Ultraviolet radiation (UVR) is estimated to be one of the most important risk factors for nonmelanoma and melanoma skin cancers. High occupational UV exposure is assumed to be associated with skin cancer. Mountain guides receive considerable UV doses due to altitude-related increase of UVR and reflection from snow-and ice-covered surfaces. The aim of our study was to assess the annual occupational UV exposure of mountain guides. Spore film test chambers containing spores of Bacillus subtilis (VioSpor) were used as UV dosimeters with a spectral sensitivity profile similar to erythema-weighted data calculated from spectroradiometric measurements. Nine mountain guide instructors carried dosimeters on the sides of their heads on a total of 1,406 working days during one year (July 1999 -June 2000). Dosimeters were changed monthly. Measurements of 92 months could be evaluated (4 -12 months/mountain guide). The mean individual monthly UV exposure was 107 standard erythema doses (SED) (median 71 SED; range 10 -505 SED). The mean annual cumulative UV exposure was 1,097 SED (median 1,273 SED; range 312-1,770 SED) per mountain guide. The mean UV dose per day (4 -10 hr) was 6.6 SED (median 5.7 SED; range 0.6 -24.2 SED). This is the second study of continuous annual UV dosimetry in a cohort of outdoor workers. Our study showed that it is not sufficient to interpolate annual UV exposure from a few days' measurements. Only long-term dosimetry can give reliable yearly information of UVR load. Median daily UV exposure exceeded limits for UV radiation (e.g., ACGIH effective dose 30 J/m 2 per 8 hr period corresponding to 1.08 SED/day) 6-fold; maximal exposure exceeded these limits 23-fold. These extremely high exposure values are suggestive for an increased risk of skin cancer and thorough epidemiologic studies in the collectives of professional and recreational mountaineering are required. © 2002 Wiley-Liss, Inc. Key words: UV radiation; mountain guide; occupational disease; UV dosimetryDuring the last decades an epidemic increase in skin cancer has been observed in the Caucasian populations of industrial countries. A rise in nonmelanoma skin cancer has been noted particularly in Australia, the United States and Central as well as Northern Europe. 1-3 UV exposure is considered to be the most important risk factor for development of nonmelanoma skin cancer and melanoma. 4,5 High occupational UV exposure is assumed to be associated with skin cancer. 4,6 -9 Numerous epidemiologic studies explored the relationship between skin cancer development and UV exposure, which were assessed by questionnaires in a retrospective manner. 5 However, the association between estimated exposure and dosimeter readings has been shown to be poor. 10 Sensitivity of the human skin to UVR is dependent on the wavelength of UV radiation from 250 -400 nm. 11,12 Biologically weighted dosimeters integrate the UVR effect over the whole spectrum and simulate the relative sensitivity curve critical for human skin for each individual wavelength within this range...

The present study demonstrates an association between high occupational ultraviolet-exposure and an increased prevalence of precancerous skin lesions and skin cancer. MG may be considered as an example for other outdoor professionals. Skin cancer of outdoor workers is likely to be an occupational disease. Primary and secondary prevention should be enforced.

Background: High incidence rates of seborrhoeic dermatitis (SD) have been reported in HIV-infected individuals, indicating immunosuppression to be involved in the pathogenesis. Objective: To establish the prevalence of SD in mountain guides who have a high occupational exposure to solar UV radiation. Patients and Methods: In November 1999, 283 mountain guides were physically examined on the face and scalp for symptoms of SD in Austria (n = 75), Switzerland (n = 123) and Germany (n = 85); they were 21.3–93.1 years of age (median age 41.4 years). Results: Forty-six of 283 (16.3%) mountain guides when examined clinically were found to have SD. The median age of mountain guides with SD was 41.2 years. There were similar incidence rates in all three countries. Conclusion: SD affects mountain guides in a clearly higher percentage as the general population. We suggest UV-induced immunosuppression due to occupational sun exposure as a pathogenetic factor.