Association between screening myopia and mixed exposure to air pollution among primary school children in four cities in China

A quantile g calculation model was employed to analyse the association between combined exposure to air pollutants and screening myopia.Results Within the overall sample, mixed exposure to air pollutants showed a positive trend with myopia risk, though the difference was not statistically significant.(β = 0.033, 95% CI: -0.004 to 0.072, P = 0.08). Stratified analysis revealed that among children with ≤1 hour of outdoor activity, combined pollutant exposure was significantly positively associated with myopia risk (β = 0.050, 95% CI: 0.002–0.099, P = 0.04); After stratification by city, mixed pollutant exposure was significantly associated with myopia risk among children in Nanchang and Shenyang (P < 0.05), whereas no significant association was observed in Hefei and Zhongshan.Conclusions Exposure to multiple air pollutants may increase the risk of myopia in school-aged children, with this risk influenced by time spent outdoors and geographical location.

It is recommended that outdoor activity management for children be strengthened in areas with higher air pollution levels, and that environmental factors be incorporated into comprehensive myopia prevention and control strategies.