Environmental and occupational exposure to pesticides according to sociodemographic factors that affect cancer patients in Mato Grosso, Brazil / Exposição ambiental e ocupacional a agrotóxicos segundo fatores sociodemográficos em pacientes com câncer em Mato Grosso, Brasil

ABSTRACT The goal of this study was to estimate the prevalence of environmental and occupational exposure to pesticides according to sociodemographic factors among cancer patients. It is a cross-sectional study with cancer patients in the state of Mato Grosso. The prevalence of environmental and occupational exposure to pesticides was calculated as to the variables gender, age, macro-region, and education. Pesticide use per agricultural crops in liters was estimated, and a thematic map was constructed following the macro-region of the agricultural economy. Of the 998 patients, most were female (54.9%), aged between 50 and 69 years old (50.1%), had less than eight years of schooling (60.7%), and resided in the South-Central macro-region (55.4%). Regarding environmental and occupational exposure, 53.1% of the patients live or have lived in a municipality with agricultural plantations; 17.4% lived near crops; 43.4% worked in agriculture, livestock, or extractivism; and 22.9% worked or work directly with pesticides. Environmental and occupational exposure was higher in males, in the older age groups, schooling from 0 to 4 years, and in the macro-regions with higher pesticide use. The study concluded that environmental and occupational exposure among cancer patients is associated to sociodemographic characteristics and macro-regions of the agricultural economy.

RESUMO O objetivo deste estudo foi estimar a prevalência de exposição ambiental e ocupacional aos agrotóxicos conforme fatores sociodemográficos entre pacientes com câncer. Trata-se de um estudo observacional de delineamento transversal com pacientes com câncer do estado de Mato Grosso. Foi calculada a prevalência de exposição ambiental e ocupacional aos agrotóxicos conforme as variáveis sexo, faixa etária, região e escolaridade. Foram estimados o uso de agrotóxicos por culturas agrícolas em litros e construído mapa temático segundo a macrorregião de economia agropecuária. Dos 998 pacientes, a maioria era do sexo feminino (54,9%), tinha entre 50 e 69 anos (50,1%), possuía menos de oito anos de escolaridade (60,7%) e residiam na macrorregião Centro-Sul (55,4%). Em relação à exposição ambiental e ocupacional, 53,1% dos pacientes moram ou moraram em município com plantação agrícola, 17,4% residiam próximo à lavoura, 43,4% trabalharam na agricultura, pecuária ou extrativismo e 22,9% trabalharam ou trabalham diretamente com agrotóxicos. A exposição ambiental e ocupacional foi maior no sexo masculino, nas faixas etárias mais elevadas, escolaridade de 0 a 4 anos e nas macrorregiões de maior uso de agrotóxicos. Conclui-se que a exposição ambiental e ocupacional entre pacientes com câncer se associou as características sociodemográficas e macrorregiões de economia agropecuária.

Salud auditiva y exposición a ruido ambiental en población de 18 a 64 años de Bogotá, Colombia, entre el 2014 y el 2018 / Hearing health and noise exposure in population between 18 to 64 years old in Bogotá, Colombia, 2014-2018

RESUMEN Introducción. La salud auditiva es un tema de interés en salud pública que afecta la calidad de vida y que puede afectarse por la exposición continua al ruido, un factor de riesgo que genera síntomas auditivos y extraauditivos. Objetivo. Identificar el estado de salud auditiva de adultos que viven en Bogotá, y su asociación con factores de exposición a ruido ambiental, individuales y otológicos. Materiales y métodos. Se realizó un estudio transversal mediante el análisis de una base de datos con 10.311 registros, obtenidos entre los años 2014 y 2018, producto de una encuesta estructurada de percepción de ruido y tamizaje auditivo. Se hizo un análisis descriptivo bivariado y una regresión logística binaria. Resultados. El 35,4 % de los participantes presentó disminución auditiva. En el componente de percepción: 13,0 % refirió no escuchar bien, 28,8 % informó síntomas extraauditivos, 53,3 % tenía antecedentes otológicos, y 69,0 % manifestó molestia por ruido extramural. En la regresión logística, las variables más asociadas con disminución auditiva fueron: de las ambientales, vivir en zonas de mayor ruido (OR = 1,50) (IC95%: 1,341,69); de las individuales, ser hombre (OR = 1,85) (IC95%: 1,64-2,09) y la edad (por cada año de vida, el riesgo de disminución auditiva aumentó 6 %); y de las otológicas, tener antecedente de síntomas otológicos (OR = 1,86) (IC95%: 1,66-2,08). Conclusiones. La disminución auditiva es multicausal en la población evaluada. Los factores que aumentan su prevalencia son incremento de la edad, ser hombre, tabaquismo, medicamentos ototóxicos, vivir en zonas de mayor exposición a ruido y presentar síntomas extraauditivos.

ABSTRACT Introduction. Hearing health is a public health concern that affects the quality of life and can be disturbed by noise exposure, generating auditory and extra-auditory symptoms. Objective. To identify the hearing health status in adults living in Bogotá and its association with environmental noise exposure and individual and otological factors. Materials and methods. We conducted a cross-sectional study using a database with 10,311 records from 2014 to 2018, consigned in a structured survey of noise perception and hearing screening. We performed a descriptive, bivariate, and binary logistic regression analysis. Results. Of the included participants, 35.4% presented hearing impairment. In the perception component, 13.0 % reported not hearing well; 28.8 % had extra-auditory symptoms, 53.3 % informed otological antecedents and 69.0 % presented discomfort due to extramural noise. In the logistic regression, the variables with the highest association for hearing impairment were living in noisy areas (OR = 1.50) (95% CI: 1.34-1.69), being male (OR = 1.85) (95% CI: 1.64-2.09), increasing age (for each year of life, the risk of hearing impairment increased 6%), and having history of extra-auditory symptoms (OR = 1.86) (95% CI: 1.66-2.08). Conclusions. Hearing impairment is multi-causal in the studied population. The factors that promote its prevalence are increasing age, being male, smoking, ototoxic medications, living in areas with high noise exposure, and extra-auditory symptoms.

