| Summary: | 碩士 === 國立成功大學 === 環境醫學研究所 === 104 === Background:
Arsenic is a naturally occurring metalloid that exists in inorganic as well as organic forms and often transported by groundwater. The association between arsenic exposure and the development of cancers and chronic diseases has been noted in humans since many years ago, such as vascular disease, neuropathy, and diabetes. Furthermore, arsenic toxicity may cause proliferation, and occlusion of vascular, which is associated with many eye diseases. Glaucoma is the second-leading of blindness and a complicated eye disease in which damage to the optic nerve leads to progressive, irreversible vision loss. Although the mechanism of glaucoma remains unclear, microangiopathy and insufficiency of blood flow may play an important role of optic nerve damage and there was no study to investigate the association between arsenic exposure and glaucoma.
However, there are many people suffer from the health effects of arsenic exposure in drinking water, and the prevalence of the second-leading of blindness, glaucoma, increases year after year. It’s important to clarify the cause of glaucoma. Therefore, arsenic exposure might be a risk factor for glaucoma. We conducted a study in Taiwan to evaluate the association between arsenic in drinking water and glaucoma.
Materials and Methods:
We conducted a retrospective cohort study of whose age is more than 40 years old and had no glaucoma before 1998 in the Longitudinal Health Insurance Database 2000 (LHID2000), which contains claim data on a random sample of one million residents in Taiwan. We adopted measurement data on 311 townships obtained by a nationwide survey of drinking water to assess arsenic levels for each subject and used ArcGIS to draw hot spot maps of exposure down to the township level. In addition, we followed the cohort member to assess the incidence of glaucoma from the index date and analyzed the difference of incidence among exposure group and non-exposure group by plotting Kaplan–Meier survival curves and conducting log-rank tests. Cox proportional hazard models were used to calculate the hazard ratio (HR) associated with arsenic exposure and adjust for the effects of potential confounders.
Results:
Of the study cohort, 365894 subjects, 5244 diagnosed OAG during the study period, including 1562 from the exposure group and 2082 from non-exposure group, and the incidence rate of OAG is 1.43%. Between exposure group and non-exposure group, the age, gender, and comorbidity such as DM, hypertension, Stroke, CAD, stroke, hyperlipidemia, Atherosclerosis, PVD, CKD are significance difference. And the incidence rate among these two group is also difference by log rank test. Furthermore, after adjusting for potential confounders, the HR for OAG was 1.13 (95% CI 1.06-1.21) in the exposure group in comparison with the non-exposure group.
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