The Association of Ambient Air Pollution With Cataract Surgery in UK Biobank Participants: Prospective Cohort Study

Abstract

Purpose Air pollution is associated with chronic diseases of later life. Cataract is the most common cause of blindess globally. It is biologically plausible that cataract risk is increased by pollution exposure. Therefore, the relationship between air pollution and incident cataract surgery was examined. Methods This was a prospective, observational study involving 433,727 UK Biobank participants. Ambient air pollution measures included particulates, nitrogen dioxide (NO 2 ) and nitrogen oxides (NO x ). Outdoor air pollution was estimated based on land use regression models. Participants undergoing cataract surgery in either eye were ascertained via data linkage to the National Health Service procedure statistics. Those undergoing cataract surgery within 1 year of baseline assessment and those reporting cataract at baseline were excluded. Cox proportional hazards models were used to examine the associations between air pollutants and incident cataract surgery, adjusting for sociodemographic and lifestyle factors. Results There were 16,307 incident cases of cataract surgery. Higher exposure to PM 2.5 was associated with a 5% increased risk of incident cataract surgery (per interquartile range [IQR] increase). Compared to the lowest quartile, participants with exposures to PM 2.5 , NO 2 , and NO x in the highest quartile were 14%, 11%, and 9% more likely to undergo cataract surgery, respectively. A continuous exposure-response relationship was observed, with the likelihood of undergoing cataract surgery being progressively higher with greater levels of PM 2.5 , NO 2 , and NO x ( P for trend P < 0.001). Conclusions Although the results of our study showed a 5% increased risk of future cataract surgery following an exposure to PM 2.5 , NO 2 , and NO x , the effect estimates were relatively small. Further research is required to determine if the associations identified are causal.

Progress on application of spatial epidemiology in ophthalmology

“…In order to estimate ground-level concentrations of multiple air pollutants such as PM 2.5 , sulfur dioxide (SO 2 ), ozone (O 3 ), and NO 2 based on the municipality, a hybrid kriging/LUR model was used, and the results indicated female exposure to high levels of NO 2 had significantly increased risk of dry eye syndrome ( 24 ). In a recent prospective, observational study to examine the relationship between ambient air pollution exposure and incident cataract surgery in the UK, those outdoor air pollution included particulates, NO 2 , and nitrogen oxides (NO x ) was estimated based on LUR models developed by the European Study of Cohorts for Air Pollution Effects (ESCAPE) project ( 36 ), and their impacts on the risk of future cataract surgery were increased ( 25 ).…”

Long-Term Exposure to Ambient PM2.5 and Age-Related Cataracts among Chinese Middle-Aged and Older Adults: Evidence from Two National Cohort Studies

“…Recently, the effect of PM 2.5 on age-related cataracts was noted by researchers, ,, but the results were inconsistent, and only the study by Chua et al . showed that exposure to PM 2.5 was associated with a significantly increased risk of cataracts, which may be due to study design and small sample size limitations.…”

“…In China, blindness caused by cataracts accounts for 33.92% of blind people . As a result of the population aging, age-related cataracts have been a substantial disease and social burden. , The risk of cataracts depends on a variety of factors, such as unhealthy lifestyle factors, genetics, age, and environmental pollution. − With the rapid development of industrialization, growing evidence suggests that air pollution could have an important role in the risk of cataracts. ,, …”

“…14−16 In recent epidemiological studies have revealed that ambient particulate matter (PM) with an aerodynamic diameter of less than 2.5 μm (PM 2.5 ) has the potential to affect intraocular pathologies such as glaucoma, age-related macular degeneration, and adverse structural features within the retina. 17−19 Recently, the effect of PM 2.5 on age-related cataracts was noted by researchers, 6,20,21 but the results were inconsistent, and only the study by Chua et al 6 showed that exposure to PM 2.5 was associated with a significantly increased risk of cataracts, which may be due to study design and small sample size limitations. To fill the gap in the association between agerelated cataracts and PM 2. for developing effective public health policies to reduce the risk of age-related cataracts.…”

“…6−9 With the rapid development of industrialization, growing evidence suggests that air pollution could have an important role in the risk of cataracts. 6,10,11 According to the Global Burden of Disease (GBD) studies, air pollution exposure has emerged as a major risk factor for disease burden. 12,13 Previous research has shown that ambient particulate matter can cause ocular surface diseases such as conjunctivitis, keratitis, and dry eye syndrome.…”