Hintergrund: Die Synkanzerogenese am Hautorgan, wissenschaftlich unstrittig, spiegelt sich im monokausal geleiteten Berufskrankheiten (BK)-Recht nicht wider. Nichtmelanozytäre Hauttumoren und deren Vorläuferläsionen können nur nach Einzelprüfung der BK-Nrn. 5103 und 5102 anerkannt werden.
Methodik: Retrospektive Auswertung von 28 zwischen September 2012 und September 2015 begutachteten Fällen (Altersmedian 72,5 J.) mit nichtmelanozytären Hauttumoren und deren Vorläuferläsionen und arbeitsbedingter Exposition gegenüber natürlicher UV-Strahlung und polyzyklischen aromatischen Kohlenwasserstoffen.
Ergebnisse: In allen 28 Fällen sahen wir die arbeitstechnischen Voraussetzungen nach den BK-Nrn. 5103 und 5102 als erfüllt an. In 26 Fällen (93 %) empfahlen wir die Hautkrebserkrankung als BK-Tatbestand nach den Nrn. 5103 und 5102 anzuerkennen. Dem folgte der Unfallversicherungsträger in vier Fällen. Achtmal wurde die Anerkennung nur nach BK-Nr. 5103, zehnmal nur nach BK-Nr. 5102 und viermal gar nicht ausgesprochen.
Schlussfolgerungen: Bei nichtmelanozytären Hauttumoren oder deren Vorläuferläsionen an UV-exponierten Hautarealen mit ausreichend kumulativer arbeitsbedingter natürlicher UV-Strahlenexposition und bei arbeitsbedingter Exposition gegenüber polyzyklischen aromatischen Kohlenwasserstoffen sollten mittels BK-Anzeige die "BK-Nrn. 5103 und 5102 im Sinne der Synkanzerogenese" gemeldet werden. Neben der gerechteren Wiedergabe der Arbeitsplatzrealitäten in einem solchen Feststellungsverfahren kann es dann im Konkreten auch zur Anerkennung von Basalzellkarzinomen kommen, die ansonsten, bei alleiniger Prüfung der BK-Nr. 5103, herausgerechnet würden.
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