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Li S, Lu L, Xian W, Li J, Xu S, Chen J, Wang Y. Time spent in outdoor light is associated with increased blood pressure, increased hypertension risk, and decreased hypotension risk. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2024; 288:117349. [PMID: 39561567 DOI: 10.1016/j.ecoenv.2024.117349] [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: 08/15/2024] [Revised: 11/11/2024] [Accepted: 11/13/2024] [Indexed: 11/21/2024]
Abstract
OBJECTIVE Light exposure is thought to be associated with blood pressure (BP). However, the existing evidence is inconsistent, and the underlying mechanisms remain unclear. METHODS This cohort study enrolled over 300,000 participants from the UK Biobank. Information on the time spent in outdoor light during typical summer and winter days was collected using questionnaires. Cases of hypertension and hypotension were identified using the 10th edition of the International Classification of Diseases codes. Cox proportional hazards regression models were employed to estimate the lightBP associations, and restricted cubic splines were utilized to detect potential nonlinear associations. Subgroup analyses were conducted to identify effect modifiers, and causal mediation analyses were performed to explore potential mechanisms. RESULTS Using summer light exposure as an illustration, after a median follow-up of 13.4 years, each additional hour of summer light exposure was found to be associated with an increased risk of hypertension (hazard ratio [HR] 1.011, 95 % confidence interval [CI] 1.0061.017, P-nonlinear=0.803) and a decreased risk of hypotension (0.988, 0.9770.998, P-nonlinear=0.109). The lightBP association was found to be stronger in females (P=0.022), those with short sleep durations (P=0.049), and those with a high genetic risk of hypertension (P<0.001). Potential mechanisms included increases in biological age (proportion mediated, 24.1 %, P<0.001), neutrophil count (5.4 %, P<0.001), body mass index (32.0 %, P<0.001), etc. CONCLUSIONS: Our study revealed a positive lightBP association. Potential mechanisms include inflammation, aging, and lifestyle changes. Further epidemiological and experimental investigations are necessary to validate these findings.
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Affiliation(s)
- Sicheng Li
- Xiamen Cardiovascular Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, Fujian, China.
| | - Liyong Lu
- Center for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China; NHC Key Lab of Health Economics and Policy Research (Shandong University), Jinan, Shandong, China
| | - Wenpan Xian
- Department of Stomatology, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, Fujian, China
| | - Jiawei Li
- Department of Epidemiology and Health Statistics, West China School of Public Health / West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Shuaiming Xu
- Department of Epidemiology and Health Statistics, West China School of Public Health / West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Jiajin Chen
- Xiamen Cardiovascular Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, Fujian, China.
| | - Yan Wang
- Xiamen Cardiovascular Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, Fujian, China.
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Lu X, Wang R, Li J, Lyu S, Zhang J, Wang Q, Chi W, Zhong R, Chen C, Wu X, Hu R, You Z, Mai Y, Xie S, Lin J, Zheng B, Zhong Q, He J, Liang W. Exposure-lag response of surface net solar radiation on lung cancer incidence: a global time-series analysis. Transl Lung Cancer Res 2024; 13:2524-2537. [PMID: 39507019 PMCID: PMC11535824 DOI: 10.21037/tlcr-24-125] [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: 02/03/2024] [Accepted: 08/23/2024] [Indexed: 11/08/2024]
Abstract
Background Recently, the impact of solar radiation (RAD) on diseases worldwide has garnered growing attention. However, the association between RAD and lung cancer remains largely unknow and no consensus has been reached. The aim of this study was to investigate the lag exposure-response of RAD on lung cancer and provide robust scientific evidence for updating prevention and treatment strategies of lung cancer. Methods Data of RAD were obtained from Google Earth Engine, which was post-processed by European Centre for Medium-Range Weather Forecasts (ECMWF). Lung cancer incidence, smoking prevalence and socio-demographic index (SDI) were obtained from Global Burden of Disease (GBD). Spearman's rank correlation tests and linear regression analyses were performed to investigate the relationship between RAD and lung cancer incidence. Additionally, a distributed lag non-linear model (DLNM) was utilized to reveal the lag effects of RAD on lung cancer incidence. Results There were 204 countries and territories and selected subnational locations with information recorded in GBD and radiation exposure was calculated in 272 countries and territories. After excluding missing and abnormal data, as well as Kashmir and Western Sahara which were two disputed districts, this study included 186 countries from 1992 to 2019. After adjusted for smoking and SDI, the Spearman's correlation coefficient ranged from -0.630 to -0.581. In the DLNM for lung cancer adjusted for smoking and SDI, the maximum relative risk (RR) was 1.013 [95% confidence interval (CI): 1.011-1.014], at RAD exposure of 12,760,000 with 5.8 lag years, while the minimum RR was 0.973 (95% CI: 0.947-0.992) at RAD exposure of 12,845,000 with 8.0 lag years. Conclusions The global rise in lung cancer incidence has been notably associated with low exposure to RAD, whereas the defensive influence of sunlight against lung cancer demonstrated hysteresis. This study shows that properly exposure to sunlight is a possible strategy for lung cancer prevention, which provides scientific support for the formulation of future health strategies. It is also crucial in epidemiological research as it offers a novel pattern for identifying additional potential risk factors for diseases.
