Stopping Transmission of COVID-19 in Public Facilities and Workplaces:Experience from China

The main transmission routes of Coronavirus Disease 2019(COVID-19)include droplet and contact transmission.Airborne transmission may be possible in specific circumstances and settings in which aerosol-generating procedures are performed^([1]).In2020,more than 83.4 million confirmed cases of COVID-19,including more than 1.8 million deaths.

Environmental health perspectives for low- and middle-income countries

In recent decades, the ecological environment has been increasingly challenged by the development of global industrialization and urbanization all over the world, even as global attention for health has raised dramatically. Common global environmental issues, such as air pollution and noise pollution, are associated with lasting impacts on health and contribute significantly to the overall burden of disease. Moreover, a global disparity exists between the burden of such environmental health issues and the global resources available to address this issue. To alleviate the environmental health impacts and ensure a sustainable future for human beings, China has made an important contribution to improving access to ecological protection, environmental governance, patriotic health campaigns, smart city construction, and so on. Experiences gained in China may be useful for some other countries, particularly the low- and middle-income countries with limited sources.

Population Attributable Fractions for Modifiable Factors of Longevity and Healthy Longevity Among the Late-Elderly Aged 75 Years or Older—China,1998-2018

Summary What is already known about this topic?Limited evidence on healthy longevity was provided in the world,and no studies investigated the fractions of healthy longevity attributed to modifiable factors.What is added by this report?Incidences of longevity and healthy longevity in China are provided.It reveals that the total weighted population attributable fractions for lifestyles and all modifiable factors were 32.8% and 83.7% for longevity,respectively,and 30.4% and 73.4% for healthy longevity,respectively.What are the implications for public health practice?China has a high potential for longevity and healthy longevity.Strategies may be targeted at education and residence in early life as well as healthy lifestyles,disease prevention,and functional optimization in late life.

Statement on Establishment of Public Health Protection Guideline for Cold Spells—China

Cold spells are extreme weather events characterized by the invasion of cold air from high latitudes into the middle and low latitudes,resulting in significant cooling.Cold spells have various adverse health effects,including epidermal damage,respiratory tract spasms,respiratory immune abnormalities,acute cardiopulmonary diseases,and exacerbation of urinary and endocrine disorders.In response to the frequent cold spells in recent years.

Acute Effects of Low Temperatures and Cold Waves on Elderly Infectious Pneumonia Mortality—Jinan City,Shandong Province,China,2014-2022

Summary What is already known about this topic?The mortality rate due to pneumonia varies depending on the infectious agents present in a low-temperature environment.What is added by this report?This study aimed to examine the relationship between low temperatures and cold waves and the risk of mortality from infectious pneumonia in the elderly.The findings indicate a significant increase in the risk of infectious pneumonia.

Facilities for Centralized Isolation and Quarantine for the Observation and Treatment of Patients with COVID-19

The coronavirus disease 2019(COVID-19)pandemic increased the burden on many healthcare systems and in the process,exposed the need for medical resources and physical space.While few studies discussed the efficient utilization of medical resources and physical space so far.Therefore,this study aimed to summarize experiences related to facilities used for centralized isolation for medical observation and treatment during the COVID-19 pandemic in China and to provide suggestions to further improve the management of confirmed cases,suspected cases,and close contacts.In China,three types of facilities for centralized isolation(Fangcang shelter hospitals,refitted non-designated hospitals,and quarantine hotels)underwent retrofitting for the treatment and isolation of confirmed and suspected cases.These facilities mitigated the immediate high demand for space.Moreover,in order to minimize infection risks in these facilities,regulators and governmental agencies implemented new designs,management measures,and precautionary measures to minimize infection risk.Other countries and regions could refer to China’s experience in optimally allocating social resources in response to the COVID-19 pandemic.As a conclusion,government should allocate social resources and construct centralized isolation and quarantine facilities for an emergency response,health authorities should issue regulations for centralized isolation facilities and pay strict attention to the daily management of these facilities,a multidisciplinary administration team is required to support the daily operation of a centralized isolation facility,in-depth studies and international collaboration on the centralized isolation policy are encouraged.

