2010 Vol. 23, No. 6
2010, 23(6): 422-429.
Objective To assess the implementation of five key tobacco control policies in China: protection from second-hand smoke (SHS); offering help to quit; health warnings regarding tobacco use; the enforcement of bans on tobacco advertising,promotion, and sponsorship; and increasing tobacco taxes and prices. Methods Using 2010 Global Adults Tobacco Survey in China (GATS-China), 10 indicators are used to assess the implementation of five key tobacco control policies of MPOWER in China. Results Overall, 63.3% and 72.7% of adultsnoticed people smoking indoor workplaces and public places,respectively. Approximately 60% of smokers were not asked about their smoking habits and approximately 67% were not advised to quit on their visit to a health worker. Sixty percent of adults noticed health warning messages on cigarette packaging and in the media in the last 30 days, 63.6% stated that they would not consider quitting. Twenty percent of respondents noticed tobacco advertising, promotion, and/or sponsorship activities in the 30 days prior to the survey. Among them, 76.3% noticed the direct advertising and 50% noticed from TV programs. Although purchasing price of one pack of cigarettes ranged from 1 to 200 RMB, 50% of current smokers (about 150 million) spent 5 RMB or less on one pack of cigarette. The expenditure on 100packets of cigarettes represents 2% of 2009 GDP per capita. Conclusion The average score for the implementation of the 5policies of MPOWER in China is 37.3 points, indicating tobacco control policies in China is poor and there is a large gaps from the FCTC requirements.
2010, 23(6): 430-436.
Objective To determine the extent of secondhand smoke exposure in China, and to explore the potential associated factors. Methods This study was a nationally representative household survey examining secondhand smoke exposure of non-institutionalized men and women aged 15 and older using a global standardized geographically clustered sample design. A total of 13 354 people completed the individual questionnaire with questions on gender, age, educational level, residence,profession, potential factors associated with secondhand smoke exposure, and workplace smoking policy. The data were used to determine whole population estimates of secondhand smoke exposure. Results Among non-smokers aged 15 years and older, it was estimated that 72.4% (556 million) were exposed to secondhand smoke, with 52.5% (292 million) exposed to secondhand smoke daily. The prevalence of secondhand smoke exposure was 74.1% for men, 71.6% for women, 70.5% for urban populations, and 74.2% for rural populations. The rates were 67.3%, 63.3%, and 72.7% respectively, within the household, indoor workplaces and public places. Secondhand smoke exposure was significantly reduced in workplaces with a smoking ban but not in workplaces with a partial smoking ban. Conclusion Although China has made some progress toward a smoke-free environment there remains a high degree of exposure to secondhand smoke.
2010, 23(6): 437-444.
Objective To determine the level of awareness of the hazards of tobacco smoking and secondhand smoke inhalation among adults in China. Methods Household surveys were conducted with a total of 13 354 respondents aged 15 years or over from 100 counties of 28 Chinese provinces using a stratified multi-stage geographically clustered sample design. Results The findings revealed that 81.8% of the population was aware that smoking causes serious diseases, and 27.2% and 38.7% were aware that smoking causes stroke and heart attack, respectively. Only 64.3% of respondents were aware that secondhand smoke can cause serious diseases, and 27.5%, 51.0%, and 52.6% were aware that secondhand smoke causes heart disease in adults,lung disease in children and lung cancer in adults, respectively. Awareness regarding smoking-related hazards across all participants was significantly associated with several factors, including gender, smoking status, urban/rural residency, education level and exposure to tobacco control publicity in the last 30 days. Awareness regarding tobacco-related hazards in smokers was significantly associated with urban/rural residency, education level, exposure to tobacco control publicity in the last 30 days,and physician's advice. Awareness relating to the hazards of inhaling secondhand smoke was associated with smoking status,urban/rural residency, age, education level, and exposure to tobacco control publicity in the last 30 days. Medical professionals were found to know more about the health hazards of tobacco compared with people in other types of employment.Conclusions Overall awareness of the health hazards of tobacco has improved in the last 15 years in China, but is still relatively poor. Improved means of communicating information and more effective warning labels on cigarette packaging are necessary for increasing public awareness of tobacco hazards, particularly among rural residents and people with less education.
Current Trends of the Prevalence of Childhood Asthma in Three Chinese Cities: A Multicenter Epidemiological Survey
2010, 23(6): 453-457.
