Health Theory, University of Osnabrück and Institute of Interdisciplinary Dermatological Prevention and Rehabilitation (iDerm) at the University of Osnabrück, Osnabrück, Germany
| | - M Fartasch
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance (DGUV), Institute of Ruhr University Bochum (IPA), Bochum, Germany
| | - T Brüning
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance (DGUV), Institute of Ruhr University Bochum (IPA), Bochum, Germany
| | - S Dugas-Breit
- Department of Dermatology, Dermatological Radiotherapy and Dermatohistopathology, Special Clinics Hornheide, Münster, Germany
| | - M Gina
- Department of Dermatology, University Hospital Jena, Jena, Germany
| | - W Weistenhöfer
- Institute and Outpatient Clinic of Occupational, Social and Environmental Medicine, Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen, Germany
| | - K Bachmann
- Department of Clinical Social Medicine, Occupational and Environmental Dermatology, University of Heidelberg, Heidelberg, Germany
| | - I Bruhn
- Department of Dermatology, University AllergyCentre, Medical Faculty Carl Gustav Carus, Technical University Dresden, Fetscherstr 74, D-01307 Dresden, Germany
| | - B M Lang
- Department of Dermatology, University Medical Centre, Johannes-Gutenberg University Mainz, Mainz, Germany
| | - R Brans
- Department of Dermatology, Environmental Medicine and Health Theory, University of Osnabrück and Institute of Interdisciplinary Dermatological Prevention and Rehabilitation (iDerm) at the University of Osnabrück, Osnabrück, Germany
| | - J P Allam
- Department of Dermatology and Allergology, Christine Kühne Center for Allergy Research and Education, University of Bonn, Bonn, Germany
| | - W Grobe
- Department of Dermatology and Allergology, Christine Kühne Center for Allergy Research and Education, University of Bonn, Bonn, Germany
| | - S Westerhausen
- Department of Radiation, Institute of Occupational Health and Safety of the German Social Accident Insurance (DGUV), Sankt Augustin, Germany
| | - P Knuschke
- Department of Dermatology, Experimental Photobiology, Medical Faculty Carl Gustav Carus, Technical University Dresden, Dresden, Germany
| | - M Wittlich
- Department of Radiation, Institute of Occupational Health and Safety of the German Social Accident Insurance (DGUV), Sankt Augustin, Germany
| | - T L Diepgen
- Department of Clinical Social Medicine, Occupational and Environmental Dermatology, University of Heidelberg, Heidelberg, Germany
| | - J Schmitt
- Centre of Evidence-based Healthcare, University Hospital and Medical Faculty Carl Gustav Carus, Technical University Dresden, Dresden, Germany
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Schmitt J, Haufe E, Trautmann F, Schulze HJ, Elsner P, Drexler H, Bauer A, Letzel S, John S, Fartasch M, Brüning T, Seidler A, Dugas-Breit S, Gina M, Weistenhöfer W, Bachmann K, Bruhn I, Lang B, Bonness S, Allam J, Grobe W, Stange T, Westerhausen S, Knuschke P, Wittlich M, Diepgen T. Is ultraviolet exposure acquired at work the most important risk factor for cutaneous squamous cell carcinoma? Results of the population-based case-control study FB-181. Br J Dermatol 2018. [DOI: 10.1111/bjd.16286] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Schmitt J, Haufe E, Trautmann F, Schulze HJ, Elsner P, Drexler H, Bauer A, Letzel S, John S, Fartasch M, Brüning T, Seidler A, Dugas-Breit S, Gina M, Weistenhöfer W, Bachmann K, Bruhn I, Lang B, Bonness S, Allam J, Grobe W, Stange T, Westerhausen S, Knuschke P, Wittlich M, Diepgen T. 在工作中遭受的紫外线照射是否是皮肤鳞状细胞癌最重要的风险因素?基于人群的病例对照研究FB-181的结果. Br J Dermatol 2018. [DOI: 10.1111/bjd.16304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Schmitt J, Haufe E, Trautmann F, Schulze HJ, Elsner P, Drexler H, Bauer A, Letzel S, John S, Fartasch M, Brüning T, Seidler A, Dugas-Breit S, Gina M, Weistenhöfer W, Bachmann K, Bruhn I, Lang B, Bonness S, Allam J, Grobe W, Stange T, Westerhausen S, Knuschke P, Wittlich M, Diepgen T. Is ultraviolet exposure acquired at work the most important risk factor for cutaneous squamous cell carcinoma? Results of the population-based case-control study FB-181. Br J Dermatol 2018; 178:462-472. [DOI: 10.1111/bjd.15906] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/15/2017] [Indexed: 12/24/2022]
