Abstract:Objective To analyze the factors influencing myopia and the interactions of outdoor activities and use of electronic products with myopia among pupils in Beijing in 2022. Methods A multi-stage cluster random sampling method was used to randomly select 6 districts in Beijing in July 2022, and then 11 primary schools were randomly selected from the 6 districts. A questionnaire survey was conducted on all pupils in Grades I-V from the selected schools. Univariate t test or χ2 test and multivariate logistic regression analysis were performed to identify the factors influencing myopia and analyze the multiplicative interactions between outdoor activities and use of electronic products. Results A total of 15,033 pupils were surveyed in this study. The mean age was (9.12±1.35) years, and the overall prevalence rate of myopia 23.63%. The prevalence rate of myopia in girls was 24.91%, and that in boys was 22.42%. The proportion of Grade I-V pupils who spent >1 hour per day in outdoor activities after school decreased gradually (Ptrend<0.001), while the proportions of pupils who spent > 30 minutes on use of electronic products (Ptrend<0.001) or > 1 hour on using eyes at a close distance without screen per day after school increased gradually (Ptrend<0.001). Older age (OR=1.872, 95%CI:1.810-1.936, P<0.001), girls (OR=1.160, 95%CI:1.068-1.260, P<0.001), myopic parents (father or mother with myopia: OR=2.268, 95%CI:2.020-2.547, P<0.001; father and mother with myopia: OR=5.053, 95%CI:4.485-5.694, P<0.001) and longtime using eyes at a close distance without screen (OR=1.224, 95%CI:1.095-1.368, P<0.001) were risk factors for myopia. Reading at a close distance (11-20 cm: OR=0.833, 95%CI:0.708-0.981, P=0.028; 21-30 cm: OR=0.609, 95%CI:0.514-0.721, P<0.001; > 30 cm: OR=0.558, 95%CI:0.457-0.681, P<0.001) and doing eye exercises once or twice a day (once a day: OR=0.853, 95%CI:0.761-0.957, P=0.007; twice a day: OR=0.880, 95%CI:0.796-0.973, P=0.013) were protective factors for myopia. There were multiplicative interactions between time of outdoor activity after school and time of using electronic products. With the increase of the time of outdoor activities, the effect of using electronic products on the prevalence rate of myopia was weakened (OR=0.803, 95%CI:0.666-0.969, P=0.022). Conclusion Outdoor activities can reduce the effect of using electronic products on myopia. It can be considered to increase children’s outdoor activity time so as to make up for the effect of longtime using electronic products on myopia.
李嘉妍, 奴比娅·阿马尔江, 李梦龙, 郑德强, 胡翼飞, 吴立娟. 2022年北京市小学生户外活动和电子产品使用与近视发生的交互作用[J]. 实用预防医学, 2024, 31(5): 513-517.
LI Jiayan, NUBIYA Amaerjiang, LI Menglong, ZHENG Deqiang, HU Yifei, WU Lijuan. Interactions of outdoor activities and use of electronic products with the occurrence of myopia among primary school students in Beijing, 2022. , 2024, 31(5): 513-517.
[1] Holden BA,Fricke TR,Wilson DA,et al. Global prevalence of myopia and high myopia and temporal trends from 2000 through 2050[J]. Ophthalmology, 2016,123(5):1036-1042. [2] 陈军, 何鲜桂, 王菁菁, 等. 2021—2030年我国6~18岁学生近视眼患病率预测分析[J]. 中华眼科杂志, 2021,57(4):261-267. [3] Ikuno Y. Overview of the complications of high myopia[J]. Retina, 2017,37(12):2347-2351. [4] Wang J,Li Y,Musch DC,et al. Progression of myopia in school-aged children after COVID-19 home confinement[J]. JAMA Ophthalmol, 2021,139(3):293-300. [5] Mirhajianmoghadam H, Pina A, Ostrin LA. Objective and subjective behavioral measures in myopic and non-myopic children during the COVID-19 pandemic[J]. Transl Vis Sci Technol, 2021,10(11):4. [6] Foreman J, Salim AT, Praveen A, et al. Association between digital smart device use and myopia: a systematic review and meta-analysis[J]. Lancet Digit Health, 2021,3(12):e806-e818. [7] Enthoven CA,Polling JR,Verzijden T,et al. Smartphone use associated with refractive error in teenagers: the myopia app study[J]. Ophthalmology, 2021,128(12):1681-1688. [8] He M, Xiang F, Zeng Y, et al. Effect of time spent outdoors at school on the development of myopia among children in China[J]. JAMA, 2015,314(11):1142-1148. [9] Guo Y, Liu L, Lv Y, et al. Outdoor jogging and myopia progression in school children from rural Beijing: the BeijingChildren Eye Study[J]. Transl Vis Sci Technol, 2019,8(3):2. [10] 符文雅, 王丽卿, 吴挺利, 等. 海南省城乡中小学生近视现况及其差异性分析[J]. 实用预防医学, 2022, 29(10):1172-1176. [11] 孙中慧, 张娟, 郭郑, 等. 徐州市2020年中小学生近视情况及影响因素分析[J]. 江苏预防医学, 2022, 33(6):736-738. [12] 王炳南. 身体活动、户外时间、近距离用眼对儿童青少年近视影响的研究[D].上海:上海体育学院, 2021. [13] 汪育文, 卓佐跑, 杨仙玲, 等. 小学五年级学生阅读行为与近视的关联性分析[J]. 中国学校卫生, 2015, 36(5):732-734. [14] 高青,刘懿卿,叶茜雯,等. 2018―2020年辽宁省学生近视流行变化趋势与其影响因素[J]. 中华疾病控制杂志, 2022, 26(6):673-678. [15] Wong CW, Tsai A, Jonas JB, et al. Digital screen time during the COVID-19 pandemic: risk for a further myopia boom?[J]. Am J Ophthalmol, 2021,223:333-337. [16] Mccrann S, Loughman J, Butler JS, et al. Smartphone use as a possible risk factor for myopia[J]. Clin Exp Optom, 2021,104(1):35-41. [17] Bababekova Y, Rosenfield M, Hue JE, et al. Font size and viewing distance of handheld smart phones[J]. Optom Vis Sci, 2011,88(7):795-797. [18] He X, Sankaridurg P, Wang J, et al. Time outdoors in reducing myopia: a school-based cluster randomized trial with objective monitoring of outdoor time and light intensity[J]. Ophthalmology, 2022,129(11):1245-1254. [19] 程玉洁, 李美秀, 范之仪, 等. 太仓市中学生近视现状及相关因素分析[J]. 实用预防医学, 2022,29(12):1528-1532. [20] Baird PN,Saw S,Lanca C,et al. Myopia[J]. Nat Rev Dis Primers, 2020,6(1):99. [21] Rose KA, Morgan IG, Ip J, et al. Outdoor activity reduces the prevalence of myopia in children[J]. Ophthalmology, 2008,115(8):1279-1285. [22] French AN, Morgan IG, Mitchell P, et al. Risk factors for incident myopia in Australian schoolchildren: the Sydney adolescent vascular and eye study[J]. Ophthalmology, 2013,120(10):2100-2108.