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Zhao H, Zhu J, Ju L, Sun L, Tse LA, Kinra S, Li Y. Osteoarthritis & stroke: a bidirectional mendelian randomization study. Osteoarthritis Cartilage 2022; 30:1390-1397. [PMID: 35798177 DOI: 10.1016/j.joca.2022.06.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Revised: 06/17/2022] [Accepted: 06/23/2022] [Indexed: 02/02/2023]
Abstract
OBJECTIVE The epidemiological evidence on the link between osteoarthritis (OA) and stroke remains inconclusive. Herein, we adopted a two-sample bidirectional Mendelian randomization (MR) study to determine the causality relationship between OA and stroke. DESIGN Summary-level data derived from the published genome-wide association studies (GWAS) were employed for analyses. The data for OA at any site (n = 455,211), knee OA (n = 403,124), and hip OA (n = 393,873) were obtained from a meta-analysis of GWAS available in the UK Biobank and Arthritis Research UK Osteoarthritis Genetics resources. The MEGASTROKE consortium provided data for stroke (n = 446,696), ischemic stroke (IS) (n = 440,328) and its subtypes, and intracerebral hemorrhage (ICH) (n = 3,026). The main MR analysis was conducted by the inverse variance weighted (IVW) method. MR-Egger regression, MR pleiotropy residual sum and outlier, weighted median, Cochran Q statistic, and leave-one-out analysis approach were leveraged as supplements. RESULTS We detected that higher risk of hip OA was significantly associated with overall stroke [IVW odds ratio (OR): 1.12, 95% confidence interval (CI): 1.06-1.20, P = 0.0002], IS (OR: 1.13, 95%CI: 1.06-1.21, P = 0.0003), and small vessel IS (OR: 1.25, 95%CI: 1.10-1.42, P = 0.0006). However, we found no evidence that stroke and subtypes had casual effects on OA in the reverse MR analyses. CONCLUSIONS The present study provides genetic support that hip OA is a potential risk factor for overall stroke, IS, and small vessel IS. Further studies are warranted to elucidate the underlying mechanisms of causal associations between site-specific OA and stroke subtypes.
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Affiliation(s)
- H Zhao
- School of Public Health, Hangzhou Medical College, Hangzhou 310053, China
| | - J Zhu
- School of Public Health, Hangzhou Medical College, Hangzhou 310053, China
| | - L Ju
- School of Public Health, Hangzhou Medical College, Hangzhou 310053, China
| | - L Sun
- Department of Orthopaedics, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310005, China
| | - L A Tse
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, New Territories 999077, Hong Kong
| | - S Kinra
- Department of Non-Communicable Disease Epidemiology, London School of Hygiene & Tropical Medicine, London WC1E 7HT, UK
| | - Y Li
- School of Public Health, Hangzhou Medical College, Hangzhou 310053, China.
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Wang Y, Shupler M, Birch A, Chu YL, Jeronimo M, Rangarajan S, Mustaha M, Heenan L, Seron P, Saavedra N, Oliveros MJ, Lopez-Jaramillo P, Camacho PA, Otero J, Perez-Mayorga M, Yeates K, West N, Ncube T, Ncube B, Chifamba J, Yusuf R, Khan A, Liu Z, Cheng X, Wei L, Tse LA, Mohan D, Kumar P, Gupta R, Mohan I, Jayachitra KG, Mony PK, Rammohan K, Nair S, Lakshmi PVM, Sagar V, Khawaja R, Iqbal R, Kazmi K, Yusuf S, Brauer M, Hystad P. Personal and household PM 2.5 and black carbon exposure measures and respiratory symptoms in 8 low- and middle-income countries. Environ Res 2022; 212:113430. [PMID: 35526584 DOI: 10.1016/j.envres.2022.113430] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 04/22/2022] [Accepted: 05/02/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Household air pollution (HAP) from cooking with solid fuels has been associated with adverse respiratory effects, but most studies use surveys of fuel use to define HAP exposure, rather than on actual air pollution exposure measurements. OBJECTIVE To examine associations between household and personal fine particulate matter (PM2.5) and black carbon (BC) measures and respiratory symptoms. METHODS As part of the Prospective Urban and Rural Epidemiology Air Pollution study, we analyzed 48-h household and personal PM2.5 and BC measurements for 870 individuals using different cooking fuels from 62 communities in 8 countries (Bangladesh, Chile, China, Colombia, India, Pakistan, Tanzania, and Zimbabwe). Self-reported respiratory symptoms were collected after monitoring. Associations between PM2.5 and BC exposures and respiratory symptoms were examined using logistic regression models, controlling for individual, household, and community covariates. RESULTS The median (interquartile range) of household and personal PM2.5 was 73.5 (119.1) and 65.3 (91.5) μg/m3, and for household and personal BC was 3.4 (8.3) and 2.5 (4.9) x10-5 m-1, respectively. We observed associations between household PM2.5 and wheeze (OR: 1.25; 95%CI: 1.07, 1.46), cough (OR: 1.22; 95%CI: 1.06, 1.39), and sputum (OR: 1.26; 95%CI: 1.10, 1.44), as well as exposure to household BC and wheeze (OR: 1.20; 95%CI: 1.03, 1.39) and sputum (OR: 1.20; 95%CI: 1.05, 1.36), per IQR increase. We observed associations between personal PM2.5 and wheeze (OR: 1.23; 95%CI: 1.00, 1.50) and sputum (OR: 1.19; 95%CI: 1.00, 1.41). For household PM2.5 and BC, associations were generally stronger for females compared to males. Models using an indicator variable of solid versus clean fuels resulted in larger OR estimates with less precision. CONCLUSIONS We used measurements of household and personal air pollution for individuals using different cooking fuels and documented strong associations with respiratory symptoms.
