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To revise GBZ 188 Technical Specification for Occupational Health Surveillance based on national laws, regulations, standards, specifications and legal documents of occupational disease, and combination with the actual situation in China. The main modifications are as follows: the occupational health surveillance for workers exposed to toluene (xylene may implement by reference), bromopropane, methyl iodide, ethylene oxide, chloroacetic acid, indium and its compounds, coal tar, coal tarasphalt, asphalt, β-naphthylamine, dust of metal and its compounds(tin, iron, antimony, barium and its compounds), hard metal dust, erionite dust, low temperature, laser, tick-borne encephalitis virus, Borrelia burgdorferi, and human immunodeficiency virus, for scraper or grind operators, and underground workers using squatting or kneeling position, crawling position, side-lying position, or shoulder position for a long period of time are included. The emergency health screening for workers exposed to arsenic, fluorine and its inorganic compounds, and acrylamide are included. The occupational medical examination (OME) for workers exposed to amino and nitro compounds of benzene, phosgene, monomethylamine, organic fluorine and dimethyl sulfate has been adjusted and made mandatory, with corresponding assessments required upon leaving the job. The special occupational health surveillance for workers exposed to mycobacterium tuberculosis and hepatitis virus is removed. The OME conclusion of reexamination is removed, and standardize recheck/additional inspection requirements. The optional items in OME performed before, during and after leaving post are removed, but the optional items in emergency medical examination are retained. Additional OME items are added. The Guideline for OME Summary Reports is added as informative appendix, and so on. The revised GBZ 188 Technical Specification for Occupational Health Surveillance is more scientific and practical.
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Objective@#To explore the mediating effect of hemoglobin (Hb) and hematocrit (HCT) on the association between alcohol consumption and blood pressure, and provide evidence for the prevention and control of alcohol-attributed hypertension.@*Methods@#1 091 male (age >50 years old) participants with drinking habit were selected from the Guangzhou biobank cohort study (GBCS). Mediation analysis was used to evaluate the mediating effect of Hb and HCT on the association of alcohol consumption (unit/day) with systolic blood pressure (SBP), diastolic blood pressure(DBP), pulse pressure(PP) and mean arterial pressure (MAP).@*Results@#After adjusting for age, body mass index, education level, personal annual income, smoking, occupation and physical activity, the associations of alcohol consumption with SBP, DBP, PP and MAP were partly mediated by Hb, the proportion of mediating effect was 11.8% (95%CI 4.8%-24.7%), 15.3% (95%CI 6.5%-32.0%), 8.4% (95%CI 2.2%-22.5%) and 13.5% (95%CI 5.9%-27.5%), respectively. The associations of alcohol consumption with SBP, DBP, and MAP were also partly mediated by HCT, the proportion of mediating effect was 6.3% (95%CI 1.0%-16.0%), 8.7% (95%CI 1.4%-21.4%), and 7.5% (95%CI 1.0%-18.6%), respectively.@*Conclusion@#There is a significant mediating effect of Hb and HCT on the association between alcohol consumption and blood pressure. Besides efforts on alcohol control, the potential effects of alcohol-induced increase on Hb and HCT, which might also increase the blood pressure, need to be considered to achieve optimal monitoring and prevention of alcohol-related hypertension.
