The Association between Exposure to Second-Hand Smoke and Disease in the Chinese Population: A Systematic Review and Meta-Analysis

Objective To analyze the association between exposure to second-hand smoke(SHS) and 23 diseases,categorized into four classifications, among the Chinese population.Methods We searched the literature up to June 30, 2021, and eligible studies were identified according to the PECOS format: Participants and Competitors(Chinese population), Exposure(SHS),Outcomes(Disease or Death), and Study design(Case-control or Cohort).Results In total, 53 studies were selected. The odds ratio(OR) for all types of cancer was 1.79(1.56–2.05), and for individual cancers was 1.92(1.42–2.59) for lung cancer, 1.57(1.40–1.76) for breast cancer, 1.52(1.12–2.05) for bladder cancer, and 1.37(1.08–1.73) for liver cancer. The OR for circulatory system diseases was 1.92(1.29–2.85), with a value of 2.29(1.26–4.159) for stroke. The OR of respiratory system diseases was 1.76(1.13–2.74), with a value of 1.82(1.07–3.11) for childhood asthma. The original ORs were also shown for other diseases. Subgroup analyses were performed for lung and breast cancer. The ORs varied according to time period and were significant during exposure in the household;For lung cancer, the OR was significant in women.Conclusion The effect of SHS exposure in China was similar to that in Western countries, but its definition and characterization require further clarification. Studies on the association between SHS exposure and certain diseases with high incidence rates are insufficient.

Impact of Smoke-Free Legislation on Acute Myocardial Infarction and Subtypes of Stroke Incidence in Shenzhen,China,2012-2016:An Interrupted Time Series Analysis

Objective This study assesses the impact of smoke-free legislation on the incidence rate for acute myocardial infarction(AMI)and stroke in Shenzhen.Methods Data on ischemic(n=72,945)and hemorrhagic(n=18,659)stroke and AMI(n=17,431)incidence covering about 12 million people in Shenzhen from 2012 to 2016 were used.Immediate and gradual changes in incidence rates were analyzed using segmented Poisson regression.Results Following the smoke-free legislation,a 9%(95%CI:3%-15%)immediate reduction was observed in AMI incidence,especially in men(8%,95%CI:1%-14%)and in those aged 65 years and older(17%,95%CI:9%-25%).The gradual annual benefits were observed only in hemorrhagic and ischemic stroke incidence,with a 7%(95%CI:2%-11%)and 6%(95%CI:4%-8%)decrease per year,respectively.This health effect extended gradually to the 50-64 age group.In addition,neither the immediate nor gradual decrease in stroke and AMI incidence rates did not show statistical significance among the 35-49 age group(P>0.05).Conclusion Smoke-free legislation was enforced well in Shenzhen,which would generate good experiences for other cities to enact and enforce smoke-free laws.This study also provided more evidence of the health benefits of smoke-free laws on stroke and AMI.

火灾烟气危害定量评价模型THVCH及其应用

为更加准确地评价实际火灾烟气的危害性,针对以往烟气毒性定量评价方法N-GAS和FED模型的不足,提出了一种新的火灾烟气危害性定量评价模型THVCH(Toxicity,Heat and Visibility Comprehensive Harmfulness)。实际火灾烟气的危害包括烟气毒性和烟气高温辐射。两者都具有时间累积效应,人员在火灾环境中的暴露时间越长,所受到的伤害越大。烟气的遮光性是影响火场中人员暴露时间的重要因素,低能见度下人员疏散所需要的时间是高能见度的3.8倍。THVCH模型在考虑烟气毒性的同时兼顾了能见度对人员暴露时间的影响以及高温辐射对人体的伤害。以重庆开县5.5火灾为工程背景,运用大涡模拟技术对其火灾过程进行数值重构。在此技术上采用N-GAS、FED和THVCH模型对不同阶段的火灾危害性进行了评价,证明了火灾烟气危害评价中考虑能见度和高温辐射的必要性。

