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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


Lin S.,Chinese University of Hong Kong | Wang X.,Chinese University of Hong Kong | Huang C.,University of Sichuan | Liu X.,Chinese University of Hong Kong | And 3 more authors.
International Journal of Cancer | Year: 2015

Etiology of esophageal cancer has not yet been clearly documented, especially in high-risk regions. To evaluate the association between salted meat intake and esophageal squamous-cell carcinoma (ESCC) and to explore its joint effects with alcohol drinking and smoking, a population-based case-control study was conducted in a high ESCC risk area in China, including 942 incident ESCC cases and 942 age- and sex-matching controls. A validated food frequency questionnaire was used to collect information on dietary factors, alcohol drinking and tobacco smoking. Conditional logistic regressions were applied to estimate the association between salted meat intake and ESCC and its interactions with alcohol drinking and smoking, with adjustment for other confounders, including total energy intake. Salted meat intake was associated with an increased risk of ESCC, showing an exposure-response relationship (p for trend <0.001). Consumption of 50 g salted meat per week was related to an increased risk by 18% (odds ratio = 1.18, 95% confidence interval: 1.13-1.23). Salted meat in combination with either alcohol drinking or smoking had a greater risk than salted meat alone, which was more than additive. The strongest association was seen in the combination of all the three factors, particularly at the highest level of salted meat intake (odds ratio = 29.27, 95% confidence interval: 13.21-64.89). Salted meat intake is strongly associated with ESCC and its interactions with alcohol drinking and/or smoking highlights the significance of reducing salted meat intake among smokers and drinkers with respect to ESCC prevention. © 2014 UICC.


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.


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.


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.

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