Effect of exposures to mixtures of lead and various metals on hypertension, pre-hypertension, and blood pressure: A cross-sectional study from the China National Human Biomonitoring.

We aimed to explore the effects of mixtures of lead and various metals on blood pressure (BP) and the odds of pre-hypertension (systolic blood pressure (SBP) 120-139 mmHg, and/or diastolic blood pressure (DBP) 80-89 mmHg) and hypertension (SBP/DBP ≥140/90 mmHg) among Chinese adults in a cross-sectional study. This study included 11,037 adults aged 18 years or older from the 2017-2018 China National Human Biomonitoring. Average BP and 13 metals (lead, antimony, arsenic, cadmium, mercury, thallium, chromium, cobalt, molybdenum, manganese, nickel, selenium, and tin) in blood and urine were measured and lifestyle and demographic data were collected. Weighted multiple linear regressions were used to estimate associations of metals with BP in both single and multiple metal models. Weighted quantile sum (WQS) regression was performed to assess the relationship between metal mixture levels and BP. In the single metal model, after adjusting for potential confounding factors, the blood lead levels in the highest quartile were associated with the greater odds of both pre-hypertension (odds ratio (OR): 1.56, 95% CI: 1.22-1.99) and hypertension (OR:1.75, 95% CI: 1.28-2.40) when compared with the lowest quartile. We also found that blood arsenic levels were associated with increased odds of pre-hypertension (OR:1.31, 95% CI:1.00-1.74), while urinary molybdenum levels were associated with lower odds of hypertension (OR:0.68, 95% CI:0.50-0.93). No significant associations were found for the other 10 metals. WQS regression analysis showed that metal mixture levels in blood were significantly associated with higher SBP (ß = 1.56, P < 0.05) and DBP (ß = 1.56, P < 0.05), with the largest contributor being lead (49.9% and 66.8%, respectively). The finding suggests that exposure to mixtures of metals as measured in blood were positively associated with BP, and that lead exposure may play a critical role in hypertension development.

Cohort profile: China National Human Biomonitoring (CNHBM)-A nationally representative, prospective cohort in Chinese population.

OBJECTIVE: Globally, developed countries such as the United States, Canada, Germany, Korea, have carried out long-term and systematic biomonitoring programs for environmental chemicals in their populations. The China National Human Biomonitoring (CNHBM) was to document the extent of human exposure to a wide array of environmental chemicals, to understand exposure profiles, magnitude and ongoing trends in exposure in the general Chinese population, and to establish a national biorepository. METHODS: CNHBM adopted three-stage sampling method to obtain a nationally representative sample of the population. A total of 21,888 participants who were permanent residents in 31 provinces were designed to interviewed in this national biomonitoring (152 monitoring sites × 3 survey units × 2 sexes × 6 age groups × 4 persons = 21,888 persons) in 2017-2018. Unlike the US National Health and Nutrition Examination Survey, the CNHBM will follow the same participants in subsequent cycles allowing for dynamic, longitudinal data sets for epidemiologic follow-up. Each survey cycle of CNHBM will last 2 years and each subsequent cycle will occur 3 years after the prior cycle's completion. RESULTS: In 2017-2018, the CNHBM created a large cohort of Chinese citizens that included districts/counties questionnaire, community questionnaire collecting information on villages/communities, individual questionnaire, household questionnaire, comprehensive medical examination, and collection of blood and urine samples for measurement of clinical and exposure biomarkers. A total of 21,746 participants were finally included in CNHBM, accounting for 99.4% of the designed sample size; and 152 PSUs questionnaires, 454 community questionnaires, 21,619 family questionnaires, 21,712 cases of medical examinations, 21,700 individual questionnaires, 21,701 blood samples and 21,704 urine samples were collected, respectively. Planned analyses of blood and urine samples were to measure both inorganic and organic chemicals, including 13 heavy metals and metalloids, 18 poly- and per-fluorinated alkyl substances, 12 phthalate metabolites, 9 polycyclic aromatic hydrocarbons metabolites, 4 environmental alkylated phenols, and 2 benzene metabolites. CONCLUSIONS: CNHBM established the first nationally representative, prospective cohort in the Chinese population to understand the baseline and trend of internal exposure of environmental chemicals in general population, and to understand environmental toxicity.

