Skin cancer in outdoor workers exposed to solar radiation: a largely underreported occupational disease in Italy

Background Solar UV radiation (sUVR) is one of the main carcinogen exposures in occupational settings, and UV-induced skin cancers are the most frequent tumours in fair-skinned individuals worldwide. Objectives According to this premise, we should expect a high number of occupational skin cancers reported to the national workers' compensation authorities each year, also considering that the incidence of skin cancers has been constantly increased in recent years Methods We examined the data on reported non-melanoma skin cancers (NMSC) and actinic keratoses (AK) to the Italian National Workers Compensation Authority (INAIL) from 2012 to 2017, and we compared the number of reported skin cancers for outdoor workers with the expected numbers, obtained from currently available NMSC incidence rates for the Italian population applied to the occupational sUVR-exposed workers estimated with the CAREX methodology in Italy in 2005. Results The cases of NMSC reported each year to INAIL in Italy are 34 per year on average, while for AK the mean number of reported cases is of only 15/year. We estimated a number of expected NMSC cases in Italy for solar UV-exposed workers ranging between 432 and 983, representing a proportion between reported vs. expected skin cancers of only 3.5-6.2%. Conclusions Our study clearly shows that occupational skin cancers in Italy are largely underreported, and, accordingly, urgent initiatives should be taken to raise appropriate awareness to the problem of occupational sUVR-induced skin cancers, so that adequate preventive measures can be implemented rapidly

The association of the original OSHA chemical hazard communication standard with reductions in acute work injuries/illnesses in private industry and the industrial releases of chemical carcinogens

Background OSHA predicted the original chemical Hazard Communication Standard (HCS) would cumulatively reduce the lost workday acute injury/illness rate for exposure events by 20% over 20 years and reduce exposure to chemical carcinogens. Methods JoinPoint trend software identified changes in the rate of change of BLS rates for days away from work for acute injuries/illnesses during 1992–2009 for manufacturing and nonmanufacturing industries for both chemical, noxious or allergenic injury exposure events and All other exposure events. The annual percent change in the rates was used to adjust observed numbers of cases to estimate their association with the standard. A case‐control study of EPA's Toxic Release Inventory 1988–2009 data compared carcinogen and non‐carcinogens' releases. Results The study estimates that the HCS was associated with a reduction in the number of acute injuries/illnesses due to chemical injury exposure events over the background rate in the range 107,569–459,395 (Hudson method/modified BIC model) depending on whether the HCS is treated as a marginal or sole factor in the decrease. Carcinogen releases have declined at a substantially faster rate than control non‐carcinogens. Discussion The previous HCS standard was associated with significant reductions in chemical event acute injuries/illnesses and chemical carcinogen exposures. Am. J. Ind. Med. 57:138–152, 2014. © 2013 Wiley Periodicals, Inc.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/102719/1/ajim22269.pd

Occupational UV exposure of environmental agents in Valencia, Spain

