每日跟讀#680: High levels of exhaust pollutants may raise risk for degenerative eye disease

Exposure to high levels of exhaust may raise the risk of the vision-robbing disease called age-related macular degeneration (AMD) a new study suggests. In a study of nearly 40,000 people in Taiwan, researchers found that high levels of exhaust could nearly double the risk of the age-related eye condition, which damages the macula, the part of the eye needed for sharp, central vision. People with AMD have trouble seeing straight ahead.

新研究指出，曝露在大量廢氣中可能會提高罹患「老年性黃斑部退化」的風險，該疾病會使人喪失視力。在這份對將近四萬名台灣民眾進行調查的研究中，研究人員發現，大量廢氣恐怕會使這種老年性眼疾的罹患風險增加一倍。「老年性黃斑部退化」會損害黃斑部，也就是眼睛敏銳中心視野不可或缺的部分，罹患此疾的病人會難以看清前方物體。

Only people with the highest exposure to exhaust had an increased risk of age-related macular degeneration (AMD), meaning that “if we can reduce exposure and try not to be in the highest exposure group, the risk can be significantly reduced,” said study coauthor Dr. Suh-Hang Hank Juo, a distinguished professor at the China Medical University in Taiwan. “Therefore, do not go jogging on the road side when there are lots of cars and try not to go outside during the heavy traffic hours,” Juo said in an email.

台灣的中國醫藥大學特聘教授卓夙航醫師是這份研究的共同作者，他表示只有廢氣曝露程度最高的人們會增加老年性黃斑部退化的風險，也就是說：「如果我們可以減少曝露，並且盡量不要成為曝露程度最高的群體，風險就會顯著地降低。」卓醫師在電子郵件中指出：「也因此，不要在車輛很多的時候去路邊慢跑，也盡量不要在交通尖峰時段出門。」

To investigate whether vehicle pollution, which has previously been tied to increased risks for respiratory and cardiovascular diseases, also impacts the risk for AMD, Juo and his colleagues turned to two large data sets: The Longitudinal Health Insurance Database (LHID) and the Taiwan Air Quality Monitoring Database (TAQMD) in the National Health Insurance Research Database. From the insurance database, the researchers selected patients who were aged 50 or older when they were enrolled, who did not have signs of AMD at that point, and who lived in areas where there were air-quality monitoring stations.

車輛排放的廢氣污染先前被視為與呼吸道和心血管疾病風險增加密切相關，為了調查這類污染是否也會影響老年性黃斑部退化的風險，卓醫師與同事們向兩個大型資料集尋求協助：全民健保的「承保抽樣歸人檔」以及「台灣空氣品質監測資料庫」。從健保的資料庫中，研究人員挑選在保時已達五十歲或以上、尚未出現老年性黃斑部退化徵兆，並且居住在空氣品質監測站設置區域的病人。

As reported in the Journal of Investigative Medicine, the researchers divided the patients into four groups depending on the level of pollutant exposure. Of the 39,819 patients in the study, 1,442 developed AMD during 11 years of follow-up. After accounting for other factors that might influence the risk of AMD, such as age, gender, household income and underlying illnesses, the researchers determined that people living in areas with the highest levels of vehicle-generated pollution were 84 percent more likely to develop AMD compared to those exposed to the lowest levels.

在這份刊載於《調查醫學期刊》的研究中，研究人員按照汙染物的曝露程度將病人分為四個群體。經過十一年的追蹤檢查，研究所調查的三萬九千八百一十九名病人中，有一千四百四十二名罹患老年性黃斑部退化。排除掉其他可能影響老年性黃斑部退化風險的因素──包括年齡、性別、家庭收入，以及潛在疾病──之後，研究人員判斷，生活在車輛污染程度最高區域的人們，比起那些曝露程度最低的人，罹患老年性黃斑部退化的比例增加了百分之八十四。

The new research is interesting but “it is a longitudinal observational study and can only show an association but not prove a cause-effect relationship,” said Dr. Fernando Arevalo, a professor of ophthalmology at the Johns Hopkins University School of Medicine and chairman of ophthalmology at the Johns Hopkins Bayview Medical Center, both in Baltimore, Maryland. “AMD is multifactorial and many genetic as well as environmental factors play a role in its development and that may confound the results. Further studies are needed.”

約翰‧霍普金斯大學醫學院的眼科學教授費南多‧阿雷瓦洛，是同樣位於馬里蘭州巴爾的摩的約翰‧霍普金斯海灣區醫療中心的眼科主任，他認為這項新研究很有意思，然而「這是一項縱貫性觀察型研究，只能夠顯示關聯，並無法證明因果關係。」阿雷瓦洛醫師解釋說：「老年性黃斑部退化是由多重因素造成，許多遺傳和環境因素都會參與此疾病的發展，可能會混淆結果。我們還需要進一步的研究。」

Dr. Joseph Martel, an assistant professsor of ophthalmology at the University of Pittsburgh, suspects that, as with smoking, air pollution may lead to oxidative damage, which “in the eye is known to be associated with macular degeneration.” That’s why doctors often prescribe an antioxidant concoction of vitamins and minerals to help slow AMD, Martel said. It’s also suggested that people with AMD consume lots of green, leafy vegetables, like spinach, he added.

匹茲堡大學的眼科助理教授喬瑟夫‧馬特爾醫師懷疑空氣汙染如同抽菸一樣，會導致氧化的傷害，「在眼部則被認為和黃斑部退化有關」。馬特爾指出，這也是為什麼醫生經常會開立抗氧化的維他命和礦物質調製藥物，以協助減緩老年性黃斑部退化。他也建議，患有該疾病的人宜攝取大量的綠色葉菜類蔬菜，例如菠菜。

Source article: http://www.taipeitimes.com/News/lang/archives/2019/09/01/2003721465/2