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Cheryl Sherrod, Kevin Frick, Pradeep Ramulu, ; The Association of Vision Loss with Work Status in the United States. Invest. Ophthalmol. Vis. Sci. 2013;54(15):4543.
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To examine the association between visual acuity and self-reported work status in a nationally representative cross-sectional sample of American adults.
A total of 23,805 adults between 18 and 74 years of age participated in both the interview and the examination component of the 1999-2008 National Health and Nutritional Examination Survey. Visual acuity (VA) testing was performed in both eyes. Upon presentation, participants were asked to wear their usual distance correction if any. Subjects were categorized as having normal vision (presenting VA of 20/40 or better), uncorrected refractive error (URE; presenting VA of 20/50 or worse improving to 20/40 or better with autorefraction), vision impairment (VI; post-refraction VA of 20/40 to 20/200), or severe VI (post-refraction acuity of 20/200 or worse). Participants were categorized as working if they described being employed within the past week, and not working if they had not worked in the last week and/or if they were looking for work. Associations between work and vision status were determined in multivariable models adjusting for age, gender, race/ethnicity, and presence of chronic disease.
A total of 19,710 participants (82.8%) had complete vision, employment, and demographic data. Among those with normal vision, the percent who were working was 71.5% (95% CI= 70.3 to 72.8) compared to 64.7% (95% CI= 60.8 to 68.6) among those with URE, 40.0% (95% CI= 30.5 to 49.6) among those with VI, and 25.8% (95% CI= 8.7 to 43.0) among those with severe VI. In a multivariable logistic regression adjusted for age, gender, race/ethnicity, and chronic disease status, URE (Odds Ratio [OR] = 0.67, 95% CI= 0.56 to 0.80), VI (OR = 0.27, 95% CI= 0.17 to 0.43), and severe VI (OR = 0.18, 95% CI= 0.07 to 0.42) were all associated with a lower likelihood of working. Increasing age, female gender, being Mexican American or non-Hispanic Black, and the presence of a chronic disease were all associated with a lower odds of working (p-values <0.01).
Decreased vision, particularly from non-refractive causes is associated with a significantly lower likelihood of working. Further investigation is warranted to understand the barriers for employment in those individuals with VI and URE.
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