title: Prospective study of ultraviolet radiation exposure and mortality risk in the United States.
abstract: Geographic variations in mortality rate in the United States could be due to several hypothesized factors, one of which is exposure to solar ultraviolet radiation (UVR). Limited evidence from previous prospective studies has been inconclusive. The association between ambient residential UVR exposure and total and cause-specific mortality risks in a regionally diverse cohort (346,615 white, non-Hispanic subjects, 50-71 years of age, in the National Institutes of Health (NIH)-AARP Diet and Health Study) was assessed, with accounting for individual-level confounders. UVR exposure (averaged for 1978-1993 and 1996-2005) from NASA's Total Ozone Mapping Spectrometer was linked to the US Census Bureau 2000 census tract of participants' baseline residence. Multivariate-adjusted Cox proportional-hazards models were used to estimate hazard ratios and 95% confidence intervals. Over 12 years, UVR exposure was associated with total deaths (n = 41,425; hazard ratio for highest vs. lowest quartiles (HRQ4 vs. Q1) = 1.06, 95% confidence interval (CI): 1.03, 1.09; Ptrend < 0.001) and with deaths (all Ptrend < 0.05) due to cancer (HRQ4 vs. Q1 = 1.06, 95% CI: 1.02, 1.11), cardiovascular disease (HRQ4 vs. Q1 = 1.06, 95% CI: 1.00, 1.12), respiratory disease (HRQ4 vs. Q1 = 1.37, 95% CI: 1.21, 1.55), and stroke (HRQ4 vs. Q1 = 1.16, 95% CI: 1.01, 1.33) but not with deaths due to injury, diabetes, or infectious disease. These results suggest that UVR exposure might not be beneficial for longevity.
authors.affiliation: Nutritional Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, 9609 Medical Center Drive, 6E404, MSC9768, Bethesda, MD 20892, USA. lins4@mail.nih.gov
authors.forename: Shih-Wen
authors.initials: SW
authors.lastname: Lin
authors.forename: David C
authors.initials: DC
authors.lastname: Wheeler
authors.forename: Yikyung
authors.initials: Y
authors.lastname: Park
authors.forename: Michael
authors.initials: M
authors.lastname: Spriggs
authors.forename: Albert R
authors.initials: AR
authors.lastname: Hollenbeck
authors.forename: D Michal
authors.initials: DM
authors.lastname: Freedman
authors.forename: Christian C
authors.initials: CC
authors.lastname: Abnet
mesh_terms: D000368:Aged; D002318:Cardiovascular Diseases / Q000401:mortality*; D002423:Cause of Death; D005260:Female; D015438:Health Behavior; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000401:mortality*; D009749:Nutrition Surveys / Q000706:statistics & numerical data; D010126:Ozone; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012140:Respiratory Tract Diseases / Q000401:mortality*; D018570:Risk Assessment; D062206:Spatial Analysis; D020521:Stroke / Q000401:mortality*; D013472:Sunlight / Q000009:adverse effects*; D014466:Ultraviolet Rays / Q000009:adverse effects*; D014481:United States / Q000453:epidemiology
chemical_list: D010126:Ozone
keywords: epidemiology; mortality; prospective; sunlight; ultraviolet radiation; vitamin D