Occupational disease “Skin cancer caused by UV radiation”– unambiguous facts, heterogeneous consequences

Sep 23, 2026

Uploaded by Ben

Clinical letter on occupational UV exposure and its link to cutaneous squamous cell carcinoma (SCC), addressing the mismatch between scientific evidence and occupational-disease recognition. Explains UV radiation as a Group 1 human carcinogen and details mechanisms including DNA mutations and immunosuppression, plus factors influencing cumulative skin damage. Discusses differentiation between occupational and recreational exposure, summarizes international assessments by WHO/ILO, compares legal recognition across countries, and outlines reasons for underreporting.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages4

Reading Time10 min

AccessFree to download

Introduction

UV radiation as a human carcinogen

Occupational exposure and distinction from recreational exposure

International assessments and legal differences

Reasons for underreporting

DOI: 10.1111/ddg.70022x CLINICAL LETTER Occupational disease “Skin cancer caused by UV radiation”– unambiguous facts, heterogeneous consequences Werner Aberer1 Rainer Hofmann-Wellenhof1 Norbert Sepp2 Barbara Ebner2 Swen-Malte John3 1 University Clinic for Dermatology, Medical University of Graz, Graz, Austria 2 Department of Dermatology and Venereology, Elisabethinen Hospital, Linz, Austria 3 Department of Dermatology, Environmental Medicine, Health Theory and Institute for Interdisciplinary Dermatological Prevention and Rehabilitation (iDerm) at the University of Osnabrück, Osnabrück, Germany Correspondence Werner Aberer, MD, Department of Dermatology and Venerology, Medical University of Graz, Auenbruggerplatz 8, 8036 Graz, Austria. [Email:](Email: werner.aberer@medunigraz.at)[ werner.aberer@medunigraz.at](Email: werner.aberer@medunigraz.at) KEYWORDS Occupational disease, outdoor workers, prevention, regulations, skin cancer, UV radiation INTRODUCTION Cutaneous squamous cell carcinoma (SCC) is the second most common malignant tumor after basal cell carcinoma.1 The main cause is ultraviolet (UV) radiation from sunlight, which has mutagenic and immunosuppressive effects. In many countries, occupational UV exposure is an increasing occupational health challenge, especially in outdoor work. Despite alarming incidence rates and clear scientific evidence regarding its etiology, SCC and its precursors are not recognized as an occupational disease in many countries. Legislative measures vary greatly – from complete neglect to the establishment of comprehensive prevention and compensation programs.1 This imbalance is often due to a lack of awareness of the problem and low reporting rates.2 UV RADIATION AS A HUMAN CARCINOGEN UV radiation has been classified by the InternationalAgency for Research on Cancer (IARC) as a Group 1 carcinogen.3 Relevant for this are DNA mutations in keratinocytes, which lead to tumor induction. Moreover, UV radiation has an immunosuppressive effect and suppresses the elimination of transformed cells, which promotes tumor development. The extent of skin damage depends not only on the duration and intensity of exposure but is also influenced by individual factors such as Fitzpatrick skin type, genetic disposition, and sex, as well as environmental factors (geographical longitude, time of year and day, weather, reflection from water, sand, or snow) .4 The damage often manifests only after decades, which complicates the attribution of causality.4 OCCUPATIONAL EXPOSURE AND DISTINCTION FROM RECREATIONAL EXPOSURE UV exposure occurs in both private and professional settings. While acute sunburns in childhood are particularly associated with melanomas, it is cumulative UV exposure that is relevant for SCC.4 In numerous professions – especially in construction, agriculture and forestry, fisheries, tourism, as well as for security personnel or outdoor teachers – UV exposure is significantly increased. However, it is not the profession per se, but the individual level of exposure in relation to risk that determines the hazard. Keratocytic carcinoma has reached the status of a common disease due to its high incidence. In particular, SCC and This is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes. © 2026 The Author(s) . Journal der Deutschen Dermatologischen Gesellschaft published by John Wiley & Sons Ltd on behalf of Deutsche Dermatologische Gesellschaft. JDDG: Journal der Deutschen Dermatologischen Gesellschaft. 2026;24:e965–[e968.](e968. wileyonlinelibrary.com/journal/ddg)[ wileyonlinelibrary.com/journal/ddg](e968. wileyonlinelibrary.com/journal/ddg) e965 its precursors, together with the even more common basal cell carcinoma, have historically been grouped under the ter

FAQs

Why is occupational UV exposure considered a risk for SCC?

UV radiation causes DNA mutations in keratinocytes and has immunosuppressive effects, promoting tumor development. Occupational exposure from outdoor work increases cumulative UV dose, which is central for SCC risk.

What complicates recognizing SCC as an occupational disease?

Causality is difficult because UV-related skin damage often manifests only after decades. In practice, occupational versus private exposure cannot always be clearly distinguished, and awareness and reporting rates can be low.

How do countries differ in recognizing UV-related NMSC as an occupational disease?

Germany recognizes it as an occupational disease since January 1, 2015, with substantial differences between suspected and recognized cases. The neighboring countries Austria and Switzerland and others show markedly different reporting and recognition rates.

Sep 23, 2026

Uploaded by Ben