New insights into occupational skin cancer (Basal Cell Carcinomas and Squamous Cell Carcinomas) following occupational UV exposure (BK 5103)

Objective

Identification of medical and exposure-related criteria based on a retrospective evaluation of occupational disease files to assess the relationship between occupational UV exposure (chronic and intermittent), basal cell carcinomas (BCC), and the progression of actinic keratoses to squamous cell carcinomas.

Initial situation

Occupationally related skin cancers, which include actinic keratoses and squamous cell carcinoma, are highly relevant to statutory accident insurance due to their frequency. The recognition of another common tumor entity, basal cell carcinoma (BCC), as an occupational disease has also been discussed. However, previous studies do not support an increased risk of BCC among employees who regularly work outdoors.

The Medical Advisory Committee on Occupational Diseases at the BMAS has pointed out that intermittent UV exposure is a known risk factor for BCC. However, the role of intermittent UV exposure in an occupational context is unclear. The issue should be addressed when meaningful study results are available.

Study design

The study population will be composed of recognised occupational disease cases under number 5103 “Squamous cell carcinoma or multiple actinic keratoses of the skin due to natural UV radiation” that were first recognised between 2015 and 2019. The aim is to include cases with high occupational UV exposure; To that purpose, the files of the occupational disease assessment procedures from that period will be evaluated and the individuals concerned will be followed up for a further four years in order to record the new occurrence or progression of basal cell carcinomas, changes in disease activity (e.g., concomitant actinic keratoses), and special disease courses.

The following main questions will be addressed:

1. Which criteria can be scientifically derived as possible prerequisites for the occupational causation of basal cell carcinomas?

2. Which criteria for the progression of actinic keratoses to squamous cell carcinomas can be scientifically derived?

Coordination

Prof. Dr. Julia Krabbe