CIGARETTE-SMOKING AND RISK FOR PROGRESSION OF NUCLEAR OPACITIES

Objective: To examine the relationships between smoking and the 5-year incidence of new nuclear opacities and between smoking and the progre ssion of nuclear opacities in a prospective study of a cohort of Chesa peake Bay watermen. Methods: A total of 442 men (age, greater than or equal to 30 years in 1985) with paired, gradable lens photographs in a t least one eye in both 1985 and 1990 were studied. Photographs were g raded by two readers who used the grading scheme of the Wilmer Institu te, Baltimore, Md, with severity ranging in decimal units between 0.0 and 4.0. Data on the smoking history of the subjects were collected by personal interviews that were conducted in 1985 and updated in 1990. Results: The incidence and progression of opacities increased with age . A nonsignificant association was observed between smoking (for both current and ex-smokers) and the incidence of a nuclear opacity. The ri sk of progression of nuclear opacities of less than grade 3 at baselin e to grade 3 or worse was 2.4-fold higher among current smokers in 198 5, compared with that among ex-smokers and nonsmokers (95% confidence limits: 1.0, 6.0) after adjustment for age, baseline opacity status, a nd alcohol use. An 18% increased risk of progression was significantly associated with each pack-year that a subject smoked between 1985 and 1990. Conclusion: These data confirm previous findings that smoking i s associated with a nuclear opacity, particularly with progression to severe opacities.