Abstract: BACKGROUND: Literature has identified detrimental health effects from the indiscriminate use of artificial nighttime light. We examined the co-distribution of light at night (LAN) and breast cancer (BC) incidence in Georgia, with the goal to contribute to the accumulating evidence that exposure to LAN increases risk of BC. METHODS: Using Georgia Comprehensive Cancer Registry data (2000-2007), we conducted a case-referent study among 34,053 BC cases and 14,458 lung cancer referents. Individuals with lung cancer were used as referents to control for other cancer risk factors that may be associated with elevated LAN, such as air pollution, and since this cancer type was not previously associated with LAN or circadian rhythm disruption. DMSP-OLS Nighttime Light Time Series satellite images (1992-2007) were used to estimate LAN levels; low (0-20 watts per sterradian cm(2)), medium (21-41 watts per sterradian cm(2)), high (>41 watts per sterradian cm(2)). LAN levels were extracted for each year of exposure prior to case/referent diagnosis in ArcGIS. RESULTS: Odds ratios (OR) and 95% confidence intervals (CI) were estimated using logistic regression models controlling for individual-level year of diagnosis, race, age at diagnosis, tumor grade, stage; and population-level determinants including metropolitan statistical area (MSA) status, births per 1,000 women aged 15-50, percentage of female smokers, MSA population mobility, and percentage of population over 16 in the labor force. We found that overall BC incidence was associated with high LAN exposure (OR = 1.12, 95% CI [1.04, 1.20]). When stratified by race, LAN exposure was associated with increased BC risk among whites (OR = 1.13, 95% CI [1.05, 1.22]), but not among blacks (OR = 1.02, 95% CI [0.82, 1.28]). CONCLUSIONS: Our results suggest positive associations between LAN and BC incidence, especially among whites. The consistency of our findings with previous studies suggests that there could be fundamental biological links between exposure to artificial LAN and increased BC incidence, although additional research using exposure metrics at the individual level is required to confirm or refute these findings.

Abstract: BACKGROUND: Night shift work, exposure to light at night (ALAN) and circadian disruption may increase the risk of hormone-dependent cancers. OBJECTIVES: We evaluated the association of exposure to ALAN during sleeping time with breast and prostate cancer in a population based multicase-control study (MCC-Spain), among subjects who had never worked at night. We evaluated chronotype, a characteristic that may relate to adaptation to light at night. METHODS: We enrolled 1,219 breast cancer cases, 1,385 female controls, 623 prostate cancer cases, and 879 male controls from 11 Spanish regions in 2008-2013. Indoor ALAN information was obtained through questionnaires. Outdoor ALAN was analyzed using images from the International Space Station (ISS) available for Barcelona and Madrid for 2012-2013, including data of remotely sensed upward light intensity and blue light spectrum information for each geocoded longest residence of each MCC-Spain subject. RESULTS: Among Barcelona and Madrid participants with information on both indoor and outdoor ALAN, exposure to outdoor ALAN in the blue light spectrum was associated with breast cancer [adjusted odds ratio (OR) for highest vs. lowest tertile, OR=1.47; 95% CI: 1.00, 2.17] and prostate cancer (OR=2.05; 95% CI: 1.38, 3.03). In contrast, those exposed to the highest versus lowest intensity of outdoor ALAN were more likely to be controls than cases, particularly for prostate cancer. Compared with those who reported sleeping in total darkness, men who slept in “quite illuminated” bedrooms had a higher risk of prostate cancer (OR=2.79; 95% CI: 1.55, 5.04), whereas women had a slightly lower risk of breast cancer (OR=0.77; 95% CI: 0.39, 1.51). CONCLUSION: Both prostate and breast cancer were associated with high estimated exposure to outdoor ALAN in the blue-enriched light spectrum. https://doi.org/10.1289/EHP1837.

