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Anne Kricker - One of the best experts on this subject based on the ideXlab platform.
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Sun Exposure and Melanoma Survival: A GEM Study
Cancer Epidemiology Biomarkers & Prevention, 2014Co-Authors: Marianne Berwick, Bruce K. Armstrong, Anne Kricker, Anne E. Cust, Anne S. Reiner, Susan Paine, Chris Goumas, Nancy E. Thomas, Pamela A. Groben, Lynn FromAbstract:Background We previously reported a significant association between higher ultraviolet radiation Exposure before diagnosis and greater survival with melanoma in a population-based study in Connecticut. We sought to evaluate the hypothesis that Sun Exposure prior to diagnosis was associated with greater survival in a larger, international population-based study with more detailed Exposure information. Methods We conducted a multi-center, international population-based study in four countries - Australia, Italy, Canada and the United States - with 3,578 cases of melanoma with an average of 7.4 years of follow-up. Measures of Sun Exposure included Sunburn, intermittent Exposure, hours of holiday Sun Exposure, hours of water-related outdoor activities, ambient UVB dose, histological solar elastosis and season of diagnosis. Results Results were not strongly supportive of the earlier hypothesis. Having had any Sunburn in one year within 10 years of diagnosis was inversely associated with survival; solar elastosis - a measure of lifetime cumulative Exposure - was not. Additionally, none of the intermittent Exposure measures - water related activities and Sunny holidays - were associated with melanoma-specific survival. Estimated ambient UVB dose was not associated with survival. Conclusion Although there was an apparent protective effect of Sunburns within 10 years of diagnosis, there was only weak evidence in this large, international, population-based study of melanoma that Sun Exposure prior to diagnosis is associated with greater melanoma-specific survival. Impact This study adds to the evidence that Sun Exposure prior to melanoma diagnosis has little effect on survival with melanoma.
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Sun Exposure, Vitamin D and Cancer
2010Co-Authors: Bruce K. Armstrong, Anne KrickerAbstract:Exposure to Sunlight is the main source of Vitamin D. The first evidence that Vitamin D might protect against cancer came from ecological studies showing, mainly in the USA, that the rates of a range of cancers were lower where ambient solar radiation was higher. Prompted by these findings and evidence of Vitamin D’s anti-carcinogenic effects in basic biological studies, a number of epidemiological studies have investigated the possible inverse associations of Sun Exposure and Vitamin D with cancer. While a number of different types of cancer have been studied, the strongest available evidence suggests that high serum Vitamin D levels protect against colorectal cancer and that Sun Exposure probably protects against non-Hodgkin lymphoma. While it is plausible that a protective effect of Sun Exposure against cancer would be mediated through production of Vitamin D, there is currently little direct evidence of it. Present evidence does not justify giving or taking Vitamin D to prevent cancer. It is sufficient, however, to justify randomised controlled trials of doses of 1000 IU to 2000 IU of Vitamin D a day to see if it will prevent cancer. Known harmful effects of Vitamin D do not occur at these levels of intake. B751_Chapter-04.qxd 10/5/2009 3:12 PM Page 79
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Sun Exposure and Non-Hodgkin Lymphoma
Cancer Epidemiology Biomarkers & Prevention, 2007Co-Authors: Bruce K. Armstrong, Anne KrickerAbstract:It was initially hypothesized that Sun Exposure might cause non-Hodgkin lymphoma (NHL) on the following grounds: its incidence was increasing in parallel with that of cutaneous melanoma; its risk was increased in those with a history of melanoma or other skin cancer; Sun Exposure causes immune suppression; and immunosuppression for other reasons is associated with an increased risk of NHL. The association of NHL with prior skin cancer has been found consistently in subsequent studies, but results of ecological analyses have only partially supported this hypothesis. Contrary to it, three recent studies of NHL in individuals found that risk decreased, generally by 25% to 40%, across categories of increasing total or recreational, but not occupational, Sun Exposure. One study, thus far reported only in abstract, showed the opposite. Production of vitamin D from Sun Exposure offers a plausible mechanism for protection against NHL by Sun Exposure. A recent study has found a reduced risk of NHL in people with a high dietary intake of vitamin D. Results of additional studies in individuals and a planned original-data meta-analysis of case-control studies should help to resolve the present conflicting results on Sun Exposure and NHL.
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Ambient UV, personal Sun Exposure and risk of multiple primary melanomas.
Cancer Causes & Control, 2007Co-Authors: Anne Kricker, Bruce K. Armstrong, Chris Goumas, Melisa Litchfield, Colin B. Begg, Amanda J. Hummer, Loraine D. Marrett, Beth Theis, Robert C. Millikan, Nancy E. ThomasAbstract:Objective Sun Exposure is the main cause of melanoma in populations of European origin. No previous study has examined the effect of Sun Exposure on risk of multiple primary melanomas compared with people who have one melanoma.
