Effects of extreme meteorological factors and high air pollutant concentrations on the incidence of hand, foot and mouth disease in Jining, China.

Background: The evidence on the effects of extreme meteorological conditions and high air pollution levels on incidence of hand, foot and mouth disease (HFMD) is limited. Moreover, results of the available studies are inconsistent. Further investigations are imperative to elucidate the specific issue. Methods: Data on the daily cases of HFMD, meteorological factors and air pollution were obtained from 2017 to 2022 in Jining City. We employed distributed lag nonlinear model (DLNM) incorporated with Poisson regression to explore the impacts of extreme meteorological conditions and air pollution on HFMD incidence. Results: We found that there were nonlinear relationships between temperature, wind speed, PM2.5, SO2, O3 and HFMD. The cumulative risk of extreme high temperature was higher at the 95th percentile (P95th) than at the 90th percentile(P90th), and the RR values for both reached their maximum at 10-day lag (P95th RR = 1.880 (1.261-2.804), P90th RR = 1.787 (1.244-2.569)), the hazardous effect of extreme low temperatures on HFMD is faster than that of extreme high temperatures. The cumulative effect of extreme low wind speeds reached its maximum at 14-day lag (P95th RR = 1.702 (1.389-2.085), P90th RR = 1.498(1.283-1.750)). The cumulative effect of PM2.5 concentration at the P90th was largest at 14-day lag (RR = 1.637 (1.069-2.506)), and the cumulative effect at the P95th was largest at 10-day lag (RR = 1.569 (1.021-2.411)). High SO2 concentration at the P95th at 14-day lag was associated with higher risk for HFMD (RR: 1.425 (1.001-2.030)). Conclusion: Our findings suggest that high temperature, low wind speed, and high concentrations of PM2.5 and SO2 are associated with an increased risk of HFMD. This study not only adds insights to the understanding of the impact of extreme meteorological conditions and high levels of air pollutants on HFMD incidence but also holds practical significance for the development and enhancement of an early warning system for HFMD.

Association of rotating night shift work, CLOCK, MTNR1A, MTNR1B genes polymorphisms and their interactions with type 2 diabetes among steelworkers: a case-control study.

BACKGROUND: The purpose of this study is to investigate the association of rotating night shift work, CLOCK, MTNR1A, MTNR1B genes polymorphisms and their interactions with type 2 diabetes among steelworkers. METHODS: A case-control study was conducted in the Tangsteel company in Tangshan, China. The sample sizes of the case group and control group were 251 and 451, respectively. The logistic regression, log-linear model and generalized multifactor dimensionality (GMDR) method were used to investigate the interaction between circadian clock gene, melatonin receptor genes and rotating night shift work on type 2 diabetes among steelworkers. Relative excess risk due to interaction (RERI) and attributable proportions (AP) were used to evaluate additive interactions. RESULTS: Rotating night shift work, current shift status, duration of night shifts, and average frequency of night shifts were associated with an increased risk of type 2 diabetes after adjustment for confounders. Rs1387153 variants in MTNR1B was found to be associated with an increased risk of type 2 diabetes, which was not found between MTNR1A gene rs2119882 locus, CLOCK gene rs1801260 locus and the risk of type 2 diabetes. The association between rotating night shift work and risk of type 2 diabetes appeared to be modified by MTNR1B gene rs1387153 locus (RERI = 0.98, (95% CI, 0.40-1.55); AP = 0.60, (95% CI, 0.07-1.12)). The interaction between MTNR1A gene rs2119882 locus and CLOCK gene rs1801260 locus was associated with the risk of type 2 diabetes (RERI = 1.07, (95% CI, 0.23-1.91); AP = 0.77, (95% CI, 0.36-1.17)). The complex interaction of the MTNR1A-MTNR1B-CLOCK-rotating night shift work model based on the GMDR methods may increase the risk of type 2 diabetes (P = 0.011). CONCLUSIONS: Rotating night shift work and rs1387153 variants in MTNR1B were associated with an increased risk of type 2 diabetes among steelworkers. The complex interaction of MTNR1A-MTNR1B-CLOCK-rotating night shift work may increase the risk of type 2 diabetes.

