Photodamage Effect of UV Rays on Skin on outdoor workers

Abstract

Background: Skin is the outermost covering of the human body that serves as a barrier from extrinsic etiological challenges including physical, chemical and biological insults. Ultraviolet (UV)-B (280–320 nm) is the lead environmental agent responsible for causing skin pathologies, overexposure of ultraviolet radiation, particularly UV-B radiations, due to high energy and shorter wave length which are causes for most of the pathological states of skin. Skin cancers are classified into two main categories, non-melanoma skin cancer (NMSC) and cutaneous melanoma (CM). While melanoma originates through the transformation of melanocytes, NMSC arises from other epidermal cells, mainly keratinocytes, are subdivided into basal cell carcinoma (BCC) and squamous cell carcinoma (SCC).  Skin cancers are considered to be one of the most preventable malignancies. By protecting the skin and limiting the amount of unprotected exposure to UVR, skin cancer risk can be decreased.

Objective: To describe the demographic and clinical features of skin cancer and evaluate the harmful effects of excess UVR exposure on human skin.

Patients and Methods: A cross-sectional stud was conducted at the dermatology department in Baquba teaching hospital in Diyala, Iraq. A total of 100 patients were included, in the study, who attended the outpatient clinic of dermatology department of Baquba teaching hospital, from first of September 2020 to end May 2021.

Results: A total of 100 patients diagnosed as skin cancer, were eligible for the study, aged between 30-80 years, The majority of them aged 41-50 years (39%), 50% of them were males and 50% were females, The majority of the patients, were laborer (31%), and 22% of them were housewives, Regarding residence, the majority of the patients (32%) lived in Kalar, and 27% resided in the Baquba, while just 3%  from Mendeley, 83%percent of the patients, had white skin while just 17% of them had brown skin, and no one had black skin color, Regarding the affected site of the body, the face was the most common affected site of the body, found in (52%) of the patients. While face and neck were the most common affected site in 35% of the patients, and the least affected site was the face and hand found in 4% of the patients. Of the total patients, 99% were exposed to normal light while just 1% exposed to additional artificial light. Most of the patients (65%) said that they were exposed to the light over, all the season, while 24% of them were exposed to light  just in summer, 8% and 3% of them were exposed in spring, summer and spring respectively. No one was  exposed to light  in autumn or winter, Just 4% of the patients had family history of skin cancer. There were 79% of the patients diagnosed as basal cell carcinoma; 14% had actinic keratosis, 5% had sun burn; and 2% had seborrheic keratosis. Regarding the patients with (BCC), most of the patients aged less than 70 years. Females were 50.6% of the patients with BCC, while males were 49.4%. The mean age of females was (53.6±12.9 years) was the same for males (53.6±11.6 years), females were  affected by BCC in < 50 and ≥70 age group more than males, while males were affected more in 50-69 age group. Sixty-five percent of the patients had white skin while just 14% of them had brown skin. Regarding the affected site of the body, the face was the most common affected site of the body, found in (53.2%) of the patients, while face and neck were the most common affected site in 34.2% of the patients, and the least affected site was the face and hand found in 5.1% of the patients.

Conclusion:Outdoor workers, especially those without protective measures, and in high altitude areas, are more liable to develop skin cancer especially basal cell carcinoma, so it is important to use sun-protective measures