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Session Date: Monday, April 28

Location: Hall B/C
Program Number/Poster Board Number: 2372/D1013
Abstract Title: Chronic Urban Conjunctivitis by Air Pollution: Individual Measures of Air
Pollution, Measures of Ocular Discomfort and Clinical Tests
Presentation Time: 3:00 PM- 4:45 PM
Reviewing Code: 281 ocular surface health and disease- CO

Author Block: P. Novaes1A , N. Kara-Jos 1A , M. Macchione 1B , M. Matsuda1A , L.A.A. Pereira 1B ,

A.J. Lichtenfels 1B , R.M. Santo1C, P.H.N. Saldiva1B , A. Berra2,3 . AOphthalmology,Laboratory of
Medical Investigation (LIM33), B Pathology,Laboratory of ExperimentalAir Pollution,
C
Ophthalmology,1 University of Sao Paulo,Sao Paulo,Brazil; 2 Pathology,University of Buenos
Aires, Sao Paulo,Argentina; 3 Ophthalmology,Laboratory of Medical Investigations (LIM33),
University of S o Paulo,S o Paulo,Brazil.
Keywords: 461 clinical (human) or epidemiologicstudies: natural history, 618 ocular irritants
Purpose: To estimate the effect of different levels of air pollution on the ocular surface by
comparing individual measures of pollution exposure, subjective measures of ocular discomfort and
clinical tests.
Methods: A panel study was carried out involving 55 volunteers in S o Paulo,Brazil, where there
are high detected levels of air pollution.Each subject received an individual pollution passive
monitoringdevice with filters for nitrogen dioxide (NO2 ) and kept it for 7 days. Mean daily pollution
concentration was estimated by dividing the accumulated dose by 7. All subjects answered the
Ocular SymptomDisease Index (OSDI)validated for the Portuguese language and a symptoms
inventory which addressed symptoms of dryness, irritation, heaviness and itching. Subsequently,
they underwent Schirmer I test, biomicroscopy, vital staining with fluorescein and rose Bengal, and
tear break-up time (BUT) measures. Exposure to NO2 was categorized in quartiles : Q1: 10.0 to

20.1 g/mm3 , Q2: 20.1 to 26.1 g/mm3 , Q3: 26.1 to 35.4 g/mm3 , and Q4: 35.4 to 53.8 g/mm3 .
Statistical analysis was performed using one-way ANOVA, Tukey HSDtest and Chi-Square test.
Results: Mean OSDIscores were 11.7 12.4, 20.1 13.8, 23.2 17.7, 32.9 15.3 for Q1, Q2, Q3
and Q4 respectively, and when computed across gradients of NO2 levels a clear dose-response
pattern was detected, with a significant difference among the quartiles (p=0.01). There was a
significant correlation between NO2 levels and reported ocular irritation ( 2 =9.2, p=0.03), with a

frequency of 38.5%, 64.3%, 71.4% and 92.9% in Q1, Q2, Q3 and Q4 respectively. No significant
correlations between NO2 levels and Schirmer I values (means 22.3 13.9 mmand 23.6 13,5 mm,
right and left eye respectively), Rose Bengal and Fluorescein scores. Mean BUTvalues were 6.8
4.6s, with a tendency towards lower levels in the third and fourth quartiles.
Conclusions: Subjects exposed to higher levels of air pollution report more symptoms of ocular
discomfort and present a tendency to greater tear film instability. The results suggest that
inhabitants of cities with high air pollution levels could develop an urban chronic conjunctivitis by air
pollution.

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Commercial Relationship: P. Novaes, None; N. Kara-Jos , None; M. Macchione , None; M.

Matsuda , None; L.A.A. Pereira , None; A.J. Lichtenfels , None; R.M. Santo, None; P.H.N.
Saldiva, None; A. Berra , None.
Support: None

2008, Copyright by the Association for Research in Vision and Ophthalmology,Inc., all rights
reserved. Go to www.iovs.org to access the version of record. For permission to reproduce any
abstract, contact the ARVO Office at arvo@arvo.org

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