Sun protection is a major concern for outdoor workers as they are particularly exposed to solar ultraviolet radiation and therefore at increased risk of developing some forms of skin cancer, cataract and ocular neoplasm. In order to provide an overview of outdoor workers' sun-related knowledge, attitudes and protective behaviours as reported in the literature and to evaluate the effectiveness of sun-safety education programmes in outdoor occupational settings, we conducted a systematic review of the literature by searching three electronic databases (PubMed, Embase, PsycINFO) from their inception up to 25 April 2012. An extensive hand search complemented the database searches. We identified 34 relevant articles on descriptive studies and 18 articles on interventional studies. Considerable numbers of outdoor workers were found to have sun-sensitive skin types; sunburn rates per season ranged from 50% to 80%. Data concerning outdoor workers' sun-related knowledge and attitudes were scarce and controversial. The reported sun-protective behaviours were largely inadequate, with many workers stating that they never or only rarely wore a long-sleeved shirt (50-80%), sun-protective headgear (30-80%) and sunscreen (30-100%) while working in the sun. However, there is growing evidence that occupational sun-safety education is effective in increasing outdoor workers' sun-protection habits and presumably in decreasing sunburn rates. Occupational sun-safety education programmes offer great potential for improving outdoor workers' largely insufficient sun-protective behaviours. It is hoped that, in the future, committed support from healthcare authorities, cancer foundations, employers and dermatologists will open the way for rapid and uncomplicated implementation of sun-safety education programmes.

BackgroundTo evaluate the adverse events profile of oral prednisolone among adult asthma patients in the UK.MethodsUsing data from the UK-based Clinical Practice Research Datalink, we conducted a series of cohort studies to quantify incidence rates and incidence rate ratios, and a series of nested case-control analyses to estimate crude and adjusted odds ratios, of 11 different potential corticosteroid-related adverse events (bone-related conditions, hypertension, peptic ulcer, severe infections, herpes zoster, diabetes mellitus type 2, cataract, glaucoma, chronic kidney disease, affective disorders, and cardiovascular events).ResultsBetween 165,900 and 269,368 asthma patients were included in each of the 11 cohorts, of whom between 836 and 16,192 developed an outcome of interest. Incidence rates per 1000 person-years of potential corticosteroid-related adverse events in patients with new current use of oral prednisolone ranged from 1.4 (95% confidence interval [CI], 1.0–1.8) for peptic ulcer to 78.0 (95% CI, 74.8–81.2) for severe infections. After adjusting for confounding, current oral prednisolone use was most strongly associated with an increased risk of severe infection, compared with non-use of prednisolone; OR 2.16 (95% CI, 2.05–2.27). There were smaller elevated risks of peptic ulcer, affective disorders, and cataract at higher doses, and marginally increased risks of herpes zoster, cardiovascular events, diabetes mellitus type 2, and bone related conditions, compared with non-use of prednisolone. We did not observe an association between oral prednisolone use and glaucoma, chronic kidney disease, or hypertension.ConclusionOral prednisolone use is associated with infections, gastrointestinal, neuropsychiatric, ocular, cardiovascular, metabolic, and bone-related complications among adult asthma patients.Electronic supplementary materialThe online version of this article (10.1186/s12931-018-0742-y) contains supplementary material, which is available to authorized users.

Background:Little is known about the epidemiology of basal cell carcinoma (BCC).Methods:Using the Clinical Practice Research Datalink, we calculated annual incidence rates. In a case–control analysis, we examined lifestyle factors and comorbidities.Results:Incidence rose significantly between 2000 and 2011. Basal cell carcinoma risk was increased in alcohol drinkers (slightly) and immunocompromised patients, but reduced in smokers and individuals with abnormal weight.Conclusions:Basal cell carcinoma places a growing public health burden. Lifestyle factors do not play a major role in pathogenesis, but immunosuppression is important.

In order to reduce the incidence of skin cancer in Switzerland, it is essential to improve children's and adolescents' sun protective behaviour. Future skin cancer prevention campaigns should teach proper use of sunscreen, and emphasise the value of wearing clothing and seeking shade as the most effective sun protection. Furthermore, major efforts are needed to change adolescents' attitude towards a suntan.

PurposeSubjective tinnitus is a common symptom with potentially negative impact on quality of life. More research is required to gain a deeper understanding of the disease and its clinical presentation. To estimate the incidence of tinnitus and to describe patient-related characteristics such as lifestyle factors and comorbidities.Patients and methodsUsing the Clinical Practice Research Datalink, we calculated incidence rates of first-time diagnosed tinnitus in an adult population between 2000 and 2016. We stratified incidence rates by sex, age, and year of diagnosis. Additionally, we performed a 1:1 matched case-control study comparing body mass index, lifestyle factors and selected comorbidities between patients with incident tinnitus and tinnitus-free controls.ResultsWe identified 109 783 adults with a first-time diagnosis of tinnitus between 2000 and 2016, yielding an overall age-standardized incidence rate of 25.0 new tinnitus cases per 10,000 person-years (95% CI: 24.6–25.5). There was a steady increase in tinnitus incidence throughout the study period. Approximately 80% of tinnitus cases were diagnosed at age 40 years or older. We observed the highest incidence rate in individuals aged 60–69 years (41.2 per 10,000 person-years, 95% CI: 40.7–41.7). Smokers and alcohol drinkers were at lower risk of being diagnosed with tinnitus compared with non-smokers and non-drinkers, respectively. The occurrence of tinnitus was strongly associated with a recent diagnosis of several otological and vestibular disorders as well as head and neck disorders.ConclusionThe present observational study found an increasing incidence of tinnitus over time, emphasizing the continuously growing health burden. The findings on patient characteristics, lifestyle factors, and selected comorbidities contribute to a better understanding of risk factors for tinnitus.