Skip to main content

Unexpected potential protective associations between outdoor air pollution and cataracts


Air pollution is one of the biggest public health issues, and the eye is continuously exposed to multiple outdoor air pollution. However, to date, no large-scale study has assessed the relationship between air pollutants and cataracts. We investigated associations between outdoor air pollution and cataracts in the Korean population. A population-based cross-sectional study was performed using data from the Korea National Health and Nutrition Examination Survey, including 18,622 adults more than 40 years of age. The presence of cataracts and their subtypes were evaluated by ophthalmologists. Air pollution data (levels of particulate matter, ozone, nitrogen dioxide, and sulfur dioxide) for the 2 years prior to the ocular examinations were collected from national monitoring stations. The associations of multiple air pollutants with cataracts were assessed by multivariate logistic regression analyses. Sociodemographic factors and previously known risk factors for cataracts were controlled as covariates (model 1 included sociodemographic factors, sun exposure, and behavioral factors, while model 2 further included clinical factors). Higher ozone concentrations were protectively associated with overall cataract which included all subtypes [single pollutant model: 0.003 ppm increase—model 1 (OR 0.89, p = 0.014), model 2 (OR 0.87, p = 0.011); multi-pollutant model: 0.003 ppm increase—model 1 (OR 0.80, p = 0.002), model 2 (OR 0.87, p = 0.002)]. Especially, higher ozone concentrations showed deeply protective association with nuclear cataract subtype [0.003 ppm increase—single pollutant model: model 2 (OR 0.84, p = 0.006), multi-pollutant model: model 2 (OR 0.73, p < 0.001)]. Higher tropospheric ozone concentrations showed protective associations with overall cataract and nuclear cataract subtype in the Korean population.

This is a preview of subscription content, access via your institution.


Download references


We thank the Epidemiologic Survey Committee of the Korean Ophthalmologic Society. The Epidemiologic Survey Committee of the Korean Ophthalmologic Society mainly participated in making and processing KNHANES data about ophthalmologic questionnaire and examinations, and helped us to access KNHANES data. We also thank Min-Jae Ju for help in accessing the Korea Census Bureau.

Financial support

This work was supported by the Gachon University Gil Medical Center (Grant number GCU-2016-5202).

Author information

Authors and Affiliations


Corresponding author

Correspondence to Dong Hyun Kim.

Ethics declarations

This study was approved by the Institutional Review Board of the Korea Centers for Disease Control and Prevention and complied with the tenets of the Declaration of Helsinki.

Conflict of interest

The authors declare that they have no conflict of interest.

Additional information

Responsible editor: Philippe Garrigues

Electronic supplementary material

High resolution image

(TIFF 219 kb)

High resolution image

(TIFF 304 kb)

High resolution image

(TIFF 745 kb)

High resolution image

(TIFF 456 kb)

Table S1

(DOCX 17 kb)

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Choi, YH., Park, S.J., Paik, H.J. et al. Unexpected potential protective associations between outdoor air pollution and cataracts. Environ Sci Pollut Res 25, 10636–10643 (2018).

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI:


  • Air pollution
  • Nuclear cataract
  • Associations
  • Ozone
  • Oxidative stress
  • Potential protective effect