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      Workplace exposure to UV radiation and strategies to minimize cancer risk

      review-article
      ,
      British Medical Bulletin
      Oxford University Press
      ultraviolet radiation, sunlight, occupational exposure, outdoor work

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          Abstract

          Background

          Workplace exposure to solar ultraviolet (UV) causes malignant melanoma and non-melanoma skin cancer. The evidence for beneficial effects of solar UV exposure in reducing the risks for other cancers is increasing. The intensity of UV radiation at the Earth’s surface is dependent on latitude, but even in northern European countries exposure can be high enough for outdoor work to cause skin cancer.

          Growing points

          Awareness of the health risks and benefits of occupational solar UV exposure is poor. Actions to reduce the risk of skin cancer have been identified and employers should recognize their responsibility to actively manage these risks. There is evidence for reduced risks for breast, ovarian and colorectal cancer and possibly other cancers linked to solar UV exposure.

          Sources of data

          This narrative review draws on published scientific articles and material designed to assist identifying strategies to protect workers from solar UV exposure.

          Areas of agreement

          Solar UV exposure can be harmful. Wavelengths in the UVB range are more effective in causing erythema and DNA damage. Solar UV is the main source of vitamin D for most people. Primary and secondary prevention for skin cancer can potentially eliminate these risks but the evidence for effectiveness is limited.

          Areas of controversy

          Potential health benefits of UV exposure, particularly for reduced cancer risk. Determining and communicating optimal exposure to maximize health benefits. The risk of non-melanoma skin cancers may be more than doubled for some workers in temperate latitudes.

          Areas timely for developing research

          Exposure-response epidemiological studies; studies of the health benefits of occupational UV exposure; studies of the effectiveness of intervention strategies to prevent skin cancer. Use of low-cost UV sensors in workplaces.

          Related collections

          Most cited references63

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          Global, Regional, and National Cancer Incidence, Mortality, Years of Life Lost, Years Lived With Disability, and Disability-Adjusted Life-Years for 29 Cancer Groups, 1990 to 2017

          This systematic analysis describes cancer burden for 29 cancer groups across 195 countries from 1990 through 2017 to provide data needed for cancer control planning.
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            Vitamin D: An overview of vitamin D status and intake in Europe

            In recent years, there have been reports suggesting a high prevalence of low vitamin D intakes and vitamin D deficiency or inadequate vitamin D status in Europe. Coupled with growing concern about the health risks associated with low vitamin D status, this has resulted in increased interest in the topic of vitamin D from healthcare professionals, the media and the public. Adequate vitamin D status has a key role in skeletal health. Prevention of the well-described vitamin D deficiency disorders of rickets and osteomalacia are clearly important, but there may also be an implication of low vitamin D status in bone loss, muscle weakness and falls and fragility fractures in older people, and these are highly significant public health issues in terms of morbidity, quality of life and costs to health services in Europe. Although there is no agreement on optimal plasma levels of vitamin D, it is apparent that blood 25-hydroxyvitamin D [25(OH)D] levels are often below recommended ranges for the general population and are particularly low in some subgroups of the population, such as those in institutions or who are housebound and non-Western immigrants. Reported estimates of vitamin D status within different European countries show large variation. However, comparison of studies across Europe is limited by their use of different methodologies. The prevalence of vitamin D deficiency [often defined as plasma 25(OH)D <25 nmol/l] may be more common in populations with a higher proportion of at-risk groups, and/or that have low consumption of foods rich in vitamin D (naturally rich or fortified) and low use of vitamin D supplements. The definition of an adequate or optimal vitamin D status is key in determining recommendations for a vitamin D intake that will enable satisfactory status to be maintained all year round, including the winter months. In most European countries, there seems to be a shortfall in achieving current vitamin D recommendations. An exception is Finland, where dietary survey data indicate that recent national policies that include fortification and supplementation, coupled with a high habitual intake of oil-rich fish, have resulted in an increase in vitamin D intakes, but this may not be a suitable strategy for all European populations. The ongoing standardisation of measurements in vitamin D research will facilitate a stronger evidence base on which policies can be determined. These policies may include promotion of dietary recommendations, food fortification, vitamin D supplementation and judicious sun exposure, but should take into account national, cultural and dietary habits. For European nations with supplementation policies, it is important that relevant parties ensure satisfactory uptake of these particularly in the most vulnerable groups of the population.
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              Guidelines on limits of exposure to ultraviolet radiation of wavelengths between 180 nm and 400 nm (incoherent optical radiation).

              (2004)
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                Author and article information

                Contributors
                Journal
                Br Med Bull
                Br Med Bull
                brimed
                British Medical Bulletin
                Oxford University Press
                0007-1420
                1471-8391
                December 2022
                17 August 2022
                17 August 2022
                : 144
                : 1
                : 45-56
                Affiliations
                IOM , Research Avenue North, Edinburgh EH14 4AP, UK
                Institute of Biological Chemistry , Biophysics and Bioengineering, Heriot Watt University, Edinburgh EH14 4AS, UK
                IOM , Research Avenue North, Edinburgh EH14 4AP, UK
                Author notes
                Correspondence address. IOM, Research Avenue North, Edinburgh EH14 4AP,UK. E-mail: J.Cherrie@ 123456hw.ac.uk
                Article
                ldac019
                10.1093/bmb/ldac019
                9744745
                35973164
                ac91ab2f-81e3-4739-bd71-f42fed6a5444
                © The Author(s) 2022. Published by Oxford University Press.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 14 March 2022
                : 1 July 2022
                : 22 July 2022
                Page count
                Pages: 12
                Categories
                Invited Review
                AcademicSubjects/MED00010
                brimed/37

                Medicine
                ultraviolet radiation,sunlight,occupational exposure,outdoor work
                Medicine
                ultraviolet radiation, sunlight, occupational exposure, outdoor work

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