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Objective: To estimate the pooled prevalence, as well as the spatial and temporal distribution, of urolithiasis among subjects in China. Materials and Methods: We conducted a comprehensive search of both Chinese and English databases to retrieve literature pertaining to the prevalence of urolithiasis in the indigenous Chinese population. A random‐effects meta‐analysis model was employed to calculate the pooled prevalence of urolithiasis. Subgroup analyses were conducted based on factors such as time, region, gender, and sample size. Prevalence and spatial distribution maps were created based on provinces and latitude/longitude coordinates. Results: A total of 46 studies conducted in 22 provinces across China were included in this meta‐analysis and the pooled prevalence of urolithiasis, kidney stones, ureteric calculi, urethral and bladder stones were 8.1% (95% confidence interval [CI] 5.6–11.1%), 7.8% (95% CI 5.8–10.0%), 3.2% (95% CI 0.6–5.7%), 0.5% (95% CI 0.1–0.9%). Most of the urolithiasis prevalence screening in China was concentrated between 100° E and 120° E, with higher rates observed in low latitude areas. Subgroup analysis of kidney stones revealed that Guangdong (12.7%) and Guangxi (10.3%) had the highest prevalence, with the eastern developed area exhibiting higher rates compared to the west. The prevalence in males was higher than in females (odds ratio 1.67, 95% CI 1.46–1.92), although the gender gap has significantly reduced since 2006. Moreover, a greater sample size is associated with a decreased prevalence of urolithiasis. Conclusions: The prevalence of urolithiasis is increasing in China, and there are noteworthy regional or provincial disparities in occurrence. It is worth noting that the current number of screening studies in some areas is insufficient. Additional investigations with appropriate sample sizes should be supplemented in time. [ABSTRACT FROM AUTHOR]

Purpose: Whether and when the innovation aspiration shortfall (e.g. innovation performance lower than aspirations) will affect emerging economy firms (EEFs)' international expansion remains an important unanswered theoretical and practical question. Design/methodology/approach: Based on performance feedback theory, this study explores the impact of innovation aspiration shortfall on EEFs' international expansion and the moderating role of CEO origin. Findings: This study finds that innovation aspiration shortfall has a positive impact on EEFs' international expansion. This study also uncovers that EEFs are less likely to implement international expansion in response to innovation aspiration shortfall when the CEO is a founder than when the CEO is a non-founder, and EEFs are more likely to implement international expansion in response to innovation aspiration shortfall when the CEO is an outsider-CEO than when the CEO is an insider-CEO. Originality/value: This study proposes that the interaction between innovation aspiration shortfall and CEO origin can be a useful predictor of EEFs' international expansion. [ABSTRACT FROM AUTHOR]

The increase in air pollution has posed numerous new challenges for human society, making the exploration of an effective method for predicting air pollutant concentrations highly significant. The current research faces several primary challenges: the neglect of non-Euclidean characteristics of site distribution on data and the strong spatiotemporal dependencies in the dispersion process of pollutants. To address these issues, this paper constructs a spatiotemporal hybrid prediction model – the MGAtt-LSTM method – for predicting PM 2.5 concentrations, which employs the dynamic multi-graph attention module (MGAtt) to tackle spatial dependencies and Long Short-Term Memory networks (LSTM) to address temporal dependencies. Additionally, extensive experiments are conducted by using historical air pollutant monitoring data and meteorological data from the Beijing-Tianjin-Hebei region. The results demonstrate that the proposed MGAtt-LSTM model achieved superior performance in concentration prediction compared to existing benchmark models. • The neural network consists of multi-graph attention network and LSTM network. • Air pollution data in North China and meteorological data are used to forecast. • The uneven distribution of pollutant sites is considered to predict PM 2.5 concentrations precisely. • The use of multi-graph attention networks addresses the issue of traditional GCN methods relying on fixed graph structures. [ABSTRACT FROM AUTHOR]

Failure is an unavoidable part of the innovation process. Previous studies have explored the impact of innovation failures on a variety of strategic actions. However, to date, whether and when firms – especially those in emerging economies – adopt overseas research and development (R&D) strategies in response to innovation failures remains unexplored. By integrating insights from the behavioural theory of the firm (BTOF) and springboard theory, our study theoretically analyzes and empirically examines the impact of continuous innovation failure on the overseas R&D activities of companies in emerging economies. Using a dataset comprised of Chinese listed manufacturing firms, we find that continuous innovation failure is positively related to the overseas R&D activities of companies in emerging economies. After considering the moderating effect of top management team (TMT) relational capital, we also find that TMT financial relational capital weakens the above relationship, while TMT government relational capital strengthens it. [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]

Background: Little is known about the different risk of silicosis in metal mines and pottery factories. We aimed to compare the silicosis risks among silica-exposed workers in different industrial circumstances.Research Question: Are the silicosis risks among silica-exposed workers in industrial circumstances different?Study Design and Methods: We studied 39,808 workers followed up from January 1, 1960 to December 31, 2003 in China. Cumulative respirable silica dust exposure (CDE) was estimated by linking a job-exposure matrix to personal work history. Silicosis of stage I or higher was diagnosed by Chinese pneumoconiosis Roentgen diagnostic criteria.Results: A total of 9,377 silicosis patients were diagnosed during 1,153,580.9 person-years' follow-up in the cohort. Hazard ratios of silicosis for each 1 mg/m3-year increase in CDE were 1.08 (1.07-1.08) for tungsten mines, 1.41 (1.33-1.48) for iron and copper mines, 1.14 (1.11-1.17) for tin mines, and 1.03 (1.02-1.04) for pottery factories, respectively. When exposed to 0.05 mg/m3 of respirable silica dust for 45 years, the cumulative risks in metal mines (2.3%, 9.9%, 1.5% for tungsten mines, iron and copper mines, and tin mines, respectively) were still higher than those in pottery factories (0.6%). The joint effect of silica and smoking on silicosis was more than multiplicative.Interpretation: The risk of silicosis in metal miners is higher than that in pottery workers when exposed to the same level of silica dust. The silica dust exposed years should be under 10 years for metal miners and 40 years for pottery workers at 0.05 mg/m3 to keep lifetime risk within 0.1%. Current exposure limits should take into account differences in various industrial circumstances. Smoking cessation could help reduce silicosis risk for silica-exposed workers. [ABSTRACT FROM AUTHOR]

Background: Obesity is reported to be associated with oxidative stress which can cause lipid peroxidation. However, the effects of gain in various weight-related anthropometric indices on lipid peroxidation remain unclear. We aimed to examine the cross-sectional and longitudinal associations between altered weight-related anthropometric indices and a marker of lipid peroxidation among urban adults in China. Methods: A total of 3762 participants from the Wuhan-Zhuhai cohort were included in the present study, with a follow-up of 3 years. Six weight-related anthropometric indicators were measured and calculated, including waist circumference (WC), body mass index (BMI), waist-to-hip ratio (WHR), waist-to-height ratio (WHtR), a body shape index (ABSI), and body adiposity index (BAI). Individual urinary 8-iso-prostaglandin-F2α (8-iso-PGF2α) was determined via enzyme-linked immunosorbent assay to evaluate lipid peroxidation. We used generalized linear models to analyze the cross-sectional and longitudinal associations of weight-related anthropometric indices with a marker of lipid peroxidation and stratified analyses to estimate effect modification. Results: We found significant relationships between WHR, WHtR, ABSI, and urinary 8-iso-PGF2α at baseline. Each 1% increase in WHR, WHtR, and ABSI was significantly associated with a 0.007, 0.004, and 0.104 increase in log-transformed 8-iso-PGF2α concentration, respectively (P< 0.05). In longitudinal analysis, positive dose–response relationships were observed between gains in BMI, BAI, and increased 8-iso-PGF2α after adjusting for potential confounders (Ptrend< 0.05). We also found that gender and smoking status modified the association of BMI gain and 8-iso-PGF2α increment, and such an association was more obvious in female and non-smokers. Conclusion: Our research implied that gain in anthropometric indices may result in a higher level of lipid peroxidation. [ABSTRACT FROM AUTHOR]

Background: With the rapid development of the socioeconomic status, the mortality of several cancers has been changed in China during the past 30 years. We aimed to estimate the trends of mortality and years of life lost (YLLs) of various cancers in urban and rural areas of China from 1990 to 2017. Methods: The mortality data were collected from Chinese yearbooks and the age structure of population from the Chinese sixth population census were used as reference to calculate age‐standardized mortality rates (ASMRs) and YLLs rates. Joinpoint regression analysis was implemented to calculate the annual percent change (APC) of mortality rates and YLL rates for cancers. YLLs owing to premature death were calculated as age‐specific cancer deaths multiplied by the reference life expectancy at birth of 80 years for male and 82.5 years for female. Results: The ASMRs of all cancers showed significant decreasing trends for urban residents from 1990 to 2017, such downward trend without significance was also observed among rural residents. Interestingly, ASMRs of lung cancer and breast cancer have raised continuously in rural areas since 1990. The age‐standardized YYL rates for urban and rural residents decreased with 1.02% and 0.85% per year, respectively. YLLs in rural areas were higher than those in urban areas, whereas YLLs of urban outstripped those of rural finally with the increasing in YLLs of urban areas (216.71% for men and 207.87% for women). Conclusion: The ASMRs and YLL rates of all cancers have declined in urban and rural areas from 1990 to 2017. YLLs increased in urban areas and remained higher level in rural areas after 2014 year. Preventive measures should be strengthened to against cancer, especially for lung cancer. [ABSTRACT FROM AUTHOR]

Previous studies have suggested that short-term exposure to ambient air pollution was associated with pediatric hospital admissions and emergency room visits for certain respiratory diseases; however, there is limited evidence on the association between short-term air pollution exposure and pediatric outpatient visits. Our aim was to quantitatively assess the short-term effects of ambient air pollution on pediatric outpatient visits for respiratory diseases. We conducted a time-series study in Yichang city, China between Jan 1, 2014 and Dec 31, 2015. Daily counts of pediatric respiratory outpatient visits were collected from 3 large hospitals, and then linked with air pollution data from 5 air quality monitoring stations by date. We used generalized additive Poisson models to conduct linear and nonlinear exposure-response analyses between air pollutant exposures and pediatric respiratory outpatient visits, adjusting for seasonality, day of week, public holiday, temperature, and relative humidity. Each interquartile range (IQR) increase in PM 2.5 (lag 0), PM 10 (lag 0), NO 2 (lag 0), CO (lag 0), and O 3 (lag 4) concentrations was significantly associated with a 1.91% (95% CI: 0.60%, 3.23%), 2.46% (1.09%, 3.85%), 1.88% (0.49%, 3.29%), 2.00% (0.43%, 3.59%), and 1.91% (0.45%, 3.39%) increase of pediatric respiratory outpatient visits, respectively. Similarly, the nonlinear exposure-response analyses showed monotonic increases of pediatric respiratory outpatient visits by increasing air pollutant exposures, though the associations for NO 2 and CO attenuated at higher concentrations. These associations were unlikely modified by season. We did not observe significant association for SO 2 exposure. Our results suggest that short-term exposures to PM 2.5 , PM 10 , NO 2 , CO, and O 3 may account for increased risk of pediatric outpatient visits for respiratory diseases, and emphasize the needs for reduction of air pollutant exposures for children. [ABSTRACT FROM AUTHOR]

Background: A minimized and concise drug alerting rule set can be effective in reducing alert fatigue. Objectives: This study aims to develop and evaluate a concise drug alerting rule set for Chinese hospitals. The rule set covers not only western medicine, but also Chinese patent medicine that is widely used in Chinese hospitals. Setting: A 2600-bed general hospital in China. Methods: In order to implement the drug rule set in clinical information settings, an information model for drug rules was designed and a rule authoring tool was developed accordingly. With this authoring tool, clinical pharmacists built a computerized rule set that contains 150 most widely used and error-prone drugs. Based on this rule set, a medication-related clinical decision support application was built in CPOE. Drug alert data between 2013/12/25 and 2015/07/01 were used to evaluate the effect of the rule set. Main outcome measure: Number of alerts, number of corrected/overridden alerts, accept/override rate. Results: Totally 18,666 alerts were fired and 2803 alerts were overridden. Overall override rate is 15.0% (2803/18666) and accept rate is 85.0%. Conclusions: The rule set has been well received by physicians and can be used as a preliminary medical order screening tool to reduce pharmacists' workload. For Chinese hospitals, this rule set can serve as a starter kit for building their own pharmaceutical systems or as a reference to tier commercial rule set. [ABSTRACT FROM AUTHOR]

Long-term noise exposure is reported to damage cardiovascular system, but the relationship between occupational noise exposure and arterial stiffness (AS) and the underlying mechanism is still unclear. We aimed to investigate the association of occupational noise exposure with arterial stiffness (AS), and further explore the mediation roles of microRNAs (miRNAs). A total of 838 workers were recruited from two companies in Wuhan, Hubei, China. Cumulative occupational noise exposure (CNE) was assessed through noise level of job title and work years in occupational noise. The AS for the participants were evaluated using brachial-ankle pulse wave velocity (baPWV) measured by an oscillometric device. Each 1-unit increase in CNE levels was significantly associated with a 0.002 (95% confidence interval (CI) = 0.001–0.003) unit increase in ln-transformed values of baPWV. In the sex-specific analysis, the association was significant in males (β = 0.002, 95%CI = 0.001–0.003). Meanwhile, the risk of bilateral hearing loss at high frequency was significantly higher in the high-exposed group than non-exposed group (OR = 1.895, 95%CI = 1.024–3.508), and participants with bilateral hearing loss at high frequency had a significantly higher level of ln-transformed baPWV (β = 0.032, 95%CI = 0.003–0.061). Occupational noise exposure and AS were both negatively associated with plasma miR-92a-3p and miR-21–5p, and the two miRNAs mediated 15.0% and 16.8% of the association of occupational noise with AS (P < 0.05). Our findings suggest that occupational noise exposure is positively associated with AS, and plasma miR-92a-3p and miR-21–5p may partly mediate such association. [Display omitted] • Occupational noise exposure is positively associated with arterial stiffness. • Bilateral high frequency hearing loss is positively associated with arterial stiffness. • Plasma miR-92a-3p and miR-21–5p mediated the association between occupational noise and arterial stiffness. [ABSTRACT FROM AUTHOR]

Background: Occupational hearing loss is an increasingly prevalent occupational condition worldwide, and has been reported to occur in a wide range of workplaces; however, its prevalence among workers from municipal solid waste landfills (MSWLs) remains less clear. This study aimed to investigate the occupational hearing loss among Chinese MSWL workers. Methods: A cross-sectional study of 247 workers from 4 Chinese MSWLs was conducted. Noise and total volatile organic compounds (TVOCs) levels at worksites were determined. We conducted hearing examinations to determine hearing thresholds. A worker was identified as having hearing loss if the mean threshold at 2000, 3000 and 4000 Hz in either ear was equal to or greater than 25 dB. Prevalence of occupational hearing loss was then evaluated. Using unconditional Logistic regression models, we estimated the odds ratios (ORs) of MSWL work associated with hearing loss. Results: According to the job title for each worker, the study subjects were divided into 3 groups, including group 1 of 63 workers without MSWL occupational hazards exposure (control group), group 2 of 84 workers with a few or short-period MSWL occupational hazards exposure, and group 3 of 100 workers with continuous MSWL occupational hazards exposure. Both noise and TVOCs levels were significantly higher at worksites for group 3. Significantly poorer hearing thresholds at frequencies of 2000, 3000 and 4000 Hz were found in group 3, compared with that in group 1 and group 2. The overall prevalence rate of hearing loss was 23. 5%, with the highest in group 3 (36.0%). The OR of MSWL work associated with hearing loss was 3.39 (95% confidence interval [CI]: 1.28-8.96). Conclusion: The results of this study suggest significantly higher prevalence of hearing loss among MSWL workers. Further studies are needed to explore possible exposure-response relationship between MSWL occupational hazards exposure and hearing loss. [ABSTRACT FROM AUTHOR]

Background: Elevated heavy metals and fasting plasma glucose (FPG) levels were both associated with increased risk of cardiovascular diseases. However, studies on the associations of heavy metals and essential elements with altered FPG and diabetes risk were limited or conflicting. The objective of this study was to evaluate the potential associations of heavy metals and essential trace elements with FPG and diabetes risk among general Chinese population. Methods: We conducted a cross-sectional study to investigate the associations of urinary concentrations of 23 metals with FPG, impaired fasting glucose (IFG) and diabetes among 2242 community-based Chinese adults in Wuhan. We used the false discovery rate (FDR) method to correct for multiple hypothesis tests. Results: After adjusting for potential confounders, urinary aluminum, titanium, cobalt, nickel, copper, zinc, selenium, rubidium, strontium, molybdenum, cadmium, antimony, barium, tungsten and lead were associated with altered FPG, IFG or diabetes risk (all P< 0.05); arsenic was only dose-dependently related to diabetes (P< 0.05). After additional adjustment for multiple testing, titanium, copper, zinc, selenium, rubidium, tungsten and lead were still significantly associated with one or more outcomes (all FDR-adjusted P< 0.05). Conclusions: Our results suggest that multiple metals in urine are associated with FPG, IFG or diabetes risk. Because the cross-sectional design precludes inferences about causality, further prospective studies are warranted to validate our findings. [ABSTRACT FROM AUTHOR]

Background: Epidemiological studies have suggested an association between external estimates of exposure to metals in air particles and altered heart rate variability (HRV). However, studies on the association between internal assessments of metals exposure and HRV are limited. Objectives: The purpose of this study was to examine the potential association between urinary metals and HRV among residents of an urban community in Wuhan, China. Methods: We performed a cross-sectional analysis of 23 urinary metals and 5-min HRV indices (SDNN, standard deviation of normal-to-normal intervals; r-MSSD, root mean square of successive differences in adjacent normal-to-normal intervals; LF, low frequency; HF, high frequency; TP, total power) using baseline data on 2,004 adult residents of Wuhan. Results: After adjusting for other metals, creatinine, and other covariates, natural log-transformed urine titanium concentration was positively associated with all HRV indices (all p < 0.05). Moreover, we estimated negative associations between cadmium and r-MSSD, LF, HF, and TP; between lead and r-MSSD, HF, and TP; and between iron, copper, and arsenic and HF, SDNN, and LF, respectively, based on models adjusted for other metals, creatinine, and covariates (all p < 0.10). Several associations differed according to cardiovascular disease risk factors. For example, negative associations between cadmium and r-MSSD were stronger among participants ≤ 52 years of age (vs. > 52), current smokers (vs. nonsmokers), body mass index < 25 kg/m2 (vs. ≥ 25), and among those who were not hypertensive. Conclusions: Urine concentrations of several metals were associated with HRV parameters in our cross-sectional study population. These findings need replication in other studies with adequate sample sizes. [ABSTRACT FROM AUTHOR]

Background: Millions of people rely on N95 filtering facepiece respirators to reduce the risk of airborne particles and prevent them from respiratory infections. However, there are no respirator fit testing and training regulations in China. Meanwhile, no study has been conducted to investigate the fit of various respirators. The objective of this study was to investigate whether people obtained adequate fit when wearing N95 filtering facepiece respirators (FFRs) used widely in China. Methods: Fifty adult participants selected using the Chinese respirator fit test panel donned 10 common models of N95 FFRs. Fit factors (FF) and inward leakage were measured using the TSI PortaCount Plus. Each subject was tested with three replications for each model. A subject was considered to pass the fit test when at least two of the three FFs were greater than 100. Two models were conducted fit tests before and after training to assess the role of training. Results: The geometric mean FFs for each model and trained subjects ranged from <10 to 74.0. The fifth percentile FFs for only two individual respirator models were greater than 10 which is the expected level of performance for FFRs. The passing rates for these two models of FFRs were 44.7% and 20.0%. The passing rates were less than 10.0% for the other eight models. There were 27 (54%) participants who passed none of the 10 FFRs. The geometric mean FFs for both models when the subjects received training (49.7 and 74.0) were significantly larger than those when the same group of subjects did not receive any training (29.0 and 30.9) (P<0.05). Conclusions: FFRs used widely in China should be improved according to Chinese facial dimensions. Respirator users could benefit from respirator training and fit testing before using respirators. [ABSTRACT FROM AUTHOR]

Crystalline silica has been classified as a human carcinogen by the International Agency for Research on Cancer (Lyon, France); however, few previous studies have provided quantitative data on silica exposure, silicosis, and/or smoking. We investigated a cohort in China (in 1960–2003) of 34,018 workers without exposure to carcinogenic confounders. Cumulative silica exposure was estimated by linking a job-exposure matrix to work history. Cox proportional hazards model was used to conduct exposure-response analysis and risk assessment. During a mean 34.5-year follow-up, 546 lung cancer deaths were identified. Categorical analyses by quartiles of cumulative silica exposure (using a 25-year lag) yielded hazard ratios of 1.26, 1.54, 1.68, and 1.70, respectively, compared with the unexposed group. Monotonic exposure-response trends were observed among nonsilicotics (P for trend < 0.001). Analyses using splines showed similar trends. The joint effect of silica and smoking was more than additive and close to multiplicative. For workers exposed from ages 20 to 65 years at 0.1 mg/m3 of silica exposure, the estimated excess lifetime risk (through age 75 years) was 0.51%. These findings confirm silica as a human carcinogen and suggest that current exposure limits in many countries might be insufficient to protect workers from lung cancer. They also indicate that smoking cessation could help reduce lung cancer risk for silica-exposed individuals. [ABSTRACT FROM PUBLISHER]

Background. The detailed lung radiographic response to silica exposure has not been described. In estimating the exposure-response relationship in silicosis with statistical models, the absence of baseline (unattributable) risk can disable relative-rate estimation or produce widely varying estimates. This obstructs identification of optimum exposure metrics and invalidates comparisons and meta-analyses, which assume a common background rate. Methods. A cohort of 3,000 Chinese tin miners with more than 1,000 cases of silicosis was analyzed for the period 1961-1994. Regular surveillance documented three stages of silicosis. To examine the exposure-response relationship, the intercept in relative-rate models was fixed to correspond to 1% of the observed silicosis rate. Exposure metrics for contributions in different time-windows were simultaneously evaluated, as were burden and cumulative burden metrics. Results. Silica exposures that most contributed to silicosis onset occurred in the period 5-10 years prior (excess annual rate per 10 mg-year/m3, ER = 0.158, 95% CI = 0.125-0.192, or 16% per year). During 10-20 year prior, the excess rate contribution was much smaller (ER = 0.048, 95% CI = 0.037-0.060) but larger again during 20-30 year prior to onset (ER = 0.112, 95% CI = 0.098-0.126). For advanced silicosis, all time periods contributed about equally to the rate of onset. Conclusions. Reliable estimates of parameters were observed, demonstrating exposure contributions over time. Burden metrics with different half-lives suggested some reversibility for silicosis onset with a half-life of 20 years. Advanced silicosis was best predicted with a cumulative burden metric which was consistent with prior observations that previously deposited silica continues to cause pulmonary damage. Am. J. Ind. Med. 56:267-275, 2013. © 2012 Wiley Periodicals, Inc. [ABSTRACT FROM AUTHOR]

In China, dust samplers were originally designed to collect ‘total dust’ for a short term during production, which is different from the widely adopted sampling strategy for dust. With the aim to provide the conversion factor from Chinese total dust to US and German respirable dust and to look at the influences on conversion factors from environment, production, and instruments, a comparative field study on the dust concentration measurements by different sampling methods was carried out in the same Chinese industries as in the 1989–1990 study and in some other factories. A supplemental experiment was also conducted in a wind tunnel. Dust concentration was measured with a parallel sampling strategy by using the following samplers: 10-mm nylon cyclone for US respirable dust (AR), FSP-Berufsgenossenschaftliches Institut für Arbeitssicherheit (BIA) cyclone for German respirable dust (GR), and samplers for Chinese total dust (CT). Totally, 1434 samples were collected (269 AR, 198 GR, and 967 CT), from which 429 matched sample pairs (249 pairs of AR/CT, 180 GR/CT) were available to calculate conversion ratios. Industry- and job-based conversion factors are presented in this study. The conversion factor of AR/CT was 0.38 for tungsten mines, 0.19 for copper/iron mines, 0.65 for tin mines, and 0.20 for pottery industry, while the factor of GR/CT was 0.69 for tungsten, 0.37 for copper/iron, and 0.52 for pottery. In the job category, AR/CT factors varied from 0.16 to 0.96 and GR/CT from 0.12 to 0.72. For the industries studied in 1988–1989, the AR/CT and GR/CT factors were 0.29 and 0.45, respectively. Both factors were definitely influenced by production, CT dust concentration, sample gain, and variation of dust concentration. Moreover, the respirable dust concentration by FSP-BIA was significantly higher than that by 10-mm cyclones, 63.27–73.10% more as showed also by the wind tunnel experiment. Meanwhile, the GR/CT ratio was significantly larger than the AR/CT in every industry or job with only few exceptions. The GR/CT estimates should be considered as independent ones. Following these results, there is a need to use ‘ideal samplers’ (consistent with the internationally accepted respirable fraction) in practice and to assess the existent samplers in order to homogenize the exposure data situation. [ABSTRACT FROM AUTHOR]

Headforms are useful for designing and testing various types of personal protective equipment used to protect millions of workers from occupational hazards in China. Although the Chinese national standard of head-and-face dimensions for adults was first published in 1981, headforms based on those dimensions were never developed. In 2006, an anthropometric survey of 3000 Chinese civilian workers was conducted. As part of the survey, 350 subjects were scanned with a Cyberware 3D Rapid Digitizer. The manual measurements and 3-D digital scans from this survey were used to develop 3-D digital headforms that represent Chinese workers.Objective: The objective of this study was to develop headforms that represent today’s Chinese workers. Methods: Ten facial dimensions relevant to respirator fit were chosen for defining a principal component analysis model which divides the user population into five face size categories. Mean facial dimensions from manual measurements were then computed to target the ideal facial dimensions for each size category. Five scans were chosen from each face size category to be used in the construction process. Selected scans were then averaged to construct a representative headform for each face size category. Results: Five digital 3-D headforms were developed: small, medium, large, long/narrow, and short/wide. These distinct sizes of digital 3-D headforms take into account the linear distance between landmarks as well as the surface contours captured during the 3-D scan. The dimensions of constructed headforms were within ∼4 mm between the corresponding computed means and manual measurements of anthropometric landmarks for the sample population in each size category. Conclusions: These new headforms represent the facial size and shape distribution of current Chinese workers and may be useful for respirator research and development. The Chinese medium headform has a wider face width, shorter face length, and smaller nose protrusion when compared with the current U.S. standard headforms. Upon validation, it may be useful to incorporate these dimensions into Chinese and international respiratory protective devices standards. [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]

The role of silica in the causation of lung cancer is an ongoing debate. In order to explore whether observed association between silica exposure and lung cancer is confounded by exposure to other occupational carcinogens, we updated a previously nested case-control study among a cohort of male workers in 29 Chinese mines and factories on the basis of an extended follow-up. Five hundred and eleven lung cancer cases and 1,879 matched controls were selected. Exposure to respirable silica as well as relevant occupational confounders were quantitatively assessed based on historical industrial hygiene data. The relationship between exposure to silica and lung cancer was analyzed by conditional logistic regression analysis adjusted for exposure to arsenic, polycyclic aromatic hydrocarbons (PAHs), radon, and smoking. In a crude analysis adjusted for smoking only, a significant trend of increasing risk of lung cancer with exposure to silica was found for tin, iron/copper miners, and pottery workers. But after adjustment for relevant occupational confounders, no relationship between silica and lung cancer can be observed. Instead, there is a significant association between lung cancer mortality and cumulative exposure to inorganic arsenic (OR = 1.86, 95% CI: 1.14, 3.04 for each mg/m3-year increase) and carcinogenic PAHs (OR = 1.35, 95% CI: 1.08, 1.69 for each 100 μg/m3-year increase). This analysis does not provide any evidence to show that exposure to silica causes lung cancer in the absence of confounding factors. [ABSTRACT FROM AUTHOR]

The Dulong Sn-Zn-In polymetallic deposit in the Yunnan province, SW China, hosts a reserve of 5.0 Mt Zn, 0.4 Mt Sn, and 7 Kt In. It is one of the most important polymetallic tin ore districts in China. Granites at Dulong mining area include mainly the Laojunshan granite (third phase), which occurs as quartz porphyry or granite porphyry dikes in the Southern edge of the Laojunshan intrusive complex. Granites of phases one and two are intersected at drill holes at depth. There are three types of cassiterite mineralization developed in the deposit: cassiterite-magnetite ± sulfide ore (Cst I), cassiterite-sulfide ore (Cst II) within the proximal skarn in contact with the concealed granite (granites of phases one to two and three), and cassiterite-quartz vein ore (Cst III) near porphyritic granite. Field geology and petrographic studies indicate that acid neutralising muscovitization and pyroxene reactions were part of mechanisms for Sn precipitation resulting from fluid-rock interaction. In situ U–Pb dating of cassiterite samples from the ore stages of cassiterite-sulfide (Cst II) and Cassiterite-quartz vein (Cst III) yielded Tera-Wasserburg U–Pb lower intercept ages of 88.5 ± 2.1 Ma and 82.1 ± 6.3 Ma, respectively. The two mineralization ages are consistent with the emplacement age of the Laojunshan granite (75.9–92.9 Ma) within error, suggesting a close temporal link between Sn-Zn(-In) mineralization and granitic magmatism. LA-ICPMS trace element study of cassiterite indicates that tetravalent elements (such as Zr, Hf, Ti, U, W) are incorporated in cassiterite by direct substitution, and the trivalent element (Fe) is replaced by coupled substitution. CL image shows that the fluorescence signal of Cst I–II is greater than that of Cst III, which is caused by differences in contents of activating luminescence elements (Al, Ti, W, etc.) and quenching luminescence element (Fe). Elevated W and Fe but lowered Zr, Hf, Nb, and Ta concentrations of the three type cassiterites from the Dulong Sn-Zn-In polymetallic deposit are distinctly different from those of cassiterites in VMS/SEDEX tin deposits, but similar to those from granite-related tin deposits. From cassiterite-magnetite ± sulfide (Cst I), cassiterite-sulfide ore (Cst II), to cassiterite-quartz vein ore-stage (Cst III), high field strength elements (HFSEs: Zr, Nb, Ta, Hf) decrease. This fact combined with cassiterite crystallization ages, indicates that Cst I–II mainly related to concealed granite (Laojunshan granites of phases one and two) while Cst III is mainly related to porphyritic granite (Laojunshan granites of phase three). [ABSTRACT FROM AUTHOR]

Faced with the difficult but urgent task of reducing carbon emission intensity, considering urban agglomeration as a fundamental spatial unit for this purpose has become increasingly important. However, as a long-standing and pivotal phenomenon in the development of urban agglomerations, the potential role of spatial functional division in urban agglomerations in reducing carbon emission intensity has been largely overlooked. To fill this gap, this paper explores the relationship between spatial functional division in urban agglomerations and carbon emission intensity, relying on a dataset of 19 urban agglomerations in China. The main results reveal an inverted U-shaped relationship between spatial functional division in urban agglomerations and carbon emission intensity. Spatial functional division in urban agglomerations increases carbon emission intensity in the initial stage; once it reaches a turning point, spatial functional division in urban agglomerations can reduce carbon emission intensity. This conclusion remains robust after conducting various robustness checks and addressing endogeneity concerns. This paper identifies productivity enhancement as an underlying mechanism that shapes this relationship. Moreover, the relationship between spatial functional division in urban agglomerations and carbon emission intensity exhibits heterogeneity based on function types and urban types. These findings emphasize that spatial functional division in urban agglomerations plays a unique role in reducing carbon emission intensity, which offers a new strategy for reducing carbon emission intensity from an individual city level to an entire urban agglomeration level. • An inverted U-shaped relationship exists between SFD and CEI. • Productivity enhancement derived from SFD is a crucial influencing mechanism. • Function types and urban types influence the relationship between SFD and CEI. • Improving SFD adds a novel urban agglomeration-level strategy to reduce CEI. [ABSTRACT FROM AUTHOR]

• 1. Predicting renal prognosis accurately in ERT- naive FD patients poses a significant challenge. • 2. COX analysis identified sex, proteinuria, eGFR, and Lyso-Gb3 as independent factors for kidney progression. • 3. Combined model and clinical model both exhibited favorable predictive performance. • 4. Lyso-Gb3 improved the predictive ability of the combined model for renal outcomes in low-risk patients compared to the clinical model. • 5. Early intervention is warranted for the underestimated-risk subgroup with eGFR over 60 ml/min/1.73 m 2 or proteinuria levels less than 1. g / d. Kidney damage is common in patients with Fabry disease (FD), but more accurate information about the risk of progression to kidney failure is needed for clinical decision-making. In particular, FD patients with mild renal involvement often lack timely intervention and treatment. We aimed to utilize a model to predict the risk of renal progression in FD patients. Between November 2011 and November 2019, ERT-naive patients with FD were recruited from three medical centers in China. To assess the risk of a 50% decline in the estimated glomerular filtration rate (eGFR) or end-stage kidney disease (ESKD), Cox proportional hazards models were utilized. The performance of these models was assessed using discrimination, calibration, and reclassification. A total of 117 individuals were enrolled. The mean follow-up time was 4.8 years, during which 35 patients (29.9 %) progressed to the composite renal outcomes. Male sex, baseline proteinuria, eGFR and globotriaosylsphingosine (Lyso-Gb3) were found to be independent risk factors for kidney progression by the Cox model, based on which a combined model containing those clinical variables and Lyso-Gb3 and clinical models including only clinical indicators were constructed. The two prediction models had relatively good performance, with similar model fit measured by R2 (59.8 % vs. 61.1 %) and AIC (51.54 vs. 50.08) and a slight increase in the C statistic (0.949 vs. 0.951). Calibration curves indicated closer alignment between predicted and actual renal outcomes in the combined model. Furthermore, subgroup analysis revealed that Lyso-Gb3 significantly improved the predictive performance of the combined model for kidney prognosis in low-risk patients with a baseline eGFR over 60 ml/min/1.73 m 2 or proteinuria levels less than 1 g / d when compared to the clinical model. Lyso-Gb3 improves the prediction of kidney outcomes in FD patients with a low risk of progression, suggesting that these patients may benefit from early intervention to assist in clinical management. These findings need to be externally validated. [ABSTRACT FROM AUTHOR]

Objective: To examine the independent and combined associations of sleep duration and sleep quality with hypertension in a middle-aged and older Chinese population.Methods: We included 21,912 individuals aged 62.2 years at baseline from September 2008 to June 2010, and they were followed until October 2013. Sleep duration was self-reported and sleep quality was evaluated with questions designed according to the Pittsburgh Sleep Quality Index. Hypertension was defined as blood pressure ≥140/90 mmHg, or self-reported physician diagnosis of hypertension, or self-reported current use of antihypertensive medication.Results: In the cross-sectional analyses, the odds ratio of hypertension prevalence was significantly elevated (OR = 1.13, 95% CI = 1.03-1.24) in those who slept less than 7 h after adjusting for sex, age, body mass index, midday napping, cigarette smoking and sleep quality. It was particularly evident among males (OR = 1.19, 95% CI = 1.01-1.40) and individuals who were thin (OR = 2.00, 95% CI = 1.01-3.93) with full adjustment. The association was also found for sleep duration of 9∼<10 h after adjusting various covariates (OR = 1.14, 95% CI = 1.04-1.27). In addition, impaired sleep quality was only associated with hypertension in obese individuals (OR = 1.25, 95% CI = 1.02-1.50), not in other subgroups. However, no significant association was detected in any category of sleep duration or sleep quality in all models in the prospective analyses, and the results remained unchanged in the subgroup analyses of sex, age and body mass index.Conclusions: The results of this study provide limited support for association of sleep duration and sleep quality with hypertension in middle-aged and older Chinese. Further studies are needed to confirm the results. [ABSTRACT FROM AUTHOR]

Association of exposure to polycyclic aromatic hydrocarbons (PAHs) with increased urinary 8-hydroxy-2′-deoxyguanosine (8-OHdG) formation has been reported in occupational population and children. However, studies on the association between them in general population are limited. A total of 1864 eligible subjects from the baseline Wuhan participants of the Wuhan-Zhuhai Cohort Study (n = 3053) were included in this study, after excluding individuals with certain disease and missing data on urinary monohydroxy PAHs (OH-PAHs) and 8-OHdG levels. Urinary monohydroxy PAHs and 8-OHdG levels were measured by gas chromatography-mass spectrometry and high performance liquid chromatography-electrochemical detection, respectively. Association of urinary OH-PAHs with urinary 8-OHdG was analyzed by multiple linear regression analysis. We found a dose-dependent relationship between urinary PAHs metabolites and urinary 8-OHdG (p < 0.05 for all). Furthermore, more evidence for the association of total concentrations of urinary OH-PAHs with 8-OHdG levels were observed in individuals with normal body mass index or central obesity (p < 0.01 for all). There was a dose-dependent relationship between urinary OH-PAHs levels and urinary 8-OHdG levels among a general Chinese population. Exposure to background PAHs may have a greater influence on urinary 8-OHdG levels in individuals with central obesity. [ABSTRACT FROM AUTHOR]

Urban environmental air pollution has become a serious public issue in China. However, the potential adverse effects of different air pollutants on liver function are still unclear. We aimed to explore the associations of air pollutants exposure with liver function, and analyzed short-term impact in two cities with different levels of air pollution. We included 3892 residents from the Wuhan (high-pollution area)-Zhuhai (low-pollution area) cohort. Liver enzymes including alanine aminotransferase (ALT) and aspartate aminotransferase (AST) in fasting peripheral blood were determined by a fully automatic biochemical analyzer. Individual air pollutants inhalation exposure was estimated by combining his/her daily breathing volume and the concentrations of six air pollutants, including particulate matter (PM 2.5), inhalable particulate matter (PM 10), nitrogen dioxide (NO 2), sulfur dioxide (SO 2), carbon monoxide (CO) and ozone (O 3), from local ambient air monitoring stations. The associations of air pollutants with ALT and AST were evaluated using linear mixed models. We found positive associations of PM 2.5 (lag01-lag07), PM 10 (lag01-lag07), NO 2 (lag01-lag07), SO 2 (lag01-lag07), CO (lag01-lag06) and O 3 (lag01-lag02) with ALT and PM 10 (lag04-lag07) with AST. In Wuhan, exposure to PM 2.5 (lag01-lag07), PM 10 (lag01-lag07), NO 2 (lag01-lag07) and SO 2 (lag01-lag07) was associated with increased ALT, and PM 10 (lag04-lag07) and NO 2 (lag01-lag03) exposure was significantly associated with increased AST. While in Zhuhai, although all six air pollutants (PM 2.5 [lag01-lag07], PM 10 [lag01-lag02], NO 2 [lag01-lag04], SO 2 [lag01-lag03], CO [lag01-lag07] and O 3 [lag01-lag03]) were significantly associated with increased ALT, no pollutant was significantly associated with increased AST. Our results suggest that short-term exposure to air pollutants has adverse effects on liver function among urban adults. Such adverse effects last longer in high-pollution area than that in low-pollution area. Image 1 • We explored adverse effect of air pollutants with higher levels on liver function. • The short-term impact in different air pollution area was analyzed in this study. • A method was adopted to assess personal air pollutants inhalation exposure. • Short-term exposure to air pollutants can affect serum ALT and AST levels. [ABSTRACT FROM AUTHOR]

Cadmium is a recognized human carcinogen, raising global concern for its ubiquitously environmental exposure on public health. Diabetogenic effects of cadmium have been suggested in previous studies, but the longitudinal associations of chronic cadmium exposure with fasting blood glucose changes and type 2 diabetes mellitus have not been fully elucidated. To investigate the effects of long-term cadmium exposure on the fasting blood glucose changes and type 2 diabetes mellitus risk in a longitudinal prospective study of China. A total of 3521 urban adults were included as baseline study population from the Wuhan-Zhuhai cohort, and followed up three years later. Urinary cadmium concentrations were determined repeatedly during the follow-up of a three-year period. The within-person and between-person variability of urinary cadmium concentrations over three years was estimated using multilevel random-effects mixed models. Multivariate regression models were performed to evaluate the associations of cadmium exposure with fasting blood glucose changes and type 2 diabetes mellitus risk. The geometric means of creatinine-corrected urinary cadmium concentration at baseline were 1.13 μg/g creatinine, which were close to the levels of follow-up (1.14 μg/g creatinine). The intra-class correlation coefficient of creatinine-corrected urinary cadmium concentrations was 0.71, achieving good reproducibility of cadmium over three years. With adjustment for potential confounders, each one-unit increase in log10-transformed cadmium was associated with a 0.11 (95%CI: 0.03 to 0.19) elevation in fasting blood glucose concentration, and was associated with a 42% (95%CI: 1.16 to 1.73) increase in risk of prevalent type 2 diabetes mellitus. Upward trends of fasting blood glucose changes and type 2 diabetes mellitus incidence were observed with increasing cadmium exposure. Individuals with the highest urinary cadmium exposure had a significant increase in fasting blood glucose change at follow-up [β (95% CI): 0.49 (0.31–0.67)]. Risk of incident type 2 diabetes mellitus were gradually elevated across increasing quartiles of cadmium exposure, though associations did not reach statistical significance (P = 0.15). Our findings suggested that relatively high chronic cadmium exposure for general population adults might contribute to elevated changes of fasting blood glucose resulting in the development of type 2 diabetes mellitus. • Excellent reproducibility was achieved for urinary Cd levels over three years. • Significant associations observed for urinary Cd with FBG and prevalent T2DM risk. • Individuals with high Cd exposure had a significant increase in FBG at follow-up. • Risk of incident T2DM were gradually elevated across increasing urinary Cd. • Associations were further confirmed in penalized regression splines models. [ABSTRACT FROM AUTHOR]

• Long-term personal PM 2.5 exposure at high level was associated with FEV 1 /FVC decline. • Significant impact of PM 2.5 exposure on lung function was obvious in 3 and 6 years. • Smoking status and resident area can predict long-term personal PM 2.5 exposure level. Exposure to fine particulate matter (PM 2.5) have been associated with adverse respiratory outcomes, but long-term effect of personal exposure on lung function remains largely unknown. We conducted a panel study of 158 adult residents with 394 measurements of personal PM 2.5 concentration and lung function within six years to investigate the long-term association. Linear mixed models were used to identify the associations between lung function changes in relation to different levels of persistent personal PM 2.5 exposure in three or six years. We further attempted to validate resident areas (city) and smoking status as potential predictors of the long-term PM 2.5 exposure levels (persistently high/ persistently low) by generating ROC curves. Compared with subjects who had persistently low exposure level, those with persistently high levels of personal PM 2.5 exposure had an additional 3.63 % decline in FEV 1 /FVC in three years (-3.63 [-7.25, -0.02]), while 7.15 % decline in six years (-7.15 [-14.27, -0.03]). BMI can modify the association. The AUCs were 0.68 (95 %CI: 0.54, 0.82), 0.75 (0.64, 0.86), and 0.82 (0.71, 0.93) for models including smoking status, resident areas, and smoking status combining resident areas respectively. These findings provide new evidence for the long-term effect of personal PM 2.5 exposure on lung function decline. [ABSTRACT FROM AUTHOR]

• Urinary 1-BP metabolites positively associated with FPG levels. • Exposure to 1-BP increased the risk of diabetes in Chinese urban adults. • Lipid peroxidation mediated the association between 1-BP and FPG. Exposure to 1-bromopropane (1-BP) has been reported to cause glutathione depletion and increase the level of oxidative damage, which play critical roles in diabetes. However, the possible associations or mechanisms of the exposure of 1-BP with the plasma glucose level and the risk of diabetes are unclear. In this study, we explored the relationships of the urinary 1-BP metabolite N-Acetyl-S-(n-propyl)- l -cysteine (BPMA) with fasting plasma glucose (FPG) levels and the risk of diabetes, and the mediating role of oxidative damage in the above relationships in 3678 urban adults from the Wuhan-Zhuhai cohort in China. We found a significant dose–response relationship between BPMA and FPG levels with a β of 0.09 (95 % CI: 0.04, 0.14). In addition, mediating effect of urinary BPMA on FPG levels was observed depending on elevated 8-isoprostane level, with a median proportion of 32.06 %. Furthermore, we observed a significant association between urinary BPMA and the risk of diabetes, with an adjusted odds ratio of 1.34 (1.18, 1.52) for all participants. These results indicated that urinary 1-BP metabolites were positively associated with FPG levels and the risk of diabetes among urban adults in this cross-sectional study. Lipid peroxidation partially mediated the association between urinary 1-BP metabolites and FPG levels. [ABSTRACT FROM AUTHOR]

• The FVC and FEV 1 levels were inversely correlated with PCDD/Fs exposure levels. • Urinary 8-OHdG levels were inversely correlated with lung function parameters. • Urinary 8-OHdG mediated the associations of PCDD/Fs exposure with FVC levels. • Urinary 8-OHdG mediated the associations of serum PCDD/Fs with FVC and FEV 1 levels. The lung has been reported to be one of the target organs of polychlorinated dibenzo-dioxins and polychlorinated dibenzo-furans (PCDD/Fs) in many toxicological studies. While the associations between PCDD/Fs exposure and lung function levels have not been investigated thoroughly. This study aimed to explore these associations and the potential mediating role of oxidative stress. In this study, 201 foundry workers and 222 non-exposed general residents were recruited from central China, and their lung function parameters were measured. Air and food samples were collected to determine the PCDD/Fs levels for individual PCDD/Fs exposure estimation. Serum PCDD/Fs levels were determined in a subgroup of individuals randomly selected from the study population to reflect the body burden. It was found that each 1-unit increase in ln-transformed concentration of PCDD/Fs exposure (fg TEQ/bw/day) was associated with a 0.47 L decrease in FVC and a 0.25 L decrease in FEV 1. Each 1-unit increase in ln-transformed concentration of serum PCDD/Fs (fg TEQ/g lipid) was associated with a 0.36 L decrease in FVC and a 0.24 L decrease in FEV 1. Urinary 8-hydroxy-2′-deoxyguanosine (8-OHdG) was not only positively related to PCDD/Fs exposure, but also inversely associated with FVC and FEV 1 are FVC (β = −0.15, 95% CI: −0.22 to −0.08) and FEV 1 (β = −0.07, 95% CI: −0.13 to −0.02). Mediation analysis revealed that urinary 8-OHdG mediated 12.22% of the associations of external PCDD/Fs exposure with FVC levels, 28.61% and 27.87% of the associations of serum PCDD/Fs with FVC and FEV 1 levels respectively. Our findings suggested that PCDD/Fs exposure was associated with decreased lung function levels by a mechanism partly involving oxidatively generated damage to DNA. [ABSTRACT FROM AUTHOR]

Polychlorinated biphenyls (PCBs) are endocrine-disrupting chemicals that have been associated with various adverse health conditions. Herein we explored the associations of PCBs with dyslipidemia and further assessed the modification effect of genetic susceptibility and lifestyle factors. Six serum PCBs (PCB-28, 101, 118, 138, 153, 180) were determined in 3845 participants from the Wuhan-Zhuhai cohort. Dyslipidemia, including hyper-total cholesterol (HyperTC), hyper-triglyceride (HyperTG), hyper-low density lipoprotein cholesterol (HyperLDL-C), and hypo-high density lipoprotein cholesterol (HypoHDL-C) were determined, and lipid-specific polygenic risk scores (PRS) and healthy lifestyle score were constructed. We found that all six PCB congeners were positively associated with the prevalence of dyslipidemias, and ΣPCB level was associated with HyperTC, HyperTG, and HyperLDL-C in dose-response manners. Compared with the lowest tertiles of ΣPCB, the odds ratios (95% confidence intervals) in the highest tertiles were 1.490 (1.258, 1.765) for HyperTC, 1.957 (1.623, 2.365) for HyperTG, and 1.569 (1.316, 1.873) for HyperLDL-C, respectively. Compared with those with low ΣPCB, healthy lifestyle, and low genetic risk, participants with high ΣPCB, unfavorable lifestyle, and high genetic risk had the highest odds of HyperTC, HyperTG, and HyperLDL-C. Our study provided evidence that high PCB exposure exacerbated the association of genetic risk and unhealthy lifestyle with dyslipidemia., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Objective: Whether coal mine dust exposure increases cardiovascular diseases (CVDs) risk was rarely explored. Our objective was to examine the association between coal mine dust exposure and cardiovascular risk., Methods: We estimated cumulative coal mine dust exposure (CDE) for 1327 coal miners by combining data on workplace dust concentrations and work history. We used brachial-ankle pulse wave velocity (baPWV, a representative indicator of arterial stiffness) and ten-year atherosclerotic cardiovascular disease (ASCVD) risk to assess potential CVD risk, exploring their associations with CDE., Results: Positive dose-response relationships of CDE with baPWV and ten-year ASCVD risk were observed after adjusting for covariates. Specifically, each 1 standard deviation (SD) increase in CDE was related to a 0.27 m/s (95% CI: 0.21, 0.34) increase in baPWV and a 1.29 (95% CI: 1.14, 1.46) elevation in OR (odds ratio) of risk of abnormal baPWV. Moreover, each 1 SD increase in CDE was associated with a 0.74% (95% CI: 0.63%, 0.85%) increase in scores of ten-year ASCVD and a 1.91 (95% CI: 1.62, 2.26) increase in OR of risk of ten-year ASCVD. When compared with groups unexposed to coal mine dust, significant increase in the risk of arterial stiffness and ten-year ASCVD in the highest CDE groups were detected., Conclusion: The study suggested that cumulative exposure to coal mine dust was associated with elevated arterial stiffness and ten-year ASCVD risk in a dose-response manner. These findings contribute valuable insights for cardiovascular risk associated with coal mine dust., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Aims: We aimed to evaluate the association of occupational noise with metabolic syndrome (MetS) and its components, and to assess the potential role of miRNAs in occupational noise-associated MetS., Methods: A total of 854 participants were enrolled in our study. Cumulative noise exposure (CNE) was estimated in conjunction with workplace noise test records and research participants' employment histories. Logistic regression models adjusted for potential confounders were used to assess the association of CNE and miRNAs with MetS and its components., Results: We observed linear positive dose-response associations between occupational noise exposure and the prevalence of MetS (OR: 1.031; 95 % CI: 1.008, 1.055). And linear and nonlinear relationship were also found for the association of occupational noise exposure with high blood pressure (OR: 1.024; 95 % CI: 1.007, 1.041) and reduced high-density lipoprotein (OR: 1.051; 95 % CI: 1.031, 1.072), respectively. MiR-200a-3p, miR-92a-3p and miR-21-5p were inversely associated with CNE, or the prevalence of MetS and its components (all P < 0.05). However, we did not find any statistically significant mediation effect of miRNAs in the associations of CNE with MetS. Furthermore, the prevalence of bilateral hearing loss in high-frequency increased (OR: 1.036; 95 % CI: 1.008, 1.067) with CNE level rising, and participants with bilateral hearing loss in high-frequency had a significantly higher risk of MetS (OR: 1.727; 95 % CI: 1.048, 2.819)., Conclusion: Our study suggests that occupational noise exposure is associated with MetS and its components, and the role of miRNAs in noise-induced increasing MetS risk needs to be confirmed in future studies., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Arsenic-related oxidative stress and resultant diseases have attracted global concern, while longitudinal studies are scarce. To assess the relationship between arsenic exposure and systemic oxidative damage, we performed two repeated measures among 5236 observations (4067 participants) in the Wuhan-Zhuhai cohort at the baseline and follow-up after 3 years. Urinary total arsenic, biomarkers of DNA oxidative damage (8-hydroxy-2'-deoxyguanosine (8-OHdG)), lipid peroxidation (8-isoprostaglandin F2alpha (8-isoPGF2α)), and protein oxidative damage (protein carbonyls (PCO)) were detected for all observations. Here we used linear mixed models to estimate the cross-sectional and longitudinal associations between arsenic exposure and oxidative damage. Exposure-response curves were constructed by utilizing the generalized additive mixed models with thin plate regressions. After adjusting for potential confounders, arsenic level was significantly and positively related to the levels of global oxidative damage and their annual increased rates in dose-response manners. In cross-sectional analyses, each 1% increase in arsenic level was associated with a 0.406% (95% confidence interval (CI): 0.379% to 0.433%), 0.360% (0.301% to 0.420%), and 0.079% (0.055% to 0.103%) increase in 8-isoPGF2α, 8-OHdG, and PCO, respectively. More importantly, arsenic was further found to be associated with increased annual change rates of 8-isoPGF2α (β: 0.147; 95% CI: 0.130 to 0.164), 8-OHdG (0.155; 0.118 to 0.192), and PCO (0.050; 0.035 to 0.064) in the longitudinal analyses. Our study suggested that arsenic exposure was not only positively related with global oxidative damage to lipid, DNA, and protein in cross-sectional analyses, but also associated with annual increased rates of these biomarkers in dose-dependent manners., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023. Published by Elsevier B.V.)

Adverse health effects of ambient ozone are getting widespread attention, but the evidence on the relationship between ozone levels and circulatory system diseases are limited and inconsistent. Daily data for ambient ozone levels and hospitalizations for total circulatory diseases and five subtypes in Ganzhou, China from January 1, 2016 to December 31, 2020 were collected. We constructed a generalized additive model with quasi-Poisson regression accounting for lag effects to estimate the associations between ambient ozone levels and the number of hospitalized cases of total circulatory diseases and five subtypes. The differences among gender, age, and season subgroups were furtherly assessed through stratified analysis. A total of 201,799 hospitalized cases of total circulatory diseases were included in the present study, including 94,844 hypertension (HBP), 28,597 coronary heart disease (CHD), 42,120 cerebrovascular disease (CEVD), 21,636 heart failure (HF), and 14,602 arrhythmia. Significantly positive associations were observed between ambient ozone levels and daily hospitalizations for total circulatory diseases and all subtypes except arrhythmia. Each 10 μg/m 3 increase in ozone concentration, the risk of hospitalizations for total circulatory diseases, HBP, CHD, CEVD, and HF increased by 0.718% (95% confidence interval, 0.156%-1.284%), 0.956% (0.346%-1.570%), 0.499% (0.057%-0.943%), 0.386% (0.025%-0.748%), and 0.907% (0.118%-1.702%), respectively. The above associations remained significant after adjusting for other air pollutants. The risk of hospitalization for circulatory diseases was higher in warm season (May to October) and varied in gender and age subgroups. This study suggested that short-term exposure to ambient ozone may increase the risk of hospitalizations for circulatory diseases. Our findings reinforce the importance of reducing ambient ozone pollution levels for protecting public health., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

Objective: Previous epidemiological studies have shown that both long-term and short-term exposure to fine particulate matters (PM 2.5 ) were associated with the morbidity and mortality of circulatory system diseases (CSD). However, the impact of PM 2.5 on CSD remains inconclusive. This study aimed to investigate the associations between PM 2.5 and circulatory system diseases in Ganzhou., Methods: We conducted this time series study to explore the association between ambient PM 2.5 exposure and daily hospital admissions for CSD from 2016 to 2020 in Ganzhou by using generalized additive models (GAMs). Stratified analyses were also performed by gender, age, and season., Results: Based on 201,799 hospitalized cases, significant and positive associations were found between short-term PM2.5 exposure and hospital admissions for CSD, including total CSD, hypertension, coronary heart disease (CHD), cerebrovascular disease (CEVD), heart failure (HF), and arrhythmia. Each 10 μg/m 3 increase in PM 2.5 concentrations was associated with a 2.588% (95% confidence interval [CI], 1.161%-4.035%), 2.773% (95% CI, 1.246%-4.324%), 2.865% (95% CI, 0.786%-4.893%), 1.691% (95% CI, 0.239%-3.165%), 4.173% (95% CI, 1.988%-6.404%) and 1.496% (95% CI, 0.030%-2.983%) increment in hospitalizations for total CSD, hypertension, CHD, CEVD, HF, and arrhythmia, respectively. As PM 2.5 concentrations rise, the hospitalizations for arrhythmia showed a slow upward trend, while other CSD increased sharply at high PM 2.5 levels. In subgroup analyses, the impacts of PM 2.5 on hospitalizations for CSD were not materially changed, although the females had higher risks of hypertension, HF, and arrhythmia. The relationships between PM 2.5 exposure and hospitalizations for CSD were more significant among individuals aged ≤65 years, except for arrhythmia. PM 2.5 had stronger effects on total CSD, hypertension, CEVD, HF, and arrhythmia during cold seasons., Conclusion: PM 2.5 exposure was positively associated with daily hospital admissions for CSD, which might provide informative insight on adverse effects of PM 2.5 ., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 You, Cao, Guo, Wang, Qiu, Zhou, Zhou, Chen and Zhang.)

The short-term impacts of urban air pollution on the platelet-lymphocyte ratio (PLR) and neutrophil-lymphocyte ratio (NLR) remain obscure. In this study, we included 3487 urban adults from the Wuhan-Zhuhai cohort. Individual inhalation exposure to air pollutants was estimated by combining participants' daily breath volume and ambient concentrations of six air pollutants (including fine particulate matter (PM 2.5 ), inhalable particulate matter (PM 10 ), nitrogen dioxide (NO 2 ), sulfur dioxide (SO 2 ), carbon monoxide (CO) and ozone (O 3 )). The cumulative impacts were assessed by applying lag structures of up to 7 days before the survey date. Associations of air pollutants with PLR and NLR were assessed using a linear mixed model and Bayesian kernel machine regression (BKMR) model. We found that PLR was negatively related to PM 2.5 (lag02-lag06), PM 10 (lag02-lag07), NO 2 (lag02-lag07), and SO 2 (lag03-lag05) and NLR was negatively related to PM 10 (lag05 and lag07). In the BKMR model, a negative joint association between the six-air-pollutant mixture and PLR and NLR was observed, whereas PM 10 and NO 2 appeared to be more important than the other pollutants in the mixture. The negative impact of air pollutants was stronger in males, participants with lower body mass index (< 24 kg/m 2 ), those cooking meals at home, drinkers, and non-exercisers. In conclusion, short-term exposure to air pollutants is significantly related to PLR and NLR in peripheral blood. PLR and NLR may provide new insight into the molecular mechanism underlying the adverse health impact of air pollutants., (Copyright © 2021. Published by Elsevier B.V.)

Background: Ambient carbon monoxide (CO) exposure is associated with increased mortality and hospitalization risk for total respiratory diseases. However, evidence on the risk of hospitalization for specific respiratory diseases from ambient CO exposure is limited., Methods: Data on daily hospitalizations for respiratory diseases, air pollutants, and meteorological factors from January 2016 to December 2020 were collected in Ganzhou, China. A generalized additive model with the quasi-Poisson link and lag structures was used to estimate the associations between ambient CO concentration and hospitalizations of total respiratory diseases, asthma, chronic obstructive pulmonary disease (COPD), upper respiratory tract infection (URTI), lower respiratory tract infection (LRTI), and influenza-pneumonia. Possible confounding co-pollutants and effect modification by gender, age, and season were considered., Results: A total of 72,430 hospitalized cases of respiratory diseases were recorded. Significant positive exposure-response relationships were observed between ambient CO exposure and hospitalization risk from respiratory diseases. For each 1 mg/m 3 increase in CO concentration (lag0-2), hospitalizations for total respiratory diseases, asthma, COPD, LRTI, and influenza-pneumonia increased by 13.56 (95% CI: 6.76%, 20.79%), 17.74 (95% CI: 1.34%, 36.8%), 12.45 (95% CI: 2.91%, 22.87%), 41.25 (95% CI: 18.19%, 68.81%), and 13.5% (95% CI: 3.41%, 24.56%), respectively. In addition, the associations of ambient CO with hospitalizations for total respiratory diseases and influenza-pneumonia were stronger during the warm season, while women were more susceptible to ambient CO exposure-associated hospitalizations for asthma and LRTI (all P < 0.05)., Conclusion: In brief, significant positive exposure-response relationships were found between ambient CO exposure and hospitalization risk for total respiratory diseases, asthma, COPD, LRTI, and influenza-pneumonia. Effect modification by season and gender was found in ambient CO exposure-associated respiratory hospitalizations., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Song, Qiu, Huang, Guo, Chen, Wang and Zhang.)

Rapid and reliable diagnosis is important for the management of individuals infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The rapid antigen detection test (RADT) is a rapid, inexpensive, and easy method. Several studies have reported that RADTs performed well in many countries; however, very few studies have been reported in China. In this study, we assessed the performance of the RADT (Ediagnosis COVID-19 antigen test kit). This study was conducted in a centralized isolation site in Shanghai and enrolled 716 patients with COVID-19 and 203 noninfected participants. Nasopharyngeal swabs from all participants were collected on the same day and tested using the RADT and real-time reverse transcription-PCR (RT-PCR). The performance of the RADT was evaluated in different scenarios, such as threshold cycle ( C T ) values, symptomatic phase, and symptoms on the day of testing. The results demonstrated that the sensitivity for patients with C T values lower than 20 was 96.55% (95% confidence interval [CI], 87.05 to 99.4). The sensitivities were 78.4% (95% CI, 69.96 to 85.05) for participants within 5 days after the first RT-PCR-positive result and 90.77% (95% CI, 80.34 to 96.19) within 5 days after symptom onset. Moreover, the sensitivity of the RADT was more than 80% for patients with symptoms on the day of testing, including fever (89.29%), cough (86.84%), stuffy nose (92.59%), runny nose (92%), sore throat (81.25%), and muscle pain (80.77%), especially for those with upper respiratory tract symptoms. The specificity of the RADT was good in all scenarios. During the SARS-CoV-2 epidemic, Ediagnosis performed excellently in individuals with a higher viral load (evidenced by lower C T values), individuals in the early symptomatic phase, and especially those with upper respiratory tract symptoms. IMPORTANCE RADTs have demonstrated excellent performance in many counties for screening SARS-CoV-2 infection, but very few studies have been conducted in China. The performance of RADTs is largely related to different real-life scenarios. In our study, the performance of the RADT was evaluated in different scenarios, such as C T values, symptomatic phase, and symptoms on the day of testing. The results demonstrated that Ediagnosis (an RADT made in China) performed excellently for individuals with a higher viral load (evidenced by lower C T values), individuals in the early symptomatic phase, and especially those with upper respiratory tract symptoms.

The adverse health effects of pyrethroids exposure have attracted wide concern. We aimed to assess the associations of bifenthrin, a widely used pyrethroid, with glucose homeostasis and risk of type 2 diabetes mellitus (T2DM) and to explore the underlying mechanism. Serum bifenthrin, fasting plasma glucose (FPG), fasting plasma insulin (FPI), and plasma protein carbonyl (PCO) were determined among 3822 participants from the Wuhan-Zhuhai cohort. Glucose homeostasis was evaluated by FPG, FPI, homeostasis model assessment of insulin resistance (HOMA-IR), impaired fasting glucose (IFG), and abnormal glucose regulation (AGR). The associations of serum bifenthrin with glucose homeostasis and risk of T2DM were assessed by generalized linear models and logistic regression models. The role of PCO in the above associations was evaluated by mediation analyses. After adjusting for covariates, each 2-fold increase in serum bifenthrin was associated with a 0.21 mmol/L increase in FPG and a 5.19%, 10.49%, and 12.18% increase in FPI, HOMA-IR, and PCO levels, respectively. Monotonically elevated ORs of IFG and AGR (all P and P for trend <0.05), but not T2DM (P > 0.05) were detected to be associated with increased bifenthrin. Compared with the participants with low bifenthrin and low PCO, participants with high bifenthrin exposure and high PCO showed a 0.40 mmol/L, 11.07%, and 22.50% increase in FPG, FPI, and HOMA-IR, as well as a 119.97% and 48.88% increase in risks of IFG and AGR, respectively (P for trend <0.05). Moreover, PCO mediated 13.61%-24.98% of the serum bifenthrin-associated glucose dyshomeostasis. The study suggested that bifenthrin exposure was dose-dependently associated with glucose dyshomeostasis in the general Chinese urban adults, and these associations were exacerbated and partly mediated by PCO. Given that other pollutants were not included in this study, the effect of co-exposure of pyrethroids with multiple pollutants is necessary to be considered in future studies., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

The link between zinc exposure and glucose metabolism or the development of type 2 diabetes (T2D) is controversial, and underlying mechanisms are unclear. This study aimed to explore the associations of zinc exposure with glucose-insulin homeostasis traits and the long-term effects of zinc on the development of T2D, and further to estimate the potential roles of inflammation and oxidative damage in such relationships. We investigated 3890 urban adults from the Wuhan-Zhuhai cohort, and followed up every three years. Mixed linear model was applied to estimate dose-response associations between urinary zinc and glycemia traits [fasting plasma insulin (FPI), fasting plasma glucose (FPG), insulin resistance (homeostasis model assessment of insulin resistance, HOMA-IR), and β-cell dysfunction (homeostasis model assessment of β-cell function, HOMA-B)], as well as zinc and biomarkers for systemic inflammation (C-reactive protein) and oxidative damage (8-isoprostane and 8-hydroxy-2'-deoxyguanosine). Logistic regression model and Cox regression model were conducted to evaluate the relationships between urinary zinc and prevalence and incidence of T2D, respectively. We further performed mediation analysis to assess the roles of inflammation and oxidative damage biomarkers in above associations. At baseline, we observed significant dose-response relationships of elevated urinary zinc with increased FPI, FPG, HOMA-IR, and T2D prevalence and decreased HOMA-B, and such associations could be strengthened by increased C-reactive protein, 8-isoprostane, and 8-hydroxy-2'-deoxyguanosine. Elevated C-reactive protein significantly mediated 9.09% and 17.67% of the zinc-related FPG and HOMA-IR increments, respectively. In longitudinal analysis, a significantly positive association between urinary zinc and T2D incidence was observed among subjects with persistent high urinary zinc levels when compared with those with persistent low zinc levels. Our results suggested that high levels of zinc exposure adversely affected on glucose-insulin homeostasis and further contributed to increased risk of T2D cross-sectionally and longitudinally. Moreover, inflammatory response might play an important role in zinc-related glucose metabolic disorder., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

1-bromopropane is a US Environmental Protection Agency-identified significant hazardous air pollutant with concerned adverse respiratory effect. We aimed to investigate the relationship between 1-bromopropane exposure and pulmonary function and the underlying role of oxidative damage, which all remain unknown. Pulmonary function and urinary biomarkers of 1-bromopropane exposure (N-Acetyl-S-(n-propyl)-L-cysteine, BPMA) and oxidative damage to DNA (8-hydroxy-deoxyguanosine, 8-OHdG) and lipid (8-iso-prostaglandin-F2α, 8-iso-PGF2α) were measured for 3259 Chinese urban adults from the Wuhan-Zhuhai cohort. The cross-sectional relationship of BPMA with pulmonary function and the joint relationship of BPMA and 8-OHdG or 8-iso-PGF2α with pulmonary function were investigated by linear mixed models. The mediating roles of 8-OHdG and 8-iso-PGF2α were evaluated by mediation analysis. Additionally, a panel of 138 subjects was randomly convened from the same cohort to evaluate the stability of BPMA repeatedly measured in urine samples collected over consecutive three days and intervals of one, two, and three years, and to estimate the longitudinal relationship of BPMA with pulmonary function change in three years. We found each 3-fold increase in BPMA was cross-sectionally related to FVC and FEV 1 reductions by 29.88-mL and 25.67-mL, respectively (all P < 0.05). Joint relationship of BPMA and 8-OHdG rather than 8-iso-PGF2α with reduced pulmonary function was observed. Moreover, 8-OHdG significantly mediated 9.44% of the BPMA-related FVC reduction. Findings from the panel revealed a fair to excellent stability (intraclass correlation coefficient: 0.43-0.79) of BPMA in repeated urines collected over a period of three years. Besides, BPMA was longitudinally related to pulmonary function reduction in three years: compared with subjects with persistently low BPMA level, those with persistently high BPMA level had 79.08-mL/year and 49.80-mL/year declines in FVC and FEV 1 , respectively (all P < 0.05). Conclusively, 1-bromopropane exposure might impair pulmonary function of urban adult population, and oxidative DNA damage might be a potential mechanism underlying 1-bromopropane impairing pulmonary function especially FVC., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

Styrene and ethylbenzene (S/EB) are the monomers of polystyrene (PS) and polyethylene (PE), respectively, and have been identified as significant hazardous air pollutants by the U.S. Environmental Protection Agency. However, the adverse effects of S/EB on human health, especially cardiovascular health, have not been well established. Urinary biomarker of S/EB exposure and heart rate variability (HRV) were measured in urban adults from the Wuhan-Zhuhai cohort and were repeated after 3-year and 6-year follow-ups. Linear mixed models were used to estimate associations of S/EB exposure biomarker with HRV and longitudinal additional annual change of HRV. The mediating role of transforming growth factor (TGF)-β1 was tested by using mediation analysis. A total of 2842 general adults were included at baseline analysis, and 4748 observations were included in the repeated measurement study. In the cross-sectional analysis, each 1% increment in urinary S/EB exposure biomarker was significantly associated with a 0.106 % (95 % CI: -0.160, -0.052), 0.109 % (-0.169, -0.049), 0.099 % (-0.145, -0.053), 0.040 % (-0.060, -0.020), and 0.031 % (-0.054, -0.007) decrement in low frequency (LF), high frequency (HF), total power (TP), standard deviation of all normal-to-normal intervals (SDNN), and square root of the mean squared difference between adjacent normal-to-normal interval, respectively. Smoking status modified the relationships of urinary S/EB exposure biomarker with TP and SDNN. TGF-β1 mediated 3.09-5.16 % of the association between urinary S/EB biomarker and lower HRV. The follow-up analyses detected a negative association between urinary S/EB exposure biomarker and the additional annual change of LF (β: -0.016; 95 % CI: -0.028, -0.004), HF (-0.014; -0.026, -0.001), and TP (-0.011; -0.021, -0.001). Our findings demonstrated that S/EB exposure was associated with HRV reduction among the general urban adults and the TGF-β pathway may play a part of the mediating role in this association., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022 Elsevier B.V. All rights reserved.)

The topic of cardiovascular hazards from multiple metal (loid)s exposures has attracted widespread attention. Here, we measured concentrations of twenty-three urinary metal (loid)s and mean platelet volume (MPV), an early cardiovascular damage biomarker, for 3396 Chinese adults. We aimed to comprehensively assess the associations of single metal (loid) and multiple metal (loid)s (as a mixture) with MPV by combined use of five statistical methods, including general linear models, Bayesian kernel machine regression (BKMR), weight quartile sum (WQS) regression, quantile g-computation (QGC), and adaptive elastic network regression (AENR). And based on that, we hope to provide insight into assessing the health effect of multipollutant exposure. After adjustment for potential covariates, at least three methods jointly suggested that of twenty-three metal (loid)s, iron, arsenic, and antimony were positively while aluminum, tungsten, and thallium were inversely associated with MPV. The environmental risk score of metal (loid)s construed by AENR was significantly positively associated with MPV, while the association between overall twenty-three metal (loid)s mixture and MPV was neutralized to be insignificant in QGC and BKMR. Conclusively, single metal (loid) may be inversely (iron, arsenic, and antimony) and positively (aluminum, tungsten, and thallium) associated with early cardiovascular damage, while the association of overall twenty-three metal (loid)s mixture with MPV was insignificant when concurrent exposures exist. It is crucial to select appropriate statistical methods based on study purpose and principles/characteristics of statistical methods, and combined employment of multimethod is insightfully suggested when assessing health effects of multipollutant exposure., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

To investigate the associations of arsenic exposure with lung function and ventilatory impairment. The repeated-measures study was developed with 8479 observations from three study periods of the Wuhan-Zhuhai cohort. Urinary arsenic and lung function were measured during each period. Linear mixed models were used to estimate the cross-sectional and longitudinal relationships between urinary arsenic and lung function. Logistic regression models and COX regression models were used to evaluate the cross-sectional and longitudinal associations between urinary arsenic and ventilatory impairment, respectively. In the cross-sectional analysis, each 1-unit increase in log-transformed urinary arsenic was associated with a -22.499 mL (95 % confidence interval (CI): -35.832 to -9.165), -15.081 mL (-25.205 to -4.957), and -0.274 % (-0.541 to -0.007) change in forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), and FEV1/FVC, respectively. In the longitudinal analysis, each 1-unit increase in log-transformed urinary arsenic was associated with an annual change rate of -6.240 mL/year (95 % CI: -12.429 to -0.051), -5.855 mL/year (-10.632 to -1.079), and -0.143 %/year (-0.234 to -0.051) in FVC, FEV1, and FEV1/FVC, respectively. Stratified analyses suggested a modification role of gender on the cross-sectional and longitudinal associations between urinary arsenic and FEV1, with the stronger associations were found among males (P for modification 0.0384 and 0.0168). Furtherly, each 1-unit increase in log-transformed urinary arsenic was associated with a 14.8 % (odds ratio 1.148, 95 % CI: 1.043 to 1.263) and 11.7 % (hazard ratio 1.117, 95 % CI: 1.023 to 1.218) increase in the prevalent and incident risk of restrictive ventilatory impairment, respectively. Source analyses suggested that fish intake and fine particulate matter inhalation positively associated with the total arsenic levels. In conclusion, arsenic exposure was associated with lung function decline and the risk of restrictive ventilatory impairment., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022 Elsevier B.V. All rights reserved.)

There has been no validated tool to assess workplace infection control towards SARS-Cov-2 in non-healthcare industries. In this first year survey during 07/2020-04/2021, 6684 workers were recruited from varied non-healthcare settings of Hong Kong, Nanjing and Wuhan of China and responded standard questionnaires containing information of prevention measures and policies implemented by companies and personal preventive behaviour towards infection control. All participants were randomly stratified into two sub-samples as training and validation sample. Workplace safety index towards SARS-Cov-2 (WSI-SC2) was developed and validated using exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). We identified 14 manifest variables in WSI-SC2, with three sub-indices named "Workplace infection control measures and prevention", "Company occupational safety and health management and commitment" and "Worker's personal preventive behavior and awareness towards infectious control". WSI-SC2 obtained a good internal consistency reliability (Cronbach's alpha coefficients ranged: 0.76-0.91), good composite reliability (composite reliability ranged: 0.70-0.95) and satisfactory fit of the model (GFI = 0.95; SRMR = 0.05; RMSEA = 0.07). We further performed stratified analysis according to cities, and the index remained stable. Workers with higher scores of WSI-SC2 were more likely to uptake COVID-19 test. This multi-city large study developed a novel and validated tool that could horizontally measure the workplace safety towards SARS-Cov-2 in non-healthcare workers., (© 2022. The Author(s).)

Polychlorinated biphenyls (PCBs) exposure has been related to the abnormal glucose metabolism and the risk of diabetes. However, the joint effects of various PCBs are uncertain and the potential mechanisms remain unclear. Our objectives were to evaluate the associations of serum PCBs with fasting plasma glucose (FPG) and the risk of diabetes among a general Chinese population, and to estimate the mediating effects of oxidative stress in the above associations. Serum levels of seven indicator-PCBs (PCB-28, 52, 101, 118, 138, 153, and 180) and FPG values were determined among 4498 subjects from the Wuhan-Zhuhai cohort. Oxidative DNA damage biomarker (urinary 8-hydroxy-2'-deoxyguanosine, 8-OHdG) and lipid peroxidation biomarker (urinary 8-isoprostane, 8-iso-PGF 2α ) were also measured. Positive relationships of serum PCBs with FPG values as well as the risk of diabetes were observed. With each 1% increment in the natural log-transformed values of wet weight serum PCBs, FPG levels increased a 0.125% for PCB-52, 0.168% for PCB-118, 0.221% for PCB-138, 0.273% for PCB-153, and 0.379% for ΣPCB (the sum of seven PCBs). The adjusted odds ratios of diabetes associated with wet weight PCBs were 1.186 for PCB-52, 1.373 for PCB-118, 1.635 for PCB-153, and 1.456 for ΣPCB. The seven serum PCBs showed positive overall effect on the risk of diabetes. Elevated PCB-28, PCB-52, PCB-118, PCB-138, PCB-153, and ΣPCB were associated with the increased urinary 8-iso-PGF 2α , which was positively related with FPG values. Furthermore, urinary 8-iso-PGF 2α partially mediated the positive associations between PCBs and FPG values, with the mediated proportions ranged from 3.20 to 12.93%. In conclusion, our results suggested that serum PCBs were positively related with increased oxidative stress, FPG values, and the risk of diabetes among a general Chinese population. Serum PCBs mixture had positive overall effect on the risk of diabetes. Lipid peroxidation partly mediated the FPG elevation induced by PCB exposure., (Copyright © 2022 Elsevier Ltd. All rights reserved.)