Associations of Sarcopenia, Handgrip Strength and Calf Circumference with Cognitive Impairment among Chinese Older Adults

Objective To evaluate the associations of sarcopenia,handgrip strength and calf circumference with cognitive impairment among Chinese older adults.Methods Totally 2,525 older adults were recruited from the Healthy Aging and Biomarkers Cohort Study.Cognitive impairment was assessed by the Chinese Mini-Mental State Examination.Handgrip strength was calculated from the means of the right and left hand values.Calf circumference was measured at the site of maximum circumference of the non-dominant leg.The formula developed by Ishii was used to define sarcopenia.Multiple logistic regression was performed to evaluate the associations of sarcopenia,handgrip strength,and calf circumference with cognitive impairment.Results The prevalence of cognitive impairment was 34.36%.The adjusted odds ratio(OR)for cognitive impairment in individuals with sarcopenia was 2.55[95% confidence interval(95%CI):1.86-3.50].Compared with individuals in the first quartile(Q1)of calf circumference,the adjusted ORs in the second,third,and fourth quartiles(Q_(2),Q_(3),and Q_(4))were 0.75(95% CI:0.58-0.96),0.59(95% CI:0.44-0.79),and 0.62(95% CI:0.45-0.8),respectively.Compared with individuals in Q1 of handgrip strength,the adjusted ORs for Q_(2),Q_(3),and Q_(4) were 0.49(95%CI:0.38-0.62),0.31(95% CI:0.23-0.41),and 0.30(95%CI:0.21-0.44),respectively.Conclusion Sarcopenia,identified by low handgrip strength and low calf circumference,was positively associated with cognitive impairment.

Urinary Creatinine Concentrations and Its Explanatory Variables in General Chinese Population:Implications for Creatinine Limits and Creatinine Adjustment

Objective The study aimed to analyze the applicability of the World Health Organization’s exclusionary guidelines for Urinary creatinine(Ucr)in the general Chinese population,and to identify Ucr related factors.Methods We conduct a cross-sectional study using baseline data from 21,167 participants in the China National Human Biomonitoring Program.Mixed linear models and restricted cubic splines(RCS)were used to analyze the associations between explanatory variables and Ucr concentration.Results The geometric mean and median concentrations of Ucr in the general Chinese population were 0.90 g/L and 1.01 g/L,respectively.And 9.36%samples were outside 0.3-3.0 g/L,including 7.83%below the lower limit and 1.53%above the upper limit.Middle age,male,obesity,smoking,higher frequency of red meat consumption and chronic kidney disease were associated significantly with higher concentrations of Ucr.Results of the RCS showed Ucr was positively and linearly associated with body mass index,inversely and linearly associated with systolic blood pressure,diastolic blood pressure,triglycerides level,and glomerular filtration rate,and were non-linearly associated with triiodothyronine.Conclusion The age-and gender-specific cut-off values of Ucr that determine the validity of urine samples in the general Chinese population were recommended.To avoid introducing bias into epidemiologic associations,the potential predictors of Ucr observed in the current study should be considered when using Ucr to adjust for variations in urine dilution.

Double-endpoint Genotoxicity Quantification and PAHs Characterization of Drinking Water Source alongside Polluted Yinghe River with High Tumor Mortality

The etiology for the high tumor mortality in heavy polluted Yinghe river basin is still unclear and polycyclic aromatic hydrocarbons(PAHs)belong to the priority pollutants in water based on the former surveillance data.In order to explore the potential genotoxicants contributing to the double-endpoint genotoxicity of polluted drinking water source,12 groundwater and 3 surface water samples were collected from 3 villages and the nearby rivers alongside Yinghe river basin,respectively and their comprehensive genotoxicity was estimated with a bioassay group of sOS/umu test and micronucleus(MN)test(MNT).Some groundwater samples showed positive genotoxicity and all surface water samples were highly genotoxic.Eight groundwater samples showed DNA genotoxic effct with the average 4-NQO equivalent concentration(TEQ_(4-NQO))of 0.067μg/L and 0.089μg/L in wet and dry season,respectively.The average MN ratios of groundwater samples were 14.19‰ and 17.52‰ in wet and dry season,respectively.Groundwater samples showed different genotoxic effect among 3 villages.The total PAHs concentrations in all water samples ranged from 8.98 to 25.17 ng/L with an average of 14.97±4.85 ng/L.BaA,CHR,BkF,BaP and DBA were the main carcinogenic PAHs contributing to the genotoxicity of water samples.In conclusion,carcinogenic PAHs are possibly related to the high tumor mortality in the target area.Characterization of carcinogenic PAHs to genotoxicity of drinking water source may shed light on the etiology study for high tumor mortality in Yinghe river basin.Key words:genotoxicity test;drinking water source;high tumor mortality;Yinghe river basin;polycyclic aromatic hydrocarbons(PAHs)

