职业性紫外线暴露是基底细胞癌的主要危险因素：基于人群的病例对照研究 FB-181 的结果。
Occupational UV-Exposure is a Major Risk Factor for Basal Cell Carcinoma: Results of the Population-Based Case-Control Study FB-181.
机构信息
Center of Evidence-based Healthcare, University Hospital and Medical Faculty Carl Gustav Carus, TU Dresden, Germany (Dr Schmitt, Dr Haufe, Trautmann, Stange); Institute and Outpatient Clinics of Occupational and Social Medicine, Medical Faculty Carl Gustav Carus, TU Dresden, Germany (Drs Haufe, Andreas Seidler); Department of Dermatology, Dermatological Radiotherapy and Dermatohistopathology, Special Clinics Hornheide, Münster, Germany (Drs Schulze, Dugas-Breit); Department of Dermatology, University Hospital Jena, Jena, Germany (Drs Elsner, Gina); Institute and Outpatient Clinic of Occupational, Social and Environmental Medicine, Friedrich-Alexander-University, Erlangen-Nürnberg, Germany (Drs Drexler, Weistenhöfer); Department of Dermatology, University Allergy Center, Medical Faculty Carl Gustav Carus, TU Dresden, Germany (Drs Bauer, Bruhn); Institute of Occupational, Social and Environmental Medicine, University Medical Center, Johannes-Gutenberg University, Mainz, Germany (Dr Letzel); Department of Dermatology, Environmental Health and Health Theory, University of Osnabrück and Institute of Interdisciplinary Dermatological Prevention and Rehabilitation (iDerm) at the University of Osnabrück, Osnabrück, Germany (Dr John); Institute for Prevention and Occupational Medicine of the German Social Accident Insurance (DGUV), Institute of Ruhr-University Bochum (IPA), Bochum, Germany (Drs Fartasch, Brüning); Department of Clinical Social Medicine, Occupational and Environmental Dermatology, University of Heidelberg, Heidelberg, Germany (Drs Bachmann, Diepgen); Department of Dermatology, University Medical Center, Johannes-Gutenberg University, Mainz, Germany (Dr Lang); Institute of Interdisciplinary Dermatological Prevention and Rehabilitation (iDerm) at the University of Osnabrück, Employer's Liability Insurance Association Clinics Hamburg, Hamburg, Germany (Dr Bonness); Department of Dermatology and Allergy, University Bonn, Bonn, Germany (Drs Allam, Grobe); Department of Radiation, Institute of Occupational Health and Safety of the German Social Accident Insurance (DGUV), Sankt Augustin, Germany (Westerhausen, Dr Wittlich); and Department of Dermatology, Experimental Photobiology, Medical Faculty Carl Gustav Carus, TU Dresden, Dresden, Germany (Knuschke).
出版信息
J Occup Environ Med. 2018 Jan;60(1):36-43. doi: 10.1097/JOM.0000000000001217.
OBJECTIVE
The aim of this study was to investigate the role of occupational and nonoccupational ultraviolet (UV)-exposure concerning the development of basal cell carcinoma (BCC).
METHODS
We undertook a population-based multicenter case-control study. Patients with first incident BCC (n = 836) were propensity score matched by age and sex to controls without skin cancer (n = 836). Sociodemographic characteristics, clinical characteristics, and lifetime UV-exposure were assessed by trained investigators. The differential estimation of occupational and nonoccupational UV-exposure dosages was based on validated instruments and established reference values. Associations were assessed using multivariable-adjusted conditional logistic regression models.
RESULTS
Individuals with high levels of occupational UV-exposure were at significantly increased BCC-risk compared with individuals with low [odds ratio (OR) 1.84; 95% confidence interval (95% CI) 1.19 to 2.83 and moderate (OR 1.97; 95% CI 1.20 to 3.22) occupational UV-exposure. Nonoccupational UV-exposure was not independently associated with BCC.
CONCLUSION
Skin cancer prevention strategies should be expanded to the occupational setting.
目的
本研究旨在探讨职业和非职业紫外线（UV）暴露在基底细胞癌（BCC）发生中的作用。
方法
我们进行了一项基于人群的多中心病例对照研究。将首次发生 BCC（n=836）的患者按年龄和性别与无皮肤癌（n=836）的对照者进行倾向评分匹配。通过受过培训的调查员评估社会人口统计学特征、临床特征和终生 UV 暴露情况。基于经过验证的仪器和既定参考值，对职业和非职业 UV 暴露剂量进行差异估计。使用多变量调整的条件逻辑回归模型评估关联。
结果
与低水平职业 UV 暴露者相比，高水平职业 UV 暴露者患 BCC 的风险显著增加（比值比 1.84；95%置信区间 95%CI 1.19 至 2.83 和中度职业 UV 暴露者 1.97；95%CI 1.20 至 3.22）。非职业性 UV 暴露与 BCC 无独立关联。
结论
应将皮肤癌预防策略扩展到职业环境。
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