Assessing the impact of specific PM2.5-Bound metallic elements on asthma emergency department visits: A case-crossover study in Taiwan.

OBJECTIVES: This study aims to assess the specific PM2.5-bound metallic elements that contribute to asthma emergency department visits by using a case-crossover study design. METHODS: This study analyzed data from 11,410 asthma emergency department visits as case group and 22,820 non-asthma onset dates occurring one week and two weeks preceding the case day as controls from 2017 to 2020. PM2.5 monitoring data and 35 PM.2.5-bound metallic elements from six different regions in Taiwan were collected. Conditional logistic regression models were used to assess the relationship between asthma and PM2.5-bound metallic elements. RESULTS: Our investigation revealed a statistically significant risk of asthma emergency department visits associated with PM2.5 exposure at lag 0, 1, 2, and 3 during autumn. Additionally, PM2.5-bound hafnium (Hf), thallium (Tl), rubidium (Rb), and aluminum (Al) exhibited a consistently significant positive correlation with asthma emergency department visits at lags 1, 2, and 3. In stratified analyses by area, age, and sex, PM2.5-bound Hf showed a significant and consistent correlation. CONCLUSIONS: This study provides evidence of PM2.5-bound metallic elements effects in asthma exacerbations, particularly for Hf. It emphasizes the importance of understanding the origins of these metallic elements and pursuing emission reductions to mitigate regional health risks.

Longitudinal assessment of oxidative stress markers and their relationship with exposure to PM2.5 and its bound metals in healthy participants.

OBJECTIVE: Exposure to ambient PM2.5 and its bound metals poses a risk to health and disease, via, in part, oxidative stress response. A variety of oxidative stress markers have been used as markers of response, but their relevance to environmental exposure remains to be established. We evaluated, longitudinally, a battery of oxidative stress markers and their relationship with the exposure of PM2.5 and its bound metals in a panel of healthy participants. MATERIAL AND METHODS: Levels of residence- and personal-based ambient air PM2.5 and its bound metals, as well as of lung function parameters, were assessed in a total of 58 questionnaire-administered healthy never smoker participants (male, 39.7%). Levels of urinary oxidative stress markers, including Nε-(hexanoyl)-lysine (HEL; an early lipid peroxidation product), 4-hydroxynonenal (4-HNE), N7-methylguanine (N7-meG), and 8-hydroxy-2-deoxyguanosine (8-OHdG), plasma antioxidants [superoxide dismutase (SOD) and glutathione peroxidase (GPx), and urinary metals were measured by ELISA, LC-MS, and ICP-MS, respectively. The results of three repeated measurements at two-month intervals were analyzed using the Generalized Estimating Equation (GEE). RESULTS: After adjusting for confounders, residence- and personal-based PM2.5 levels were positively associated with HEL (ß = 0.22 and 0.18) and N7-meG (ß = 0.39 and 0.13). Significant correlations were observed between personal air PM2.5-Pb and urinary Pb with HEL (ß = 0.08 and 0.26). While FVC, FEV1, FEV1/FVC, MMF, and PEFR predicted% were normal, a negative interaction (pollutant*time, P < 0.05) was noted for PM2.5-V, Mn, Co, Ni, Zn, As, and Pb. Additionally, a negative interaction was found for N7-meG (ß = -21.35, -18.77, -23.86) and SOD (ß = -26.56, -26.18, -16.48) with FEV1, FVC, and PEFR predicted%, respectively. CONCLUSION: These findings emphasize potential links between environmental exposure, internal dose, and health effects, thereby offering valuable markers for future research on metal exposure, oxidative stress, and health outcomes.

Assessing the effectiveness of mitigating pesticide-related disease risk among pesticide-spraying drone operators in Taiwan.

