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Ma S, Alsabawi Y, El-Serag HB, Thrift AP. Exposure to Light at Night and Risk of Cancer: A Systematic Review, Meta-Analysis, and Data Synthesis. Cancers (Basel) 2024; 16:2653. [PMID: 39123381 PMCID: PMC11311462 DOI: 10.3390/cancers16152653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2024] [Revised: 07/09/2024] [Accepted: 07/16/2024] [Indexed: 08/12/2024] Open
Abstract
BACKGROUND Emerging interest surrounds the role of environmental factors, notably exposure to light at night (LAN), as a potential cause of cancer. The aim of this study was to conduct a systematic review and, if possible, meta-analysis of observational studies on LAN and cancer risk of multiple types. METHODS A systematic literature search in PubMed, Web of Science, and Embase, spanning from inception to May 2023, was conducted. Studies focusing on the association between LAN exposure and cancer risk in adult populations were included. We used random effects models to calculate pooled risk estimates (RR) and 95% confidence intervals (CI). We assessed study quality using the Risk of Bias in Non-randomized Studies of Interventions. RESULTS Among 8492 initially identified studies, 26 met the inclusion criteria (13 were case-control and 13 were cohort studies). These studies were published from 2001 to 2023 and assessed diverse cancer types in North America, Asia, Europe, and Australia. Except for breast cancer, there was a paucity of site-specific cancer studies. In the meta-analysis of 19 breast cancer studies, higher exposure to indoor (summary RR, 1.08; 95% CI 1.01-1.15) and outdoor (summary RR, 1.10; 95% CI, 1.04-1.15) LAN were associated with increased risk. After excluding one low-quality study, the results were unchanged. CONCLUSIONS We found a positive association between LAN exposure and breast cancer risk in women. However, data are lacking for other cancer types, and further studies are required to better understand the role of LAN on cancer.
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Affiliation(s)
- Samuel Ma
- School of Medicine, Baylor College of Medicine, Houston, TX 77030, USA;
| | - Yossef Alsabawi
- School of Medicine, University of Texas Rio Grande Valley, Edinburg, TX 78539, USA;
| | - Hashem B El-Serag
- Section of Gastroenterology and Hepatology, Department of Medicine, Baylor College of Medicine, Houston, TX 77030, USA;
- Veterans Affairs Health Services Research and Development Service Center for Innovations in Quality, Effectiveness, and Safety (IQuESt), Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX 77030, USA
| | - Aaron P Thrift
- Section of Epidemiology and Population Sciences, Department of Medicine, Baylor College of Medicine, Houston, TX 77030, USA
- Dan L Duncan Comprehensive Cancer Center, Baylor College of Medicine, Houston, TX 77030, USA
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Fang L, Ma C, Wang G, Peng Y, Zhao H, Chen Y, Ma Y, Cai G, Cao Y, Pan F. Outdoor Artificial Light at Night and Reproductive Endocrine and Glucose Homeostasis and Polycystic Ovary Syndrome in Women of Reproductive Age. Epidemiology 2024; 35:559-567. [PMID: 38534181 DOI: 10.1097/ede.0000000000001736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/28/2024]
Abstract
BACKGROUND Artificial light at night, a well-recognized circadian clock disrupter, causes disturbances in endocrine homeostasis. However, the association of artificial light at night with polycystic ovary syndrome (PCOS) is still unknown. This study examines the effects of outdoor artificial light at night on sex hormones, glucose homeostasis markers, and PCOS prevalence in Anhui Province, China. METHODS We recruited 20,633 women of reproductive age from Anhui Medical University Reproductive Medicine Center. PCOS was diagnosed according to Rotterdam criteria. We estimated long-term (previous year) and short-term (previous month) artificial light at night values for residential addresses using 500 m resolution satellite imagery. We fitted multivariable models, using both linear and logistic regression, to estimate the association of artificial light at night with sex hormones, glucose homeostasis markers, and PCOS prevalence. RESULTS Both long-term and short-term exposure to outdoor artificial light at night were negatively associated with follicle-stimulating hormone and luteinizing hormone levels, while positively associated with testosterone, fasting insulin, homeostasis model assessment-insulin resistance, and homeostasis model assessment-insulin resistance-β levels. The second-highest quintile of artificial light at night was associated with increased PCOS prevalence (odds ratio [OR long-term ] = 1.4; 95% confidence interval [CI] = 1.2, 1.6 and OR short-term = 1.3; 95% CI = 1.1, 1.5) compared with the lowest quintile. In addition, prevalence of PCOS was linearly associated with long-term exposure to artificial light at night, but nonlinearly associated with short-term exposure. This association was more evident in younger, obese or overweight, moderately educated, rural women, and for the summer and fall seasons. CONCLUSION Outdoor artificial light at night may be a novel risk factor for PCOS.
