Physical fitness associated with reduced risk for allergic conjunctivitis in children
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Children who are more physically fit than their peers experience reduced risk for allergic conjunctivitis, according to a study presented at American Academy of Ophthalmology 2022.
But poor air quality may mitigate some of the advantages of going outside to play, Tsai-Chu Yeh, MD, of Taipei Veterans General Hospital and National Yang Chiao Tung University in Taipei City, Taiwan, and colleagues wrote in the study.
“The rising prevalence of allergic diseases, particularly in the pediatric population, is a serious global public health concern,” Yeh said in a press release.
“Although symptoms in allergic conjunctivitis are often considered minor, it tends to have a chronic course with multiple recurrent episodes and can negatively affect school performance and quality of life in children,” Yeh continued.
According to the presented poster, the study involved 1,271,730 children in Taiwan who were examined at age 10 years between Jan. 1, 2010, and Dec. 31, 2018, and followed for at least 1 year. The researchers tracked occurrences of allergic conjunctivitis among these children through national registers.
Using results from the national Physical Fitness Test, the researchers also objectively measured the children’s aerobic capacity, muscular strength, cardiorespiratory endurance and flexibility.
Six-year cumulative incidences of allergic conjunctivitis included 0.64% for students in the first quartile on musculoskeletal power — indicating the best power — 0.73% for students in the second quartile, 0.78% for those in the third quartile and 0.88% for the fourth quartile (P < .001), according to the poster.
In a multivariate analysis that adjusted for age, BMI, comorbidities, socioeconomics and environmental factors, greater musculoskeletal power was associated with reduced risk (adjusted HR per 1 incremental meter of standing broad jump = 0.69; 95% CI, 0.61-0.78), with similar associations seen for increases in aerobic capacity (adjusted HR per quartile = 0.89; 95% CI, 0.85-0.93) and cardiorespiratory endurance (aHR per quartile = 0.92; 95% CI, 0.91-0.94), according to the study’s abstract.
These associations were consistent across all BMI groups as well, the researchers continued.
Further, the researchers noted in their poster that increased risks for allergic conjunctivitis and associations with female sex (aHR = 1.05; 95% CI, 1-1.11) and poorer air quality index (aHR = 1.06; 95% CI, 1.06-1.07) in a modified Cox regression analysis.
Additional risk factors for allergic conjunctivitis included urbanization, history of asthma, history of allergic rhinitis and previous use of antibiotics (P < .001 for all). The researchers indicated that children who were overweight and children with increased exposure to air pollution had an increased risk as well.
These results support previous studies suggesting a relationship between allergic conjunctivitis and air pollution as well as a relationship between allergic conjunctivitis and urbanization, the researchers continued.
Additionally, the researchers wrote, these relationships between allergic conjunctivitis, physical fitness and environmental factors are of great significance to public health and should be noted by people who make decisions about policy.
Reference:
- Yeh TC, et al. The association between physical fitness and risk of allergic conjunctivitis in children and youth: A nationwide cohort study. Presented at: American Academy of Ophthalmology 2022; Sept. 30-Oct. 3, 2022; Chicago.
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Debora Lee Chen, OD, MPH, FAAO
These findings could be significant, but it seems that there are a number of confounders that may need to be addressed before we can draw a solid association between physical activity and allergic conjunctivitis.
The authors also raise a good point about allergic conjunctivitis being considered minor, but perhaps it needs more attention from providers given its growing prevalence, chronicity and impact on daily function. I don’t think it is as simple as making a blanket recommendation for more physical activity, but perhaps we can be asking more questions about environment, activity and other potential factors.
Additional research is needed to clarify what about increased physical activity could be associated with allergic conjunctivitis. Is it because kids who live in less air-polluted areas (and are perhaps less exposed to allergens contributing to allergic conjunctivitis) can be outdoors more? Do kids who are more physically active tend to be less atopic or have other risk factors for developing allergic conjunctivitis? Some follow-up studies would be helpful in flushing this out.
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