Dana K. Mirick

Bio: Dana K. Mirick is an academic researcher from Fred Hutchinson Cancer Research Center. The author has contributed to research in topics: Population & Breast cancer. The author has an hindex of 19, co-authored 31 publications receiving 2247 citations.

Night Shift Work, Light at Night, and Risk of Breast Cancer

Abstract: Background Exposure to light at night may increase the risk of breast cancer by suppressing the normal nocturnal production of melatonin by the pineal gland, which, in turn, could increase the release of estrogen by the ovaries. This study investigated whether such exposure is associated with an increased risk of breast cancer in women. Methods Case patients (n = 813), aged 20-74 years, were diagnosed from November 1992 through March 1995; control subjects (n = 793) were identified by random-digit dialing and were frequency matched according to 5-year age groups. An in-person interview was used to gather information on sleep habits and bedroom lighting environment in the 10 years before diagnosis and lifetime occupational history. Odds ratios (ORs) and 95% confidence intervals (CIs) were estimated by use of conditional logistic regression, with adjustment for other potential risk factors. Results Breast cancer risk was increased among subjects who frequently did not sleep during the period of the night when melatonin levels are typically at their highest (OR = 1.14 for each night per week; 95% CI = 1.01 to 1.28). Risk did not increase with interrupted sleep accompanied by turning on a light. There was an indication of increased risk among subjects with the brightest bedrooms. Graveyard shiftwork was associated with increased breast cancer risk (OR = 1.6; 95% CI = 1.0 to 2.5), with a trend of increased risk with increasing years and with more hours per week of graveyard shiftwork (P =.02, Wald chi-squared test). Conclusion The results of this study provide evidence that indicators of exposure to light at night may be associated with the risk of developing breast cancer.

Circadian disruption, shift work and the risk of cancer: a summary of the evidence and studies in Seattle.

Abstract: There is increasing interest in the possibility that disruption of normal circadian rhythm may increase the risk of developing cancer. Persons who engage in nightshift work may exhibit altered nighttime melatonin levels and reproductive hormone profiles that could increase the risk of hormone-related diseases, including breast cancer. Epidemiologic studies are now beginning to emerge suggesting that women who work at night, and who experience sleep deprivation, circadian disruption, and exposure to light-at-night are at an increased risk of breast cancer, and possibly colorectal cancer as well. Several studies have been conducted in Seattle recently to investigate the effects of factors that can disrupt circadian rhythm and alter normal nocturnal production of melatonin and reproductive hormones of relevance to breast cancer etiology. Studies completed to date have found: (1) an increased risk of breast cancer associated with indicators of exposure to light-at-night and night shift work; and (2) decreased nocturnal urinary levels of 6-sulphatoxymelatonin associated with exposure to 60-Hz magnetic fields in the bedroom the same night, and a number of other factors including hours of daylight, season, alcohol consumption and body mass index. Recently completed is an experimental crossover study designed to investigate whether exposure to a 60-Hz magnetic field under controlled conditions in the home sleeping environment is associated with a decrease in nocturnal urinary concentration of 6-sulphatoxymelatonin, and an increase in the urinary concentration of luteinizing hormone, follicle stimulating hormone, and estradiol in a sample of healthy women of reproductive age. Presently underway is a study to determine whether working at night is associated with decreased levels of urinary 6-sulphatoxymelatonin, and increased urinary concentrations of the reproductive hormones listed above in a sample of healthy women of reproductive age, and to elucidate characteristics of sleep among night shift workers that are related to the hormone patterns identified. A proposal is under review to extend these studies to a sample of healthy men to investigate whether working at night is associated with decreased levels of urinary 6-sulphatoxymelatonin, and increased concentrations of urinary cortisol and cortisone, urinary levels of a number of androgen metabolites, and serum concentrations of a number of reproductive hormones. Secondarily, the proposed study will elucidate characteristics of sleep among night shift workers that are related to the hormone patterns identified, as well as investigate whether polymorphisms of the genes thought to regulate the human circadian clock are associated with the ability to adapt to night shift work. It is anticipated that collectively these studies will enhance our understanding of the role of circadian disruption in the etiology of cancer.

Melatonin as a biomarker of circadian dysregulation

Abstract: It would be most useful to identify a biomarker of circadian dysregulation that could be used in epidemiologic studies of the effects of circadian disruption in humans. An indicator of circulating melatonin level has been shown to be a good biomarker of circadian dysregulation and has been associated with nightshift work and exposure to light-at-night in both laboratory-based and field studies. Among other circadian markers (such as core body temperature), it remains comparatively robust in the presence of various external influences. It can be reliably measured directly and indirectly through its metabolites in urine, blood, and saliva. Urinary melatonin has been shown to be stable over time, making it useful in epidemiologic studies in which laboratory processing is not immediately available, as well as studies of cancer with long latency periods. Several studies have shown melatonin to be useful in measuring diurnal type, which is of increasing interest as it becomes more apparent that successful adaptation to shift work may be dependent on diurnal preference.

