Background:The relationship between occupational sun exposure and melanoma risk is complex and multifaceted, with existing evidence yielding contradictory findings. Unlike Non-Melanoma Skin Cancer (NMSC), for which occupational sun exposure is a well-established risk factor, the link with cutaneous melanoma remains contentious.Objectives:This study aimed to evaluate whether, in a cohort of patients with cutaneous melanoma, an association existed between occupational sun exposure and melanoma, specifically with histotype, site of occurrence, and Breslow index.Methods:This is a retrospective cohort analysis conducted to evaluate whether occupational sun exposure constitutes a risk factor for the development of cutaneous melanoma in patients diagnosed between January 2005 and October 2023 at the Dermatology Unit, Azienda USL Toscana Centro, Florence. Occupational ultraviolet (UV) exposure was examined by classifying each participant’s job into categories based on solar UV exposure levels—outdoor (e.g., agriculture and construction roles), mixed indoor/outdoor (e.g., trades and public safety professions), and indoor settings (e.g., office-based work).Results:A final total of 1417 patients were analyzed. Occupational categorization revealed that 1171 patients (82.64%) were classified as non-occupationally exposed (indoor), while 246 (17.36%) were occupationally exposed to solar UV radiation (including 14.82% mixed indoor/outdoor and 2.54% outdoor workers). A significant association was observed between occupational sun exposure and lentigo maligna, which was more prevalent among exposed workers and even more so in the outdoor subgroup. Anatomical site distribution exhibited a significant association with occupational sun exposure. Indeed occupationally exposed individuals showed a higher prevalence of melanomas in the head and neck region, a distribution pattern particularly evident among outdoor workers, suggesting that these sites may be more susceptible to chronic sun exposure in outdoor and mixed occupations. Moreover, a significant association was found between occupational exposure and Breslow thickness, with exposed workers presenting with thicker melanomas at diagnosis, suggesting more advanced disease.Conclusions:The finding of this study may reflect variations in occupational sun exposure patterns and warrants further investigation into protective measures and early-detection strategies tailored to occupational groups.
背景：职业性日光暴露与黑色素瘤风险之间的关系复杂且多面，现有证据呈现矛盾结果。与职业性日光暴露已被确认为明确风险因素的非黑色素瘤皮肤癌不同，其与皮肤黑色素瘤的关联仍存争议。 目的：本研究旨在评估皮肤黑色素瘤患者队列中，职业性日光暴露与黑色素瘤（特别是组织学亚型、发生部位及Breslow指数）之间是否存在关联。 方法：本研究为回顾性队列分析，旨在评估职业性日光暴露是否构成2005年1月至2023年10月期间在佛罗伦萨托斯卡纳中部地方卫生局皮肤病科确诊患者发生皮肤黑色素瘤的风险因素。通过依据日光紫外线暴露水平将参与者职业分类（户外职业如农业与建筑业、室内外混合职业如技工与公共安全行业、室内职业如办公室工作）来考察职业紫外线暴露情况。 结果：最终共分析1417例患者。职业分类显示：1171例患者（82.64%）被归类为非职业暴露（室内工作），246例（17.36%）存在职业性日光紫外线暴露（其中14.82%为室内外混合职业，2.54%为户外工作者）。研究发现职业性日光暴露与恶性雀斑样痣存在显著关联，该亚型在暴露劳动者中更为普遍，在户外工作者亚组中尤为明显。解剖部位分布与职业性日光暴露呈现显著相关性：职业暴露个体的头颈部黑色素瘤发生率更高，这种分布模式在户外工作者中特别显著，提示这些部位在户外及混合职业中可能更易受到慢性日光暴露影响。此外，职业暴露与Breslow厚度存在显著关联，暴露劳动者确诊时黑色素瘤厚度更大，提示疾病进展更晚。 结论：本研究结果可能反映了职业性日光暴露模式的差异性，值得针对职业群体开展防护措施和早期检测策略的进一步研究。
肿瘤(癌症)患者之家