Coal mining environment causes adverse effects on workers.

Background: The objective of this study is to study the adverse effects of coal mining environment on workers to discover early effective biomarkers. Methods: The molecular epidemiological study was conducted with 502 in-service workers, who were divided into miner and auxiliary. We measured the individual levels of dust exposure for participants. Clinical examinations were conducted by qualified doctors. Peripheral blood was collected to measure biochemistry, hemogram, and karyocyte apoptosis. Results: All workers were healthy who have not found with any diseases that can be diagnosed medically in the physical examination and showed no difference in dust exposure level, age, height, weight, and body mass index between groups. The working years of miners were lower than that of auxiliaries (p < 0.001). Compared with auxiliaries, the concentration and percentage of lymphocytes (p = 0.040, p = 0.012), basophils (p = 0.027, p = 0.034), and red blood cells (p < 0.001) and the concentration of hemoglobin of miners were lower (p < 0.001). The percentage of neutrophils (p = 0.003), the concentration of mean corpuscular hemoglobin concentration (p = 0.002), and the proportion of karyocyte apoptosis in miners were higher (p < 0.001). Miners presented higher blood urea nitrogen (p < 0.001), ratio of blood urea nitrogen to creatinine (p < 0.001), the high density lipoprotein cholesterol (p < 0.001), lower creatinine (p < 0.05), and cholesterol (p < 0.001). Conclusion: The coal mining environment impacted mining workers' immune function, renal function, and the hematopoietic system, including BUN/CRE, HGB, RBC, and LYMPH, which could be used as early biomarkers to screen the health of coal miners.

MTBE exposure may increase the risk of insulin resistance in male gas station workers.

Insulin resistance is closely related to many metabolic diseases and has become a serious public health problem worldwide. So, it is crucial to find its environmental pathogenic factors. Methyl tert-butyl ether (MTBE), a widely used unleaded gasoline additive, has been proven to affect glycolipid metabolism. However, results from population studies are lacking. For this purpose, the potential relationships between MTBE exposure and the triglyceride glucose (TyG) index, a useful surrogate marker of insulin resistance, were evaluated using a small-scale occupational population. In this study, 201 participants including occupational and non-occupational MTBE exposure workers were recruited from the Occupational Disease Prevention and Control Hospital of Huaibei, and their health examination information and blood samples with informed consent were collected. The internal exposure levels were assessed by detecting blood MTBE using solid-phase-micro-extraction gas chromatography-mass spectrometry. Then the adjusted linear regression model was used to assess the relationship between MTBE exposure and fasting plasma glucose (FPG), or TyG index. Then, receiver-operating-characteristic (ROC) curves were performed to calculate the optimal cut-off points. Multivariable and hierarchical logistic regression models were used to analyze the impact of MTBE exposure on the risk of insulin resistance. Obvious correlations were observed between blood MTBE levels with TyG index (p = 0.016) and FPG (p = 0.001). Further analysis showed that using the mean of the TyG index (8.77) as a cutoff value had a good effect on reflecting the risk of insulin resistance. Multivariable logistic regression analysis also indicated that MTBE exposure was an independent risk factor for a high TyG index (OR = 1.088, p = 0.038), which indicated that MTBE exposure might be a new environmental pathogenic factor leading to insulin resistance, and MTBE exposure might increase the risk of insulin resistance by independently elevating the TyG index in male gas station workers.

Mediation effect of serum zinc on insulin secretion inhibited by methyl tert-butyl ether in gas station workers.