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Affiliation(s)
- Ying Wang
- College of Public Health and Human Sciences, Oregon State University, Corvallis, OR, United States
| | - Matthew Shupler
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada; Department of Public Health, Policy and Systems, University of Liverpool, Liverpool, United Kingdom
| | - Aaron Birch
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - Yen Li Chu
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - Matthew Jeronimo
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - Sumathy Rangarajan
- Population Health Research Institute, Hamilton Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Maha Mustaha
- Population Health Research Institute, Hamilton Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Laura Heenan
- Population Health Research Institute, Hamilton Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | | | | | | | | | - Paul A Camacho
- Fundación Oftalmológica de Santander (FOSCAL), Floridablanca, Colombia
| | - Johnna Otero
- Fundación Oftalmológica de Santander (FOSCAL), Floridablanca, Colombia
| | | | - Karen Yeates
- Pamoja Tunaweza Research Centre, Moshi, Tanzania; Department of Medicine, Queen's University, Kingston, Ontario, Canada
| | - Nicola West
- Pamoja Tunaweza Research Centre, Moshi, Tanzania
| | - Tatenda Ncube
- Department of Biomedical Sciences, University of Zimbabwe, Harare, Zimbabwe
| | - Brian Ncube
- Department of Biomedical Sciences, University of Zimbabwe, Harare, Zimbabwe
| | - Jephat Chifamba
- Department of Biomedical Sciences, University of Zimbabwe, Harare, Zimbabwe
| | - Rita Yusuf
- School of Life Sciences, Independent University, Dhaka, Bangladesh
| | - Afreen Khan
- School of Life Sciences, Independent University, Dhaka, Bangladesh
| | - Zhiguang Liu
- Beijing An Zhen Hospital of the Capital University of Medical Sciences, China
| | - Xiaoru Cheng
- Medical Research & Biometrics Center, National Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences, China
| | - Li Wei
- Medical Research & Biometrics Center, National Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences, China
| | - L A Tse
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, HKSAR, China
| | - Deepa Mohan
- Madras Diabetes Research Foundation, Chennai, India
| | | | - Rajeev Gupta
- Eternal Heart Care Centre & Research Institute, Jaipur, India
| | - Indu Mohan
- Mahatma Gandhi University of Medical Sciences and Technology, Jaipur, India
| | - K G Jayachitra
- St. John's Medical College & Research Institute, Bangalore, India
| | - Prem K Mony
- St. John's Medical College & Research Institute, Bangalore, India
| | - Kamala Rammohan
- Health Action By People, Government Medical College, Trivandrum, India
| | - Sanjeev Nair
- Health Action By People, Government Medical College, Trivandrum, India
| | - P V M Lakshmi
- Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Vivek Sagar
- Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Rehman Khawaja
- Department of Community Health Science, Aga Khan University Hospital, Karachi, Pakistan
| | - Romaina Iqbal
- Department of Community Health Science, Aga Khan University Hospital, Karachi, Pakistan
| | - Khawar Kazmi
- Department of Community Health Science, Aga Khan University Hospital, Karachi, Pakistan
| | - Salim Yusuf
- Population Health Research Institute, Hamilton Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Michael Brauer
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - Perry Hystad
- College of Public Health and Human Sciences, Oregon State University, Corvallis, OR, United States.
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Wang Y, Shupler M, Birch A, Chu YL, Jeronimo M, Rangarajan S, Mustaha M, Heenan L, Seron P, Lanas F, Salazar L, Saavedra N, Oliveros MJ, Lopez-Jaramillo P, Camacho PA, Otero J, Perez-Mayorga M, Yeates K, West N, Ncube T, Ncube B, Chifamba J, Yusuf R, Khan A, Liu Z, Bo H, Wei L, Tse LA, Mohan D, Kumar P, Gupta R, Mohan I, Jayachitra KG, Mony PK, Rammohan K, Nair S, Lakshmi PVM, Sagar V, Khawaja R, Iqbal R, Kazmi K, Yusuf S, Brauer M, Hystad P. Measuring and predicting personal and household Black Carbon levels from 88 communities in eight countries. Sci Total Environ 2022; 818:151849. [PMID: 34822894 DOI: 10.1016/j.scitotenv.2021.151849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Revised: 11/16/2021] [Accepted: 11/17/2021] [Indexed: 06/13/2023]
Abstract
Black Carbon (BC) is an important component of household air pollution (HAP) in low- and middle- income countries (LMICs), but levels and drivers of exposure are poorly understood. As part of the Prospective Urban and Rural Epidemiological (PURE) study, we analyzed 48-hour BC measurements for 1187 individual and 2242 household samples from 88 communities in 8 LMICs (Bangladesh, Chile, China, Colombia, India, Pakistan, Tanzania, and Zimbabwe). Light absorbance (10-5 m-1) of collected PM2.5 filters, a proxy for BC concentrations, was calculated via an image-based reflectance method. Surveys of household/personal characteristics and behaviors were collected after monitoring. The geometric mean (GM) of personal and household BC measures was 2.4 (3.3) and 3.5 (3.9)·10-5 m-1, respectively. The correlation between BC and PM2.5 was r = 0.76 for personal and r = 0.82 for household measures. A gradient of increasing BC concentrations was observed for cooking fuels: BC increased 53% (95%CI: 30, 79) for coal, 142% (95%CI: 117, 169) for wood, and 190% (95%CI: 149, 238) for other biomass, compared to gas. Each hour of cooking was associated with an increase in household (5%, 95%CI: 3, 7) and personal (5%, 95%CI: 2, 8) BC; having a window in the kitchen was associated with a decrease in household (-38%, 95%CI: -45, -30) and personal (-31%, 95%CI: -44, -15) BC; and cooking on a mud stove, compared to a clean stove, was associated with an increase in household (125%, 95%CI: 96, 160) and personal (117%, 95%CI: 71, 117) BC. Male participants only had slightly lower personal BC (-0.6%, 95%CI: -1, 0.0) compared to females. In multivariate models, we were able to explain 46-60% of household BC variation and 33-54% of personal BC variation. These data and models provide new information on exposure to BC in LMICs, which can be incorporated into future exposure assessments, health research, and policy surrounding HAP and BC.
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Affiliation(s)
- Ying Wang
- College of Public Health and Human Sciences, Oregon State University, Corvallis, OR, United States
| | - Matthew Shupler
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada; Department of Public Health, Policy and Systems, University of Liverpool, Liverpool, United Kingdom
| | - Aaron Birch
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - Yen Li Chu
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - Matthew Jeronimo
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - Sumathy Rangarajan
- Population Health Research Institute, Hamilton Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Maha Mustaha
- Population Health Research Institute, Hamilton Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Laura Heenan
- Population Health Research Institute, Hamilton Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | | | | | | | | | | | | | - Paul A Camacho
- Fundación Oftalmológica de Santander (FOSCAL), Floridablanca, Colombia
| | - Johnna Otero
- Fundación Oftalmológica de Santander (FOSCAL), Floridablanca, Colombia
| | - Maritza Perez-Mayorga
- Facultad de Medicina Universidad Militar Nueva Granada and Clinica de Marly, Bogota, Colombia
| | - Karen Yeates
- Pamoja Tunaweza Research Centre, Moshi, Tanzania; Department of Medicine, Queen's University, Kingston, Ontario, Canada
| | - Nicola West
- Pamoja Tunaweza Research Centre, Moshi, Tanzania
| | - Tatenda Ncube
- Department of Biomedical Sciences, University of Zimbabwe, Harare, Zimbabwe
| | - Brian Ncube
- Department of Biomedical Sciences, University of Zimbabwe, Harare, Zimbabwe
| | - Jephat Chifamba
- Department of Biomedical Sciences, University of Zimbabwe, Harare, Zimbabwe
| | - Rita Yusuf
- School of Life Sciences, Independent University, Dhaka, Bangladesh
| | - Afreen Khan
- School of Life Sciences, Independent University, Dhaka, Bangladesh
| | - Zhiguang Liu
- Beijing An Zhen Hospital of the Capital University of Medical Sciences, China
| | - Hu Bo
- Medical Research & Biometrics Center, National Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences, China
| | - Li Wei
- Medical Research & Biometrics Center, National Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences, China
| | - L A Tse
- Jockey Club School of Public health and Primary Care, the Chinese University of Hong Kong, HKSAR, China
| | - Deepa Mohan
- Madras Diabetes Research Foundation, Chennai, India
| | | | - Rajeev Gupta
- Eternal Heart Care Centre & Research Institute, Jaipur, India
| | - Indu Mohan
- Mahatma Gandhi University of Medical Sciences and Technology, Jaipur, India
| | - K G Jayachitra
- St. John's Medical College & Research Institute, Bangalore, India
| | - Prem K Mony
- St. John's Medical College & Research Institute, Bangalore, India
| | - Kamala Rammohan
- Health Action By People, Government Medical College, Trivandrum, India
| | - Sanjeev Nair
- Health Action By People, Government Medical College, Trivandrum, India
| | - P V M Lakshmi
- Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Vivek Sagar
- Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Rehman Khawaja
- Department of Community Health Science, Aga Khan University Hospital, Karachi, Pakistan
| | - Romaina Iqbal
- Department of Community Health Science, Aga Khan University Hospital, Karachi, Pakistan
| | - Khawar Kazmi
- Department of Community Health Science, Aga Khan University Hospital, Karachi, Pakistan
| | - Salim Yusuf
- Population Health Research Institute, Hamilton Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Michael Brauer
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - Perry Hystad
- College of Public Health and Human Sciences, Oregon State University, Corvallis, OR, United States.