Health risks from non-optimal temperatures in different populations and regions in China:Tailored intervention strategies are needed

Identifying temperature-sensitive diseases,vulnerable populations and attributable disease burden is crucial for the development and implementation of tailored climate change adaptation strategies in the context of climate change,especially through both mortality and morbidity analysis by using the data from same regions and populations.We re-analyzed and outlined the whole picture of the impacts of extreme temperatures on both mortality and morbidity among various populations and regions,based on the researches from a well-planned national project of Scientific Survey of Regional Meteorological Sensitive Diseases(SRMSD)with consistent methodology in China.The twenty-four representative regions of the SRMSD project cover all eleven geographical meteorological divisions in the country,including urban and rural areas.In addition to circulatory and respiratory diseases,we found that neurological diseases,injuries,digestive diseases,endocrine diseases,genitourinary diseases,skin and subcutaneous tissue diseases were sensitive to extreme heat,while digestive diseases were sensitive to extreme cold.The extreme temperature-sensitive diseases and the attributable disease burden varied by region.Females and the elderly people(65 years old and above)were more vulnerable to extreme heat when using mortality as a health outcome,whereas males and the young and middle-aged adults were more vulnerable to morbidity risk from heat.Our findings provide important scientific evidence for regional distribution of temperature-sensitive diseases and identification of vulnerable populations in China.It provides evidence and implications of developing regional heat/cold-exposure intervention policies,especially for hospital emergency departments and ambulance services during hot seasons.

Evaluating the Applicability and Health Benefits of the Graded Heat Health Risk Early Warning Model-Jinan City,Shandong Province,China,2022

What is already known about this topic?The heat health early warning model serves as an effective strategy for reducing health risks related to heatwaves and improving population adaptability.Several high-income countries have taken the lead in conducting research and implementing measures aimed at safeguarding their populations.What is added by this report?The graded heat health risk early warning model(GHREWM)in Jinan City has demonstrated efficacy in safeguarding males,females,individuals aged above 75 years,and those with cardiopulmonary diseases.During the summer of 2022,the warning stage of GHREWM contributed to the prevention of 10.9 deaths per million individuals,concurrently averting health-related economic losses estimated at approximately 227 million Chinese Yuan(CNY).What are the implications for public health practice?The GHREWM has the potential to enhance cities’adaptability to climate change.It is crucial to incorporate additional adverse health endpoint data in the development of early warning models,as this will improve their applicability and protective efficacy.

Ambient fine particulate matter and cardiopulmonary health risks in China

In China, the level of ambient fine particulate matter (PM_(2.5)) pollution far exceeds the air quality standards recommended by the World Health Organization. Moreover, the health effects of PM_(2.5) exposure have become a major public health issue. More than half of PM_(2.5)-related excess deaths are caused by cardiopulmonary disease, which has become a major health risk associated with PM_(2.5) pollution. In this review, we discussed the latest epidemiological advances relating to the health effects of PM_(2.5) on cardiopulmonary diseases in China, including studies relating to the effects of PM_(2.5) on mortality, morbidity, and risk factors for cardiovascular and respiratory diseases. These data provided important evidence to highlight the cardiopulmonary risk associated with PM_(2.5) across the world. In the future, further studies need to be carried out to investigate the specific relationship between the constituents and sources of PM_(2.5) and cardiopulmonary disease. These studies provided scientific evidence for precise reduction measurement of pollution sources and public health risks. It is also necessary to identify effective biomarkers and elucidate the biological mechanisms and pathways involved;this may help us to take steps to reduce PM_(2.5) pollution and reduce the incidence of cardiopulmonary disease.

