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Background: Exposure to traffic-related air pollutants, including polycyclic aromatic hydrocarbons (PAH) and heavy metals, has been associated with the etiology and prognosis of many illnesses. However, the specific causal agents and underlying mechanisms for different health outcomes remain unclear. The aims of this study were to assess the relations between urinary biomarkers of exposure to PAHs (1-hydroxypyrene-glucuronide, 1-OHPG) and heavy metals (cadmium, Cd; nickel, Ni; arsenic, As; lead, Pb; and copper, Cu) and the effect of their interaction on DNA damage (8-oxo-7,8-dihydro-guanine, 8-oxodG).Methods: We recruited 91 traffic conductors and 53 indoor office workers between May 2009 and June 2011 in Taipei, Taiwan. Postshift urine samples from 2 consecutive days were analyzed for 1-OHPG, Cd, Ni, As, Pb, Cu, and 8-oxodG. To estimate the effects from PAHs and metals on DNA damage, we constructed a linear mixed model adjusted for confounding variables.Results: We found that urinary 1-OHPG and Cd levels were independent predictors of urinary 8-oxodG levels (β = 0.112; P = 0.015 for 1-OHPG; β = 0.138; P = 0.031 for urinary Cd). The joint effect of urinary 1-OHPG and Cd levels was associated with urinary 8-oxodG levels (P = 0.001).Conclusions: Co-exposure to environmental PAHs and Cd could cause oxidative DNA damage.Impact: These findings suggest that the additive interaction between exposure to environmental PAHs and Cd could enhance the burden of oxidative stress. Cancer Epidemiol Biomarkers Prev; 22(1); 102–8. ©2012 AACR.

BackgroundWe hypothesised that occupational exposures differently affect subtypes of adult-onset asthma.ObjectiveWe investigated potential relations between occupation and three subtypes of adult asthma, namely atopic asthma, non-atopic asthma and asthma–COPD overlap syndrome (ACOS).MethodsThis is a population-based case–control study of incident asthma among working-age adults living in Pirkanmaa Hospital District in Southern Finland. The determinant of interest was occupation at the time of diagnosis of asthma or the job that the subject had quit due to respiratory symptoms. Asthma was divided into three mutually exclusive subtypes on the basis of any positive IgE antibody (atopic and non-atopic asthma) and presence of persistent airways obstruction in spirometry (ACOS). We applied unconditional logistic regression analysis to estimate adjusted OR (aOR), taking into account gender, age and smoking.ResultsThe following occupational groups showed significantly increased risk of atopic asthma: chemical industry workers (aOR 15.76, 95% CI 2.64 to 94.12), bakers and food processors (aOR 4.69, 95% CI 1.18 to 18.69), waiters (aOR 4.67, 95% CI 1.40 to 15.56) and those unemployed (aOR 3.06, 95% CI 1.52 to 6.17). The following occupations showed clearly increased risk of non-atopic asthma: metal workers (aOR 8.37, 95% CI 3.77 to 18.59) and farmers and other agricultural workers (aOR 2.36, 95% CI 1.10 to 5.06). Some occupational groups showed statistically significantly increased OR of ACOS: electrical and electronic production workers (aOR 30.6, 95% CI 6.10 to 153.35), fur and leather workers (aOR 16.41, 95% CI 1.25 to 215.85) and those retired (aOR 5.55, 95% CI 1.63 to 18.97).ConclusionsOur results show that different occupations are associated with different subtypes of adult-onset asthma.

Breast cancer is the most commonly occurring cancer in women, and it is a major cause of cancer death around the world. With the development of diagnostic methods and improvements in treatment methods, the incidence rate of breast cancer and the number of breast cancer survivors continue to simultaneously increase. We used national registry database to analyze the features that affect employment and return to work among breast cancer survivors. A total of 23,220 employees, who were newly diagnosed with breast cancer were recruited based on the Labor Insurance Database (LID), the Taiwan Cancer Registry (TCR), and National Health Insurance Research Database (NHIRD) during the period 2004–2015. The correlations between return to work (RTW) and independent confounding factors were examined using Cox proportional hazards model. Survival probability was analyzed using the Kaplan–Meir method. After adjusting for confounding variables, cancer stage, chemotherapy and higher income were significantly negatively correlated with RTW. Among breast cancer survivors, RTW was found to be related to a lower risk of all-cause mortality in both the unadjusted and fully adjusted model. Patients who had RTW exhibited better survival in all stages. Work-, disease- and treatment-related factors influenced RTW among employees with breast cancer. RTW was associated with better breast cancer survival. Our study demonstrates the impact of RTW and the associated factors on breast cancer survivorship.

