INTRODUCTION
The incidence of melanoma and non-melanoma skin cancer (NMSC) has been increasing worldwide.1 NMSC mainly consists of keratinocyte skin cancer, with about 80% basal cell carcinoma (BCC) and about 20% squamous cell carcinoma (SCC).2 Studies have shown that 65-90% of all skin cancers are attributable to solar ultraviolet radiation (UVR) exposure.3,4
This exposure can be impacted by certain occupations. Pega et al found that globally in 2019, 1.6 billion workers were occupationally exposed to UVR. They also found that over 2000-2019, attributable deaths and disability-adjusted life years almost doubled.5 Bauer et al found that participants with high occupational ultraviolet (UV) exposure had a greater than two-fold increased risk of developing BCC in commonly UV-exposed body sites compared to participants with no or moderate occupational UV exposure. The risk in individuals with occupational exposure increases independently of histological subtype, tumor localization, and Fitzpatrick phototype.6 Keim et al conducted a population-based cohort study of 1621 subjects, with no previous keratinocyte carcinoma (KC), who were followed up to sixteen years. They found that 21% of the patients developed one KC, and 47% of those patients developed at least 2 KCs.7 Also, there have been several studies reporting the coexistence of different types of KC, melanoma, and premalignant lesions in the same individual.8 Rarely, malignant melanoma has been found within BCC and SCC.9 Another significant risk factor is chemical exposure.
Our review aims to provide a comprehensive overview of occupational risks of skin cancers, highlighting the importance of skin surveillance and public health campaigns.
Occupations
Welder
Globally, there are about 11 million welders and an estimated 110 million additional workers who obtain welding-related exposures. The latter may be employed in fields such as construction, farming, shipbuilding, or vehicle servicing.10 Arc welding exposes individuals to the full range of UVR, including UVA, UVB, and UVC radiation, as well as fumes, gases, and co-exposures to asbestos and solvents.11 While the association between welding and skin cancer is still being studied, the International Agency for Research on Cancer (IARC) classified UVR and fumes from arc welding as Group 1 or 'carcinogenic to humans' in 2017.10
Ocular melanoma is a well-recognized risk linked to UVR exposure from welding. Case-control studies have shown positive associations with risks persisting after adjusting for sun exposure, sunbed use, or both. A dose–response relationship with job duration was also observed.12 Other case-control studies looked to see the association of welding with NMSC. Heltoft et al examined a cohort of 4333 metal arc welders who were followed for 25 years, and they found a significantly increased risk of BCC in the head and neck region of welders compared with controls.11 Most other case-control studies did not find an increased prevalence of skin cancer in welders,
This exposure can be impacted by certain occupations. Pega et al found that globally in 2019, 1.6 billion workers were occupationally exposed to UVR. They also found that over 2000-2019, attributable deaths and disability-adjusted life years almost doubled.5 Bauer et al found that participants with high occupational ultraviolet (UV) exposure had a greater than two-fold increased risk of developing BCC in commonly UV-exposed body sites compared to participants with no or moderate occupational UV exposure. The risk in individuals with occupational exposure increases independently of histological subtype, tumor localization, and Fitzpatrick phototype.6 Keim et al conducted a population-based cohort study of 1621 subjects, with no previous keratinocyte carcinoma (KC), who were followed up to sixteen years. They found that 21% of the patients developed one KC, and 47% of those patients developed at least 2 KCs.7 Also, there have been several studies reporting the coexistence of different types of KC, melanoma, and premalignant lesions in the same individual.8 Rarely, malignant melanoma has been found within BCC and SCC.9 Another significant risk factor is chemical exposure.
Our review aims to provide a comprehensive overview of occupational risks of skin cancers, highlighting the importance of skin surveillance and public health campaigns.
Occupations
Welder
Globally, there are about 11 million welders and an estimated 110 million additional workers who obtain welding-related exposures. The latter may be employed in fields such as construction, farming, shipbuilding, or vehicle servicing.10 Arc welding exposes individuals to the full range of UVR, including UVA, UVB, and UVC radiation, as well as fumes, gases, and co-exposures to asbestos and solvents.11 While the association between welding and skin cancer is still being studied, the International Agency for Research on Cancer (IARC) classified UVR and fumes from arc welding as Group 1 or 'carcinogenic to humans' in 2017.10
Ocular melanoma is a well-recognized risk linked to UVR exposure from welding. Case-control studies have shown positive associations with risks persisting after adjusting for sun exposure, sunbed use, or both. A dose–response relationship with job duration was also observed.12 Other case-control studies looked to see the association of welding with NMSC. Heltoft et al examined a cohort of 4333 metal arc welders who were followed for 25 years, and they found a significantly increased risk of BCC in the head and neck region of welders compared with controls.11 Most other case-control studies did not find an increased prevalence of skin cancer in welders,
