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Prevention of Health Risks Related to Occupational Solar Ultraviolet Radiation Exposure in Times of Climate Change and COVID-19 Pandemic. ATMOSPHERE 2022. [DOI: 10.3390/atmos13071147] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Occupational exposure to solar ultraviolet (UV) radiation is a recognized work-related risk, as is associated with the induction of long-term adverse health effects such as Non-Melanoma Skin Cancers and cataracts. Recent research provided new data suggesting an increased risk of specific forms of malignant melanoma, i.e., Lentigo Maligna Melanoma, for outdoor workers, while the relation of cumulative exposure to solar radiation with ocular diseases, such as uveal melanoma and macular degeneration, is still debated. Nowadays, one of the main focuses of prevention activities is the organization of multicomponent sun safety initiatives, which are proved to be effective, particularly when including technologies that are able to directly interact with individuals, such as phone apps, such as the recently released SunSmart Global UV App. Nevertheless, we should not forget that we are living in an era of profound changes, and phenomena such as climate change and the COVID-19 pandemic have an impact on all aspects of our lives, including how and when we perform, as well as the perception of, outdoor activities. In the future, this may result in possible changes in the scenario of occupational and leisure-time solar radiation exposure-related health risks.
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San Martín O, Llombart B, Carretero Hernandez G, Flórez Menéndez Á, Botella-Estrada R, Herrera Ceballos E, Puig S. Sonidegib in the Treatment of Locally Advanced Basal Cell Carcinoma. ACTAS DERMO-SIFILIOGRAFICAS 2021. [DOI: 10.1016/j.adengl.2021.01.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Sanmartín O, Llombart B, Carretero Hernández G, Flórez Menéndez Á, Botella-Estrada R, Herrera Ceballos E, Puig S. Sonidegib in the Treatment of Locally Advanced Basal Cell Carcinoma. ACTAS DERMO-SIFILIOGRAFICAS 2020; 112:295-301. [PMID: 33197438 DOI: 10.1016/j.ad.2020.11.002] [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: 11/05/2020] [Accepted: 11/05/2020] [Indexed: 10/23/2022] Open
Abstract
Sonidegib is an antagonist of the transmembrane protein Smoothened in the Hedgehog signaling pathway. It is indicated for the treatment of locally advanced basal cell carcinoma (BCC) that is not amenable to curative surgery or radiotherapy. Sonidegib's efficacy and safety were demonstrated in the phase 2 BOLT trial, where 61% (95% CI, 48-72%) of patients with locally advanced BCC treated with sonidegib 200 mg achieved an objective response to treatment with a mean time to response of 4 months. The median duration of response was 26.1 months and the median progression-free survival was 22.1 months. The most common adverse events were muscle spasms (54.4%), hair loss (49.4%), and loss of taste (44.3%); most events were grade 1 or 2. In this review, we summarize the main findings on the efficacy, safety, and tolerability of sonidegib and discuss the management of locally advanced BCC with this drug.
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Affiliation(s)
- O Sanmartín
- Servicio de Dermatología, Instituto Valenciano de Oncología, Valencia, España
| | - B Llombart
- Servicio de Dermatología, Instituto Valenciano de Oncología, Valencia, España
| | - G Carretero Hernández
- Servicio de Dermatología, Hospital Universitario de Gran Canaria Doctor Negrín, Las Palmas de Gran Canaria, España
| | - Á Flórez Menéndez
- Servicio de Dermatología, Complejo Hospitalario Universitario de Pontevedra, Pontevedra, España
| | - R Botella-Estrada
- Servicio de Dermatología, Hospital Universitario La Fe. Grupo de Investigación «Dermatología y Regeneración Tisular», Instituto de Investigación Sanitaria La Fe, Universidad de Valencia, Valencia, España
| | - E Herrera Ceballos
- Unidad de Gestión Clínica de Dermatología, Hospital Universitario Virgen de la Victoria, Universidad de Málaga, Málaga, España
| | - S Puig
- Servicio de Dermatología, Hospital Clínic Barcelona, Grupo de investigación «Melanoma: Imaging, genetics and immunolog» del Instituto de Investigaciones Biomédicas August Pi i Sunyer (IDIBAPS), Universidad de Barcelona, Barcelona, España; Centro de Investigación biomédica en Red de Enfermedades raras. (CIBERER), Instituto de Salud Carlos III, Barcelona, España.
