Collatuzzo Giulia, Boffetta Paolo, Dika Emi, Visci Giovanni, Zunarelli Carlotta, Mastroeni Simona, Antonelli Gianluca, Fortes Cristina
Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy.
Stony Brook Cancer Center, Stony Brook University, Stony Brook, NY, 11794, USA.
Int Arch Occup Environ Health. 2023 Apr;96(3):443-449. doi: 10.1007/s00420-022-01935-8. Epub 2022 Nov 15.
Melanoma is mainly caused by sunlight radiation, but other environmental risk factors are not well known. We investigated the association between cutaneous melanoma and occupational exposure to arsenic, mercury and UV radiation.
A hospital-based case-control study was conducted in the inpatient wards of IDI-San Carlo Rome, Italy, including 304 incident cases of cutaneous melanoma and 305 frequency-matched controls. Detailed sociodemographic, clinical and host-related factors were collected, and all participants were physically examined using dermoscopy and following standard protocol for recording pigmented lesions. Four experts assessed exposure to arsenic, mercury and UV radiation based on occupational history. A multidimensional variable was created for each risk factor, by combining intensity and probability of exposure. Multivariable logistic regression models were run to calculate odds ratios (OR) and 95% confidence intervals (CI) of the association between exposure to these agents and melanoma.
A total of 5.4% of the cases vs 2.4% of the controls were exposed to arsenic (OR = 3.12; 95% CI = 1.10-8.86 for high probability and high exposure to arsenic) after controlling for sex, age, smoking status, number of nevi, phototype and history of sunburns in childhood/adolescence. Occupational exposure to mercury and UV radiation was not associated with the risk of melanoma.
Subjects exposed to arsenic at the workplace may be at increased risk of developing cutaneous melanoma in comparison to subjects not exposed to this agent. Further studies should be designed to investigate occupational exposure to arsenic and mercury and melanoma and confirm the findings are warranted.
黑色素瘤主要由阳光辐射引起，但其他环境风险因素尚不清楚。我们调查了皮肤黑色素瘤与职业性接触砷、汞和紫外线辐射之间的关联。
在意大利罗马圣卡罗医院的住院病房进行了一项基于医院的病例对照研究，包括304例皮肤黑色素瘤新发病例和305例频率匹配的对照。收集了详细的社会人口统计学、临床和宿主相关因素，所有参与者均使用皮肤镜检查并按照记录色素沉着病变的标准方案进行体格检查。四位专家根据职业史评估砷、汞和紫外线辐射的暴露情况。通过结合暴露强度和暴露概率，为每个风险因素创建了一个多维变量。运行多变量逻辑回归模型以计算接触这些物质与黑色素瘤之间关联的比值比（OR）和95%置信区间（CI）。
在控制了性别、年龄、吸烟状况、痣的数量、光类型和儿童期/青少年期晒伤史后，共有5.4%的病例和2.4%的对照接触过砷（高概率和高暴露于砷的OR = 3.12；95%CI = 1.10 - 8.86）。职业性接触汞和紫外线辐射与黑色素瘤风险无关。
与未接触砷的受试者相比，在工作场所接触砷的受试者患皮肤黑色素瘤的风险可能增加。应设计进一步的研究来调查职业性接触砷和汞与黑色素瘤的关系，并确认这些发现是有必要的。
