FNIP1 suppresses colorectal cancer progression through inhibiting STAT3 phosphorylation and nuclear translocation.

Folliculin interacting protein 1 (FNIP1) primarily participates in regulating cellular energy metabolism and is associated with Birt-Hogg-Dubé (BHD) syndrome. Although FNIP1 has been demonstrated to function as both a tumor suppressor and promoter, its role in colorectal cancer (CRC) remains unclear. Our study demonstrated a significant downregulation of FNIP1 in CRC, correlating with shorter overall and disease-specific survival. FNIP1 may potentially serve as an independent prognostic factor in CRC. Moreover, FNIP1 inhibited CRC progression in vitro and in vivo. Mechanistically, FNIP1 bound to phosphorylated signal transducer and activator of transcription-3 (p-STAT3) and downregulated its expression. FNIP1 deletion increased STAT3 phosphorylation and nuclear localization, thereby promoting CRC progression. The use of p-STAT3-specific chemical inhibitors successfully mitigated excessive tumorigenesis resulting from FNIP1 absence. Thus, our results suggest that FNIP1 hinders CRC progression by suppressing STAT3 phosphorylation and nuclear translocation. FNIP1 may be a candidate prognostic indicator and a therapeutic target for intervention in CRC.

Prediction of return to work outcomes under an injured worker case management program.

INTRODUCTION: Many factors affect worker return to work (RTW) after occupational injury, among which effective case management strategies play a particularly vital role in prompting workers for a successful RTW. Objectives This study aimed at predicting the RTW outcome and optimizing the intervention scheme of a case management program initiated in China. METHODS: A retrospective cohort was formed with 523 injured workers treated at a rehabilitation center for work injuries in southern China. The social demographic information, medical data and intervention process were extracted from the medical records of the rehabilitation center. A Cox Regression Model was used to examine the predictors of RTW case management. RESULTS: 261 patients (77.9%) out of the 335 valid subjects successfully returned to work after median absence duration of 36.0 days. A computer skills training program was a positive factor for RTW outcomes (hazard ratio 1.5, P < 0.001). Psychological counseling was possibly an important measure to improve RTW with a hazard ratio of 3.4 (95% CI 0.94-16, P > 0.05). Disability adjustment accommodations did not specifically benefit RTW. Education level, family's attitude to RTW, personal perceptions about social support for RTW, and injury severity were significantly associated with outcomes of RTW. CONCLUSIONS: It was implied that RTW intervention should be focused on a specific skill reconstruction and training which was presumably related with labor market needs. However, tailored psychological counseling and disability adjustment activity should not be ignored in RTW.

Case management after long-term absence from work in China: a case report.

INTRODUCTION: Return-to-work (RTW) after occupational injuries is an important and challenging issue. Case managers are expected to play a vital role in successful RTW. In China, RTW intervention is in its early phase and requires further research and practice. OBJECTIVES: This case report describes Mr. H's RTW process for illustrating the work of a case management team in China. Suggestions on developing and optimizing the process in China are given. METHODS: After 9 years of absence from work due to severe burn injuries at work, Mr. H was referred for RTW interventions. Mr. H received social and occupational rehabilitation services of 3 months, and the following workplace visits and work trials. After the job placement, the case manager continued the liaison with the worker and employer. RESULTS: Mr. H showed positive changes in occupational and social adjustment after the case management interventions. This was reflected from the shift from the contemplation to action stage on the Lam Assessment of Stages of Employment Readiness. Despite he did not show significant changes on functional capacity and fear avoidance beliefs, Mr. H passed the job credential test and was offered a maintenance technician position at a new company. Both the worker and the employer were satisfied with the outcome of the case management. CONCLUSIONS: The RTW interventions carried out by the case managers appeared to be effective within the Chinese system. The results suggested that professional training of case managers, RTW-related policies and technological standards, early integrated interventions should be further developed in China. Disability Adjustment Group Therapy and RTW Support Groups perhaps are useful approaches in workers' returning to work.

Retrospective occupational exposure assessment for case-control and case-series epidemiology studies based in Shanghai China.

