Household ventilation may reduce effects of indoor air pollutants for prevention of lung cancer: a case-control study in a Chinese population

Health effects associated with exposure to secondhand smoke: a Burden of Proof study

Despite a gradual decline in smoking rates over time, exposure to secondhand smoke (SHS) continues to cause harm to nonsmokers, who are disproportionately children and women living in low- and middle-income countries. We comprehensively reviewed the literature published by July 2022 concerning the adverse impacts of SHS exposure on nine health outcomes. Following, we quantified each exposure-response association accounting for various sources of uncertainty and evaluated the strength of the evidence supporting our analyses using the Burden of Proof Risk Function methodology. We found all nine health outcomes to be associated with SHS exposure. We conservatively estimated that SHS increases the risk of ischemic heart disease, stroke, type 2 diabetes and lung cancer by at least around 8%, 5%, 1% and 1%, respectively, with the evidence supporting these harmful associations rated as weak (two stars). The evidence supporting the harmful associations between SHS and otitis media, asthma, lower respiratory infections, breast cancer and chronic obstructive pulmonary disease was weaker (one star). Despite the weak underlying evidence for these associations, our results reinforce the harmful effects of SHS on health and the need to prioritize advancing efforts to reduce active and passive smoking through a combination of public health policies and education initiatives.

Cellular mechanisms linking to outdoor and indoor air pollution damage during pregnancy

Pregnancies are a critical window period for environmental influences over the mother and the offspring. There is a growing body of evidence associating indoor and outdoor air pollution exposure to adverse pregnancy outcomes such as preterm birth and hypertensive disorders of pregnancy. Particulate matter (PM) could trigger oxi-inflammation and could also reach the placenta leading to placental damage with fetal consequences. The combination of strategies such as risk assessment, advise about risks of environmental exposures to pregnant women, together with nutritional strategies and digital solutions to monitor air quality can be effective in mitigating the effects of air pollution during pregnancy.

Assessment of Indoor Air Quality in Academic Buildings Using IoT and Deep Learning

Humans spend most of their lifetime indoors; thus, it is important to keep indoor air quality within acceptable levels. As a result, many initiatives have been developed by multiple research centers or through academic studies to address the harmful effects of increased indoor pollutants on public health. This research introduces a system for monitoring different air parameters to evaluate the indoor air quality (IAQ) and to provide real-time readings. The proposed system aims to enhance planning and controlling measures and increase both safety and occupants’ comfort. The system combines microcontrollers and electronic sensors to form an Internet of Things (IoT) solution that collects different indoor readings. The readings are then compared with outdoor readings for the same experiment period and prepared for further processing using artificial intelligence (AI) models. The results showed the high effectiveness of the IoT device in transferring data via Wi-Fi with minimum disruptions and missing data. The average readings for temperature, humidity, air pressure, CO2, CO, and PM2.5 in the presented case study are 30 °C, 42%, 100,422 pa, 460 ppm, 2.2 ppm, and 15.3 µ/m3, respectively. The developed model was able to predict multiple air parameters with acceptable accuracy. It can be concluded that the proposed system proved itself as a powerful forecasting and management tool for monitoring and controlling IAQ.

Comparative Research on Ventilation Characteristics of Scattering and Sample Room from Chinese Spallation Neutron Source

Ventilation design of the scattering room and sample room in the Chinese Spallation Neutron Source (CSNS) is of great significance to maintain good indoor air quality and ensure the health of radiation workers. Based on the computational fluid dynamics (CFD) theory, the three-dimensional models of the scattering and sample rooms were established and fourteen layout schemes were simulated. Subsequently, the best schemes were selected among three typical layout schemes. On this basis, the paper presents research about the influence of changing the height of the outlet on the ventilation quality. The results show that the trend of numerical simulation is consistent with experimental data, which verifies the reliability of the numerical method. The change of the exhaust port position has an apparent influence on indoor ventilation, which reduces the air age by 4–27%. When the position of the outlet descends 0.5 m, the air age decreases by 2–11%, and this study provides guidance and suggestions for the design of the scattering and sample rooms.

