Light at Night Co‐distributes with Incident Breast but not Lung Cancer in the Female Population of Israel

Limiting the impact of light pollution on human health, environment and stellar visibility

Light pollution is one of the most rapidly increasing types of environmental degradation. Its levels have been growing exponentially over the natural nocturnal lighting levels provided by starlight and moonlight. To limit this pollution several effective practices have been defined: the use of shielding on lighting fixture to prevent direct upward light, particularly at low angles above the horizon; no over lighting, i.e. avoid using higher lighting levels than strictly needed for the task, constraining illumination to the area where it is needed and the time it will be used. Nevertheless, even after the best control of the light distribution is reached and when the proper quantity of light is used, some upward light emission remains, due to reflections from the lit surfaces and atmospheric scatter. The environmental impact of this "residual light pollution", cannot be neglected and should be limited too. Here we propose a new way to limit the effects of this residual light pollution on wildlife, human health and stellar visibility. We performed analysis of the spectra of common types of lamps for external use, including the new LEDs. We evaluated their emissions relative to the spectral response functions of human eye photoreceptors, in the photopic, scotopic and the 'meltopic' melatonin suppressing bands. We found that the amount of pollution is strongly dependent on the spectral characteristics of the lamps, with the more environmentally friendly lamps being low pressure sodium, followed by high pressure sodium. Most polluting are the lamps with a strong blue emission, like Metal Halide and white LEDs. Migration from the now widely used sodium lamps to white lamps (MH and LEDs) would produce an increase of pollution in the scotopic and melatonin suppression bands of more than five times the present levels, supposing the same photopic installed flux. This increase will exacerbate known and possible unknown effects of light pollution on human health, environment and on visual perception of the Universe by humans. We present quantitative criteria to evaluate the lamps based on their spectral emissions and we suggest regulatory limits for future lighting.

Measurements of light at night (LAN) for a sample of female school teachers

Epidemiological studies have shown an association between rotating shiftwork and breast cancer (BC) risk. Recently, light at night (LAN) measured by satellite photometry and by self-reports of bedroom brightness has been shown to be associated with BC risk, irrespective of shiftwork history. Importance has been placed on these associations because retinal light exposures at night can suppress the hormone melatonin and/or disrupt circadian entrainment to the local 24-h light-dark cycle. The present study examined whether it was valid to use satellite photometry and self-reports of brightness to characterize light, as it might stimulate the circadian system and thereby affect BC incidence. Calibrated photometric measurements were made at the bedroom windows and in the bedrooms of a sample of female school teachers, who worked regular dayshifts and lived in a variety of satellite-measured sky brightness categories. The light levels at both locations were usually very low and were independent of the amount of satellite-measured light. Calibrated photometric measurements were also obtained at the corneas of these female school teachers together with calibrated accelerometer measurements for seven consecutive days and evenings. Based upon these personal light exposure and activity measurements, the female teachers who participated in this study did not have disrupted light-dark cycles like those associated with rotating shiftworkers who do exhibit a higher risk for BC. Rather, this sample of female school teachers had 24-h light-dark and activity-rest patterns very much like those experienced by dayshift nurses examined in an earlier study who are not at an elevated risk of BC. No relationship was found between the amount of satellite-measured light levels and the 24-h light-dark patterns these women experienced. It was concluded from the present study that satellite photometry is unrelated to personal light exposures as they might affect melatonin suppression and/or circadian disruption. More generally, photometric devices calibrated in terms of the operational characteristics of the human circadian system must be used to meaningfully link LAN and BC incidence.

[Shift- and Nightwork - a scientometric analysis]

Economic restructuring processes in Germany require changes within all social and health care systems regarding night shiftwork. The aim of this paper was to analyse research results referring to shift- and nightwork using scientometric methods. A total of 3092 items could be detected. A constant increase in the number of publications per year since 1977, especially since 1990' was obvious. One third of the research results, a total of 884 articles could be assigned to the USA. Great Britain could be identified with 365 articles and France with 244 published articles. Sleep, Ergonomics and Chronobiology International are the most prolific journals. The Swedish scientist Torbjörn Akerstedt is to this date the most acclaimed researcher referring to his issue. He has written 105 articles about shift- and nightwork. He is not only a most efficient author, but also has the highest h-index [30]. Self-citations and multiple co-authorships distort parameters like impact factor and h-index enormously and should be regarded from a critical point of view.