Objective To analyze the prevalence of asthma and asthma related symptoms among children aged 0-14 years in three Chinese cities and to obtain a crude estimation of the trend of childhood asthma prevalence in China. Methods A cross-sectional, population-based survey of prevalence of asthma was conducted in children aged from 0 to 14 years in 3 major cities of China (Beijing, Chongqing, and Guangzhou) with different geographic locations. All the subjects were randomly selected by a multi-stage sampling method. Three to five schools and kindergartens in 2 urban districts in each city were randomly selected for the survey, and a validated questionnaire that included the core questions of the International Study of Asthma and Allergies in Childhood, Phase Ⅲ questionnaire and several additional questions were used. All questionnaires were completed by parents or guardians of the selected children. Children whose parents responded affirmatively to the question"Has your child ever been diagnosed as asthma by a doctor" were recognized as victims of asthma. Results The prevalence of asthma in Beijing, Chongqing, and Guangzhou was 3.15%, 7.45%, and 2.09%, respectively. These values were significantly higher than those obtained 10 years ago in the national epidemiological survey in 2000 which used the same method of investigation and the same diagnotic criteria (χ2=3.938, P=0.047; χ2=73.506, P≤0.001; χ2=11.956, P=0.001, in each city). Of the asthmatic children 57.21%, 69.91%, and 60.00% had their first attack before the age of 3 in Beijing, Chongqing, and Guangzhou, respectively. Wheezing was the primary clinical manifestation for all asthmatic children, followed by persistent cough and repeated respiratory infections. Both the prevalence of asthma and asthma-related symptoms were statistically higher in males than in females. Conclusion The prevalence of childhood asthma is statistically higher than that 10 years ago in the three Chinese cities.
2010, 23(6): 458-465.
Objective To examine maternal and fetal exposure levels to four carcinogenic metals, arsenic (As), cadmium (Cd),nickel (Ni), and beryllium (Be), and to investigate their environmental influences. Methods Metal concentrations in maternal and umbilical cord blood were measured by inductively coupled plasma-mass spectrometry (ICP-MS). Environmental factors that might play a role in exposure were analyzed using Mann-Whitney nonparametric U-tests and multiple linear regression. Results The concentrations of As, Cd, and Ni in umbilical cord blood (5.41, 0.87, and 139.54 μg/L) were significantly lower than those in maternal blool (6.91, 1.93, and 165.93 μg/L). There were significant positive correlations between the maternal and cord concentrations of each carcinogen. Our results showed that: (i) exposures to potentially harmful occupational factors during pregnancy were associated with high levels of maternal As, Cd, and Ni; (ii) living close to major transportation routes (<500 m) or exposure to second-hand smoke during pregnancy increased the maternal Cd levels and (iii)living close to industrial chimneys induced high maternal Ni levels. Multiple linear regression analysis showed that these environmental factors remained significant in models of the influences of these four carcinogens. Conclusion Both mothers and fetuses had been exposed to As, Cd, Ni, and Be. The increased levels of these carcinogens in pregnant women were associated with some detrimental environmental factors, such as occupational exposure, contact with second-hand smoke and living close to major transportation routes or industrial chimneys.
Reported Willingness and Associated Factors Related to Utilization of Voluntary Counseling and Testing Services by Female Sex Workers in Shandong Province,China
2010, 23(6): 466-472.
Objective To explore reported willingness and factors associated with utilization of voluntary counseling and testing services by female sex workers (FSWs) in China and to offer recommendations to optimize use of such services. Methods A questionnaire to explore willingness to use VCT was designed based on social ecological theory and formative qualitative research. A cross-sectional survey was conducted among FSWs from entertainment venues. Single and multiple logistic regression analyses were employed to examine factors associated with reported willingness to utilize VCT. Results A total of 970 FSWs provided valid questionnaires, with 69% (669) expressing willingness to utilize VCT. Factors at the interpersonal level associated with reported willingness included knowledge about VCT, desire to get help if diagnosed as HIV positive,ability to imagine life after an HIV positive diagnosis, and perceived support for VCT from peers, managers, and family members. Availability of free antiretroviral (ARV) treatment represented a factor at policy level. Other factors included intention to leave sex work in the near future, having had a previous HIV test, and lack of a suspected STD history.Conclusions The rate of reported willingness to use VCT among FSWs was substantially higher than that of actual VCT utilization (11%). The next step is to explore the connection between reported willingness and actual use. Based on these findings, peer education, VCT knowledge dissemination, and free ARV treatment should be emphasized to increase FSWs'willingness to use VCT.
Comparative Study on Inorganic Composition and Crystallographic Properties of Cortical and Cancellous Bone
2010, 23(6): 473-480.
