Bauer A
Klinik und Poliklinik für Dermatologie, UniversitätsAllergieCentrum, Universitätsklinikum Carl Gustav Carus, Technische Universität Dresden, Fetscherstr. 74, 01307, Dresden, Deutschland.
Hautarzt. 2016 Nov;67(11):884-890. doi: 10.1007/s00105-016-3877-0.
The incidence of epithelial skin neoplasms, such as squamous cell carcinoma and basal cell carcinoma is significantly increasing worldwide. Leisure time solar UV exposure is causative in the overwhelming majority of cases in the general population; however, occupational exposure is responsible for a certain percentage of cases. Employees with a relevant exposure to polycyclic aromatic hydrocarbons in soot, raw paraffin, coal tar, anthracene, pitch or similar substances, to sunlight in outdoor occupations as well as to arsenic and ionizing radiation have a significantly increased risk to develop occupational skin cancer compared to the general population. In the official occupational disease list in the appendix of the German by-law on occupational diseases, the following occupational diseases concerning skin cancer are listed: BK 5102 "skin cancer and carcinoma in situ caused by soot, raw paraffin, coal tar, anthracene, pitch or similar substances" (e.g. various solid paraffins, asphalt and mazut as well as mineral oils, grease, cylinder and drilling oils), BK 5103 "squamous cell carcinoma or multiple actinic keratosis caused by natural UV radiation", BK 1108 "diseases caused by arsenic and its compounds" and BK 2402 "diseases caused by ionizing radiation". For further occupational exposure to carcinogenic substances and potential occupationally acquired skin tumors, no official lists are currently available. These cancers might be considered under a special opt out paragraph in the German Social Law (§ 9 para 2 SGB VII). Tumors in scars after occupational skin trauma or occupational burns are compensated as consequences of work accidents. The current official list of occupational skin cancers and new developments for expert opinions are described in this article.
上皮性皮肤肿瘤,如鳞状细胞癌和基底细胞癌的发病率在全球范围内显著上升。在普通人群中,绝大多数病例是由休闲时间的日光紫外线照射引起的;然而,职业暴露也导致了一定比例的病例。与普通人群相比,接触烟灰、粗石蜡、煤焦油、蒽、沥青或类似物质中的多环芳烃、从事户外职业时接触阳光以及接触砷和电离辐射的员工患职业性皮肤癌的风险显著增加。在德国职业病相关法律附录中的官方职业病列表中,列出了以下与皮肤癌相关的职业病:BK 5102“由烟灰、粗石蜡、煤焦油、蒽、沥青或类似物质引起的皮肤癌和原位癌”(如各种固体石蜡、沥青和重油以及矿物油、油脂、汽缸油和钻探油),BK 5103“由自然紫外线辐射引起的鳞状细胞癌或多发性光化性角化病”,BK 1108“由砷及其化合物引起的疾病”以及BK 2402“由电离辐射引起的疾病”。对于进一步的职业性致癌物接触和潜在的职业性获得性皮肤肿瘤,目前尚无官方列表。这些癌症可能在德国社会法(《社会法典》第七编第9条第2款)的一个特殊排除条款下予以考虑。职业性皮肤创伤或职业性烧伤后疤痕中的肿瘤作为工作事故的后果获得赔偿。本文介绍了当前职业性皮肤癌的官方列表以及专家意见的新进展。