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European Journal of Epidemiology
Article . 2024 . Peer-reviewed
License: CC BY
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Occupational solar exposure and basal cell carcinoma. A review of the epidemiologic literature with meta-analysis focusing on particular methodological aspects

Authors: Wendt, Andrea; Möhner, Matthias;

Occupational solar exposure and basal cell carcinoma. A review of the epidemiologic literature with meta-analysis focusing on particular methodological aspects

Abstract

Abstract Background Numerous epidemiologic studies and a few systematic reviews have investigated the association between occupational solar exposure and basal cell carcinoma (BCC). However, previous reviews have several deficits with regard to included and excluded studies/risk estimates and the assessment of risk of selection bias (RoSB). Our aim was to review epidemiologic studies with a focus on these deficits and to use meta-(regression) analyses to summarize risk estimates. Methods We systematically searched PubMed (including MEDLINE) and Embase for epidemiologic studies. Study evaluation considered four main aspects of risk of bias assessments, i.e. Selection of subjects (selection bias); Exposure variables; Outcome variables; Data analysis. Results Of 56 identified references, 32 were used for meta-(regression) analyses. The overall pooled risk estimate for BCC comparing high/present vs. low/absent occupational solar exposure was 1.20 (95% CI 1.02–1.43); among studies without major deficits regarding data analysis, it was 1.10 (95% CI 0.91–1.33). Studies with low and high RoSB had pooled risk estimates of 0.83 (95% CI 0.73–0.93) and 1.95 (95% CI 1.42–2.67), respectively. The definitions of exposure and outcome variables were not correlated with study risk estimates. Studies with low RoSB in populations with the same latitude or lower than Germany had a pooled risk estimate of 1.01 (95% CI 0.88–1.15). Conclusion Due to the different associations between occupational solar exposure and BCC among studies with low and high RoSB, we reason that the current epidemiologic evidence base does not permit the conclusion that regular outdoor workers have an increased risk of BCC.

Keywords

Occupational Exposure/analysis [MeSH] ; Basal cell carcinoma ; Selection Bias [MeSH] ; Humans [MeSH] ; Meta-analysis ; Carcinoma, Basal Cell/etiology [MeSH] ; Skin Neoplasms/epidemiology [MeSH] ; Carcinoma, Basal Cell/epidemiology [MeSH] ; Occupational exposure ; Germany [MeSH] ; Review ; Occupational Exposure/adverse effects [MeSH] ; Ultraviolet Radiation ; Skin Neoplasms/etiology [MeSH], Skin Neoplasms, Carcinoma, Basal Cell, Germany, Occupational Exposure, Humans, Review, Selection Bias

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    popularity
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    Top 10%
    influence
    This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
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    impulse
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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
2
Top 10%
Average
Average
Green
hybrid