Correlations of CO, SO₂, PM₁₀, NO₂, and O₃ with dry eye disease in Saudi Arabia

Dry eye disease (DED) is a multifactorial disease and has become a significant public health issue due to rapid urbanization and industrialization. This study aims to explore the association between air pollutant levels and DED in King Abdulaziz Medical City, Jeddah , Saudi Arabia.

A total number of 492 patients were diagnosed with DED between January 1, 2017, and December 31, 2018. During the same study period, the Saudi Arabian General Authority of Meteorology and Environment Protection collected daily air data from three environmental monitoring stations in Jeddah measuring particulate matter (PM₁₀), sulfur dioxide (SO₂), nitrogen dioxide (NO₂), ozone (O₃), and carbon monoxide (CO).

Significant variation was reported for O₃, SO₂, and CO across the three monitoring stations. Multivariate regression analysis indicated SO₂ and CO were significantly correlated with diagnosed cases of DED (odds ratios [ORs]). According to adjusted OR, a one-unit rise in SO₂ (OR 1.182, 95% confidence interval [CI] 0.908-1.111, P = 0.021) was related to an 18% increase in diagnosed cases of DED in the western region, while the one-unit rise in CO (OR: 1.162, 95% CI 1.022-2.354, P = 0.041) was related to a 16% increase of diagnosed cases in the southern region.

The prevalence of DED was highest in women and the elderly, mainly during the summer months (May-July). Correlations of air pollutants with DED indicated that SO₂ and CO levels were significantly correlated with DED, suggesting air pollutants are potential risk factors for DED. Controlling traffic emissions and industrial operations and adopting green commuting programs may contribute to lower occurrences of DED.