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Affiliation(s)
- Lanlan Fang
- From the Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, China
- The Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Anhui Medical University, Hefei, China
| | - Cong Ma
- Department of Obstetrics and Gynecology, the First Affiliated Hospital of Anhui Medical University, Hefei, China
- NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Anhui Medical University, Hefei, China
| | - Guosheng Wang
- From the Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, China
- The Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Anhui Medical University, Hefei, China
| | - Yongzhen Peng
- From the Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, China
- The Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Anhui Medical University, Hefei, China
| | - Hui Zhao
- From the Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, China
- The Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Anhui Medical University, Hefei, China
| | - Yuting Chen
- From the Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, China
- The Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Anhui Medical University, Hefei, China
| | - Yubo Ma
- From the Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, China
- The Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Anhui Medical University, Hefei, China
| | - Guoqi Cai
- From the Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, China
- The Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Anhui Medical University, Hefei, China
| | - Yunxia Cao
- Department of Obstetrics and Gynecology, the First Affiliated Hospital of Anhui Medical University, Hefei, China
- NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Anhui Medical University, Hefei, China
| | - Faming Pan
- From the Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, China
- The Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Anhui Medical University, Hefei, China
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Kim SH, Kim YK, Shin YI, Kang G, Kim SP, Lee H, Hong IH, Chang IB, Hong SB, Yoon HJ, Ha A. Nighttime Outdoor Artificial Light and Risk of Age-Related Macular Degeneration. JAMA Netw Open 2024; 7:e2351650. [PMID: 38227312 DOI: 10.1001/jamanetworkopen.2023.51650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2024] Open
Abstract
Importance Light pollution's impact on human health is increasingly recognized, but its link to exudative age-related macular degeneration (EAMD) remains unclear. Objective To investigate the association between exposure to outdoor artificial light at night (OALAN) and the risk of incident EAMD. Design, Setting, and Participants In this nationwide population-based case-control study, all individuals 50 years or older with newly diagnosed EAMD between January 1, 2010, and December 31, 2011, were identified with reference to the Korean National Health Insurance Service registration program database for rare and intractable diseases. Birth year- and sex-matched controls (with no EAMD diagnosis until 2020) were selected at a 1:30 ratio. Data were acquired from May 1 to December 31, 2021, and analyzed from June 1 to November 30, 2022. Exposures Mean levels of OALAN at participants' residential addresses during 2008 and 2009 were estimated using time-varying satellite data for a composite view of persistent nighttime illumination at an approximate scale of 1 km2. Main Outcomes and Measures The hazard ratios (HRs) and 95% CIs of the association between residential OALAN and risk of incident EAMD were determined based on maximum likelihood estimation after adjusting for sociodemographic characteristics, comorbidities, and area-level risk factors (ie, nighttime traffic noise and particulate matter of aerodynamic diameter ≤10 μm in each participant's administrative district of residence). Results A total of 126 418 participants were included in the analysis (mean [SD] age, 66.0 [7.9] years; 78 244 men [61.9%]). Of these, 4078 were patients with newly diagnosed EAMD and 122 340 were EAMD-free matched controls. In fully adjusted models, an IQR (55.8 nW/cm2/sr) increase in OALAN level was associated with an HR of 1.67 (95% CI, 1.56-1.78) for incident EAMD. The exposure-response curve demonstrated a nonlinear, concave upward slope becoming more pronounced at higher levels of light exposure (ie, at approximately 110 nW/cm2/sr). In a subgroup analysis, an IQR increase in OALAN was associated with increased risk of incident EAMD in urban areas (HR, 1.46 [95% CI, 1.33-1.61]) but not in rural areas (HR, 1.01 [95% CI, 0.84-1.22]). Conclusions and Relevance In this nationwide population-based case-control study, higher levels of residential OALAN were associated with an increased risk of incident EAMD. Future studies with more detailed information on exposure, individual adaptive behaviors, and potential mediators are warranted.
