{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T13:33:23Z","timestamp":1790688803551,"version":"4.1.0"},"reference-count":118,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2020,2,20]],"date-time":"2020-02-20T00:00:00Z","timestamp":1582156800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Near infrared or infrared A (IRA) accounts for over 40% of the solar spectrum (SS) and is able to reach subcutaneous tissue as well as the retina. Outdoor workers are occupationally exposed to solar radiation (SR), but the level of exposure may differ widely depending on the job performed, time spent outdoors, latitude, altitude, season, personal protection, etc. Until now, risk assessment and management for outdoor workers has focused on the prevention of both acute and long-term effects on the eye and the skin due to solar ultraviolet radiation (UVR) with little consideration of the other components of the SS (a possible exception is represented by visible radiation with reference to the eye). A growing body of evidence coming from in vitro studies indicates that IRA is involved in cellular reactive oxygen species (ROS) production and may interfere with the respiratory chain in the mitochondria. Moreover, it can modulate gene expression and some metabolic pathways. The biological action of IRA is only partly attributable to a thermal mechanism, should it be also involved in photochemical ones. The cellular and molecular pathways affected by IRA are partly similar and partly different with respect to those involved in the case of visible ultraviolet A (UVA) and ultraviolet B (UVB) radiation. Consequently, the net effect of the SS is very difficult to predict at different levels of the biological organization, making more difficult the final balance of health risk and benefits (for the skin, eye, immune system, blood pressure, etc.) in a given exposure situation. Moreover, few in vivo studies and no epidemiological data are presently available in this regard. Investigating this topic may contribute to better defining the individual exposome. More practically, it is expected to bring benefits to the risk assessment and management for outdoor workers exposed to SS, contributing to: (1) better definition of the individual profiles of susceptibility, (2) more focused preventive and protective measures, (3) better implementation of the health surveillance and (4) a more effective information and training.<\/jats:p>","DOI":"10.3390\/ijerph17041357","type":"journal-article","created":{"date-parts":[[2020,2,21]],"date-time":"2020-02-21T08:59:47Z","timestamp":1582275587000},"page":"1357","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":39,"title":["Balance between Health Risks and Benefits for Outdoor Workers Exposed to Solar Radiation: An Overview on the Role of Near Infrared Radiation Alone and in Combination with Other Solar Spectral Bands"],"prefix":"10.3390","volume":"17","author":[{"given":"Carlo","family":"Grandi","sequence":"first","affiliation":[{"name":"Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, Italian Workers\u2019 Compensation Authority (INAIL), 00078 Monte Porzio Catone, Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Concetta","family":"D\u2019Ovidio","sequence":"additional","affiliation":[{"name":"Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, Italian Workers\u2019 Compensation Authority (INAIL), 00078 Monte Porzio Catone, Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2020,2,20]]},"reference":[{"key":"ref_1","unstructured":"World Health Organization (2002). Global Solar UV Index: A Practical Guide: A Joint Recommendation of WHO, WMO, UNEP and ICNIRP, WHO."},{"key":"ref_2","unstructured":"International Agency for Research on Cancer (IARC) (2012). A Review of Human Carcinogens, IARC Monographs on the Evaluation of Carcinogenic Risks to Humans, Vol. 100 D-Radiation, IARC. Available online: http:\/\/publications.iarc.fr\/121."},{"key":"ref_3","unstructured":"(1999). Photophysics, photochemistry and photobiology. Dermatology in General Medicine, McGraw-Hill."