Occupational exposure to solar ultraviolet radiation amongst outdoor workers in Lisbon, 2023 – first results of the MEAOW study

Fernanda Carvalho^1,2Claudine Strehl³Jorge Barroso-Dias^4,5Maria Miguel Castela⁶Fabriziomaria Gobba⁷Luís Velez Lapão^10,8,9Tom Loney¹¹Mélanie Raimundo Maia¹²Alberto Modenese⁷Swen Malte John^13,14Ana Rodrigues⁴Cristina Pinho⁴Cara Bieck^14,15Thomas Tenkate¹⁶Stephan Westerhausen¹⁷Marc Wittlich¹⁷Marília Silva Paulo^18,19*

• ¹Portuguese Institute for Sea and Atmosphere (IPMA), Lisbon, Portugal
• ²Center for Sci-Tech Research in Earth System and Energy - CREATE, IIFA, University of Évora, Évora, Portugal
• ³Institut für Arbeitsschutz der Deutschen Gesetzlichen Unfallversicherung (IFA), Sankt Augustin, North Rhine-Westphalia, Germany
• ⁴Departamento de Saúde, Higiene e Segurança, Câmara Municipal de Lisboa, Lisbon, Portugal
• ⁵Portuguese Society of Occupational Medicine, Lisbon, Portugal
• ⁶NOVA National School of Public Health, Universidade Nova de Lisboa, Lisboa, Portugal
• ⁷Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Emilia-Romagna, Italy
• ⁸Intelligent Decision Support Systems Laboratory, Research & Development Unit for Mechanical and Industrial Engineering (UNIDEMI), NOVA School of Science and Technology, Universidade NOVA de Lisboa, Caparica, Portugal
• ⁹Laboratório Associado de Sistemas Inteligentes (LASI), Escola de Engenharia, Universidade do Minho, Guimarães, Portugal, Guimarães, Portugal
• ¹⁰WHO Collaborating Centre on Health Workforce Policy and Planning, Global Health and Tropical Medicine, Universidade Nova de Lisboa, Portugal, Lisboa, Portugal
• ¹¹College of Medicine, Mohamed Bin Rashid University of Medicine and Health Sciences, Dubai, Dubai, United Arab Emirates
• ¹²Intelligent Decision Support Systems Laboratoty, Research & Development Unit for Mechanical and Industrial Engineering (UNIDEMI), NOVA School of Science and Technology, Universidade NOVA de Lisboa, Caparica, Portugal
• ¹³Institute for Interdisciplinary Dermatological Prevention and Rehabilitation (iDerm), Osnabrueck, Germany
• ¹⁴Department of Dermatology, Environmental Medicine and health Theory, Institute for Health Research Education (IGB) , Faculty of Human Sciences, Osnabrueck University, Osnabrueck, Germany
• ¹⁵Division of Occupational Medicine, Department of Occupational Medicine, Hazardous Substances and Health Sciences, German Social Accident Insurance for the Health and Welfare Services, Hamburg, Germany, Hamburg, Germany
• ¹⁶Toronto Metropolitan University, Toronto, Canada
• ¹⁷Institute for Occupational Safety and Health of the German Social Accidents Insurance (IFA), Germany, Saint Augustin, Germany
• ¹⁸CHRC, NOVA Medical School, Faculdade de Ciências Médicas, NMS, FCM, Universidade NOVA de Lisboa; Lisboa, Portugal, Lisboa, Portugal
• ¹⁹NOVA National School of Public Health, Public Health Research Center, Comprehensive Health Research Center, CHRC, REAL, CCAL, NOVA University Lisbon, 1600-560 Lisbon, Portugal, Lisboa, Portugal

Introduction: Solar ultraviolet radiation (UVR) exposure is the primary external factor associated with the development of skin cancer. Accurate, valid, and reliable objective estimates of individual UVR exposure are required to quantify the risk of skin cancer in outdoor workers. Such data can be used to develop and implement policies and practices to reduce, or at least manage, UVR exposure in outdoor workers. Currently, there is a dearth of objective exposure data for many countries. Lisbon, as a low-mid-latitude region (38°46′ N), experiences a high UV Index (UVI) for a long period of the year, increasing the potential risk of skin cancer amongst outdoor workers in Portugal. This is the first study to objectively measure personal solar UVR exposure amongst outdoor workers in Portugal. Methods: This study used a prospective observational design during seven consecutive months (April to October 2023) studying personal UV exposure of Asphalthers, Gardeners, Gravediggers, Pavers, and Sanitation Workers. Measurements of personal exposure were conducted using the GENESIS-UV measurement system, and ambient solar UVR data was estimated Jm-2 utilizing a UV-Biometer radiometer. Results: Personal hourly and daily doses measured by the GENESIS-UV measurement system were lower than the solar irradiation measured on a horizontal surface by the UV-Biometer radiometer. Gravediggers and Gardeners showed in average, the highest monthly daily averages (250 Jm-2 and 266 Jm-2 , respectively). The maximum monthly daily average occurred for Gravediggers in the month of April (363 Jm-2 ). Pavers recorded the lowest solar UVR average daily doses (62 Jm-2). Sanitation Workers recorded the highest average daily dose (837 Jm-2 , July 7th). The maximum single dosimeter value was accumulated by Gravediggers (1097 Jm-2 , May 9th). Discussion: This study measured solar UVR exposure in important occupations not so often studied. The ICNRIP occupational limit value of 133 J/m-2 was surpassed in all occupations except the Pavers. These results showcase that the design of adequate prevention campaigns for preventing occupational skin cancer in outdoor workers should include personalized exposure risk messaging in the future.