A Case-Control Study: Evaluating The Relationship Between Cataract Disease And Occupation

It is aimed to determine whether the current or previous works of the patients who visited to the ophthalmology clinic of a university hospital and some of the factors encountered during working hours, lead to a relative risk increase for cataract disease.

The data for the case-control study design were collected through face-to-face interviews using a questionnaire form with participants aged 18-80 between November 2018 and May 2019. Detailed work histories of the participants were obtained, and they were asked whether they were exposed to occupational factors related to cataracts in their respective jobs.

For each cataract patient, a non-cataract eye patient was selected as a control, matched by gender and age, resulting in a total of 554 individuals included in the study. The calculated margin of error for the sample size was between 0.55-0.60. Descriptive statistics, Pearson Chi-square, and Mann-Whitney U tests were employed in statistical analyses. Estimated relative risk (Odds Ratio - OR) values were calculated, and logistic regression analysis was conducted. Memory bias could be a potential source of error, and the limitation of not assessing the doses of exposure is acknowledged as a constraint in the research.

Cataract patients showed significantly higher percentages in postgraduate education, myopia, age-related macular degeneration, diabetes, asthma, corticosteroid use, and eye-affecting accidents compared to controls (p<0.05). No significant differences were observed in tobacco use, computer use, non-work-related factors, and family history of cataracts (p>0.05). Occupational exposure to ultraviolet radiation was higher in cases than controls (11.9%) (p=0.001). Univariate odds ratio (OR) was 2.1 (95% CI: 1.3-3.4), and in three logistic regression models, it ranged from 1.9 to 2.1. Working in jobs with known cataract-related factors or experiencing direct eye trauma during work was 2.3 times more likely for cases than controls (p<0.001). 

Cataract patients, primarily engaged in outdoor occupations, have a higher percentage of exposure to ultraviolet radiation at work, including jobs known to be associated with cataract according to occupational disease lists. This finding supports the research hypothesis. Workplace training should focus on increasing awareness of potential health risks related to working outdoors and exposure to relevant factors such as ultraviolet radiation. Emphasis should be placed on the rationale and importance of using protective equipment. Direct exposure to sunlight due to working conditions should be minimized, and the use of sunglasses should be promoted.