陕西省中小学校教室环境与学生筛查性近视的关联

李敏敏; 赵静珺; 王妍昕; 米白冰; 贺文香; 史伟

doi:10.16835/j.cnki.1000-9817.2024298

陕西省中小学校教室环境与学生筛查性近视的关联

doi: 10.16835/j.cnki.1000-9817.2024298

李敏敏¹,
赵静珺¹,
王妍昕¹,
米白冰^{2, 3, ,},
贺文香⁴,
史伟^1, ,

1.
陕西省疾病预防控制中心学校卫生所，西安 710054
2.
西安交通大学医学部公共卫生学院
3.
陕西省疾病防控与健康促进研究重点实验室
4.
西安市儿童医院中西医结合科

基金项目:

国家自然科学基金项目 82103944

陕西省卫生健康委科研基金项目 2022E014

详细信息

作者简介:
李敏敏(1992-)，女，陕西渭南人，硕士，主管医师，主要从事儿童青少年生长发育影响因素与干预、学生常见病监测等工作

通讯作者:
米白冰，E-mail: xjtu.mi@xjtu.edu.cn

史伟，E-mail: shi.w@163.com

利益冲突声明 所有作者声明无利益冲突。
中图分类号: G478 R179 R778.1⁺¹ B845.6
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- 被引次数: 0
出版历程
- 收稿日期: 2024-07-22
- 修回日期: 2024-08-20
- 网络出版日期: 2024-11-02
- 刊出日期: 2024-10-25

Relationship between classroom environment in primary and secondary schools and screening myopia in Shaanxi Province

LI Minmin¹,
ZHAO Jingjun¹,
WANG Yanxin¹,
MI Baibing^{2, 3
, ,},
HE Wenxiang⁴,
SHI Wei^{1
, ,}

1.
Department of School Health, Shaanxi Provincial Center for Disease Control and Prevention, Xi'an (710054), Shaanxi Province, China

摘要

摘要: 目的了解陕西省中小学教室环境与学生近视的关联，为制定有效的儿童青少年近视防控发展策略提供参考。方法 2022年11月至2023年3月，采用分层整群随机抽样方法从陕西省10个地市所有区县抽取中小学校，以整班为单位对386间教室进行环境卫生学检测，对3 760名学生采用对数视力表和非散瞳电脑验光进行视力检查，同时进行问卷调查。采用Logistic回归模型分析中小学校教室环境与学生筛查性近视的关联。结果有2 299名中小学生筛查出近视，检出率为61.14%。调整性别、学段、睡眠时间、户外活动时间、电子移动设备使用时间和放学后作业时间等因素后，多因素Logistic回归分析结果显示，黑板面平均照度、黑板面照度均匀度不合格教室中小学生发生筛查性近视的风险分别是合格教室的1.24(OR=1.24，95%CI=1.08~1.43)和1.31倍(OR=1.31，95%CI=1.06~1.60)(P值均 < 0.05)。亚组分析结果显示，黑板面平均照度不合格教室男生检出筛查性近视的风险是合格教室的1.26倍(OR=1.26，95%CI=1.04~1.54)，黑板尺寸不合格教室女生检出筛查性近视风险是合格教室的1.55倍(OR=1.55，95%CI=1.19~2.02)，黑板面照度均匀度不合格教室女生筛查性近视的检出风险是合格教室的1.38倍(OR=1.38，95%CI=1.01~1.89)(P值均 < 0.05)。结论陕西省中小学教室环境卫生合格率有待提高，黑板尺寸、黑板面平均照度和照度均匀度不合格与学生筛查性近视发生风险的增加有关。
- 环境 /
- 近视 /
- 回归分析 /
- 学生
Abstract: Objective To understand the correlation between classroom environment in primary and secondary schools in Shaanxi Province with students' myopia, so as to provide the reference for the development of effective strategies for myopia prevention and control in children and adolescents. Methods From November 2022 to March 2023, primary and secondary schools were selected from all districts and counties in 10 cities in Shaanxi Province by a stratified cluster random sampling method. A total of 386 classrooms received environmental hygiene evaluation, and 3 760 students underwent visual examinations using logarithmic visual acuity chart and non dilated computer optometry, as well as questionnaire surveys. The association between classroom environment in primary and secondary schools and screening myopia in students were analyzed by the Logistic regression model. Results A total of 2 299 primary and secondary school students were screened for myopia, with a detection rate of 61.14%. After adjusting factors such as gender, academic stage, sleep time, outdoor activity time, electronic mobile device usage time and homework time after school, the results of multiple Logistic regression analysis showed that the risk of screening myopia among students with unqualified average illuminance on blackboard and uniformity ratio of illuminance of blackboard was 1.24 times (OR=1.24, 95%CI=1.08-1.43) and 1.31 times (OR=1.31, 95%CI=1.06-1.60) higher than that of qualified classrooms respectively (P < 0.05). Subgroup analysis showed that the risk of screening myopia detected by boys in classrooms with unqualified blackboard illumination was 1.26 times (OR=1.26, 95%CI=1.04-1.54) than that of qualified classrooms, the risk of screening myopia detected by girls in classrooms with unqualified blackboard size was 1.55 times (OR=1.55, 95%CI=1.19-2.02) and unqualified blackboard illumination uniformity was 1.38 times (OR=1.38, 95%CI=1.01-1.89) higher than that of qualified classrooms (P < 0.05). Conclusions Teaching environment health of primary and secondary schools in Shaanxi Province need to be improved. The risk increasing of screening myopia among students is related to the size of the blackboard, average illuminance on the blackboard surface and uneven illuminance.
- Environment /
- Myopia /
- Regression analysis /
- Students
注释:

1) 利益冲突声明 所有作者声明无利益冲突。

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表 1 不同组别中小学生筛查性近视检出率比较

Table 1. Comparison of screening myopia detection rates among primary and secondary school students in different groups

组别	选项	人数	近视检出人数	χ²值	P值
性别	男	1 933	1 093(56.54)	35.42	< 0.01
	女	1 827	1 206(66.01)
学段	小学	1 825	810(44.38)	462.10	< 0.01
	初中	798	545(68.30)
	高中	1 137	944(83.03)
睡眠时间/(h·d^-1)^*	< 8	1 697	1 014(59.75)	4.04	0.04
	≥8	1 946	1 226(63.00)
户外活动时间/(h·d^-1)^*	< 2	2 407	1 499(62.28)	5.40	0.02
	≥2	1 119	651(58.18)
电子移动设备使用时间/(h·d^-1)^*	< 1.5	956	547(57.22)	5.19	0.02
	≥1.5	1 253	781(62.33)
放学后作业时间/(h·d^-1)^*	< 2	2 363	1 457(61.66)	1.26	0.26
	≥2	1 310	783(59.77)
注： ()内数字为检出率/%；^*存在缺失值。

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表 2 陕西省中小学校教室环境与学生筛查性近视关联的Logistic回归分析(n=3 760)

Table 2. Logistic regression analysis of the association between classroom environment and student screening for myopia in primary and secondary schools in Shaanxi Province(n=3 760)

自变量	选项	人数	近视人数	近视检出率/%	OR值(95%CI)	校正OR值(95%CI)
教室人均面积	合格	1 526	940	61.60	1.00	1.00
	不合格	2 234	1 359	60.83	0.97(0.85~1.11)	0.87(0.71~1.05)
黑板尺寸	合格	3 162	1 868	59.08	1.00	1.00
	不合格	598	431	72.07	1.79(1.48~2.17)^**	0.78(0.59~1.03)
黑板面反射比	合格	1 215	739	60.82	1.00	1.00
	不合格	2 545	1 560	61.30	1.02(0.89~1.17)	1.18(0.96~1.45)
黑板面平均照度	合格	1 548	905	58.46	1.00	1.00
	不合格	2 212	1 394	63.02	1.21(1.06~1.38)^**	1.24(1.08~1.43)^**
黑板面照度均匀度	合格	2 805	1 663	59.29	1.00	1.00
	不合格	955	636	66.60	1.37(1.17~1.60)^**	1.31(1.06~1.60)^*
课桌面平均照度	合格	2 853	1 716	60.15	1.00	1.00
	不合格	907	583	64.28	1.19(1.02~1.39)^*	1.06(0.86~1.32)
课桌面照度均匀度	合格	2 383	1 440	60.43	1.00	1.00
	不合格	1 377	859	62.38	1.09(0.95~1.25)	1.01(0.83~1.22)
注： ^P < 0.05，^*P < 0.01。

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