Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong SAR, China.
The Nethersole School of Nursing, The Chinese University of Hong Kong, Hong Kong SAR, China.
JAMA Netw Open. 2023 May 1;6(5):e2313006. doi: 10.1001/jamanetworkopen.2023.13006.
Secondhand smoke (SHS) exposure potentially threatens ocular health; however, its association with myopia is unknown.
To examine the association between SHS exposure and childhood myopia.
DESIGN, SETTING, AND PARTICIPANTS: Cross-sectional data from the population-based Hong Kong Children Eye Study were used. Data were collected from March 5, 2015, to September 12, 2021, at The Chinese University of Hong Kong Eye Center. Participants included children aged 6 to 8 years. Secondhand smoke exposure was evaluated using a validated questionnaire. All participants underwent comprehensive ophthalmic and physical examinations.
Secondhand smoke exposure.
Generalized estimating equations were constructed to examine the association of SHS exposure with spherical equivalent and axial length; logistic regression models, with myopia rate; and linear regression models, with myopia onset.
A total of 12 630 children (mean [SD] age, 7.37 [0.88] years; 53.2% boys) were included in the analysis. Among the participants, 4092 (32.4%) had SHS exposure. After adjusting for age, sex, parental myopia, body mass index, near-work time, outdoor time, and family income, SHS exposure was associated with greater myopic refraction (β = -0.09 [95% CI, -0.14 to -0.03]) and longer axial length (β = 0.05 [95% CI, 0.02-0.08]). Children with SHS exposure were more likely to develop moderate (odds ratio [OR], 1.30 [95% CI, 1.06-1.59]) and high myopia (OR, 2.64 [95% CI, 1.48-4.69]). The association of SHS exposure with spherical equivalence and axial length was magnified in younger children. For each younger year of a child's exposure to SHS, SHS exposure was associated with a 0.07-D decrease in spherical equivalence (β = 0.07 [95% CI, 0.01-0.13]) and a 0.05-mm increase in axial length (β = -0.05 [95% CI, -0.08 to -0.01]). Exposure to SHS was associated with an earlier mean (SD) age at onset of myopia (72.8 [0.9] vs 74.6 [0.6] months; P = .01). Every increase in SHS exposure in units of 10 cigarettes per day was associated with greater myopic refraction (β = -0.07 [95% CI, -0.11 to -0.02]), axial length (β = 0.04 [95% CI, 0.01-0.06]), and likelihood of developing moderate (OR, 1.23 [95% CI, 1.05-1.44]) and high myopia (OR, 1.75 [95% CI, 1.20-2.56]), and earlier myopia onset (β = -1.30 [95% CI, -2.32 to -0.27]).
The findings of this cross-sectional study suggest that SHS exposure was associated with greater myopic refraction, longer axial length, greater likelihood of developing moderate and high myopia, and earlier myopia onset. The larger the quantity of SHS exposure and the younger the child, the more advanced myopia development and progression with which SHS exposure is associated.
二手烟（SHS）暴露可能会威胁到眼部健康；然而，其与近视的关系尚不清楚。
研究 SHS 暴露与儿童近视之间的关系。
设计、地点和参与者：使用基于人群的香港儿童眼科研究的横断面数据。数据收集于 2015 年 3 月 5 日至 2021 年 9 月 12 日，在香港中文大学眼科中心进行。参与者包括 6 至 8 岁的儿童。使用经过验证的问卷评估二手烟暴露情况。所有参与者都接受了全面的眼科和身体检查。
二手烟暴露。
使用广义估计方程来检查 SHS 暴露与球镜等效和眼轴长度的关系；使用逻辑回归模型来检查近视率；使用线性回归模型来检查近视发病时间。
共纳入 12630 名儿童（平均[标准差]年龄为 7.37[0.88]岁；53.2%为男孩）进行分析。参与者中，有 4092 人（32.4%）有 SHS 暴露。在校正年龄、性别、父母近视、体重指数、近距工作时间、户外活动时间和家庭收入后，SHS 暴露与更高度近视（β=-0.09[95%CI，-0.14 至-0.03]）和更长的眼轴长度（β=0.05[95%CI，0.02-0.08]）相关。有 SHS 暴露的儿童更有可能发展为中度（比值比[OR]，1.30[95%CI，1.06-1.59]）和高度近视（OR，2.64[95%CI，1.48-4.69]）。SHS 暴露与球镜等效和眼轴长度的关系在年龄较小的儿童中更为明显。对于儿童 SHS 暴露的每年轻一年，SHS 暴露与球镜等效减少 0.07D（β=0.07[95%CI，0.01-0.13]）和眼轴长度增加 0.05mm（β=-0.05[95%CI，-0.08 至-0.01]）相关。暴露于 SHS 与近视发病的平均（标准差）年龄较早有关（72.8[0.9] vs 74.6[0.6]个月；P=0.01）。SHS 暴露每增加 10 支/天，与更大的近视（β=-0.07[95%CI，-0.11 至-0.02]）、眼轴长度（β=0.04[95%CI，0.01-0.06]）和发展为中度（OR，1.23[95%CI，1.05-1.44]）和高度近视（OR，1.75[95%CI，1.20-2.56]）的可能性以及近视发病时间更早（β=-1.30[95%CI，-2.32 至-0.27]）相关。
这项横断面研究的结果表明，SHS 暴露与更大的近视、更长的眼轴长度、更高的中高度近视发展和发病以及更早的近视发病有关。SHS 暴露量越大，儿童年龄越小，与 SHS 暴露相关的近视发展和进展越严重。
