Associations of long-term joint exposure to multiple ambient air pollutants with the incidence of age-related eye diseases

Abstract

<h3>Objectives</h3><p>The associations between long-term joint exposure to low levels of multiple air pollutants and the incidence of common age-related eye diseases (AREDs), including cataract, glaucoma, and age-related macular degeneration (AMD), remain underexplored.</p><h3>Methods</h3><p>We conducted a prospective cohort study using UK Biobank data from 441,567 participants without cataract, glaucoma, or AMD at baseline. An air pollution score was constructed to assess the combined effect of multiple air pollutants, including PM_2.5, PM_2.5–10, PM₁₀, NO₂ and NO. Cox proportional hazards models were used to evaluate associations.</p><h3>Results</h3><p>Over a median follow-up of 14.41 years, 55,104 participants developed cataract, 11,940 glaucoma, and 9060 AMD. A relatively stronger association was observed between combined exposure to multiple pollutants and AREDs incidence compared to exposure to individual pollutants. For every interquartile range increase in the air pollution score, the risk of incident AREDs increased by 4–5 % (cataract, HR [95 % CI], 1.05 [1.04–1.06]; glaucoma, 1.04 [1.02, 1.06]; AMD, 1.04 [1.01, 1.07]), suggesting the potential additive or synergistic effects of exposure to pollutant mixtures. Compared to individuals in the lowest exposure quartile, those in the highest had a 13 %, 9 %, and 14 % greater risk of developing cataract (1.13 [1.10–1.16]), glaucoma (1.09 [1.03–1.15]), and AMD (1.14 [1.07–1.22]), respectively.</p><h3>Conclusions</h3><p>Long-term joint exposure to multiple air pollutants, even at low concentrations, is associated with an increased risk of AREDs incidence, suggesting that reducing air pollution level could improve human ocular health. These findings provide a more comprehensive understanding of air pollution’s impact on ocular health in the real world.</p>