SLIDE 6 2/27/2017 6
Establishing the occupational causation of skin cancer
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Occupational UV exposure is >40 %
exposure at the time of diagnosis (Acarc)
Work activity needs to double the risk of skin cancer
Diepgen et al. JDDG. 2016
Work‐related criteria contributing to
- ccupational skin cancer
- The individual has to have worked a substantial part of their
work life outdoors
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- Greater exposure is attributed to working closer to the
equator or at high altitude
- If only part of the day was spent working outdoors the
- ccupational activity has to have been performed for a
longer period of time
Diepgen et al. JDDG. 2016
Clinical requirements for the diagnosis of
Location of tumor On irradiated sites Confirmation of diagnosis SCC: by histopathology Multiple AK: clinical diagnosis*
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- Clinical criteria must be met:
- Medical experts, accident insurance, court make a final decision
Signs of chronic UV damage Distribution in occupationally exposed body areas corroborate the diagnosis Fitzpatrick skin phototype Provided with the report, does not form part of the diagnosis Non occupational risk factors These are taken into account: immunosuppression, presence of photosensitizing drugs Additional 40% occupational UV exposure As calculated by the occupational accident insurance Differences with respect to vacation activities Number and location of vacation and leisure activities
- Other factors included in the report that are taken into account:
Diepgen et al. JDDG. 2016
Occupational skin cancer in the US
- 5 million outdoor workers in the US
- UVR: one of the most frequent occupational
carcinogens in American workplaces
- Not formally recognized, but Howard Maibach
MD has called it occupational for 40 years
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