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Personal Sun Exposure and risk of non Hodgkin lymphoma: a pooled analysis from the Interlymph Consortium.
International Journal of Cancer, 2007Co-Authors: Anne Kricker, Bruce K. Armstrong, Chris Goumas, Ann Maree Hughes, Karin E. Smedby, Tongzhang Zheng, John J. Spinelli, S. Sanjose, Patricia Hartge, Mads MelbyeAbstract:In 2004-2007 4 independent case-control studies reported evidence that Sun Exposure might protect against NHL; a fifth, in women only, found increased risks of NHL associated with a range of Sun Exposure measurements. These 5 studies are the first to examine the association between personal Sun Exposure and NHL. We report here on the relationship between Sun Exposure and NHL in a pooled analysis of 10 studies participating in the International Lymphoma Epidemiology Consortium (InterLymph), including the 5 published studies. Ten case-control studies covering 8,243 cases and 9,697 controls in the USA, Europe and Australia contributed original data for participants of European origin to the pooled analysis. Four kinds of measures of self-reported personal Sun Exposure were assessed at interview. A two-stage estimation method was used in which study-specific odds ratios (ORs) and 95% confidence intervals (CIs), adjusted for potential confounders including smoking and alcohol use, were obtained from unconditional logistic regression models and combined in random-effects models to obtain the pooled estimates. Risk of NHL fell significantly with the composite measure of increasing recreational Sun Exposure, pooled OR = 0.76 (95% CI 0.63-0.91) for the highest Exposure category (p for trend 0.01). A downtrend in risk with increasing total Sun Exposure was not statistically significant. The protective effect of recreational Sun Exposure was statistically significant at 18-40 years of age and in the 10 years before diagnosis, and for B cell, but not T cell, lymphomas. Increased recreational Sun Exposure may protect against NHL.
Bruce K. Armstrong - One of the best experts on this subject based on the ideXlab platform.
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Insufficient Sun Exposure Has Become a Real Public Health Problem.
International Journal of Environmental Research and Public Health, 2020Co-Authors: Lars Alfredsson, Bruce K. Armstrong, David G. Hoel, Frank R. De Gruijl, D. Allan Butterfield, Rajiv Chowdhury, Martin Feelisch, Cedric F. Garland, Prue H. Hart, Ramune JacobsenAbstract:This article aims to alert the medical community and public health authorities to accumulating evidence on health benefits from Sun Exposure, which suggests that insufficient Sun Exposure is a significant public health problem. Studies in the past decade indicate that insufficient Sun Exposure may be responsible for 340,000 deaths in the United States and 480,000 deaths in Europe per year, and an increased incidence of breast cancer, colorectal cancer, hypertension, cardiovascular disease, metabolic syndrome, multiple sclerosis, Alzheimer's disease, autism, asthma, type 1 diabetes and myopia. Vitamin D has long been considered the principal mediator of beneficial effects of Sun Exposure. However, oral vitamin D supplementation has not been convincingly shown to prevent the above conditions; thus, serum 25(OH)D as an indicator of vitamin D status may be a proxy for and not a mediator of beneficial effects of Sun Exposure. New candidate mechanisms include the release of nitric oxide from the skin and direct effects of ultraviolet radiation (UVR) on peripheral blood cells. Collectively, this evidence indicates it would be wise for people living outside the tropics to ensure they expose their skin sufficiently to the Sun. To minimize the harms of excessive Sun Exposure, great care must be taken to avoid Sunburn, and Sun Exposure during high ambient UVR seasons should be obtained incrementally at not more than 5-30 min a day (depending on skin type and UV index), in season-appropriate clothing and with eyes closed or protected by Sunglasses that filter UVR.
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Sun Exposure and Melanoma Survival: A GEM Study
Cancer Epidemiology Biomarkers & Prevention, 2014Co-Authors: Marianne Berwick, Bruce K. Armstrong, Anne Kricker, Anne E. Cust, Anne S. Reiner, Susan Paine, Chris Goumas, Nancy E. Thomas, Pamela A. Groben, Lynn FromAbstract:Background We previously reported a significant association between higher ultraviolet radiation Exposure before diagnosis and greater survival with melanoma in a population-based study in Connecticut. We sought to evaluate the hypothesis that Sun Exposure prior to diagnosis was associated with greater survival in a larger, international population-based study with more detailed Exposure information. Methods We conducted a multi-center, international population-based study in four countries - Australia, Italy, Canada and the United States - with 3,578 cases of melanoma with an average of 7.4 years of follow-up. Measures of Sun Exposure included Sunburn, intermittent Exposure, hours of holiday Sun Exposure, hours of water-related outdoor activities, ambient UVB dose, histological solar elastosis and season of diagnosis. Results Results were not strongly supportive of the earlier hypothesis. Having had any Sunburn in one year within 10 years of diagnosis was inversely associated with survival; solar elastosis - a measure of lifetime cumulative Exposure - was not. Additionally, none of the intermittent Exposure measures - water related activities and Sunny holidays - were associated with melanoma-specific survival. Estimated ambient UVB dose was not associated with survival. Conclusion Although there was an apparent protective effect of Sunburns within 10 years of diagnosis, there was only weak evidence in this large, international, population-based study of melanoma that Sun Exposure prior to diagnosis is associated with greater melanoma-specific survival. Impact This study adds to the evidence that Sun Exposure prior to melanoma diagnosis has little effect on survival with melanoma.