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Objective To investigate the association between people who were under lack of care in childhood and the development of cognitive impairment in their middle-aged and elderly life spans.Methods Based on the baseline survey data of the third phase of "Guangzhou Biobank Cohort study" conducted from January 2007 to January 2008,9 223 residents aged ≥50 years with records on Mini Mental State Examination (MMSE) were included in a retrospective survey on received childhood carc of their early lives.Questions would include:feelings of care and support from their close relatives during childhood,the status of separation from their mothers for ≥ 1 year,and the current status of their parents.Linear regression,unconditional and multinomial logistic regression models were used to analyze the associations between the received childhood care and cognitive function (i.e.,MMSE scores and cognitive impairment) in middle and old age,of this population under study.Results After adjusting for age,gender,education,place of residence,marital status,physical activity,smoking,drinking,occupation,personal income,childhood socioeconomic position and depressive symptoms etc.,factors as feeling lack of concern and support from close relatives (LC),status of separation from the mother for ≥ 1 year (SM),and the current status of their parents etc.,were all negatively associated with the MMSE score when in middle and old age,with partial regression coefficient β (95％CI) as-0.44 (-0.65--0.23),-0.26 (-0.38--0.14) and-0.61 (-0.96--0.27),respectively.The presence ofLC,SM or PD were associated with the increased risks of cognitive impairment,and the adjusted odds ratio OR (95％CI) appeared as 1.43 (1.15-1.78),1.26 (1.08-1.47) and 1.64 (1.16-2.31)respectively in all the participants,but 1.27 (1.01-1.62),1.29 (1.09-1.55) and 1.75 (1.19-2.55) respectively,in those with education level of primary school or below.In those with secondary school education or above,only the presence of item A was associated with an increased risk of cognitive impairment (OR=2.26,95％CI:1.41-3.50).Conclusion We noticed that ‘lack of care'in childhood was associated with cognitive impairment during middle and old age,mainly in those population with lower education.
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Objective To investigate the association between people who were under lack of care in childhood and the development of cognitive impairment in their middle-aged and elderly life spans.Methods Based on the baseline survey data of the third phase of "Guangzhou Biobank Cohort study" conducted from January 2007 to January 2008,9 223 residents aged ≥50 years with records on Mini Mental State Examination (MMSE) were included in a retrospective survey on received childhood carc of their early lives.Questions would include:feelings of care and support from their close relatives during childhood,the status of separation from their mothers for ≥ 1 year,and the current status of their parents.Linear regression,unconditional and multinomial logistic regression models were used to analyze the associations between the received childhood care and cognitive function (i.e.,MMSE scores and cognitive impairment) in middle and old age,of this population under study.Results After adjusting for age,gender,education,place of residence,marital status,physical activity,smoking,drinking,occupation,personal income,childhood socioeconomic position and depressive symptoms etc.,factors as feeling lack of concern and support from close relatives (LC),status of separation from the mother for ≥ 1 year (SM),and the current status of their parents etc.,were all negatively associated with the MMSE score when in middle and old age,with partial regression coefficient β (95％CI) as-0.44 (-0.65--0.23),-0.26 (-0.38--0.14) and-0.61 (-0.96--0.27),respectively.The presence ofLC,SM or PD were associated with the increased risks of cognitive impairment,and the adjusted odds ratio OR (95％CI) appeared as 1.43 (1.15-1.78),1.26 (1.08-1.47) and 1.64 (1.16-2.31)respectively in all the participants,but 1.27 (1.01-1.62),1.29 (1.09-1.55) and 1.75 (1.19-2.55) respectively,in those with education level of primary school or below.In those with secondary school education or above,only the presence of item A was associated with an increased risk of cognitive impairment (OR=2.26,95％CI:1.41-3.50).Conclusion We noticed that ‘lack of care'in childhood was associated with cognitive impairment during middle and old age,mainly in those population with lower education.
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Objective To examine the association between weight changes during early and middle adulthood and the risk of type 2 diabetes mellitus in middle aged and elderly population.Methods Based on the Guangzhou Biobank Cohort Study (GBCS),28 736 residents aged ≥50 years were included in Guangzhou.Multivariate logistic regression was used to analyze the association between body weight changes during early or middle adulthood and age when the heaviest weight reaching the threshold on the risk of type 2 diabetes mellitus in middle age or elderly population.Adjustments on age,smoking,alcohol consumption,physical activity,education level,occupation,district of residence and body mass index etc.,were made.Results The mean age was 64.3 (standard deviation=6.7) years in men and 61.0 (standard deviation=7.0) years in women,with the prevalence rates of diabetes as 13.1％ and 13.7％ in men and women,respectively.Compared to those with stable body weight,the risk of diabetes increased with weight gain during early and middle adulthood in both men and women (both P values for trend ＜0.01).Participants who gained more than 20 kg during early and middle adulthood were associated with the highest risk of diabetes in men (OR=2.83,95％ CI:1.99-4.02) and women (OR=3.13,95％CI:2.47-3.96).Compared to those who reached the highest weight at age 20,those who reaching the highest weight at 40 to 49 years were associated with the highest risk of diabetes,with OR being 5.32 (95％CI:1.92-14.8) in men and 3.41 (95％CI:2.49-4.67) in women,respectively.Weight loss in adulthood was associated with self-reported but not newly diagnosed diabetic cases in both middle and older aged men and women.Conclusion Weight gain during early and middle adulthood may increase the risk of diabetes in middle and older aged population.The detrimental effect of obesity on diabetes might become significantly visible in the next decades.
