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ORIGINAL RESEARCH article

Front. Med.
Sec. Ophthalmology
Volume 11 - 2024 | doi: 10.3389/fmed.2024.1469422
This article is part of the Research Topic Differences Between Emmetropic and Myopic Eyes: Implications for Myopia Development, its Progression, and Ocular Health View all 5 articles

Association of outdoor artificial light at night with myopia among Chinese adolescents: a representative cross-sectional study

Provisionally accepted
Ting Liu Ting Liu 1Weixing Tan Weixing Tan 2Youjuan Fu Youjuan Fu 3Beijing Cheng Beijing Cheng 4Hua Tian Hua Tian 2Liu Can Liu Can 1Zhixiang Wang Zhixiang Wang 3Yanting Zhang Yanting Zhang 2Suzhen Guan Suzhen Guan 1Zhihong Liu Zhihong Liu 1*
  • 1 School of Public Health, Ningxia Medical University, Yinchuan, China
  • 2 School Health Section, Ningxia Center for Disease Control and Prevention, Yinchuan, China
  • 3 School of inspection, Ningxia Medical University, Yinchuan, China
  • 4 School of Public Health, Southeast University, Nanjing, Chile

The final, formatted version of the article will be published soon.

    The association between the rapid increase in myopia among adolescents and the amount of outdoor artificial light at night (ALAN) remains unclear. The aim of this study was to investigate the association between outdoor ALAN and myopia in adolescents.Methods: Stratified cluster random sampling was used to obtain a sample of 33,160 students (age range: 9-18 years; mean: 13.51 years) with complete data from 120 primary and secondary schools across the Ningxia region in China in 2021. Myopia was defined as a spherical equivalent (SE) ≤ -0.5 diopters (D) in at least one eye, determined by automated refractometers without cycloplegia. Outdoor ALAN data were obtained from satellite data and the two-year average outdoor ALAN exposure for each participant was determined by matching it to their school address (home addresses were not available). The association between ALAN and myopia was assessed using multiple logistic regression models and restricted cubic spline (RCS) regression.Stratified analyses were performed by age, sex, residence, school level, and outdoor exercise time.The myopia group had higher outdoor ALAN levels than the non-myopia group [median (interquartile spacing): 14.44 (3.88-26.56) vs. 6.95 (1.21-21.74) nanoWatts/cm²/sr]. After adjusting for covariates identified through stepwise regression, it was observed that the prevalence of myopia increased by 4% for every 10-unit change (95% confidence interval (CI): 1.02-1.07). Compared to the first quantile (Q1) of outdoor ALAN exposure, the odds ratio (OR) of myopia was 1.20 (95% CI: 1.08-1.34) in the fourth quantile. RCS further showed a positive nonlinear relationship between outdoor ALAN exposure and myopia (P for nonlinear < 0.001). Stronger effects were not found in subgroup analyses.Outdoor ALAN exposure is positively and nonlinearly associated with the prevalence of myopia in adolescents. Controlling outdoor light pollution may constitute a potential strategy to reduce the incidence of myopia in adolescents.

    Keywords: ALAN, Artificial light at night, Myopia, representative cross-sectional study, Chinese adolescents

    Received: 01 Aug 2024; Accepted: 18 Sep 2024.

    Copyright: © 2024 Liu, Tan, Fu, Cheng, Tian, Can, Wang, Zhang, Guan and Liu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Zhihong Liu, School of Public Health, Ningxia Medical University, Yinchuan, China

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