Methyl tert-butyl ether (MTBE), a type of gasoline additive, has been found to affect insulin function and glucose homeostasis in animal experiments, but there is still no epidemiological evidence. Zinc (Zn) is a key regulatory element of insulin secretion and function, and Zn homeostasis can be disrupted by MTBE exposure through inducing oxidative stress. Therefore, we suspected that Zn might be involved and play an important role in the process of insulin secretion inhibited by MTBE exposure. In this study, we recruited 201 male subjects including occupational and non-occupational MTBE exposure from Anhui Province, China in 2019. Serum insulin and functional analog fibroblast growth factor 1 (FGF1) and blood MTBE were detected by Elisa and headspace solid-phase microextraction and gas chromatography-high-resolution mass spectrometry. According to MTBE internal exposure level, the workers were divided into low- and high-exposed groups and found that the serum insulin level in the high-exposed group was significantly lower than that in the low-exposed group (p = 0.003) while fasting plasma glucose (FPG) level increased obviously in the high-exposed group compared to the low-exposed group (p = 0.001). Further analysis showed that MTBE exposure level was positively correlated with FPG level, but negatively correlated with serum insulin level, which suggested that the FPG level increase might be related to the decrease of serum insulin level induced by MTBE exposure. The results of further mediation effect analysis showed that changes in serum zinc levels played a major intermediary role in the process of insulin secretion inhibition and blood glucose elevation caused by MTBE exposure. In addition, a significant negative correlation was found between MTBE exposure and serum Zn level, which might play a strong mediating effect on the inhibition of insulin secretion induced by MTBE exposure. In conclusion, our study provided evidence that MTBE could inhibit insulin secretion and interfere with Zn metabolism in gas station workers for the first time, and found that Zn might play an important mediation effect during the process of inhibiting insulin secretion and interfering with glucose metabolism induced by MTBE exposure.

Associations between multiple heavy metals exposure and neural damage biomarkers in welders: A cross-sectional study.

BACKGROUND: Both occupational and environmental exposure to heavy metals are associated with various neurodegenerative diseases. However, limited evidence is available on the potential effects of exposure to metallic mixtures and neural damage. OBJECTIVES: This study aimed to evaluate the association between metal mixtures in urine and neural damage biomarkers in welders. METHODS: In this cross-sectional study, a total of 186 workers were recruited from steel mills. Twenty-three metals in urine were measured by inductively coupled plasma mass spectrometry. Serum neural damage biomarkers, including neurofilament light chain (NfL), sphingosine-1-phosphate (S1P), prolactin (PRL), and dopamine (DA) were detected using enzyme-linked immunosorbent assay kits. Multivariable linear regression, Bayesian kernel machine regression (BKMR), and Quantile g-computation (QG-C) were employed to estimate the association between metals exposure and neural damage biomarkers. RESULTS: Inverted u-shaped associations of nickel with NfL, S1P, and DA were observed in the BKMR model. A non-linear relationship was also found between Fe and PRL. Urinary cobalt was positively associated with serum PRL and had the strongest positive weights in the QG-C model. Urinary lead was associated with higher serum S1P levels. We also found the interaction among nickel, zinc, arsenic, strontium, iron, and lead with the neural damage biomarkers. CONCLUSION: This study provides new evidence of a direct association between metal mixture exposure and the serum biomarkers of neural damage. Several metals Ni, Co, Pb, Sr, As and Fe, may have adverse effects on the nervous system, while Zn may have neuroprotective effects.

Associations of multiple metals with lung function in welders by four statistical models.