OBJECTIVES: The purpose of this study was to evaluate the risk of pesticide poisoning, liver and renal failure, dermatitis, respiratory problems, hypersensitivity pneumonitis, keratitis, and epilepsy among pesticide-spraying personnel and to assess the effectiveness of a new method of aerial pesticide application in reducing this risk. METHODS: A total of 2268 pesticide spraying operators (1651 ground-based field crop operators and 617 aerial pesticide spraying drone operators) who passed the national certification examination between 2010 and 2020 in Taiwan were included. Ground-based operators served as the positive control group, while 2463 farmer controls were matched from the Farmers' Health Insurance database as the negative control group. Data from the National Health Insurance Research Database were used to track possible pesticide-related disease cases. Logistic regression was employed to calculate odds ratios and 95% confidence intervals (95% CI). RESULTS: Drone operators had significantly reduced risks of dermatitis, asthma and chronic bronchitis compared to ground-based operators. This was observed in allergic contact dermatitis (OR = 0.40, 95% CI: 0.24-0.68), unspecified contact dermatitis (OR = 0.58, 95% CI: 0.35-0.97), asthma (OR = 0.27, 95% CI: 0.12-0.60), and chronic bronchitis (OR = 0.24, 95% CI: 0.06-0.93), after adjusting for age, sex, working areas, and licensing years. However, no significant differences were found when comparing drone operators to matching farmers. CONCLUSIONS: Aerial pesticide spraying using drones may contribute to a decreased risk of dermatitis, asthma and chronic bronchitis, suggesting potential health benefits for operators. Further field pesticide exposure surveys are recommended to validate these findings and assess health risk indicators.

Cancer risks in a population-based study of agricultural workers: results from the Taiwan's Farmers and Health Cohort study.

OBJECTIVE: The purpose of this study was to assess cancer risk among agricultural workers compared to the general population. METHODS: The study utilized data from Farmers' Health Insurance (FHI) in Taiwan, which enrolled agricultural workers (N=1 175 149). The enrolled workers were matched to a general population (N=1 175 149) of the same age, gender, township, and enrollment year. The study population was linked to the National Cancer Registry to identify new cancer cases between 2000 and 2018. The Cox proportional hazards model was used to estimate the hazard ratio and 95% confidence interval for outcomes. RESULTS: During the study period, 136 913 new cancers among agricultural workers were identified. The study found that male farmers had an increased cancer risk, including lymphocytic leukemia, chronic myelogenous leukemia, non-Hodgkin's lymphoma (NHL), oral cancer, lip cancer, esophagus cancer, rectum and rectosigmoid junction cancer, liver and intrahepatic bile duct cancer, lung cancer, trachea and bronchi cancer, and other non-melanoma skin cancer, even when considering the latency period. Female farmers had an elevated risk of multiple myeloma and other non-melanoma skin cancer. Moreover, only lymphoma, NHL, other lymphoid, and multiple myeloma, were both found to occur at different insurance periods. CONCLUSIONS: This study provides farmer cancer patterns and risk, adding to the evidence that farmers are at increased risk of certain types of cancer, especially for hematological cancers. As exposure varies by farm operation type, individual farmer exposure may vary widely. Further understanding of the complex relationship between occupational exposure, environmental factors, and lifestyle factors is needed.

Study Protocol for Radiation Exposure and Cancer Risk Assessment: The Taiwan Nuclear Power Plants and Epidemiology Cohort Study (TNPECS).

BACKGROUND: This cohort was established to evaluate whether 38-year radiation exposure (since the start of nuclear reactor operations) is related to cancer risk in residents near three nuclear power plants (NPPs). METHODS: This cohort study enrolled all residents who lived within 8 km of any of the three NPPs in Taiwan from 1978 to 2016 (n = 214,502; person-years = 4,660,189). The control population (n = 257,475; person-years = 6,282,390) from three towns comprised all residents having lived more than 15 km from all three NPPs. Radiation exposure will be assessed via computer programs GASPAR-II and LADTAP-II by following methodologies provided in the United States Nuclear Regulatory Commission regulatory guides. We calculated the cumulative individual tissue organ equivalent dose and cumulative effective dose for each resident. This study presents the number of new cancer cases and prevalence in the residence-nearest NPP group and control group in the 38-year research observation period. CONCLUSION: TNPECS provides a valuable platform for research and opens unique possibilities for testing whether radiation exposure since the start of operations of nuclear reactors will affect health across the life course. The release of radioactive nuclear species caused by the operation of NPPs caused residents to have an effective dose between 10-7 and 10-3 mSv/year. The mean cumulative medical radiation exposure dose between the residence-nearest NPP group and the control group was not different (7.69; standard deviation, 18.39 mSv and 7.61; standard deviation, 19.17 mSv; P = 0.114).

