Occupational UV-Exposure is a Major Risk Factor for Basal Cell Carcinoma: Results of the Population-Based Case-Control Study FB-181

Objective: The aim of this study was to investigate the role of occupational and nonoccupational ultraviolet (UV)-exposure concerning the development of basal cell carcinoma (BCC). Methods: We undertook a population-based multicenter case–control study. Patients with first incident BCC (n = 836) were propensity score matched by age and sex to controls without skin cancer (n = 836). Sociodemographic characteristics, clinical characteristics, and lifetime UV-exposure were assessed by trained investigators. The differential estimation of occupational and nonoccupational UV-exposure dosages was based on validated instruments and established reference values. Associations were assessed using multivariable-adjusted conditional logistic regression models. Results: Individuals with high levels of occupational UV-exposure were at significantly increased BCC-risk compared with individuals with low [odds ratio (OR) 1.84; 95% confidence interval (95% CI) 1.19 to 2.83 and moderate (OR 1.97; 95% CI 1.20 to 3.22) occupational UV-exposure. Nonoccupational UV-exposure was not independently associated with BCC. Conclusion: Skin cancer prevention strategies should be expanded to the occupational setting.

[1]  A. Seidler,et al.  Effects of the German skin cancer screening programme on melanoma incidence and indicators of disease severity , 2016, The British journal of dermatology.

[2]  T. Diepgen.  New developments in occupational dermatology , 2016, Journal der Deutschen Dermatologischen Gesellschaft = Journal of the German Society of Dermatology : JDDG.

[3]  Paula R. Blasi,et al.  Screening for Skin Cancer in Adults: Updated Evidence Report and Systematic Review for the US Preventive Services Task Force. , 2016, JAMA.

[4]  S. Manne,et al.  Efficacy of an Intervention to Alter Skin Cancer Risk Behaviors in Young Adults. , 2016, American journal of preventive medicine.

[5]  C. Surber,et al.  Occupational risk factors for skin cancer and the availability of sun protection measures at German outdoor workplaces , 2016, International Archives of Occupational and Environmental Health.

[6]  C. Ulrich,et al.  Non‐melanoma skin cancer by solar UV: the neglected occupational threat , 2016, Journal of the European Academy of Dermatology and Venereology : JEADV.

[7]  M. Wittlich,et al.  An approximation of occupational lifetime UVR exposure: algorithm for retrospective assessment and current measurements , 2016, Journal of the European Academy of Dermatology and Venereology : JEADV.

[8]  G. Pellacani,et al.  CONSENSUS REPORT: Recognizing non‐melanoma skin cancer, including actinic keratosis, as an occupational disease – A Call to Action , 2016, Journal of the European Academy of Dermatology and Venereology : JEADV.

[9]  J. Lehmann,et al.  Photocarcinogenesis and Skin Cancer Prevention Strategies. , 2016, Anticancer research.

[10]  S. Kalia,et al.  Trends in Non-Melanoma Skin Cancer (Basal Cell Carcinoma and Squamous Cell Carcinoma) in Canada , 2016, Journal of cutaneous medicine and surgery.

[11]  Greta M. Massetti,et al.  CDC Grand Rounds: Prevention and Control of Skin Cancer , 2016, American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons.

[12]  Melanie Crane,et al.  Benefit Cost Analysis of Three Skin Cancer Public Education Mass-Media Campaigns Implemented in New South Wales, Australia , 2016, PloS one.

[13]  Lisa I. Wang,et al.  The incidence of metastatic basal cell carcinoma (mBCC) in Denmark, 1997–2010 , 2015, European Journal of Dermatology.

[14]  A. Marghoob,et al.  Burden of basal cell carcinoma in USA. , 2015, Future oncology.

[15]  C. Johnson,et al.  Self-reported quality of life after skin cancer in young adults , 2015, The Journal of dermatological treatment.

[16]  C. Prieto-Granada,et al.  Basal cell carcinoma: Epidemiology, clinical and histologic features, and basic science overview. , 2015, Current problems in cancer.