The aim of this paper is to measure UV exposure of environmental agents in their occupational schedules in summer in Valencia province (Spain) using VioSpor personal dosimeters attached to several parts of their bodies. Due to its geographical situation, Valencia receives large UVR doses throughout the year, and the work of environmental agents is directly related to the protection, care, and custody of natural, often in mountainous areas. Comparison with the occupational UV exposure limit showed that the agents received an erythemal UV dose in excess of occupational guidelines, indicating that protective measures against this risk are highly advisable.The authors wish to thank the environmental agents of the Conselleria de Infraestructuras, Territorio y Medio Ambiente of the Generalitat Valenciana for their cooperation in this study. We also wish to thank the Head of the Conselleria for permitting the workers to take part. We are also grateful to the State Agency for Meteorology and the Generalitat Valenciana for providing us with access to their meteorological data. The data used in this work were originally acquired as part of the activities of NASA's Science Mission Directorate, and are archived and distributed by the Goddard Earth Sciences (GES) Data and Information Services Center (DISC). The translation of this study was funded by the Universitat Politecnica de Valencia, Spain. The research was supported by the Spanish Ministry of Education and Science within Research Project CGL2010-15931 and by the Generalitat Valenciana within the PROMETEO/2010/064 Project.Serrano Jareño, MA.; Cañada, J.; Moreno Esteve, JC.; Gurrea Ysasi, G. (2014). Occupational UV exposure of environmental agents in Valencia, Spain. Photochemistry and Photobiology. 90:911-918. https://doi.org/10.1111/php.12252S91191890Juzeniene, A., Brekke, P., Dahlback, A., Andersson-Engels, S., Reichrath, J., Moan, K., … Moan, J. (2011). Solar radiation and human health. Reports on Progress in Physics, 74(6), 066701. doi:10.1088/0034-4885/74/6/066701Norval, M., Lucas, R. M., Cullen, A. P., de Gruijl, F. R., Longstreth, J., Takizawa, Y., & van der Leun, J. C. (2011). The human health effects of ozone depletion and interactions with climate change. Photochemical & Photobiological Sciences, 10(2), 199. doi:10.1039/c0pp90044cSklar, L. R., Almutawa, F., Lim, H. W., & Hamzavi, I. (2013). Effects of ultraviolet radiation, visible light, and infrared radiation on erythema and pigmentation: a review. Photochem. Photobiol. Sci., 12(1), 54-64. doi:10.1039/c2pp25152cGarbe, C., & Leiter, U. (2009). Melanoma epidemiology and trends. Clinics in Dermatology, 27(1), 3-9. doi:10.1016/j.clindermatol.2008.09.001Madan, V., Lear, J. T., & Szeimies, R.-M. (2010). Non-melanoma skin cancer. The Lancet, 375(9715), 673-685. doi:10.1016/s0140-6736(09)61196-xLomas, A., Leonardi‐Bee, J., & Bath‐Hextall, F. (2012). A systematic review of worldwide incidence of nonmelanoma skin cancer. British Journal of Dermatology, 166(5), 1069-1080. doi:10.1111/j.1365-2133.2012.10830.xArnold , M. C. Holterhues L. M. Hollestein J. W. W. Coebergh T. Nijsten E. Pukkala B. Holleczek L. Tryggvad_ottir H. Comber M. J. Bento C. H. S. Diba R. Micallef M. Primic_Zakelj M. I. Izarzugaza J. Perucha R. Marcos-Gragera J. Galceran E. Ardanaz R. Schaffar A. Pring E. de Vries 2013 Trends in incidence and predictions of cutaneous melanoma across Europe up to 2015 10.1111/jdv.12236Erdmann, F., Lortet-Tieulent, J., Schüz, J., Zeeb, H., Greinert, R., Breitbart, E. W., & Bray, F. (2012). International trends in the incidence of malignant melanoma 1953-2008-are recent generations at higher or lower risk? International Journal of Cancer, 132(2), 385-400. doi:10.1002/ijc.27616Ferlay , J. H. R. Shin F. Bray D. Forman C. Mathers D. M. Parkin 2010 GLOBOCAN 2008 v2.0, Cancer Incidence and Mortality Worldwide: IARC CancerBase No. 10 [Internet] International Agency for Research on Cancer Lyon, France http://globocan.iarc.frHousman, T. S., Feldman, S. R., Williford, P. M., Fleischer, A. B., Goldman, N. D., Acostamadiedo, J. M., & Chen, G. J. (2003). Skin cancer is among the most costly of all cancers to treat for the Medicare population. Journal of the American Academy of Dermatology, 48(3), 425-429. doi:10.1067/mjd.2003.186De Vries, E., van de Poll-Franse, L. V., Louwman, W. J., de Gruijl, F. R., & Coebergh, J. W. W. (2005). Predictions of skin cancer incidence in the Netherlands up to 2015. British Journal of Dermatology, 152(3), 481-488. doi:10.1111/j.1365-2133.2005.06386.xCáncer en cifras Centro Nacional de Epidemiología Instituto de