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Affiliation(s)
- Su Hwan Kim
- Biomedical Research Institute, Seoul National University Hospital (SNUH), Seoul, Korea
| | - Young Kook Kim
- Department of Ophthalmology, SNUH, Seoul, Korea
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Korea
- EyeLight Data Science Laboratory, Seoul National University College of Medicine, Seoul, Korea
| | - Young In Shin
- Department of Ophthalmology, SNUH, Seoul, Korea
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Korea
| | - Goneui Kang
- EyeLight Data Science Laboratory, Seoul National University College of Medicine, Seoul, Korea
| | - Seong Pyo Kim
- Interdisciplinary Program of Medical Informatics, Seoul National University College of Medicine, Seoul, Korea
| | - Hajoung Lee
- EyeLight Data Science Laboratory, Seoul National University College of Medicine, Seoul, Korea
| | - In Hwan Hong
- Department of Ophthalmology, Dongtan Sacred Heart Hospital, Hwaseong, Korea
- Department of Ophthalmology, Hallym University Medical Center, Hwaseong, Korea
| | | | - Soon-Beom Hong
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Korea
- Department of Psychiatry, SNUH, Seoul, Korea
- Institute of Human Behavioral Medicine, SNU Medical Research Center, Seoul, Korea
| | - Hyung-Jin Yoon
- Medical Bigdata Research Center, SNU College of Medicine, Seoul, Korea
| | - Ahnul Ha
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Korea
- Department of Ophthalmology, Jeju National University Hospital, Jeju, Korea
- Department of Ophthalmology, Jeju National University College of Medicine, Jeju, Korea
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Luo Z, Liu Z, Chen H, Liu Y, Tang N, Li H. Light at night exposure and risk of breast cancer: a meta-analysis of observational studies. Front Public Health 2023; 11:1276290. [PMID: 38106885 PMCID: PMC10722424 DOI: 10.3389/fpubh.2023.1276290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Accepted: 11/01/2023] [Indexed: 12/19/2023] Open
Abstract
Objective The aim of this meta-analysis is to evaluate the impact of light at night (LAN) exposure on the risk of breast cancer across varying factors. Method We conducted a systematic search of literature up to July 15, 2023, including PubMed, Cochrane Library, and Embase databases, using keywords related to breast cancer and LAN exposure. Cohort study and case-control study literature on night light exposure and breast cancer risk were included. Statistical analyses were performed using Stata software version 17.0. To address heterogeneity among different studies, we employed a random-effects model for analysis and assessed publication bias using funnel plots and Egger's test. Results We included 13 case-control and 8 cohort studies with 734,372 participants worldwide. In the Newcastle-Ottawa Scale (NOS) assessments, the average score was 7.43 (ranging from 5 to 9). The overall meta-analysis demonstrated a significant association between exposure to LAN and risk of breast cancer (RR = 1.12; 95% CI: 1.06-1.17; I2 = 31.3%, p < 0.001). In the subgroup analysis, the results of the analysis for study types (case-control studies: RR = 1.16; 95% CI: 1.06-1.27; I2 = 40.4%, p = 0.001; cohort studies: RR = 1.08; 95% CI: 1.04-1.14; I2 = 0.0%, p < 0.001) and the results for light exposure types (outdoor LAN: RR = 1.07; 95% CI: 1.02-1.13; I2 = 30.9%, p = 0.004) are presented. In the analysis conducted for continents, the highest breast cancer risk was observed in the Asian population (Asian: RR = 1.24; 95% CI: 1.15-1.34; I2 = 0.0%, p < 0.001) and in the analysis of estrogen receptor status (ER+: RR = 1.10; 95% CI: 1.03-1.18; I2 = 17.0%, p = 0.005;). We also conducted an analysis on menopausal status and various lifestyles but did not find any statistically significant findings. Conclusion Our study demonstrates that LAN exposure is associated with an increased risk of breast cancer, particularly in the Asian population. Among the existing hypotheses, the idea that LAN exposure leads to a decrease in melatonin is widely accepted. However, until the mechanism of this effect is clearly elucidated, it is not recommended to take melatonin supplements for breast cancer prevention without medical advice. We hope to conduct more high-quality research, especially concerning the investigation of other environmental confounding factors, to further advance this field.
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Affiliation(s)
| | | | | | - Ying Liu
- *Correspondence: Zhenglong Liu, : Ying Liu,
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Liang X, Wang Z, Cai H, Zeng YQ, Chen J, Wei X, Dong G, Huang Y, Lao XQ. Outdoor light at night and mortality in the UK Biobank: a prospective cohort study. Occup Environ Med 2023:oemed-2023-109036. [PMID: 38053269 DOI: 10.1136/oemed-2023-109036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Accepted: 10/12/2023] [Indexed: 12/07/2023]
Abstract
BACKGROUND More than 83% of the world's population lives under light-polluted skies while information about health effects of outdoor light at night (LAN) is limited. We examined the association of LAN with natural cause (NC) and cardiovascular disease (CVD) mortality using the UK Biobank. METHODS We included 273 335 participants recruited between 2006 and 2010. Level of LAN was estimated at each participant's address using time-varying satellite data for a composite of persistent night-time illumination at ~1 km2 scale. Information on causes of death until 12 November 2021 was obtained through record linkage. Cox proportional hazards regression was used. RESULTS In the follow-up with an average of 12.4 years, 14 864 NC and 3100 CVD deaths were identified. Compared with the participants exposed to the first quartile of LAN, participants exposed to the highest quartile showed an 8% higher risk of NC mortality (HR: 1.08, 95% CI 1.03 to 1.13) after adjusting for age, sex, social-economic status, shift work, lifestyle factors and body mass index. However, the association disappeared after further adjustment for PM2.5 and evening noise, with HRs (95% CIs) of 1.02 (0.97 to 1.07), 1.01 (0.97 to 1.06) and 1.03 (0.97 to 1.08), respectively, for the participants exposed to the second, third and fourth quartiles of LAN. No significant associations were observed between LAN and CVD mortality, either. CONCLUSIONS We did not observe significant associations of LAN with NC and CVD mortality in this large nationwide cohort. The health effects of LAN remain unclear. Further studies are warranted to address this public health concern.
