Chun-Yuh Yang

Statin Use and the Risk of Liver Cancer: A Population-Based Case - Control Study

OBJECTIVES:Experimental studies have shown that statins have potential protective effects against cancer. The aim of this study was to investigate whether the use of statins was associated with liver cancer risk.METHODS:We conducted a population-based case–control study in Taiwan. Data were retrospectively collected from the Taiwan National Health Insurance Research Database. Cases consisted of all patients who were aged ≥50 years and had a first-time diagnosis of liver cancer for the period between 2005 and 2008. Controls were pair matched to cases by age, sex, and index date. Adjusted odds ratios (ORs) and 95% CIs (95% confidence intervals) were estimated using multiple logistic regression.RESULTS:We examined 1,166 liver cancer cases and 1,166 controls. Compared with the group with no use of statins, the adjusted ORs were 0.62 (95% CI=0.42–0.91) for the group having been prescribed statins below 215.4 defined daily dose (DDD) and 0.63 (95% CI=0.37–1.06) for the group with cumulative statin use ≥215.4 DDD. The ORs for the group with cumulative statin use ≥215.4 DDD were not statistically significant, but this may be due to the relatively small number of subjects.CONCLUSIONS:The results of this study suggest that statins may reduce the risk of liver cancer.

Epidemiological features of biliary atresia in Taiwan, a national study 1996–2003

Background and Aim:u2002 The incidence of biliary atresia (BA) varies among different countries. It is supposed to be higher in Asian countries than in Western countries; however, the incidence of BA in Taiwan has not been well investigated. The aim of this study was to analyze the epidemiological characteristics and the incidence of BA in Taiwan.

Consequences of Exposure to Asian Dust Storm Events on Daily Pneumonia Hospital Admissions in Taipei, Taiwan

In spring, windblown dust storms originating in the deserts of Mongolia and China travel to Taipei city. These occurrences are known as Asian dust storm (ADS) events. The objective of this study was to assess the possible associations of constituents of ADS with hospital pneumonia admissions of residents in Taipei, Taiwan, during the period 1996–2001. Fifty-four dust storm episodes were identified and were classified as index days. Daily pneumonia admissions on the index days were compared with admissions on comparison days. Two comparison days for each index day, 7 d before the index days and 7 d after the index days, were selected. The study results indicated a statistically significant association between ADS events and daily pneumonia admissions 1 d after the event. It is worthwhile to pay more attention to ADS events and health in the future based on the findings in this investigation.

Air Pollution and Hospital Admissions for Congestive Heart Failure in a Subtropical City: Taipei, Taiwan

This study was undertaken to determine whether there was an association between air pollutant levels and hospital admissions for congestive heart failure (CHF) in Taipei, Taiwan. Hospital admissions for CHF and ambient air pollution data for Taipei were obtained for the period from 1996 to 2004. The relative risk of hospital admission was estimated using a case-crossover approach, controlling for weather variables, day of the week, seasonality, and long-term time trends. In the single-pollutant model, the number of CHF admissions was significantly associated with the environmental presence of the contaminants particulate matter (PM10), nitrogen dioxide (NO2), carbon monoxide (CO), and ozone (O3) on warm days (>20°C). However, statistically significant positive effects on increased CHF admissions on cool days (<20°C) was observed only for CO levels. For the two-pollutant model, NO2 and O3 were significant in combination with each of the other four pollutants on warm days for enhanced CHF admissions. This study provides evidence that higher levels of ambient air pollutants increase the risk of hospital admissions for CHF.

Effects of Asian dust storm events on daily clinical visits for conjunctivitis in Taipei, Taiwan.

In spring, windblown dust storms originating in the deserts of Mongolia and China make their way to Taipei city. These occurrences are known as Asian dust storm (ADS) events. The objective of this study was to assess the possible associations of ADS with daily clinic visits for conjunctivitis in residents in Taipei, Taiwan, during the period from 1997–2001. Forty-nine dust storm episodes were classified and classified as index days. Daily clinical visits for conjunctivitis on the index days were compared with clinical visits on the comparison (non-storm) days. Two comparison days for each index day, 7 d before the index days and 7 d after the index days, were selected. The effects of dust storms on clinic visits for conjunctivitis were prominent 4 d after the event. However, the association was not statistically significant. There may not have been enough power to detect associations resulting from the inadequate sample size of conjunctivitis visits on ADS events days. However, it seems worthwhile to pay more attention to the ADS events and health in the future.

Analgesic use and the risk for progression of chronic kidney disease

The chronic effect of various analgesics on the progression of chronic kidney disease (CKD) is inconclusive. There is also lack of information on the renal safety of selective cyclooxygenase‐2 (COX‐2) inhibitors. This study aimed to clarify the renal risk of analgesic use in CKD patients.

