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Liu X.,Chinese University of Hong Kong | Wong C.C.-Y.,Chinese University of Hong Kong | Yu I.T.S.,Chinese University of Hong Kong | Yu I.T.S.,Hong Kong Occupational and Environmental Health Academy | And 6 more authors.
Scientific Reports | Year: 2017

This study was to investigate the association between dietary patterns and rhinitis in primary school children. 1,599 students without rhinitis at baseline survey were selected from a primary school children cohort. Information on food consumption, respiratory symptoms, and confounders was collected using questionnaires. Dietary patterns were defined using principal component analysis. Logistic regression was performed to calculate odds ratio (OR) with 95% confidence intervals (95% CI). The incidence of rhinitis during 12 months follow-up was 21.2%. Three patterns were extracted and labeled as pattern I, II and III. Dietary pattern II which had higher factor loadings of legumes, butter, nuts and potatoes was associated with an increased risk of rhinitis (OR: 1.34, 95% CI: 1.01-1.87) when the highest tertile of pattern score was compared to the lowest tertile, after adjusted for confounders. Besides, every 1-unit increase of score of pattern II was also associated with an increased risk of rhinitis (OR: 1.19, 95% CI: 1.05-1.35). Neither pattern I nor Pattern III was observed to be associated with risk of rhinitis. A diet with higher levels of consumption of legumes, butter, nuts and potatoes may increase the risk of allergic rhinitis in primary school children. © The Author(s) 2017.


Liu X.,Chinese University of Hong Kong | Wang X.,Chinese University of Hong Kong | Wang X.,Hong Kong Occupational and Environmental Health Academy | Lin S.,Chinese University of Hong Kong | And 7 more authors.
Clinical Nutrition | Year: 2015

Background & aims: Few studies were available in exploring the roles of dietary patterns in the development of esophageal cancer, especially in China. This study aimed to investigate the roles of dietary patterns in the risk of esophageal squamous cell carcinoma (ESCC) in a Chinese rural population. Methods: A population-based cases-control study was designed and conducted in Yanting County, Sichuan Province of China during two years (between June 2011 and May 2013). A total of 942 pairs of ESCC cases and controls were recruited. A food frequency questionnaire was adopted to collect information of dietary consumption. Dietary patterns were extracted by using principle component and factor analysis based on 24 dietary groups. Odds ratios (ORs) with 95% confidence intervals (95% CI) were calculated by using logistic regression model, with adjustment for possible confounding variables. Results: Four major dietary patterns were identified, which were labeled as "prudent", "vegetable and fruits", "processed food" and "alcohol drinking". In comparison of the highest with the lowest quartiles of pattern scores, the processed food pattern (OR: 2.84, 95% CI: 2.13-3.80) and alcohol drinking pattern (OR: 2.69, 95% CI: 1.95-3.71) were significantly associated with an increased risk of ESCC, while the vegetable and fruit pattern (OR: 0.70, 95% CI: 0.53-0.92) was associated with reduced risk by 30%. The prudent pattern was associated with a reduced risk by 33% (OR: 0.67, 95% CI: 0.50-0.88) in a multivariate logistic regression model, but no statistical significance was reached in a composite model. Conclusions: The results suggest an important role of dietary patterns in ESCC. Diets rich in vegetables and fruits may decrease the risk of ESCC, whereas diets rich in processed food and drinking alcohol may increase the risk. © 2015 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism.


Liu X.,Chinese University of Hong Kong | Lao X.Q.,Chinese University of Hong Kong | Chiu-Yi Wong C.,Chinese University of Hong Kong | Tan L.,Chinese University of Hong Kong | And 6 more authors.
Journal of Allergy and Clinical Immunology | Year: 2016