BACKGROUND: Exposure to heavy metals has been related to decreased lung function in workers. However, due to limitations in statistical methods for mixtures, previous studies mainly focused on single or several toxic metals, with few studies involving metal exposome and lung function. OBJECTIVES: The study aimed to evaluate the effects of co-exposure to the metal mixtures on multiple parameters of pulmonary function tests and to identify the elements that play an essential role in elastic-net regression (ENET), multivariate linear regression, bayesian kernel machine regression (BKMR), and quantile g-computation (QG-C) models. METHODS: We have recruited 186 welders from Anhui (China) in 2019. And their end-of-shift urine and lung function measure data were collected with informed consent. The urinary concentrations of 23 metals were measured by inductively coupled urinary mass spectrometry. The lung function measures including forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1) and peak expiratory flow (PEF) were also detected as outcome indicators. Four statistical methods, ENET, multivariate linear regression, BKMR, and QG-C models were used to evaluate the associations of element mixtures on lung function comprehensively. RESULTS: Lead and cadmium were negatively associated with FVC and FEV1, nickel and chromium were inversely associated with PEF, and strontium showed significant positive effects in linear regression models, which were consistent with the results in BKMR and QG-C models. Both BKMR and QG-C models showed a significantly negative overall effect of metal mixtures on lung function parameters (FVC, FEV1, and PEF). Meanwhile, BKMR showed the non-linear relationships of cadmium with FVC. CONCLUSION: Multi-pollutant mixtures of metals were negatively associated with lung function. Lead, cadmium, nickel, and strontium might be crucial elements. Our findings highlight a need to prioritize workers' environmental health, and guide future research into the toxic mechanisms of metal-mediated lung function injury.

Near Full-Length Genomic Characterization of a Novel Unique Recombinant (CRF01_AE/CRF07_BC) in Fuyang City of China.

Recombinant forms contribute substantially to the genetic diversity of HIV-1. Recent studies have also revealed that three major viral strains (CRF07_BC, CRF01_AE, and subtype B) have been cocirculating among men who have sex with men (MSM) in Anhui, suggesting a high probability of generating new recombinants. In this study, we reported a novel CRF01_AE and CRF07_BC HIV-1 recombinant form in MSM in Fuyang city of China. Two near full-length genome (NFLG) named FY184 and FY208 were successfully obtained. The genomic composition analysis of the NFLG reveals that it was divided into four segments by three breakpoints, with two regions of CRF07_BC inserted into a CRF01_AE backbone's gag and pol regions. The CRF01_AE regions were originated from a subcluster lineage of CRF01_AE, which is mainly circulating among MSM in China. The emergence of a novel recombinant of CRF01_AE/CRF07_BC is indicative of the increasing genetic diversity of the HIV epidemic in MSM in Anhui.

Phylogenetic analysis highlights the role of older people in the transmission of HIV-1 in Fuyang, Anhui Province, China.

BACKGROUND: The proportion of older HIV-1 infected people in China has increased rapidly in recent years. Elucidation of the transmission characteristics of this high-risk population subgroup is helpful for the development of tailored interventions. METHODS: A phylogenetic analysis was performed that uses available HIV-1 pol sequences amplified with nested RT-PCR from plasma samples of all newly diagnosed participants spanning from October 2017 to September 2018 in Fuyang, Anhui Province. Transmission clusters were identified as two or more sequences that shared a corresponding node with an aLRT-SH value ≥90 in the maximum-likelihood phylogenetic tree and had an overall mean genetic distance of ≤1.5%. A local transmission cluster was defined as a cluster that had more than 80% of its sequences from Fuyang. The role of older people in local HIV-1 transmission was determined using an integration of molecular and demographic data. RESULTS: Of 362 available sequences, 14 subtypes, and 28 local transmission clusters were identified. It was found that the proportion of older people in the local transmission cluster (69/77, 89.61%) was much higher than that of younger people (46/114, 40.35%) (χ2 test, P < 0.001). In the pretreatment drug resistance analysis, the proportion of sequences with PDRMs in the local transmission cluster was not significantly different between the older people group (57.14%, 4/7) and non-old-aged group (11.11%, 1/9) (Fisher's exact test, P > 0.05). CONCLUSION: By combining phylogenetic analyses with demographic data, more detailed information was provided about the local transmission structure in Fuyang. These findings suggested that older people play an important role in local transmission, and more tailored interventions for this population subgroup are urgently needed.

Need for Intervention Services for Promotion of Condom Use by Female Sex Workers to Consider Size of Entertainment Venues: A Cross-Sectional Study.