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Objective To examine the association between weight changes during early and middle adulthood and the risk of type 2 diabetes mellitus in middle aged and elderly population.Methods Based on the Guangzhou Biobank Cohort Study (GBCS),28 736 residents aged ≥50 years were included in Guangzhou.Multivariate logistic regression was used to analyze the association between body weight changes during early or middle adulthood and age when the heaviest weight reaching the threshold on the risk of type 2 diabetes mellitus in middle age or elderly population.Adjustments on age,smoking,alcohol consumption,physical activity,education level,occupation,district of residence and body mass index etc.,were made.Results The mean age was 64.3 (standard deviation=6.7) years in men and 61.0 (standard deviation=7.0) years in women,with the prevalence rates of diabetes as 13.1％ and 13.7％ in men and women,respectively.Compared to those with stable body weight,the risk of diabetes increased with weight gain during early and middle adulthood in both men and women (both P values for trend ＜0.01).Participants who gained more than 20 kg during early and middle adulthood were associated with the highest risk of diabetes in men (OR=2.83,95％ CI:1.99-4.02) and women (OR=3.13,95％CI:2.47-3.96).Compared to those who reached the highest weight at age 20,those who reaching the highest weight at 40 to 49 years were associated with the highest risk of diabetes,with OR being 5.32 (95％CI:1.92-14.8) in men and 3.41 (95％CI:2.49-4.67) in women,respectively.Weight loss in adulthood was associated with self-reported but not newly diagnosed diabetic cases in both middle and older aged men and women.Conclusion Weight gain during early and middle adulthood may increase the risk of diabetes in middle and older aged population.The detrimental effect of obesity on diabetes might become significantly visible in the next decades.
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<p><b>OBJECTIVE</b>To examine the association of fasting plasma glucose (FPG) and serum uric acid (SUA) in middle and elderly Chinese.</p><p><b>METHODS</b>10 413 Guangzhou residents aged ≥50 were included in the present study. Information on personal history, physical examination and biochemical parameters were collected. Subjects were grouped by the FPG level, association between FPG and SUA. Levels of hyperuricemia (HUA) were evaluated.</p><p><b>RESULTS</b>The SUA levels and the incidence of HUA showed trends of increasing, with the increasing FPG levels in women, with statistically significant differences seen among all the FPG groups (P value for trend<0.05). While the statistical differences of SUA levels and the incidence rates of HUA among diabetes group (DM group) and impaired fasting glucose (IFG) groups were non-significant (P > 0.05) but it was higher than normal FPG group in men (P < 0.05). Logistic regression models were built between various FPG groups and HUA. After adjusting for age, smoking status, drinking status, physical activity, hypertension, body mass index and the levels of triglyceride and creatin. When compared to the normal FPG group, the risk of women suffering from HUA increased by 40% (95%CI:1.19-1.64) under the FPG in the range of 6.1-6.9 mmol/L. Compared to those non-diabetic individuals, the risk of diabetic patients suffering from HUA also increased by 44% (95% CI:1.15-1.79) in women. However, the risk of suffering from HUA did not relate to the increase of FPG in men.</p><p><b>CONCLUSION</b>The SUA level and the incidence of HUA tended to increase along with the increasing levels of FPG in middle and elderly Chinese women and the increase of FPG might also increase the risk of HUA, but not in men.</p>
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Aged , Female , Humans , Male , Middle Aged , Asian People , Blood Glucose , China , Epidemiology , Diabetes Mellitus , Epidemiology , Fasting , Blood , Hyperuricemia , Epidemiology , Incidence , Prediabetic State , Epidemiology , Risk Factors , Sex Distribution , Uric Acid , BloodABSTRACT
