Abstract
PDS 67: Outdoor air pollution cardiometabolic effects, Exhibition Hall (PDS), Ground floor, August 27, 2019, 4:30 PM - 5:30 PM Background/Aim: Exposure to air pollution has been linked to adverse effects on vascular diseases. However, the effects of air pollution exposure on diabetic retinopathy (DR), a form of vascular disease, have not been studied. The aim of this study was to determine the association between ambient air pollution exposure and diabetic retinopathy occurrence. Material and Methods Retrospective cohort study design was applied for investigating the long-term effect of ambient air pollution on DR occurrence among diabetics. Newly diagnosed diabetes mellitus (DM) cases during 2003-2012 from the National Health Insurance Research Database (NHIRD) – Longitudinal Health Insurance Database 2005 (LHID2005) were included in the study cohort. Yearly air exposure levels were obtained from the Taiwan EPA air monitoring station. Kriging method was used to interpolate concentrations of air pollutants in township levels. We linked yearly townships exposure levels with townships of residence in each year, and calculated the average concentrations of follow-up period as personal exposure. The Cox proportional hazard models were performed adjusting for sex, age of DM onset and comorbidities. Results: A total of 17,403 subjects with newly diagnosed DM were included in the study. Among them, 585 newly diagnosed DR cases were found during the follow-up periods (mean: 5.6 years). The hazard ratio (HR) of DR occurrence associated with per 10 μg/m3 increase in PM2.5, PM2.5-10, 1 ppb in nitrogen dioxide (NO2) and sulfur dioxide (SO2), were 2.06 (95% confidence interval, CI: 1.60-2.66), 1.71 (95%CI: 1.39-2.10), 1.05 (95%CI: 1.03-1.08), and 1.23 (95%CI: 1.13-1.34), respectively. In two-pollutant models, the effects of PM2.5, PM2.5-10, NO2 and SO2 remained robust after adjusting for other air pollutants. Conclusion: Exposure to higher levels of air pollution was associated with increased risk of DR occurrence in diabetic patients.
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