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European Journal of Epidemiology
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Open Access 03-01-2024 | Basalioma | REVIEW

Occupational solar exposure and basal cell carcinoma. A review of the epidemiologic literature with meta-analysis focusing on particular methodological aspects

Authors: Andrea Wendt, Matthias Möhner

Published in: European Journal of Epidemiology | Issue 1/2024

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Abstract

Background

Numerous epidemiologic studies and a few systematic reviews have investigated the association between occupational solar exposure and basal cell carcinoma (BCC). However, previous reviews have several deficits with regard to included and excluded studies/risk estimates and the assessment of risk of selection bias (RoSB). Our aim was to review epidemiologic studies with a focus on these deficits and to use meta-(regression) analyses to summarize risk estimates.

Methods

We systematically searched PubMed (including MEDLINE) and Embase for epidemiologic studies. Study evaluation considered four main aspects of risk of bias assessments, i.e. Selection of subjects (selection bias); Exposure variables; Outcome variables; Data analysis.

Results

Of 56 identified references, 32 were used for meta-(regression) analyses. The overall pooled risk estimate for BCC comparing high/present vs. low/absent occupational solar exposure was 1.20 (95% CI 1.02–1.43); among studies without major deficits regarding data analysis, it was 1.10 (95% CI 0.91–1.33). Studies with low and high RoSB had pooled risk estimates of 0.83 (95% CI 0.73–0.93) and 1.95 (95% CI 1.42–2.67), respectively. The definitions of exposure and outcome variables were not correlated with study risk estimates. Studies with low RoSB in populations with the same latitude or lower than Germany had a pooled risk estimate of 1.01 (95% CI 0.88–1.15).

Conclusion

Due to the different associations between occupational solar exposure and BCC among studies with low and high RoSB, we reason that the current epidemiologic evidence base does not permit the conclusion that regular outdoor workers have an increased risk of BCC.
Appendix
Available only for authorised users
Footnotes
1
There is no consensus on definitive critical proportions. Furthermore, a certain proportion of missing observations does not indicate selection bias, just as a certain proportion of available observations does not indicate the absence of selection bias. The differentiation of studies will be used in meta-(regression) analysis in order to assess whether systematic selection bias might be present or not.
 
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Metadata
Title
Occupational solar exposure and basal cell carcinoma. A review of the epidemiologic literature with meta-analysis focusing on particular methodological aspects
Authors
Andrea Wendt
Matthias Möhner
Publication date
03-01-2024
Publisher
Springer Netherlands
Published in
European Journal of Epidemiology / Issue 1/2024
Print ISSN: 0393-2990
Electronic ISSN: 1573-7284
DOI
https://doi.org/10.1007/s10654-023-01061-w

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