Association Between Air Pollution and the Risk of Uveitis: A Nationwide, Population-Based Cohort Study

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.

The Adverse Effects of Air Pollution on the Eye: A Review

“…Regarding environmental cigarette smoke exposure, a case-control study showed increased risks of neovascular and atrophic AMD [107]. However, in the Blue Mountains Eye Study, Smith and associates found that passive smoking does not significantly increase the risk for late AMD [108]. Cigarette vapor was reported to accelerate the progression of inflammation and angiogenesis in the retina of mice, which were possibly associated with the onset of wet AMD [109].…”

Uveitis increases the risk of stroke among patients with ankylosing spondylitis: A nationwide population-based longitudinal study

“…Second, the participants in our study were predominantly Taiwanese; therefore, the effects of different races and ethnicities could not be assessed. Third, we used the ICD-9 coding (Outpatient visits≧ 3 or ≧1 inpatient) as the basis for a diagnosis of uveitis, which have used in several studies (49)(50)(51). After literature review, one Hawaii's study reported that the positive predictive value (PPV) of ICD-9 codes for identifying individual uveitis codes ranged from 0% to 100% and the overall PPV was 61%.…”

Influence of Indoor Temperature Exposure on Emergency Department Visits Due to Infectious and Non-Infectious Respiratory Diseases for Older People

“…Taiwanese researchers use an anonymous identification number to link each registry data and related medical information for academic purposes. Recently, some studies also used LHID to investigate public health issues [ 23 , 24 , 25 ].…”