Analysis of methyl tert-butyl ether in urine of primary school students in Beijing / 中国学校卫生

Objective@#To investigate the urine methyl tert-butyl ether (MTBE) level of a primary school students in Changping District, Beijing, and analysis the effect factors, give the advice if the MTBE is eligibility as an exposure biomarker of automobile exhaust.@*Methods@#Using the panel study, randomly selected 20 sixthgrade students (10 male and 10 female) from Zhixing School in Changping district, Beijing, from June 7th to 13th, 2018. All participants completed a questionnaire for collecting demographic and geographic information and daily activities. All participants were given guidance to repeatedly collected urine samples 3 times (8:00, 11:00 and 16:00 instant urien) a day for 7 days, totally 420 urine samples were collected. Urine MTBE were measured and the statistic significant of the Urine MTBE at different groups were evaluated.@*Results@#MTBE were detected in all 420 urine samples of primary school students, the geometric mean of creatinine-corrected MTBE exposure level in 8:00, 11:00 and 16:00 instant urine were 0.12, 0.12 and 0.12 mg/g creatinine, respectively. Urine MTBE concentration was statistical significant in different daily outdoor activity time, the distance of home address to the main road, and daily use time of air purification equipment in class(P=0.00, 0.04, 0.00).@*Conclusion@#There was a universal MTBE exposure among students in a primary school in Beijing, and the impact factors to exposure level were daily outdoor activity time, distance from home address to the closest main road, and daily use time of air purification equipment in class. This result indicate MTBE may be a valuable candidate for exposure biomarker of automobile exhaust, and more research should be done.

Combined associations of hs-CRP and cognitive function with all-cause mortality among oldest-old adults in Chinese longevity areas: a prospective cohort study.

BACKGROUND: Inflammatory markers, such as high sensitivity C-reactive protein (hs-CRP), and cognitive impairment (CI) are associated with mortality; CRP is related to the deterioration of CI. However, it is still unknown whether these two indices predict mortality independent of each other. Furthermore, their joint effect on all-cause mortality has not been well established, especially in oldest-old adults. METHODS: Based on data from the 2012 wave of the Chinese Longitudinal Healthy Longevity Survey (CLHLS), we included 1447 oldest-old adults (mean age 84.7 years and 58.7% were female, weighted) with information on hs-CRP (stratified by a cutoff value of 3.0 mg/L) and cognition (quantified by Mini-Mental Status Examination (MMSE) scored according to the personal educational level) at baseline. Mortality was assessed in followed 2014 and 2017 waves. Cox proportional hazards regression models were used, with adjustment for hs-CRP and cognition (mutually controlled) and several traditional mortality risk factors. RESULTS: During a median follow-up period of 32.8 months (Q1-Q3, 9.7-59.0 months), 826 participants died. Hs-CRP [HR > 3.0 mg/L vs ≤ 3.0 mg/L: 1.64 (95% CI, 1.17, 2.30)] and cognition [HR CI vs normal: 2.30 (95% CI, 1.64, 3.21)] each was independent predictor of all-cause mortality, even after accounting for each other and other covariates. Monotonic and positive associations were observed in combined analyses, in which the highest mortality risk was obtained in elders with both high hs-CRP> 3.0 mg/L and CI [HR: 3.56 (95% CI, 2.35, 5.38)].The combined effects were stronger in male and younger oldest-old (aged 80-89 years). CONCLUSION: High hs-CRP and CI, both individually and jointly, were associated with increased all-cause mortality risks in Chinese oldest-old. Intervention strategies for preventing inflammation and maintaining adequate cognitive function may be more important in male and younger oldest-old for reducing mortality risk.

[Study on predictive value of pulmonary ventilation function of healthy coal mine workers].

OBJECTIVE: To establish the predictive value of pulmonary ventilation function for dust-exposed-workers in some coal mine. METHODS: From March to August in 2011, 2994 coal workers were involved in the research, their pulmonary ventilation function were examined by pulmonary function measuring instrument. 1389 worker's pulmonary ventilation function were normal, the data of 1139 workers established the predictive value equation, and those of 250 workers tested the equation. RESULTS: Age was negatively correlated with FVC, FEV1, FEV1%, MMF and PEFR (P < 0.05). Height was negatively correlated with FEV1%, however, it was positively correlated with others (P < 0.05). Weight was negatively correlated with MMF and positively correlated with FVC and PEFR (P < 0.05). The regression equation of the predictive value was established by age, height and weight as in dependent variables. It were above 90% that the accordance ratio to test the equation by original data and test data. Predictive value of pulmonary ventilatory function from predictive value equation were lower than that of lung fucntion machine (P < 0.05). CONCLUSION: Predictive value of pulmonary ventilatory function from predictive value equation was superior to that of lung fucntion machine.