Abstract
Air composition influences Dry Eye (DE) symptoms as demonstrated by studies that have linked the outdoor environment to DE. However, there is insufficient data on the effect of short-term exposure to indoor environments on DE symptoms. We conducted a prospective experimental research, in which an older building served as an experimental site, and a newer building served as the control site. Indoor air quality was monitored in both buildings. One-hundred-and-ninety-four randomly selected individuals were interviewed in the afternoon exiting the buildings and de-identified responses were recorded. Self-reported DE symptoms were modeled with respect to experimental and control buildings, adjusting for potential confounders. The experimental site had 2-fold higher concentration of airborne particulate matter (24,436 vs. 12,213 ≥ 0.5 µm/ft3) and microbial colonies (1066 vs. 400/m3), as compared to the control building. DE symptoms were reported by 37.5% of individuals exiting the experimental and 28.4% exiting the control building. In the univariate analysis, subjects exiting the experimental building were 2.21× more likely to report worsening of DE symptoms since morning compared to the control building (p < 0.05). When adjusting for confounders, including a history of eye allergy, subjects from the experimental building were 13.3× more likely to report worsening of their DE symptoms (p < 0.05). Our findings suggest that short-term exposure to adverse indoor environmental conditions, specifically air pollution and bioaerosols, has an acutely negative impact on DE symptoms.
Highlights
Dry eye (DE) disease is a “multifactorial disease” of the ocular surface characterized by a loss of homeostasis of the tear film, and accompanied by ocular symptoms, in which tear film instability and hyperosmolarity, ocular surface inflammation and damage, and neurosensory abnormalities play etiological roles [1]
When adjusted for demographics and comorbidities, including a history of eye allergy, eye surgery, and time spent in the building, subjects from the experimental building were 13.30 times more likely to report worsening of their DE symptoms (OR = 13.30, 95% confidence interval (CI) = 2.80–63.31; p < 0.01)
This study investigated the impact of short-term exposure to indoor air environment on ocular surface symptoms
Summary
Dry eye (DE) disease is a “multifactorial disease” of the ocular surface characterized by a loss of homeostasis of the tear film, and accompanied by ocular symptoms, in which tear film instability and hyperosmolarity, ocular surface inflammation and damage, and neurosensory abnormalities play etiological roles [1]. While studies have described the adverse effects of chronic exposure to air pollutants on respiratory, cardiovascular, and ocular health [26], an understanding of the effects of short-term exposure to indoor environments in diseases is lacking, including in relation to DE symptoms. This study bridges this knowledge gap by evaluating the frequency and change in DE symptoms in response to short-term exposure to two different building environments. We hypothesize that short-term exposure to an adverse environment will be associated with worsening DE symptoms as compared with a healthier environment
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