Population attributable risks of cigarette smoking for deaths of all causes, all cancers and other chronic diseases among adults aged 40-74 years in urban Shanghai, China

Objective： To evaluate the population attributable risks （PARs） between cigarette smoking and deaths of all causes, all cancers, lung cancer and other chronic diseases in urban Shanghai. Methods： In total, 61,480 men aged 40-74 years from 2002 to 2006 and 74,941 women aged 40-70 years from 1997 to 2000 were recruited to undergo baseline surveys in urban Shanghai, with response rates of 74.0% and 92.3%, respectively. A Cox proportional hazards regression model was used to estimate relative risks （RRs） and 95% confidence intervals （95% CIs） of deaths associated with cigarette smoking. PARs and 95 % CIs for deaths were estimated from smoking exposure rates and the estimated RRs. Results： Cigarette smoking was responsible for 23.9% （95% CI： 19.4-28.3%） and 2.4% （95% Ch 1.6- 3.2%） of all deaths in men and women, respectively, in our study population. Respiratory disease had the highest PAR in men [37.5% （95% CI： 21.5-51.6%）], followed by cancer [31.3% （95% Ch 24.6-37.7%）] and cardiovascular disease （CVD） [24.1% （95% CI： 16.7-31.2%）]. While the top three PARs were 12.7% （95% CI： 6.1-19.3%）, 4.0% （95% CI： 2.4-5.6%）, and 1.1% （95% CI： 0.0-2.3%）, for respiratory disease, CVD, and cancer, respectively in women. For deaths of lung cancer, the PAR of smoking was 68.4% （95% CI： 58.2- 76.5%） in men. Conclusions： In urban Shanghai, 23.9% and 2.4% of all deaths in men and women could have been prevented if no people had smoked in the area. Effective control programs against cigarette smoking should be strongly advocated to reduce the increasing smoking-related death burden.

A risk assessment method considering risk attributes and work safety informational needs and its application

The technological revolution has spawned a new generation of industrial systems,but it has also put forward higher requirements for safety management accuracy,timeliness,and systematicness.Risk assessment needs to evolve to address the existing and future challenges by considering the new demands and advancements in safety management.The study aims to propose a systematic and comprehensive risk assessment method to meet the needs of process system safety management.The methodology first incorporates possibility,severity,and dynamicity(PSD)to structure the“51X”evaluation indicator system,including the inherent,management,and disturbance risk factors.Subsequently,the four-tier(risk point-unit-enterprise-region)risk assessment(RA)mathematical model has been established to consider supervision needs.And in conclusion,the application of the PSD-RA method in ammonia refrigeration workshop cases and safety risk monitoring systems is presented to illustrate the feasibility and effectiveness of the proposed PSD-RA method in safety management.The findings show that the PSD-RA method can be well integrated with the needs of safety work informatization,which is also helpful for implementing the enterprise's safety work responsibility and the government's safety supervision responsibility.

Burden of Cardiometabolic Risk Factors on Cerebrovascular Events in a Southern Italian Population

Background: Stroke is the second leading cause of death in the world and the third due to disability. However, there are few data available that identify the risk factors associated with it and their weight in different populations (population risk). Aim: Contribute to the knowledge of burden risk factors in stroke in a large cohort of Southern Italy. Methods: The data refer to a randomized Campania cohort of 1200 subjects (35 - 74 years) enrolled in 2008-09. Ten years later (2018-19) they were re-evaluated. We analyzed data from 32 patients who reported a cerebrovascular event (stroke or TIA) with the event-free group of subjects (804 subjects: 378 men and 426 women). We evaluated: absolute risk, Odds Ratio (OR), Additional Risk (AR), Risk Attributable to the Population (PAR) and, finally, the Population Attributable risk Fraction (FAP). Results: In the comparison between the two groups (patients with events and patients without events) the risk factors with statistically significant differences were: age, Systolic Blood Pressure (SBP), BMI, cholesterol, triglycerides, glycemia and hyperinsulinemia. The ORs with the greatest impact were: blood glucose (5.1), BMI (3.3) and BPS (2.9). Linear regression analysis identified Glycemia and BMI as the only independent variables. The FAPs with the greatest impact were SBP (47.4%) and BMI (42.6%). Discussion and Conclusions: Our data confirm that the high incidence of stroke in Campania is particularly related to the high prevalence of obesity and hypertension. In the single patient, however, the risk factors with the greatest impact are: glycaemia BMI an SBP.

Excess Alcohol Use and Death among Tuberculosis Patients in the United States, 1997-2012

Rationale: Excess alcohol use (EAU) is associated with adverse TB treatment outcomes. Objective: We investigated the relationship between EAU and death among TB patients 15 years and older prescribed anti-TB treatment in the United States. Design: Using data reported to the National Tuberculosis Surveillance System for 1997-2012, we calculated adjusted odds ratios and excess attributable risk percent for death among TB patients with reported EAU. Results: EAU was associated with death among patients younger than 65. The excess attributable risk percent for death among those with reported EAU for those younger than 65 was >35%. Conclusions: Interventions to reduce EAU in patients <65 years may reduce deaths.

