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Little MP, Tatalovich Z, Linet MS, Fang M, Kendall GM, Kimlin MG. Improving Assessment of Lifetime Solar Ultraviolet Radiation Exposure in Epidemiologic Studies: Comparison of Ultraviolet Exposure Assessment Methods in a Nationwide U.S. Occupational Cohort. Photochem Photobiol 2018; 94:1297-1307. [PMID: 29896764 DOI: 10.1111/php.12964] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Accepted: 06/10/2018] [Indexed: 01/19/2023]
Abstract
Solar ultraviolet radiation is the primary risk factor for skin cancers and sun-related eye disorders. Estimates of individual ambient ultraviolet irradiance derived from ground-based solar measurements and from satellite measurements have rarely been compared. Using self-reported residential history from 67 189 persons in a nationwide occupational US radiologic technologists' cohort, we estimated ambient solar irradiance using data from ground-based meters and noontime satellite measurements. The mean distance moved from city of longest residence in childhood increased from 137.6 km at ages 13-19 to 870.3 km at ages ≥65, with corresponding increases in absolute latitude difference moved. At ages 20/40/60/80, the Pearson/Spearman correlation coefficients of ground-based and satellite-derived potential solar ultraviolet exposure, using irradiance and cumulative radiant exposure metrics, were high (=0.87-0.92). There was also moderate correlation (Pearson/Spearman correlation coefficients = 0.51-0.60) between irradiance at birth and at last-known address, for ground-based and satellite data. Satellite-based lifetime estimates of ultraviolet radiation were generally 14-15% lower than ground-based estimates, albeit with substantial uncertainties, possibly because ground-based estimates incorporate fluctuations in cloud and ozone, which are incompletely incorporated in the single noontime satellite-overpass ultraviolet value. If confirmed elsewhere, the findings suggest that ground-based estimates may improve exposure assessment accuracy and potentially provide new insights into ultraviolet radiation-disease relationships in epidemiologic studies.
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Affiliation(s)
- Mark P Little
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Bethesda, MD
| | - Zaria Tatalovich
- Surveillance Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, NIH, DHHS, Bethesda, MD
| | - Martha S Linet
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Bethesda, MD
| | - Michelle Fang
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Bethesda, MD
| | | | - Michael G Kimlin
- NHMRC Centre for Research Excellence in Sun and Health, University of the Sunshine Coast, Maroochydore, Qld, Australia
- Cancer Council Queensland, Qld, Australia
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Cust AE, Fenton GL, Smit AK, Espinoza D, Dobbinson S, Brodie A, Dang HTC, Kimlin MG. Validation of Questionnaire and Diary Measures of Time Outdoors Against an Objective Measure of Personal Ultraviolet Radiation Exposure. Photochem Photobiol 2018; 94:815-820. [DOI: 10.1111/php.12893] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2017] [Accepted: 12/20/2017] [Indexed: 10/18/2022]
Affiliation(s)
- Anne E Cust
- Cancer Epidemiology and Prevention Research; Sydney School of Public Health; The University of Sydney; Sydney NSW Australia
- Melanoma Institute Australia; The University of Sydney; Sydney NSW Australia
| | - Georgina L Fenton
- Cancer Epidemiology and Prevention Research; Sydney School of Public Health; The University of Sydney; Sydney NSW Australia
| | - Amelia K Smit
- Cancer Epidemiology and Prevention Research; Sydney School of Public Health; The University of Sydney; Sydney NSW Australia
- Melanoma Institute Australia; The University of Sydney; Sydney NSW Australia
| | - David Espinoza
- NHMRC Clinical Trials Centre; The University of Sydney; Sydney NSW Australia
| | | | - Alison Brodie
- The University of the Sunshine Coast; Maroochydore Qld Australia
| | | | - Michael G Kimlin
- The University of the Sunshine Coast; Maroochydore Qld Australia
- Cancer Council Queensland; Brisbane Qld Australia
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King L, Xiang F, Swaminathan A, Dear K, Harrison SL, van der Mei I, Kimlin MG, D'Este C, Lucas RM. Validation of Sun Exposure Reported Annually Against Interim Self-report and Daily Sun Diaries. Photochem Photobiol 2017; 93:1294-1302. [DOI: 10.1111/php.12780] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2016] [Accepted: 03/20/2017] [Indexed: 01/09/2023]
Affiliation(s)
- Laura King
- National Centre for Epidemiology and Population Health; Research School of Population Health; The Australian National University; Canberra ACT Australia
| | - Fan Xiang
- National Centre for Epidemiology and Population Health; Research School of Population Health; The Australian National University; Canberra ACT Australia
| | | | | | - Simone L. Harrison
- College of Public Health, Medical & Veterinary Sciences; James Cook University; Townsville Qld Australia
| | - Ingrid van der Mei
- Menzies Research Institute Tasmania; University of Tasmania; Hobart Tasmania
| | - Michael G. Kimlin
- Queensland University of Technology; Brisbane Qld Australia
- University of the Sunshine Coast; Sippy Downs Qld Australia