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Occupational Sun Exposure and risk of melanoma according to anatomical site
International Journal of Cancer, 2013Co-Authors: Kylie Vuong, Bruce K. Armstrong, Kevin Mcgeechan, Anne E. CustAbstract:Although Sunburn and intermittent Sun Exposures are associated with increased melanoma risk, most studies have found null or inverse associations between occupational (more continuous pattern) Sun Exposure and melanoma risk. The association of melanoma with occupational Sun Exposure may differ according to anatomical site, with some studies finding a positive association with melanoma on the head and neck. We examined the association between occupational Sun Exposure (self-reported weekday Sun Exposure) and melanoma risk according to anatomical site, using data from two multicentre population-based case-control studies: the Australian Melanoma Family Study (588 cases, 472 controls) and the Genes, Environment and Melanoma study (GEM; 1079 cases, 2,181 controls). Unconditional logistic regression was used to estimate odds ratios (OR) and their 95% confidence intervals, adjusting for potential confounders. Occupational Sun Exposure was not positively associated with melanoma risk overall or at different body sites in both studies. The GEM study found inverse associations between occupational Sun Exposure and melanoma on the head and neck [OR for highest vs. lowest quartile: 0.56, 95% confidence intervals (CI) 0.36-0.86, ptrend 0.02], and between the proportion of total Sun Exposure occurring on weekdays and melanoma on the upper limbs (OR for highest vs. lowest quartile: 0.66, 95% CI 0.42-1.02, ptrend 0.03). Our results suggest that occupational Sun Exposure does not increase risk of melanoma, even of melanomas situated on the head and neck. This finding seemed not to be due to negative confounding of occupational Sun Exposure by weekend Sun.
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Sun Exposure, Vitamin D and Cancer
2010Co-Authors: Bruce K. Armstrong, Anne KrickerAbstract:Exposure to Sunlight is the main source of Vitamin D. The first evidence that Vitamin D might protect against cancer came from ecological studies showing, mainly in the USA, that the rates of a range of cancers were lower where ambient solar radiation was higher. Prompted by these findings and evidence of Vitamin D’s anti-carcinogenic effects in basic biological studies, a number of epidemiological studies have investigated the possible inverse associations of Sun Exposure and Vitamin D with cancer. While a number of different types of cancer have been studied, the strongest available evidence suggests that high serum Vitamin D levels protect against colorectal cancer and that Sun Exposure probably protects against non-Hodgkin lymphoma. While it is plausible that a protective effect of Sun Exposure against cancer would be mediated through production of Vitamin D, there is currently little direct evidence of it. Present evidence does not justify giving or taking Vitamin D to prevent cancer. It is sufficient, however, to justify randomised controlled trials of doses of 1000 IU to 2000 IU of Vitamin D a day to see if it will prevent cancer. Known harmful effects of Vitamin D do not occur at these levels of intake. B751_Chapter-04.qxd 10/5/2009 3:12 PM Page 79
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Sun Exposure and melanoma risk at different latitudes: a pooled analysis of 5700 cases and 7216 controls
International Journal of Epidemiology, 2009Co-Authors: Yu-mei Chang, Bruce K. Armstrong, Marianne Berwick, Jennifer H. Barrett, Timothy Bishop, Veronique Bataille, Wilma Bergman, Paige M. Bracci, Mark Elwood, Marc S. ErnstoffAbstract:Background Melanoma risk is related to Sun Exposure; we have investigated risk variation by tumour site and latitude. Methods We performed a pooled analysis of 15 case-control studies (5700 melanoma cases and 7216 controls), correlating patterns of Sun Exposure, Sunburn and solar keratoses (three studies) with melanoma risk. Pooled odds ratios (pORs) and 95% Bayesian confidence intervals (CIs) were estimated using Bayesian unconditional polytomous logistic random-coefficients models. Results Recreational Sun Exposure was a risk factor for melanoma on the trunk (pOR 1.7; 95% CI: 1.4-2.2) and limbs (pOR 1.4; 95% CI: 1.1-1.7), but not head and neck (pOR 1.1; 95% CI: 0.8-1.4), across latitudes. Occupational Sun Exposure was associated with risk of melanoma on the head and neck at low latitudes (pOR 1.7; 95% CI: 1.0-3.0). Total Sun Exposure was associated with increased risk of melanoma on the limbs at low latitudes (pOR 1.5; 95% CI: 1.0-2.2), but not at other body sites or