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Silicosis not a disease of the past. It is an irreversible, fibrotic lung disease specifically caused by exposure to respirable crystalline silica (RCS) dust. Over 20,000 incident cases of silicosis were identified in 2017 and millions of workers continue to be exposed to RCS. Identified case numbers are however a substantial underestimation due to deficiencies in reporting systems and occupational respiratory health surveillance programmes in many countries. Insecure workers, immigrants and workers in small businesses are at particular risk of more intense RCS exposure. Much of the focus of research and prevention activities has been on the mining sector. Hazardous RCS exposure however occurs in a wide range of occupational setting which receive less attention, in particular the construction industry. Recent outbreaks of silicosis associated with the fabrication of domestic kitchen benchtops from high‐silica content artificial stone have been particularly notable because of the young age of affected workers, short duration of RCS exposure and often rapid disease progression. Developments in nanotechnology and hydraulic fracking provide further examples of how rapid changes in technology and industrial processes require governments to maintain constant vigilance to identify and control potential sources of RCS exposure. Despite countries around the world dealing with similar issues related to RCS exposure, there is an absence of sustained global public health response including lack of consensus of an occupational exposure limit that would provide protection to workers. Although there are complex challenges, global elimination of silicosis must remain the goal. See relatedEditorial [ABSTRACT FROM AUTHOR]

BACKGROUND: The potential role of occupational exposures in the development of nasopharyngeal carcinoma (NPC) remains unclear, particularly in high‐incidence areas. METHODS: The authors conducted a population‐based case‐control study, consisting of 2514 incident NPC cases and 2586 randomly selected population controls, in southern China from 2010 to 2014. Occupational history and other covariates were self‐reported using a questionnaire. Multivariate logistic regression was used to estimate odds ratios (ORs) with 95% confidence intervals (CIs) for the risk of NPC associated with occupational exposures. Restricted cubic splines were used to evaluate potentially nonlinear duration‐response relations. RESULTS: Individuals who had exposure to occupational dusts (OR, 1.45; 95% CI, 1.26‐1.68), chemical vapors (OR, 1.37; 95% CI, 1.17‐1.61), exhausts/smokes (OR, 1.42; 95% CI, 1.25‐1.60), or acids/alkalis (OR, 1.56; 95% CI, 1.30‐1.89) in the workplace had an increased NPC risk compared with those who were unexposed. Risk estimates for all 4 categories of occupational exposures appeared to linearly increase with increasing duration. Within these categories, occupational exposure to 14 subtypes of agents conferred significantly higher risks of NPC, with ORs ranging from 1.30 to 2.29, including dust from metals, textiles, cement, or coal; vapor from formaldehyde, organic solvents, or dyes; exhaust or smoke from diesel, firewood, asphalt/tar, vehicles, or welding; and sulfuric acid, hydrochloric acid, nitric acid, and concentrated alkali/ammonia. CONCLUSIONS: Occupational exposures to dusts, chemical vapors, exhausts/smokes, or acids/alkalis are associated with an excess risk of NPC. If the current results are causal, then the amelioration of workplace conditions might alleviate the burden of NPC in endemic areas. LAY SUMMARY: The role of occupational exposures in the development of nasopharyngeal carcinoma (NPC) remains unclear, particularly in high‐incidence areas.The authors conducted a population‐based study with 2514 incident NPC cases and 2586 population controls in southern China and observed that occupational exposures were associated with an increased risk of NPC.Duration‐response trends were observed with increasing duration of exposure.These findings provide new evidence supporting an etiologic role of occupational exposures for NPC in a high‐incidence region. Occupational exposures are associated with an increased risk of nasopharyngeal carcinoma, and the association is primarily driven by 14 subtypes of occupational agents. Duration‐response trends are observed with increasing duration of exposure. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to identify the epidemiological characteristics and transmission dynamics of paediatric cases.Methods: Information on 1369 paediatric cases with COVID-19 from 8 December 2019 to 7 March 2020 in Hubei province was extracted from the National Infectious Disease Surveillance System. The analysis included epidemic curves, temporal-spatial distribution, clinical classification and interval times between onset and diagnosis.Results: Among 1369 paediatric cases, the median age was 9 years and 58.2% of them were males. The proportion of severe and critical cases in children was lower than that in adults and the proportion of asymptomatic cases in children was five times greater than for adult cases. The first paediatric case was reported on 2 January 2020, and the daily number of new paediatric cases remained high from 1 February through to 22 February. The epidemiological curve of paediatric cases lagged behind that of adults by 19 days, and the first spike of the epidemic curve in senior high school students occurred 1 week earlier than in other paediatric groups. The proportion of clustered cases among children was about twice that for adults. The median of the interval in paediatric cases between onset and diagnosis, isolation and notification were 3, 0 and 3 days, respectively, and all of those were significantly shorter than in adults.Conclusions: The epidemic curve of child cases lagged behind that of adult cases by 19 days, and the major form of transmission observed was in clusters. [ABSTRACT FROM AUTHOR]

We aimed to explore the association between occupational noise exposure duration and heart rate variability (HRV) and the underlying mechanism. A total of 449 subjects in a manufacturing company in Wuhan, China were included in our study and six candidate miRNAs (miR-200a-3p, miR-200b-3p, miR-200c-3p, miR-1-3p, miR-92a-3p and miR-21–5p) were tested among 200 individuals. Information combining the work histories and the occupational noise monitoring records were used to calculate the exposure of occupational noise, HRV indices were measured by using 3-channel digital Holter monitors, including the standard deviation of all normal R-R intervals (SDNN), the root mean of the square of successive differences between adjacent normal NN intervals (r-MSSD), SDNN index, low-frequency power (LF), high-frequency power (HF) and TP (total power). We found a significant linear negative dose-response relationship between occupational noise exposure duration and HRV indices (P for overall <0.05, P for nonlinear >0.05), including SDNN, r-MSSD, SDNN index, LF and HF. In the continuous models, the β (95% CIs) for each 1-year occupational noise exposure were −0.002 (−0.004, −0.001) for SDNN, −0.002 (−0.004, −0.001) for r-MSSD, −0.002 (−0.004, −0.001) for SDNN index, and −0.006 (−0.012, −0.001) for HF. Meanwhile, we also found that occupational noise exposure duration was significantly associated with lower expression of five miRNAs, when adjusting for other covariates. The β (95% CIs) were −0.039 (−0.067, −0.011) for miRNA-200c-3p, −0.053 (−0.083, −0.022) for miRNA-200a-3p, −0.044 (−0.070, −0.019) for miRNA-200b-3p, −0.032 (−0.048, −0.017) for miRNA-92a-3p, and −0.063 (−0.089, −0.038) for miRNA-21–5p in the continuous models. In addition, we found a positive association between miRNA-1-3p and LF (β = 0.039, 95% CI = 0.002, 0.080). Our study suggests that occupational noise exposure duration is associated with cardiac autonomic dysfunction, and the role of miRNAs in noise induced HRV reduction needs to be confirmed in future studies. [Display omitted] • Occupational noise exposure duration is associated with reduced SDNN, SDNN index, and HF. • Occupational noise exposure duration is associated with lower miR-200c-3p, miR-200a-3p, miR-200b-3p, miR-92a-3p, and miR-21–5p. • The role of miRNAs in noise induced HRV reduction needs to be confirmed. [ABSTRACT FROM AUTHOR]

Objectives: Little is known about the long-term health impact of pregnancy on women. The objective of this study was to examine the association between parity and the risk of diabetes among a population of Chinese women. Study design: A total of 14,196 women (aged ≥45 years) from the Dongfeng-Tongji Cohort study who had experienced at least one live birth completed baseline questionnaires, medical examinations, and provided baseline blood samples. Participants were categorized into four groups according to parity (one, two, three, or four or more live births). Logistic regression models were used to investigate the association between parity and the risk of diabetes after controlling potential confounders. Results: The prevalence of diabetes in the study population was 18.0% (2,552/14,196). Fasting plasma glucose levels increased with the increasing number of live births (P<0.001) and parity had a positive graded association with diabetes without adjustment for any covariates (P for trend <0.001). After adjusting for potential confounders, women who had had two, three, and four or more live births had 1.35 times (95% CI, 1.20–1.52), 1.59 times (95% CI, 1.39–1.82) and 1.44 times (95% CI, 1.21–1.71), respectively, higher risk of diabetes compared with women who had had one live birth. Conclusion: Multiparity was associated with increasing risk of diabetes in this population of Chinese women. These findings suggested that multiparity may be a risk factor for the development of diabetes among Chinese women. Future studies are needed to examine the physiological changes during pregnancy for risk of diabetes in later life. [ABSTRACT FROM AUTHOR]

Background: Shift work has been associated with adverse health effects by disturbing circadian rhythms. However,its potential long-term health effects and the persistent effects after leaving shifts have not been well established. Methods and Results: We studied 26,463 workers from Tongji-Dongfeng Cohort in China. All the participants are retired employees of Dongfeng Motor Company. Information on demographics, occupational history and medical history were gathered through questionnaires. After adjusting potential confounders in the logistic regression models, shift work was associated with poor sleeping quality, diabetes and hypertension independently. We observed significant effects of shift work on poor sleeping quality, diabetes and hypertension; the ORs (95%CI) are 1.18 (1.09–1.27), 1.10 (1.03–1.17) and 1.05 (1.01–1.09) respectively. In the further analysis, we found elevated ORs (95%CI) for participants with poor sleeping quality, the ORs (95%CI) are 1.34 (1.08–1.60), 1.13 (1.05–1.21), 1.05 (1.03–1.07) and 1.05 (1.01–1.09) for 1–4, 5–9, 10–19, ≥20 years of shift work respectively. However, with the extension of leaving shift work duration, the effects of shift work on sleep quality gradually reduced. Conclusions: Shift work may be an independent risk factor for sleeping quality, diabetes and hypertension even in retired workers. Applicable intervention strategies are needed for prevention of sleep loss, diabetes, and hypertension for shift workers. [ABSTRACT FROM AUTHOR]

Suicide is the second leading cause of death among adolescents in Canada and globally. The purpose of our study was to calculate what proportion of adolescent suicide attempts could be prevented in the absence of verbal, physical, and sexual violence. Using the province-wide 2008 British Columbia Adolescent Health Survey ( N = 29,315) we calculated population-attributable fractions for each type of violence, as well as exposure to any violence, separately by gender, among adolescents age 12-19. We found violence victimization is implicated in the majority of suicide attempts. Focusing on violence prevention may be an important strategy for reducing suicide among young people. [ABSTRACT FROM AUTHOR]

The purpose of this study was to examine the relationship between substance use and sexual orientation among Asian adolescents in Canada. We analyzed an East- and Southeast-Asian subsample of a province-wide, school-based survey (weighted N = 51,349). Compared to heterosexual adolescents of the same gender, gay, lesbian, bisexual, and mostly heterosexual adolescents were more likely to use alcohol, marijuana, or other illicit drugs. Particularly, sexual minority girls were at increased risk for substance use. The findings suggest the need for substance use prevention interventions that are sensitive to gender, sexual orientation, and culture. [ABSTRACT FROM AUTHOR]

This study examined enacted stigma and problem substance use among Asian sexual minority youth and the buffering role of protective factors. Logistic regression analyses of a weighted sample of 5,423 Asian youth who completed the 2003 BC Adolescent Health Survey indicated that sexual minority youth were more likely to be victimized compared to heterosexual peers. Furthermore, protective factors, such as involvement in extracurricular activities or healthy connections to peers or school, reduced the likelihood of problem substance use, even among stigmatized youth. The study highlights the need to create safe, supportive school and community environments for Asian sexual minority adolescents. [ABSTRACT FROM AUTHOR]

Objectives To explore the prevalence of menopausal symptoms in Chinese women aged 40-65 years living in Guangdong province in southern China, and to investigate their care-seeking behavior. Design A cross-sectional population-based study performed in Guangdong province, PR China. Methods A total of 9939 women were selected by multistage cluster sampling. From November 2003 to July 2004, women were interviewed in person with a prepared questionnaire about symptoms experienced in the 2 months preceding the survey. The main outcome measurements were self-reported menopausal symptoms and related factors. Results The mean age of natural menopause was 48.9 years. The prevalence and severity of menopausal symptoms were low. The three most prevalent symptoms were insomnia, joint and muscle pain, and dizziness (in 37.2%, 35.7%, and 31.5% of the sample, respectively). Hot flushes were experienced by 17.5% of women. The factors associated with the frequency of menopausal symptoms included profession, education, type of menopause and the presence of physical or emotional problems. Ever and current hormone replacement therapy usage was reported in 0.8% and 1.3% of women, respectively. Of the total study population, 28.9% had sought health care because of menopausal symptoms. Conclusions The prevalence of menopausal symptoms in southern Chinese women is low, and this is accompanied by low usage of hormone replacement therapy. [ABSTRACT FROM AUTHOR]

Background: The prevalence of metabolic syndrome (MetS) is growing rapidly in China. Tai chi and dancing are common types of exercise among middle-aged and elderly Chinese. It remains unclear whether these activities are associated with a lower risk of MetS. Methodology/Principal Findings A total of 15,514 individuals (6,952 men, 8,562 women) aged 50 to 70 years from the Dongfeng-Tongji Cohort in Shiyan, China participated in a cross-sectional study. Physical activity and other lifestyle factors were assessed with semi-structured questionnaires during face-to-face interviews. MetS was defined by the current National Cholesterol Education Program/Adult treatment Panel III criteria for Asian Americans. The prevalence of MetS was 33.2% in the study population. In the multivariable-adjusted logistic regression analyses, total physical activity levels were monotonically associated with a lower odds of MetS [OR 0.75 comparing extreme quintiles, 95% confidence interval (CI) 0.66–0.86, P<0.001]. Compared with non-exercisers in a specific exercise type, jogging (OR 0.82, 95% CI 0.68–1.00, P = 0.046), tai chi (OR 0.72, 95% CI 0.60–0.88, P<0.001), and dancing (OR 0.56, 95% CI 0.47–0.67, P<0.001) were associated with significantly lower odds of MetS. Furthermore, each 1–h/week increment in tai chi and dancing was associated with a 5% (95% CI 2%–9%) and a 9% (95% CI 6%, 12%) lower risk of MetS. Conclusions/Significance: Jogging, tai chi and dancing are associated with a significantly lower risk of having MetS in middle-aged and older Chinese. Future intervention studies should consider the role of jogging, tai chi and dancing in preventing MetS.

Autophagy associated genes (ATGs) played an important role in the repair process of DNA damage and decreased autophagy may weaken the repair process and aggravate DNA damage. Based on this, we hypothesized that DNA damage levels might be modified by genetic variants in autophagy associated genes. In order to validate our hypothesis, 307 subjects were recruited from three different cities (Zhuhai, Wuhan and Tianjin) in China. Demographic data, individual 24-h PM 2.5 exposure and peripheral blood DNA damage levels were also detected. Seven potentially functional polymorphisms in four essential autophagy associated genes ( ATG5 , ATG7 , ATG8 and ATG13 ) were screened to evaluate the relationship between the polymorphisms of autophagy associated genes and DNA damage levels. This association was assessed by using multivariable linear regression model, age, sex, smoke and PM 2.5 exposure levels were adjusted in each city. We found that rs12599322 in ATG8 (A > G, β = 0.263, 95% CI: 0.108–0.419, P = 8.98 × 10 − 4 ) and rs7484002 in ATG13 (A > G, β = 0.396, 95% CI: 0.085–0.708, P = 0.013) were significantly associated with higher DNA damage levels. Furthermore, functional annotations showed that both rs12599322 and rs7484002 located at transcription factor binding sites (TFBS), indicating that they could regulate the expression of related genes through TF regulation. Following allelic trend analysis revealed that the DNA damage levels were significantly aggravated with the increasing number of risk variants in autophagy associated genes ( P for trend: 8.09 × 10 − 5 ). Our findings suggested that the polymorphisms in ATGs may influence DNA damage levels in one of the Chinese population. [ABSTRACT FROM AUTHOR]

Background Epidemiological studies suggest an association between sleep duration and risk of coronary heart disease, however, the results are controversial. We conducted this systematic review and meta-analysis to summarize the potential dose-response relationship between sleep duration and risk of coronary heart disease. Methods The electronic reference databases (PubMed and Embase) were searched through January 2016 with selection criteria for relevant studies. Both semiparametric and parametric methods were used to calculate the pooled risk estimates. Results Seventeen articles with 22 independent reports involving 17,841 incident cases of coronary heart disease among 517,440 participants were included in our meta-analysis. A U-shaped relationship was detected between sleep duration and risk of coronary heart disease, with the lowest risk at 7–8 h per day. Compared with 7 h sleep duration per day, the combined relative risk of coronary heart disease were 1.11 (95% CI = 1.05–1.16) for an reduction of 1 h and 1.07 (95% CI = 1.00–1.15) for an increment of 1 h. And the results almost did not change in the subgroup analysis of gender and fatal cases. Exclusion of any single study did not alter the combined relative risk. In addition, visual inspection of funnel plots, Begg's and Egger's tests failed to identify publication bias. Conclusions Both short and long sleep durations are significantly associated with increased risk of coronary heart disease. Compared with 7 h sleep duration per day, the risk of coronary heart disease increases 11% for an hour decrease and increases 7% for an hour increase. [ABSTRACT FROM AUTHOR]