To provide exposure information for epidemiology studies conducted in Shanghai from 2001 to 2008, we completed retrospective exposure assessments (EA) of benzene and other hazards. Interviewers administered questionnaires to subjects from Shanghai area hospitals. An initial exposure screening by EA staff members, blinded as to case-control status, stratified jobs into exposed, unexposed, or uncertain categories prior to review by a separate expert panel (EP). Resources for the EA included job/industry-specific questionnaire responses by subjects, short-term benzene area concentration measurements from a Shanghai regulatory agency database, Chinese literature for qualitative and short-term quantitative measurements, on-site investigations, summaries of technology changes, and selected task simulations with concurrent benzene concentration measurements. An EP in Shanghai completed semi-quantitative benzene exposure assignments, with categories of 0 to 4 corresponding to intensity ranges of none, <1, 1 to 10, >10 to 100, and >100 mg/m(3). For other hazards, sources included the EP's knowledge of the industries and Chinese and Western literature. For benzene, 20% of the EAs selected by a stratified random process were evaluated by two alternate methods. The study database of potential cases and controls included 18,857 jobs from the subjects' work histories. From 818 individuals initially screened as probably benzene exposed, 964 jobs underwent further review. From subjects with final diagnoses, 755 jobs qualified for inclusion in the final database for any study. For other exposures, the EA considered 17,893 jobs from 7654 subjects for possible exposures and were in the final study database. Of these, 2565 individuals had exposures of study interest from their 4909 exposed jobs. The prevalent exposures included agricultural chemicals, petroleum products, and metals. The EA involved extensive information assembly and exposure assignment by an EP and periodic reviews. The methods described went beyond those typically applied in past general population studies and may have provided improved information for the epidemiologic analyses. However, sufficient, reliable measured historical data are lacking to evaluate this conclusion.

Patterns of work-related traumatic hand injury among hospitalised workers in the People's Republic of China.

OBJECTIVES: This study describes the type, location and severity of work-related acute traumatic hand injuries of 560 workers treated in 11 hospitals in three economically active cities in the People's Republic of China (PRC) over a 2-year period. METHODS: A structured questionnaire was used to collect participant's information. Log-linear and logistic models were constructed to identify factors associated with injury occurrence and severity, respectively. RESULTS: Participants (n=560) had a mean age of 31.7 years (SD 10.5), 74.4% were men. 85.4% of participants were employed in manufacturing industries; 51.7% of 750 injuries were to the left hand. The index finger was injured most often and the most severe injury occurred to the right thumb. 68.3% of participants had only a single type of injury (29.7% crushes, 25.7% amputations and 18.5% fractures). Severe injuries occurred most often while working with food products (79.2% severe), furniture (72.2%), non-metallic mineral products (71.4%) and wood products (70.6%). Powered machines were involved in 59.5% of injuries. Injury frequency was associated with gender (male vs female, odds ratio (OR) 2.9, 95% CI 2.4 to 3.5) and company size (100 employees, OR 2.5, 95% CI 2.1 to 3.1). Injury severity was associated with gender (male vs female OR 0.6, 95% CI 0.4 to 0.9) and powered machine use (OR 2.2, 95% CI 1.3 to 3.7). CONCLUSIONS: The present study suggests that working in manufacturing industries and working with powered machines are the primary sources of severe hand injuries in hospitalised workers in economically active areas of the PRC.

Determinants of return to work after occupational injury.

INTRODUCTION: The promotion of return to work (RTW) following occupational injury benefits injured workers, their families, enterprises and the society. The identification of the potential determinants would be helpful in improving RTW rate and minimizing the duration of absenteeism following injury. OBJECTIVES: The aim of the study was to identify the potential determinants of RTW following work-related injury. METHODS: A historical cohort of workers with occupational injury in a state-owned locomotive vehicles company in central China was followed up on the outcomes of RTW. Demographic, employment and medical information was retrieved from the company archival documents; and post-injury information was interviewed by structured questionnaires. Univariate analysis and Cox Regression Model were used to examine the associations between potential determinants and outcomes of RTW. RESULTS: Three hundred of the 323 cases (92.9%) eventually returned to work after the median absence of 43 days. Factors from socio-demographic, clinical, economic, and psychological domains affected RTW in the univariate analyses. The multivariate analysis indicated that age, injury severity, injury locus, injury nature, pain in the injury locus, self-report health status and pre-injury monthly salary were significant determinants of RTW. CONCLUSIONS: There were multidimensional factors affecting RTW after occupational injury. Proper clinical treatment and rehabilitation, as well as economic and social support to facilitate workers' RTW would be the priorities upon intervention. Future studies should be conducted in larger representative samples to confirm the findings and to develop a multidisciplinary intervention strategy towards promoting RTW.

[Predictors of return to work after occupational injury in a locomotive enterprise].

