Effects of low body mass index and smoking on all-cause mortality among middle-aged and elderly Japanese

To investigate effects of low body mass index (BMI) and smoking on all-cause mortality among middle-aged and elderly Japanese, we conducted a community-based prospective study. A mail survey was conducted in 1987-1990 in four towns, western Japan. A cohort of 7,301 Japanese men and 8,825 Japanese women was followed up from the date of the mail survey to 1995 in three of the towns and 1998 in the fourth town. We investigated the effect of BMI and smoking on all-cause mortality by using Cox's proportional hazards model. The relationship between BMI and all-cause mortality was a reverse J-shape with minimal mortality in 24 < or = BMI < 26 in men and a U-shape with minimal mortality in 22 < or = BMI < 24 in women, after adjusting for age and smoking. The lowest BMI category (BM < 20) had the highest all-cause mortality in men and also in women. Taking only never-smokers, the highest risk for all-cause mortality was observed in the lowest BMI category for men and for women. This does not seem to be explained by smoking and pre-existing diseases. More attention should be paid to persons with low BMI.     

Association between 24-hour urinary cadmium and pulmonary function among community-exposed men: the VA Normative Aging Study

BACKGROUND: High levels of cadmium exposure are known to cause emphysema in occupationally exposed workers, but little has been reported to date on the association between chronic environmental cadmium exposure and pulmonary function. OBJECTIVE: In this study we examined the association between pulmonary function and cadmium body burden in a subcohort of the Normative Aging Study, a community-based study of aging. METHODS: We examined 96 men who had cadmium measured in single 24-hr urinary specimens collected in 1994-1995 and who had one to three tests of pulmonary function between 1994 and 2002 (a total of 222 observations). We used mixed-effect models to predict pulmonary function based on individual 24-hr urinary cadmium output, adjusted for age, height, time elapsed from the baseline, and smoking status. We assessed effect modification by smoking status. RESULTS: Among all subjects, a single log-unit increase in baseline urinary cadmium was inversely associated with forced expiratory volume in 1 sec (FEV(1)) percent predicted [beta = -7.56%; 95% confidence interval (CI) -13.59% to -1.53%]; forced vital capacity (FVC) percent predicted (beta = -2.70%; 95% CI -7.39% to 1.99%), and FEV(1)/FVC ratio (beta = -4.13%; 95% CI -7.61% to -0.66%). In models including an interaction between urinary cadmium and smoking status, there was a graded, statistically significant reduction in FEV(1)/FVC ratio across smoking status in association with urinary cadmium. CONCLUSIONS: This study suggests that chronic cadmium exposure is associated with reduced pulmonary function, and cigarette smoking modifies this association. These results should be interpreted with caution because the sample size is small, and further studies are needed to confirm our findings.     

沈阳市大气污染对小学生肺功能的影响

目的　调查沈阳市大气污染对小学生肺功能的影响 ,比较不同季节分析动车尾气污染与燃煤污染水平。方法　根据近 10年沈阳市大气污染监测资料和沈阳市交通流量分布资料 ,选择地处机沈阳市机动车流量大中小不同区域的 3所小学校 (依次分为A ,B ,C小学 ) ,调查其中居住 3年以上家住距学校 1km以内的 8～ 10岁 (三年级 )健康学生 ,每个学校调查小学生 10 0名 ,与冬季和夏季分别检测用力肺活量 (FVC) ,第 1秒用力肺活量 (FEV1 0 )和 1秒率(FEV1 0 /FVC) ,结果　C小学儿童大小气道功能为好于A ,B小学 ;B小学儿童的大气道功能 (FVC)在冬季采暖期结束后下降明显 ;A小学儿童小气道功能 (FEV1 0 ,FEV1 0 /FVC)在采暖期结束后下降明显 ,好于C小学 (P <0 0 5 ) ,但大气道功能改变不明显。环境空气质量资科分析表明 ,A小学空气环境受交通尾气污染较B、C小学重 ;B小学学生在采暖期结束后肺功能明显改善 ,表明B小学环境空气主要以煤烟型污染为主。结论　在交通流量大的A小学附近 ,机动车尾气污染十分严重 ,可影响小学生的肺功能。提示机动车尾气污染可能成为主要污染源 ,建议有关部门重视加强防控工作。     