other latitudes. The pORs for Sunburn in childhood were 1.5 (95% CI: 1.3-1.7), 1.5 (95% CI: 1.3-1.7) and 1.4 (95% CI: 1.1-1.7) for melanoma on the trunk, limbs, and head and neck, respectively, showing little variation across latitudes. The presence of head and neck solar keratoses was associated with increased risk of melanoma on the head and neck (pOR 4.0; 95% CI: 1.7-9.1) and limbs (pOR 4.0; 95% CI: 1.9-8.4). Conclusion Melanoma risk at different body sites is associated with different amounts and patterns of Sun Exposure. Recreational Sun Exposure and Sunburn are strong predictors of melanoma at all latitudes, whereas measures of occupational and total Sun Exposure appear to predict melanoma predominately at low latitudes. Keywords Melanoma, recreational Sun Exposure, occupational Sun Exposure, total Sun Exposure, Sunburn, solar keratoses
Dallas R. English - One of the best experts on this subject based on the ideXlab platform.
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Sun Exposure and pterygium of the eye a dose response curve
American Journal of Ophthalmology, 1999Co-Authors: Timothy Threlfall, Dallas R. EnglishAbstract:Abstract PURPOSE: To present a quantitative analysis of pterygium and ocular Sun Exposure, a dose-response curve, and a discussion of the health-promotion implications of the findings. METHODS: A hospital-based, case-control study was conducted in Perth, Western Australia. Case subjects had surgical removal of a pterygium; control subjects had an ear, nose, or throat procedure. A lifetime history of residence, Sun Exposure patterns, and use of hats, spectacles, and Sunglasses was obtained at interview. Measures of potential Sun Exposure included latitude, daily Sunshine hours, and daily global solar radiant energy. The most complex estimate of actual Sun Exposure was the daily ocular solar radiation dose, calculated from climatic data, time spent outdoors not under shade, and the use of hats and spectacles. RESULTS: There were strong positive associations between pterygium and measures of potential and actual Sun Exposure. Associations were as strong for whole-life measures as for those in any specific age range. Pterygium odds ratios increased with Exposure level; the odds ratio was 4.0 (95% confidence interval, 1.6 to 10.9) for the highest quarter of the daily Sun Exposure. The strongest associations were seen for the estimated daily ocular solar radiation dose, with an odds ratio of 6.8 (95% confidence interval, 2.6 to 19.7) for the highest quarter of Exposure. CONCLUSIONS: Pterygium is strongly related to ocular Sun Exposure, with little evidence that Exposure during any particular period of life is more important than in other periods; the implication for prevention of pterygium is that ocular protection is beneficial at all ages.
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Sun Exposure and Skin Cancer
Australasian Journal of Dermatology, 1997Co-Authors: Bruce K. Armstrong, Anne Kricker, Dallas R. EnglishAbstract:By 1927 for basal cell carcinoma (BCC) and squamous cell carcinoma (SCC), and by 1955 for melanoma, the broad grounds for relating Sun Exposure to skin cancer had been established: that these are more frequent in residents of areas of high ambient solar irradiance, are more frequent in Sun-sensitive people, occur mainly on Sun-exposed body sites, are more frequent in people with high Sun Exposure, and are more frequent in people with benign Sun-related skin conditions. The past 40 years have added both quantity and quality to the epidemiological evidence and, most recently, provided direct evidence that Sun Exposure is the cause of mutations in critical tumour suppressor genes in BCC, SCC and melanoma. Complete or more convincing answers are still needed to many questions of detail. They include whether the pattern of Sun Exposure is really important in, and acts independently of amount of Sun Exposure in, affecting the risk of melanoma and BCC; what the shape of the relationship between the amount of Sun Exposure and risk of BCC and melanoma is when the pattern of Exposure is held constant; whether there really is a plateau in risk of BCC and melanoma beyond some level of the amount of Exposure; whether this Exposure-response relationship depends on cutaneous sensitivity to the Sun and in what way; whether Sunburn makes a specific contribution to the risk of skin cancer independent of the amount of Sun Exposure; whether Sun Exposure close to the time of diagnosis of skin cancer contributes anything to the development of the cancer; what the solar radiation action spectrum is for each kind of skin cancer; and whether Sunscreens are effective in protecting against skin cancer.
