Ambient PM 2.5 and O 3 and their combined effects on prevalence of presbyopia among the elderly: A cross-sectional study in six low- and middle-income countries

• Published in: The Science of the total environment Vol. 655; p. 168
• Main Authors: Lin, Hualiang, Guo, Yanfei, Ruan, Zengliang, Yang, Yin, Chen, Yanbing, Zheng, Yang, Cummings-Vaughn, Lenise A, Rigdon, Steven E, Vaughn, Michael G, Sun, Shengzhi, Zhang, Lingli, Wang, Xiaojie, Qian, Zhengmin Min, Wu, Fan
• Format: Journal Article
• Language: English
• Published: Netherlands 10.03.2019
• Subjects: Low- and middle-income countries; Presbyopia; Air pollution; PM(2.5); O
• ISSN: 1879-1026

Ambient air pollutant directly contacts with the eyes, however, the effect of ambient fine particulate matter (PM ) and ozone (O ) on vision impairment, such as presbyopia, has been kept largely unknown. We surveyed a total of 36,620 participants aged 50 years and above in six low- and middle-income countries. Ambient annual concentrations of PM and O for the residential community were estimated using satellite data and chemical transport model. A mixed effects model was utilized to assess the effects of ambient PM and O on presbyopia, as well as their combined effects. A total of 13,841 presbyopia cases were identified among the participants with a prevalence rate of 41.17%. For both PM and O , we found a J-shaped exposure-response relationship with the threshold being identified at 15 μg/m for PM and 55 μg/m for O . The odds ratio (OR) of presbyopia was 1.15 (95% CI: 1.09, 1.21) for each 10 μg/m increase in PM above 15 μg/m and 1.37 (95% CI: 1.23, 1.54) for O above 55 μg/m after adjusting for various potential confounding factors. There appeared to be a synergistic interaction between ambient PM and O on presbyopia in the additive model, the combined effect was significantly larger than the sum of their individual effects, with a synergistic index of 2.39. This study supports that exposures to ambient PM and O might be important risk factors of presbyopia among old adults, and simultaneously exposure to high level of the two pollutants could intensify their individual effects.