Abstract
BACKGROUND: Ocular Surface Diseases (OSDs), such as dry eye disease and conjunctivitis, pose significant public health challenges globally, especially in China where they affect millions and lead to substantial economic costs. With the development of digital technology, online consultations have become increasingly popular, yet the association between environmental factors and the volume of online consultations for OSDs remains unclear. This study explores the impact of environmental factors, particularly air pollution, on the volume of online consultations for OSDs in China. METHODS: We used web crawler technology to obtain OSDs online consultation data from China's leading online medical platform "Good Doctor Online" from 2015-2019, and used correlation methods and fixed-effects regression models to analyze the impact of air pollution on the volume of online consultations for OSDs, and its potential regional variations and seasonal trends. RESULTS: The results reveal significant positive correlations between online consultations for OSDs and air pollutants, notably PM(10), and NO(2) (p < 0.05). Regression analyses demonstrate that Air Quality Index (AQI) and PM(10) significantly affect online consultation volumes, indicating that worsening air quality directly alters health-seeking behavior. Additionally, the impact of air pollution on online consultations shows regional variability: AQI, PM(2.5), and CO were notably impactful in the Fenwei Plain, SO(2) in the Jiangsu-Zhejiang-Shanghai region, and NO₂ in the Beijing-Tianjin-Hebei and Zhujiang Delta regions. Seasonal trends also showed peaks in consultation volumes corresponding with periods of high pollution, particularly during summer and winter. CONCLUSION: Our findings demonstrate that air pollution is positively associated with online consultations for OSDs, with AQI and PM(10) showing particularly robust effects. The impacts vary by region-different pollutants play a dominant role in different areas-and consultations tend to peak during highly polluted summer and winter seasons.