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Khan S, Claeson M, Khan A, Neale R. The effect of physical activity on vitamin D: A systematic review and meta-analysis of intervention studies in humans. PUBLIC HEALTH IN PRACTICE 2024; 7:100495. [PMID: 38601179 PMCID: PMC11004199 DOI: 10.1016/j.puhip.2024.100495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2023] [Accepted: 03/27/2024] [Indexed: 04/12/2024] Open
Abstract
Objectives Cross-sectional studies demonstrate a positive association between higher physical activity and serum 25-hydroxyvitamin D (25(OH)D) concentration. However, whether this association is causal is unclear. We conducted a systematic review to identify intervention studies that examined the effect of physical activity on serum 25(OH)D concentration in humans. Study design Systematic review and meta-analysis. Methods We searched PubMed, Scopus and Web of Science to identify full-text peer-reviewed articles published in English from inception until January 2023. Eligible studies were randomised controlled trials or quasi-experimental studies. We used random effects meta-analysis to calculate the weighted mean difference (WMD) in the change in 25(OH)D concentration between physical activity and control groups. We used the revised Cochrane risk-of-bias tool for randomized trials (RoB 2) to assess the methodological quality of included studies. Results We included 32 articles in the systematic review and 24 in the meta-analysis. The intervention varied from resistance and weight-bearing exercises (n = 13) to aerobic exercises (n = 10), moderate and moderate-to-vigorous exercises (n = 5), aquatic exercise (n = 2), and multicomponent traditional exercises (n = 2) (Tai Chi and Yijinjing). The WMD in 25(OH)D in the physical activity and control groups was 9.51 and 4.87, respectively (between-group mean difference 4.64, p = 0.002). However, the difference was only evident in studies that implemented the intervention outdoors (n = 3; between-group mean difference 17.33, p < 0.0001); when the intervention was indoors there was no significant effect of physical activity on 25(OH)D (n = 16; between-group mean difference 1.80, p = 0.113). Conclusions This meta-analysis of physical activity interventions in humans showed that physical activity does not lead to increased 25(OH)D independently of time outdoors. However, most studies were under-powered, in many the exercise was low intensity, and vitamin D was not the primary outcome.
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Affiliation(s)
- S.R. Khan
- Kirby Institute, University of New South Wales, Kensington, NSW, 2052, Australia
| | - M. Claeson
- Department of Dermatology and Venereology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, 413 45, Gothenburg, Sweden
- Population Health Program, QIMR Berghofer Medical Research Institute, Herston, QLD, 4029, Australia
| | - A. Khan
- School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, QLD, 4072, Australia
| | - R.E. Neale
- Population Health Program, QIMR Berghofer Medical Research Institute, Herston, QLD, 4029, Australia
- School of Public Health, The University of Queensland, Herston, QLD, 4029 Australia
- Sunshine Coast University Hospital, Birtinya, QLD, 4575, Australia
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2
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Lashway SG, Worthen ADM, Abuasbeh JN, Harris RB, Farland LV, O'Rourke MK, Dennis LK. A meta-analysis of sunburn and basal cell carcinoma risk. Cancer Epidemiol 2023; 85:102379. [PMID: 37201363 DOI: 10.1016/j.canep.2023.102379] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 05/01/2023] [Accepted: 05/03/2023] [Indexed: 05/20/2023]
Abstract
Basal cell carcinoma (BCC) is the most common cancer in the United States. Sunburn is a modifiable risk factor for BCC. The objective of this project was to synthesize research on BCC and sunburn to quantify the impact and severity of sunburn at different life stages on BCC risk in the general population. A systematic literature search of four electronic databases was conducted and data were extracted by two independent reviewers using standardized forms. Data from 38 studies were pooled using both dichotomous and dose-response meta-analytic methods. BCC risk increased with ever experiencing a sunburn in childhood (OR=1.43, 95% CI: 1.19, 1.72) and with ever experiencing a sunburn in life (OR= 1.40, 95% CI: 1.02, 1.45). Every five sunburns experienced per decade in childhood increased BCC risk by 1.86 (95% CI: 1.73, 2.00) times. Every five sunburns experienced per decade in adulthood increased BCC risk by 2.12 (95% CI: 1.75, 2.57) times and every five sunburns per decade of life increased BCC risk by 1.91 (95% CI: 1.42, 2.58) times. The data on sunburn exposure and BCC show that an increase in number of sunburns at any age increased the risk of BCC. This may inform future prevention efforts.
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Affiliation(s)
- Stephanie G Lashway
- Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, 1295 N. Martin Ave., Tucson, AZ 85724, USA.
| | - Aimee D M Worthen
- Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, 1295 N. Martin Ave., Tucson, AZ 85724, USA
| | - Jumanah N Abuasbeh
- Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, 1295 N. Martin Ave., Tucson, AZ 85724, USA
| | - Robin B Harris
- Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, 1295 N. Martin Ave., Tucson, AZ 85724, USA
| | - Leslie V Farland
- Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, 1295 N. Martin Ave., Tucson, AZ 85724, USA
| | - Mary Kay O'Rourke
- Department of Community, Environment and Policy, Mel and Enid Zuckerman College of Public Health, University of Arizona, 1295 N. Martin Ave., Tucson, AZ 85724, USA
| | - Leslie K Dennis
- Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, 1295 N. Martin Ave., Tucson, AZ 85724, USA
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Lonsdorf AS, Enk AH, Hartmann J. Patterns of photoprotective behavior, cumulative sun-exposure and skin cancer risk among solid organ transplant recipients: a dermatology transplant clinic experience. Eur J Cancer Prev 2023; 32:155-162. [PMID: 35671255 DOI: 10.1097/cej.0000000000000751] [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: 02/03/2023]
Abstract
BACKGROUND The risk for keratinocyte cancer is dramatically increased in solid organ transplant recipients (OTR) with a first post-transplant keratinocyte cancer conferring a high risk for subsequent keratinocyte cancer arising with accelerated dynamics. Despite cumulative ultraviolet radiation (UVR) being the primary responsible environmental carcinogen reduced compliance with photoprotective measures among OTR has been reported. Risk assessment tools could help guide clinical decision-making and targeted prevention strategies for patients at particularly high risk for post-transplant keratinocyte cancer. OBJECTIVES To evaluate cumulative sun exposure by means of an assigned total sun burden (TSB) score, sunscreen use and associated risk factors for keratinocyte cancer in the post-transplantation phase of OTR. METHODS A retrospective single-center cohort study analyzing medical records and standardized questionnaires of 290 OTR cared for at a German dermatology transplant clinic. RESULTS Significantly lower TSB scores were noted in OTR not developing a first keratinocyte cancer compared to OTR developing keratinocyte cancer during their follow-up period ( P = 0.005). Regression analysis assigned a significantly higher risk for the development of first keratinocyte cancer to OTR with TSB scores >10. In total 70.7% of OTR with a history of ≥1 keratinocyte cancer reported intermittent sunscreen use, while daily sunscreen use was overall associated with female gender (21.3%) and age >30 years (17.6%). CONCLUSIONS The risk of OTR for developing keratinocyte cancer is reflected by their UV-exposure patterns, which may be assessed by the TSB-score, a scored risk assessment tool. Complementing clinical data, the TSB score may help clinicians to identify OTR at particularly high risk for keratinocyte cancer and to endorse intensified prevention strategies and dermato-oncologic care.
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Affiliation(s)
- Anke S Lonsdorf
- Department of Dermatology, Ruprecht-Karls-University of Heidelberg
- Skin Cancer Center, National Center for Tumor Diseases Heidelberg, Heidelberg, Germany
| | - Alexander H Enk
- Department of Dermatology, Ruprecht-Karls-University of Heidelberg
- Skin Cancer Center, National Center for Tumor Diseases Heidelberg, Heidelberg, Germany
| | - Julia Hartmann
- Department of Dermatology, Ruprecht-Karls-University of Heidelberg
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Aguilar M, Muñoz-Aguirre P, Cortés-Valencia A, Flores-Torres MH, Catzin-Kuhlmann A, López-Ridaura R, Lajous M, Rodriguez BL, Cantú-Brito C, Denova-Gutiérrez E. Sun Exposure and Intima-Media Thickness in the Mexican Teachers' Cohort Study. J Womens Health (Larchmt) 2023; 32:366-374. [PMID: 36795998 DOI: 10.1089/jwh.2022.0135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/18/2023] Open
Abstract
Objective: To determine whether long-term sun exposure has a protective role in subclinical cardiovascular disease in adult Mexican women. Materials and Methods: We conducted a cross-sectional analysis of a sample of women from the Mexican Teachers' Cohort (MTC) study. Sun exposure was assessed in the MTC 2008 baseline questionnaire, in which women were asked about their sun-related behavior. Vascular neurologists measured carotid intima-media thickness (IMT) using standard techniques. Multivariate linear regression models were used to estimate the difference in mean IMT and 95% confidence intervals (95% CIs), according to categories of sun exposure and multivariate logistic regression models were used to estimate the odds ratio (OR) and 95% CIs for carotid atherosclerosis. Results: The mean age of participants was 49.6 ± 5.5 years, the mean IMT was 0.678 ± 0.097 mm, and the mean accumulated hours of weekly sun exposure were 2.9 ± 1.9. Prevalence of carotid atherosclerosis was 20.9%. Compared with women in the lowest quartile of sun exposure, women in the highest quartile had lower mean IMT, but this was not significant in the multivariable adjusted analysis. (Adjusted mean % difference: -0.8; 95% CI: -2.3 to 0.8). The multivariate adjusted ORs of carotid atherosclerosis were 0.54 (95% CI: 0.24-1.18) for women who were exposed 9 hours. For women who denied regular sunscreen use, those in the higher exposure category (9 hours) had lower mean IMT compared with those in the lower category (multivariable-adjusted mean % difference = -2.67; 95% CI: -6.9 to -1.5). Conclusions: We observed that cumulative sun exposure was inversely associated with IMT and subclinical carotid atherosclerosis. If these findings are further replicated and seen for other cardiovascular outcomes, sun exposure could be an easy, affordable strategy to lower overall cardiovascular risk.
