Outdoor light at night and breast cancer incidence in the Danish Nurse Cohort

Clarke, R.B.; Amini, Heresh; James, Peter; Euler‐Chelpin, My von; Jørgensen, Jeanette Therming; Mehta, Amar; Cole‐Hunter, Tom; Westendorp, Rudi G. J.; Mortensen, Laust Hvas; Loft, Steffen; Brandt, Jørgen; Hertel, Ole; Ketzel, Matthias; Backalarz, Claus; Andersen, Zorana Jovanovic; Lim, Youn‐Hee

doi:10.1016/j.envres.2020.110631

Cited by 23 publications

(25 citation statements)

References 36 publications

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“…Follow-up duration was reported in only two studies (16 and 6.1 years) [ 23 , 42 ]. LAN was assessed according to two main methods: from outdoor (N = 7) [ 23 , 24 , 40 , 41 , 43 , 44 , 52 ] and indoor (N = 11) sources [ 41 – 43 , 45 – 51 , 53 ]. In all cohort and case-cohort studies assessing outdoor LAN, the unit of measurement for LAN was nano-Watt/square centimeters/steradian (nW/cm 2 /sr) [ 23 , 24 , 40 , 43 , 44 , 52 ].…”

Section: Resultsmentioning

confidence: 99%

“…LAN was assessed according to two main methods: from outdoor (N = 7) [ 23 , 24 , 40 , 41 , 43 , 44 , 52 ] and indoor (N = 11) sources [ 41 – 43 , 45 – 51 , 53 ]. In all cohort and case-cohort studies assessing outdoor LAN, the unit of measurement for LAN was nano-Watt/square centimeters/steradian (nW/cm 2 /sr) [ 23 , 24 , 40 , 43 , 44 , 52 ]. The only exception was a Spanish study that assessed outdoor LAN using an index of outdoor blue light spectrum to calculate melatonin suppression index (MSI).…”

Section: Resultsmentioning

confidence: 99%

“…Risk of bias assessment (Additional file 1 : Table S5) showed that most studie s were at low risk of bias due to confounding, while four w ere at moderate risk of bias because they did not control for some breast cancer risk factors, typically family history of breast cancer, postmenopausal hormone use, or sm oking [ 24 , 40 , 47 , 48 ]. Concerning exposure assessment, studies assessing outdoor LAN exposure were at low risk of bias [ 23 – 25 , 40 , 44 , 52 ], while those assessing both outdoor and indoor LAN or only indoor LAN were generally at moderate risk due to possible misclassification bias [ 41 – 43 , 45 – 47 , 49 – 51 , 53 ].…”

Section: Resultsmentioning

confidence: 99%

“…Findings were also similar when we additionally excluded the two studies considered at moderate risk of bias in selection of reported results [ 46 , 51 ] (Additional file 1 : Table S7). To further limit the effect of potential biases, we then performed the analyses excluding three additional studies [ 24 40 , 47 ] considered at moderate risk of bias due to confounding. Still, there were little changes in the results, and the estimates were substantially confirmed (Additional file 1 : Table S8).…”

Section: Resultsmentioning

confidence: 99%

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Light at night and risk of breast cancer: a systematic review and dose–response meta-analysis

