Air pollution is one of the biggest public health issues, and the eye is continuously exposed to multiple outdoor air pollution. However, to date, no large-scale study has assessed the relationship between air pollutants and cataracts. We investigated associations between outdoor air pollution and cataracts in the Korean population. A population-based cross-sectional study was performed using data from the Korea National Health and Nutrition Examination Survey, including 18,622 adults more than 40 years of age. The presence of cataracts and their subtypes were evaluated by ophthalmologists. Air pollution data (levels of particulate matter, ozone, nitrogen dioxide, and sulfur dioxide) for the 2 years prior to the ocular examinations were collected from national monitoring stations. The associations of multiple air pollutants with cataracts were assessed by multivariate logistic regression analyses. Sociodemographic factors and previously known risk factors for cataracts were controlled as covariates (model 1 included sociodemographic factors, sun exposure, and behavioral factors, while model 2 further included clinical factors). Higher ozone concentrations were protectively associated with overall cataract which included all subtypes [single pollutant model: 0.003 ppm increase—model 1 (OR 0.89, p = 0.014), model 2 (OR 0.87, p = 0.011); multi-pollutant model: 0.003 ppm increase—model 1 (OR 0.80, p = 0.002), model 2 (OR 0.87, p = 0.002)]. Especially, higher ozone concentrations showed deeply protective association with nuclear cataract subtype [0.003 ppm increase—single pollutant model: model 2 (OR 0.84, p = 0.006), multi-pollutant model: model 2 (OR 0.73, p < 0.001)]. Higher tropospheric ozone concentrations showed protective associations with overall cataract and nuclear cataract subtype in the Korean population.
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We thank the Epidemiologic Survey Committee of the Korean Ophthalmologic Society. The Epidemiologic Survey Committee of the Korean Ophthalmologic Society mainly participated in making and processing KNHANES data about ophthalmologic questionnaire and examinations, and helped us to access KNHANES data. We also thank Min-Jae Ju for help in accessing the Korea Census Bureau.
This work was supported by the Gachon University Gil Medical Center (Grant number GCU-2016-5202).
Compliance with ethical standards
This study was approved by the Institutional Review Board of the Korea Centers for Disease Control and Prevention and complied with the tenets of the Declaration of Helsinki.
Conflict of interest
The authors declare that they have no conflict of interest.
Distributed lag models between outdoor air pollutants (particulate matter, ozone, nitrogen dioxide, and sulfur dioxide) and cataracts: a) model 1, b) model 2. (multi-pollutant model). PM: particulate matter; O3: ozone, NO2: nitrogen dioxide; SO2: sulfur dioxide. Model 1: sociodemographic factors, sun exposure, and behavioral factors (age, sex, region of residence, education level, income level, sun exposure, smoking, and alcohol drinking), were included as covariates. Model 2: Aforementioned factors and clinical factors (age, sex, region of residence, education level, income level, smoking, alcohol drinking, hypertension, diabetes mellitus, hypercholesterolemia, myopia, and obesity), were included as covariates. *: Associated with cataract in multivariate logistic regression after controlling with Bonferroni’s correction (each p < 0.017) (GIF 1216 kb)
Distributed lag models between ozone, nitrogen dioxide levels and nuclear cataracts in models 1 and 2: a) ozone, b) nitrogen dioxide. (multi-pollutant model). O3: ozone; NO2: nitrogen dioxide. Model 1: sociodemographic factors, sun exposure, and behavioral factors (age, sex, region of residence, education level, income level, sun exposure, smoking, and alcohol drinking), were included as covariates. Model 2: Aforementioned factors and clinical factors (age, sex, region of residence, education level, income level, smoking, alcohol drinking, hypertension, diabetes mellitus, hypercholesterolemia, myopia, and obesity), were included as covariates. *: Associated with cataract in multivariate logistic regression after controlling with Bonferroni’s correction (each p < 0.017) (GIF 679 kb)
Dabass A, Talbott EO, Venkat A, Rager J, Marsh GM, Sharma RK, Holguin F (2016) Association of exposure to particulate matter (PM2.5) air pollution and biomarkers of cardiovascular disease risk in adult NHANES participants (2001-2008). Int J Hyg Environ Health 219(3):301–310. https://doi.org/10.1016/j.ijheh.2015.12.002CrossRefGoogle Scholar
Nam G, Han K, Ha S, Han B, Kim D, Kim Y, Cho K, Park Y, Ko B (2015) Relationship between socioeconomic and lifestyle factors and cataracts in Koreans: the Korea National Health and nutrition examination Survey 2008–2011. Eye 29(7):913–920. https://doi.org/10.1038/eye.2015.66CrossRefGoogle Scholar
Nita M, Grzybowski A (2016) The role of the reactive oxygen species and oxidative stress in the pathomechanism of the age-related ocular diseases and other pathologies of the anterior and posterior eye segments in adults. Oxidative Med Cell Longev. (12):1–23. https://doi.org/10.1155/2016/3164734
O’Neill CA, van der Vliet A, Eiserich JP, Last JA, Halliwell B, Cross CE (1995) Oxidative damage by ozone and nitrogen dioxide: synergistic toxicity in vivo but no evidence of synergistic oxidative damage in an extracellular fluid. Biochem Soc Symp 61:139–152. https://doi.org/10.1042/bss0610139CrossRefGoogle Scholar
Park S, Lee E-H (2015) Association between metabolic syndrome and age-related cataract. Int J Ophthalmol 8:804Google Scholar
Shalini VK, Luthra M, Srinivas L, Rao SH, Basti S, Reddy M, Balasubramanian D (1994) Oxidative damage to the eye lens caused by cigarette smoke and fuel smoke condensates. Indian J Biochem Biophys 31(4):261–266Google Scholar
Thylefors B, Negrel AD, Pararajasegaram R, Dadzie KY (1995) Global data on blindness. Bull World Health Organ 73(1):115–121Google Scholar
Torricelli AA, Novaes P, Matsuda M, Braga A, Saldiva PH, Alves MR, Monteiro ML (2013) Correlation between signs and symptoms of ocular surface dysfunction and tear osmolarity with ambient levels of air pollution in a large metropolitan area. Cornea 32(4):e11–e15. https://doi.org/10.1097/ICO.0b013e31825e845dCrossRefGoogle Scholar
World Health Organization (2006) WHO air quality guidelines for particulate matter, ozone, nitrogen dioxide and sulfur dioxide: global update 2005: summary of risk assessmentGoogle Scholar
Wu R, Wang JJ, Mitchell P, Lamoureux EL, Zheng Y, Rochtchina E, Tan AG, Wong TY (2010) Smoking, socioeconomic factors, and age-related cataract: the Singapore Malay Eye study. Arch Ophthalmol (Chicago, Ill.: 1960) 128:1029–1035CrossRefGoogle Scholar