},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"ICNIRP (International Commission on Non-Ionizing Radiation Protection) (2010). ICNIRP guidelines on limits of exposure to incoherent visible and infrared radiation. Health Phys., 105, 74\u201396.","DOI":"10.1097\/HP.0b013e318289a611"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"222","DOI":"10.1038\/eye.2015.252","article-title":"What is light? The visible spectrum and beyond","volume":"30","author":"Sliney","year":"2016","journal-title":"Eye"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"78","DOI":"10.1016\/j.jphotobiol.2015.12.014","article-title":"Infrared and skin: Friend or foe","volume":"155","author":"Barolet","year":"2016","journal-title":"J. Photochem. Photobiol. B Biol."},{"key":"ref_7","unstructured":"EU-OSHA (European Agency for Safety and Health at Work) (2019, November 12). Outlook 1\u2014New and Emerging Risks in Occupational Safety and Health. Available online: https:\/\/osha.europa.eu\/en\/publications\/new-and-emerging-risks-occupational-safety-and-health\/view."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1093\/occmed\/kqu156","article-title":"Investigating work-related neoplasia associated with solar radiation","volume":"65","author":"Turner","year":"2015","journal-title":"Occup. Med."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"109","DOI":"10.4161\/derm.20013","article-title":"Beneficial effects of UV radiation other than via vitamin D production","volume":"4","author":"Juzeniene","year":"2012","journal-title":"Dermatoendocrinol"},{"key":"ref_10","first-page":"1934518","article-title":"Sunlight effects on immune system: Is there something else in addition to UV-induced immunosuppression?","volume":"2016","author":"Paz","year":"2016","journal-title":"Biomed Res. Int."},{"key":"ref_11","first-page":"343","article-title":"Impact of climate change on occupational exposure to solar radiation","volume":"52","author":"Grandi","year":"2016","journal-title":"Ann. Ist. Super. Sanit\u00e0"},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Modenese, A., Korpinen, L., and Gobba, F. (2018). Solar radiation exposure and outdoor work: An underestimated occupational risk. Int. J. Environ. Res. Public Health, 15.","DOI":"10.3390\/ijerph15102063"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"341","DOI":"10.3389\/fendo.2019.00341","article-title":"Editorial: Classic and pleiotropic actions of Vitamin D","volume":"10","author":"Pludowski","year":"2019","journal-title":"Front. Endocriniol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"485","DOI":"10.1016\/j.cll.2017.05.004","article-title":"Update on Merkel cell carcinoma","volume":"37","author":"Harms","year":"2017","journal-title":"Clin. Lab. Med."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"224","DOI":"10.1111\/j.1600-0781.2010.00524.x","article-title":"Vitamin D in health and disease","volume":"26","author":"Lim","year":"2010","journal-title":"Photodermatol. Photoimmunol. Photomed."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1186\/1475-2891-9-65","article-title":"Vitamin D in health and disease: Current perspectives","volume":"9","author":"Zhang","year":"2010","journal-title":"Nutr. J."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"190","DOI":"10.1136\/archdischild-2014-307214","article-title":"Sunshine and vitamin D","volume":"101","author":"Saraff","year":"2016","journal-title":"Arch. Dis. Child."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"532","DOI":"10.1097\/CEJ.0000000000000334","article-title":"Vitamin D status and risk for malignant cutaneous melanoma: Recent advances","volume":"26","author":"Ombra","year":"2017","journal-title":"Eur. J. Cancer Prev."},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Sowah, D., Fan, X., Dennett, L., Hagtvedt, R., and Straube, S. (2017). Vitamin D levels and deficiency with different occupations: A systematic review. BMC Public Health., 17.","DOI":"10.1186\/s12889-017-4436-z"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"907","DOI":"10.1111\/bjd.17980","article-title":"The effect of sunscreen on vitamin D: A review","volume":"181","author":"Neale","year":"2019","journal-title":"Br. J. Dermatol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"e1248325","DOI":"10.1080\/19381980.2016.1248325","article-title":"The risks and benefits of sun exposure 2016","volume":"8","author":"Hoel","year":"2016","journal-title":"Dermatoendocrinol"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1016\/j.mehy.2016.10.011","article-title":"Regular sun exposure benefits health","volume":"97","author":"Coebergh","year":"2016","journal-title":"Med. Hypoth."