Association of Lead with Cataracts and Vision-Related Problems in Perimenopausal Women

The Association of Lead with Cataracts and Vision-Related Problems in Perimenopausal Women by Imogene Audrine Walcott-Drakes Dissertation Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy Public Health Walden University December 2014 Abstract Around the world, women are subject to an earlier incidence of cataracts, have a higher risk for cataracts, and also have a higher risk for other vision-related problems than men. Previous research has indicated an association between endogenous lead stored in long bones and cataracts in men over 60 years of age; however, a similar study in women did not reveal an association. This case control study was conducted to investigate whether perimenopausal mobilization of endogenous lead serves as a possible causative factor for women’s generalized vision issues and cataract incidence in particular. Secondary data were gathered from 1,416 women aged 40 to 55 years of age from the 2005-2006 and 2007-2008 National Health and Nutrition Examination Surveys. Variables of interest included vision-related issues, cataract surgeries, bone density data, blood lead levels, and markers of lead mobilization. The results of the logistic regression analysis in the absence of confounders (OR = 1.50, 95% CI [1.08, 2.09]) indicated that endogenous lead is a possible causative factor for the low-level vision problems women experience during their perimenopausal years. Chi-square analysis of mobilized lead was also associated with cataract surgeries, p < . 05. This appears to be the first report of a possible association between lead and cataracts in women and highlights the need for women to be studied in the context of their biology when their clinical results differ from those of men. These results should engender positive social change initiatives to minimize women’s perimenopausal exposure to endogenous lead. Recommendations for further researchAround the world, women are subject to an earlier incidence of cataracts, have a higher risk for cataracts, and also have a higher risk for other vision-related problems than men. Previous research has indicated an association between endogenous lead stored in long bones and cataracts in men over 60 years of age; however, a similar study in women did not reveal an association. This case control study was conducted to investigate whether perimenopausal mobilization of endogenous lead serves as a possible causative factor for women’s generalized vision issues and cataract incidence in particular. Secondary data were gathered from 1,416 women aged 40 to 55 years of age from the 2005-2006 and 2007-2008 National Health and Nutrition Examination Surveys. Variables of interest included vision-related issues, cataract surgeries, bone density data, blood lead levels, and markers of lead mobilization. The results of the logistic regression analysis in the absence of confounders (OR = 1.50, 95% CI [1.08, 2.09]) indicated that endogenous lead is a possible causative factor for the low-level vision problems women experience during their perimenopausal years. Chi-square analysis of mobilized lead was also associated with cataract surgeries, p < . 05. This appears to be the first report of a possible association between lead and cataracts in women and highlights the need for women to be studied in the context of their biology when their clinical results differ from those of men. These results should engender positive social change initiatives to minimize women’s perimenopausal exposure to endogenous lead. Recommendations for further research include a case control study, which includes plasma lead levels, and a longitudinal study. The Association of Lead with Cataracts and Vision-Related Problems in Perimenopausal Women by Imogene Audrine Walcott-Drakes Dissertation Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy Public Health Walden University December 2014 Dedication Give God the glory. Great things He has done. (F. Crosby, 1875) This dissertation is dedicated to my sons, Atsu and Attakuma, and to my mother, Elaine Louise, who with unconditional love continue to ensure I never lack emotional support. This dissertation is also dedicated to my father, Sydney, for his confidence in me. To my departed grandparents – Thomas, Ellen Elizabeth, James, and Martha Hilda – I am proud that I descended from you. You will always be remembered for the assurance you gave to me and for your humor in times of stress. To the memory of Ina Daniels and her love for me, I also dedicate this dissertation.