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Affiliation(s)
- Xuanzhuang Lu
- Department of Thoracic Surgery and Oncology, the First Affiliated Hospital of Guangzhou Medical University, State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou, China
- Nanshan School, Guangzhou Medical University, Guangzhou, China
| | - Runchen Wang
- Department of Thoracic Surgery and Oncology, the First Affiliated Hospital of Guangzhou Medical University, State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou, China
| | - Jianfu Li
- Department of Thoracic Surgery and Oncology, the First Affiliated Hospital of Guangzhou Medical University, State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou, China
| | - Shixuan Lyu
- Department of Civil Engineering, University of Bristol, Bristol, UK
| | - Jianrong Zhang
- Centre for Cancer Research & Department of General Practice, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Australia
- Victorian Comprehensive Cancer Centre, Melbourne, Australia
| | - Qixia Wang
- Department of Thoracic Surgery and Oncology, the First Affiliated Hospital of Guangzhou Medical University, State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou, China
| | - Wenhao Chi
- Academy of Mathematics and Systems Science, Chinese Academy of Sciences, Beijing, China
| | - Ran Zhong
- Department of Thoracic Surgery and Oncology, the First Affiliated Hospital of Guangzhou Medical University, State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou, China
| | - Chao Chen
- Department of Neurology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Xinjian Wu
- Department of Thoracic Surgery and Oncology, the First Affiliated Hospital of Guangzhou Medical University, State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou, China
- First Clinical School, Guangzhou Medical University, Guangzhou, China
| | - Ruiyu Hu
- Department of Thoracic Surgery and Oncology, the First Affiliated Hospital of Guangzhou Medical University, State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou, China
- First Clinical School, Guangzhou Medical University, Guangzhou, China
| | - Zhixuan You
- Department of Thoracic Surgery and Oncology, the First Affiliated Hospital of Guangzhou Medical University, State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou, China
- Nanshan School, Guangzhou Medical University, Guangzhou, China
| | - Yuqi Mai
- First Clinical School, Guangzhou Medical University, Guangzhou, China
| | - Songlin Xie
- Nanshan School, Guangzhou Medical University, Guangzhou, China
| | - Jiayu Lin
- Nanshan School, Guangzhou Medical University, Guangzhou, China
| | - Boyu Zheng
- Nanshan School, Guangzhou Medical University, Guangzhou, China
| | - Qiu Zhong
- Nanshan School, Guangzhou Medical University, Guangzhou, China
| | - Jianxing He
- Department of Thoracic Surgery and Oncology, the First Affiliated Hospital of Guangzhou Medical University, State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou, China
| | - Wenhua Liang
- Department of Thoracic Surgery and Oncology, the First Affiliated Hospital of Guangzhou Medical University, State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou, China
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You W. Ambient ultraviolet radiation as a cardioprotective factor: A global and regional analysis. Health Sci Rep 2024; 7:e70065. [PMID: 39286740 PMCID: PMC11403301 DOI: 10.1002/hsr2.70065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Revised: 08/23/2024] [Accepted: 08/28/2024] [Indexed: 09/19/2024] Open
Abstract
Background Ambient ultraviolet radiation (UVR) has been found to have a greater cardioprotective effect than previously believed. This study aimed to quantitatively measure the role of UVR in protecting against the progression of cardiovascular disease (CVD) in general on a global and regional scale. Methods Population-level data on UVR, CVD incidence, aging, economic affluence, CVD genetic background (indexed with the Biological State Index, Ibs), obesity prevalence, and urbanization were collected and analysed. The correlation between UVR and CVD was examined using bivariate correlations, partial correlation, and stepwise multiple linear regression. Countries were grouped to investigate regional correlations between UVR and CVD, and Fisher's r-to-z transformation was used to compare correlation coefficients. Results UVR showed a significant inverse correlation with CVD incidence rates in bivariate correlation analyses globally (r = - 0.775 and r = - 0.760, p < 0.001), as well as within high-income (r = -0.704, p < 0.001) and low- and middle-income countries (LMIC) (r = -0.851, p < 0.001). These correlations remained significant even after controlling for confounding variables (r = -0.689 to -0.812, p < 0.001). In stepwise regression models, UVR was found to be the most significant predictor of CVD incidence. The inverse correlation between UVR and CVD was stronger in LMICs compared to high-income countries (z = -1.96, p < 0.050). Conclusions Low ambient UVR may be a significant risk factor for the progression of CVD worldwide. The protective effect of UVR appears to be stronger in LMICs than in high-income countries, suggesting a greater impact of UVR on CVD prevention in these regions. These findings emphasize the need for further research into the mechanisms underlying the cardioprotective effects of UVR and the development of public health strategies to mitigate CVD risk associated with low UVR exposure.
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Affiliation(s)
- Wenpeng You
- Adelaide Medical School The University of Adelaide Adelaide South Australia Australia
- Heart and Lung, Royal Adelaide Hospital Adelaide South Australia Australia
- Adelaide Nursing School The University of Adelaide Adelaide South Australia Australia
- School of Nursing and Midwifery Western Sydney University Sydney New South Wales Australia
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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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Chang MS, Hartman RI, Trepanowski N, Giovannucci EL, Nan H, Li X. Cumulative Erythemal Ultraviolet Radiation and Risk of Cancer in 3 Large US Prospective Cohorts. Am J Epidemiol 2022; 191:1742-1752. [PMID: 35671977 PMCID: PMC9991893 DOI: 10.1093/aje/kwac101] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Revised: 05/20/2022] [Accepted: 06/01/2022] [Indexed: 01/29/2023] Open
Abstract
Ultraviolet radiation (UVR) exposure is the major risk factor for melanoma. However, epidemiologic studies on UVR and noncutaneous cancers have reported inconsistent results, with some suggesting an inverse relationship potentially mediated by vitamin D. To address this, we examined 3 US prospective cohorts, the Health Professionals Follow-up Study (HPFS) (1986) and Nurses' Health Study (NHS) I and II (1976 and 1989), for associations between cumulative erythemal UVR and incident cancer risk, excluding nonmelanoma skin cancer. We used a validated spatiotemporal model to calculate erythemal UVR. Participants (47,714 men; 212,449 women) were stratified into quintiles by cumulative average erythemal UVR, using the first quintile as referent, for Cox proportional hazards regression analysis. In the multivariable-adjusted meta-analysis of all cohorts, compared with the lowest quintile, risk of any cancer was slightly increased across all other quintiles (highest quintile hazard ratio (HR) = 1.04, 95% confidence interval (CI): 1.01, 1.07; P for heterogeneity = 0.41). All UVR quintiles were associated with similarly increased risk of any cancer excluding melanoma. As expected, erythemal UVR was positively associated with risk of melanoma (highest quintile HR = 1.17, 95% CI: 1.04, 1.31; P for heterogeneity = 0.83). These findings suggest that elevated UVR is associated with increased risk of both melanoma and noncutaneous cancers.
