Outdoor artificial light at night and human health: A review of epidemiological studies

Real-ambient bedroom light at night increases systemic inflammation and disrupts circadian rhythm of inflammatory markers

BACKGROUND

Exposure to light at night (LAN) has been associated with multiple adverse health outcomes. However, evidence is limited regarding the impacts of LAN exposure on human inflammation.

OBJECTIVES

To examine the association between real-ambient bedroom LAN exposure with systemic inflammation and circadian rhythm of inflammatory markers.

METHODS

Using data from a prospective cohort study of Chinese young adults. At baseline, bedroom LAN exposure was measured with a portable illuminance meter; fasting blood sample for high-sensitivity C-reactive protein (hs-CRP) assay was collected. At 3-year follow-up, 20 healthy young adults (10 LANavg < 5 lx, 10 LANavg ≥ 5 lx) were recruited from the same cohort; time-series venous blood samples were sampled every 4 h over a 24 h-cycle for the detection of 8 inflammatory markers. Circadian rhythm of inflammatory markers was assessed using cosinor analysis.

RESULTS

At baseline, the average age of the 276 participants was 18.7 years, and 33.3 % were male. Higher levels of bedroom LAN exposure were significantly associated with increased hs-CRP levels. The association between bedroom LAN exposure and systemic inflammation was only significant in the inactive group (MVPA < 2 h/d) but not in the physically active group (MVPA ≥ 2 h/d). In addition, exposure to higher levels of nighttime light (LANavg ≥ 5 lx) disrupted circadian rhythms (including rhythmic expression, circadian amplitude and circadian phase) of some inflammatory cytokines and inflammatory balance indicators.

CONCLUSION

Exposure to bedroom nighttime light increases systemic inflammation and disrupts circadian rhythm of inflammatory markers. Keep bedroom darkness at night may represent important strategies for the prevention of chronic inflammation. Additionally, for people living a community with higher nighttime light pollution, regular physical activity may be a viable option to counteract the negative impacts of LAN exposure on chronic inflammation.

Water, Soil, Noise, and Light Pollution: JACC Focus Seminar, Part 2

Various forms of pollution carry a substantial burden with respect to increasing the risk of causing and exacerbating noncommunicable diseases, especially cardiovascular disease. The first part of this 2-part series on pollution and cardiovascular disease provided an overview of the impact of global warming and air pollution. This second paper provides an overview of the impact of water, soil, noise, and light pollution on the cardiovascular system. This review discusses the biological mechanisms underlying these effects and potential environmental biometrics of exposure. What is clear from both these pollution papers is that significant efforts and redoubled urgency are needed to reduce the sources of pollution in our environment, to incorporate environmental risk factors into medical education, to provide resources for research, and, ultimately, to protect those who are particularly vulnerable and susceptible.

Outdoor artificial light at night exposure and gestational diabetes mellitus: a case-control study

Objective

This study aims to explore the association between outdoor artificial light at night (ALAN) exposure and gestational diabetes mellitus (GDM).

Methods

This study is a retrospective case-control study. According with quantiles, ALAN has been classified into three categories (Q1-Q3). GDM was diagnosed through oral glucose tolerance tests. Conditional logistic regression models were used to evaluate the association between ALAN exposure and GDM risk. The odds ratio (OR) with 95% confidence interval (CI) was used to assess the association. Restricted cubic spline analysis (RCS) was utilized to investigate the no liner association between ALAN and GDM.

Results

A total of 5,720 participants were included, comprising 1,430 individuals with GDM and 4,290 matched controls. Pregnant women exposed to higher levels of ALAN during the first trimester exhibited an elevated risk of GDM compared to those with lower exposure levels (Q2 OR = 1.39, 95% CI 1.20-1.63, p < 0.001); (Q3 OR = 1.70, 95% CI 1.44-2.00, p < 0.001). Similarly, elevated ALAN exposure during the second trimester also conferred an increased risk of GDM (second trimester: Q2 OR = 1.70, 95% CI 1.45-1.98, p < 0.001; Q3 OR = 2.08, 95% CI 1.77-2.44, p < 0.001). RCS showed a nonlinear association between ALAN exposure and GDM risk in second trimester pregnancy, with a threshold value of 4.235.

Conclusion

Outdoor ALAN exposure during pregnancy is associated with an increased risk of GDM.

Outdoor Nighttime Light Exposure (Light Pollution) is Associated with Alzheimer's Disease

Alzheimer's disease (AD) prevalence has increased in the last century which can be attributed to increased lifespan, but environment is also important. This study evaluated the relationship between outdoor nighttime light exposure and AD prevalence in the United States. Higher outdoor nighttime light was associated with higher prevalence of AD. While atrial fibrillation, diabetes, hyperlipidemia, hypertension, and stroke were associated more strongly with AD prevalence than nighttime light intensity, nighttime light was more strongly associated with AD prevalence than alcohol abuse, chronic kidney disease, depression, heart failure, and obesity. Startlingly, nighttime light exposure more strongly associated with AD prevalence in those under the age of 65 than any other disease factor examined. These data indicate a need to investigate how nighttime light exposure influences AD pathogenesis.

