Joint effects of meteorological factors and PM_2.5 on age-related macular degeneration: a national cross-sectional study in China

Abstract

Background: Weather conditions are a possible contributing factor to age-related macular degeneration (AMD), a leading cause of irreversible loss of vision. The present study evaluated the joint effects of meteorological factors and fine particulate matter (PM 2.5 ) on AMD. Methods: Data was extracted from a national cross-sectional survey conducted across 10 provinces in rural China. A total of 36,081 participants aged 40 and older were recruited. AMD was diagnosed clinically by slit-lamp ophthalmoscopy, fundus photography, and spectral domain optical coherence tomography (OCT). Meteorological data were calculated by European Centre for Medium-Range Weather Forecasts (ECMWF) reanalysis and were matched to participants' home addresses by latitude and longitude. Participants' individual PM 2.5 exposure concentrations were calculated by a satellite-based model at a 1-km resolution level. Multivariable-adjusted logistic regression models paired with interaction analysis were performed to investigate the joint effects of meteorological factors and PM 2.5 on AMD. Results: The prevalence of AMD in the study population was 2.6% (95% CI 2.42-2.76%). The average annual PM 2.5 level during the study period was 63.1 « 15.3 µg/m 3 . A significant positive association was detected between AMD and PM 2.5 level, temperature (T), and relative humidity (RH), in both the independent and the combined effect models. For PM 2.5 , compared with the lowest quartile, the odds ratios (ORs) with 95% confidence intervals (CIs) across increasing quartiles were 0.

Association between ambient air pollution and age-related macular degeneration: a meta-analysis

“…The assessment and definition of AMD varied among studies. Among six studies applying standardised criteria for AMD diagnosis, grading was performed by at least two independent ophthalmologists to ensure the accuracy of diagnosis in three studies [ 8 , 16 , 17 ], whereas the other three did not describe the specific grading methodology [ 7 , 14 , 18 ]. Different from the standardised criteria, cases were diagnosed based on medical record review or self-reporting in two studies [ 13 , 15 ].…”

“…It was demonstrated that NO 2 , SO 2 , CO and PM 2.5 did not increase the AMD risk, whereas the exact effect size of them was not reported [ 18 ]. Both Hwang et al and Yan et al found a significant positive association between AMD and higher PM 2.5 levels (HR = 1.19; 95% CI: 1.13–1.25 and OR = 2.602; 95% CI: 1.516–4.468, respectively) [ 8 , 14 ]. Recently, multipollutant model findings by Sun et al have revealed that the AMD risk was on a monotonic increasing trend with higher O 3 concentration; the harmful effect increased rapidly after reaching a turning point of 110 μg/m 3 (OR = 1.15; 95% CI: 1.13–1.16 and OR = 1.66; 95% CI: 1.63–1.69, respectively) increase [ 17 ].…”

“…We used the data of single-pollutant models for effect estimates. Two articles calculated and divided air pollution concentrations into four quartiles; we used the data of the highest quartile in the meta-analysis [ 7 , 14 ]. According to quantitative methods in the review of epidemiologic articles, we ignored the distinctions among the HRs and ORs and calculated the pooled OR [ 19 ].…”

“…It should be noted that meterological variables have a significant effect on changes in air pollution. Yan et al reported that combined exposure to PM 2.5 and atmospheric pressure remarkably increased the risk of AMD, while temperature and humidity acted a weakly antagonistic effect on AMD [ 14 ]. Higher temperature is known to cause lower relative humidity.…”

“…For example, a national cross-sectional study in China reported a significant positive association between PM 2.5 and AMD. For PM 2.5 , compared with the lowest quartile, the odds ratios (ORs) and 95% confidence intervals (CIs) across increasing quartiles were 0.828 (0.674, 1.018), 1.105 (0.799, 1.528), and 2.602 (1.516, 4.468) [ 14 ]. However, conflicting findings were observed on the association between AMD and NO 2 or O 3 [ 7 , 13 ].…”