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Mult Scler. 2014 Jul;20(8):1042-9. doi: 10.1177/1352458513513968. Epub 2014 Jan 10.

Sun exposure and multiple sclerosis risk in Norway and Italy: The EnvIMS study.

Author information

1
Department of Global Public Health and Primary Care, University of Bergen, Norway Department of Neurology, The Norwegian Multiple Sclerosis Competence Centre, Haukeland University Hospital, Norway kjetil.bjornevik@igs.uib.no.
2
Department of Global Public Health and Primary Care, University of Bergen, Norway Department of Neurology, The Norwegian Multiple Sclerosis Competence Centre, Haukeland University Hospital, Norway.
3
Department of Biomedical and Surgical Sciences, Section of Clinical Neurology, University of Ferrara, Italy.
4
Clinic of Neurology, Faculty of Medicine, University of Belgrade, Serbia.
5
Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Norway Department of Neurology, Akershus University Hospital, Norway.
6
Department of Clinical Neurology, University of Tromsø, Norway Department of Neurology, University Hospital of North Norway, Norway.
7
Division of Neurology, Department of Clinical and Experimental Medicine, UHL, County Council, Linköping University, Sweden.
8
Griesheim, Darmstadt, Germany.
9
Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Norway Institute of Immunology, Oslo University Hospital Rikshospitalet, Norway.
10
Department of Epidemiology and Biostatistics and Occupational Health, McGill University, Canada.
11
Department of Neurology, The Norwegian Multiple Sclerosis Competence Centre, Haukeland University Hospital, Norway The KG Jebsen Centre for MS-Research, Department of Clinical Medicine, University of Bergen, Bergen, Norway.
12
Institute of Epidemiology, Faculty of Medicine, University of Belgrade, Serbia.
13
Research Institute of the McGill University Health Centre, Canada.
14
Department of Global Public Health and Primary Care, University of Bergen, Norway Department of Clinical and Experimental Medicine, University of Sassari, Italy.

Abstract

OBJECTIVES:

The objective of this paper is to estimate the association between multiple sclerosis (MS) and measures of sun exposure in specific age periods in Norway and Italy.

METHODS:

A total of 1660 MS patients and 3050 controls from Italy and Norway who participated in a multinational case-control study (EnvIMS) reported sun habits during childhood and adolescence.

RESULTS:

A significant association between infrequent summer outdoor activity and increased MS risk was found in Norway and in Italy. The association was strongest between the ages of 16 and 18 years in Norway (odds ratio (OR) 1.83, 95% confidence interval (CI) 1.30-2.59), and between birth and age 5 years in Italy (OR 1.56, 95% CI 1.16-2.10). In Italy a significant association was also found during winter (OR 1.42, 95% CI 1.03-1.97). Frequent sunscreen use between birth and the age of 6 years was associated with MS in Norway (OR 1.44, 95% CI 1.08-1.93) after adjusting for outdoor activity during the same period. Red hair (OR 1.67, 95% CI 1.06-2.63) and blonde hair (OR 1.36, 95% CI 1.09-1.70) were associated with MS after adjusting for outdoor activity and sunscreen use.

CONCLUSION:

Converging evidence from different measures underlines the beneficial effect of sun exposure on MS risk.

KEYWORDS:

Multiple sclerosis; epidemiology; sun exposure; sunscreen; vitamin D

PMID:
24414538
DOI:
10.1177/1352458513513968
[Indexed for MEDLINE]

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