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Warszawik-Hendzel O, Olszewska M, Rakowska A, Sikora M, Hendzel P, Rudnicka L. Cardiovascular Drug Use and Risk of Actinic Keratosis: A Case-Control Study. Dermatol Ther (Heidelb) 2020; 10:735-743. [PMID: 32506248 PMCID: PMC7367976 DOI: 10.1007/s13555-020-00405-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Indexed: 11/28/2022] Open
Abstract
INTRODUCTION Actinic keratosis (AK) is a precancerous skin lesion. Currently, many experts treat actinic keratosis as squamous cell carcinoma in situ. It is well established that exposure of the skin to ultraviolet radiation is a major risk factor for the development of actinic keratosis. Some studies suggest an association between keratinocyte cancers and photosensitizing cardiovascular drugs. The aim of this study was to establish an association between cardiovascular drug use and the presence of AK. METHODS A total of 400 patients were enrolled into the study (200 with AK; 200 healthy persons in the control group). The group of patients with AK consisted of 106 women and 94 men (mean age 71 years). The control group included 102 women and 98 men (mean age 69 years). An analysis of the risk factors for developing actinic keratosis was performed in all patients with AK on the basis of a detailed, standardized interview. RESULTS The statistical analysis showed that features independently associated with increased risk of AK included: age > 80 years (OR 4.14; 95% CI 2.4-7.3), positive cancer history (OR 1.94; 95% CI 1.0-3.6), positive history of sunburns when < 18 years old (OR 2.18; 95% CI 1.3-3.7) and taking angiotensin-converting enzyme inhibitors (OR 2.28; 95% CI 1.2-4.3), angiotensin receptor AT1 blockers (OR 2.90; 95% CI 1.1-7.9) and calcium channel blockers (OR 2.4; 95% CI 1.0-5.3). CONCLUSION In conclusion, our study presented an association between cardiovascular drug use and the risk of developing AK.
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Affiliation(s)
| | | | - Adriana Rakowska
- Department of Dermatology, Medical University of Warsaw, Warsaw, Poland
| | - Mariusz Sikora
- Department of Dermatology, Medical University of Warsaw, Warsaw, Poland
| | - Piotr Hendzel
- Department of Cardiac Surgery, Medical University of Warsaw, Warsaw, Poland
| | - Lidia Rudnicka
- Department of Dermatology, Medical University of Warsaw, Warsaw, Poland
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Modenese A, Loney T, Ruggieri FP, Tornese L, Gobba F. Sun protection habits and behaviors of a group of outdoor workers and students from the agricultural and construction sectors in north-Italy. LA MEDICINA DEL LAVORO 2020; 111:116-125. [PMID: 32352425 PMCID: PMC7810007 DOI: 10.23749/mdl.v111i2.8929] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Accepted: 02/07/2020] [Indexed: 01/14/2023]
Abstract
Background: Despite the relevant frequency of ultraviolet induced adverse health effects in workers, solar ultraviolet radiation (UVR) exposure is an occupational risk not adequately minimized in Italy. Objective: To assess the characteristics and prevalence of sun exposure habits and behaviors in a group of students and outdoor workers (OW) from the agricultural and construction sectors of a north-Italian region. Methods: Based on a previously developed standardized questionnaire, we collected full information on individual sun exposure habits at work and during leisure activities. Results: In 2018, 380 high school students and OW from the agricultural and construction sectors participated in a sun-safety campaign. More than a third (39.0%) of OW reported never using sunglasses, 52.8% never applied sunscreens at work, and a quarter never wear a UV protective hat. Considering leisure-time, students reported more frequent sunburns compared to OW: 25.0% vs. 13.8%; half (51.6%) of students and a third (36.4%) of OW reported never wearing a UV protective hat. A third (30.1%) of students and 37.2% of OW never or only seldom applied sunscreens on holidays. Discussion: The majority of OW in our study reported poor protective solar exposure habits. Young students of the construction and agricultural sectors indicated even worse sun-protective behaviors, both during apprenticeship and leisure activities. Our study highlights the low health literacy related to solar UVR in OW and apprentices. Further educational initiatives are required in Italy to improve the adoption of protective behaviors during outdoor activities.
