Preventing Melanoma with the Help of Occupational Physicians
Keywords:Malignant melanoma, occupational cancer, solar radiation, outdoor work, UV exposure prevention.
Melanoma incidence is increasing constantly worldwide in recent years: 132,000 melanoma skin cancers occur globally each year (WHO-INTERSUN). Despite this, no adequate evidence regarding the role of cumulative solar UV exposure in inducing the skin cancer has been provided. Recently, some studies appear to indicate that, also in patients with melanoma history, the habit of completely avoiding sun exposure is not a positive prognostic factor. According to IARC monograph published in 2012, evidences regarding UV risk factors for melanoma are the intermittent UV exposure with recurrent sunburns, especially in childhood and adolescence.
According to these findings, various studies on occupational exposure to solar radiation (SR) failed to find an association between the performance of an outdoor job and the risk of melanoma. Recently, in Italy melanoma due to SR exposure has been erased from the national list of occupational diseases (D.P.R. 1124/65, last modification in 2014). But, in Europe an occupational health surveillance is needed for workers exposed to Artificial UV radiation according to EU Directive 2006/25/CE, and a skin examination for these workers is suggested, but quite paradoxically there are not similar indications for workers exposed to natural UV radiation.
Considering the great number of outdoor workers employed in Europe, at least 14 million according to OSHA, and worldwide, the consideration of occupational solar radiation exposure as a specific professional risk requiring the health surveillance of exposed workers will be very helpful in order to prevent melanoma and other UV related diseases.