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A dose-response curve for Sun Exposure and basal cell carcinoma.
International Journal of Cancer, 1995Co-Authors: Anne Kricker, Bruce K. Armstrong, Dallas R. English, Peter J. HeenanAbstract:A population-based case-control study of Sun Exposure and basal cell carcinoma (BCC) was conducted in Western Australia in 1988. Its aim was to examine the relationship between risk of BCC and the amount and pattern of Sun Exposure. This report deals with amount of Exposure. The odds ratios (ORs) for BCC on the head and neck and limbs decreased with increasing total Exposure, whereas the opposite was observed for BCC on the less heavily exposed trunk, with the highest OR in those with the greatest Exposure. In an analysis of all body sites together in which the total hours of Exposure to the specific site was treated as a continuous variable, an initial rise in risk of BCC was seen with a peak OR of 1.4 at about 35,000 hr of Exposure, followed by a fall. In contrast to these site-specific patterns, lifetime accumulated Sun Exposure of the whole body showed no appreciable association with BCC either in total or for working days only. Risk of BCC was positively associated with lifetime Exposure on non-working days, however, with an OR for higher than baseline categories of around 1.7. There was a significant interaction between ability to tan and total and occupational Sun Exposure. Risk increased with increasing Exposure in those who tanned well but not in those who tanned poorly. This pattern is consistent with other observations which indicate that beyond a certain level of Sun Exposure risk of BCC does not increase further.
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Sun Exposure and non-melanocytic skin cancer
Cancer Causes & Control, 1994Co-Authors: Anne Kricker, Bruce K. Armstrong, Dallas R. EnglishAbstract:Non-melanocytic skin cancer has long been regarded as one of the harmful effects of solar ultraviolet (UV) radiation on human health. In this review, we examine epidemiologic evidence linking Sun Exposure and skin cancer coming from both descriptive studies in populations and analytical studies involving estimates of Exposure in individuals. Particular attention is given to the quality of the published data. The epidemiologic evidence that Sun Exposure causes skin cancer is mainly indirect. Incidence or mortality is inversely related to latitude in populations of mainly European origin (e.g., the United States, Australia), and is higher in people born in Australia (high ambient solar radiation) than in migrants to Australia from the United Kingdom (lower ambient radiation). Skin cancer occurs mainly at Sun-exposed body sites and in people who are sensitive to the Sun; a reduced capacity to repair UV-induced DNA damage appears to increase the risk. The direct evidence linking Sun Exposure and skin cancer is weaker with few well-conducted studies of Sun Exposure in individuals. Mostly, studies of total Sun Exposure have not found statistically significant positive associations; those that did, had not adjusted for potential confounding by age and gender and thus their interpretation is limited. Studies of occupational Sun Exposure had relative risks not greater than 2.0; recreational Exposure has been little studied. Other measurements, less direct but potentially less prone to measurement error, are Sunburn (not evidently associated with skin cancer risk) and indicators of benign cutaneous Sun-damage (strongly associated but lacking empirical evidence that Sun Exposure is their main cause). Many questions remain about the relationship between Sun Exposure and skin cancer.Cancer Causes and Control 1994, 5, 367–392
Terence Dwyer - One of the best experts on this subject based on the ideXlab platform.
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The Influence of Sun Exposure in Childhood and Adolescence on Atopic Disease at Adolescence
Pediatric Allergy and Immunology, 2013Co-Authors: Andrew S Kemp, Annelouise Ponsonby, Terence Dwyer, Angela Pezic, Jennifer Cochrane, Graeme JonesAbstract:BACKGROUND: It has been postulated that ultraviolet ray Exposure in childhood might influence the development of allergic disease. We examined whether reported Sun Exposure during childhood or in adolescence is related to the occurrence of atopy or allergic disease. METHODS: Population-based longitudinal cohort study with sixteen-year follow-up (N = 415). Subjects were recruited at birth as part of an infant health study. The reported daily duration of Sun Exposure in the summer months was recorded at 8 and 16 yrs of age. Allergen sensitization and the presence of eczema, asthma, and rye grass positive rhinitis were recorded at age 16. RESULTS: Reported Sun Exposures of more than 4 h per day during summer holidays in adolescence were associated with reduced eczema and rhinitis but not inhalant allergen sensitization or asthma risk. Thus, higher Sun Exposure during summer holidays and summer weekends in adolescence was associated with significantly reduced eczema (test of trend p-value = 0.001 summer holidays; test of trend p-value = 0.003 summer weekends) and rye grass positive rhinitis (test of trend p-value = 0.03 summer holidays; test of trend p-value = 0.02 summer weekends). Sun Exposure at adolescence or age 8 was not related to inhalant allergen sensitization. There was no association between serum 25(OH)D levels at adolescence with either inhalant allergen sensitization or allergic disease and adjustment for serum 25(OH)D levels did not alter these findings. CONCLUSIONS: Increased Sun Exposure during summer holidays in adolescence was associated with reduced eczema and rhinitis risk, independently of measured vitamin D levels but no difference in inhalant allergen sensitization or asthma. The beneficial effects of Sun Exposure on allergic disease may operate independently from vitamin D or an effect on allergen sensitization.
