Abstract：
OBJECTIVE: To examine the association between ambient air pollution and dry eye symptoms (DES) during the COVID-19 pandemic and explore whether air pollution had increased the risk of DES to a greater extent than other risk factors.
METHODS: A nationwide cross-sectional survey was conducted from June 20, 2022 to August 31, 2022. The Ocular Surface Disease Index-6 (OSDI-6) questionnaire was used to assess the presence of DES. Logistic regression models were employed to analyze the associations between DES and air pollution variables, including air quality index (AQI), fine particulate matter (PM2.5), PM10, sulfur dioxide (SO2), carbon monoxide (CO), nitrogen dioxide (NO2), ozone (O3) and residing near industrial zones. We explored the interactions of air pollutants and other risk factors in the additive models by calculating the synergy index (SI). Standardized regression coefficients were calculated to compare the relative importance of risk factors for DES.
RESULTS: A total of 21,909 participants were included in the analysis. Residing near industrial zones was significantly correlated with a higher risk of DES (Odds ratio (OR): 1.57, 95 % confidence interval (CI): 1.38-1.79). No significant associations were found between DES and air pollutants except SO2 (OR: 1.05, 95 % CI: 1.02-1.09, per standard deviation increment in SO2 concentration). The restricted cubic spline analyses revealed a linear concentration-response relationship between SO2 and DES. The interaction analyses suggested synergetic interactions of SO2 with depression and problematic internet use. Among the risk factors, depression, anxiety and problematic Internet use contributed more to the increased risk of DES.
CONCLUSIONS: The association between ambient air pollutants and DES may have been mitigated during the pandemic due to increased time spent indoors. Despite this, our findings support the deleterious health impact of air pollutants. Future urban planning should plan industrial zones further away from residential areas.
METHODS: A nationwide cross-sectional survey was conducted from June 20, 2022 to August 31, 2022. The Ocular Surface Disease Index-6 (OSDI-6) questionnaire was used to assess the presence of DES. Logistic regression models were employed to analyze the associations between DES and air pollution variables, including air quality index (AQI), fine particulate matter (PM2.5), PM10, sulfur dioxide (SO2), carbon monoxide (CO), nitrogen dioxide (NO2), ozone (O3) and residing near industrial zones. We explored the interactions of air pollutants and other risk factors in the additive models by calculating the synergy index (SI). Standardized regression coefficients were calculated to compare the relative importance of risk factors for DES.
RESULTS: A total of 21,909 participants were included in the analysis. Residing near industrial zones was significantly correlated with a higher risk of DES (Odds ratio (OR): 1.57, 95 % confidence interval (CI): 1.38-1.79). No significant associations were found between DES and air pollutants except SO2 (OR: 1.05, 95 % CI: 1.02-1.09, per standard deviation increment in SO2 concentration). The restricted cubic spline analyses revealed a linear concentration-response relationship between SO2 and DES. The interaction analyses suggested synergetic interactions of SO2 with depression and problematic internet use. Among the risk factors, depression, anxiety and problematic Internet use contributed more to the increased risk of DES.
CONCLUSIONS: The association between ambient air pollutants and DES may have been mitigated during the pandemic due to increased time spent indoors. Despite this, our findings support the deleterious health impact of air pollutants. Future urban planning should plan industrial zones further away from residential areas.
摘要：
目的：研究COVID-19大流行期间环境空气污染与干眼症状（DES）之间的关系，并探讨空气污染是否比其他危险因素在更大程度上增加了DES的风险。
方法：从2022年6月20日至2022年8月31日进行了全国性的横断面调查。眼表疾病指数-6(OSDI-6)问卷用于评估DES的存在。采用Logistic回归模型分析DES与空气污染变量之间的关联，包括空气质量指数(AQI)，细颗粒物（PM2.5），PM10、二氧化硫(SO2)、一氧化碳(CO),二氧化氮(NO2),臭氧（O3）和居住在工业区附近。我们通过计算协同指数（SI），探索了空气污染物与其他风险因素在添加剂模型中的相互作用。计算标准化回归系数以比较DES危险因素的相对重要性。
结果：共有21,909名参与者被纳入分析。居住在工业区附近与较高的DES风险显着相关（赔率比（OR）：1.57，95％置信区间（CI）：1.38-1.79）。除SO2外，DES与空气污染物之间没有显着关联（OR：1.05，95％CI：1.02-1.09，SO2浓度的标准偏差增量）。有限的三次样条分析揭示了SO2和DES之间的线性浓度-响应关系。相互作用分析表明，SO2与抑郁症和有问题的互联网使用之间存在协同相互作用。在风险因素中，抑郁症,焦虑和有问题的互联网使用更多地导致了DES的风险增加。
结论：在大流行期间，由于室内时间增加，环境空气污染物与DES之间的关联可能已得到缓解。尽管如此,我们的研究结果支持空气污染物对健康的有害影响.未来的城市规划应规划远离居民区的工业区。
方法：从2022年6月20日至2022年8月31日进行了全国性的横断面调查。眼表疾病指数-6(OSDI-6)问卷用于评估DES的存在。采用Logistic回归模型分析DES与空气污染变量之间的关联，包括空气质量指数(AQI)，细颗粒物（PM2.5），PM10、二氧化硫(SO2)、一氧化碳(CO),二氧化氮(NO2),臭氧（O3）和居住在工业区附近。我们通过计算协同指数（SI），探索了空气污染物与其他风险因素在添加剂模型中的相互作用。计算标准化回归系数以比较DES危险因素的相对重要性。
结果：共有21,909名参与者被纳入分析。居住在工业区附近与较高的DES风险显着相关（赔率比（OR）：1.57，95％置信区间（CI）：1.38-1.79）。除SO2外，DES与空气污染物之间没有显着关联（OR：1.05，95％CI：1.02-1.09，SO2浓度的标准偏差增量）。有限的三次样条分析揭示了SO2和DES之间的线性浓度-响应关系。相互作用分析表明，SO2与抑郁症和有问题的互联网使用之间存在协同相互作用。在风险因素中，抑郁症,焦虑和有问题的互联网使用更多地导致了DES的风险增加。
结论：在大流行期间，由于室内时间增加，环境空气污染物与DES之间的关联可能已得到缓解。尽管如此,我们的研究结果支持空气污染物对健康的有害影响.未来的城市规划应规划远离居民区的工业区。