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Affiliation(s)
| | | | | | | | | | - Xin Li
- Correspondence to Dr. Xin Li, Department of Epidemiology, Richard M. Fairbanks School of Public Health, Indiana University, Health Sciences Building, RG 5114, 1050 Wishard Boulevard., Indianapolis, IN 46202 (e-mail: )
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Chang Z, Chen Y, Zhao Y, Fu J, Liu Y, Tang S, Han Y, Fan Z. Association of sunshine duration with acute myocardial infarction hospital admissions in Beijing, China: A time-series analysis within-summer. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 828:154528. [PMID: 35292318 DOI: 10.1016/j.scitotenv.2022.154528] [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: 12/29/2021] [Revised: 02/16/2022] [Accepted: 03/08/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Over the years, various epidemiological studies found that acute myocardial infarction (AMI) often shows seasonal rhythm patterning, which is usually influenced by the variations of environmental factors, such as air pollution, ambient temperature, solar activity, relative humidity. However, there are few studies on the impact of sunlight-induced AMI especially in developing countries, and they had inconsistent results. This study aimed to examine within-summer variations in the temporal association between sun exposure and AMI. METHODS We obtained hospitalization data for AMI of Beijing during 2013-2019. We used a distributed lag non-linear model (DLNM) combined with a quasi-Poisson regression model to estimate the non-linear lag effects of sunshine duration on AMI incidences. We evaluated the overall effect of AMI admissions with exposure to sunshine duration in the lag 0-21 days. RESULTS A total of 45,301 AMI cases were enrolled in our study during summer (June-September). The minimum of the morbidity was during days with a sunshine duration of 3.9 h. We found significant and U-shaped associations between sunshine duration and AMI, and the overall estimated relative risk was 1.29 (95% CI: 1.02,1.62) and 1.69 (95% CI: 1.28,2.24) for short (1st percentile) and long (99th percentile) sunshine duration, respectively. The males and younger people (<65 years) were most susceptible to these effects. CONCLUSION Our results suggest that both short and long sunshine duration could increase the risk of AMI admissions, especially for males and younger people. We suggest that public health policymakers should fully consider the balance of the pros and cons of solar exposure, and provide appropriate public health recommendations accordingly to gain the greatest benefits from sunlight.
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Affiliation(s)
- Zhen'ge Chang
- Department of Cardiology, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing, China
| | - Yuxiong Chen
- Department of Cardiology, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing, China
| | - Yakun Zhao
- Department of Cardiology, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing, China
| | - Jia Fu
- Department of Cardiology, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing, China
| | - Yijie Liu
- Department of Cardiology, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing, China
| | - Siqi Tang
- Department of Cardiology, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing, China
| | - Yitao Han
- Department of Cardiology, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing, China
| | - Zhongjie Fan
- Department of Cardiology, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing, China.
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Davis GE, Davis MJ, Lowell WE. The effect of ultraviolet radiation on the incidence and severity of major mental illness using birth month, birth year, and sunspot data. Heliyon 2022; 8:e09197. [PMID: 35368522 PMCID: PMC8969152 DOI: 10.1016/j.heliyon.2022.e09197] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2021] [Revised: 08/06/2021] [Accepted: 03/22/2022] [Indexed: 11/16/2022] Open
Abstract
Background and objectives The evaluation of the severity of patients afflicted with major mental illness (MMI) has been problematic because of confounding variables and genetic variability. There have been multiple studies that suggest several human diseases, especially schizophrenia, are predisposed to be born in certain months or seasons. This observation implied an epigenetic effect of sunlight, likely ultraviolet radiation (UVR), which is damaging to DNA, especially in an embryo. This paper outlines a method to evaluate the severity of schizophrenia (SZ), bipolar disorder (BPD), and schizoaffective disorder (SZ-AFF) using the month/year of birth of those affected compared to the month/year of birth of the general population (GP). Relevance Our previous research found that more intense UVR (equal to or greater than 90 sunspot number (SSN)) had a negative effect on the average human lifespan. Also, human birth rates vary in frequency by month of birth reflecting variables like availability of food, sunlight, and other unknown epigenetic factors. We wanted to see if the patient month of birth varied from the average birth months of the general population and if UVR has an epigenetic effect promoting these diseases. Methods We obtained the month and year of birth of 1,233 patients admitted over a 15-year period to Maine's largest state psychiatric hospital and counted the months of birth for each diagnosis of SZ, BPD, and SZ-AFF, and compared these results to the general population's birth months of 4,265,555 persons from U. S. Census Year 2006. The number of patients in each month was normalized to August and compared with the normalized birth months of the general population (GP). Plots of the normalized months were considered rates of change (e.g., derivatives) and their respective integrals gave domains of each mental illness relative to the GP. Normalizing the GP to unity was then related to the factor 1.28, e.g., 28% more entropy, deduced from the Sun's fractal dimension imprinted on biological organisms. Results The percent of patients meeting our criterion for severity: SZ = 27%; BPD = 26%; SZ-AFF = 100%. Conclusions High UVR intensity or a rapid increase in UVR in early gestation are likely epigenetic triggers of major mental illness. BPD is more epigenetically affected than SZ or SZ-AFF disorders. We found that 52% of 1,233 patients comprised the core function of a tertiary-care psychiatric hospital. Also, mental illness exacerbated when the median SSN doubled. This work also validates the Kraeplinian dichotomy. What is new in this research This paper offers a new paradigm for evaluating the severity of MMI and supports significant epigenetic effects from UVR.
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Affiliation(s)
- George E Davis
- Riverview Psychiatric Center, 250 Arsenal Street, State House Station #11, Augusta, Maine, 04333-0011, USA
| | - Matthew J Davis
- Riverview Psychiatric Center, 250 Arsenal Street, State House Station #11, Augusta, Maine, 04333-0011, USA
| | - Walter E Lowell
- Riverview Psychiatric Center, 250 Arsenal Street, State House Station #11, Augusta, Maine, 04333-0011, USA
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Solar UV Exposure and Mortality from Skin Tumors: An Update. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2020. [PMID: 32918217 DOI: 10.1007/978-3-030-46227-7_7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/05/2023]
Abstract
Solar UV exposure is critical and complex in the etiology and prognosis of skin cancer, particularly cutaneous malignant melanoma. Sun exposure and one of its "derivatives," vitamin D, have been implicated in protection against mortality from melanoma. However, the relationships are inconsistent. At this time, it is not possible to make clear recommendations for or against sun exposure in relationship to melanoma prognosis. However, this relationship deserves continued exploration.
