Air-pollution–vulnerable industries and the prevalence of diabetic retinopathy: a county-level study in the United States

초록

This study investigated the relationship between employment in industries vulnerable to air pollutant exposure and the county-level prevalence of diabetic retinopathy (DR) in the United States. A cross-sectional dataset of 3,127 counties was assembled by integrating 2020 emissions data for seven major ambient pollutants (NOₓ, PM₂.₅, PM₁₀, CO, NH₃, SO₂, and VOCs) with 2021 modeled DR prevalence estimates and 2020 workforce composition indicators from nationally representative datasets. Spatial autoregressive models were used to account for spatial dependence in county-level health outcomes. The results showed that a 1% increase in employment in agriculture, forestry, fishing & hunting, and mining was associated with a 0.01% increase in the prevalence of vision-threatening DR. Similarly, each 1% increase in employment in the transportation, warehousing, and utilities sectors corresponded to a 0.02% increase in DR prevalence. Overall, the findings suggest that counties with higher concentrations of workers in pollutant-intensive industries experience elevated burdens of vision-threatening DR, underscoring the need to consider both environmental and occupational factors in efforts to reduce geographic disparities in diabetes-related eye disease. © 2025 Informa UK Limited, trading as Taylor & Francis Group.

키워드