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Journal of Peking University (Health Sciences) ›› 2025, Vol. 57 ›› Issue (3): 554-561. doi: 10.19723/j.issn.1671-167X.2025.03.020

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Epidemiological investigation of asthenopia and dry eye among visual display terminal workers

Longao YANG1, Xu JIN1, Wenchu HUANG1, Lihua HE1,*(), Juan CHEN2,3,*()   

  1. 1. Department of Occupational & Environmental Health Sciences, Peking University School of Public Health, Beijing 100191, China
    2. Department of Health Policy and Management, Peking University School of Public Health, Beijing 100191, China
    3. Peking University Medicine-Zhengda Guangming Joint Laboratory for Visual Health, Beijing 100191, China
  • Received:2025-02-19 Online:2025-06-18 Published:2025-06-13
  • Contact: Lihua HE, Juan CHEN
  • Supported by:
    the Peking University Medicine-Zhengda Guangming Joint Laboratory for Visual Health Funds

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Abstract:

Objective: To investigate the prevalence of asthenopia and dry eye, and to further explore the potential occupational hazard factors, so as to provide a theoretical basis for their prevention and control. Methods: A cross-sectional survey was conducted on the selected respondents. For visual display terminal (VDT) workers in employing organizations such as banks, colleges, and government departments, an online questionnaire independently developed by the research group was used for population surveys. Information including general information, work-related situations, work environment, visual health, and ergonomic factors was collected. The respondents were analyzed according to whether they suffered from asthenopia and dry eye. Relevant factors of asthenopia and dry eye were screened through t-test and Chi-square test. Subsequently, binary Logistic regression analysis was carried out to determine the risk factors of asthenopia and dry eye among the VDT workers. Results: The overall prevalence of asthenopia was 52.5% (235/448) and dry eye was 36.8% (165/448). There were no significant diffe-rences in the prevalence of asthenopia and dry eye among different genders, age groups, and groups of length of service in VDT work. However, the highest prevalence of dry eye was observed in underweight individuals (42.9%), followed by normal weight (40.6%), overweight (28.0%), and obese indivi-duals (17.4%). There was a significant difference in the prevalence of dry eye among different body mass index (BMI) groups (χ2=9.505, P=0.023). The lowest prevalence of asthenopia was observed among securities industry employees (22.6%), while higher rates were found in employees in companies (59.5%) and other employing organizations (68.8%). A significant difference in the prevalence of asthenopia among different employing organizations (χ2=14.832, P=0.022). The result of Logistic regression showed that a longer length of service in VDT work (OR=1.006, P < 0.001), a longer duration of VDT after working hours (OR=1.002, P=0.032), a too-bright monitor (OR=2.875, P=0.022), glare during work (OR=1.500, P=0.038), a louder noise in work environment (OR=1.586, P=0.012), work-related musculoskeletal disorders (WMSDs) (OR=4.366, P < 0.001) and other factors were independent risk factors of asthenopia, while wearing frame glasses (OR=0.452, P=0.037) was an independent protective factor. Glare during work (OR=2.198, P < 0.001), WMSDs (OR=2.226, P=0.001) and other factors were independent risk factors of dry eye, while overweight (OR=0.448, P=0.006), obesity (OR=0.228, P=0.032) were independent protective factors of dry eye. Conclusion: The prevalence of asthenopia and dry eye among VDT workers is relatively high, and it is associated with multiple risk factors. During prevention and control, attention should be paid to taking reasonable breaks during work, controlling glare, and strengthening visual health training and promotion.

Key words: Visual display terminal, Asthenopia, Dry eye syndromes, Risk factor

CLC Number: 

  • R181.3

Table 1

General information of the respondents (n=448)"

Variables n Proportion/%
Gender
  Male 217 48.4
  Female 231 51.6
Age group/years
   < 20 6 1.3
  20- 210 46.9
  30- 113 25.2
  40- 78 17.4
  ≥50 41 9.2
Career
  Securities 31 6.9
  Bank 14 3.1
  Hospital 115 25.7
  College/Research institution 101 22.5
  Public/Government institution 87 19.4
  Company 84 18.8
  Other 16 3.6
BMI
  Underweight 42 9.4
  Normal weight 283 63.2
  Overweight 100 22.3
  Obesity 23 5.1
Education
  High school and below 17 3.8
  Junior college 58 13.0
  College 286 63.8
  Postgraduate and above 87 19.4
Monthly income/yuan
  ≤5 000 118 26.3
  5 001-7 000 98 21.9
  7 001-8 000 50 11.2
  8 001-10 000 52 11.6
  >10 000 130 29.0

Table 2

The prevalence of asthenopia and dry eye under different demographic characteristics"