Background: Despite the popular use of household cleaning products worldwide, there is no published study investigating the health effects of these products on rhinitis in children. Objective: We sought to investigate the household use of cleaning products and rhinitis patterns in Chinese children. Methods: A total of 2299 children were recruited from 21 primary schools with wide geographic coverage in Hong Kong. Self-administered questionnaires were completed by parents/guardians to collect detailed information on respiratory symptoms and household use of 14 types of chemical cleaning products, as well as clean water. Students were categorized into 4 mutually exclusive rhinitis patterns (never, occasional, frequent, and persistent). The total chemical burden (TCB) score was used as the exposure indicator by calculating the total time of exposure to the 14 cleaning products. Multinomial logistic regression was used to assess the relationship between rhinitis patterns and the use of household cleaning products. Results: Every 10-unit increment of TCB score was associated with an increase in the odds of occasional (odds ratio [OR], 1.21; 95% CI, 1.05-1.41), frequent (OR, 1.36; 95% CI, 1.13-1.60), and persistent (OR, 1.21; 95% CI, 1.01-1.56) rhinitis after adjustment for a wide range of potential confounders. Compared with the children within the lowest tertile of TCB scores, the adjusted ORs of occasional, frequent, and persistent rhinitis in children within the highest tertile were 1.29 (95% CI, 1.01-1.65), 1.97 (95% CI, 1.40-2.76), and 1.67 (95% CI, 1.10-2.54), respectively. Conclusion: Frequent use of chemical cleaning products at home is associated with an increase in the odds of rhinitis in Chinese primary school children. © 2016 The Authors.


Courtice M.N.,Chinese University of Hong Kong | Wang X.,Hong Kong Occupational and Environmental Health Academy | Lin S.,Chinese University of Hong Kong | Yu I.T.S.,Hong Kong Occupational and Environmental Health Academy | And 2 more authors.
American Journal of Industrial Medicine | Year: 2016

Background: Cumulative fiber exposures, predominantly chrysotile, were estimated in a Chinese asbestos worker cohort and exposure-response relationships with lung cancer mortality and cumulative incidence of asbestosis were determined. Methods: Individual time-dependent cumulative exposures were estimated for 577 asbestos workers, followed prospectively for 37 years. Occupational history and smoking data were obtained from company records and personal interviews; vital status and causes of death were ascertained from death registries and hospital records. Hazard ratios were generated for disease outcomes, with adjustments for smoking and age. Results: Median cumulative fiber exposure for the cohort was 132.6 fiber-years/ml (IQR 89.3-548.4). Exposure-response relationships were demonstrated for both disease outcomes, with nearly sixfold and threefold increased risks seen at the highest exposure level for lung cancer deaths and asbestosis, respectively. Conclusion: Evidence using quantitative exposure estimates was provided for increased risks of lung cancer mortality and development of asbestosis in a predominantly chrysotile-exposed cohort. © 2016 Wiley Periodicals, Inc.


PubMed | Chinese University of Hong Kong, Aeolus Inc., Teikyo University and Hong Kong Occupational and Environmental Health Academy
Type: Journal Article | Journal: American journal of industrial medicine | Year: 2016

Cumulative fiber exposures, predominantly chrysotile, were estimated in a Chinese asbestos worker cohort and exposure-response relationships with lung cancer mortality and cumulative incidence of asbestosis were determined.Individual time-dependent cumulative exposures were estimated for 577 asbestos workers, followed prospectively for 37 years. Occupational history and smoking data were obtained from company records and personal interviews; vital status and causes of death were ascertained from death registries and hospital records. Hazard ratios were generated for disease outcomes, with adjustments for smoking and age.Median cumulative fiber exposure for the cohort was 132.6 fiber-years/ml (IQR 89.3-548.4). Exposure-response relationships were demonstrated for both disease outcomes, with nearly sixfold and threefold increased risks seen at the highest exposure level for lung cancer deaths and asbestosis, respectively.Evidence using quantitative exposure estimates was provided for increased risks of lung cancer mortality and development of asbestosis in a predominantly chrysotile-exposed cohort.


Qiu H.,University of Hong Kong | Tian L.,University of Hong Kong | Ho K.-F.,Chinese University of Hong Kong | Yu I.T.S.,Hong Kong Occupational and Environmental Health Academy | And 2 more authors.
International Journal of Biometeorology | Year: 2015

The short-term effects of ambient cold temperature on mortality have been well documented in the literature worldwide. However, less is known about which subpopulations are more vulnerable to death related to extreme cold. We aimed to examine the personal characteristics and underlying causes of death that modified the association between extreme cold and mortality in a case-only approach. Individual information of 197,680 deaths of natural causes, daily temperature, and air pollution concentrations in cool season (November–April) during 2002–2011 in Hong Kong were collected. Extreme cold was defined as those days with preceding week with a daily maximum temperature at or less than the 1st percentile of its distribution. Logistic regression models were used to estimate the effects of modification, further controlling for age, seasonal pattern, and air pollution. Sensitivity analyses were conducted by using the 5th percentile as cutoff point to define the extreme cold. Subjects with age of 85 and older were more vulnerable to extreme cold, with an odds ratio (OR) of 1.33 (95 % confidence interval (CI), 1.22–1.45). The greater risk of extreme cold-related mortality was observed for total cardiorespiratory diseases and several specific causes including hypertensive diseases, stroke, congestive heart failure, chronic obstructive pulmonary disease (COPD), and pneumonia. Hypertensive diseases exhibited the greatest vulnerability to extreme cold exposure, with an OR of 1.37 (95 % CI, 1.13–1.65). Sensitivity analyses showed the robustness of these effect modifications. This evidence on which subpopulations are vulnerable to the adverse effects of extreme cold is important to inform public health measures to minimize those effects. © 2015 ISB