Metabolically Healthy Obesity and Carotid Plaque among Steelworkers in North China: The Role of Inflammation.

This study aimed to investigate the association between metabolically healthy obesity (MHO) and carotid plaque. In this cross-sectional survey, 3467 steelworkers in North China were surveyed. There are two criteria for defining a carotid plaque: (1) the lesion structure exceeds 50% of the peripheral intima-media thickness value or invades the arterial lumen by at least 0.5 mm; (2) a thickness > 1.5 mm from the intima−lumen interface to the media−adventitia interface. Metabolic health was defined as the nonexistence of one of the metabolic syndrome (MetS) diagnostic criteria for metabolic abnormalities. Obesity was defined as having a BMI ≥ 25 kg/m2. To calculate the odds ratio (OR) for the prevalence carotid plaque, a logistic regression was used for the analysis. The prevalence of carotid plaque in the subjects was 14.3% for metabolically healthy non-obesity (MHNO), 32.4% for MHO, 18.9% for metabolically unhealthy non-obesity (MUNO), and 46.8% for metabolically unhealthy obesity (MUO). The odds ratios for suffering from carotid plaque were 1.27 (95% CI: 0.69 to 2.32) for MHO, 1.83 (95% CI: 1.29 to 2.58) for MUNO, and 1.81 (1.28 to 2.56) for MUO in comparison with MHNO after adjusting for confounders. There was no association between the MHO phenotype and carotid plaque prevalence among steelworkers in North China.

Fat mass index as a screening tool for the assessment of non-alcoholic fatty liver disease.

Non-alcoholic fatty liver disease (NAFLD) is replacing hepatitis B as the leading cause of chronic liver disease in China. The purpose of this study is to select good tools to identify NAFLD from the body composition, anthropometry and related routine clinical parameters. A total of 5076 steelworkers, aged 22-60 years, was included in this study. Body fat mass was measured via bioelectrical impedance analysis (BIA) and fat mass index (FMI) was derived. Ultrasonography method was used to detect hepatic steatosis. Random forest classifier and best subset regression were used to select useful parameters or models that can accurately identify NAFLD. Receiver operating characteristic (ROC) curves were used to describe and compare the performance of different diagnostic indicators and algorithms including fatty liver index (FLI) and hepatic steatosis index (HSI) in NAFLD screening. ROC analysis indicated that FMI can be used with high accuracy to identify heavy steatosis as determined by ultrasonography in male workers [area under the curve (AUC) 0.95, 95% CI 0.93-0.98, sensitivity 89.0%, specificity 91.4%]. The ability of single FMI to identify NAFLD is no less than that of combination panels, even better than the combination panel of HSI. The best subset regression model that including FMI, waist circumference, and serum levels of triglyceride and alanine aminotransferase has moderate accuracy in diagnosing overall NAFLD (AUC 0.83). FMI and the NAFLD best subset (BIC) score seem to be good tools to identify NAFLD in Chinese steelworkers.

Association of Metabolically Healthy Obesity and Glomerular Filtration Rate among Male Steelworkers in North China.

This study aims to investigate the association between metabolically healthy obesity (MHO) and the early stages of renal dysfunction and whether systemic inflammation affects the study's outcome. Male steelworkers in northern China were investigated in this cross-sectional survey (n = 6309). A decrease in estimated glomerular filtration rate (eGFR) was used as the primary outcome, which was defined as an eGFR of ≤89 mL/min/1.73 m2. A BMI ≥ 25 kg/m2 was used to determine obesity. In the definition of metabolic health, the absence of metabolic syndrome components is considered metabolically healthy. An assessment of inflammation was carried out using a surrogate marker called high-sensitivity C-reactive protein (hs-CRP). The adjusted odds ratio (OR) and confidence intervals (CIs) were estimated using the multivariable logistic regression model. After adjusting for hs-CRP, MHO (OR = 1.97; 95% CI: 1.21 to 3.21) was significantly associated with decreased eGFR compared to metabolically healthy non-obesity (MHNO). With the MHNO/hs-CRP ≤ 0.01 mg/dL group as a reference, the OR was 2.17 (95% CI: 1.17 to 4.02) for decreased eGFR in the group with MHO/hs-CRP > 0.01 mg/dL. MHO is associated with renal dysfunction at an early stage. To some degree, this risk can be explained by the level of inflammation.

