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Vikram Paranjpe, Emily P Rabinovich, Namrata Sharma, Arun Srivastava, Anat Galor, Abigail Hackam, Bennie H Jeng, Naresh Kumar; Solid fuel exposure and the development of cataracts. Invest. Ophthalmol. Vis. Sci. 2019;60(9):4254.
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© ARVO (1962-2015); The Authors (2016-present)
Cataracts are a progressive opacification of the lens, leading to visual impairment and often blindness. In India, about 3.8 million individuals become blind each year due to cataracts. Aging, as well as smoking and sun exposure, which both induce oxidative stress, are known risk factors for developing cataracts. Given the similarities in the toxicological mechanism of exposure to smoking and to combustion of solid fuel (crop residue, wood and charcoal), we hypothesized that chronic solid fuel exposure would increase the risk of developing cataracts.
Health surveys were conducted in 2004 and again in 2009 in the Delhi, India metropolitan area. A sample of households was drawn using a spatial probabilistic design. The survey was administered to all adult individuals in the home who consented to participate in the study and included self-reported data on cataract diagnosis, lifetime cooking history with specific data on the type of fuel and appliances used, and the presence of an exhaust fan in kitchen. Individuals with a self-reported cataract diagnosis were defined as cases and those without as controls. Multivariate logistic regression and instrumental regressions were used to model the risk of cataracts with respect to solid fuel exposure, adjusting for potential confounders including smoking and age.
3,197 individuals aged 30 or greater consented to participate in the study. 259 (8.1%) individuals reported a cataract diagnosis, and of these, 203 (78.4%) individuals reported any solid fuel exposure during their lifetime. Of the individuals who reported solid fuel exposure, 158 (61%) individuals reported 20 or more years of exposure. Adjusting for smoking and age, individuals with 20 or more years of solid fuel exposure were 10.4 times more likely to develop cataracts compared to unexposed subjects (95% CI 9.57 -11.28; p < 0.001). Furthermore, the odds of developing cataracts increased by 7% (95% CI 1.06 - 1.07; p < 0.001) with each additional year of solid fuel exposure.
Solid fuel exposure increased the likelihood of cataracts. Household air pollutants, such as solid fuel, may pose a health threat particularly to families with exposure to other risk factors, and may accelerate cataract formation. Strategies to limit solid fuel exposure should be considered to mitigate the cumulative health effects.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.
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