[17]  P. Fernández-Peñas,et al.  Quality of life in non‐melanoma skin cancer , 2015, The Australasian journal of dermatology.

[18]  L. Goldberg,et al.  Increased Burden of Melanoma and Nonmelanoma Skin Cancer in Young Women , 2014, Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.].

[19]  S. Surdu.  Non-melanoma skin cancer: occupational risk from UV light and arsenic exposure , 2014, Reviews on environmental health.

[20]  J. Schmitt,et al.  Durch UV-Strahlung induzierte bösartige Hauttumoren – Erarbeitung und Evaluation von versicherungsrechtlich relevanten Abgrenzungskriterien beruflicher gegenüber nicht beruflicher Verursachung. Wissenschaftlicher Abschlussbericht des DGUV- , 2014 .

[21]  C. Surber,et al.  Epidemiology of basal cell carcinoma in the United Kingdom: incidence, lifestyle factors, and comorbidities , 2014, British Journal of Cancer.

[22]  Lin Fritschi,et al.  Occupational exposure to solar radiation in Australia: who is exposed and what protection do they use? , 2014, Australian and New Zealand journal of public health.

[23]  D. Vernez,et al.  Estimating the contribution of occupational solar ultraviolet exposure to skin cancer , 2014, The British journal of dermatology.

[24]  M. Weiss,et al.  Outdoor workers’ sun‐related knowledge, attitudes and protective behaviours: a systematic review of cross‐sectional and interventional studies , 2013, The British journal of dermatology.

[25]  J. Lear,et al.  Utilities for advanced basal cell carcinoma , 2013, Journal of medical economics.

[26]  H. Drexler,et al.  The relationship between occupational sun exposure and non-melanoma skin cancer: clinical basics, epidemiology, occupational disease evaluation, and prevention. , 2012, Deutsches Arzteblatt international.

[27]  T L Diepgen,et al.  Occupational skin cancer induced by ultraviolet radiation and its prevention , 2012, The British journal of dermatology.

[28]  J. Schmitt,et al.  Is occupational solar ultraviolet irradiation a relevant risk factor for basal cell carcinoma? A systematic review and meta‐analysis of the epidemiological literature , 2011, The British journal of dermatology.

[29]  A Seidler,et al.  Occupational ultraviolet light exposure increases the risk for the development of cutaneous squamous cell carcinoma: a systematic review and meta‐analysis , 2011, The British journal of dermatology.

[30]  J. Schmitt,et al.  Berufliche Exposition gegenüber natürlicher UV‐Strahlung und nicht‐melanozytärer Hautkrebs – ein systematischer Review zur Frage einer neuen Berufskrankheit , 2010 .

[31]  Thomas Diepgen,et al.  Occupational exposure to non‐artificial UV‐light and non‐melanocytic skin cancer – a systematic review concerning a new occupational disease , 2009, Journal der Deutschen Dermatologischen Gesellschaft = Journal of the German Society of Dermatology : JDDG.

[32]  Patrick Royston,et al.  Multivariable Model-Building: A Pragmatic Approach to Regression Analysis based on Fractional Polynomials for Modelling Continuous Variables , 2008 .

[33]  T. Diepgen,et al.  Hautkrebs durch UV-Licht – die neue Berufskrankheit Nr. 5103 der BKV? Teil 1 , 2007 .

[34]  S. Rosso,et al.  The multicentre south European study 'Helios'. II: Different sun exposure patterns in the aetiology of basal cell and squamous cell carcinomas of the skin. , 1996, British Journal of Cancer.

[35]  A. Körner,et al.  Nonmelanoma skin cancer: disease-specific quality-of-life concerns and distress. , 2014, Oncology nursing forum.

[36]  R. Saladi,et al.  The causes of skin cancer: a comprehensive review. , 2005, Drugs of today.

[37]  D. Ratner,et al.  Basal-cell carcinoma. , 2005, The New England journal of medicine.

[38]  Désirée Ratner,et al.  Current concepts : Basal-cell carcinoma , 2005 .