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Ma CL, Yu B, Fan YZ, Ye TT, Cai CW, Yang B, Zeng HL, Jia P, Yang SJ. [Association between unhealthy lifestyles and diabetic dyslipidemia in occupational population and network analysis]. Zhonghua Liu Xing Bing Xue Za Zhi 2024; 45:425-431. [PMID: 38514320 DOI: 10.3760/cma.j.cn112338-20230715-00007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 03/23/2024]
Abstract
Objective: To understand the influence of unhealthy lifestyle on diabetic dyslipidemia and the key influencing factors in occupational population and provided scientific evidence for the prevention of diabetic dyslipidemia. Methods: Based on baseline data and follow-up data of Southwest Occupational Population Cohort from China Railway Chengdu Group Co., Ltd. during 2021. Diabetic dyslipidemia was defined as diabetes plus one or more forms of dyslipidemia, and unhealthy lifestyle factors included smoking, alcohol consumption, unhealthy dietary patterns, low physical activity, and abnormal BMI. Multivariate logistic regression model was used to analyze the relationship between unhealthy lifestyle scores and diabetic dyslipidemia, network analysis was used to find and explore the key lifestyles influencing glycolipid metabolism. Results: A total of 25 631 subjects were included. People with unhealthy lifestyle score 2 and 3 were 1.93 (95%CI: 1.31-2.86) times and 2.37 (95%CI: 1.60-3.50) times more likely to have diabetes with ≥1 forms of dyslipidemia than those with scores of 0; People with unhealthy lifestyle score 1, 2 and 3 were 1.98 (95%CI: 1.08-3.61) times, 2.87 (95%CI: 1.60-5.14) times and 3.95 (95%CI: 2.22-7.06) times more likely to have diabetes with ≥2 forms of dyslipidemia than those with score 0. Network analysis found that abnormal BMI and HDL-C were the "bridge nodes" that link unhealthy lifestyles with diabetic dyslipidemia. Conclusion: The higher the score of unhealthy lifestyle, the higher the risk for diabetic dyslipidemia, abnormal BMI and HDL-C are key factors influencing the association between unhealthy lifestyle and diabetic dyslipidemia.
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Affiliation(s)
- C L Ma
- West China School of Public Health/The Fourth Hospital of West China, Sichuan University, Chengdu 610041, China
| | - B Yu
- West China School of Public Health/The Fourth Hospital of West China, Sichuan University, Chengdu 610041, China Institute for Disaster Management and Reconstruction, Sichuan University-the Hong Kong Polytechnic University, Chengdu 610207, China
| | - Y Z Fan
- West China School of Public Health/The Fourth Hospital of West China, Sichuan University, Chengdu 610041, China
| | - T T Ye
- West China School of Public Health/The Fourth Hospital of West China, Sichuan University, Chengdu 610041, China
| | - C W Cai
- West China School of Public Health/The Fourth Hospital of West China, Sichuan University, Chengdu 610041, China
| | - B Yang
- Affiliated Hospital of Chengdu University, Chengdu 610081, China
| | - H L Zeng
- Affiliated Hospital of Chengdu University, Chengdu 610081, China
| | - P Jia
- School of Resource and Environmental Sciences, Wuhan University, Wuhan 430072, China School of Public Health, Wuhan University, Wuhan 430071, China International Institute of Spatial Lifecourse Health, Wuhan University, Wuhan 430072, China
| | - S J Yang
- West China School of Public Health/The Fourth Hospital of West China, Sichuan University, Chengdu 610041, China Affiliated Hospital of Chengdu University, Chengdu 610081, China International Institute of Spatial Lifecourse Health, Wuhan University, Wuhan 430072, China
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Wang ZH, Hu YQ, Yang B, Fan YZ, Cai CW, Ye TT, Ma CL, Feng CT, Jia P, Yang SJ. [Association between unhealthy lifestyles and hyperuricemia in occupational population and modification effect of hypertension and dyslipidemia]. Zhonghua Liu Xing Bing Xue Za Zhi 2024; 45:432-439. [PMID: 38514321 DOI: 10.3760/cma.j.cn112338-20230715-00010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 03/23/2024]
Abstract
Objective: To understand the relationship between unhealthy lifestyle and hyperuricemia, as well as the modification effects of hypertension and dyslipidemia in occupational population and provide a theoretical basis for the prevention of hyperuricemia. Methods: A cross-sectional survey design was adopted, based on baseline data from the Southwest Occupational Population Cohort from China Railway Chengdu Group Co., Ltd., which included the population in 28 prefectures from Sichuan Province and Guizhou Province, and 33 districts (counties) from Chongqing Municipality between October and December 2021. This study collected the information about the demographics characteristics, lifestyles, and prevalence of chronic non-communicable diseases of the study subjects through questionnaire, physical measurement and laboratory biochemical test. The unhealthy lifestyle score was scored based on smoking, alcohol consumption, dietary patterns, physical activity, and low weight or overweight, with higher scores being associated with more unhealthy lifestyles. The multivariate logistic regression model was used to analyze the relationship between unhealthy lifestyle score, smoking, alcohol consumption, other factors and hyperuricemia, and the stratified analysis was used to explore the modification effect of hypertension and other diseases on the relationship between unhealthy lifestyle and hyperuricemia. Results: A total of 11 748 participants were included in this study, the prevalence of hyperuricemia was 34.4%. Multivariate logistic regression model showed that current/previous smoking, current/previous alcohol consumption and BMI abnormality were risk factors for hyperuricemia, and the unhealthy lifestyle score showed a "cumulative" effect on the risk for hyperuricemia, with higher score increasing the risk of hyperuricemia, and the OR increased from 1.64 (95%CI: 1.34-2.00) to 2.89 (95%CI: 2.39-3.50). Stratified analysis showed that unhealthy lifestyles had a greater impact on the risk for hyperuricemia in people with hypertension and dyslipidemia. Conclusions: The coexistence of multiple unhealthy lifestyles might increase the risk of hyperuricemia, and this effect was stronger in participants with hypertension and dyslipidemia. Timely correction of unhealthy lifestyles, and control of hypertension and dyslipidemia might reduce the risk for hyperuricemia.
