Hualiang Lin1, Yanfei Guo2, Zengliang Ruan1, Yin Yang1, Yanbing Chen3, Yang Zheng2, Lenise A Cummings-Vaughn4, Steven E Rigdon5, Michael G Vaughn5, Shengzhi Sun6, Lingli Zhang1, Xiaojie Wang1, Zhengmin Min Qian7, Fan Wu8. 1. Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China. 2. Shanghai Municipal Centre for Disease Control and Prevention, Shanghai, China. 3. Medical Genetic Center Guangdong Women and Children Hospital, Xing Nan Street, Panyu, Guangzhou, Guangdong 511442, China. 4. Division of Geriatrics and Nutritional Science, School of Medicine, Washington University-St. Louis, St. Louis, MO 63110, USA. 5. College for Public Health & Social Justice, Saint Louis University, St. Louis, MO 63104, USA. 6. Department of Epidemiology, Brown University School of Public Health, Providence, RI 02912, USA. 7. College for Public Health & Social Justice, Saint Louis University, St. Louis, MO 63104, USA. Electronic address: zhengmin.qian@slu.edu. 8. Shanghai Municipal Centre for Disease Control and Prevention, Shanghai, China. Electronic address: wufan@scdc.sh.cn.
Abstract
BACKGROUND: Ambient air pollutant directly contacts with the eyes, however, the effect of ambient fine particulate matter (PM2.5) and ozone (O3) on vision impairment, such as presbyopia, has been kept largely unknown. METHODS: We surveyed a total of 36,620 participants aged 50 years and above in six low- and middle-income countries. Ambient annual concentrations of PM2.5 and O3 for the residential community were estimated using satellite data and chemical transport model. A mixed effects model was utilized to assess the effects of ambient PM2.5 and O3 on presbyopia, as well as their combined effects. RESULTS: A total of 13,841 presbyopia cases were identified among the participants with a prevalence rate of 41.17%. For both PM2.5 and O3, we found a J-shaped exposure-response relationship with the threshold being identified at 15 μg/m3 for PM2.5 and 55 μg/m3 for O3. The odds ratio (OR) of presbyopia was 1.15 (95% CI: 1.09, 1.21) for each 10 μg/m3 increase in PM2.5 above 15 μg/m3 and 1.37 (95% CI: 1.23, 1.54) for O3 above 55 μg/m3 after adjusting for various potential confounding factors. There appeared to be a synergistic interaction between ambient PM2.5 and O3 on presbyopia in the additive model, the combined effect was significantly larger than the sum of their individual effects, with a synergistic index of 2.39. CONCLUSION: This study supports that exposures to ambient PM2.5 and O3 might be important risk factors of presbyopia among old adults, and simultaneously exposure to high level of the two pollutants could intensify their individual effects.
BACKGROUND: Ambient air pollutant directly contacts with the eyes, however, the effect of ambient fine particulate matter (PM2.5) and ozone (O3) on vision impairment, such as presbyopia, has been kept largely unknown. METHODS: We surveyed a total of 36,620 participants aged 50 years and above in six low- and middle-income countries. Ambient annual concentrations of PM2.5 and O3 for the residential community were estimated using satellite data and chemical transport model. A mixed effects model was utilized to assess the effects of ambient PM2.5 and O3 on presbyopia, as well as their combined effects. RESULTS: A total of 13,841 presbyopia cases were identified among the participants with a prevalence rate of 41.17%. For both PM2.5 and O3, we found a J-shaped exposure-response relationship with the threshold being identified at 15 μg/m3 for PM2.5 and 55 μg/m3 for O3. The odds ratio (OR) of presbyopia was 1.15 (95% CI: 1.09, 1.21) for each 10 μg/m3 increase in PM2.5 above 15 μg/m3 and 1.37 (95% CI: 1.23, 1.54) for O3 above 55 μg/m3 after adjusting for various potential confounding factors. There appeared to be a synergistic interaction between ambient PM2.5 and O3 on presbyopia in the additive model, the combined effect was significantly larger than the sum of their individual effects, with a synergistic index of 2.39. CONCLUSION: This study supports that exposures to ambient PM2.5 and O3 might be important risk factors of presbyopia among old adults, and simultaneously exposure to high level of the two pollutants could intensify their individual effects.