Adverse effects of asbestos exposure and smoking on lung function

BACKGROUND: Exposure to asbestos is a well-recognized cause of both malignant and nonmalignant diseases of lung parenchyma and pleura. This study was conducted to determine the adverse effects of exposure to asbestos and smoking on pulmonary function. METHODS: Four hundred and sixty-eight workers who were occupationally exposed to asbestos for an average of 13 years were selected from an asbestos-product factory in China. Of them, 85 workers were diagnosed with asbestosis. Additionally, 282 workers who had no experience of exposure to industrial dust were included as a control group. A questionnaire was administered during a face-to-face interview and spirometric maneuvers and single-breath CO diffusing capacity (DL(CO)) were performed. RESULTS: Multivariate regression analysis showed that exposure to asbestos was more strongly associated with decreased forced vital capacity (FVC) and DL(CO), and asbestosis more strongly associated with decreased FVC, while smoking was a major contributing factor to reduced FEV1/FVC. The results were confirmed by a further analysis where the subjects were grouped exclusively by smoking, asbestos exposure, and chest radiographic changes. No interaction or joint effect was observed between asbestos exposure and smoking. CONCLUSIONS: This analysis suggested that asbestos and smoking might play independent roles, in which asbestos caused mainly a restrictive impairment, and smoking was a major causal factor for airway obstruction in the workers who were intensively exposed to asbestos.     

Smoking prevalence and smoking attributable mortality in Italy, 2010

Objective

To provide updated information on smoking prevalence and attributable mortality in Italy.

Method

A representative survey on smoking was conducted in 2010 on a sample of 3020 Italian adults (1453 men and 1567 women). We used SAMMEC software to update smoking attributable mortality in Italy.

Results

In 2010, 21.7% of Italians (23.9% of men and 19.7% of women) described themselves as current smokers. Smoking prevalence was higher in men than in women in all age groups, except for the middle-aged population (45-64 years; 25.6% in men and 25.9% in women). Age-standardized smoking prevalence was higher in men than in women among less educated subjects and in southern Italy. No substantial difference was observed either in educated subjects or in northern and central Italy. Overall, 71,445 deaths in Italy (52,707 men and 18,738 women, 12.5% of total mortality) are attributable to smoking.

Conclusion

The overall smoking prevalence of 21.7% in 2010 is the lowest registered over the last 50 years. Since 1998, smoking related deaths declined by almost 15%. Given that Italy has now reached the final stage of the tobacco epidemic, anti-smoking strategies should focus on support for smoking cessation.     

The impacts of health examinations and smoking on disease mortality risk in Japan: a longitudinal cohort of 720,611 Japanese life insured persons

Objectives To evaluate the impacts of health examinations (HE) and smoking on disease mortality risk in Japan. Methods By using the large cohort database of a Japanese life insurance company, 720,611 subjects aged 20 to 80 years, who had contracted for life insurance between April 1, 1995 and March 31, 1998, were followed up until September 30, 1999. Cox’s proportional hazard model was used to estimate age-adjusted relative risk (RR) for disease death. Results After adjusting for age, disease mortality in smokers was significantly higher than that in non-smokers (men, RR 1.51, 95% CI: 1.25–1.81; women, RR 1.54, 95% CI: 1.12–2.11). Meanwhile, disease mortality in HEees (those who had got HE within the past 2 years) was significantly lower than that in non-HEees (men, RR 0.70, 95% CI: 0.56–0.88; women, RR 0.71, 95% CI: 0.54–0.92). The magnitude of the impact of HE on disease mortality risk varied according to smoking status. Non-smokers showed a significantly lower risk associated with HE, whereas smokers did not. Conclusions HE may allow an appreciable reduction in disease mortality, however, the reduction effect may be limited to non-smokers. Smoking cessation may be essential to improve the preventive effects of HE.     

Cigarette smoking,proteinuria, and renal function in middle-aged Japanese men from an occupational population

Objectives  

To clarify the renal effects of cigarette smoking in a middle-aged occupational population because the effects have previously been demonstrated mainly in community populations that included many elderly people who are thought to be vulnerable to such effects.     

Relationship between cigarette smoking and one leg with eyes closed balance in Japanese men

Objective

To investigate the link between cigarette smoking and one leg with eyes closed balance in Japanese men.

Subjects and methods

We used data from 4224 Japanese men, aged 43.3 ± 13.9 years, in this cross-sectional study. Balance, such as one leg with eyes closed balance was measured. In addition, cigarette smoking habits were obtained by well-trained medical staff. The effect of cigarette smoking on one leg with eye closed balance was evaluated.