Demographic factors Total Asthenopia, n (%) Dry eye, n (%)
Gender
  Male 217 104 (47.9) 84 (38.7)
  Female 231 131 (56.7) 81 (35.1)
  χ2 3.461 0.639
  P value 0.063 0.424
Age group/years
   < 20 6 5 (83.3) 3 (50.0)
  20- 210 104 (49.5) 87 (41.4)
  30- 113 57 (50.4) 34 (30.1)
  40- 78 45 (57.7) 26 (33.3)
  ≥50 41 24 (58.5) 15 (36.6)
  χ2 4.667 4.974
  P value 0.323 0.290
BMI
  Underweight 42 20 (47.6) 18 (42.9)
  Normal weight 283 150 (53.0) 115 (40.6)
  Overweight 100 54 (54.0) 28 (28.0)
  Obesity 23 11 (47.8) 4 (17.4)
  χ2 0.721 9.505
  P value 0.868 0.023*
Types of employing organizations
  Securities 31 7 (22.6) 6 (19.4)
  Bank 14 7 (50.0) 7 (50.0)
  Hospital 115 59 (51.3) 42 (36.5)
  College/Research institution 101 53 (52.5) 45 (44.6)
  Public/Government institution 87 48 (55.2) 30 (34.5)
  Company 84 50 (59.5) 30 (35.7)
  Other 16 11 (68.8) 5 (31.3)
  χ2 14.832 8.173
  P value 0.022* 0.226
Length of service in VDT work/years
   < 5 234 116 (49.6) 73 (31.2)
  5- 69 33 (47.8) 18 (26.1)
  10- 101 60 (59.4) 29 (28.7)
  ≥20 44 26 (59.1) 17 (38.6)
  χ2 4.106 2.209
  P value 0.250 0.530

Table 3

Risk factors of asthenopia"

Variables B SE Wald χ2 P value OR (95%CI)
Types of employing organizations
  Securities Reference
  Bank 2.621 0.941 7.758 0.005 13.751 (2.174-86.964)
  Hospital 1.457 0.603 5.844 0.016 4.291 (1.317-13.980)
  College/Research institution 1.211 0.608 3.972 0.046 3.356 (1.020-11.042)
  Public/Government institution 1.899 0.635 8.947 0.003 6.682 (1.925-23.197)
  Company 2.318 0.644 12.941 < 0.001 10.158 (2.873-35.923)
  Other 2.648 0.878 9.100 0.003 14.119 (2.528-78.860)
Length of service in VDT work (by month) 0.006 0.001 13.617 < 0.001 1.006 (1.003-1.008)
Duration of VDT after working hours (by minute) 0.002 0.001 4.605 0.032 1.002 (1.000-1.004)
Monitor brightness
  Suitable Reference
  Too bright 1.056 0.461 5.250 0.022 2.875 (1.165-7.094)
Frequent head-down postures (over 4 times per minute) 0.386 0.111 12.175 < 0.001 1.471 (1.184-1.828)
Completion of conflicting tasks 0.297 0.125 5.657 0.017 1.346 (1.054-1.721)
Utilizing special talents -0.256 0.129 3.962 0.047 0.774 (0.602-0.996)
Glare 0.406 0.195 4.307 0.038 1.500 (1.023-2.200)
Noise 0.461 0.184 6.287 0.012 1.586 (1.106-2.275)
Myopia 1.413 0.388 13.268 < 0.001 4.107 (1.920-8.783)
Astigmatism 0.686 0.291 5.547 0.019 1.986 (1.122-3.517)
Glasses
  No glasses Reference
  Frame glasses -0.794 0.380 4.364 0.037 0.452 (0.215-0.952)
Eye drops using 1.566 0.339 21.322 < 0.001 4.787 (2.463-9.306)
WMSDs 1.474 0.248 35.360 < 0.001 4.366 (2.686-7.098)

Table 4

Risk factors of dry eye"

Variables B SE Wald χ2 P value OR (95%CI)
BMI
  Normal weight Reference
  Overweight -0.804 0.291 7.615 0.006 0.448 (0.253-0.792)
  Obesity -1.479 0.688 4.616 0.032 0.228 (0.059-0.878)
Smoking
  No smoking Reference
  Quitting smoking 1.314 0.428 9.419 0.002 3.722 (1.608-8.614)
Monthly income -0.151 0.076 3.996 0.046 0.860 (0.741-0.997)
Duration of computer during working hours (by minute) -0.005 0.001 16.662 < 0.001 0.995 (0.993-0.998)
Work shifts
  Day shifts Reference
  Swing shifts 1.852 0.686 7.293 0.007 6.370 (1.662-24.421)
Frequent head-turning postures (over 4 times per minute) 0.318 0.114 7.804 0.005 1.374 (1.100-1.718)
Glare 0.787 0.178 19.553 < 0.001 2.198 (1.550-3.115)
Eye drops using 0.645 0.295 4.765 0.029 1.905 (1.068-3.399)
WMSDs 0.800 0.237 11.417 0.001 2.226 (1.400-3.542)
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