| | - Catherine D'Este
- National Centre for Epidemiology and Population Health; Research School of Population Health; The Australian National University; Canberra ACT Australia
| | - Robyn M. Lucas
- National Centre for Epidemiology and Population Health; Research School of Population Health; The Australian National University; Canberra ACT Australia
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King L, Xiang F, Swaminathan A, Lucas RM. Measuring sun exposure in epidemiological studies: Matching the method to the research question. JOURNAL OF PHOTOCHEMISTRY AND PHOTOBIOLOGY B-BIOLOGY 2015; 153:373-9. [PMID: 26555640 DOI: 10.1016/j.jphotobiol.2015.10.024] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/20/2015] [Revised: 10/26/2015] [Accepted: 10/28/2015] [Indexed: 12/11/2022]
Abstract
Sun exposure has risks and benefits for health. Testing these associations requires tools for measuring sun exposure that are feasible and relevant to the time-course of the health outcome. Recent sun exposure, e.g. the last week, is best captured by dosimeters and sun diaries. These can also be used for medium-term sun exposure e.g. over several weeks, but incur a high participant burden. Self-reported data on "typical time outdoors" for working and non-working days, is less detailed and not influenced by day-to-day variation. Over a longer period, e.g. the lifetime, or for particular life stages, proxies of sun exposure, such as latitude of residence or ambient ultraviolet (UV) radiation levels (from satellites or ground-level monitoring) can be used, with additional detail provided by lifetime sun exposure calendars that include locations of residence, usual time outdoors, and detail of sunburn episodes. Objective measures of lifetime sun exposure include microtopography of sun-exposed skin (e.g. using silicone casts) or conjunctival UV autofluorescence. Potential modifiers of the association between sun exposure and the health outcome, such as clothing coverage and skin colour, may also need to be measured. We provide a systematic approach to selecting sun exposure measures for use in epidemiological health research.
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Affiliation(s)
- Laura King
- National Centre for Epidemiology and Population Health, Research School of Population Health, The Australian National University, Canberra 0200, Australia.
| | - Fan Xiang
- National Centre for Epidemiology and Population Health, Research School of Population Health, The Australian National University, Canberra 0200, Australia
| | - Ashwin Swaminathan
- Acute and General Medicine Service, The Canberra Hospital, Canberra 2605, Australia
| | - Robyn M Lucas
- National Centre for Epidemiology and Population Health, Research School of Population Health, The Australian National University, Canberra 0200, Australia
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O′Neill DG, Church DB, McGreevy PD, Thomson PC, Brodbelt DC. Prevalence of disorders recorded in dogs attending primary-care veterinary practices in England. PLoS One 2014; 9:e90501. [PMID: 24594665 PMCID: PMC3942437 DOI: 10.1371/journal.pone.0090501] [Citation(s) in RCA: 201] [Impact Index Per Article: 20.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2013] [Accepted: 02/03/2014] [Indexed: 01/17/2023] Open
Abstract
Purebred dog health is thought to be compromised by an increasing occurence of inherited diseases but inadequate prevalence data on common disorders have hampered efforts to prioritise health reforms. Analysis of primary veterinary practice clinical data has been proposed for reliable estimation of disorder prevalence in dogs. Electronic patient record (EPR) data were collected on 148,741 dogs attending 93 clinics across central and south-eastern England. Analysis in detail of a random sample of EPRs relating to 3,884 dogs from 89 clinics identified the most frequently recorded disorders as otitis externa (prevalence 10.2%, 95% CI: 9.1-11.3), periodontal disease (9.3%, 95% CI: 8.3-10.3) and anal sac impaction (7.1%, 95% CI: 6.1-8.1). Using syndromic classification, the most prevalent body location affected was the head-and-neck (32.8%, 95% CI: 30.7-34.9), the most prevalent organ system affected was the integument (36.3%, 95% CI: 33.9-38.6) and the most prevalent pathophysiologic process diagnosed was inflammation (32.1%, 95% CI: 29.8-34.3). Among the twenty most-frequently recorded disorders, purebred dogs had a significantly higher prevalence compared with crossbreds for three: otitis externa (P = 0.001), obesity (P = 0.006) and skin mass lesion (P = 0.033), and popular breeds differed significantly from each other in their prevalence for five: periodontal disease (P = 0.002), overgrown nails (P = 0.004), degenerative joint disease (P = 0.005), obesity (P = 0.001) and lipoma (P = 0.003). These results fill a crucial data gap in disorder prevalence information and assist with disorder prioritisation. The results suggest that, for maximal impact, breeding reforms should target commonly-diagnosed complex disorders that are amenable to genetic improvement and should place special focus on at-risk breeds. Future studies evaluating disorder severity and duration will augment the usefulness of the disorder prevalence information reported herein.
