Tobia L, Fanelli C, Bianchi S, Paglione M, Diana S, Di Fabio G, Paoletti A
Dipartimento di Medicina Interna e Sanità Pubblica, Cattedra dDi Medicina del Lavoro Università degli Studi di L'Aquila.
G Ital Med Lav Ergon. 2007 Jul-Sep;29(3 Suppl):422-4.
The aim of our study was to verify the impact of work risk factor in causing cutaneous neoplasia on a group of patients and to assess the risk of exposure to UV on outdoor workers. The survey was divided in three phases: a) Questionnaire, b) Dermatological clinical examination. c) Exposure measurement by spectral radiance method (mW/cm2). 248 subjects were enrolled, 100 of which affected by basal cellular carcinoma (BCC) (68% M and 32% F: mean age 70 +/- 11.93 y) 130 by melanoma (42% M and 58% F; mean age 53 +/- 17.35 y) and 18 by squamous cellular carcinoma (33% F and 67% M: mean age 78 +/- 11.41 y). In addiction 22 healthy male subjects exposed to UV were examined (mean age 38.59 +/- 13.65 y; specific working age 11.88 +/- 10.92 y). The assessment of UV exposure was performed over a 24 days timeframe during summer 2007, all over the working day. Furthermore, maximum allowed exposure time (t(max)) without protection was calculated according to ACGIH guidelines in order to prevent cutaneous alterations. It turned out that the UV exposure, both in working and spare time, is the root cause for squamous cellular cancer developing. Furthermore our results proved that also BCC is related to the overall UV exposure. No clear link to the UV exposure was found for cutaneous melanoma. No precancerous lesions were observed on shortly exposed subjects. The measurements performed revealed, as expected, lower exposure during first and last hours of the day without any particular constrain on t(max), and maximum exposure in the timeframe between 10:00 AM and 4:00 PM. Therefore, it is necessary to pay higher attention to the UV exposure and related consequences on employees health in order to provide with the most suitable preventing measures such the usage of protections depending from the requested exposure time.
我们研究的目的是验证工作风险因素对一组患者发生皮肤肿瘤的影响,并评估户外工作者暴露于紫外线的风险。该调查分为三个阶段:a)问卷调查,b)皮肤科临床检查,c)通过光谱辐射法(mW/cm²)进行暴露测量。共招募了248名受试者,其中100名患有基底细胞癌(BCC)(男性68%,女性32%:平均年龄70±11.93岁),130名患有黑色素瘤(男性42%,女性58%;平均年龄53±17.35岁),18名患有鳞状细胞癌(女性33%,男性67%:平均年龄78±11.41岁)。此外,还检查了22名暴露于紫外线的健康男性受试者(平均年龄38.59±13.65岁;特定工作年限11.88±10.92年)。紫外线暴露评估于2007年夏季的24天时间内,在整个工作日进行。此外,根据美国政府工业卫生学家会议(ACGIH)指南计算了无防护情况下的最大允许暴露时间(t(max)),以防止皮肤改变。结果表明,无论是在工作时间还是业余时间,紫外线暴露都是鳞状细胞癌发生的根本原因。此外,我们的结果证明基底细胞癌也与总体紫外线暴露有关。未发现皮肤黑色素瘤与紫外线暴露有明确联系。在短期暴露的受试者中未观察到癌前病变。所进行的测量显示,正如预期的那样,在一天的开始和最后几个小时暴露较低,对t(max)没有任何特别限制,而在上午10:00至下午4:00之间的时间段暴露最高。因此,有必要更加关注紫外线暴露及其对员工健康的相关后果,以便提供最适合的预防措施,例如根据所需暴露时间使用防护用品。