Objective To investigate the relationship between classroom lighting and poor vision of students in primary and secondary schools in Tianjin, and to provide reference for targeted prevention measures for comprehensive school eye health programmes. Methods A total of 623 classrooms and 24 713 students in 89 primary and secondary schools in Tianjin were selected using stratified cluster sampling method in Sep.to Oct. of 2020. The illuminometer was used to monitor the lighting environment of the classroom, and the standard logarithmic vision light box was used to detect the naked eye vision of students. Chi-square test, variance analysis and binary Logistic regression were used in SPSS software. Results Rate of low vision among primary and secondary school students in Tianjin was 67.86%. The qualification rate of blackboard reflectance, blackboard average illumination, blackboard illumination uniformity, desk average illumination and desk illumination uniformity were 58.11%, 53.13%, 73.19%, 66.61% and 75.12%, respectively. Univariate analyses showed that the blackboard reflectance, blackboard average illumination, desk average illumination, and desk illumination uniformity were associated with low vision among students (χ 2 = 311.29, 62.54, 61.71, 6.59, P<0.05). Multivariable Logistic regression analysis showed that blackboard reflectance, average illumination of blackboard and desk were associated with higher risk of poor vision [ OR (95% CI) = 1.19 (1.11-1.27), 1.27 (1.17-1.37), 1.11 (1.02-1.20), P<0.05]. Conclusion Prevalence of low vision among primary and secondary school students in Tianjin is relatively high. Blackboard reflectance, average illumination of blackboard and desk are the important determinants for poor vision of primary and secondary school students. Creating effective classroom lighting scheme is crucial for vision health among students. 【摘要】 目的 了解天津市中小学校教室采光照明和学生视力不良的关系, 为有针对性地制定中小学生视力保护措施提 供参考依据。 方法 于 2020 年 9—10 月, 采用分层整群抽样的方法, 选取天津市 89 所中小学共 623 间教室、24 713 名学生 为研究对象。采用照度计监测教室采光照明环境, 标准对数视力灯箱检测学生裸眼视力。采用 SPSS 24.0 进行 χ 2 检验、方 差分析和二元 Logistic 回归分析。 结果 天津市中小学生视力不良检出率为 67.86%, 黑板反射比、黑板面平均照度、黑板 面照度均匀度、课桌面平均照度、课桌面照度均匀度合格率分别为 58.11%, 53.13%, 73.19%, 66.61%, 75.12%。单因素分析 显示, 黑板反射比、黑板面平均照度、课桌面平均照度、课桌面照度均匀度是否合格对中小学生视力不良影响差异均有统计 学意义 (χ 2 值分别为 311.29, 62.54, 61.71, 6.59, P 值均<0.05)。多因素 Logistic 回归分析显示, 黑板反射比、黑板面平均照 度、课桌面平均照度不合格与中小学生视力不良均呈正相关 [ OR 值 ( OR 值 95% CI) 分别为 1.19(1.11~1.27), 1.27(1.17~1.37), 1.11(1.02~1.20), P 值均<0.05]。 结论 天津市中小学生视力不良问题较严重, 黑板反射比、黑板面平均照度、课 桌面平均照度是中小学生发生视力不良的重要影响因素, 应营造良好的教室采光照明环境。