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      Macular degeneration and occupational risk factors: a systematic review

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          Abstract

          Purpose

          Macular degeneration is a multi-factorial disease, leading cause of blindness for people over 50 years old in developed countries. To date, the knowledge on possible occupational factors involved in the development of the disease is scant.

          Method

          We performed a systematic scientific literature search on the association between macular degeneration and occupational risk factors searching the MedLine and Scopus databases.

          Results

          We examined 158 articles and, according to the inclusion criteria, 13 peer-reviewed studies evaluating occupational risk factors for macular degeneration or reporting the frequency of the disease in specific groups of workers were included in the review. Ten on thirteen articles evaluated the presence of macular degeneration in workers exposed to solar radiation. Only one study found that non-specific history of occupational chemical exposure was associated with the disease. Two studies showed an association between macular degeneration and the general category of “blue-collar” workers, but they did not identify the specific risk factors involved.

          Conclusions

          To date few studies have examined occupational risk factors for macular degeneration. Nevertheless, available data indicate that long-term occupational solar radiation exposure, in particular for its blue-light component, is associated with macular degeneration in outdoor workers.

          Electronic supplementary material

          The online version of this article (10.1007/s00420-018-1355-y) contains supplementary material, which is available to authorized users.

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          Most cited references53

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          Autophagy and Exosomes in the Aged Retinal Pigment Epithelium: Possible Relevance to Drusen Formation and Age-Related Macular Degeneration

          Age-related macular degeneration (AMD) is a major cause of loss of central vision in the elderly. The formation of drusen, an extracellular, amorphous deposit of material on Bruch's membrane in the macula of the retina, occurs early in the course of the disease. Although some of the molecular components of drusen are known, there is no understanding of the cell biology that leads to the formation of drusen. We have previously demonstrated increased mitochondrial DNA (mtDNA) damage and decreased DNA repair enzyme capabilities in the rodent RPE/choroid with age. In this study, we found that drusen in AMD donor eyes contain markers for autophagy and exosomes. Furthermore, these markers are also found in the region of Bruch's membrane in old mice. By in vitro modeling increased mtDNA damage induced by rotenone, an inhibitor of mitochondrial complex I, in the RPE, we found that the phagocytic activity was not altered but that there were: 1) increased autophagic markers, 2) decreased lysosomal activity, 3) increased exocytotic activity and 4) release of chemoattractants. Exosomes released by the stressed RPE are coated with complement and can bind complement factor H, mutations of which are associated with AMD. We speculate that increased autophagy and the release of intracellular proteins via exosomes by the aged RPE may contribute to the formation of drusen. Molecular and cellular changes in the old RPE may underlie susceptibility to genetic mutations that are found in AMD patients and may be associated with the pathogenesis of AMD in the elderly.
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            Guidelines on limits of exposure to ultraviolet radiation of wavelengths between 180 nm and 400 nm (incoherent optical radiation).

            (2004)
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              Prevalence of age-related maculopathy in older Europeans: the European Eye Study (EUREYE).

              To estimate the prevalence of age-related maculopathy in an older population from 7 European countries. Randomly sampled people 65 years and older were invited to an eye examination in centers across 7 European countries (Norway, Estonia, United Kingdom, France, Italy, Greece, and Spain). Fundus images of each eye were graded at a single reading center. Prevalence rates were calculated for stage of age-related maculopathy with 95% confidence intervals (CIs) estimated for clustered data. Of 5040 participants (45% response rate), 4753 (2128 men and 2625 women) had gradable fundus images. The prevalences were grade 0, 47.59% (95% CI, 43.53%-51.65%); grade 1, 36.48% (95% CI, 32.66%-40.30%); grade 2, 10.14% (95% CI, 8.92% to 11.37%); grade 3, 2.46% (95% CI, 1.79%-3.13%); and grade 4 (age-related macular degeneration [AMD]), 3.32% (95% CI, 2.52%-4.13%) and large drusen only (> or = 125 microm), 15.41% (95% CI, 13.61%-17.21%). The prevalence of geographic atrophic AMD was 1.2% (95% CI, 0.8%-1.7%) and of neovascular AMD, 2.3% (95% CI, 1.7%-2.9%). The prevalence of bilateral AMD was 1.4% (95% CI, 1.0%-1.8%). Age-specific prevalences of age-related maculopathy in the European Eye Study (EUREYE) are similar to other population-based studies in Western populations.
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                Author and article information

                Contributors
                00390592055475 , alberto.modenese@unimore.it
                Journal
                Int Arch Occup Environ Health
                Int Arch Occup Environ Health
                International Archives of Occupational and Environmental Health
                Springer Berlin Heidelberg (Berlin/Heidelberg )
                0340-0131
                1432-1246
                6 September 2018
                6 September 2018
                2019
                : 92
                : 1
                : 1-11
                Affiliations
                ISNI 0000000121697570, GRID grid.7548.e, Department of Biomedical, Metabolic and Neural Sciences, , University of Modena and Reggio Emilia, ; Via G. Campi 287, 41125 Modena, Italy
                Author information
                http://orcid.org/0000-0002-0850-5615
                http://orcid.org/0000-0002-1267-1632
                Article
                1355
                10.1007/s00420-018-1355-y
                6323067
                30191305
                ca7331ae-5c30-423b-8fa7-9ce88ed1291d
                © The Author(s) 2018

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.

                History
                : 27 September 2017
                : 4 September 2018
                Categories
                Review
                Custom metadata
                © Springer-Verlag GmbH Germany, part of Springer Nature 2019

                Occupational & Environmental medicine
                macular degeneration,occupational exposure,solar radiation,blue light,ultraviolet radiation,chemical exposure

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