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Women with fair phenotypes seem to confer a survival advantage in a low UV milieu. A nested matched case control study. PLoS One 2020; 15:e0228582. [PMID: 31999788 PMCID: PMC6992199 DOI: 10.1371/journal.pone.0228582] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2019] [Accepted: 01/18/2020] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Sun exposure in combination with skin pigmentation is the main determinant for vitamin D status. Human skin color seems to be adapted and optimized for regional sun ultraviolet (UV) intensity. However, we do not know if fair, UV-sensitive skin is a survival advantage in regions with low UV radiation. METHODS A population-based nested case-control study of 29,518 Caucasian women, ages 25 to 64 years from Southern Sweden who responded to a questionnaire regarding risk-factors for malignant melanoma in 1990 and followed for 25 years. For each fair woman, defined as having red hair or freckles (n = 11,993), a control was randomly selected from all non-fair women from within the cohort of similar age, smoking habits, education, marital status, income, and comorbidity, i.e., 11,993 pairs. The main outcome was the difference in all-cause mortality between fair and non-fair women in a low UV milieu, defined as living in Sweden and having low-to-moderate sun exposure habits. Secondary outcomes were mortality by sun exposure, and among those non-overweight. RESULTS In a low UV milieu, fair women were at a significantly lower all-cause mortality risk as compared to non-fair women (log rank test p = 0.04) with an 8% lower all-cause mortality rate (hazard ratio [HR] = 0.92, 95% CI 0.84‒1.0), including a 59% greater risk of dying from skin cancer among fair women (HR 1.59, 95% CI 1.26‒2.0). Thus, it seem that the beneficial health effect from low skin coloration outweigh the risk of skin cancer at high latitudes. CONCLUSION In a region with low UV milieu, evolution seems to improve all-cause survival by selecting a fair skin phenotype, i.e., comprising fair women with a survival advantage.
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Tse BCY, Byrne SN. Lipids in ultraviolet radiation-induced immune modulation. Photochem Photobiol Sci 2020; 19:870-878. [DOI: 10.1039/d0pp00146e] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Ultraviolet (UV) radiation modulates cutaneous lipids which in turn mediates immune suppression – a key mechanism conferring both detrimental and beneficial impacts of sun exposure on human health.
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Affiliation(s)
- Benita C. Y. Tse
- The University of Sydney
- School of Medical Sciences
- Faculty of Medicine and Health
- Sydney
- Australia
| | - Scott N. Byrne
- The University of Sydney
- School of Medical Sciences
- Faculty of Medicine and Health
- Sydney
- Australia
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Park HY, Hong YC, Lee K, Koh J. Vitamin D status and risk of non-Hodgkin lymphoma: An updated meta-analysis. PLoS One 2019; 14:e0216284. [PMID: 31034511 PMCID: PMC6488072 DOI: 10.1371/journal.pone.0216284] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2018] [Accepted: 04/17/2019] [Indexed: 01/11/2023] Open
Abstract
Purpose This meta-analysis aimed to extensively investigate the association between various measures of vitamin D status and non-Hodgkin lymphoma (NHL) and its subtypes. Methods We searched MEDLINE (PubMed), Embase, and the Cochrane Library in February 2018. Two authors independently reviewed and selected articles based on predetermined criteria. Results A total of 30 studies with 56,458 NHL cases were finally selected, with 24, 9, and 3 studies on sunlight/ultraviolet radiation (UVR) exposure, dietary intake, and serum/plasma 25-hydroxyvitamin D levels, respectively. Significant protective effects of overall sunlight/UVR exposure on NHL and subtypes were observed, with summary relative risks (RRs) ranging from 0.67–0.80 (RR for NHL = 0.80; 95% confidence interval [CI]: 0.71–0.90) among subjects with high exposure compared to those with low exposure. The results were consistent with various classifications of sunlight/UVR exposure. In contrast, when exposure measures of dietary vitamin D intake (RR for NHL = 1.03; 95% CI: 0.90–1.19) and serum/plasma 25-hydroxyvitamin D levels (RR for NHL = 0.97; 95% CI: 0.82–1.15) were used, risk estimates were inconsistent or non-significant for NHL and the subtypes. Conclusion While risk estimates varied by different measures of vitamin D status, a protective effect of sunlight/UVR exposure on NHL incidence was verified, across most of the tested subtypes as well as exposure categories.
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Affiliation(s)
- Hye Yin Park
- Samsung Health Research Institute, Samsung Electronics Co. Ltd., Hwaseong-si, Gyeonggi-do, Korea
- Institute of Environmental Medicine, Seoul National University Medical Research Center, Seoul, Korea
- * E-mail:
| | - Yun-Chul Hong
- Institute of Environmental Medicine, Seoul National University Medical Research Center, Seoul, Korea
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea
- Environment Health Center, Seoul National University, Seoul, Korea
| | - Kyoungho Lee
- Samsung Health Research Institute, Samsung Electronics Co. Ltd., Hwaseong-si, Gyeonggi-do, Korea
| | - Jaewoo Koh
- Samsung Health Research Institute, Samsung Electronics Co. Ltd., Hwaseong-si, Gyeonggi-do, Korea
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12
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Kimlin MG, Fang L, Feng Y, Wang L, Hao L, Fan J, Wang N, Meng F, Yang R, Cong S, Liang X, Wang B, Linet M, Potischman N, Kitahara C, Chao A, Wang Y, Sun J, Brodie A. Personal ultraviolet Radiation exposure in a cohort of Chinese mother and child pairs: the Chinese families and children study. BMC Public Health 2019; 19:281. [PMID: 30849990 PMCID: PMC6408854 DOI: 10.1186/s12889-019-6610-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Accepted: 02/28/2019] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Few studies in China have examined personal ultraviolet radiation (UVR) exposure using polysulfone dosimetry. METHODS In this study, 93 mother and adolescent child pairs (N = 186) from two locations in China, one rural (higher latitude) and one urban (lower latitude), completed 3 days of personal UVR dosimetry and a sun/clothing diary, as part of a larger pilot study. RESULTS The average daily ambient UVR in each location as measured by dosimetry was 20.24 Minimal Erythemal Doses (MED) in the rural location and 20.53 MED in the urban location. Rural mothers had more average daily time outdoors than urban mothers (5.5 h, compared with 1.5 h, in urban mothers) and a much higher daily average personal UVR exposure (4.50 MED, compared with 0.78 MED in urban mothers). Amongst adolescents, rural males had the highest average daily personal UVR exposure, followed by rural females, urban females and urban males (average 2.16, 1.05, 0.81, and 0.48 MED, respectively). CONCLUSIONS Although based on small numbers, our findings show the importance of geographic location, age, work/school responsibilities, and sex of the adolescents in determining personal UVR exposure in China. These results suggest that latitude of residence may not be a good proxy for personal UVR exposure in all circumstances.
