{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,25]],"date-time":"2026-07-25T02:16:10Z","timestamp":1784945770673,"version":"3.55.0"},"reference-count":32,"publisher":"Public Library of Science (PLoS)","issue":"7","license":[{"start":{"date-parts":[[2021,7,29]],"date-time":"2021-07-29T00:00:00Z","timestamp":1627516800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100008904","name":"Taipei Hospital","doi-asserted-by":"publisher","award":["TPCH-103-032"],"award-info":[{"award-number":["TPCH-103-032"]}],"id":[{"id":"10.13039\/100008904","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>Cataract is a public health concern worldwide that differentially affects rural residents of outlying islands where ultraviolet radiation (UVR) may have greater penetration because of less shading.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Objectives<\/jats:title>\n<jats:p>To assess the relationships between attitudes and practices of eye protection and eye diseases for residents of an offshore island of Taiwan.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Methods<\/jats:title>\n<jats:p>Questionnaire survey was administered to local residents (age &gt; 50 years) regarding socio-demographic information, attitudes\/practices of eye protection under sun exposure and eye diseases.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Results<\/jats:title>\n<jats:p>A total of 816 participants (response rate 90.7%, 816\/900) completed the questionnaires. Mean age was 63.7 (+ 10.8) years. Among these participants, 44.4%, 15.1% and 8.3% had cataract, dry eye and glaucoma, respectively. Although 86.3% and 88.2% of participants agreed that they should avoid outdoor activities and wear glasses\/broad-brimmed hats in harsh daylight, 69.4% and 48.3% of participants never\/rarely used glasses or hats\/umbrellas in harsh daylight, respectively. Predictors of less practices of eye protection against solar UVR included residents who were male, with lower education level, with longer residence and lack of commercial health insurance. Multivariate logistic regression revealed that practices of eye protection under sun exposure were significantly associated with less cataract, but not glaucoma or dry eye. Participants who did not wear glasses, broad-brimmed hats\/use umbrellas or both in harsh sunlight (almost) every time were respectively associated with a 57% (<jats:italic>P<\/jats:italic> = 0.028), 45% (<jats:italic>P<\/jats:italic> = 0.027) or 70% (<jats:italic>P<\/jats:italic> = 0.026) increase of cataract than those who did in harsh sunlight (almost) every time.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec005\">\n<jats:title>Conclusions<\/jats:title>\n<jats:p>Practices of eye protection under sun exposure is associated with lower risk of cataract.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0255136","type":"journal-article","created":{"date-parts":[[2021,7,29]],"date-time":"2021-07-29T18:45:22Z","timestamp":1627584322000},"page":"e0255136","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":12,"title":["Relationship between practices of eye protection against solar ultraviolet radiation and cataract in a rural area"],"prefix":"10.1371","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8370-9001","authenticated-orcid":true,"given":"Li-Ju","family":"Chen","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yun-Jau","family":"Chang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chun-Fu","family":"Shieh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jy-Haw","family":"Yu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ming-Chin","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2021,7,29]]},"reference":[{"issue":"10","key":"pone.0255136.ref001","doi-asserted-by":"crossref","first-page":"1074","DOI":"10.1038\/sj.eye.6701964","article-title":"External factors in the development of cataract","volume":"19","author":"L Robman","year":"2005","journal-title":"Eye (Lond)"},{"key":"pone.0255136.ref002","unstructured":"World Health Organization. Blindness and visual impairment. Available from: https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/blindness-and-visual-impairment"},{"issue":"22","key":"pone.0255136.ref003","doi-asserted-by":"crossref","first-page":"1429","DOI":"10.1056\/NEJM198812013192201","article-title":"Effect of ultraviolet radiation on cataract formation","volume":"319","author":"HR Taylor","year":"1988","journal-title":"N Engl J Med"},{"issue":"8","key":"pone.0255136.ref004","doi-asserted-by":"crossref","first-page":"e0135870","DOI":"10.1371\/journal.pone.0135870","article-title":"The association of outdoor activity and age-related cataract in a rural population of Taizhou Eye Study: phase 1 report","volume":"10","author":"Y Tang","year":"2015","journal-title":"PLoS One"},{"issue":"4","key":"pone.0255136.ref005","doi-asserted-by":"crossref","first-page":"e0215338","DOI":"10.1371\/journal.pone.0215338","article-title":"Association between ultraviolet radiation exposure dose and cataract in Han people living in China and Taiwan: a cross-sectional study","volume":"14","author":"H Miyashita","year":"2019","journal-title":"PLoS One"},{"issue":"4","key":"pone.0255136.ref006","doi-asserted-by":"crossref","first-page":"168","DOI":"10.1097\/ICL.0b013e31821cb0cf","article-title":"An epidemiological perspective of ultraviolet exposure\u2014public health concerns","volume":"37","author":"RM Lucas","year":"2011","journal-title":"Eye Contact Lens"},{"key":"pone.0255136.ref007","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1016\/j.jphotobiol.2014.07.002","article-title":"Knowledge, attitude and practice regarding solar ultraviolet exposure among medical university students in Northeast China","volume":"140","author":"Q Gao","year":"2014","journal-title":"J Photochem Photobiol B"},{"issue":"4","key":"pone.0255136.ref008","doi-asserted-by":"crossref","first-page":"250","DOI":"10.1097\/ICL.0b013e31822126d4","article-title":"Intraocular and crystalline lens protection from ultraviolet damage","volume":"37","author":"DH Sliney","year":"2011","journal-title":"Eye Contact Lens"},{"issue":"2","key":"pone.0255136.ref009","doi-asserted-by":"crossref","first-page":"383","DOI":"10.1007\/s10792-013-9791-x","article-title":"Ultraviolet light and ocular diseases","volume":"34","author":"JC Yam","year":"2014","journal-title":"Int Ophthalmol"},{"issue":"2","key":"pone.0255136.ref010","doi-asserted-by":"crossref","first-page":"165","DOI":"10.1097\/OPX.0b013e318194eae7","article-title":"Use of sunglasses in public outdoor recreation settings in Honolulu, Hawaii","volume":"86","author":"JE Maddock","year":"2009","journal-title":"Optom Vis Sci"},{"key":"pone.0255136.ref011","author":"World Health Organization","journal-title":"Protection against exposure to ultraviolet radiation"},{"key":"pone.0255136.ref012","first-page":"87","article-title":"Ultraviolet damage to the eye revisited: eye-sun protection factor (E-SPF@), a new ultraviolet protection label for eyewear","volume":"8","author":"F Behar-Cohen","year":"2014","journal-title":"Clin Ophthalmol"},{"issue":"2","key":"pone.0255136.ref013","doi-asserted-by":"crossref","first-page":"449","DOI":"10.1111\/j.1751-1097.2009.00677.x","article-title":"Ultraviolet radiation protection by a beach umbrella","volume":"86","author":"MP Utrillas","year":"2010","journal-title":"Photochem Photobiol"},{"issue":"2","key":"pone.0255136.ref014","doi-asserted-by":"crossref","first-page":"163","DOI":"10.1111\/j.1751-1097.1985.tb01555.x","article-title":"The ocular dose of ultraviolet radiation from sunlight exposure","volume":"42","author":"FS Rosenthal","year":"1985","journal-title":"Photochem Photobiol"},{"issue":"4","key":"pone.0255136.ref015","doi-asserted-by":"crossref","first-page":"489","DOI":"10.1111\/j.1751-1097.1989.tb05553.x","article-title":"The biological effects of UV-B on the eye","volume":"50","author":"HR Taylor","year":"1989","journal-title":"Photochem Photobiol"},{"issue":"1","key":"pone.0255136.ref016","doi-asserted-by":"crossref","first-page":"e0227868","DOI":"10.1371\/journal.pone.0227868","article-title":"Association of cataract and sun exposure in geographically diverse populations of India: the CASE study. 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