Cloud coverage acts as an amplifier for ecological light pollution in urban ecosystems

The diurnal cycle of light and dark is one of the strongest environmental factors for life on Earth. Many species in both terrestrial and aquatic ecosystems use the level of ambient light to regulate their metabolism, growth, and behavior. The sky glow caused by artificial lighting from urban areas disrupts this natural cycle, and has been shown to impact the behavior of organisms, even many kilometers away from the light sources. It could be hypothesized that factors that increase the luminance of the sky amplify the degree of this “ecological light pollution”. We show that cloud coverage dramatically amplifies the sky luminance, by a factor of 10.1 for one location inside of Berlin and by a factor of 2.8 at 32 km from the city center. We also show that inside of the city overcast nights are brighter than clear rural moonlit nights, by a factor of 4.1. These results have important implications for choronobiological and chronoecological studies in urban areas, where this amplification effect has previously not been considered.

Rotating night shifts and risk of skin cancer in the nurses' health study

Night shift work is associated with increased risk of several cancers, but the risk of skin cancer among night shift workers is unknown. We documented 10,799 incident skin cancers in 68,336 women in the Nurses' Health Study from June 1988 to June 2006 and examined the relationship between rotating night shifts and skin cancer. We used Cox proportional hazard models, adjusted for confounding variables (phenotypic and established risk factors of skin cancer), and performed stratified analysis to explore the modifying effect of hair color. Working 10 years or more on rotating night shifts was associated with a 14% decreased risk of skin cancer compared with never working night shifts (age-standardized incidence rate: 976 per 100,000 person-years (PY) vs 1070 per 100,000 PY, respectively; adjusted hazard ratios = 0.86, 95% confidence interval = 0.81 to 0.92, P(trend) < .001). This association was strongest for cutaneous melanoma; working 10 years or more of rotating night shifts was associated with 44% decreased risk of melanoma, after adjustment for melanoma risk factors (age-standardized incidence rate: 20 per 100,000 PY vs 35 per 100,000 PY, respectively; adjusted hazard ratios = 0.56, 95% confidence interval = 0.36 to 0.87, P(trend) = .005). Hair color, a surrogate for an individual's susceptibility to skin cancer, was a statistically significant effect modifier for the observed associations; darker-haired women had the lowest risk (P(interaction) = .02).

Differential effects of photophase irradiance on metabolic and urinary stress hormone concentrations in blind and sighted rodents

The effects of different photophase irradiance levels on the daily rhythms of energy expenditure (DEE, calculated from oxygen consumption, VO(2)) and urinary metabolites of stress hormones in sighted (Microtus socialis) and blind (Spalax ehrenbergi) rodents were compared. Five groups of each species were exposed to different irradiance levels (73, 147, 293, 366, and 498 microW/cm(2)) under short photoperiod (8L:16D) condition with constant ambient temperature 25 +/- 2 degrees C for 21 days before assessments. As light intensity increased from 73 microW/cm(2), both species reduced DEE, especially among M. socialis. Cosinor analysis revealed significant ultradian rhythms in VO(2) of M. socialis with period length being inversely related to irradiance level. Conversely, in S. ehrenbergi, robust 24 h VO(2) rhythms were detected at all irradiances. In M. socialis, significant 24 h rhythms in urinary output of adrenaline were detected only at 293 microW/cm(2), whereas for cortisol, unambiguous rhythms were detected at 73 and 147 microW/cm(2). Distinct adrenaline daily rhythms of S. ehrenbergi were observed at 73 and 293 microW/cm(2), whereas this species exhibited significant rhythms in cortisol at 147 and 293 microW/cm(2). Changes in photophase irradiance levels affected stress hormone concentrations in a dose-dependent manner. There were significant negative and positive correlations of M. socialis and S. ehrenbergi stress hormones, respectively, with increasing irradiance. Our results indicate photophase light intensity is another environmental factor that can significantly affect entrainment of mammalian daily rhythms. Both low and high irradiance conditions can trigger stress responses, depending on the species' natural habitat.

Nighttime light level co-distributes with breast cancer incidence worldwide

Breast cancer incidence varies widely among countries of the world for largely unknown reasons. We investigated whether country-level light at night (LAN) is associated with incidence. We compared incidence rates of five common cancers in women (breast, lung, colorectal, larynx, and liver), observed in 164 countries of the world from the GLOBOCAN database, with population-weighted country-level LAN, and with several developmental and environmental indicators, including fertility rate, per capita income, percent of urban population, and electricity consumption. Two types of regression models were used in the analysis: Ordinary Least Squares and Spatial Errors. We found a significant positive association between population LAN level and incidence rates of breast cancer. There was no such an association between LAN level and colorectal, larynx, liver, and lung cancers. A sensitivity test, holding other variables at their average values, yielded a 30-50% higher risk of breast cancer in the highest LAN exposed countries compared to the lowest LAN exposed countries. The possibility that under-reporting from the registries in the low-resource, and also low-LAN, countries created a spurious association was evaluated in several ways and shown not to account for the results. These findings provide coherence of the previously reported case-control and cohort studies with the co-distribution of LAN and breast cancer in entire populations.