Salud Carlos III http://193.146.50.130/morta/grafs.php#grafsDe Vries, E., Bray, F. I., Coebergh, J. W. W., & Parkin, D. M. (2003). Changing epidemiology of malignant cutaneous melanoma in Europe 1953-1997: Rising trends in incidence and mortality but recent stabilizations in Western Europe and decreases in Scandinavia. International Journal of Cancer, 107(1), 119-126. doi:10.1002/ijc.11360Ferlay, J., Steliarova-Foucher, E., Lortet-Tieulent, J., Rosso, S., Coebergh, J. W. W., Comber, H., … Bray, F. (2013). Cancer incidence and mortality patterns in Europe: Estimates for 40 countries in 2012. European Journal of Cancer, 49(6), 1374-1403. doi:10.1016/j.ejca.2012.12.027European Detailed Mortality Database World Health Organization Regional Office for Europe http://data.euro.who.int/hfamdb/De Gruijl, F. R. (2011). Sufficient Vitamin D from Casual Sun Exposure? Photochemistry and Photobiology, 87(3), 598-601. doi:10.1111/j.1751-1097.2011.00918.xWebb, A. R., Kift, R., Berry, J. L., & Rhodes, L. E. (2011). The Vitamin D Debate: Translating Controlled Experiments into Reality for Human Sun Exposure Times. Photochemistry and Photobiology, 87(3), 741-745. doi:10.1111/j.1751-1097.2011.00898.xJohn, E. M., Koo, J., & Schwartz, G. G. (2007). Sun Exposure and Prostate Cancer Risk: Evidence for a Protective Effect of Early-Life Exposure. Cancer Epidemiology Biomarkers & Prevention, 16(6), 1283-1286. doi:10.1158/1055-9965.epi-06-1053Grant, W. B. (2010). Relation between prediagnostic serum 25-hydroxyvitamin D level and incidence of breast, colorectal, and other cancers. Journal of Photochemistry and Photobiology B: Biology, 101(2), 130-136. doi:10.1016/j.jphotobiol.2010.04.008Kampman, M. T., & Steffensen, L. H. (2010). The role of vitamin D in multiple sclerosis. Journal of Photochemistry and Photobiology B: Biology, 101(2), 137-141. doi:10.1016/j.jphotobiol.2010.04.003Zittermann, A., & Gummert, J. F. (2010). Sun, vitamin D, and cardiovascular disease. Journal of Photochemistry and Photobiology B: Biology, 101(2), 124-129. doi:10.1016/j.jphotobiol.2010.01.006EUROMELANOMA Campaign 2012 http://www.euromelanoma.org/spain/home-1Stratigos, A. J., Forsea, A. M., van der Leest, R. J. T., de Vries, E., Nagore, E., Bulliard, J.-L., … del Marmol, V. (2012). Euromelanoma: a dermatology-led European campaign against nonmelanoma skin cancer and cutaneous melanoma. Past, present and future. British Journal of Dermatology, 167, 99-104. doi:10.1111/j.1365-2133.2012.11092.xCAREX project http://www.esf.org/research-areas/space-sciences/activities/carex-project.htmlGies, P., & Wright, J. (2003). Measured Solar Ultraviolet Radiation Exposures of Outdoor Workers in Queensland in the Building and Construction Industry¶. Photochemistry and Photobiology, 78(4), 342. doi:10.1562/0031-8655(2003)0782.0.co;2Moehrle, M., Dennenmoser, B., & Garbe, C. (2003). Continuous long-term monitoring of UV radiation in professional mountain guides reveals extremely high exposure. International Journal of Cancer, 103(6), 775-778. doi:10.1002/ijc.10884Thieden, E., Collins, S. M., Philipsen, P. A., Murphy, G. M., & Wulf, H. C. (2005). Ultraviolet exposure patterns of Irish and Danish gardeners during work and leisure. British Journal of Dermatology, 153(4), 795-801. doi:10.1111/j.1365-2133.2005.06797.xGlanz, K., Buller, D. B., & Saraiya, M. (2007). Reducing ultraviolet radiation exposure among outdoor workers: State of the evidence and recommendations. Environmental Health, 6(1). doi:10.1186/1476-069x-6-22Milon, A., Sottas, P.-E., Bulliard, J.