A Longitudinal Analysis about the Effect of Air Pollution on Astigmatism for Children and Young Adults

Purpose: This study aimed to investigate the correlation between air pollution and astigmatism, considering the detrimental effects of air pollution on respiratory, cardiovascular, and eye health. Methods: A longitudinal study was conducted with 127,709 individuals aged 4-27 years from 9 cities in Guangdong Province, China, spanning from 2019 to 2021. Astigmatism was measured using cylinder values. Multiple measurements were taken at intervals of at least 1 year. Various exposure windows were used to assess the lagged impacts of air pollution on astigmatism. A panel data model with random effects was constructed to analyze the relationship between pollutant exposure and astigmatism. Results: The study revealed significant associations between astigmatism and exposure to carbon monoxide (CO), nitrogen dioxide (NO2), and particulate matter (PM2.5) over time. A 10 {\mu}g/m3 increase in a 3-year exposure window of NO2 and PM2.5 was associated with a decrease in cylinder value of -0.045 diopters and -0.017 diopters, respectively. A 0.1 mg/m3 increase in CO concentration within a 2-year exposure window correlated with a decrease in cylinder value of -0.009 diopters. No significant relationships were found between PM10 exposure and astigmatism. Conclusion: This study concluded that greater exposure to NO2 and PM2.5 over longer periods aggravates astigmatism. The negative effect of CO on astigmatism peaks in the exposure window of 2 years prior to examination and diminishes afterward. No significant association was found between PM10 exposure and astigmatism, suggesting that gaseous and smaller particulate pollutants have easier access to human eyes, causing heterogeneous morphological changes to the eyeball.