RAMB - Maio / Junho 2016

ccupational

skin

cancer

: S

ystematic

review

ssoc

ras

2016; 62(3):280-286

281

Lilacs, Scielo, Medline and the Cochrane Library databas-

es. The search for articles was performed in February 2014

and was limited to articles published between January 1

2008, and December 31

, 2013.

Initially, the search strategy was based on the inter-

section of the following terms:

•

#1 “Skin neoplasms” (DeCS);

•

#2 “Occupational exposure” (DeCS);

•

#3 “Epidemiology” (DeCS);

•

#4 “Prevention” (keyword).

The following searches were conducted: #1 and #2; #1 and

#3; #1 and #4. A search with the above terms in Portu-

guese was performed subsequently. The articles found

using this strategy were firstly selected using their titles

and abstracts.

The analysis of the articles followed subsequently in-

clusion and exclusion criteria. We included: a) articles

that presented at least one combination of the established

terms in the title; b) manuscripts in English or Portu-

guese; c) original texts with full online access; d) prospec-

tive or retrospective observational (descriptive or analyt-

ical), experimental or quasi-experimental studies. We

excluded: a) case reports, case series and literature review

type studies; b) non-original studies, including editorials,

reviews and letters to the editor.

The articles included in the sample were read in their

entirety, and the relevant data for the research was ex-

tracted and included in a worksheet containing the au-

thors, year of publication, description of the sample and

main conclusions of the study.

esults

Initially, the search strategies for examining the titles and

abstracts of the articles resulted in 83 references. After

analysis according to the eligibility criteria, 61 articles

were deleted and 22 articles were retrieved and included

in the final sample (Figure 1 and Table 1).

iscussion

Only 14 of the 22 articles analyzed assessed the epidemi-

ological profile of the professionals at risk of skin cancer,

noting a similarity of the data collected from the articles.

The references analyzed noted that occupational skin can-

cer arises in individuals at more advanced ages, that is,

from the sixth decade of life onward.

6-9

The only discrepancy noted among the articles was

that Lee et al.

conducted a case control study and noted

that the average age of individuals with cutaneous malig-

nant melanoma was 48.9 years, which did not differ much

from the age of the control group. Even though this is an

earlier age than that observed in other articles, this does

not contradict the literature, as according to Korand et al.

cutaneous melanoma has a higher incidence in the age

range of 40 to 60 years of age.

Another variable of the epidemiological profile ana-

lyzed was that light-skinned individuals, that is, types I

and II in the Fitzpatrick scale (light skin that burns easi-

ly, but never tans and light skin that burns easily and tans

minimally, respectively) are more likely to develop skin

cancer, as well as individuals of European descent.

7,8,10,12-16

Most of the articles that analyzed the epidemiologi-

cal profile noted that workers who had risk factors for

occupational skin cancer have, in general, a low level of

education, which is consistent with the literature, given

that this favors these professionals not being aware of the

risk factors for skin cancer and preventive measures. Also,

the lower the educational level, the greater the tendency

to work for larger periods, whether hours or days of work,

than those with a higher level of education.

15,17-19

For Hammond et al.,

their study observed profes-

sions at risk of skin cancer, who were builders, gardeners

and road workers. These had a larger percentage of work-

ers with secondary education, noting that they had a great-

er knowledge of preventive measures against skin cancer,

since those who had an average risk of developing this neo-

plasm protected themselves less than those with a high

risk. However, the sample of these workers was small, and

may not have provided sufficient evaluation because the

workers composing the sample might not have known the

preventative measures for this neoplasm.

The risk factors of skin cancer for professionals in the

work environment were analyzed in 16 articles selected in

this study. Ten of these 16 articles noted that sun exposure

is the main factor of occupational risk. Ultraviolet radia-

tion reaches the Earth’s surface every day; therefore, pro-

fessionals in the outdoor environment have a high risk of

sun exposure and consequent risk of skin cancer.

4,6-8,12,18-22

In view of this, it has been observed that chronic and

excessive exposure in the first 10 to 20 years of life, espe-

cially at times when the sun’s rays are more intense, this is,

from 10 am to 4 pm, increases the risk of skin cancer, as at

a young age there is a higher chance of cumulative sun ex-

posure in the workplace.

18,19

According to Simões et al.

builders are professionals at risk, as they have a 44 hour

work week, with excessive exposure to UV rays.

Popim et al.

analyzed postal workers in the city of

Botucatu, SP, Brazil and assessed that these profession-

als are exposed to variables that can promote the emer-

gence of skin cancer, namely: Skin color, as white skin of-