2021

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Breast cancer is the most common malignancy in women and the second leading cause of cancer death overall. Besides genetic, reproductive, and hormonal factors involved in disease onset and progression, greater attention has focused recently on the etiologic role of environmental factors, including exposure to artificial lighting such as light-at-night (LAN). We investigated the extent to which LAN, including outdoor and indoor exposure, affects breast cancer risk. We performed a systematic review of epidemiological evidence on the association between LAN exposure and breast cancer risk, using a dose–response meta-analysis to examine the shape of the relation. We retrieved 17 eligible studies through September 13, 2021, including ten cohort and seven case–control studies. In the analysis comparing highest versus lowest LAN exposure, we found a positive association between exposure and disease risk (risk ratio [RR] 1.11, 95% confidence interval-CI 1.07–1.15), with comparable associations in case–control studies (RR 1.14, 95% CI 0.98–1.34) and cohort studies (RR 1.10, 95% CI 1.06–1.15). In stratified analyses, risk was similar for outdoor and indoor LAN exposure, while slightly stronger risks were observed for premenopausal women (premenopausal: RR 1.16, 95% CI 1.04–1.28; postmenopausal: 1.07, 95% CI 1.02–1.13) and for women with estrogen receptor (ER) positive breast cancer (ER + : RR 1.09, 95% CI 1.02–1.17; ER–: RR 1.07, 95% CI 0.92–1.23). The dose–response meta-analysis, performed only in studies investigating outdoor LAN using comparable exposure assessment, showed a linear relation up to 40 nW/cm2/sr after which the curve flattened, especially among premenopausal women. This first assessment of the dose–response relation between LAN and breast cancer supports a positive association in selected subgroups, particularly in premenopausal women.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Light at night and risk of breast cancer: a systematic review and dose–response meta-analysis

2021

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“… 8 This is characterized by disturbance of the nocturnal environment due to light emitted from anthropogenic sources, and its negative effects on human health recently have become a pressing concern. 9 The potential detrimental health impacts of light pollution have expanded beyond sleep disorders 10 , 11 , 12 to include obesity, 13 , 14 cardiovascular diseases, 15 , 16 , 17 cancers, 18 , 19 , 20 , 21 and mental disorders. 22 , 23 The primary mechanism through which these effects occur is believed to be the disruption of circadian rhythms and subsequent impaired hormone secretion, particularly those associated with sleep disturbances.…”

Section: Introductionmentioning

confidence: 99%

Nighttime Outdoor Artificial Light and Risk of Age-Related Macular Degeneration

Kim,

Shin

et al. 2024

JAMA Netw Open

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ImportanceLight pollution’s impact on human health is increasingly recognized, but its link to exudative age-related macular degeneration (EAMD) remains unclear.ObjectiveTo investigate the association between exposure to outdoor artificial light at night (OALAN) and the risk of incident EAMD.Design, Setting, and ParticipantsIn this nationwide population-based case-control study, all individuals 50 years or older with newly diagnosed EAMD between January 1, 2010, and December 31, 2011, were identified with reference to the Korean National Health Insurance Service registration program database for rare and intractable diseases. Birth year– and sex-matched controls (with no EAMD diagnosis until 2020) were selected at a 1:30 ratio. Data were acquired from May 1 to December 31, 2021, and analyzed from June 1 to November 30, 2022.ExposuresMean levels of OALAN at participants’ residential addresses during 2008 and 2009 were estimated using time-varying satellite data for a composite view of persistent nighttime illumination at an approximate scale of 1 km2.Main Outcomes and MeasuresThe hazard ratios (HRs) and 95% CIs of the association between residential OALAN and risk of incident EAMD were determined based on maximum likelihood estimation after adjusting for sociodemographic characteristics, comorbidities, and area-level risk factors (ie, nighttime traffic noise and particulate matter of aerodynamic diameter ≤10 μm in each participant’s administrative district of residence).ResultsA total of 126 418 participants were included in the analysis (mean [SD] age, 66.0 [7.9] years; 78 244 men [61.9%]). Of these, 4078 were patients with newly diagnosed EAMD and 122 340 were EAMD-free matched controls. In fully adjusted models, an IQR (55.8 nW/cm2/sr) increase in OALAN level was associated with an HR of 1.67 (95% CI, 1.56-1.78) for incident EAMD. The exposure-response curve demonstrated a nonlinear, concave upward slope becoming more pronounced at higher levels of light exposure (ie, at approximately 110 nW/cm2/sr). In a subgroup analysis, an IQR increase in OALAN was associated with increased risk of incident EAMD in urban areas (HR, 1.46 [95% CI, 1.33-1.61]) but not in rural areas (HR, 1.01 [95% CI, 0.84-1.22]).Conclusions and RelevanceIn this nationwide population-based case-control study, higher levels of residential OALAN were associated with an increased risk of incident EAMD. Future studies with more detailed information on exposure, individual adaptive behaviors, and potential mediators are warranted.

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