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Affiliation(s)
- Mercedes Aguilar
- Center for Population Health Research, National Institute of Public Health, Cuernavaca, Mexico
| | - Paloma Muñoz-Aguirre
- CONACYT-Center for Population Health Research, National Institute of Public Health, Cuernavaca, Mexico
| | - Adrian Cortés-Valencia
- Center for Population Health Research, National Institute of Public Health, Cuernavaca, Mexico
| | - Mario H Flores-Torres
- Center for Population Health Research, National Institute of Public Health, Cuernavaca, Mexico
| | - Andrés Catzin-Kuhlmann
- Department of Medicine, National Institute of Medical Sciences and Nutrition, Mexico City, Mexico
| | - Ruy López-Ridaura
- Dirección General, Centro Nacional de Programas Preventivos y Control de Enfermedades, Mexico City, Mexico
| | - Martin Lajous
- Center for Population Health Research, National Institute of Public Health, Cuernavaca, Mexico.,Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Beatriz L Rodriguez
- Department of Geriatric Medicine, John A. Burns School of Medicine, University of Hawaii, Honolulu, Hawaii.,Escuela de Medicina y Ciencias de la Salud, Tecnológico de Monterrey, Monterrey, Mexico
| | - Carlos Cantú-Brito
- Department of Neurology, National Institute of Medical Sciences and Nutrition, Mexico City, Mexico
| | - Edgar Denova-Gutiérrez
- Department of Healthy Environments and Chronic Disease Prevention, Nutrition and Health Research Center, National Institute of Public Health, Cuernavaca, Mexico
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5
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Davis Z, de Groh M, Rainham DG. The Canadian Environmental Quality Index (Can-EQI): Development and calculation of an index to assess spatial variation of environmental quality in Canada's 30 largest cities. ENVIRONMENT INTERNATIONAL 2022; 170:107633. [PMID: 36413927 DOI: 10.1016/j.envint.2022.107633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 11/08/2022] [Accepted: 11/12/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Multiple characteristics of the urban environment have been shown to influence population health and health-related behaviours, though the distribution and combined effects of these characteristics on health is less understood. A composite measure of multiple environmental conditions would allow for comparisons among different urban areas; however, this measure is not available in Canada. OBJECTIVES To develop an index of environmental quality for Canada's largest urban areas and to assess the influence of population size on index values. METHODS We conducted a systematic search of potential datasets and consulted with experts to refine and select datasets for inclusion. We identified and selected nine datasets across five domains (outdoor air pollution, natural environments, built environments, radiation, and climate/weather). Datasets were chosen based on known impacts on human health across the life course, complete geographic coverage of the cities of interest, and temporal alignment with the 2016 Canadian census. Each dataset was then summarized into dissemination areas (DAs). The Canadian Environmental Quality Index (Can-EQI) was created by summing decile ranks of each variable based on hypothesized relationships to health outcomes. RESULTS We selected 30 cities with a population of more than 100,000 people which included 28,026 DAs and captured approximately 55% of the total Canadian population. Can-EQI scores ranged from 21.1 to 88.9 out of 100, and in Canada's largest cities were 10.2 (95% CI: -10.7, -9.7) points lower than the smallest cities. Mapping the Can-EQI revealed high geographic variability within and between cities. DISCUSSION Our work demonstrates a valuable methodology for exploring variations in environmental conditions in Canada's largest urban areas and provides a means for exploring the role of environmental factors in explaining urban health inequalities and disparities. Additionally, the Can-EQI may be of value to municipal planners and decision makers considering the allocation of investments to improve urban conditions.
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Affiliation(s)
- Zoë Davis
- School of Ecosystem and Forest Sciences, Faculty of Science, University of Melbourne, Richmond, VIC 3121, Australia
| | - Margaret de Groh
- Centre for Surveillance and Applied Research, Public Health Agency of Canada, Ottawa, ON K1A 0K9, Canada
| | - Daniel G Rainham
- School of Health and Human Performance, Faculty of Health, Dalhousie University, Halifax, NS B3H 4R2, Canada; Healthy Populations Institute, Dalhousie University, Halifax, NS B3H 4R2, Canada.
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6
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Nguyen R, Clare IM, Gamage N, Alvares GA, Black LJ, Hart PH, Lucas RM, Strickland M, Jaimangal M, White J, Gorman S. Developing an Online Tool to Promote Safe Sun Behaviors With Young Teenagers as Co-researchers. Front Digit Health 2021; 3:626606. [PMID: 34713099 PMCID: PMC8521794 DOI: 10.3389/fdgth.2021.626606] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Accepted: 02/08/2021] [Indexed: 11/13/2022] Open
Abstract
Despite education about the risks of excessive sun exposure, teenagers in Australia are sun-seeking, with sunburn common in summer. Conversely, some regular (time-limited) exposure to sunlight (that avoids sunburn) is necessary for vitamin D and healthy bones and other molecules important for immune and metabolic health. New interventions are thus required to better support teenagers to make healthy and balanced decisions about their sun behaviors. This paper describes the development of a prototype online tool—a smartphone app—that aimed to foster safe sun practices in teenagers. We recruited young adolescents (aged 12–13 years, n = 24) as “co-researchers” to provide ongoing input into the nature and design of the online tool. This age group was selected, as it is a critical time when young people transition from primary education, where “SunSmart” behaviors are entrenched in Australian schools, to high school, where risky behaviors emerge. Through a series of interviews and workshops, we codesigned an Apple iOS smartphone app with the co-researchers, leading health promotion professionals, researchers, and app designers. The developed app, Sun Safe, contains educational content relevant to teenagers about safe sun behaviors, complemented by other features requested by co-researchers and stakeholders to help engage young people, including gamified quizzes to test their sun health knowledge, real-time weather data on the UV Index and temperature, a sunscreen application timer, and reminders to check the UV Index. The developed prototype app was rated well by co-researchers, suggesting it is suitable for further feasibility and efficacy testing as an intervention tool to improve knowledge and promote safe sun behaviors by young adolescents.
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Affiliation(s)
- Rebecca Nguyen
- Telethon Kids Institute, University of Western Australia, Perth, WA, Australia
| | - Isabelle M Clare
- Telethon Kids Institute, University of Western Australia, Perth, WA, Australia
| | - Nisali Gamage
- Telethon Kids Institute, University of Western Australia, Perth, WA, Australia
| | - Gail A Alvares
- Telethon Kids Institute, University of Western Australia, Perth, WA, Australia
| | - Lucinda J Black
- School of Public Health, Curtin University, Bentley, WA, Australia
| | - Prue H Hart
- Telethon Kids Institute, University of Western Australia, Perth, WA, Australia
| | - Robyn M Lucas
- National Centre for Epidemiology and Population Health, Research School of Population Health, Australian National University, Canberra, ACT, Australia.,Centre for Ophthalmology and Visual Science, University of Western Australia, Perth, WA, Australia
| | | | | | - James White
- Reach Health Promotion Innovations, Perth, WA, Australia
| | - Shelley Gorman
- Telethon Kids Institute, University of Western Australia, Perth, WA, Australia
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Linde K, Wright CY, du Plessis JL. Personal Solar Ultraviolet Radiation Exposure of Farmworkers: Seasonal and Anatomical Differences Suggest Prevention Measures Are Required. Ann Work Expo Health 2021; 66:41-51. [PMID: 34302333 DOI: 10.1093/annweh/wxab049] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Revised: 05/31/2021] [Accepted: 06/18/2021] [Indexed: 11/14/2022] Open
Abstract
INTRODUCTION Farmworkers are at risk of excess exposure to solar ultraviolet radiation (UVR) during their work activities, especially if they work in geographical areas with high ambient solar UVR levels such as in South Africa. Excess exposure to solar UVR may lead to several negative health effects such as certain cataracts and skin cancer. This study evaluated personal solar UVR exposure of a group of farmworkers to determine if they were at risk of health-related problems due to excess solar UVR exposure. METHODS Polysulphone film (PSF) badges were placed on the shoulder, arm, and top of the head of outdoor and indoor farmworkers on a macadamia nut and avocado farm in the Limpopo province for the duration of their daily work shift to evaluate their total daily solar UVR exposure. Sixteen days were assessed for each of the three, high solar UVR seasons, i.e. autumn, spring, and summer. RESULTS During autumn, farmworkers' arms received the highest solar UVR exposures (geometric mean (GM) = 7.8 SED, where 1 standard erythemal dose (SED) = 100 J/m2, 95% CI 6.1-9.8 SED) while the highest exposures were on the top of the head during spring (GM = 11.6 SED, 95% CI 7.3-17.4 SED) and summer (GM = 13.9, 95% CI 10.4-17.9 SED). Statistically significant differences in solar UVR exposure were found between the body sites during spring and summer but not autumn. CONCLUSIONS The relatively high daily solar UVR exposure levels of farmworkers suggest this occupational group is at risk of excess solar UVR exposure and preventive measures with awareness information to safeguard health is necessary for employers and employees.
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Affiliation(s)
- Karlien Linde
- Occupational Hygiene and Health Research Initiative (OHHRI), North-West University, Potchefstroom 2520, South Africa.,Department of Physiology and Environmental Health, University of Limpopo, Sovenga 0727, South Africa
| | - Caradee Yael Wright
- Environmental and Health Research Unit, South African Medical Research Council, Pretoria 0002, South Africa.,Department of Geography, Geoinformatics and Meteorology, University of Pretoria, Pretoria 0001, South Africa
| | - Johannes Lodewykus du Plessis
- Occupational Hygiene and Health Research Initiative (OHHRI), North-West University, Potchefstroom 2520, South Africa
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Shiner B, Peltzman T, Cornelius SL, Gui J, Jiang T, Riblet N, Gottlieb DJ, Watts BV. Influence of contextual factors on death by suicide in rural and urban settings. J Rural Health 2021; 38:336-345. [PMID: 33900641 DOI: 10.1111/jrh.12579] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
PURPOSE To examine the association between contextual factors, represented by geographic and community health variables, and suicide among rural and urban Department of Veterans Affairs health care users (VA users). METHODS We performed a retrospective cohort study of 12,700,847 VA users between 2003 and 2017. We assigned contextual factors based on individuals' home address at the ZIP Code (area deprivation), county (sunlight exposure, altitude, and community health), and state level (firearm ownership), using publicly available data sources. We grouped contextual factors by quintiles or prespecified thresholds, depending on the nature of each variable. We obtained mortality data from the National Death Index. We measured the effect of living in a place with the highest versus lowest level of each contextual factor on odds of suicide using logistic regression, adjusting for individual compositional factors abstracted from VA electronic medical records data. We used random forest modeling to build prediction models for suicide based on contextual factors among rural and urban veterans. FINDINGS Almost all contextual factors we examined were significantly associated with suicide among rural and urban VA users, even after adjusting for individual compositional factors. However, no contextual variables were strong protective or risk factors (0.5<OR>2.0), and prediction models leveraging these contextual factors had poor accuracy among both rural (0.51, 95% CI: 0.48-0.54) and urban (0.53, 95% CI: 0.51-0.55) VA users. CONCLUSIONS A wide variety of contextual factors is significantly associated with suicide among rural and urban VA users. However, the factors we measured contributed very little to individual-level suicide risk.