Occupational health surveillance and detection of emerging occupational diseases among Taiwan farmers, through analysis of national-based farmers' and medico-administrative databases.

OBJECTIVES: The purpose of this study was to identify occupational injuries and diseases associated with agriculture in Asia, to provide a reference for prevention and hypotheses for future research. METHODS: We matched data on agricultural workers (n = 963,124) enrolled in Taiwan's national Farmers Health Insurance since its inception in 1989, to general population controls of the same age, gender, and township. The study population was linked to the National Health Insurance Research Database from 2001 to 2016 for inpatient cases. Logistic regression was used to assess odds ratios for outcomes. RESULTS: Farmers had 2.76 times the risk of mycotic corneal ulcer (95% CI: 1.96-3.87) and 1.65 times the risk of typhus fever infections (95% CI: 1.47-1.85) compared to the general population. The odds ratio for poisonous animal bites was 2.22 (95% CI: 2.07-2.38), for falling into a storm drain or manhole was 2.04 (95% CI: 1.30-3.20), and for toxic effects from pesticides was 2.01 (95% CI: 1.92-2.11). The toxic effects of organophosphate and carbamate insecticides were correlated with the cultivation of rice, fruit trees, and flowers. Q fever and motorcycle accidents were associated with fruit tree cultivation. CONCLUSIONS: The study identifies agricultural occupational injuries and diseases that may inform occupational health policy and the development of prevention priorities to prevent occupational hazards for farmers.

The association of job fatigue with mental disorders among bus drivers.

OBJECTIVE: Mental disorders are a global problem with growing importance. However, the contribution of work factors to the development of mental disorders is inconclusive. This study aimed to assess the impact of fatigue and job stress on mental disorders in a prospective cohort of bus drivers. METHODS: The Taiwan Bus Driver Cohort Study (TBDCS) recruited 1652 bus drivers from a bus company in 2005. Participants self-completed a structured questionnaire in 2007, which included the Demand-Control-Support (DCS) model questions and the Swedish Occupational Fatigue Inventory-Chinese (SOFI-C). Psychiatric care visits and admissions were obtained from the National Health Insurance Research Dataset (NHIRD) from 2003 to 2016 for as a proxy for psychiatric diagnoses. Drivers with a history of psychiatric disorders before the questionnaire survey time were excluded (N=69). During the follow-up period, a new diagnosis with a psychiatric disorder was defined as an event. Cox proportional hazards model was used to estimate the hazard ratio (HR) for new one-set psychiatric disorders, adjusting for age, body mass index, marital status, education, alcohol consumption, smoking, exercise, bus driving experience, shift work, and chronic diseases. RESULTS: Among the 896 bus drivers retained for analysis, 85 were newly diagnosed with a psychiatric disorders. DCS score was not associated with the risk of developing a psychiatric disorders, but bus drivers with high SOFI-C scores (≥5) had an elevated risk for anxiety or mood disorders (HR 3.35, 95% confidence interval 1.23-9.09). CONCLUSIONS: Among bus drivers, occupational fatigue, as indicated by high a SOFI-C score, might result in an elevated risk of anxiety or mood disorders. Health service organizations should provide recommendations and guidance for drivers with high fatigue levels to avoid anxiety or mood disorders.

Return to Work and Mortality in Breast Cancer Survivors: A 11-Year Longitudinal Study.

