Epidemiological investigation of risk factors for cataract among people aged 50 and over in Tacheng area, Xinjiang / 中华实验眼科杂志

Objective:To investigate the prevalence of cataract and its risk factors in the Jiu Shi Hospital of Xinjiang Production and Construction Corps and Han and Kazak people aged 50 years old and over in Emin County, Tacheng area, Xinjiang.Methods:A cross-sectional study was conducted.An epidemiological survey on the prevalence of cataract among people aged 50 years old and over was performed by the Department of Ophthalmology of North China University of Science and Technology Affiliated Hospital in the Jiu Shi Hospital of Xinjiang Production and Construction Corps and Emin County from October 2015 to June 2018.The basic sampling units (BSUs) were divided according to the administrative regions, with about 1 000 people in each administrative region.With a population exceeding 1 500, sample units would be divided into more than two BSUs according to the population.Xinjiang Tacheng area was divided into 240 BSUs, and 12 BSUs were selected by random number table method for inspection.With the lens opacity classification system Ⅱ (LOCS Ⅱ) as the diagnostic standard, the prevalence rate of cataract in different nationalities and different ages in this area was evaluated, and the relationship between age, nationality, sex, hypertension, diabetes, smoking, hyperlipidemia, coronary heart disease, ultraviolet irradiation time and the prevalence rate of cataract was analyzed.This study protocol was approved by the Ethics Committee of the Jiu Shi Hospital of Xinjiang Production and Construction Corps (No.SW-201501-04).Results:The prevalence rate of cataract among people aged 50 and over in the Jiu Shi Hospital of Xinjiang Production and Construction Corps and Emin County was 76.34%.The prevalence rate of cataract in 50-<60-year-old group, 60-<70-year-old group, 70-<80-year-old group and ≥80-year-old group was 23.30%, 77.40%, 89.60% and 100.00%, respectively.There were significant differences in the prevalence among people between different ages, different nationalities, with and without hypertension, with and without diabetes, with and without hyperlipidemia (all at P<0.01). There was no significant difference in the prevalence among people between different sexes, with and without coronary heart disease, smoking or not, different ultraviolet irradiation time (all at P>0.05). Multiple logistic regression analysis showed that age (50-<60 years old: [ OR=39.93, 95% CI: 20.77-76.77; 60-<70 years old: OR=3.81, 95% CI: 2.05-7.08; 70-<80 years old: OR=1.72, 95% CI: 0.92-3.22]), hypertension ( OR=1.54, 95% CI: 1.13-2.11) and hyperlipidemia ( OR=1.41, 95% CI: 1.10-2.03) were independent risk factors for cataract. Conclusions:The incidence of cataract in the Jiu Shi Hospital of Xinjiang Production and Construction Corps and people aged 50 and over in Emin County is higher than that in other parts of China, in which age, hypertension and hyperlipidemia are independent risk factors for cataract.

The CEBPE rs2239633 genetic polymorphism on susceptibility to childhood acute lymphoblastic leukemia: an updated meta-analysis

OBJECTIVES@#We performed an updated meta-analysis to clarify the relationship between the CEBPE rs2239633 polymorphism and the childhood acute lymphoblastic leukemia (CALL) susceptibility.@*METHODS@#All the case-control studies were updated on October 5, 2020, through Web of Science, PubMed, Cochrane Library, Embase, and China National Knowledge Infrastructure (CNKI) electronic database. The heterogeneity in the study was tested by the Q test and I@*RESULTS@#A total of 20 case-control studies were selected, including 7014 patients and 16,428 controls. There was no association of CEBPE rs2239633 polymorphism with CALL (CC vs CT + TT: OR = 1.08, 95% CI = 0.94-1.26; CC + CT vs TT: OR = 1.10, 95% CI = 0.94-1.30; C vs T: OR = 1.02, 95% CI = 0.92-1.13). In the subgroup analysis by ethnicity, there is no significant association of this polymorphism and CALL risks among Asian and Caucasian populations in the three genetic models (CC vs CT + TT, CC + CT vs TT, and C vs T).@*CONCLUSION@#This meta-analysis found no significant association between the CEBPE rs2239633 polymorphism and susceptibility to CALL.

Further promotion on children injury prevention and control in China / 中华流行病学杂志

Injury is an important public health problem that threatening children’s health. Researches have been carried out to prevent child injuries in China. Disease burden on injury for children have been moderated, but remained as the first cause of death in Chinese children, so injury prevention among children should still be treated as priority to promote children’s health. It is necessary to establish and improve strategies in injury prevention which should be led by the government and correlated institutes, as to carry out a systematic, comprehensive and scientific system for children injury prevention and control. In order to reduce children’s injuries and promote children’s health, relevant policies and regulations should base on "Healthy China 2030" to formulate and implement action plans, to carry out practice and scientific research on children injury prevention, and to strengthen the team construction and talent training on this issue.

