Occupational Solar UV Exposure and Skin Cancer: A Quantitative Framework for Individual Causal Attribution in Dermatology Practice

IF 3.2 3区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Safety and Health at Work Pub Date : 2026-09-01 Epub Date: 2026-05-22 DOI:10.1016/j.shaw.2026.05.001

Eytan Ellenberg, Arieh Ingber, Akshaya S. Bhagavathula, Eldad Katorza, Yuval Ramot

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引用次数: 0

Abstract

Background

Occupational solar ultraviolet radiation (UVR) exposure is a major risk factor for keratinocyte carcinomas in outdoor workers. Individual causal attribution for medico-legal purposes requires partitioning risk contributions between occupational exposure and individual susceptibility factors—a question distinct from population-level burden estimation. This study is primarily a quantitative/methodological application of FAIR to occupational UV-related skin cancer.

Methods

This methodological framework study applies the FAIR approach (Filtering evidence, Association quantification, Individual partitioning, Reasoned interpretation) to occupational solar UVR and skin cancer. Meta-analyses (1995–2025) were reviewed and adjusted for phototype, sex, and immune status. Individual attribution was estimated using game-theory–based decomposition (Shapley values) and stochastic Monte Carlo simulation to propagate uncertainty. Preventive scenarios incorporated sector-specific compliance and long-term economic modeling.

Results

Mean occupational causal shares were 35% for squamous cell carcinoma (SCC), 25% for basal cell carcinoma (BCC), 10% for melanoma, and 50% for actinic keratosis. The probability of exceeding the 20% medico-legal attribution threshold reached 85% for SCC and 75% for BCC. Prevention reduced expected cases by 10-15% and healthcare costs by 8-12%.

Conclusions

The FAIR framework provides a transparent, reproducible approach for integrating epidemiological evidence with individual attribution. These quantitative thresholds support the clinical and medico-legal recognition of work-related skin cancers.

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职业性太阳紫外线照射与皮肤癌：皮肤病学实践中个体因果归因的定量框架

背景：职业性太阳紫外线辐射（UVR）暴露是户外工作人员发生角化细胞癌的主要危险因素。医学-法律目的的个人因果归因需要在职业暴露和个人易感因素之间划分风险贡献-这是一个不同于人口水平负担估计的问题。本研究主要是对FAIR在职业性紫外线相关皮肤癌中的定量/方法学应用。方法采用FAIR方法（过滤证据、关联量化、个体划分、理性解释）研究职业性太阳紫外线辐射与皮肤癌的关系。回顾了1995-2025年的荟萃分析，并根据光型、性别和免疫状态进行了调整。利用基于博弈论的分解（Shapley值）和随机蒙特卡罗模拟来传播不确定性，估计个体归因。预防性方案结合了特定部门的遵从性和长期经济模型。结果鳞状细胞癌（SCC）的平均职业病因占比为35%，基底细胞癌（BCC）为25%，黑色素瘤为10%，光化性角化病为50%。超过20%医学法律归属阈值的概率在SCC和BCC中分别达到85%和75%。预防使预期病例减少10-15%，医疗费用减少8-12%。结论FAIR框架为整合流行病学证据和个体归因提供了一种透明、可重复的方法。这些定量阈值支持临床和医学法律对工作相关皮肤癌的认可。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Safety and Health at Work Social Sciences-Safety Research

CiteScore

6.40

自引率

5.70%

发文量

1080

审稿时长

38 days

期刊介绍： Safety and Health at Work (SH@W) is an international, peer-reviewed, interdisciplinary journal published quarterly in English beginning in 2010. The journal is aimed at providing grounds for the exchange of ideas and data developed through research experience in the broad field of occupational health and safety. Articles may deal with scientific research to improve workers'' health and safety by eliminating occupational accidents and diseases, pursuing a better working life, and creating a safe and comfortable working environment. The journal focuses primarily on original articles across the whole scope of occupational health and safety, but also welcomes up-to-date review papers and short communications and commentaries on urgent issues and case studies on unique epidemiological survey, methods of accident investigation, and analysis. High priority will be given to articles on occupational epidemiology, medicine, hygiene, toxicology, nursing and health services, work safety, ergonomics, work organization, engineering of safety (mechanical, electrical, chemical, and construction), safety management and policy, and studies related to economic evaluation and its social policy and organizational aspects. Its abbreviated title is Saf Health Work.