Physical fitness associated with reduced risk of allergic conjunctivitis in children


November 07, 2022

2 minute read

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According to a study presented at the 2022 American Academy of Ophthalmology, children who are more physically fit than their peers have a reduced risk of allergic conjunctivitis.

But poor air quality can dampen some of the benefits of going outside to play, Tsai-Chu Yeh, MD, from Taipei Veterans General Hospital and National Yang Chiao Tung University in Taipei City, Taiwan, and colleagues wrote in the study.

Physically fit children are less at risk of allergic conjunctivitis, as long as their time outdoors does not increase their exposure to air pollution. Source: Adobe Stock

“The increasing prevalence of allergic diseases, especially in the pediatric population, is a serious global public health concern,” Yeh said in a press release.

“Although the symptoms of allergic conjunctivitis are often considered minor, they tend to have a chronic course with multiple recurring episodes and can negatively affect school performance and quality of life in children,” Yeh continued.

According to the poster presented, the study involved 1,271,730 children in Taiwan who were examined at the age of 10 between January 1, 2010 and December 31, 2018 and followed for at least 1 year. The researchers followed occurrences of allergic conjunctivitis among these children through national registers.

Using the results of the National Physical Fitness Test, the researchers also objectively measured the children’s aerobic capacity, muscle strength, cardiorespiratory endurance and flexibility.

The six-year cumulative incidences of allergic conjunctivitis included 0.64% for first quartile students on musculoskeletal power – indicating the best power – 0.73% for second quartile students, 0.78% for those of the third quartile and 0.88% for the fourth quartile. (P

In a multivariate analysis adjusted for age, BMI, comorbidities, socioeconomic and environmental factors, greater musculoskeletal power was associated with reduced risk (adjusted HR per additional meter of jumping in standing length = 0.69; 95% CI, 0.61-0.78), with similar associations seen for increases in aerobic capacity (quartile-adjusted HR = 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 abstract.

These associations were also consistent across all BMI groups, the researchers continued.

Additionally, the researchers noted in their poster that increased risks of allergic conjunctivitis and associations with female sex (aHR=1.05; 95% CI, 1-1.11) and an index of quality of lower air (aHR = 1.06; 95% CI, 1.06-1.07) in a modified Cox regression analysis.

Other risk factors for allergic conjunctivitis included urbanization, history of asthma, history of allergic rhinitis, and previous use of antibiotics (P

These findings 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.

Moreover, the researchers wrote, these relationships between allergic conjunctivitis, physical fitness and environmental factors are of great public health importance and should be noted by people making policy decisions.


  • Yeh TC, et al. The association between physical fitness and the risk of allergic conjunctivitis in children and youth: a nationwide cohort study. Presented to: American Academy of Ophthalmology 2022; Sept. 30-Oct. 3, 2022; Chicago.

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