High expression of serine and arginine-rich splicing factor 9 (SRSF9) is associated with hepatocellular carcinoma progression and a poor prognosis.

BACKGROUND: Serine and arginine-rich splicing factor 9 (SRSF9) has been linked to the occurrence and progression of various cancers; however, its effects and mechanism of action hepatocellular carcinoma (HCC) have not been reported. In this study, we used a bioinformatics approach and in vitro assays to evaluate the expression of SRSF9 in HCC, its prognostic value, and its underlying regulatory mechanisms, including analyses of related pathways and the role of methylation. METHODS: Transcriptomic and DNA methylation data for 357 HCC cases and 50 paratumor tissues in The Cancer Genome Atlas database were obtained. Additionally, protein expression data for cell lines and tissue samples were obtained from the Human Protein Atlas. The CMap databased was used to predict candidate drugs targeting SRSF9. Various cell lines were used for in vitro validation. RESULTS: SRSF9 expression was significantly elevated in HCC and was negatively regulated by its methylation site cg06116271. The low expression of SRSF9 and hypermethylation of cg06116271 were both associated with a longer overall survival time. A correlation analysis revealed ten genes that were co-expressed with SRSF9; levels of CDK4, RAN, DENR, RNF34, and ANAPC5 were positively correlated and levels of RBP4, APOC1, MASP2, HP, and HPX were negatively correlated with SRSF9 expression. The knockdown of SRSF9 in vitro inhibited the proliferation and migration of HCC cells and significantly reduced the expression of proteins in the Wnt signaling pathway (DVL2 and ß-catenin) and cell cycle pathway (Cyclin D and Cyclin E). A CMap analysis identified two drugs, camptothecin and apigenin, able to target and inhibit the expression of SRSF9. CONCLUSIONS: This study expands our understanding of the molecular biological functions of SRSF9 and cg06116271 and provides candidate diagnostic and therapeutic targets for HCC.

Increased ATP2A1 Predicts Poor Prognosis in Patients With Colorectal Carcinoma.

Colorectal cancer is one of the most common malignant tumors in the digestive system. Traditional diagnosis and treatment methods have not significantly improved the overall survival of patients. In this study, we explored the value of ATP2A1 as a biomarker in predicting the prognosis of colorectal cancer patients. We used the TCGA database to reveal the relationship between ATP2A1 mRNA level and prognosis, methylation, and immune invasion in colorectal cancer. The results showed that the expression of ATP2A1 was increased in colorectal cancer. The overall survival of patients with high expression of ATP2A1 was significantly lower than patients with low expression of ATP2A1. Cox regression analysis showed that high expression of ATP2A1 was an independent risk factor for poor prognosis in colorectal cancer patients. In addition, we used three datasets to perform a meta-analysis, which further confirmed the reliability of the results. Furthermore, we revealed that ATP2A1 could significantly inhibit the proliferation of colorectal cancer cells by inhibiting the autophagy process and was associated with several immune cells, especially CD8 + T cells. Finally, four small molecule drugs with potential inhibition of ATP2A1 expression were found by CMap analysis. This study demonstrates for the first time that ATP2A1 is a potential pathogenic factor, which may play a significant role in colorectal cancer.

The diverse life-course cohort (DLCC): protocol of a large-scale prospective study in China.