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Affiliation(s)
- Xue Liang
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Zixin Wang
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Honglin Cai
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
- Department of Rehabilitation Science, the Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Yi Qian Zeng
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Jinjian Chen
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Xianglin Wei
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Guanghui Dong
- Department of Preventive Medicine, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Yu Huang
- Department of Biomedical Sciences, City University of Hong Kong, Hong Kong SAR, China
| | - Xiang Qian Lao
- Department of Biomedical Sciences, City University of Hong Kong, Hong Kong SAR, China
- School of Public Health, Zhengzhou University, Zhengzhou, China
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Shen M, Li Y, Li S, Chen X, Zou B, Lu Y. Association of exposure to artificial light at night during adolescence with blood pressure in early adulthood. Chronobiol Int 2023; 40:1419-1426. [PMID: 37818634 DOI: 10.1080/07420528.2023.2266485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Accepted: 09/28/2023] [Indexed: 10/12/2023]
Abstract
Artificial light at night (ALAN) is related to various diseases, such as cancer, obesity, and coronary heart disease. However, its impact on blood pressure in adolescents is not well understood. To investigate this, we conducted a cross-sectional study with a nationwide sample of college students in China, who were freshmen from four disperse universities during Sep. and Oct. 2018. Mean levels of ALAN at participants' residential addresses during 2013-2018 were estimated using time-varying satellite data. The association of the 6-y average of ALAN with blood pressure was estimated by using generalized linear mixed models. A total of 17 046 participants (18.2 ± 0.7 y of age, 46.79% female) from 2,412 counties and cities were included in the final analysis. After a full adjustment for potential confounders, ALAN was positively associated with systolic blood pressure (β = 0.20, p = 0.032) and pulse pressure (β = 0.28, p = 0.001), but there was no association between ALAN and diastolic blood pressure (β = -0.08, p = 0.213). In the sensitivity analysis, the results consistent with the main analysis were observed. The blood pressure of males and those with a BMI ≤24 kg/m2 were more susceptible to ALAN exposure. Our findings highlight the importance of ALAN management for blood pressure control, particularly among male and normal-weight individuals.
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Affiliation(s)
- Minxue Shen
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, China
| | - Yalan Li
- Clinical Research Center, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Shenxin Li
- Department of Surveying and Remote Sensing Science, School of Geosciences and Info-physics, Central South University, Changsha, China
| | - Xiang Chen
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, China
| | - Bin Zou
- Department of Surveying and Remote Sensing Science, School of Geosciences and Info-physics, Central South University, Changsha, China
| | - Yao Lu
- Clinical Research Center, The Third Xiangya Hospital, Central South University, Changsha, China
- Faculty of Life Sciences & Medicine, King's College London, London, UK
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Cao M, Xu T, Yin D. Understanding light pollution: Recent advances on its health threats and regulations. J Environ Sci (China) 2023; 127:589-602. [PMID: 36522088 DOI: 10.1016/j.jes.2022.06.020] [Citation(s) in RCA: 21] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 06/13/2022] [Accepted: 06/13/2022] [Indexed: 06/17/2023]
Abstract
The prevalence of artificial lights not only improves the lighting conditions for modern society, but also poses kinds of health threats to human health. Although there are regulations and standards concerning light pollution, few of them are based on the potential contribution of improper lighting to diseases. Therefore, a better understanding of the health threats induced by light pollution may promote risk assessment and better regulation of artificial lights, thereby a healthy lighting environment. This review is based on a careful collection of the latest papers from 2018 to 2022 about the health threats of light pollution, both epidemiologically and experimentally. In addition to summing up the novel associations of light pollution with obesity, mental disorders, cancer, etc., we highlight the toxicological mechanism of light pollution via circadian disruption, since light pollution directly interferes with the natural light-dark cycles, and damages the circadian photoentrainment of organisms. And by reviewing the alternations of clock genes and disturbance of melatonin homeostasis induced by artificial lights, we aim to excavate the profound impacts of light pollution based on accumulating studies, thus providing perspectives for future research and guiding relevant regulations and standards.