Exposição ambiental e risco à saúde - Brasil / Environmental exposure and health risks in Brazil

Objetivo: Identificar possíveis fatores sociodemográficos, econômicos, de saúde, ambientais e de hábitos de vida associados a efeitos adversos sobre a saúde de moradores em três cidades brasileiras. Método: Estudo transversal com abordagem quantitativa realizado nas cidades de Imperatriz (Maranhão), Palmas (Tocantins) e Salvador (Bahia). Participaram 975 pacientes (18 a 75 anos) atendidos em unidades básicas de saúde no período de junho de 2021 a junho de 2022. Esses indivíduos foram selecionados aleatoriamente (amostra de conveniência). Foi aplicado o questionário padronizado sobre fatores sociodemográficos e exposição a fatores ambientais, assim como o de hábitos de vida. Empregou-se a situação de saúde (excelente/boa x regular/ má/péssima) como desfecho, foi realizada análise multivariada seguida por regressão logística respeitando-se cada município individualmente e o seu coletivo. Os dados foram apresentados como odds ratio (OR) e intervalos de confiança de 95% (IC95%). Resultados: Em todas as cidades houve predomínio de pacientes do sexo feminino: 58,3% em Imperatriz, 67,5% em Tocantins e 65,4% em Salvador. A prevalência de tabagismo (presente e/ou passado) foi significantemente mais elevada em Salvador, assim como a de consumo de álcool. Houve maior referência de saúde regular/má/péssima entre os moradores de Imperatriz, apesar de em Salvador haver o maior relato de comorbidades. Os fatores ambientais associados à condição precária de saúde, em ambos os modelos de análise, foram: ter sido exposto durante a infância a fogão a lenha/carvão/querosene/outro; passar mais de duas horas na cozinha, com fogão em funcionamento; e residir próximo a uma fonte poluidora. Morar em Imperatriz revelou chance 1,8 vezes maior de ter saúde debilitada quando comparado aos moradores de Salvador, e de 1,7 vezes para os de Palmas. Conclusões: Profissionais de saúde deverão orientar a população quanto as questões socioambientais que interferem nos índices de saúde. Os dados demográficos, ambientais e econômicos podem interferir nas condições de saúde.

Objective: To identify potential sociodemographic, socioeconomic, health, environmental, and lifestyle factors associated with adverse health effects in residents of 3 Brazilian cities. Methods: This cross-sectional study with a quantitative approach was conducted in the cities of Imperatriz (Maranhão), Palmas (Tocantins), and Salvador (Bahia). A total of 975 patients aged 18 to 75 years treated at primary health care units from June 2021 to June 2022 were selected via convenience sampling. A standardized questionnaire on sociodemographic characteristics, exposure to environmental factors, and lifestyle habits was administered. The outcome measured was health status (excellent/good vs fair/bad/very poor). Multivariate analysis was performed using logistic regression, respecting each municipality individually and collectively. Data were presented as odds ratios (OR) and 95%CIs. Results: Women predominated in all cities: 58.3% in Imperatriz, 67.5% in Tocantins, and 65.4% in Salvador. The prevalence of smoking (present and/or past) was significantly higher in Salvador, as was the prevalence of alcohol consumption. Despite Salvador having the highest rate of comorbidities, residents of Imperatriz reported more instances of fair/poor/very poor health. Environmental factors significantly associated with poor health conditions in both analysis models included exposure to wood/ coal/kerosene/other stoves during childhood, spending more than 2 hours in the kitchen with a working stove, and living close to a pollution source. Residents of Imperatriz were 1.8 times and 1.7 times more likely to have poor health compared with residents of Salvador (a more developed center with more health resources) and Palmas, respectively. Conclusions: Health professionals should guide the population regarding socio-environmental issues affecting health indices. Demographic, environmental, and economic data can impact health conditions.

Follow up study of the association between bedroom light at night exposure and body mass index in children / 中国学校卫生

Objective@#To explore the association between bedroom light at night (LAN) exposure and body mass index (BMI) in children at 1 year follow up, so as to provide new strategies for obesity prevention.@*Methods@#From December 2021 to May 2022, cluster random sampling was conducted, involving 648 children from two primary schools in Tianchang, Chuzhou City, Anhui Province, China, to assess bedroom LAN exposure of children during sleep. A questionnaire survey and physical examination were carried out in May 2022. Multivariate linear regression was performed to analyze the correlation between bedroom LAN exposure and BMI variable quantity at 1 year follow up (May, 2023).@*Results@#The median intensity of bedroom LAN exposure during the sleep episode was [1.11(0.35,3.24)lx] in children. The proportion of the sample exposed to an average light intensity of ≥3 lx was 27.5%, while 19.0% was exposed to a LAN intensity of ≥5 lx during the sleep episode. In the multivariable linear regression, after adjusting for covariates, including sex, baseline age, sleep duration, family monthly income, and maternal education level, exposure to a 1 h-average post bedtime LAN intensity of ≥3 lx ( β=0.25, 95%CI =0.05-0.44) and LAN≥5 lx ( β=0.34, 95% CI = 0.12-0.55) was associated with a gain of 0.25 and 0.34 kg/m 2, respectively, in the children s BMI at the 1 year follow up ( P < 0.05).@*Conclusions@#A positive correlation was found between bedroom LAN exposure and BMI variable quantity at 1 year follow up in children. Thus, reduced bedroom LAN exposure might be useful for interventions aimed at obesity prevention.