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Sun Exposure and vitamin d are independent risk factors for cns demyelination
Neurology, 2011Co-Authors: Robyn M. Lucas, Annelouise Ponsonby, Keith Dear, Patricia C Valery, Michael P Pender, Bruce V Taylor, Trevor J Kilpatrick, Terence Dwyer, Alan Coulthard, Caron ChapmanAbstract:Objectives: To examine whether past and recent Sun Exposure and vitamin D status (serum 25-hydroxyvitamin D [25(OH)D] levels) are associated with risk of first demyelinating events (FDEs) and to evaluate the contribution of these factors to the latitudinal gradient in FDE incidence in Australia. Methods: This was a multicenter incident case-control study. Cases (n = 216) were aged 18–59 years with a FDE and resident within one of 4 Australian centers (from latitudes 27°S to 43°S), from November 1, 2003, to December 31, 2006. Controls (n = 395) were matched to cases on age, sex, and study region, without CNS demyelination. Exposures measured included self-reported Sun Exposure by life stage, objective measures of skin phenotype and actinic damage, and vitamin D status. Results: Higher levels of past, recent, and accumulated leisure-time Sun Exposure were each associated with reduced risk of FDE, e.g., accumulated leisure-time Sun Exposure (age 6 years to current), adjusted odds ratio (AOR) = 0.70 (95% confidence interval [CI] 0.53–0.94) for each ultraviolet (UV) dose increment of 1,000 kJ/m 2 (range 508–6,397 kJ/m 2 ). Higher actinic skin damage (AOR = 0.39 [95% CI 0.17–0.92], highest grade vs the lowest) and higher serum vitamin D status (AOR = 0.93 [95% CI 0.86–1.00] per 10 nmol/L increase in 25(OH)D) were independently associated with decreased FDE risk. Differences in leisure-time Sun Exposure, serum 25(OH)D level, and skin type additively accounted for a 32.4% increase in FDE incidence from the low to high latitude regions. Conclusions: Sun Exposure and vitamin D status may have independent roles in the risk of CNS demyelination. Both will need to be evaluated in clinical trials for multiple sclerosis prevention.
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melanocortin 1 receptor genotype past environmental Sun Exposure and risk of multiple sclerosis
Neurology, 2008Co-Authors: Terence Dwyer, Annelouise Ponsonby, Bruce V Taylor, Jim Stankovich, J Mckay, Russell Thomson, Andrea Polanowski, Joanne L DickinsonAbstract:OBJECTIVE: Low past Sun Exposure, fair skin type, and polymorphisms of the MC1R gene have been associated with multiple sclerosis (MS) risk. We aimed to investigate the interplay between melanocortin 1 receptor gene variants, red hair/fair skin phenotype, and past environmental Sun Exposure in MS. METHODS: Population-based case-control study in Tasmania, Australia, involving 136 cases with MS and 272 controls randomly drawn from the community and matched on sex and year of birth. Measures included past Sun Exposure by calendar and questionnaire, spectrophotometric skin type, and MC1R genotype, with any MC1R Arg151Cys, Arg160Trp, or Asp294His alleles present denoted as red hair color (RHC) variant. RESULTS: The association between RHC variant genotype and MS was more evident for women (odds ratio 2.02 [1.15-3.54]) than for men (odds ratio 0.65 [0.27-1.57]) (difference in effect, p = 0.03). The RHC variant genotype was associated with behavioral Sun avoidance. In addition, increasing summer Sun Exposure at ages 6 through 10 years was associated with reduced MS risk among those with no RHC variant (p = 0.03), but not among those with RHC variant genotype (p = 0.15; difference in effect, p = 0.02). Similar findings were evident for other past Sun Exposure measures and when the sample was restricted to women only. CONCLUSION: The interplay between red hair color variant genotype, red hair/fair skin phenotype, and multiple sclerosis (MS) is complex. The modification of past Sun Exposure by MC1R genotype provides further support that ultraviolet radiation or derivatives such as vitamin D may be causally related to a reduced MS risk.