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Lee P, Tse LA, László KD, Wei D, Yu Y, Li J. Association of maternal gestational weight gain with intellectual developmental disorder in the offspring: a nationwide follow-up study in Sweden. BJOG 2021; 129:540-549. [PMID: 34455681 DOI: 10.1111/1471-0528.16887] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/20/2021] [Indexed: 12/01/2022]
Abstract
OBJECTIVES To investigate the association between maternal gestational weight gain (GWG) and offspring's intellectual developmental disorders (IDD); how this association is modified by maternal early-pregnancy BMI. DESIGN Population-based cohort study. SETTING AND POPULATION All liveborn singletons with information on maternal GWG in the Swedish Medical Register during 1992-2006 (n = 467 485). METHODS We used three GWG classifications, (1) Institute of Medicine (IOM) guidelines ('ideal' GWG: maternal underweight = 12.7-18.1 kg; normal = 11.3-15.9 kg; overweight = 6.8-11.3 kg; obesity = 5.0-9.1 kg), (2) LifeCycle project recommendation ('ideal' GWG: maternal underweight = 14.0-16.0 kg; normal = 10.0-18.0 kg; overweight = 2.0-16.0 kg; obesity class I = 2.0-6.0 kg; obesity class II ≤0.0-4.0 kg; obesity class III ≤0.0-6.0 kg) and (3) GWG centiles. Hazard ratio (HR) and 95% CI for offspring's IDD risk using Cox regression. MAIN OUTCOME MEASURES IDD was extracted from Swedish National Patient Register (code ICD-9:317-319/ICD-10:F70-F79). RESULTS Forty-one per cent of children were born to mothers with excessive GWG, 32.8% with ideal GWG and 26.2% with inadequate GWG according to IOM guidelines. Inadequate GWG was associated with 21% higher risk of offspring's IDD (95% CI 1.11-1.31) relative to ideal GWG. In contrast, when using the LifeCycle classification, children of mothers with inadequate GWG (HR 1.14, 95% CI 1.05-1.24) or excessive GWG (HR 1.09, 95% CI 1.01-1.17) had higher risks of IDD than those of mothers with ideal GWG. When using GWG centiles, extremely low GWG (<20th centile) and low GWG (20th-40th centile) were associated with elevated offspring's IDD risk. Further stratified analysis by maternal early-pregnancy body mass index (BMI) showed that overweight/obese mothers (BMI ≥25 kg/m2 ) with extremely excessive GWG (>25 kg) was associated with an increased offspring's IDD. CONCLUSION Our findings suggest that inadequate maternal GWG may increase offspring's IDD risk, irrespective of maternal early-pregnancy BMI. Extremely excessive GWG (>25 kg) may increase offspring's IDD risk, but only among mothers with an early-pregnancy BMI ≥25 kg/m2 . TWEETABLE ABSTRACT Inadequate maternal weight gain during pregnancy may increase the risk of offspring's intellectual disability, regardless of maternal BMI.
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Affiliation(s)
- Pmy Lee
- JC School of Public Health and Primary Care, the Chinese University of Hong Kong, Hong Kong Special Administrative Region, China
| | - L A Tse
- JC School of Public Health and Primary Care, the Chinese University of Hong Kong, Hong Kong Special Administrative Region, China
| | - K D László
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - D Wei
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Y Yu
- Department of Clinical Medicine-Department of Clinical Epidemiology, Aarhus University, Aarhus, Denmark
| | - J Li
- Department of Clinical Medicine-Department of Clinical Epidemiology, Aarhus University, Aarhus, Denmark
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Yang S, Yeoh KW, Wong MCS, Mang OWK, Tse LA. Disparities of birth cohort effects on pancreatic cancer incidence between the United States and urban China. ESMO Open 2021; 6:100240. [PMID: 34416471 PMCID: PMC8377550 DOI: 10.1016/j.esmoop.2021.100240] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 07/16/2021] [Accepted: 07/20/2021] [Indexed: 12/16/2022] Open
Abstract
Background Pancreatic cancer has been associated with lifestyle factors, but few comparative studies were conducted among countries of different culture and lifestyle habits. This study compared the trends of pancreatic cancer incidence and birth cohort effects in the United States and urban China and explored the potential discrepancies of risk patterns. Materials and methods Age-standardized incidence rates (ASIRs) were calculated using data from national or regional cancer registries of the United States and two large cities of China (Shanghai, Hong Kong). The temporal trends of incidence were assessed by joinpoint regression. The effects of birth cohort and calendar period were identified through age–period–cohort modeling. Results The ASIR in the United States from 1976 to 2015 was 8.26/100 000, which was higher than that in Hong Kong (4.29/100 000) and Shanghai of China (6.63/100 000). Shanghai had lower incidence (4.41/100 000) in 1976-1980 but increased annually by 1.38% in males and 1.67% in females, with a sharper upward trend than the United States and Hong Kong. Males had higher risks than females, with a male-to-female ratio of 1.34, 1.44, and 1.37 in the United States, Hong Kong, and Shanghai, respectively. A significant and prominent increase in incidence rate was observed among successive generations in China particularly for Shanghai, but such a pattern was not apparent in the United States. Conclusions The differences in pancreatic cancer incidence by sex may be multi-factorial involving known risk factors like tobacco smoking and alcohol consumption. The significant birth cohort effects among recent and early generations in the Shanghai population were in line with a society in socioeconomic transition and adoption of Western lifestyle mainly including consumption of calorie-rich foods and physical inactivity. Differences in these risk patterns will have implications on health care efforts and policies for cancer control. The ASIR of pancreatic cancer in the U.S. is higher than that in urban China. Higher risk of pancreatic cancer was observed in the youth of urban China, but this pattern was not prominent in the U.S. The disparities of birth cohort effects are consistent with a society in socioeconomic transition.
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Affiliation(s)
- S Yang
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - K W Yeoh
- Department of Radiation Oncology, National Cancer Centre Singapore, Singapore
| | - M C-S Wong
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - O W-K Mang
- Hong Kong Cancer Registry, Hospital Authority, Hong Kong, China
| | - L A Tse
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China.