Effects and the associated factors of the 2016 China Motivational Healthy Walking Program among occupational population / 中华预防医学杂志

Objective@#To examine the effects and associated factors of the China Motivational Healthy Walking Program among occupational population.@*Methods@#The 2016 China Motivational Healthy Walking Program recruited 29 224 participants from 139 demonstration areas for comprehensive prevention and control of chronic and non-communicable disease at national level and 70 at provincial level. Intervention on walking was carried out by adopting group and individual motivating measures. Walking steps were recorded by electronic pedometer. We used percent of days achieving 10 000 steps (P10 000), percent of days fulfilling continuous walking (PCW), and proportion of valid walking (PVW) steps to reflect walking quantity, pattern and quality of participants. Motivation intensity was measured by summing up scores of each motivating activity. Questionnaire-based online survey collected information about demographic characteristics, lifestyle risk factors and chronic diseases. This study finally included 12 368 individuals in the analysis. Multilevel logistic regression model was used to assess the effect of group and individual motivating measures on walking activity and corresponding associated factors.@*Results@#Age of the study sample was (41.2±8.99) years, and 58.17% (7 194) of them were female. After 100-day intervention, the P10 000, PCW and PVW of all participants were 93.89%±14.42%,92.01%±15.97% and 81.00%±7.45%, respectively. The mean P10 000 and PCW increased with rising group-motivated scores, self-motivated scores and individual-activity scores (P<0.001 for all). The mean PVW decreased with both higher group-motivated scores and self-motivated scores (both P<0.05), and varied little among groups with different level individual-activity scores (P=0.525). According to the results from the multilevel model, those who had greater group-motivated scores and self-motivated scores tended to have more likelihood of high-level of P10 000 and PCW. Age, sex, smoking status, education attainment and alcohol drinking were associated with P10 000 and PCW (P<0.05 for all).@*Conclusion@#The Motivational Healthy Walking Program had positive effect on promoting healthy walking among occupational population. Group-motivated and self-motivated activities were associated with healthy walking.

The impact of five-year Chinese rural area cervical cancer screening program on screening rate / 中华预防医学杂志

Objective@#To assess the impact of Chinese Cervical Cancer Screening Program for Rural Area (NACCSPRA) on population-based screening rates.@*Methods@#The subjects were selected from 2013-2014 Chinese Chronic Diseases and Risk Factors Surveillance (CDRFS2013), which adopting multi-stage stratified cluster sampling from 31 provinces. A total of 169 632 participants aged 18 years and older in 297 surveillance points were interviewed, of whom 65 476 women aged 35-64 years were included in the analysis. The surveillance points in CDRFS 2013 were divided into the screening areas and the control areas by matching points in CDRFS2014 with counties in NACCSPRA. The difference in socioeconomic status between areas was compared. The screening rates and 95% confidence interval (95%CI) were estimated by Tylar series variance method. The Propensity Score was evaluated for individuals by multivariate logistic regression and the greedy matching method based on propensity score value was used to conduct 1∶1 matching sample for the screening areas and the control areas. After matching, multivariate conditional logistic regression model was fitted to assess the impact of national cervical cancer screening intervention on the likelihood of undergoing cervical cancer screening at population level.@*Results@#Among 65 476 subjects, 48.6% (n=31 794) was in the screening areas. Before matching, in the rural area the screening rate in the screening areas (24.0% (4 763/19 838), 95%CI: 21.8%-26.3%) was higher than that in the control areas (15.6% (2 331/14 942), 95%CI: 13.4%-17.8%); whereas in the urban area the screening rate in the screening areas (28.5% (3 413/11 956), 95%CI: 26.1%-31.0%) was similar to that in the control areas (26.3% (4 923/18 740), 95%CI: 24.1%-28.4%). After matching, in rural area the screening rate in the screening areas (23.2% (3 454/14 875), 95% CI: 20.9%-25.5%) was higher than that in the control areas (15.6% (2 315/14 875), 95% CI: 13.3%-17.8%); in urban area the screening rate in the screening areas (28.7% (3 202/11 146), 95% CI: 26.2%-31.2%) was higher than that in the control areas (23.1% (2 571/11 146), 95%CI: 20.9%-25.3%). Multivariate conditional logistic regression model showed that the cervical cancer screening rates in intervention areas significantly increased among women aged 35-64 years both in urban areas (OR=1.44, 95%CI: 1.34-1.54) and rural areas (OR=1.78, 95%CI: 1.67-1.90) as compared with those in control areas.@*Conclusion@#The implementation of Chinese cervical cancer screening program during the five years substantially increased the population-based screening rates both in urban and rural areas.

