Loney T, Paulo M S, Modenese A, Gobba F, Tenkate T, Whiteman D C, Green A C, John S M
College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates.
Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates.
Br J Dermatol. 2021 Feb;184(2):208-218. doi: 10.1111/bjd.19152. Epub 2020 Jun 30.
Individual studies have suggested that the association between occupational exposure to solar ultraviolet radiation (UVR) and the development of keratinocyte cancers (KCs) may only be valid in populations of European ancestry living in certain geographical regions. Comparative global data are scarce and so this review aimed to summarize current evidence on the association between occupational exposure to solar UVR and the development of KCs, with a specific focus on geographical location and skin colour. Ovid MEDLINE, PubMed, Embase and Web of Science were searched for potentially relevant records. Extracted data were summarized by study, country and region. We included one prospective cohort study and 18 case-control studies (n = 15 233) from 12 countries in regions where the majority of the population is white skinned (Americas, Europe and Oceania). Eighteen of the 19 studies reported effect estimates suggesting an increased risk of basal cell carcinoma (BCC) and/or squamous cell carcinoma (SCC) among outdoor workers. Only 11 studies found a significantly increased risk and many had imprecise estimates. There was a significantly increased risk of BCC and SCC in individual studies in North America, Latin America and the Caribbean, Western Europe and Southern Europe, but not across regions or countries. Overall, 95% of studies reported higher risks among outdoor workers, although the increases in risk were statistically significant in just over half of the studies. Well-designed and sufficiently powered occupational case-control and cohort studies with adequate adjustment for confounding factors and other risk factors are required to provide more accurate risk estimates for occupational KC.
个别研究表明，职业性暴露于太阳紫外线辐射（UVR）与角质形成细胞癌（KCs）发生之间的关联可能仅在生活在某些地理区域的欧洲血统人群中成立。全球比较数据稀缺，因此本综述旨在总结职业性暴露于太阳UVR与KCs发生之间关联的现有证据，特别关注地理位置和肤色。检索了Ovid MEDLINE、PubMed、Embase和科学网以查找潜在相关记录。提取的数据按研究、国家和地区进行汇总。我们纳入了一项前瞻性队列研究和来自12个国家的18项病例对照研究（n = 15233），这些国家所在地区的大多数人口为白种人（美洲、欧洲和大洋洲）。19项研究中的18项报告了效应估计值，表明户外工作者患基底细胞癌（BCC）和/或鳞状细胞癌（SCC）的风险增加。只有11项研究发现风险显著增加，且许多研究的估计值不准确。在北美、拉丁美洲和加勒比地区、西欧和南欧的个别研究中，BCC和SCC的风险显著增加，但并非在所有地区或国家都如此。总体而言，95%的研究报告户外工作者的风险更高，尽管只有略超过一半的研究中风险增加具有统计学意义。需要设计良好且样本量充足的职业病例对照研究和队列研究，并充分调整混杂因素和其他风险因素，以提供更准确的职业性KCs风险估计。