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"130","DOI":"10.1159\/000441266","article-title":"Sunlight has cardiovascular benefits independently of vitamin D","volume":"41","author":"Weller","year":"2016","journal-title":"Blood Purif."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"228","DOI":"10.1034\/j.1600-0781.2003.00054.x","article-title":"Cutaneous effects of infrared radiation: From clinical observations to molecular response mechanisms","volume":"19","author":"Schieke","year":"2003","journal-title":"Photodermatol. Photoimmunol. Photomed."},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"ICNIRP (International Commission on Non-Ionizing Radiation Protection) (2006). ICNIRP statement on far infrared radiation exposure. Health Phys., 91, 630\u2013645.","DOI":"10.1097\/01.HP.0000240533.50224.65"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"300","DOI":"10.1097\/HP.0000000000000539","article-title":"A closer look at the thresholds of thermal damage: Workshop report byan ICNIRP task group","volume":"111","author":"Sienkiewicz","year":"2016","journal-title":"Health Phys."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1159\/000330721","article-title":"Full-body skin mapping for six biophysicalparameters: Baseline values at 16 anatomical sites in 125 human subjects","volume":"25","author":"Kleesz","year":"2012","journal-title":"Skin Pharmacol. Physiol."},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Shan, Q., Ma, F., Wei, J., Li, H., Ma, H., and Sun, P. (2019). Physiological functions of heat shock proteins. Curr. Protein Pept. Sci.","DOI":"10.2174\/1389203720666191111113726"},{"key":"ref_29","unstructured":"Kettelhut, E.A., Traylor, J., and Roach, J.P. (2019, November 19). Erythema Ab Igne; Bookshelf, 2019 Bookshelf ID: NBK538250PMID:30855838, Available online: https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK538250\/."},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Ozturk, M., and An, I. (2019). Clinical features and etiology of patients with erythema ab igne: A retrospective multicenter study. J. Cosmet. Dermatol.","DOI":"10.1111\/jocd.13210"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.arr.2014.03.006","article-title":"Molecular action mechanisms of solar infrared radiation and heat on human skin","volume":"16","author":"Akhalaya","year":"2014","journal-title":"Ageing Res. Rew."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"197","DOI":"10.1016\/j.jphotobiol.2017.04.014","article-title":"Biological effects and medical applications of infrared radiation","volume":"170","author":"Tsai","year":"2017","journal-title":"J. Photochem. Photobiol. B Biol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"337","DOI":"10.3934\/biophy.2017.3.337","article-title":"Mechanisms and applications of the anti-inflammatory effects of photobiomodulation","volume":"4","author":"Hamblin","year":"2017","journal-title":"AIMS Biophys."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1111\/phpp.12282","article-title":"Noninvasive red and near-infrared wavelength-induced photobiomodulation: Promoting impaired cutaneous wound healing","volume":"33","author":"Yadav","year":"2017","journal-title":"Photodermatol. Photoimmunol. Photomed."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"1091","DOI":"10.1111\/j.1751-1097.2008.00394.x","article-title":"Mitochondrial signalling in mammalian cells activated by red and near-IR radiation","volume":"84","author":"Karu","year":"2008","journal-title":"Photochem. Photobiol."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"e201800025","DOI":"10.1002\/jbio.201800025","article-title":"Near infrared low-level laser therapy and cell proliferation: The emerging role of redox sensitive signal transduction pathways","volume":"11","author":"Migliario","year":"2018","journal-title":"J. Biophotonics"},{"key":"ref_37","doi-asserted-by":"crossref","unstructured":"Sommer, A.P. (2019). Mitochondrial cytochrome c oxidase is not the primary acceptor for near infrared light-it is mitochondrial bound water: The principles of low-level light therapy. Ann. Transl. Med., 7.","DOI":"10.21037\/atm.2019.01.43"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"629","DOI":"10.1016\/j.exger.2008.04.010","article-title":"The role of near infrared radiation in photoaging of the skin","volume":"43","author":"Schroeder","year":"2008","journal-title":"Exp. Gerontol."