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Affiliation(s)
- Michael G. Kimlin
- University of the Sunshine Coast, Maroochydore, Faculty of Science, Health, Education and Engineering, Locked Bag 4, Maroochydore DC, Queensland 4558 Australia
- Cancer Council Queensland, Brisbane, Australia
| | - Liwen Fang
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, 27 Nanwei Road, Xicheng District, Beijing, 100050 Beijing China
| | - Yajing Feng
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, 27 Nanwei Road, Xicheng District, Beijing, 100050 Beijing China
| | - Linhong Wang
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, 27 Nanwei Road, Xicheng District, Beijing, 100050 Beijing China
| | - Ling Hao
- US Centers for Disease Control and Prevention, Atlanta, GA USA
| | - Jing Fan
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, 27 Nanwei Road, Xicheng District, Beijing, 100050 Beijing China
| | - Ning Wang
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, 27 Nanwei Road, Xicheng District, Beijing, 100050 Beijing China
| | - Fanwen Meng
- Laoting County Maternal and Child Health Hospital, Laoting, Hebei China
| | - Ruilan Yang
- Taicang County Maternal and Child Health Hospital, Taicang, Jiangsu China
| | - Shu Cong
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, 27 Nanwei Road, Xicheng District, Beijing, 100050 Beijing China
| | - Xiaofeng Liang
- Chinese Center for Disease Control and Prevention, Beijing, China
| | - Baohua Wang
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, 27 Nanwei Road, Xicheng District, Beijing, 100050 Beijing China
| | - Martha Linet
- National Cancer Institute (NIH) - Division of Cancer Epidemiology and Genetics, Bethesda, MD USA
| | - Nancy Potischman
- National Cancer Institute, Office of Dietary Supplements, Bethesda, MD USA
| | - Cari Kitahara
- National Cancer Institute (NIH) - Division of Cancer Epidemiology and Genetics, Bethesda, MD USA
| | - Ann Chao
- National Cancer Institute, Center for Global Health, Bethesda, MD USA
| | - Yu Wang
- Chinese Center for Disease Control and Prevention, Beijing, China
| | - Jiandong Sun
- University of the Sunshine Coast, Maroochydore, Faculty of Science, Health, Education and Engineering, Locked Bag 4, Maroochydore DC, Queensland 4558 Australia
| | - Alison Brodie
- University of the Sunshine Coast, Maroochydore, Faculty of Science, Health, Education and Engineering, Locked Bag 4, Maroochydore DC, Queensland 4558 Australia
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13
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Scragg R, Rahman J, Thornley S. Association of sun and UV exposure with blood pressure and cardiovascular disease: A systematic review. J Steroid Biochem Mol Biol 2019; 187:68-75. [PMID: 30412763 DOI: 10.1016/j.jsbmb.2018.11.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2018] [Accepted: 11/05/2018] [Indexed: 12/24/2022]
Abstract
BACKGROUND Ecological studies show that sun or ultraviolet (UV) exposure have inverse associations with blood pressure (BP) and cardiovascular disease (CVD). Although sunlight is the primary source of vitamin D, recent meta-analyses of clinical trials have not reported a beneficial effect from vitamin D supplementation on BP or CVD. Sunlight may have beneficial effects independent of vitamin D. We carried out a systematic review to appraise the extent and quality of the evidence from human studies. METHODS Observational and interventional studies that measured sun or UV exposure, along with BP or CVD, were selected after searching databases. RESULTS Identified studies could not be combined quantitatively in meta-analysis because of different exposure measures. Solar exposure was inversely associated with BP in 3 out of 4 cross-sectional publications, and with CVD and/or total mortality in 5 out of 6 publications of cohort studies. Two of the cohort studies reported inverse associations between sun exposure and CVD, after adjusting for serum 25-hydroxyvitamin D. Five clinical trials with an appropriate control group were identified, the outcome being BP. Two trials compared UVB with UVA (as control), with only one finding a significant reduction in BP (after 6 weeks). Three trials compared short-term UVA exposure (<30 min) with placebo (or crossover control), of which two reported short-term lowering of BP. CONCLUSION This review has identified a small body of evidence that suggests sun exposure protects against high BP and CVD, but further research is required to determine if this is independent of vitamin D.
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Affiliation(s)
- Robert Scragg
- School of Population Health, University of Auckland, Auckland, New Zealand.
| | - Juma Rahman
- School of Population Health, University of Auckland, Auckland, New Zealand
| | - Simon Thornley
- School of Population Health, University of Auckland, Auckland, New Zealand
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14
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Vitamin D deficiency in relation to the poor functional outcomes in nondiabetic patients with ischemic stroke. Biosci Rep 2018; 38:BSR20171509. [PMID: 29437901 PMCID: PMC5835715 DOI: 10.1042/bsr20171509] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2017] [Revised: 01/24/2018] [Accepted: 01/29/2018] [Indexed: 12/25/2022] Open
Abstract
To assess the hypothesis that vitamin D, reflected by 25-hydroxyvitamin D (25(OH) D) would be associated with higher risk of poor functional outcomes amongst nondiabetic stroke patients. The present study was conducted in Nanchang, China. Serum concentration of 25(OH) D and National Institutes of Health Stroke Scale (NIHSS) were measured at the time of admission. Functional outcome was measured by modified Rankin scale (mRS) at 1 year after admission. Multivariate analyses were performed using logistic regression models. The cut point of 25(OH) D level for vitamin D deficiency was 20 ng/ml. In the present study, 266 nondiabetic subjects with stroke were included; 149 out of the 266 patients were defined as vitamin D deficiency (56%). The poor outcome distribution across the 25(OH) D quartiles ranged between 64% (first quartile) and 13% (fourth quartile). In those 149 patients with vitamin D deficiency, 75 patients were defined as poor functional outcomes, giving a prevalence rate of 50% (95% confidence interval (CI): 42–58%). In multivariate analysis models, for vitamin D deficiency, the adjusted risk of poor functional outcomes and mortality increased by 220% (odds ratio (OR): 3.2; 95% CI: 1.7–4.2, P<0.001) and 290% (OR: 3.9; 95% CI: 2.1–5.8, P<0.001), respectively. Vitamin D deficiency is associated with an increased risk of poor functional outcome events in Chinese nondiabetic stroke individuals.