BACKGROUND Consistent condom use among female sex workers (FSWs) is a key intervention in China's AIDS Control Program. Female sex workers (FSWs) in China are at increased risk for acquiring HIV/AIDS because of low knowledge about HIV transmission and inconsistent use of condoms, the grade of venues may play a role in HIV/AIDS-related knowledge and consistent condom use of female sex workers. MATERIAL AND METHODS A cross-sectional study was conducted among 802 FSWs in 2016 in Fuyang, China. A self-administered questionnaire was used to assess whether there is a need of different intervention services promotion of consistent condom use among FSWs in different-grade entertainment venues. RESULTS Multivariate logistic regression analysis indicated that knowledge scores of HIV transmission routes and peer education were associated with consistent condom use in large-size venues, while peer education was associated with consistent condom use in mid-size venues. Knowledge scores of HIV non-transmission routes, knowledge scores of AIDS prevention/control, and peer education were associated with consistent condom use in small venues. CONCLUSIONS Our data suggested that the strategies for strengthen interventions on health benefits of consistent condom use of FSWs should differ by size of venue.

[The effect of pneumoconiosis observation object and coal workers' pneumoconiosis in one stage again in the dust exposure work after whole lung lavage].

OBJECTIVE: To investigate the effects of secondary dust exposure after whole-lung lavage (WLL) on the clinical symptoms, arterial blood gas parameters, and pulmonary function in subjects with pneumoconiosis and patients with stage I coal workers' pneumoconiosis (CWP). METHODS: The subjects with pneumoconiosis and patients with stage I CWP who underwent WLL in our hospital during the study period were selected. All patients were divided into postoperative dust exposure group (n = 86) and lavage control group (n = 86) according to whether they were exposed to dust after conventional operation. In addition, their workmates with similar age, history of dust exposure, and type of dust exposure were selected as non-lavage control group (n = 86). Follow-up was performed before and at one month and one year after WLL to evaluate clinical symptoms, arterial blood gas parameters, and pulmonary function. RESULTS: One month after operation, the clinical scores of the postoperative dust-exposure group and lavage control group were significantly reduced compared with their preoperative scores and the clinical score of the non-lavage control group (P < 0.01). One year after operation, the clinical scores of the postoperative dust-exposure group and lavage control group were significantly reduced compared with their preoperative scores and the clinical score of the non?lavage control group (P < 0.01), and the lavage control group had a significantly lower clinical score than the postoperative dust exposure group (P < 0.01). One month after operation, the arterial partial pressure of oxygen (PaO2) of the postoperative dust-exposure group and lavage control group were significantly higher than their preoperative values and the arterial PaO2 of the non-lavage control group (P < 0.01). One year after operation, the lavage control group had significantly higher arterial PaO2 than the postoperative dust exposure group and the arterial PaO2 of the non-lavage control group was significantly lower than its preoperative value and the arterial PaO2 of the postoperative dust exposure group and lavage control group (P < 0.05 or P < 0.01); the postoperative dust exposure group showed a significant decrease in arterial PaO2 (P < 0.01), while the lavage control group showed a significant increase in arterial PaO2 (P < 0.01). The partial pressure of carbon dioxide showed no significant differences between the three groups before and at one month and one year after operation (P > 0.05). CONCLUSION: Dust exposure should be avoided after WLL to ensure the treatment outcome.

CHARACTERISTICS AND FACTORS INFLUENCING UNPROTECTED ANAL INTERCOURSE AMONG MEN WHO HAVE SEX WITH MEN IN FUYANG, CHINA.