Few studies have quantified the effects of particulate air pollution reductions on electronic toll collection (ETC) and manual toll collection (MTC). Our study evaluated the levels of particulate pollutants, including particulate polycyclic aromatic hydrocarbons (p-PAHs), PM1.0, PM2.5, and PM10, from MTC and ETC systems in booths at a manual/electric hybrid toll station on a highway in Taiwan. A two-week sampling campaign was conducted at the toll station on the first highway in the Taipei metropolitan area. Indoor tollbooth monitoring samples were collected for the ETC and MTC lanes to assess the hourly p-PAH, PM1.0, PM2.5, and PM10 concentrations. The hourly average particle concentration was calculated for different types of toll collection based on 100 vehicles per hour. The average traffic density in the truck and bus lanes or car and van lanes with ETC was significantly higher than that with MTC. The mean p-PAH, PM1.0, and PM2.5 concentrations in the car and van lanes with MTC were higher than those for ETC. The increases in PM1.0 and PM2.5 concentrations per 100 vehicles in the bus and truck lanes with MTC were approximately 2 times greater than those for ETC. ETC technologies serve as a solution to traffic delay problems at toll stations in Taiwan and may more homogeneously reduce the levels of p-PAHs, PM1.0, and PM2.5 particulate pollutants from traffic emissions than the MTC along highways.

IntroductionMetabolic 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.MethodsThis 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.ResultsFrom 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; pConclusionsMS 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.

Shipyard welders are often exposed to welding metal fumes. Ocular surfaces are continually exposed to environmental hazards. However, limited information on the associations between metal exposure and dry eye metrics in occupational settings is available. This study employed a cross-sectional design that involved the participation of 59 welders and 25 administrative staff in a shipyard in northern Taiwan from September 2020 to October 2020. The participants’ individual information, laboratory data, exposure to particulate matter < 2.5 μm, urinary, and toenail metal concentrations were collected. Dry eye metrics were evaluated using standardized questionnaires and a noninvasive ocular surface analyzer. Urinary V and Cr and toenail V, Cr, Mn, Fe, Ni, Zn, As, and Cd and Pb were significantly higher in the exposed group than in the control group. After adjustment for confounding factors, dry eye metrics were associated with urinary Cd (β = 0.407; p = 0.007) and toenail Pb (β = 0.482; p = 0.002). The participants with higher urinary Cd exhibited higher odds ratios for elevated dry eye metrics. Our study revealed that exposure to welding procedures increases several metal biomarkers. In addition, urinary Cd, and toenail Pb might be related to dry eye disease in shipyard welders.

The impact of airborne particulate matter and its metal components on autonomic nervous system (ANS) dysfunction in healthy subjects remains unclear. The aim of this study was to examine the effects of personal exposure to airborne particulate matter on the ANS in young, healthy adults. This longitudinal study recruited 82 adults aged 20 to 35 years from districts A and B. District A had lower ambient PM2.5 levels than district B. Personal exposure to fine particulate matter and metals in PM2.5 was collected every two months. The heart rate variability (HRV) indices of each participant were measured three times. The relationship among the PM2.5 concentration, metals in PM2.5 and HRV level was investigated by a generalized estimating equation with an autoregression of order 1. The average age of the participants was 26.4 ± 3.6 years in district A and 21.9 ± 1.5 years in district B (p < 0.001). After adjusting for covariables, significant changes in Log10 standard deviation of normal to normal (SDNN) intervals and Log10 square root of the mean of the sum of the squares of differences (r-MSSDs) were related to unit changes in Log10 iron in PM2.5 (β = –0.033, 95% CI = –0.060 to –0.0056, p < 0.05 and β = –0.041, 95% CI = –0.075 to –0.0076, p < 0.05, respectively). The Log10 SDNN levels were significantly positively related to Log10 gallium in PM2.5 (β = 0.054, 95% CI = 0.0064 to 0.10, p < 0.05). Exposure to heavy metals in airborne particulate matter was associated with ANS dysfunction.