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Affiliation(s)
- Miao Cao
- Key Laboratory of Yangtze River Water Environment, Ministry of Education, College of Environmental Science and Engineering, Tongji University, Shanghai 200092, China
| | - Ting Xu
- Key Laboratory of Yangtze River Water Environment, Ministry of Education, College of Environmental Science and Engineering, Tongji University, Shanghai 200092, China; Shanghai Institute of Pollution Control and Ecological Security, Shanghai 200092, China.
| | - Daqiang Yin
- Key Laboratory of Yangtze River Water Environment, Ministry of Education, College of Environmental Science and Engineering, Tongji University, Shanghai 200092, China; Shanghai Institute of Pollution Control and Ecological Security, Shanghai 200092, China.
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Wang T, Kaida N, Kaida K. Effects of outdoor artificial light at night on human health and behavior: A literature review. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2023; 323:121321. [PMID: 36805469 DOI: 10.1016/j.envpol.2023.121321] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 02/16/2023] [Accepted: 02/17/2023] [Indexed: 06/18/2023]
Abstract
The quality of life of human beings has improved tremendously through improved productivity, convenience, safety, and livability due to nighttime lights that illuminate outdoor work, leisure, and mobility. Recently, however, concerns have been growing over outdoor artificial light at night (ALAN) and its effects on human beings as well as ecosystems including animals and plants. This literature review aims to deliver a critical overview of the findings and the areas for future research on the effects of outdoor ALAN on human health and behaviors. Through a narrative literature review, we found that scientific research crucially lacks studies on the effects of outdoor ALAN on human behaviors and health, including social interaction, which may be more widespread compared to what is recognized so far. This review also highlights the importance of investigating the causal and complex relationships between outdoor ALAN, health, and behaviors with sleep as a key mediating factor. We elucidate that outdoor ALAN has both positive and negative effects on human life. Therefore, it is important for societies to be able to access facts and evidence about these effects to plan, agree to, and realize the optimal usage of nighttime lighting that balances its merits and demerits. Researchers in related areas of study must investigate and deliver the science of outdoor ALAN to various stakeholders, such as citizens, policymakers, urban and landscape planners, relevant practitioners, and industries. We believe that our review improves the understanding of outdoor ALAN in relation to human life and contributes to sustainable and thriving societies.
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Affiliation(s)
- Tongyu Wang
- Graduate School of Systems and Information Engineering, University of Tsukuba, Japan; Institute for Information Technology and Human Factors, National Institute of Advanced Industrial Science and Technology (AIST), Japan.
| | - Naoko Kaida
- Institute of Systems and Information Engineering, University of Tsukuba, Japan; Institute for Information Technology and Human Factors, National Institute of Advanced Industrial Science and Technology (AIST), Japan.
| | - Kosuke Kaida
- Institute for Information Technology and Human Factors, National Institute of Advanced Industrial Science and Technology (AIST), Japan.
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Bożejko M, Tarski I, Małodobra-Mazur M. Outdoor artificial light at night and human health: A review of epidemiological studies. ENVIRONMENTAL RESEARCH 2023; 218:115049. [PMID: 36521545 DOI: 10.1016/j.envres.2022.115049] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/12/2022] [Revised: 11/24/2022] [Accepted: 12/10/2022] [Indexed: 06/17/2023]
Abstract
We conducted a non-systematic review of epidemiological studies on a potential link between exposure to outdoor artificial light at night (O-ALAN) and disease occurrence in humans published since 2009. In recent years, a number of presses have been published on this issue, but the conclusions have been mixed. We therefore decided to critically analyze the available epidemiological evidence of such a correlation. After a careful search, 51 studies were identified and included in the review. They addressed the potential link between O-ALAN exposure and the incidence of breast cancer, other cancers, sleep and circadian rhythm disorders, obesity and cardiovascular diseases, mental disorders, infectious diseases, and complications during pregnancy and childbirth. The vast majority of papers revealed the existence of such a link. However, the amount of epidemiological evidence supporting the correlation across groups of disorders varied widely. In addition, we found that all papers contained at least one of the following omissions: lack of the temporal and spatial resolution in light at night measurements, measuring only light intensity without considering its wavelength, and not accounting for many important confounding factors in their statistical analyses. Therefore, we believe that the link between O-ALAN exposure and the occurrence of the disorders in question suggested by the authors of the reviewed papers may be in some cases at least to some extent, a coincidence. Further epidemiological studies, free of significant omissions highlighted in this paper, are needed.