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Validity and Reliability of Adult Recall of Past Sun Exposure in a Case-Control Study of Multiple Sclerosis
Cancer Epidemiology Biomarkers & Prevention, 2006Co-Authors: I.a.f. Van Der Mei, Annelouise Ponsonby, Leigh Blizzard, Terence DwyerAbstract:Background: Measurement of past Sun Exposure through recall by adults has the potential for measurement error. We aimed to investigate aspects of validity and reliability of self-reported past Sun Exposure. Methods: A population-based case-control study was conducted in Tasmania on 136 cases with multiple sclerosis and 272 age- and sex-matched community controls. Repeat interviews on 52 cases and 52 controls were done on average 11 weeks after the initial interview. Sun Exposure was assessed by questionnaire and lifetime calendar. Other measurements included serum 25-hydroxyvitamin D, actinic damage, and skin phenotype. Results: There was an association between recent Sun Exposure and serum vitamin D (time in the Sun: r = 0.22, P < 0.01; activities outside: r = 0.31, P < 0.01 for controls) and between lifetime Sun Exposure and actinic damage [correlation between 0.34 ( P < 0.01) and 0.17 ( P = 0.01) for controls]. The test-retest weighted κ statistic of self-reported Sun Exposure ranged from 0.43 to 0.74. Recall of childhood/adolescent Sun Exposure by standardized questioning was no less reproducible than recall of recent adult Sun Exposure and no less reliable when made with the calendar method. Comparing the questionnaire and calendar method, the measures of childhood/adolescent Sun Exposure had a similar predictive validity for multiple sclerosis. Conclusions: The results of this study provide further evidence that adults are able to recall past Sun Exposure with shown validity and reliability and present information about the possible reasons for the good reliability of recalled Sun Exposure measures. (Cancer Epidemiol Biomarkers Prev 2006;15(8):1538–44)
Annelouise Ponsonby - One of the best experts on this subject based on the ideXlab platform.
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The Influence of Sun Exposure in Childhood and Adolescence on Atopic Disease at Adolescence
Pediatric Allergy and Immunology, 2013Co-Authors: Andrew S Kemp, Annelouise Ponsonby, Terence Dwyer, Angela Pezic, Jennifer Cochrane, Graeme JonesAbstract:BACKGROUND: It has been postulated that ultraviolet ray Exposure in childhood might influence the development of allergic disease. We examined whether reported Sun Exposure during childhood or in adolescence is related to the occurrence of atopy or allergic disease. METHODS: Population-based longitudinal cohort study with sixteen-year follow-up (N = 415). Subjects were recruited at birth as part of an infant health study. The reported daily duration of Sun Exposure in the summer months was recorded at 8 and 16 yrs of age. Allergen sensitization and the presence of eczema, asthma, and rye grass positive rhinitis were recorded at age 16. RESULTS: Reported Sun Exposures of more than 4 h per day during summer holidays in adolescence were associated with reduced eczema and rhinitis but not inhalant allergen sensitization or asthma risk. Thus, higher Sun Exposure during summer holidays and summer weekends in adolescence was associated with significantly reduced eczema (test of trend p-value = 0.001 summer holidays; test of trend p-value = 0.003 summer weekends) and rye grass positive rhinitis (test of trend p-value = 0.03 summer holidays; test of trend p-value = 0.02 summer weekends). Sun Exposure at adolescence or age 8 was not related to inhalant allergen sensitization. There was no association between serum 25(OH)D levels at adolescence with either inhalant allergen sensitization or allergic disease and adjustment for serum 25(OH)D levels did not alter these findings. CONCLUSIONS: Increased Sun Exposure during summer holidays in adolescence was associated with reduced eczema and rhinitis risk, independently of measured vitamin D levels but no difference in inhalant allergen sensitization or asthma. The beneficial effects of Sun Exposure on allergic disease may operate independently from vitamin D or an effect on allergen sensitization.
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Sun Exposure and vitamin d are independent risk factors for cns demyelination
Neurology, 2011Co-Authors: Robyn M. Lucas, Annelouise Ponsonby, Keith Dear, Patricia C Valery, Michael P Pender, Bruce V Taylor, Trevor J Kilpatrick, Terence Dwyer, Alan Coulthard, Caron ChapmanAbstract:Objectives: To examine whether past and recent Sun Exposure and vitamin D status (serum 25-hydroxyvitamin D [25(OH)D] levels) are associated with risk of first demyelinating events (FDEs) and to evaluate the contribution of these factors to the latitudinal gradient in FDE incidence in Australia. Methods: This was a multicenter incident case-control study. Cases (n = 216) were aged 18–59 years with a FDE and resident within one of 4 Australian centers (from latitudes 27°S to 43°S), from November 1, 2003, to December 31, 2006. Controls (n = 395) were matched to cases on age, sex, and study region, without CNS demyelination. Exposures measured included self-reported Sun Exposure by life stage, objective measures of skin phenotype and actinic damage, and vitamin D status. Results: Higher levels of past, recent, and accumulated leisure-time Sun Exposure were each associated with reduced risk of FDE, e.g., accumulated leisure-time Sun Exposure (age 6 years to current), adjusted odds ratio (AOR) = 0.70 (95% confidence interval [CI] 0.53–0.94) for each ultraviolet (UV) dose increment of 1,000 kJ/m 2 (range 508–6,397 kJ/m 2 ). Higher actinic skin damage (AOR = 0.39 [95% CI 0.17–0.92], highest grade vs the lowest) and higher serum vitamin D status (AOR = 0.93 [95% CI 0.86–1.00] per 10 nmol/L increase in 25(OH)D) were independently associated with decreased FDE risk. Differences in leisure-time Sun Exposure, serum 25(OH)D level, and skin type additively accounted for a 32.4% increase in FDE incidence from the low to high latitude regions. Conclusions: Sun Exposure and vitamin D status may have independent roles in the risk of CNS demyelination. Both will need to be evaluated in clinical trials for multiple sclerosis prevention.