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Abstract
Despite it is now undeniable that indoor tanning exposure is associated with a number of skin cancers, its favorable effects on vitamin D status may bear some underestimated and currently unexplored health benefits. Vitamin D is a fat-soluble vitamin naturally present in a limited number of foods, the concentration of which largely depends on ultraviolet (UV) B sources exposure in humans. A strong, graded, and inverse association has been documented between serum vitamin D and the risk of developing certain types of malignancy, especially colorectal, breast, lung, bladder, and kidney cancers. The overall mortality from any type of cancer is also apparently lower in subjects with increased values of serum vitamin D. Both genomic and nongenomic mechanisms have been identified to support the anticancer effects of vitamin D. Notably, UVB radiation emitted from indoor tanning devices is effective to linearly increase the serum vitamin D concentration, up to twofold. Therefore, some favorable effects against the risk of developing many human diseases, including nonskin cancers, cannot be excluded at first glance, although they may not be only linked to vitamin D status. Further large, prospective or randomized studies should be hence planned to definitely establish whether the unfavorable effects of indoor tanning exposure on skin cancers may be outweighed by the still unexplored benefits attributable to amelioration of vitamin D status.
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16
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VoPham T, Bertrand KA, Yuan JM, Tamimi RM, Hart JE, Laden F. Ambient ultraviolet radiation exposure and hepatocellular carcinoma incidence in the United States. Environ Health 2017; 16:89. [PMID: 28821245 PMCID: PMC5562984 DOI: 10.1186/s12940-017-0299-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2017] [Accepted: 08/14/2017] [Indexed: 05/07/2023]
Abstract
BACKGROUND Hepatocellular carcinoma (HCC), the most commonly occurring type of primary liver cancer, has been increasing in incidence worldwide. Vitamin D, acquired from sunlight exposure, diet, and dietary supplements, has been hypothesized to impact hepatocarcinogenesis. However, previous epidemiologic studies examining the associations between dietary and serum vitamin D reported mixed results. The purpose of this study was to examine the association between ambient ultraviolet (UV) radiation exposure and HCC risk in the U.S. METHODS The Surveillance, Epidemiology, and End Results (SEER) database provided information on HCC cases diagnosed between 2000 and 2014 from 16 population-based cancer registries across the U.S. Ambient UV exposure was estimated by linking the SEER county with a spatiotemporal UV exposure model using a geographic information system. Poisson regression with robust variance estimation was used to calculate incidence rate ratios (IRRs) and 95% confidence intervals (CIs) for the association between ambient UV exposure per interquartile range (IQR) increase (32.4 mW/m2) and HCC risk adjusting for age at diagnosis, sex, race, year of diagnosis, SEER registry, and county-level information on prevalence of health conditions, lifestyle, socioeconomic, and environmental factors. RESULTS Higher levels of ambient UV exposure were associated with statistically significant lower HCC risk (n = 56,245 cases; adjusted IRR per IQR increase: 0.83, 95% CI 0.77, 0.90; p < 0.01). A statistically significant inverse association between ambient UV and HCC risk was observed among males (p for interaction = 0.01) and whites (p for interaction = 0.01). CONCLUSIONS Higher ambient UV exposure was associated with a decreased risk of HCC in the U.S. UV exposure may be a potential modifiable risk factor for HCC that should be explored in future research.
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Affiliation(s)
- Trang VoPham
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA USA
| | | | - Jian-Min Yuan
- Division of Cancer Control and Population Sciences, University of Pittsburgh Cancer Institute, Pittsburgh, PA USA
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA USA
| | - Rulla M. Tamimi
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA USA
| | - Jaime E. Hart
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA USA
- Exposure, Epidemiology, and Risk Program, Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA USA
| | - Francine Laden
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA USA
- Exposure, Epidemiology, and Risk Program, Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA USA
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17
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Onozuka D, Hagihara A. Within-summer variation in out-of-hospital cardiac arrest due to extremely long sunshine duration. Int J Cardiol 2017; 231:120-124. [DOI: 10.1016/j.ijcard.2016.12.179] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2016] [Revised: 12/18/2016] [Accepted: 12/21/2016] [Indexed: 12/30/2022]
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18
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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: 1.1] [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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19
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VoPham T, Hart JE, Bertrand KA, Sun Z, Tamimi RM, Laden F. Spatiotemporal exposure modeling of ambient erythemal ultraviolet radiation. Environ Health 2016; 15:111. [PMID: 27881169 PMCID: PMC5121956 DOI: 10.1186/s12940-016-0197-x] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2016] [Accepted: 11/19/2016] [Indexed: 05/08/2023]
Abstract
BACKGROUND Ultraviolet B (UV-B) radiation plays a multifaceted role in human health, inducing DNA damage and representing the primary source of vitamin D for most humans; however, current U.S. UV exposure models are limited in spatial, temporal, and/or spectral resolution. Area-to-point (ATP) residual kriging is a geostatistical method that can be used to create a spatiotemporal exposure model by downscaling from an area- to point-level spatial resolution using fine-scale ancillary data. METHODS A stratified ATP residual kriging approach was used to predict average July noon-time erythemal UV (UVEry) (mW/m2) biennially from 1998 to 2012 by downscaling National Aeronautics and Space Administration (NASA) Total Ozone Mapping Spectrometer (TOMS) and Ozone Monitoring Instrument (OMI) gridded remote sensing images to a 1 km spatial resolution. Ancillary data were incorporated in random intercept linear mixed-effects regression models. Modeling was performed separately within nine U.S. regions to satisfy stationarity and account for locally varying associations between UVEry and predictors. Cross-validation was used to compare ATP residual kriging models and NASA grids to UV-B Monitoring and Research Program (UVMRP) measurements (gold standard). RESULTS Predictors included in the final regional models included surface albedo, aerosol optical depth (AOD), cloud cover, dew point, elevation, latitude, ozone, surface incoming shortwave flux, sulfur dioxide (SO2), year, and interactions between year and surface albedo, AOD, cloud cover, dew point, elevation, latitude, and SO2. ATP residual kriging models more accurately estimated UVEry at UVMRP monitoring stations on average compared to NASA grids across the contiguous U.S. (average mean absolute error [MAE] for ATP, NASA: 15.8, 20.3; average root mean square error [RMSE]: 21.3, 25.5). ATP residual kriging was associated with positive percent relative improvements in MAE (0.6-31.5%) and RMSE (3.6-29.4%) across all regions compared to NASA grids. CONCLUSIONS ATP residual kriging incorporating fine-scale spatial predictors can provide more accurate, high-resolution UVEry estimates compared to using NASA grids and can be used in epidemiologic studies examining the health effects of ambient UV.
