Guowei Pan

Decreased Serum Free Testosterone in Workers Exposed to High Levels of Di-n-butyl Phthalate (DBP) and Di-2-ethylhexyl Phthalate (DEHP): A Cross-Sectional Study in China

Background Observations of adverse developmental and reproductive effects in laboratory animals and wildlife have fueled increasing public concern regarding the potential for various chemicals to impair human fertility. Objective Our objective in this study was to assess the effect of occupational exposure to high levels of phthalate esters on the balance of gonadotropin and gonadal hormones including luteinizing hormone, follicle-stimulating hormone, free testosterone (fT), and estradiol. Methods We examined urine and blood samples of 74 male workers at a factory producing unfoamed polyvinyl chloride flooring exposed to di-n-butyl phthalate (DBP) and di-2-ethylhexyl phthalate (DEHP) and compared them with samples from 63 male workers from a construction company, group matched for age and smoking status. Results Compared to the unexposed workers, the exposed workers had substantially and significantly elevated concentrations of mono-n-butyl phthalate (MBP; 644.3 vs. 129.6 μg/g creatinine, p < 0.001) and mono-2-ethylhexyl phthalate (MEHP; 565.7 vs. 5.7 μg/g creatinine, p < 0.001). fT was significantly lower (8.4 vs. 9.7 μg/g creatinine, p = 0.019) in exposed workers than in unexposed workers. fT was negatively correlated to MBP (r = −0.25, p = 0.03) and MEHP (r = −0.19, p = 0.095) in the exposed worker group. Regression analyses revealed that fT decreases significantly with increasing total phthalate ester score (the sum of quartiles of MBP and MEHP; r = −0.26, p = 0.002). Conclusion We observed a modest and significant reduction of serum fT in workers with higher levels of urinary MBP and MEHP compared with unexposed workers.

Association of Particulate Air Pollution With Daily Mortality The China Air Pollution and Health Effects Study

China is one of the few countries with some of the highest particulate matter levels in the world. However, only a small number of particulate matter health studies have been conducted in China. The study objective was to examine the association of particulate matter with an aerodynamic diameter of less than 10 μm (PM(10)) with daily mortality in 16 Chinese cities between 1996 and 2008. Two-stage Bayesian hierarchical models were applied to obtain city-specific and national average estimates. Poisson regression models incorporating natural spline smoothing functions were used to adjust for long-term and seasonal trends of mortality, as well as other time-varying covariates. The averaged daily concentrations of PM(10) in the 16 Chinese cities ranged from 52 μg/m(3) to 156 μg/m(3). The 16-city combined analysis showed significant associations of PM(10) with mortality: A 10-μg/m(3) increase in 2-day moving-average PM(10) was associated with a 0.35% (95% posterior interval (PI): 0.18, 0.52) increase of total mortality, 0.44% (95% PI: 0.23, 0.64) increase of cardiovascular mortality, and 0.56% (95% PI: 0.31, 0.81) increase of respiratory mortality. Females, older people, and residents with low educational attainment appeared to be more vulnerable to PM(10) exposure. Conclusively, this largest epidemiologic study of particulate air pollution in China suggests that short-term exposure to PM(10) is associated with increased mortality risk.

Fine particulate air pollution and daily mortality in Shenyang, China.

Fine particulate matter (PM₂.₅) is not a criteria pollutant in China, and few studies were conducted in the country to investigate the health impact of PM₂.₅. In this study, we did a time-stratified case-crossover analysis to examine the association between PM₂.₅ and daily mortality in Shenyang, an industrial center in northeast China. Daily mortality, air pollution and weather data from August 1, 2006 to December 31, 2008 in Shenyang were collected. A time-stratified case-crossover approach was used to estimate the association of PM₂.₅ with both total and cause-specific mortality. Controls were selected as matched days of the week in the same month. Potential effect modifiers, such as age, gender, and season, were also examined. We found significant associations between PM₂.₅ and daily mortality in Shenyang. A 10 μg/m³ increment in the 2-day moving average (lag 01) concentrations of PM₂.₅ corresponded to 0.49% (95% CI: 0.19%, 0.79%), 0.53% (95% CI: 0.09%, 0.97%), and 0.97% (95% CI: 0.01%, 1.94%) increase of total, cardiovascular, and respiratory mortality, respectively. The associations appeared to be stronger in older people (aged ≥ 75 years), in females and during the warm season. To our knowledge, this is the longest PM₂.₅ health study in time duration in China. Our findings provide new information on the adverse health effects of PM₂.₅, and may have implications for environmental policy making and standard setting in China.

