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Is there a link between passive smoke exposure and early-onset myopia in preschool Asian children?
Sharon Yu Lin Chua1, Mohammad Kamran Ikram2,3, Chuen Seng Tan1
1Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore.
Insights
Childhood exposure to passive smoke, particularly in the first six months, is linked to an increased risk of early-onset myopia in three-year-olds. This finding highlights potential long-term effects of environmental tobacco smoke on vision development.
Area of Science:
- Ophthalmology
- Pediatrics
- Environmental Health
Background:
- Myopia, or nearsightedness, is a growing global health concern.
- Early-onset myopia can have significant impacts on a child's visual development and quality of life.
- Understanding environmental risk factors for myopia is crucial for prevention strategies.
Purpose of the Study:
- To investigate the association between passive tobacco smoke exposure and early-onset myopia in three-year-old children.
- To determine if early-life exposure to secondhand smoke influences the development of myopia.
Main Methods:
- A prospective birth cohort study (GUSTO) in Singapore.
- Recruited 572 three-year-old children with cycloplegic autorefraction and axial length measurements.
- Assessed passive smoke exposure via parental questionnaires at 6 months, 1, and 2 years of age.
Main Results:
- Children exposed to passive smoke from birth to six months had a higher prevalence of myopia (adjusted OR = 2.79).
- Exposure to smoking at home or in the car significantly increased myopia odds (adjusted OR = 3.95).
- Passive smoke exposure did not systematically affect spherical equivalent or axial length in this age group.
Conclusions:
- Childhood passive smoke exposure before six months slightly increases the risk of early-onset myopia by age three.
- Suggests a potential delayed response to early smoke exposure on refractive development.
- Recommends larger studies with objective measures to confirm findings and explore effects in older children.
Purpose:
To investigate the association of passive tobacco smoke exposure with early-onset myopia among three-year-old children in Singapore.
Methods:
Pregnant mothers who attended their first trimester clinic at two major maternity units were recruited into the GUSTO birth cohort. The current analysis comprised 572 three-year-old children, who underwent cycloplegic autorefraction and axial length (AL) measurements. Myopia was defined as spherical equivalent (SE) of ≤-0.50 dioptres (D). Either parent completed questionnaires describing their child's exposure to passive smoke at six months, one and two years of age.
Results:
There were 197 children (36.2%) who were exposed to passive smoke from birth to before six months. Compared to non-exposed children, children exposed to any passive smoke from birth to before six months experienced greater myopia prevalence (adjusted OR = 2.79; 95% CI: 1.24-6.29; p = 0.01). The odds of myopia in a child was greater if a smoker smokes at home, in the family car, or in the presence of the child (adjusted OR = 3.95; 95% CI: 1.41-11.09; p < 0.01) compared to non-exposed child. In contrast to myopia, childhood exposure to passive smoke did not systematically shift mean values for SE or AL.
Conclusions:
In this prospective birth cohort study, we found that childhood exposure to passive smoke from birth to before six months slightly increased the risk of early-onset myopia. This may indicate a delayed response to passive smoke exposure before six months and the development of myopia at three years of age. Our study is limited by the small number of myopic children at this young age. Thus, larger prospective studies using more objective cotinine level measures are required to fully establish and understand the influence of tobacco smoke on refractive development in older children.