Association between environmental exposure and hormone-sensitive cough in patients with chronic cough / 中华全科医师杂志

Objective:To explore the association between environment exposure and hormone-sensitive cough in patients with chronic cough.Methods:Clinical data of 197 patients with chronic cough visited outpatient clinic of the Second Affiliated Hospital of Guangzhou Medical University from June 2016 to June 2021 were retrospectively analyzed, including 130 cases of corticosteroid responsive cough (CRC, 66.0%) and 67 cases of non-corticosteroid responsive cough (NCRC, 34.0%). The association between living environment exposure and hormone sensitivity was examined with a binary logistic regression analysis.Results:Among 197 patients with chronic cough, there were 82 males (41.6%) and 115 females (58.4%). 75.1% (148/197) had a history of smoking, and 16.8% (33/197) had a history of allergies. 66.0% (130/197) lived in the city center, 18.3% (36/197) had a chemical factory around their place of residence, 11.2% (22/197) renovated their homes within the first six months of the disease, 15.7% (31/197) purchase new furniture, 54.3% (107/197) plant flowers and plants in their houses, 21.3% (42/197) keep pets in their houses, 79.2% (156/197) had lived in their houses for more than 2 years, 71.1% (140/197) had cockroaches in their houses, 16.2% (32/197) had mold in their houses, 83.3% (164/197) had a frequency of air conditioning cleaning exceeds 2 months per time.There were 130 patients (66.0%) with CRC and 67 patients (34.0%) with NCRC.Binary logistic regression analysis showed that living close to the main road ( OR=2.296, 95% CI: 1.350-3.904, P=0.002), living near chemical factories ( OR=3.322, 95% CI: 2.158-5.573, P<0.001), history of allergy ( OR=2.175, 95% CI: 1.165-4.058, P=0.015), purchasing new furniture within 6 months ( OR=2.828, 95% CI: 1.402-5.706, P=0.004), cotton and linen curtains ( OR=1.875, 95% CI: 1.038-3.388, P=0.037) were positively correlated with CRC; while down and wool pillowcases and quilts ( OR=0.142, 95% CI: 0.033-0.602, P=0.008; OR=0.207, 95% CI: 0.067-0.640, P=0.006) and low ventilation frequency ( OR=0.281, 95% CI: 0.131-0.603, P=0.001) were negatively correlated with CRC. Conclusion:Hormone-sensitive cough patients account the most of chronic cough cases, and there are differences in the living environment exposure between CRC and NCRC patients, which provides information for corresponding interventions to prevent and manage CRC.

Applications and advancements of instrumental variable approach in causal inference in environmental epidemiology / 环境与职业医学

In environmental epidemiological research, extensive non-random environmental exposures and complex confounding biases pose significant challenges when attempting causal inference. In recent years, the introduction of causal inference methods into observational studies has provided a broader range of statistical tools for causal inference research in environmental epidemiology. The instrumental variable (IV) approach, as a causal inference technique for effectively controlling unmeasured confounding factors, has gradually found application in the field of environmental epidemiological research. This article reviewed the basic principles of IV and summarized the current research progress and limitations of applying IV for causal inference in environmental epidemiology. IV application in the field of environmental epidemiology is still in the initial stage. Rational use of IV and effective integration with other causal inference methods will become the focus of the development of causal inference in environmental epidemiology. The aim of this paper is to provide a methodological reference and basis for future studies involving causal inference to target population health effects of environmental exposures in China.

Epidemiological research advances on antibiotic exposure in early life and child health / 环境与职业医学

Early life is a critical window period that determines the growth and development of children, but this delicate and complex period is highly susceptible to the disturbance of various exogenous chemicals, which in consequence may lead to short-term or long-term adverse health effects in human beings. The massive use of antibiotics has contributed to widespread exposure in early life, along with the potentially adverse effects on child health, and has caused great concern in public health. This review summarized recent epidemiological studies on the population with early-life antibiotic exposure and associated health outcomes such as growth and development, allergies, and psycho-behavioral problems in children, as well as potential biological mechanisms underlying these associations. Current findings suggested that antibiotic exposure early in life, including pregnancy and infancy, is strongly associated with childhood allergic diseases (e.g., atopic dermatitis and asthma), growth and development (e.g., obesity and birth length), and childhood psycho-behavioral problems (e.g., autism and anxiety). It also suggested that antibiotic exposure may affect individual health through gut microbiota, thyroid function, inflammation factors, mitochondrial function, and epigenetic mechanisms. In the future, more large prospective birth cohorts should be established to determine the levels of internal exposure to different types of antibiotics at multiple time points in early life and to explore their associations with child health outcomes, as well as to further validate relevant mechanisms, aiming to provide high-quality scientific evidence for research on child health associated with environmental exposure in early life.