The Diverse Life-Course Cohort (DLCC) is a large-scale prospective study including around 130,000 participants in mainland China. The primary aims of DLCC include contributing to knowledge on noncommunicable chronic disease determinants, particularly cardiometabolic diseases, and exploring the long-term effect of ambient air pollutants or other environmental risk factors on health among all-age populations. The cohort consists of several sub-populations that cover the whole life-course and diverse resources: from premarital to adolescents, adults from workplace and communities ranged from 18 to 93 years old. Baseline assessment (2017-2021) included face-to-face standardized questionnaire interview and measurements to assess social and biological factors of health. Blood samples were collected from each participant (except for children younger than 6) to establish the biobank. DLCC consists of two visits. Visit 1 was conducted from 2017, and 114850 individuals from one of the world-class urban agglomerations: Beijing, Tianjin, and Hebei area were recruited. By the end of 2021, at least one follow-up was carried out, with an overall follow-up rate of 92.33%. In 2021, we initiated Visit 2, newly recruited 9,866 adults from Guangdong province (South China) and Hebei province (Central China), with research focuses on the comparations on ambient pollution hazards and other unique dietary or environmental risks for health. The baseline survey of Visit 2 was finished in July 2021. DLCC is still ongoing with a long-term follow-up design, and not limited by the current funding period. With reliable data and the well-established biobank which consists of over 120,000 individuals' blood samples, DLCC will provide invaluable resources for scientific research.

Different Exposure Metrics of Rotating Night-Shift Work and Serum Lipid Profiles Among Steelworkers: A Cross-Sectional Survey in North China.

OBJECTIVES: To examine the association and potential mediators between rotating night shift work and serum lipid profiles in Chinese steelworkers. METHODS: Different exposure metrics of night shifts collected through face-to-face personal interviews. Serum lipid profiles were measured using an automatic biochemical analyzer. Generalized linear models and mediation analyses were used to analyze the main associations. RESULTS: Compared with day workers, the total cholesterol level in night-shift workers increased in those with 13 to 20 years of night shifts and in those with average frequency of four or more night shifts per month. The association between the duration of night shifts and the total cholesterol level was mediated by systolic and diastolic blood pressure and body mass index. CONCLUSIONS: Rotating night-shift work for 13 to 20 years was associated with an increase in the total cholesterol levels in steelworkers, and blood pressure and body mass index may be involved in the causal pathway.

Association between rotating night shift work and carotid intima-media thickness among Chinese steelworkers: a cross-sectional survey.

OBJECTIVE: This study aimed to examine the association between rotating night shift work and subclinical athero-sclerosis among Chinese steelworkers. METHODS: We evaluated 3582 steelworkers who participated in the legally required health examination in 2017. Carotid intima-media thickness (CIMT) was measured using ultrasonography. Different exposure metrics of night shifts collected by face-to-face personal interviews were used to examine the relationship between night shift work and the mean CIMT. RESULTS: The mean CIMT values were 0.66 (standard deviation 0.22) mm in the study population. Current shift workers shown higher mean CIMT compared to day workers. There were no significant associations between the current shift status, the duration of night shifts, the cumulative number of night shifts, the average frequency of night shifts, and the mean CIMT after all confounding factors adjusted both in male and female. CONCLUSIONS: Rotating night shift work is not associated with subclinical atherosclerosis among steelworkers. Further large-scale prospective longitudinal studies are warranted to confirm our findings.

Association between Neck Circumference and Subclinical Atherosclerosis among Chinese Steelworkers: A Cross-Sectional Survey.

The purpose of this study was to determine whether neck circumference (NC) is associated with subclinical atherosclerosis among Chinese steelworkers in North China. A cross-sectional survey was conducted among steelworkers in northern China (n = 3467). Carotid intima-media thickness (CIMT) was measured at the distal wall of the common carotid artery proximal to the bifurcation point along a plaque-free segment 10 mm long on each side by B-ultrasound. The mean of the common CIMT was used bilaterally in this study. In the cross-sectional analysis, large NC was associated with the presence of abnormal CIMT. Logistic regression analysis was used to assess the relationship between NC tertiles and CIMT. The multivariable-adjusted odds ratio was 1.76 (95% CI: 1.40 to 2.22; p for trend <0.001) for the highest tertile versus the lowest tertile and was 1.07 (95% CI: 1.04 to 1.10; p < 0.001) per 1 standard deviation increment in NC. Among steelworkers in North China, relatively large NC level is associated with elevated odds of subclinical atherosclerosis.

