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PURPOSE: This study comprehensively examined the correlation between unclean cooking fuels (UCF) and ocular health, covering diverse eye conditions such as cataracts, visual impairments, and ocular discomfort. METHODS: According to MOOSE and PRISMA guidelines, a meta-analysis and systematic review was conducted on 28 studies from 3 databases. Literature quality was assessed using the Newcastle-Ottawa Scale. Heterogeneity among articles was gaged with the statistic, sensitivity analysis used 'leave-one-out test', and publication bias was evaluated using Egger, Begg tests, and funnel plot analysis. RESULTS: The study evidenced a significant association between UCF exposure and cataracts [OR 2.29, 95% CI (1.24, 4.23)], visual impairments [OR 1.70, 95% CI (1.45, 2.00)], and eye diseases/symptoms [OR 2.03, 95% CI (1.25, 3.29)]. However, no correlation was found between UCF exposure and glaucoma or elevated intraocular pressure [OR 0.96, 95% CI (0.84, 1.10), = 2]. Subgroup analysis revealed that UCF cooking had an impact on nuclear cataracts [OR 1.98, 95% CI (1.67, 2.33), = 4]. But not on cortical cataracts [OR 1.25, 95% CI (0.98, 1.60), = 3]. Additionally, UCF exposure was linked to severe visual impairments like night blindness [OR 2.03, 95% CI (1.00, 4.96)], blindness [OR 1.43, 95% CI (1.32, 1.55)], and specific ocular symptoms such as tearing while cooking (OR = 3.20), eye irritation (OR = 2.58), and red eyes (OR = 2.03). CONCLUSION: UCF cooking had significant impact on ocular health, notably on eye symptoms, cataracts, and visual impairments. UCF exposure presented demographic inequalities in cataract prevalence, while eye symptoms can serve as a reliable self-assessment of UCF exposure.
National Clinical Research Center for Metabolic Diseases, Metabolic Syndrome Research Center, Key Laboratory of Diabetes Immunology, Ministry of Education, and Department of Metabolism and Endocrinology, The Second Xiangya Hospital of Central South University, Changsha, China.
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