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melanocortin 1 receptor genotype past environmental Sun Exposure and risk of multiple sclerosis
Neurology, 2008Co-Authors: Terence Dwyer, Annelouise Ponsonby, Bruce V Taylor, Jim Stankovich, J Mckay, Russell Thomson, Andrea Polanowski, Joanne L DickinsonAbstract:OBJECTIVE: Low past Sun Exposure, fair skin type, and polymorphisms of the MC1R gene have been associated with multiple sclerosis (MS) risk. We aimed to investigate the interplay between melanocortin 1 receptor gene variants, red hair/fair skin phenotype, and past environmental Sun Exposure in MS. METHODS: Population-based case-control study in Tasmania, Australia, involving 136 cases with MS and 272 controls randomly drawn from the community and matched on sex and year of birth. Measures included past Sun Exposure by calendar and questionnaire, spectrophotometric skin type, and MC1R genotype, with any MC1R Arg151Cys, Arg160Trp, or Asp294His alleles present denoted as red hair color (RHC) variant. RESULTS: The association between RHC variant genotype and MS was more evident for women (odds ratio 2.02 [1.15-3.54]) than for men (odds ratio 0.65 [0.27-1.57]) (difference in effect, p = 0.03). The RHC variant genotype was associated with behavioral Sun avoidance. In addition, increasing summer Sun Exposure at ages 6 through 10 years was associated with reduced MS risk among those with no RHC variant (p = 0.03), but not among those with RHC variant genotype (p = 0.15; difference in effect, p = 0.02). Similar findings were evident for other past Sun Exposure measures and when the sample was restricted to women only. CONCLUSION: The interplay between red hair color variant genotype, red hair/fair skin phenotype, and multiple sclerosis (MS) is complex. The modification of past Sun Exposure by MC1R genotype provides further support that ultraviolet radiation or derivatives such as vitamin D may be causally related to a reduced MS risk.
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Validity and Reliability of Adult Recall of Past Sun Exposure in a Case-Control Study of Multiple Sclerosis
Cancer Epidemiology Biomarkers & Prevention, 2006Co-Authors: I.a.f. Van Der Mei, Annelouise Ponsonby, Leigh Blizzard, Terence DwyerAbstract:Background: Measurement of past Sun Exposure through recall by adults has the potential for measurement error. We aimed to investigate aspects of validity and reliability of self-reported past Sun Exposure. Methods: A population-based case-control study was conducted in Tasmania on 136 cases with multiple sclerosis and 272 age- and sex-matched community controls. Repeat interviews on 52 cases and 52 controls were done on average 11 weeks after the initial interview. Sun Exposure was assessed by questionnaire and lifetime calendar. Other measurements included serum 25-hydroxyvitamin D, actinic damage, and skin phenotype. Results: There was an association between recent Sun Exposure and serum vitamin D (time in the Sun: r = 0.22, P < 0.01; activities outside: r = 0.31, P < 0.01 for controls) and between lifetime Sun Exposure and actinic damage [correlation between 0.34 ( P < 0.01) and 0.17 ( P = 0.01) for controls]. The test-retest weighted κ statistic of self-reported Sun Exposure ranged from 0.43 to 0.74. Recall of childhood/adolescent Sun Exposure by standardized questioning was no less reproducible than recall of recent adult Sun Exposure and no less reliable when made with the calendar method. Comparing the questionnaire and calendar method, the measures of childhood/adolescent Sun Exposure had a similar predictive validity for multiple sclerosis. Conclusions: The results of this study provide further evidence that adults are able to recall past Sun Exposure with shown validity and reliability and present information about the possible reasons for the good reliability of recalled Sun Exposure measures. (Cancer Epidemiol Biomarkers Prev 2006;15(8):1538–44)