Coarse particles and mortality in three Chinese cities: The China Air Pollution and Health Effects Study (CAPES)

Evidence concerning the health risks of coarse particles (PM(10-2.5)) is limited. There have been no multi-city epidemiologic studies of PM(10-2.5) in developing Asian countries. We examine the short-term association between PM(10-2.5) and daily mortality in three Chinese cities: Beijing, Shanghai, and Shenyang. PM(10-2.5) concentrations were estimated by subtracting PM(2.5) from PM(10) measurements. Data were analyzed using the over-dispersed generalized linear Poisson models. The average daily concentrations of PM(10-2.5) were 101 μg/m(3) for Beijing (2007-2008), 50 μg/m(3) for Shanghai (2004-2008), and 49 μg/m(3) for Shenyang (2006-2008). In the single-pollutant models, the three-city combined analysis showed significant associations between PM(10-2.5) and daily mortality from both total non-accidental causes and from cardiopulmonary diseases. A 10-μg/m(3) increase in 1-day lagged PM(10-2.5) was associated with a 0.25% (95% CI: 0.08 to 0.42) increase in total mortality, 0.25% (95% CI: 0.10 to 0.40) increase in cardiovascular mortality, and 0.48% (95% CI: 0.20 to 0.76) increase in respiratory mortality. However, these associations became statistically insignificant after adjustment for PM(2.5). PM(2.5) was significantly associated with mortality both before and after adjustment for PM(10-2.5). In conclusion, there were no statistically significant associations between PM(10-2.5) and daily mortality after adjustment for PM(2.5) in the three Chinese cities.

Recent Mortality from Pleural Mesothelioma, Historical Patterns of Asbestos Use, and Adoption of Bans: A Global Assessment

Background In response to the health risks posed by asbestos exposure, some countries have imposed strict regulations and adopted bans, whereas other countries have intervened less and continue to use varying quantities of asbestos. Objectives This study was designed to assess, on a global scale, national experiences of recent mortality from pleural mesothelioma, historical trends in asbestos use, adoption of bans, and their possible interrelationships. Methods For 31 countries with available data, we analyzed recent pleural mesothelioma (International Classification of Diseases, 10th Revision) mortality rates (MRs) using age-adjusted period MRs (deaths/million/year) from 1996 to 2005. We calculated annual percent changes (APCs) in age-adjusted MRs to characterize trends during the period. We characterized historical patterns of asbestos use by per capita asbestos use (kilograms per capita/year) and the status of national bans. Results Period MRs increased with statistical significance in five countries, with marginal significance in two countries, and were equivocal in 24 countries (five countries in Northern and Western Europe recorded negative APC values). Countries adopting asbestos bans reduced use rates about twice as fast as those not adopting bans. Turning points in use preceded bans. Change in asbestos use during 1970–1985 was a significant predictor of APC in mortality for pleural mesothelioma, with an adjusted R2 value of 0.47 (p < 0.0001). Conclusions The observed disparities in global mesothelioma trends likely relate to country-to-country disparities in asbestos use trends.

Ambient air pollution and daily mortality in Anshan, China: A time-stratified case-crossover analysis

Few case-crossover studies were conducted in China to investigate the acute health effects of air pollution. We conducted a time-stratified case-crossover analysis to examine the association between air pollution and daily mortality in Anshan, a heavily-polluted industrial city in northeastern China. Daily mortality, air pollution, and weather data in 2004-2006 in Anshan were collected. Time-stratified case-crossover approach was used to estimate the effect of air pollutants (PM(10), SO(2), NO(2) and CO) on total and cardiopulmonary mortality. Controls were selected as matched days of the week in the same month. Potential effect modifiers, such as gender and age, were also examined. We found significant associations between air pollution and daily mortality from cardiovascular diseases in Anshan. A 10μg/m(3) elevation of 2-day moving average (lag 01) concentration in PM(10), SO(2), NO(2) and CO corresponded to 0.67% (95% CI: 0.29%, 1.04%), 0.38% (95% CI: -0.06%, 0.83%), 2.11% (95% CI: 0.22%, 4.00%) and 0.04% (95% CI: 0.01%, 0.07%) increase of cardiovascular mortality. The associations for total and respiratory mortality were generally positive but statistically insignificant. The air pollution health effects were significantly modified by age, but not by gender. Conclusively, our study showed that short-term exposure to air pollution was associated with increased cardiovascular mortality in Anshan. These findings may have implications for local environmental and social policies.