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"1524","DOI":"10.1038\/jid.2010.9","article-title":"Infrared A radiation influences the skin fibroblast transcriptome: Mechanisms and consequences","volume":"130","author":"Calles","year":"2010","journal-title":"J. Investig. Dermatol."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"235","DOI":"10.1016\/j.redox.2017.05.008","article-title":"Non-linear actions of physiological agents: Finite disarrangements elicit fitness benefits","volume":"13","author":"Sedlic","year":"2017","journal-title":"Redox Biol."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"1559325818803428","DOI":"10.1177\/1559325818803428","article-title":"Acquired resilience: An evolved system of tissue protection in mammals","volume":"16","author":"Stone","year":"2018","journal-title":"Dose Response"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"152249","DOI":"10.1016\/j.tox.2019.152249","article-title":"Hormesis: The dose response for the 21st century: The future has arrived","volume":"425","author":"Agathokleous","year":"2019","journal-title":"Toxicology"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"227","DOI":"10.1016\/j.sder.2008.08.003","article-title":"Light-emitting diodes (LEDs) in dermatology","volume":"27","author":"Barolet","year":"2008","journal-title":"Semin. Cutan. Med. Surg."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"602","DOI":"10.2203\/dose-response.11-009.Hamblin","article-title":"Biphasic dose response in low level light therapy\u2014An update","volume":"9","author":"Huang","year":"2011","journal-title":"Dose Response"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"450","DOI":"10.1111\/j.1751-1097.2007.00286.x","article-title":"Effects of visible light on the skin","volume":"84","author":"Mahmoud","year":"2008","journal-title":"Photochem. Photobiol."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"1901","DOI":"10.1038\/jid.2011.476","article-title":"Irradiation of skin with visible light induces reactive oxygen species and matrix-degrading enzymes","volume":"132","author":"Liebel","year":"2012","journal-title":"J. Investig. Dermatol."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"140","DOI":"10.1111\/php.12368","article-title":"Oxidatively generated damage to cellular DNA by UVB and UVA radiation","volume":"91","author":"Cadet","year":"2015","journal-title":"Photochem. Photobiol."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"579675","DOI":"10.1155\/2015\/579675","article-title":"Blue-violet light irradiation dose dependently decreases carotenoids in human skin, which indicates the generation of free radicals","volume":"2015","author":"Vandersee","year":"2015","journal-title":"Oxid. Med. Cell. Longev."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"110","DOI":"10.1016\/j.freeradbiomed.2017.01.029","article-title":"Sunlight damage to cellular DNA: Focus on oxidatively generated lesions","volume":"107","author":"Schuch","year":"2017","journal-title":"Free Rad. Biol. Med."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"300","DOI":"10.1016\/j.freeradbiomed.2017.03.010","article-title":"Blue light-induced oxidative stress in live skin","volume":"108","author":"Nakashima","year":"2017","journal-title":"Free Rad. Biol. Med."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"164","DOI":"10.1016\/j.cbi.2014.10.016","article-title":"Free radicals, reactive oxygen species, oxidative stress and its classification","volume":"224","author":"Lushchak","year":"2014","journal-title":"Chem. Biol. Interact."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"761264","DOI":"10.1155\/2014\/761264","article-title":"Oxidative stress, prooxidants, and antioxidants: The interplay","volume":"2014","author":"Rahal","year":"2014","journal-title":"BioMed Res. Int."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"1173","DOI":"10.1111\/bjd.15940","article-title":"Synergistic effects of long-wavelength ultraviolet A1 and visible light on pigmentation and erythema","volume":"178","author":"Kohli","year":"2018","journal-title":"Br. J. Dermatol."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1016\/j.canlet.2013.05.039","article-title":"Heat stress: A risk factor for skin carcinogenesis","volume":"337","author":"Calapre","year":"2013","journal-title":"Cancer Lett."