Section of Dermatology, DISSAL, IRCCS Ospedale Policlinico San Martino, University of Genoa, Genoa, Italy.
Section of Dermatology, Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy -
Ital J Dermatol Venerol. 2021 Dec;156(6):692-702. doi: 10.23736/S2784-8671.20.06699-7. Epub 2020 Nov 12.
Sun exposure is the main external risk factor for keratinocytic non-melanoma skin cancer (NMSC). Outdoor workers are at increased risk, but the relationship of NMSC with occupational solar exposure is often confounded by concurrent recreational sun exposure. We compared the percentage of outdoor workers in NMSC patients versus controls without history of NMSC and assessed occupational and recreational sun exposure in both groups, evaluating also other risk factors and use of protective measures.
Adult NMSC patients and controls without history of NMSC or actinic keratoses, matched for sex and age range, were recruited in the Departments of Dermatology of seven Italian University Hospitals, with a 1:2 patient/control ratio whenever possible. Data were collected using specifically designed questionnaires.
Eight hundred thirty-four patients and 1563 controls were enrolled. History of outdoor work was significantly (P=0.033) more frequent in patients. Patients were more sun exposed from outdoor leisure activities (P=0.012) and sunbathed for longer periods (P=0.13) and between 12 pm and 3.30 pm (P=0.011). Cumulative sun exposure during hobbies was similar between patients and controls in outdoor workers, higher (P<0.05) in patients among indoor workers. Patients and controls with history of outdoor work were more sun exposed at work than during leisure activities (P<0.001). Use of sunscreens by outdoor workers was very low, particularly at work (19.9%). Patients used sunscreens more than controls (P=0.002).
Occupational and recreational sun exposure are relevant risk factors for outdoor and indoor workers respectively. Sunscreens are alarmingly underused, particularly at work, and are used mainly by patients.
阳光照射是导致角质形成细胞非黑素瘤皮肤癌（NMSC）的主要外部风险因素。户外工作者面临更高的风险，但 NMSC 与职业性太阳暴露的关系往往受到同时发生的娱乐性太阳暴露的影响。我们比较了 NMSC 患者与无 NMSC 病史对照者中户外工作者的比例，并评估了两组患者的职业性和娱乐性太阳暴露情况，同时还评估了其他危险因素和使用防护措施的情况。
在意大利七所大学医院的皮肤科招募了成年 NMSC 患者和无 NMSC 或光化性角化病病史的对照者，尽可能按照性别和年龄范围 1:2 的比例匹配。使用专门设计的问卷收集数据。
共纳入 834 例患者和 1563 例对照者。户外工作史在患者中明显更为常见（P=0.033）。患者的户外休闲活动中阳光暴露时间更长（P=0.012），日光浴时间更长（P=0.13），且时间在中午 12 点到下午 3 点半之间（P=0.011）。户外工作者中，业余爱好的累积阳光暴露在患者和对照组中相似，但在室内工作者中，患者的暴露量更高（P<0.05）。有户外工作史的患者和对照者在工作中比在休闲活动中受到更多的阳光照射（P<0.001）。户外工作者使用防晒霜的比例非常低，尤其是在工作中（19.9%）。患者比对照组更常使用防晒霜（P=0.002）。
职业性和娱乐性阳光暴露分别是户外和室内工作者的重要危险因素。防晒霜的使用惊人地不足，特别是在工作中，而且主要由患者使用。
