Aims/Purpose: This study investigated the relationship between environmental pollution and dry eye disease (DED), focusing on the cumulative impact of air pollutants.Methods: Cross‐sectional data from the 7th and 8th Korea National Health and Nutrition Examination Survey (KNHANES) (2017‐2020) were analyzed alongside air pollution data from the National Ambient Air Quality Management Information System (NAMIS). Non‐smokers aged between 40 and 80 were selected (n = 8,840). The daily cumulative index (CI) of air quality was calculated for each region of residence based on key pollutants, including SO₂, NO₂, PM2.5, and PM10. Using Gaussian mixture models, each day was categorized as usual,poor, or bad based on CI values. Multiple logistic regression analysis assessed the impact of air pollutants on DED while accounting for clinical, demographic, and meteorological factors. Additionally, the Aggregated Air Quality Index (AAQI) was calculated and evaluated for the same dataset.Results: Multiple logistic regression analysis indicated that the proportion of high pollution days within a year significantly increased the odds of DED (OR: 4.19, 95% CI: 1.23–14.25, p = 0.02), after adjusting for factors associated with DED as covariates. Although the AAQI did not show statistical significance, the Cumulative Index effectively demonstrated the aggregated effect of multiple air pollutants on DED.Conclusions: This research highlights the utility of a model using regularly measured air quality indicators, providing a comprehensive assessment of the aggregated effect of air pollutants. Implementing these measures can help identify at‐risk populations and consider environmental factors in managing and preventing DED.References Saxena, A., & Shekhawat, S. (2017). Ambient Air Quality Classification by Grey Wolf Optimizer Based Support Vector Machine. Journal of environmental and public health, 2017, 3131083. Kyrkilis, G., Chaloulakou, A., & Kassomenos, P. A. (2007). Development of an aggregate Air Quality Index for an urban Mediterranean agglomeration: relation to potential health effects. Environment international, 33(5), 670–676.
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