Session Type: ACR Poster Session B
Session Time: 9:00AM-11:00AM
Methods: We analyzed data from adult patients (ages 18-65) in a national myositis patient registry (including 658 dermatomyositis [DM], 451 polymyositis [PM], and 309 inclusion body myositis [IBM]) diagnosed through 2011. A questionnaire collected data on geographic residence, sun sensitivity (tendency to experience severe or painful sunburns), history of sunburn in the 12 months prior to diagnosis, and history of specific jobs, longest job and hobbies (specified as outdoor and other) prior to diagnosis. Using a job-exposure matrix and consensus review blinded to myositis subgroup, jobs and hobbies were rated for sun exposure intensity (high, moderate, low, or none), with a certainty level assigned to each estimate (high or low). Maximum residential UV exposures were identified for the 12 months prior to diagnosis for cases diagnosed after 1990, using data on UV-B Erythemal irradiances from the NASA Total Ozone Mapping Spectrometer (TOMS). Comparing DM with PM and IBM patients, odds ratios (OR) and 95% confidence intervals (CI) were estimated for sunburn and UV exposures in the year prior to diagnosis using logistic regression models adjusted for age, skin tone, and sex. Stratified models explored the potential modifying role of maximum residential UV levels and sun sensitivity on recreational/occupational exposures.
Results: Sunburn in the year prior to diagnosis was reported by 41% of DM compared with 28% of PM/IBM patients (OR=1.55: 95%CI 1.22, 1.96). DM was associated with high or moderate sun exposures from outdoor recreation or hobbies in the year prior to diagnosis (OR=1.38: 95%CI 1.08, 1.76, vs. PM/IBM), and together, high or moderate recreational or occupational sun exposure was associated with DM vs. PM/IBM (high OR=1.61: 95%CI 1.08, 2.42; moderate OR=1.37: 95%CI 1.05, 1.79). The association of DM with moderate recreational/occupational exposures was most apparent in patients with higher environmental UV levels (OR=1.56: 95%CI 1.06, 2.30) and those who reported being less likely to have severe sunburns (OR=1.62: 95%CI 1.16, 2.26). Sensitivity analyses showed the associations with occupational or recreational exposures remained after excluding patients reporting any sunburn in the year prior to diagnosis, and in analyses limited to high certainty exposure estimates.
Conclusion: These findings suggest that sunburn and high intensity sun exposures from recreational or occupational activities within a year prior to diagnosis may be associated with greater risk of developing DM compared to other myositis subtypes. Results support investigation of the role of sun exposures in relation to environmental UV, individual susceptibility and protective behaviors, in the risk of DM.
To cite this abstract in AMA style:Parks CG, Wilkerson J, Rose KM, Faiq A, Noroozi Farhadi P, Long CS, Bayat N, Brunner HI, Goldberg B, McGrath J, Miller FW, Rider LG. Ultraviolet Radiation Exposures Are Associated with Dermatomyositis in a National Myositis Registry [abstract]. Arthritis Rheumatol. 2016; 68 (suppl 10). https://acrabstracts.org/abstract/ultraviolet-radiation-exposures-are-associated-with-dermatomyositis-in-a-national-myositis-registry/. Accessed February 18, 2020.
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ACR Meeting Abstracts - https://acrabstracts.org/abstract/ultraviolet-radiation-exposures-are-associated-with-dermatomyositis-in-a-national-myositis-registry/