Pesquisa participativa com populações expostas aos agrotóxicos em Mato Grosso: aspectos metodológicos e desafios políticos / Participatory research with populations exposed to pesticides in Mato Grosso: methodological aspects and political challenges

RESUMO Objetivou-se descrever os aspectos metodológicos, operacionais e atravessamentos políticos do projeto 'Avaliação da contaminação ocupacional, ambiental e em alimentos por agrotóxicos na Bacia do Juruena, Mato Grosso (MT)', realizado entre 2015 e 2019, em municípios de elevada produção agrícola voltada para o agronegócio: Campo Novo do Parecis, Sapezal e Campos de Júlio. Fundamentada na epidemiologia crítica, na vigilância popular e do desenvolvimento, a pesquisa participativa envolveu a população por meio de articulações com prefeituras, sindicatos e escolas públicas e trabalhadores(as) rurais e urbanos. Coletaram-se amostras de matriz ambiental (água, ar, sedimento), alimentar (hortaliças, commodities e animais) e humanas (sangue e urina) e realizou-se um inquérito populacional das condições de saúde autorreferidas, exposição ambiental, alimentar e ocupacional de trabalhadores(as) e moradores(as). Os dados revelaram um processo de contaminação impositiva em todo o território da bacia do rio Juruena, no ambiente, em alimentos, e o adoecimento agudo e crônico supostamente relacionado com a exposição ambiental e ocupacional aos agrotóxicos. O processo participativo na pesquisa almejou fortalecer a luta por territórios saudáveis e sustentáveis mediante redes cooperativas, vigilância popular de base territorial e das populações expostas aos agrotóxicos, além de outros desdobramentos que modifiquem legislações e processos destrutivos do atual modelo de desenvolvimento.

ABSTRACT The aim was to describe the methodological, operational, and political aspects of the project 'Assessment of occupational, environmental and food contamination by pesticides in the Juruena Basin, Mato Grosso (MT)', carried out between 2015 and 2019 in municipalities with high agricultural production geared towards agribusiness: Campo Novo do Parecis, Sapezal, and Campos de Júlio. Based on critical epidemiology, popular and developmental surveillance, the participatory research involved the population through links with town halls, unions public schools, and rural and urban workers. Environmental (water, air, sediment), food (vegetables, commodities, and animals), and human (blood and urine) samples were collected, and a population survey was carried out on self-reported health conditions, environmental, food, and occupational exposure of workers and residents. The data revealed a process of imposing contamination throughout the territory of the Juruena River basin, in the environment, in food, and in acute and chronic illnesses supposedly related to environmental and occupational exposure to pesticides. The participatory process in the research aimed to strengthen the struggle for healthy and sustainable territories through cooperative networks, grassroots territorial surveillance, and populations exposed to pesticides, as well as other developments that modify legislation and destructive processes of the current development model.

Brazilian Thoracic Society recommendations for the diagnosis and monitoring of asbestos-exposed individuals

ABSTRACT Asbestos was largely used in Brazil. It is a mineral that induces pleural and pulmonary fibrosis, and it is a potent carcinogen. Our objective was to develop recommendations for the performance of adequate imaging tests for screening asbestos-related diseases. We searched peer-reviewed publications, national and international technical documents, and specialists' opinions on the theme. Based on that, the major recommendations are: Individuals exposed to asbestos at the workplace for ≥ 1 year or those with a history of environmental exposure for at least 5 years, all of those with a latency period > 20 years from the date of initial exposure, should initially undego HRCT of the chest for investigation. Individuals with pleural disease and/or asbestosis should be considered for regular lung cancer monitoring. Risk calculators should be adopted for lung cancer screening, with a risk estimate of 1.5%.

Exposição a agrotóxicos e o risco de tumores do Sistema Nervoso Central em crianças: revisão sistemática com metanálise / Pesticide exposure and risk of Central Nervous System tumors in children: a systematic review with meta-analysis

Resumo Os tumores do Sistema Nervoso Central (SNC) representam mais da metade das neoplasias infantis malignas que acometem crianças. Objetivou-se analisar o risco de exposição a agrotóxicos relacionado com o desenvolvimento de tumores do SNC em crianças. Realizou-se uma revisão sistemática da literatura nas bases de dados PubMed/MEDILINE, Embase, Web of Science, Scopus e CINAHL. Foram incluídos estudos de coorte e caso-controle sobre o desenvolvimento de tumores do SNC (todos os tipos histológicos do grupo III Classificação de Câncer Infantil) decorrentes da exposição a agrotóxicos em crianças de 0-14 anos. Na metanálise utilizou-se o modelo de efeito aleatório e o método estatístico de Mantel-Haenszel. A Razão de Chances (RC) ou Odds Ratio (OR) foi a medida de associação aplicada. A revisão foi registrada no International Prospective Register of Systematic Reviews (PROSPERO) sob o número CRD42021209354. A busca identificou 1.158 estudos, dos quais 14 compuseram a revisão. Verificou-se evidência de associação entre o desenvolvimento de astrocitomas e a exposição a todas as classes de pesticidas (OR 1,50; IC95% 1,15-1,96; p=0,03). A síntese dos resultados apontou para uma relação da exposição aos agrotóxicos com o desfecho de alguns tipos histológicos de tumores do SNC na infância.

