Abstract
BackgroundExposure to sunlight may decrease the risk of several diseases through the synthesis of vitamin D, whereas solar radiation is the main cause of some skin and eye diseases. However, to the best of our knowledge, the association of sun-induced skin damage with mortality remains unknown.Methodology/Principal FindingsSubjects were 8472 white participants aged 25–74 years in the First National Health and Nutrition Examination Survey Epidemiologic Follow-up Study. Cardiovascular disease mortality, cancer mortality, and all-cause mortality were obtained by either a death certificate or a proxy interview, or both. Actinic skin damage was examined and recorded by the presence and severity (absent, minimal, moderate, or severe) of overall actinic skin damage and its components (i.e., fine telangiectasia, solar elastosis, and actinic keratoses). Cox regression and Kaplan-Meier methods were applied to explore the associations. A total of 672 cancer deaths, 1500 cardiovascular disease deaths, and 2969 deaths from all causes were documented through the follow-up between 1971 and 1992. After controlling for potential confounding variables, severe overall actinic skin damage was associated with a 45% higher risk for all-cause mortality (95% CI: 1.22, 1.72; P<0.001), moderate overall skin damage with a 20% higher risk (95% CI: 1.08., 1.32; P<0.001), and minimal overall skin damage with no significant mortality difference, when compared to those with no skin damage. Similar results were obtained for all-cause mortality with fine telangiectasia, solar elastosis, and actinic keratoses. The results were similar for cancer and cardiovascular disease mortality.ConclusionsThe present study gives an indication of an association of actinic skin damage with cardiovascular disease, cancer and all-cause mortality in white subjects. Given the lack of support in the scientific literature and potential unmeasured confounding factors, this finding should be interpreted with caution. More independent studies are needed before any practical recommendations can be made.
Highlights
Exposure to sunlight can provide people with a sense of wellbeing and a tanned body is viewed as a sign of good health. [1,2] Humans get vitamin D from exposure to sunlight, which may play a role in the maintenance of healthy bones, and in reducing the risk of some illnesses, including autoimmune, infectious, and cardiovascular diseases, and colon, prostate, and breast cancers.[3]
The present study gives an indication of an association of actinic skin damage with cardiovascular disease, cancer and all-cause mortality in white subjects
Chronic repeated sunlight exposure can induce degenerative changes in skin cells, fibrous tissue, and blood vessels, leading to visible signs of actinic skin damage, [4] which is partially characterized by telangiectasia, solar elastosis, and actinic keratoses. [6,7,8,9] Epidemiologic studies have found that people with accelerated aging looking have an increased mortality risk, [10,11] and the skin damage caused by overexposure to sunlight is an important environmental factor for increased facial ‘‘aging’’
Summary
Exposure to sunlight can provide people with a sense of wellbeing and a tanned body is viewed as a sign of good health. [1,2] Humans get vitamin D from exposure to sunlight, which may play a role in the maintenance of healthy bones, and in reducing the risk of some illnesses, including autoimmune, infectious, and cardiovascular diseases, and colon, prostate, and breast cancers.[3]. [6,7,8,9] Epidemiologic studies have found that people with accelerated aging looking have an increased mortality risk, [10,11] and the skin damage caused by overexposure to sunlight is an important environmental factor for increased facial ‘‘aging’’. The present study aims to examine the associations of actinic skin damage with cardiovascular disease mortality, cancer mortality, and all-cause mortality in whites based on the data from the First National Health and Nutrition Examination Survey (NHANES I) Epidemiologic Follow-up Study (NHEFS), which is characterized by a large sample size and an average of a 16-year follow-up. Exposure to sunlight may decrease the risk of several diseases through the synthesis of vitamin D, whereas solar radiation is the main cause of some skin and eye diseases. To the best of our knowledge, the association of sun-induced skin damage with mortality remains unknown
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