Abstract: OBJECTIVES: Growing but limited evidence suggests that night shift work is associated with breast cancer. The authors conducted a nationwide case-control study nested within a cohort of 18,551 female military employees born in 1929-1968 to investigate the risk for breast cancer after night shift work and to explore the role of leisure time sun exposure and diurnal preference. METHODS: The authors documented 218 cases of breast cancer (1990-2003) and selected 899 age-matched controls from the cohort by incidence density sampling. Information on shift work, sun exposure habits, diurnal preference and other potential confounders was obtained from a structured questionnaire. ORs were estimated by multivariate conditional logistic regression. RESULTS: Overall, the authors observed an adjusted OR of 1.4 (95% CI 0.9 to 2.1) among women with ever compared with never night shifts. The RR for breast cancer tended to increase with increasing number of years of night shift work (p=0.03) and with cumulative number of shifts (p=0.02),with a neutral risk for fewer than three night shifts per week. The OR for the group with the highest tertile of cumulative exposure was 2.3 (95% CI 1.2 to 4.6). The most pronounced effect of night shift work on breast cancer risk was observed in women with morning chronotype preference and intense night shifts (OR=3.9, 95% CI 1.6 to 9.5). Night shift workers tended to sunbathe more frequently than day workers. CONCLUSIONS: The results indicate that frequent night shift work increases the risk for breast cancer and suggest a higher risk with longer duration of intense night shifts. Women with morning preference who worked on night shifts tended to have a higher risk than those with evening preference.

Abstract: PURPOSE: To evaluate whether implantation of a blue-light-blocking intraocular lens (IOL) affects sleep quality. SETTING: Repatriation General Hospital, Adelaide, Australia. METHODS: This study comprised patients who had bilateral cataract surgery during the preceding 12 months with implantation of a conventional SI40NB IOL or an AcrySof Natural SN60WF blue-light-blocking IOL. Patients were contacted by telephone at least 6 months after second-eye surgery, and the Pittsburgh Sleep Quality Index (PSQI) questionnaire was administered. Results were compared between groups. RESULTS: Of the 49 patients, 31 received conventional IOLs and 18, blue-light-blocking IOLs. The mean age of the patients was 80 years +/- 8.1 (SD). The median PSQI score was 6 (interquartile range 3 to 8). There were no statistically significant differences in PSQI scores between the 2 IOL groups (P = .65). This remained true after adjustment for sex, age, medication, and time since surgery. CONCLUSION: The blue-light-blocking IOL had no effect on the sleep quality of patients, indicating that these IOLs might serve as an alternative to conventional IOLs without a detrimental effect on circadian rhythm.

Abstract: CONTEXT: Obesity and exposure to light at night (LAN) have increased globally. Although LAN suppresses melatonin secretion and disturbs body mass regulation in experimental settings, its associations with melatonin secretion, obesity, and other metabolic consequences in uncontrolled home settings remain unclear. OBJECTIVE: The aim of this study was to determine the association of exposure to LAN in an uncontrolled home setting with melatonin secretion, obesity, dyslipidemia, and diabetes. DESIGN AND PARTICIPANTS: A cross-sectional study was performed in 528 elderly individuals (mean age, 72.8 yr). MEASURES: The intensity of LAN in the bedroom was measured at 1-min intervals during two consecutive nights, along with overnight urinary melatonin excretion and metabolic parameters. RESULTS: Compared with the Dim group (average <3 lux; n = 383), the LAN group (average >/=3 lux; n = 145) showed significantly higher body weight (adjusted mean, 58.8 vs. 56.6 kg; P = 0.01), body mass index (23.3 vs. 22.7 kg/m(2); P = 0.04), waist circumference (84.9 vs. 82.8 cm; P = 0.01), triglyceride levels (119.7 vs. 99.5 mg/dl; P < 0.01), and low-density lipoprotein cholesterol levels (128.6 vs. 122.2 mg/dl; P = 0.04), and showed significantly lower high-density lipoprotein cholesterol levels (57.4 vs. 61.3 mg/dl; P = 0.02). These associations were independent of numerous potential confounders, including urinary melatonin excretion. Furthermore, LAN exposure is associated with higher odds ratios (ORs) for obesity (body mass index: OR, 1.89; P = 0.02; abdominal: OR, 1.62; P = 0.04) and dyslipidemia (OR, 1.72; P = 0.02) independent of demographic and socioeconomic parameters. In contrast, urinary melatonin excretion and glucose parameters did not show significant differences between the two groups. CONCLUSIONS: Exposure to LAN in an uncontrolled home setting is associated with impaired obese and lipid parameters independent of nocturnal urinary melatonin excretion in elderly individuals. Moreover, LAN exposure is associated with higher ORs for obesity and dyslipidemia independent of demographic and socioeconomic parameters.