OBJECTIVE: To identify the potential determinants of return to work (RTW) following work-related injury. METHODS: A historical cohort of workers with occupational injury in a state-owned locomotive vehicle company in central China was followed up for RTW. Demographic, employment and medical information was retrieved from the company archival documents; and post-injury information was interviewed by questionnaires. Univariate analysis and Cox Regression Model were used to examine the associations between potential determinants and outcomes of RTW. RESULTS: Three hundred of the 323 included cases (92.9%) eventually returned to work after the median absence of 43 days (average of 49.2 days). Factors from socio-demographic, clinical, economic and psychological domains were found affecting RTW in the univariate analyses. The multivariate analysis indicated that age, injury severity, injury locus, injury nature, pain in the injury locus, self-reported health status and pre-injury monthly salary were significant determinants of RTW. CONCLUSIONS: There are multidimensional factors affecting RTW after occupational injury. Proper clinical treatment and rehabilitation, as well as economic and social support to facilitate workers' RTW would be the priorities for intervention. Future studies should be conducted in a larger representative sample to confirm the findings and to develop a multidisciplinary intervention strategy towards promoting RTW.

[Synergistic interaction between MMP-3, VDR gene polymorphisms and occupational risk factors on lumbar disc degeneration].

OBJECTIVE: To explore the synergistic interaction between MMP-3,VDR gene polymorphisms and occupational risk factors on lumbar disc degeneration. METHODS: A case-control study including 178 cases of lumbar disc degeneration and 284 controls was carried out through questionnaire and polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) technology. Additive model was used to analyze the synergistic interaction between gene polymorphisms and occupational risk factors. RESULTS: The non-conditional logistic regression analysis showed that bending/twisting, whole-body vibration, heavy physical workload, alleles 5A of MMP-3 (6A5A/5A5A) and A of VDR-Apa (AA/Aa) were significantly associated with lumbar disc degeneration(OR = 4.06, 8.96, 5.46, 1.96 and 1.70, respectively, P < 0.05). There were synergistic interactions between the mutation genotype 5A of MMP-3 and whole-body vibration exposure, between the mutation genotype 5A of MMP-3 and bending/twisting, and between the mutation genotype A of VDR-Apa and whole-body vibration exposure (SI: 13.27, 2.91 and 2.35 respectively, P < 0.05). CONCLUSION: People with the mutation genotypes 5A of MMP-3 and/or A of VDR-Apa may have the increased risk of developing lumbar disc degeneration if they are exposed to whole-body vibration and/or bending/twisting.

Benzene exposure in industries using or manufacturing paint in China--a literature review, 1956-2005.

A systematic review of the Chinese literature was conducted from 1956 to 2005. The survey included both online and manual searching, as well as expert discussions aimed at providing insight into factors affecting benzene exposure levels in paint/coatings industries. Data extracted from 204 papers included: (1) year of occurrence, (2) type of paint/coatings products, (3) type of industries where the products were used or produced, (4) job titles and work activities, (5) type of literature searched, (6) working conditions whenever data were available, and (7) exposure levels. Most benzene measurements were short-term samples for comparison with the Chinese maximum allowable concentration standard. The accuracy and precision of the sampling and analytical methods were not reported. The distribution of benzene concentrations was tested and found to fit neither normal nor lognormal distributions. Analysis of variance (comparison for more than two groups) and t-test (comparison for two groups) were conducted on Blom-transformed benzene concentration data. The overall median benzene exposure levels were 215, 82, 31, and 6 mg/m(3) during the periods 1956-1978, 1979-1989, 1990-2001, and 2002-2005, respectively. Mean benzene exposure was significantly lower for paint manufacturing than paint spraying. No significant difference was found among paint types and benzene exposure for paint application. Benzene exposure was significantly higher in workplaces judged to have poor ventilation. No significant differences were found in benzene exposure as a function of industry type. Even though substantially lower when compared with levels in the past, recent benzene exposure measurements suggested that many facilities in the paint/coatings industries in China still have benzene concentrations that are above the current China occupational exposure limit for benzene (6 mg/m(3) as a time-weighted average). Benzene concentrations from the present exercise, while not directly supporting quantitative retrospective exposure estimating, provide insight on relative benzene exposure for painting tasks in the reported industries over time.

The relationship between socio-demographic variables, job stressors, burnout, and hardy personality in nurses: an exploratory study.