BACKGROUND A return to work (RTW) is a challenge for survivors of oral cancer. Further light could be shed on the RTW of patients with oral cancer, which remains largely uninvestigated. The objective of this study was to investigate the trajectories of RTW and their impact on survival in workers with oral cancer. METHODS In total, 12,222 workers who were newly diagnosed with oral cancer were identified during the period from 2004 to 2015 and were included in this cohort study. The associations between independent variables and RTW were analyzed using Cox proportional hazard models. RESULTS Overall, 8793 workers returned to work in the first years after a diagnosis of oral cancer. Chemotherapy (hazard ratio [HR], 0.88; 95% CI, 0.78-0.99) and radiation therapy (HR, 0.83; 95% CI, 0.75-0.92) were inversely associated with RTW. Patients who had received surgical treatment (HR, 1.24; 95% CI, 1.01-1.53) were more likely to RTW. Employees with stage I (HR, 1.66; 95% CI, 1.47-1.87), stage II (HR, 1.52; 95% CI, 1.35-1.72), and stage III (HR, 1.32; 95% CI, 1.16-1.51) disease were associated with an increased likelihood of RTW in the fifth year after diagnosis. Kaplan-Meier survival analysis demonstrated better survival for the RTW group versus the non-RTW group in patients with stage III and IV oral cancer (P

Background: The influence of welding-associated air pollutants on workers’ health is mainly regarded as a core issue in public health and occupational medicine. Previous studies have indicated that workers exposed to metal fumes had an increased risk of metabolic syndrome, which was correlated with decreased serum adiponectin levels. This study aimed to explore whether heavy metal exposure affects the concentration of adiponectin among welding workers. Methods: The study participants were recruited from a shipyard with 31 office workers and 100 welding workers in 2015. Urinary metal concentrations were measured by inductively coupled plasma–mass spectrometry. Serum adiponectin was measured by enzyme-linked immunosorbent assay. Inferential statistics on repeated measures were performed using generalized estimating equations (GEEs). A weighted quantile sum (WQS) regression model was conducted to examine the joint effect of the association of multimetal exposure with serum adiponectin. Results: After adjustment for all confounding variables through a GEE analysis, significantly negative associations of numerous urinary metals with serum adiponectin were detected in the welding workers, including Cr (β = -0.088; 95% CI: -0.148, -0.027), Mn (β = -0.174; 95% CI: -0.267, -0.081), Co (β = -0.094; 95% CI: -0.158, -0.029), Ni (β = -0.108; 95% CI: -0.208, -0.008), Cd (β = -0.067; 95% CI: -0.115, -0.018), and Pb (β = -0.089; 95% CI: -0.163, -0.015). The contributions of multiple urinary metal levels to serum adiponectin levels, determined individually by WQS regression, suggested that Pb was the greatest contributor. Conclusions: Welding workers exposed to heavy metals such as Pb, Cr, Co, Mn, Ni, and Cd might have reduced serum adiponectin levels and an increased risk of cardiovascular disease.