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Affiliation(s)
- Trang VoPham
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA USA
| | - Jaime E. Hart
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA USA
- Exposure, Epidemiology, and Risk Program, Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA USA
| | | | - Zhibin Sun
- U.S. Department of Agriculture UV-B Monitoring and Research Program, Colorado State University, Fort Collins, CO USA
| | - Rulla M. Tamimi
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA USA
| | - Francine Laden
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA USA
- Exposure, Epidemiology, and Risk Program, Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA USA
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van der Rhee HJ, de Vries E, Coebergh JW. Regular sun exposure benefits health. Med Hypotheses 2016; 97:34-37. [PMID: 27876126 DOI: 10.1016/j.mehy.2016.10.011] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2016] [Revised: 09/21/2016] [Accepted: 10/18/2016] [Indexed: 12/23/2022]
Abstract
Since it was discovered that UV radiation was the main environmental cause of skin cancer, primary prevention programs have been started. These programs advise to avoid exposure to sunlight. However, the question arises whether sun-shunning behaviour might have an effect on general health. During the last decades new favourable associations between sunlight and disease have been discovered. There is growing observational and experimental evidence that regular exposure to sunlight contributes to the prevention of colon-, breast-, prostate cancer, non-Hodgkin lymphoma, multiple sclerosis, hypertension and diabetes. Initially, these beneficial effects were ascribed to vitamin D. Recently it became evident that immunomodulation, the formation of nitric oxide, melatonin, serotonin, and the effect of (sun)light on circadian clocks, are involved as well. In Europe (above 50 degrees north latitude), the risk of skin cancer (particularly melanoma) is mainly caused by an intermittent pattern of exposure, while regular exposure confers a relatively low risk. The available data on the negative and positive effects of sun exposure are discussed. Considering these data we hypothesize that regular sun exposure benefits health.
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Affiliation(s)
- H J van der Rhee
- Department of Dermatology, Haga Teaching Hospital, Leyweg 275, 2545 CH Den Haag, The Netherlands.
| | - E de Vries
- Department of Clinical Epidemiology and Biostatistics, Pontificia Universidad Javeriana, Bogota, Carrera 7 No. 40-62, Colombia; Department of Public Health, Erasmus Medical Center, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands
| | - J W Coebergh
- Department of Public Health, Erasmus Medical Center, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands
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21
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Wright F, Weller RB. Risks and benefits of UV radiation in older people: More of a friend than a foe? Maturitas 2015; 81:425-31. [DOI: 10.1016/j.maturitas.2015.05.003] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2015] [Accepted: 05/11/2015] [Indexed: 12/17/2022]
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22
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Brøndum-Jacobsen P, Nordestgaard BG, Nielsen SF, Benn M. Authors' response to: skin cancer as a marker of sun exposure. Int J Epidemiol 2014; 43:1992-3. [PMID: 25335502 DOI: 10.1093/ije/dyu211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Peter Brøndum-Jacobsen
- Department of Clinical Biochemistry, Herlev Hospital, Copenhagen University Hospital and Faculty of Health and Medical Sciences, University of Copenhagen and Department of Clinical Biochemistry, Gentofte Hospital, Denmark Department of Clinical Biochemistry, Herlev Hospital, Copenhagen University Hospital and Faculty of Health and Medical Sciences, University of Copenhagen and Department of Clinical Biochemistry, Gentofte Hospital, Denmark
| | - Børge G Nordestgaard
- Department of Clinical Biochemistry, Herlev Hospital, Copenhagen University Hospital and Faculty of Health and Medical Sciences, University of Copenhagen and Department of Clinical Biochemistry, Gentofte Hospital, Denmark Department of Clinical Biochemistry, Herlev Hospital, Copenhagen University Hospital and Faculty of Health and Medical Sciences, University of Copenhagen and Department of Clinical Biochemistry, Gentofte Hospital, Denmark
| | - Sune F Nielsen
- Department of Clinical Biochemistry, Herlev Hospital, Copenhagen University Hospital and Faculty of Health and Medical Sciences, University of Copenhagen and Department of Clinical Biochemistry, Gentofte Hospital, Denmark
| | - Marianne Benn
- Department of Clinical Biochemistry, Herlev Hospital, Copenhagen University Hospital and Faculty of Health and Medical Sciences, University of Copenhagen and Department of Clinical Biochemistry, Gentofte Hospital, Denmark Department of Clinical Biochemistry, Herlev Hospital, Copenhagen University Hospital and Faculty of Health and Medical Sciences, University of Copenhagen and Department of Clinical Biochemistry, Gentofte Hospital, Denmark
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23
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Shapiro BB, Streja E, Chen JLT, Kovesdy CP, Kalantar-Zadeh K, Rhee CM. The relationship between ultraviolet light exposure and mortality in dialysis patients. Am J Nephrol 2014; 40:224-32. [PMID: 25322752 DOI: 10.1159/000367903] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2014] [Accepted: 08/25/2014] [Indexed: 01/05/2023]
Abstract
BACKGROUND Emerging data suggest that reduced exposure to ultraviolet (UV) radiation is associated with increased mortality in the general population. To date, the association between UV exposure and mortality in dialysis patients has not been examined. METHODS We examined the association between UV index, a proxy of UV exposure, and all-cause mortality among 47,286 US dialysis patients (entry period 2001-2006, with follow-up through 2009) from a large national dialysis organization using multivariable Cox regression. The UV index was ascertained by linking individual patients' residential zip codes to National Oceanic and Atmospheric Administration data, and was categorized as low (0-<3), moderate (3-<5), moderate-high (5-<6), high (6-<7), and very-high (≥7). In secondary analyses, we examined the UV index-mortality association within subgroups of age (<65 vs. ≥65 years old), sex, and race (white vs. non-white). RESULTS The study population's mean ± SD age was 60 ± 16 and included 46% women and 56% diabetics. Compared to patients residing in moderate-high UV index regions, those residing in high and very-high UV index regions had a lower mortality risk: adjusted HRs 0.84 (95% CI) 0.81-0.88 and 0.83 (95% CI) 0.75-0.91, respectively. A similar inverse association between UV index and mortality was observed across all subgroups, although there was more pronounced reduction in mortality among whites vs. non-whites. CONCLUSION These data suggest that dialysis patients residing in higher UV index regions have lower all-cause mortality compared to those living in moderate-high UV regions. Further studies are needed to determine the mechanisms underlying the UV index-mortality association.
