Freedman D M, Dosemeci M, Alavanja M C
Radiation Epidemiology Branch, National Cancer Institute, 6120 Executive Boulevard, Bethesda, Maryland 20892, USA.
Occup Environ Med. 2000 Jun;57(6):418-21. doi: 10.1136/oem.57.6.418.
To explore whether mortality from multiple sclerosis is negatively associated with exposure to sunlight.
Two case-control studies based on death certificates were conducted for mortality from multiple sclerosis and non-melanoma skin cancer (as a positive control) to examine associations with residential and occupational exposure to sunlight. Cases were all deaths from multiple sclerosis between 1984 and 1995 in 24 states of the United States. Controls, which were age frequency matched to a series of cases, excluded cancer and certain neurological deaths. The effects of occupational exposure to sunlight were assessed among subjects with usual occupations requiring substantial activity, so as to exclude those whose indoor jobs resulted from disabilities subsequent to the onset of the disease. Multiple logistic regression analyses were applied, with adjustment for age, sex, race, and socioeconomic status.
Unlike mortality from skin cancer, mortality from multiple sclerosis was negatively associated with residential exposure to sunlight (odds ratio (OR)=0.53 (multiple sclerosis) and OR=1.24 (skin cancer)). Odds ratios for the highest occupational exposure to sunlight were 0.74 (95% confidence interval (95% CI) 0.61 to 0.89) for mortality from multiple sclerosis, compared with 1.21 (1.09 to 1.34) for mortality from non-melanoma skin cancer. The OR was 0.24 for the combined effect of the highest levels of residential and occupational exposure to sunlight on multiple sclerosis, compared with an OR of 1.38 for skin cancer.
In this exploratory study, mortality from multiple sclerosis, unlike mortality from skin cancer, was negatively associated with both residential and occupational exposure to sunlight.
探讨多发性硬化症死亡率是否与阳光照射呈负相关。
基于死亡证明开展了两项病例对照研究，以研究多发性硬化症和非黑素瘤皮肤癌（作为阳性对照）的死亡率与居住及职业性阳光照射之间的关联。病例为1984年至1995年美国24个州所有死于多发性硬化症的患者。对照与一系列病例进行年龄频数匹配，排除癌症及某些神经系统疾病死亡病例。在从事需要大量活动的常规职业的受试者中评估职业性阳光照射的影响，以排除因疾病发作后残疾而从事室内工作的人员。应用多元逻辑回归分析，并对年龄、性别、种族和社会经济地位进行了调整。
与皮肤癌死亡率不同，多发性硬化症死亡率与居住性阳光照射呈负相关（比值比（OR）=0.53（多发性硬化症），OR=1.24（皮肤癌））。多发性硬化症死亡率的最高职业性阳光照射比值比为0.74（95%置信区间（95%CI）0.61至0.89），而非黑素瘤皮肤癌死亡率的比值比为1.21（1.09至1.34）。居住和职业性阳光照射最高水平对多发性硬化症综合影响的OR为0.24，而对皮肤癌的OR为1.38。
在这项探索性研究中，与皮肤癌死亡率不同，多发性硬化症死亡率与居住及职业性阳光照射均呈负相关。