BACKGROUND: Nursing is considered as a risk profession with high levels of stress and burnout, and these levels are probably increasing. OBJECTIVES: A model of prediction of burnout in nursing that includes socio-demographic variables, job stressors, and personal vulnerability, or resistance, is proposed. DESIGN: A cross-sectional correlational design was used. A sample of 473 nurses and student nurses in practice from three General Hospitals in Madrid (Spain) completed the "Nursing Burnout Scale". The data were analysed using descriptive statistics, Pearson correlations, and hierarchical multiple regression. RESULTS: The proposed model is a good predictor of the diverse burnout sub-dimensions: emotional exhaustion, depersonalisation, and lack of personal accomplishment. Significant predictors of burnout included age, job status, job stressors (workload, experience with pain and death, conflictive interaction, and role ambiguity), and hardy personality (commitment, control, and challenge). CONCLUSIONS: Identifying an integrative process of burnout among nurses is an essential step to develop effective managerial strategies so as to reduce the burnout problem. Specifically, the present study suggests that intervention aimed at reducing the risk for burnout may achieve better results if it includes enhancement of workers' hardy personality rather than just decreasing environmental stressors.

[A psychophysical evaluation of NIOSH Lifting Equation in a Chinese young male population: a pilot study].

OBJECTIVE: To determine the maximum acceptable weight of lift (MAWL) in a Chinese young male population, and examine whether the revised weight limit recommended by the US. National Institute for Occupational Safety and Health can be used for Chinese workers. METHODS: Eleven young male college students participated in the experiment. The psychophysical approach was used to determine the MAWL with the different frequencies of lift, the heart rate and the self-evaluation. The weight was lifted from the floor to the work-table (760 mm). The results were compared with the recommended weight limit (RWL) and the MAWL by Snook. RESULTS: The MAWL of young male was 34.1 kg while the MAWL with frequency of 1, 4 and 8/min was 17.4, 14.7 and 12.2 kg respectively. The overall MAWL were lower than RWL of NIOSH and the results of Snook. CONCLUSION: The NIOSH 1991 equation such as load constant and frequency multiple should be revised when the NIOSH limits is used in Chinese population.

[Effects of dusts on workers' health in enzyme production plants].

OBJECTIVE: To assess the health effects of dusts in enzyme production plants. METHODS: The concentration of enzyme-containing dusts, the enzyme and the wheat-containing dusts and their health effects on workers were investigated in three enzyme production plants. Air samples were collected by high volume sampler and personal sampler. Total dust was weighed and its content of enzyme was analyzed by enzyme activity method. Health effects were assessed by the questionnaire, the pulmonary function and the skin prick test. RESULTS: It was found that the geometric mean of enzyme-containing dust was 8.91 mg/m(3), the industrial enzyme was 1.68 mg/m(3), and the wheat-containing dust was 6.93 mg/m(3). The enzyme-containing dust higher than 20 mg/m(3) caused eye symptoms. The wheat-containing dust at 6.93 mg/m(3) might result in skin and nose symptoms. The sensitization could be observed in enzyme and wheat exposed workers. CONCLUSION: Adverse effects may arise for the health of the workers if the concentration of enzyme-containing dusts and the wheat-containing dusts is up to a certain limit and it is necessary to make the limit of these indexes.

An overview of published benzene exposure data by industry in China, 1960-2003.

This article presents an overview of occupational benzene exposures in China based on data published in Chinese medical journals. The data were derived from 384 reports of benzene poisoning or industrial hygiene surveys published in Chinese medical journals between 1960 and 2003. The following information was extracted whenever available: industry, occupation, task, date, benzene levels, sampling location, workplace descriptions and, for case reports, medical diagnosis. Each paper provided one or more sets of benzene data, each set representing a sampling location or job title with one to several measurements including, mainly, breathing zone area concentration measurements, and much less frequently personal monitoring. Two criteria based on data quality were applied to select suitable data for analyses. The selected exposure data were analyzed by industry and time period. Nine hundred five sets of benzene measurements from 72 industries were reported in the 384 papers selected for this review, and 621 sets (68.6%) presented average benzene concentrations, which covered 55 industries. The distribution of the reported average benzene exposures was skewed with a median of 51.5 mg/m3. The average benzene concentrations were below 100 mg/m3 for 406 (65%) of the 621 reported average concentrations. The medians of the reported averages in mg/m3 for the five industries with the highest exposures were: 124.8 for leather products, 98.7 for electronic devices, 75.4 for machinery, 50.4 for shoes, and 50.3 for office supplies and sports equipment manufacturing. These data describe the concentrations and changing patterns of occupational benzene exposure by industry and time period in China.

[Isometric muscle strength measurements and assessment: a pilot study].

