Diepgen T L, Drexler H
Abteilung Klinische Sozialmedizin mit Schwerpunkt Berufs- und Umweltdermatologie, Universitätsklinikum Heidelberg, Ruprecht-Karls Universität Heidelberg, Heidelberg.
Hautarzt. 2004 Jan;55(1):22-7. doi: 10.1007/s00105-003-0652-9.
Although it is universally accepted that UV light exposure can cause malignant skin tumors, UV-induced skin cancers are not recognized as an occupational disease in Germany. Exposure to natural or artificial UV light occurs in many work places, so that the induction of occupational skin cancers is certainly plausible. In recent years, a special clause in the occupational disability rules has recognized some cases of UV-induced skin cancers. We discuss the nature of occupational UV exposure, explore preventative measures and review the data regarding occupational UV-induced skin tumors. After evaluating recent publications, we conclude that for squamous cell carcinoma the epidemiological proof of an at least doubled risk (RR >2) due to occupational UV radiation can be given. The clear dose response relationship supports these epidemiological findings. For the individual risk assessment, an attributive UV radiation >40% due to occupational factors must exist. Under those circumstances, squamous cell carcinoma should be recognized and compensated as an occupational disease.
尽管紫外线照射会引发恶性皮肤肿瘤这一点已被广泛认可,但在德国,紫外线诱发的皮肤癌并不被认定为职业病。在许多工作场所都会接触到自然或人工紫外线,因此职业性皮肤癌的诱发确实是有可能的。近年来,职业残疾评定规则中的一项特殊条款已认定了一些紫外线诱发皮肤癌的病例。我们讨论职业性紫外线暴露的性质,探索预防措施,并回顾有关职业性紫外线诱发皮肤肿瘤的数据。在评估近期的出版物后,我们得出结论,对于鳞状细胞癌,可以给出职业性紫外线辐射导致风险至少翻倍(相对危险度>2)的流行病学证据。明确的剂量反应关系支持了这些流行病学研究结果。对于个体风险评估,必须存在因职业因素导致的归因紫外线辐射>40%的情况。在这种情况下,鳞状细胞癌应被认定为职业病并给予赔偿。