Men who have sex with men (MSM) are at risk for contracting hu- man immunodeficiency virus (HIV) infection. The objective of this study was to explore the characteristics and factors influencing unprotected anal intercourse (UAI) among MSM in Fuyang, China in order to develop an intervention program to prevent the spread of HIV infection among MSM. We conducted this cross sectional study among 413 MSM in 2013. Participants completed an interviewer- administered questionnaire and were tested for HIV and syphilis infections. Three hundred fifty of 413 subjects reported sexual activity with a male partner during the previous 6 months; of these 27(7.7%) had unprotected sex. Forty-four subjects had sex with a female partner during the previous 6 months; of these 25 (58.1%) had unprotected sex. The frequency of having unprotected sex with a female was significantly greater than with a male (χ2 = 84.52, p < 0.001). Multivariate logistic analysis showed education level (OR = 0.45, p = 0.003), length of time of current residence (OR = 0.47, p = 0.014), knowledge about HIV infection (OR = 0.09, p = 0.022) and integrated interventions (OR = 0.32, p < 0.001) were all significantly associated with UAI. High-risk sex behavior was common among the study population. A targeted interventions needs to be developed urgently.

Stigmatizing attitudes and behaviors toward PLHA in rural China.

Stigma is a significant barrier to effective control of HIV/AIDS, despite laws to control it. The purpose of this study was to examine factors associated with HIV stigma in a rural Chinese community. A survey was conducted in north-west Anhui province among 963 residents to assess HIV-related knowledge, attitudes, and behaviors. Participants scored a mean of 16.6/26 (63.8%) for knowledge. Sixty-eight percent of respondents held at least one fear of casual transmission, 42% would blame people living with HIV/AIDS (PLHA) for their disease, and 73% thought having HIV is shameful. More than half reported that they had observed at least one stigmatizing behavior toward PLHA in their villages. Multivariable analysis indicated that people with higher education, higher HIV knowledge, higher household wealth and who learned about HIV from professional sources were less likely to hold a stigmatizing attitude, while people who had observed discriminating behaviors toward PLHA in their community and lived in villages with fewer PLHA were more likely to hold a stigmatizing attitude. Despite education campaigns, knowledge remains low and stigmatizing attitudes and behaviors toward PLHA remain a problem.

[The median survival and the effect of antiretroviral therapy among HIV-positive former blood donors in Anhui province].

OBJECTIVE: To estimate the median survival and the effect of antiretroviral therapy (ART) among HIV-positive former blood donors of Fuyang in Anhui province, China. METHODS: A retrospective survey was conducted among HIV-positive former blood donors, and data was collected on survivors who had received ART. Weibull function was used to calculate median survival of HIV-positive former blood donors. The effect of ART was estimated through comparing the actual number of deaths after ART with the expected number of deaths in those who did not receive ART. RESULTS: The median period of HIV infection was at the end of 1994, with the median survival of HIV-positive former blood donors in Fuyang as 10.8 years. By the end of September 2008, among 159 former blood donors, 74 received ART, with their mean CD(4)(+) T-cell count increased from 247.8/microl to 475.1/microl (P < 0.0001). 76 of the 159 former blood donors died. When comparing the expected number of deaths calculated by Weibull function, 31.7% of the total number of deaths was reduced. CONCLUSION: Result from this study was in consistent to the UNAIDS' figures that in the absence of treatment, the net median survival time after infection with HIV was estimated to be 11 years and ART has reduced about one third of the expected deaths.

Association between Vgamma2Vdelta2 T cells and disease progression after infection with closely related strains of HIV in China.

BACKGROUND: Human immunodeficiency virus (HIV) infection and disease are accompanied by decreases in the absolute number and function of Vgamma2Vdelta2 T cells, suggesting that this subset of cells may play an important role in controlling disease. We performed a cross-sectional study involving HIV-infected former blood donors and assessed the association between Vgamma2Vdelta2 T cells and markers of disease progression. METHODS: Changes in Vgamma2Vdelta2 T cell count and function were compared between HIV-infected individuals and healthy blood donors using the Mann-Whitney U test. The relationships between Vgamma2Vdelta2 T cell count, plasma viral load, and CD4 T cell count were analyzed using the Spearman correlation. RESULTS: We found significant positive correlations between CD4 T cell count and both total Vgamma2Vdelta2 T cell count (P<.001) and functional (isopentenyl pyrophosphate-responsive) Vgamma2Vdelta2 T cell count (P<.001). We found significant reverse correlations between viral load and both total Vgamma2Vdelta2 T cell count (P<.05) and functional Vgamma2Vdelta2 T cell count (P<.05). CONCLUSIONS: The association of Vgamma2Vdelta2 T cells with disease progression in 146 HIV-infected participants supports the view that intact Vgamma2Vdelta2 T cell populations are important for controlling HIV disease.