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Affiliation(s)
- Dan G. O′Neill
- Veterinary Epidemiology, Economics and Public Health, Royal Veterinary College, London, United Kingdom
| | - David B. Church
- Small Animal Medicine and Surgery Group, Royal Veterinary College, London, United Kingdom
| | - Paul D. McGreevy
- Faculty of Veterinary Science, University of Sydney, Sydney, New South Wales, Australia
| | - Peter C. Thomson
- Faculty of Veterinary Science, University of Sydney, Sydney, New South Wales, Australia
| | - Dave C. Brodbelt
- Veterinary Epidemiology, Economics and Public Health, Royal Veterinary College, London, United Kingdom
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Cargill J, Lucas RM, Gies P, King K, Swaminathan A, Allen MW, Banks E. Validation of Brief Questionnaire Measures of Sun Exposure and Skin Pigmentation Against Detailed and Objective Measures Including Vitamin D Status. Photochem Photobiol 2012; 89:219-26. [DOI: 10.1111/j.1751-1097.2012.01221.x] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2012] [Accepted: 08/07/2012] [Indexed: 11/27/2022]
Affiliation(s)
- Jessica Cargill
- National Centre for Epidemiology and Population Health; The Australian National University; Canberra; Australia
| | - Robyn M. Lucas
- National Centre for Epidemiology and Population Health; The Australian National University; Canberra; Australia
| | - Peter Gies
- Australian Radiation Protection and Nuclear Safety Agency; Melbourne; Australia
| | - Kerryn King
- Australian Radiation Protection and Nuclear Safety Agency; Melbourne; Australia
| | - Ashwin Swaminathan
- National Centre for Epidemiology and Population Health; The Australian National University; Canberra; Australia
| | - Martin W. Allen
- MacDiarmid Institute for Advanced Materials and Nanotechnology; University of Canterbury; Christchurch; New Zealand
| | - Emily Banks
- National Centre for Epidemiology and Population Health; The Australian National University; Canberra; Australia
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Glanz K, Gies P, O'Riordan DL, Elliott T, Nehl E, McCarty F, Davis E. Validity of self-reported solar UVR exposure compared with objectively measured UVR exposure. Cancer Epidemiol Biomarkers Prev 2010; 19:3005-12. [PMID: 20940277 DOI: 10.1158/1055-9965.epi-10-0709] [Citation(s) in RCA: 60] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Reliance on verbal self-report of solar exposure in skin cancer prevention and epidemiologic studies may be problematic if self-report data are not valid due to systematic errors in recall, social desirability bias, or other reasons. METHODS This study examines the validity of self-reports of exposure to ultraviolet radiation (UVR) compared to objectively measured exposure among children and adults in outdoor recreation settings in 4 regions of the United States. Objective UVR exposures of 515 participants were measured using polysulfone film badge UVR dosimeters on 2 days. The same subjects provided self-reported UVR exposure data on surveys and 4-day sun exposure diaries, for comparison to their objectively measured exposure. RESULTS Dosimeter data showed that lifeguards had the greatest UVR exposure (24.5% of weekday ambient UVR), children the next highest exposures (10.3% ambient weekday UVR), and parents had the lowest (6.6% ambient weekday UVR). Similar patterns were observed in self-report data. Correlations between diary reports and dosimeter findings were fair to good and were highest for lifeguards (r = 0.38-0.57), followed by parents (r = 0.28-0.29) and children (r = 0.18-0.34). Correlations between survey and diary measures were moderate to good for lifeguards (r = 0.20-0.54) and children (r = 0.35-0.53). CONCLUSIONS This is the largest study of its kind to date, and supports the utility of self-report measures of solar UVR exposure. IMPACT Overall, self-reports of sun exposure produce valid measures of UVR exposure among parents, children, and lifeguards who work outdoors.
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Affiliation(s)
- Karen Glanz
- Rollins School of Public Health, Emory University, Atlanta, Georgia, USA.
