中小学校教学环境及与筛查性近视关联的多水平模型分析  

Teaching environmental health in primary and secondary schools in Shanghai and its association with screening myopia applying multilevel models

作　　者：曲爽笑 杨东玲[1] 黄生垒 齐文娟 黄雨婷 何鲜桂[2] 王菁菁 罗春燕[1] QU Shuangxiao;YANG Dongling;HUANG Shenglei;QI Wenjuan;HUANG Yuting;HE Xiangui;WANG Jingjing;LUO Chunyan(Division of Child and Adolescent Health,Shanghai Municipal Center for Disease Control and Prevention,Shanghai(200336),China;不详)

机构地区：[1]上海市疾病预防控制中心儿童青少年健康所,200336 [2]上海市眼病防治中心临床研究中心

出　　处：《中国学校卫生》2023年第8期1256-1260,共5页Chinese Journal of School Health

基　　金：上海市第五轮公共卫生体系建设三年行动计划项目(GWV-9.1);2022—2023年度上海市疾病预防控制青年骨干人才项目(22QNGG03)。

摘　　要：目的 了解中小学校教室教学环境卫生状况及其与近视的关联,为儿童青少年近视精准防控提供依据。方法 于2020年9—10月采用分层整群抽样法,在上海市16个区抽取中小学校以整班为单位进行调查,将教学环境检测教室与进行问卷调查学生所在的教室进行匹配,检测教室共470间,调查学生14 624名。由经过培训的专业技术人员采用激光测距仪、照度计等设备检测教学环境指标,并对学生进行视力检查和问卷调查。采用多水平模型分析教学环境与筛查性近视的关联。结果 2020年上海市中小学校教学环境各指标合格率分别为窗地比(93.0%)、教室人均面积(82.1%)、黑板照度均匀度(79.7%)、黑板尺寸(68.7%)、采光系数(67.0%)、黑板悬挂高度(66.9%)、课桌面平均照度(66.4%)、课桌面照度均匀度(63.6%)、黑板反射比(46.8%)、黑板平均照度(41.4%)、墙面反射比(33.2%)、课桌椅分配符合率(19.8%)。两水平Logistic模型分析结果显示,黑板面平均照度不合格与学生筛查性近视呈正相关(OR=1.24,95%CI=1.05~1.47,P<0.05)。结论 上海市中小学校教学环境现况不容乐观,教学环境尤其是课桌椅符合率有待改善,黑板面平均照度不合格与学生筛查性近视的发生呈正相关。学校近视防控工作应重点关注课桌椅分配符合情况,提高黑板面照度。Objective To understand the status of teaching environmental health in primary and secondary schools and explore its association with myopia,so as to provide a basis for precision myopia prevention and control.Methods From September to October 2020,a stratified cluster sampling method was used in 16 districts of Shanghai.After matching the teaching environment testing classrooms with the classrooms where the students were surveyed,totally 470 classrooms and 14624 students were monitored.Trained professional technicians used laser range finder,luxmeter to measure parameters about teaching environmental health.Students were subject vision testing and questionnaires.Multilevel models was used to analyze the association between teaching environment and screening myopia.Results The qualified rates of each indicators of teaching environmental health were as follows:window to floor area ratio(93.0%),classroom area per capita(82.1%),uniformity ratio of illuminance of blackboard(79.7%),blackboard size(68.7%),daylight factor(67.0%),blackboard hanging height(66.9%),average illuminance on desk(66.4%),uniformity ratio of illuminance of desk(63.6%),reflectance of blackboard(46.8%),average illuminance on blackboard(41.4%),reflectance of wall(33.2%),desk and chair allocation compliance rate(19.8%).The results of two-level Logistic model analysis showed that unqualified average illuminance on blackboard was positively associated with screening myopia(OR=1.24,95%CI=1.05-1.47,P<0.05).Conclusion Teaching environmental health of primary and secondary schools in Shanghai is not optimistic,teaching environment especially the desk and chair allocation compliance rate need to be improved.The average illumination on blackboard is positively correlated with screening myopia,suggesting that myopia prevention and control can focus on improving the illuminance on blackboard.

关 键 词：环境卫生 近视 合格鉴定 回归分析 学生 

分 类 号：G478[文化科学—教育学] R778.1+1[文化科学—教育技术学] R179[医药卫生—眼科]