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Affiliation(s)
- K. Y. Lee
- Department of Anaesthesia and Operating Services, North District Hospital, Hong Kong
| | - P. P. Chen
- Department of Anaesthesia and Operating Services, North District Hospital, Hong Kong
| | - L. A. Tse
- Department of Anaesthesia and Operating Services, North District Hospital, Hong Kong
- Division of Occupational and Environmental Health, JC School of Public Health and Primary Care, The Chinese University of Hong Kong
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Tse LA, Ho WM, Wang F, He YH, Ng CF. Environmental risk factors of prostate cancer: a case-control study. Hong Kong Med J 2018; 24 Suppl 4:30-33. [PMID: 30135272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023] Open
Affiliation(s)
- L A Tse
- Division of Occupational and Environmental Health, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong
| | - W M Ho
- Department of Clinical Oncology, Prince of Wales Hospital
| | - F Wang
- Division of Occupational and Environmental Health, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong
| | - Y H He
- Guilin Medical College, Guangxi Province, China
| | - C F Ng
- SH Ho Urology Centre, Department of Surgery, The Chinese University of Hong Kong
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8
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Lao XQ, Liu X, Deng HB, Chan TC, Ho KF, Wang F, Vermeulen R, Tam T, Wong MCS, Tse LA, Chang LY, Yeoh EK. Sleep Quality, Sleep Duration, and the Risk of Coronary Heart Disease: A Prospective Cohort Study With 60,586 Adults. J Clin Sleep Med 2018; 14:109-117. [PMID: 29198294 DOI: 10.5664/jcsm.6894] [Citation(s) in RCA: 131] [Impact Index Per Article: 21.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2017] [Accepted: 09/14/2017] [Indexed: 12/21/2022]
Abstract
STUDY OBJECTIVES There is limited information on the relationship between risk of cardiovascular disease and the joint effects of sleep quality and sleep duration, especially from large, prospective, cohort studies. This study is to prospectively investigate the joint effects of sleep quality and sleep duration on the development of coronary heart disease. METHODS This study examined 60,586 adults aged 40 years or older. A self-administered questionnaire was used to collect information on sleep quality and sleep duration as well as a wide range of potential confounders. Events of coronary heart disease were self-reported in subsequent medical examinations. Two types of Sleep Score (multiplicative and additive) were constructed to reflect the participants' sleep profiles, considering both sleep quality and sleep duration. The Cox regression model was used to estimate the hazard ratio (HR) and the 95% confidence interval (CI). RESULTS A total of 2,740 participants (4.5%) reported new events of coronary heart disease at follow-up. For sleep duration, participants in the group of < 6 h/d was significantly associated with an increased risk of coronary heart disease (HR: 1.13, 95% CI: 1.04-1.23). However, the association in the participants with long sleep duration (> 8 h/d) did not reach statistical significance (HR: 1.11, 95% CI: 0.98-1.26). For sleep quality, both dreamy sleep (HR: 1.21, 95% CI: 1.10-1.32) and difficult to fall asleep/use of sleeping pills or drugs (HR: 1.40, 95% CI: 1.25-1.56) were associated with an increased risk of the disease. Participants in the lowest quartile of multiplicative Sleep Score (HR: 1.31, 95% CI: 1.16-1.47) and of additive sleep score (HR: 1.31, 95% CI: 1.16-1.47) were associated with increased risk of coronary heart disease compared with those in the highest quartile. CONCLUSIONS Both short sleep duration and poor sleep quality are associated with the risk of coronary heart disease. The association for long sleep duration does not reach statistical significance. Lower Sleep Score (poorer sleep profile) increases the risk of coronary heart disease, suggesting the importance of considering sleep duration and sleep quality together when developing strategies to improve sleep for cardiovascular disease prevention.
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Affiliation(s)
- Xiang Qian Lao
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Xudong Liu
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China.,School of Public Health, Yat-sen University, Guangzhou, China
| | - Han-Bing Deng
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Ta-Chien Chan
- Research Center for Humanities and Social Sciences, Academia Sinica, Taiwan
| | - Kin Fai Ho
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Feng Wang
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Roel Vermeulen
- Institute for Risk Assessment Sciences, Utrecht University, The Netherlands
| | - Tony Tam
- Department of Sociology, the Chinese University of Hong Kong, Hong Kong
| | - Martin C S Wong
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - L A Tse
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Ly-Yun Chang
- Institute of Sociology, Academia Sinica, Taiwan.,MJ Health Research Foundation, MJ Group, Taiwan
| | - Eng-Kiong Yeoh
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
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9
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Sun M, Feng W, Wang F, Li P, Li Z, Li M, Tse G, Vlaanderen J, Vermeulen R, Tse LA. Meta-analysis on shift work and risks of specific obesity types. Obes Rev 2018; 19:28-40. [PMID: 28975706 DOI: 10.1111/obr.12621] [Citation(s) in RCA: 191] [Impact Index Per Article: 31.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2017] [Revised: 08/27/2017] [Accepted: 08/28/2017] [Indexed: 12/17/2022]
Abstract
AIMS This systematic review and meta-analysis evaluated the associations between shift work patterns and risks of specific types of obesity. METHODS PubMed was searched until March 2017 for observational studies that examined the relationships between shift work patterns and obesity. Odds ratio for obesity was extracted using a fixed-effects or random-effects model. Subgroup meta-analyses were carried out for study design, specific obesity types and characteristics of shift work pattern. RESULTS A total of 28 studies were included in this meta-analysis. The overall odds ratio of night shift work was 1.23 (95% confidence interval = 1.17-1.29) for risk of obesity/overweight. Cross-sectional studies showed a higher risk of 1.26 than those with the cohort design (risk ratio = 1.10). Shift workers had a higher frequency of developing abdominal obesity (odds ratio = 1.35) than other obesity types. Permanent night workers demonstrated a 29% higher risk than rotating shift workers (odds ratio 1.43 vs. 1.14). CONCLUSION This meta-analysis confirmed the risks of night shift work for the development of overweight and obesity with a potential gradient association suggested, especially for abdominal obesity. Modification of working schedules is recommended, particularly for prolonged permanent night work. More accurate and detailed measurements on shift work patterns should be conducted in future research.
