Correlation of Ultraviolet Radiation Levels With the Incidence of Cutaneous Squamous Cell and Merkel Cell Carcinomas in Non-sunbelt Locales in the United States: 2010-2017

BACKGROUND

Non-melanoma skin cancer (NMSC) is the most common human malignancy worldwide, with increasing incidence in the United States (US). Recent environmental data have shown that ultraviolet radiation (UVR) levels have increased in the US, particularly in the higher latitudes, but the potential impact of this on NMSC incidence is not well known, despite estimates that 90% of NMSC is due to sun exposure. Our exploratory study synthesizes environmental data with demographic and clinical data to determine whether UV indices (UVIs) and non-sunbelt (non-SB) locale (latitudes >40 degrees, which comprises most of the US) might contribute to incidence rates of two types of NMSC: cutaneous squamous cell and Merkel cell carcinomas.

METHODS

UVIs from 2010 to 2017 were obtained from the National Oceanic and Atmospheric Administration database and meshed with corresponding locales in the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) database (version 8.4.0.1). Four SB and five NSB locales contained sufficient data for analysis. Linear mixed modeling was performed with the outcome variable of the age-adjusted incidence of NMSC cancer (comprised of cutaneous squamous cell carcinoma of the head and neck (CSCCHN) and Merkel cell carcinoma (MCC)), the two most common types of NMSC contained within SEER). Non-SB locale and percent of days with UVI >3 were independent variables.

RESULTS

Percent of days with UVI >3 increased during this period, as did the overall NMSC (combined CSCCHN and MCC) skin cancer incidence, though MCC incidence alone did not increase during our study period. Environmental factors that significantly contributed to the age-adjusted overall NMSC (combined CSCCHN and MCC) cancer incidence (per 100,000 individuals) included NSB locale (b=1.227, p=0.0019) and percent of days with UVIs >3 (b=0.028, p<0.0001), as well as clinical factors of percent white race and percent male, by linear mixed modeling.

CONCLUSIONS

Our results are limited by the completeness of the NOAA and SEER databases, and do not include basal cell carcinoma. Nevertheless, our data demonstrate that environmental factors, such as latitude in NSB locale and UVI indices, can affect the age-adjusted overall NMSC (defined as CSCCHN and MCC in this study) incidence even in this relatively short period of time. Prospective studies over longer time periods are needed to identify the extent to which these findings are clinically significant so that increased educational efforts to promote sun-safe behaviors can be maximally effective.

Assessment of Practice and Factors associated with Sunlight Exposure of Infants among Mothers in Debre Berhan Town, North Shewa Zone, Amhara Region, Ethiopia

Background

Vitamin D deficiency is a common worldwide problem with its prevalence magnified in infants. Prevalence in infants is believed to range from 2.7% to 45% in different countries of the world. Appropriate sunlight exposure of skin is thought to be vital for the prevention of vitamin D deficiency. However, due to a dearth of study the practice of sunlight exposure is incompletely understood. Thus, assessing practice and factors affecting sunlight exposure of infants by mothers was relevant.

Objective

To assess practice level and factors associated with sunlight exposure of infants by mothers in Debre Berhan town, North Showa, Ethiopia, 2019.

Materials and Methods

A community-based cross-sectional study was conducted to collect relevant data among 530 mothers with infants at selected kebeles in Debre Berhan town. A simple random sampling technique was used to select kebeles and systematic sampling was complemented to identify study participant. Data were collected with interview using a pre-tested structured and semi-structured questionnaire. Bivariable and multivariable logistic regressions were run to examine the association among dependent and independent variable. Significant association was declared at P value ≤0.05.

Results

All the mothers were interviewed and 65.7% of them had good practice in sunning of their infant. In multi-variable analysis, mothers who are housewives or government employees, have a maternal age of 33 and above, perceive that sunlight strengthen infant bones, perceive that sunlight makes their infants healthier, and who got information from health-care professionals were significantly associated with good practice in sunning of their infant.

Conclusion and Recommendation

Finding of this study indicated that 34.3% of participants have poor practice in sunning of infants. This is a pointer that sunlight exposure of infants still needs attention from the government and other concerned bodies.