-L., & Vernez, D. (2006). Effective exposure to solar UV in building workers: influence of local and individual factors. Journal of Exposure Science & Environmental Epidemiology, 17(1), 58-68. doi:10.1038/sj.jes.7500521Siani, A. M., Casale, G. R., Diémoz, H., Agnesod, G., Kimlin, M. G., Lang, C. A., & Colosimo, A. (2008). Personal UV exposure in high albedo alpine sites. Atmospheric Chemistry and Physics, 8(14), 3749-3760. doi:10.5194/acp-8-3749-2008Gies, P., Watzl, R., Javorniczky, J., Roy, C., Henderson, S., Ayton, J., & Kingston, M. (2009). Measurement of the UVR Exposures of Expeditioners on Antarctic Resupply Voyages. Photochemistry and Photobiology, 85(6), 1485-1490. doi:10.1111/j.1751-1097.2009.00602.xHammond, V., Reeder, A. I., & Gray, A. (2009). Patterns of real-time occupational ultraviolet radiation exposure among a sample of outdoor workers in New Zealand. Public Health, 123(2), 182-187. doi:10.1016/j.puhe.2008.12.007Serrano, M. A., Cañada, J., & Moreno, J. C. (2009). Erythemal Ultraviolet Exposure in Two Groups of Outdoor Workers in Valencia, Spain. Photochemistry and Photobiology, 85(6), 1468-1473. doi:10.1111/j.1751-1097.2009.00609.xSchmalwieser, A. W., Cabaj, A., Schauberger, G., Rohn, H., Maier, B., & Maier, H. (2010). Facial Solar UV Exposure of Austrian Farmers During Occupation. Photochemistry and Photobiology, 86(6), 1404-1413. doi:10.1111/j.1751-1097.2010.00812.xSiani, A. M., Casale, G. R., Sisto, R., Colosimo, A., Lang, C. A., & Kimlin, M. G. (2011). Occupational Exposures to Solar Ultraviolet Radiation of Vineyard Workers in Tuscany (Italy). Photochemistry and Photobiology, 87(4), 925-934. doi:10.1111/j.1751-1097.2011.00934.xHåkansson, N., Floderus, B., Gustavsson, P., Feychting, M., & Hallin, N. (2001). Occupational Sunlight Exposure and Cancer Incidence among Swedish Construction Workers. Epidemiology, 12(5), 552-557. doi:10.1097/00001648-200109000-00015Gandini, S., Sera, F., Cattaruzza, M. S., Pasquini, P., Picconi, O., Boyle, P., & Melchi, C. F. (2005). Meta-analysis of risk factors for cutaneous melanoma: II. Sun exposure. European Journal of Cancer, 41(1), 45-60. doi:10.1016/j.ejca.2004.10.016Radespiel-Tröger, M., Meyer, M., Pfahlberg, A., Lausen, B., Uter, W., & Gefeller, O. (2008). Outdoor work and skin cancer incidence: a registry-based study in Bavaria. International Archives of Occupational and Environmental Health, 82(3), 357-363. doi:10.1007/s00420-008-0342-0Kenborg, L., Jørgensen, A. D., Budtz-Jørgensen, E., Knudsen, L. E., & Hansen, J. (2010). Occupational exposure to the sun and risk of skin and lip cancer among male wage earners in Denmark: a population-based case–control study. Cancer Causes & Control, 21(8), 1347-1355. doi:10.1007/s10552-010-9562-1Lichte, V., Dennenmoser, B., Dietz, K., Häfner, H.-M., Schlagenhauff, B., Garbe, C., … Moehrle, M. (2009). Professional risk for skin cancer development in male mountain guides - a cross-sectional study. Journal of the European Academy of Dermatology and Venereology, 24(7), 797-804. doi:10.1111/j.1468-3083.2009.03528.xDiepgen, T. L., Fartasch, M., Drexler, H., & Schmitt, J. (2012). Occupational skin cancer induced by ultraviolet radiation and its prevention. British Journal of Dermatology, 167, 76-84. doi:10.1111/j.1365-2133.2012.11090.xSchmitt, J., Seidler, A., Diepgen, T. L., & Bauer, A. (2011). Occupational ultraviolet light exposure increases the risk for the development of cutaneous squamous cell carcinoma: a systematic review and meta-analysis. British Journal of Dermatology, 164(2), 291-307. doi:10.1111/j.1365-2133.2010.10118.xDe Vries, E., Trakatelli, M., Kalabalikis, D., Ferrandiz, L., Ruiz-de-Casas, A., … Moreno-Ramirez, D. (2012). Known and potential new risk factors for skin cancer in European populations: a multicentre case-control study. British Journal of Dermatology, 167, 1-13. doi:10.1111/j.1365-2133.2012.11081.xSchmitt, J., Diepgen, T., & Bauer, A. (2010). Berufliche Exposition gegenüber natürlicher UV-Strahlung und nicht-melanozytärer Hautkrebs - ein systematischer Review zur Frage einer neuen Berufskrankheit. JDDG: Journal der Deutschen Dermatologischen Gesellschaft, 8(4), 250-264. doi:10.1111/j.1610-0387.2009.07260_supp.xBlumthaler, M., Ambach, W., & Ellinger, R. (1997). Increase in solar UV radiation with altitude. Journal of Photochemistry and Photobiology B: Biology, 39(2), 130-134. doi:10.1016/s1011-1344(96)00018-8Aceituno-Madera, P., Buendía-Eisman, A., Olmo, F. J., Jiménez-Moleón, J. J., & Serrano-Ortega, S. (2011). Melanoma, altitud y radiación UVB. Actas Dermo-Sifiliográficas, 