Although dry eye syndrome (DES) is known to be associated with a wide range of risk factors, there have been just as many controversies and limitations in previous studies. Combined with the prevalence of DES increasing due to environmental issues, researchers decided to investigate risk factors in a population-based cohort study.

A total of 475 individuals were enrolled in the Study Group for Environmental Eye Disease. The DES severity was measured using the Ocular Surface Disease Index (OSDI) and defined DES as OSDI score of more than 13. Current symptoms of DES and possible risk factors such as body mass index, occupations, comorbidities, exercise, smoking and drinking status were assessed by multivariate logistic regression.

Prevalence of DES was significantly higher in women (52.6%) than in men (41.9%). Compared to white-collar workers, blue-collar workers and unemployed people showed higher DES prevalence and severity. Compared to those with low BMI, people with extremely high BMI had a higher odds ratio of having DES after fully adjusted for sex, age, hypertension, diabetes, menopausal status, hormone replacement therapy, occupation and lifestyle factors.

The study concludes someone’s unemployment status, blue-collar work, alcohol habit and obesity with DES suggests a person’s condition—not individual factors—contribute significantly in developing DES.

The authors noted they were surprised to find DES was more common in blue-collar workers and the unemployed than in their white-collar counterparts, since previous studies reported higher incidence of DES among office workers, particularly those in jobs with heavy computer use.

“In our study population, most blue-collar workers work in agriculture or in factories. Blue-collar workers might have a higher likelihood for DES than white-collar workers, because they were more exposed to environmental risk factors such as UV exposure, fine dust, or toxic chemicals in the air,” the authors noted. “On the other hand, most white-collar workers work in service or sales, which usually does not require the use of visual display terminals.”