Multilevel logistic regression analysis on hypercholesterolemia related risk factors among adults in China / 中华预防医学杂志

Objective@#To investigate the prevalence of hypercholesterolemia among Chinese adults in different geographic areas, and to analyze the related factors.@*Methods@#China Chronic and Non-Communicable Disease and Risk Factor Surveillance was conducted in 2013, based on 298 counties/districts in 31 provinces of Chinese mainland. The adults aged 18 years old were randomly selected using multi-stage stratified clustering sampling method. Information on chronic disease and risk factors was collected using face-to-face questionnaire interview and physical measurement. Blood samples were collected by local staffs. Serum total cholesterol (TC) was determined using standard method in a central laboratory. After excluding 565 participants missing key variables and 1 558 participants with abnormal TC values, a total of 174 976 participants were included. Weighted prevalence of hypercholesterolemia was calculated. Hypercholesterolemia related individual or geographic determinants were defined using multilevel logistic regression.@*Results@#The prevalence of hypercholesterolemia in Chinese adults age 18 years old and above was 6.9% (95%CI: 6.4%-7.3%), ranged from 3.0% (95%CI: 2.5%-3.4%) in the northwest of China to 14.2% (95%CI: 12.9%-15.5%) in the south (χ2=183.42, P<0.001). The prevalence of hypercholesterolemia was higher in 6 provinces including Tianjin, Liaoning, Fujian, Guangdong, Guangxi, and Hainan (≥9.0%), but lower in 7 provinces including Shanxi, Shannxi, Gansu, Qinghai, Ningxia, Xinjiang, and Tibet (<3.9%). There was a 1.27 fold variation in hypercholesterolemia prevalence by provincial level, and 72.5% of the geographical variation in hypercholesterolemia prevalence was account for by area-level determinants. With multilevel logistic analysis, the individual risk factors associated with hypercholesterolemia included aging, higher education level or annual household income per capita, regular drinking, too much red meal intake, inactivity, overweight or obesity. For geographic factors, residents living at south China, counties/districts with higher urbanization rates, higher education level or lower standardized death rates were more likely to have hypercholesterolemia (all P<0.05).@*Conclusion@#The prevalence of hypercholesterolemia was high in Chinese adults, it was different between regions and related with characteristics of population, individual behaviors and geographical regions.

Survey and analyses of rate of spirometry examination in adults aged 40 years and older in China,2014 / 中华流行病学杂志

Objective To understand the performance of spirometry examination in adults aged ≥40 years and provide evidence for the improvement of comprehensive prevention and control of COPD and the evaluation on the effects of current prevention and control measures.Methods The study subjects were those included in national COPD surveillance in China during 2014-2015.The surveillance used a multi-stage,stratified cluster sampling strategy and a total of 125 surveillance points in 31 provinces were covered.A total of 75 107 adults aged ≥40 years received a questionnaire survey in face to face interviews to collect the information about their acceptance of spirometry examination in previous years.The estimated rate (95％CI) of spirometry examination was calculated based on complex sampling weight design.Results A total of 74 591 subjects were included in the analyses.The estimated rate of spirometry examination was 4.5％ (95％CI:3.7％-5.2％),and it was significantly higher in men than in women (P＜0.001),in urban population than in rural population (P＜0.001).The rate of spirometry examination increased with the increase of education level (P＜ 0.001).The rate of spirometry examination was highest in retirees (10.8％,95％CI:8.2％-13.3％),and lowest in those working in the industry of agriculture,forestry,animal husbandry,fishery and water conservancy (2.4％,95％CI:2.0％-2.9％).The rate of spirometry examination was high in those with previous chronic respiratory diseases and respiratory symptoms,i.e.13.4％ (95％ CI:10.5％-16.4％) and 15.0％ (95％ CI:10.5％-19.4％) respectively.The rate of spirometry examination in former smokers was 7.4％ (95％ CI:6.0％-8.8％),slightly higher than those in current smokers and never smokers,4.7％ (95％ CI:3.9％-5.5％) and 3.9％ (95％ CI:3.0％-4.7％),respectively.In different population groups,the rate of spirometry examination was lowest in rural population who had received no formal education (1.8％,95％ CI:1.2％-2.3％) and highest in urban population with respiratory symptoms (20.2％,95％ CI:12.6％-27.8％).Conclusion The rate of spirometry examination is extremely low in adults aged ≥40 years in China,therefore effective measures should be taken to increase the rate of spirometry examination in adults in China.