Objective: Polycyclic aromatic hydrocarbons (PAHs) are not only natural but also anthropogenic contaminants that exist in many places in the environment. Human beings often accidentally ingest PAHs via smoking. Furthermore, smoking may increase the risk of bowel disorder, including diarrhea and other gastrointestinal problems. Therefore, PAH exposure is hypothesized to be related to diarrhea risk. This study discusses the association between diarrhea and PAH exposure in the United States adult population. Method: 10,537 participants from the National Health and Nutrition Examination Survey (NHANES 2001–2006) were involved in this cross-sectional analysis. Bowel disorders were assessed via examination of stool frequency and stool type. The concentrations of urinary PAH metabolites were used to evaluate PAH exposure. The association between bowel habits and PAH exposure was assessed using a multivariate logistic regression model with covariate assessment of gender, age, race, liver function, kidney function, and common chronic health diseases. Results: All PAH metabolites except 1-hydroxynaphthalene, 1-hydroxypyrene, and 9-hydroxyfluorene were substantially correlated with an increased risk of diarrhea (p &lt, 0.05) after modification of relevant covariables. This study also revealed significant association in the group of females (p &lt, 0.05). Furthermore, all PAH metabolites except 1-hydroxynaphthalene, 2-hydroxyphenanthrene, 1-hydroxypyrene, and 9-hydroxyfluorene show significantly positive association in the non-obesity group (BMI &lt, 30, p &lt, 0.05). Conclusions: PAH exposure is highly associated with risk of bowel disorders among the adult population in the United States, especially in female and non-obesity populations. More research is necessary to shed light on the pathophysiological mechanisms associated to PAH exposure and diarrhea.

Particulate matter with an aerodynamic diameter of ≤ 2.5 µm (PM2.5) has been linked to adverse health outcomes in welding workers. The objective of this study was to investigate associations of chronic exposure to metal fume PM2.5 in shipyard workers with health outcomes. A longitudinal study was conducted to determine the effects of metal fume PM2.5 on FeNO, urinary metals, urinary oxidative stress, inflammation, and stress hormones in workers. There were 20 office workers and 49 welding workers enrolled in this study who were followed-up for a second year. We observed that Fe, Zn, and Mn were abundant in PM2.5 to which welding workers were personally exposed, whereas PM2.5 to which office workers were personally exposed was dominated by Pb, Cu, and Zn. We observed in the first and/or second visits that urinary 8-iso-prostaglandin F2-α (PGF2α) and 8-hydroxy-2′-deoxy guanosine (8-OHdG) were significantly increased by exposure. An increase in urinary interleukin (IL)-6 and decreases in urinary serotonin and cortisol were observed in the first and/or second visits after exposure. PM2.5 was associated with decreases in urinary 8-OHdG and cortisol among workers. Next, we observed that urinary Ni, Co, and Fe had significantly increased among workers after a year of exposure. Urinary metals were associated with decreases in urinary 8-iso-PGF2α and cortisol among workers. Urinary Ni, Cu, and Fe levels were associated with an increase in urinary IL-6 and a decrease in urinary cortisol among workers. In conclusion, chronic exposure to metal fume PM2.5 was associated with inflammation and a cortisol deficiency in shipyard workers, which could associate with adrenal glands dysfunction.

Background: The theory of planned behaviour (TPB) explanation of smoking cessation intentions consists of gender differences. The purpose of this study is to adopt the extended TPB to discuss factors influencing the smoking cessation intentions of young adult volunteer soldiers and to further compare the respective factors for both genders. Methods: This is a cross-sectional study. Data were collected from 139 and 165 male and female volunteer soldiers who smoked, respectively. Research participants completed a self-administered questionnaire that comprised items pertaining to the participants’ demographic characteristics, smoking behaviours, smoking cessation experiences, social environments, and TPB variables. Results: Subjective norms (friends) are a positive key factor for young adult male (β = 0.033, p = 0.012) and female (β = 0.076, p &lt, 0.001) volunteer soldiers’ smoking cessation intentions, and perceived behavioural control is a key factor for male young (β = 0.226, p = 0.040) adult volunteer soldiers’ smoking cessation intention. The extended TPB accounted for 27.9% and 53.2% of the variance in the intention to quit smoking in the male and female volunteer soldiers, respectively. Conclusions: We suggest that smoking cessation strategies can reinforce gender-specific intervention strategies to assist young adult volunteer soldiers in smoking cessation.