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Affiliation(s)
- Brian Shiner
- VA Medical Center, White River Junction, Vermont, USA.,Geisel School of Medicine at Dartmouth College, Hanover, New Hampshire, USA
| | | | | | - Jiang Gui
- Geisel School of Medicine at Dartmouth College, Hanover, New Hampshire, USA
| | - Tammy Jiang
- Boston University School of Public Heath, Boston, Massachusetts, USA
| | - Natalie Riblet
- VA Medical Center, White River Junction, Vermont, USA.,Geisel School of Medicine at Dartmouth College, Hanover, New Hampshire, USA
| | - Daniel J Gottlieb
- VA Medical Center, White River Junction, Vermont, USA.,Geisel School of Medicine at Dartmouth College, Hanover, New Hampshire, USA
| | - Bradley V Watts
- Geisel School of Medicine at Dartmouth College, Hanover, New Hampshire, USA.,Veterans Rural Health Resource Center, White River Junction, Vermont, USA.,VA Office of Systems Redesign and Improvement, Washington, DC, USA
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Bonatto S, Vieira Paniz VM, de Freitas Dutra C, Dutra BV, Henn RL. Serum 25-hydroxyvitamin D concentration among users of a referral outpatient unit for vascular diseases and associated factors. Clin Nutr ESPEN 2021; 42:299-306. [PMID: 33745596 DOI: 10.1016/j.clnesp.2021.01.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2020] [Revised: 12/15/2020] [Accepted: 01/10/2021] [Indexed: 12/25/2022]
Abstract
OBJECTIVE Assess serum 25-hydroxyvitamin D (25OHD) concentration and associated factors among users of a referral outpatient unit for vascular diseases in Southern Brazil. DESIGN Cross-sectional study conducted for almost one year, from March 2016 to January 2017. The serum vitamin D level was determined biochemically and classified as: sufficient (>50 nmol/L), insufficient (30-50 nmol/L) and deficient (<30 nmol/L). Associations were tested through multiple linear regression. SETTING At a reference outpatient clinic specialized in vascular diseases located in a southern Brazilian medium-sized city (latitude 29°S). SUBJECTS Consecutive sample of 133 individuals of both sexes, aged at least 40 years. RESULTS The mean serum 25OHD concentration was 54.9 ± 25.9 nmol/L (57.7 ± 27.9 nmol/L for men; 52.2 ± 24.2 nmol/L for women, p = 0.267). A total of 12.8% of the participants had vitamin D deficiency and 32.3% had insufficiency. Regarding the total sample, variables associated to the serum 25OHD concentration were: age (β = -0.55; CI95% -0.95; -0.17), sun exposure (β = 1.22; CI95% 0.32; 2.10) and vitamin D intake (β = 7.29; CI95% 2.10; 12.48). Among men, a significant association was observed for age (β = -0.82; CI95% -1.47; -0.17, p = 0.015) and borderline for sun exposure (β = 1.22; CI95% 0.32; 2.10, p = 0.053). Among women, only vitamin D intake was significantly associated with serum concentration of this vitamin (β = 8.74; CI95% 1.32; 16.17, p = 0.022). CONCLUSION Although the mean 25OHD concentration was greater than 50 nmol/L, about 45% of this consecutive sample presented poor vitamin D nutritional status. Unadjusted for seasonality, factors associated with serum 25OHD concentration were age and sun exposure among men and vitamin D intake among women.
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Affiliation(s)
- Simone Bonatto
- Field of Knowledge Life Sciences, Caxias do Sul University, City of Caxias do Sul, Rio Grande do Sul (RS) state, Brazil; Collective Health Graduate Program, Vale do Rio dos Sinos University, City of São Leopoldo, RS, Brazil.
| | - Vera Maria Vieira Paniz
- Collective Health Graduate Program, Vale do Rio dos Sinos University, City of São Leopoldo, RS, Brazil
| | - Clandio de Freitas Dutra
- Field of Knowledge Life Sciences, Caxias do Sul University, City of Caxias do Sul, Rio Grande do Sul (RS) state, Brazil
| | - Bruna Valduga Dutra
- Field of Knowledge Life Sciences, Caxias do Sul University, City of Caxias do Sul, Rio Grande do Sul (RS) state, Brazil
| | - Ruth Liane Henn
- Collective Health Graduate Program, Vale do Rio dos Sinos University, City of São Leopoldo, RS, Brazil
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10
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Time spent outdoors in childhood is associated with reduced risk of myopia as an adult. Sci Rep 2021; 11:6337. [PMID: 33737652 PMCID: PMC7973740 DOI: 10.1038/s41598-021-85825-y] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Accepted: 02/25/2021] [Indexed: 12/12/2022] Open
Abstract
Myopia (near-sightedness) is an important public health issue. Spending more time outdoors can prevent myopia but the long-term association between this exposure and myopia has not been well characterised. We investigated the relationship between time spent outdoors in childhood, adolescence and young adulthood and risk of myopia in young adulthood. The Kidskin Young Adult Myopia Study (KYAMS) was a follow-up of the Kidskin Study, a sun exposure-intervention study of 1776 children aged 6–12 years. Myopia status was assessed in 303 (17.6%) KYAMS participants (aged 25–30 years) and several subjective and objective measures of time spent outdoors were collected in childhood (8–12 years) and adulthood. Index measures of total, childhood and recent time spent outdoors were developed using confirmatory factor analysis. Logistic regression was used to assess the association between a 0.1-unit change in the time outdoor indices and risk of myopia after adjusting for sex, education, outdoor occupation, parental myopia, parental education, ancestry and Kidskin Study intervention group. Spending more time outdoors during childhood was associated with reduced risk of myopia in young adulthood (multivariable odds ratio [OR] 0.82, 95% confidence interval [CI] 0.69, 0.98). Spending more time outdoors in later adolescence and young adulthood was associated with reduced risk of late-onset myopia (≥ 15 years of age, multivariable OR 0.79, 95% CI 0.64, 0.98). Spending more time outdoors in both childhood and adolescence was associated with less myopia in young adulthood.
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11
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Ferguson NN. Challenges and Controversy in Determining UV Exposure as a Risk Factor for Cutaneous Melanoma in Skin of Color. JAMA Dermatol 2021; 157:151-153. [PMID: 33326000 DOI: 10.1001/jamadermatol.2020.4615] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Nkanyezi N Ferguson
- University of Iowa Hospitals and Clinics, Department of Dermatology, Iowa City
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12
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Tribby CP, Julian AK, Oh AY, Perna FM, Berrigan D. Associations between ultraviolet radiation, tree cover and adolescent sunburns. Int J Health Geogr 2020; 19:59. [PMID: 33317555 PMCID: PMC7734787 DOI: 10.1186/s12942-020-00253-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Accepted: 12/06/2020] [Indexed: 11/18/2022] Open
Abstract
Background Sunburn is the strongest risk factor for melanoma and non-melanoma skin cancers. Adolescent sunburns are related to higher risk of developing melanoma later in life. Little is known about the association of sunburns and shade, particularly tree cover, around adolescent homes and schools. This linkage study assessed associations of adolescent self-reported sunburns with ambient ultraviolet radiation (UV) and tree cover. Methods We analyzed a U.S. national sample of parent–child dyads (n = 1333) from the 2014 Family Life, Activity, Sun, Health, and Eating (FLASHE) study conducted by the National Cancer Institute. The outcome was adolescent sunburns reported for the previous 12 months. GIS buffers around geocoded home and school addresses were used to summarize UV and tree cover. A sensitivity analysis assessed different UV measures and tree cover buffer distances. Logistic regression models estimated the adjusted odds of any sunburns for five models: (1) no environmental variables; (2) spatial variables of latitude and longitude; (3) UV; (4) tree cover; and, (5) a combined model with UV and tree cover. Covariates included common sunburn-related items such as sun protective behaviors, socio-demographics, and latitude. Model residuals were assessed for spatial dependency and clustering. Results Overall, 44% of adolescents reported any sunburns in the previous 12 months. For the bivariate associations, lower categories of UV were associated with any reported sunburns (p-trend = 0.002). Home tree cover was not associated with any reported sunburns (p-trend = 0.08), whereas schools with lower categories of tree cover were associated with sunburns (p-trend = 0.008). The adjusted odds of any sunburns by UV tertiles, as a linear tread, was 0.89 (0.76–1.05) (p = 0.17); school tree cover was: 0.91 (0.78–1.07) (p = 0.25). Neither UV nor tree cover, in a combined model, were significant. Sensitivity analyses resulted in the optimal buffer size of 200 m for summarizing tree cover. Spatial dependence of residuals was not significant and clustering was significant for about 6% or less of the sample in each model. Conclusions We did not find significant relationships between UV or tree cover and adolescent sunburns, when adjusted by sunburn-related covariates. Better contextual data about where sunburns occurred is needed to identify environmental correlates of sunburn.
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Affiliation(s)
- Calvin P Tribby
- Department of Geography, University of Hong Kong, Room 1023, 10th Floor, The Jockey Club Tower Centennial Campus, Pokfulam Road, Hong Kong, Hong Kong.
| | - Anne K Julian
- Health Behaviors Research Branch, Behavioral Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, MD, USA.,Cancer Prevention Fellowship Program, Division of Cancer Prevention, National Cancer Institute, Bethesda, MD, USA
| | - April Y Oh
- Implementation Science Team, Office of the Director, Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, MD, USA
| | - Frank M Perna
- Health Behaviors Research Branch, Behavioral Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, MD, USA
| | - David Berrigan
- Health Behaviors Research Branch, Behavioral Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, MD, USA
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13
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Hyde MA, Grossman D, Wu YP, Buys S, Gren LH, Hashibe M. Vitamin D, melanoma risk, and tumor thickness in PLCO cancer screening trial patients. JAAPA 2020; 33:35-41. [PMID: 32452960 DOI: 10.1097/01.jaa.0000662388.18867.42] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE The incidence of melanoma is increasing. Other than limiting UV exposure, few factors prevent or reduce the risk of melanoma. The aim of this study is to evaluate the relationship between vitamin D intake and melanoma risk in the Prostate, Lung, Colorectal, and Ovarian (PLCO) cancer screening trial. METHODS A secondary data analysis was performed on PLCO data. More than 1,300 participants developed melanoma. RESULTS Melanoma risk may be increased among men within the highest quartile of vitamin D intake (HR 1.27, 95% CI 0.99, 1.61). Women in the highest quartile of vitamin D intake had a decreased risk of invasive melanoma (HR 0.63, 95% CI 0.41, 0.96). Higher education and being white corresponded with deeper tumors (P < .001). CONCLUSION High reported vitamin D intake resulted in an increased risk of melanoma among men. Vitamin D intake yielded a protective effect against invasive melanoma in women.