<p><b>OBJECTIVE</b>To describe the influenza viruses antibody levels and contact patterns of individuals in rural and urban regions of Guangzhou and to understand how contact patterns and other factors would correlate with the levels on the titers of antibody.</p><p><b>METHODS</b>"Google Map" was used to randomly select the study points from the administrative areas in Guangzhou region. Each participant was required to provide 5 ml blood serum sample to be tested against different strains of H1N1 and H3N2 influenza viruses.</p><p><b>RESULTS</b>1) Using "Google map", 50 study points were selected but only 40 study points would meet the inclusion criteria. The cohort of this study consisted 856 households with 2 801 individuals. 1 821 participants (65% of the total number individuals in the cohort) completed the questionnaires. Among the 1 821 participants, 77.3% (1 407/1 821) and 22.7% (414/1 821) of them were from rural and urban areas respectively. There were more male participants in the rural but more female participants in the urban regions. Majority of the participants were from age group 18-59 followed by group 60 with aged 2-17 the least, in both rural and urban areas. 2) 78.1% (1 423/1 821) of the participants provided their serum samples. There appeared a strong correlation between age of the participants and the strength of their antibodies against that strain when a strain first circulated. In particular, seroprevalence was the highest at the age group 2-17. 3) 'Contact' was defined as persons having physical touch or/and conversation within one meter with the participants. Participants reported all having had large number of contacts. The proportion of participants having contacts with ten persons or above was the highest, ranging from 49.8% to 72.6%, particularly in age group 6-17. Compared to weekdays, participants had fewer contact persons on weekends.</p><p><b>CONCLUSION</b>There was a strong correlation between the age of participants at the time when the strains first circulated and the seroprevalence against influenza virus strains of H1N1 and H3N2. Also, age of the participants and the frequencies of their contacts to people, was also correlated.</p>
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Adolescent , Adult , Child , Child, Preschool , Female , Humans , Male , Middle Aged , Young Adult , Antibodies, Viral , Blood , China , Epidemiology , Contact Tracing , Influenza A Virus, H1N1 Subtype , Allergy and Immunology , Influenza A Virus, H3N2 Subtype , Allergy and Immunology , Influenza, Human , Epidemiology , Seroepidemiologic StudiesABSTRACT
Objective To examine the association of fasting plasma glucose (FPG) and serum uric acid (SUA) in middle and elderly Chinese. Methods 10 413 Guangzhou residents aged ≥50 were included in the present study. Information on personal history,physical examination and biochemical parameters were collected. Subjects were grouped by the FPG level,association between FPG and SUA. Levels of hyperuricemia(HUA)were evaluated. Results The SUA levels and the incidence of HUA showed trends of increasing,with the increasing FPG levels in women,with statistically significant differences seen among all the FPG groups(P value for trend<0.05). While the statistical differences of SUA levels and the incidence rates of HUA among diabetes group(DM group)and impaired fasting glucose(IFG)groups were non-significant(P>0.05)but it was higher than normal FPG group in men (P<0.05). Logistic regression models were built between various FPG groups and HUA. After adjusting for age,smoking status,drinking status,physical activity, hypertension,body mass index and the levels of triglyceride and creatin. When compared to the normal FPG group,the risk of women suffering from HUA increased by 40%(95%CI:1.19-1.64) under the FPG in the range of 6.1-6.9 mmol/L. Compared to those non-diabetic individuals,the risk of diabetic patients suffering from HUA also increased by 44%(95%CI:1.15-1.79) in women. However,the risk of suffering from HUA did not relate to the increase of FPG in men. Conclusion The SUA level and the incidence of HUA tended to increase along with the increasing levels of FPG in middle and elderly Chinese women and the increase of FPG might also increase the risk of HUA,but not in men.