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Affiliation(s)
- Z H Wang
- West China School of Public Health/The Fourth Hospital of West China, Sichuan University, Chengdu 610041, China
| | - Y Q Hu
- Social Insurance Management Department of China Railway Chengdu Bureau Group, Co., Ltd., Chengdu 610081, China
| | - B Yang
- Affiliated Hospital of Chengdu University, Chengdu 610081, China
| | - Y Z Fan
- West China School of Public Health/The Fourth Hospital of West China, Sichuan University, Chengdu 610041, China
| | - C W Cai
- West China School of Public Health/The Fourth Hospital of West China, Sichuan University, Chengdu 610041, China
| | - T T Ye
- West China School of Public Health/The Fourth Hospital of West China, Sichuan University, Chengdu 610041, China
| | - C L Ma
- West China School of Public Health/The Fourth Hospital of West China, Sichuan University, Chengdu 610041, China
| | - C T Feng
- West China School of Public Health/The Fourth Hospital of West China, Sichuan University, Chengdu 610041, China Institute for Disaster Management and Reconstruction, Sichuan University-the Hong Kong Polytechnic University, Chengdu 610207, China
| | - P Jia
- School of Resource and Environmental Sciences, Wuhan University, Wuhan 430072, China School of Public Health, Wuhan University, Wuhan 430071, China International Institute of Spatial Lifecourse Health, Wuhan University, Wuhan 430072, China
| | - S J Yang
- West China School of Public Health/The Fourth Hospital of West China, Sichuan University, Chengdu 610041, China Affiliated Hospital of Chengdu University, Chengdu 610081, China International Institute of Spatial Lifecourse Health, Wuhan University, Wuhan 430072, China
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Yang SJ, Yu B, Dong S, Cai CW, Liu HY, Ye TT, Jia P. [Progress in complex network theory-based studies on the associations between health-related behaviors and chronic non-communicable diseases]. Zhonghua Liu Xing Bing Xue Za Zhi 2024; 45:408-416. [PMID: 38514318 DOI: 10.3760/cma.j.cn112338-20230715-00006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 03/23/2024]
Abstract
In recent years, the research focus on health-related behavior and chronic non-communicable diseases has shifted from the analysis on independent effects of multiple causes on a single outcome to the evaluation the complex relationships between multiple causes and multiple effects. Complex network theory, an important branch of system science, considers the relationships among factors in a network and can reveal how health-related behaviors interact with chronic diseases through a series of complex network models and indicators. This paper summarizes the definition and development of complex network theory and its commonly used models, indicators, and case studies in the field of health-related behavior and chronic disease to promote the application of complex network theory in the field of health and provide reference and tools for future research of the relationship between health-related behavior and chronic disease.