},{"key":"ref_55","doi-asserted-by":"crossref","unstructured":"Calapre, L., Gray, E.S., Kurdykowski, S., David, A., Hart, P., Descargues, P., and Mel Ziman, M. (2016). Heat-mediated reduction of apoptosis in UVB-damaged keratinocytes in vitro and in human skin ex vivo. BMC Dermatol., 16.","DOI":"10.1186\/s12895-016-0043-4"},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"303","DOI":"10.1007\/s12192-017-0843-4","article-title":"Heat shock proteins and DNA repair mechanisms: An updated overview","volume":"23","author":"Sottile","year":"2018","journal-title":"Cell Stress Chaperones"},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"1123","DOI":"10.1039\/c4pp00066h","article-title":"Skin temperature during sunbathing\u2013relevance for skin cancer","volume":"13","author":"Petersen","year":"2014","journal-title":"Photochem. Photobiol. Sci."},{"key":"ref_58","first-page":"425","article-title":"Carcinogenesis with ultraviolet radiation of wavelength 2800\u20133400 A","volume":"3","author":"Bain","year":"1943","journal-title":"Cancer Res."},{"key":"ref_59","first-page":"610","article-title":"The effect of temperature upon ultraviolet carcinogenesis with wavelength 2800\u20133400 A","volume":"3","author":"Bain","year":"1943","journal-title":"Cancer Res."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"858","DOI":"10.1001\/archderm.1964.01590300086023","article-title":"Influence of temperature on ultraviolet injury","volume":"89","author":"Freeman","year":"1964","journal-title":"Arch. Dermatol."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"324","DOI":"10.1039\/b201025a","article-title":"Climate change and skin cancer","volume":"1","year":"2002","journal-title":"Photochem. Photobiol. Sci."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"730","DOI":"10.1039\/b719302e","article-title":"Climate change and human skin cancer","volume":"7","author":"Piacentini","year":"2008","journal-title":"Photochem. Photobiol. Sci."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1111\/exd.13818","article-title":"Effects and interactions of increased environmental temperature and UV radiation on photoageing and photocarcinogenesis of the skin","volume":"28","author":"Lan","year":"2019","journal-title":"Exp. Dermatol."},{"key":"ref_64","unstructured":"IPCC (Intergovernmental Panel on Climate Change) (2019, November 20). AR5 Synthesis Report: Climate Change 2014. Available online: https:\/\/www.ipcc.ch\/report\/ar5\/syr\/."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1039\/c4pp90032d","article-title":"Ozone depletion and climate change: Impacts on UV radiation","volume":"14","author":"Bais","year":"2015","journal-title":"Photochem. Photobiol. Sci."},{"key":"ref_66","first-page":"657","article-title":"An action spectrum for ultraviolet radiation-induced immunosuppression in humans","volume":"164","author":"Damian","year":"2011","journal-title":"Br. J. Dermatol."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"214","DOI":"10.1016\/j.sder.2011.08.002","article-title":"Ultraviolet A radiation: Its role in immunosuppression and carcinogenesis","volume":"30","author":"Halliday","year":"2011","journal-title":"Semin. Cutan. Med. Surg."},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"57","DOI":"10.1111\/phpp.12021","article-title":"Photoimmunosuppression: A brief overview","volume":"29","author":"Gibbs","year":"2013","journal-title":"Photodermatol Photoimmunol Photomed."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"538","DOI":"10.1016\/j.clindermatol.2016.05.003","article-title":"The symbiosis of phototherapy and photoimmunology","volume":"34","author":"Matos","year":"2016","journal-title":"Clin. Dermatol."},{"key":"ref_70","first-page":"138","article-title":"The interplay between solar radiation, climate change and immunotoxicants in relation to immune response modulation: A Concern for outdoor workers\u2019 health","volume":"6","author":"Grandi","year":"2018","journal-title":"Am. J. Health Res."},{"key":"ref_71","first-page":"15345","article-title":"Outdoor Workers Exposed to Solar Radiation: A Spotlight on Immunomodulation","volume":"20","author":"Grandi","year":"2019","journal-title":"Biomed. J. Sci. Tech. Res."},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"1495","DOI":"10.1111\/j.1751-1097.2006.tb09805.x","article-title":"The effect of ultraviolet radiation on human viral infections","volume":"82","author":"Norval","year":"2006","journal-title":"Photochem. Photobiol."