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Affiliation(s)
- Mateusz Bożejko
- Faculty of Medicine, Wroclaw Medical University, Mikulicza-Radeckiego 5, 50-345, Wrocław, Poland.
| | - Ignacy Tarski
- Faculty of Medicine, Wroclaw Medical University, Mikulicza-Radeckiego 5, 50-345, Wrocław, Poland.
| | - Małgorzata Małodobra-Mazur
- Department of Forensic Medicine, Division of Molecular Techniques, Wroclaw Medical University, Skłodowskiej-Curie 52, 50-369, Wrocław, Poland.
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Xu YX, Zhang JH, Tao FB, Sun Y. Association between exposure to light at night (LAN) and sleep problems: A systematic review and meta-analysis of observational studies. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 857:159303. [PMID: 36228789 DOI: 10.1016/j.scitotenv.2022.159303] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/20/2022] [Revised: 10/03/2022] [Accepted: 10/04/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Accumulating evidence have investigated the effects of nighttime light exposure on sleep problems. Nevertheless, the evidence of the relationship between light at night (LAN) and sleep problems remains scarce and inconsistent. OBJECTIVE Conducted a systematic review and meta-analysis based on observational studies to examine the association between LAN exposure and sleep problems among human subjects. METHODS We systematically searched three databases (PubMed, Web of Science, and Embase) to identify potentially eligible studies through May 25, 2022. The risk of bias and the quality of the generated evidence were assessed by two authors using the National Toxicology Program's Office of Health Assessment and Translation (OHAT) risk of bias rating tool and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) guideline. Random-effects model was applied to synthesize the risk estimates across eligible studies. The heterogeneity of included studies was quantified by the statistics of I2. RESULTS A total of 7 cross-sectional studies comprising 577,932 participants were included. Individuals with higher levels of LAN exposure were associated with a 22 % (Summary Odds Ratio, SOR: 1.22, 95 %CI: 1.13-1.33) increased prevalence of sleep problems. The pooled effect size of indoor LAN exposure (SOR: 1.74, 95%CI: 1.27-2.37) associated with sleep problems was significantly higher than outdoor LAN exposure (SOR: 1.19, 95%CI: 1.11-1.29; P = 0.022). Additionally, dose-response analysis demonstrated that LAN intensity threshold exceeding 5.8 nW/cm2/sr (SOR: 1.04, 95%CI: 1.01-1.07) had a significant effect on sleep problems and the prevalence of sleep problems was increasing with increase in LAN intensity. CONCLUSIONS Overall, our findings support the detrimental effects of LAN exposure on sleep. Maintaining bedroom darkness at night may be a feasible measure to reduce the prevalence of sleep problems. Future longitudinal studies with more advanced LAN assessment methods are required to move the field forward.
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Affiliation(s)
- Yu-Xiang Xu
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, Anhui, China
| | - Jiang-Hui Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei 230032, China
| | - Fang-Biao Tao
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, Anhui, China; Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No 81 Meishan Road, Hefei 230032, Anhui, China; Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, No 81 Meishan Road, Hefei 230032, Anhui, China
| | - Ying Sun
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, Anhui, China; Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No 81 Meishan Road, Hefei 230032, Anhui, China; Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, No 81 Meishan Road, Hefei 230032, Anhui, China.
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11
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Chen Y, Tan J, Liu Y, Dong GH, Yang BY, Li N, Wang L, Chen G, Li S, Guo Y. Long-term exposure to outdoor light at night and mild cognitive impairment: A nationwide study in Chinese veterans. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 847:157441. [PMID: 35863567 DOI: 10.1016/j.scitotenv.2022.157441] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Revised: 07/01/2022] [Accepted: 07/13/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Evidence is limited for the association between outdoor light at night (LAN) and mild cognitive impairment (MCI), a transitional stage between normal aging and dementia and Alzheimer's disease in the elderly. In this study, the association between outdoor LAN and MCI was examined based on a multi-city study among veterans in China. METHODS A total of 5496 participants from 18 cities across China were investigated during 2009-2011, selected using a multi-stage random sampling method. Participants' cognitive function was firstly assessed using the Mini Mental State Examination and the Montreal Cognitive Assessment in the Chinese version, and then was further confirmed by clinical examination. Participants' exposure to outdoor LAN was estimated using the Global Radiance Calibrated Nighttime Lights Product at a spatial resolution of around 1 km. The mixed-effects logistic regression model was used to examine the association between outdoor LAN and MCI. RESULTS After controlling for covariates, odds ratio (OR) and 95 % confidence intervals (95%CI) of MCI was 1.44 (95%CI: 1.36, 1.52) associated with per interquartile range (IQR = 21.17 nW/cm2/sr) increase in exposure to outdoor LAN during the 3 years before the investigation, and for categorical variable of LAN, the highest OR was observed for the highest against the lowest quartile of LAN with a monotonically increasing trend (p values for trend <0.001). Furthermore, higher ORs were observed for females, veterans who had less educational attainment, and had no regular social activities. CONCLUSIONS Our study revealed that exposure to excessive outdoor LAN was associated with higher risk of MCI. Effective measures should be taken to reduce LAN exposure, which may help to prevent MCI.