Abstract Central Nervous System (CNS) tumors represent more than half of all childhood malignant neoplasms. The aim of this study was to determine the relationship between environmental exposure to pesticides and the development of CNS tumors in children. We conducted a systematic review of the literature in the PubMed/MEDILINE, Embase, Web of Science, Scopus, and CINAHL databases. The inclusion criteria were cohort and case-control studies investigating the association between exposure to pesticides and CNS tumors (all histological types included in group III of the WHO Classification of Childhood Cancer) in children aged 0-14 years. The meta-analysis was performed using a random effects model and the Mantel-Haenszel method. Strength of association was measured using odds ratios (OR). The review was registered in the International Prospective Register of Systematic Reviews (PROSPERO) under identification number CRD42021209354. The search identified 1,158 studies, 14 of which were included in the review. There was evidence of an association between the development of astrocytomas and exposure to all classes of pesticides (OR 1.50; 95%CI 1.15-1.96; p=0.03). The synthesis of the evidence pointed to a relationship between exposure to pesticides and some histological types of CNS tumors in childhood.

Association between bedroom night light exposure during sleep and children s emotional symptoms / 中国学校卫生

Objective@#To explore the association between exposure to bedroom night light during sleep and emotional symptoms in children and provide a scientific basis for subsequent effective prevention and intervention.@*Methods@#In December 2021, 1 926 students from grades 4 to 6 were recruited to conduct a student questionnaire survey in two primary schools in Tianchang of Chuzhou City, Anhui Province. The data, including general demographic information, use of night lights and curtains, emotional symptoms, and other information, was collected. Binary Logistic regression analysis was used to examine the correlation between night light use and children s emotional symptoms.@*Results@#The reporting rates of depression symptoms, generalized anxiety symptoms, social phobia, and obsessive compulsive symptoms of the children were 2.5%, 2.6%, 3.4% and 2.5%, respectively. About 12.6% of children often sleep with a night light on, and 22.0% of children did not close the curtains. Binary Logistic regression analysis revealed that frequent sleep with night lights was associated with an increased risk of depression symptoms( OR=2.29, 95%CI = 1.04- 5.03), social phobia ( OR=1.93, 95%CI =1.02-3.64) and obsessivecompulsive symptoms ( OR=3.44, 95%CI =1.72-6.88) in children( P < 0.05).@*Conclusion@#There is a positive correlation between bedroom night light exposure during sleep and the detection rate of children s emotional symptoms. The attention should be paid to bedroom light environment of children during sleep to reduce the adverse effects of night light exposure on the mental health.

Characterization and application of exposure biomarkers of polycyclic aromatic hydrocarbons in diesel exhaust / 环境与职业医学

Diesel exhaust (DE), Group 1 carcinogen, is an important source of air pollutants. Studies show that DE exposure associates with elevated incidences of respiratory and cardiovascular diseases. The toxic effects of DE are closely related to its components. Polycyclic aromatic hydrocarbons (PAHs) are one of the main toxic components in DE and are often used as human exposure biomarkers to DE. However, the exposure assessment of DE using PAHs as biomarkers could be interfered due to the other sources of PAHs. Therefore, identification of highly specific and reliable PAHs sourced biomarkers of DE exposure has become a hotspot of current research. New biomarkers of DE may play an important role in determining human exposure to DE and establishing dose-response relationship of DE exposure and health outcomes of interest. This paper focused on current progress in terms of PAHs sourced biomarkers of human exposure to DE with the following aims: (1) to clarify the types of PAHs sourced biomarkers to DE; (2) to explore the applicability and limitations of PAHs sourced biomarkers for DE exposure assessment in occupational exposure and environmental exposure analysis; and (3) to summarize the analysis methods for PAHs sourced exposure biomarkers in human urine samples and compare the advantages and disadvantages of different analytical methods.

EGFR gene mutations and environmental exposure factors in patients with non-small cell lung cancer in Bazhong City / 公共卫生与预防医学

Objective To analyze the EGFR gene mutations and environmental exposure factors in patients with non-small cell lung cancer (NSCLC) in Bazhong City, and to provide a theoretical basis for the diagnosis and treatment of NSCLC patients. Methods A total of 356 NSCLC patients admitted to Bazhong Hospital from 2019 to 2020 were selected. All patients underwent EGFR gene detection and were divided into mutant group (n=171) and wild-type group (n=185) according to EGFR gene mutation. Environmental exposure data of patients were collected, including smoking status, smoking index, frequent frying of food, etc. Univariate analysis and logistic regression were used to analyze the environmental risk factors of EGFR gene mutations in NSCLC patients. Results A total of 171 EGFR gene mutations were detected in 356 NSCLC patients, and the mutation rate was 48.03%. The mutation rate of EGFR gene in females was significantly higher than that in males (P0.05). The mutation rate of EGFR gene in patients with adenocarcinoma was significantly higher than that in patients without adenocarcinoma (P0.05). Among the 356 NSCLC patients, there were 171 cases with EGFR gene mutations (48.03%), including 335 single mutations, 181 exon 19 mutations, 129 exon 21 L858R mutations, 12 exon 21 L861Q mutations, 8 exon 20 insertion mutations, and 5 Exon 18 mutations. There were 18 cases carrying double mutations and 3 cases carrying triple mutations. There were significant differences between the two groups in smoking status, smoking index, use of coal stove, use of smoke extraction equipment, cooking fumes, fried food intake, and family history of cancer (P<0.05). Non-smoking (OR=3.19), not using smoke exhaust equipment (OR=3.58), and using coal stove (OR=2.19) were the environmental exposure factors of EGFR mutation in NSCLC patients (P<0.05). Conclusion The EGFR gene mutation rate is high in NSCLC patients in Bazhong City, and most of them are female non-smoking patients. EGFR gene detection should be performed in NSCLS patients without smoke exhaust equipment and using coal stoves to improve the detection rate of EGFR mutation.