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Cooper GS, Wither J, Bernatsky S, Claudio JO, Clarke A, Rioux JD, Fortin PR. Occupational and environmental exposures and risk of systemic lupus erythematosus: silica, sunlight, solvents. Rheumatology (Oxford) 2010; 49:2172-80. [PMID: 20675707 DOI: 10.1093/rheumatology/keq214] [Citation(s) in RCA: 94] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVES We examined occupational and non-occupational exposures in relation to risk of SLE in a case-control study conducted through the Canadian Network for Improved Outcomes in SLE (CaNIOS). METHODS SLE cases (n = 258) were recruited from 11 rheumatology centres across Canada. Controls (without SLE, n = 263) were randomly selected from phone number listings and matched to cases by age, sex and area of residence. Data were collected using a structured telephone interview. RESULTS An association was seen with outdoor work in the 12 months preceding diagnosis [odds ratio (OR) 2.0; 95% CI 1.1, 3.8]; effect modification by sun reaction was suggested, with the strongest effect among people who reported reacting to midday sun with a blistering sunburn or a rash (OR 7.9; 95% CI 0.97, 64.7). Relatively strong but imprecise associations were seen with work as an artist working with paints, dyes or developing film (OR 3.9; 95% CI 1.3, 12.3) and work that included applying nail polish or nail applications (OR 10.2; 95% CI 1.3, 81.5). Patients were more likely than controls to report participation in pottery or ceramics work as a leisure activity, with an increased risk among individuals with a total frequency of at least 26 days (OR 2.1; 95% CI 1.1, 3.9). Analyses of potential respirable silica exposures suggested an exposure-response gradient (OR 1.0, 1.4. and 2.1 for zero, one and two or more sources of exposure, respectively; trend test P < 0.01). CONCLUSIONS This study supports the role of specific occupational and non-occupational exposures in the development of SLE.
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Affiliation(s)
- Glinda S Cooper
- Department of Environmental and Occupational Health, The George Washington University, School of Public Health and Health Services, Washington, DC, USA.
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Yu CL, Li Y, Freedman DM, Fears TR, Kwok R, Chodick G, Alexander B, Kimlin MG, Kricker A, Armstrong BK, Linet MS. Assessment of lifetime cumulative sun exposure using a self-administered questionnaire: reliability of two approaches. Cancer Epidemiol Biomarkers Prev 2009; 18:464-71. [PMID: 19190171 DOI: 10.1158/1055-9965.epi-08-0894] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Few studies have evaluated the reliability of lifetime sun exposure estimated from inquiring about the number of hours people spent outdoors in a given period on a typical weekday or weekend day (the time-based approach). Some investigations have suggested that women have a particularly difficult task in estimating time outdoors in adulthood due to their family and occupational roles. We hypothesized that people might gain additional memory cues and estimate lifetime hours spent outdoors more reliably if asked about time spent outdoors according to specific activities (an activity-based approach). Using self-administered, mailed questionnaires, test-retest responses to time-based and to activity-based approaches were evaluated in 124 volunteer radiologic technologist participants from the United States: 64 females and 60 males 48 to 80 years of age. Intraclass correlation coefficients (ICC) were used to evaluate the test-retest reliability of average number of hours spent outdoors in the summer estimated for each approach. We tested the differences between the two ICCs, corresponding to each approach, using a t test with the variance of the difference estimated by the jackknife method. During childhood and adolescence, the two approaches gave similar ICCs for average numbers of hours spent outdoors in the summer. By contrast, compared with the time-based approach, the activity-based approach showed significantly higher ICCs during adult ages (0.69 versus 0.43, P = 0.003) and over the lifetime (0.69 versus 0.52, P = 0.05); the higher ICCs for the activity-based questionnaire were primarily derived from the results for females. Research is needed to further improve the activity-based questionnaire approach for long-term sun exposure assessment.
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Affiliation(s)
- Chu-Ling Yu
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Rockville, MD 20892-7238, USA.
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Kwok RK, Linet MS, Chodick G, Kleinerman RA, Freedman DM, Fears T, Johnson RE, Alexander BH. Simplified categorization of outdoor activities for male and female U.S. indoor workers-a feasibility study to improve assessment of ultraviolet radiation exposures in epidemiologic study questionnaires. Photochem Photobiol 2008; 85:45-9. [PMID: 18643910 DOI: 10.1111/j.1751-1097.2008.00393.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Skin cancer studies depend on questionnaires to estimate exposure to ultraviolet light and subsequent risk but are limited by recall bias. We investigate the feasibility of developing a short checklist of categories comprising outdoor activities that can improve sun exposure questionnaires for use in epidemiologic studies. We recruited 124 working and retired U.S. radiologic technologists (52% women). Each subject was instructed to complete a daily activity diary, listing main indoor and outdoor activities between 9:00 A.M. and 5:00 P.M. during a 7 day period. A total of 4,697 entries were associated with 1408 h (21.1%) of the total 6,944 h spent outdoors. We were able to classify the activities into seven main activity categories: driving, yard work, home-maintenance, walking or performing errands, water activities, other recreational or sports activities and leisure activities or relaxing outside. These activities accounted for more than 94% of time spent outdoors both for working and retired men and women. Our data document the feasibility and guidance for developing a short checklist of outdoor activities for use in epidemiologic questionnaires for estimating sunlight exposures of working and retired indoor workers.
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Affiliation(s)
- Richard K Kwok
- Statistics and Epidemiology Division, RTI International, Research Triangle Park, NC, USA.
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