| Title | Greenness Surrounding Schools and Visual Impairment in Chinese Children and Adolescents |
| Authors | Yang, Bo-Yi Li, Shanshan Zou, Zhiyong Markevych, Iana Heinrich, Joachim Bloom, Michael S. Luo, Ya-Na Huang, Wen-Zhong Xiao, Xiang Gui, Zhaohuan Bao, Wen-Wen Jing, Jin Ma, Jun Ma, Yinghua Chen, Yajun Dong, Guang-Hui |
| Affiliation | Sun Yat Sen Univ, Guangzhou Key Lab Environm Pollut & Hlth Risk Ass, Dept Occupat & Environm Hlth, Sch Publ Hlth,Guangdong Prov Engn Technol Res Ctr, Guangzhou, Peoples R China Monash Univ, Sch Publ Hlth & Prevent Med, Dept Epidemiol & Prevent Med, Melbourne, Vic, Australia Peking Univ, Sch Publ Hlth, Inst Child & Adolescent Hlth, Beijing 100191, Peoples R China Jagiellonian Univ, Inst Psychol, Krakow, Poland Ludwig Maximilians Univ Munchen LMU Munich, Univ Hosp, Inst & Clin Occupat Social & Environm Med, Munich, Germany Ludwig Maximilians Univ Munchen, Comprehens Pneumol Ctr Munich, Munich, Germany Ludwig Maximilians Univ Munchen, German Ctr Lung Res, Munich, Germany George Mason Univ, Dept Global & Community Hlth, Fairfax, VA 22030 USA Sun Yat Sen Univ, Sch Publ Hlth, Dept Maternal & Child Hlth, 74 Zhongshan 2nd Rd, Guangzhou 510080, Peoples R China |
| Keywords | PREVALENCE MYOPIA SCHOOLCHILDREN OPHTHALMOLOGY MEDIATION SATELLITE HEALTH TRENDS |
| Issue Date | Oct-2021 |
| Publisher | ENVIRONMENTAL HEALTH PERSPECTIVES |
| Abstract | BACKGROUND: Evidence concerning the effects of greenness on childhood visual impairment is scarce. OBJECTIVES: We aimed to assess whether greenness surrounding schools was associated with visual impairment prevalence and visual acuity levels in Chinese schoolchildren and whether the associations might he explained by reduced air pollution. METHODS: In September 2013, we recruited 61,995 children and adolescents 6-18 years of age from 94 schools in seven provinces/municipalities in China. Greenness exposure was assessed using the normalized difference vegetation index (NDVI) and the soil-adjusted vegetation index (SAVI) from July to August 2013. Visual impairment was defined as at least one visual acuity level (dimensionless) lower than 4.9 (Snellen 5/6 equivalent). Three-year annual averages of particulate matter (PM) with an aerodynamic diameter of <= 1 mu m (PM1) and nitrogen dioxide (NO2) at each school were assessed using machine learning methods. We used generalized linear mixed models to estimate the associations between greenness and prevalent visual impairment and visual acuity levels and used mediation analyses to explore the potential mediating role of air pollution. RESULTS: In the adjusted model, an interquartile range increase in N DVI500m was associated with lower odds of prevalent visual impairment [odds ratio (OR) = 0.95; 95% confidence interval (CI): 0.93, 0971] The same increase in NDVI500m was also associated with 0.012 (95% CI: 0.008, 0.015) and 0.011 (95% CI: 0.007, 0.015) increases in visual acuity levels for left- and right-eye, respectively. Our results also suggested that PM1 and NO2 significantly mediated the association between NDVI500m and visual impairment. Similar effect estimates were observed for SAVI(500m) and our estimates were generally robust in several sensitivity analyses. DISCUSSION: These findings suggest higher greenness surrounding schools might reduce the risk of visual impairment, possibly owing in part to lower PM1 and NO2 in vegetated areas. Further longitudinal studies with more precise greenness assessment are warranted to confirm these findings. |
| URI | http://hdl.handle.net/20.500.11897/629505 |
| ISSN | 0091-6765 |
| DOI | 10.1289/EHP8429 |
| Indexed | SCI(E) |
| Appears in Collections: | 公共卫生学院 |