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Affiliation(s)
- S J Yang
- West China School of Public Health/The Fourth Hospital of West China, Sichuan University, Chengdu 610041, China Affiliated Hospital of Chengdu University, Chengdu 610081, China International Institute of Spatial Lifecourse Health, Wuhan University, Wuhan 430072, China
| | - B Yu
- West China School of Public Health/The Fourth Hospital of West China, Sichuan University, Chengdu 610041, China Institute for Disaster Management and Reconstruction, Sichuan University-the Hong Kong Polytechnic University, Chengdu 610207, China
| | - S Dong
- West China School of Public Health/The Fourth Hospital of West China, Sichuan University, Chengdu 610041, China
| | - C W Cai
- West China School of Public Health/The Fourth Hospital of West China, Sichuan University, Chengdu 610041, China
| | - H Y Liu
- West China School of Public Health/The Fourth Hospital of West China, Sichuan University, Chengdu 610041, China
| | - T T Ye
- West China School of Public Health/The Fourth Hospital of West China, Sichuan University, Chengdu 610041, China
| | - P Jia
- International Institute of Spatial Lifecourse Health, Wuhan University, Wuhan 430072, China School of Resource and Environmental Sciences, Wuhan University, Wuhan 430072, China School of Public Health, Wuhan University, Wuhan 430071, China
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Ye TT, Shao Y, Yu B, Cai CW, Feng CT, Jia P, Yang SJ. [Association between unhealthy lifestyles and hypertension, diabetes and dyslipidemia in old adults in China]. Zhonghua Liu Xing Bing Xue Za Zhi 2024; 45:385-392. [PMID: 38514315 DOI: 10.3760/cma.j.cn112338-20230715-00008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 03/23/2024]
Abstract
Objective: To analyze the individual and cumulative effects of unhealthy lifestyle on the prevalence of hypertension, diabetes and dyslipidemia in old adults in China, and find out the critical lifestyle in the network. Methods: Based on the baseline data of Yunnan Behavior and Disease Surveillance Cohort in 2021, a total of 16 763 older adults aged ≥60 years were included in our study. The unhealthy lifestyle factors including smoking, drinking, unhealthy eating habit, lower physical activity level, abnormal BMI and abnormal waist circumference. We calculated the unhealthy lifestyle score by using the cumulative exposures of each participant. Multiple logistic regression and mixed graphical models were used to describe the association between unhealthy lifestyle and the prevalence of hypertension, diabetes and dyslipidemia. Results: The prevalence of hypertension, diabetes and dyslipidemia were 57.0%, 11.5% and 37.0%, respectively. Most of the unhealthy lifestyles included in the study were risk factors for hypertension, diabetes and dyslipidemia, and the risks of disease increased with the increase of the unhealthy lifestyle score. The participants with the highest score (score: 6) had significantly higher prevalence of hypertension (OR=3.99, 95%CI: 1.81-8.80), diabetes (OR=4.64, 95%CI: 1.64-13.15) and dyslipidemia (OR=4.26, 95%CI: 2.08-8.73) compared with those with lowest score (score: 0). In the network constructed by mixed graphical model, abnormal waist circumference (bridge strength=0.81) and hypertension (bridge strength=0.55) were vital bridge nodes connecting unhealthy lifestyle and hypertension, diabetes and dyslipidemia. Conclusions: The unhealthy lifestyle score was associated with risks for hypertension, diabetes and dyslipidemia. Abnormal waist circumference was the key factor for chronic diseases in old adults.
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Affiliation(s)
- T T Ye
- West China School of Public Health/The Fourth Hospital of West China, Sichuan University, Chengdu 610041, China
| | - Y Shao
- Yunnan Provincial Center for Disease Control and Prevention, Kunming 650022, China
| | - B Yu
- West China School of Public Health/The Fourth Hospital of West China, Sichuan University, Chengdu 610041, China Institute for Disaster Management and Reconstruction, Sichuan University-the Hong Kong Polytechnic University, Chengdu 610207, China
| | - C W Cai
- West China School of Public Health/The Fourth Hospital of West China, Sichuan University, Chengdu 610041, China
| | - C T Feng
- West China School of Public Health/The Fourth Hospital of West China, Sichuan University, Chengdu 610041, China Institute for Disaster Management and Reconstruction, Sichuan University-the Hong Kong Polytechnic University, Chengdu 610207, China
| | - P Jia
- School of Resource and Environmental Sciences, Wuhan University, Wuhan 430072, China School of Public Health, Wuhan University, Wuhan 430071, China International Institute of Spatial Lifecourse Health, Wuhan University, Wuhan 430072, China
| | - S J Yang
- West China School of Public Health/The Fourth Hospital of West China, Sichuan University, Chengdu 610041, China International Institute of Spatial Lifecourse Health, Wuhan University, Wuhan 430072, China Affiliated Hospital of Chengdu University, Chengdu 610081, China
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Wu HY, Pei J, Jia YX, Ye TT, Chen WH. [Merkel cell carcinoma of tongue: a case report]. Zhonghua Kou Qiang Yi Xue Za Zhi 2022; 57:292-294. [PMID: 35280008 DOI: 10.3760/cma.j.cn112144-20211120-00514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Affiliation(s)
- H Y Wu
- Department of Pathology, The Affiliated Stomatological Hospital of Nanchang University & The Key Laboratory of Oral Biomedicine, Jiangxi Province & Jiangxi Province Clinical Research Center for Oral Diseases, Nanchang 330006, China
| | - J Pei
- Department of Pathology, The Affiliated Stomatological Hospital of Nanchang University & The Key Laboratory of Oral Biomedicine, Jiangxi Province & Jiangxi Province Clinical Research Center for Oral Diseases, Nanchang 330006, China
| | - Y X Jia
- Department of Pathology, The Affiliated Stomatological Hospital of Nanchang University & The Key Laboratory of Oral Biomedicine, Jiangxi Province & Jiangxi Province Clinical Research Center for Oral Diseases, Nanchang 330006, China
