Impact of congenital colour vision deficiency on education and unintentional injuries: findings from the 1958 British birth cohort
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《英国医生杂志》
1 Centre for Paediatric Epidemiology and Biostatistics, Institute of Child Health, London WC1N 1EH
Correspondence to: J S Rahi j.rahi@ich.ucl.ac.uk
Introduction
Increasing use of colour in education has raised concerns for children with CVD, but robust evidence is lacking.5 Our findings indicate that affected children do as well as their peers educationally, during school and subsequently. Although the use of colour has increased since the early schooling of the subjects of this study, only a minority with severely impaired colour vision would be potentially disadvantaged and any limitation would depend on the specific environment as well as the individual's abilities.
That unintentional injuries were no more common among those with CVD supports current standards for driving in the United Kingdom (in which CVD is not a preclusion) and also indicates that normal colour vision is not a prerequisite for safe working in many occupations or environments.
Most people with colour vision defects develop effective adaptive strategies and behaviours, and they use other clues, such as a colour's saturation, to deal with any potential limitations in their professional and personal lives.1 At a population level, congenital CVD confers no functional disadvantage in relation to educational attainment and unintentional injury. This challenges the rationale for and the value of population screening for these disorders.
What is already known on this topic
Congenital colour vision defects are common, non-progressive, and untreatable disorders, for which screening is done so that affected children can be informed about occupations which require normal colour vision
Little population based work exists on the broader functional impact of these disorders
What this study adds
At a population level, colour vision defects confer no functional disadvantages in relation to educational attainment or unintentional injury—challenging the rationale for and value of screening
This article was posted on bmj.com on 1 October 2004: http://bmj.com/cgi/doi/10.1136/bmj.38176.685208.F7
JR has a joint appointment within the Division of Epidemiology, Institute of Ophthalmology, London EC1V 9EL. We thank the Centre for Longitudinal Studies (Institute of Education), National Birthday Trust Fund, National Children's Bureau, City University Social Statistics Research Unit, and the Data Archive distributor, SN:3138, Colchester, for archived data. We thank Angie Wade for comments on a previous draft.
Contributors: JSR designed the study; PC did the analysis; and PC, JSR, and CSP interpreted the findings and wrote the paper. JSR is guarantor.
Funding: Project grant from the BUPA Foundation.
Competing interests: None declared.
Ethical approval: Institute of Child Health's Research Ethics Committee.
References
Health and Safety Executive. Colour vision. London: HMSO, 1987: 1-8. (Medical series guidance notes MS7).
Holroyd E, Hall DMB. A re-appraisal of screening for colour vision impairments. Child Care Health Dev 1997;23: 391-8.
Essen J, Fogelman K, Ghodsian M. Long-term changes in the school attainment of a national sample of children. Educ Res 1978;20: 300-5.
Jefferis BJMH, Power C, Hertzman C. Birth weight, childhood socio-economic environment, and cognitive development in the 1958 British birth cohort study. BMJ 2002;325: 305-8.
Lampe LML, Doster ME, Beal BB. Summary of three year study of academic and school achievement between color-deficient and normal primary age pupils: phase 2. J Sch Health 1973;43: 309-11.(P Cumberland, senior rese)
Correspondence to: J S Rahi j.rahi@ich.ucl.ac.uk
Introduction
Increasing use of colour in education has raised concerns for children with CVD, but robust evidence is lacking.5 Our findings indicate that affected children do as well as their peers educationally, during school and subsequently. Although the use of colour has increased since the early schooling of the subjects of this study, only a minority with severely impaired colour vision would be potentially disadvantaged and any limitation would depend on the specific environment as well as the individual's abilities.
That unintentional injuries were no more common among those with CVD supports current standards for driving in the United Kingdom (in which CVD is not a preclusion) and also indicates that normal colour vision is not a prerequisite for safe working in many occupations or environments.
Most people with colour vision defects develop effective adaptive strategies and behaviours, and they use other clues, such as a colour's saturation, to deal with any potential limitations in their professional and personal lives.1 At a population level, congenital CVD confers no functional disadvantage in relation to educational attainment and unintentional injury. This challenges the rationale for and the value of population screening for these disorders.
What is already known on this topic
Congenital colour vision defects are common, non-progressive, and untreatable disorders, for which screening is done so that affected children can be informed about occupations which require normal colour vision
Little population based work exists on the broader functional impact of these disorders
What this study adds
At a population level, colour vision defects confer no functional disadvantages in relation to educational attainment or unintentional injury—challenging the rationale for and value of screening
This article was posted on bmj.com on 1 October 2004: http://bmj.com/cgi/doi/10.1136/bmj.38176.685208.F7
JR has a joint appointment within the Division of Epidemiology, Institute of Ophthalmology, London EC1V 9EL. We thank the Centre for Longitudinal Studies (Institute of Education), National Birthday Trust Fund, National Children's Bureau, City University Social Statistics Research Unit, and the Data Archive distributor, SN:3138, Colchester, for archived data. We thank Angie Wade for comments on a previous draft.
Contributors: JSR designed the study; PC did the analysis; and PC, JSR, and CSP interpreted the findings and wrote the paper. JSR is guarantor.
Funding: Project grant from the BUPA Foundation.
Competing interests: None declared.
Ethical approval: Institute of Child Health's Research Ethics Committee.
References
Health and Safety Executive. Colour vision. London: HMSO, 1987: 1-8. (Medical series guidance notes MS7).
Holroyd E, Hall DMB. A re-appraisal of screening for colour vision impairments. Child Care Health Dev 1997;23: 391-8.
Essen J, Fogelman K, Ghodsian M. Long-term changes in the school attainment of a national sample of children. Educ Res 1978;20: 300-5.
Jefferis BJMH, Power C, Hertzman C. Birth weight, childhood socio-economic environment, and cognitive development in the 1958 British birth cohort study. BMJ 2002;325: 305-8.
Lampe LML, Doster ME, Beal BB. Summary of three year study of academic and school achievement between color-deficient and normal primary age pupils: phase 2. J Sch Health 1973;43: 309-11.(P Cumberland, senior rese)