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Affiliation(s)
- Yan Chen
- Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Jiping Tan
- Geriatric Neurology Department of the Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, China
| | - Yuewei Liu
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Guang-Hui Dong
- Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Bo-Yi Yang
- Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Nan Li
- Research Center of Clinical Epidemiology, Peking University Third Hospital, Beijing, China
| | - Luning Wang
- Geriatric Neurology Department of the Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, China.
| | - Gongbo Chen
- Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China.
| | - Shanshan Li
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Yuming Guo
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
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12
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Sweeney MR, Nichols HB, Jones RR, Olshan AF, Keil AP, Engel LS, James P, Jackson CL, Sandler DP, White AJ. Light at night and the risk of breast cancer: Findings from the Sister study. ENVIRONMENT INTERNATIONAL 2022; 169:107495. [PMID: 36084405 PMCID: PMC9561075 DOI: 10.1016/j.envint.2022.107495] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Revised: 08/19/2022] [Accepted: 08/29/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Light at night (LAN) may alter estrogen regulation through circadian disruption. High levels of outdoor LAN may increase breast cancer risk, but studies have largely not considered possible residual confounding from correlated environmental exposures. We evaluated the association between indoor and outdoor LAN and incident breast cancer. METHODS In 47,145 participants in the prospective Sister Study cohort living in the contiguous U.S., exposure to outdoor LAN was determined using satellite-measured residential data and indoor LAN was self-reported (light/TV on, light from outside the room, nightlight, no light). We used Cox proportional hazards models to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) for the associations between outdoor and indoor LAN and breast cancer risk. Models were adjusted for age, race/ethnicity, educational attainment, annual household income, neighborhood disadvantage, latitude, and population density as a proxy for urbanicity. To evaluate the potential for residual confounding of the outdoor LAN and breast cancer relationship by factors associated with urbanicity, we considered further adjustment for exposures correlated with outdoor LAN including NO2 [Spearman correlation coefficient, rho (ρ) = 0.78], PM2.5 (ρ = 0.36), green space (ρ = - 0.41), and noise (ρ = 0.81). RESULTS During 11 years of follow-up, 3,734 breast cancer cases were identified. Outdoor LAN was modestly, but non-monotonically, associated with a higher risk of breast cancer (Quintile 4 vs 1: HR = 1.10, 95% CI: 0.99-1.22; Quintile 5 vs 1: HR = 1.04, 95% CI: 0.93-1.16); however, no association was evident after adjustment for correlated ambient exposures (Quintile 4 vs 1: HR = 0.99, 95% CI: 0.86-1.14; Quintile 5 vs 1: HR = 0.89, 95% CI: 0.74-1.06). Compared to those with no indoor LAN exposure, sleeping with a light or TV on was associated with a HR = 1.09 (95% CI: 0.97-1.23) in the adjusted model. CONCLUSIONS Outdoor LAN does not appear to increase the risk of breast cancer after adjustment for correlated environmental exposures.
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Affiliation(s)
- Marina R Sweeney
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA; Epidemiology Branch, National Institute of Environmental Health Sciences, Durham, NC, USA
| | - Hazel B Nichols
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - Rena R Jones
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
| | - Andrew F Olshan
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - Alexander P Keil
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - Lawrence S Engel
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - Peter James
- Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA; Department of Environmental Health, Harvard TH Chan School of Public Health, Boston, MA, USA
| | - Chandra L Jackson
- Epidemiology Branch, National Institute of Environmental Health Sciences, Durham, NC, USA; Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, USA
| | - Dale P Sandler
- Epidemiology Branch, National Institute of Environmental Health Sciences, Durham, NC, USA
| | - Alexandra J White
- Epidemiology Branch, National Institute of Environmental Health Sciences, Durham, NC, USA.