Breast cancer is the most commonly occurring cancer in women, and it is a major cause of cancer death around the world. With the development of diagnostic methods and improvements in treatment methods, the incidence rate of breast cancer and the number of breast cancer survivors continue to simultaneously increase. We used national registry database to analyze the features that affect employment and return to work among breast cancer survivors. A total of 23,220 employees, who were newly diagnosed with breast cancer were recruited based on the Labor Insurance Database (LID), the Taiwan Cancer Registry (TCR), and National Health Insurance Research Database (NHIRD) during the period 2004-2015. The correlations between return to work (RTW) and independent confounding factors were examined using Cox proportional hazards model. Survival probability was analyzed using the Kaplan-Meir method. After adjusting for confounding variables, cancer stage, chemotherapy and higher income were significantly negatively correlated with RTW. Among breast cancer survivors, RTW was found to be related to a lower risk of all-cause mortality in both the unadjusted and fully adjusted model. Patients who had RTW exhibited better survival in all stages. Work-, disease- and treatment-related factors influenced RTW among employees with breast cancer. RTW was associated with better breast cancer survival. Our study demonstrates the impact of RTW and the associated factors on breast cancer survivorship.

Aryl hydrocarbon receptor activation-mediated vascular toxicity of ambient fine particulate matter: contribution of polycyclic aromatic hydrocarbons and osteopontin as a biomarker.

BACKGROUND: Exposure to ambient fine particulate matter (PM2.5) is associated with vascular diseases. Polycyclic aromatic hydrocarbons (PAHs) in PM2.5 are highly hazardous; however, the contribution of PM2.5-bound PAHs to PM2.5-associated vascular diseases remains unclear. The ToxCast high-throughput in vitro screening database indicates that some PM2.5-bound PAHs activate the aryl hydrocarbon receptor (AhR). The present study investigated whether the AhR pathway is involved in the mechanism of PM2.5-induced vascular toxicity, identified the PAH in PM2.5 that was the major contributor of AhR activation, and identified a biomarker for vascular toxicity of PM2.5-bound PAHs. RESULTS: Treatment of vascular smooth muscle cells (VMSCs) with an AhR antagonist inhibited the PM2.5-induced increase in the cell migration ability; NF-κB activity; and expression of cytochrome P450 1A1 (CYP1A1), 1B1 (CYP1B1), interleukin-6 (IL-6), and osteopontin (OPN). Most PM2.5-bound PAHs were extracted into the organic fraction, which drastically enhanced VSMC migration and increased mRNA levels of CYP1A1, CYP1B1, IL-6, and OPN. However, the inorganic fraction of PM2.5 moderately enhanced VSMC migration and only increased IL-6 mRNA levels. PM2.5 increased IL-6 secretion through NF-κB activation; however, PM2.5 and its organic extract increased OPN secretion in a CYP1B1-dependent manner. Inhibiting CYP1B1 activity and silencing OPN expression prevented the increase in VSMC migration ability caused by PM2.5 and its organic extract. The AhR activation potencies of seven PM2.5-bound PAHs, reported in the ToxCast database, were strongly correlated with their capabilities of enhancing the migration ability of VSMCs. Benzo(k)fluoranthene (BkF) contributed the most to the AhR agonistic activity of ambient PM2.5-bound PAHs. The association between PM2.5-induced vascular toxicity, AhR activity, and OPN secretion was further verified in mice; PM2.5-induced intimal hyperplasia in pulmonary small arteries and OPN secretion were alleviated in mice with low AhR affinity. Finally, urinary concentrations of 1-hydroxypyrene, a major PAH metabolite, were positively correlated with plasma OPN levels in healthy humans. CONCLUSIONS: The present study offers in vitro, animal, and human evidences supporting the importance of AhR activation for PM2.5-induced vascular toxicities and that BkF was the major contributor of AhR activation. OPN is an AhR-dependent biomarker of PM2.5-induced vascular toxicity. The AhR activation potency may be applied in the risk assessment of vascular toxicity in PAH mixtures.

Return to Work in Survivors With Occupational Cancers.

