The association of ambient air pollution with cataract surgery in UK biobank participants: Prospective cohort study

TY - JOUR

T1 - The association of ambient air pollution with cataract surgery in UK biobank participants

T2 - Prospective cohort study

AU - Chua, Sharon Y.L.

AU - Khawaja, Anthony P.

AU - Desai, Parul

AU - Rahi, Jugnoo S.

AU - Day, Alex C.

AU - Hammond, Christopher J.

AU - Khaw, Peng T.

AU - Foster, Paul J.

N1 - Funding Information: Supported by grants from Moorfields Eye Charity, The NIHR Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, the Alcon Research Institute and the International Glaucoma Association (UK). P.T.K. and P.J.F. received salary support from the NIHR BRC at Moorfields Eye Hospital. P.T.K. is supported in part by the Helen Hamlyn Trust. P.J.F. received support from the Richard Desmond Charitable Trust, via Fight for Sight, London. A.P.K. is supported by a Moorfields Eye Charity Career Development Fellowship and a UKRI Future Leaders Fellowship. Funding Information: Supported by grants from Moorfields Eye Charity, The NIHR Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, the Alcon Research Institute and the International Glaucoma Association (UK). Funding Information: P.T.K. is supported in part by the Helen Hamlyn Trust. P.J.F. received support from the Richard Desmond Charitable Trust, via Fight for Sight, London. Funding Information: A.P.K. is supported by a Moorfields Eye Charity Career Development Fellowship and a UKRI Future Leaders Fellowship. Funding Information: Conflict of Interest: All authors have completed the ICMJE uniform disclosure form at www.icmje.org/coi_disclosure.pdf and report. P.J.F. reports personal fees from Allergan, Carl Zeiss, Google/DeepMind and Santen, a grant from Alcon, outside the submitted work. A.P.K. reports personal fees from Aerie, Allergan, Google Health, Novartis, Thea, and Santen, all outside the submitted work. C.J.H. reports personal fees from Nevakar, outside the submitted work. Publisher Copyright: Copyright © 2021 The Authors

PY - 2021/12

Y1 - 2021/12

N2 - 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 (NO2) and nitrogen oxides (NOx). 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 PM2.5 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 PM2.5, NO2, and NOx 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 PM2.5, NO2, and NOx (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 PM2.5, NO2, and NOx, the effect estimates were relatively small. Further research is required to determine if the associations identified are causal.

AB - 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 (NO2) and nitrogen oxides (NOx). 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 PM2.5 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 PM2.5, NO2, and NOx 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 PM2.5, NO2, and NOx (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 PM2.5, NO2, and NOx, the effect estimates were relatively small. Further research is required to determine if the associations identified are causal.

KW - Ambient air pollution

KW - Cataract surgery

KW - PM

KW - Prospective cohort

KW - UK Biobank

UR - https://www.scopus.com/pages/publications/85121267759

U2 - 10.1167/iovs.62.15.7

DO - 10.1167/iovs.62.15.7

M3 - Article

AN - SCOPUS:85121267759

SN - 0146-0404

VL - 62

JO - Investigative Ophthalmology and Visual Science

JF - Investigative Ophthalmology and Visual Science

IS - 15

M1 - 7

ER -