Association between urbanization and metabolic syndrome in low- and middle-income countries: A systematic review and meta-analysis

AIMS

The prevalence of metabolic syndrome (MetS) is on the rise in an increasingly urbanized world. The study aimed to review the association between urbanization and MetS in low- and middle-income countries (LMICs).

DATA SYNTHESIS

A comprehensive search of five databases (MEDLINE, Web of Science, Scopus, EMBASE, and CENTRAL) was performed in January 2022 and updated in October 2022. Peer-reviewed studies that met the eligibility selection criteria were included. Search terms were used for the main concepts which are MetS, dietary patterns, and urbanization in LMICs. Study selection was done in two stages and in duplicate. Random effects models were used to calculate the overall pooled prevalence and main study-level characteristics. Out of 9,773 identified studies, nineteen were included in the systematic review and meta-analysis. The studies were done on 313,644 participants (149,616 urban and 164,028 rural). The pooled risk ratio (RR, 95% confidence interval) of MetS between urban and rural dwellers was RR = 1.24; 95%CI [1.15, 1.34] (I2 = 96.0%, P < 0.0001). A relatively higher prevalence of MetS among urban than rural residents has been observed, especially with the International Diabetes Federation criteria (RR = 1.54; 95%CI [1.21, 1.96]; I2 = 65.0%), and in the population in India (RR = 2.19; 95%CI = 1.24, 3.88, I2 = 85%). Overall, the role of dietary patterns in the development of MetS was inconsistent, and few studies showed a lower risk of MetS with adherence to recommended healthy dietary patterns.

CONCLUSIONS

There was an association between urbanization and the high prevalence of MetS. Interventions and policies to reduce the risk of MetS are needed.

Associations of nighttime light exposure during pregnancy with maternal and neonatal gut microbiota: A cohort study

BACKGROUND

Nighttime light (NTL) pollution has been reported as a risk factor for human health. However, the relationship between NTL and gut microbiota has not been reported in pregnant women and neonates. This study was conducted to investigate the relationship between NTL and gut microbial diversity and composition in mothers and their neonates.

METHODS

This study analyzed 44 mothers and 28 newborns. The composition of gut microbiota was evaluated using 16S rRNA V3-V4 sequencing. The monthly mean NTL exposure during pregnancy was respectively calculated based on each participant's residential address (NTLpoint) and a concentric 1 km radius buffer zone around their address (NTL1000m). The relationships between NTL exposure and gut microbiota of mothers and newborns were assessed using generalized linear models.

RESULTS

NTL exposure during pregnancy was not associated with alpha diversity of mothers or neonates. For mothers, results revealed that after adjusting for covariates, NTLpoint was negatively correlated with Prevotella_2 (p = 0.004, FDR-adjusted p = 0.030) and norank_o__Gastranaerophilales (p = 0.018, FDR-adjusted p = 0.049) at the genus level. In addition, Lachnospira (p = 0.036, FDR-adjusted p = 0.052) and Coprococcus_3 (p = 0.025, FDR-adjusted p = 0.052) were positively correlated with NTLpoint. The association between Coprococcus_3 (p = 0.01, FDR-adjusted p = 0.046) and NTLpoint persisted even after controlling for covariates. For neonates, Thauera was positively associated with NTLpoint (p = 0.015) and NTL1000m (p = 0.028), however, after adjusting for covariates and FDR correction, Thauera was not significantly associated with NTLpoint and NTL1000m.

CONCLUSIONS

This study found that NTL exposure was associated with maternal gut microbiota composition. Our findings provide a foundation for the potential impact of NTL exposure on maternal gut microbiota from a microbiological perspective. More population-based validation of the effects of NTL exposure on human gut microbiota is needed in future.

Night shift work, sleep duration and endometrial cancer risk: A pooled analysis from the Epidemiology of Endometrial Cancer Consortium (E2C2)