| | - T T Ye
- Department of Pathology, The Affiliated Stomatological Hospital of Nanchang University & The Key Laboratory of Oral Biomedicine, Jiangxi Province & Jiangxi Province Clinical Research Center for Oral Diseases, Nanchang 330006, China
| | - W H Chen
- Department of Pathology, The Affiliated Stomatological Hospital of Nanchang University & The Key Laboratory of Oral Biomedicine, Jiangxi Province & Jiangxi Province Clinical Research Center for Oral Diseases, Nanchang 330006, China
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Wang AJ, Cui CK, Ye TT, Jiang LH, Chen XR, Zhang GW, Zou YF. [Voxel-based morphometry (VBM) MRI analysis of gray matter in patients with occupational noise-induced hearing loss]. Zhonghua Lao Dong Wei Sheng Zhi Ye Bing Za Zhi 2019; 36:677-681. [PMID: 30419671 DOI: 10.3760/cma.j.issn.1001-9391.2018.09.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To investigate the changes of brain gray matter volume in patients with occupational noise-induced hearing loss by voxel based morphometry (VBM) . Methods: 16 age-and education-matched healthy controls and 42 patients with occupational noise induced hearing loss, including 27 in mild group and 15 in severe group, received MRI 3D-FSPGR sequence T1WI sagittal scan, and then underwent VBM of brain gray matter volume data analysis. Results: The brain gray matter volume of the left occipitotemporal lateral gyrus, the anterior cingulate gyrus, the bilateral angular gyrus, the precuneus and the near midline area of cerebellum differed between experimental group and control group (P<0.01) . Conclusion: The volume of gray matter in specific brain areas of patients with occupational noise-induced hearing loss was changed, and the effect of noise on brain structure was revealed from the perspective of imaging.
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Affiliation(s)
- A J Wang
- Yantaishan Hospital, Yantai 264001, China
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Abstract
BACKGROUND Macrovascular disease is a common complication of Diabetes Mellitus (DM). Study of renal artery endothelium may serve as a surrogate for cardiovascular and renal vascular disease. OBJECT This study is to elucidate (1) how about the changes of renal endothelial ultrastructures it is in different time of diabetes animals (2) Whether PPARgamma ligand (such as rosiglitazone: ROS) could improve endothelium destruction in diabetes. METHODS Streptozoticin (STZ) induced diabetic rats were stratified by age groups from 6 to 10 weeks of age and were paired with age-matched control non-diabetic rats. Further, another group of diabetic rats were treated with ROS and matched with non-treated diabetic rats. RESULT The renal artery endothelium of diabetic rats was partially coarse, distended, cracked and destroyed. The Vascular Endothelial Structure Score (VESS) was 34.5 in diabetic rats compared with non-diabetic control male rats (P=0.001). The older rats demonstrated more endothelial wall damage, more pronounced in male rats. Compared with non-treated control diabetic rats, ROS prevented diabetic endothelial damage (VESS=4.6, P=0.001). CONCLUSION Renal artery endothelium damage in STZ induced diabetic rats was significantly attenuated by rosiglitazone.
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Affiliation(s)
- Y L Lu
- Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital Affiliated Shanghai Jiaotong University School of Medicine, Shanghai, China.
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Christiani DC, Ye TT, Zhang S, Wegman DH, Eisen EA, Ryan LA, Olenchock SA, Pothier L, Dai HL. Cotton dust and endotoxin exposure and long-term decline in lung function: results of a longitudinal study. Am J Ind Med 1999; 35:321-31. [PMID: 10086207 DOI: 10.1002/(sici)1097-0274(199904)35:4<321::aid-ajim1>3.0.co;2-l] [Citation(s) in RCA: 61] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND To evaluate the relationship between long-term exposure to cotton dust and Gram-negative bacterial endotoxin on lung function, we conducted an 11-year follow-up study of cotton textile workers in Shanghai, China. METHODS Workers at a nearby silk-thread manufacturing mill were used as a referent population. Ninety percent of the original cohort of 445 cotton and 467 silk textile workers--both active and retired--were identified for testing in the 11th year. Questionnaires and spirometric testing were performed, as well as cotton dust and endotoxin sampling at three points over the 11-year follow-up period: at baseline, at Year 5, and at Year 11. After excluding deaths and subjects on sick-leave, 84% of the original cohort had complete health and environmental data. RESULTS The data were reanalyzed using generalized estimating equations feedback model which allow for subject transfer over time between work areas, various exposure levels to dust and endotoxin, and FEV1. Cotton workers had a larger loss of FEV1 during the first 5 years of study (-40 mls/yr) as compared with the second 6 years of follow-up (-18 mls/yr). During the same periods, the average decline among silk workers was slightly higher in the first period, but was more consistent (-30 mls/yr vs. -27 mls/yr), and these differences could not be explained by worker selection or dropout. When cumulative exposure to dust and endotoxin were estimated and used in a multivariate model (GEE) for FEV1 loss, cumulative dust, but not endotoxin, was associated with 11-year loss in FEV1 after adjustments for confounders. There was evidence of feedback between dust-exposure levels and FEV1, indicating the existence of a healthy-worker survivor effect. After accounting for a healthy-worker survivor effect, we found a significant relationship between dust exposure and FEV1 decline. CONCLUSIONS Our results suggest that cotton dust is more strongly associated with chronic airflow limitation than associated endotoxins. Further work is needed to clarify potential reversibility after cessation of exposure, and the relative contributions of dust, endotoxin, and tobacco to chronic respiratory impairment in cotton and other vegetable-exposed workers.
