Department of Environmental Health, School of Public Health, China Medical University, Shenyang 110122, Liaoning, China.
Department of Ophthalmology, the Fourth Affiliated Hospital, China Medical University, Shenyang 110032, Liaoning, China.
Biomed Environ Sci. 2021 Feb 20;34(2):101-109. doi: 10.3967/bes2021.015.
To assess the association of socioeconomic status with the burden of cataract blindness in terms of year lived with disability (YLD) rates and to determine whether ultraviolet radiation (UVR) levels modify the effect of socioeconomic status on this health burden.
National and subnational age-standardized YLD rates associated with cataract-related blindness were derived from the Global Burden of Disease (GBD) study 2017. The human development index (HDI) from the Human Development Report was used as a measure of socioeconomic status. Estimated ground-level UVR exposure was obtained from the Ozone Monitoring Instrument (OMI) dataset of the National Aeronautics and Space Administration (NASA).
Across 185 countries, socioeconomic status was inversely associated with the burden of cataract blindness. Countries with a very high HDI had an 84% lower age-standardized YLD rate [95% confidence interval ( ): 60%-93%, < 0.001] than countries with a low HDI; for high-HDI countries, the proportion was 76% (95% : 53%-88%, < 0.001), and for medium-HDI countries, the proportion was 48% (95% : 15%-68%, = 0.010; for trend < 0.001). The interaction analysis showed that UVR exposure played an interactive role in the association between socioeconomic status and cataract blindness burden ( value for interaction = 0.047).
Long-term high-UVR exposure amplifies the association of poor socioeconomic status with the burden of cataract-related blindness. The findings emphasize the need for strengthening UVR exposure protection interventions in developing countries with high-UVR exposure.
评估社会经济地位与白内障致盲负担的关联，从伤残调整生命年（YLD）率方面进行评估，并确定紫外线辐射（UVR）水平是否会改变社会经济地位对这一健康负担的影响。
从 2017 年全球疾病负担（GBD）研究中得出与白内障相关致盲相关的国家和次国家年龄标准化 YLD 率。人类发展指数（HDI）来自人类发展报告，用作社会经济地位的衡量标准。从美国国家航空航天局（NASA）的臭氧监测仪器（OMI）数据集获得估计的地面 UVR 暴露量。
在 185 个国家中，社会经济地位与白内障致盲负担呈负相关。人类发展指数非常高的国家的年龄标准化 YLD 率比人类发展指数低的国家低 84%（95%置信区间：60%-93%，<0.001）；高人类发展指数国家的比例为 76%（95%：53%-88%，<0.001），中人类发展指数国家的比例为 48%（95%：15%-68%，=0.010；趋势检验<0.001）。交互作用分析表明，UVR 暴露在社会经济地位与白内障致盲负担之间的关联中起交互作用（交互作用值=0.047）。
长期高 UVR 暴露放大了贫困社会经济地位与白内障相关致盲负担之间的关联。这些发现强调了在高 UVR 暴露的发展中国家加强 UVR 暴露保护干预措施的必要性。