Rotating night shift work and liver enzymes-associated abnormalities among steelworkers: a cross-sectional study from a Chinese cohort.

OBJECTIVE: The association between shift schedules and liver enzymes is unclear. This study aims to explore the effect of rotating night shift work on increased liver enzymes. METHODS: The in-service workers of Tangsteel Company who participated in occupational health examination in Tangshan in 2017 were selected as the research objects. Multifaceted exposure metrics of night shift work and comprehensive liver enzymes were used to evaluate rotating night shift work and liver enzymes-associated abnormalities, respectively. RESULTS: There were positive associations between the odds of all liver enzymes-associated abnormalities and duration of night shifts. Different exposure metrics of night shift work were significantly associated with higher odds of elevated alanine aminotransferase (ALT), elevated gamma-glutamyl transaminase (GGT) and increased liver enzymes. Compared with those who never worked night shift, the groups of current night shift, duration of night shifts ≤ 18 years, duration of night shifts > 18 years, cumulative number of night shifts ≤ 1643 nights, cumulative number of night shifts > 1643 nights and average frequency of night shifts > 7 nights/month had an OR of increased liver enzymes of 1.31 (95% CI 1.08-1.58), 1.28 (95% CI 1.05-1.58), 1.27 (95% CI 1.04-1.55), 1.28 (95% CI 1.04-1.58), 1.27 (95% CI 1.04-1.55), 1.32 (95% CI 1.08-1.60) after adjusting for all confounders, respectively. No significant association was found between rotating night shift work and liver enzymes-associated abnormalities among female steelworkers. CONCLUSIONS: Rotating night shift work is associated with elevated ALT, elevated GGT and increased liver enzymes in male steelworkers.

Association between insomnia and subclinical atherosclerosis among Chinese steelworkers: a cross-sectional survey.

BACKGROUND: Insomnia is a common prevalent sleep disorder. Difficulty maintaining sleep or poor in quality in insomnia caused by disrupted or misaligned circadian rhythms may play an important role in the development of atherosclerosis. This study aimed to examine the association between insomnia and subclinical atherosclerosis in Chinese steelworkers. METHODS: A total of 3240 subjects from a large enterprise located in northern China were included in this study. The Athens Insomnia Scale (AIS) was used to assess the status of insomnia. Subclinical atherosclerosis was evaluated using ultrasonographic measurements of carotid plaque. Multivariable logistic regression was used to identify association between insomnia and carotid atherosclerosis. RESULTS: The overall prevalence of insomnia and carotid plaque were 35.3 and 31.7% in the study population. Compared with non-insomnia workers, significantly increased odds of carotid plaque were observed among insomnia workers after adjusting for potential confounders, odds ratio (OR) = 1.38, 95% confidence interval (CI): 1.17 to 1.63. Exposure to current shift work and insomnia simultaneously can significantly elevated the odds of carotid plaque. CONCLUSION: Insomnia is associated with elevated odds of carotid atherosclerosis in male steelworkers. Insomnia problems of workers should receive further attention in occupational worker health interventions.

Association between rotating night shift work and carotid atherosclerosis among Chinese steelworkers: a cross-sectional survey.

This study aimed to examine the association between rotating night shift work and carotid atherosclerosis in Chinese steelworkers. A total of 3582 subjects were included in this study. Different exposure metrics of night shifts, including current shift status, duration of night shifts (years), the cumulative number of night shifts (nights), cumulative length of night shifts (hours) and average frequency of night shifts (nights/month), were used to examine the relationship between night shift work and carotid atherosclerosis, including carotid plaque and carotid plaque scores. The prevalence of carotid plaque was 29.9% in the study population. Compared with day workers, significantly increased odds of carotid plaque were observed among shift workers in each quartile of the duration of night shifts after adjusting for potential confounders, especially in the third and fourth quartiles: odds ratio (OR) = 1.91, 95% confidence interval (CI): 1.46 to 2.49, in the third quartiles; OR = 1.69, 95% CI: 1.30 to 2.20, in the fourth quartiles. Positive associations of different exposure metrics of night shifts (continuous) with the odds of carotid plaque and the carotid plaque score were observed in the restricted cubic spline (RCS) models. No significant association was found in female workers between night shift work and carotid plaque. Rotating night shift work is associated with elevated odds of carotid atherosclerosis in male steelworkers.