中国西南边疆少数民族地区吸烟及危害认知调查分析

目的了解边疆少数民族地区15岁以上居民吸烟状况及对烟草危害认知情况,为制定有针对性的控烟措施提供基础资料。方法采用多阶段分层整群随机抽样的方法于2013年对云南省瑞丽市≥15岁居民通过问卷调查收集吸烟及危害认知等相关信息。本研究共调查1614人。结果瑞丽市15岁以上居民现在吸烟率为38.3%,其中男性70.9%,女性7%。男性从事体力劳动者吸烟率更高;女性景颇族、处于丧偶/离婚/分居婚姻状态、从事体力劳动、年龄越大、文化程度越低者吸烟率越高。男性和女性现在吸烟者每日吸烟量均以汉族最高(男性16.4支,女性12.5支)。傣族/景颇族、年龄越大、从事体力劳动、文化程度越低、丧偶/离婚/分居者吸烟危害健康知识得分更低。二手烟暴露比例为69.7%,其中男性79.9%,女性60%。结论西南边疆少数民族地区15岁以上男性居民吸烟行为普遍存在,景颇族女性吸烟率较高,"二手烟"暴露严重。吸烟者吸烟危害健康知识水平较低。

英语自学日语考试指导(12)

上期的第二个话题“跳槽”是目前普遍存在的现象,对此人们看法不一。有些人认为这在国外并非什么新鲜事,中国人也开始这样做说明人们的思想解放了.打破了过去那种在一个单位干一辈子的传统观念.这是社会的进步。也有人把“跳槽”看做是人的私欲膨胀,是对金钱和物质利益的过分追求,不利于一个企业或部门的发展,不应提倡。考生如同意后一种观点就可以说:“I don’t think it is reasonable for aperson to change his(her)job frequently.A

Socio-economic and Psychosocial Determinants of Smoking and Passive Smoking in Older Adults

Objective To determine the associations of socio-economic and psychosocial factors with active and passive smoking in older adults. Methods Using a standard interview method, we examined random samples of 6071 people aged 〉 60 years in 5 provinces of China during 2007-2009. Results World age-standardised prevalence for current and former smoking in men was 45.6% and 20.5%, and in women 11.1% and 4.5%. Current smoking reduced with older age but increased with men, low socioeconomic status （SES）, alcohol drinking, being never-married, pessimistic and depressive syndromes. Former smoking was associated with men, secondary school education, a middle-high income, being a businessman, being widowed, less frequencies of visiting children/relatives and friends, and worrying about children. Among 3774 never-smokers, the prevalence of passive smoking was 31.5%, and the risk increased with women, low SES, alcohol drinking, being married, having a religious believe, and daily visiting children/relatives. There were sex differences in the associations, and an interaction effect of education and income on smoking and passive smoking. Conclusion Older Chinese had a higher level of smoking and passive smoking than those in high income countries, reflecting China＇s failures in controlling smoking. The associations with low SES and different psychosocial aspects and sex differences suggest preventative strategies for active and passive smoking.

CLINICAL TRIALS ON ANTIMUTAGENIC ACTIVITY OF CHLOROPHYLLIN

Two male smokers who smoke 20 cigarettesevery day have been shown to have mutagenicactivity in their urine(323 and 1200).Oraladministration chlorophyllin 20 mg twicedaily have been shown decreased mutagenicactivity in urine(127 and 115).

SISTER CHROMATID EXCHANGES FREQUENCY IN PATIENTS WITH MONONUCLEOSIS

Biomonitoring with cytogenetic methods consistto compare a known or suspected exposed groups with acontrol group with different endpoints.Generallyfactors which may influence the baseline levels ofsister chromatid exchanges frequency fall in 2 cate-gories:technical and biological factors.In additionto age,sex,drug use,smoking habits,health statusmight also be relevant.During a long term survey ofpeople professionally exposed to ethylene oxide

Nose-only cigarette smoke exposure plus airway lipopolysaccharide inhalation induced chronic obstructive pulmonary disease and associated pulmonary hypertension in mice

Objective To establish a mouse model of chronic obstructive pulmonary disease(COPD)and associated pulmonary hypertension(COPD-PH)induced by noseonly cigarette smoking exposure plus airway lipopolysaccharide(LPS)inhalation.Methods There were 24 male C57B6 mice divided into a control group and a

Investigation on injury of liver and kindey among the workers exposed to terephthalic acid, ethylene glycol and (or) dowtherm A.