OBJECTIVES: The aim of this study is to investigate the change in employment status in survivors with occupational cancers at the time of diagnosis until 2 years. METHODS: In this study, we included 382 occupational cancer workers from Labor Insurance Database. After applying exclusion criteria, 86 workers in 2004 to 2015 were included. The mean age of cancer workers were 51.38 ±â€Š9.1119 years old and the average salary of industry of NTD 31,492 ±â€Š10,696. RESULTS: Salary adjustment was the most change in the employment status in cancer survivors. Salary adjustment (37%), 28- to 45-year-old group (55%), male (30%), and Southern district (34%), had the most workers on day 730. Wholesale and Retail Trade had the most of percentage of cancer survivals remained on workplace. CONCLUSIONS: Change of employment status in cancer survivors are important to decrease the impact of economic burden on society.

Identification of a High-Risk Group of New-Onset Cardiovascular Disease in Occupational Drivers by Analyzing Heart Rate Variability.

PURPOSE: This cohort study evaluated the effectiveness of noninvasive heart rate variability (HRV) analysis to assess the risk of cardiovascular disease over a period of 8 years. METHODS: Personal and working characteristics were collected before biochemistry examinations and 5 min HRV tests from the Taiwan Bus Driver Cohort Study (TBDCS) in 2005. This study eventually identified 161 drivers with cardiovascular disease (CVD) and 627 without between 2005 and 2012. Estimation of the hazard ratio was analyzed by using the Cox proportional-hazards model. RESULTS: Subjects with CVD had an overall lower standard deviation of NN intervals (SDNN) than their counterparts did. The SDNN index had a strong association with CVD, even after adjusting for risk factors. Using a median split for SDNN, the hazard ratio of CVD was 1.83 (95% CI = 1.10-3.04) in Model 1 and 1.87 (95% CI = 1.11-3.13) in Model 2. Furthermore, the low-frequency (LF) index was associated with a risk of CVD in the continuous approach. For hypertensive disease, the SDNN index was associated with increased risks in both the continuous and dichotomized approaches. When the root-mean-square of the successive differences (RMSSDs), high frequency (HF), and LF were continuous variables, significant associations with hypertensive disease were observed. CONCLUSIONS: This cohort study suggests that SDNN and LF levels are useful for predicting 8 year CVD risk, especially for hypertensive disease. Further research is required to determine preventive measures for modifying HRV dysfunction, as well as to investigate whether these interventions could decrease CVD risk among professional drivers.

The Fact of Return to Work in Cervical Cancer Survivors and the Impact of Survival Rate: An 11-Year Follow-Up Study.

The aim of the current cohort study was to explore the relationship between return to work (RTW) after cervical cancer treatment and different medical and occupational covariates. We also investigated the effect of RTW on all-cause mortality and survival outcomes of cervical cancer survivors. Data were collected between 2004 and 2015 from the database of the Taiwan Cancer Registry, Labor Insurance Database, and National Health Insurance Research Database. The associations between independent variables and RTW were analyzed by Cox proportional hazard models. A total of 4945 workers (82.3%) who returned to work within 5 years after being diagnosed with cervical cancer. Patients who underwent surgical treatment were more likely to RTW by the 5th year compared to other groups, with a hazard ratio (HR) of 1.21 (95% CI: 1.01~1.44). Small company size and a monthly income greater than NT 38,200 were inversely associated with RTW (HR = 0.91, 95% CI: 0.84~0.98 and HR = 0.48, 95% CI: 0.44~0.53). Furthermore, RTW showed a statistically significant decrease in the risk of all-cause mortality in the fully adjusted HR, (HR = 0.42, p < 0.001). Some medical and occupational factors are associated with RTW in cervical cancer survivors. Returning to work may have a beneficial effect on the survival of patients with cervical cancer.

Investigation on returning to work in liver cancer survivors in Taiwan: a 5-year follow-up study.