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Affiliation(s)
- Alberto Modenese
- Dipartimento di Scienze Biomediche, Metaboliche e Neuroscienze, Università di Modena e Reggio Emilia, Modena (IT) .
| | - Tom Loney
- College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai (United Arab Emirates).
| | - Francesco Pio Ruggieri
- Dipartimento di Scienze Biomediche, Metaboliche e Neuroscienze, Università di Modena e Reggio Emilia, Modena (IT) .
| | - Lorenzo Tornese
- Dipartimento di Scienze Biomediche, Metaboliche e Neuroscienze, Università di Modena e Reggio Emilia, Modena (IT) .
| | - Fabriziomaria Gobba
- Dipartimento di Scienze Biomediche, Metaboliche e Neuroscienze, Università di Modena e Reggio Emilia, Modena (IT) .
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Vimercati L, De Maria L, Caputi A, Cannone ESS, Mansi F, Cavone D, Romita P, Argenziano G, Di Stefani A, Parodi A, Peris K, Scalvenzi M, Girolomoni G, Foti C. Non-Melanoma Skin Cancer in Outdoor Workers: A Study on Actinic Keratosis in Italian Navy Personnel. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17072321. [PMID: 32235587 PMCID: PMC7177289 DOI: 10.3390/ijerph17072321] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Revised: 03/26/2020] [Accepted: 03/28/2020] [Indexed: 12/12/2022]
Abstract
Occupational exposure to ultraviolet radiation is one of the main risk factors for non-melanoma skin cancer (NMSC) development. The most common variants of NMSC are basal cell carcinomas, squamous cell carcinomas, and actinic keratosis (AK). The latter is nowadays considered by most authors as an early squamous cell carcinoma rather than a precancerous lesion. Outdoor workers have a higher risk of developing NMSC because they spend most of the working day outside. The aim of this descriptive study was to assess the prevalence of skin lesions, especially AK, in a professional category of individuals exposed to ultraviolet (UV) radiation: the Italian Navy. From January to June 2016, a questionnaire and a total skin examination of 921 military personnel were administered by medical specialists (dermatologists) in seven different Italian Navy centres. AK was detected in 217 of 921 (23.5%) workers. Older age, outdoor occupation, longer working life, and fair skin seem to promote the development of AK. Of the 217 workers with AK, 187 (86.2%) had lesions in chronically sun-exposed skin areas. Italian Navy personnel have a high AK prevalence. Further studies are needed to investigate occupational hazards and their health effects among outdoor workers to promote protective behaviour and raise awareness of skin cancer.
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Affiliation(s)
- Luigi Vimercati
- Interdisciplinary Department of Medicine (DIM), Unit of Occupational Medicine, University of Bari, 70124 Bari, Italy; (L.D.M.); (A.C.); (E.S.S.C.); (F.M.); (D.C.)
- Correspondence: ; Tel.: 0039-080-547-8256
| | - Luigi De Maria
- Interdisciplinary Department of Medicine (DIM), Unit of Occupational Medicine, University of Bari, 70124 Bari, Italy; (L.D.M.); (A.C.); (E.S.S.C.); (F.M.); (D.C.)
| | - Antonio Caputi
- Interdisciplinary Department of Medicine (DIM), Unit of Occupational Medicine, University of Bari, 70124 Bari, Italy; (L.D.M.); (A.C.); (E.S.S.C.); (F.M.); (D.C.)
| | - Enza Sabrina Silvana Cannone
- Interdisciplinary Department of Medicine (DIM), Unit of Occupational Medicine, University of Bari, 70124 Bari, Italy; (L.D.M.); (A.C.); (E.S.S.C.); (F.M.); (D.C.)
| | - Francesca Mansi
- Interdisciplinary Department of Medicine (DIM), Unit of Occupational Medicine, University of Bari, 70124 Bari, Italy; (L.D.M.); (A.C.); (E.S.S.C.); (F.M.); (D.C.)
| | - Domenica Cavone
- Interdisciplinary Department of Medicine (DIM), Unit of Occupational Medicine, University of Bari, 70124 Bari, Italy; (L.D.M.); (A.C.); (E.S.S.C.); (F.M.); (D.C.)
| | - Paolo Romita
- Department of Biomedical Science and Human Oncology, Dermatological Clinic, University of Bari, 70124 Bari, Italy; (P.R.); (C.F.)
| | - Giuseppe Argenziano
- Dermatology Unit, Department of Mentals and Physical Health and Preventive medicine, University of Campania Luigi Vanvitelli Naples, 80138 Naples, Italy
| | - Alessandro Di Stefani
- Institute of Dermatology, Università Cattolica, 00168 Rome, Italy; (A.D.S.); (K.P.)
- Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
| | - Aurora Parodi
- Section of Dermatology, Di.S.Sal. Department of Health Science, University of Genoa, San Martino Polyclinic Hospital, 16132 Genoa, Italy;
| | - Ketty Peris
- Institute of Dermatology, Università Cattolica, 00168 Rome, Italy; (A.D.S.); (K.P.)
- Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
| | - Massimiliano Scalvenzi
- Dermatology Unit, Department of Clinical Medicine and Surgery, University of Naples Federico II, 80138 Naples, Italy;
| | - Giampiero Girolomoni
- Department of Medicine, Section of Dermatology, University of Verona, 37134 Verona, Italy;
| | - Caterina Foti
- Department of Biomedical Science and Human Oncology, Dermatological Clinic, University of Bari, 70124 Bari, Italy; (P.R.); (C.F.)
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Wright CY, du Preez DJ, Millar DA, Norval M. The Epidemiology of Skin Cancer and Public Health Strategies for Its Prevention in Southern Africa. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17031017. [PMID: 32041101 PMCID: PMC7037230 DOI: 10.3390/ijerph17031017] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Revised: 01/22/2020] [Accepted: 01/23/2020] [Indexed: 12/24/2022]
Abstract
Skin cancer is a non-communicable disease that has been underexplored in Africa, including Southern Africa. Exposure to solar ultraviolet radiation (UVR) is an important, potentially modifiable risk factor for skin cancer. The countries which comprise Southern Africa are Botswana, Lesotho, Namibia, South Africa, and Swaziland. They differ in population size and composition and experience different levels of solar UVR. Here, the epidemiology and prevalence of skin cancer in Southern African countries are outlined. Information is provided on skin cancer prevention campaigns in these countries, and evidence sought to support recommendations for skin cancer prevention, especially for people with fair skin, or oculocutaneous albinism or HIV-AIDS who are at the greatest risk. Consideration is given to the possible impacts of climate change on skin cancer in Southern Africa and the need for adaptation and human behavioural change is emphasized.
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Affiliation(s)
- Caradee Y. Wright
- Environment and Health Research Unit, South African Medical Research Council, Pretoria 0001, South Africa;
- Department of Geography, Geoinformatics and Meteorology, University of Pretoria, Pretoria 0002, South Africa;
- Correspondence: ; Tel.: +27-12-339-8543
| | - D. Jean du Preez
- Department of Geography, Geoinformatics and Meteorology, University of Pretoria, Pretoria 0002, South Africa;
- LACy, Laboratoire de l’Atmosphère et des Cyclones (UMR 8105 CNRS, Université de La Réunion, Météo-France), 97744 Saint-Denis de La Réunion, France
| | - Danielle A. Millar
- Environment and Health Research Unit, South African Medical Research Council, Pretoria 0001, South Africa;
| | - Mary Norval
- Biomedical Sciences, University of Edinburgh Medical School, Edinburgh EH8 9AG UK;
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Filippini T, Malagoli C, Wise LA, Malavolti M, Pellacani G, Vinceti M. Dietary cadmium intake and risk of cutaneous melanoma: An Italian population-based case-control study. J Trace Elem Med Biol 2019; 56:100-106. [PMID: 31442947 DOI: 10.1016/j.jtemb.2019.08.002] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2019] [Revised: 07/31/2019] [Accepted: 08/01/2019] [Indexed: 02/06/2023]
Abstract