Psychological Antecedents of the Intention to Open the Windows at Home and Exposure to a Ventilation Recommendation

Objective

The psychological antecedents of the intention to open the windows at home were explored through the Theory of Planned Behavior (TPB), supplemented with Habits regarding the behavior and contextual factors.

Design

A four-treatment design compared the effect of an exposure to a recommendation about home ventilation and the effect of one's own awareness odors (negative vs. positive) as a manipulated variable. Two quasi-experimental online surveys were conducted. A student sample (Study 1; N = 159) was replicated with a general population sample (Study 2; N = 338).

Results

Multiple hierarchical regression models were conducted (3 for Study 1; 3 for Study 2). The extended TPB model provided stable predictors explaining around sixty percent of variance. Attitude and Habits were the main predictors of window openings, Perceived Behavioral control as a secondary predictor. Perceived Behavioral Control contributed significatively with a negative interaction with Attitudes. Odor awareness decreased Intention to manually ventilate. No effect of recommendation was observed.

Discussion

The results filled a gap in the literature about the willingness to manually ventilate at home and efficacy of a recommendation. Practical implications argue that beyond a generic recommendation, effective messages need to be tailored regarding the determinants of willingness to open the windows.

Indoor solid fuel use for heating and cooking with blood pressure and hypertension: A cross-sectional study among middle-aged and older adults in China

A cross-sectional study was conducted to investigate the impact of solid fuel use for heating and cooking on blood pressure (BP) and hypertension, using data from the China Health and Retirement Longitudinal Study (CHARLS). The primary fuels used for indoor heating and cooking were collected by questionnaires, respectively. Hypertension was defined based on self-report of physician's diagnosis, and/or measured BP, and/or anti-hypertensive medication use. Multivariate logistic regression models were constructed to assess the associations. Among 10 450 eligible participants, 68.2% and 57.2% used indoor solid fuel for heating and cooking, respectively. Compared with none/clean fuel users, solid fuel for heating was associated with elevated BP (adjusted β: 2.02, 95% CI: 1.04-3.01 for systolic BP; adjusted β: 1.36, 95% CI: 0.78-1.94 for diastolic BP) and increased risk of hypertension (adjusted odds ratio: 1.15, 95% CI: 1.03-1.29). The impact of indoor solid fuel for heating on BP was more evident in rural and north residents, and hypertensive patients. We did not detect any significant associations between solid fuel use for cooking and BP/hypertension. Indoor solid fuel use is prevalent in China, especially in the rural areas. Its negative impact on BP suggested that modernization of household fuel use may help to reduce the burden of hypertension in China.

Landscape of epigenetically regulated lncRNAs and DNA methylation in smokers with lung adenocarcinoma

In this study, we identified long non-coding RNAs (lncRNAs) associated with DNA methylation in lung adenocarcinoma (LUAD) using clinical and methylation/expression data from 184 qualified LUAD tissue samples and 21 normal lung-tissue samples from The Cancer Genome Atlas (TCGA). We identified 1865 differentially expressed genes that correlated negatively with the methylation profiles of normal lung tissues, never-smoker LUAD tissues and smoker LUAD tissues, while 1079 differentially expressed lncRNAs were identified using the same criteria. These transcripts were integrated using ingenuity pathway analysis to determine significant pathways directly related to cancer, suggesting that lncRNAs play a crucial role in carcinogenesis. When comparing normal lung tissues and smoker LUAD tissues, 86 candidate genes were identified, including six lncRNAs. Of the 43 candidate genes revealed by comparing never-smoker LUAD tissues and smoker LUAD tissues, 13 were also different when compared to normal lung tissues. We then investigated the expression of these genes using the Gene Expression of Normal and Tumor Tissues (GENT) and Methylation and Expression Database of Normal and Tumor Tissues (MENT) databases. We observed an inverse correlation between the expression of 13 genes in normal lung tissues and smoker LUAD tissues, and the expression of five genes between the never-smoker and smoker LUAD tissues. These findings were further validated in clinical specimens using bisulfite sequencing, revealing that AGR2, AURKB, FOXP3, and HMGA1 displayed borderline differences in methylation. Finally, we explored the functional connections between DNA methylation, lncRNAs, and gene expression to identify possible targets that may contribute toward the pathogenesis of cigarette smoking-associated LUAD. Together, our findings suggested that differentially expressed lncRNAs and their target transcripts could serve as potential biomarkers for LUAD.