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Affiliation(s)
- Mark A Hyde
- At the University of Utah Health Sciences Center in Salt Lake City, Mark A. Hyde is an assistant professor of dermatology at the Huntsman Cancer Institute and an assistant professor in the department of community and public health at Utah Valley University, Douglas Grossman is a professor in the Department of Dermatology and codirector of the melanoma and cutaneous oncology program at the Huntsman Cancer Institute, Yelena P. Wu is an assistant professor in the Department of Dermatology, Saundra Buys is a professor in the Department of Medicine and medical director of the High Risk Breast Cancer Clinic at the Huntsman Cancer Institute, Lisa H. Gren is an associate professor in the Department of Family and Preventive Medicine, and Mia Hashibe is an associate professor in the Department of Family and Preventive Medicine and at the Huntsman Cancer Institute. This work was supported by the National Cancer Institute (NCI) of the National Institutes of Health (K07CA196985). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health or NCI. The authors have disclosed no other potential conflicts of interest, financial or otherwise
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14
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Karlsson E, Hübner IM, Haluza D, Falk M. Validation of SEPI in German-A German Translation of the Sun Exposure and Protection Index. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17176172. [PMID: 32854416 PMCID: PMC7504206 DOI: 10.3390/ijerph17176172] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Revised: 08/13/2020] [Accepted: 08/20/2020] [Indexed: 11/16/2022]
Abstract
The Sun Exposure and Protection Index (SEPI) is a brief instrument for scoring of sun exposure habits and propensity to increase sun protection, previously validated in English and in Swedish, as well as in two different outdoor sun intensity environments (Australia and Northern Europe). The aim of the present study was to study reliability and validity of a German translated version of the SEPI to be used in German-speaking populations. Data was collected at University of Flensburg and at Hamburg University of Applied Sciences from November 2018 to April 2019. Participants (n = 205) filled out the SEPI and also a selection of corresponding questions from the Austrian Vienna UV Questionnaire in German. After three weeks, the participants filled out the SEPI once again in order to assess test–retest stability. Of the 205 participants completing the baseline questionnaire, 135 participants completed it once again after three weeks. Internal consistency, by Cronbach’s alpha, for the baseline responses was 0.70 (95% C.I: 0.63–0.76) for SEPI part 1 (sun exposure habits) and 0.72 (95% C.I: 0.66–0.78) for part 2 (propensity to increase sun protection). Test–retest stability was high, with weighted Kappa >0.6 for all items but one, and the instrument correlated well with the previously validated German-language UV Skin Risk Survey Questionnaire. In conclusion, the German version of SEPI can reliably be used for mapping of individual sun exposure patterns.
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Affiliation(s)
- Elias Karlsson
- Department of Medicine, Health and Caring Sciences, Linköping University, SE-581 83 Linköping, Sweden; (E.K.); (M.F.)
| | - Inga-Marie Hübner
- Association of Dermatological Prevention [ADP], 20457 Hamburg, Germany
- Correspondence:
| | - Daniela Haluza
- Department of Environmental Health, Medical University of Vienna, 1090 Vienna, Austria;
| | - Magnus Falk
- Department of Medicine, Health and Caring Sciences, Linköping University, SE-581 83 Linköping, Sweden; (E.K.); (M.F.)
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15
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Stevenson LJ, Mackey DA, Lingham G, Burton A, Brown H, Huynh E, Tan IJ, Franchina M, Sanfilippo PG, Yazar S. Has the Sun Protection Campaign in Australia Reduced the Need for Pterygium Surgery Nationally? Ophthalmic Epidemiol 2020; 28:105-113. [PMID: 32729768 DOI: 10.1080/09286586.2020.1797120] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND The Slip! Slop! Slap! Sunsmart safety campaign was an Australian initiative implemented in the 1980s. To assess this campaign's effect on pterygium, we examined the rate of pterygium surgery across Australia and described the prevalence and associations of pterygium in Perth, Australia's sunniest capital city. METHODS The rate of pterygium surgery was examined using Australian Medicare data. A cross-sectional analysis of the Generation 1 (Gen1) cohort of the Raine Study was performed to investigate the prevalence of pterygium in Perth. We investigated the association between pterygium and conjunctival ultraviolet autofluorescence (CUVAF) area, an objective biomarker of sun exposure, and demographics and health variables derived from a detailed questionnaire. RESULTS Between 1994 and 2017, the rate of Medicare funded pterygium surgery in Western Australia fell 11%, well below the national average decline of 47%. Of the 1049 Gen1 Raine Study participants, 994 (571 females; mean age 56.7 years, range = 40.9-81.7) were included in the analysis. The lifetime prevalence of pterygium was 8.4% (n = 83). A higher prevalence of pterygium was associated with outdoor occupation (p-trend = 0.007), male sex (p-trend 0.01) and increasing CUVAF area (p-value <0.001). CONCLUSIONS The effect of Australia's Slip! Slop! Slap! Sunsmart safety campaign on pterygium been mixed. Since 1994, the rate of private pterygium surgery has declined significantly in all Australian states except Western Australia. Perth, Western Australia, has the highest pterygium prevalence of any mainland-Australian cohort. Higher CUVAF area, male sex, and outdoor occupation were associated with an increased risk of pterygium.
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Affiliation(s)
- Louis J Stevenson
- Lions Eye Institute, Centre for Ophthalmology and Visual Science, University of Western Australia, Nedlands, Western Australia.,Faculty of Medicine and Health, University of Sydney, Camperdown, New South Wales, New South Wales, Australia
| | - David A Mackey
- Lions Eye Institute, Centre for Ophthalmology and Visual Science, University of Western Australia, Nedlands, Western Australia
| | - Gareth Lingham
- Lions Eye Institute, Centre for Ophthalmology and Visual Science, University of Western Australia, Nedlands, Western Australia
| | - Alex Burton
- Lions Eye Institute, Centre for Ophthalmology and Visual Science, University of Western Australia, Nedlands, Western Australia
| | - Holly Brown
- Lions Eye Institute, Centre for Ophthalmology and Visual Science, University of Western Australia, Nedlands, Western Australia
| | - Emily Huynh
- Lions Eye Institute, Centre for Ophthalmology and Visual Science, University of Western Australia, Nedlands, Western Australia
| | - Irene J Tan
- Lions Eye Institute, Centre for Ophthalmology and Visual Science, University of Western Australia, Nedlands, Western Australia
| | - Maria Franchina
- Lions Eye Institute, Centre for Ophthalmology and Visual Science, University of Western Australia, Nedlands, Western Australia
| | - Paul G Sanfilippo
- Centre for Eye Research Australia, University of Melbourne, Royal Victorian Eye and Ear Hospital, East Melbourne, Victoria, Victoria, Australia
| | - Seyhan Yazar
- Lions Eye Institute, Centre for Ophthalmology and Visual Science, University of Western Australia, Nedlands, Western Australia
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16
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Wright CY, du Preez DJ, Martincigh BS, Allen MW, Millar DA, Wernecke B, Blesic S. A Comparison of Solar Ultraviolet Radiation Exposure in Urban Canyons in Venice, Italy and Johannesburg, South Africa. Photochem Photobiol 2020; 96:1148-1153. [PMID: 32495950 DOI: 10.1111/php.13291] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Accepted: 05/27/2020] [Indexed: 11/30/2022]
Abstract
Urban environments can have high-risk spaces that can provide excess personal sun exposure, such as urban or street canyons, and the spaces between buildings, among others. In these urban spaces, sun exposure can be high or low depending on several factors. Polysulphone film (PSF) was used to assess possible daily solar ultraviolet radiation (UVR) exposure in urban canyons in Venice, Italy and, for the first time in Africa, in Johannesburg, South Africa. The photodegradation of PSF upon solar exposure was monitored at a wavelength of 330 nm by ultraviolet-visible spectrophotometry, and the resultant change was converted to standard erythemal dose (SED) units (1 SED = 100 J m-2 ). Mean daily ambient solar UVR exposure measured for Venice and Johannesburg ranged between 20-28 SED and 33-43 SED, respectively. Canyon-located PSF exposures were lower in Venice (1-9 SED) than those in Johannesburg (9-39 SED), depending mainly on the sky view factor and orientation to the sun. There was large variation in solar UVR exposure levels in different urban canyons. These preliminary results should be bolstered with additional studies for a better understanding of excess personal exposure risk in urban areas, especially in Africa.
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Affiliation(s)
- Caradee Y Wright
- Environment and Health Research Unit, South African Medical Research Council, Pretoria, South Africa.,Department of Geography, Geoinformatics and Meteorology, University of Pretoria, Pretoria, South Africa
| | - David Jean du Preez
- Department of Geography, Geoinformatics and Meteorology, University of Pretoria, Pretoria, South Africa.,LACy, Laboratoire de l'Atmosphère et des Cyclones (UMR 8105 CNRS, Université de La Réunion, Météo-France), Saint-Denis de La Réunion, France
| | - Bice S Martincigh
- School of Chemistry and Physics, University of KwaZulu-Natal, Durban, South Africa
| | - Martin W Allen
- MacDiarmid Institute for Advanced Materials and Nanotechnology, University of Canterbury, Christchurch, New Zealand
| | - Danielle A Millar
- Environment and Health Research Unit, South African Medical Research Council, Pretoria, South Africa
| | - Bianca Wernecke
- Environment and Health Research Unit, South African Medical Research Council, Johannesburg, South Africa.,Department of Environmental Health, Faculty of Health Sciences, University of Johannesburg, Johannesburg, South Africa
| | - Suzana Blesic
- Institute for Medical Research, University of Belgrade, Belgrade, Serbia.,Center for Participatory Science, Belgrade, Serbia
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17
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Nagelhout ES, Lensink R, Zhu A, Parsons BG, Jensen JD, Wu YP. The Feasibility and Acceptability of Using a Wearable UV Radiation Exposure Monitoring Device in Adults and Children: Cross-Sectional Questionnaire Study. JMIR DERMATOLOGY 2020; 3:e15711. [PMID: 33043275 PMCID: PMC7546527 DOI: 10.2196/15711] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND In the United States, melanoma is the 5th most common cancer. Reducing ultraviolet radiation (UVR) exposure is essential for the prevention of melanoma. Objectively assessing individual-level UVR exposure with the use of wearable technology offers a promising tool for reducing UVR exposure. However, the feasibility and acceptability of using UVR monitoring wearable devices have not been assessed. OBJECTIVE The aim of this study was to assess the feasibility and acceptability of a commercially available UVR monitoring wearable device among adults and children. METHODS The study recruited families (one parent and one child) to test a new, commercially-available UVR monitoring device (Shade). Participants wore the Shade device for two weeks and completed questionnaires assessing the feasibility and acceptability of wearing the device. Qualitative analyses were conducted to summarize participants' open-ended responses regarding device feasibility. RESULTS A total of 194 individuals (97 adults and 97 children) participated. Participating children were on average 12.7 years old. Overall, adults and children reported moderate satisfaction with wearing the Shade device. Feasibility of use of the Shade device was adequate with 73% of adults and 61% of children reporting that they wore the device "all of the time they were outside." Through open-ended responses, participants reported appreciating the device's ease of use, compact size, and that it increased their awareness about their UVR exposure. CONCLUSIONS A new, wearable UVR monitoring device can be feasibly used by adults and children and use of the device was acceptable to participants. The device could be integrated into melanoma preventive interventions to increase individual's and families' awareness of their UVR exposure and to facilitate the use of recommended melanoma preventive strategies.