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Affiliation(s)
- M Sun
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Sha Tin, Hong Kong
| | - W Feng
- Shenzhen Prevention and Treatment Center for Occupational Diseases, Shenzhen, China
| | - F Wang
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Sha Tin, Hong Kong
| | - P Li
- Shenzhen Prevention and Treatment Center for Occupational Diseases, Shenzhen, China
| | - Z Li
- Shenzhen Prevention and Treatment Center for Occupational Diseases, Shenzhen, China
| | - M Li
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Sha Tin, Hong Kong
| | - G Tse
- Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Sha Tin, Hong Kong
| | - J Vlaanderen
- Division of Environmental Epidemiology, Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
| | - R Vermeulen
- Division of Environmental Epidemiology, Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
| | - L A Tse
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Sha Tin, Hong Kong.,Shenzhen Municipal Key Laboratory for health Risk Analysis, Shenzhen Research Institute of the Chinese University of Hong Kong, Shenzhen, China
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10
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Wang Z, Xu F, Ye Q, Tse LA, Xue H, Tan Z, Leslie E, Owen N, Wang Y. Childhood obesity prevention through a community-based cluster randomized controlled physical activity intervention among schools in china: the health legacy project of the 2nd world summer youth olympic Games (YOG-Obesity study). Int J Obes (Lond) 2017; 42:625-633. [PMID: 28978975 PMCID: PMC5984083 DOI: 10.1038/ijo.2017.243] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2017] [Revised: 09/04/2017] [Accepted: 09/17/2017] [Indexed: 01/22/2023]
Abstract
Background: Childhood obesity has been becoming a worldwide public health problem. We conducted a community-based physical activity (PA) intervention program aiming at childhood obesity prevention in general student population in Nanjing of China, the host city of the 2nd World Summer Youth Olympic Games (YOG-Obesity study). Methods: This was a cluster randomized controlled intervention study. Participants were the 4th (mean age±s.e.: 9.0±0.01) and 7th (mean age±s.e.: 12.0±0.01) grade students (mean age±s.e.: 10.5±0.02) from 48 schools and randomly allocated (1:1) to intervention or control groups at school level. Routine health education was provided to all schools, whereas the intervention schools additionally received an 1-year tailored multi-component PA intervention program, including classroom curricula, school environment support, family involvement and fun programs/events. The primary outcome measures were changes in body mass index, obesity occurrence and PA. Results: Overall, 9858 (97.7%) of the 10091 enrolled students completed the follow-up survey. Compared with the baseline, PA level increased by 33.13 min per week (s.e. 10.86) in the intervention group but decreased by 1.76 min per week (s.e. 11.53) in the control group (P=0.028). After adjustment for potential confounders, compared with the control group, the intervention group were more likely to have increased time of PA (adj. Odds ratio=1.15, 95% confidence interval=1.06–1.25), but had a smaller increase in mean body mass index (BMI) (0.22 (s.e. 0.02) vs 0.46 (0.02), P=0.01) and BMI z-score (0.07 (0.01) vs 0.16 (0.01), P=0.01), and were less likely to be obese (adj. Odds ratio=0.7, 95% confidence interval=0.6, 0.9) at study end. The intervention group had fewer new events of obesity/overweight but a larger proportion of formerly overweight/obese students having normal weight by study end. Conclusions: This large community-based PA intervention was feasible and effective in promoting PA and preventing obesity among the general student population in a large city in China. Experiences from this study are the lessons for China to control the childhood obesity epidemic.
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Affiliation(s)
- Z Wang
- Nanjing Municipal Center for Disease Control and Prevention, Nanjing, China
| | - F Xu
- Nanjing Municipal Center for Disease Control and Prevention, Nanjing, China
| | - Q Ye
- Nanjing Municipal Center for Disease Control and Prevention, Nanjing, China
| | - L A Tse
- Department of Epidemiology and Biostatistics, School of Public Health, Nanjing Medical University, Nanjing, China
| | - H Xue
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Z Tan
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - E Leslie
- Systems-Oriented Global Childhood Obesity Intervention Program, Fisher Institute of Health and Well-Being, College of Health, Ball State University, Muncie, IN, USA
| | - N Owen
- School of Health Sciences, Faculty of Medicine, Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
| | - Y Wang
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China.,Swinburne University of Technology and the Baker IDI Heart and Diabetes Institute, Melbourne, Victoria Australia
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11
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Lee PMY, Ng CF, Liu ZM, Ho WM, Lee MK, Wang F, Kan HD, He YH, Ng SSM, Wong SYS, Tse LA. Reduced prostate cancer risk with green tea and epigallocatechin 3-gallate intake among Hong Kong Chinese men. Prostate Cancer Prostatic Dis 2017; 20:318-322. [PMID: 28417981 DOI: 10.1038/pcan.2017.18] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2016] [Revised: 01/27/2017] [Accepted: 02/14/2017] [Indexed: 11/09/2022]
Abstract
BACKGROUND In vitro and in vivo studies suggested that polyphenol epigallocatechin 3-gallate (EGCG) in tea may have anti-carcinogenic effect on prostate cells, but this protective effect has less been examined in epidemiology studies. We aimed to investigate the association between prostate cancer (PCA) risk and habitual green tea intake among Chinese men in Hong Kong; meanwhile, the relationship with EGCG was also explored. METHODS We consecutively recruited 404 PCA cases and 395 controls from the same hospital who had complete data on habitual tea consumption, including green, oolong, black and pu'er tea. We reconstructed the level of EGCG intake according to a standard questionnaire and the analytic values for EGCG extracted from the literature published by Lin et al. in 2003. We calculated odds ratios (ORs) for tea consumption and EGCG intake using unconditional multiple logistic regression, and examined their exposure--response relationships with PCA risk. RESULTS A total of 32 cases and 50 controls reported habitual green tea drinking, showing an adjusted OR of 0.60 (95% confidence interval (CI): 0.37, 0.98). A moderate excess risk was observed among the habitual pu'er tea drinkers (OR=1.44, 95% CI: 1.02, 1.91). A significantly lower intake of EGCG was observed among cases (54.4 mg) than the controls (72.5 mg), which resulted in an inverse gradient of PCA risk with the increasing intake of EGCG (test for trend, P=0.015). CONCLUSION PCA risk among Chinese men in Hong Kong was inversely associated with green tea consumption and EGCG intake, but these results need to be replicated in larger studies.
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Affiliation(s)
- P M Y Lee
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - C F Ng
- SH Ho Urology Centre, Department of Surgery, Prince of Wales Hospital, Hong Kong SAR, China
| | - Z M Liu
- Department of Nutrition, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - W M Ho
- Department of Clinical Oncology, Prince of Wales Hospital, Hong Kong SAR, China
| | - M K Lee
- Department of Family Medicine, Prince of Wales Hospital, Hong Kong SAR, China
| | - F Wang
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - H D Kan
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and Key Lab of Health Technology Assessment of the Ministry of Health, Fudan University, Shanghai, China
| | - Y H He
- School of Public Health, Guilin Medical University, Guilin, China
| | - S S M Ng
- SH Ho Urology Centre, Department of Surgery, Prince of Wales Hospital, Hong Kong SAR, China
| | - S Y S Wong
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - L A Tse
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
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12
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Wong MCS, Tam WWS, Wang HHX, Lao XQ, Zhang DD, Chan SWM, Kwan MWM, Fan CKM, Cheung CSK, Tong ELH, Cheung NT, Tse LA, Yu ITS. Exposure to air pollutants and mortality in hypertensive patients according to demography: a 10 year case-crossover study. Environ Pollut 2014; 192:179-185. [PMID: 24953346 DOI: 10.1016/j.envpol.2014.05.025] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/07/2014] [Accepted: 05/28/2014] [Indexed: 06/03/2023]
Abstract
This study evaluated whether short term exposures to NO2, O3, particulate matter <10 mm in diameter (PM10) were associated with higher risk of mortality. A total of 223,287 hypertensive patients attended public health-care services and newly prescribed at least 1 antihypertensive agent were followed-up for up to 5 years. A time-stratified, bi-directional case-crossover design was adopted. For all-cause mortality, significant positive associations were observed for NO2 and PM10 at lag 0-3 days per 10 μg/m(3) increase in concentration (excess risks 1.187%-2.501%). Significant positive associations were found for O3 at lag 1 and 2 days and the excess risks were 1.654% and 1.207%, respectively. We found similarly positive associations between these pollutants and respiratory disease mortality. These results were significant among those aged ≥65 years and in cold seasons only. Older hypertensive patients are susceptible to all-cause and respiratory disease-specific deaths from these air pollutants in cold weather.