Personal strategies to minimise effects of air pollution on respiratory health: advice for providers, patients and the public

As global awareness of air pollution rises, so does the imperative to provide evidence-based recommendations for strategies to mitigate its impact. While public policy has a central role in reducing air pollution, exposure can also be reduced by personal choices. Qualified evidence supports limiting physical exertion outdoors on high air pollution days and near air pollution sources, reducing near-roadway exposure while commuting, utilising air quality alert systems to plan activities, and wearing facemasks in prescribed circumstances. Other strategies include avoiding cooking with solid fuels, ventilating and isolating cooking areas, and using portable air cleaners fitted with high-efficiency particulate air filters. We detail recommendations to assist providers and public health officials when advising patients and the public regarding personal-level strategies to mitigate risk imposed by air pollution, while recognising that well-designed prospective studies are urgently needed to better establish and validate interventions that benefit respiratory health in this context.

Household Fuel Use and the Risk of Gastrointestinal Cancers: The Golestan Cohort Study

BACKGROUND

Three billion people burn nonclean fuels for household purposes. Limited evidence suggests a link between household fuel use and gastrointestinal (GI) cancers.

OBJECTIVES

We investigated the relationship between indoor burning of biomass, kerosene, and natural gas with the subsequent risk of GI cancers.

METHODS

During the period 2004-2008, a total of 50,045 Iranian individuals 40-75 years of age were recruited to this prospective population-based cohort. Upon enrollment, validated data were collected on demographics, lifestyle, and exposures, including detailed data on lifetime household use of different fuels and stoves. The participants were followed through August 2018 with < 1 % loss.

RESULTS

During the follow-up, 962 participants developed GI cancers. In comparison with using predominantly gas in the recent 20-y period, using predominantly biomass was associated with higher risks of esophageal [hazard ratio (HR): 1.89; 95% confidence interval (CI): 1.02, 3.50], and gastric HR: 1.83; 95% CI: 1.01, 3.31) cancers, whereas using predominantly kerosene was associated with higher risk of esophageal cancer (HR: 1.84; 95% CI: 1.10, 3.10). Lifetime duration of biomass burning for both cooking and house heating (exclusive biomass usage) using heating-stoves without chimney was associated with higher risk of GI cancers combined (10-y HR: 1.14; 95% CI: 1.07, 1.21), esophageal (10-y HR: 1.19; 95% CI: 1.08, 1.30), gastric (10-y HR: 1.11; 95% CI: 1.00, 1.23), and colon (10-y HR: 1.26; 95% CI: 1.03, 1.54) cancers. The risks of GI cancers combined, esophageal cancer, and gastric cancer were lower when biomass was burned using chimney-equipped heating-stoves (strata difference p -values = 0.001 , 0.003, and 0.094, respectively). Duration of exclusive kerosene burning using heating-stoves without chimney was associated with higher risk of GI cancers combined (10-y HR: 1.05; 95% CI: 1.00, 1.11), and esophageal cancer (10-y HR: 1.14; 95% CI: 1.04, 1.26).

DISCUSSION

Household burning of biomass or kerosene, especially without a chimney, was associated with higher risk of some digestive cancers. Using chimney-equipped stoves and replacing these fuels with natural gas may be useful interventions to reduce the burden of GI cancers worldwide. https://doi.org/10.1289/EHP5907.

Molecular characterization of lung adenocarcinoma from Korean patients using next generation sequencing

