RAMB - Maio / Junho 2016

ccupational

skin

cancer

: S

ystematic

review

ssoc

ras

2016; 62(3):280-286

285

in the absence of occupational exposure to sunlight. How-

ever, this conclusion is not significant because it was based

on only four exposed controls.

Nevertheless, it is believed that chronic arsenic expo-

sure increases the mutagenicity of other carcinogens, such

as UV radiation.

Dennis et al.

found a consistent asso-

ciation of melanoma and pesticide applicators, due to con-

tact with pesticides containing arsenic, as well as pesticides

containing maneb/mancozeb and parathion.

The absence of UV exposure can be a protective fac-

tor for skin cancer, as Schernhammer et al.

noted that

nurses with more than 10 years of nighttime work have

less chance of developing skin cancer than nurses who

never worked on the night shift. For McCool et al.,

sun

exposure is a risk factor present in the environment of

outdoor work, but modifying the work shift to reduce

this risk is often not feasible. Therefore, other alternative

measures should be taken, consisting of the use of sun-

screen to reduce excessive exposure to UV rays.

According to Lee et al.,

the case control study par-

ticipants who had high levels of occupational activities

have an increased risk of cutaneous malignant melano-

ma; however, this article had no statistical significance

and no dose-response relationship was observed. The

article by Chang et al.

noted that the risk of melano-

ma to the head and neck is increased in workers exposed

to the sun, especially at low latitudes due to high tem-

peratures.

The prevention of occupational skin cancer occurs

when there is a contact protection of causative agents of

cellular damage in the workplace with the skin of the

professionals. Prevention measures were examined in

eight articles, which noted a predominance of the use of

the following sun protection equipment: sunscreen, hats,

caps, long pants, long-sleeve shirts, sunglasses and sun-

shades.

3,4,13-16,18,19,24

The protection measures were used significantly more

among women, especially sunscreen.

4,13,16,24

According to

McCool et al.,

males and younger people have a lower

index of adherence to the use of protective equipment be-

cause they underestimate the risk and overestimate the

ability to cope with that risk.

There was a contradiction among the articles in the

assessment of the protection method most widely used

in the workplace. In the study conducted by McCool et

al.,

the authors found that viticulture, landscaping and

postal workers used more sunscreen than the other pro-

fessional groups evaluated in the study. For Hall et al.,

the most common protection method among the life-

guards was the use of sunglasses.

Reeder, Gray and McCool,

concluded that the equip-

ment used most by professionals was “any kind of hat”,

but less than a third of these were wide-brimmed to pro-

tect the areas that usually develop skin cancer, namely,

the face, ears and neck, and the profession that showed

the highest protection index among those studied was

viticulture. According to this study, only 5% of the sam-

ple reported not using sun protection measures, but the

method of protection was being performed in an unsat-

isfactory manner.

In view of this, the encouragement of programs for

prevention of skin cancer associated with intervention

measures in health and safety at work are recommended,

because in order for this protection to be effective this as-

sociation must be consolidated and be relevant to the

professional groups.

According to Hall et al.,

lifeguards teaching lessons

in swimming pools presented higher protection scores,

although while reporting that they perform these pro-

tective measures, more than half of these professionals

reported having had sunburn at least once, further in-

dicating the need to improve solar safety measures. There-

fore, it was concluded that even after providing the equip-

ment, if there is no incentive the professionals do not

value its use.

For Stock et al.,

the use of UV photography and in-

formation about skin cancer intervention to reduce ex-

posure to sunlight in male outdoor workers was effective.

Likewise, the media is an important communication tool

for spreading information about prevention and promo-

tion of health. This article also noted that the workplace

was cited as a means of disseminating preventive mea-

sures, therefore there is a need to improve safety condi-

tions in the workplace, that is, to provide personal pro-

tective equipment, as well as investing in programs

encouraging the use of such equipments and teaching

the correct way to use them.

onclusion

We conclude that sun exposure is the main occupation-

al risk factor for skin cancer, with a higher incidence in

rural and construction workers. Few articles assessing

other causative agents of occupational skin cancer be-

yond solar radiation were retrieved, as well as professions

that do present sunlight as the main risk factor. As such,

this review shows the need for further studies to investi-

gate other professions and risk factors that may be asso-

ciated with this occupational cancer.

Our study revealed that professionals do not protect

themselves properly in the work environment, and that