title: Smoking, socioeconomic factors, and age-related cataract: The Singapore Malay Eye study.
abstract: OBJECTIVE
  To describe the relationship of smoking, sex, and socioeconomic factors with age-related cataract in Malay adults in Singapore.
  
  
  METHODS
  In a population-based study, 3280 Malay individuals aged 40 to 80 years participated (78.7% response rate). All had interviews, systemic examination, and laboratory investigations. Lens opacity was graded from slitlamp and retroillumination photographs using the Wisconsin Cataract Grading System. Smoking-cataract associations were compared with the Blue Mountains Eye Study in Australia.
  
  
  RESULTS
  Of 2927 participants (89.2%) with gradable lens photographs, 1338 (45.7%) had cataract. After adjusting for age, sex, body mass index, hypertension, and diabetes, current smokers had a higher prevalence of nuclear cataract (odds ratio [OR], 2.06; 95% confidence interval [CI], 1.46-2.98), cortical cataract (OR, 1.33; 95% CI, 1.02-1.74), posterior subcapsular cataract (OR, 1.39; 95% CI, 1.02-1.91), or any cataract (OR, 1.48; 95% CI, 1.10-1.99). These associations were not seen in the Blue Mountains Eye Study. Primary or lower education (OR, 1.67; 95% CI, 1.06-2.64) and low monthly income (OR, 1.43; 95% CI, 1.09-1.87) were both associated with nuclear cataract, while small-sized public housing was associated with posterior subcapsular cataract (OR, 1.70; 95% CI, 1.28-2.25). Among men, 43.5% currently smoked compared with only 3.2% of women. The population attributable risk of nuclear cataract due to smoking was estimated to be 17.6% in men.
  
  
  CONCLUSIONS
  Smoking and indicators of low socioeconomic status were associated with cataract in Malay persons, with 1 in 6 nuclear cataract cases in men attributable to smoking. Smoking-cataract associations were stronger in Malay than in white persons.
authors.affiliation: Singapore Eye Research Institute, Singapore.
authors.forename: Renyi
authors.initials: R
authors.lastname: Wu
authors.forename: Jie Jin
authors.initials: JJ
authors.lastname: Wang
authors.forename: Paul
authors.initials: P
authors.lastname: Mitchell
authors.forename: Ecosse L
authors.initials: EL
authors.lastname: Lamoureux
authors.forename: Yingfeng
authors.initials: Y
authors.lastname: Zheng
authors.forename: Elena
authors.initials: E
authors.lastname: Rochtchina
authors.forename: Ava G
authors.initials: AG
authors.lastname: Tan
authors.forename: Tien Yin
authors.initials: TY
authors.lastname: Wong
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D044466:Asian People / Q000706:statistics & numerical data*; D015992:Body Mass Index; D002386:Cataract / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology*; D003430:Cross-Sectional Studies; D048909:Diabetes Complications / Q000175:diagnosis; D004522:Educational Status; D005260:Female; D006801:Humans; D006973:Hypertension / Q000175:diagnosis; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors; D012846:Singapore / Q000453:epidemiology; D012907:Smoking / Q000009:adverse effects*; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires