Search

Background Attempts to identify predictors of atopic dermatitis (AD) have focused on genetic and immunologic factors. However, the role of neuro-mediators remains to be elucidated. Objective To evaluate nerve growth factor (NGF) and vaso-active intestinal peptide (VIP) in predicting paediatric AD and assess their correlation with intrinsic and extrinsic types of AD. Methods We performed a nested case–control study in the prospective Taiwan birth panel cohort study. Cord and maternal plasma and questionnaires were gathered at birth. During follow-up, we identified 40 available AD cases, which were matched to 80 unaffected controls chosen from this cohort. The concentrations of IgE, NGF, and VIP in cord and maternal plasma of these subjects were performed by ELISA. Receiver-operating characteristic (ROC) curves were generated to see how well each biomarker could predict AD. Results The NGF levels were significantly higher in AD patients than controls (mean±SD: 65.47±44.45 vs. 49.21±12.18 pg/mL for cord plasma and 89.68±41.04 vs. 66.96±23.05 pg/mL for maternal plasma) ( P<0.05). VIP levels were also higher but not statistically significant. Plasma NGF may be a better biomarker than IgE in detecting paediatric AD (area under the ROC curve=0.65 vs. 0.61 for cord plasma and 0.69 vs. 0.61 for maternal plasma). Maternal NGF levels were significantly higher in patients with both intrinsic (96.18±48.15 pg/mL) and extrinsic (86.18±37.23 pg/mL) types of AD compared with controls (66.96±23.05 pg/mL) ( P<0.05). We assessed a significant correlation between self-reported stress during pregnancy and maternal NGF levels ( r=0.22, P=0.02). Conclusion Our results suggest that NGF is a good alternative biomarker in predicting children with a risk of AD. [ABSTRACT FROM AUTHOR]

Background The β-chain of a high-affinity IgE receptor (FcℇRIβ) has been proposed as a candidate gene for atopic diseases, but previous studies have come to inconsistent conclusions. Because some air pollutants would produce oxidative stress, increase serum IgE, and trigger T-helper type 2 (Th2)-type airway inflammation, the associations of FcℇRIβ polymorphism with wheezing illness may vary by their exposures and variants of oxidant defence genes. The purpose of this study was to investigate the association of FcℇRIβ E237G polymorphism with wheezing illness and to determine whether these associations vary with air pollution and glutathione S-transferase (GST) P1-105 and M1 genotypes. Methods In 2001, we conducted a case–control study comprised of 214 children with any history of wheezing and 185 non-wheezing controls, all of whom were selected from 2558 fourth- to ninth-grade schoolchildren in southern Taiwan. We examined differences in associations with ambient air pollution and by GST genotypes. Results Compared with the FcℇRIβ EE genotype, children with the G allele had a significantly reduced risk of lifetime wheezing with low-ozone exposure [adjusted odds ratio (aOR)=0.25, 95% confidence interval (CI) 0.08–0.69]. The risk was not reduced in children living in high-ozone communities (aOR=0.98, 95% CI 0.57–1.67). This difference in genotypic effects between low- and high-pollution environments was statistically significant. The reduction of the protective effect from the G allele with higher air pollution was most marked in the GSTP1-105 Ile/Val or Val/Val and GSTM1 null groups. Conclusion The FcℇRIβ E237G allele may have a protective role in wheezing illness among Taiwanese schoolchildren, depending on airway oxidative stress levels. [ABSTRACT FROM AUTHOR]

Previous studies of predictors of atopic dermatitis (AD) in Asia have had limited sample size and small numbers of variables focused primarily on family history or dietary exposures. The purpose of this study was to evaluate the influence of various environmental risk factors for early infantile AD. We used multistage, stratified systematic sampling to recruit 2048 mother–child pairs from the Taiwan national birth registration in 2003. Information on environmental risk factors for infant AD gathered by questionnaire were available from 1760 infants at 6 months of age. Multiple logistic regression was used to estimate adjusted odds ratios (aORs) and their 95% confidence intervals (CIs) for risk factors for AD after adjusting for potential confounders. AD was noted in 118 of 1760 (6.7%) of the infants. After adjusting for maternal age and education, family history of atopy, infant gender, and gestational age, fungi on walls of the house [aOR 2.14 (95% CI 1.41–3.22)] and frequent use of microwave oven at home [aOR 1.71 (95% CI 1.13–2.58)] increased the risk of early infantile AD. This study suggests that environmental factors do play a role in early infantile AD. Fungi, a kind of aeroallergen, are especially important in humid climate as in Taiwan and their impacts might be felt at the early infant stage. The hazards of microwave use should be paid more attention. [ABSTRACT FROM AUTHOR]

Background: Polymorphisms at the glutathione S-transferase (GST) were associated with asthma-related phenotypes. We hypothesized that the GSTP1 and GSTM1 genotypes could modify the effects of household environmental tobacco smoke (ETS) on childhood wheezing illness. Methods: We conducted a case-control study comprised of 216 lifetime wheezing children and 185 nonwheezing controls, all of whom were selected from 2524 fourth- to ninth-grade school children in southern Taiwan. Results: Homozygous GSTP1 Ile-105 was significantly associated with current wheezing (OR = 1.78, 95% CI 1.04–3.12), but insignificantly associated with ever wheezing (OR = 1.26, 95% CI 0.82–1.94). The risks of ever or current wheezing on GSTM1 null genotype were positive but not statistically significant. Although household ETS exposure was not associated with wheezing illness, after excluding subjects having in utero ETS or active smoking habits, the adverse effects of household ETS exposure differed significantly by GSTP1-105 genotypes. In children without any ETS exposure at home, GSTP1 Ile-105 homozygosity was significantly related to increased risks for both ever wheezing (OR = 2.29, 95% CI 1.17–4.49) and current wheezing (OR = 4.86, 95% CI 1.86–12.70). In children with household ETS exposure, the risks of wheezing illness did not increase for those carrying two GSTP1 Ile-105 alleles. Children carrying any GSTP1 Val-105 allele were at a significantly greater risk of both ever and current wheezing when exposed to ETS, with a clear dose-response relationship to the number of smokers at home. Conclusion: Household ETS exposure is a modifiable cause of wheezing illness in a genetically susceptible subpopulation. [ABSTRACT FROM AUTHOR]

The article reports on polychiorinated biphenyls in Taiwanese primipara human milk and associated factors. Halogenated aromatic hydrocarbons such as polychiorinated biphenyls (PCBs) are lipophilic, anthropogenic, and toxic chemicals. PCBs had been used in various commercial mixtures, such as transformers, capacitors, non-flammable oils, heat transfer media and paints. These organochlorine compounds persist in the environment and enter the food chain. After consumption, they accumulate in fatty tissues of animals and humans.

An investigation of employers' awareness and compliance with occupational health and safety (OHS) regulations was conducted in a representative group of employers randomly selected from the manufacturing industry in Taiwan. A total of 1,003 employers were interviewed by trained public health personnel. Ten questions related to perceptions of general OHS and five practices on OHS regulations were measured. The results of this study show that the employers were better aware of their responsibility for posting safety warnings, personal protection and providing safety and health equipment. They were less aware of their responsibility in minimizing injuries and accidents in the workplace and in not hiring someone who was found unfit for a certain job from pre-employment physical examination. Less than half of employers knew about regulations of environmental monitoring and even fewer had heard of Material Safety Data Sheets. Level of education and size of the plant were highly associated with employers' awareness of OHS and the awareness was the most significant predictor in the five practices of OHS regulations in this study. Promotion of employers' awareness of OHS in small sized industries itt particular, is warranted to enhance better compliance, and a focus for these efforts is identified by this investigation. [ABSTRACT FROM PUBLISHER]

Objectives: To determine the prevalence, clinical features, and patterns of hand dermatosis in hairdressers in Tainan, Taiwan, and to examine the associations between patterns of dermatosis and risk factors such as job description, work exposure, and sensitisation to common allergens.Methods: Interviews, examinations, and patch tests of the hairdressers from nine hairdressing stores randomly selected from Tainan City. Patch test agents included 41 substances with common allergens, shampoo preservatives, hair dyes, permanent waving and bleaching agents.Results: 98 hairdressers finished the examination, 83% of them had occupational dermatosis and 32% had scissor induced scars or wounds. Most of the dermatoses belonged to either dry metacarpophalangeal dermatitis or eczema of the fingers. 44% of the hairdressers showed positive skin reaction to one or more patch test agents. The patch test results were different from previous reports in that the most common allergens were nickel, thimerosal, Captan, Kathon CG, and fragrance mix, and that the sensitivity to hair dye and permanent wave ingredients were low. The dry metacarpophalangeal dermatitis was associated with exposure to shampoo, and the eczema of the fingers with skin sensitivity to patch test agents.Conclusion: Hairdressers in Tainan City had a high prevalence of dermatoses including traumatic wounds, and allergic and irritant contact dermatitis. The rates of sensitivity to some of the common sensitising agents were different from previous reports. [ABSTRACT FROM AUTHOR]

To investigate whether changes in outdoor air pollutants, meteorology data, certain personal or environmental factors explain the changing prevalence of current wheeze, ever wheeze and physician-diagnosed asthma among Taiwanese middle-schools children.Data from two cross-sectional national surveys between 1995 and 2001 were used. Study population was limited from 22 middle schools located within one-kilometer catchment areas of 22 air-monitoring stations in Taiwan. The main outcome measures were physician-diagnosed asthma, lifetime wheezy symptoms, and wheeze in current 12 months, as reported by parents. The effects of several personal and environmental factors on the change of three diseases were assessed by multiple logistic regression. Changes in air pollutants and meteorology data in communities were also compared with estimated prevalence changes of three diseases.44,118 data from 1995 survey and 11,738 data from 2001 survey were left for final analysis. The prevalence of ever wheeze and physician-diagnosed asthma increased from 1995 to 2001 in both sexes. Prevalence of current wheeze decreased significantly in boys but not in girls. Three diseases were more commonly reported among children of lower age, higher parental education level, higher parental reported ambient air pollution level, and those who were exposed to ETS or incense, performed less exercise, and suffered from atopic eczema. When adjusted for these factors, the relative odds of three diseases (2001 to 1995) did not show significant changes. Communities with lower decreasing rate in sulfur dioxides level had higher increasing percentage in prevalence of three diseases.Changes in listed personal and environmental factors did not seem to explain any of the observed changes in prevalence. However, correlates of these factors which have changed over time may still underlie recent changes in diseases. Sulfur dioxides may play an essential role as an indicator in trends of three diseases. [ABSTRACT FROM AUTHOR]

In 1979, a mass poisoning of more than 2000 people occurred in central Taiwan due to consumption of rice-bran oil contaminated with PCBs and their heat-degraded byproducts. The incident was later referred to as Yucheng (oil disease). Serum samples from 56 women with the 1979exposure were collected in February 1992 and analyzed for their contaminant content using sample enrichment and isotope dilution mass spectrometry. In most of the samples, levels of PCDFs and PCBs were detectable, and the median values of 2,3,4,7,8-PCDFs and 1,2,3,4,7,8-PCDFs were 1,030 and 2,220 ng/kg serum lipid, respectively. The median level of the total PCBs on a whole weight basis was 8,730 ng/kg. The PCB/PCDF concentrations in Yucheng women 14 years after the toxic exposure were still one to two orders of magnitude higher than controls. Concentrations of PCB levels in 1992 were positively correlated with the 1980-1981 measured PCB levels in these women and both PCBs and PCDFs were negatively correlated with the total duration when these women breast fed their children between 1979 and 1992. It is concluded that serum levels of congener-specific PCBs/PCDFs in exposed women are good indicators of previous exposure and may provide important information for more reliable estimation of dose-response relationship. [ABSTRACT FROM AUTHOR]

Large-scale poisoning occurred in central Taiwan in 1979 from ingestion of cooking oil contaminated by polychlorinated biphenyls (PCBs) and polychlorinated dibenzofurans. To determine whether in-utero exposure to these chemicals alters reproductive function, all prenatally exposed boys and appropriate controls were contacted for medical examination in 1998. Sperm of exposed children have increased abnormal morphology, reduced motility, and reduced capacity to penetrate hamster oocytes. Whether this will cause reduced fecundity, and how these effects can be extrapolated to the general population exposed to background levels of PCBs and dioxin-like chemicals, warrants further investigation. [ABSTRACT FROM AUTHOR]

Introduction: Metabolic syndrome (MS) is strongly associated with cardiovascular diseases and diabetes but can be prevented with regular physical activity. This study aimed to assess the impact of a physical fitness training programme on MS among military personnel., Methods: This retrospective observational study included volunteer army soldiers who underwent annual health examinations between 2011 and 2014. In 2011, the reformed physical fitness training programme and physical fitness test were introduced to the participants. MS evaluation and physical fitness performances were evaluated before and after implementing the training programme using a mixed-effects model and generalised estimating equation, adjusted for sex, age and smoking., Results: From 2011 to 2014, 1720 soldiers underwent the annual health examination. In 2011, before the fitness programme, 246 soldiers (14.3%) had MS. After implementation, decreases in blood pressure and fasting glucose levels were observed and maintained for 3 years. Running performance was negatively correlated to triglycerides (ß=-11.37; p<0.001) and waist circumference (ß=-0.42; p<0.001) and positively correlated to high-density lipoprotein cholesterol levels (ß=2.14; p<0.001). The severity of MS was reduced following introduction of the physical fitness programme., Conclusions: MS and its components improved after introducing the reformed fitness programme, with running performance proving to be most relevant to MS. Clinicians should encourage increased physical activity to prevent MS among military personnel., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Reporting of percutaneous injuries (PIs) to the Chinese Exposure Prevention Information Network (EPINet) became mandatory for all public and tertiary referral hospitals in Taiwan in 2011. We have estimated the number of microbially contaminated PIs and the national PI incidence using a retrospective secondary data analysis approach to analyse 2011 data from the Chinese EPINet to determine the types of PI, mechanisms of occurrence and associated risks. The results revealed a national estimate of PIs between 6710 and 8319 in 2011. The most common incidents for physicians were disposable syringes, suture needles, and disposable scalpels; while for nurses they were disposable syringes, intravenous catheters, and lancets. About 13·0% of the source patients were seropositive for hepatitis B virus (HBV) surface antigen, 13·8% were seropositive for hepatitis C virus (HCV), and 1·1% seropositive for human immunodeficiency virus (HIV). From these results we estimate that annually 970 full-time healthcare workers (HCWs) would be exposed to HBV, 1094 to HCV, and 99 to HIV. This study improves our understanding of the mechanisms and risks of PIs and informs the development of more efficient preventive measures to protect HCWs from such injuries.

Background: Hereditary and environmental factors have been related to the occurrence of atopic dermatitis (AD) in early childhood. However, the role of prenatal and early postnatal exposure to air pollutants has not been totally elucidated., Objectives: To evaluate the association between prenatal air pollutant exposure and occurrence of AD., Methods: In total 24 200 infant-mother pairs were recruited to participate in the Taiwan Birth Cohort Study in 2005 using multistage stratified sampling. Medical history, including physician-diagnosed AD, was inquired by questionnaire at the infant's age of 6 months. Monthly averages of five criteria air pollutants - NO2 , CO, O3 , SO2 and PM10 - were retrieved from 66 air-quality-monitoring stations, and interpolated to all administrative districts using the kriging method. Exposure data during each of the three gestational trimesters and three months after birth were calculated for each study subject, and odds ratios (ORs) of AD occurrence were calculated by logistic regression., Results: Among the participants, 16 686 mother-infant pairs were qualified for and included in the analysis. Among them, 1206 infants (7·2%) had been diagnosed as having AD before the age of 6 months, and the prevalence was higher in boys (8·3%) than in girls (6·1%). The occurrence of AD was significantly associated with CO exposure during the whole gestational period [adjusted OR (aOR) 1·37, 95% confidence interval (CI) 1·06-1·78] and the first trimester (aOR 1·51, 95% CI 1·16-1·97). We did not observe any significant association among the other air pollutants during either the whole gestational period or any period of the three trimesters and 3 months after birth., Conclusions: Our study found a relationship between AD occurrence and gestational exposure to CO, where exposure during the first trimester seemed to be the most important., (© 2015 British Association of Dermatologists.)

Background: Considering the early onset of atopic dermatitis (AD), which most often arises in the first year of life, risk factors occurring very early in life must be considered. Little is known about the effects of maternal occupational exposure on the development of atopic disorders in children., Objectives: The aim of this study was to evaluate associations between maternal employment and childhood AD., Methods: We used multistage stratified systematic sampling to recruit 24,200 mother-newborn pairs from the Taiwan national birth register. Information on maternal occupation categories, work stress, working time, shift work and potential confounders during pregnancy was gathered by questionnaires after birth. At 3 years of age, information on the development of AD was assessed by home interviews. Multiple logistic regression analysis was performed to estimate the association of maternal employment and AD., Results: Overall, 11,962 out of 19,381 mothers (61·7%) worked during pregnancy. The children of mothers who worked during pregnancy had an increased risk of AD compared with those whose mothers did not work [odds ratio (OR) 1·38, 95% confidence interval (CI) 1·25-1·53]. The children of mothers with a professional or technical occupation had a higher risk of AD (OR 1·64, 95% CI 1·44-1·87). The risk of AD was found to increase with maternal work stress during pregnancy in a dose-response manner (P(trend)<0·01). The mothers of children with AD had a longer working time than those without AD (P<0·0001). However, no significant association between AD and maternal shift work was found., Conclusions: Working in professional or technical occupations increased the risk of childhood AD in addition to work stress during pregnancy., (© 2013 The Authors. BJD © 2013 British Association of Dermatologists.)

Background: Hereditary and environmental factors contribute to the occurrence of atopic dermatitis (AD). However, the interaction of these two factors is not totally understood., Objectives: To evaluate the early risk factors for infantile AD at the age of 6 months and to develop a predictive model for the development of AD., Methods: In 2005, a representative sample of mother and newborn pairs was obtained by multistage, stratified systematic sampling from the Taiwan national birth register. Information on hereditary and environmental risk factors was collected by home interview when babies were 6 months old. Multivariate regression analysis was applied to determine the risk factors for AD in the infants., Results: A total of 20 687 pairs completed the study satisfactorily. AD was diagnosed in 7.0% of 6-month-old infants by physicians. Parental asthma, atopic dermatitis and allergic rhinitis, and maternal education levels were risk factors for AD in infants. Among environmental factors, fungus on walls at home and renovation/painting in the house during pregnancy were significantly associated with early infantile AD. Using these factors, the probability of having infantile AD was estimated and grouped into low, high and very high. With five runs of tests in mutually exclusive subsets of this population, the likelihood of AD for 6-month-old infants was consistent in all the groups with the predictive model. The highest predicted probability of AD was 70.1%, among boys with maternal education levels > 12 years, both parents with AD, renovation and painting of the house during pregnancy and fungus on walls at home. The lowest probability was 3.1%, among girls with none of the above factors., Conclusions: This investigation provides a technique for predicting the risk of infantile AD based on hereditary and environmental factors, which could be used for developing a preventive strategy against AD, especially among those children with a family history of atopy.

Background: Increasing attention was focused on the beta2-adrenergic receptor gene (ADRB2), whose genetic variability has been implicated as a risk factor for asthma-related phenotypes. However, only a few studies reported the associations by utilizing haplotypic approaches. We therefore examined the relationship of childhood wheezing illness with polymorphisms at codons 16 and 27, and evaluated the influence of polymorphisms individually and in combination as haplotypes., Methods: We conducted a genetic case-control study comprising 215 wheezing children and 183 nonwheezing controls, all of whom were selected from 2524 fourth- to ninth-grade schoolchildren in southern Taiwan., Results: All participants were homozygous at the ADRB2 Thr164 locus. After controlling for possible confounders, ADRB2 Glu27 allele was significantly associated with wheezing illness in all genetic models, but the risks on Arg16Gly genotypes were inconclusive. Estimated frequencies for the three main hyplotypes were Arg16/Gln27 57.2%, Gly16/Gln27 35.3%, Gly16/Glu27 7.4% in wheezing children, and Arg16/Gln27 56.3%, Gly16/Gln27 32.2%, Gly16/Glu27 10.4% in controls. The protective effect of Gly16/Glu27 haplotype remained relative to all other ADRB2 haplotypes [adjusted relative risk (aRR) = 0.58; 95% confidence interval (CI) 0.35-0.97]. As compared with children without Gly16/Glu27 haplotype, those with Gly16/Glu27 haplotype had a significantly lower risk for wheezing illness (aRR = 0.56; 95% CI 0.33-0.99). The copy numbers of Gly16/Glu27 haplotype also showed a clear dose-response relationship on the decreased risks. No significant association was found with the prevalence of wheezing illness for other haplotypes., Conclusion: We concluded that ADRB2 Glu27 allele and Gly16/Glu27 haplotype were significantly protective factors for wheezing illness in Taiwanese schoolchildren.

Background: Parental atopy and environmental exposure are recognized risk factors for atopic eczema (AE) in childhood. However, the relative contributions of specific risk factors and the overall contributions of hereditary and environmental exposure remain unexplored., Objectives: To identify risk factors, estimate the population attributable risk (PAR) of environmental exposure, and compare the AE data for boys vs. girls in primary-school children., Methods: During a February to June 2001 cross-sectional, Taiwan-based questionnaire survey, we investigated 23 980 children from 22 primary schools, all located within 1 km of an air-monitoring station., Results: The 12-month prevalence of AE was reported as 6.1% in boys and 4.9% in girls. In both sexes, the risk of AE was strongly associated with parental atopy and perceived ambient air pollution. The presence of cockroaches [odds ratio (OR) 1.18, 95% confidence interval (CI) 1.00-1.40] and visible mould on walls at home (OR 1.46, 95% CI 1.22-1.70) were also significantly related to AE for girls; however, only visible mould on walls (and not the presence of cockroaches) at home was related to AE for boys (OR 1.40, 95% CI 1.18-1.66). While mutually adjusted models were applied, we found adjusted ORs and PARs were similar in boys and girls in hereditary and outdoor environmental factors. The PAR of indoor environmental factors was higher in girls (8.4%) than in boys (5.5%). There was no interaction between parental atopy and environmental factors., Conclusions: Parental atopy contributed more to AE than indoor or outdoor environmental factors. Girls may be more susceptible to indoor environmental factors than boys.

Background: The prevalence of atopic eczema in adolescents has recently been reported as increasing in many countries, a phenomenon yet to be fully explained. This study compared the prevalence of atopic eczema among Taiwanese adolescents with individual-level risk factors and community-level data of temperature, relative humidity, and air pollutants to determine whether changes in these factors could explain the observed change in prevalence., Methods: We conducted two nationwide, cross-sectional surveys of atopic illness and symptoms among Taiwanese 12-15-year-old schoolchildren in 1995-1996 and 2001. The effects of personal and environmental factors were assessed and temporal changes of outdoor monitoring data were also compared with the prevalence difference of atopic eczema., Results: A total of 42 919 adolescents from the 1995 to 1996 survey and 10 215 adolescents from the 2001 survey attended schools located within 1 km of 22 monitoring stations. The 12-month prevalence of atopic eczema increased significantly during this period [adjusted prevalence ratio (PR)=1.43, 95% confidence interval (CI) 1.21-1.70 in boys; PR=1.77, 95% CI 1.49-2.10 in girls]. After adjustment for potential risk factors, the prevalence differences were statistically unchanged. Although parental education level contributed the most, changes in personal and environmental factors might not explain the observed prevalence increases of atopic eczema. Temporal change in the relative humidity was significantly associated with prevalence increase among boys but its contribution was also small., Conclusion: Correlates of the investigated risk factors that have changed over time still underlie the prevalence increases of atopic eczema in Taiwanese adolescents. The exact reasons for the rising trends remain to be elucidated.

Background: There is evidence that long term exposure to ambient air pollution increases the risk of childhood asthma, but the role of different sources and components needs further elaboration. To assess the effect of air pollutants on the risk of asthma among school children, a nationwide cross sectional study of 32 672 Taiwanese school children was conducted in 2001., Methods: Routine air pollution monitoring data for sulphur dioxide (SO2), nitrogen oxides (NOx), ozone (O3), carbon monoxide (CO), and particles with an aerodynamic diameter of 10 microm or less (PM10) were used. Information on individual characteristics and indoor environments was from a parent administered questionnaire (response rate 93%). The exposure parameters were calculated using the mean of the 2000 monthly averages. The effect estimates were presented as odds ratios (ORs) per 10 ppb changes for SO2, NOx, and O3, 100 ppb changes for CO, and 10 microg/m3 changes for PM10., Results: In a two stage hierarchical model adjusting for confounding, the risk of childhood asthma was positively associated with O3 (adjusted OR 1.138, 95% confidence interval (CI) 1.001 to 1.293), CO (adjusted OR 1.045, 95% CI 1.017 to 1.074), and NOx (adjusted OR 1.005, 95% CI 0.954 to 1.117). Against our prior hypothesis, the risk of childhood asthma was weakly or not related to SO2 (adjusted OR 0.874, 95% CI 0.729 to 1.054) and PM10 (adjusted OR 0.934, 95% CI 0.909 to 0.960)., Conclusions: The results are consistent with the hypothesis that long term exposure to traffic related outdoor air pollutants such as NOx, CO, and O3 increases the risk of asthma in children.

Little is known about the relevance of genetic polymorphisms to arsenic-related bladder cancer. A preliminary case-control study was conducted to explore the association between genetic polymorphisms of GSTT1, p53 codon 72 and bladder cancer in southern Taiwan, a former high arsenic exposure area. Fifty-nine urinary transitional cell carcinoma (TCC) patients from a referral centre in south-western Taiwan and 81 community controls matched on residence were recruited from 1996 to 1999. A questionnaire was administered to obtain arsenic exposure and general health information. Genotypes of p53 codon 72 and GSTT1 were analysed by polymerase chain reaction-restriction fragment length polymerase. The combined variant genotypes (heterozygous or homozygous variant) of p53 codon 72 and GSTT1 null were observed in 29% of cases and in 44% of controls, respectively. In this preliminary study, bladder cancer risk was slightly elevated for subjects carrying the variant genotype of p53 codon 72 or in subjects carrying the GSTT1 null genotype. Variants in p53 codon 72 increased the risk of bladder cancer among smokers. However, the results were not statistically significant and larger confirmatory studies are needed to clarify the role of candidate gene polymorphisms and bladder cancer risk in arsenic exposed populations.

The prevalence of allergic rhinitis, a common respiratory disorder, may be rapidly increasing. Epidemiological studies, however, indicate little about its association with climatic factors and air pollution. The relationship between traffic-related air pollutants and allergic rhinitis in middle-school students was therefore investigated. In a nationwide survey of middle-school students in Taiwan conducted in 1995/1996, the lifetime prevalence of physician-diagnosed allergic rhinitis and typical symptoms of allergic rhinitis were compared with air-monitoring station data on temperature, relative humidity, sulphur dioxide (SO2), nitrogen oxides (NOx), ozone (O3), carbon monoxide (CO) and particulate matter with a 50% cut-off aerodynamic diameter of 10 microm (PM10). A total of 331,686 nonsmoking children attended schools located within 2 km of 55 stations. Mean (range) annual exposures were: CO 853 (381-1,610) parts per billion (ppb), NOx 35.1 (10.2-72.4) ppb, SO2 7.57 (0.88-21.2) ppb, PM10 69.2 (40.1-116.2) microg x m(-3), O3 21.3 (12.4-34.1) ppb, temperature 22.9 (19.6-25.1) degrees C, and relative humidity 76.2 (64.8-86.2)%. The prevalence of physician-diagnosed allergic rhinitis was 28.6 and 19.5% in males and females, respectively, with prevalence of questionnaire-determined allergic rhinitis 42.4 and 34.0%. After adjustment for age, parental education and history of atopic eczema, physician-diagnosed allergic rhinitis was found to be associated with higher nonsummer (September-May) warmth and traffic-related air pollutants, including CO, NOx and O3. Questionnaire-determined allergic rhinitis correlated only with traffic-related air pollutants. Nonsummer warmth and traffic-related air pollution, probably mediated through exposure to common allergens such as dust mites, are possible risk factors for allergic rhinitis in middle-school-aged children.

Blastocystis hominis found in stool specimens has been the most frequently identified parasite among foreign workers from Southeast Asia in Taiwan since 1992. The prevalence of B. hominis was 14.1% in this study. In their quarantine physical examinations, 121 male Thai workers were examined hematologically and screened for stool parasites using the merthiolate-iodine-formaldehyde concentration method. Hematological values were compared in workers with and without a B. hominis infection. Multiple regressions were used to adjust for age. Those infected with any parasite other than B. hominis were excluded from further analysis. The workers infected with B. hominis had a lower leukocyte count (6.5+/-0.4 X 10(3)/microl) than those who were not (7.4+/-0.2 X 10(3)/microl). This was mainly caused by a reduced neutrophil count (3.2+/-0.4 vs 4.2+/-0.2 X 10(3)/microl). Hemoglobin (13.9+/-0.3 vs 14.5+/-0.1 g/dl) and hematocrit (41.4+/-0.6 vs 42.9+/-0.2%) were also reduced in B. hominis-positive workers.

Sharps injuries (SIs) among support personnel in hospitals have received little attention in the scientific literature. A cross-sectional study was undertaken to measure the incidence of SIs in Taiwanese support personnel. All support personnel, including laundry workers, cleaners, porters and central supply workers, from 16 hospitals were surveyed for SIs, sustained between June 1996 and July 1997. Either a questionnaire or face-to-face interviews, for those staff with a literacy problem, were used. Of the 862 persons eligible for study, 79.4% (684) were evaluable. Few staff (30.4%) had attended a prevention programme and 61% had suffered an SI in the past year. Few (25.4%) reported their injury. Hollow-bore needles, of which 72.2% had been used, were associated with 42.2% of injuries. Cleaners sustained the majority (65.7%) of injuries, and inappropriate disposal was associated with 54.7% of all injuries. For those staff employed for more than four years, the risk of sustaining an injury increased significantly with length of employment (P<0.001). Most of the injuries were sustained by cleaners handling sharps inappropriately disposed of by clinical staff. A safer environment for support staff could be achieved with the co-operation of clinical staff to correctly dispose of sharps to ensure single handling of sharps. A formal orientation of support staff in the reporting of SIs would enable clinical assessment and management of injuries, as well as an evaluation of needle and sharps safety in the healthcare setting., (Copyright 2001 The Hospital Infection Society.)

This presentation focuses on the four most important skin diseases in Taiwan thought to be of environmental and/or occupational origin. The majority of work-related dermatoses are contact dermatitis patients. Among occupational contact dermatitis patients, 58.5% involved irritant and 41.5%, allergic dermatitis. Electronics, hairdressing, medical practice, and construction were the most important occupations causing contact dermatitis. An endemic occurrence of chronic arsenism causing hyperpigmentation, keratosis, and cancer has been reported in Taiwan. Arsenical skin cancers present as multiple lesions at different disease stages. The skin cancers are usually found in non-sun-exposed areas. UVB exerts an inhibitory effect on the proliferation of arsenical cancers; this may explain its non-sun-exposed nature. An outbreak of premalignant and malignant skin lesions was reported among paraquat manufacturers in 1985. The skin lesions were mainly distributed over the sun-exposed areas. Photodamage and photocarcinogenesis revealed a strong association with exposure to bipyridines among paraquat manufacturers. In 1979, a mass poisoning occurred in Taiwan from cooking oil contaminated by polychlorinated biphenyls (PCBs). Over 60% of patients were in grades O-II by the Japanese classification. The blood PCB levels of the Taiwanese patients were found to be higher than those of the Yusho subjects.

Objectives: The prevalence of job stress, distributions of major job stressors, and the associations of job stress with multiple self-reported health complaints were examined in a national survey conducted in 1994 in Taiwan., Methods: A total of 9,746 men and 5,599 women who were employed at the time of the survey and aged between 25 and 65-years were studied. Information on employment status, perceived level of job stress, major job stressors, and health complaints were obtained by a self-administered questionnaire., Results: Overall, 7.6% of men and 6.5% of women reported often or always feeling very stressed at work. Higher levels of perceived job stress were found among subjects who were younger, with higher education level, working in a larger firm, working for longer hours per week, and who were administrators or managers. Problems with individual job content were ranked as the most important job stressor in men across all employment categories and in most women. Other major job stressors included problems with monetary rewards and lack of career prospects. The patterns of major job stressors appear to vary by employment grade and by gender. After adjustment for age and education, employees who perceived higher levels of job stress had significantly increased risks of multiple health problems, including strained eyes, ringing ears, chronic cough with phlegm, chest tightness. stomach problems, headache, and musculoskeletal discomfort., Conclusions: These results suggest that psychosocial stress in the workplace has profound impacts on health. This study identified high-risk groups and major types of job stressors for further investigation.

Background: From 1978 to 1979, a group of people in Taiwan were exposed to high levels of heat-degraded polychlorinated biphenyls (PCBs) owing to accidental ingestion of contaminated rice oil. Children born to mothers following the exposure ('Yucheng' children) were known to have hyperpigmented skin and other dysmorphology after birth., Aims: To determine the effect of prenatal exposure to PCBs on cognitive development in Yucheng children., Method: One hundred and eighteen Yucheng children prenatally exposed to PCBs and degradation products, and community-matched control children who were exposed to background levels only, were followed from 1985 to 1998. The Bayley Scale for Infant Development, Chinese version of the Stanford-Binet IQ Test, Raven's Coloured Progressive Matrices and Raven's Standardised Progressive Matrices were used to assess the cognitive development of these children., Results: The Yucheng children scored lower than control children on each of these methods of measurement between the ages of 2 and 12 years., Conclusions: Prenatal exposure to PCBs and their derivatives has long-term adverse effects on cognitive development in humans.

Background: In 1979 in Taiwan, about 2000 people were poisoned by cooking oil contaminated with heat-degraded polychlorinated biphenyls (PCBs). Victims developed chloracne and other symptoms; the illness is called Yucheng (oil disease). The chemicals persist in the victims' bodies and some are toxic to the female reproductive system in experimental animals., Methods: In 1993-1994, we identified the living Yucheng women and neighbourhood controls and interviewed them about their reproductive experience. Of the 596 living Yucheng women aged 30-59 years, we found 368, and interviewed 356. We identified 329 controls, and interviewed 312., Results: Of the Yucheng women, 16% reported abnormal menstrual bleeding compared to 8% (P < 0.05) of control women; 4.2% versus 1.7% reported a stillbirth since 1979 (P = 0.068). Other characteristics of the menses, fertility, frequency of intercourse, and age at menopause appeared unaffected. More of the Yucheng women reported that one of their offspring had died during childhood (10.2% versus 6.1%, P < 0. 05), and that they had decided to limit childbearing because of health problems (7% versus 2%, P = 0.01)., Conclusions: These findings suggest that high level PCB/polychlorinated dibenzofuran (PCDF) exposure has some effect on female endocrine and reproductive function.

This study compared the prevalence of asthma with climate and air pollutant data to determine the relationship between asthma prevalence and these factors. We conducted a nationwide survey of respiratory illness and symptoms in middle-school students in Taiwan. Lifetime prevalences of physician-diagnosed asthma and of typical symptoms of asthma were compared to air monitoring station data for temperature, relative humidity, sulfur dioxide, nitrogen oxides, ozone, carbon monoxide, and particulate matter with aerodynamic diameter [less than/equal to] 10 microm (PM(10)). A total of 331,686 nonsmoking children attended schools located within 2 km of 55 stations. Asthma prevalence rates adjusted for age, history of atopic eczema, and parental education were associated with nonsummer (June-August) temperature, winter (January-March) humidity, and traffic-related air pollution, especially carbon monoxide and nitrogen oxides, for both girls and boys. Nonsummer temperature, winter humidity, and traffic-related air pollution, especially carbon monoxide and nitrogen oxides, were positively associated with the prevalence of asthma in middle-school students in Taiwan.

In 1979, a mass poisoning involving 2,000 people occurred in central Taiwan from ingestion of cooking oil contaminated by polychlorinated biphenyls (PCBs) and polychlorinated dibenzofurans (PCDFs). We studied the prevalence of medical conditions in the exposed individuals and in a neighborhood control group. Starting with a registry of the exposed individuals from 1983, we updated the addresses of exposed individuals and identified a control group matched for age, sex, and neighborhood in 1979. In 1993, individuals 30 years of age or older were interviewed by telephone. We obtained usable information from 795 exposed subjects and 693 control subjects. Lifetime prevalence of chloracne, abnormal nails, hyperkeratosis, skin allergy, goiter, headache, gum pigmentation, and broken teeth were observed more frequently in the PCB/PCDF-exposed men and women. The exposed women reported anemia 2. 3 times more frequently than controls. The exposed men reported arthritis and herniated intervertebral disks 4.1 and 2.9 times, respectively, more frequently than controls. There was no difference in reported prevalences of other medical conditions. We conclude that Taiwanese people exposed to high levels of PCBs and PCDFs reported more frequent medical problems, including skin diseases, goiter, anemia, and joint and spine diseases.

Background: Health care workers (HCWs) were surveyed to identify factors associated with nonreporting behavior of sharps injuries (SIs) in Taiwan., Methods: We surveyed 10,469 full-time medical, nursing, technical, and supporting personnel employed at 16 randomly selected hospitals from 132 available accredited teaching hospitals in Taiwan. Information about the most recent injury and reporting behavior after an SI were collected from July 1996 to June 1997 by using a pretested structured questionnaire. Eleven categories, including an open-ended option, were provided for participants to explain their nonreporting behavior., Results: Questionnaires were completed by 82.6% (8645) of our sample, of whom 87.3% reported to have experienced a recent SI. A used item was the most commonly (P <. 001) involved item in an SI, and SIs with a used item were significantly more likely (odds ratio 3.6; CI 95%, 3.03-4.26; P <. 001) to be reported compared with an SI that involved unused items. A total of 81.8% of injuries were not reported, with job category significantly affecting reporting behavior (P <.001). Medical staff had the highest nonreporting rate (85.2%). Although attendees of a prevention program were statistically more likely (P <.001) to report an injury compared with nonattendees, the level of reporting in both groups was not encouraging (21.3% and 17.2%, respectively). All reasons given for nonreporting were disconcerting, but none more so than the use of subjective assessment of risk by 21.7% of HCWs who did not report their injuries. Other reasons for not reporting SIs included that the item was unused (34%) and that the HCW was too busy to report the SI (14.9%), unaware of reporting requirements (14. 4%), or immune to hepatitis B virus (12.4%)., Conclusions: With 82% of SIs in Taiwanese HCWs going unreported, the expected national incidence will be seriously underestimated and impact the appropriateness of prevention programs. The very low rate of reporting suggests that the current reporting system requires simplification. Because most injuries involved used items, the reporting systems also should include a more responsive management component. The results also suggest that the current prevention programs, currently provided by the general nursing department, require expert content knowledge in infection control if nonreporting and SIs are to be reduced.

Sharps injuries are a major cause of transmission of hepatitis B and C viruses and human immunodeficiency virus in health-care workers. To determine the yearly incidence and causes of sharps injuries in health-care workers in Taiwan, we conducted a questionnaire survey in a total of 8645 health care workers, including physicians, nurses, laboratory technicians, and cleaners, from teaching hospitals of various sizes. The reported incidence of needlestick and other sharps injuries was 1.30 and 1.21 per person in the past 12 months, respectively. Of most recent episodes of needlestick/sharps injury, 52.0% were caused by ordinary syringe needles, usually in the patient units. The most frequently reported circumstances of needlestick were recapping of needles, and those of sharps injuries were opening of ampoules/vials. Of needles which stuck the health-care workers, 54.8% had been used in patients, 8.2% of whom were known to have hepatitis B or C, syphilis, or human immunodeficiency virus infection. Sharps injuries in health-care workers in Taiwan occur more frequently than generally thought and risks of contracting blood-borne infectious diseases as a result are very high.

Construction workers are known to have occupational dermatoses. The prevalence of such dermatoses was unknown in Taiwanese construction workers. The objective of this study was to determine the work exposure, prevalence of skin manifestations, and sensitivity to common contact allergens in cement workers of southern Taiwan. A total of 1147 current regular cement workers were telephone-interviewed about skin problems during the past 12 months, work exposure, and personal protection. Among those interviewed, 166 were examined and patch tested with common contact allergens. A high % of cement workers reported skin problems in the past 12 months. More men (13.9%) reported skin problems possibly related to work than women (5.4%). Prevalence was associated with lower use of gloves, duration of work as cement worker, and more time in jobs involving direct manual handling of cement, especially tiling. A high % of dermatitis was noted in the 166 workers examined, which correlated with reported skin problems. On patch testing, construction workers had a high frequency of sensitivity to chromate. Sensitivity to chromate or cobalt was associated with reported skin problems, or dorsal hand dermatitis on examination. These workers' dermatitis was under-diagnosed and inadequately managed. It is concluded that cement workers in southern Taiwan had a high prevalence of skin problems related to cement use. Protective measures, work practice, and physician education should be improved to prevent or manage such problems.

Despite a wide interindividual variation of cytochrome P-450 1A2 (CYP1A2) activity, genetic polymorphism of CYP1A2 has not been reported. By amplification of exons of CYP1A2 by polymerase chain reaction in eight Chinese subjects, the polymerase chain reaction products were directly sequenced. One subject showed heterozygous C2866-->G (Phe21-->Leu) polymorphism. DNA from 157 Chinese subjects (104 polychlorinated biphenyl-exposed subjects and 53 control subjects) was screened for polymorphism by single-strand conformation polymorphism method and MboII endonuclease digestion. Only 1 of 157 samples showed another heterozygous C2866-->G mutation. The subject was previously exposed to polychlorinated biphenyl and showed a value of 3.5% in the caffeine breath test. The value is not significantly higher than the mean value of polychlorinated biphenyl-exposed subjects (3.12 +/- 0.29%, mean +/- S.E.M.). The incidence of the point mutation in these Chinese subjects is less than 1%. The prevalence of the F21L mutation in other ethnic groups and its effect on the metabolic activity of CYP1A2 remain to be further evaluated.

Background: The occurrence of occupational illness and injury has been seriously underestimated in Taiwan, which subsequently contributes to difficulties in performing effective control of occupational hazards and implementing intervention programs for protecting workers., Methods: Based on the successful experience of the nationwide blood lead level surveillance program, the Department of Health, the Executive Yuan, Taiwan, Republic of China, has established a work-related diseases surveillance system. This government-administered system requests practicing physicians to report the suspected cases suffering from six categories of work-related disorders., Results: An occupational illness and injury surveillance program in Taiwan has been in operation since June of 1995., Conclusion: Background information of work-related diseases obtained from this surveillance system will be useful for providing better management of available resources for occupational medicine, for preventing hazards, and for enforcing occupational diseases prevention programs. Our experience in establishing this surveillance system will be used in other countries and settings.

Objectives: Agricultural workers are known to have occupational skin diseases. The prevalence and pattern of skin diseases are unknown in Taiwanese fruit farmers. The objective of this study is to determine the work exposure, prevalence of skin diseases, and sensitivity to common skin allergens and agricultural chemicals in fruit farmers of southern Taiwan., Methods: 122 fruit farmers who regularly prepared and sprayed pesticides and a group of 63 printing press workers with no known exposure to pesticides were examined and patch tested with common skin allergens and agricultural chemicals. The farmers were also interviewed for their work habits, use of protective clothing, and exposure to pesticides., Results: Most farmers reported regular use of hat, boots, and mask, but not gloves, raincoat, and goggles. This resulted in frequent skin contact with pesticides especially on the hands and face. About 30% of farmers had hand dermatitis, and more than two thirds had pigmentation and thickening on the hands. Fungal infection of the skin was noted in a quarter of subjects. By patch test, farmers and the printing press workers had a similar rate of sensitivity to common skin allergens. 40% of farmers were sensitive to agricultural chemical allergens, which was about twofold higher than that of the comparison group. Farmers were most frequently sensitive to Captofol, Folpet, and Captan which were associated with dermatitis on the volar aspects of the hands., Conclusions: Fruit farmers in southern Taiwan had a high prevalence of skin diseases related to use of pesticides, and appropriate protective measures and work practices should be taken to prevent such problems.

The purpose of this study was to investigate environmental lead exposure in the general Taiwanese population. A total of 8828 Taiwanese adults selected by a multistage sampling method were investigated. Characteristics of the participants were ascertained by questionnaire and 10 ml venous blood was drawn by public health nurses. The blood specimens were distributed to six laboratories for blood lead level (BLL) measurement. A quality control program was applied during the analysis of the BLLs in order to improve precision and accuracy. The arithmetic mean BLL of the 8828 Taiwanese adults was 7.70 +/- 5.23 micrograms/dl, with a maximal level of 69.1 micrograms/dl. The median was 6.5 micrograms/dl and the 90th percentile was 14.0 micrograms/dl. After logarithmic transformation, the geometric mean was 1.84 +/- 0.67 microgram/dl. This study also found that elevated BLLs were associated with certain personal characteristics, i.e., gender, ethnic group, and education level; life-style factors, such as smoking, alcohol consumption, Chinese herbal drug consumption, milk consumption, and sources of drinking water; residential location, i.e., level of urbanization; and occupational history of lead exposure. However, age, floor level of residence, distance from house to road, and betel nut consumption were not associated with elevated BLLs. These results showed that BLLs in the Taiwanese population were not higher than those in developed and developing countries. Most of the influencing factors were also found in other studies; however, local factors such as ethnic group, Chinese herbal drug consumption, and sources of drinking water are important considerations in Taiwan when examining ways to prevent overexposure to lead in the general population.

Venous blood samples, 24-h total food duplicate samples, and rice samples were collected from 52 adult non-smoking women in the city of Tainan, southern Taiwan, in 1994, and analyzed for cadmium (Cd) and lead (Pb) by wet-digestion followed by graphite furnace atomic absorption spectrophotometry. Daily dietary intake was 10 micrograms for Cd and 22 micrograms for Pb as geometric means, of which Cd and Pb in rice accounted for 34% and 1.4% of daily Cd and Pb intakes, respectively. The counterpart values for blood were 1.11 ng/ml and 44.5 ng/ml for Cd and Pb, respectively. International comparison with recently published data suggests that the exposure to Cd in Tainan should be among the lowest in the world.

Occupational skin disease is one of the most common occupational diseases. The hand is the most frequent site of involvement in occupational skin disease. We interviewed and examined patients seen in the Contact Dermatitis Clinic of the National Taiwan University Medical Center, a tertiary referral center in Taipei City. For patients suspected of having allergic skin diseases, patch testing was carried out using the European standard series and suspected allergens. Occupational hand dermatitis (OHD) was diagnosed according to medical history, work exposure, physical examination, and patch test findings. 36% of patients seen were diagnosed as having OHD. Electronics, hairdressing, medical, chemical, and construction were the most important industries causing OHD. In the 164 patients with OHD, 58.5% had irritant contact dermatitis (ICD) and 41.5% allergic contact dermatitis (ACD). Dorsal fingers, nail folds, and dorsal hands were most frequently involved in patients with ACD; dorsal fingers, volar fingers and fingertips were most frequently involved in those with ICD. Using logistic regression analysis, we were able to identify the most important clinical presentations that predicted the types of OHD, ACD versus ICD. Patients with atopic history and palm involvement were more likely to have ICD, and those with nail fold involvement more likely to have ACD. In patients with ACD, the most important allergens were dichromate, nickel, cobalt, fragrance mix, epoxy resin, thiuram mix, and p-phenylenediamine. In this study, we identified the important industries and causal agents for OHD. Future preventive measures focused on these industries and agents to reduce OHD will be warranted.

Levels of PCDDs, PCDFs and coplanar PCBs were measured in the blood and stool obtained from seventeen patients with Yu-Cheng in Taiwan. The average total concentrations of PCDDs, PCDFs and coplanar PCBs in the blood collected from Yu-Cheng patients in January 1993 and August 1994 were 590 and 570 pg Toxic Equivalents (TEQs)/g lipid, respectively. The concentrations of PCDDs, PCDFs and coplanar PCBs in the blood of patients were 21, 540 and 10 pg TEQs/g fat, respectively. On the other hand, the fecal excretion of PCDDs, PCDFs and coplanar PCBs were 26, 720 and 15 pg TEQs/day, respectively. The composition of congeners in the feces was quite similar to the one in the blood. The half lives were estimated as 9.1 and 8.6 years for 2, 3, 4, 7, 8-pentachlorodibenzofuran and 1, 2, 3, 4, 7, 8-hexachlorodibenzofuran based on fecal excretion, respectively.

In Taiwanese children born seven to twelve years after their mothers' or fathers' intoxication of heat-degraded polychlorinated biphenyls (PCBs) (Yu-Cheng mothers or fathers), we measured the development and behavioral problems in 1991-2. The development was assessed with the Chinese Child Developmental Inventory (CCDI), and the behavioral problems with Rutter's Child Behavior Scale A. Children of Yu-Cheng mothers had delayed development on several subscales of CCDI and on the combined general development score. Girls were more affected than boys in their development. Children of Yu-Cheng fathers did not score differently from unexposed controls on this measurement. In Rutter's scale, the scores in Yu-Cheng mothers' children and Yu-Cheng fathers' children were not different from those of their unexposed controls. We conclude that children born seven to twelve years after mothers' exposure to degraded PCBs had delayed development, but they did not show more behavior problems when compared with unexposed controls.

Behavioral problems were evaluated in Taiwanese children who were born between July 1978 and June 1985 to women who had consumed rice oil that was contaminated by heat-degraded polychlorinated biphenyls (PCBs). One hundred and eighteen such children, referred to as 'the early-born Yucheng children', and matched controls were followed with the Chinese version of Rutter's Child Behavior Scale A annually from 1985 to 1991. At any fixed age, the early-born Yucheng children had mean Rutter behavior scores 1.75 to 2.40 points higher (14-38% worse) than that of their controls. The effects were similar in the health, habit, and behavioral subscores and persistent as the children aged.

We have been following up the biological and mental development of children exposed prenatally to polychlorinated biphenyls and their contaminants (Yucheng children). When we started this 12-year follow-up study in August 1985, 118 Yucheng children we assigned a non-exposed child matched by sex, age, locality of residence, mother's age, socio-economic status of the family. This article reports the cognitive aspect of the development of Yucheng children as compared to their matched controls. A consistent tendency which indicates that Yucheng children score lower in each kind of measurement tool at each age level has been observed. This seems to imply that congenitally exposure to PCBs and their contaminants has long-term adverse effects on the cognitive development of human being.

The purpose of this study was to investigate the environmental lead exposure of the general population in Taiwan. A total of 2919 residents of Taiwan were selected by multistage sampling methods. The participants were characterized by questionnaires and 10 ml venous blood was collected for blood lead measurement. A quality assurance/quality control program was designed during the analysis of blood lead levels. The mean blood lead level of 2719 residents without occupational lead exposure was 8.29 +/- 5.92 micrograms/dl. After adjustment for age and sex distribution to the Taiwan general population, the mean blood lead level was 8.10 micrograms/dl. Adjusted for an 11% underestimation of blood lead levels among the six laboratories, the mean blood lead level was estimated to be 8.99 micrograms/dl. This study also found that blood lead levels were associated with personal characteristics, i.e., gender, ethnic group, education level; lifestyle factors, i.e., smoking, alcohol consumption, sources of drinking water; and residential location, i.e., levels of urbanization, distance of house from the road. However, age, floor of residence, milk consumption, betel nut consumption, and Chinese herbal drug consumption were not found to be associated with blood lead levels. These results show that blood lead levels in Taiwan residents were not higher than in most developed and developing countries. Environmental lead pollution does not seem to be a serious problem in Taiwan.

Objective: To compare the cognitive development in Taiwanese children who had been exposed prenatally to high levels of heat-degraded polychlorinated biphenyls (PCBs) with control children who were exposed to background levels. The disorder was called Yu-Cheng, "oil disease," in Taiwan., Design: Matched-pair cohort study., Setting: Communities in central Taiwan in which there had been a cooking-oil contamination and mass poisoning by heat-degraded PCBs in 1978 through 1979., Participants: One hundred eighteen children born between June 1978 and March 1985 during or after their mothers' consumption of contaminated rice oil; 118 children matched for age, sex, neighborhood, maternal age, and parental education and occupational class; and 15 older siblings of exposed children, born before the poisoning., Main Outcome Measures: Cognitive development measured from 1985 through 1990 using the Chinese versions of the Stanford-Binet test and the Wechsler Intelligence Scale for Children, Revised,, Results: The exposed children scored approximately 5 points lower on the Stanford-Binet test at the ages of 4 and 5 years and approximately 5 points lower on the Wechsler Intelligence Scale for Children, Revised, at the ages of 6 and 7 years. Children born up to 6 years after their mothers' exposure were as affected as children born within a year or two after exposure when examined at 6 and 7 years of age. Older siblings resembled the control children., Conclusion: Children prenatally exposed to heat-degraded PCBs had poorer cognitive development than their matched controls. The effect persisted in the children up to the age of 7 years, and children born long after the exposure were still affected.

An intoxication episode resulting from rice-bran oil (Yu-Cheng) contaminated with polychlorinated biphenyls (PCBs) occurred in Taiwan from 1978 to 1979. After that episode, the authors found 15 Yu-Cheng children who were born to intoxicated mothers after their documented consumption of PCB-contaminated oil; these children had older siblings, born before PCB exposure, without prenatal PCB exposure. The cognitive development of these Yu-Cheng children and the youngest of their elder siblings were assessed annually from 1985 to 1990 using the Chinese version of the Wechsler Intelligence Scale for Children, Revised Version (WISC-R) for those over six years of age. Compared with their elder siblings, the Yu-Cheng children scored significantly lower (p < 0.05) on the verbal intelligence quotient, by 6.8-16.1 points; on performance IQ by 10.2-18.4 points; and on full-scale IQ by 8.9-18.5 points, during the six measurements performed from 1985 to 1990. The differences in WISC-R IQ scores between the two groups have remained unchanged during these six years of follow-up.