Physical fitness associated with reduced risk for allergic conjunctivitis in children

07 November 2022

2 min read

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

But poor air quality can mitigate some of the benefits of playing outside, Tsai-Chu Yeh, Managing Director, from Taipei Veterans General Hospital and National Yang Chiao Tung University in Taipei City, Taiwan, and colleagues wrote in the study.

children playing football outside

Children who are more physically fit experience less 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, 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, 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 proposed poster, 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 tracked the prevalence of allergic conjunctivitis among these children through national registries.

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.

Six-year cumulative incidence of allergic conjunctivitis included 0.64% for students in the first quartile on musculoskeletal strength – indicating the best strength – 0.73% for students in the second quartile, 0.78% for those in the third quartile and 0.88% for the fourth quartile (P

In a multivariable analysis adjusted for age, BMI, comorbidities, socioeconomics, and environmental factors, greater musculoskeletal strength was associated with reduced risk (adjusted HR per 1 incremental meter 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 summary.

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

Furthermore, the researchers noted in their poster that increased risks for allergic conjunctivitis and associations with female gender (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 include urbanization, history of asthma, history of allergic rhinitis, and previous use of antibiotics (P

These results support previous studies suggesting a link between allergic conjunctivitis and air pollution, as well as a link between allergic conjunctivitis and urbanization, the researchers continued.

In addition, 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 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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