Sage Journals: Discover world-class research

Abstract

Background:

Low exposure to ultraviolet radiation (UVR) from sunlight may be a risk factor for developing multiple sclerosis (MS). Possible pathways may be related to effects on immune system function or vitamin D insufficiency, as UVR plays a role in the production of the active form of vitamin D in the body.

Objective:

This study examined whether lower levels of residential UVR exposure from sunlight were associated with increased MS risk in a cohort of radiologic technologists.

Methods:

Participants in the third and fourth surveys of the US Radiologic Technologists (USRT) Cohort Study eligible (N = 39,801) for analysis provided complete residential histories and reported MS diagnoses. MS-specialized neurologists conducted medical record reviews and confirmed 148 cases. Residential locations throughout life were matched to satellite data from NASA’s Total Ozone Mapping Spectrometer (TOMS) project to estimate UVR dose.

Results:

Findings indicate that MS risk increased as average lifetime levels of UVR exposures in winter decreased. The effects were consistent across age groups <40 years. There was little indication that low exposures during summer or at older ages were related to MS risk.

Conclusion:

Our findings are consistent with the hypothesis that UVR exposure reduces MS risk and may ultimately suggest prevention strategies.

Keywords

Epidemiology ultraviolet radiation vitamin D

Get full access to this article

View all access options for this article.

References

Simon

Munger

Ascherio

Vitamin D and multiple sclerosis: Epidemiology, immunology, and genetics. Curr Opin Neurol 2012; 25: 246–251.

Kurtzke

Beebe

Norman

et al . Epidemiology of multiple sclerosis in U.S. veterans: 1. Race, sex, and geographic distribution. Neurology 1979; 29: 1228–1235.

Miller

Hammond

McLeod

et al . Multiple sclerosis in Australia and New Zealand: Are the determinants genetic or environmental? J Neurol Neurosurg Psychiatry 1990; 53: 903–905.

Simpson

Jr Blizzard

Otahal

et al . Latitude is significantly associated with the prevalence of multiple sclerosis: A meta-analysis. J Neurol Neurosurg Psychiatry 2011; 82: 1132–1141.

Ascherio

Munger

KL.

Environmental risk factors for multiple sclerosis. Part II: Noninfectious factors. Annal Neurol 2007; 61: 504–513.

Lucas

Byrne

Correale

et al . Ultraviolet radiation, vitamin D and multiple sclerosis. Neurodegener Dis Manag 2015; 5: 413–424.

Beretich

TM.

Explaining multiple sclerosis prevalence by ultraviolet exposure: A geospatial analysis. Mult Scler 2009; 15: 891–898.

Orton

Wald

Confavreux

et al . Association of UV radiation with multiple sclerosis prevalence and sex ratio in France. Neurology 2011; 76: 425–431.

Ramagopalan

Handel

Giovannoni

et al . Relationship of UV exposure to prevalence of multiple sclerosis in England. Neurology 2011; 76: 1410–1414.

10.

Sloka

Pryse-Phillips

Stefanelli

The relation of ultraviolet radiation and multiple sclerosis in Newfoundland. Can J Neurol Sci 2008; 35: 69–74.

11.

Sloka

Silva

Pryse-Phillips

et al . A quantitative analysis of suspected environmental causes of MS. Canad J Neurol Sci 2011; 38: 98–105.

12.

Tremlett

Zhu

Ascherio

et al . Sun exposure over the life-course and associations with multiple sclerosis. Neurology 2018; 90(14): e1191–e1199

13.

Bjornevik

Riise

Casetta

et al . Sun exposure and multiple sclerosis risk in Norway and Italy: The EnvIMS study. Mult Scler 2014; 20: 1042–1049.

14.

Lucas

Ponsonby

Dear

et al . Sun exposure and vitamin D are independent risk factors for CNS demyelination. Neurology 2011; 76: 540–548.

15.

McDowell

T-Y

Amr

Culpepper

et al . Sun exposure, vitamin D and age at disease onset in relapsing multiple sclerosis. Neuroepidemiology 2011; 36: 39–45.

16.

Torkildsen

Grytten

Aarseth

et al . Month of birth as a risk factor for multiple sclerosis: An update. Acta Neurol Scand Suppl 2012; 195: 58–62.

17.

Kampman

Wilsgaard

Mellgren

Outdoor activities and diet in childhood and adolescence relate to MS risk above the Arctic Circle. J Neurol 2007; 254: 471–477.