[Effect of GBV-C/HIV coinfection on HIV/AIDS disease progression and HIV replication].

Several research groups have recently reported that persistent GB virus C (GBV-C) co-infected with human immunodeficiency virus (HIV) leads to slower AIDSs disease progression than HIV-1 infection alone. However, these findings were not confirmed by several other studies. To investigate the association between GBV-C replication and plasma HIV loads and CD4+ T cell counts, 203 HIV-1 positive former blood/plasma donors(FBDs) were enrolled from Fuyang city of Anhui Province in China. Plasma specimens were collected from them and were tested for GBV-C using RT-PCR and ELISA. Out of 203 specimens, 52 (25.6%) cases were positive for GBV-C, including 35 male (67.3%) and 17 female (32.7%) cases. No significant association was identified between GBV-C infection and CD4+ T-cell counts or between GBV-C infection and HIV viral loads. Since all the subjects studied were naive to ART, the influence of therapy on AIDS disease progression was ruled out in this study. Overall, our data indicated that HIV-1 positive male FBDs were prone to be infected, GBV-C coinfection with HIV-1 does not significantly influence HIV/AIDS disease progression during the late stage of chronic HIV-1 infection.

Epidemiology, clinical and laboratory characteristics of currently alive HIV-1 infected former blood donors naive to antiretroviral therapy in Anhui Province, China.

BACKGROUND: Unregulated commercial blood/plasma collection among farmers occurred between 1992 and 1995 in central China and caused the second major epidemic of human immunodeficiency virus type 1 (HIV-1) infection in China. It is important to characterize HIV-1-infected former blood donors and to study characteristics associated with disease progression for future clinical intervention and vaccine development. METHODS: A cross-sectional study was performed on HIV-1-infected former blood donors (FBDs) and age-matched HIV-seronegative local residents. Demographic, epidemiologic, clinical and key laboratory data were collected from all study participants. Both unadjusted and adjusted multivariate linear regressions were employed to analyze the association of the decrease of CD4(+) T-cell counts with other characteristics. RESULTS: Two hundred and ninety-four HIV-1-infected FBDs and 59 age-matched HIV-seronegative local residents were enrolled in this study. The unregulated blood/plasma collection occurred more than a decade (10.8 - 12.8 years) ago, which caused the rapid spread of HIV-1 infection and the high prevalence of co-infection with hepatitis C virus (HCV, 89.5%); hepatitis B virus (HBV) co-infection was observed in only 11 HIV(+)participants (3.7%). Deterioration in both clinical manifestation and laboratory parameters and increase of viral loads were observed in parallel with the decrease of CD4(+) T-cell counts. The decrease of total lymphocyte counts (P < 0.001) and hemoglobin levels (P < 0.001) and the appearance of dermatosis (P = 0.03) were observed in parallel with the decrease of CD4(+) T-cell counts whereas viral loads (P < 0.001) and CD8(+) T-cell counts (P = 0.01) were inversely associated with CD4(+) T-cell counts. CONCLUSIONS: Co-infection with HCV but not HBV is highly prevalent among HIV-1-infected FBDs. CD4(+) T-cell counts is a reliable indicator for disease progression among FBDs. Total lymphocyte counts, hemoglobin level and appearance of dermatosis were positively associated with CD8(+) T-cell counts and viral loads were inversely associated with the decreased CD4(+) T-cell counts.