Awareness of knowledge about chronic obstructive pulmonary disease and related factors in residents aged 40 years and older in China, 2014 / 中华流行病学杂志

Objective To understand the awareness of knowledge about COPD and related factors in residents aged ≥40 years in China.Methods Through multi-stage stratified cluster sampling,residents aged ≥40 years were selected from 125 sites of COPD surveillance (2014-2015) in 31 provinces of China for a facc to face questionnaire survey.The demographic characteristics and awareness rate of knowledge about COPD among 75 082 subjects were described as frequency and percentage.The awareness rate of knowledge about COPD and its 95％ confidence interval (CI) among the residents aged ≥40 years were estimated with complicated sampling weights.Meanwhile,the knowledge awareness related factors were screened in complicated sampling data.Results The awareness rate of COPD was 9.2％.The awareness rate of pulmonary function test was 3.6％ and the awareness rate of COPD-related knowledge was 5.8％.All of the awareness rates were associated with gender,age,education level and occupation.Besides,the awareness rate of pulmonary function test and COPD-related knowledge were related with living area.Compared with females,the ORs of the three awareness rates among males were 0.88,0.81 and 0.78.Compared with the residents aged ≥70 years,the ORs of the three awareness rates among those aged 60-69 years were 1.28,1.08 and 1.51.Compared with the residents with education level of primary school or below,the ORs of the three awareness rates among those with college degree or above were 2.28,3.43 and 3.14.The OR of the awareness rate of pulmonary function test among the residents in the eastern area was 1.77 compared with those in the central area.The ORs of the awareness rate of COPD-related knowledge among the residents in the eastern and western areas were 1.95 and 2.16 compared with those in the central area (all above P＜0.05).Among COPD symptoms,the awareness rate of dyspnea was highest (67.9％),and among the risk factors for COPD,the awareness rate of smoking was highest (81.3％).The source of awareness of COPD for most residents was television program (38.2％).Conclusion The awareness rate of knowledge about COPD was low in residents aged ≥40 years in China in 2014.It is necessary to strengthen the health education about COPD to improve the prevention and control of the disease.

Survey and analyses of population at high risk of chronic obstructive pulmonary disease in China, 2014 / 中华流行病学杂志

Objective To understand the distribution and characteristics of people aged ≥ 40 years who are at high risk of COPD in China and provide evidence for COPD prevention and control.Methods The survey was conducted among the subjects selected through multi-stage stratified cluster sampling from 31 provinces (autonomous regions and municipalities) in China for 2014-2015 national chronic obstructive pulmonary disease surveillance.A total of 75 107 people aged ≥ 40 years in 125 surveillance points were surveyed in face to face interviews.Subjects who met at least one of the following conditions,including chronic respiratory symptoms,exposure to risk factors,medical history of respiratory diseases,and family history,were defined as population at high risk.The weighted proportion of the population at high risk of COPD and 95％ CI were estimated by using complex sampling design.Results Among eligible 74 296 subjects,the proportion of population at high risk of COPD was 89.5％ (95％CI:87.8％-91.2％).The proportion significantly increased with age (P＜0.001).The proportion of the population at high risk was significantly higher in men than in women (P＜0.001),and in rural area than in urban area (P＜0.001).The highest proportion of population at high risk was observed in men in rural area in western China.The proportion of population at high risk of COPD who met at least two conditions was 32.0％ (95％CI:29.7％-34.2％),the proportion of those who met at least three conditions was 7.4％ (95％CI:6.6％-8.3％),and the proportion of those who met all the conditions was 1.5％ (95％CI:1.2％-1.8％).Among population at high risk of COPD,those who only had exposure to one risk factor accounted for 61.7％ (95％ CI:59.8％-63.7％).Conclusion About 90％ of people aged ≥40 years in China are at high risk for COPD.It is necessary to conduct population-based screening for COPD and take comprehensive measures to reduce prevalence of risk factors.