18.

van der Mei

IAF

Ponsonby

Dwyer

et al . Past exposure to sun, skin phenotype, and risk of multiple sclerosis: Case-control study. BMJ 2003; 327: 316.

19.

Boice

Jr Mandel

Doody

et al . A health survey of radiologic technologists. Cancer 1992; 69: 586–598.

20.

Sigurdson

Doody

Rao

et al . Cancer incidence in the US radiologic technologists health study, 1983-1998. Cancer 2003; 97: 3080–3089.

21.

Zamoiski

Freedman

Linet

et al . Prospective study of ultraviolet radiation exposure and risk of breast cancer in the United States. Environ Res 2016; 151: 419–427.

22.

McDonald

Compston

Edan

et al . Recommended diagnostic criteria for multiple sclerosis: Guidelines from the International Panel on the Diagnosis of Multiple Sclerosis. Ann Neurol 2001; 50: 121–127.

23.

Polman

Reingold

Edan

et al . Diagnostic criteria for multiple sclerosis: 2005 revisions to the “McDonald Criteria.” Ann Neurol 2005; 58: 840–846.

24.

Polman

Reingold

Banwell

et al . Diagnostic criteria for multiple sclerosis: 2010 revisions to the McDonald Criteria. Ann Neurol 2011; 69: 292–302.

25.

Kurtzke

JF.

Rating neurologic impairment in multiple sclerosis: An Expanded Disability Status Scale (EDSS). Neurology 1983; 33: 1444–1452.

26.

Total Ozone Mapping Spectrometer (TOMS), Erythemal UV Exposure 2012, http://toms.gsfc.nasa.gov/ery_uv/ (accessed 31 July 2012).

27.

Google Maps API. Google maps API geocoding, 2008, http://code.google.com/apis/maps/documentation/services.html#Geocoding

28.

Holick

MF.

Vitamin D: A millenium perspective. J Cell Biochem 2003; 88: 296–307.

29.

Schuurman

Amram

Saeedi

et al . A proposed methodology to estimate the cumulative life-time UVB exposure using geographic information systems: An application to multiple sclerosis. Mult Scler Relat Disord 2013; 2: 29–35.

30.

Fernandes de Abreu

Eyles

Féron

Vitamin D, a neuro-immunomodulator: Implications for neurodegenerative and autoimmune diseases. Psychoneuroendocrinology 2009; 34: S265–S277.

31.

Cantorna

Hayes

DeLuca

HF.

1,25-Dihydroxyvitamin D3 reversibly blocks the progression of relapsing encephalomyelitis, a model of multiple sclerosis. Proc Natl Acad Sci USA 1996; 93: 7861–7864.

32.

Spach

Nashold

Dittel

et al . IL-10 signaling is essential for 1,25-dihydroxyvitamin D3-mediated inhibition of experimental autoimmune encephalomyelitis. J Immunol 2006; 177: 6030–6037.

33.

Becklund

Severson

Vang

et al . UV radiation suppresses experimental autoimmune encephalomyelitis independent of vitamin D production. Proc Natl Acad Sci USA 2010; 107: 6418–6423.

34.

Wang

Marling

McKnight

et al . Suppression of experimental autoimmune encephalomyelitis by 300-315 nm ultraviolet light. Arch Biochem Biophys 2013; 536: 81–86.

35.

DeLuca

Plum

LA.

Vitamin D deficiency diminishes the severity and delays onset of experimental autoimmune encephalomyelitis. Arch Biochem Biophys 2011; 513: 140–143.

36.

Wang

Marling

Zhu

et al . Development of experimental autoimmune encephalomyelitis (EAE) in mice requires vitamin D and the vitamin D receptor. Proc Natl Acad Sci USA 2012; 109: 8501–8504.

37.

Bronnum-Hansen

Koch-Henriksen

Stenager

Trends in survival and cause of death in Danish patients with multiple sclerosis. Brain 2004; 127: 844–850.

Supplementary Material

Please find the following supplemental material available below.

For Open Access articles published under a Creative Commons License, all supplemental material carries the same license as the article it is associated with.

For non-Open Access articles published, all supplemental material carries a non-exclusive license, and permission requests for re-use of supplemental material or any part of supplemental material shall be sent directly to the copyright owner as specified in the copyright notice associated with the article.

0.00 MB

0.35 MB

Lifetime exposure to ultraviolet radiation and the risk of multiple sclerosis in the US radiologic technologists cohort study

Abstract

Background:

Objective:

Methods:

Results:

Conclusion:

Keywords

Get full access to this article

References

Supplementary Material