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Open Access Research article

Occupation and skin cancer: the results of the HELIOS-I multicenter case-control study

Berta Suárez1, Gonzalo López-Abente1*, Carmen Martínez2, Carmen Navarro3, Maria José Tormo3, Stefano Rosso4, Simon Schraub5, Lorenzo Gafà6, Hélène Sancho-Garnier7, Janine Wechsler8 and Roberto Zanetti4

Author Affiliations

1 Environmental and Cancer Epidemiology Unit, National Center for Epidemiology, Carlos III Institute of Health, Sinesio Delgado 6, 28029 Madrid, Spain

2 Andalusian School of Public Health, Granada, Spain

3 Directorate-General for Public Health, Murcia, Spain

4 Registro Tumori Piemonte, Turin, Italy

5 Centre de lutte contre le cancer Paul Strauss, Université Luis Pasteur, 67000 Strasbourg, France

6 Lega Italiana per la lotta contro I tumori Sezione provinciale Ragusa. Ragusa, Italy

7 Epidaure, Montpellier, France

8 Service d'Anatomie et de Cytologie Pathologiques, Hospital Henry Mondor, 94010 Créteil, France

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BMC Public Health 2007, 7:180  doi:10.1186/1471-2458-7-180

Published: 26 July 2007



Non-melanoma skin cancer (NMSC) is the most frequent tumour among Caucasian populations worldwide. Among the risk factors associated with this tumour, there are host-related factors and several environmental agents. A greater likelihood of high exposure to physical agents (with the exception of solar radiation) and chemical agents depends on the work setting. Our objective is to evaluate the role of occupational exposures in NMSC, with special emphasis on risk factors other than solar radiation and skin type.


We analysed 1585 cases (1333 basal cell carcinoma (BCC) and 183 squamous cell carcinoma (SCC)) and 1507 controls drawn from the Helios-I multicenter study. Odds ratios (OR) and 95% confidence intervals (CI) were estimated using logistic regression mixed models.


For NMSC as a whole (both histological types), miners and quarrymen, secondary education teachers, and masons registered excess risk, regardless of exposure to solar radiation and skin type (OR 7.04, 95% CI 2.44–20.31; OR 1.75, 95% CI 1.05–2.89 and OR 1.54, 95% CI 1.04–2.27, respectively). Frequency of BCC proved higher among railway engine drivers and firemen (OR 4.55; 95% CI 0.96–21.57), specialised farmers (OR 1.65; 95% CI 1.05–2.59) and salesmen (OR 3.02; 95% CI 1.05–2.86), in addition to miners and quarrymen and secondary education teachers (OR 7.96; 95% CI 2.72–23.23 and OR 1.76; 95% CI 1.05–2.94 respectively). The occupations that registered a higher risk of SCC (though not of BCC) were those involving direct contact with livestock, construction workers not elsewhere classified (OR 2.95, 95% CI 1.12–7.74), stationary engine and related equipment operators not elsewhere classified (OR 5.31, 95% CI 1.13–21.04) and masons (OR 2.55, 95% CI 1.36–4.78).


Exposure to hazardous air pollutants, arsenic, ionizing radiations and burns may explain a good part of the associations observed in this study. The Helios study affords an excellent opportunity for further in-depth study of physical and chemical agents and NMSC based on matrices of occupational exposure.