Association between Air Pollution Exposure and Daily Outpatient Visits for Dry Eye Disease: A Time-Series Study in Urumqi, China

Abstract

The potential effects of air pollution on the ocular surface environment have not been fully evaluated, and even fewer studies have been conducted on the lagged effects of air pollution on dry eye disease (DED). The data of 9970 DED outpatients between 1 January 2013 and 31 December 2020, and data for six air pollutants, including PM10, PM2.5, carbon monoxide (CO), sulfur dioxide (SO2), nitrogen dioxide (NO2), and ozone (O3), were obtained from 11 standard urban background stationary air quality monitors in Urumqi, Xinjiang, China. Time series analysis design and quasi-Poisson generalized linear regression models combined with distributed lagged nonlinear models (DLNM) were used. Single- and multi-pollutant model results suggest that each additional per 10 μg/m3 of PM10, NO2, and SO2 is associated with an increased risk of outpatient DED on lag day 0 and PM2.5, NO2, and SO2 with other cumulative lag days; R software version 4.0.4 (15 February 2021) was used for the analysis. We conducted first time series analysis with a large sample size in northwest China (Xinjiang) and confirmed, for the first time, the impact of air pollution including particulate pollutants (PM10, PM2.5) and acidic gasses (SO2, NO2) on DED risk in the Urumqi region, and suggested the potential lagged effects of PM2.5, SO2, and NO2.