Outdoor work and skin cancer incidence: a registry-based study in Bavaria

Objective To analyse the association between occupational ultraviolet (UV) light exposure and skin cancer (basal cell carcinoma, BCC; squamous cell carcinoma, SCC; cutaneous malignant melanoma, CMM) based on data from the Bavarian population-based cancer registry. Methods The population-based cancer registry of Bavaria (Germany) provided data on incident cases of BCC, SCC, and CMM, respectively, during the period 2001 until 2005. Eleven Bavarian districts with complete skin cancer registration were included in this analysis based on 2,156,336 person years. Cases were assigned to ?indoor?, ?mixed indoor/outdoor?, and ?outdoor? exposure categories according to their job title. We computed age-specific and age-adjusted incidence rates of BCC (n = 1,641), SCC (n = 499), and CMM (n = 454) by work type, and the relative risk (RR) of skin cancer occurrence for ?outdoor? and ?mixed indoor/outdoor? workers, respectively, compared to ?indoor? workers. Results The risk of BCC was substantially elevated in male (RR, 2.9; 95% CI, 2.2?3.9) and female (RR, 2.7; 95% CI, 1.8?4.1) outdoor workers compared to male and female indoor workers, respectively. We also found an elevated risk of similar magnitude for SCC in male (RR, 2.5; 95% CI, 1.4?4.7) and female (RR, 3.6; 95% CI, 1.6?8.1) outdoor workers compared to male and female indoor workers, respectively. CMM risk was not significantly associated with outdoor work. Conclusion Our study confirms previous reports on the increased risk of BCC and SCC in outdoor workers compared to indoor workers.