Antiperspirant Use and the Risk of Breast Cancer

Abstract: The rumor that antiperspirant use causes breast cancer continues to circulate the Internet. Although unfounded, there have been no published epidemiologic studies to support or refute this claim. This population-based case- control study investigated a possible relationship between use of products applied for underarm perspiration and the risk for breast cancer in women aged 20-74 years. Case patients (n = 813) were diagnosed between November 1992 and March 1995; control subjects (n = 793) were identified by random digit dialing and were frequency-matched by 5-year age groups. Product use information was obtained during an in-person interview. Odds ratios (ORs) and 95% confidence intervals were estimated by the use of conditional logistic regression. P values were determined with the Wald chi(2) test. All statistical tests were two-sided. The risk for breast cancer did not increase with any of the following activities: 1) antiperspirant (OR = 0.9; P =.23) or deodorant (OR = 1.2; P =.19) use; 2) product use among subjects who shaved with a blade razor; or 3) application of products within 1 hour of shaving (for antiperspirant, OR = 0.9 and P =.40; for deodorant, OR = 1.2 and P =.16). These findings do not support the hypothesis that antiperspirant use increases the risk for breast cancer.

Residential Magnetic Fields, Light-at-Night, and Nocturnal Urinary 6-Sulfatoxymelatonin Concentration in Women

Abstract: Exposure to 60-Hz magnetic fields may increase breast cancer risk by suppressing the normal nocturnal rise in melatonin. This 1994-1996 Washington State study investigated whether such exposure was associated with lower nocturnal urinary concentration of 6-sulfatoxymelatonin in 203 women aged 20-74 years with no history of breast cancer. Each woman was interviewed and provided data on the following for a 72-hour period at two different seasons of the year: 1) magnetic field and ambient light measured every 30 seconds in her bedroom, 2) personal magnetic field measured at 30-second intervals, and 3) complete nighttime urine samples on three consecutive nights. Lower nocturnal urinary 6-sulfatoxymelatonin level was associated with more hours of daylight, older age, higher body mass index, current alcohol consumption, and current use of medications classified as beta blockers, calcium channel blockers, or psychotropics. After adjustment for these factors, higher bedroom magnetic field level was associated with significantly lower urinary concentration of 6-sulfatoxymelatonin during the same night, primarily in women who used these medications and during times of the year with the fewest hours of darkness. These results suggest that exposure to nighttime residential 60-Hz magnetic fields can depress the normal nocturnal rise in melatonin.

The Rotterdam Study: Objectives and design update

Abstract: The Rotterdam Study is a prospective cohort study ongoing since 1990 in the city of Rotterdam in The Netherlands. The study targets cardiovascular, endocrine, hepatic, neurological, ophthalmic, psychiatric, dermatological, oncological, and respiratory diseases. As of 2008, 14,926 subjects aged 45 years or over comprise the Rotterdam Study cohort. The findings of the Rotterdam Study have been presented in over a 1,000 research articles and reports (see www.erasmus-epidemiology.nl/rotterdamstudy). This article gives the rationale of the study and its design. It also presents a summary of the major findings and an update of the objectives and methods.

A clockwork web: circadian timing in brain and periphery, in health and disease

Abstract: The hypothalamic suprachiasmatic nuclei (SCN) are our principal circadian oscillator, coordinating daily cycles of physiology and behaviour that adapt us to the world. Local versions of the SCN clockwork are also active in peripheral, non-neural tissues, driving the tissue-specific cycles of gene expression that underpin circadian organization. These local oscillators are tuned to each other, and to solar time, by neuroendocrine and metabolic cues that depend on the SCN. The discovery of these local circadian clocks forces a re-appraisal of established models of circadian biology. It also presents new avenues for therapeutic intervention in conditions where disturbance of circadian gene expression is an important cause of morbidity.

Night Shift Work, Light at Night, and Risk of Breast Cancer

Abstract: Background Exposure to light at night may increase the risk of breast cancer by suppressing the normal nocturnal production of melatonin by the pineal gland, which, in turn, could increase the release of estrogen by the ovaries. This study investigated whether such exposure is associated with an increased risk of breast cancer in women. Methods Case patients (n = 813), aged 20-74 years, were diagnosed from November 1992 through March 1995; control subjects (n = 793) were identified by random-digit dialing and were frequency matched according to 5-year age groups. An in-person interview was used to gather information on sleep habits and bedroom lighting environment in the 10 years before diagnosis and lifetime occupational history. Odds ratios (ORs) and 95% confidence intervals (CIs) were estimated by use of conditional logistic regression, with adjustment for other potential risk factors. Results Breast cancer risk was increased among subjects who frequently did not sleep during the period of the night when melatonin levels are typically at their highest (OR = 1.14 for each night per week; 95% CI = 1.01 to 1.28). Risk did not increase with interrupted sleep accompanied by turning on a light. There was an indication of increased risk among subjects with the brightest bedrooms. Graveyard shiftwork was associated with increased breast cancer risk (OR = 1.6; 95% CI = 1.0 to 2.5), with a trend of increased risk with increasing years and with more hours per week of graveyard shiftwork (P =.02, Wald chi-squared test). Conclusion The results of this study provide evidence that indicators of exposure to light at night may be associated with the risk of developing breast cancer.