BACKGROUND: Primary liver cancer is the fifth most common malignancy and limits patients' quality of life and working ability. Return to work after cancer treatment is an important step in social recovery. In addition, return to work represents the recovery of financial ability and improvements in self-confidence. The purpose of this article is to discuss the relationship between return to work and various covariables in workers with liver cancer. METHODS: The national registry cohort study collected adult workers newly diagnosed with liver cancer from 2004 to 2010 in Taiwan. There were 2451 workers included in our study. Primary liver cancer was diagnosed by using the International Classification of Diseases for Oncology code. Return to work after liver cancer survival was determined as returning to the same work or reemployment within five years after cancer diagnosis. The associations between independent variables and return to work were analyzed by Cox proportional hazard models. RESULTS: Workers who underwent surgery were more likely to return to work not only in the 2nd year but also in the 5th year. A lower survival rate was noted in the non-return-to-work group (p < 0.001) among all patients with liver cancer. The completely adjusted model identified that the rate of return to work was related to all-cause mortality with a hazard ratio of 0.244 (95% Confidence Intervals: 0.235-0.253). CONCLUSIONS: Our study indicated the impacts of treatment on the return to work of liver cancer survivors. In addition, in patient with liver cancer, return to work had positive effect on the survival rate.

Life expectancy estimations and determinants of return to work among cancer survivors over a 7-year period.

Due to advances in medical science and technology, the number of cancer survivors continues to increase. The workplace needs and employment difficulties cancer survivors face after treatment need to be addressed to protect these individuals' right to work and to maintain the overall labor force of the country. We conducted a retrospective cohort study with a follow-up period from 2004 to 2010. All data analyzed in the study were obtained from the Labor Insurance Database, the Taiwan Cancer Registry of the Ministry of Health and Welfare, and the National Health Insurance Research Database. The relationships between risk factors and the presence of returning to work were analyzed by a Cox proportional hazard model. The survival rates of patients with different cancer stages were evaluated using Kaplan-Meier survival analysis. Among the employees with an initial diagnosis of cancer, 70.4% remained employed through 1 year after the diagnosis, accounting for 83.4% of all cancer survivors; only 51.1% remained employed through 5 years after the diagnosis, accounting for 78.7% of all cancer survivors, a notable decrease. Age, gender, salary, treatment method, company size, and cancer stage were the factors that affected whether employees could return to work or not. The long-term survival of people diagnosed with cancer depends on their chances of returning to work. Strengthening existing return-to-work policies and assisting cancer survivors with returning to work after the treatment should be priorities for protecting these individuals' right to work and for maintaining the overall labor force.

Risk factors for return to work in colorectal cancer survivors.

BACKGROUND: The increasing incidence of colorectal cancer among individuals in the productive age-group has adversely affected the labor force and increased healthcare expenses in recent years. Return to work (RTW) is an important issue for these patients. In this study, we explored the factors that influence RTW and investigated the influence of RTW on survival outcomes of patients with colorectal cancer. METHODS: Data of individuals (N = 4408) in active employment who were diagnosed with colorectal cancer between 2004 and 2010 were derived from 2 nationwide databases. Subjects were categorized into 2 groups according to their employment status at 5-year follow-up. Logistic regression analysis was performed to identify the factors associated with RTW. Survivors were further followed up for another 8 years. Propensity score matching was applied to ensure comparability between the two groups, and survival analysis was performed using the Kaplan-Meier method. RESULTS: In multivariable regression analysis for 5-year RTW with different characteristics, older age (OR: 0.57 [95% CI, 0.48-0.69]; p < 0.001), treatment with radiotherapy (OR: 0.69 [95% CI, 0.57-0.83]; p < 0.001), higher income (OR: 0.39 [95% CI, 0.32-0.47]; p < 0.001), medium company size (OR: 0.78 [95% CI, 0.63-0.97]; p = 0.022), and advanced pathological staging (stage I, OR: 16.20 [95% CI, 12.48-21.03]; stage II, OR: 13.12 [95% CI, 10.43-16.50]; stage III, OR: 7.68 [95% CI, 6.17-9.56]; p < 0.001 for all) revealed negative correlations with RTW. In Cox proportional hazard regression for RTW and all-cause mortality, HR was 1.11 (95% CI, 0.80-1.54; p = 0.543) in fully adjusted model. CONCLUSION: Older age, treatment with radiotherapy, higher income, medium company size, and advanced pathological stage showed negative correlations with RTW. However, we observed no significant association between employment and all-cause mortality. Further studies should include participants from different countries, ethnic groups, and patients with other cancers.