Effects of arsenic exposure during pregnancy on maternal and neonatal health: a review / 预防医学

@#Arsenic is a toxic metalloid, which may enter the human body through a variety of routes, including drinking water, food, and air. Previous studies have shown that arsenic exposure during pregnancy may cause pregnancy complications and adverse pregnancy outcomes, and maternal arsenic levels correlate with neonatal neurodevelopment and adult health. However, the negative impact of arsenic exposure during pregnancy on maternal and child health has not been widely accepted because of inconsistent study conclusions and unclear mechanisms. Based on international and national studies pertaining to the effect of arsenic exposure during pregnancy on maternal and child health during the period between 2007 and 2022, this review describes the influencing factors and biomarkers of arsenic exposure during pregnancy, associations of arsenic exposure during pregnancy with pregnancy complications and adverse pregnancy outcomes and impact of arsenic exposure during pregnancy on neonatal neurodevelopment, and discusses the mechanisms underlying negative health effects caused by arsenic exposure during pregnancy, so as to provide the evidence for assessing the hazards of arsenic exposure during pregnancy and formulating the control strategy.

A survey on the prevalence and associated factors of arsenic poisoning-related skin lesions in an arsenic tailing area in Hunan Province, China / 中华皮肤科杂志

Objective:To investigate epidemiological characteristics of arsenic poisoning-related skin lesions in an arsenic tailing area in Hunan Province.Methods:A cross-sectional study was conducted. From October 2016 to January 2017, all residents aged over 18 years (except pregnant women) were enrolled from 3 villages in Baiyun Town, Shimen County, Hunan Province by using a cluster-sampling method. Demographic information was collected through a face-to-face questionnaire interview. All residents received skin examination performed by professional dermatologists, and blood, urine, and hair samples were collected for the measurement of arsenic levels. Non-conditional logistic regression analysis was performed to analyze factors associated with arsenic poisoning-related skin lesions.Results:A total of 1 092 eligible residents in the arsenic tailing area were recruited in this study, and 756 (69.2%, 95% CI: 66.5%, 72.0%) presented with arsenic poisoning-related skin lesions, including hyperkeratosis, hypo- or hyper-pigmentation. The median ( Q1, Q3) arsenic levels were 0.31 (0.14, 0.74) μg/g in hair samples ( n = 1 079), 0.84 (0.67, 1.10) μg/L in blood samples ( n =1 091), and 60.31 (41.71, 91.52) μg/L in urine samples ( n =1 092). Multivariable analysis showed that the occurrence of arsenic poisoning-related skin lesions was associated with age, residential location, and occupational arsenic exposure history, but was not associated with gender, ethnicity, education levels, migration history, arsenic levels in hair, blood, or urine. Compared with the group aged 18 - 39 years, the group aged 40 - 59 years and the group aged over 60 years showed significantly higher risks of arsenic poisoning-related skin lesions (adjusted OR = 11.34, 95% CI: 5.98, 21.50, P < 0.001; adjusted OR = 71.82, 95% CI: 35.81, 144.05, P < 0.001, respectively). Compared with the residents in the Wangyangqiao village, residents in the Heshan village and Huangchang village showed significantly higher risks of arsenic poisoning-related skin lesions (adjusted OR = 2.89, 95% CI: 2.05, 4.08, P < 0.001; adjusted OR = 4.13, 95% CI: 1.94, 8.78, P < 0.001, respectively). The risk of arsenic poisoning-related skin lesions was significantly higher in residents with occupational exposure history than in those without (adjusted OR = 1.99, 95% CI: 1.04, 3.83, P = 0.039) . Conclusion:Nearly 70% of the residents presented with arsenic poisoning-related skin lesions in an arsenic tailing area in Hunan Province, and the duration and previous degree of arsenic exposure were associated with the risk of arsenic poisoning-related skin lesions.

Possible mechanisms of toxic effects of per-and polyfluoroalkyl substances exposure on thyroid / 环境与职业医学

Per- and polyfluoroalkyl substances (PFASs) are persistent organic pollutants (POPs). They are widely used in food packaging, tableware coating, stain resistant furniture, and other industrial production. Humans are exposed to PFASs on a daily basis through drinking water and intaking food, use of consumer products containing PFASs, and occupational exposure during the production of PFASs or related products. A growing body of toxicological studies has shown that PFASs exposure disrupts the thyroid hormone (TH) system and causes hypothyroidism, which is further supported by population epidemiological studies. PFASs can damage thyroid follicular cells and sodium/iodine transporters to impair iodine uptake by thyroid cells. They interfere with the synthesis of thyroglobulin, reduce the activity of thyroid peroxidase, and affect the synthesis and secretion of TH. They interfere with TH transportation and biological effects via TH competitive binding thyroid transporter or thyroid hormone receptor. They suppress TH signaling pathway and deiodinase activity, interfere negative feedback mechanism, and accelerate TH metabolism and excretion. The processes of TH synthesis, transport, degradation, and biological effects may all be affected by PFASs exposure. This paper described possible toxic mechanisms of PFASs on the thyroid from four aspects: TH biosynthesis, transport, action on target cells, and metabolic excretion stage, and summarized the thyroid toxicity associated with PFASs exposure.

