Association between short-term ozone exposure and allergic conjunctivitis in China: A multi-city case-crossover study,Environmental Pollution

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Association between short-term ozone exposure and allergic conjunctivitis in China: A multi-city case-crossover study
Environmental Pollution ( IF 7.6 ) Pub Date : 2024-07-03 , DOI: 10.1016/j.envpol.2024.124506
Yun Qiu ₁ , Jin Zhou ₂ , Yanfeng Liao ₃ , Wenhui Liu ₄ , Zuqiong Song ₃ , Zhen Wang ₅ , Wei Shan ₆ , Hui Guo ₇ , Dehui Zheng ₂ , Lihong Yang ₂ , Zengliang Ruan ₈

Affiliation

Department of Public Health, School of Medicine, Nanjing University of Chinese Medicine, Nanjing, China.
Department of Ophthalmology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, Guangdong, China.
Huizhou First Maternal and Child Health Care Hospital, Huizhou, Guangdong, China.
Department of Ophthalmology, Jiangnan University Medical Center, Wuxi, China.
Department of Ophthalmology, Suzhou Municipal Hospital & the Affiliated Suzhou Hospital of Nanjing Medical University, Nanjing Medical University, Suzhou, China.
Administrative Office, Suzhou Municipal Hospital & the Affiliated Suzhou Hospital of Nanjing Medical University, Nanjing Medical University, Suzhou, China.
Department of Ophthalmology, Qilu Hospital of Shandong University, Jinan, China.
Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, And Department of Epidemiology & Health Statistics, School of Public Health, Southeast University, Nanjing, China; Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; Department of Epidemiology, School of Public Health, Sun Yat-Sen University, Guangzhou, China.

Short-term exposure to ozone has been linked to multiple allergic diseases, but the relationship between ozone exposure and allergic conjunctivitis (AC) remains unclear. This study aimed to investigate the association between short-term exposure to ozone and the risk of AC. We conducted a time-stratified case-crossover study across five Chinese cities from 2014 to 2022. Daily outpatient visit records for AC were identified in five hospitals using either the diagnosis name or ICD-10 code H10.1. Data on air pollution and meteorological conditions were also collected. We first examined the city-specific association between short-term ozone exposure and AC using conditional logistic regression. A random-effects meta-analysis was then conducted to obtain overall estimates. During the study period, 130,093 outpatient visits for AC occurred, with 58.8% (76,482) being male and 41.2% (53,611) female. A one-standard-deviation (SD) increase in ozone was associated with an 8.3% increase (95% CI: 3.8%, 13.0%) in AC outpatient visits. Similar positive associations were observed when adjusting for other pollutants (PM2.5, CO, SO2 and NO2) in two-pollutant and multi-pollutant models. Furthermore, the positive association remained consistent when using mixed-effects regression models or further adjusting for meteorological conditions. In addition, no effect modification of the AC-ozone association by sex, age and season was apparent. This study provides evidence supporting a positive association between short-term ozone exposure and AC risk in China. This highlights the potential value of mitigating ozone pollution to reduce the risk of ocular surface disorders.

更新日期：2024-07-03

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