Polycyclic aromatic hydrocarbons (PAHs) are environmental pollutants. Exposure to PAHs is associated with several adverse health outcomes. However, no previous study has examined the relationship between PAH exposure and functional dependence in an elderly population. Our aim was to examine whether PAH exposure was associated with functional dependence including total disability, activities of daily living (ADL), instrumental activities of daily living (IADL), leisure and social activities (LSA), lower extremity mobility (LEM), and general physical activities (GPA) in an elderly population. A total of 5816 elderly adults from the National Health and Nutrition Examination Survey (NHANES) from 2001 to 2006 were examined. PAH exposure was measured by urinary biomarkers. Functional dependence was assessed by 19 structured questions. The association between PAH exposures with functional dependence was performed by using a multivariable linear regression model. After adjusting for pertinent variables, positive associations were observed between the total number of disabilities and 2-naphthalene and 1-pyrene quartiles (all Ptrend

Objective To explore the prediction of aerobic exercise and resistance training on incidental metabolic syndrome (MetS) and diabetes in a Taiwanese cohort. Methods The participant underwent annual health examinations and physical fitness tests, including 2-min push-up, 2-min sit-up, and endurance 3000-m none weight-bearing running exercise test from 2013 to 2015, were recruited. The cohort study involved 27,787 participants aged ≥20 years in military services. Multivariate logistic regression odd ratios models were used to explore the associations between the performance of physical fitness and the development of MetS and diabetes. Results The male participants without MetS at baseline with poor performance in aerobic and resistance exercise tests were likely to develop the MetS and diabetes two years later; while the female participants did not show the same results in statistical significance. Additionally, only poor performance measuring by resistance training exercise test was significantly associated with increased risk of metabolic components numbers at follow-up in all subjects without MetS (all P Conclusions The poor performance in aerobic and resistance exercise tests might be predicting tools for MetS and diabetes in Taiwanese men without MetS at baseline. And resistance exercise displayed a substantial predicting ability in development of metabolic abnormality, MetS and diabetes in our study.

Oxidative stress plays a crucial role in the development of diseases induced by welding fumes. To our knowledge, little information is available on the relationship between multiple heavy metal exposure and oxidative stress in welders. We assessed the relationship between multiple heavy metal exposure and oxidative damage by analyzing 174 nonsmoking male welders in a shipyard. Urinary metals were used as the internal dose of exposure to metals in welding fumes, and urinary 8-hydroxy-2'-deoxyguanosine (8-OHdG) was used as an oxidative DNA damage marker. The relationship between workers' metal levels and 8-OHdG was estimated using a multiple linear regression model. The geometric mean levels of urinary chromium (Cr), nickel (Ni), cadmium (Cd), and lead (Pb) were considerably higher in welders than in controls. Urinary Cr and Ni were determined as effective predictors of urinary 8-OHdG levels after adjusting for covariates. Oxidative DNA damage was associated with both Cr and Ni of welding fume exposure in shipyard welders (Ln Cr: β = 0.33, 95%C.I. = 0.16-0.49; Ln Ni: β = 0.27, 95%C.I. = 0.12-0.43). In this study, we investigated the significantly positive relationship between urinary metals (especially Cr and Ni) and 8-OHdG in nonsmoking shipyard welders. Moreover, the use of particulate respirators did not reduce metal exposure and oxidative damage. Therefore, we infer that hazard identification for welders should be conducted.

Our study was aimed to investigate the association between the use of antidepressants and the risk of preterm birth in pregnant women who have had perinatal depression. We extracted data from the Taiwanese National Health Insurance Research Database (NHIRD) and analyzed them using multivariate Cox proportional hazard regression models. Identified from the NHIRD, we matched 1789 women aged 18-55 years who were using antidepressants during pregnancy and 1789 women who were experiencing depression but who were not using antidepressants during pregnancy for age, index date, and medical comorbidities. We enrolled the women in our study, which we conducted using 12 years’ worth of data between 2000 and 2012, and then followed up individually with them for up to 1 year to identify any occurrence of preterm birth. Results highlighted that, compared with the women with perinatal depression who were not using antidepressants during pregnancy, the women taking antidepressants had a 1.762-fold risk of preterm birth (adjusted HR=1.762, 95% CI 1.351 to 2.294, p

