The relationship between occupation and dry eye

Introduction: Environmental factors play an important aetiological role in dry eye.This cross-sectional study investigated the relationship between types of occupation and symptomatic dry eye. Methods: 40,501 employed people working >= 8 h a week were included from the population-based Lifelines cohort in the Netherlands. Logistic regression was used to determine the association between symptomatic dry eye (assessed by the WHS questionnaire) and occupation (using the ISCO-08 classification system). Results: After correction for age and sex, the professionals (e.g. legal, health, and business and administration professionals) (OR = 1.14, 95%CI = 1.08-1.19, P < 0.001) and clerical support workers (OR = 1.14, 95%CI = 1.07-1.22, P < 0.001) had the highest risk of dry eye of all 10 major occupation groups. Skilled agricultural workers (OR = 0.57, 95%CI = 0.49-0.67, P < 0.001) and elementary occupations (OR = 0.77, 95%CI = 0.69-0.85, P < 0.001), such as cleaners and carers, carried the lowest risk of dry eye. After additional correction for 45 dry eye associated comorbidities, professionals and clerical support workers showed no increased risk anymore, while craft and related trades workers, e.g. building workers and metal and machinery workers, showed the highest risk of dry eye (OR = 1.12, 95%CI = 1.02-1.24, P = 0.01). Conclusions: This study underlines the importance of asking about type of occupation in dry eye patients. Screening for symptomatic dry eye in high risk occupations such as in building workers and in indoor occupations with high screen use is relevant from an occupational health and work productivity perspective. The lower risk of dry eye in outdoor and active occupation is intriguing and justifies future studies to investigate potential protective and treatment effects.