Affiliation(s)
- J. Schmitt
- Center of Evidence-based Healthcare; Medical Faculty Carl Gustav Carus; University Hospital; Technical University Dresden; Germany
- Institute and Outpatient Clinics of Occupational and Social Medicine; Medical Faculty Carl Gustav Carus; Technical University Dresden; Germany
| | - E. Haufe
- Center of Evidence-based Healthcare; Medical Faculty Carl Gustav Carus; University Hospital; Technical University Dresden; Germany
- Institute and Outpatient Clinics of Occupational and Social Medicine; Medical Faculty Carl Gustav Carus; Technical University Dresden; Germany
| | - F. Trautmann
- Center of Evidence-based Healthcare; Medical Faculty Carl Gustav Carus; University Hospital; Technical University Dresden; Germany
| | - H.-J. Schulze
- Department of Dermatology; Dermatological Radiotherapy and Dermatohistopathology; Special Clinics Hornheide; Münster Germany
| | - P. Elsner
- Department of Dermatology; University Hospital Jena; Jena Germany
| | - H. Drexler
- Institute and Outpatient Clinic of Occupational, Social and Environmental Medicine; Friedrich-Alexander-University Erlangen-Nuernberg; Nuernberg Germany
| | - A. Bauer
- Department of Dermatology - University Allergy Center; Medical Faculty Carl Gustav Carus; Technical University Dresden; Germany
| | - S. Letzel
- Institute of Occupational, Social and Environmental Medicine; Johannes-Gutenberg University Mainz; Mainz Germany
| | - S.M. John
- Department of Dermatology; Environmental Health and Health Theory; University of Osnabrueck; Osnabrueck Germany
- Institute of Interdisciplinary Dermatological Prevention and Rehabilitation (iDerm); University of Osnabrück; Osnabrück Germany
| | - M. Fartasch
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance (DGUV); Institute of Ruhr-University Bochum (IPA); Bochum Germany
| | - T. Brüning
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance (DGUV); Institute of Ruhr-University Bochum (IPA); Bochum Germany
| | - A. Seidler
- Institute and Outpatient Clinics of Occupational and Social Medicine; Medical Faculty Carl Gustav Carus; Technical University Dresden; Germany
| | - S. Dugas-Breit
- Department of Dermatology; Dermatological Radiotherapy and Dermatohistopathology; Special Clinics Hornheide; Münster Germany
| | - M. Gina
- Department of Dermatology; University Hospital Jena; Jena Germany
| | - W. Weistenhöfer
- Institute and Outpatient Clinic of Occupational, Social and Environmental Medicine; Friedrich-Alexander-University Erlangen-Nuernberg; Nuernberg Germany
| | - K. Bachmann
- Department of Clinical Social Medicine; Occupational and Environmental Dermatology; University of Heidelberg; Heidelberg Germany
| | - I. Bruhn
- Department of Dermatology - University Allergy Center; Medical Faculty Carl Gustav Carus; Technical University Dresden; Germany
| | - B.M. Lang
- Department of Dermatology; University Medical Center; Johannes-Gutenberg University Mainz; Germany
| | - S. Bonness
- Institute of Interdisciplinary Dermatological Prevention and Rehabilitation (iDerm); University of Osnabrück; Osnabrück Germany
- Employer's Liability Insurance Association Clinics Hamburg; Hamburg Germany
| | - J.P. Allam
- Department of Dermatology and Allergy; University Bonn; Bonn Germany
| | - W. Grobe
- Department of Dermatology and Allergy; University Bonn; Bonn Germany
| | - T. Stange
- Center of Evidence-based Healthcare; Medical Faculty Carl Gustav Carus; University Hospital; Technical University Dresden; Germany
| | - S. Westerhausen
- Department of Radiation; Institute of Occupational Health and Safety of the German Social Accident Insurance (DGUV); Sankt Augustin Germany
| | - P. Knuschke
- Department of Dermatology - Experimental Photobiology; University Hospital and Medical Faculty Carl Gustav Carus; Technical University Dresden; Dresden Germany
| | - M. Wittlich
- Department of Radiation; Institute of Occupational Health and Safety of the German Social Accident Insurance (DGUV); Sankt Augustin Germany
| | - T.L. Diepgen
- Department of Clinical Social Medicine; Occupational and Environmental Dermatology; University of Heidelberg; Heidelberg Germany
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