{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,26]],"date-time":"2026-01-26T17:54:27Z","timestamp":1769450067192,"version":"3.49.0"},"reference-count":38,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,1,26]],"date-time":"2026-01-26T00:00:00Z","timestamp":1769385600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>\n                      Solar ultraviolet radiation (UVR) is one of the main causes of skin cancer, with squamous cell carcinoma (SCC) being particularly prevalent among outdoor workers due to chronic UVR exposure. Despite the increasing incidence of SCC in this group, cases remain under-reported and are not always classified as an occupational disease. Current guidelines for UVR exposure are established for a limit of 30\u202fJ\/m\n                      <jats:sup>2<\/jats:sup>\n                      over an 8-h workday, and they are implemented for both solar and artificial UVR (non-specific). This study aimed to calculate the excess risk of SCC among gardeners, gravediggers, pavers, asphalters, sanitation workers, and sailors in Lisbon based on measured solar UVR, in comparison with indoor workers.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A prospective observational study using personal dosimeters was conducted to assess solar UVR in 90 outdoor workers from Lisbon Municipality, from April to October 2023. This data was used to calculate the relative risk (RR) of SCC for each of the investigated occupations as well as for each individual using a formula developed by Milon et al.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Solar UVR exposure was associated with an increased risk of developing SCC by values ranging from 22 to 437%, in terms of individual UVR dose assessment. Pavers had an increased risk of developing SCC by 65%, Asphalters by 133%, Sanitation Workers by 179%, Gravediggers by 187%, and Gardeners by 193%. Despite some limitations, a novel approach was tested by using direct UVR dose measurements in real environmental exposure conditions to estimate the risk of developing SCC.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>Outdoor work is associated with a substantially increased risk of SCC. However, the current model needs to be refined to improve the accuracy of risk assessment and to support the development of targeted prevention interventions. The relevance of the study provides valuable insights for health and safety policies in reducing UVR exposure and SCC risk among outdoor workers.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpubh.2026.1662734","type":"journal-article","created":{"date-parts":[[2026,1,26]],"date-time":"2026-01-26T07:18:57Z","timestamp":1769411937000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Increased risk of squamous cell carcinoma based on solar ultraviolet radiation measurements from outdoor workers in Lisbon, Portugal"],"prefix":"10.3389","volume":"14","author":[{"given":"Mar\u00edlia Silva","family":"Paulo","sequence":"first","affiliation":[{"name":"CHRC, NOVA Medical School, Faculdade de Ci\u00eancias M\u00e9dicas, NMS, FCM, Universidade NOVA de Lisboa","place":["Lisboa, Portugal"]},{"name":"NOVA National School of Public Health, Public Health Research Center, Comprehensive Health Research Center, CHRC, REAL, CCAL, NOVA University Lisbon","place":["Lisbon, Portugal"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria Miguel","family":"Castela","sequence":"additional","affiliation":[{"name":"NOVA National School of Public Health, NOVA University Lisbon","place":["Lisbon, Portugal"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Claudine","family":"Strehl","sequence":"additional","affiliation":[{"name":"Institute for Occupational Safety and Health of the German Social Accident Insurance (IFA)","place":["Sankt Augustin, Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fernanda","family":"Carvalho","sequence":"additional","affiliation":[{"name":"Portuguese Institute for Sea and Atmosphere","place":["Lisbon, Portugal"]},{"name":"Center for Sci-Tech Research in Earth System and Energy - CREATE, IIFA, University of \u00c9vora","place":["\u00c9vora, 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Seguran\u00e7a, C\u00e2mara Municipal de Lisboa","place":["Lisboa, Portugal"]},{"name":"Portuguese Society of Occupational Medicine, Working Committee \u201cWork at Open Air\u201d","place":["Lisboa, Portugal"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cristina","family":"Pinho","sequence":"additional","affiliation":[{"name":"Departamento de Sa\u00fade, Higiene e Seguran\u00e7a, C\u00e2mara Municipal de Lisboa","place":["Lisboa, Portugal"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ana","family":"Rodrigues","sequence":"additional","affiliation":[{"name":"Departamento de Sa\u00fade, Higiene e Seguran\u00e7a, C\u00e2mara Municipal de Lisboa","place":["Lisboa, Portugal"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas","family":"Tenkate","sequence":"additional","affiliation":[{"name":"School of Occupational and Public Health, Toronto Metropolitan University","place":["Toronto, ON, Canada"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Swen Malte","family":"John","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Environmental Medicine, Health Theory, Osnabr\u00fcck University","place":["Osnabr\u00fcck, Germany"]},{"name":"Institute for Interdisciplinary Dermatological Prevention and Rehabilitation (iDerm) at Osnabr\u00fcck University","place":["Osnabr\u00fcck, Germany"]},{"name":"Lower-Saxonian Institute of Occupational Dermatology (NIB)","place":["Osnabr\u00fcck, Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cara","family":"Bieck","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Environmental Medicine, Health Theory, Osnabr\u00fcck University","place":["Osnabr\u00fcck, Germany"]},{"name":"Department of Occupational Medicine, Hazardous Substances and Health Sciences, Statutory Accident Insurance for the Health and Welfare Services","place":["Hamburg, Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lu\u00eds V.","family":"Lap\u00e3o","sequence":"additional","affiliation":[{"name":"Intelligent Decision Support Systems Laboratory, Research and Development Unit for Mechanical and Industrial Engineering (UNIDEMI), NOVA School of Science and Technology, Universidade NOVA de Lisboa","place":["Lisbon, Portugal"]},{"name":"Laborat\u00f3rio Associado de Sistemas Inteligentes (LASI), Escola de Engenharia, Universidade do Minho","place":["Guimar\u00e3es, Portugal"]},{"name":"WHO Collaborating Centre on Health Workforce Policy and Planning, Global Health and Tropical Medicine, Universidade Nova de Lisboa","place":["Lisbon, Portugal"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M\u00e9lanie R.","family":"Maia","sequence":"additional","affiliation":[{"name":"Intelligent Decision Support Systems Laboratory, Research and Development Unit for Mechanical and Industrial Engineering (UNIDEMI), NOVA School 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