PubMed | Chinese University of Hong Kong, University of Hong Kong and Hong Kong Occupational and Environmental Health Academy
Type: Journal Article | Journal: International journal of biometeorology | Year: 2016

The short-term effects of ambient cold temperature on mortality have been well documented in the literature worldwide. However, less is known about which subpopulations are more vulnerable to death related to extreme cold. We aimed to examine the personal characteristics and underlying causes of death that modified the association between extreme cold and mortality in a case-only approach. Individual information of 197,680 deaths of natural causes, daily temperature, and air pollution concentrations in cool season (November-April) during 2002-2011 in Hong Kong were collected. Extreme cold was defined as those days with preceding week with a daily maximum temperature at or less than the 1st percentile of its distribution. Logistic regression models were used to estimate the effects of modification, further controlling for age, seasonal pattern, and air pollution. Sensitivity analyses were conducted by using the 5th percentile as cutoff point to define the extreme cold. Subjects with age of 85 and older were more vulnerable to extreme cold, with an odds ratio (OR) of 1.33 (95 % confidence interval (CI), 1.22-1.45). The greater risk of extreme cold-related mortality was observed for total cardiorespiratory diseases and several specific causes including hypertensive diseases, stroke, congestive heart failure, chronic obstructive pulmonary disease (COPD), and pneumonia. Hypertensive diseases exhibited the greatest vulnerability to extreme cold exposure, with an OR of 1.37 (95 % CI, 1.13-1.65). Sensitivity analyses showed the robustness of these effect modifications. This evidence on which subpopulations are vulnerable to the adverse effects of extreme cold is important to inform public health measures to minimize those effects.


Liu X.,Chinese University of Hong Kong | Wang X.,Chinese University of Hong Kong | Wang X.,Hong Kong Occupational and Environmental Health Academy | Lin S.,Chinese University of Hong Kong | And 4 more authors.
PLoS ONE | Year: 2015

Objective This study was conducted to assess the reproducibility and validity of a food frequency questionnaire (FFQ) that was developed to assess the overall dietary consumption via dietary pattern method in a rural population in southwest China. Methods A total of 179 participants aged between 40 and 70 years old were included in this study. Participants administered FFQ at baseline (FFQ1) and one year later (FFQ2) to assess the reproducibility. Six 3-day 24-hour recalls (24HRs) were completed between the administrations of two FFQs to determine the validity. Dietary patterns from three separate dietary sources were derived by using principle component factor analysis. Comparisons between dietary pattern scores were made by using Pearson or intraclass correlation coefficient, cross-classification analysis, weighted kappa (κ) statistic and Bland-Altman analysis. The de-attenuated method was adopted to correct the monthly and seasonally variation and the partial correlation analysis was used correct the influence by total energy intake. Results Two major dietary factors, labeled as prudent pattern and processed food pattern, were identified. The prudent pattern was characterized by higher factor loadings of wheat, rice, fresh vegetables, bean products, nuts, red meat, white meat and fresh eggs; and the processed food pattern was characterized by higher factor loadings of pickled vegetables, preserved vegetables and salted meat. Between Two FFQs, intraclass correlation coefficients were 0.57 for prudent pattern and 0.55 for processed food pattern, partial Pearson correlation coefficients were 0.51 for the prudent pattern and 0.56 for the processed food pattern; weighted κ statistic ranged from 0.45 (for the prudent pattern) to 0.56 (for the processed food pattern). Between FFQs and 24HRs, de-attenuated correlation coefficients ranged from 0.54 to 0.78 for the prudent pattern and from 0.55 to 0.61 for the processed food pattern; partial Pearson correlation coefficients ranged from 0.41 to 0.56 for the prudent pattern and from 0.42 to 0.44 for the processed food pattern; weighted κ statistic ranged from 0.42 to 0.46 for prudent pattern and from 0.43 to 0.60 for processed food pattern. The Bland-Altman plots and limits of agreement indicated that the deviation/divergence was not obvious for both of the patterns between FFQ1 and FFQ2 and between FFQs and 24HRs. Conclusion The study suggests that the FFQ is reasonably reproducible and valid to assess the overall dietary consumption via dietary pattern methods in the Chinese rural population. © 2015 Liu et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.