The treatment of Lung adenocarcinoma (LUAD) could benefit from the incorporation of precision medicine. This study was to identify cancer-related genetic alterations by next generation sequencing (NGS) in resected LUAD samples from Korean patients and to determine their associations with clinical features. A total of 201 tumors and their matched peripheral blood samples were analyzed using targeted sequencing via the Illumina HiSeq 2500 platform of 242 genes with a median depth of coverage greater than 500X. One hundred ninety-two tumors were amenable to data analysis. EGFR was the most frequently mutated gene, occurring in 106 (55%) patients, followed by TP53 (n = 67, 35%) and KRAS (n = 11, 6%). EGFR mutations were strongly increased in patients that were female and never-smokers. Smokers had a significantly higher tumor mutational burden (TMB) than never-smokers (average 4.84 non-synonymous mutations/megabase [mt/Mb] vs. 2.84 mt/Mb, p = 0.019). Somatic mutations of APC, CTNNB1, and AMER1 in the WNT signaling pathway were highly associated with shortened disease-free survival (DFS) compared to others (median DFS of 89 vs. 27 months, p = 0.018). Patients with low TMB, annotated as less than 2 mt/Mb, had longer DFS than those with high TMB (p = 0.041). A higher frequency of EGFR mutations and a lower of KRAS mutations were observed in Korean LUAD patients. Profiles of 242 genes mapped in this study were compared with whole exome sequencing genetic profiles generated in The Cancer Genome Atlas Lung Adenocarcinoma. NGS-based diagnostics can provide clinically relevant information such as mutations or TMB from readily available formalin-fixed paraffin-embedded tissue.

Tobacco Smoking Modifies the Association between Hormonal Factors and Lung Cancer Occurrence among Post-Menopausal Chinese Women

Inconsistent evidence has been reported on the role of female hormonal factors in the development of lung cancer. This population-based case–control study evaluated the main effect of menstrual/reproductive factors on the risk of lung cancer, and the effect modification by smoking status. Multivariable unconditional logistic regression models were applied adjusted for age, income, education, county of residence, body mass index, smoking status, pack-years of smoking, and family history of lung cancer. Among 680 lung cancer cases and 1,808 controls, later menopause (at >54 vs. <46 years old) was associated with increased risk of lung cancer (SBOR, semi-Bayes adjusted odds ratio = 1.61, 95% PI, posterior interval = 1.10–2.36). More pregnancies (2 or 3 vs. 0 or 1) was associated with decreased risk (SBOR = 0.71, 95% PI = 0.53, 0.95). Ever being a smoker and having two or fewer pregnancies in one's lifetime could jointly increase the odds of lung cancer (RERI, relative excess risk due to interaction = 1.71, 95% CI = 0.03, 3.38). An increased number of ovulatory cycles was associated with increased risk of lung cancer (SBOR for 13 ovulatory cycles = 1.02, 95% CI = 1.00+, 1.04).

Meta-Analysis and Systematic Review in Environmental Tobacco Smoke Risk of Female Lung Cancer by Research Type

More than 50% of women worldwide are exposed to Environmental Tobacco Smoke (ETS). The impact of ETS on lung cancer remains unclear. Cohort studies since the late 1990s have provided new evidence of female lung cancer risk due to ETS. The objective of this meta-analysis and systematic review was to analyze the association of ETS with female lung cancer risk from 1997 to 2017, organised based on research design. According to our applied inclusion and exclusion criteria, 41 published studies were included. The relative risk (RR) from the cohort studies or odds ratio (OR) from case-control studies were extracted to calculate the pooled risks based on the type of study. The summary risks of ETS were further explored with the modulators of ETS exposure sources and doses. The pooled risks of lung cancer in non-smoking women exposed to ETS were 1.35 (95% CI: 1.17⁻1.56), 1.17 (95% CI: 0.94⁻1.44), and 1.33 (95% CI: 1.17⁻1.51) for case-control studies, cohort studies, and both types of studies, respectively. The summary RR estimate of the cohort studies was not statistically significant, but the RR increased with increasing doses of ETS exposure (p trend < 0.05). Based on the results of this study, ETS might be an important risk factor of female lung cancer in non-smokers.

Jiangsu Four Cancers Study: a large case-control study of lung, liver, stomach, and esophageal cancers in Jiangsu Province, China