Early Warning Interventions for Environmental Risk Factors at China CDC

BACKGROUND President Xi Jinping emphasized the paramount importance of bolstering early surveillance and early warning capacities within a robust public health system(1).These elements constitute one of the five major functionalities of the National Bureau of Disease Control and Prevention(2).As an integral division of the National Bureau of Disease Control and Prevention,the Center for Disease Control and Prevention(CDC)is responsible for executing early surveillance and warning procedures in the realm of public health.Nonetheless,a deficiency persists concerning the early warning of public health risk factors.

Acute Effects of Individual Exposure to Fine Particulate Matter on Pulmonary Function in Schoolchildren

Objective This panel study aimed to determine the acute effects of exposure to fine particulate matter(PM2.5) on schoolchildren’s pulmonary function.Methods We selected 51 schoolchildren aged 9–12 years attending a full-time boarding school in Beijing, China, measured the indoor and outdoor PM2.5 concentrations for five consecutive days,calculated the PM2.5 time-weighted individual exposure levels based on the school micro-environmental concentrations and the time activity pattern recorded by schoolchildren, measured schoolchildren’s pulmonary function on the fifth day. The survey was performed three times from December 2018 to April 2019. We used a linear mixed-effects model to evaluate the associations between PM2.5 and pulmonary function.Results During the three surveys, the median PM2.5 time-weighted individual exposure concentrations were 15.30 μg/m3, 48.92 μg/m^3, and 42.89 μg/m^3, respectively. There was a significant difference between the three surveys in vital capacity(VC), forced vital capacity(FVC), forced expiratory volume in one second(FEV1) and forced expiratory volume in one second/forced vital capacity(FEV1/FVC)(P <0.05). The relevance analysis found that PM2.5 had lag effect on schoolchildren’s pulmonary function,each 10 μg/m3 increase in PM2.5 could cause largest decreases in FEF25%–75%, FEV1/FVC, FEF75%, and FEV1 on lag 0–1 d(80.44 mL/s, 35.85%, 78.58 mL/s, and 61.34 mL, respectively), and largest decreases in FEF25% on lag 1 d(83.68 mL/s), in VC on lag 4 d(32.34 mL), and in FVC on lag 0–4 d(37.76 mL). Gender subgroup analysis revealed that the increase in PM2.5 caused a decrease in FEV1/FVC and VC on the day of physical examination only in boys, and on lag days it caused changes in different pulmonary function indicators, both for boys and girls, but most of the pulmonary function indicators decreased more in boys than in girls.Conclusion Our findings show that acute PM2.5 exposure has significant effects on pulmonary function within 0–4 d, on both small airway indicators and large airway indicators. Boys’ pulmonary function is more sensitive to PM2.5 than girls.

Projection of Temperature-Related Excess Mortality by Integrating Population Adaptability Under Changing Climate—China,2050s and 2080s

What is already known about this topic?An increasing number of studies have projected temperature-related mortality,but few consider the change of population’s adaptability to future temperature and mortality burden from cold and heat effects.What is added by this report?This study offers a comprehensive characterization of human adaptability and excess mortality burden of temperature across various regions of China.What are the implications for public health practice?The temperature-related excess mortality was projected to increase in the 2050s and decrease in the 2080s.Heat adaptability was projected to increase in the future,but along with the rising temperatures,the heatrelated excess mortality continuously rose,except for the low-speed rising scenario.Although the excess mortality of cold was projected to decrease in the nearer future,it might not keep declining in the long run,due to the decreasing cold-adaptability,which deserves more attention.

