Lihua Huang1, Katrina L Schmid2, Jingyu Zhang3, Gui-You Yang4, Jianbo Wu5, Xiao-Na Yin3, Guanhao He4, Zengliang Ruan4, Xiao-Qin Jiang3, Chuan-An Wu6, Wei-Qing Chen7. 1. Department of Epidemiology, Guangzhou Key Laboratory of Environmental Pollution and Health Assessment, Guangdong Provincial Key Laboratory of Food, Nutrition and Health, School of Public Health, Sun Yat-sen University, 510080, Guangzhou, China. Electronic address: hlihua2@mail2.sysu.edu.cn. 2. Centre for Eye and Vision Research, School of Optometry and Vision Science, Faculty of Health, Queensland University of Technology, Brisbane, 4059, QLD, Australia. Electronic address: k.schmid@qut.edu.au. 3. Longhua District Maternal and Child Health Hospital, 518109, Shenzhen, China. 4. Department of Epidemiology, Guangzhou Key Laboratory of Environmental Pollution and Health Assessment, Guangdong Provincial Key Laboratory of Food, Nutrition and Health, School of Public Health, Sun Yat-sen University, 510080, Guangzhou, China. 5. Department of Epidemiology, Guangzhou Key Laboratory of Environmental Pollution and Health Assessment, Guangdong Provincial Key Laboratory of Food, Nutrition and Health, School of Public Health, Sun Yat-sen University, 510080, Guangzhou, China; Longhua District Maternal and Child Health Hospital, 518109, Shenzhen, China. 6. Longhua District Maternal and Child Health Hospital, 518109, Shenzhen, China. Electronic address: wuca@163.com. 7. Department of Epidemiology, Guangzhou Key Laboratory of Environmental Pollution and Health Assessment, Guangdong Provincial Key Laboratory of Food, Nutrition and Health, School of Public Health, Sun Yat-sen University, 510080, Guangzhou, China; Department of Information Management, Xinhua College of Sun Yat-sen University, 510080, Guangzhou, China. Electronic address: chenwq@mail.sysu.edu.cn.
Abstract
OBJECTIVE: Rapid urbanization has led to reduced greenness in many areas, this has been linked to adverse health outcomes. The aim was to determine the association between residential greenness experienced during very early childhood with preschool myopia and astigmatism and to explore the potential mediating role of screen time on any associations. METHOD: Information regarding socio-demographic characteristics, home address, screen time during early childhood, and refraction data from vision screenings of 53,575 preschoolers from Longhua Child Cohort Study were collected via questionnaires. Residential greenness was calculated as the average of satellite-derived Normalized Difference Vegetation Index in buffers of 100, 250, and 500 m around each child's home address. Logistic and linear regression models were used to examine the relationships between residential greenness, screen time, and preschool myopia and astigmatism. RESULT: The mean (SD) age of the 53,575 preschoolers was 5.0 (0.7) years, and 24,849 (46.4%) were girls. A total of 1236 (2.3%) preschoolers had myopia and 5347 (10.0%) had astigmatism. In the adjusted model, a higher neighborhood greenness level within 100 m buffers around the home address was associated with decreased risk of myopia (adjusted odds ratios (AOR): 0.62, 95% confidence interval (CI): 0.38-0.99), and higher neighborhood greenness levels within 100, 250, and 500 m decreased the risk of astigmatism, and their AORs (95% CIs) were 0.55 (0.43-0.70) for 100 m, 0.59 (0.41-0.83) for 250 m, 0.61 (0.42-0.90) for 500 m, respectively. Greater screen time during early childhood increased the risk of myopia (AOR = 1.33) and astigmatism (AOR = 1.23). Reduction in screen time fully mediated the benefits of greater residential greenness on preschool myopia, but partially mediated that on preschool astigmatism (p < 0.05). CONCLUSION: Higher residential greenness reduces the risk of preschool myopia and astigmatism; the benefits of residential greenness were mediated through reduced daily screen time.
OBJECTIVE: Rapid urbanization has led to reduced greenness in many areas, this has been linked to adverse health outcomes. The aim was to determine the association between residential greenness experienced during very early childhood with preschool myopia and astigmatism and to explore the potential mediating role of screen time on any associations. METHOD: Information regarding socio-demographic characteristics, home address, screen time during early childhood, and refraction data from vision screenings of 53,575 preschoolers from Longhua Child Cohort Study were collected via questionnaires. Residential greenness was calculated as the average of satellite-derived Normalized Difference Vegetation Index in buffers of 100, 250, and 500 m around each child's home address. Logistic and linear regression models were used to examine the relationships between residential greenness, screen time, and preschool myopia and astigmatism. RESULT: The mean (SD) age of the 53,575 preschoolers was 5.0 (0.7) years, and 24,849 (46.4%) were girls. A total of 1236 (2.3%) preschoolers had myopia and 5347 (10.0%) had astigmatism. In the adjusted model, a higher neighborhood greenness level within 100 m buffers around the home address was associated with decreased risk of myopia (adjusted odds ratios (AOR): 0.62, 95% confidence interval (CI): 0.38-0.99), and higher neighborhood greenness levels within 100, 250, and 500 m decreased the risk of astigmatism, and their AORs (95% CIs) were 0.55 (0.43-0.70) for 100 m, 0.59 (0.41-0.83) for 250 m, 0.61 (0.42-0.90) for 500 m, respectively. Greater screen time during early childhood increased the risk of myopia (AOR = 1.33) and astigmatism (AOR = 1.23). Reduction in screen time fully mediated the benefits of greater residential greenness on preschool myopia, but partially mediated that on preschool astigmatism (p < 0.05). CONCLUSION: Higher residential greenness reduces the risk of preschool myopia and astigmatism; the benefits of residential greenness were mediated through reduced daily screen time.