Short and long-term exposure to fine particulate matter, nitrogen dioxide and meteorological factor and the risk of glaucoma: evidence from the China health and retirement longitudinal study, distributed lag non-linear and Mendelian randomization models.

This study investigates the relationship between environmental factors, meteorological data and air pollution (PM2.5, PM10, and NO2), and the risk of glaucoma, using a comprehensive approach combining time-series analysis, cohort data from the China Health and Retirement Longitudinal Study (CHARLS), and Mendelian randomization (MR). Using distributed lag non-linear models (DLNM), the study first analyzed air pollution and temperature data in Shenyang (2013-2021), revealing that ambient temperature did not show significant short-term effects on glaucoma incidence. In contrast, NO2 was significantly associated with short-term increases in glaucoma risk, particularly within a few days following exposure. PM2.5 demonstrated short-term effects, with a stronger risk observed during colder months, when pollutant levels were elevated. PM10 also exhibited a delayed impact on glaucoma risk, although its effect was less pronounced. Further analysis using CHARLS data confirmed these findings, with long-term exposure to PM2.5 and NO2 associated with higher odds and hazard of developing glaucoma, especially among smokers. To assess causality, Mendelian randomization analyses provided genetic evidence that genetically predicted exposure to PM2.5 (IVW OR = 1.367) and NO₂ (IVW OR = 1.463) were causally linked to an increased risk of glaucoma. The study found no significant causal association with PM10 or workplace (indoor) temperature exposure. Overall, this study underscores the critical role of air pollution, particularly PM2.5 and NO2, in glaucoma risk. It highlights the importance of environmental policies aimed at improving air quality, particularly for vulnerable populations such as smokers, and suggests further investigation into the underlying biological mechanisms of pollutant-induced glaucoma.