Results

A total of 1613 men (38.2 %) had smoking habit and 1471 men (34.8 %) regularly exercised. Age-related changes in one leg with eyes closed balance were noted. One leg with eyes closed balance in subjects with cigarette smoking (30.9 ± 31.8 s) was significantly lower than those in subjects without cigarette smoking (32.4 ± 33.5 s) even after adjusting for confounding factors i.e. age, body weight and exercise habits.

Conclusion

Cigarette smoking might be associated with one leg with eyes closed balance in Japanese men.     

Nested case-control study of lung cancer among pulp and paper workers in relation to exposure to dusts

BACKGROUND: Numerous studies have indicated an increased risk of lung cancer in pulp and paper industry workers. In a 1990 survey, standardized mortality ratio (SMR) was found to be 122 (95% CI:96-153) for lung cancer in Polish male workers in the pulp and paper industry, and 166 (95% CI:95-270) among workers engaged in paper production. METHODS: A nested case-control design within a cohort of pulp and paper workers was applied. Seventy-nine lung cancer cases and 237 "healthy" controls were selected from the cohort of 10,460 workers employed during the years 1968-1990, and observed until the end of 1995. Based on personnel files, occupational exposure was reconstructed by experts. Using a questionnaire, data on smoking habits were collected. ORs unadjusted and adjusted for smoking were calculated applying the model of conditional logistic regression. RESULTS: Occupational exposure to inorganic dusts (kaolin, lime, cement, brick, grindstone) adjusted for smoking was a significant lung cancer risk factor, with a 4.0-fold risk (95% CI:1.3-12.6), and a dose-response by cumulative dose index. Among organic dusts only wood dust increased albeit insignificantly the risk for those exposed (adjusted for smoking OR = 2.1, 95% CI:0.9-4.9), but without dose-response relationship. CONCLUSIONS: Exposure to occupational dust with relatively low content of silica, but at high concentrations may be considered as a factor increasing lung cancer risk. However, the observation made in this study should be viewed with caution as it was based on a small number of cases, and further evidence is needed to confirm or refute the authors' hypothesis.     

基于倾向性评分法的藏族非吸烟人群被动吸烟暴露与失眠的关联研究

目的  描述中国藏族非吸烟人群被动吸烟暴露与失眠症状的分布特征,探究被动吸烟暴露与失眠症状的关联程度。方法  基于“西南区域自然人群队列”项目2018年5月―2019年8月在拉萨市调查的7 737名藏族居民数据,采用倾向性评分逆概率加权法和边际结构模型分析被动吸烟暴露与失眠症状的关联,并比较该关联在不同年龄、性别、BMI、负性生活事件、社会支持组别之间的差异。结果  调查人群中被动吸烟暴露率为22.50%,失眠检出率为33.67%。利用倾向性评分均衡潜在混杂因素后,被动吸烟暴露组发生失眠症状的风险为非被动吸烟暴露组的1.24倍(OR=1.24, 95% CI: 1.14~1.34);年龄≥50岁(OR=1.25, 95% CI: 1.01~1.54)、男性(OR=1.60, 95% CI: 1.17~2.18)、超重(OR=1.24, 95% CI: 1.05~1.47)、有过1次负性生活事件(OR=1.46, 95% CI: 1.01~2.10)和中等社会支持(OR=1.46, 95% CI: 1.12~1.92)人群被动吸烟暴露与失眠有显著关联。结论  在藏族非吸烟人群中被动吸烟暴露是失眠的危险因素,应该采取相关降低被动吸烟暴露的干预措施去促进人群睡眠健康。     

Reanalysis of a longitudinal study of pulmonary function in coal miners in lorraine,France

Multiple methods of statistical analysis were applied on data collected on 384 coal miners from the Lorraine region of France. Despite the irregularity of timing of visits over the follow-up period, similar estimates of decline resulted irrespective of the statistical method used. Deceased smokers showed the highest rates of decline in forced expiratory volume during 1 second (FEV₁) of 65 to 72 ml/yr, whereas the alive non-smokers had the lowest decline estimates of 42 to 48 ml/yr. Estimates of FVC decline were found to parallel those of FEV₁. For about one-half of the cohort, data were available to compare FEV₁ decline before and after retirement using a profile analysis. Based upon a “differencing” method of regression, retirement from the coal mine had the effect of decreasing the rate of decline for those who had never smoked; smokers, however, showed an increasing rate of decline. © 1994 Wiley-Liss, Inc.     