Spectral identification of lighting type and character

We investigated the optimal spectral bands for the identification of lighting types and the estimation of four major indices used to measure the efficiency or character of lighting. To accomplish these objectives we collected high-resolution emission spectra (350 to 2,500 nm) for forty-three different lamps, encompassing nine of the major types of lamps used worldwide. The narrow band emission spectra were used to simulate radiances in eight spectral bands including the human eye photoreceptor bands (photopic, scotopic, and “meltopic”) plus five spectral bands in the visible and near-infrared modeled on bands flown on the Landsat Thematic Mapper (TM). The high-resolution continuous spectra are superior to the broad band combinations for the identification of lighting type and are the standard for calculation of Luminous Efficacy of Radiation (LER), Correlated Color Temperature (CCT) and Color Rendering Index (CRI). Given the high cost that would be associated with building and flying a hyperspectral sensor with detection limits low enough to observe nighttime lights we conclude that it would be more feasible to fly an instrument with a limited number of broad spectral bands in the visible to near infrared. The best set of broad spectral bands among those tested is blue, green, red and NIR bands modeled on the band set flown on the Landsat Thematic Mapper. This set provides low errors on the identification of lighting types and reasonable estimates of LER and CCT when compared to the other broad band set tested. None of the broad band sets tested could make reasonable estimates of Luminous Efficacy (LE) or CRI. The photopic band proved useful for the estimation of LER. However, the three photoreceptor bands performed poorly in the identification of lighting types when compared to the bands modeled on the Landsat Thematic Mapper. Our conclusion is that it is feasible to identify lighting type and make reasonable estimates of LER and CCT using four or more spectral bands with minimal spectral overlap spanning the 0.4 to 1.0 um region.

Nocturnal illumination dimmer than starlight altered the circadian rhythm of adult locomotor activity of a fruit fly

The effects of nocturnal irradiance tenfold dimmer than starlight intensity on the locomotor activity rhythm of Drosophila jambulina were investigated in two types of light-dark (12 h:12 h) cycles, in which light intensity of the photophase was 10 lux while that of the scotophase was either 0 lux for control flies or 0.0006 lux for experimental flies. Activity onset in the experimental flies was approximately 5.4 h prior to lights-on, so it occurred around midnight. However, activity onset of the control flies coincided almost with the lights-on. Nevertheless, activity offset was the same in both groups, occurring at lights-off. Duration of the active phase (alpha) and activity passes/fly/cycle (APC) in the experimental flies was far greater than in controls. After-effects of the nocturnal illumination of the light-dark cycles when the flies were transferred to constant darkness were evident as the period of the free-running rhythm was shortened, alpha was lengthened, and APC was enhanced in the experimental compared to control flies. Thus, very low photic sensitivity of these flies appears to be a physiological adaptation to dim-light ambiance in its natural breeding site in the field.

Do restless legs syndrome (RLS) and periodic limb movements of sleep (PLMS) play a role in nocturnal hypertension and increased cardiovascular risk of renally impaired patients?

Hypertension can cause or promote renal failure and is related to cardiovascular mortality, the major cause of death in patients with renal impairment. Changes in the circadian BP pattern, particularly the blunting or reversal of the nocturnal decline in BP, are common in chronic renal failure. These changes in turn are among the major determinants of left ventricular hypertrophy. Using a chronobiological approach, it is possible to obtain better insight into the reciprocal relationship between hypertension, renal disease, and increased cardiovascular risk of renal patients. Disruption of the normal circadian rhythm of rest/activity may be hypothesized to underlie the high cardiovascular morbidity and mortality of such patients. Epidemiological studies reveal that hemodialysis patients experience poor subjective sleep quality and insomnia and, in comparison to healthy persons, are more likely to show shorter sleep duration and lower sleep efficiency. Sleep apnea may be present and is usually investigated in these patients; however, the prevalence of restless legs syndrome (RLS), which is high in dialysis patients and which has been associated with increased risk for cardiovascular disease in the general population, could also play a role in the pathogenesis of sleep-time hypertension in renal patients. Careful assessment of sleep quality, in particular, diagnostic screening for RLS and periodic limb movements (PLM) in renal patients, is highly recommended. In renal failure, attention to sleep quality and related perturbations of the sleep/wake cycle may help prevent the occurrence and progression of cardiovascular disease.

Is light-at-night a health risk factor or a health risk predictor?

