West Sheila K, Longstreth Janice D, Munoz Beatriz E, Pitcher Hugh M, Duncan Donald D
Dana Center for Preventive Ophthalmology, Wilmer Eye Institute, Johns Hopkins School of Medicine, Baltimore, MD 21287, USA.
Am J Epidemiol. 2005 Dec 1;162(11):1080-8. doi: 10.1093/aje/kwi329. Epub 2005 Oct 26.
The authors modeled the possible consequences for US cataract incidence of increases in ultraviolet B radiation due to ozone depletion. Data on the dose-response relation between ocular exposure to ultraviolet B radiation and cortical cataract were derived from a population-based study (the Salisbury Eye Evaluation Project, Salisbury, Maryland) in which extensive data on cataract and ultraviolet radiation were collected in persons aged 65-84 years. Exposure estimates for the US population were derived using estimated ultraviolet radiation fluxes as a function of wavelength. US Census data were used to obtain the age, ethnicity, and sex distribution of the population. Predicted probabilities of cataract were derived from the age-, sex-, and ethnicity-specific ocular ultraviolet exposure data and were modeled under conditions of 5-20% ozone depletion. The analysis indicated that by 2050, the prevalence of cortical cataract will increase above expected levels by 1.3-6.9%. The authors estimate that with 5-20% ozone depletion, there will be 167,000-830,000 additional cases of cortical cataract by 2050. Because of the high prevalence of cataract in older persons, at a 2003 cost of 3,370 dollars per cataract operation, this increase could represent an excess cost of 563 million dollars to 2.8 billion dollars.
作者模拟了因臭氧损耗导致紫外线B辐射增加对美国白内障发病率可能产生的后果。眼部暴露于紫外线B辐射与皮质性白内障之间剂量反应关系的数据来自一项基于人群的研究(索尔兹伯里眼评估项目,马里兰州索尔兹伯里),该研究收集了65至84岁人群中有关白内障和紫外线辐射的大量数据。美国人群的暴露估计值是通过将估计的紫外线辐射通量作为波长的函数得出的。使用美国人口普查数据来获取人口的年龄、种族和性别分布。白内障的预测概率是根据特定年龄、性别和种族的眼部紫外线暴露数据得出的,并在臭氧损耗5%至20%的条件下进行建模。分析表明,到2050年,皮质性白内障的患病率将比预期水平高出1.3%至6.9%。作者估计,在臭氧损耗5%至20%的情况下,到2050年皮质性白内障病例将增加16.7万至83万例。由于老年人白内障患病率很高,按照2003年每例白内障手术3370美元的成本计算,这一增加可能意味着额外成本5.63亿美元至28亿美元。