TY - JOUR
T1 - Skin cancer risk in outdoor workers
T2 - A European multicenter case-control study
AU - Trakatelli, M.
AU - Barkitzi, K.
AU - Apap, C.
AU - Majewski, S.
AU - De Vries, E.
AU - Coebergh, Jan Willem
AU - Apalla, Zoe
AU - Ioannides, Dimitrios
AU - Kalabalikis, Dimitrios
AU - Kalokasidis, Kostantinos
AU - Kitsou, Anastasia
AU - Siskou, Stella
AU - Traianou, Athina
AU - Sotiriadis, Dimitrios
AU - Moreno-Ramirez, David
AU - Ferrandiz, Lara
AU - Ruiz-De-Casas, Andres
AU - Micallef, Rita
AU - Ranki, Annamari
AU - Saksela, Olli
AU - Pitkänen, Sari
AU - Stockfleth, Eggert
AU - Altsitsiadis, Efthimios
AU - Hinrichs, Birgit
AU - Ulrich, Martina
AU - Magnoni, Cristina
AU - Fiorentini, Chiara
AU - Proby, Charlotte
AU - Crawford, Leaca
N1 - Publisher Copyright:
© 2016 European Academy of Dermatology and Venereology.
PY - 2016/4/1
Y1 - 2016/4/1
N2 - Background Exposure to ultraviolet radiation (UVR) is the most important external risk factor for skin cancer. Outdoor workers, who are exposed to high ambient UVR levels are at increased risk. Objective To compare outdoor with indoor workers in terms of: (i) skin cancer risk factors, and (ii) risk of developing skin cancer. Methods Using descriptive methods and a large multicenter European case-control study, we compared risk factor patterns between outdoor (N = 1416) and indoor workers (N = 1863). Risk of developing basal cell carcinoma (BCC), squamous cell carcinoma (SCC), melanoma and actinic keratosis (AK) were analysed by type of work using multivariate logistic regression models, for three categories of work: indoor; farming/construction; other outdoor work. Results Although skin phototype was equally distributed by type of work, significantly less outdoor than indoor workers used sunscreen in their own country (44.3% vs. 60.2%), but had more outdoor hobbies (66.2% vs. 58.2%). Outdoor workers had lower educational levels, and felt less confident in understanding medical information and filling medical forms (all P < 0.001). Outdoor workers had more signs of photodamage (78.1% vs. 65.5%) and among the skin cancer patients, 37.7% of outdoor workers vs. 28.6% of indoor workers had ≥2 skin cancers diagnosed during their lifetime. Multivariate logistic regression models showed significantly increased risk of outdoor vs. indoor work for AK (ORother outdoor = 1.55, ORfarming/construction = 2.58), SCC (ORother outdoor = 1.32, ORfarming/construction = 2.77) and BCC (ORother outdoor = 1.53, ORfarming/construction = 1.83). No significant associations were found for melanoma. The risk of all types of skin cancer and AK was significantly increased for workers with ≥5 years of outdoor work. Conclusions Outdoor workers had more risk behaviour with similar constitutional skin cancer risk factors: more UV exposure (both occupational and leisure) and less sunscreen use and lower health literacy. This results in higher exposure, more photodamage and an increased risk of developing AK, BCC and SCC.
AB - Background Exposure to ultraviolet radiation (UVR) is the most important external risk factor for skin cancer. Outdoor workers, who are exposed to high ambient UVR levels are at increased risk. Objective To compare outdoor with indoor workers in terms of: (i) skin cancer risk factors, and (ii) risk of developing skin cancer. Methods Using descriptive methods and a large multicenter European case-control study, we compared risk factor patterns between outdoor (N = 1416) and indoor workers (N = 1863). Risk of developing basal cell carcinoma (BCC), squamous cell carcinoma (SCC), melanoma and actinic keratosis (AK) were analysed by type of work using multivariate logistic regression models, for three categories of work: indoor; farming/construction; other outdoor work. Results Although skin phototype was equally distributed by type of work, significantly less outdoor than indoor workers used sunscreen in their own country (44.3% vs. 60.2%), but had more outdoor hobbies (66.2% vs. 58.2%). Outdoor workers had lower educational levels, and felt less confident in understanding medical information and filling medical forms (all P < 0.001). Outdoor workers had more signs of photodamage (78.1% vs. 65.5%) and among the skin cancer patients, 37.7% of outdoor workers vs. 28.6% of indoor workers had ≥2 skin cancers diagnosed during their lifetime. Multivariate logistic regression models showed significantly increased risk of outdoor vs. indoor work for AK (ORother outdoor = 1.55, ORfarming/construction = 2.58), SCC (ORother outdoor = 1.32, ORfarming/construction = 2.77) and BCC (ORother outdoor = 1.53, ORfarming/construction = 1.83). No significant associations were found for melanoma. The risk of all types of skin cancer and AK was significantly increased for workers with ≥5 years of outdoor work. Conclusions Outdoor workers had more risk behaviour with similar constitutional skin cancer risk factors: more UV exposure (both occupational and leisure) and less sunscreen use and lower health literacy. This results in higher exposure, more photodamage and an increased risk of developing AK, BCC and SCC.
UR - http://www.scopus.com/inward/record.url?scp=84962615419&partnerID=8YFLogxK
U2 - 10.1111/jdv.13603
DO - 10.1111/jdv.13603
M3 - Article
C2 - 26995016
AN - SCOPUS:84962615419
SN - 0926-9959
VL - 30
SP - 5
EP - 11
JO - Journal of the European Academy of Dermatology and Venereology
JF - Journal of the European Academy of Dermatology and Venereology
ER -