OBJECTIVE: To determine the anthropometric parameters and the isometric muscle strength in a working population sample in China, and to investigate the relationship between muscle strength and individual attributes, such as age, gender, height and weight. METHODS: The study population consisted of 146 male and 47 female people including workers, administrators and college students. Four types of muscle strength, i.e., handgrip, arm lift, shoulder lift, and torso pull, were measured. RESULTS: Left handgrip, right handgrip, arm lift, shoulder lift and torso pull of male workers were (42.07 +/- 7.20), (43.92 +/- 7.14), (26.79 +/- 4.64), (33.79 +/- 6.88), (88.56 +/- 17.98) kg, respectively while those of female workers were (21.29 +/- 5.09), (23.26 +/- 5.47), (13.29 +/- 3.37), (18.52 +/- 4.01), (41.06 +/- 12.04) kg, respectively. The female's strength was about 50% lower than the male's. The strength in the 40 approximately years old group was higher than that in other age groups. There were significant positive correlation between the gender and the isometric strength as well as between the body weight and the isometric strength. If the body weight served as the corrected parameter, there was no significant difference in the handgrip among the groups (P < 0.05), but the torso pull of male workers > college students > administrators. All relative muscle strengths except the torso pull were similar for all age groups. CONCLUSION: The body weight as the independent variable can be used for establishing the predictive equation of the muscle strength. Calculation of the relative muscle strength can relieve the interference of the body weight for the muscle strength.

Occupational health services in PR China.

In China, the origin of occupational health started in the mid 1950s soon after the founding of the People's Republic of China. However, more complete concept and practice of occupational health was defined after the early 1980s, when China started her full-scale drive for economic reform and policy of openness. The integrity intends to cover occupational health, occupational medicine, industrial toxicology, industrial hygiene, occupational ergonomics, and occupational psychology as theoretical and practical components of occupational health. As a result, occupational health in China has undergone many changes and has improved over the past decades. These changes and improvements came about, most likely due to a new scheme, where a holistic approach of the recognition, regulation, and provision of occupational health services in a wider coverage is gradually formed and brought into effect. This presentation provides the current status of occupational health and safety problems, the latest legislative to occupational health and safety, and a general scenario of the organizational structure and function of occupational health services in China. It attempts to share with participants both our experience and lessons learned towards creating a more open and effective channel of ideas and information sharing.

Study on musculoskeletal disorders in a machinery manufacturing plant.

Musculoskeletal disorders and related risk factors in machinery manufacturing were investigated using interviews, postural analysis, and the revised National Institute for Occupational Safety & Health lifting equation. Sixty-nine workers involved in manual materials handling (Job A) and 51 machinery workers less involved with manual material-handling tasks (Job B) were studied. Low back pain (LBP) (at least one episode lasting for 24 hours or more in past 12 months) prevalence rates were 63.8% and 37.3% for Jobs A and B, respectively. Prevalence rates of LBP every day for a week or more attributed to lifting were 26.09% and 5.88% for Jobs A and B, respectively. Multiple regression analysis revealed that lifting repetitiveness and work age contributed to the occurrence of LBP. The "composite load" (object weight x activity repetitiveness) had a significant adverse effect on LBP.

[Study on the application of benchmark dose and biological monitoring indexes of fluorides in drinking water].

OBJECTIVE: By using Benchmark Dose (BMD) approach to explore the relations among drinking water fluoride, urine fluoride, serum fluoride and dental fluorosis; and to evaluate the significance of urine fluoride and serum fluoride in control and prevention of endemic fluorosis. METHODS: 512 children (290 in Xinhuai Village, 222 in Wamiao Village) aged 8-13 years were recruited in the study. Epidemiological methods were used to investigate the prevalence of dental fluorosis, and the levels of urine fluoride, serum fluoride, and drinking water fluoride in superficial well. The children were divided into six subgroups by the concentration of fluoride in drinking water: < 0.5 mg/L, 0.5-mg/L, 1.0-mg/L, 2.0-mg/L, 3.0-mg/L and > or = 4.0 mg/L. RESULTS: There was significant dose-response relationship between the drinking water fluoride and the prevalence of dental fluorosis or the prevalence of defect dental fluorosis. The BMDLs (Benchmark Dose Lower Bound) were 1.01 and 1.30 mg/L, respectively. Urine fluoride and serum fluoride also had significant dose-response relationship to the prevalence of dental fluorosis or defect dental fluorosis. The correlation coefficient between drinking water fluoride and urine fluoride was 0.717, and it was 0.855 between drinking water fluoride and serum fluoride, and 0.617 between urine fluoride and serum fluoride. CONCLUSIONS: The currently national standard of fluoride in drinking water in China is safe and reasonable. As a biological monitoring index, the levels of fluoride in serum may be more useful than that in urine in the control and prevention of endemic fluorosis.