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Affiliation(s)
- Martin C S Wong
- JC School of Public Health and Primary Care, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong, China.
| | - Wilson W S Tam
- JC School of Public Health and Primary Care, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong, China
| | - Harry H X Wang
- JC School of Public Health and Primary Care, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong, China
| | - X Q Lao
- JC School of Public Health and Primary Care, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong, China
| | - Daisy Dexing Zhang
- JC School of Public Health and Primary Care, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong, China
| | - Sky W M Chan
- JC School of Public Health and Primary Care, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong, China
| | - Mandy W M Kwan
- JC School of Public Health and Primary Care, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong, China
| | - Carmen K M Fan
- JC School of Public Health and Primary Care, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong, China
| | - Clement S K Cheung
- Hospital Authority Information Technology Division - Health Informatics Section, Hong Kong, China
| | - Ellen L H Tong
- Hospital Authority Information Technology Division - Health Informatics Section, Hong Kong, China
| | - N T Cheung
- Hospital Authority Information Technology Division - Health Informatics Section, Hong Kong, China
| | - L A Tse
- JC School of Public Health and Primary Care, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong, China
| | - Ignatius T S Yu
- JC School of Public Health and Primary Care, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong, China
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13
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Wang F, Zhang L, Zhang Y, Zhang B, He Y, Xie S, Li M, Miao X, Chan EYY, Tang JL, Wong MCS, Li Z, Yu ITS, Tse LA. Meta-analysis on night shift work and risk of metabolic syndrome. Obes Rev 2014; 15:709-20. [PMID: 24888416 DOI: 10.1111/obr.12194] [Citation(s) in RCA: 174] [Impact Index Per Article: 17.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2014] [Revised: 04/30/2014] [Accepted: 04/30/2014] [Indexed: 12/30/2022]
Abstract
This study aims to quantitatively summarize the association between night shift work and the risk of metabolic syndrome (MetS), with special reference to the dose-response relationship with years of night shift work. We systematically searched all observational studies published in English on PubMed and Embase from 1971 to 2013. We extracted effect measures (relative risk, RR; or odd ratio, OR) with 95% confidence interval (CI) from individual studies to generate pooled results using meta-analysis approach. Pooled RR was calculated using random- or fixed-effect model. Downs and Black scale was applied to assess the methodological quality of included studies. A total of 13 studies were included. The pooled RR for the association between 'ever exposed to night shift work' and MetS risk was 1.57 (95% CI = 1.24-1.98, pheterogeneity = 0.001), while a higher risk was indicated in workers with longer exposure to night shifts (RR = 1.77, 95% CI = 1.32-2.36, pheterogeneity = 0.936). Further stratification analysis demonstrated a higher pooled effect of 1.84 (95% CI = 1.45-2.34) for studies using the NCEP-ATPIII criteria, among female workers (RR = 1.61, 95% CI = 1.10-2.34) and the countries other than Asia (RR = 1.65, 95% CI = 1.39-1.95). Sensitivity analysis confirmed the robustness of the results. No evidence of publication bias was detected. The present meta-analysis suggested that night shift work is significantly associated with the risk of MetS, and a positive dose-response relationship with duration of exposure was indicated.
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Affiliation(s)
- F Wang
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China; CUHK Centre for Public Health and Primary Care (Shenzhen), Shenzhen Research Institute of the Chinese University of Hong Kong, Shenzhen, China
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14
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Wang F, Yeung KL, Chan WC, Kwok CCH, Leung SL, Wu C, Chan EYY, Yu ITS, Yang XR, Tse LA. A meta-analysis on dose-response relationship between night shift work and the risk of breast cancer. Ann Oncol 2013; 24:2724-32. [PMID: 23975662 DOI: 10.1093/annonc/mdt283] [Citation(s) in RCA: 128] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
This study aimed to conduct a systematic review to sum up evidence of the associations between different aspects of night shift work and female breast cancer using a dose-response meta-analysis approach. We systematicly searched all cohort and case-control studies published in English on MEDLINE, Embase, PSYCInfo, APC Journal Club and Global Health, from January 1971 to May 2013. We extracted effect measures (relative risk, RR; odd ratio, OR; or hazard ratio, HR) from individual studies to generate pooled results using meta-analysis approaches. A log-linear dose-response regression model was used to evaluate the relationship between various indicators of exposure to night shift work and breast cancer risk. Downs and Black scale was applied to assess the methodological quality of included studies. Ten studies were included in the meta-analysis. A pooled adjusted relative risk for the association between 'ever exposed to night shift work' and breast cancer was 1.19 [95% confidence interval (CI) 1.05-1.35]. Further meta-analyses on dose-response relationship showed that every 5-year increase of exposure to night shift work would correspondingly enhance the risk of breast cancer of the female by 3% (pooled RR = 1.03, 95% CI 1.01-1.05; Pheterogeneity < 0.001). Our meta-analysis also suggested that an increase in 500-night shifts would result in a 13% (RR = 1.13, 95% CI 1.07-1.21; Pheterogeneity = 0.06) increase in breast cancer risk. This systematic review updated the evidence that a positive dose-response relationship is likely to present for breast cancer with increasing years of employment and cumulative shifts involved in the work.
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Affiliation(s)
- F Wang
- JC School of Public Health and Primary Care, the Chinese University of Hong Kong, Hong Kong SAR
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15
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Tse LA, Griffiths SM. Guest editorial: health protection and communicable disease control in Hong Kong, China. Public Health 2012; 126:999-1000. [PMID: 23141146 DOI: 10.1016/j.puhe.2012.09.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/27/2012] [Indexed: 10/27/2022]
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16
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Tse LA, Fang XH, Wang WZ, Qiu H, Yu ITS. Incidence of ischaemic and haemorrhagic stroke and the association with smoking and smoking cessation: a 10-year multicentre prospective study in China. Public Health 2012; 126:960-6. [PMID: 23062630 DOI: 10.1016/j.puhe.2012.07.010] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2011] [Revised: 05/11/2012] [Accepted: 07/31/2012] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To examine the effects of cigarette smoking and smoking cessation on the incidence of ischaemic and haemorrhagic stroke in a multicentre prospective cohort study among Chinese. STUDY DESIGN A multicentre population-based prospective cohort study. METHODS The incidence of, and deaths from, stroke were monitored among 26,607 participants (12,560 men and 14,047 women) who were enrolled in 1986 and free from stroke until 2000. Cox's proportional hazard model was performed to obtain the hazard ratio (HR) of cigarette smoking for stroke risk after adjustment for major confounders. RESULTS After an average of 9.5 years of follow-up, 1108 subjects developed stroke. The excess risk of all types of stroke (total stroke) among male current smokers [HR 1.39, 95% confidence interval (CI) 1.15-1.67] was mainly due to a significantly elevated risk of ischaemic stroke (HR 1.49, 95% CI 1.17-1.90). A significantly increased risk for total stroke and ischaemic stroke was observed among men who smoked >15 cigarettes/day and men who had smoked for >25 years. The rate of smoking cessation was very low among Chinese men (7.2%) and women (1.5%). Smoking cessation did not appear to reduce the risk of haemorrhagic stroke, but may reduce the risk of ischaemic stroke; however, the possibility that this result was due to chance cannot be excluded (HR 0.74, 95% CI 0.26-2.08). CONCLUSION This study confirmed that cigarette smoking is a major determinant for the incidence of ischaemic and haemorrhagic stroke in Chinese men, and emphasizes the need for improved strategies to help people quit smoking.