INTRODUCTION Exposure to the heavy metal cadmium has been associated with many adverse health effects, such as atherosclerosis, diabetes, and cancer, possibly melanoma. In non-occupationally exposed individuals, food intake is a major source of cadmium exposure, after smoking. We aimed to assess the risk of melanoma in relation to dietary cadmium intake. METHODS Using a population-based case-control study design, we recruited 380 incident cases of newly-diagnosed cutaneous melanoma and 719 matched controls in the Emilia-Romagna Region, Northern Italy in the years 2005-2006. We evaluated dietary intake using a semi-quantitative food frequency questionnaire. We used conditional logistic regression to compute odds ratios (ORs) and 95% confidence intervals (CIs) for melanoma according to quintiles of dietary cadmium intake, adjusting for several potential confounders, and we modeled the association non-parametrically, using restricted cubic splines. RESULTS Median energy-adjusted intake of cadmium was 6.11 μg/day (interquartile range 5.38-6.91) among cases and 5.97 μg/day (5.15-6.79) among controls. For each 1 μg/day-increase in cadmium intake, the OR for melanoma was 1.11 (95% CI 1.00-1.24). Melanoma risk generally increased with increasing quintile of cadmium exposure, with ORs of 1.55 (95% CI 0.99-2.42), 1.54 (95% CI 0.99-2-40), 1.75 (95% CI 1.12-2.75), and 1.65 (95% CI 1.05-2.61) for the second through fifth quintiles, compared with the lowest quintile. Sex-stratified analysis showed ORs per 1 μg/day-increase in cadmium intake of 1.10 (95% CI 0.93-1-29) among men and 1.15 (95% CI 0.99-1.33) among women. Using spline regression analysis, we observed a generally linear increase in melanoma risk up to 6 μg/day of cadmium intake, after which the risk appeared to plateau. CONCLUSIONS We observed a positive non-linear association between dietary cadmium intake and risk of cutaneous melanoma in a Northern Italy population. However, further studies are needed to elucidate this association, due to concerns about exposure misclassification, unmeasured confounding, and the limited and conflicting evidence from epidemiological findings.
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Affiliation(s)
- Tommaso Filippini
- Environmental, Genetic and Nutritional Epidemiology Research Center, Department of Biomedical, Metabolic and Neural Sciences - Section of Public Health, University of Modena and Reggio Emilia, Modena, Italy
| | - Carlotta Malagoli
- Environmental, Genetic and Nutritional Epidemiology Research Center, Department of Biomedical, Metabolic and Neural Sciences - Section of Public Health, University of Modena and Reggio Emilia, Modena, Italy
| | - Lauren A Wise
- Department of Epidemiology, Boston University School of Public Health, Boston, USA
| | - Marcella Malavolti
- Environmental, Genetic and Nutritional Epidemiology Research Center, Department of Biomedical, Metabolic and Neural Sciences - Section of Public Health, University of Modena and Reggio Emilia, Modena, Italy
| | - Giovanni Pellacani
- Department of Dermatology, University of Modena and Reggio Emilia, Italy
| | - Marco Vinceti
- Environmental, Genetic and Nutritional Epidemiology Research Center, Department of Biomedical, Metabolic and Neural Sciences - Section of Public Health, University of Modena and Reggio Emilia, Modena, Italy; Department of Epidemiology, Boston University School of Public Health, Boston, USA.
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Gobba F, Modenese A, John SM. Skin cancer in outdoor workers exposed to solar radiation: a largely underreported occupational disease in Italy. J Eur Acad Dermatol Venereol 2019; 33:2068-2074. [PMID: 31265157 PMCID: PMC6899887 DOI: 10.1111/jdv.15768] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Accepted: 06/13/2019] [Indexed: 12/11/2022]
Abstract
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.