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Affiliation(s)
- Elizabeth S. Nagelhout
- Division of Public Health, Department of Family & Preventive Medicine, University of Utah, 375 Chipeta Way, Suite A, Salt Lake City, UT 84108
| | - Riley Lensink
- Huntsman Cancer Institute, 2000 Circle of Hope, Salt Lake City, UT 84112
| | - Angela Zhu
- Huntsman Cancer Institute, 2000 Circle of Hope, Salt Lake City, UT 84112
| | - Bridget G. Parsons
- Huntsman Cancer Institute, 2000 Circle of Hope, Salt Lake City, UT 84112
| | - Jakob D. Jensen
- Department of Communication, University of Utah, 255 Central Campus Dr #2400, Salt Lake City, UT 84112
| | - Yelena P. Wu
- Huntsman Cancer Institute, 2000 Circle of Hope, Salt Lake City, UT 84112
- Department of Dermatology, University of Utah, 30 North 1900 East, 4A330, Salt Lake City, Utah 84132
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18
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Blesić SM, du Preez DJ, Stratimirović DI, Ajtić JV, Ramotsehoa MC, Allen MW, Wright CY. Characterization of personal solar ultraviolet radiation exposure using detrended fluctuation analysis. ENVIRONMENTAL RESEARCH 2020; 182:108976. [PMID: 31830694 DOI: 10.1016/j.envres.2019.108976] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Revised: 11/07/2019] [Accepted: 11/28/2019] [Indexed: 06/10/2023]
Abstract
Studies of personal solar ultraviolet radiation (pUVR) exposure are important to identify populations at-risk of excess and insufficient exposure given the negative and positive health impacts, respectively, of time spent in the sun. Electronic UVR dosimeters measure personal solar UVR exposure at high frequency intervals generating large datasets. Sophisticated methods are needed to analyze these data. Previously, wavelet transform (WT) analysis was applied to high-frequency personal recordings collected by electronic UVR dosimeters. Those findings showed scaling behavior in the datasets that changed from uncorrelated to long-range correlated with increasing duration of time spent in the sun. We hypothesized that the WT slope would be influenced by the duration of time that a person spends in continuum outside. In this study, we address this hypothesis by using an experimental study approach. We aimed to corroborate this hypothesis and to characterize the extent and nature of influence time a person spends outside has on the shape of statistical functions that we used to analyze individual UVR exposure patterns. Detrended fluctuation analysis (DFA) was applied to personal sun exposure data. We analyzed sun exposure recordings from skiers (on snow) and hikers in Europe, golfers in New Zealand and outdoor workers in South Africa. Results confirmed validity of the DFA superposition rule for assessment of pUVR data and showed that pUVR scaling is determined by personal patterns of exposure on lower scales. We also showed that this dominance ends at the range of time scales comparable to the maximal duration of continuous exposure to solar UVR during the day; in this way the superposition rule can be used to quantify behavioral patterns, particularly accurate if it is determined on WT curves. These findings confirm a novel way in which large datasets of personal UVR data may be analyzed to inform messaging regarding safe sun exposure for human health.
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Affiliation(s)
- Suzana M Blesić
- Institute for Medical Research, University fo Belgrade, Belgrade, Serbia; Department of Environmental Sciences, Informatics and Statistics, Ca'Foscari University fo Venice, Venice, Italy; Center for Participatory Science, Belgrade, Serbia.
| | - D Jean du Preez
- Department of Geography, Geoinformatics and Meteorology, University of Pretoria, Pretoria, South Africa.
| | | | - Jelena V Ajtić
- Faculty of Veterinary Medicine, University of Belgrade, Serbia.
| | - M Cynthia Ramotsehoa
- Occupational Hygiene and Health Research Initiative (OHHRI), Faculty of Health Sciences, North-West University, Potchefstroom, South Africa.
| | - Martin W Allen
- MacDiarmid Institute for Advanced Materials and Nanotechnology, University of Canterbury, New Zealand.
| | - Caradee Y Wright
- Department of Geography, Geoinformatics and Meteorology, University of Pretoria, Pretoria, South Africa; Environment and Health Research Unit, South African Medical Research Council, Pretoria, South Africa.
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19
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Lingham G, Milne E, Yazar S, Mackey DA, Cross D, Lucas RM. Recalling our day in the sun: comparing long-term recall of childhood sun exposure with prospectively collected parent-reported data. Photochem Photobiol Sci 2020; 19:382-389. [PMID: 32010915 DOI: 10.1039/c9pp00240e] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
To examine the impact of sun exposure on human health, accurate measures of past sun exposure are required. We investigated how young adults' recall of childhood sun-related behaviours compares with parent-reported measures collected during childhood. The Kidskin-Young Adult Myopia Study (KYAMS) is a follow-up of the Kidskin Study, a sun-protection intervention study conducted from 1995-2001. KYAMS participants, aged 25-30 years, reported time in sun, and use of hats and sunscreen, for each year from ages 5-26 years (n = 244). Using weighted kappa, we assessed agreement between these data and corresponding variables derived from the Kidskin Study parent questionnaires completed when KYAMS participants were aged 6-12 years. Ordinal logistic regression was used to test the association between self-reported sun-behaviours and corresponding parent-reported data. We found slight agreement between self-reported and parent-reported data for all sun-behaviour measures except hat use at 12 years. KYAMS recall of time in sun at 8-12 years was not associated with Kidskin Study parent-reported responses after adjustment for current time in sun. Recall of higher hat and sunscreen use was associated with higher parent-reported hat and sunscreen use (OR[hat] = 1.37, 95% CI: 1.16, 1.62; OR[sunscreen] = 1.23, 95% CI: 1.03, 1.48). However, KYAMS self-reported data were unable to predict corresponding parent-reported responses. Group data from retrospective recall of sun-related behaviours may be of limited value in studying the relationship between sun exposure and health outcomes; however, individual data are likely of little use.
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Affiliation(s)
- Gareth Lingham
- Centrefor Ophthalmology and Visual Science, Lions Eye Institute, The University of Western Australia, Perth, Australia.
| | - Elizabeth Milne
- Telethon Kids Institute, The University of Western Australia, Perth, Australia
| | - Seyhan Yazar
- Centrefor Ophthalmology and Visual Science, Lions Eye Institute, The University of Western Australia, Perth, Australia
| | - David A Mackey
- Centrefor Ophthalmology and Visual Science, Lions Eye Institute, The University of Western Australia, Perth, Australia
| | - Donna Cross
- Telethon Kids Institute, The University of Western Australia, Perth, Australia
| | - Robyn M Lucas
- Centrefor Ophthalmology and Visual Science, Lions Eye Institute, The University of Western Australia, Perth, Australia.,Telethon Kids Institute, The University of Western Australia, Perth, Australia.,National Centre for Epidemiology and Population Health, Research School of Population Health, The Australian National University, Canberra, Australia
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20
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Are Environmental Interventions Targeting Skin Cancer Prevention among Children and Adolescents Effective? A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17020529. [PMID: 31947667 PMCID: PMC7013813 DOI: 10.3390/ijerph17020529] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Revised: 12/20/2019] [Accepted: 12/24/2019] [Indexed: 11/17/2022]
Abstract
Skin cancer, which is increasing exceedingly worldwide, is substantially preventable by reducing unprotected exposure to ultraviolet radiation (UVR). Several comprehensive interventions targeting sun protection behaviors among children and adolescents in various outdoor settings have been developed; however, there is a lack of insight on stand-alone effectiveness of environmental elements. To compose future skin cancer prevention interventions optimally, identification of effective environmental components is necessary. Hence, an extensive systematic literature search was conducted, using four scientific databases and one academic search engine. Seven relevant studies were evaluated based on stand-alone effects of various types of environmental sun safety interventions on socio-cognitive determinants, sun protection behaviors, UVR exposure, and incidence of sunburns and nevi. Free provision of sunscreen was most often the environmental component of interest, however showing inconsistent results in terms of effectiveness. Evidence regarding shade provision on shade-seeking behavior was most apparent. Even though more research is necessary to consolidate the findings, this review accentuates the promising role of environmental components in skin cancer prevention interventions and provides directions for future multi-component sun safety interventions targeted at children and adolescents in various outdoor settings.
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21
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Clarke CL, Bell LM, Gies P, Henderson S, Siafarikas A, Gorman S. Season, Terrestrial Ultraviolet Radiation, and Markers of Glucose Metabolism in Children Living in Perth, Western Australia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16193734. [PMID: 31623384 PMCID: PMC6801873 DOI: 10.3390/ijerph16193734] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Revised: 09/20/2019] [Accepted: 09/24/2019] [Indexed: 11/16/2022]
Abstract
Seasonality in glucose metabolism has been observed in adult populations; however, little is known of the associations between season and glucose metabolism in children. In this study, we examined whether markers of glucose metabolism (fasting glucose, insulin and HbA1c) varied by season in a paediatric population (6-13 years of age) located in Perth (Western Australia, n = 262) with data categorised by weight. Linear regression was used to analyse the nature of the relationships between mean daily levels of terrestrial ultraviolet radiation (UVR) (prior to the day of the blood test) and measures of glucose metabolism. Fasting blood glucose was significantly lower in autumn compared to spring, for children in combined, normal and obese weight categories. Fasting insulin was significantly lower in autumn and summer compared to winter for individuals of normal weight. HbA1c was significantly higher in summer (compared with winter and spring) in overweight children, which was in the opposite direction to other published findings in adults. In children with obesity, a strong inverse relationship (r = -0.67, p = 0.002) was observed for fasting glucose, and daily terrestrial UVR levels measured in the previous 6 months. Increased safe sun exposure in winter therefore represents a plausible means of reducing fasting blood sugar in children with obesity. However, further studies, using larger paediatric cohorts are required to confirm these relationships.