PubMed | Chinese University of Hong Kong, Capital Medical University and Hong Kong Occupational and Environmental Health Academy
Type: Journal Article | Journal: PloS one | Year: 2015

This study was conducted to assess the reproducibility and validity of a food frequency questionnaire (FFQ) that was developed to assess the overall dietary consumption via dietary pattern method in a rural population in southwest China.A total of 179 participants aged between 40 and 70 years old were included in this study. Participants administered FFQ at baseline (FFQ1) and one year later (FFQ2) to assess the reproducibility. Six 3-day 24-hour recalls (24HRs) were completed between the administrations of two FFQs to determine the validity. Dietary patterns from three separate dietary sources were derived by using principle component factor analysis. Comparisons between dietary pattern scores were made by using Pearson or intraclass correlation coefficient, cross-classification analysis, weighted kappa () statistic and Bland-Altman analysis. The de-attenuated method was adopted to correct the monthly and seasonally variation and the partial correlation analysis was used correct the influence by total energy intake.Two major dietary factors, labeled as prudent pattern and processed food pattern, were identified. The prudent pattern was characterized by higher factor loadings of wheat, rice, fresh vegetables, bean products, nuts, red meat, white meat and fresh eggs; and the processed food pattern was characterized by higher factor loadings of pickled vegetables, preserved vegetables and salted meat. Between Two FFQs, intraclass correlation coefficients were 0.57 for prudent pattern and 0.55 for processed food pattern, partial Pearson correlation coefficients were 0.51 for the prudent pattern and 0.56 for the processed food pattern; weighted statistic ranged from 0.45 (for the prudent pattern) to 0.56 (for the processed food pattern). Between FFQs and 24HRs, de-attenuated correlation coefficients ranged from 0.54 to 0.78 for the prudent pattern and from 0.55 to 0.61 for the processed food pattern; partial Pearson correlation coefficients ranged from 0.41 to 0.56 for the prudent pattern and from 0.42 to 0.44 for the processed food pattern; weighted statistic ranged from 0.42 to 0.46 for prudent pattern and from 0.43 to 0.60 for processed food pattern. The Bland-Altman plots and limits of agreement indicated that the deviation/divergence was not obvious for both of the patterns between FFQ1 and FFQ2 and between FFQs and 24HRs.The study suggests that the FFQ is reasonably reproducible and valid to assess the overall dietary consumption via dietary pattern methods in the Chinese rural population.


PubMed | Hong Kong Occupational and Environmental Health Academy
Type: | Journal: Scandinavian journal of work, environment & health | Year: 2017

Objective The aim of this study was to evaluate the effectiveness of a participatory training program in preventing accidental occupational injuries in factories in Shenzhen, China. Methods We conducted a cluster randomized study with the worker as the unit of analysis, providing 918 workers from 30 factories participatory training. Two control groups received traditional didactic training, including 907 workers from the same 30 factories and 1654 workers in matched control factories. We used generalized estimating equations to compare the before/after person-based injury rate difference in the three groups and binary logistic regression to compare the re-injury rates. Results The person- and event-based incidence rates of accidental injury in the intervention group reduced from 89.3 to 52.1 per 1000 workers (P=0.002) and from 138.3 to 74.5 per 1000 person-years (P<0.001), respectively. The rate reductions in the two control groups were not statistically significant. Compared with the intervention group, the risk of accidental work injury over time was higher in the control groups, with odds ratios (OR) 1.78 (1.04-3.04) and 1.77 (1.13-2.79) for control_1 and control_2 group, respectively. The re-injury rates were 27.1% (13/48) in the intervention group, and 41.7% (15/36) and 52.6% (51/97) in the two control groups respectively, with the latter being significantly higher than the intervention group. Conclusions Our study documented the effectiveness of a participatory approach to occupational health and safety training in reducing accidental work injuries and re-injuries among frontline workers.

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