Seasonal UV exposure and vitamin D: association with the dynamics of COVID-19 transmission in Europe

Several recent studies have demonstrated that low plasma 25(OH) vitamin D levels are associated with the risk of COVID‐19 infection. The primary source of vitamin D production in humans is environmental UV radiation. In many viral respiratory diseases, peak infection rates are observed during winter due to reduced UV exposure and low temperatures. In Europe, the second wave of COVID‐19 began early in the winter of 2020. Investigating the impact of seasonal temperature and UV exposure on COVID‐19 transmission could thus aid in prevention and intervention. As such, we first performed a comprehensive meta‐analysis of all related published literature based on the association between vitamin D and COVID‐19, which supported the hypothesis that the low vitamin D level is a critical risk factor for COVID‐19 infection. Next, to understand the potential impact of seasonal UV and temperature levels on COVID‐19 cases, we analyzed meteorological data and daily COVID‐19 cases per million in the populations of 26 European countries. We observed that low temperature, UV index, and cloud‐free vitamin D UV dose (UVDVF) levels are negatively correlated with COVID‐19 prevalence in Europe. Furthermore, a distributed lag nonlinear model was used to assess the nonlinear delayed effects of individual seasonal factors on COVID‐19 cases. Such analysis highlighted the significantly delayed impact of UVDVF on the cumulative relative risk of COVID‐19 infection. The findings of this study suggest that low UV exposure can affect the required production of vitamin D in the body, which substantially influences the dynamics of COVID‐19 transmission and severity.

Does Climate Play Any Role in COVID-19 Spreading?-An Australian Perspective

Compared to other countries, the COVID-19 pandemic did not severely affect Australia as measured by total deaths until mid-2021. Though a substantial number of daily confirmed cases (up to 698) were reported during the second wave, most of them were from the southern state of Victoria. This study examined the possible correlations between climate variables and the number of daily confirmed COVID-19 cases in Victoria, Australia, from 25 January to 31 October 2020. Appropriate regression models and cross-correlation diagnostics were used to examine the effect of temperature, rainfall, solar exposure, and ultraviolet index (UVI) with the number of daily confirmed cases. Significant positive associations were identified for solar exposure and maximum and average UVI for confirmed cases one and 19 days later. Negative associations for these variables were found for confirmed cases five days later. Minimum temperature had a significant negative correlation one day later and a positive effect 21 days later. No significant correlation was found for maximum temperature and rainfall. The most significant relationships were found for confirmed cases 19 days after changes in the meteorological variables. A 1% increase in solar exposure, maximum UVI, and average UVI was associated with a 0.31% (95% CI: 0.13 to 0.51), 0.71% (95% CI: 0.43 to 0.98), and 0.63% (95%CI: 0.20 to 1.61) increase 19 days later in the number of confirmed cases, respectively. The implications of these results can be used in the public health management of any possible future events in Australia. It also highlights the significance of considering the climatic variables and seasonality in all kinds of epidemics and pandemics.

The Ultraviolet Index Is Well Estimated by the Terrestrial Irradiance at 310 nm

Ultraviolet (UV) exposure significantly contributes to non-melanoma skin cancer. In the context of health, UV exposure is the product of time and the UV Index (UVI), a weighted sum of the irradiance I(λ) over all wavelengths from λ = 250 to 400 nm. In our analysis of the United States Environmental Protection Agency’s UV-Net database of over 400,000 spectral irradiance measurements taken over several years, we found that the UVI is well estimated by 77 I₃₁₀. To further understand this result, we applied an optical atmospheric model to generate terrestrial irradiance spectra and found that it applies across a wide range of conditions. An accurate UVI radiometer can be built from a photodiode covered by a bandpass filter centered at 310 nm.

Impact of Heat Index and Ultraviolet Index on COVID-19 in Major Cities of Pakistan

INTRODUCTION

The world population is under the grip of global pandemic of COVID-19. The present study analyzed relationship between meteorological parameters and COVID-19 in three major cities of Pakistan, that is, Karachi, Lahore, and Peshawar.

METHODS

The impacts of heat index (HI) and ultraviolet index (UVI) over daily COVID-19 cases have examined to identify its transmission and propagation. The significance of basic reproductive number (R0), growth rate (Gr) and doubling time (Td) of COVID-19 with HI and UVI was determined.

RESULTS

Both indices show a significant positive correlation (at 5% significance level) to R0, Td, and Gr of COVID-19 patients. Our results showed that the minimum threshold temperature of 33 °C for HI (with a positive variation of 3 °C to 5 °C) put a significant impact on new cases.

CONCLUSION

HI and UVI impacted significantly to decline COVID-19 cases over the region.

Association of pollution and climate with atopic eczema in US children

BACKGROUND

We sought to determine the relationship between childhood eczema, climate, and environmental pollutants.