Objective: To study injury of liver and kidney among the workers exposed to terephthalic acid (TPA), ethylene glycol(EG) and (or) dowtherm A(DOW), and to research for the early biological monitoring indexes.

中国2012年18～59岁就业流动人口吸烟状况分析

目的 了解中国18～59岁就业流动人口吸烟状况,为制定其慢性非传染性疾病（慢性病）防控方案提供依据.方法 利用中国慢性病及其危险因素监测（2012）流动人口专题调查数据,并根据18～ 59岁就业流动人口分布状况选取170个调查县（区、团）,按照6个职业分层,采用多阶段等额整群抽样方法,以面对面访谈方式收集该人群吸烟信息,并使用复杂抽样设计方法进行统计分析.结果 共纳入样本人群48 699人,现在吸烟率为32.5％（95％CI：32.0％～33.0％）,其中男性（55.3％,95％CI：54.6％～ 56.0％）显著高于女性（1.9％,95％CI：1.7％～2.1％）（x2=2.6,P=0.103 7）;男性各年龄组现在吸烟率的差异无统计学意义（x2=2.6,P=0.103 7）,但随文化程度提高而有降低趋势（x2=140.7,P＜0.000 1）,以建筑业人群现在吸烟率最高（58.6％,95％ CI：57.3％～60.0％）.现在每日吸烟率为27.9％ （95％CI：27.4％ ～ 28.4％）,其中男性（47.8％,95％CI：47.1％～48.5％）显著高于女性（1.3％,95％CI：1.1％～1.4％）.现在吸烟者人均每日吸烟量为15.6（95％CI：15.5～15.8）支,其中男性为15.7（95％CI：15.6～ 15.9）支,女性为10.3 （95％CI：9.3 ～ 11.3）支;男性现在吸烟者人均每日吸烟量呈随年龄增加而上升趋势（t=34.89,P＜0.000 1）和随文化程度提高而降低趋势（t=-14.63,P＜0.000 1）,以建筑业人群人均每日吸烟量最高为18.2 （95％CI：17.9～ 18.6）支.样本人群中每日吸烟者日均吸烟量≥20支者的比例为47.1％,男性（47.6％）明显高于女性（21.9％）,并呈随年龄增加及文化程度降低而升高,且以建筑业人群最高（60.4％）.吸烟者戒烟率为10.3％ （95％CI：9.7％ ～ 10.8％）,其中男性为10.1％ （95％CI：9.6％ ～ 10.7％）,女性为14.8％（95％CI：11.1％～ 18.5％）,且有随吸烟者年龄增加而上升趋势（x2=118.9,P＜0.000 1）,不同文化程度和职业者戒烟率的差异均无统计学意义.戒烟者成功戒烟率为6.1％（95％CI：5.7％～6.5％）,其中男性为6.1％（95％CI：5.7％～6.5％）,女性为7.2％（95％CI：4.6％～9.8％）,并呈随吸烟者年龄增加而升高趋势（x2=269.0,P＜0.000 1）.“二手烟”暴露者比例为68.7％（95％CI：68.1％～69.3％）,其中男性（76.4％,95％CI：75.5％ ～ 77.3％）高于女性（64.0％,95％CI：63.2％～64.9％）.结论 中国18 ～ 59岁男性就业流动人口普遍存在吸烟行为,“二手烟”暴露比例较高,以建筑业流动人口最为突出.吸烟者戒烟率较低,且成功戒烟的比例更低.