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Affiliation(s)
- Catherine L Clarke
- Telethon Kids Institute, University of Western Australia, Perth 6872, Australia.
| | - Lana M Bell
- Department of Paediatric Endocrinology and Diabetes, Perth Children's Hospital, Nedlands 6009, Australia.
| | - Peter Gies
- Australian Radiation Protection and Nuclear Safety Agency (ARPANSA), Yallambie 3085, Victoria, Australia.
| | - Stuart Henderson
- Australian Radiation Protection and Nuclear Safety Agency (ARPANSA), Yallambie 3085, Victoria, Australia.
| | - Aris Siafarikas
- Telethon Kids Institute, University of Western Australia, Perth 6872, Australia.
- Department of Paediatric Endocrinology and Diabetes, Perth Children's Hospital, Nedlands 6009, Australia.
- Medical School, Division of Paediatrics, University of Western Australia, Crawley 6009, Australia.
- Institute for Health Research, University of Notre Dame, Fremantle 6160, Australia.
| | - Shelley Gorman
- Telethon Kids Institute, University of Western Australia, Perth 6872, Australia.
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22
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Ghaly S, Bliuc D, Center JR, Clarke MW, Jones AP, Trend S, Kermode AG, Neale RE, Hart PH. Vitamin D C3-epimer levels are proportionally higher with oral vitamin D supplementation compared to ultraviolet irradiation of skin in mice but not humans. J Steroid Biochem Mol Biol 2019; 186:110-116. [PMID: 30296587 DOI: 10.1016/j.jsbmb.2018.10.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2018] [Revised: 09/30/2018] [Accepted: 10/04/2018] [Indexed: 12/22/2022]
Abstract
A proportion of circulating 25-hydroxy vitamin D3 (25(OH)D3)) undergoes epimerization to form C3-epi 25(OH)D3 and C3-epi 1,25(OH)2D3. These epimers have less calcaemic activity than non-epimerized metabolites and are not differentiated by many immunoassays when reporting total 25(OH)D3 levels. This study aimed to compare the effect of exposure to ultraviolet radiation (UVR) and oral vitamin D3 supplementation on vitamin D C3-epimer levels. C57Bl/6 female mice were fed either vitamin D-sufficient (vitamin D3 2000 IU/kg) or -deficient diets (no vitamin D3) for 4 weeks. Among the vitamin D-deficient group, the shaved backs of half were irradiated daily for 4 days with 1 kJ/m2 UVR, followed by twice weekly irradiation for 4 weeks. Despite similar 25(OH)D3 levels, the UV-irradiated group had a lower proportion of C3-epi 25(OH)D3 at week 7 (p < 0.05) and week 9 (p < 0.01). C3-epimer concentrations and %C3-epi 25(OH)D3 were also analysed in serum samples from two human clinical trials. These trials investigated the effect of high dose oral vitamin D3 supplementation and narrowband UVB phototherapy, respectively. Serum 25(OH)D3 and the %C3-epi 25(OH)D3 levels measured at 12 months after oral vitamin D3 supplementation were not significantly different to those measured at the time of maximal effect of phototherapy (2 months). Thus, the proportion of 25(OH)D3 that undergoes epimerization is greater with oral vitamin D3 supplementation than exposure to UVR in mice, but not in humans. This important difference between human and murine vitamin D metabolism warrants consideration when interpreting animal studies.
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Affiliation(s)
- Simon Ghaly
- Telethon Kids Institute, The University of Western Australia, Perth, WA, Australia; School of Medicine and Pharmacology, The University of Western Australia, Perth, WA, Australia; Department of Gastroenterology and Hepatology, St. Vincent's Hospital, Sydney, NSW, Australia.
| | - Dana Bliuc
- Clinical Studies and Epidemiology, Garvan Institute of Medical Research, Sydney, NSW, Australia
| | - Jacqueline R Center
- Clinical Studies and Epidemiology, Garvan Institute of Medical Research, Sydney, NSW, Australia
| | - Michael W Clarke
- Metabolomics Australia, Centre for Microscopy, Characterisation and Analysis, The University of Western Australia, Perth, WA 6009, Australia
| | - Anderson P Jones
- Telethon Kids Institute, The University of Western Australia, Perth, WA, Australia
| | - Stephanie Trend
- Telethon Kids Institute, The University of Western Australia, Perth, WA, Australia
| | - Allan G Kermode
- Centre for Neuromuscular and Neurological Disorders, Perron Institute for Neurological and Translational Science, University of Western Australia, Perth, WA, Australia; Institute for Immunology and Infectious Disease, Murdoch University, Perth, Australia
| | - Rachel E Neale
- Cancer Aetiology and Prevention Group, QIMR Berghofer, Brisbane, QLD, Australia
| | - Prue H Hart
- Telethon Kids Institute, The University of Western Australia, Perth, WA, Australia
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23
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Jung AM, Dennis LK, Jacobs ET, Wondrak GT. Sun sensitivity and sun protective behaviors during sun exposure among indoor office workers in the American Midwest. PHOTODERMATOLOGY, PHOTOIMMUNOLOGY & PHOTOMEDICINE 2018; 34:393-399. [PMID: 29888418 DOI: 10.1111/phpp.12403] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 06/07/2018] [Indexed: 12/23/2022]
Abstract
BACKGROUND/PURPOSE Sun sensitivity, a confounder between sun exposure and sun protection, is often overlooked. We examined how sun exposure and sun protection behaviors among indoor workers varied by sun sensitivity. METHODS Sun exposure and sun protection diaries over a 45-day period from Midwestern United States indoor workers were examined. We categorized sun sensitivity (fair and non-fair complexion) using tanning inability and sunburn tendency. Total exposure (sunrise to sunset) and peak exposure (10 am and 4 pm) lasting at least 60 minutes were examined. Percentages of time using sun protection were reported. We determined associations between fair complexion, mean sun exposure, and mean sun protection times with logistic regression. RESULTS Fair individuals spent less time in the sun than non-fair individuals, but a greater proportion of time using sun protection behaviors, including sunscreen with SPF 30+ (odds ratio (OR) = 1.36; 95% confidence interval (95% CI) = 0.98, 1.87)), or wearing long-sleeved shirts (OR = 2.89; 95% CI = 1.24, 6.73). CONCLUSION Fair individuals spent less time in the sun and practiced more sun protective behaviors than non-fair individuals. This complex association between sun sensitivity, sun protection and sun exposure has not consistently been addressed in studies of skin cancer.
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Affiliation(s)
- Alesia M Jung
- Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA
| | - Leslie K Dennis
- Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA.,University of Arizona Cancer Center, Tucson, AZ, USA.,Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, IA, USA
| | - Elizabeth T Jacobs
- Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA.,University of Arizona Cancer Center, Tucson, AZ, USA
| | - Georg T Wondrak
- University of Arizona Cancer Center, Tucson, AZ, USA.,Department of Pharmacology & Toxicology, College of Pharmacy, University of Arizona, Tucson, AZ, USA
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24
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Morvová M, Jeczko P, Šikurová L. Gender differences in the fluorescence of human skin in young healthy adults. Skin Res Technol 2018; 24:599-605. [PMID: 29700858 DOI: 10.1111/srt.12471] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/02/2018] [Indexed: 11/30/2022]
Abstract
BACKGROUND Human skin naturally contains many endogenous fluorophores; therefore, fluorescence techniques can be used for monitoring of the human skin even in in vivo mode. The aim of this work was to study skin autofluorescence in vivo regarding the possible effect of gender. MATERIALS AND METHODS Fluorescence emission spectra of young healthy Caucasian adults in 3 anatomical regions (forehead, hand, and inner upper arm) were taken with excitation at 280, 325, or 400 nm. RESULTS Three emission bands were found in the spectra for both men and women: (1) an intensive band peaked at 340/280 nm (peak emission/excitation wavelength), corresponding to aromatic amino acids of proteins in epidermis; (2) a broad band with emission between 360 nm and 480 nm (excitation 325 nm) with a base peak around 390 nm and 2 side peaks at 420 and 450 nm, mainly due to collagen cross-links in dermis with a possible weak contribution of elastin and mitochondrial NADPH; (3) a weak but distinct peak at 600/400 nm corresponding presumably to skin unmetalled porphyrins. CONCLUSION The intensity of skin autofluorescence showed differences between genders and among anatomical regions. The 340 nm intensity was 1.4 times higher in the male group in all 3 anatomical regions studied. The highest intensity of skin autofluorescence for the peaks at 340/280 nm and 600/400 nm was found on the forehead, whereas the 390/325 nm band was most intensive on the inner upper arm in both genders.
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Affiliation(s)
- M Morvová
- Department of Nuclear Physics and Biophysics, Faculty of Mathematics, Physics and Informatics, Comenius University, Bratislava, Slovakia
| | - P Jeczko
- Department of Nuclear Physics and Biophysics, Faculty of Mathematics, Physics and Informatics, Comenius University, Bratislava, Slovakia
| | - L Šikurová
- Department of Nuclear Physics and Biophysics, Faculty of Mathematics, Physics and Informatics, Comenius University, Bratislava, Slovakia
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25
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Hacker E, Horsham C, Allen M, Nathan A, Lowe J, Janda M. Capturing Ultraviolet Radiation Exposure and Physical Activity: Feasibility Study and Comparison Between Self-Reports, Mobile Apps, Dosimeters, and Accelerometers. JMIR Res Protoc 2018; 7:e102. [PMID: 29666044 PMCID: PMC5930172 DOI: 10.2196/resprot.9695] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Revised: 03/01/2018] [Accepted: 03/09/2018] [Indexed: 12/18/2022] Open
Abstract
Background Skin cancer is the most prevalent cancer in Australia. Skin cancer prevention programs aim to reduce sun exposure and increase sun protection behaviors. Effectiveness is usually assessed through self-report. Objective It was the aim of this study to test the acceptance and validity of a newly developed ultraviolet radiation (UVR) exposure app, designed to reduce the data collection burden to research participants. Physical activity data was collected because a strong focus on sun avoidance may result in unhealthy reductions in physical activity. This paper provides lessons learned from collecting data from participants using paper diaries, a mobile app, dosimeters, and accelerometers for measuring end-points of UVR exposure and physical activity. Methods Two participant groups were recruited through social and traditional media campaigns 1) Group A—UVR Diaries and 2) Group B—Physical Activity. In Group A, nineteen participants wore an UVR dosimeter wristwatch (University of Canterbury, New Zealand) when outside for 7 days. They also recorded their sun exposure and physical activity levels using both 1) the UVR diary app and 2) a paper UVR diary. In Group B, 55 participants wore an accelerometer (Actigraph, Pensacola, FL, USA) for 14 days and completed the UVR diary app. Data from the UVR diary app were compared with UVR dosimeter wristwatch, accelerometer, and paper UVR diary data. Cohen kappa coefficient score was used to determine if there was agreement between categorical variables for different UVR data collection methods and Spearman rank correlation coefficient was used to determine agreement between continuous accelerometer data and app-collected self-report physical activity. Results The mean age of participants in Groups A (n=19) and B (n=55) was 29.3 and 25.4 years, and 63% (12/19) and 75% (41/55) were females, respectively. Self-reported sun exposure data in the UVR app correlated highly with UVR dosimetry (κ=0.83, 95% CI 0.64-1.00, P<.001). Correlation between self-reported UVR app and accelerometer-collected moderate to vigorous physical activity data was low (ρ=0.23, P=.10), while agreement for low-intensity physical activity was significantly different (ρ=-0.49, P<.001). Seventy-nine percent of participants preferred the app over the paper diary for daily self-report of UVR exposure and physical activity. Conclusions This feasibility study highlights self-report using an UVR app can reliably collect personal UVR exposure, but further improvements are required before the app can also be used to collect physical activity data.