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Affiliation(s)
- D C Christiani
- Department of Environmental Health (Occupational Health Program), Harvard School of Public Health and Pulmonary/Critical Care Unit, Massachusetts General Hospital, Boston, USA
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Ye TT, Huang JX, Shen YE, Lu PL, Christiani DC. Respiratory symptoms and pulmonary function among Chinese rice-granary workers. Int J Occup Environ Health 1998; 4:155-9. [PMID: 10026476 DOI: 10.1179/oeh.1998.4.3.155] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
The authors conducted a cross-sectional study of 474 rice-granary workers and 235 non-granary worker controls in a rural area near Shanghai, the People's Republic of China. Responses to a respiratory-symptom questionnaire and pre- and post-shift spirometry were obtained for all subjects. Area sampling was performed for total and vertically elutriated (</= 15 micrometer) dust levels. Total dust levels were high, ranging from 6.6 mg/m(3) to 59.8 mg/m(3), with vertical elutriated dust concentrations ranging from 2.0 to 10. 4 mg/m(3). The granary workers reported significantly more respiratory symptoms, including chronic cough, sputum production, chronic bronchitis, grain fever (ODTS), and nasal and skin irritation. Grain dust and tobacco smoking were more than additive for the prevalence of chronic cough and chronic bronchitis. After adjusting for confounders, the granary workers had lower mean FEV&inf1;/FVC values both pre- and post-shift, indicating an association between chronic grain-dust exposure and chronic airway obstruction. The results suggest that exposure to rice dust can induce pulmonary responses similar to those observed with exposures to other types of grains.
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Affiliation(s)
- T T Ye
- Harvard School of Public Health, 665 Huntington Avenue, I-1405, Boston, MA 02115, USA
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Shen SX, Wang HB, Chen ZW, Shen YE, Fu H, Wu CE, Ye TT, Wang JJ, Wang KA, Li TL, Yang Z, LaPorte RE, Dorman JS. The incidence of insulin-dependent diabetes mellitus in urban districts of Shanghai (1989-1993). J Pediatr Endocrinol Metab 1996; 9:469-73. [PMID: 8910816 DOI: 10.1515/jpem.1996.9.4.469] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
A retrospective study on the incidence of insulin-dependent diabetes mellitus (IDDM) among children aged 0-14 years was carried out from 1989-1993 in urban Shanghai, China. The average annual population at risk (0-14 yr) consisted of 1,401,664 children. All the cases were collected from the hospitals (primary source) and from primary and middle schools and kindergartens (second source) with independent validation of case ascertainment. There were 53 IDDM cases from the primary source, 23 from the secondary source, with a total of 58. The ascertainment corrected total number of IDDM cases was 67 by the capture-recapture method. The average crude annual incidence rate was 0.83 [95% confidence interval (CI) 0.61-1.04] and ascertainment corrected incidence rate 0.96 (95% CI 0.80-1.12) per 100,000. Peak incidence fell in 1992 and in the 9 year-old group. The incidence of childhood IDDM in the urban districts of Shanghai was reconfirmed to be the lowest in the world but by comparing the results of former investigations a trend was found of increasing incidence of IDDM.