Current status of household polluting fuel use in adults aged 40 years and older in China, 2014 / 中华流行病学杂志

Objective To analyze the status and distribution characteristics of household polluting fuel use in China.Methods The data were collected from the adults aged ≥40 years who were recruited through multi-stage stratified cluster sampling in 2014-2015 COPD surveillance conducted in 31 provinces (autonomous regions and municipalities) in China.A total of 75 107 adults aged ≥40 years in 125 surveillance points were surveyed in face to face interview.Polluting fuels included biomass fuels (wood,dung,crop residues and charcoal),coal (including coal dust and lignite) and kerosene.The weighted percentage of family using polluting fuels,combustion method for cooking or heating and ventilation installation with 95％ CI were estimated by complex sampling design.Results According to the survey results from 75 075 adults,the percentage of family using polluting fuels for cooking or heating was 59.9％ (95％CI:54.2％-65.7％),the percentage in rural areas was significantly higher than that in urban areas (P＜0.001).As for different polluting fuels,the percentage of using only biomass fuels for cooking or heating was 25.9％ (95％CI:20.5％-31.3％),the percentage of using only coal (including kerosene) was 18.9％ (95％CI:13.2％-24.7％),and the percentage of using both biomass fuels and coal was 15.1％ (95％CI:10.8％-19.4％).Among seven geographic areas in China,the percentages of using biomass fuels ranged from 53.8％ in southern China to 23.0％ in northem China (P=0.039),the percentages of using coal (including kerosene) ranged from 59.5％ in northwestern China to 22.3％ in southern China (P=0.001).Among the families using polluting fuels,the percentages of mainly using traditional open fires and stoves were 21.3％ (95％CI:16.9％-25.8％)and 31.5％ (95％CI:25.8％-37.2％),respectively;the percentage of having ventilation installation was 72.7％ (95％CI:66.9％-78.5％).Conclusions Household polluting fuel use is common in China,but differs with area,traditional fuel combustion method is widely used,the coverage of ventilation installation need to be improved.In order to promote COPD prevention and control,it is necessary to develop strategies on fuels and fuel combustion method improvement to reduce indoor air pollution resulted from household fuel combustion.

Analysis on occupational exposure to dust and harmful gas and corresponding protection in adults aged 40 years and older in China, 2014 / 中华流行病学杂志

Objective To understand the current status of dust and/or harmful gas exposure in adults aged ≥40 years and corresponding protection in China,and provide evidence for strengthening the occupational protection against dust and harmful gas exposure.Methods The data were obtained from 2014-2015 COPD surveillance in China.A total of 75 107 adults aged ≥40 years selected through multi-stage stratified cluster sampling from 125 surveillance points in 31 provinces (autonomous regions and municipalities) were surveyed in face to face interviews.Occupational exposure was defined as occupational exposure to dust and/or harmful gas for more than 1 year.The weighted percentages of exposure were estimated by using complex sampling design.Results Among eligible 71 061 participants,the exposure rate of dust and/or harmful gas was 46.3％.The exposure rate in rural area (51.7％) was significantly higher than that in urban area (40.3％),and the exposure rate in the western area was higher than those in the eastern and central areas (P＜0.001).Among the groups with different education level,the exposure rate in those with education level of primary school and below was highest (49.7％,P＜0.001).The exposure protection rate was 26.7％,and the exposure protection rate was highest in the eastern area (29.9％),followed by that in the central area (27.0％) and that in the western area (22.9％) The exposure protection rate in urban area was significantly higher than that in rural area,and the exposure protection rate was lowest in those with education level of primary school and below.The regular exposure protection was taken by only 50.7％ of the adults surveyed.Conclusion The exposure rate of dust and/or harmful gas is high in China,while the exposure protection rate is very low.Health education,occupational protection and supervision should be strengthened among those with low education level,and those living in rural area and in the western area.

Analysis on passive smoking exposure in adults aged 40 years and older in China, 2014 / 中华流行病学杂志

Objective To describe and analyze the passive smoking exposure level in adults aged ≥40 years in China.Methods A total of 75 107 adults from 125 sites of COPD surveillance points in China were surveyed by electronic questionnaire during face to face interviews.After comprehensive weighting of the samples,the passive smoking exposure level was analyzed.Results The passive smoking exposure rate of the adults aged ≥40 years was 44.9％ (95％CI:42.3％-47.5％).The exposure rate was highest in those aged from 40 to 49 years (51.0％,95％CI:47.9％-54.1％) in term of age groups,in those with senior high school education level and above (48.6％,95％ CI:44.9％-52.2％) in term of education level,and in office workers (57.7％,95％CI:51.8％-63.7％) in term of occupation.The adults reporting passive smoking exposure every days in a week accounted for 27.7％ (95％CI:25.5％-29.8％),and those reporting household passive smoking exposure accounted for 28.3％ (95％ CI:26.2％-30.5％).Logistic regression analysis showed that the passive smoking exposure level was different in different age groups and occupation groups.Conclusion The passive smoking exposure level is still high in adults in China.Age and occupation are the influencing factors of passive smoking exposure level.