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Affiliation(s)
- Elke Hacker
- Institute of Health and Biomedical Innovation, School of Public Health and Social Work, Queensland University of Technology, Brisbane, Australia
| | - Caitlin Horsham
- Institute of Health and Biomedical Innovation, School of Public Health and Social Work, Queensland University of Technology, Brisbane, Australia
| | - Martin Allen
- Department of Electrical and Computer Engineering, University of Canterbury, Christchurch, New Zealand.,The MacDiarmid Institute for Advanced Materials and Nanotechnology, Wellington, New Zealand
| | - Andrea Nathan
- Institute for Health and Ageing, Australian Catholic University, Melbourne, Australia
| | - John Lowe
- Faculty of Science, Health, Education and Engineering, School of Health and Sport Sciences, University of the Sunshine Coast, Maroochydore, Australia
| | - Monika Janda
- Institute of Health and Biomedical Innovation, School of Public Health and Social Work, Queensland University of Technology, Brisbane, Australia
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26
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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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27
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Langer-Gould A, Lucas R, Xiang AH, Chen LH, Wu J, Gonzalez E, Haraszti S, Smith JB, Quach H, Barcellos LF. MS Sunshine Study: Sun Exposure But Not Vitamin D Is Associated with Multiple Sclerosis Risk in Blacks and Hispanics. Nutrients 2018; 10:E268. [PMID: 29495467 PMCID: PMC5872686 DOI: 10.3390/nu10030268] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2018] [Revised: 02/14/2018] [Accepted: 02/23/2018] [Indexed: 12/13/2022] Open
Abstract
Multiple sclerosis (MS) incidence and serum 25-hydroxyvitamin D (25OHD) levels vary by race/ethnicity. We examined the consistency of beneficial effects of 25OHD and/or sun exposure for MS risk across multiple racial/ethnic groups. We recruited incident MS cases and controls (blacks 116 cases/131 controls; Hispanics 183/197; whites 247/267) from the membership of Kaiser Permanente Southern California into the MS Sunshine Study to simultaneously examine sun exposure and 25OHD, accounting for genetic ancestry and other factors. Higher lifetime ultraviolet radiation exposure (a rigorous measure of sun exposure) was associated with a lower risk of MS independent of serum 25OHD levels in blacks (adjusted OR = 0.53, 95% CI = 0.31-0.83; p = 0.007) and whites (OR = 0.68, 95% CI = 0.48-0.94; p = 0.020) with a similar magnitude of effect that did not reach statistical significance in Hispanics (OR = 0.66, 95% CI = 0.42-1.04; p = 0.071). Higher serum 25OHD levels were associated with a lower risk of MS only in whites. No association was found in Hispanics or blacks regardless of how 25OHD was modeled. Lifetime sun exposure appears to reduce the risk of MS regardless of race/ethnicity. In contrast, serum 25OHD levels are not associated with MS risk in blacks or Hispanics. Our findings challenge the biological plausibility of vitamin D deficiency as causal for MS and call into question the targeting of specific serum 25OHD levels to achieve health benefits, particularly in blacks and Hispanics.
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Affiliation(s)
- Annette Langer-Gould
- Los Angeles Medical Center, Department of Neurology, Southern California Permanente Medical Group, 100 S Los Robles, Pasadena, CA 91101, USA.
| | - Robyn Lucas
- College of Medicine, Biology & Environment, Australian National University, Canberra, ACT 2000, Australia.
| | - Anny H Xiang
- Department of Research & Evaluation, Kaiser Permanente Southern California, 100 S. Los Robles Avenue, Pasadena, CA 91101, USA.
| | - Lie H Chen
- Department of Research & Evaluation, Kaiser Permanente Southern California, 100 S. Los Robles Avenue, Pasadena, CA 91101, USA.
| | - Jun Wu
- Department of Research & Evaluation, Kaiser Permanente Southern California, 100 S. Los Robles Avenue, Pasadena, CA 91101, USA.
| | - Edlin Gonzalez
- Department of Research & Evaluation, Kaiser Permanente Southern California, 100 S. Los Robles Avenue, Pasadena, CA 91101, USA.
| | - Samantha Haraszti
- Department of Research & Evaluation, Kaiser Permanente Southern California, 100 S. Los Robles Avenue, Pasadena, CA 91101, USA.
- Philadelphia College of Osteopathic Medicine, 4170 City Avenue, Philadelphia, PA 19131, USA.
| | - Jessica B Smith
- Department of Research & Evaluation, Kaiser Permanente Southern California, 100 S. Los Robles Avenue, Pasadena, CA 91101, USA.
| | - Hong Quach
- QB3 Genetic Epidemiology and Genomics Lab, School of Public Health, University of California Berkeley, 209 Hildebrand Hall, Berkeley, CA 94720-7356, USA.
| | - Lisa F Barcellos
- QB3 Genetic Epidemiology and Genomics Lab, School of Public Health, University of California Berkeley, 209 Hildebrand Hall, Berkeley, CA 94720-7356, USA.
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28
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Langer-Gould A, Lucas RM, Xiang AH, Wu J, Chen LH, Gonzales E, Haraszti S, Smith JB, Quach H, Barcellos LF. Vitamin D-Binding Protein Polymorphisms, 25-Hydroxyvitamin D, Sunshine and Multiple Sclerosis. Nutrients 2018; 10:E184. [PMID: 29414925 PMCID: PMC5852760 DOI: 10.3390/nu10020184] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2018] [Revised: 02/01/2018] [Accepted: 02/02/2018] [Indexed: 12/29/2022] Open
Abstract
Blacks have different dominant polymorphisms in the vitamin D-binding protein (DBP) gene that result in higher bioavailable vitamin D than whites. This study tested whether the lack of association between 25-hydroxyvitamin D (25OHD) and multiple sclerosis (MS) risk in blacks and Hispanics is due to differences in these common polymorphisms (rs7041, rs4588). We recruited incident MS cases and controls (blacks 116 cases/131 controls; Hispanics 183/197; whites 247/267) from Kaiser Permanente Southern California. AA is the dominant rs7041 genotype in blacks (70.0%) whereas C is the dominant allele in whites (79.0% AC/CC) and Hispanics (77.1%). Higher 25OHD levels were associated with a lower risk of MS in whites who carried at least one copy of the C allele but not AA carriers. No association was found in Hispanics or blacks regardless of genotype. Higher ultraviolet radiation exposure was associated with a lower risk of MS in blacks (OR = 0.06), Hispanics and whites who carried at least one copy of the C allele but not in others. Racial/ethnic variations in bioavailable vitamin D do not explain the lack of association between 25OHD and MS in blacks and Hispanics. These findings further challenge the biological plausibility of vitamin D deficiency as causal for MS.
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Affiliation(s)
- Annette Langer-Gould
- Los Angeles Medical Center, Neurology Department, Southern California Permanente Medical Group, 1505 N Edgemont Street, Los Angeles, CA 90027, USA.
| | - Robyn M Lucas
- College of Medicine, Biology & Environment, Australian National University, Canberra, ACT 2000, Australia.
| | - Anny H Xiang
- Department of Research & Evaluation, Kaiser Permanente Southern California, 100 S. Los Robles Avenue, Pasadena, CA 91101, USA.
| | - Jun Wu
- Department of Research & Evaluation, Kaiser Permanente Southern California, 100 S. Los Robles Avenue, Pasadena, CA 91101, USA.
| | - Lie H Chen
- Department of Research & Evaluation, Kaiser Permanente Southern California, 100 S. Los Robles Avenue, Pasadena, CA 91101, USA.
| | - Edlin Gonzales
- Department of Research & Evaluation, Kaiser Permanente Southern California, 100 S. Los Robles Avenue, Pasadena, CA 91101, USA.
| | - Samantha Haraszti
- Department of Research & Evaluation, Kaiser Permanente Southern California, 100 S. Los Robles Avenue, Pasadena, CA 91101, USA.
- Philadelphia College of Osteopathic Medicine, 4000 Presidential Blvd., Apt. 819, Philadelphia, PA 19131, USA.
| | - Jessica B Smith
- Department of Research & Evaluation, Kaiser Permanente Southern California, 100 S. Los Robles Avenue, Pasadena, CA 91101, USA.
| | - Hong Quach
- QB3 Genetic Epidemiology and Genomics Lab, School of Public Health, University of California Berkeley, 209 Hildebrand Hall, Berkeley, CA 94720, USA.
| | - Lisa F Barcellos
- QB3 Genetic Epidemiology and Genomics Lab, School of Public Health, University of California Berkeley, 209 Hildebrand Hall, Berkeley, CA 94720, USA.