Objective To comparatively investigate the inorganic composition and crystallographic properties of cortical and cancellous bone via thermal treatment under 700 ℃. Methods Thermogravimetric measurement, infrared spectrometer,X-ray diffraction, chemical analysis and X-ray photo-electron spectrometer were used to test the physical and chemical properties of cortical and cancellous bone at room temperature 250 ℃, 450 ℃, and 650 ℃, respectively. Results The process of heat treatment induced an extension in the a-lattice parameter and changes of the c-lattice parameter, and an increase in the crystallinity reflecting lattice rearrangement after release of lattice carbonate and possible lattice water. The mineral content in cortical and cancellous bone was 73.2wt% and 71.5wt%, respectively. For cortical bone, the weight loss was 6.7% at the temperature from 60 ℃ to 250 ℃, 17.4% from 250 ℃ to 450 ℃, and 2.7% from 450 ℃ to 700 ℃. While the weight loss for the cancellous bone was 5.8%, 19.9%, and 2.8 % at each temperature range, the Ca/P ratio of cortical bone was 1.69 which is higher than the 1.67 of stoichiometric HA due to the B-type CO32- substitution in apatite lattice. The Ca/P ratio of cancellous bone was lower than 1.67, suggesting the presence of more calcium deficient apatite. Conclusion The collagen fibers of cortical bone were arrayed more orderly than those of cancellous bone, while their mineralized fibers ollkded similar.The minerals in both cortical and cancellous bone are composed of poorly crystallized nano-size apatite crystals with lattice carbonate and possible lattice water. The process of heat treatment induces a change of the lattice parameter, resulting in lattice rearrangement after the release of lattice carbonate and lattice water and causing an increase in crystal size and crystallinity.This finding is helpful for future biomaterial design, preparation and application.
2010, 23(6): 481-486.
Objective This study was conducted to optimize the operational parameters of anaerobic-anoxic-oxic (A2/O) processes to reduce the toxicity of municipal wastewater and evaluate its ability to reduce toxicity. Methods A luminescent bacterium toxicity bioassay was employed to assess the toxicity of influent and effluent of each reactor in the A2/O system. Results The optimum operational parameters for toxicity reduction were as follows: anaerobic hydraulic retention time (HRT) = 2.8 h,anoxic HRT = 2.8 h, aerobic HRT = 6.9 h, sludge retention time (SRT) = 15 days and internal recycle ratio (IRR) = 100%. An important toxicity reduction (%) was observed in the optimized A2/O process, even when the toluene concentration of the influent was 120.7 mg.L-1. Conclusions The toxicity of municipal wastewater was reduced significantly during the A2/Oprocess. A2/O process can be used for toxicity reduction of municipal wastewater under toxic-shock loading.
Increased Levels of p53 and PARP-1 in EL-4 Cells Probably Related with the Immune Adaptive Response Induced by Low Dose Ionizing Radiation in vitro
2010, 23(6): 487-495.
Objective This paper is to explore the DNA repair mechanism of immune adaptive response (AR) induced by low dose radiation (LDR), the changes of mRNA levels and protein expressions of p53, ATM, DNA-PK catalytic subunit (DNA-PKcs)and PARP-1 genes in the LDR-induced AR in EL-4 cells. Methods The apoptosis and cell cycle progression of EL-4 cells were detected by flow cytometry in 12 h after the cells received the pre-exposure of 0.075 Gy X-rays (inductive dose, D 1) and the succeeding high dose irradiation (challenge dose, D2; 1.0, 1.5, and 2.0 Gy X-rays, respectively) with or without wortmannin(inhibitor of ATM and DNA-PK) and 3-aminobenzamid (inhibitor of PARP-1). And the protein expressions and mRNA levels related to these genes were detected with flow cytometry and reverse transcription-polymerase chain reaction in 12 h after irradiation with D2. Results The mRNA and protein expressions of p53 and PARP-1 in EL-4 cells in the D1 + D2 groups were much lower than those in the D2 groups, and those of PARP-1 in the 3-AB + D2 and the 3-AB + D1 + D2 groups were much lower than those in the D2 and the D1 + D2 groups. The percentage of apoptotic EL-4 cells in the 3-AB + D1 + D2groups was much higher than that in the D1 + D2 groups, that in the G0/G1 and the G2 + M phases was much higher, and that in the S phase were much lower. Although the ATM and DNA-PKcs mRNA and protein expressions in wortmannin + D1 + D2groups were much lower than those in the D1 + D2 groups, there were no significant changes in the apoptosis and cell cycle progression between the wortmannin + D1 + D2 and the D1 + D2 groups. Conclusion PARP-1 and p53 might play important roles in AR induced by LDR.
2010, 23(6): 496-501.
Objective The assay of DNA mismatch repair (MMR) activity can be used as a biomarker for environmental condition detection and human disease diagnosis. Radioactive 32P-endlabeled DNA containing mismatch is extensively used as the substrate for MMR activity analyses. The aim of the present study is to develop a simple non-radioactive, but equally specific and sensitive method for the MMR activity assay. Methods A fluorescent label was chosen to replace the radioactive isotope label. Sensitive evaluation of the fluorescent label was carried out for the first time, and then the fluorescent label was compared with the isotope label in the MMR activity and DNA binding assays. Result LOD (limit of detection) of the fluorescent label was about 0.1 fmol and the relative signal strength displayed a pretty good linear relationship. Moreover, the fluorescent label method has equivalent sensitivity and performance as compared with the classical radioactive method in experiments. Conclusion In light of the sensitivity, reproducibility, safety, rapidity and long lifespan of the fluorescent label,this improved method can be applied to evaluation of biologic and toxic effects of environmental pollutants on man and other forms of life.