TY - JOUR
T1 - Global, regional and national burdens of non-melanoma skin cancer attributable to occupational exposure to solar ultraviolet radiation for 183 countries, 2000–2019
T2 - a systematic analysis from the WHO/ILO Joint Estimates of the Work-related Burden of Disease and Injury
AU - Pega, Frank
AU - Momen, Natalie C.
AU - Streicher, Kai N.
AU - Neupane, Subas
AU - Leon-Roux, Maria
AU - Schubauer-Berigan, Mary K.
AU - Schüz, Joachim
AU - Technical Advisory Group on Occupational Burden of Disease Estimation
AU - Baker, Marissa
AU - Driscoll, Tim
AU - Guseva Canu, Irina
AU - Kiiver, Hannah M.
AU - Li, Jian
AU - Nwanaji-Enwerem, Jamaji C.
AU - Turner, Michelle C.
AU - Viegas, Susana
AU - Villeneuve, Paul J.
N1 - Funding Information:
Countries provided feedback on the estimates through WHO's consultation of its 194 Member States. We specially acknowledge the ILO for its strategic contributions, as well as its sharing of data and contributions to the production of the estimates. Eurostat produced and shared the transition probabilities for exposure to UVR assigned via proxy of occupation for 27 countries in the European Region. Dr Yuka Ujita (ILO) and then Dr Halim Hamzaoui (ILO) were the ILO focal point for the WHO/ILO Joint Estimates. Marion McFeedy (consultant to the ILO) contributed to initial database development, and Dr Bochen Cao (WHO) shared WHO Global Health Estimates. Dr Claudine Backes (WHO) and Dr Emilie van Deventer (WHO) contributed to the early development of the estimation approach. Jessica CY Ho (WHO), Wahyu R Mahanani (WHO), Dr Bálint Náfrádi (ILO), Dr Annette M Prüss (WHO) and Dr Yuka Ujita provided feedback on an earlier version of the manuscript. Dr Ivan D Ivanov (WHO), Nancy Leppink (ILO), Franklin Muchiri (ILO), Dr Maria P Neira (WHO), Vera L Isaac Paquete-Perdigão (ILO) and Joaquim P Pintado Nunes (ILO) contributed to the WHO/ILO Joint Estimates of the Work-related Burden of Disease and Injury. Dr Maria P Neira and Vera L Isaac Paquete-Perdigão provided overall guidance.
Funding Information:
This modelling study was prepared with financial support to WHO from: the National Institute for Occupational Safety and Health of the Centers for Disease Control and Prevention of the United States of America (Grant 1E11OH0010676-02, Grant 6NE11OH010461-02-01 and Grant 5NE11OH010461-03-00); the German Federal Ministry of Health (BMG Germany) under the BMG-WHO Collaboration Programme 2020–2023 (WHO specified award ref. 70672); and the Spanish Agency for International Cooperation (AECID) (WHO specified award ref. 71208). The funders had no role in study design, data collection and analysis, decision to publish or preparation of the manuscript.
Publisher Copyright:
© 2023 International Labour Organization, World Health Organization
PY - 2023/11
Y1 - 2023/11
N2 - Background: A World Health Organization (WHO) and International Labour Organization (ILO) systematic review reported sufficient evidence for higher risk of non-melanoma skin cancer (NMSC) amongst people occupationally exposed to solar ultraviolet radiation (UVR). This article presents WHO/ILO Joint Estimates of global, regional, national and subnational occupational exposures to UVR for 195 countries/areas and the global, regional and national attributable burdens of NMSC for 183 countries, by sex and age group, for the years 2000, 2010 and 2019. Methods: We calculated population-attributable fractions (PAFs) from estimates of the population occupationally exposed to UVR and the risk ratio for NMSC from the WHO/ILO systematic review. Occupational exposure to UVR was modelled via proxy of occupation with outdoor work, using 166 million observations from 763 cross-sectional surveys for 96 countries/areas. Attributable NMSC burden was estimated by applying the PAFs to WHO's estimates of the total NMSC burden. Measures of inequality were calculated. Results: Globally in 2019, 1.6 billion workers (95 % uncertainty range [UR] 1.6–1.6) were occupationally exposed to UVR, or 28.4 % (UR 27.9–28.8) of the working-age population. The PAFs were 29.0 % (UR 24.7–35.0) for NMSC deaths and 30.4 % (UR 29.0–31.7) for disability-adjusted life years (DALYs). Attributable NMSC burdens were 18,960 deaths (UR 18,180–19,740) and 0.5 million DALYs (UR 0.4–0.5). Men and older age groups carried larger burden. Over 2000–2019, attributable deaths and DALYs almost doubled. Conclusions: WHO and the ILO estimate that occupational exposure to UVR is common and causes substantial, inequitable and growing attributable burden of NMSC. Governments must protect outdoor workers from hazardous exposure to UVR and attributable NMSC burden and inequalities.
AB - Background: A World Health Organization (WHO) and International Labour Organization (ILO) systematic review reported sufficient evidence for higher risk of non-melanoma skin cancer (NMSC) amongst people occupationally exposed to solar ultraviolet radiation (UVR). This article presents WHO/ILO Joint Estimates of global, regional, national and subnational occupational exposures to UVR for 195 countries/areas and the global, regional and national attributable burdens of NMSC for 183 countries, by sex and age group, for the years 2000, 2010 and 2019. Methods: We calculated population-attributable fractions (PAFs) from estimates of the population occupationally exposed to UVR and the risk ratio for NMSC from the WHO/ILO systematic review. Occupational exposure to UVR was modelled via proxy of occupation with outdoor work, using 166 million observations from 763 cross-sectional surveys for 96 countries/areas. Attributable NMSC burden was estimated by applying the PAFs to WHO's estimates of the total NMSC burden. Measures of inequality were calculated. Results: Globally in 2019, 1.6 billion workers (95 % uncertainty range [UR] 1.6–1.6) were occupationally exposed to UVR, or 28.4 % (UR 27.9–28.8) of the working-age population. The PAFs were 29.0 % (UR 24.7–35.0) for NMSC deaths and 30.4 % (UR 29.0–31.7) for disability-adjusted life years (DALYs). Attributable NMSC burdens were 18,960 deaths (UR 18,180–19,740) and 0.5 million DALYs (UR 0.4–0.5). Men and older age groups carried larger burden. Over 2000–2019, attributable deaths and DALYs almost doubled. Conclusions: WHO and the ILO estimate that occupational exposure to UVR is common and causes substantial, inequitable and growing attributable burden of NMSC. Governments must protect outdoor workers from hazardous exposure to UVR and attributable NMSC burden and inequalities.
KW - Carcinogens
KW - Global burden of disease
KW - Health inequalities
KW - Non-melanoma skin cancer
KW - Occupational risk factor
KW - Skin neoplasms
KW - Solar ultraviolet radiation
UR - http://www.scopus.com/inward/record.url?scp=85176608768&partnerID=8YFLogxK
U2 - 10.1016/j.envint.2023.108226
DO - 10.1016/j.envint.2023.108226
M3 - Article
C2 - 37945424
AN - SCOPUS:85176608768
SN - 0160-4120
VL - 181
JO - Environment International
JF - Environment International
M1 - 108226
ER -