Verification on the Developmental Toxicity of Short-term Exposure to Phenol in Rats

Objective To verify the health advisory for short-term exposure to phenol.Methods The method of this validation experiment was the same as the US Environmental Protection Agency(EPA)methodology for toxicology experiments used to determine phenol drinking water equivalent level(DWEL).Pregnant female Sprague-Dawley rats were administered phenol in distilled water by gavage at daily doses of 15,30,60,120,and 240 mg/kg body weight(b.w.)from implantation(the 6 th day post-mating)to the day prior to the scheduled caesarean section(the 20th day of pregnancy).The following information was recorded:general behavior;body weight;number of corpus luteum,live birth,fetus,stillbirth,and implantation;fetal gender;body weight;body length;tail length;and abnormalities and pathomorphological changes in the dams.Results In the 60 mg/kg b.w.dose group,the mortality of pregnant rats increased with increasing doses,suggesting maternal toxicity.Fetal and placental weights decreased as phenol dose increased from30 mg/kg b.w.,and were significantly different compared those in the vehicle control group,which suggested developmental toxicity in the fetuses.However,the phenol-exposed groups showed no significant change in other parameters compared with the vehicle control group(P>0.05).Conclusion Despite using the same method as the US EPA,a different NOEAL of 15 mg/(kg·d)was obtained in this study.

Oxidative Damage to BV2 Cells by Trichloroacetic Acid:Protective Role of Boron via the p53 Pathway

This study aimed to investigate the neurotoxicity induced by trichloroacetic acid(TCA)and the possible protective mechanisms of boron(B).Mouse BV2 cells were treated with TCA(0,0.39,0.78,1.56,3.12,6.25,or 12.5 mmol/L)and B(0,7.8,15.6,31.25,62.5,125,500,or 1,000 mmol/L)for 3 h and 24 h,respectively.Then,reactive oxygen species,and supernatant proinflammatory cytokine and protein levels were analyzed after 24 h of combined exposure.Beyond the dose-dependent decrease in the cellular viability,it clearly increased after B supplementation(P<0.05).Moreover,B decreased oxidative damage,and significantly down-regulated IL-6 levels and up-regulated TNF-βproduction(P<0.05).B also decreased apoptosis via the p53 pathway.The present findings indicated that TCA may induce oxidative damage,whereas B mitigates these adverse effects by decreasing cell apoptosis.

Targeted Prevention and Control of Key Links in Airports to Mitigate Public Health Risks

Airports are the gateways of foreign trade goods,inbound and outbound people,etc.,as well as an important gathering places of domestic long-distance passenger and cargo transportation.On July 20,2021,9 positive cases of coronavirus disease 2019(COVID-19)were found in routine nucleic acid tests of staff in key positions at Nanjing Lukou Airport.Epidemiological investigation and analysis showed that the cabin environment was contaminated with COVID-19 by infected passengers of Russian inbound flight CA910 from Russia on July 10 and led to an infection of a cleaning staff member.The epidemic at Lukou Airport then caused the spread of families,communities.

Acute Effects of Air Pollution on Human Health in China:Evidence and Prospects

The adverse impacts of air pollution on human health have already been a major environmental issue globally,and the challenges are even more severe in China.The World Health Organization(WHO)estimates that 4.2 million deaths annually can be attributed to outdoor air pollution in 2016(1).For example,ambient fine particulate matter(PM2.5)has been ranked as the fourth leading risk factor for disease in China(2).Atmospheric ozone(O3)pollution has demonstrated an increasing trend year by year,and the problem of regional compound pollution has become prominent.

Recommendations of Controlling and Preventing Acute Health Risks of Fine Particulate Matter Pollution—China,2021

An expert consensus is the unanimous recognition of experts from multiple disciplines on specific research topics based on scientific evidence and interpretation.This expert consensus on recommendations of controlling and preventing acute health risks of fine particulate matter pollution completes the drafting process that was initiated by selecting several influential experts from different professional fields to form a writing group.After that,the membership of experts was expanded and opinions were obtained from various experts through email,focused discussions,and expert tribunals.Finally,the drafts were revised and feedback was provided until the expert members reach a consensus and formed the final consensus draft.This consensus provides scientific reference for improving and optimizing China’s air pollution prevention and control policies,scientific guidance for public health protection,and research directions for carrying out related scientific research.In order to share the recommendation domestically and internationally,the Chinese version is jointly published in the National Medical Journal of China.