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Objective To examine the association of fasting plasma glucose (FPG) and serum uric acid (SUA) in middle and elderly Chinese. Methods 10 413 Guangzhou residents aged ≥50 were included in the present study. Information on personal history,physical examination and biochemical parameters were collected. Subjects were grouped by the FPG level,association between FPG and SUA. Levels of hyperuricemia(HUA)were evaluated. Results The SUA levels and the incidence of HUA showed trends of increasing,with the increasing FPG levels in women,with statistically significant differences seen among all the FPG groups(P value for trend<0.05). While the statistical differences of SUA levels and the incidence rates of HUA among diabetes group(DM group)and impaired fasting glucose(IFG)groups were non-significant(P>0.05)but it was higher than normal FPG group in men (P<0.05). Logistic regression models were built between various FPG groups and HUA. After adjusting for age,smoking status,drinking status,physical activity, hypertension,body mass index and the levels of triglyceride and creatin. When compared to the normal FPG group,the risk of women suffering from HUA increased by 40%(95%CI:1.19-1.64) under the FPG in the range of 6.1-6.9 mmol/L. Compared to those non-diabetic individuals,the risk of diabetic patients suffering from HUA also increased by 44%(95%CI:1.15-1.79) in women. However,the risk of suffering from HUA did not relate to the increase of FPG in men. Conclusion The SUA level and the incidence of HUA tended to increase along with the increasing levels of FPG in middle and elderly Chinese women and the increase of FPG might also increase the risk of HUA,but not in men.
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Objective To investigate the prevalence and charateristics of carotid atherosclerosis among healthy middle-aged people of community. Methods Totally 1930 subjects aged 50 years and above were selected randomly from 10027 participants recruited during Phase 3 of the Guangzhou Biobank Cohort Study (GBCS).Common carotid artery intima-media thickness (CCA-IMT) and carotid plaques (CP) were measured by B-mode ultrasonography using ALT HDI 3000 mainframe with a high-resolution. Results The prevalences of CCA-IMT and CP in men were higher than women [41.5％(400/963)vs.16.2 (157/967),34.1％ (328/967) vs.13.8％ (133/967),both P＜0.001].The prevalence of CCA-1MT was higher with age increasing in either men or women in groups of 50-yrs,60-yrs and 70-79 yrs (all P＜0.001).The most of CP was cankerous spot (37.8％),secondly hard spot (24.9％),soft spot (22.1％) and the prevalence of flat spot was lowest (15.2％).The number of CP was not significantly different between the left and right side (51.0％ and 49.0％).The most common location of CP was bifurcations of carotid arteries (61.7 ％),next the common carotid artery (21.0％) and internal carotid artery (ICA) was lowest (17.3 ％).The prevalence of CP was 44.4％ (83/87) in women aged 50- yrs,it was higher than that in men 20.9％ (108/517).However,the prevalence of CP was 79.1％ (409/517) in men aged more than 60 yrs,higher than that in women (55.6％). Conclusions The carotid atherosclerosis is commonly encountered disease in the male elderly,and the most of CP was cankerous spot in bifurcations of carotid arteries
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<p><b>OBJECTIVE</b>To study the main causes of death in workers from different industries in Guangzhou.</p><p><b>METHODS</b>The industrial systems in Guangzhou were classified into six categories according to the Chinese Public Health Inspection Statistical Report. Baseline data on 79,547 workers, age > or = 35, were retrieved from individual health records under the Guangzhou Occupational Health Surveillance Record System established in 1989-1992. In this prospective cohort study, the workers' vital status and causes of death were followed up until 31 December 1998. Using SPSS 10.0, crude death rates were calculated and relative risks(RR) (95% CI) were estimated using Cox proportional-hazard models.</p><p><b>RESULTS</b>(1) Among 79,547 workers were 49,355 men and 30,192 women, with mean age of (43.8 +/- 6.5) years, and 64% were aged 35-44. The mean age difference of workers in different industries was +/- 1 year. At baseline, 41% had been exposed to occupational hazards. Exposure was most prevalent in petroleum chemical industry(53.9%), followed by metallurgical industry, and the lowest exposure was in mechanical industry (30.2%). (2) The mean follow-up period was (8.0 +/- 1.3) years with 633,510 person-years. 