Data on the role of circadian related factors in the etiology of endometrial cancer are scarce. We collected individual data on night shift work or daily sleep duration from 7,207 cases and 22,027 controls participating in 11 studies from the Epidemiology of Endometrial Cancer Consortium (E2C2). Main analyses were performed among postmenopausal women: 6,335 endometrial cancer cases and 18,453 controls. Using individual data, study-specific odd ratios (ORs) and their corresponding 95% confidence intervals (CIs) were estimated with logistic regression and pooled analyses were conducted using random-effects meta-analyses. A non-significant inverse association was observed between endometrial cancer and night shift work (OR=0.89, 95%CI=0.72-1.09; I2=0.0%, Pheterogeneity=0.676). Associations did not vary by shift type (permanent or rotating), or duration of night work. Categorizations of short (<7h) or long (≥9h) sleep duration were not associated with endometrial cancer risk (ORshort=1.02, 95%CI=0.95-1.10; I2=55.3%, Pheterogeneity=0.022; ORlong=0.93, 95%CI=0.81-1.06; I2=11.5%, Pheterogeneity=0.339). No associations were observed per 1-h increment of sleep (OR=0.98, 95%CI=0.95-1.01; I2=46.1%, Pheterogeneity=0.063), but an inverse association was identified among obese women (OR=0.93, 95%CI=0.89-0.98 per 1-h increment; I2=12.7%, Pheterogeneity=0.329). Overall, these pooled analyses provide evidence that night shift work and sleep duration are not strong risk factors for endometrial cancer in postmenopausal women.

Outdoor artificial light at night and risk of early-onset dementia: A case-control study in the Modena population, Northern Italy

Background

Dementia is a neurological syndrome characterized by severe cognitive impairment with functional impact on everyday life. It can be classified as young onset dementia (EOD) in case of symptom onset before 65, and late onset dementia (LOD). The purpose of this study is to assess the risk of dementia due to light pollution, and specifically outdoor artificial light at night (LAN).

Methods

Using a case-control design, we enrolled dementia patients newly-diagnosed in the province of Modena in the period 2017-2019 and a referent population from their caregivers. We geo-referenced the address of residence on the date of recruitment, provided it was stable for the previous five years. We assessed LAN exposure through 2015 nighttime luminance satellite images from the Visible Infrared Imaging Radiometer Suite (VIIRS). Using a logistic regression model adjusted for age, sex, and education, we calculated the risk of dementia associated with increasing LAN exposure, namely using <10 nW/cm²/sr as reference and considering ≥10-<40 nW/cm²/sr intermediate and ≥40 nW/cm²/sr high exposure, respectively We also implemented non-linear assessment using a spline regression model.

Results

We recruited 58 EOD cases, 34 LOD cases and 54 controls. Average LAN exposure levels overlapped for EOD cases and controls, while LOD cases showed higher levels. Compared with the lowest exposure, the risk of EOD associated with LAN was higher in the intermediate exposure (OR = 1.36, 95% CI 0.54-3.39), but not in the high exposure category (OR = 1.04, 95% CI 0.32-3.34). In contrast, the risk of LOD was positively associated with LAN exposure, with ORs of 2.58 (95% CI 0.26-25.97) and 3.50 (95% CI 0.32-38.87) in the intermediate and high exposure categories, respectively. The spline regression analysis showed substantial lack of association between LAN and EOD, while almost linear although highly imprecise association emerged for LOD.

Conclusions

Although the precision of the estimates was affected by the limited sample size and the study design did not allow us to exclude the presence of residual confounding, these results suggest a possible role of LAN in the etiology of dementia, particularly of its late-onset form.

Reducing nighttime light exposure in the urban environment to benefit human health and society

Nocturnal light pollution can have profound effects on humans and other organisms. Recent research indicates that nighttime outdoor lighting is increasing rapidly. Evidence from controlled laboratory studies demonstrates that nocturnal light exposure can strain the visual system, disrupt circadian physiology, suppress melatonin secretion, and impair sleep. There is a growing body of work pointing to adverse effects of outdoor lighting on human health, including the risk of chronic diseases, but this knowledge is in a more nascent stage. In this Review, we synthesize recent research on the context-specific factors and physiology relevant to nocturnal light exposure in relation to human health and society, identify critical areas for future research, and highlight recent policy steps and recommendations for mitigating light pollution in the urban environment.

Indoor Environmental Comfort Assessment of Traditional Folk Houses: A Case Study in Southern Anhui, China

Due to the unique geographical location and historical culture, the traditional houses in the southern region of Anhui Province, China (South Anhui) have different indoor environments. In summer and winter, this study adopted a field survey, questionnaire survey, and statistical analysis to carry out a comprehensive field survey on Xixinan Village in South Anhui, and selected a typical traditional residence in the village to evaluate its indoor environment status. The final results show that the overall indoor environment of the traditional houses in South Anhui was awful, including the indoor thermal environment, with high temperature and humidity in summer and cold and humidity in winter. Additionally, the indoor light environment with dim light still had much room for improvement, while the indoor air quality and sound environment were relatively excellent. In addition, this study determined that the neutral temperatures of residents are 15.5 °C and 28.7 °C in winter and summer, respectively, and the comfort range of indoor light intensity is 752.6-1252.5 lx, which determines the adjustment range of indoor environmental parameters for residents' comfort needs. This paper's research methods and results provide a reference for the study of residential indoor environments in other regions with similar climatic conditions as South Anhui, and a theoretical basis for architects and engineers to enhance the indoor environment of traditional houses in this region.