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

Schmitt J, Haufe E, Trautmann F, Schulze HJ, Elsner P, Drexler H, Bauer A, Letzel S, John SM, Fartasch M, Bruening T, Seidler A, Dugas-Breit S, Gina M, Weistenhöfer W, Bachmann K, Bruhn I, Lang BM, Bonness S, Allam JP, Grobe W, Stange T, Westerhausen S, Knuschke P, Wittlich M, Diepgen TL (2018)

Publication Type: Journal article

Publication year: 2018

Journal

British Journal of Dermatology Wiley-Blackwell

Book Volume: 178

Pages Range: 462-472

Journal Issue: 2

DOI: 10.1111/bjd.15906

Abstract

BACKGROUND: Squamous cell carcinoma (SCC) is one of the most frequent types of cancer constituting a significant public health burden. Prevention strategies focus on limiting ultraviolet (UV) exposure during leisure time. However, the relative impact of occupational and nonoccupational UV exposure for SCC occurrence is unclear. OBJECTIVES: To investigate the association between occupational and nonoccupational UV exposure for SCC in a multicentre population-based case-control study hypothesizing that high occupational UV exposure increases the risk of SCC. METHODS: Consecutive patients with incident SCC (n = 632) were recruited from a German national dermatology network. Population-based controls (n = 996) without history of skin cancer were recruited from corresponding residents' registration offices and propensity score matched to cases. Lifetime UV exposure, sociodemographic and clinical characteristics were assessed by trained physicians. Occupational and nonoccupational UV exposure doses were estimated by masked investigators using established reference values. Odds ratios (ORs) and corresponding 95% confidence intervals (CIs) were assessed using conditional logistic regression adjusting for relevant confounders. RESULTS: Total solar UV exposure was significantly associated with increased SCC. The OR for high (> 90th percentile) vs. low (< 40th percentile) and high vs, moderate (40-59th percentile) occupational UV exposure was 1·95 (95% CI 1·19-3·18) and 2·44 (95% CI 1·47-4·06) for SCC. Adjusting for occupational UV exposure, nonoccupational UV exposure was not significantly related to SCC incidence. Dose-response relationships were observed for occupational but not for nonoccupational solar UV exposure. CONCLUSIONS: Solar occupational UV exposure is a major determinant of incident SCC. Our findings indicate that prevention strategies should be further expanded to the occupational setting.

Authors with CRIS profile

Johann Drexler Lehrstuhl für Arbeits-, Sozial- und Umweltmedizin Wobbeke Weistenhöfer Lehrstuhl für Arbeits-, Sozial- und Umweltmedizin

Related research project(s)

DGUV - FB 181 Jan. 1, 2013 - Dec. 31, 2015

Involved external institutions

Technische Universität Dresden DE Germany (DE) Fachklinik Hornheide DE Germany (DE) Universitätsklinikum Jena DE Germany (DE) Johannes Gutenberg-Universität Mainz (JGU) DE Germany (DE) Universität Osnabrück DE Germany (DE) Institut für Prävention und Arbeitsmedizin der Deutschen Gesetzlichen Unfallversicherung (IPA) DE Germany (DE) Ruprecht-Karls-Universität Heidelberg DE Germany (DE) Rheinische Friedrich-Wilhelms-Universität Bonn DE Germany (DE) Deutsche Gesetzliche Unfallversicherung e.V. (DGUV) DE Germany (DE)

How to cite

APA:

Schmitt, J., Haufe, E., Trautmann, F., Schulze, H.-J., Elsner, P., Drexler, H.,... Diepgen, T.L. (2018). 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. British Journal of Dermatology, 178(2), 462-472. https://doi.org/10.1111/bjd.15906

MLA:

Schmitt, J., et al. "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." British Journal of Dermatology 178.2 (2018): 462-472.

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