吸烟、被动吸烟与肺癌发病风险的病例对照研究

目的 探讨吸烟、被动吸烟与肺癌的关联.方法 采用病例对照研究设计,面访肺癌新发病例1 303例和按性别、年龄(±2岁)频数匹配的健康对照1 303例.结果 吸烟是男性肺癌的重要危险因素(调整OR=4.974,95％ CI:3.933 ～6.291),随着开始吸烟年龄提前、吸烟年限延长、日吸烟量、吸烟包年以及吸烟深度的增加,患肺癌危险性增高,呈剂量反应关系(Ptrend＜0.001),戒烟≥10年患肺癌的危险性降低45.4％.男性吸烟患肺鳞癌的危险性比患肺腺癌大.被动吸烟是非吸烟者肺癌的危险因素(调整OR=1.912,95％CI:1.486～2.460),工作环境被动吸烟的男性非吸烟者患肺癌的调整OR为2.221(95％CI:1.361 ～3.625),家庭环境被动吸烟的女性非吸烟者患肺癌的调整OR为1.804(95％ CI:1.270～2.562).68.04％男性肺癌的发生可归因于吸烟,26.51％非吸烟者肺癌的发生可归因于被动吸烟.结论 吸烟是肺癌的重要危险因素,工作环境被动吸烟是男性非吸烟者肺癌的主要危险因素,家庭环境被动吸烟是女性肺癌的主要危险因素.戒烟具有重大的公共卫生学意义.     

Predicting all causes mortality in the general population as a function of blood pressure and smoking habits measured in population samples: A pilot study

Nine population samples of mean aged 40–59, for a total of 1777 individuals drawn from nine health units, were examined in 1978–79 for the measurement of some risk factors possibly related to total mortality. The analysis evaluated the possible relationship between blood pressure levels and smoking habits measured in the population samples and the official death rates covering the period 1980–82 in the health units from which the samples were drawn. The analysis was conducted in a direct way but also by the help of a risk function linking blood pressure and smoking habits as obtained from another Italian population sample. The cograduation test between mean blood pressure in the nine areas and total mortality was 0.58 (linear correlation 0.57); the cograduation test was-0.70 for non-smokers, 0.62 for ex-smokers, 0.50 for present smokers (linear correlation of-0.27, 0.29, and 0.14 respectively). The death rates estimated by the risk function (Cox model) tended to overestimate the death rates from 5 to 64% (average 36.3%). The cograduation test between expected and observed death rates was 0.56 (linear correlation coefficient 0.66). Some limitations of this pilot study are largely explained by the small size of the sample and by the need to use a risk function provided by another population sample. see appendix Research partly developed within the Targeted Project FATMA (Prevention and Control of Risk Factors), Sub Project Community Medicine, of the CNR (Italian National Research Council) Contract CNR. 91. 00289. PF41     

Retrospective cohort study of smoking and lung cancer incidence in rural prefecture,Japan

Objectives We conducted an epidemiological study of the relationship between lung cancer incidence and smoking, with special reference to the benefits of smoking cessation for reducing lung cancer incidence, to promote a local smoking control program. Methods The study was a retrospective cohort study. The population studied was 16,383 male examinees of lung cancer health examinations in 1995 in Tottori Prefecture, Japan. Smoking status from the questionnaire during the health examination was used as the exposure variable. Endpoint (lung cancer incidence) was obtained from the Tottori population-based cancer registry. A multivariable analysis using the Cox proportional hazard model was adapted for statistical analysis. The average follow-up period was 4.3 years. Results The hazard ratio of current smokers for the incidence of lung cancer was 4.9, whereas that of ex-smokers was 2.2. The dose-response relationship between lung cancer incidence and lifetime cigarette consumption (pack year) was determined. The ratio increased among younger subjects (under 65 years old). The hazard ratio of ex-smokers decreased with years just after quitting smoking, and reached the level of never smokers after 10–19 years from smoking cessation. Conclusions We reconfirmed that the magnitude of risk estimates of smoking for lung cancer incidence was similar to those of previous studies, and smoking cessation was effective for reducing lung cancer risk.     

The social patterning of child mortality: the importance of social class, gender, family structure, immigrant status and population density

Which structural dimensions are most important for life chances have been the subject of debate. In this study, which uses data from the Swedish Census-linked Deaths registry for the period 1980–86, structural differences in child mortality are analysed. The structural dimensions focused on are social class, gender, family structure, immigrant status and population density. When all structural dimensions were controlled for simultaneously, only social class and gender influenced disease mortality. Of these two structural dimensions, social class seemed to be the most important in terms of producing the greatest differences. For mortality due to accidents, on the other hand, all dimensions proved to be important. The mortality risk was higher for children in single-parent households, for children whose parents were born outside Sweden, and for children living in the least densely populated areas. The greatest differences in mortality from accidents, however, were attributable to gender, followed by social class. Furthermore, mortality differences by the father's, the mother's and the family's class position, determined by the dominance method of class assignment, were compared. The class position of both parents was independently associated with child mortality but the family's position seemed to be the better discriminator in terms of class variation. The implications of these findings are that death risks during the whole childhood period are socially structured in Sweden and that social class is still a structural dimension of great importance.     