Survey of smoking prevalence in adults aged 40 years and older in China, 2014 / 中华流行病学杂志

Objective Smoking is the most important risk factor for COPD.Understanding the smoking rate,current smoking rate,average age to start smoking and average daily consumption of cigarettes among people aged ≥40 years in China can provide scientific evidence for the effective control and prevention of COPD.Methods Data were from COPD surveillance in China (2014 to 2015) which covered 31 provinces,autonomous regions and municipalities.A total of 75 107 adults aged ≥40 years selected through multi-stage stratified cluster sampling from 125 surveillance sites (county/district) were surveyed by electronic questionnaire during face to face interviews.The smoking rate and other smoking index were estimated by using weighting complex sampling design.Results The smoking rate and current smoking rate were 40.0％ (95％CI:38.5％-42.0％) and 31.0％ (95％CI:29.7％-32.0％),respectively,among the Chinese aged ≥40 years in 2014.The smoking rate and current smoking rate in males (74.1％ and 57.6％) were much higher than those in females (5.4％ and 4.0％).And the two rates were significantly higher in rural area (41.2％ and 32.4％) than in urban area (38.8％ and 29.5％).The mean age of smokers to start smoking was 20.1 (95％CI:19.7-20.5) years.The younger the smokers were,the earlier their average age to start smoking was (The ages to start smoking for smokers aged 40-,50-,60-,≥70 years were 18.3,19.2,20.9 and 23.1 years,respectively).Average daily cigarette consumption of current daily smokers was 18.9 (95％ CI:18.1-19.7) cigarettes,and the daily cigarette consumption was higher in males (19.3 cigarettes) than in females (12.5 cigarettes).Conclusion The smoking rate in males aged ≥40 years is high in China.Compared with urban area,the smoking rate in rural area is higher,posing a big challenge for COPD control and prevention.

A summary of item and method of national chronic obstructive pulmonary disease surveillance in China / 中华流行病学杂志

COPD refers to a group of chronic respiratory diseases which seriously influence the people's health and life quality.The national COPD surveillance in China has been implemented since 2014 with the goal of monitoring the prevalence and trend of COPD and related risk factors in China.The paper summarizes the item and method of national COPD surveillance in China.

Importance for surveillance on chronic obstructive pulmonary disease among Chinese adults / 中华流行病学杂志

The first national surveillance of COPD in mainland China was carried out in 2014,with the nationally representative data obtained.The national surveillance was significantly important for the monitoring of prevalence,risk factors,and changing trend of COPD among Chinese adults aged ≥ 40.The surveillance was also important in the development of national COPD prevention and control policy,the evaluation of prevention and control progress,the establishment of COPD comprehensive surveillance system,and the building of a professional COPD monitoring and prevention team.In this editorial,we briefly introduced the method and content of COPD surveillance,and reported the rate of spirometry examination and COPD awareness among adults aged ≥40 in China.We also analyzed the rate of main risk factors for COPD,such as tobacco smoking,occupational exposure to dust or chemical and indoor exposure to biomass or coal,and the distribution of high-risk population.This study provided fundamental data for the prevention and control of COPD in China.

Prevalence, awareness, status of treatment and control on type 2 diabetes mellitus among Chinese premenopausal women aged 18-49 in 2013 / 中华流行病学杂志