Exposure profiles of workers from indium tin oxide target manufacturing and recycling factories in Taiwan.

Indium tin oxide exposure poses a potential health risk, but the exposure assessment in occupational setting remains incomplete and continues to be a significant challenge. To this end, we investigated the association of work type, airborne indium concentration, respirable fraction of total indium, and cumulative indium exposure index (CEI) with the levels of plasma indium (P-In) and urinary indium (U-In) among 302 indium tin oxide target manufacturing and recycling workers in Taiwan. We observed that recycling-crushing produced the highest concentrations of total indium (area: 2084.8 µg/m3; personal: 3494.5 µg/m3) and respirable indium (area: 533.4 µg/m3; personal: 742.0 µg/m3). Powdering produced the highest respirable fraction of total indium (area: 58.6%; personal: 81.5%), where the workers had the highest levels of P-In (geometric mean: 2.0 µg/L) and U-In (1.0 µg/g creatinine). After adjusting for the confounder, the CEIs of powdering (ßPR = 0.78; ßPR = 0.44), bonding (ßPT = 0.61; ßPT = 0.37), and processing workers (ßPT = 0.43; ßPT = 0.28) showed significant associations with P-In and U-In, validating its utility in monitoring the exposure. Also, the respirable fraction of total indium significantly contributed to the increased levels of P-In and U-In among workers. The varying levels of relationship noted between indium exposure and the levels of P-In and U-In among workers with different work types suggested that setting the exposure limits among different work types is warranted.

Lipid peroxidation metabolites associated with biomarkers of inflammation and oxidation stress in workers handling carbon nanotubes and metal oxide nanoparticles.

The purpose of this study was to assess the effects of lipid peroxidation with occupational exposure to different types of nanomaterials (NMs). In this cross-sectional study, urine and exhaled breath condensate (EBC) samples were collected from 80 NM-handling workers [30 workers handling nano-titanium oxide (nano-TiO2), 28 handling nano-silicon dioxide (nano-SiO2), 22 handling carbon nanotubes (CNTs)], and 69 controls (office workers) from 2010 to 2012. Urinary 8-isoPGF2α, 2,3 dinor-8-isoPGF2α, PGF2α, and EBC 8-iso PGF2α were measured as lipid peroxidation biomarkers in 2013. A significant positive correlation was found between 8-isoPGF2α, 2,3 dinor-8-isoPGF2α, PGF2α, and total isoprostane in urine. Furthermore, significant positive correlations were noted between EBC 8-iso PGF2α and urinary 2,3 dinor-8-isoPGF2α (Spearman correlation r = 0.173, p = 0.035). Exposure to nano-TiO2 resulted in significantly higher levels of urinary 8-isoPGF2α, 2,3 dinor-8-isoPGF2α and PGF2α, even after controlling for confounding factors. Moreover, significant associations and exposure intensity-response relationships between EBC 8-iso PGF2α and NMs were observed in workers, whether handling nano-TiO2, nano-SiO2, or CNTs. Among them, the significant trends were identified based on the intensity of risk levels. These results provided evidence that exposure to nano-TiO2, nano-SiO2, and CNTs may lead to lipid peroxidation in EBC. For routine biomonitoring purposes, this finding, which came through noninvasive methods, may be useful for workers exposed to NMs.HighlightsData regarding the effects of nano-titanium oxide (nano-TiO2), nano-silicon dioxide (nano-SiO2), and carbon nanotubes (CNTs) on lipid peroxidation in workers are limited.8-Iso PGF2α in exhaled breath condensate of workers exposed to nanoparticles was higher than that of office workers.Exposure to titanium oxide (TiO2) and silica (SiO2) may lead to lipid peroxidation, as indicated by 8-isoPGF2α, 2,3 dinor-8-isoPGF2α, and PGF2α.Examination of lipid peroxidation in EBC has seems to be a useful technique for noninvasive monitoring of workers exposed to nanoparticles.

