{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,30]],"date-time":"2025-09-30T00:03:30Z","timestamp":1759190610307,"version":"3.44.0"},"reference-count":60,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,9,29]],"date-time":"2025-09-29T00:00:00Z","timestamp":1759104000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Primary acquired lacrimal duct obstruction (PALDO) is the most common lacrimal drainage disease in clinics, which can be caused by multiple factors. However, few studies have investigated environmental risk factors contributing to PALDO exacerbation. This study aimed to investigate the potential association between short-term exposure to major ambient air pollutants and outpatient visits for PALDO.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Data of outpatients with PALDO who visited the Eye Center of the Second Affiliated Hospital, Zhejiang University School of Medicine (Hangzhou, Zhejiang Province, China) from January 1, 2014 to December 31, 2022 were collected. The concentrations of particulate matter (PM<jats:sub>10<\/jats:sub> and PM<jats:sub>2.5<\/jats:sub>), nitrogen dioxide (NO<jats:sub>2<\/jats:sub>), sulfur dioxide (SO<jats:sub>2<\/jats:sub>), carbon monoxide (CO) and ozone (O<jats:sub>3<\/jats:sub>), as well as the meteorological factors during the same period were obtained from Resource and Environment Science and Data Center, Chinese Academy of Science. A conditional logistic regression with a time-stratified case-crossover design was conducted to analyze the association between air pollutants and outpatient visits for PALDO.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In the single-pollutant model, significant associations were observed between PM<jats:sub>10<\/jats:sub> (Odds ratio (OR) = 1.0022; 95% confidence interval (CI):1.0008, 1.004), PM<jats:sub>2.5<\/jats:sub> (OR = 1.0025; 95% CI: 1.0004, 1.005), NO<jats:sub>2<\/jats:sub> (OR = 1.006; 95% CI: 1.0025, 1.010), SO<jats:sub>2<\/jats:sub> (OR = 1.0124; 95% CI: 1.0027, 1.022) and CO (OR = 1.3273; 95% CI: 1.0183, 1.73) and outpatient visits for PALDO. These associations remained significant after adjusting for the certain pollutant in the multi-pollutant model except NO<jats:sub>2<\/jats:sub>. Moreover, variations occurred between sexes, among different age groups and different seasons.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Our study provided new and robust evidence that short-term exposure to air pollution may increase the risk of PALDO. Further studies are needed to decipher the underlying mechanisms.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fpubh.2025.1632109","type":"journal-article","created":{"date-parts":[[2025,9,29]],"date-time":"2025-09-29T05:26:23Z","timestamp":1759123583000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Association between ambient air pollution and outpatient visits for primary acquired lacrimal duct obstruction in Hangzhou, China"],"prefix":"10.3389","volume":"13","author":[{"given":"Qi","family":"Miao","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuwei","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peifang","family":"Xu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xin","family":"Shi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yihua","family":"Wu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Juan","family":"Ye","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Han","family":"Wu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2025,9,29]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"656","DOI":"10.1038\/s41569-020-0371-2","article-title":"Environmental determinants of cardiovascular disease: lessons learned from air pollution","volume":"17","author":"Al-Kindi","year":"2020","journal-title":"Nat Rev Cardiol."},{"key":"B2","doi-asserted-by":"publisher","first-page":"882","DOI":"10.1161\/STROKEAHA.122.035498","article-title":"Ambient air pollution and stroke: an updated review","volume":"54","author":"Kulick","year":"2023","journal-title":"Stroke."},{"key":"B3","doi-asserted-by":"publisher","first-page":"693","DOI":"10.1164\/rccm.201804-0673PP","article-title":"Air pollution in the Asia-Pacific region a joint Asian Pacific Society of Respirology\/American Thoracic Society perspective","volume":"199","author":"North","year":"2019","journal-title":"Am J Resp Crit Care."},{"key":"B4","doi-asserted-by":"publisher","first-page":"E535","DOI":"10.1016\/S2542-5196(22)00090-0","article-title":"Pollution and health: a progress update","volume":"6","author":"Fuller","year":"2022","journal-title":"Lancet Planet Health."},{"key":"B5","unstructured":"Ambient (Outdoor) Air Pollution\n          \n          2019"},{"key":"B6","doi-asserted-by":"publisher","first-page":"124257","DOI":"10.1016\/j.jenvman.2025.124257","article-title":"The spatial impact of population semi-urbanization on sulfur dioxide emissions: empirical evidence from China","volume":"375","author":"Zhang","year":"2025","journal-title":"J Environ Manage."},{"key":"B7","doi-asserted-by":"publisher","first-page":"118164","DOI":"10.1016\/j.jenvman.2023.118164","article-title":"The pollution control effect of the atmospheric environmental policy in autumn and winter: evidence from the daily data of Chinese cities","volume":"343","author":"Zhang","year":"2023","journal-title":"J Environ Manage."},{"key":"B8","doi-asserted-by":"publisher","first-page":"123765","DOI":"10.1016\/j.jenvman.2024.123765","article-title":"Towards organic collaborative governance for a more sustainable environment: Evolutionary game analysis within the policy implementation of China's net-zero emissions goals","volume":"373","author":"Zhou","year":"2025","journal-title":"J Environ Manage."},{"key":"B9","doi-asserted-by":"publisher","first-page":"116584","DOI":"10.1007\/s11356-022-21501-6","article-title":"The spatial impact of atmospheric environmental policy on public health based on the mediation effect of air pollution in China","volume":"30","author":"Zhang","year":"2023","journal-title":"Environ Sci Pollut Res Int."},{"key":"B10","doi-asserted-by":"publisher","first-page":"117442","DOI":"10.1016\/j.envres.2023.117442","article-title":"Can digitalization reduce industrial pollution? 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