TY - JOUR
T1 - Urban greenspace and visual acuity in schoolchildren
T2 - a large prospective cohort study in China
AU - Bao, Wen Wen
AU - Zhao, Yu
AU - Dadvand, Payam
AU - Jiang, Nan
AU - Chen, Gongbo
AU - Yang, Boyi
AU - Huang, Wenzhong
AU - Xiao, Xiang
AU - Liang, Jinghong
AU - Chen, Yican
AU - Huang, Shan
AU - Pu, Xueya
AU - Huang, Shaoyi
AU - Lin, Haotian
AU - Guo, Yuming
AU - Dong, Guanghui
AU - Chen, Yajun
N1 - This project was funded by the Science and Technology Planning Project of Guangdong Province of China (No.2014A020220002; No.2016A020225002); the National Natural Science Foundation of China (No.81673193; No.82273650). We are grateful for the cooperation of all participants in this work who have generously spent their precious time and efforts help us, as well as all staff of Guangzhou Primary and Secondary School Health Promotion Center, to coordinate schoolchildren’s physical examinations and the completion of questionnaires. ISGlobal acknowledges the support from the Spanish Ministry of Science and Innovation and State Research Agency through the “Centro de Excelencia Severo Ochoa 2019-2023” Program (CEX2018-000806-S), and support from the Generalitat de Catalunya through the CERCA Program.
Publisher Copyright:
© 2024 The Author(s).
PY - 2024/2
Y1 - 2024/2
N2 - Background: Greenspace is known to have a positive impact on human health and well-being, but its potential effects on visual acuity have not been extensively studied.Objectives: Our aim was to examine the relationship between long-term greenspace exposure and visual acuity in children, while also exploring the potential mechanisms in this association.Methods: We conducted this prospective cohort study based on the Children's growth environment, lifestyle, physical, and mental health development project (COHERENCE), which screened 286,801 schoolchildren in Guangzhou, China, starting in the 2016/17 academic year and followed them up for three academic years (2017/18-2019/20). Visual acuity was measured using a standardized logarithmic chart, and visual impairment was defined as visual acuity worse than 0.0 logarithm of the minimum angle of resolution (LogMAR) units in the better eye. We used the Normalized Difference Vegetation Index (NDVI), the Soil-Adjusted Vegetation Index (SAVI), and the Enhanced Vegetation Index (EVI) to assess the greenspace surrounding child's geocoded home and school at each visit.Results: Our analysis indicated that higher greenspace exposure was associated with greater visual acuity z-score at baseline and with slower decline in visual acuity z-score during the 3-year follow-up. An interquartile range increase in home-school-based NDVI 300m was associated with a 7% decrease [hazard ratios (HRs): 0.93, 95% confidence interval (CI): 0.92, 0.94] in the risk of visual impairment. We also found that air pollution, physical activity, outdoor time, and recreational screen time partially mediated the greenspace-visual acuity association.Conclusion: Our findings suggest that increasing greenspace exposure could benefit children's visual acuity development and reduce the risk of visual impairment by reducing air pollution and recreational screen time while increasing physical activity and outdoor time. All results could have potential policy implications, given the individual and societal burdens associated with visual impairment.
AB - Background: Greenspace is known to have a positive impact on human health and well-being, but its potential effects on visual acuity have not been extensively studied.Objectives: Our aim was to examine the relationship between long-term greenspace exposure and visual acuity in children, while also exploring the potential mechanisms in this association.Methods: We conducted this prospective cohort study based on the Children's growth environment, lifestyle, physical, and mental health development project (COHERENCE), which screened 286,801 schoolchildren in Guangzhou, China, starting in the 2016/17 academic year and followed them up for three academic years (2017/18-2019/20). Visual acuity was measured using a standardized logarithmic chart, and visual impairment was defined as visual acuity worse than 0.0 logarithm of the minimum angle of resolution (LogMAR) units in the better eye. We used the Normalized Difference Vegetation Index (NDVI), the Soil-Adjusted Vegetation Index (SAVI), and the Enhanced Vegetation Index (EVI) to assess the greenspace surrounding child's geocoded home and school at each visit.Results: Our analysis indicated that higher greenspace exposure was associated with greater visual acuity z-score at baseline and with slower decline in visual acuity z-score during the 3-year follow-up. An interquartile range increase in home-school-based NDVI 300m was associated with a 7% decrease [hazard ratios (HRs): 0.93, 95% confidence interval (CI): 0.92, 0.94] in the risk of visual impairment. We also found that air pollution, physical activity, outdoor time, and recreational screen time partially mediated the greenspace-visual acuity association.Conclusion: Our findings suggest that increasing greenspace exposure could benefit children's visual acuity development and reduce the risk of visual impairment by reducing air pollution and recreational screen time while increasing physical activity and outdoor time. All results could have potential policy implications, given the individual and societal burdens associated with visual impairment.
KW - Greenness
KW - Myopia
KW - Visual acuity
KW - Mediation
KW - Children
KW - Repeated measures
UR - http://www.scopus.com/inward/record.url?scp=85183053927&partnerID=8YFLogxK
U2 - 10.1016/j.envint.2024.108423
DO - 10.1016/j.envint.2024.108423
M3 - Journal article
C2 - 38241831
AN - SCOPUS:85183053927
SN - 0160-4120
VL - 184
JO - Environment International
JF - Environment International
M1 - 108423
ER -