Cancer is a major public health burden both globally and in China. The most common cancer-related deaths in China are attributable to cancers of the lung, liver, stomach, and esophagus. Previous epidemiologic studies on cancer in China have often been limited by small sample sizes, inconsistent measurements, and lack of precise and accurate data. The Jiangsu Four Cancers (JFC) Study is a population-based case-control study carried out in an effort to obtain consistent and high-quality data to investigate the life style, behavioral, environmental, and genetic factors associated with the four major cancers in China. The aim of this paper is to describe the overall design of the JFC Study and report selected findings on the major risk factors for cancers. Epidemiologic data were collected from 2003 to 2010 through in-person interviews using a structured questionnaire and blood samples were drawn. Unconditional logistic regression was used to estimate the associations of putative risk factors with risks of cancers of the lung, liver, stomach, and esophagus. The study included 2871 lung cancer cases, 2018 liver cancer cases, 2969 esophageal cancer cases, 2216 stomach cancer cases, and 8019 community controls. Low educational level, low income level, tobacco smoking, alcohol drinking, and family history of cancer were confirmed as risk factors for these major cancers. The JFC Study is one of the largest case-control studies of cancers in the Chinese population and will serve as a rich resource for future research on the four major cancers in China.

The risk of lung cancer among cooking adults: a meta-analysis of 23 observational studies

PURPOSE

Cooking has been regarded as a potential risk factor for lung cancer. We aim to investigate the evidence of cooking oil fume and risk of lung cancer.

METHODS

Medline and Embase were searched for eligible studies. We conducted a meta-analysis to summarize the evidences of case-control or cohort studies, with subgroup analysis for the potential discrepancy. Sensitivity analysis was employed to test the robustness.

RESULTS

We included 23 observational studies, involving 9411 lung cancer cases. Our meta-analysis found that, for cooking female, the pooled OR of cooking oil fume exposure was 1.98 (95% CI 1.54, 2.54, I ² = 79%, n = 15) among non-smoking population and 2.00 (95% CI 1.46, 2.74, I ² = 75%, n = 10) among partly smoking population. For cooking males, the pooled OR of lung cancer was 1.15 (95% CI 0.71, 1.87; I ² = 80%, n = 4). When sub grouped by ventilation condition, the pooled OR for poor ventilation was 1.20 (95% CI 1.10, 1.31, I ² = 2%) compared to good ventilation. For different cooking methods, our results suggested that stir frying (OR = 1.89, 95% CI 1.23, 2.90; I ² = 66%) was associated with increased risk of lung cancer while not for deep frying (OR = 1.41, 95% CI 0.87, 2.29; I ² = 5%). Sensitivity analysis suggested our results were stable.

CONCLUSION

Cooking oil fume is likely to be a risk factor for lung cancer for female, regardless of smoking status. Poor ventilation may increase the risk of lung cancer. Cooking methods may have different effect on lung cancer that deep frying may be healthier than stir frying.

Sleep Duration across the Adult Lifecourse and Risk of Lung Cancer Mortality: A Cohort Study in Xuanwei, China

Sufficient sleep duration is crucial for maintaining normal physiological function and has been linked to cancer risk; however, its contribution to lung cancer mortality is unclear. Therefore, we evaluated the relationship between average sleep duration in various age-periods across the adult lifecourse, and risk of lung cancer mortality in Xuanwei, China. An ambidirectional cohort study was conducted in 42,422 farmers from Xuanwei, China. Participants or their surrogates were interviewed in 1992 to assess average sleep hours in the age periods of 21-30, 31-40, 41-50, 51-60, 61-70, and ≥71 years, which were categorized as ≤7, 8 (reference), 9, and ≥10 hours/day. Vital status was followed until 2011. Sex-specific Cox regression models were used to estimate hazard ratios (HR) and 95% confidence intervals (CI) for lung cancer mortality in 1994-2011, adjusted for demographic, anthropometric, medical, and household characteristics. J-shaped relationships were found between average sleep duration and lung cancer mortality. The patterns were consistent across sex, age periods, and fuel usage. Compared with sleeping 8 hours/day on average, ≤7 hours/day was associated with significantly increased HRs ranging from 1.39 to 1.58 in ages ≥41 years in men, and 1.29 to 2.47 in ages ≥51 years in women. Furthermore, sleeping ≥10 hours/day was associated with significantly increased HRs ranging from 2.44 to 3.27 in ages ≥41 year in men, and 1.31 to 2.45 in ages ≤60 years in women. Greater and less than 8 hours/day of sleep in various age-periods may be associated with elevated risk of lung cancer mortality in Xuanwei, China. Cancer Prev Res; 10(6); 327-35. ©2017 AACR.

