title: Occupational exposure to ultraviolet radiation and risk of non-melanoma skin cancer in a multinational European study.
abstract: BACKGROUND
  Studies suggest that ambient sunlight plays an important role in the pathogenesis of non-melanoma skin cancers (NMSC). However, there is ongoing controversy regarding the relevance of occupational exposure to natural and artificial ultraviolet radiation (UV) radiation.
  
  
  OBJECTIVE
  We investigated potential associations between natural and artificial UV radiation exposure at work with NMSC in a case-control study conducted in Hungary, Romania, and Slovakia.
  
  
  METHODS
  Occupational exposures were classified by expert assessment for 527 controls and 618 NMSC cases (515 basal cell carcinoma, BCC). Covariate information was collected via interview and multiple logistic regression models were used to assess associations between UV exposure and NMSC.
  
  
  RESULTS
  Lifetime prevalence of occupational exposure in the participants was 13% for natural UV radiation and 7% for artificial UV radiation. Significant negative associations between occupational exposure to natural UV radiation and NMSC were detected for all who had ever been exposed (odds ratio (OR) 0.47, 95% confidence interval (CI) 0.27-0.80); similar results were detected using a semi-quantitative metric of cumulative exposure. The effects were modified by skin complexion, with significantly decreased risks of BCC among participants with light skin complexion. No associations were observed in relation to occupational artificial UV radiation exposure.
  
  
  CONCLUSIONS
  The protective effect of occupational exposure to natural UV radiation was unexpected, but limited to light-skinned people, suggesting adequate sun-protection behaviors. Further investigations focusing on variations in the individual genetic susceptibility and potential interactions with environmental and other relevant factors are planned.
authors: Department of Environmental Health Sciences, School of Public Health, University at Albany, State University of New York, Rensselaer, New York, United States of America. ssurdu@albany.edu
authors: Simona
authors: S
authors: Surdu
authors: Edward F
authors: EF
authors: Fitzgerald
authors: Michael S
authors: MS
authors: Bloom
authors: Francis P
authors: FP
authors: Boscoe
authors: David O
authors: DO
authors: Carpenter
authors: Richard F
authors: RF
authors: Haase
authors: Eugen
authors: E
authors: Gurzau
authors: Peter
authors: P
authors: Rudnai
authors: Kvetoslava
authors: K
authors: Koppova
authors: Joëlle
authors: J
authors: Févotte
authors: Giovanni
authors: G
authors: Leonardi
authors: Marie
authors: M
authors: Vahter
authors: Walter
authors: W
authors: Goessler
authors: Rajiv
authors: R
authors: Kumar
authors: Tony
authors: T
authors: Fletcher
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002280:Basal Cell Carcinoma / Q000453:epidemiology / Q000209:etiology; D002294:Carcinoma, Squamous Cell / Q000453:epidemiology / Q000209:etiology; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D006814:Hungary / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D016273:Occupational Exposure / Q000009:adverse effects*; D016017:Odds Ratio; D012306:Risk; D012383:Romania / Q000453:epidemiology; D012878:Skin Neoplasms / Q000453:epidemiology* / Q000209:etiology*; D018154:Slovakia / Q000453:epidemiology; D014466:Ultraviolet Rays / Q000009:adverse effects*
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