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13
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Urbano T, Vinceti M, Wise LA, Filippini T. Light at night and risk of breast cancer: a systematic review and dose-response meta-analysis. Int J Health Geogr 2021; 20:44. [PMID: 34656111 PMCID: PMC8520294 DOI: 10.1186/s12942-021-00297-7] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Accepted: 10/01/2021] [Indexed: 12/13/2022] Open
Abstract
Breast cancer is the most common malignancy in women and the second leading cause of cancer death overall. Besides genetic, reproductive, and hormonal factors involved in disease onset and progression, greater attention has focused recently on the etiologic role of environmental factors, including exposure to artificial lighting such as light-at-night (LAN). We investigated the extent to which LAN, including outdoor and indoor exposure, affects breast cancer risk. We performed a systematic review of epidemiological evidence on the association between LAN exposure and breast cancer risk, using a dose–response meta-analysis to examine the shape of the relation. We retrieved 17 eligible studies through September 13, 2021, including ten cohort and seven case–control studies. In the analysis comparing highest versus lowest LAN exposure, we found a positive association between exposure and disease risk (risk ratio [RR] 1.11, 95% confidence interval-CI 1.07–1.15), with comparable associations in case–control studies (RR 1.14, 95% CI 0.98–1.34) and cohort studies (RR 1.10, 95% CI 1.06–1.15). In stratified analyses, risk was similar for outdoor and indoor LAN exposure, while slightly stronger risks were observed for premenopausal women (premenopausal: RR 1.16, 95% CI 1.04–1.28; postmenopausal: 1.07, 95% CI 1.02–1.13) and for women with estrogen receptor (ER) positive breast cancer (ER + : RR 1.09, 95% CI 1.02–1.17; ER–: RR 1.07, 95% CI 0.92–1.23). The dose–response meta-analysis, performed only in studies investigating outdoor LAN using comparable exposure assessment, showed a linear relation up to 40 nW/cm2/sr after which the curve flattened, especially among premenopausal women. This first assessment of the dose–response relation between LAN and breast cancer supports a positive association in selected subgroups, particularly in premenopausal women.
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Affiliation(s)
- Teresa Urbano
- CREAGEN - Environmental, Genetic and Nutritional Epidemiology Research Center, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Marco Vinceti
- CREAGEN - Environmental, Genetic and Nutritional Epidemiology Research Center, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy. .,Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA.
| | - Lauren A Wise
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
| | - Tommaso Filippini
- CREAGEN - Environmental, Genetic and Nutritional Epidemiology Research Center, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
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14
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McIsaac MA, Sanders E, Kuester T, Aronson KJ, Kyba CCM. The impact of image resolution on power, bias, and confounding: A simulation study of ambient light at night exposure. Environ Epidemiol 2021; 5:e145. [PMID: 33870017 PMCID: PMC8043729 DOI: 10.1097/ee9.0000000000000145] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Accepted: 02/22/2021] [Indexed: 11/26/2022] Open
Abstract
Studies of the impact of environmental pollutants on health outcomes can be compromised by mismeasured exposures or unmeasured confounding with other environmental exposures. Both problems can be exacerbated by measuring exposure from data sources with low spatial resolution. Artificial light at night, for example, is often estimated from low-resolution satellite images, which may result in substantial measurement error and increased correlation with air or noise pollution. METHODS Light at night exposure was considered in simulated epidemiologic studies in Vancouver, British Columbia. First, we assessed statistical power and bias for hypothetical studies that replaced true light exposure with estimates from sources with low resolution. Next, health status was simulated based on pollutants other than light exposure, and we assessed the frequency with which studies might incorrectly attribute negative health impacts to light exposure as a result of unmeasured confounding by the other environmental exposures. RESULTS When light was simulated to be the causal agent, studies relying on low-resolution data suffered from lower statistical power and biased estimates. Additionally, correlations between light and other pollutants increased as the spatial resolution of the light exposure map decreased, so studies estimating light exposure from images with lower spatial resolution were more prone to confounding. CONCLUSIONS Studies estimating exposure to pollutants from data with lower spatial resolution are prone to increased bias, increased confounding, and reduced power. Studies examining effects of light at night should avoid using exposure estimates based on low-resolution maps, and should consider potential confounding with other environmental pollutants.
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Affiliation(s)
- Michael A. McIsaac
- School of Mathematical and Computational Sciences, University of Prince Edward Island, Charlottetown, PEI, Canada
- Department of Public Health Sciences, Queen’s University, Kingston, ON, Canada
| | - Eric Sanders
- Department of Statistics, University of British Columbia, Vancouver, BC, Canada
| | - Theres Kuester
- GFZ German Research Centre for Geosciences, Potsdam, Germany
| | - Kristan J. Aronson
- Department of Public Health Sciences, Queen’s University, Kingston, ON, Canada
- Division of Cancer Care and Epidemiology, Cancer Research Institute, Queen’s University, Kingston, ON, Canada
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