Impact of air pollution on the burden of chronic respiratory diseases in China: time for urgent action

In China, where air pollution has become a major threat to public health, public awareness of the detrimental effects of air pollution on respiratory health is increasing-particularly in relation to haze days. Air pollutant emission levels in China remain substantially higher than are those in developed countries. Moreover, industry, traffic, and household biomass combustion have become major sources of air pollutant emissions, with substantial spatial and temporal variations. In this Review, we focus on the major constituents of air pollutants and their impacts on chronic respiratory diseases. We highlight targets for interventions and recommendations for pollution reduction through industrial upgrading, vehicle and fuel renovation, improvements in public transportation, lowering of personal exposure, mitigation of the direct effects of air pollution through healthy city development, intervention at population-based level (systematic health education, intensive and individualised intervention, pre-emptive measures, and rehabilitation), and improvement in air quality. The implementation of a national environmental protection policy has become urgent.

Fuel for Life: Domestic Cooking Fuels and Women's Health in Rural China

BACKGROUND

There is evidence that household air pollution is associated with poor health in China, and that this form of air pollution may even be more of a health concern in China than the much-publicized outdoor air pollution. However, there is little empirical evidence on the relationship between household air pollution and health in China based on nationally representative and longitudinal data. This study examines the association between the type of domestic cooking fuel and the health of women aged ≥16 in rural China.

METHODS

Using longitudinal and biomarker data from the China Family Panel Studies (n = 12,901) and the China Health and Nutrition Survey (n = 15,539), we investigate the impact of three major domestic cooking fuels (wood/straw, coal, liquefied petroleum gas (LPG)) on health status using both cross-sectional and panel approaches.

RESULTS

Compared to women whose households cook with dirty fuels like wood/straw, women whose households cook with cleaner fuels like LPG have a significantly lower probability of chronic or acute diseases and are more likely to report better health. Cooking with domestic coal instead of wood or straw is also associated with elevated levels of having certain risks (such as systolic blood pressure) related to cardiovascular diseases.

CONCLUSIONS

Our study provides evidence that using cleaner fuels like LPG is associated with better health among women in rural China, suggesting that the shift from dirty fuels to cleaner choices may be associated with improved health outcomes.

Cancer incidence and mortality in Shandong province, 2012

OBJECTIVE

Population-based cancer registration data in 2012 from all available cancer registries in Shandong province were collected by Shandong Center for Disease Control and Prevention (SDCDC). SDCDC estimated the numbers of new cancer cases and cancer deaths in Shandong province with compiled cancer incidence and mortality rates.

METHODS

In 2015, there were 21 cancer registries submitted data of cancer incidence and deaths occurred in 2012. All the data were checked and evaluated based on the National Central Cancer Registry (NCCR) criteria of data quality. Qualified data from 15 registries were used for cancer statistics analysis as provincial estimation. The pooled data were stratified by area (urban/rural), gender, age group (0, 1.4, 5.9, 10.14, …, 85+ years) and cancer type. New cancer cases and deaths were estimated using age-specific rates and corresponding provincial population in 2012. The Chinese census data in 2000 and Segi's population were applied for age-standardized rates. All the rates were expressed per 100,000 person-year.

RESULTS

Qualified 15 cancer registries (4 urban and 11 rural registries) covered 17,189,988 populations (7,486,039 in urban and 9,703,949 in rural areas). The percentage of cases morphologically verified (MV%) and death certificate-only cases (DCO%) were 66.12% and 2.93%, respectively, and the mortality to incidence rate ratio (M/I) was 0.60. A total of 253,060 new cancer cases and 157,750 cancer deaths were estimated in Shandong province in 2012. The incidence rate was 263.86/100,000 (303.29/100,000 in males, 223.23/100,000 in females), the age-standardized incidence rates by Chinese standard population (ASIRC) and by world standard population (ASIRW) were 192.42/100,000 and 189.50/100,000 with the cumulative incidence rate (0.74 years old) of 22.07%. The cancer incidence, ASIRC and ASIRW in urban areas were 267.64/100,000, 195.27/100,000 and 192.02/100,000 compared to 262.32/100,000, 191.26/100,000 and 188.48/100,000 in rural areas, respectively. The cancer mortality was 164.47/100,000 (207.42/100,000 in males, 120.23/100,000 in females), the age-standardized incidence rates by Chinese standard population (ASMRC) and by world standard population (ASMRW) were 117.54/100,000 and 116.90/100,000, and the cumulative mortality rate (0.74 years old) was 13.53%. The cancer mortality, ASMRC and ASMRW were 141.59/100,000, 101.17/100,000 and 100.33/100,000 in urban areas, and 173.79/100,000, 124.20/100,000 and 123.64/100,000 in rural areas, respectively. Cancers of the lung, stomach, liver, esophagus, colorectum, female breast, brain, leukemia, bladder and pancreas were the most common cancers, accounting for about 82.12% of all cancer new cases. Lung cancer, stomach cancer, liver cancer, esophageal cancer, colorectal cancer, female breast cancer, pancreatic cancer, brain tumor, leukemia and lymphoma were the leading causes of cancer death, accounting for about 89.01% of all cancer deaths. The cancer spectrum showed difference between urban and rural, males and females both in incidence and mortality rates.

