The association between multi-heavy metals exposure and lung function in a typical rural population of Northwest China.

BACKGROUND: Heavy metal exposure is acknowledged to be associated with decrease of lung function, but the relationship between metals co-exposure and lung function in rural areas of Northwest China remains unclear, particularly in an area famous for heavy metal pollution and solid fuel use. Therefore, the purpose of this study is to explore the effects of heavy metal exposure on lung function and the potential impacts of living habit in a rural cohort of Northwest China. METHODS: The study area included five villages of two regions in Northwestern China-Gansu province. All participants were recruited from the Dongdagou-Xinglong (DDG-XL) rural cohort in the study area. Urine levels of 10 common and representative heavy metals were detected by ICP-MS, including Cobalt (Co), Nickel (Ni), Molybdenum (Mo), Cadmium (Cd), Stibium (Sb), Copper (Cu), Zinc (Zn), Mercury (Hg), Lead (Pb), and Manganese (Mn). The lung function was detected by measuring percentages of predicted forced vital capacity (FVC%) and predicted forced expiratory volume in one second (FEV1%) as well as the ratio of FEV1/FVC. We also analyzed the association between heavy metals and pulmonary ventilation dysfunction (PVD). Restricted cubic spline, logistic regression, linear regression, and bayesian kernel machine regression (BKMR) model were used to analyze the relationship between heavy metal exposure and lung function. RESULTS: Finally, a total of 382 participants were included in this study with an average age of 56.69 ± 7.32 years, and 82.46% of them used solid fuels for heating and cooking. Single metal exposure analysis showed that the higher concentration of Hg, Mn, Sb, and lower Mo may be risk factors for PVD. We also found that FEV1% and FVC% were negatively correlated with Sb, Hg, and Mn, but positively correlated with Mo. The effect of mixed heavy metals exposure could be observed through BKMR model, through which we found the lung function decreased with the increase of heavy metal concentration. Furthermore, the males, BMI ≥ 24 kg/m2 and who used solid fuels showed a higher risk of PVD when exposed to Co, Zn, and Hg. CONCLUSIONS: Our results suggested that heavy metal exposure was associated with decrease of lung function regardless of single exposure or mixed exposure, particularly for Sb, Hg, Mn and those who use solid fuels.

Effect of welding operations on the health status of workers with low working age / 中华劳动卫生职业病杂志

Objective@#To explore the impact of welding operations on the health status of workers with low working age, and provide a basis for occupational health risk assessment for workers of low working age.@*Methods@#Used the method of cluster sampling to randomly selected workers from an automobile manufacturing plant in Guangzhou as research subjects: 982 workers with welding posts of 1 year ≤working age ≤5 years were welding groups, 707 workers with simple exposure noise of 1 year ≤working age ≤5 years were assembly groups, and 717 workers in pre-job medical examinations were pre-job groups from June 2017 to September 2018. Then conducted occupational health checks on all subjects, investigated and detected the occupational hazards in welding posts and assembly posts.@*Results@#There was no statistical difference between the noise over-standard rate of welding posts' (59.3%, 16/27) and the assembly posts' (47.4%, 9/19) (P>0.05) . The over-standard rate of welding fume, manganese and its inorganic compounds in welding posts was 11.11% (3/27) . The results of occupational health examination showed that the detection rate of disease or abnormal of the welding group was 78.4% (770/982) higher than 70.2% (496/707) in the assembly group and 53.0% (380/717) in the pre-job group (the value of 2 were 14.92 and 122.37, respectively, P<0.05) . The rate of hearing loss of the assembly group and the welding group were 14.7% (104/707) and 19.3% (190/982) , respectively, which was higher than that of the pre-job group (10.5%, 75/717) , and the hearing loss rate gradually increased with the increase of working age (the value of linear-by-linear association were 12.04 and 44.67, respectively, P<0.01) . Compared with the hearing loss rate of each working age of the assembly group, the hearing loss rate of each working age of the welding group was higher, and when the working age was 3 years, the risk of hearing loss in the welding group was 2.70 times that of the assembly group (P<0.01) . The rate of pulmonary dysfunction in the welding group was 19.2% (189/982) higher than that in the pre-job group (12.6%, 90/717) , and it increased with the increase of working age (the value of linear-by-linear association was 15.97, P<0.01) .@*Conclusion@#Welding work seriously damages the health of workers with low working age, increases the hearing loss of workers and the occurrence of pulmonary dysfunction; manganese and its compounds increases noise-induced damage to the hearing system.

Analysis on application effect of strengthened pulmonary rehabilitation exercise in lung cancer patients with severe pulmonary ventilation dysfunction in perioperative period / 中国实用护理杂志

Objective To explore the application effect of strengthened pulmonary rehabilitation exercise in lung cancer patients with severe pulmonary ventilation dysfunction during perioperative period. Methods A total of 96 patients receiving lung cancer radical treatment under thoracoscope in our hospital during March 2013 to April 2015 were collected, and for all these patients, pulmonary function test before treatment showed that there was severe pulmonary ventilation dysfunction. The patients were divided into the routine group and the intervention group by random digital table method, with 48 patients in each group;patients in the routine group received routine perioperative nursing, and those in the intervention group received the strengthened pulmonary rehabilitation intervention plan; change in pulmonary function before treatment, duration of mechanical ventilation, time of oxygen therapy, retaining time of chest tube, length of hospital stay and occurrence of complications after treatment were compared between the two groups. Results After strengthened pulmonary rehabilitation intervention in the intervention group, the FVC was (2.63±0.47) L, the MVV was(53.14±9.40) L, the DLCO was(19.26±2.63) ml·min-1·mmHg-1, the VO2 was (23.15±4.36) ml/kg and the O2Pulse was(10.98±2.52) ml·min-1·times-1, Which were significantly improved compared with those before treatment, (2.41±0.40) L,(46.98±8.91) L,(17.56±2.83) ml·min -1·mmHg -1, (20.17±4.35)ml/kg and(9.82±2.07) ml·min-1·times-1, t=2.521, 3.512, 3.112, 3.421, 2.515, P<0.01 or 0.05. While there was no obvious change in the above- mentioned indexes of those in the routine group. After treatment of patients in the intervention group the duration of mechanical ventilation was (9.42±3.17) hours, time of oxygen therapy was (76.23±21.18) hours, retaining time of chest tube was (3.58±1.44) days and length of hospital stay was (6.62±2.14) days, which were significantly shorter than those in the routine group, (17.29±4.79) hours,(92.14±24.29) hours, (4.73±2.15) days and(8.68±2.96) days. The occurrence rates of complications such as pulmonary infection, pulmonary atelectasis and respiratory failure were 12.50%(6/48),10.42%(5/48) and 4.17%(2/48)in the intervention group, significantly lower than those in the routine group, 41.67%(20/48),29.17%(14/48) and 18.75%(9/48), χ2=10.338, 5.315, 5.031, P <0.01 or 0.05. Conclusions Strengthened pulmonary rehabilitation intervention can improve pulmonary function of lung cancer patients with severe pulmonary ventilation dysfunction before treatment, reduce the occurrence rate of post- operative complications and enhance safety during the perioperative period; it is worth of being further promoted clinically.