},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"561","DOI":"10.1586\/14760584.2014.990387","article-title":"The potential impact of climate change and ultraviolet radiation on vaccine preventable infectious diseases and immunization service delivery system","volume":"14","author":"Guo","year":"2015","journal-title":"Exp. Rev. Vaccines"},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"1545","DOI":"10.1016\/j.jid.2018.12.025","article-title":"Exposure to solar UVR suppresses cell-mediated immunization responses in humans: The Australian ultraviolet radiation and immunity study","volume":"139","author":"Swaminathan","year":"2019","journal-title":"J. Investig. Dermatol."},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"1235","DOI":"10.3389\/fmicb.2016.01235","article-title":"The skin microbiome: Is it affected by UV-induced immune suppression?","volume":"7","author":"Patra","year":"2016","journal-title":"Front. Microbiol."},{"key":"ref_76","doi-asserted-by":"crossref","unstructured":"Didona, D., Paolino, G., Bottoni, U., and Cantisani, C. (2018). Non melanoma skin cancer pathogenesis overview. Biomedicines, 6.","DOI":"10.3390\/biomedicines6010006"},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"1872","DOI":"10.1039\/c7pp00312a","article-title":"Ultraviolet radiation-induced immunosuppression and its relevance for skin carcinogenesis","volume":"17","author":"Hart","year":"2018","journal-title":"Photochem. Photobiol. Sci."},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"83","DOI":"10.1016\/j.det.2018.07.009","article-title":"Skin cancer and immunosuppression","volume":"37","author":"Collins","year":"2019","journal-title":"Dermatol. Clin."},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"344","DOI":"10.3109\/02656736.2011.562873","article-title":"Toward establishment of temperature thresholds for immunological impact of heat exposure in humans","volume":"27","author":"Beachy","year":"2011","journal-title":"Int. J. Hypertherm."},{"key":"ref_80","doi-asserted-by":"crossref","unstructured":"Zininga, T., Ramatsui, L., and Shonhai, A. (2018). Heat shock proteins as immunomodulants. Molecules, 23.","DOI":"10.3390\/molecules23112846"},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"4796","DOI":"10.4049\/jimmunol.1402804","article-title":"In vivo suppression of HSP27 and HSP70 accelerates DMBA-induced skin carcinogenesis by inducing antigenic unresponsiveness to the initiating carcinogenic chemical","volume":"194","author":"Yusuf","year":"2015","journal-title":"J. Immunol."},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"98","DOI":"10.1016\/j.jphotobiol.2016.01.006","article-title":"Differential immunological effects of infrared irradiation and its associated heat in vivo","volume":"155","author":"Lee","year":"2016","journal-title":"J. Photochem. Photobiol. B Biol."},{"key":"ref_83","doi-asserted-by":"crossref","first-page":"91","DOI":"10.2486\/indhealth.2012-0145","article-title":"Health impacts of workplace heat exposure: An epidemiological review","volume":"52","author":"Xiang","year":"2014","journal-title":"Ind. Health"},{"key":"ref_84","first-page":"323","article-title":"Climate change and occupational health","volume":"52","author":"Grandi","year":"2016","journal-title":"Ann. Ist. Super. Sanit\u00e0"},{"key":"ref_85","doi-asserted-by":"crossref","unstructured":"Moda, H.M., Filho, W.L., and Minhas, A. (2019). Impacts of climate change on outdoor workers and their safety: Some research priorities. Int. J. Environ. Res. Public Health, 16.","DOI":"10.3390\/ijerph16183458"},{"key":"ref_86","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1007\/s40572-016-0081-4","article-title":"An overview of occupational risks from climate change","volume":"3","author":"Applebaum","year":"2016","journal-title":"Curr. Environ. Health Rep."},{"key":"ref_87","first-page":"163","article-title":"Impact of climate change on occupational health and productivity: A systematic literature review focusing on workplace heat","volume":"109","author":"Levi","year":"2018","journal-title":"Med. Lav."},{"key":"ref_88","doi-asserted-by":"crossref","unstructured":"Modenese, A., Ruggieri, F.P., Bisegna, F., Borra, M., Burattini, C., Della Vecchia, E., Grandi, C., Grasso, A., Gugliermetti, L., and Manini, M. (2019). Occupational exposure to solar UV radiation of a group of fishermen working in the Italian North Adriatic sea. Int. J. Environ. Res. Public Health, 16.","DOI":"10.3390\/ijerph16163001"},{"key":"ref_89","unstructured":"(1989). Council Directive 89\/391\/EEC of 12 June 1989 on the introduction of measures to encourage improvements in the safety and health of workers at work. Off. J. Eur. Communities, 183, 1\u201311."