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Affiliation(s)
- L A Tse
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, PR China
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17
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Abstract
OBJECTIVES This 37-year prospective cohort study was undertaken to provide additional evidence for mortality risks associated with exposure to chrysotile asbestos. METHODS 577 asbestos workers and 435 control workers in original cohorts were followed from 1972 to 2008, achieving a follow-up rate of 99% and 73%, respectively. Morality rates were determined based on person-years of observation. Cox proportional hazard models were constructed to estimate HRs of cause-specific mortality, while taking into account age, smoking and asbestos exposure level. RESULTS There were 259 (45%) deaths identified in the asbestos cohort, and 96 died of all cancers. Lung cancer (n=53) and non-malignant respiratory diseases (n=81) were major cause-specific deaths, in contrast to nine lung cancers and 11 respiratory diseases in the controls. Age and smoking-adjusted HRs for mortality by all causes and all cancers in asbestos workers were 2.05 (95% CI 1.56 to 2.68) and 1.89 (1.25 to 2.87), respectively. The risks for lung cancer and respiratory disease deaths in asbestos workers were over threefold that in the controls (HR 3.31(95% CI 1.60 to 6.87); HR 3.23 (95% CI 1.68 to 6.22), respectively). There was a clear exposure-response trend with asbestos exposure level and lung cancer mortality in both smokers and non-smokers. CONCLUSION Data from this prospective cohort provide strong evidence for increased mortality risks, particularly from lung cancer and non-malignant respiratory diseases, associated with exposure to chrysotile asbestos, while taking into account of the smoking effect.
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Affiliation(s)
- Xiaorong Wang
- Division of Occupational and Environmental Health, School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China.
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18
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Tse LA, Yu IS, Au JSK, Qiu H, Wang XR. Silica dust, diesel exhaust, and painting work are the significant occupational risk factors for lung cancer in nonsmoking Chinese men. Br J Cancer 2010; 104:208-13. [PMID: 21102581 PMCID: PMC3039806 DOI: 10.1038/sj.bjc.6606006] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
Background: Few epidemiological studies have explored the associations between occupational exposures and lung cancer in lifelong nonsmoking men. Methods: We obtained lifetime occupational history and other relevant information for 132 newly diagnosed lung cancer cases among nonsmoking Chinese men and 536 nonsmoking community referents. Unconditional multiple logistic regression analysis was performed to estimate the odds ratio (OR) of lung cancer for specific occupational exposures. Results: Significantly increased lung cancer risk was found for nonsmoking workers occupationally exposed to silica dust (OR=2.58, 95% confidence interval (CI): 1.11, 6.01), diesel exhaust (OR=3.47, 95% CI: 1.08, 11.14), spray painting (OR=2.81, 95% CI: 1.14, 6.93), and nonspray painting work (OR=2.36, 95% CI: 1.04, 5.37). Silica dust exposure was associated with a significantly increased risk of adenocarcinoma (OR=2.91, 95% CI: 1.10, 7.68). We observed a positive gradient of all lung cancers and of adenocarcinoma with duration of employment for workers exposed to silica dust and spray painting. Conclusion: This study found an increased risk of lung cancer among nonsmoking Chinese men occupationally exposed to silica dust, diesel exhaust, and painting work.
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Affiliation(s)
- L A Tse
- Division of Occupational and Environmental Health, School of Public Health and Primary Care, The Chinese University of Hong Kong, 4/F School of Public Health, Prince of Wales Hospital, Shatin, N.T., HKSAR, China
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Lam TS, Tse LA, Yu IT, Griffiths S. Prevalence of smoking and environmental tobacco smoke exposure, and attitudes and beliefs towards tobacco control among Hong Kong medical students. Public Health 2008; 123:42-6. [PMID: 19095273 DOI: 10.1016/j.puhe.2008.07.016] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2007] [Revised: 07/02/2008] [Accepted: 07/28/2008] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To investigate the prevalence of active smoking and environmental tobacco smoke (ETS) exposure among medical students in Hong Kong, and their attitudes and beliefs towards tobacco control. STUDY DESIGN A cross-sectional survey with a self-administrated questionnaire. METHODS All medical students from a university in Hong Kong were invited to participate in this survey and completed structured questionnaires. Descriptive data analyses were performed. RESULT In total, 313 medical students participated in this study (response rate 44.7%). Only 7.2% [95% confidence interval (CI) 4.3-10.1] reported having ever smoked and 0.7% (95% CI 0-1.6%) were current smokers. ETS exposure at home was reported by 19.3% (95% CI 14.9-23.8) of students, but the proportion of ETS exposure in public places was much higher (61.6%, 95% CI 56.2-67.1%). More than 85% of students had positive attitudes towards tobacco control, but 30.8% (95% CI 25.6-36.0) disagreed with banning smoking in disco/bars/pubs. Although the majority (93.1%, 95% CI 90.3-96.0) of students thought that health professionals should receive specific training for counselling on smoking cessation, only 38.0% (95% CI 32.5-43.5) reported having received any formal training in this area. CONCLUSIONS This study suggests that a specific professional training programme, including counselling on smoking cessation and actions on legislation and tobacco tax policy, should be built into the undergraduate medical curriculum.
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Affiliation(s)
- T S Lam
- School of Public Health, The Chinese University of Hong Kong, Hong Kong SAR, China; Centre for Health Protection, Department of Health, Hong Kong SAR, China
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Koskela RS, Sorsa JA, Koski A, Mutanen P, Gibbs GW, Yu ITS, Tse LA, de Vocht F, Burstyn I, Ferro G, Olsson A, Hashibe M, Kromhout H, Boffetta P, Olsson AC, Fevotte J, Mannetje AT, Fletcher T, Zaridze D, Szeszenia-Dabrowska N, Rudnai P, Lissowska J, Fabianova E, Cassidy A, Mates D, Bencko V, Foretova L, Janout V, Brennan P, Boffetta P, Schubauer-Berigan MK, Deddens JA, Steenland K, Sanderson WT, Petersen MR. Cancer 2. Occup Environ Med 2007. [DOI: 10.1136/oem.64.12.e19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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McElvenny D, Armstrong BG, Kirkham TL, Demers PA, McLeod C, Tamburic L, Koehoorn M, Ahn YS, Jung SY, Bochmann F, Taeger D, Krahn U, Wiethege T, Ickstadt K, Johnen G, Eisenmenger A, Wesch H, Bruening T, Pesch B, Tse LA, Yu ITS, Sapkota A, Hashibe M, Gajalakshmi V, Jetly D, Roychowdhury S, Dikshit R, Brennan P, Boffetta P, Robinson CF, Sullivan PA, Walker JT. Cancer 1. Occup Environ Med 2007. [DOI: 10.1136/oem.64.12.e8] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Abstract
BACKGROUND The link between silica dust/silicosis and lung cancer is still very controversial. We examined the relationship between silica dust exposure and/or silicosis and lung cancer in a large cohort of silicotic workers in Hong Kong. PATIENTS AND METHODS All workers with silicosis in Hong Kong diagnosed during the period 1981-1998 were followed up till the end of 1999 to ascertain their vital status and causes of death. Standardized mortality ratio (SMR) for lung cancer and other major causes of death were calculated. Axelson's indirect method was used to adjust for smoking effect. Multiple Cox regression models were carried out to examine the exposure-response relationship between silica dust and lung cancer. RESULTS About 10% (86) of all 853 deaths were from lung cancer, giving a SMR of 1.69 [95% confidence interval (CI) 1.35-2.09]. Lung cancer SMR for caisson and surface construction workers were 2.39 (95% CI 1.50-3.62) and 1.61 (95% CI 1.21-2.10), respectively, which became 1.56 (95% CI 0.98-2.36) and 1.09 (95% CI 0.82-1.42) after adjusting for smoking. No consistent exposure-response relationship was detected between silica dust or severity of silicosis and lung cancer death. CONCLUSION Our cohort study did not offer positive support to a link between silica or silicosis and lung cancer.