1,577 workers had died with a total death rate of 248.9 per 100,000 person-years. The death rate in rubber industry was the highest, followed by metallurgical and petroleum chemical industries. Malignant neoplasms, vascular and respiratory diseases were most common, constituting 80.3% of all causes of death. (3) For all causes of death and the three main categories, the top three crude death rates were observed in rubber and petroleum chemical industries, and in the metallurgical industry except for vascular causes. The rubber industry had the highest crude death rate for all and vascular causes, and the metallurgical industry for malignant neoplasms and respiratory causes. (4) With the light industry as a reference (RR = 1.0), the metallurgical industry had the highest adjusted relative risks (RR) (95% CI) of 1.62(1.20-2.18) and 7.42(3.38-16.31) for malignant neoplasms and respiratory causes, respectively. The rubber industry had the highest RR of 1.69(1.40-2.04) for all causes. A significant RR of 2.03(1.43-2.88) for vascular causes was observed only in the rubber industry.</p><p><b>CONCLUSIONS</b>The main causes of death varied from industry. Malignant neoplasms and respiratory diseases were the leading causes in metallurgical and petroleum chemical industries. In rubber industry, vascular and respiratory causes were most common. Preventive measures for disease control should be tailor-made for each industry.</p>
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Adult , Aged , Female , Humans , Male , Middle Aged , Cause of Death , Cohort Studies , Industry , Occupational Diseases , Mortality , Occupational Exposure , Proportional Hazards Models , Prospective StudiesABSTRACT
<p><b>OBJECTIVE</b>To observe the heart damage in 10 patients with acute fluoroacetamide poisoning.</p><p><b>METHODS</b>Monitoring serum activities of myocardial enzymes [creatine kinase (CK), asparate aminotransferase (AST), lactate dehydrogenase(LDH) and hydroxybutyrate dehydrogenase(HBDH)] and recording ECG on these 10 patients were performed during the period of their hospitalization. In the mean while, 24 hour dynamic ECG were also recorded and analysed using GP7000L Holter.</p><p><b>RESULTS</b>(1) Urinary fluorine ion concentrations were increased in 9 patients before therapy and in all these 10 patients during therapeutic period. (2) The activities of serum CK in 2 patients and that of serum HBDH in one patient were increased before therapy. However, the serum activities of one or more than one myocardial enzymes were increased in all these 10 patients during therapeutic period. (3) Four patients had abnormal change of ECG before therapy and 5 patients during therapeutic period. (4) 24 hour dynamic ECG records showed that there were heart electrical alternans in 9 patients. One patient had wandering pacemaker and 6 patients had arythmia.</p><p><b>CONCLUSION</b>Fluoroacetamide may cause obvious heart damage, and also heart electrical alternation.</p>
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Humans , Acute Disease , Alanine Transaminase , Blood , Creatine Kinase , Blood , Electrocardiography , Fluoroacetates , Poisoning , Heart , Hydroxybutyrate Dehydrogenase , Blood , L-Lactate Dehydrogenase , BloodABSTRACT
<p><b>OBJECTIVE</b>To study the effect of dust exposure and smoking on mortality.</p><p><b>METHODS</b>Based on the Guangzhou Occupational Health Surveillance Record System established in 1989-1992, 61,648 factory workers, aged > or = 30, occupationally exposed to dust and non-exposure to dust or any other hazardous substances(controls), were included in a prospective cohort study.</p><p><b>RESULTS</b>(1) 28 were lost to follow-up. Malignant neoplasm was most common among 1,186 deaths. (2) Most subjects were male workers, aged 35 to 44, with secondary education, and married. 42.2% had ever smoked and 32.8% were ever-drinkers. (3) To compare with non-exposure, non-smoking + non-smoking and non-exposure respectively, the adjusted RR of death from all causes, malignant neoplasm and respiratory diseases were 1.24, 1.34 and 1.96 respectively for dust exposed workers(compared to control, P < 0.01), 1.16, 1.37 and 1.63 respectively for those smoking(compared to non-smoker except RR of death from respiratory diseases, P < 0.01), and 1.48, 1.85 and 3.12 respectively for those smoking and dust exposure, which were far greater than those either smoked or exposed to dust alone(P < 0.01). (4) The influence of dust exposure on death was mainly showed in occupational exposure to silica dust and wood dust.</p><p><b>CONCLUSION</b>Both dust exposure and smoking may increase the mortality, and they had synergistic effect.</p>