Objectives: To provide a description of refractive errors in healthy, term-born children, aged 1 through 48 months, and to test the hypotheses that spherical equivalent becomes significantly less hyperopic and less variable with increasing age. Methods: Following a prospective, cross-sectional design, cycloplegic retinoscopy was used to measure the refractive error in both eyes of 514 healthy, term-born children in 12 age groups. Three hundred were aged 12 months or younger. Spherical equivalent and cylindrical power and axis were analyzed as a function of age. Prediction limits for spherical equivalent were calculated. Results: Spherical equivalents of right and left eyes did not differ at any age. Hyperopia declined significantly with increasing age. The variability in spherical equivalent also decreased significantly with age. Cylindrical error of 1 diopter or more was found in 25% of the children; the proportion with astigmatism was highest in infancy and then waned. Myopia and anisometropia were rare, occurring in 3% and 1% of the sample, respectively. Conclusions: Significant declines in hyperopia and variability of spherical equivalent appear to be features of emmetropization. The normal prediction limits provide guidelines against which data from individual patients can be compared.
National biomonitoring program can offer solid scientific evidence on exposure profiles of environmental chemicals at a national level, and provide a snapshot of changing exposure level over time. Therefore, several countries have maintained such programs for developing environmental health policies. The Korean National Environmental Health Survey (KoNEHS) was designed to understand the level of human exposure to environmental chemicals by time and location, and to identify possible sources of such exposure. The 2nd stage of KoNEHS, which was conducted between 2012 and 2014, examined a total of 6478 adult subjects over 19 years of age, and measured 21 environmental chemicals of major policy concern. Compared to the findings from the first stage monitoring (2009-2011), slightly higher levels of blood lead were observed, while those of mercury remained similar. Blood metal concentrations, however, were higher than those reported from national biomonitoring programs of United States, Germany and Canada. The urinary concentrations of phthalates metabolites were lower, but those of t,t-muconic acid and BPA were higher than those reported in the first stage survey. The urinary cotinine level decreased perhaps reflecting general declining patterns of first- and second-hand smoking. The results of the second stage survey were made available for public use since April 2016. Some policy efforts appear to be at least in part effective on mitigating chemical exposure among people, e.g., urinary phthalate metabolites and cotinine, while further confirmations are warranted. In-depth assessments will be conducted to identify vulnerable groups and important exposure pathways.
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