Effect of ACE, ACE2 and CYP11B2 gene polymorphisms and noise on essential hypertension among steelworkers in China: a case-control study.

BACKGROUND: Previous studies on the relationship between ACE I/D, ACE2 G8790A and CYP11B2-344T/C gene polymorphisms and essential hypertension (EH) were inconsistent. Moreover, few studies have reported the combined effect of these gene polymorphisms and noise exposure on EH. The purpose of this study was to explore the combined and separate effects of ACE I/D, ACE2 G8790A and CYP11B2-344T/C gene polymorphisms and noise on EH among steelworkers. METHODS: A case-control study was conducted on 725 male workers between March 2014 and July 2014 in the Tangsteel Company, China. The noise exposure of the workers were measured. Logistic regression and crossover analysis were used to analyse the effects of the interactions on the EH among steelworkers. GMDR was used to determine the best combination model of gene-noise interactions. RESULTS: Multivariate logistic regression showed that noise exposure increased the odds of EH, and the OR is 1.52 (95% CI 1.04-2.22). The risk of having EH for ACE I/D DD genotype carriers was 1.99 times that for II genotype carriers (95% CI 1.14-3.51). There was a negative additive interaction between ACE2 G8790A and CYP11B2-344T/C on EH (U3 = - 2.221, P = 0.026, and S = 0.128) and a positive multiplicative interaction between ACE I/D and CYP11B2-344T/C on essential hypertension (P = 0.041). In addition, there was no significant gene-noise interaction model through the GMDR method after adjusting the confounders. CONCLUSIONS: The ACE DD genotype may make men susceptible to EH. Simultaneously carrying the DD genotype of ACE I/D and the TC genotype of CYP11B2-344T/C increased the risk of EH.

Rotating night shift work, sleep duration and elevated gamma-glutamyl transpeptidase among steelworkers: cross-sectional analyses from a Chinese occupational cohort.

OBJECTIVES: This study aimed to evaluate the separate and combined effects of rotating night shift work and lifestyle factors with elevated gamma-glutamyl transpeptidase (GGT) among steelworkers. DESIGN, SETTING AND PARTICIPANTS: This cross-sectional study used the baseline information from a Chinese occupational cohort. The in-service workers of the production department of Tangsteel Company who participated in the occupational health examination in Tangshan from February to June 2017 were selected as the research objects. MAIN OUTCOME MEASURES: The separate and combined effects of rotating night shift work and lifestyle factors with elevated GGT among steelworkers. RESULTS: The information of 7031 subjects from the production department of Tangsteel Company was analysed. Results showed that the current shift workers and the workers with the duration of night shifts>19 years, the cumulative number of night shifts>1774 nights, the average frequency of night shifts≤7 nights/month and the average frequency of night shifts>7 nights/month had elevated odds of elevated GGT, compared with those who never worked night shifts, and ORs, (95% CIs) were 1.39, (1.10 to 1.75), 1.46, (1.15 to 1.86), 1.46, (1.15 to 1.85), 1.34, (1.04 to 1.73) and 1.37, (1.09 to 1.74) after adjustment for potential confounders. The independent effect of shorter sleep duration (<7 hours/day) on elevated GGT was not statistically significant. Among workers who had shorter sleep duration, the association between rotating night shift work and elevated GGT was statistically significant, but no associations were found among workers with the sleep duration of ≥7 hours/day. In addition, other lifestyle factors affected the association between rotating night shift work and elevated GGT. CONCLUSIONS: Rotating night shift work is associated with elevated GGT among steelworkers. In particular, the effect of rotating night shift work on elevated GGT was affected by sleep duration and other lifestyle factors.

Association of Rotating Night Shift Work with Body Fat Percentage and Fat Mass Index among Female Steelworkers in North China.

