Moehrle Matthias, Dennenmoser Bernhard, Garbe Claus
Department of Dermatology, Eberhard-Karls-University, Tuebingen, Germany.
Int J Cancer. 2003 Mar 1;103(6):775-8. doi: 10.1002/ijc.10884.
Ultraviolet radiation (UVR) is estimated to be one of the most important risk factors for nonmelanoma and melanoma skin cancers. High occupational UV exposure is assumed to be associated with skin cancer. Mountain guides receive considerable UV doses due to altitude-related increase of UVR and reflection from snow- and ice-covered surfaces. The aim of our study was to assess the annual occupational UV exposure of mountain guides. Spore film test chambers containing spores of Bacillus subtilis (VioSpor) were used as UV dosimeters with a spectral sensitivity profile similar to erythema-weighted data calculated from spectroradiometric measurements. Nine mountain guide instructors carried dosimeters on the sides of their heads on a total of 1,406 working days during one year (July 1999-June 2000). Dosimeters were changed monthly. Measurements of 92 months could be evaluated (4-12 months/mountain guide). The mean individual monthly UV exposure was 107 standard erythema doses (SED) (median 71 SED; range 10-505 SED). The mean annual cumulative UV exposure was 1,097 SED (median 1,273 SED; range 312-1,770 SED) per mountain guide. The mean UV dose per day (4-10 hr) was 6.6 SED (median 5.7 SED; range 0.6-24.2 SED). This is the second study of continuous annual UV dosimetry in a cohort of outdoor workers. Our study showed that it is not sufficient to interpolate annual UV exposure from a few days' measurements. Only long-term dosimetry can give reliable yearly information of UVR load. Median daily UV exposure exceeded limits for UV radiation (e.g., ACGIH effective dose 30 J/m(2) per 8 hr period corresponding to 1.08 SED/day) 6-fold; maximal exposure exceeded these limits 23-fold. These extremely high exposure values are suggestive for an increased risk of skin cancer and thorough epidemiologic studies in the collectives of professional and recreational mountaineering are required.
紫外线辐射(UVR)被认为是非黑素瘤和黑素瘤皮肤癌最重要的风险因素之一。高职业性紫外线暴露被认为与皮肤癌有关。由于紫外线辐射随海拔升高以及冰雪覆盖表面的反射,登山向导会受到相当大剂量的紫外线照射。我们研究的目的是评估登山向导的年度职业性紫外线暴露情况。含有枯草芽孢杆菌孢子(VioSpor)的芽孢膜测试腔被用作紫外线剂量计,其光谱灵敏度曲线与根据分光辐射测量计算出的红斑加权数据相似。9名登山向导教练在一年(1999年7月至2000年6月)的1406个工作日里,将剂量计戴在头部两侧。剂量计每月更换一次。92个月的测量数据可以进行评估(每位登山向导4 - 12个月)。每位登山向导每月平均紫外线暴露量为107标准红斑剂量(SED)(中位数71 SED;范围10 - 505 SED)。每位登山向导每年累计紫外线暴露量平均为1097 SED(中位数1273 SED;范围312 - 1770 SED)。每天(4 - 10小时)的平均紫外线剂量为6.6 SED(中位数5.7 SED;范围0.6 - 24.2 SED)。这是第二项针对一组户外工作者进行连续年度紫外线剂量测定的研究。我们的研究表明,仅通过几天的测量来推断年度紫外线暴露量是不够的。只有长期剂量测定才能提供可靠的年度紫外线辐射负荷信息。每日紫外线暴露量中位数超过紫外线辐射限值(例如,美国政府工业卫生学家会议规定的每8小时有效剂量30 J/m²,相当于每天1.08 SED)6倍;最大暴露量超过这些限值23倍。这些极高的暴露值表明皮肤癌风险增加,需要对专业和业余登山群体进行全面的流行病学研究。