Bauer A, Beissert S, Knuschke P
Klinik und Poliklinik für Dermatologie, UniversitätsAllergieZentrum, Universitätsklinikum Carl Gustav Carus, Technische Universität Dresden, Fetscherstr. 74, 01307, Dresden, Deutschland,
Hautarzt. 2015 Mar;66(3):173-8. doi: 10.1007/s00105-015-3584-2.
Malignancies of the skin, with an incidence of more than 200,000 newly registered cases/year, are the most frequently notified malignances in Germany. In Europe, squamous cell carcinoma (SCC) and basal cell carcinoma (BCC) account for about 30 cases/100,000 persons and 50-100 cases/100,000 persons, respectively. Ultraviolet (UV) exposure is the main risk factor to induce these cancers. Increased incidence rates were shown for persons having red/blonde hair as well as light eye colour, acquire sun burns easily, hardly tan and develop freckles. The majority of the malignancies and precursor lesions are acquired by UV exposure in leisure time. However, in highly occupationally UV-exposed outdoor workers, UV monitoring revealed that exposure levels are 2-3 times higher compared to the general population. Occupations likely to be highly exposed are farmers, forestry workers, gardeners, landscapers, fishermen and seafarers, construction workers, builders, tin smiths, sport teachers, mountain guides, etc. Recent metaanalyses showed that occupational UV exposure is a relevant and independent risk factor for SCC and to a lesser extent also for BCC. To prevent occupationally caused malignancies of the skin a significant reduction of occupationally acquired UV dosages in outdoor workers is mandatory. Relevant factors influencing the cumulative sun exposure in outdoor workers are the amount of UV exposure, the specific tasks to be performed in the sun as well as the UV protection habits of the workers. Besides adequate behavior, textile protection by headgear and clothing as well as the regular use of sunscreens and sun glasses are important.
皮肤恶性肿瘤是德国报告最为频繁的恶性肿瘤，每年新登记病例超过20万例。在欧洲，鳞状细胞癌（SCC）和基底细胞癌（BCC）的发病率分别约为每10万人30例和每10万人50 - 100例。紫外线（UV）暴露是诱发这些癌症的主要危险因素。头发为红色或金色、眼睛颜色浅、容易晒伤、不易晒黑且易长雀斑的人发病率较高。大多数恶性肿瘤及其前驱病变是在休闲时间因紫外线暴露所致。然而，对于户外工作中紫外线暴露程度高的职业人群，紫外线监测显示其暴露水平比普通人群高2至3倍。可能遭受高暴露的职业有农民、林业工人、园丁、景观设计师、渔民和海员、建筑工人、施工人员、锡匠、体育教师、登山向导等。最近的荟萃分析表明，职业性紫外线暴露是鳞状细胞癌的一个相关且独立的危险因素，对基底细胞癌的影响程度相对较小。为预防职业性皮肤恶性肿瘤，必须大幅降低户外工作者职业性获得的紫外线剂量。影响户外工作者累积日照量的相关因素包括紫外线暴露量、在阳光下执行的特定任务以及工作者的紫外线防护习惯。除了适当的行为外，通过佩戴帽子和穿着衣物进行纺织品防护以及定期使用防晒霜和太阳镜也很重要。
