Smoking, socioeconomic factors, and age-related cataract: The Singapore Malay Eye study.
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.
Wu
Renyi
R
Singapore Eye Research Institute, Singapore.
Wang
Jie Jin
JJ
Mitchell
Paul
P
Lamoureux
Ecosse L
EL
Zheng
Yingfeng
Y
Rochtchina
Elena
E
Tan
Ava G
AG
Wong
Tien Yin
TY
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