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职业性皮肤癌

Occupational skin cancers.

作者信息

Gawkrodger D J

机构信息

Department of Dermatology, Royal Hallamshire Hospital, Sheffield S10 2JF, UK.

出版信息

Occup Med (Lond). 2004 Oct;54(7):458-63. doi: 10.1093/occmed/kqh098.

Abstract

Skin cancer due to occupation is more common than is generally recognized, although it is difficult to obtain an accurate estimate of its prevalence. Over the past two centuries, occupational skin cancers have particularly been due to industrial exposure of men (it seems more so than women) to chemical carcinogens such as polycyclic hydrocarbons (e.g. from coal tar products) or to arsenic. Industrial processes have improved in most Western countries to limit this type of exposure, but those with outdoor occupations are still exposed to solar ultraviolet irradiation without this being widely recognized as an industrial hazard. Ionizing radiation such as X-rays can also cause skin cancer. Occupational skin cancers often resemble skin tumours found in non-occupational subjects, e.g. basal cell carcinoma, squamous cell carcinoma and malignant melanoma, but some pre-malignant lesions can be more specific and point to an occupational origin, e.g. tar keratoses or arsenical keratoses. An uncommon but well-recognized cause of occupational skin cancer is that which results from scar formation following an industrial burn. In the future it will be necessary to focus on preventative measures, e.g. for outdoor workers, the need to cover up in the sun and use sun protective creams and a campaign for earlier recognition of skin cancers, which are usually curable if treated in their early stages.

摘要

职业性皮肤癌比人们普遍认为的更为常见,尽管很难准确估计其发病率。在过去的两个世纪里,职业性皮肤癌尤其源于男性(似乎比女性更常见)在工业环境中接触化学致癌物,如多环烃(如来自煤焦油产品)或砷。大多数西方国家的工业生产流程已有所改进,以限制此类接触,但从事户外工作的人仍暴露于太阳紫外线辐射之下,而这并未被广泛视为一种工业危害。诸如X射线之类的电离辐射也可引发皮肤癌。职业性皮肤癌通常类似于在非职业人群中发现的皮肤肿瘤,如基底细胞癌、鳞状细胞癌和恶性黑色素瘤,但一些癌前病变可能更具特异性,并指向职业性病因,如焦油角化病或砷角化病。一种罕见但广为人知的职业性皮肤癌病因是工业烧伤后形成的瘢痕。未来有必要关注预防措施,例如对于户外工作者,需要在阳光下做好防护、使用防晒乳膏,并开展一场提高对皮肤癌早期识别的宣传活动,因为皮肤癌如果在早期得到治疗通常是可以治愈的。

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