Verification and Evaluation of a Visual Reaction System for Badminton Training.

The two aims of this study were (1) designing and developing an affordable visual reaction system for badminton training that monitors and provides instant feedback on agility; and (2) to measure and improve the footwork and movement of badminton players and output useful reference data. Ten junior high school badminton players were invited to serve as the subjects of this study. They participated in a three-week (nine sessions) training program. Training was primarily in the form of fixed or random footwork drills. Timed tests were performed before and after each session to measure the players' agility in performing six-point and four-point footwork drills. The results were compared to the training effects calculated using dependent-sample t-tests. In addition, the long-term durability and functionality of the training system were tested. The training system was able to maintain stable and reliable training and evaluation operations for extended periods. Results showed significant improvements in the visual reaction time (p = 0.003) and agility (p = 0.001) of players. The proposed training system is an affordable option for training and monitoring, evaluating, and recording training performance. It can accurately record movement and response times and simulate competitive environments.

Assessment of resident doses near nuclear power plants in Taiwan for epidemiology study.

Dose assessments were required for the epidemiological study of residents living near nuclear power plants. In the present work, environmental pathway models have been applied to estimate radiation doses to residents living near the nuclear power plants in Taiwan. Best estimates of doses were made for residents by their age groups in different compass sectors centered at the nuclear power plants. In each sector, radiation doses were assessed using the averaged environmental, consumption and lifestyle data. For epidemiological analyses of cancer risks in different organs or tissues, individual organ absorbed doses were assessed for both the airborne and waterborne effluent releases. Such assessments were performed based on the historic data, including measured effluent releases, detected meteorological parameters, and surveyed data on the production and consumption of local agricultural, fishery and livestock products, etc. Exposure pathways consisted of the external irradiations from air submersion, ground deposition and water immersion plus the internal irradiations from inhalation and ingestion. Age-dependent annual intakes and occupancy time were locally surveyed. Dose conversion coefficients were taken from published data after International Commission on Radiological Protection Publication 60. Annual doses and cumulated doses during residence were assessed and examined for their dependence on age, organ and compass sector.

Examining relationship between occupational acid exposure and oral health in workplace.

BACKGROUND: Acid mist can suspend in the air and enter the body via skin contact, the respiratory tract, or even oral intake, which pose various health hazards. Previous studies have shown that occupational exposure to acid mist or acidic solutions is a major risk factor for oral diseases. However, the findings are inconsistent and do not consider individual factors and lifestyles that may cause the same oral diseases. Therefore, we conducted a comprehensive oral health survey and collected detail information to confirm the effect of acidic solution exposure on worker's oral health. METHODS: From 4 acidic solution factories, a total of 309 subjects (157 in control and 152 in exposed group) was enrolled. All participants competed oral examinations and self-report questionnaire, including the decayed, missing, and filled teeth (DMFT) index, community periodontal index (CPI), loss of attachment (LA) index, and tooth erosion. Multivariate logistic regression analysis was used to determine the association between the acidic solution exposure and oral health. RESULTS: The results showed that acid exposure was correlated with soft oral tissue injury rather than hard oral tissue in our survey. In the multivariate model (adjusted for sex, age, worked years, education level, mouthwash use, dental floss use, tooth brushing, mask use, smoking, drinking, chewing areca and dietary habits with acidic foods), significant relationships of acid exposure with LA score were observed (OR = 2.32, 95% CI 1.03-5.26). However, the presence of acid exposure was not significantly associated with tooth erosion, DMFT, and CPITN. CONCLUSION: Our study highlighted that occupational acid exposure was an independent risk factor for periodontal health, especially LA. It is important to strengthen occupational hazard control, educate workers on oral disease and related factors, and raise the awareness of oral hygiene.