Certain studies have reported various insulin resistance responses to ambient heavy metal pollution, but few have reported such responses to occupational heavy metal pollution. Even fewer have demonstrated a relationship between mixture effects of heavy metals and insulin resistance in welding workers. Overall, we recruited 53 welders and 48 administrative staff from a shipyard located in northern Taiwan. Personal exposure to heavy metals was monitored for PM2.5 and urine. Blood samples from each participant were collected from the antecubital vein after fasting. Urine samples from each participant were collected in the same period as blood samples. The geometric mean levels for chromium (Cr), manganese (Mn), iron (Fe), cobalt (Co), nickel (Ni), copper (Cu), zinc (Zn), and cadmium (Cd) in the PM2.5 of the personal breathing zone and urinary Mn of welders were significantly higher than those in administrative staffs. Ambient Cr, Co, Ni, and Cu levels in the PM2.5 and urinary Cd were positively related to HOMA2-IR after adjusting for personal covariates (PM2.5-Cr: β=0.036, 95%C.I.: 0.002 to 0.070; PM2.5-Co: β=0.040, 95%C.I.: 0.002 to 0.077; PM2.5-Ni: β=0.054, 95%C.I.: 0.013 to 0.094; PM2.5-Cu: β=0.049, 95%C.I.: 0.010 to 0.088; U-Cd: β=0.209, 95%C.I.: 0.052 to 0.366, respectively). Our findings indicated the PM2.5 metal components and urinary metals were associated with increased insulin resistance in shipyard welders.

Particulate matter with an aerodynamic diameter of ≤ 2.5 µm (PM

Background Acid mist can suspend in the air and enter the body via skin contact, the respiratory tract, or even oral intake, which pose various health hazards. Previous studies have shown that occupational exposure to acid mist or acidic solutions is a major risk factor for oral diseases. However, the findings are inconsistent and do not consider individual factors and lifestyles that may cause the same oral diseases. Therefore, we conducted a comprehensive oral health survey and collected detail information to confirm the effect of acidic solution exposure on worker’s oral health. Methods From 4 acidic solution factories, a total of 309 subjects (157 in control and 152 in exposed group) was enrolled. All participants competed oral examinations and self-report questionnaire, including the decayed, missing, and filled teeth (DMFT) index, community periodontal index (CPI), loss of attachment (LA) index, and tooth erosion. Multivariate logistic regression analysis was used to determine the association between the acidic solution exposure and oral health. Results The results showed that acid exposure was correlated with soft oral tissue injury rather than hard oral tissue in our survey. In the multivariate model (adjusted for sex, age, worked years, education level, mouthwash use, dental floss use, tooth brushing, mask use, smoking, drinking, chewing areca and dietary habits with acidic foods), significant relationships of acid exposure with LA score were observed (OR = 2.32, 95% CI 1.03–5.26). However, the presence of acid exposure was not significantly associated with tooth erosion, DMFT, and CPITN. Conclusion Our study highlighted that occupational acid exposure was an independent risk factor for periodontal health, especially LA. It is important to strengthen occupational hazard control, educate workers on oral disease and related factors, and raise the awareness of oral hygiene.

Advanced glycation end products (AGE) and the receptor for AGE (RAGE) have been found to be pivotal biomarkers to predict the risk of inflammation and oxidative stress. Limited evidence focuses on the influence of occupational exposure to polycyclic aromatic hydrocarbon (PAH) and metal fumes on AGE and RAGE in shipyard welders. Our aim was to determine the relationships among PAH, metal exposure, and inflammatory biomarkers. From September 1 to December 31, 2017, 53 welding workers (exposed group) and 29 office workers (control group) were enrolled in the study. Comprehensive workups included demographic characteristics, laboratory data, AGE, RAGE, Interleukin-6 (IL-6), tumor necrosis factor-α, PAH, and urinary metal concentrations. RAGE levels were measured by flow cytometric analysis. Urinary 1-hydroxypyrene (1-OHP) was used as a biomarker of exposure to PAH. Several metals were elevated in the personal fine particulate matter (PM2.5) samples, including Mn, Fe, V, Co, Zn, and Cu. The exposed group had significantly higher exposure to PM2.5 (p = 0.015), RAGE (p = 0.020), IL-6 (p = 0.008) than the control group. After adjusting for pertinent variables, there was still a significant and positive association between Ni level and AGE (β = 0.101; 95% CI, 0.031–0.172). Significant relationship between Cr and Cd levels and RAGE was observed (β = 0.173; 95% CI, 0.017–0.329; β = 0.084; 95% CI, 0.011–0.157, respectively). Participants with elevated 1-OHP level had higher odds of high RAGE level in the model 1 (OR = 3.466, 95% CI, 1.053–11.412) and model 2 (OR = 3.454, 95% CI, 1.034–11.536). The RAGE expression of participants was significantly associated with IL-6 levels in the fully adjusted model (β = 0.294; 95% CI, 0.083–0.732). Our findings highlighted that urinary metal levels and PAH were associated with increased AGE and RAGE formation in shipyard workers. Elevated serum RAGE might induce the production of proinflammatory cytokines and trigger ensuing inflammatory cascades.