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Affiliation(s)
- S X Shen
- Children's Hospital, Shanghai Medical University, China
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Christiani DC, Ye TT, Wegman DH, Eisen EA, Dai HL, Lu PL. Cotton dust exposure, across-shift drop in FEV1, and five-year change in lung function. Am J Respir Crit Care Med 1994; 150:1250-5. [PMID: 7952548 DOI: 10.1164/ajrccm.150.5.7952548] [Citation(s) in RCA: 70] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
To evaluate chronic loss of lung function in cotton dust-exposed workers, a 5-yr follow-up study was performed in Shanghai, China from 1981 to 1986. Workers at a nearby silk thread manufacturing mill were used as a control population. There were 384 cotton textile workers restudied from an original group of 446, and 403 silk workers restudied from the original 468. The presence of byssinosis among retested cotton workers at the time of first survey was 7.3%. The prevalence of byssinosis was 9.7% at the initial survey among those lost to follow-up. No byssinosis was found among control subjects. The mean annual decline in FEV1 was 39.5 ml among cotton workers and 30.6 ml for silk workers (p < 0.05). The greatest annual decrements were found among smoking cotton workers, but nonsmoking cotton workers also lost lung function at a faster rate than silk nonsmokers (annual loss = 33.3 ml versus 24.4 ml, respectively). Autoregressive modeling revealed that after adjustments for age, sex, height, and smoking, cotton dust exposure was significantly associated with decline in FEV1. Moreover, across-shift drop of 5% or more at the time of first survey was predictive of 5-yr decline in FEV1. Cotton workers who had an acute response (5% or greater drop in FEV1 at the time of first survey) suffered a 57.0 ml/yr FEV1 drop compared with a 35.1-ml drop among cotton workers with less acute response at baseline (p < 0.01). Silk workers with or without 5% across-shift drops had similar annual rates of decline (-33.8 ml and -36.1 ml, respectively).(ABSTRACT TRUNCATED AT 250 WORDS)
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Affiliation(s)
- D C Christiani
- Department of Environmental Health (Occupational Health Program), Harvard School of Public Health, Boston, MA 02115
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Abstract
OBJECTIVE To determine the incidence of insulin-dependent diabetes mellitus in 0- to 14-year-old children in Shanghai, China, from 1980 to 1991. RESEARCH DESIGN AND METHODS Data were collected from hospitals with pediatric departments. The secondary source of validation was primary and middle schools. RESULTS The average crude annual incidence rate was 0.61/100,000 (95% confidence interval, 0.48-0.77). The ascertainment-corrected incidence rates were 0.72/100,000 (0.57-0.91). CONCLUSIONS The incidence of childhood diabetes in Shanghai, China, was one of the lowest, if not the lowest, in the world.
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Affiliation(s)
- H Fu
- Department of Preventive Medicine, School of Public Health, Hospital of Pediatrics, Shanghai Medical University, China
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Hayes GB, Ye TT, Lu PL, Dai HL, Christiani DC. Respiratory disease in cotton textile workers: epidemiologic assessment of small airway function. Environ Res 1994; 66:31-43. [PMID: 8013436 DOI: 10.1006/enrs.1994.1042] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
We performed a cross-sectional study of 705 textile workers in two cotton mills and one silk mill in Shanghai, People's Republic of China, to assess small airway function among cotton textile workers and to compare the FEV1 to the FEF25-75 in detecting airflow obstruction in these workers. All workers had at least 2 years of work experience. Environmental sampling was performed with vertical elutriators and revealed that in the cotton mills mean elutriated dust levels were 1.07 +/- 0.23 mg/m3 in mill 1 and 1.01 mg/m3 +/- 0.24 mg/m3 in mill 2. Mean endotoxin levels were 332 +/- 83 ng/m3 in mill 1 and 101 +/- 46 ng/m3 in mill 2. No differences were found in preshift FEV1 or FEF25-75 between cotton and silk workers. Cotton workers had significantly greater declines than silk workers in FEV1 across a workshift, but not in FEF25-75. These acute changes in FEV1 were noted in both byssinotic and nonbyssinotic workers. Although cotton dust may affect both large and small airways, spirometric measures of small airway function (e.g., FEF25-75) add little to the FEV1 and FVC in detecting airflow limitation in cotton dust-exposed workers.
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Affiliation(s)
- G B Hayes
- Pulmonary Critical Care Unit, Massachusetts General Hospital, Boston 02114
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Christiani DC, Ye TT, Wegman DH, Eisen EA, Dai HL, Lu PL. Pulmonary function among cotton textile workers. A study of variability in symptom reporting, across-shift drop in FEV1, and longitudinal change. Chest 1994; 105:1713-21. [PMID: 8205865 DOI: 10.1378/chest.105.6.1713] [Citation(s) in RCA: 26] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
Longitudinal variability in respiratory responses, including symptom reporting and across-shift change in ventilatory function, were examined in relation to long-term loss of ventilatory function in a group of 447 cotton textile workers in Shanghai, China. The study used a standardized respiratory questionnaire and standardized spirometric testing before and after a work shift on the first day of the workweek. Prediction equations for FEV1 were generated from a group of silk textile workers from the same city. Environmental samples included both vertical elutriated cotton dust and endotoxin levels. There was considerable variability in symptom reporting between the baseline and 5-year follow-up survey for all symptoms. However, subjects who consistently reported symptoms had a significantly accelerated 5-year loss in FEV1 compared with those who never reported symptoms. Subjects with symptoms of chest tightness or dyspnea at one survey lost FEV1 at a rate intermediate between the never or both groups. Moreover, subjects with an across-shift change in FEV1 of more than 5 percent at both surveys had the greatest loss in FEV1 over 5 years (-267 ml) when compared with one-time responders (-224 ml), and nonresponders (-180 ml), though the differences were not significant. Workers with chest tightness and chronic bronchitis in both surveys were overrepresented in the high dust and endotoxin areas. Our results indicate that even with substantial survey-to-survey variability in responses, there is important information contained in both questionnaires and across-shift spirometry. Among cotton workers, consistent responders to either symptom questionnaire or across-shift FEV1 decrements of > or = 5 percent appear to be at increased risk for lung function impairment.
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Affiliation(s)
- D C Christiani
- Department of Environmental Health, Harvard School of Public Health, Boston
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Hu JF, Chen ZQ, Ye TT. [Urinary nicotine and intervention test for absorption of nicotine in female workers in tobacco industry]. Zhonghua Yi Xue Za Zhi 1994; 74:29-30, 63. [PMID: 8032982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
The concentration of urinary nicotine of non-smoking female workers, 56 from shredding workshop, 65 from packing workshop and 54 from beverage factory (as controls), was determined, and intervention test for the absorption of nicotine was carried out in female workers from shredding workshop. The mean geometric concentration of urinary nicotine of shredding workers and packing workers at the end of shift was 44.8 +/- 5.1 ng/ml and 9.9 +/- 5.4 ng/ml, and was significantly higher than that of the controls (1.0 +/- 1.0 ng/ml) (P < 0.01). The concentration of urinary nicotine of shredding workers was significantly higher at the end of shift than pre-exposure period (11.46 +/- 6.73 ng/ml). The intervention test for the absorption of nicotine showed that there were good protection effects for the absorption of nicotine when glove and mask were used simultaneously and ventilator was used in summer.
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Affiliation(s)
- J F Hu
- Shandong Medical University, Jinan
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Christiani DC, Wegman DH, Eisen EA, Ye TT, Lu PL, Olenchock SA. Cotton dust and gram-negative bacterial endotoxin correlations in two cotton textile mills. Am J Ind Med 1993; 23:333-42. [PMID: 8427261 DOI: 10.1002/ajim.4700230210] [Citation(s) in RCA: 25] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Exposure to cotton dust is known to cause both acute and chronic respiratory illness. A specific pattern of symptoms called byssinosis is well described to occur among workers in the cotton processing (e.g., yarn preparation) industry. Recent studies have implicated Gram-negative bacterial endotoxin as one of the agents responsible for acute, and possibly chronic, respiratory illness. Laboratory experiments using a model cardroom have found poor correlations between airborne dust and associated endotoxin. This study reports the results of vertical elutriated dust and endotoxin levels in 11 work areas of 2 cotton textile mills in 1986 in Shanghai, China. The overall correlation between dust and endotoxin was strong, rs = 0.66 and 0.79 (p < 0.0001) for mills 1 and 2, respectively. The dust-endotoxin correlation was relatively poor in early yarn preparation in the workshops and improved in the later preparation areas. Our findings suggest that in these mill settings, dust and endotoxin levels may be well correlated in most work areas. Therefore, dust may be a useful index for monitoring populations employed in the cotton textile industry throughout the world. Additional field studies need to be performed which consider the various determinants of dust and endotoxin levels.
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Affiliation(s)
- D C Christiani
- Department of Environmental Health, Harvard School of Public Health, Boston, MA 02115
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Abstract
Cross-sectional studies were conducted during 1981-1983 among 861 textile workers in 3 cotton mills and 822 controls in 2 silk factories. Questionnaire and lung function tests were taken and inhalable dust concentrations were measured. Prevalence of byssinosis was 5.6%. Average dust concentrations were highest in carding rooms, 1.47-1.99 mg/m3. The correlations (r) between prevalence of byssinosis and dust concentrations was 0.64 (p less than 0.05). The prevalence of chronic bronchitis was 14.4% in cotton workers and 5.1% in controls (p less than 0.05). Acute FEV1 percent decrement (greater than 5%) was higher among cotton workers (32.1%) compared to controls (14.5%) (p less than 0.001). In one cotton blanket factory, the prevalence of byssinosis and chronic bronchitis was higher among workers in the high-dust work areas. Long-term effect studies included pulmonary function test among 173 cotton workers and 373 controls, retired 1-10 years, using the flow volume curve (FVC); chest X-rays of 140 pairs of cotton workers and controls with working tenures over 20 years; and examination of lobectomy specimens of 8 textile workers matched with 16 controls. In male cotton workers, only smokers had a prominent decrement of lung function indices, except FVC. For non-smoking females, there was no difference between the two groups. Additive effects were seen between smoking and dust exposure. According to the International Labor Organization (ILO) Pneumoconiosis Classification, the prevalence of abnormality (profusion greater than 1/0) was 4.3% and 8.7% in non-smoking controls and cotton workers. The interstitial changes on X-ray due to smoking would be much heavier. Additive effects also existed between smoking and dust exposures. No significant changes attributable to dust exposure were seen on pathological section of lobectomy specimens.
