Po-Wen Ku1, Andrew Steptoe2, Yun-Ju Lai3, Hsiao-Yun Hu4, Dachen Chu5, Yung-Feng Yen6, Yung Liao7, Li-Jung Chen8. 1. Graduate Institute of Sports and Health, National Changhua University of Education, Taiwan; Department of Epidemiology and Public Health, University College London, UK. 2. Department of Behavioural Science and Health, University College London, UK. 3. Division of Endocrinology and Metabolism, Department of Internal Medicine, Puli Branch of Taichung Veterans General Hospital, Nantou, Taiwan; Department of Exercise Health Science, National Taiwan University of Sport, Taiwan; School of Medicine, National Yang-Ming University, Taipei, Taiwan. 4. Department of Education and Research, Taipei City Hospital, Taipei, Taiwan; Institute of Public Health, National Yang-Ming University, Taipei, Taiwan. 5. School of Medicine, National Yang-Ming University, Taipei, Taiwan; Department of Neurosurgery, Taipei City Hospital, Taipei, Taiwan; Department of Health Care Management, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan. 6. School of Medicine, National Yang-Ming University, Taipei, Taiwan; Department of Health Care Management, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan; Section of Infectious Diseases, Taipei City Hospital, Taipei City Government, Taipei, Taiwan. 7. Department of Health Promotion and Health Education, National Taiwan Normal University, Taichung, Taiwan. Electronic address: liaoyung@ntnu.edu.tw. 8. Department of Epidemiology and Public Health, University College London, UK; Department of Exercise Health Science, National Taiwan University of Sport, Taiwan. Electronic address: ljchen@gm.ntupes.edu.tw.
Abstract
OBJECTIVE: This nationwide population-based study aimed to examine the prospective association between near visual activities and incident myopia in Taiwanese children 7 to 12 years old over a 4-year follow-up period. DESIGN: Prospective cohort design. PARTICIPANTS: There were 1958 children aged 7 to 12 years from the Taiwan 2009 National Health Interview Survey who were linked to the 2009 through 2013 claims data from the National Health Insurance system. METHODS: Multivariable Cox proportional hazard models were used to estimate the associations between 3 types of near visual activities in sedentary posture, namely reading (< 0.5, 0.5-0.9, ≥1.0 hours per day [h/d]), use of computer, Internet, and games (<0.5, 0.5-0.9, ≥1.0 h/d), and "cram school" attendance (<0.5, 0.5-1.9, ≥2.0 h/d), and incident myopia. MAIN OUTCOME MEASURES: Prevalent myopia was defined as those who had ≥2 ambulatory care claims (International Classification of Diseases code 367.1) in 2008-2009. Incident myopia was defined by those who had at least 2 ambulatory care claims (International Classification of Diseases code 367.1) during the 4-year follow-up period (2010-2013) after excluding prevalent cases. RESULTS: Overall, 26.8% of children had myopia at baseline, and 27.7% of those without myopia at baseline developed incident myopia between 2010 and 2013. On average, they spent 0.68±0.86 h/d on computer/Internet use, 0.63±0.67 h/d on reading, and 2.78±3.53 h/d on cram school. The results showed that children attending cram schools ≥2 h/d (hazard ratio, 1.31; 95% confidence interval, 1.03-1.68) had a higher risk of incident myopia. The effects of these activities remained similar in sensitivity analyses. CONCLUSIONS: Cram school attendance for ≥2 h/d may increase the risk of children's incident myopia. This effect may be due to increased near visual activity or reduced time outdoors.
OBJECTIVE: This nationwide population-based study aimed to examine the prospective association between near visual activities and incident myopia in Taiwanese children 7 to 12 years old over a 4-year follow-up period. DESIGN: Prospective cohort design. PARTICIPANTS: There were 1958 children aged 7 to 12 years from the Taiwan 2009 National Health Interview Survey who were linked to the 2009 through 2013 claims data from the National Health Insurance system. METHODS: Multivariable Cox proportional hazard models were used to estimate the associations between 3 types of near visual activities in sedentary posture, namely reading (< 0.5, 0.5-0.9, ≥1.0 hours per day [h/d]), use of computer, Internet, and games (<0.5, 0.5-0.9, ≥1.0 h/d), and "cram school" attendance (<0.5, 0.5-1.9, ≥2.0 h/d), and incident myopia. MAIN OUTCOME MEASURES: Prevalent myopia was defined as those who had ≥2 ambulatory care claims (International Classification of Diseases code 367.1) in 2008-2009. Incident myopia was defined by those who had at least 2 ambulatory care claims (International Classification of Diseases code 367.1) during the 4-year follow-up period (2010-2013) after excluding prevalent cases. RESULTS: Overall, 26.8% of children had myopia at baseline, and 27.7% of those without myopia at baseline developed incident myopia between 2010 and 2013. On average, they spent 0.68±0.86 h/d on computer/Internet use, 0.63±0.67 h/d on reading, and 2.78±3.53 h/d on cram school. The results showed that children attending cram schools ≥2 h/d (hazard ratio, 1.31; 95% confidence interval, 1.03-1.68) had a higher risk of incident myopia. The effects of these activities remained similar in sensitivity analyses. CONCLUSIONS: Cram school attendance for ≥2 h/d may increase the risk of children's incident myopia. This effect may be due to increased near visual activity or reduced time outdoors.
Authors: Chee Wai Wong; Andrew Tsai; Jost B Jonas; Kyoko Ohno-Matsui; James Chen; Marcus Ang; Daniel Shu Wei Ting Journal: Am J Ophthalmol Date: 2020-07-29 Impact factor: 5.258
Authors: Gui-You Yang; Li-Hua Huang; Katrina L Schmid; Chen-Guang Li; Jing-Yi Chen; Guan-Hao He; Li Liu; Zeng-Liang Ruan; Wei-Qing Chen Journal: Int J Environ Res Public Health Date: 2020-02-07 Impact factor: 3.390