Outdoor air pollution and female lung cancer in Taiwan.

To investigate the relationship between air pollution and female lung cancer, the authors conducted a matched case-control study using female deaths that occurred in Taiwan from 1994 through 2003. Data on all eligible female lung cancer deaths were obtained from the Bureau of Vital Statistics of the Taiwan Provincial Department of Health. The control group consisted of women who died from causes other than cancer or diseases associated with respiratory problems. The controls were pair matched to the cases by sex, year of birth, and year of death. Each matched control was selected randomly from the set of possible controls for each case. A municipality-based aggregate index of long-term exposure to air pollution was created by dividing the annual average of the measured values for each pollutant by the National Ambient Air Quality Standard for that pollutant. The ratios for each pollutant were scaled to a 100-point scale and then averaged together to generate an index value representing the net burden of these pollutants, with each weighted equally. The subjects were divided into tertiles according to the levels of the index just described. Women who lived in the group of municipalities with highest levels of air pollution exposure index were at a statistically significant increased lung cancer risk compared to the group living in municipalities with the lowest air pollution exposure index after controlling for possible confounders (OR = 1.28, 95% CI = 1.02–1.61). The findings of this study warrant further investigation of the role of air pollutants in the etiology of lung cancer.

Effects of Asian Dust Storm Events on Hospital Admissions for Congestive Heart Failure in Taipei, Taiwan

In spring, windblown dust storms originating in the deserts of Mongolia and China make their way to Taipei city. These occurrences are known as Asian dust storm (ADS) events. These ADS events lead to enhanced PM10 levels over those generated by the usual local sources. The objective of this study was to assess the possible associations of PM10 with hospital admissions for congestive heart failure (CHF) in Taipei, Taiwan, during the period from 1996 to 2001. Fifty-four dust storm episodes, which were classified as index days, were identified. Daily CHF admissions on index days were compared with admissions on comparison days. Two comparison days were selected for each index day, 7 d before the index days and 7 d after the index days. The effects of ADS on hospital admissions for CHF were prominent 1 d after the event (relative risku2009=u20091.114; 95% confidence intervalu2009=u20090.993–1.250). However, the association was not statistically significant. There may not have been enough power to detect associations resulting from the inadequate sample size of CHF admissions on ADS events days. However, it seems worthwhile to pay more attention to the ADS events and health in the future.

Nitrate in Drinking Water and Risk of Death from Bladder Cancer: An Ecological Case-Control Study in Taiwan

The relationship between nitrate levels in drinking water and bladder cancer development is controversial. A matched cancer case-control with nitrate ecology study was used to investigate the association between bladder cancer mortality occurrence and nitrate exposure from Taiwan drinking water. All bladder cancer deaths of Taiwan residents from 1999 through 2003 were obtained from the Bureau of Vital Statistics of the Taiwan Provincial Department of Health. Controls were deaths from other causes and were pair-matched to the cases by gender, year of birth,and year of death. Each matched control was selected randomly from the set of possible controls for each cancer case. Data on nitrate-nitrogen (NO3-N) levels in drinking water throughout Taiwan were collected from Taiwan Water Supply Corporation (TWSC). The municipality of residence for cancer cases and controls was assumed to be the source of the subjects nitrate exposure via drinking water. The adjusted odds ratios for bladder cancer death for those with high nitrate levels in their drinking water were 1.76 (1.28–2.42) and 1.96 (1.41–2.72) as compared to the lowest tertile. The results of the present study show that there was a significant positive relationship between the levels of nitrate in drinking water and risk of death from bladder cancer.

Air Pollution and Hospital Admissions for Asthma in a Subtropical City: Taipei, Taiwan

This study was undertaken to determine whether there is an association between exposure to air pollutants levels and number of hospital admissions for asthma in Taipei, Taiwan. Hospital admissions for asthma and ambient air pollution data for Taipei were obtained for the period from 1996 through 2003. The relative risk of hospital admission for asthma was estimated using a case-crossover approach, controlling for weather variables, day of the week, seasonality, and long-term time trends. In the single-air-pollutant model, on warm days (≥25°C) statistically significant positive associations were found for SO2, NO2, and CO levels with an increase in asthmatic admissions. On cool days (<25°C), all air pollutants were significantly associated with elevated asthma admissions except SO2. For the two-air-pollutant model, CO significantly increases hospital admissions for asthma in combination with each of the other four pollutants on warm days. On cool days, NO2 and O3 significantly elevated asthma rates in all the two-air-pollutant models. This study provides evidence that higher levels of ambient air pollutant concentrations increase the risk of hospital admissions for asthma.