CONCLUSIONS

Cancer surveillance information in Shandong province is making great progress with the increasing number of cancer registries, population coverage and the improving data quality. Cancer registration plays a fundamental role in cancer control by providing basic information on population-based cancer incidence, mortality, survival and time trend. The disease burden of cancer is serious in Shandong province, and so cancer prevention and control in Shandong province should be enhanced including health education, health promotion, cancer screening and cancer care services.

An Investigation on Formaldehyde Emission Characteristics of Wood Building Materials in Chinese Standard Tests: Product Emission Levels, Measurement Uncertainties, and Data Correlations between Various Tests

As a large producer and consumer of wood building materials, China suffers product formaldehyde emissions (PFE) but lacks systematic investigations and basic data on Chinese standard emission tests (CST), so this paper presented a first effort on this issue. The PFE of fiberboards, particleboards, blockboards, floorings, and parquets manufactured in Beijing region were characterized by the perforator extraction method (PE), 9–11 L and 40 L desiccator methods (D9, D40), and environmental chamber method (EC) of the Chinese national standard GB 18580; based on statistics of PFE data, measurement uncertainties in CST were evaluated by the Monte Carlo method; moreover, PFE data correlations between tests were established. Results showed: (1) Different tests may give slightly different evaluations on product quality. In PE and D9 tests, blockboards and parquets reached E1 grade for PFE, which can be directly used in indoor environment; but in D40 and EC tests, floorings and parquets achieved E1. (2) In multiple tests, PFE data characterized by PE, D9, and D40 complied with Gaussian distributions, while those characterized by EC followed log-normal distributions. Uncertainties in CST were overall low, with uncertainties for 20 material-method combinations all below 7.5%, and the average uncertainty for each method under 3.5%, thus being acceptable in engineering application. A more complicated material structure and a larger test scale caused higher uncertainties. (3) Conventional linear models applied to correlating PFE values between PE, D9, and EC, with R² all over 0.840, while novel logarithmic (exponential) models can work better for correlations involving D40, with R² all beyond 0.901. This research preliminarily demonstrated the effectiveness of CST, where results for D40 presented greater similarities to EC—the currently most reliable test for PFE, thus highlighting the potential of Chinese D40 as a more practical approach in production control and risk assessment.

Exposure to second hand smoke at home and work among nonsmokers

Exposure to second hand smoke (SHS) is associated with adverse health effects. This study was undertaken to assess comparative levels of exposure to SHS at home and work among nonsmokers aged ⩾12 years. Data from National Health Examination Survey for 1999-2010 were analyzed to estimate exposure to SHS. Total number of subjects included in the study was 24,791. Those who self-reported not having used any tobacco products during the last five days were considered nonsmokers for the purpose of this study. Serum cotinine levels were used as the outcome variable to indicate the level of exposure to SHS. Adjusted serum cotinine levels for those with no exposure to SHS, exposure to SHS at work only, exposure to SHS at home only, and exposure to SHS at home and work were 0.047 (0.044-0.050)n g/mL, 0.055 (0.047-0.064) ng/mL, 0.522 (0.401-0.678) ng/mL, and 0.485 (0.280-0.0840) ng/mL respectively. Public efforts to reduce exposure to SHS at home should be strengthened.