Abstract
Previous studies have revealed an association between ocular surface disorders and air pollution, few studies have focused on the risk of uveitis. We aimed to investigate whether air pollution increases the risk of uveitis. We used the Taiwan Longitudinal Health Insurance Database (LHID) and the Taiwan Air Quality Monitoring Database (TAQMD) to conduct a retrospective cohort study. Air pollutant concentrations, including those of carbon dioxide (CO2), were grouped into four levels according to quartiles. The outcome was the incidence of uveitis, as defined in the International Classification of Diseases, Ninth Revision. We used univariable and multivariable Cox proportional hazard regression models to calculate the adjusted hazard ratios (aHRs) and determine the potential risk factors of uveitis. Overall, 175,489 subjects were linked to their nearby air quality monitoring stations. We found that for carbon monoxide, the aHRs of uveitis risk for the Q3 and Q4 levels were 1.41 (95% confidence interval (CI) = 1.23–1.61) and 2.19 (95% CI = 1.93–2.47), respectively, in comparison with those for the Q1 level. For nitric oxide, the aHRs for the Q3 and Q4 levels were 1.46 (95% CI = 1.27–1.67) and 2.05 (95% CI = 1.81–2.32), respectively. For nitrogen oxide (NOx), the aHRs for the Q2, Q3, and Q4 levels were 1.27 (95% CI = 1.11–1.44), 1.34 (95% CI = 1.16–1.53), and 1.85 (95% CI = 1.63–2.09), respectively. For total hydrocarbon (THC), the aHRs for the Q2, Q3, and Q4 levels were 1.42 (95% CI = 1.15–1.75), 3.80 (95% CI = 3.16–4.57), and 5.02 (95% CI = 4.19–6.02), respectively. For methane (CH4), the aHRs for the Q3 and Q4 levels were 1.94 (95% CI = 1.60–2.34) and 7.14 (95% CI = 6.01–8.48), respectively. In conclusion, air pollution was significantly associated with incidental uveitis, especially at high THC and CH4 levels. Furthermore, the uveitis risk appeared to increase with increasing NOx and THC levels.
Highlights
Uveitis is an inflammatory and sight-threatening disorder that contributes to 2.8%–10% of all cases of blindness [1,2,3,4]
We found that for carbon monoxide, the adjusted hazard ratios (aHRs) of uveitis risk for the Quartile 3 (Q3) and Quartile 4 (Q4) levels were 1.41 (95% confidence interval (CI) = 1.23–1.61) and 2.19, respectively, in comparison with those for the Quartile 1 (Q1) level
Previous reports showed that anterior uveitis accounted for 24.5%–52.3%, panuveitis accounted for 11.8%–52.9%, posterior uveitis accounted for 7.1%–46.0%, and the prevalence of intermediate uveitis accounted for 6.3%–19.3%; anterior uveitis is the most common form of uveitis in Asia [10, 11]
Summary
Uveitis is an inflammatory and sight-threatening disorder that contributes to 2.8%–10% of all cases of blindness [1,2,3,4]. It aggravates pain and decreases visual function, thereby affecting the quality of life of patients, and may cause socio-economic impacts at the country level [5, 6]. The degree of urbanization of a country affects the cause of uveitis and varies greatly. Previous studies have found that both genetic and environmental factors may affect uveitis [17]. Data on the impact of air pollution on uveitis in clinical settings are limited
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