Objective To analyze the rates on prevalence,awareness,status on treatment and control of type 2 diabetes mellitus among Chinese premenopausal women aged 18-49,in 2013.Methods Data on China Chronic and Non-Communicable Disease Surveillance in year 2013 was used for analysis.Source of data covered 302 surveillance points which were selected by Multi-stage cluster random sampling method that including 176 534 adults over 18 years of age,with 46 674 premenopausal women aged 18-49.Plasma glucose and hemoglobin A 1 c levels were determined after a 10-hour overnight fast for all the participants,before a 2-hour oral glucose tolerance test was conducted among participants without a self-reported history of diagnosed diabetes.Diabetes was defined according to the 1999 WHO diagnostic criteria-fasting blood glucose level as ≥7.0 mmol/L and/or 2 hours oral glucose tolerance test (OGTT-2 h) level as ≥ 11.1 mmol/L.After being weighed,according to complex sampling scheme and post-stratification,the sample was used to estimate the rates of prevalence,awareness,treatment and control of type 2 diabetes mellitus by age,education,urban and rural areas,and geographic locations.Results The overall prevalence of type 2 diabetes mellitus was 5.6％ among the Chinese premenopausal women aged 18-49.No statistical difference on the prevalence rates (5.7％ and 5.4％,respectively) was seen,between participants from the rural or the urban areas.Prevalence rates in the eastern,central or western geographic areas were 5.8％,6.2％ and 4.4％ respectively.The rates of awareness,treatment and control of diabetes appeared as 29.3％,27.9％ and 29.4％ in childbearing women aged 18-49.The rate of treatment was 95.4％ among those who knew their diabetic situation in childbearing women aged 18-49 years.The control rate of diabetes was 38.9％ among those who had taken measures to control glucose,in 18-49-year-old childbearing women.The rate of awareness on diabetes in childbearing women aged 18-49 years in urban areas was higher than that in the rural areas.There were significantly statistical differences on the treatment rates among groups of different education levels but not in the trend test.Conclusion The prevalence of type 2 diabetes mellitus in childbearing women aged 18-49 appeared high,but with low rates on awareness,treatment and control.However,statistical difference was seen on awareness,between urban and rural areas.

Study on the coverage of cervical and breast cancer screening among women aged 35-69 years and related impact of socioeconomic factors in China, 2013 / 中华流行病学杂志

Objective To estimate the cervical and breast cancer screening coverage and related factors among women aged 35-69 years who were in the National Cervical and Breast Screening Program,to provide evidence for improving cervical and breast cancer control and prevention strategy.Methods Data used in this study were abstracted from the 2013 Chinese Chronic Diseases and Risk Factors Surveillance Program.A total of 66 130 women aged 35-64 years and 72 511 women aged 35-69 years were included for this study.Weighted prevalence,(with 95％ confidence interval,CI) was calculated for complex sampling design.Rao-Scottx2 method was used to compare the screening coverage among subgroups.A random intercept equation which involved the logit-link function,was fitted under the following five levels:provincial,county,township,village and individual.Fix effects of all explanatory variables were converted into OR with 95％CI.Results In 2013,26.7％ (95％CI:24.6％-28.9％) of the 35-64 year-old women reported that they ever had been screened for cervical cancer and 22.5％ (95％ CI:20.4％-24.6％) of the 35-69 year-olds had ever undergone breast cancer screening.Lower coverage was observed among women residing in rural and central or western China than those in urban or eastern China (P＜0.000 1).The coverage among women aged 50 years or older was substantially lower than those aged 35-49 years.Those who were with low education level,unemployed,low household income and not covered by insurance,appeared fewer number on this cervical or breast cancer screening program (P＜0.000 1).Women living in rural and western China were having less chance of receiving the breast cancer screening (P＜0.05),but the difference was not statistically significant.Conclusion It is essential to strengthen the communitybased cervical and breast cancer screening programs,in order to increase the coverage.More attention should be paid to women aged 50 years or older,especially those socioeconomically disadvantaged ones.

Survey and analyses of rate of spirometry examination in adults aged 40 years and older in China,2014 / 中华流行病学杂志

Objective To understand the performance of spirometry examination in adults aged ≥40 years and provide evidence for the improvement of comprehensive prevention and control of COPD and the evaluation on the effects of current prevention and control measures.Methods The study subjects were those included in national COPD surveillance in China during 2014-2015.The surveillance used a multi-stage,stratified cluster sampling strategy and a total of 125 surveillance points in 31 provinces were covered.A total of 75 107 adults aged ≥40 years received a questionnaire survey in face to face interviews to collect the information about their acceptance of spirometry examination in previous years.The estimated rate (95％CI) of spirometry examination was calculated based on complex sampling weight design.Results A total of 74 591 subjects were included in the analyses.The estimated rate of spirometry examination was 4.5％ (95％CI:3.7％-5.2％),and it was significantly higher in men than in women (P＜0.001),in urban population than in rural population (P＜0.001).The rate of spirometry examination increased with the increase of education level (P＜ 0.001).The rate of spirometry examination was highest in retirees (10.8％,95％CI:8.2％-13.3％),and lowest in those working in the industry of agriculture,forestry,animal husbandry,fishery and water conservancy (2.4％,95％CI:2.0％-2.9％).The rate of spirometry examination was high in those with previous chronic respiratory diseases and respiratory symptoms,i.e.13.4％ (95％ CI:10.5％-16.4％) and 15.0％ (95％ CI:10.5％-19.4％) respectively.The rate of spirometry examination in former smokers was 7.4％ (95％ CI:6.0％-8.8％),slightly higher than those in current smokers and never smokers,4.7％ (95％ CI:3.9％-5.5％) and 3.9％ (95％ CI:3.0％-4.7％),respectively.In different population groups,the rate of spirometry examination was lowest in rural population who had received no formal education (1.8％,95％ CI:1.2％-2.3％) and highest in urban population with respiratory symptoms (20.2％,95％ CI:12.6％-27.8％).Conclusion The rate of spirometry examination is extremely low in adults aged ≥40 years in China,therefore effective measures should be taken to increase the rate of spirometry examination in adults in China.

