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 ...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.展开更多
Background The neonatal period is the most vulnerable period during childhood,with the risk of death being the highest even in developed countries/regions.Hong Kong’s neonatal mortality(1‰)is among the world’s lowe...Background The neonatal period is the most vulnerable period during childhood,with the risk of death being the highest even in developed countries/regions.Hong Kong’s neonatal mortality(1‰)is among the world’s lowest and has remained similar for 15 years.This study aimed to explore neonatal deaths in Hong Kong in detail and determine whether neonatal mortality is reducible at such a low level.Methods Live births in public hospitals in Hong Kong during 01 Jan 2006–31 Dec 2017 were included.Relevant data were extracted from the electronic medical records.Gestational age-specific mortality was calculated,and the trends were analyzed using the Cochran–Armitage trend test.Causes of death were summarized,and risk factors were identified in multivariate logistic regression analysis.Results In 490,034 live births,755 cases(1.54‰)died during the neonatal period,and 293(0.6‰)died during the post-neonatal period.The neonatal mortality remained similar overall(P=0.17)and among infants born at 24–29 weeks’gestation(P=0.4),while it decreased in those born at 23(P=0.04),30–36(P<0.001)and≥37(P<0.001)weeks’gestation.Neonates born at<27 weeks’gestation accounted for a significantly increased proportion among cases who died(27.6%to 51.9%),with hemorrhagic conditions(24%)being the leading cause of death.Congenital anomalies were the leading cause of death in neonates born≥27 weeks’gestation(52%),but its cause-specific mortality decreased(P=0.002,0.6‰to 0.41‰),with most of the decrease attributed to trisomy 13/18 and multiple anomalies.Conclusion Reduction of neonatal mortality in developed regions may heavily rely on improved quality of perinatal and neonatal care among extremely preterm infants.展开更多
基金supported by the funds of Key Discipline and Specialty Foundation of Shanghai Municipal Commission of Health and Family Planningthe National Key Basic Research Program "973 project" (2015CB554000)grants from US National Institutes of Health (R37 CA070867, R01 CA82729, UM1CA173640, and UM1 CA182910)
文摘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.
文摘Background The neonatal period is the most vulnerable period during childhood,with the risk of death being the highest even in developed countries/regions.Hong Kong’s neonatal mortality(1‰)is among the world’s lowest and has remained similar for 15 years.This study aimed to explore neonatal deaths in Hong Kong in detail and determine whether neonatal mortality is reducible at such a low level.Methods Live births in public hospitals in Hong Kong during 01 Jan 2006–31 Dec 2017 were included.Relevant data were extracted from the electronic medical records.Gestational age-specific mortality was calculated,and the trends were analyzed using the Cochran–Armitage trend test.Causes of death were summarized,and risk factors were identified in multivariate logistic regression analysis.Results In 490,034 live births,755 cases(1.54‰)died during the neonatal period,and 293(0.6‰)died during the post-neonatal period.The neonatal mortality remained similar overall(P=0.17)and among infants born at 24–29 weeks’gestation(P=0.4),while it decreased in those born at 23(P=0.04),30–36(P<0.001)and≥37(P<0.001)weeks’gestation.Neonates born at<27 weeks’gestation accounted for a significantly increased proportion among cases who died(27.6%to 51.9%),with hemorrhagic conditions(24%)being the leading cause of death.Congenital anomalies were the leading cause of death in neonates born≥27 weeks’gestation(52%),but its cause-specific mortality decreased(P=0.002,0.6‰to 0.41‰),with most of the decrease attributed to trisomy 13/18 and multiple anomalies.Conclusion Reduction of neonatal mortality in developed regions may heavily rely on improved quality of perinatal and neonatal care among extremely preterm infants.