102(3), 199-205. doi:10.1016/j.ad.2010.08.003Biosense Laboratories www.biosense.de/home-e.htmMoehrle, M., & Garbe, C. (2000). Personal UV Dosimetry by Bacillus subtilis Spore Films. Dermatology, 200(1), 1-5. doi:10.1159/000018306O’Riordan, D. L., Glanz, K., Gies, P., & Elliott, T. (2008). A Pilot Study of the Validity of Self-reported Ultraviolet Radiation Exposure and Sun Protection Practices Among Lifeguards, Parents and Children. Photochemistry and Photobiology, 84(3), 774-778. doi:10.1111/j.1751-1097.2007.00262.xFurusawa, Y., Quintern, L. E., Holtschmidt, H., Koepke, P., & Saito, M. (1998). Determination of erythema-effective solar radiation in Japan and Germany with a spore monolayer film optimized for the detection of UVB and UVA - results of a field campaign. Applied Microbiology and Biotechnology, 50(5), 597-603. doi:10.1007/s002530051341Munakata, N., Kazadzis, S., Bais, A. F., Hieda, K., Rontó, G., Rettberg, P., & Horneck, G. (2000). Comparisons of Spore Dosimetry and Spectral Photometry of Solar-UV Radiation at Four Sites in Japan and Europe¶. Photochemistry and Photobiology, 72(6), 739. doi:10.1562/0031-8655(2000)0722.0.co;2Quintern, L. ., Furusawa, Y., Fukutsu, K., & Holtschmidt, H. (1997). Characterization and application of UV detector spore films: the sensitivity curve of a new detector system provides good similarity to the action spectrum for UV-induced erythema in human skin. Journal of Photochemistry and Photobiology B: Biology, 37(1-2), 158-166. doi:10.1016/s1011-1344(96)04414-4Seckmeyer , G. B. Mayer G. Bernhard 1998 The 1997 Status of Solar UV Spectroradiometry in Germany: Results from the National Intercomparison of UV Spectroradiometers, with contributions from Albold A., Baum W., Dehne K., Feister U., Gericke K., Grewe R., Gross C., Sandmann H., Schreiber J., Seidlitz H.K., Steinmetz M., Thiel S., Wallasch M. and Weller M., Garmisch-Partenkirchen 55 166 Shaker-Verlag Aachen, GermanyPrograma Meteorología de la Fundación Centro de Estudios Ambientales del Mediterráneo (Generalitat Valenciana) http://www.gva.es/ceamet/vigilancia/radUV/radUV.htmlVilaplana, J. M., Cachorro, V. E., Sorribas, M., Luccini, E., de Frutos, A. M., Berjón, A., & de la Morena, B. (2006). Modified Calibration Procedures for a Yankee Environmental System UVB-1 Biometer Based on Spectral Measurements with a Brewer Spectrophotometer. Photochemistry and Photobiology, 82(2), 508. doi:10.1562/2005-06-23-ra-590Hülsen, G., & Gröbner, J. (2007). Characterization and calibration of ultraviolet broadband radiometers measuring erythemally weighted irradiance. Applied Optics, 46(23), 5877. doi:10.1364/ao.46.005877Cañada, J., Esteve, A. R., Marín, M. J., Utrillas, M. P., Tena, F., & Martínez-Lozano, J. A. (2008). Study of erythemal, UV (A + B) and global solar radiation in Valencia (Spain). International Journal of Climatology, 28(5), 693-702. doi:10.1002/joc.1569Tena, F., Martínez-Lozano, J. A., Utrillas, M. P., Marín, M. J., Esteve, A. R., & Cañada, J. (2009). The erythemal clearness index for Valencia, Spain. International Journal of Climatology, 29(1), 147-155. doi:10.1002/joc.1710GIOVANNI OMI/Aura Online Visualization and Analysis. Daily Level 3 Global Gridded Products http://gdata1.sci.gsfc.nasa.gov/daac-bin/G3/gui.cgi?instance_id=omiAcker, J. G., & Leptoukh, G. (2007). Online Analysis Enhances Use of NASA Earth Science Data. Eos, Transactions American Geophysical Union, 88(2), 14. doi:10.1029/2007eo020003MIRADOR NASA's Goddard Earth Sciences Data and Information Services Center (GES DISC) http://mirador.gsfc.nasa.gov/cgi-in/mirador/collectionlist.pl?keyword=omuvbdKalliskota, S., Kaurola, J., Taalas, P., Herman, J. R., Celarier, E. A., & Krotkov, N. A. (2000). Comparison of daily UV doses estimated from Nimbus 7/TOMS measurements and ground-based spectroradiometric data. Journal of Geophysical Research: Atmospheres, 105(D4), 5059-5067. doi:10.1029/1999jd900926AErosol RObotic NETwork (AERONET) Ground-based Remote Sensing Aerosol Networks Established by NASA and PHOTONS (Univ. of Lille 