Accepted for/Published in: JMIR Public Health and Surveillance
Date Submitted: Sep 15, 2022
Date Accepted: Nov 28, 2022
Effects of greenness on myopia risk and school-level prevalence among high school-aged adolescent: a cross sectional study
ABSTRACT
Background:
Adolescent myopia was an alarming public health issue. Green space had some certain association with the myopia protective factors that it could benefit against myopia.
Objective:
This study aimed to examine the effects of green space around schools on myopia risk.
Methods:
Green space was measured by the normalized difference vegetation index (NDVI). A total of 13,380 samples of 51 high schools were selected from a 2021 Beijing Municipal Health Commission survey. Adolescent myopia was defined as a spherical equivalent of ≤-1.00 diopters in the worse eye. Generalized linear mixed models with a binomial error structure were used to analyze the effects of NDVI and adjust them by other factors, e.g., demographics, exposure time, outdoor exercise. The NDVI influence on school-level myopia prevalence with adjusted demographics and tree relative position factors was analyzed through quasibinomial regression.
Results:
The overall prevalence of myopia was 80.61% (10,785/13,380, 95% CI=79.93-81.27%). While with a 0.1 increase in NDVI of 500 m and 1000 m buffer adjusted by demographic and other factors, significantly dropped the high-aged personal myopia risk by 16% (OR=0.84, 95% CI=0.73-0.97) and 12% (OR=0.88, 95% CI=0.79-0.99), respectively. However, only the adjusted 500 m buffer NDVI (by demographics and the position of trees) with its 0.1 increase could significantly reduce the school-level myopia prevalence by 15% (OR=0.85, 95% CI=0.74-0.98). Subgroup analysis showed that the adjusted effects of NDVI within the 500 m buffer were significant in schoolgirls (OR=0.82, 95% CI=0.71-0.93), juniors (OR=0.82, 95% CI=0.71-0.94), Han nationality (OR=0.84, 95% CI=0.72-0.97), 1-year (OR=0.84, 95% CI=0.71-0.99) and 3-years exposure groups (OR=0.78, 95% CI=0.65-0.94).
Conclusions:
The greenness of 500 m buffer around school was associated with a lower personal myopia risk among adolescents and a lower prevalence of myopia in the school. With regard to prevention and control activities, green space within a 500 m buffer around schools suggested as an independent protective factor for adolescent myopia.
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