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Affiliation(s)
- I T S Yu
- Department of Community and Family Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China.
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Abstract
The overall decline in incidence rate of nasopharyngeal carcinoma in Hong Kong during 1988–2002 was limited primarily to a decrease in keratinising carcinoma, which could be explained by the decline in cigarette smoking. Genetic and Epstein–Barr virus interactions may explain the relatively stable incidence rate of non-keratinising carcinoma.
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Affiliation(s)
- L A Tse
- Department of Community and Family Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - IT-S Yu
- Department of Community and Family Medicine, The Chinese University of Hong Kong, Hong Kong, China
- E-mail:
| | - O W-K Mang
- Hong Kong Cancer Registry, Hospital Authority, Hong Kong, China
| | - S-L Wong
- Department of Community and Family Medicine, The Chinese University of Hong Kong, Hong Kong, China
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Tse LA, Yu ITS, Leung CC, Tam W, Wong TW. Mortality from non-malignant respiratory diseases among people with silicosis in Hong Kong: exposure-response analyses for exposure to silica dust. Occup Environ Med 2006; 64:87-92. [PMID: 16973737 PMCID: PMC2078445 DOI: 10.1136/oem.2006.028506] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
OBJECTIVES To examine the exposure-response relationships between various indices of exposure to silica dust and the mortality from non-malignant respiratory diseases (NMRDs) or chronic obstructive pulmonary diseases (COPDs) among a cohort of workers with silicosis in Hong Kong. METHODS The concentrations of respirable silica dust were assigned to each industry and job task according to historical industrial hygiene measurements documented previously in Hong Kong. Exposure indices included cumulative dust exposure (CDE) and mean dust concentration (MDC). Penalised smoothing spline models were used as a preliminary step to detect outliers and guide further analyses. Multiple Cox's proportional hazard models were used to estimate the dust effects on the risk of mortality from NMRDs or COPDs after truncating the highest exposures. RESULTS 371 of the 853 (43.49%) deaths occurring among 2789 workers with silicosis during 1981-99 were from NMRDs, and 101 (27.22%) NMRDs were COPDs. Multiple Cox's proportional hazard models showed that CDE (p = 0.009) and MDC (p<0.001) were significantly associated only with NMRD mortality. Subgroup analysis showed that deaths from NMRDs (p<0.01) and COPDs (p<0.05) were significantly associated with both CDE and MDC among underground caisson workers and among those ever employed in other occupations with high exposure to silica dust. No exposure-response relationship was observed for surface construction workers with low exposures. A clear upward trend for both NMRDs and COPDs mortality was found with increasing severity of radiological silicosis. CONCLUSION This study documented an exposure-response relationship between exposure to silica dust and the risk of death from NMRDs or COPDs among workers with silicosis, except for surface construction workers with low exposures. The risk of mortality from NMRDs increased significantly with the progression of International Labor Organization categories, independent of dust effects.
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Affiliation(s)
- L A Tse
- Department of Community and Family Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
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Tse LA, Fu ZM. A prospective case-control study of ankle fracture in postmenopausal women. Hong Kong Med J 2006; 12:327; author reply 327. [PMID: 16912365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/11/2023] Open
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Yu TS, Wong TW, Tse LA, Wang XR. Overview of occupational health research in Hong Kong. Asia Pac J Public Health 2001; 12 Suppl:S34-40. [PMID: 11338734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/20/2023]
Abstract
A review was undertaken to collect and collate information on studies that have been done in Hong Kong in the field of occupational health. Both published and unpublished reports related to occupational health research in Hong Kong during the period 1966-1997 were sought. The data collection was performed through various means, including electronic Medline searches and manual searches of local academic and professional journals. Relevant information for each report was abstracted and collated. A total of 357 studies/reports related to occupational health in Hong Kong were identified during the period 1964 to 1997. Few reports were available before 1980. Roughly similar numbers of reports were found for chemical hazards, dust and ergonomics (including psychosocial factors). In addition, there were substantial numbers of reports on physical hazards. Organic solvents, silica dust, compressed air and noise were the specific hazards more frequently reported. The manufacturing and construction industries were the more frequently studied groups. Recent studies have focused more attention on the non-industrial sectors, including the service sector, offices, schools, hospitals and transport. The vast majority of the reports were based on cross-sectional surveys. A significant number of published reports were discussion or review papers. Most studies were less than adequate in terms of documenting causal relationships. Despite the limited resources, occupational health researchers in Hong Kong have made great achievements in the past decades. The study subjects and the numbers of studies reflected major health problems accompanying the development and changes of local industries and trades from time to time.
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Affiliation(s)
- T S Yu
- Department of Community and Family Medicine, Chinese University of Hong Kong, Lek Yuen Health, Centre, Shatin, New Territories, Hong Kong
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Yu TS, Tse LA, Wong TW, Wong SI. Recent trends of stroke mortality in Hong Kong: age, period, cohort analyses and the implications. Neuroepidemiology 2000; 19:265-74. [PMID: 10965239 DOI: 10.1159/000026264] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
This study describes the time trend of cerebrovascular disease (CVD) mortality during the period 1976-1995 in Hong Kong and explores the period and birth cohort effects using Poisson regression models with correction for overdispersion of data. A clear downward trend was observed for age-adjusted CVD mortality rate in both sexes. It decreased from 84 per 100,000 to 41 per 100,000 among men (a 51% drop), and from 56 per 100,000 to 35 per 100,000 among women (a 38% drop). The rate of decline was in general greater in the second decade and among males, resulting in a significant downward trend for the male-to-female rate ratio. Both the period of death and the birth cohort showed a significant effect on the reduction in mortality rates, but the latter seemed to have a more substantial influence. However, an increasing trend was observed among younger males in the second decade, and the protective cohort effect seemed to be waning for the more recent cohorts in both sexes. Closer monitoring of the situation in the next years is warranted.
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Affiliation(s)
- T S Yu
- Department of Community and Family Medicine, The Chinese University of Hong Kong, PRC.
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