Additional file 1: Table S1. Diagnostic criteria of oral health in the study

Additional file 3. Questionnaire. English version of personnel health survey questionnaire

Additional file 2: Table S2. The oral hard/soft tissue indices for study survey

Sleep disorders may pose a risk to workers in the workplace. We aimed to investigate the associations between metal fume fine particulate matter (PM2.5) and sleep quality in workers. We assessed the effects of personal exposure to metal fume PM2.5 on lung functions, urinary biomarkers, and sleep quality in shipyard welding workers. In total, 96 welding workers and 54 office workers were recruited in the present study; office workers were exposed to 82.1 ± 94.1 μg/m3 PM2.5 and welding workers were exposed to 2166.5 ± 3149.1 μg/m3. Welding workers had significantly lower levels of FEV25-75 than office workers (p

Lung cancer is the second most common cancer and the leading cause of cancer-related deaths worldwide. Return to work (RTW) plays an important role for lung cancer survivors. Few studies focus solely on the relationship among possible variables and the RTW of lung cancer patients. The aim of our study was to examine sociodemographic, disease-related and work-related factors associated with RTW among lung cancer survivors in Taiwan. A total of 2206 employees who had been diagnosed with lung cancer at the Labor Insurance Database (LID), Taiwan Cancer Registry (TCR) and the National Health Insurance Research Database (NHIRD) during the period 2004–2015, were included in the study. We used the Cox proportional hazards model to investigate the associations between sociodemographic, disease-related and work-related factors on one hand and RTW on the other hand. The Kaplan–Meier method was used for analyzing the survival probability. Patients with an early cancer stage and those who underwent surgery had a higher likelihood of RTW. Factors including older age, male, higher monthly income and receipt of radiotherapy were inversely correlated with RTW. For lung cancer patients, RTW was a predictor of a lower risk of all-cause mortality in both the unadjusted and fully adjusted model. A better survival rate was found in stage III and IV lung cancer patients who had RTW. Sociodemographic and clinical-related variables had an impact on RTW among employees with lung cancer. RTW was correlated with a lower risk of all-cause mortality and better lung cancer survival. Our study showed the influence of RTW and independent confounding factors in lung cancer survivorship.

Exposure to metals poses potential health risks, including insulin resistance (IR), to those exposed to them in excess. Limited studies have examined such risks in occupational workers, including welders, and these have yielded inconsistent results. Thus, we examined the associations between exposure to welding metals and IR in welders. We recruited 78 welders and 75 administrative staff from a shipyard located in northern Taiwan. Personal exposure to heavy metals, including chromium (Cr), manganese (Mn), iron (Fe), nickel (Ni), copper (Cu), zinc (Zn), and cadmium (Cd), was monitored through particulate matter with an aerodynamic diameter of less than 2.5 μm (PM2.5) and urine analysis by inductively coupled plasma mass spectrometry (ICP–MS). After each participant fasted overnight, blood samples were collected and analyzed for IR assessment through updated homeostasis model assessment (HOMA2) modeling. Air sampling in the personal breathing zone was performed during a Monday shift prior to the blood and urine sample collection the following morning. The welders’ median personal Cr, Mn, Fe, Ni, Cu, and Zn airborne PM2.5 levels and urinary Cd levels were significantly higher than those of the administrative staff. After adjustment for covariates, logarithmic PM2.5-Mn, PM2.5-Fe, PM2.5-Cu, and PM2.5-Zn levels were positively correlated with logarithmic fasting plasma glucose (P-FGAC) levels (PM2.5-Mn: β = 0.0105, 95% C.I.: 0.0027–0.0183; PM2.5-Fe: β = 0.0127, 95% C.I.: 0.0027–0.0227; PM2.5-Cu: β = 0.0193, 95% C.I.: 0.0032–0.0355; PM2.5-Zn: β = 0.0132, 95% C.I.: 0.0005–0.0260). Logarithmic urinary Zn was positively correlated with logarithmic serum insulin and HOMA2-IR levels and negatively correlated with logarithmic HOMA2-insulin sensitivity (%S; βinsulin = 0.2171, 95% C.I.: 0.0025–0.4318; βIR = 0.2179, 95% C.I.: 0.0027–0.4330; β%S = −0.2180, 95% C.I.: −0.4334 to −0.0026). We observed that glucose homeostasis was disrupted by Mn, Fe, Cu, and Zn exposure through increasing P-FGAC and IR levels in shipyard welders.