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Affiliation(s)
- F Gobba
- Department of Biomedical, Metabolic and Neural Sciences, Chair of Occupational Medicine, University of Modena & Reggio Emilia, Modena, Italy
| | - A Modenese
- Department of Biomedical, Metabolic and Neural Sciences, Chair of Occupational Medicine, University of Modena & Reggio Emilia, Modena, Italy
| | - S M John
- Department of Dermatology, Environmental Medicine, Health Theory, Institute for Interdisciplinary Dermatological Prevention and Rehabilitation (iDerm), Lower-Saxonian Institute of Occupational Dermatology (NIB), University of Osnabrueck, Osnabrueck, Germany
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Tizek L, Schielein M, Seifert F, Biedermann T, Böhner A, Zink A. Skin diseases are more common than we think: screening results of an unreferred population at the Munich Oktoberfest. J Eur Acad Dermatol Venereol 2019; 33:1421-1428. [DOI: 10.1111/jdv.15494] [Citation(s) in RCA: 47] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Accepted: 01/18/2019] [Indexed: 02/06/2023]
Affiliation(s)
- L. Tizek
- Department of Dermatology and Allergy Technical University of Munich Munich Germany
- Institute for Medical Information Processing, Biometry and Epidemiology (IBE) LMU Munich Munich Germany
| | - M.C. Schielein
- Department of Dermatology and Allergy Technical University of Munich Munich Germany
- Institute for Medical Information Processing, Biometry and Epidemiology (IBE) LMU Munich Munich Germany
| | | | - T. Biedermann
- Department of Dermatology and Allergy Technical University of Munich Munich Germany
| | - A. Böhner
- Department of Dermatology and Allergy Technical University of Munich Munich Germany
| | - A. Zink
- Department of Dermatology and Allergy Technical University of Munich Munich Germany
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Yin Y, Meng F, Sui C, Jiang Y, Zhang L. Arsenic enhances cell death and
DNA
damage induced by ultraviolet B exposure in mouse epidermal cells through the production of reactive oxygen species. Clin Exp Dermatol 2018; 44:512-519. [PMID: 30456849 DOI: 10.1111/ced.13834] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/29/2018] [Indexed: 01/03/2023]
Affiliation(s)
- Y. Yin
- Cancer Institute The First Affiliated Hospital China Medical University Shenyang Liaoning China
| | - F. Meng
- Cancer Institute The First Affiliated Hospital China Medical University Shenyang Liaoning China
| | - C. Sui
- Cancer Institute The First Affiliated Hospital China Medical University Shenyang Liaoning China
| | - Y. Jiang
- Cancer Institute The First Affiliated Hospital China Medical University Shenyang Liaoning China
| | - L. Zhang
- The First Affiliated Hospital China Medical University Shenyang Liaoning China
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Modenese A, Korpinen L, Gobba F. Solar Radiation Exposure and Outdoor Work: An Underestimated Occupational Risk. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:E2063. [PMID: 30241306 PMCID: PMC6209927 DOI: 10.3390/ijerph15102063] [Citation(s) in RCA: 75] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Revised: 09/17/2018] [Accepted: 09/18/2018] [Indexed: 12/22/2022]
Abstract
A considerably high number of outdoor workers worldwide are constantly exposed for the majority of their working life to solar radiation (SR); this exposure is known to induce various adverse health effects, mainly related to its ultraviolet (UV) component. The skin and the eye are the principal target organs for both acute and long-term exposure. Actinic keratosis, non-melanoma skin cancers, and malignant melanoma are the main long-term adverse skin effects, whereas in the eye pterygium, cataracts, and according to an increasing body of evidence, macular degeneration may be induced. Despite this, SR exposure risk is currently undervalued, if not neglected, as an occupational risk factor for outdoor workers. SR exposure is influenced by various environmental and individual factors, and occupation is one of the most relevant. For a better understanding of this risk and for the development of more effective prevention strategies, one of the main problems is the lack of available and adequate methods to estimate SR worker exposure, especially long-term exposure. The main aims of this review were to provide a comprehensive overview of SR exposure risk of outdoor workers, including the UV exposure levels and the main methods recently proposed for short-term and cumulative exposure, and to provide an update of knowledge on the main adverse eye and skin effects. Finally, we also outline here preventive interventions to reduce occupational risk.
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Affiliation(s)
- Alberto Modenese
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena & Reggio Emilia, 41124 Modena, Italy.
| | - Leena Korpinen
- Clinical Physiology and Neurophysiology Unit, The North Karelia Central Hospital, 80210 Joensuu, Finland.
| | - Fabriziomaria Gobba
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena & Reggio Emilia, 41124 Modena, Italy.