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Affiliation(s)
- P L Lu
- School of Public Health, Shanghai Medical University, People's Republic of China
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Kennedy SM, Christiani DC, Eisen EA, Wegman DH, Greaves IA, Olenchock SA, Ye TT, Lu PL. Cotton dust and endotoxin exposure-response relationships in cotton textile workers. Am Rev Respir Dis 1987; 135:194-200. [PMID: 3800146 DOI: 10.1164/arrd.1987.135.1.194] [Citation(s) in RCA: 44] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Endotoxin exposure has been implicated in the etiology of lung disease in cotton workers. We investigated this potential relationship in 443 cotton workers from 2 factories in Shanghai and 439 control subjects from a nearby silk mill. A respiratory questionnaire was administered and pre- and postshift forced expiratory volume (FVC) and flow in one second (FEV1) were determined for each worker. Multiple area air samples were analyzed for total elutriated dust concentration (range: 0.15 to 2.5 mg/m3) and endotoxin (range: 0.002 to 0.55 microgram U.S. Reference Endotoxin/m3). The cotton worker population was stratified by current and cumulative dust or endotoxin exposure. Groups were compared for FEV1, FVC, FEV1/FVC%, % change in FEV1 over the shift (delta FEV1%), and prevalences of chronic bronchitis and byssinosis, and linear and logistic regression models were constructed. No dose-response relationships were demonstrated comparing dust concentration to any pulmonary function or symptom variable. A dose-response trend was seen with the current endotoxin level and FEV1, delta FEV1%, and the prevalence of byssinosis and chronic bronchitis, except for the highest exposure level group in which a reversal of the trend was seen. The regression coefficients for current endotoxin exposure were significant (p less than 0.05) in the models for FEV1 and chronic bronchitis but not in the models for delta FEV1% (i.e., acute change in FEV1) or byssinosis prevalence. The coefficient for dust level was never significant in the models.(ABSTRACT TRUNCATED AT 250 WORDS)
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Christiani DC, Eisen EA, Wegman DH, Ye TT, Lu PL, Gong ZC, Dai HL. Respiratory disease in cotton textile workers in the People's Republic of China. I. Respiratory symptoms. Scand J Work Environ Health 1986; 12:40-5. [PMID: 3961440 DOI: 10.5271/sjweh.2176] [Citation(s) in RCA: 39] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
The prevalence of byssinosis and nonspecific respiratory symptoms was studied in 887 textile workers with at least two years of employment in two cotton mills and one silk mill in Shanghai, the People's Republic of China. A standardized respiratory questionnaire was used, and environmental sampling was performed with vertical elutriators and colorimeter grading. Eight percent of the cotton textile workers complained of byssinosis. The reports of byssinosis were mostly mild (grade 1/2), more prevalent among women, and unrelated to duration of employment or elutriator dust levels. Nonspecific respiratory symptoms were significantly more prevalent among cotton textile workers than silk workers. After adjustment for age, gender, and smoking in logistic regression models, the odds ratios for the effect of working in cotton textile mills on chronic bronchitis, chronic cough, and frequent chest illness were 3.3, 2.9 and 4.7, respectively. Although none of the symptoms were related to current dust levels, the range of exposures was narrow, and information was only available on current levels of cotton dust. This study represents the first respiratory survey of the textile industry in China using diagnostic criteria similar to that used in the United States and England; it defines a cohort for prospective investigation.
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Christiani DC, Eisen EA, Wegman DH, Ye TT, Gong ZC, Lu PL, Dai HL. Respiratory disease in cotton textile workers in the People's Republic of China. II. Pulmonary function results. Scand J Work Environ Health 1986; 12:46-50. [PMID: 3961441 DOI: 10.5271/sjweh.2175] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Pulmonary function tests were performed pre and post workshift on 887 textile workers with at least two years of employment in two cotton mills and one silk mill in Shanghai, the People's Republic of China. Environmental sampling was performed with vertical elutriators, and pulmonary function was performed with standardized techniques. Cotton textile workers were found to have greater across-shift decrements in forced expiratory volume in 1 s (FEV1.0) than silk workers. Increasing duration of exposure resulted in increasing acute decrements in FEV1.0, although significant acute decrements were found in workers with less than five years of exposure. The acute changes in FEV 1.0 were noted in both symptomatic and asymptomatic cotton workers, though the difference between the across-shift change in FEV1.0 (delta FEV1.0%) of the byssinotics and nonbyssinotics increased as work duration increased. There was no difference in preshift FEV1.0 between the cotton and silk workers, but several selection factors likely influenced the observations.
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Olenchock SA, Christiani DC, Mull JC, Ye TT, Lu PL. Endotoxins in baled cottons and airborne dusts in textile mills in the People's Republic of China. Appl Environ Microbiol 1983; 46:817-20. [PMID: 6639029 PMCID: PMC239473 DOI: 10.1128/aem.46.4.817-820.1983] [Citation(s) in RCA: 25] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
Bulk cotton samples and airborne vertical elutriated cotton dusts were obtained from textile mills in Shanghai, People's Republic of China. Analysis of endotoxin contents revealed that baled cottons which were grown in different countries varied in endotoxin contamination. The two textile mills, which operated at similar overall airborne dust levels, differed markedly in the levels of airborne endotoxins. The data suggest that the biological activity or "toxicity" of airborne cotton dusts may not be correlated directly with gravimetric dust levels.
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