In 2007, the IARC (WHO) has classified "shift-work that involves circadian disruption" as potentially carcinogenic. Ample evidence leaves no doubt that shift-work is detrimental for health, but the mechanisms behind this effect are not well understood. The hormone melatonin is often considered to be a causal link between night shift and tumor development. The underlying "light-at-night" (LAN) hypothesis is based on the following chain of arguments: melatonin is a hormone produced under the control of the circadian clock at night, and its synthesis can be suppressed by light; as an indolamine, it potentially acts as a scavenger of oxygen radicals, which in turn can damage DNA, which in turn can cause cancer. Although there is no experimental evidence that LAN is at the basis of increased cancer rates in shiftworkers, the scenario "light at night can cause cancer" influences research, medicine, the lighting industry and (via the media) also the general public, well beyond shiftwork. It is even suggested that baby-lights, TVs, computers, streetlights, moonlight, emergency lights, or any so-called "light pollution" by urban developments cause cancer via the mechanisms proposed by the LAN hypothesis. Our commentary addresses the growing concern surrounding light pollution. We revisit the arguments of the LAN theory and put them into perspective regarding circadian physiology, physical likelihood (e.g., what intensities reach the retina), and potential risks, specifically in non-shiftworkers.

Light-at-night, circadian disruption and breast cancer: assessment of existing evidence

BACKGROUND

Breast cancer incidence is increasing globally for largely unknown reasons. The possibility that a portion of the breast cancer burden might be explained by the introduction and increasing use of electricity to light the night was suggested >20 years ago.

METHODS

The theory is based on nocturnal light-induced disruption of circadian rhythms, notably reduction of melatonin synthesis. It has formed the basis for a series of predictions including that non-day shift work would increase risk, blind women would be at lower risk, long sleep duration would lower risk and community nighttime light level would co-distribute with breast cancer incidence on the population level.

RESULTS

Accumulation of epidemiological evidence has accelerated in recent years, reflected in an International Agency for Research on Cancer (IARC) classification of shift work as a probable human carcinogen (2A). There is also a strong rodent model in support of the light-at-night (LAN) idea.

CONCLUSION

If a consensus eventually emerges that LAN does increase risk, then the mechanisms for the effect are important to elucidate for intervention and mitigation. The basic understanding of phototransduction for the circadian system, and of the molecular genetics of circadian rhythm generation are both advancing rapidly, and will provide for the development of lighting technologies at home and at work that minimize circadian disruption, while maintaining visual efficiency and aesthetics. In the interim, there are strategies now available to reduce the potential for circadian disruption, which include extending the daily dark period, appreciate nocturnal awakening in the dark, using dim red light for nighttime necessities, and unless recommended by a physician, not taking melatonin tablets.

Global co-distribution of light at night (LAN) and cancers of prostate, colon, and lung in men

The incidence rates of cancers in men differ by countries of the world. We compared the incidence rates of three of the most common cancers (prostate, lung, and colon) in men residing in 164 different countries with the population-weighted light at night (LAN) exposure and with several developmental and environmental indicators, including per capita income, percent urban population, and electricity consumption. The estimate of per capita LAN exposure was a novel aspect of this study. Both ordinary least squares (OLS) and spatial error (SE) regression models were used in the analysis. We found a significant positive association between population exposure to LAN and incidence rates of prostate cancer, but no such association with lung cancer or colon cancer. The prostate cancer result is consistent with a biological theory and a limited number of previous studies of circadian disruption and risk. The LAN-prostate cancer connection is postulated to be due to suppression of melatonin and/or disruption of clock gene function. An analysis holding other variables at average values across the 164 countries yielded a risk of prostate cancer in the highest LAN-exposed countries 110% higher than in the lowest LAN exposed countries. This observed association is a necessary condition for a potentially large effect of LAN on risk of prostate cancer. However, it is not sufficient due to potential confounding by factors that increase the risk of prostate cancer and are also associated with LAN among the studied countries.

Electric light causes cancer? Surely you're joking, Mr. Stevens

Night is no longer dark in the modern world, and the Milky Way has disappeared. Electric light has benefits but there are also a few detriments. These are (1) loss of the night sky, (2) wasted energy, (3) harm to animal and plant life, (4) and perhaps increases in some severe human maladies such as cancers of breast and prostate. The science on phototransduction for the circadian system and on clock gene function is evolving rapidly, and it provides a rationale for the idea that circadian disruption from light at night could cause disease. Direct evidence from humans and rodent models has also accumulated to the point where the idea is no longer fanciful. Although it may seem logical now, the journey on the path from electric light to breast cancer has been a tortuous one, at least for me.