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American Journal of Epidemiology Advance Access published online on March 3, 2007
American Journal of Epidemiology, doi:10.1093/aje/kwm007
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American Journal of Epidemiology Copyright © 2007 by the Johns Hopkins Bloomberg School of Public Health All rights reserved; printed in U.S.A.

ORIGINAL CONTRIBUTION

The Relation between Patterns of Vacation Sun Exposure and the Development of Acquired Melanocytic Nevi in German Children 6–7 Years of Age

Olaf Gefeller1, Jasmin Tarantino1, Peter Lederer2, Wolfgang Uter1 and Annette B. Pfahlberg1

1 Department of Medical Informatics, Biometry, and Epidemiology, University of Erlangen-Nuremberg, Erlangen, Germany
2 Regional Health Authority, Erlangen, Germany

Correspondence to Dr. Olaf Gefeller, Department of Medical Informatics, Biometry, and Epidemiology, University of Erlangen-Nuremberg, Waldstr. 6, D-91054 Erlangen, Germany (e-mail: gefeller{at}rzmail.uni-erlangen.de).

Received for publication April 12, 2006. Accepted for publication November 2, 2006.

Sun exposure is the main environmental risk factor for the development of melanocytic nevi. Although the general association is not disputed, the interplay between intense intermittent and the cumulative amount of sun exposure in defining the promoting effect on melanocytic nevus development is an area of debate. Trained staff members ascertained total body counts of melanocytic nevi in a cross-sectional study of 2,189 children 6–7 years of age who were recruited in two German centers in 2002. Their parents provided information about a variety of exposure factors. The distribution of melanocytic nevi was skewed markedly to the right; therefore, a negative binomial regression model provided the appropriate framework for a multivariable analysis. A steep gradient with respect to the (adjusted) number of melanocytic nevi was apparent only for the frequency of vacation episodes associated with sun exposure in areas with an intense ultraviolet radiation. In contrast, no such gradients were found for the cumulative duration of vacation sun exposure in such areas or for any variable related to vacation sun exposure in areas with a low ultraviolet radiation. This observation supports the hypothesis that intermittent exposure to high doses of ultraviolet radiation plays an especially important role in nevus development.

child; dermatology; environmental exposure; holidays; melanoma; nevus; sunlight; ultraviolet rays


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