Nested case-control study of esophageal cancer in relation to occupational exposure to silica and other dusts

BACKGROUND Standardized proportionate mortality ratio (SPMR) was found to be 2.2 (95% CI = 1.3-3.5) for esophageal cancer (EC) among workers exposed to refractory brick dust in a large iron-steel complex in China. METHODS A nested case-control design within a cohort of industrial workers. One hundred and twenty-five EC cases and 250 controls were identified from the death registry file. Interviews were conducted of the next of kin for past exposure information on job, domestic, and lifestyle factors. History of occupational exposure to various dusts was reconstructed from personnel files and by interviewing colleagues utilizing a job-exposure matrix. RESULTS After adjusting for confounders, occupational exposure to silica dust was the most important risk factor among all variables investigated, with a 2.8-fold risk and a clear dose-response by length of exposure. Alcohol drinking (OR = 1.8) and coal cooking (OR = 2.0) were risk factors and high consumption of fruit diet (OR = 0.5) and meat diet (OR = 0.6) were protective factors. CONCLUSIONS The relationship between occupational exposure to silica dust and the risk of EC found in an earlier SPMR study was confirmed. Ingestion of silica particles after lung clearance may increase the risk of EC among workers exposed to silica.

Ambient carbon monoxide and daily mortality in three Chinese cities: The China Air Pollution and Health Effects Study (CAPES)

Ambient carbon monoxide (CO) is an air pollutant primarily generated by traffic. CO has been associated with increased mortality and morbidity in developed countries, but few studies have been conducted in Asian developing countries. In the China Air Pollution and Health Effects Study (CAPES), the short-term associations between ambient CO and daily mortality were examined in three Chinese cities: Shanghai, Anshan and Taiyuan. Poisson regression models incorporating natural spline smoothing functions were used to adjust for long-term and seasonal trend of mortality, as well as other time-varying covariates. Effect estimates were obtained for each city and then for the cities combined. In both individual-city and combined analysis, significant associations of CO with both total non-accidental and cardiovascular mortality were observed. In the combined analysis, a 1 mg/m(3) increase of 2-day moving average concentrations of CO corresponded to 2.89% (95%CI: 1.68, 4.11) and 4.17% (95%CI: 2.66, 5.68) increase of total and cardiovascular mortality, respectively. CO was not significantly associated with respiratory mortality. Sensitivity analyses showed that our findings were generally insensitive to alternative model specifications. In conclusion, ambient CO was associated with increased risk of daily mortality in these three cities. Our findings suggest that the role of exposure to CO and other traffic-related air pollutants should be further investigated in China.

Mortality of Iron-Steel Workers in Anshanl China: A Retrospective Cohort Study

Abstract Foundry workers have increased mortality and morbidity risks from numerous causes, including various cancers. A retrospective Chinese iron-steel cohort study was conducted to examine the mortality effects of exposure to foundry work. Standardized mortality ratios (SMRs) and standardized rate ratios (SRRs) were calculated to evaluate mortality risks among male workers with exposure to 15 hazardous factors, acljusting for confounders. During 14 years of follow-up, 13,363 of 121,846 male workers died. SMR analysis showed a healthy-worker effect in comparison with the general population. SRR analysis showed increased risks for all causes, all neoplasms, and others among the exposed workers compared with nonexposed blue-collar workers. Combined exposure to polycyclic aromatic hydrocarbons and two or more dusts increased the risks of lung cancer (SRR = 654; 95% CI: 113–3,780) and other malignancies. Foundry work has adverse health effects, including carcinogenic risks.

Cytochrome P450 1B1 mRNA levels in peripheral blood cells and exposure to polycyclic aromatic hydrocarbons in Chinese coke oven workers.

Cytochrome P450 1B1 (CYP1B1) is induced through the Ah receptor and is involved in the activation of polycyclic aromatic hydrocarbons (PAHs). To determine the validity of a quantitative analysis of CYP1B1 mRNA in peripheral human blood cells for the estimation of PAH exposure, a real-time quantitative polymerase chain reaction method was used to measure the relative levels of CYP1B1 mRNA in 37 Chinese coke oven workers and 13 control workers. A large inter-individual difference in the levels was observed. The average level of the CYP1B1 mRNA in workers at the top work site, where the PAH exposure level from the coke ovens was highest, was significantly higher than in workers at the middle site (P<0.01) or the controls (P=0.02). A non-significant positive correlation was found between the CYP1B1 mRNA levels and urinary 1-hydroxypyrene (R=0.22, P=0.13), and a significant correlation between these mRNA levels and urinary cotinine (R=0.33, P=0.02). It was interesting that a significant positive correlation between CYP1B1 mRNA and 1-hydroxypyrene was observed in subjects with the Leu/Leu type of CYP1B1 Leu432Val polymorphism (R=0.33, P=0.02, n=38) and a non-significant correlation in subjects with the Leu/Val and Val/Val types (R=-0.36, P=0.25, n=12), although the number of subjects in this strata analysis was small. Our preliminary study suggests that PAH exposure in coke ovens and smoking maybe associated with CYP1B1 mRNA levels in peripheral blood cells although mRNA is generally unstable and could be expressed following exposure to other agents.