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Non-melanoma skin cancer: occupational risk from UV light and arsenic exposure

机译:非黑色素瘤皮肤癌:紫外线和砷暴露的职业风险

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Non-melanoma skin cancer (NMSC) has a significant impact on public health and health care costs as a result of high morbidity and disfigurement due to the destruction of surrounding tissues. Although the mortality rates of these tumors are low, the high incidence rates determine a considerable number of deaths. NMSC is the most common type of skin cancer, representing about 1/3 of all malignancies diagnosed worldwide each year. The most common NMSC are basal cell carcinoma (BCC) and squamous cell carcinoma (SCC). Studies on humans and experimental animals indicate that ultraviolet (UV) light and arsenic play important roles in the development of these skin malignancies. Several epidemiological studies have investigated the risk of developing NMSC and the potential link between exposure to sunlight and arsenic in the agricultural and industrial occupational settings. To date, the published literature suggests that there is no apparent skin cancer risk as regards workplace exposure to artificial UV light or arsenic. Concerning UV light from sun exposure at the workplace, most published studies indicated an elevated risk for SCC, but are less conclusive for BCC. Many of these studies are limited by the methodology used in the evaluation of occupational exposure and the lack of adjustment for major confounders. Therefore, further epidemiological studies are required to focus on exposure assessment at the individual level as well as potential interactions with other occupational and non-occupational exposures and individual susceptibility. In doing so, we can better quantify the true risk of skin cancer in exposed workers and inform effective public health prevention programs.
机译:非黑素瘤皮肤癌(NMSC)由于周围组织的破坏而导致高发病率和毁容性,因此对公共卫生和医疗保健成本具有重大影响。尽管这些肿瘤的死亡率很低,但高发病率决定了相当数量的死亡。 NMSC是最常见的皮肤癌类型,约占全世界每年诊断出的所有恶性肿瘤的1/3。最常见的NMSC是基底细胞癌(BCC)和鳞状细胞癌(SCC)。对人类和实验动物的研究表明,紫外线(UV)和砷在这些皮肤恶性肿瘤的发展中起着重要作用。几项流行病学研究调查了在农业和工业职业环境中发展成NMSC的风险以及暴露于阳光和砷之间的潜在联系。迄今为止,已公开的文献表明,就工作场所暴露于人造紫外线或砷而言,没有明显的皮肤癌风险。关于工作场所暴露于阳光下的紫外线,大多数已发表的研究表明,SCC的风险较高,但对于BCC的结论则较少。这些研究中有许多受到职业暴露评估方法的限制,并且缺乏对主要混杂因素的调整。因此,需要进一步的流行病学研究,以侧重于个人水平的暴露评估以及与其他职业和非职业暴露以及个体易感性的潜在相互作用。这样,我们可以更好地量化暴露工人中皮肤癌的真实风险,并为有效的公共卫生预防计划提供信息。

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