Prevalence of term low birth weight andits determinants in Shanghai, China

Objective: To investigate the prevalence of term low birth weight (TLBW) and its risk factors. Methods: A follow-up study with 7, 872 couples was conducted from 1987 to 199o beginning from the time they got marriage licenses in two districts defined in Shanghai. They were interviewed in the third month and again in the fifteenth month and in the fifth to sixth year afterwards individually at home. The total follow up rate reached 98%. Couple’s background characteristics as well as the information on their general health. reproductivc history and contraceptive use etc.. were collected dynamically. All of the single live births with term delivery were Included for data analysis in this paper. Adjusted odd ratios and population attributable risk (PAR%) were computed. Results: The prevalence of TLBW in Shanghai single term live births was 2. 0% (134,/6.573), represents 54. 7% (134/245) of the total low birth weights in our sam pie. Significant social and behaviour risk factors relating with TI-BW were wife’s dissat- isfaction with marriage; low education level of husband; co-residence with parents during pregnancy; heavy housework done by the wife while being pregnant. Significant biomedical risky factors were menarche age greater than 16 years old; maternal age at delivery greater than 29 years old; maternal body mass index less than 19. 8; wife suf- fered from serious disease prior to conceiving; having pregnancy complication; gestational weight gain less than 20 % of pre-pregnancy weight; having abortion, stillbirth and fetal death history. Conclusion: TL.BW constituted over half of all low birth weights in Shanghai. Special attention should be paid to the determinants mentioned above in TLBW intervention program. Improving couples’ economic and living condition and husband ’s education at tainment, and caloric supplementation with women while being pregnant would all be particularly effective in reducing the occurrence of TLBW in Shnaghai.

Temporal Trend in Lung Cancer Burden Attributed to Ambient Fine Particulate Matter in Guangzhou, China

Objective To estimate the lung cancer burden that may be attributable to ambient fine particulate matter （PM2.5） pollution in Guangzhou city in China from 2005 to 2013. Methods The data regarding PM2.5 exposure were obtained from the ＆#39;Ambient air pollution exposure estimation for the Global Burden of Disease 2013＇ dataset at 0.1° ×0.1° spatial resolution. Disability-adjusted life years （DALYs） were estimated based on the information of mortality and incidence of lung cancer. Comparative risk analysis and integrated exposure-response function were used to estimate attributed disease burden. Results The population-weighted average concentration of PM2.5 was increased by 34.6% between 1990 and 2013, from 38.37 μg/m3 to 51.31 μg/m^3. The lung cancer DALYs in both men and women were increased by 36.2% from 2005 to 2013. The PM2.5 attributed lung cancer DALYs increased from 12105.0 （8181.0 for males and 3924.0 for females） in 2005 to 16489.3 （11291.7 for males and 5197.6 for females） in 2013. An average of 23.1% lung cancer burden was attributable to PM2.5 pollution in 2013. Conclusion PM2.5 has caused serious but under-appreciated public health burden in Guangzhou and the trend deteriorates. Effective strategies are needed to tackle this major public health problem.

An extreme rainfall event in summer 2018 of Hami city in eastern Xinjiang, China

Extreme rainfall events are rare in inland arid regions, but have exhibited an increasing trend in recent years, causing many casualties and substantial socioeconomic losses. A series of heavy rains that began on July 31st, 2018, battered the Hami prefecture of eastern Xinjiang, China for four days. These rains sparked devastating floods, caused 20 deaths, eight missing, and the evacuation of about 5500 people. This study examines the extreme rainfall event in a historical context and explores the anthropogenic causes based on analysis of multiple datasets (i.e., the observed daily data, the global climate models (GCMs) from the Coupled Model Intercomparison Project Phase 5 (CMIP5), the NCEP/NCAR Reanalysis 1, and the satellite cloud data) and several statistical techniques. Results show that this extraordinarily heavy rainfall was due mainly to the abnormal weather system (e.g., the abnormal subtropical high) that transported abundant water vapor from the Indian Ocean and the East China Sea crossed the high mountains and formed extreme rainfall in Hami prefecture, causing the reservoir to break and form a flood event with treat loss, which is a typical example of a comprehensive analysis of the extreme rainfall event in summer in Northwest China. Also, the fraction of attributable risk (FAR) value was 1.00 when the 2018 July–August RX1day (11.52 mm) was marked as the threshold, supporting the claim of a significant anthropogenic influence on the risk of this extreme rainfall. The results offer insights into the variability of precipitation extremes in arid areas contributing to better manage water-related disasters.

An investigation on the link between driver demographic characteristics and distracted driving by using the SHRP 2 naturalistic driving data

Purpose–The purpose of this paper is to investigate the influence of driver demographic characteristics on the driving safety involving cell phone usages.Design/methodology/approach–A total of 1,432 crashes and 19,714 baselines were collected for the Strategic Highway Research Program 2 naturalistic driving research.The authors used a case-control approach to estimate the prevalence and the population attributable risk percentage.The mixed logistic regression model is used to evaluate the correlation between different driver demographic characteristics(age,driving experience or their combination)and the crash risk regarding cell phone engagements,as well as the correlation among the likelihood of the cell phone engagement during the driving,multiple driver demographic characteristics(gender,age and driving experience)and environment conditions.Findings–Senior drivers face an extremely high crash risk when distracted by cell phone during driving,but they are not involved in crashes at a large scale.On the contrary,cell phone usages account for a far larger percentage of total crashes for young drivers.Similarly,experienced drivers and experienced-middle-aged drivers seem less likely to be impacted by the cell phone while driving,and cell phone engagements are attributed to a lower percentage of total crashes for them.Furthermore,experienced,senior or male drivers are less likely to engage in cell phone-related secondary tasks while driving.Originality/value–The results provide support to guide countermeasures and vehicle design.