The aim of this study was to evaluate the associations of rotating night shift work with body fat percentage (BF%) and fat mass index (FMI). A cross-sectional study was conducted among 435 female steelworkers, aged 26-57 years in Tangshan, China. BF% was assessed via bioelectrical impedance analysis and FMI was calculated. Different exposure metrics of night shift work were used to examine the effects of night shift work on BF% and FMI. The duration (years), cumulative number (nights), and cumulative length of night shifts (hours) were positively correlated with FMI and BF%, and these relationships were independent of body mass index (BMI). Compared with day workers, night shift workers with an average frequency of night shifts >7 nights/month (odds ratio (OR) 2.50, 95% confidence interval (CI) 1.17 to 5.35) and percentage of hours on night shifts >30% (OR 2.55, 95% CI 1.21 to 5.39) had elevated odds of obesity (BF% ≥ 35.0%). Nonobese night shift workers by the BMI criterion should also be alert to the risk of the excess accumulation of body fat, which is actually responsible for most obesity-associated adverse health consequences. Health interventions for related populations need to be improved, which is currently more focused on overall weight control.

An association between cumulative exposure to light at night and the prevalence of hyperuricemia in steel workers.

OBJECTIVES: Exposure to light at night (LAN) can disturb circadian endocrine and metabolic rhythms. Hyperuricemia (HUA) is an early-onset metabolic disorder. However, it is still not clear whether LAN exposure increases the prevalence of HUA. MATERIAL AND METHODS: The authors used crosssectional data on the Beijing-Tianjin-Hebei occupational populations cohort from March-July 2017. A total of 7664 steel workers were finally selected to investigate the relationship between LAN exposure and the prevalence of HUA among steel workers. The authors collected demographic and socio-economic data, as well as information on lifestyle factors, anthropometric measures, and laboratory tests. The restricted cubic spline method was used to analyze the dose-response relationship between cumulative LAN exposure and the prevalence of HUA. Logistic regression analyses were used to fit the relationship between them. RESULTS: The average age of the participants was 43.5±8.6 years; 7051 (91.7%) of them were males, 2749 (35.9%) reported to suffer from HUA, and 1241 (16.2%) were not exposed to LAN. There was a significant non-linear dose-response relationship between them. After adjustment for the confounding factors, including demographic data, lifestyle factors, etc., the lower LAN exposure was significantly associated with HUA (0-1931.7 days, OR = 1.180, and the 95% CI: 1.000-1.394; 1931.7-4343 days, OR = 1.215, 95% CI: 1.035-1.426). CONCLUSIONS: This study revealed that a certain amount of exposure to LAN is independently related to the prevalence of HUA in steel workers in China. Int J Occup Med Environ Health. 2021;34(3):385-401.

Associations of Occupational Heat Stress and Noise Exposure with Carotid Atherosclerosis among Chinese Steelworkers: A Cross-Sectional Survey.

Occupational exposure to heat stress and noise at the workplace are widespread physical hazards and have been associated with an increase in both morbidity and mortality. This study aims to examine the association between occupational heat stress and noise exposure and carotid atherosclerosis in Chinese steelworkers. A total of 3471 subjects were included in this study. Carotid plaque was measured using ultrasonography. The occupational information was collected by face-to-face personal interviews and all of the reported information was verified with the company's records. Workers were divided into non-exposure and exposure groups according to the company's records regarding previous and/or current heat stress and noise exposure status in the workplace. The prevalence of carotid plaque was 30.1% in the study population and workers exposed to both occupational heat stress and noise had the highest prevalence of carotid plaque at 37.2%. The odds of carotid plaque in individuals of different exposure status were significantly elevated after adjustment for potential confounders, especially in the heat stress and noise exposure combination group: OR = 1.32, 95% CI: 1.06 to 1.65, in individuals who had experienced heat stress exposure; OR = 1.49, 95% CI: 1.18 to 1.88, in individuals who had experienced noise exposure; OR = 2.02, 95% CI: 1.60 to 2.56, in the combination group. No significant association in female workers and no significant multiplicative or additive interactions were found between occupational heat stress and noise exposure and carotid plaque. Exposure to occupational heat stress and noise are statistically associated with carotid atherosclerosis among male steelworkers.