OBJECTIVE To examine the association between ultraviolet radiation (UVR) exposure and the risk of herpes zoster (HZ) in 3 prospective cohorts. PATIENTS AND METHODS We included 205,756 participants from the Health Professionals Follow-up Study (HPFS; 1986-2008), Nurses' Health Study (NHS; 1996-2012), and Nurses' Health Study II (NHS II; 1991-2013). Ambient UVR exposure was based on updated geocoded address histories linked with a high-resolution spatiotemporal ultraviolet model. Incident HZ cases were identified by self-reported clinician diagnosis. Sunburn history and medical, lifestyle, and dietary factors were assessed using biennial questionnaires. Multivariable Cox proportional hazards models were used. RESULTS A total of 24,201 cases of HZ occurred during 3,626,131 person-years. Ambient UVR exposure was associated with a higher risk of HZ in men (HPFS: multivariable-adjusted hazard ratio [MVHR] comparing highest vs lowest quintiles, 1.14; 95% CI, 1.02-1.29; P=.03 for trend) but not in women (NHS: MVHR, 0.99; 95% CI, 0.93-1.05; NHS II: MVHR, 0.96; 95% CI, 0.90-1.03). A higher lifetime number of severe sunburns was associated with a higher risk of HZ in all cohorts (HPFS: MVHR for ≥10 sunburns vs none, 1.08; 95% CI, 0.96-1.20; P=.02 for trend; NHS: MVHR, 1.14; 95% CI, 1.05-1.22; P=.01 for trend; NHS II: MVHR, 1.13; 95% CI, 1.00-1.28; P<.001 for trend). CONCLUSION Ambient UVR exposure was associated with a higher risk of HZ in men but not in women. A history of severe sunburn was associated with a modest increased risk of HZ in men and women, possibly because of immunosuppression from overexposure to the sun.

中文翻译：

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在三项前瞻性队列研究中，紫外线辐射和带状疱疹的风险。

目的探讨3个预期人群的紫外线（UVR）暴露与带状疱疹（HZ）风险之间的关系。患者与方法我们纳入了205,756名健康专业人员随访研究（HPFS; 1986-2008），护士健康研究（NHS; 1996-2012）和护士健康研究II（NHS II; 1991-2013）的参与者。环境UVR暴露是基于与高分辨率时空紫外线模型相关联的最新地理编码地址历史记录。通过自我报告的临床医生诊断确定了HZ事件。使用两年一次的调查表评估了晒伤史以及医疗，生活方式和饮食因素。使用多变量Cox比例风险模型。结果在3,626,131人年期间，共发生了24,201例HZ病例。暴露于紫外线的环境与男性罹患HZ的风险较高有关（HPFS：多变量调整的危险比[MVHR]，最高五分位数与最低五分位数相比较，为1.14； 95％CI，1.02-1.29；趋势为P = .03），而在五分位数中则没有。女性（NHS：MVHR，0.99; 95％CI，0.93-1.05; NHS II：MVHR，0.96; 95％CI，0.90-1.03）。在所有队列中，一生中发生严重晒伤的次数越多，罹患HZ的风险就越高（HPFS：≥10次晒伤的MVHR比无，1.08； 95％CI，0.96-1.20；趋势P = .02； NHS：MVHR， 1.14； 95％CI，1.05-1.22；趋势P = .01； NHS II：MVHR，1.13； 95％CI，1.00-1.28；趋势P <.001）。结论男性暴露于紫外线辐射与罹患HZ的风险较高有关，而女性则与之无关。严重晒伤史与男性和女性患HZ的风险适度增加有关，这可能是由于过度暴露于阳光导致免疫抑制所致。