Résumé
Purpose: Cataract, the leading cause of blindness worldwide, is a multifactorial disease involving oxidative stress mechanisms. The aim of our study was to investigate the relationship between air pollution exposure and the incidence of cataract surgery. Methods: The 3C-Alienor study is a population-based cohort of residents of Bordeaux, France, aged 65 years or more, recruited in 1999-2000 and followed every 2-3 years until 2017. Cataract surgery was self-reported and checked at slit-lamp by trained professionals. Average air pollution exposure (particulate matter <= 2.5 mu m (PM2.5), black carbon (BC), nitrogen dioxide (NO2)) in the 10 years preceding baseline was estimated at the participants' geocoded residential address, using temporally adjusted land use regression. Associations of 10-year average air pollution exposure with incidence of cataract were estimated using Cox proportional hazard models adjusted for confounders. Results: The study included 829 subjects without cataract surgery prior to inclusion; the mean age at inclusion was 72.6 years (standard deviation (SD): 4.2) and 61% were women. The median (Interquartile-range (IQR)) follow-up duration was 14.1 (6.4) years during which 507 participants underwent cataract surgery. Exposure to a concentration >= 40 mu g/m(3) of NO2 (the current regulatory limit value in Europe) was associated with incident cataract surgery (HR = 1.46, CI (1.16, 1.84), p = 0.001). No statistically significant association was found with PM2.5 and BC. Conclusion: Long-term exposure to a NO2 concentration >= 40 mu g/m(3) was associated with an increased incidence of cataract surgery. Complying with current European air pollution standards could reduce cataract surgery costs and improve population quality of life.