EFFECT OF ULTRAVIOLET-RADIATION ON CATARACT FORMATION
EFFECT OF ULTRAVIOLET-RADIATION ON CATARACT FORMATION
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DOI：
10.1056/nejm198812013192201
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发表时间：
1988-12-01
影响因子：
158.5
通讯作者：
EMMETT, EA
中科院分区：
文献类型：
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作者：
TAYLOR, HR;WEST, SK;EMMETT, EA
为了探讨紫外线辐射与白内障形成的关系，我们对切萨皮克湾838名（平均年龄53岁）工作的海员进行了流行病学调查。每年的眼睛暴露计算从16岁的每一个waterman结合详细的职业史与实验室和现场测量的阳光照射。通过眼科检查对白内障的类型和严重程度进行分级。在111名水手中发现了一定程度的皮质性白内障（13%），在229名水手中发现了一定程度的核性白内障（27%）。Logistic回归分析显示，高累积水平的紫外线B暴露显著增加皮质性白内障的风险（回归系数，0.70; P = 0.04）。累积暴露量加倍会使皮质性白内障的风险增加1.60倍（95%置信区间为1.01 ~ 2.64）。年平均暴露量在上四分位数的人与最低四分位数的人相比，风险增加了3.30（置信区间为0.90至9.97）。使用连续添加剂预期剂量模型的分析显示，皮质透镜混浊的水上运动员平均每年暴露于紫外线B的水平高出21%（t检验，2.23; P = 0.03）。核性白内障与紫外线B暴露或白内障与紫外线A暴露之间没有发现关联。我们的结论是暴露于紫外线B辐射和白内障形成之间存在关联，这支持了对紫外线B的眼睛保护的需要。
To investigate the relation of ultraviolet radiation and cataract formation, we undertook an epidemiologic survey of 838 watermen (mean age, 53 years) who worked on Chesapeake Bay. The annual ocular exposure was calculated from the age of 16 for each waterman by combining a detailed occupational history with laboratory and field measurements of sun exposure. Cataracts were graded by ophthalmologic examination for both type and severity. Some degree of cortical cataract was found in 111 of the watermen (13 percent), and some degree of nuclear cataract in 229 (27 percent). Logistic regression analysis showed that high cumulative levels of ultraviolet B exposure significantly increased the risk of cortical cataract (regression coefficient, 0.70; P = 0.04). A doubling of cumulative exposure increased the risk of cortical cataract by a factor of 1.60 (95 percent confidence interval, 1.01 to 2.64). Those whose annual average exposure was in the upper quartile had a risk increased by 3.30 (confidence interval, 0.90 to 9.97) as compared with those in the lowest quartile. Analysis using a serially additive expected-dose model showed that watermen with cortical lens opacities had a 21 percent higher average annual exposure to ultraviolet B (t-test, 2.23; P = 0.03). No association was found between nuclear cataracts and ultraviolet B exposure or between cataracts and ultraviolet A exposure. We conclude that there is an association between exposure to ultraviolet B radiation and cataract formation, which supports the need for ocular protection from ultraviolet B.