METHODS

We analyzed data from the 2007-2008 National Survey of Children's Health including a representative sample of 91,642 children age 0-17 years and the 2006-2007 Environmental Protection Agency measurements of carbon monoxide (CO), nitrate (NO3 ), nitrogen dioxide (NO2 ), organic carbon (OC), sulfate (SO3 ), sulfur dioxide (SO2 ), particulate matter ≤2.5 μm (PM-2.5) and <10 μm (PM-10), and tropospheric ozone levels, and the National Climate Data Center measurements of relative humidity (%), issued UV index, outdoor air temperature, and precipitation levels.

RESULTS

In multivariate survey logistic regression models controlling for age, sex, race/ethnicity, household income, US birthplace, and history of moving to a new location, eczema was associated with higher mean annual NO2 (p = 0.008), SO2 (p = 0.006), SO3 (p = 0.0002), arsenic (p = 0.0007), nickel (p = 0.0002), lead (p = 0.03), vanadium (p < 0.0001), and zinc (p = 0.003), but lower NO3 (p = 0.002), OC (p = 0.03), PM-2.5 (p = 0.006), cadmium (p < 0.0001), copper (p = 0.004), and potassium (p < 0.0001). In contrast, moderate-severe eczema was associated with higher NO3 (p = 0.03), OC (p = 0.008) and PM-2.5 (p = 0.01), copper (p = 0.04), lead (p = 0.008), and zinc (p = 0.01), but lower CO (p = 0.03). Principal component analysis was used and identified 4 combinations of pollutants and climate factors occurring in the USA, of which 1 was associated with higher prevalence and two were associated with lower prevalences of eczema (p < 0.05).

CONCLUSIONS

Pollutants in conjunction with climate factors may differentially impact eczema prevalence and severity, some with apparent harmful effects.

Think UV, not heat!

BACKGROUND

Australia has the highest incidence of skin cancer in the world, a preventable disease caused primarily by exposure to ultraviolet radiation (UVR) in sunlight. Health promotion strategies play a significant role in sun protection.

OBJECTIVES

To assess the understanding of a population sample as to the time of year that the sun was 'at its most burning' in Melbourne, Australia.

METHODS

A cross-sectional study was performed using questionnaires completed at corporate skin checks, conducted on 668 participants during 2011 to 2013.

RESULTS

Only a minority (n = 82, 12%) gave the correct theoretical answer; the summer solstice or 21-22 December, while another 38% (n = 254) correctly named December and January as the times when the UVR is actually highest. In all, 18% (n = 122) said February was the month when the temperature is hottest and 170 (25%) either mentioned the period May-August when UVR is negligible in Melbourne or had no idea, including saying 'all year round'. There was no significant difference in this knowledge between different age groups.

CONCLUSION

One-quarter of participants did not understand that sunburn was related to high levels of UVR, which occur in summer. Almost one-fifth associated the heat of February with the highest UVR. Understanding these concepts is important for Australians residing in cooler parts of southern Australia, as UVR levels may be high and yet the temperature may be relatively cool. There needs to be more emphasis on UVR in sun awareness campaigns to prompt sun-protective behaviour.

Association between climate factors, pollen counts, and childhood hay fever prevalence in the United States

BACKGROUND

Climate factors and pollen counts may play a role in hay fever.

OBJECTIVE

We sought to determine the impact of specific climate factors and pollen counts on the US prevalence of hay fever and statewide variation in prevalence.

METHODS

We used a merged analysis of the 2007 National Survey of Children's Health from a representative sample of 91,642 children aged 0 to 17 years and the 2006-2007 National Climate Data Center and Weather Service measurements of relative humidity (%), indoor heating degree days, precipitation, Palmer Hydrological Drought Index, clear sky and issued ultraviolet indices, stratospheric ozone levels, and outdoor air temperature and National Allergy Bureau total pollen counts. Multivariate survey logistic regression models controlled for sex, race/ethnicity, age, household income, and birthplace.

RESULTS

The US prevalence of hay fever in childhood was 18.0% (95% CI, 17.7% to 18.2%), with the highest prevalence in southeastern and southern states. Hay fever prevalence was significantly lower with second and third quartile mean annual relative humidity (logistic regression, P ≤ .01 for both), fourth quartile mean annual Palmer Hydrological Drought Index (P = .02), third and fourth quartile mean annual heating degree days (P < .0001 for both), and third and fourth quartile mean annual stratospheric ozone levels but increased with second, third, and fourth quartile mean annual temperature (P ≤ .02 for both), fourth quartile mean annual precipitation (P = .0007), mean total pollen counts (P = .01), and second, third, and fourth quartile issued ultraviolet index (P ≤ .0001 for all). Principal-component analysis was also used to determine the combined effects of correlated climate variables and pollen counts.

CONCLUSIONS

This study provides evidence of the influence of climate on the US prevalence of childhood hay fever.