Impacts of educational level and employment status on mortality for Japanese women and men: the Jichi Medical School cohort study

The objective of this study was to examine educational levels and employment status as independent determinants of overall and cause-specific mortality in a Japanese population. Participants were 4,301 men and 6,780 women in a multi-center community-based prospective study, and data of the baseline survey was collected between 1992 and 1995. The participants were followed up until December 31, 2002 (the average follow-up period was 9.17 years). Early termination of education was associated with an increased risk of mortality from all causes for both men and women. This tendency was more prominent in women aged 59 and younger (hazard ratio (HR) = 3.82, 95% confidence interval (CI): 1.18–12.34), after adjusting for confounding factors using the Cox proportional hazard models. Similar trends were shown for men; specifically, cardiovascular disease mortality for all men was increased by early termination of education (HR = 2.97, 95% CI: 1.17–7.52) compared to later termination. For employment status, unemployed men showed increased mortality from all causes compared to white-collar workers (HR = 1.51, 95% CI: 1.00–2.28). Female farmers and forestry workers showed reduced mortality from all causes compared to white-collar workers (HR = 0.55, 95% CI: 0.33–0.93). Male farmers and forestry workers also showed reduced mortality from cardiovascular diseases compared to white-collar workers (HR = 0.34, 95% CI: 0.14–0.82). Educational level and employment status may affect mortality for Japanese women and men.Funding: The Foundation for the Development of the Community, Tochigi, Japan.     

河北省城乡居民吸烟现状比较研究

目的 了解河北省城乡居民的吸烟现状。方法 采取多级分层整群随机抽样方法，选取5998户的16640名15岁及以上常住居民为调查对象，用统一规格的调查表进行询问调查。结果 调查人群的吸烟率为26.08％，农村高于城市；不同性别、年龄组、婚姻状况和职业的人群吸烟率不同；开始吸烟的平均年龄为21．76岁；日平均吸烟量为15．26支，农村高于城市，与2年前比较有增加趋势。结论 河北省城乡居民的吸烟率低于1998年第2次国家卫生服务调查的全国水平，高于本省水平；农村居民的吸烟率和吸烟量均高于城市。     

母亲围孕期被动吸烟与子代先天性心脏病关系的病例对照研究

目的 探讨母亲围孕期被动吸烟与子代先天性心脏病（CHD）的关系。方法 采用病例对照研究设计,于2014年1月至2016年12月在陕西省开展的CHD病例对照研究。病例组为妊娠满28周至出生后7 d确诊为CHD的围产儿和妊娠<28周但经超声等检查确诊为CHD的胎儿;对照组为未发生任何出生缺陷的同时期新生儿。采用logistic回归模型分析母亲围孕期被动吸烟与子代发生CHD的关系,并进行亚组分析探索其稳定性。结果 共纳入2 259例调查对象,其中病例组695例,对照组1 564例。病例组中围孕期被动吸烟者占26.76%,而对照组中仅占6.01%。在控制了混杂因素后,围孕期被动吸烟者子代患CHD的风险是无被动吸烟者的3.32倍（OR=3.32,95% CI：2.41～4.56）。该风险随着孕妇被动吸烟暴露频率的增加而增大：每周被动吸烟1～3 d的孕妇生育CHD子代的风险是无被动吸烟者的2.75倍（OR=2.75,95% CI：1.62～4.66）;而每周被动吸烟超过3 d的孕妇生育CHD子代的风险是无被动吸烟者的3.62倍（OR=3.62,95% CI：2.48～5.29）。亚组分析显示,母亲围孕期被动吸烟和子代CHD的关系稳定。结论 母亲围孕期被动吸烟是子代发生CHD的危险因素。孕妇应尽可能避免二手烟的暴露,防范被动吸烟的危害。     

The relationship between social capital and self-rated health in a Japanese population: a multilevel analysis

Objective  

The aim of this study was to use a multilevel analysis to examine whether cognitive and structural dimensions of regional social capital were associated with individual health outcomes after adjusting for compositional factors.