Centre for Environment and Occupational Health Research, School of Public Health and Family Medicine, University of Cape Town, South Africa; Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Switzerland.
Institute for Risk Assessment Sciences (IRAS), Utrecht University, 3584, Utrecht, Netherlands.
Environ Res. 2020 May;184:109315. doi: 10.1016/j.envres.2020.109315. Epub 2020 Mar 4.
Electronic media use is increasing in low- and middle-income countries, thus we aim to investigate the prevalence of different aspects of e-media use and its association to symptoms and neurocognitive outcomes in rural South Africa.
In the cohort study, "Child health Agricultural Pesticide study in South Africa (CapSA)", of 1001 children and adolescents, aged 9-16 years, we enquired at baseline about the following aspects of e-media use: (1) call duration (2) total screen time (3) night-time awakenings from mobile phone use, and (4) Mobile Phone Problematic Use. Four health outcomes were included: sleep disturbance, health related quality of life (HRQoL), headaches and cognitive performance, assessed through six tests on domains of attention, memory and processing speed, using the iPad-based software, CAmbridge Neuropsychological Test Automated Battery (CANTAB). Linear regression analysis adjusted for relevant confounders was conducted with categorized exposure variables low, medium and high use.
One third of the cohort (31.8%) are mobile phone users reporting average duration of calls per day up to 75 min (mean = 2.5 mins; SD = 8.9 mins). Amongst 46% of the cohort who report e-media device use, total screen time ranged from 1 min to 441 min (mean = 28.3; SD = 53.0). Findings Amongst those reporting regular night-time awakenings (≥1 times per week) from mobile phones, HRQol declined by 2.9 (95% CI: -6.1, 0.3), the sleep disturbance score increased by 2.0 (1.1, 2.9) units and headache impact score significantly increased by 5.4 (2.6; 8.2) units compared to non-exposed. Cognitive performance scores tended to be slightly improved mostly in moderate e-media users. The reaction response speed was consistently improved amongst all four exposure groups compared to non-users.
These results are among the first from Africa on benefits and risks associated with e-media use. Our findings imply that with regard to the education of adolescents, a vigilant balance is needed to profit from the beneficial effects of moderate e-media use on cognition, while preventing the negative side effects for HRQoL, sleep disturbance and headache severity.
在低收入和中等收入国家，电子媒体的使用正在增加，因此我们旨在调查农村南非不同方面的电子媒体使用情况及其与症状和神经认知结果的关联。
在“南非儿童健康农业农药研究（CapSA）”的队列研究中，我们对 1001 名 9-16 岁的儿童和青少年进行了基线调查，询问了以下电子媒体使用方面的情况：（1）通话时长；（2）总屏幕时间；（3）手机夜间唤醒次数；（4）手机使用问题。我们纳入了四个健康结果：睡眠障碍、健康相关生活质量（HRQoL）、头痛和认知表现，通过使用 iPad 上的软件 CAmbridge 神经心理学测试自动化电池（CANTAB）对注意力、记忆和处理速度等六个测试领域进行评估。使用线性回归分析对低、中、高暴露组进行了调整。
三分之一的队列（31.8%）是手机用户，每天的通话时间平均可达 75 分钟（平均值=2.5 分钟；标准差=8.9 分钟）。在报告使用电子媒体设备的 46%的队列中，总屏幕时间从 1 分钟到 441 分钟不等（平均值=28.3；标准差=53.0）。结果显示，经常（每周至少一次）从手机夜间醒来的人群中，HRQol 下降了 2.9（95%CI：-6.1，0.3），睡眠障碍评分增加了 2.0（1.1，2.9）单位，头痛影响评分显著增加了 5.4（2.6；8.2）单位，与非暴露人群相比。认知表现分数大多在中度电子媒体使用者中略有提高。与非使用者相比，所有四个暴露组的反应速度都有所提高。
这些结果是非洲关于电子媒体使用相关益处和风险的首批研究结果之一。我们的研究结果表明，在对青少年进行教育时，需要谨慎地平衡电子媒体适度使用对认知的有益影响，同时防止对 HRQoL、睡眠障碍和头痛严重程度的负面影响。