Accuracy and stability of a smart wearable device for quantitative analysis of environmental risks related to myopia / 中华实验眼科杂志

Objective:To evaluate the accuracy and stability of Eye-Monitor, a smart wearable device, in quantifying environmental risks related to myopia.Methods:A diagnostic test study was conducted.Forty-two subjects aged 18-25 years old were recruited from Shandong University of Traditional Chinese Medicine in December 2021.Forty-two Eye-Monitors were selected from 80 devices using the simple random sampling method.Static and dynamic tests were carried out to compare environmental risks related to myopia.The static tests included measurements under different working distances, different head tilt angles when sitting, and different light intensities.The dynamic tests included measurements under different near-work time, different outdoor activity time, different time watching computers, and different phone viewing time.Eye-Monitor with the largest sum of absolute values of total relative error was selected, Spearman rank correlation analysis was used to analyze the correlation between the set values and Eye-Monitor measurements, and the accuracy of the objectively measured values was evaluated by Bland-Altman consistency analysis.The stability of the objectively measured values from Eye-Monitor was evaluated by the coefficient of variation.This study adhered to the Declaration of Helsinki.The study protocol was approved by the Ethics Committee of the Affiliated Eye Hospital of Shandong University of Traditional Chinese Medicine (No.HEC-KS-2021005KY). Written informed consent was obtained from each subject.Results:There were significant correlations between the measured values and setting values in the working distance, head tilt angle when sitting, indoor light intensity, total near-work time, average continuous near-work time, outdoor activity time, time watching computers, and time viewing phones ( rs=0.999, 0.998, 0.999, 0.998, 0.976, 0.959, 0.992, 0.997; all at P<0.001), with the 95% limits of agreement (LoA) of-1.23-2.32 cm, -1.49-4.24°, -13.90-26.90 lx, -6.46-0.11 minutes, -4.50-1.20 minutes, -4.01-1.34 minutes, -2.54-1.94 minutes and-2.15-0.45 minutes, respectively.More than 95% of dots were within the clinically acceptable LoA.The coefficients of variation of the measured values ranged from 1.23%-2.99%, 2.39%-8.25%, 0.87%-8.03%, 1.49%-12.52%, 6.63%-13.59%, 0.00%-14.15%, 1.20%-8.33 and 1.49%-12.51%, respectively, showing good stability.Eye-Monitor had good accuracy in measuring outdoor light intensity (95% LoA: -336.50-130.00 lx). Conclusions:The smart wearable device Eye-Monitor can be used to objectively monitor working distance, head tilt angle when sitting, indoor light intensity, total near-work time, average continuous near-work time, outdoor activity time, time watching computers, and time watching phones, which are with good accuracy and stability.

Chronic consumption of contaminated feed with 2 4 dichlorophenoxyacetic acid (2 4 D) herbicide in rodents: effects on male reproductive health / Consumo crônico de ração contaminada com herbicida ácido 2 4 di clorofenoxiacético (2 4 D) em roedores: efeitos na saúde reprodutiva masculina

Introduction: The herbicide 2,4-dichlorophenoxyacetic acid (2,4-D) is one of the most widely used pesticides in the world. There is evidence that this herbicide can induce deleterious effects in non-target organisms, including impairment of reproduction function. Objective: The aim of this study was to evaluate the reproductive effects of the chronic consumption of contaminated feed with 2,4-D in rats using food environmental spraying simulation. Methods: Animals orally exposed received nebulized chow with 2,4-D solution in different concentrations for 180 days: 0 (control - CG), 20.69 (LCG), 34.63 (MCG), or 51.66 ppm day−1 (HCG). Results: Sperm quality was impaired to 2,4-D. The percentage of sperm with progressive movement, number of sperm in the testis and daily sperm production were decreased in all exposed groups to the herbicide compared to CG. Sperm counts in the caput/corpus and cauda epididymis were reduced in MCG and HCG, and sperm transit time was delayed in the epididymis of LCG. There was a negative impact on sperm morphology and plasma membrane integrity in MCG and HCG, respectively. Germ cell exfoliation within the lumen of the seminiferous tubules and epithelial vacuolization in epididymis were found in the HCG. Conclusion: This is the first study to describe the negative impact on male reproductive morphophysiology after chronic exposure to 2,4-D using food nebulization in environmentally relevant concentrations, based on agronomic use of the herbicide. The reproductive injuries identified raise concerns about the impacts of wide population exposure to 2,4-D (AU).

Introdução: O herbicida 2,4- ácido diclorofenoxiacético (2,4-D) é um dos agrotóxicos mais utilizados no mundo. Há evidências de que este herbicida pode induzir efeitos deletérios em organismos não-alvo, incluindo prejuízo na função reprodutiva. Objetivo: O objetivo deste estudo foi avaliar os efeitos reprodutivos do consumo crônico de ração contaminada com 2,4-D em ratos, utilizando simulação de pulverização ambiental de alimentos. Métodos: Animais expostos oralmente receberam ração nebulizada com solução de 2,4-D em diferentes concentrações por 180 dias: 0 (controle - GC), 20,69 (LCG), 34,63 (MCG) ou 51,66 ppm dia−1 (HCG). Resultados: A qualidade espermática foi prejudicada pelo 2,4-D. A porcentagem de espermatozoides com movimento progressivo, número de espermatozoides no testículo e produção diária de espermatozoides foram menores em todos os grupos expostos ao herbicida, quando comparados ao GC. A contagem de espermatozoides na cabeça/corpo e cauda do epidídimo foi reduzida em MCG e HCG, e o tempo de trânsito espermático atrasou no epidídimo em LCG. Houve impacto negativo na morfologia espermática e na integridade da membrana plasmática em MCG e HCG, respectivamente. Esfoliação de células germinativas no lúmen dos túbulos seminíferos e vacuolização epitelial no epidídimo foram encontradas em HCG. Conclusão: Este é o primeiro estudo a descrever o impacto negativo na morfofisiologia reprodutiva masculina após exposição crônica ao 2,4-D, utilizando nebulização de alimentos em concentrações ambientalmente relevantes, com base no uso agronômico do herbicida. As lesões reprodutivas identificadas levantam preocupações sobre os impactos da ampla exposição da população ao 2,4-D (AU).