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Affiliation(s)
- Bryan B Shapiro
- Harold Simmons Center for Chronic Disease Research and Epidemiology, Division of Nephrology and Hypertension, University of California Irvine Medical Center, Orange, Calif., USA
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Ohn JH, Kwon IH, Park J, Ryu OH, Lee SJ, Kim DM, Ihm SH, Choi MG, Yoo HJ, Hong EG. Unprotected daily sun exposure is differently associated with central adiposity and β-cell dysfunction by gender: the Korean National Health and Nutrition Examination Survey (KNHANES) V. ENVIRONMENTAL RESEARCH 2014; 133:253-259. [PMID: 24981823 DOI: 10.1016/j.envres.2014.05.033] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/29/2013] [Revised: 05/24/2014] [Accepted: 05/30/2014] [Indexed: 06/03/2023]
Abstract
BACKGROUND Ultraviolet irradiation by sun exposure has been associated with both harms and benefits to metabolic health. OBJECTIVE The objective of this study was to determine whether unprotected daily sun exposure is associated with the prevalence of diabetes and explore the underlying mechanism. METHODS We analyzed the Korean National Health and Nutrition Survey V from 2010 to 2011. Participants 19-60 years of age were asked about the average amount of time they had been exposed to direct sunlight per day since the age of 19. We categorized participants into three groups with different levels of lifetime daily sun exposure and explored the association of sun exposure with the prevalence of diabetes. RESULTS The risk of diabetes was higher in subjects with more than 5h of unprotected sun exposure per day, with an odds ratio of 2.39 (95% CI 1.75-3.25), compared to those with less than 2h of sun exposure, and the association remained significant after adjusting for diabetes risk factors. Long-term sun exposure was associated with increased central obesity and the possibility of an increase in visceral adiposity, especially among women, and with decrease in beta cell function and peripheral adiposity or percent body fat in men. CONCLUSIONS Our study provides a cutoff for upper limit of sun exposure and suggests unprotected daily sun exposure for more than 5h should be avoided to prevent diabetes. Increased central adiposity and decreased beta cell function were observed in women and men, respectively, who had long-term unprotected daily sun exposure.
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Affiliation(s)
- Jung Hun Ohn
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Hallym University College of Medicine, Chuncheon, Republic of Korea
| | - In Ho Kwon
- Department of Dermatology, Hallym University Dongtan Sacred Heart Hospital, Hwaseong, Republic of Korea
| | - Juri Park
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Hallym University College of Medicine, Chuncheon, Republic of Korea
| | - Ohk Hyun Ryu
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Hallym University College of Medicine, Chuncheon, Republic of Korea
| | - Seong Jin Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Hallym University College of Medicine, Chuncheon, Republic of Korea
| | - Doo-Man Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Hallym University College of Medicine, Chuncheon, Republic of Korea
| | - Sung-Hee Ihm
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Hallym University College of Medicine, Chuncheon, Republic of Korea
| | - Moon-Gi Choi
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Hallym University College of Medicine, Chuncheon, Republic of Korea
| | - Hyung Joon Yoo
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Hallym University College of Medicine, Chuncheon, Republic of Korea
| | - Eun-Gyoung Hong
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Hallym University College of Medicine, Chuncheon, Republic of Korea.
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Thayer ZM. The vitamin D hypothesis revisited: race-based disparities in birth outcomes in the United States and ultraviolet light availability. Am J Epidemiol 2014; 179:947-55. [PMID: 24618066 DOI: 10.1093/aje/kwu023] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
Skin color has been proposed to contribute to race-based health disparities in the United States because of differences in ultraviolet (UV) light-induced vitamin D synthesis. The prediction of this hypothesis, herein named the UVD hypothesis, is that racial disparities in health outcomes are correlated with UV light availability. This paper investigates whether UV light availability is associated with disparities in the rates of low birth weight (LBW) and preterm birth (PTB) between whites and blacks, because these outcomes are thought to be influenced by vitamin D status and to shape disease risk in later life. Data on LBW and PTB from 2007 (n = 2,825,620 births) were compared with data on UV light exposure across the United States. Contrary to the predictions of the UVD hypothesis, LBW and PTB rate disparities were greatest in states with the highest UV light exposure. Notably, income inequality was positively and significantly related to LBW and PTB disparities, even after controlling for UV light availability. The results of this analysis demonstrate that there is a significant environmental gradient in racial disparities in birth outcomes in the United States, but other social or environmental factors associated with living in the southern United States are likely stronger contributors to disparities in birth outcomes than UV light-induced vitamin D status.
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Hu H. Re: "prospective study of ultraviolet radiation exposure and mortality risk in the United States". Am J Epidemiol 2013; 178:1761-2. [PMID: 24243741 DOI: 10.1093/aje/kwt281] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Hui Hu
- Department of Epidemiology, College of Public Health and Health Professions and College of Medicine, University of Florida, Gainesville, FL 32610
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Grant WB. Re: "prospective study of ultraviolet radiation exposure and mortality risk in the United States". Am J Epidemiol 2013; 178:1760-1. [PMID: 24264295 DOI: 10.1093/aje/kwt265] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Affiliation(s)
- William B Grant
- Sunlight, Nutrition, and Health Research Center, P.O. Box 641603, San Francisco, CA 94164-1603
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The association of ultraviolet radiation-B (305 nm), season of diagnosis, and latitude on the survival outcome of prostate cancer in the high UV environment of Australia. Cancer Causes Control 2013; 24:2005-11. [PMID: 23974842 DOI: 10.1007/s10552-013-0277-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2013] [Accepted: 08/14/2013] [Indexed: 10/26/2022]
Abstract
BACKGROUND Positive associations between sun exposure and cancer survival have been observed in regions of high latitudes, where ambient solar ultraviolet (SUV) radiation is generally low. PURPOSE We examined the effects of ambient ultraviolet-B radiation (UVB) at time of diagnosis, season of diagnosis and latitude of residence on survival outcome from prostate cancer. METHOD Regression models for relative survival were used to estimate relative excess risks (RER) of death after diagnosis of prostate cancer from cancer registries in Eastern Australia (Queensland, New South Wales, Victoria and Tasmania). RESULTS Relative excess risks was increased with diagnosis in summer (RER = 1.20; 95 % CI 1.14-1.26) relative to winter, high ambient UVB at the time of diagnosis (>60 mW/m(2); RER = 1.10; 95 % CI 1.05-1.15) relative to low SUV (<30 mW/m(2)), and with residence in high latitudes (35°S-43°S; RER = 1.20; 95 % CI 1.14-1.26) relative to low latitudes (9°S-29.9°S). RER was highest for summer diagnosis in all three latitude bands, after adjusting for age, follow-up period, and socioeconomic status. CONCLUSION The contradictory outcome from season and latitude suggests that their use as surrogates for UV warrants validation. Our data suggest that high ambient solar ultraviolet radiation at the time of diagnosis of prostate cancer increases the risk of dying from this cancer.
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