苯作业人员血小板相关抗体水平变化规律探讨

目的探讨苯作业人员血小板相关抗体的变化规律。方法设计统一问卷调查表,对121名苯作业人员和110名健康工人进行职业流行病学调查,获得研究对象的一般资料,利用ELISA法检测血小板相关抗体PAIgG、PAIgA、PAIgM。结果本组研究对象作业环境空气中苯浓度0.25~15.70 mg/m3,个体累积接苯浓度1.71~74.20 mg（m3.年）。接触组PAIgG、PAIgA、PAIgM增高,PAIgA异常检出率升高,随累积接苯浓度增加,PAIgA、PAIgM有升高趋势,存在剂量-效应关系。吸烟、饮酒苯作业工人PAIg明显高于对照组,而非吸烟以及非饮酒苯作业工人PAIgG、PAIgM异常不显著。结论接触低浓度苯时,血小板相关抗体改变可能出现于外周血常规异常以前,吸烟、饮酒等因素可能起到协同作用。

手术烟雾职业暴露人群对手术烟雾基础知识的认知情况及培训效果分析

目的：对手术烟雾职业暴露人群进行手术烟雾基础知识的试卷考核，了解其对手术烟雾知识认知情况，制定实施医护不同的培训计划后再次考核了解培训效果。方法选择120名手术烟雾职业暴露人群，其中医生50名，护士70名，对其进行手术烟雾基础知识试卷考核，根据考核结果制定医护不同的培训计划，培训后再次考核，评价培训效果。结果暴露人群对手术烟雾的基础知识极度缺乏，其中手术烟雾的物理性质知晓率最低，有必要对手术烟雾人员进行手术烟雾基础知识培训。培训前暴露人群医生护士之间各维度知识得分有差异。培训前后成绩比较，除组成维度的分数培训前后差异无统计学意义外，其他维度及总分均提高，差异有统计学意义（P〈0.01），培训有效。培训后暴露人群医生护士之间各维度知识得分有差异，培训后医生的总分、物理性质、权威组织防护标准、对机体的影响、化学性质分数优于护士，而护士关于烟雾来源及组成分数优于医生，差异有统计学意义（P〈0.01）。结论暴露人群对手术烟雾的基础知识极度缺乏，培训能有效提高暴露人群对手术烟雾的基础知识认知水平，其中医生的培训效果优于护士。

四川省非吸烟者中40岁及以上人群二手烟暴露情况及其影响因素研究

目的了解四川省非吸烟者中40岁及以上人群二手烟暴露情况及其影响因素,为制定控烟策略和干预措施提供参考依据。方法结合慢阻肺调查工作,采用多阶段分层整群随机抽样的方法,在6个县区,每个县区抽取600名40岁以上人员开展问卷调查,并对调查数据进行单因素和多因素Logistic回归分析。结果共分析有效调查问卷2 425人,接触二手烟的占46.7%;接触二手烟的居民中,每周接触时间为7 d的调查对象最多(28.9%);接触二手烟的场所中所占比例最高的是家里(60.9%),其次是其他(茶馆等)(29.5%)、工作场所(25.6%);每天接触二手烟平均时间最长为2.2小时,发生在其他场所(茶馆等),其次为工作场所2.1 h;多因素分析显示对二手烟暴露影响因素中,城市高于农村、年龄越大暴露水平越低;而分性别、分文化程度、婚姻情况,接触二手烟概率差异无统计学意义。结论四川省非吸烟者中40岁及以上人群二手烟暴露现状严峻,应加强对家庭、其他场所(茶馆等)、工作场所吸烟行为的干预,加强对人群的健康宣传教育,提高公众对二手烟危害的认知水平,加强对自身健康权利的维护,提高居民拒绝二手烟的主动意识;在家庭,重点宣传二手烟对家人的危害;在其他场所中,重点加强对茶馆类场所的监管,同时,应进一步做实对工作场所的监管。

RESPIRATORY SYSTEM

2004494 Respiratory control in obstructive sleep apnea hypopnea syndrome. WANG Wei (王玮), et al. Instit Respir Dis, 1st Affili Hosp, China Med Limy, Shenyang 110001. Chin J Intern Med 2004; 43 (9): 647-650.