Awareness of knowledge about chronic obstructive pulmonary disease and related factors in residents aged 40 years and older in China, 2014 / 中华流行病学杂志

Objective To understand the awareness of knowledge about COPD and related factors in residents aged ≥40 years in China.Methods Through multi-stage stratified cluster sampling,residents aged ≥40 years were selected from 125 sites of COPD surveillance (2014-2015) in 31 provinces of China for a facc to face questionnaire survey.The demographic characteristics and awareness rate of knowledge about COPD among 75 082 subjects were described as frequency and percentage.The awareness rate of knowledge about COPD and its 95％ confidence interval (CI) among the residents aged ≥40 years were estimated with complicated sampling weights.Meanwhile,the knowledge awareness related factors were screened in complicated sampling data.Results The awareness rate of COPD was 9.2％.The awareness rate of pulmonary function test was 3.6％ and the awareness rate of COPD-related knowledge was 5.8％.All of the awareness rates were associated with gender,age,education level and occupation.Besides,the awareness rate of pulmonary function test and COPD-related knowledge were related with living area.Compared with females,the ORs of the three awareness rates among males were 0.88,0.81 and 0.78.Compared with the residents aged ≥70 years,the ORs of the three awareness rates among those aged 60-69 years were 1.28,1.08 and 1.51.Compared with the residents with education level of primary school or below,the ORs of the three awareness rates among those with college degree or above were 2.28,3.43 and 3.14.The OR of the awareness rate of pulmonary function test among the residents in the eastern area was 1.77 compared with those in the central area.The ORs of the awareness rate of COPD-related knowledge among the residents in the eastern and western areas were 1.95 and 2.16 compared with those in the central area (all above P＜0.05).Among COPD symptoms,the awareness rate of dyspnea was highest (67.9％),and among the risk factors for COPD,the awareness rate of smoking was highest (81.3％).The source of awareness of COPD for most residents was television program (38.2％).Conclusion The awareness rate of knowledge about COPD was low in residents aged ≥40 years in China in 2014.It is necessary to strengthen the health education about COPD to improve the prevention and control of the disease.

Survey and analyses of population at high risk of chronic obstructive pulmonary disease in China, 2014 / 中华流行病学杂志

Objective To understand the distribution and characteristics of people aged ≥ 40 years who are at high risk of COPD in China and provide evidence for COPD prevention and control.Methods The survey was conducted among the subjects selected through multi-stage stratified cluster sampling from 31 provinces (autonomous regions and municipalities) in China for 2014-2015 national chronic obstructive pulmonary disease surveillance.A total of 75 107 people aged ≥ 40 years in 125 surveillance points were surveyed in face to face interviews.Subjects who met at least one of the following conditions,including chronic respiratory symptoms,exposure to risk factors,medical history of respiratory diseases,and family history,were defined as population at high risk.The weighted proportion of the population at high risk of COPD and 95％ CI were estimated by using complex sampling design.Results Among eligible 74 296 subjects,the proportion of population at high risk of COPD was 89.5％ (95％CI:87.8％-91.2％).The proportion significantly increased with age (P＜0.001).The proportion of the population at high risk was significantly higher in men than in women (P＜0.001),and in rural area than in urban area (P＜0.001).The highest proportion of population at high risk was observed in men in rural area in western China.The proportion of population at high risk of COPD who met at least two conditions was 32.0％ (95％CI:29.7％-34.2％),the proportion of those who met at least three conditions was 7.4％ (95％CI:6.6％-8.3％),and the proportion of those who met all the conditions was 1.5％ (95％CI:1.2％-1.8％).Among population at high risk of COPD,those who only had exposure to one risk factor accounted for 61.7％ (95％ CI:59.8％-63.7％).Conclusion About 90％ of people aged ≥40 years in China are at high risk for COPD.It is necessary to conduct population-based screening for COPD and take comprehensive measures to reduce prevalence of risk factors.