3 8.9–14.4 55–59 156/335,543 46.5 39.7–54.4 99/380,614 26.0 21.4–31.7 66/255,528 25.8 20.3–32.9 24/204,113 11.8 7.9–17.5 126/664,703 19.0 15.9–22.6 Table 3 presents age- and sex-specific RRs for manual workers and (in women only) housewives relative to non-manual workers. These ratios were consistently greater than 1, in most cases to the point of statistical significance. Table 3 Age- and sex-specific RR for manual workers and full-time housewives (with respect to non-manual workers) in Tuscany Age (years) Men Women Manual workers Manual workers Housewives RR 95 % CI Epacadostat RR 95 % CI RR 95 % CI 25–29 1.4 0.7–2.8 1.8 0.9–3.6 2.9 1.2–6.9‡ 30–34 1.4 0.9–2.2 2.5 1.3–4.8†

3.3 1.6–6.8* 35–39 1.6 1.1–2.3† 2.2 1.2–3.8† 1.9 1.0–3.5‡ 40–44 1.8 1.3–2.4* 1.8 1.1–2.8‡ 1.8 1.1–2.9‡ 45–49 2.2 1.6–2.9* 1.7 1.1–2.6† 1.3

0.8–2.0 50–54 1.8 1.4–2.3* 1.8 1.2–2.6† 1.2 0.8–1.8 55–59 1.8 1.4–2.3* 2.2 1.4–3.5* 1.6 1.0–2.5‡ * P < 0.001; †  P < 0.01; ‡ P < 0.05 A sensitivity analysis excluding the first 2 years of the observation period produced findings very similar to those of the main analysis (data not shown), suggesting that distortion due to inclusion of prevalent cases was unlikely. Discussion This large population-based study indicates that in Tuscany, surgically treated idiopathic RRD is almost twice as common among manual as in non-manual workers. This seems to be in contrast to the association with affluence and higher educational attainment which has been reported from Scotland (Saidkasimova et al. 2009; Mitry et al. 2010b), but consistent with the hypothesis that heavy manual work may be a cause of the disease (Mattioli et al. 2008). The association Defactinib clinical trial with manual work is unlikely to be explained by a confounding effect of myopia, since if anything, myopia tends to be associated with higher levels of education and higher socioeconomic status (Saw et al. 1996). In the EPIC-Norfolk Eye Study, there were no major differences

in refractive error learn more between manual and non-manual workers (Foster et al. 2010). High BMI appears to be associated with surgically treated RD (Mattioli et al. 2008, 2009b) and, even if people of lower socioeconomic status are more likely to have higher BMI (Vannoni et al. 2005), this is unlikely to have caused important confounding since the prevalence of overweight/obese subjects in Tuscany is very low [National Institute of Statistics (ISTAT) 2002]. Many manual workers may live in less deprived areas, and a relatively high PP2 chemical structure proportion of residents from the most deprived areas in Scotland may have been unemployed.