},{"key":"ref_90","doi-asserted-by":"crossref","first-page":"84","DOI":"10.1097\/HP.0000000000000742","article-title":"Review of the global solar UV index 2015 workshop report","volume":"114","author":"Gies","year":"2018","journal-title":"Health Phys."},{"key":"ref_91","first-page":"736","article-title":"UV doses worldwide","volume":"81","author":"Godar","year":"2005","journal-title":"Photochem. Photobiol."},{"key":"ref_92","doi-asserted-by":"crossref","first-page":"577","DOI":"10.13075\/mp.5893.00461","article-title":"Outdoor work and solar radiation exposure: Evaluation method for epidemiological studies","volume":"67","author":"Modenese","year":"2016","journal-title":"Med. Pracy"},{"key":"ref_93","first-page":"27","article-title":"An approximation of occupational lifetime UVR exposure: Algorithm for retrospective assessment and currentmeasurements","volume":"30","author":"Wittlich","year":"2016","journal-title":"JEADV"},{"key":"ref_94","unstructured":"Vecchia, P., Hietanen, M., Stuck, B.E., van Deventer, E., and Niu, S. (2007). Protecting Workers from Ultraviolet Radiation, Available online: https:\/\/www.who.int\/uv\/publications\/Protecting_Workers_UV_pub.pdf?ua=1."},{"key":"ref_95","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1590\/abd1806-4841.20143971","article-title":"Brazilian consensus on photoprotection","volume":"89","author":"Schalka","year":"2014","journal-title":"An. Bras. Dermatol."},{"key":"ref_96","unstructured":"European Dermatology Forum (2019, November 20). European Dermatology Guideline for the photodermatoses. 3. Photoprotection. Available online: https:\/\/www.edf.one\/dam\/jcr:46edc745-1bdd-459c-a323-b7e48971891f\/guideline_Photoprotection.pdf."},{"key":"ref_97","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1186\/s13012-015-0277-2","article-title":"Sun Safety at Work Canada: A multiple case-study protocol to develop sun safety and heat protection programs and policies for outdoor workers","volume":"10","author":"Kramer","year":"2015","journal-title":"Implement. Sci."},{"key":"ref_98","doi-asserted-by":"crossref","first-page":"S110","DOI":"10.1016\/j.jaad.2016.09.039","article-title":"Photoprotection in specific populations: Children and people of color","volume":"76","author":"Cestari","year":"2017","journal-title":"J. Am. Acad. Dermatol."},{"key":"ref_99","doi-asserted-by":"crossref","first-page":"171","DOI":"10.1111\/1753-6405.12873","article-title":"When to apply sunscreen: A consensus statement for Australia and New Zealand","volume":"43","author":"Whiteman","year":"2019","journal-title":"Aust. New Zealand J. Public Health."},{"key":"ref_100","unstructured":"Cancer Council Victoria, Victorian Health Promotion Foundation (VicHealth) (2019, November 20). Sun Smart. Available online: https:\/\/www.sunsmart.com.au\/."},{"key":"ref_101","doi-asserted-by":"crossref","unstructured":"ICNIRP (International Commission on Non Ionizing Radiation Protection) (2010). Statement\u2013protection of workers against ultraviolet radiation. Health Phys., 99, 66\u201387.","DOI":"10.1097\/HP.0b013e3181d85908"},{"key":"ref_102","doi-asserted-by":"crossref","first-page":"928","DOI":"10.1111\/bjd.12160","article-title":"Outdoor workers\u2019 sun-related knowledge, attitudes and protective behaviours: A systematic review of cross-sectional and interventional studies","volume":"168","author":"Reinau","year":"2013","journal-title":"Br. J. Dermatol."},{"key":"ref_103","doi-asserted-by":"crossref","unstructured":"Rocholl, M., Ludewig, M., John, S.M., Bitzer, E.M., and Wilke, A. (2019). Outdoor workers\u2019 perceptions of skin cancer risk and attitudes to sun-protective measures: A qualitative study. J. Occup. Health.","DOI":"10.1002\/1348-9585.12083"},{"key":"ref_104","doi-asserted-by":"crossref","first-page":"1471","DOI":"10.1111\/j.1751-1097.2007.00189.x","article-title":"Outdoor workers\u2019 acceptance of personal protective measures against solar ultraviolet radiation","volume":"83","author":"Weber","year":"2007","journal-title":"Photochem. Photobiol."},{"key":"ref_105","doi-asserted-by":"crossref","first-page":"452","DOI":"10.1111\/j.1751-1097.2010.00838.x","article-title":"Radical protection by sunscreens in the infrared spectral range","volume":"87","author":"Meinke","year":"2011","journal-title":"Photochem. Photobiol."