[Skin cancer and occupational disease].
Although it is universally accepted that UV light exposure can cause malignant skin tumors, UV-induced skin cancers are not recognized as an occupational disease in Germany. Exposure to natural or artificial UV light occurs in many work places, so that the induction of occupational skin cancers is certainly plausible. In recent years, a special clause in the occupational disability rules has recognized some cases of UV-induced skin cancers. We discuss the nature of occupational UV exposure, explore preventative measures and review the data regarding occupational UV-induced skin tumors. After evaluating recent publications, we conclude that for squamous cell carcinoma the epidemiological proof of an at least doubled risk (RR >2) due to occupational UV radiation can be given. The clear dose response relationship supports these epidemiological findings. For the individual risk assessment, an attributive UV radiation >40% due to occupational factors must exist. Under those circumstances, squamous cell carcinoma should be recognized and compensated as an occupational disease.
Diepgen
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TL
Abteilung Klinische Sozialmedizin mit Schwerpunkt Berufs- und Umweltdermatologie, Universitätsklinikum Heidelberg, Ruprecht-Karls Universität Heidelberg, Heidelberg. thomas_diepgen@med.uni-heidelberg.de
Drexler
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D002280:Basal Cell Carcinoma / Q000175:diagnosis / Q000209:etiology* / Q000517:prevention & control; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis / Q000209:etiology* / Q000517:prevention & control; D004185:Disability Evaluation; D005858:Germany; D006801:Humans; D008545:Melanoma / Q000175:diagnosis / Q000209:etiology* / Q000517:prevention & control; D009364:Neoplasm Recurrence, Local / Q000209:etiology / Q000517:prevention & control; D009381:Neoplasms, Radiation-Induced / Q000175:diagnosis / Q000209:etiology* / Q000517:prevention & control; D016273:Occupational Exposure / Q000009:adverse effects*; D018570:Risk Assessment; D012878:Skin Neoplasms / Q000175:diagnosis / Q000209:etiology* / Q000517:prevention & control; D014466:Ultraviolet Rays / Q000009:adverse effects*; D014942:Workers' Compensation / Q000331:legislation & jurisprudence