Alteración de la función pulmonar en vendedores informales de gasolina expuestos a sus vapores en Maicao, Colombia

Objetivo: Determinar los efectos de la exposición a vapores de gasolina sobre la función pulmonar en vendedores informales. Material y métodos: Estudio descriptivo de corte transversal realizado en expendedores informales de gasolina expuestos a sus vapores en el municipio de Maicao, Colombia. Se registraron datos sociodemográficos, se evaluó la función pulmonar por medio de espirometría, oximetría de pulso y, evaluación de la exposición a biomasa. Resultados: Se evaluaron 74 pacientes. El 87,8% eran de sexo masculino, encontrándose principalmente entre los 18 - 40 años (71,6%). El 21,6% (n=16) de la población reportó tener afecciones respiratorias, el 59,4% obtuvo un VEF1 <80% predicho, el 68,9% un FVC <80% predicho y, el 32,4% un VEF1/FVC <70% predicho. De aquellos que tuvieron espirometría anormal (n=45), el 62,2% reportó tener un tiempo de labor ≥ 5 años. Los síntomas reportados con mayor frecuencia fueron disfonía (14,8%), conjuntivitis (14,8%), epigastralgia (10,8%) y cefalea (9,45%). No se encontraron diferencias estadísticamente significativas entre la alteración de la espirometría y antecedentes, saturación de oxígeno medida y presencia de afección respiratoria. Conclusión: Este estudio encontró que un porcentaje representativo de vendedores informales de gasolina expuestos a vapores de combustibles en la frontera colombo-venezolana, presentaron alteración en la función pulmonar comprobado por espirometría anormal y, algunos reportaron sintomatología y afección respiratoria. Estos, son principalmente hombres, adultos jóvenes, con nivel socioeconómico y educacional bajo y, expuestos a diario de forma prolongada y por varios años, a gases derivados del manejo de combustibles fósiles.

SUMMARY Objective: To determine the effects of fuel vapor exposure on pulmonary function among informal sellers. Methods: Cross-sectional study carried-out among informal fuel sellers in Maicao, Colombia. Sociodemographic data were gathered as well as pulmonary function by spirometry, pulse oximetry and evaluation of biomass exposure. Results: 74 patients were evaluated; 87.8% were males, 71.6% of them had between 18 to 40 years of age; 21.6% (n=16) reported pulmonary diseases; 59.4% had a predicted FEV1 <80%; 68.9% had a predicted FVC <80% and 32.4% had a predicted FEV1/FVC < 70%. Among those who had abnormal spirometry, (n=45) 62.2% reported to had worked ≥5 years. The most common reported symptoms were dysphonia (14.8%), conjunctivitis (14.8), epigastric pain (10.8) and headache (9.45%). No statistically significant differences were found between spirometry alterations and history of p pulmonary diseases, mean oxygen saturations and presence of a respiratory disease. Conclusions: This study demonstrates that a significant proportion of informal fuel sellers exposed to fuel vapors in the Colombian-Venezuelan border had derangement of the pulmonary function measured by spirometry and that some of them reported symptoms and respiratory disease. Young male adults of low socioeconomic and educational levels with prolonged exposure to fuel vapors are mostly affected.

Association between exposure to artificial light at night and the occurrence of menarche in Han girls / 中国学校卫生

Objective@#To analyze the association between the occurrence of menarche and the exposure to artificial light at night (ALAN) in female Han nationality girls aged 9-18 in China, so as to provide a reference for the research on the disturbance mechanism of ALAN on puberty, as well as provide a scientific evidence for controlling ALAN and making public sanitary policy.@*Methods@#A total of 74 483 Han girls aged 9-18 with complete records of menarche, height, and weight were included in the 2014 Chinese National Surveys on Students Constitution and Health. Pearson correlation was used to explore the correlation between the incidence of menarche and the exposure to artificial light at night in 11-year-old Han girls, and the third quantiles of the area covered by outdoor night lights (0.16, 0.60) and the third quantiles of the average night light intensity [0.97, 5.91 nw/(sr ·cm) 2] were used respectively to divide the study subjects into 3 groups, and the multifactor Logistic regression model was used to analyze the effect of artificial light at night exposure on menarche.@*Results@#In 2014, the median age of menarche of Chinese Han girls was 12.18 years old, and the incidence of menarche in the 11-year-old group was 26.31%. After controlling for body mass index, local population and the logarithmic values of per capita GDP, the incidence of menarche of 11-year-old Han girls was positively correlated with the local outdoor average night light coverage area ratio and the night average light intensity logarithmic adjustment value( r =0.29, 0.30, P <0.05).The higher the local outdoor night light coverage area ratio ( OR =1.28, 1.52) and the average night light intensity ( OR =1.47, 1.58), the higher the incidence of menarche in 11-year-old Han girls( P <0.05).@*Conclusion@#There is a positive correlation between artificial light at night exposure and the menarche rate of 11-year-old Han girls. Research on artificial light at night exposure may provide scientific evidence on puberty onset and its effects on population health.