},{"key":"ref_106","doi-asserted-by":"crossref","first-page":"248","DOI":"10.1111\/php.12375","article-title":"Effective photoprotection of human skin against infrared A radiation by topically applied antioxidants: Results from a vehicle controlled, double-blind, randomized study","volume":"91","author":"Marini","year":"2015","journal-title":"Photochem. Photobiol."},{"key":"ref_107","doi-asserted-by":"crossref","first-page":"224","DOI":"10.1111\/ics.12036","article-title":"Beyond UV radiation: A skin under challenge","volume":"35","author":"Dupont","year":"2013","journal-title":"Int. J. Cosmetic Sci."},{"key":"ref_108","doi-asserted-by":"crossref","first-page":"162","DOI":"10.3389\/fmed.2018.00162","article-title":"Novel means for photoprotection","volume":"5","author":"Sondenheimer","year":"2018","journal-title":"Front. Med."},{"key":"ref_109","doi-asserted-by":"crossref","first-page":"S40","DOI":"10.1007\/s40257-018-0369-2","article-title":"Homeostasis in topical photoprotection: Getting the spectral balance right","volume":"19","author":"Stengel","year":"2018","journal-title":"Am. J. Clin. Dermatol."},{"key":"ref_110","unstructured":"(2006). Directive 2006\/25\/EC of the European Parliament and of the Council of 5 April 2006 on the minimum health and safety requirements regarding the exposure of workers to risks arising from physical agents (artificial optical radiation) (19th individual Directive within the meaning of Article 16(1) of Directive 89\/391\/EEC). Off. J. Eur. Union, 114, 38\u201359."},{"key":"ref_111","first-page":"A419","article-title":"The role of near infrared with regard to potential long-term adverse effects in outdoor workers exposed to solar radiation","volume":"75","author":"Grandi","year":"2018","journal-title":"Occup. Environ. Med."},{"key":"ref_112","doi-asserted-by":"crossref","first-page":"920","DOI":"10.3389\/fphar.2018.00920","article-title":"Targeting mitochondrial oxidative stress to mitigate UV-induced skin damage","volume":"9","author":"Brand","year":"2018","journal-title":"Front. Pharmacol."},{"key":"ref_113","doi-asserted-by":"crossref","first-page":"306","DOI":"10.1089\/rej.2014.1577","article-title":"Paradoxical effects of antioxidants on cancer","volume":"17","author":"Mendelsohn","year":"2014","journal-title":"Rejuvenation Res."},{"key":"ref_114","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1016\/j.ejmech.2015.04.040","article-title":"The role of antioxidants in the chemistry of oxidative stress: A review","volume":"97","author":"Pisoschi","year":"2015","journal-title":"Eur. J. Med. Chem."},{"key":"ref_115","doi-asserted-by":"crossref","first-page":"793","DOI":"10.1590\/abd1806-4841.20175875","article-title":"Global and gene-specific DNA methylation and hydroxymethylation in human skin exposed and not exposed to sun radiation","volume":"92","author":"Barroso","year":"2017","journal-title":"An. Bras. Dermatol."},{"key":"ref_116","doi-asserted-by":"crossref","first-page":"1847","DOI":"10.1158\/1055-9965.EPI-05-0456","article-title":"Complementing the genome with an \u201cexposome\u201d: The outstanding challenge of environmental exposure measurement in molecular epidemiology","volume":"14","author":"Wild","year":"2005","journal-title":"Cancer Epidemiol. Biomark. Prev."},{"key":"ref_117","doi-asserted-by":"crossref","first-page":"104","DOI":"10.1183\/16000617.0034-2016","article-title":"The exposome concept: A challenge and a potential driver for environmental health research","volume":"25","author":"Siroux","year":"2016","journal-title":"Eur. Respir. Rev."},{"key":"ref_118","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1515\/reveh-2016-0032","article-title":"Future of environmental research in the age of epigenomics and exposomics","volume":"32","author":"Holland","year":"2017","journal-title":"Rev. Environ. Health"}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/17\/4\/1357\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T08:59:16Z","timestamp":1760173156000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/17\/4\/1357"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,2,20]]},"references-count":118,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2020,2]]}},"alternative-id":["ijerph17041357"],"URL":"https:\/\/doi.org\/10.3390\/ijerph17041357","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,2,20]]}}}