1, CNES, and CNRS-INSU) http://aeronet.gsfc.nasa.gov/cgi-bin/bamgomas_interactiveICNIRP STATEMENT—PROTECTION OF WORKERS AGAINST ULTRAVIOLET RADIATION. (2010). Health Physics, 99(1), 66-87. doi:10.1097/hp.0b013e3181d85908International Commission on Non-Ionizing Radiation Protection (ICNIRP) 2007 Protecting Workers from Ultraviolet Radiation P. Vecchia M. Hietanen B. E. Stuck E. van Deventer S. Niu ICNIRP14 Oberschleissheim, GermanyAgencia Estatal de Meteorología (AEMET) http://www.aemet.es/NASA Total Ozone Mapping Spectrometer http://jwocky.gsfc.nasa.gov/Weihs, P., Blumthaler, M., Rieder, H. E., Kreuter, A., Simic, S., Laube, W., … Tanskanen, A. (2008). Measurements of UV irradiance within the area of one satellite pixel. Atmospheric Chemistry and Physics, 8(18), 5615-5626. doi:10.5194/acp-8-5615-2008Kazadzis, S., Bais, A., Balis, D., Kouremeti, N., Zempila, M., Arola, A., … Kazantzidis, A. (2009). Spatial and temporal UV irradiance and aerosol variability within the area of an OMI satellite pixel. Atmospheric Chemistry and Physics, 9(14), 4593-4601. doi:10.5194/acp-9-4593-2009Tanskanen, A., Lindfors, A., Määttä, A., Krotkov, N., Herman, J., Kaurola, J., … Tamminen, J. (2007). Validation of daily erythemal doses from Ozone Monitoring Instrument with ground-based UV measurement data. Journal of Geophysical Research, 112(D24). doi:10.1029/2007jd008830Buchard, V., Brogniez, C., Auriol, F., Bonnel, B., Lenoble, J., Tanskanen, A., … Veefkind, P. (2008). Comparison of OMI ozone and UV irradiance data with ground-based measurements at two French sites. Atmospheric Chemistry and Physics, 8(16), 4517-4528. doi:10.5194/acp-8-4517-2008Reinau, D., Weiss, M., Meier, C. R., Diepgen, T. L., & Surber, C. (2013). Outdoor workers’ sun-related knowledge, attitudes and protective behaviours: a systematic review of cross-sectional and interventional studies. British Journal of Dermatology, 168(5), 928-940. doi:10.1111/bjd.12160De Vries, E., Arnold, M., Altsitsiadis, E., Trakatelli, M., Hinrichs, B., … Stockfleth, E. (2012). Potential impact of interventions resulting in reduced exposure to ultraviolet (UV) radiation (UVA and UVB) on skin cancer incidence in four European countries, 2010-2050. British Journal of Dermatology, 167, 53-62. doi:10.1111/j.1365-2133.2012.11087.

Toxic ignorance and right-to-know in biomonitoring results communication: a survey of scientists and study participants

<p>Abstract</p> <p>Background</p> <p>Exposure assessment has shifted from pollutant monitoring in air, soil, and water toward personal exposure measurements and biomonitoring. This trend along with the paucity of health effect data for many of the pollutants studied raise ethical and scientific challenges for reporting results to study participants.</p> <p>Methods</p> <p>We interviewed 26 individuals involved in biomonitoring studies, including academic scientists, scientists from environmental advocacy organizations, IRB officials, and study participants; observed meetings where stakeholders discussed these issues; and reviewed the relevant literature to assess emerging ethical, scientific, and policy debates about personal exposure assessment and biomonitoring, including public demand for information on the human health effects of chemical body burdens.</p> <p>Results</p> <p>We identify three frameworks for report-back in personal exposure studies: clinical ethics; community-based participatory research; and citizen science 'data judo.' The first approach emphasizes reporting results only when the health significance of exposures is known, while the latter two represent new communication strategies where study participants play a role in interpreting, disseminating, and leveraging results to promote community health. We identify five critical areas to consider in planning future biomonitoring studies.</p> <p>Conclusion</p> <p>Public deliberation about communication in personal exposure assessment research suggests that new forms of community-based research ethics and participatory scientific practice are emerging.</p