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29
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Shi Y, Manco M, Moyal D, Huppert G, Araki H, Banks A, Joshi H, McKenzie R, Seewald A, Griffin G, Sen-Gupta E, Wright D, Bastien P, Valceschini F, Seité S, Wright JA, Ghaffari R, Rogers J, Balooch G, Pielak RM. Soft, stretchable, epidermal sensor with integrated electronics and photochemistry for measuring personal UV exposures. PLoS One 2018; 13:e0190233. [PMID: 29293664 PMCID: PMC5749742 DOI: 10.1371/journal.pone.0190233] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2016] [Accepted: 12/11/2017] [Indexed: 12/21/2022] Open
Abstract
Excessive ultraviolet (UV) radiation induces acute and chronic effects on the skin, eye and immune system. Personalized monitoring of UV radiation is thus paramount to measure the extent of personal sun exposure, which could vary with environment, lifestyle, and sunscreen use. Here, we demonstrate an ultralow modulus, stretchable, skin-mounted UV patch that measures personal UV doses. The patch contains functional layers of ultrathin stretchable electronics and a photosensitive patterned dye that reacts to UV radiation. Color changes in the photosensitive dyes correspond to UV radiation intensity and are analyzed with a smartphone camera. A software application has feature recognition, lighting condition correction, and quantification algorithms that detect and quantify changes in color. These color changes are then correlated with corresponding shifts in UV dose, and compared to existing UV dose risk levels. The soft mechanics of the UV patch allow for multi-day wear in the presence of sunscreen and water. Two evaluation studies serve to demonstrate the utility of the UV patch during daily activities with and without sunscreen application.
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Affiliation(s)
- Yunzhou Shi
- L’Oréal Tech Incubator–California Research Center, San Francisco, California, United States of America
| | - Megan Manco
- L’Oréal Early Clinical, Clark, NJ, United States of America
| | - Dominique Moyal
- La Roche-Posay Dermatological Laboratories, Asnières Cedex, France
| | - Gil Huppert
- MC10 Inc., Lexington, Massachusetts, United States of America
| | - Hitoshi Araki
- Science and Engineering, and Frederick Seitz Materials Research Laboratory, University of Illinois at Urbana-Champaign, Urbana, Illinois, United States of America
| | - Anthony Banks
- Science and Engineering, and Frederick Seitz Materials Research Laboratory, University of Illinois at Urbana-Champaign, Urbana, Illinois, United States of America
| | - Hemant Joshi
- L’Oréal Tech Incubator, Clark, NJ, United States of America
| | - Richard McKenzie
- National Institute of Water and Atmospheric Research (NIWA), Lauder, Central Otago, New Zealand
| | - Alex Seewald
- MyStudioFactory, The Landing, Media City UK, Salford, United Kingdom
| | - Guy Griffin
- MC10 Inc., Lexington, Massachusetts, United States of America
| | | | - Donald Wright
- MC10 Inc., Lexington, Massachusetts, United States of America
| | | | | | - Sophie Seité
- L’Oréal Early Clinical, Clark, NJ, United States of America
| | - John A. Wright
- MC10 Inc., Lexington, Massachusetts, United States of America
| | | | - John Rogers
- Science and Engineering, and Frederick Seitz Materials Research Laboratory, University of Illinois at Urbana-Champaign, Urbana, Illinois, United States of America
| | - Guive Balooch
- L’Oréal Tech Incubator–California Research Center, San Francisco, California, United States of America
- L’Oréal Tech Incubator, Clark, NJ, United States of America
| | - Rafal M. Pielak
- L’Oréal Tech Incubator–California Research Center, San Francisco, California, United States of America
- * E-mail:
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30
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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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31
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King L. A criteria‐validated sun‐exposure questionnaire to evaluate skin cancer prevention campaigns. Br J Dermatol 2017; 176:298-299. [DOI: 10.1111/bjd.15135] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- L. King
- National Centre for Epidemiology and Population Health The Australian National University Canberra 0200 Australia
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32
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Langston M, Dennis L, Lynch C, Roe D, Brown H. Temporal Trends in Satellite-Derived Erythemal UVB and Implications for Ambient Sun Exposure Assessment. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14020176. [PMID: 28208641 PMCID: PMC5334730 DOI: 10.3390/ijerph14020176] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/24/2016] [Accepted: 02/07/2017] [Indexed: 12/13/2022]
Abstract
Ultraviolet radiation (UVR) has been associated with various health outcomes, including skin cancers, vitamin D insufficiency, and multiple sclerosis. Measurement of UVR has been difficult, traditionally relying on subject recall. We investigated trends in satellite-derived UVB from 1978 to 2014 within the continental United States (US) to inform UVR exposure assessment and determine the potential magnitude of misclassification bias created by ignoring these trends. Monthly UVB data remotely sensed from various NASA satellites were used to investigate changes over time in the United States using linear regression with a harmonic function. Linear regression models for local geographic areas were used to make inferences across the entire study area using a global field significance test. Temporal trends were investigated across all years and separately for each satellite type due to documented differences in UVB estimation. UVB increased from 1978 to 2014 in 48% of local tests. The largest UVB increase was found in Western Nevada (0.145 kJ/m2 per five-year increment), a total 30-year increase of 0.87 kJ/m2. This largest change only represented 17% of total ambient exposure for an average January and 2% of an average July in Western Nevada. The observed trends represent cumulative UVB changes of less than a month, which are not relevant when attempting to estimate human exposure. The observation of small trends should be interpreted with caution due to measurement of satellite parameter inputs (ozone and climatological factors) that may impact derived satellite UVR nearly 20% compared to ground level sources. If the observed trends hold, satellite-derived UVB data may reasonably estimate ambient UVB exposures even for outcomes with long latency phases that predate the satellite record.
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Affiliation(s)
- Marvin Langston
- Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ 85724, USA.
- Division of Public Health Sciences, Department of Surgery, Washington University in Saint Louis School of Medicine, St. Louis, MO 63110, USA.
| | - Leslie Dennis
- Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ 85724, USA.
- Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, IA 52246, USA.
| | - Charles Lynch
- Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, IA 52246, USA.
| | - Denise Roe
- Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ 85724, USA.
| | - Heidi Brown
- Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ 85724, USA.
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Lee A, Samy W, Chiu CH, Chan SKC, Gin T, Chui PT. Determinants of Serum 25-Hydroxyvitamin D Concentrations and a Screening Test for Moderate-to-Severe Hypovitaminosis D in Chinese Patients Undergoing Total Joint Arthroplasty. J Arthroplasty 2016; 31:1921-6. [PMID: 27017200 DOI: 10.1016/j.arth.2016.02.052] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2015] [Revised: 02/19/2016] [Accepted: 02/19/2016] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Hypovitaminosis D is associated with adverse surgical outcomes. We quantified the environmental, demographic, and modifiable determinants of serum 25-hydroxyvitamin D (25-OHD) concentration and assessed the potential impact of a preoperative screening questionnaire for moderate-to-severe hypovitaminosis D (25-OHD <30 nmol/L). METHODS In a retrospective cohort study of 227 Chinese patients (69 males and 158 females) undergoing 261 joint arthroplasty, we collected information on recent sun exposure, dietary vitamin D intake, vitamin D supplementation, and Western Ontario and McMaster Universities osteoarthritis index using a questionnaire and measured a fasting 25-OHD concentration using a liquid chromatography-tandem mass spectrometry before surgery. RESULTS The multiple regression model on the determinants of 25-OHD concentration described 14% of the total variance, with the greatest relative contribution from ambient ultraviolet radiation (42%). A 4-item screening test for moderate-to-severe hypovitaminosis D had acceptable discrimination (area under receiver operating characteristic curve = 0.76, 95% CI, 0.65-0.87), good calibration (Hosmer-Lemeshow goodness-of-fit; P = .93). Decision curve analysis showed that the screening test can potentially reduce unnecessary 25-OHD testing by 390 per 1000 patients at a threshold probability of 10%. CONCLUSION The screening test appears moderately useful in avoiding a substantial number of unnecessary 25-OHD testing in a setting where the prevalence of moderate-to-severe hypovitaminosis D is less than 10%.
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Affiliation(s)
- Anna Lee
- Department of Anaesthesia and Intensive Care, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, NT, Hong Kong
| | - Winnie Samy
- Department of Anaesthesia and Intensive Care, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, NT, Hong Kong
| | - Chun Hung Chiu
- Department of Anaesthesia and Intensive Care, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, NT, Hong Kong
| | - Simon Kin Cheong Chan
- Department of Anaesthesia and Intensive Care, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, NT, Hong Kong
| | - Tony Gin
- Department of Anaesthesia and Intensive Care, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, NT, Hong Kong
| | - Po Tong Chui
- Department of Anaesthesia and Intensive Care, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, NT, Hong Kong
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34
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King L, Dear K, Harrison SL, van der Mei I, Brodie AM, Kimlin MG, Lucas RM. Investigating the patterns and determinants of seasonal variation in vitamin D status in Australian adults: the Seasonal D Cohort Study. BMC Public Health 2016; 16:892. [PMID: 27565723 PMCID: PMC5002142 DOI: 10.1186/s12889-016-3582-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2016] [Accepted: 08/24/2016] [Indexed: 12/11/2022] Open
Abstract
Background Vitamin D status generally varies seasonally with changing solar UVB radiation, time in the sun, amount of skin exposed, and, possibly, diet. The Seasonal D Study was designed to quantify the amplitude and phase of seasonal variation in the serum concentration of 25-hydroxyvitamin D, (25OH)D)) and identify the determinants of the amplitude and phase and those of inter-individual variability in seasonal pattern. Methods The Seasonal D Study collected data 2-monthly for 12 months, including demographics, personal sun exposure using a diary and polysulphone dosimeters over 7 days, and blood for serum 25(OH)D concentration. The study recruited 333 adults aged 18–79 years living in Canberra (35°S, n = 168) and Brisbane (27°South, n = 165), Australia. Discussion We report the study design and cohort description for the Seasonal D Study. The study has collected a wealth of data to examine inter- and intra-individual seasonal variation in vitamin D status and serum 25(OH)D levels in Australian adults. Electronic supplementary material The online version of this article (doi:10.1186/s12889-016-3582-z) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Laura King
- National Centre for Epidemiology and Population Health, The Australian National University, Canberra, Australia
| | | | - Simone L Harrison
- College of Public Health, Medical & Veterinary Sciences, James Cook, University, Townsville, Australia
| | - Ingrid van der Mei
- Menzies Research Institute Tasmania, University of Tasmania, Hobart, Australia
| | - Alison M Brodie
- Health Research Institute, University of the Sunshine Coast, Sippy Downs, Australia.,Queensland University of Technology, Brisbane, Australia
| | - Michael G Kimlin
- Health Research Institute, University of the Sunshine Coast, Sippy Downs, Australia.,Queensland University of Technology, Brisbane, Australia
| | - Robyn M Lucas
- National Centre for Epidemiology and Population Health, The Australian National University, Canberra, Australia.
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