An increased understanding is needed of the physiological effects and plausible biological mechanisms that link PM2.5 (particulate matter with an aerodynamic diameter below 2.5μm) exposure to mortality and morbidities such as atherosclerosis and respiratory disease. PM2.5 causes carcinogenic health effects. Biomonitoring in humans has suggested that 8-oxo-7, 8-dihydro-2-deoxyguanosine (8-oxodG) and N7-methylguanine (N7-MeG) are correlated with oxidative and methylated DNA damage. Thus, it is meaningful to explore the mechanisms of mutagenesis and carcinogenesis associated with oxidative and methylated DNA damage by simultaneously measuring these two markers. We recruited 72 participants from 2 areas (residential and commercial as well as residential and industrial) in the greater Taipei metropolitan area at baseline. Personal samplers were used to collect 24-hour PM2.5-integrated samples. All participants completed an interview, and blood and urine samples were collected the next morning. All collection procedures were repeated twice after a two-month follow-up period. Urinary 8-oxodG and N7-MeG were assayed as biomarkers of oxidative and methylated DNA damage, respectively. Plasma superoxide dismutase (SOD) and glutathione peroxidase-1 (GPX-1) were measured as biomarkers of antioxidants. Urinary 1-hydroxypyrene (1-OHP) was used as a biomarker of exposure to polycyclic aromatic hydrocarbons (PAHs). The mean PM2.5 level was 37.3μg/m3 at baseline. PM2.5 concentrations were higher during winter than during spring and summer. After adjusting for confounds through a generalized estimating equation (GEE) analysis, N7-MeG was significantly increased by 8.1% (β=0.034, 95% CIs=0.001-0.068) per 10μg/m3 increment in PM2.5. 8-oxodG levels were positively correlated with N7-MeG according to both cross-sectional and longitudinal analyses, and 1-OHP was significantly associated with increasing 8-oxodG and N7-MeG concentrations. Exposure to PM2.5 increases methylated DNA damage. The mean level of urinary N7-MeG was 1000-fold higher than that of 8-oxodG.

Accurate identification of smoking behaviour is crucial to monitor the smoking rate. This study used urinary cotinine (UC) as a biomarker to verify the effectiveness of self-reported smoking behaviour among conscripts during recruit training. The influence of second-hand smoke (SHS) on the UC concentration was also analysed. A cross-sectional study was conducted from July 2014 to December 2014. The participants comprised a total of 621 military service and basic military training conscripts. A self-administered questionnaire survey and a urine test were performed to verify the participants’ smoking behaviour. The UC concentration of 100 ng/mL was adopted as the baseline to identify smokers. A high level of consistency was observed between the conscripts’ self-reported results and the results validated by the UC concentrations (the overall kappa coefficient was 0.918). Moreover, the overall sensitivity and specificity were 92.9% and 98.1%, respectively. The sensitivity for the military service conscripts was significantly lower than that for the basic military training conscripts (86.1% vs. 97.5%, P-value = 0.002). For the self-reported nonsmokers among the military service conscripts, SHS exposure was related to their UC concentrations. The method of self-reporting through a questionnaire survey can serve as a tool to assess conscripts’ smoking behaviour.