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13
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Modenese A, Gobba F. Macular degeneration and occupational risk factors: a systematic review. Int Arch Occup Environ Health 2018; 92:1-11. [PMID: 30191305 PMCID: PMC6323067 DOI: 10.1007/s00420-018-1355-y] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2017] [Accepted: 09/04/2018] [Indexed: 01/08/2023]
Abstract
Purpose Macular degeneration is a multi-factorial disease, leading cause of blindness for people over 50 years old in developed countries. To date, the knowledge on possible occupational factors involved in the development of the disease is scant. Method We performed a systematic scientific literature search on the association between macular degeneration and occupational risk factors searching the MedLine and Scopus databases. Results We examined 158 articles and, according to the inclusion criteria, 13 peer-reviewed studies evaluating occupational risk factors for macular degeneration or reporting the frequency of the disease in specific groups of workers were included in the review. Ten on thirteen articles evaluated the presence of macular degeneration in workers exposed to solar radiation. Only one study found that non-specific history of occupational chemical exposure was associated with the disease. Two studies showed an association between macular degeneration and the general category of “blue-collar” workers, but they did not identify the specific risk factors involved. Conclusions To date few studies have examined occupational risk factors for macular degeneration. Nevertheless, available data indicate that long-term occupational solar radiation exposure, in particular for its blue-light component, is associated with macular degeneration in outdoor workers. Electronic supplementary material The online version of this article (10.1007/s00420-018-1355-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Alberto Modenese
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Via G. Campi 287, 41125, Modena, Italy.
| | - Fabriziomaria Gobba
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Via G. Campi 287, 41125, Modena, Italy
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Zink A, Tizek L, Schielein M, Böhner A, Biedermann T, Wildner M. Different outdoor professions have different risks - a cross-sectional study comparing non-melanoma skin cancer risk among farmers, gardeners and mountain guides. J Eur Acad Dermatol Venereol 2018; 32:1695-1701. [PMID: 29806193 DOI: 10.1111/jdv.15052] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2018] [Accepted: 04/06/2018] [Indexed: 01/09/2023]
Abstract
BACKGROUND One of the main risk factors for non-melanoma skin cancer (NMSC), the most common cancer worldwide, is solar ultraviolet radiation (UVR). This has led to the recognition of NMSC as occupational disease for outdoor workers in several countries. However, outdoor professions are a very heterogeneous group with diverse daily activities and associated UVR exposure. OBJECTIVE To compare the prevalence of NMSC and associated risk behaviour in different outdoor professions. METHODS Cross-sectional study among outdoor workers (farmers, gardeners, mountain guides) and indoor workers (office employees) as control group using a paper-based questionnaire on UVR exposure and protective behaviour followed by a skin examination by a dermatologist. RESULTS A total of 563 participants (46.9% women, 46.9 ± 13.8 years) consisting of 348 outdoor workers (38.8% farmer, 35.3% gardener, 25.9% mountain guides) and 215 indoor workers were included in the study between March and September 2017. NMSC incl. actinic keratosis was diagnosed in 33.3% of mountain guides, 27.4% of farmers, 19.5% of gardeners and in 5.6% of indoor workers. Significant differences were seen between the outdoor professions with mountain guides at highest risk compared to farmers (OR = 2.6, 95% CI = 1.2-5.7). Substantial differences between the professions were also seen in skin cancer screening attendance rates (indoor worker 61.4%, mountain guides 57.8%, farmers 31.9%, gardeners 27.6%), daily UVR exposure during work and protective behaviour such as sunscreen use during work. CONCLUSION Different outdoor professions have significant different risks for NMSC and show different risk behaviour. Tailoring prevention efforts to different professions based on their individual needs could be the key to lower the global burden of (occupational) NMSC.
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Affiliation(s)
- A Zink
- Department of Dermatology and Allergy, Technical University of Munich, Munich, Germany.,Pettenkofer School of Public Health, LMU Munich, Munich, Germany
| | - L Tizek
- Department of Dermatology and Allergy, Technical University of Munich, Munich, Germany
| | - M Schielein
- Department of Dermatology and Allergy, Technical University of Munich, Munich, Germany
| | - A Böhner
- Department of Dermatology and Allergy, Technical University of Munich, Munich, Germany
| | - T Biedermann
- Department of Dermatology and Allergy, Technical University of Munich, Munich, Germany
| | - M Wildner
- Bavarian Health and Food Safety Authority, Munich, Germany.,Pettenkofer School of Public Health, LMU Munich, Munich, Germany
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15
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John S, Trakatelli M, Ulrich C. Non-melanoma skin cancer by solar UV: the neglected occupational threat. J Eur Acad Dermatol Venereol 2016; 30 Suppl 3:3-4. [DOI: 10.1111/jdv.13602] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
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