Abstract
Background: Solar UltraViolet Radiation (UVR) is considered the most relevant occupational carcinogenic exposure in terms of the number of workers exposed (i.e., outdoor workers) and UVR-induced skin cancers are among the most frequent types of occupational cancers worldwide. This review aims to collect and evaluate all the available preventive interventions conducted on outdoor workers to reduce their solar UVR related risk, with the final purpose of reducing the burden of occupational skin cancers for outdoor workers.Methods: We will search the following databases for peer-reviewed original research published: MEDLINE (through PubMed), Scopus, and EMBASE. We will include only interventional studies, both randomized and non-randomized, with an adequate comparison group, therefore excluding cross-sectional studies, as well as case-reports/series, reviews, and letters/comments. The systematic review will adhere to the “Preferred Reporting Items for Systematic reviews and Meta-Analyses” (PRISMA) guidelines for reporting systematic reviews. After the literature search, studies to be included will be independently reviewed by two Authors, first based on title and abstract, then based on the full text, according to the inclusion criteria. Conflicts will be solved by a third Author. Two authors will independently extract the required data from included studies and perform quality assessment according to the relevant domain for Risk of Bias assessment proposed by the Cochrane collaboration group. In case of sufficient homogeneity of interventions and outcomes evaluated, results from subgroups of studies will be pooled together in a meta-analysis.Discussion: Following the principles for the evaluation of interventions for cancer prevention established by the International Agency for Research on Cancer, this systematic review will investigate the effectiveness of the interventions, and consequently it will provide reliable indications for the actual reduction of skin cancer incidence in outdoor workers.
Highlights
Occupational Solar Ultraviolet Exposure and Skin CancersSolar UltraViolet Radiation (UVR) is the most relevant occupational carcinogenic exposure in terms of the number of workers exposed [1,2,3] and it is the most important risk factor for the development of non-melanoma skin cancer (NMSC; referred to as keratinocyte carcinoma—KC) [4] and malignant melanoma (MM) [5]
MM is associated with UVR exposure, but especially intermittent solar radiation exposure, and in particular in early life, and the relation with occupational solar UVR exposure is considered less conclusive, even if some recent studies suggested a possible association of specific MM subtypes, such as lentigo maligna melanoma (LMM), with chronic lifetime sun damage [5, 13]
The systematic review aims to fill a relevant gap in the scientific literature, evaluating the effectiveness of the available preventive interventions, as e.g., the ones listed in the previous sub-section, conducted in outdoor workplaces to reduce the solar UVR related risk of the exposed workers, with the final purpose of the prevention of UV-induced skin cancers among outdoor workers according to the definitions provided in the “International Agency for Research on Cancer (IARC) Handbooks of Cancer Prevention” [19, 23]
Summary
Solar UltraViolet Radiation (UVR) is considered the most relevant occupational carcinogenic exposure in terms of the number of workers exposed (i.e., outdoor workers) and UVR-induced skin cancers are among the most frequent types of occupational cancers worldwide. This review aims to collect and evaluate all the available preventive interventions conducted on outdoor workers to reduce their solar UVR related risk, with the final purpose of reducing the burden of occupational skin cancers for outdoor workers
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