Industrial Noise Exposure and Risk Factors for Cardiovascular Disease: Findings from the CORDIS Study

Previous studies of the association between occupational noise exposure and cardiovascular disease (CVD) or risk factors for CVD are primarily either cross-sectional or retrospective, whereas the design of the CORDIS study was both cross-sectional and longitudinal. It had three phases: Phase I was conducted during 1985-87 among 6,016 employees from 21 factories. Recorded were medical, ergonomic, environmental (including noise levels at the various work stations) and psychological data. Phase II was conducted during 1988-90, at 18 of the 21 original factories and included similar data collected from 3,509 subjects. Phase III was conducted during the years 1995-96 and 4,995 workers who participated in Phases I and II completed questionnaires pertaining to medical, occupational and life style variables. Mortality and cancer morbidity data were obtained over an 8 year follow-up period for all subjects. Results from Phase I, revealed no association between noise exposure and resting blood pressure. Positive association was found for serum lipids in women and in young men. Noise annoyance had an additive effect on this outcome. In addition, recurrent daily noise exposure was found to be associated with elevated acute resting heart rate. Results of Phase II showed that chronic exposure to high noise levels during the 2-4 years of the follow-up resulted in changes of 3.9 mmHg in SBP and 3.3 mmHg in DBP, among workers performing complex jobs. In workers performing simple jobs these changes were 0.3 and 0.4 mmHg. Thus the type of work performed appears to be a significant factor. Results of Phase III revealed that there was a trend for positive association between past noise exposure measured at Phase I and 8 years incidence of cardiovascular morbidity, mortality and total mortality. This trend was statistically significant for total mortality (hazard ratio = 1.97, 95% CI 1.28-4.54) even after controlling for possible confounders. In summary, tests for association between noise exposure and cardiovascular risk factors, or cardiovascular morbidity and mortality, and total mortality have yielded mixed results. Reasons for this are discussed, as well as suggestions for further research.     

心血管疾病危险因素研究进展

心血管疾病泛指所有循环系统疾病，包括心脏和血管疾病、肺循环疾病以及脑血管疾病。在发达国家中列首位死因，对中国城乡居民的健康影响也日益严重。据国家卫生部公布的统计报表显示2003年城市居民死亡率最高的是心血管疾病，为212．03／10万，其中65岁以上人群高达881．29／10万。《新英格兰医学》一项中国多省市代表性队列研究的结果也表明心血管病已成为中国女性首位死亡原因，在男性死因中列居第二。     

25(OH)D(3) and Cardiovascular Risk Factors in Female Nonhuman Primates

Abstract Objective: To determine if interindividual differences in plasma concentrations of 25-hydroxyvitamin D(3) (25(OH)D(3)) have pathophysiologic significance, we evaluated a cohort of female monkeys, seeking to identify associations with clinically relevant cardiovascular risk factors, including age, abdominal obesity (waist circumference), and high-density lipoprotein cholesterol (HDL-C). Methods: One hundred fifty-five female vervet monkeys (Chlorocebus aethiops sabaeus) aged 3-25 years consumed a typical western diet for 7-8 weeks that provided a woman's equivalent of approximately 1000?IU/day of vitamin D(3). Measurements of vitamin D(3) and HDL-C concentrations, as well as waist circumference, were obtained. Results: Among young monkeys (aged 3-5 years), compared to older monkeys (aged 16-25 years), the mean plasma 25(OH)D(3) concentrations were 82.3±3.2?ng/mL and 58.6±2.9?ng/mL (p<0.0001), respectively. Plasma 25(OH)D(3) concentrations had a range of 19.6-142.0?ng/mL (mean±standard error [SE] 66.4±1.7?ng/mL). 25(OH)D(3) concentrations were inversely associated with age (p<0.0001) and waist circumference (p=0.016) and were positively correlated with HDL-C (p=0.01). However, when statistically controlling for age, none of these relationships remained significant. Conclusions: Higher plasma concentrations of 25(OH)D(3) were associated with more favorable cardiovascular risk factors, with inverse associations observed between 25(OH)D(3) and abdominal obesity, HDL-C, and age. These associations were no longer significant when controlling for age.     

Psychological Distress and Cardiovascular Disease: The Circulatory Risk in Communities Study (CIRCS)

Although a number of epidemiological studies have reported that psychological factors are associated with increased risk of cardiovascular morbidity and mortality, the relevant epidemiological data are mostly limited to Western populations. The present study sought to examine associations of depressive symptoms, anger expression, and tension with the incidence of cardiovascular disease in the Circulatory Risk in Communities Study (CIRCS). Depressive symptoms were measured in 901 men and women by using the Zung Self-Rating Depression Scale (SDS); anger expression and tension were measured in 6292 men and women by using the Anger Expression Scale and Framingham Tension Scale. As compared with the participants with SDS scores in the lowest tertile, those with scores in the highest tertile had twice the age- and sex-adjusted hazard ratio of total stroke. However, this excess risk was present only for ischemic stroke. Participants in the highest tertile also had a 7-fold adjusted hazard ratio of coronary heart disease, as compared with those in the lowest tertile. These associations were virtually unchanged after further adjustment for covariates. Men with “anger-in” scores in the highest tertile had a 1.5-fold age-adjusted relative risk of hypertension as compared with those in the lowest tertile; anger-in score was not associated with hypertension in women. In men and women, there were no associations between hypertension and either “anger-out” or tension scores. These findings generally support the hypothesis that—as is the case in Western populations—anger suppression and depression increase the risk of cardiovascular disease among Japanese.Key words: anger, cardiovascular disease, depression, population-based, tension-anxiety     

Association of serum lipoproteins and health-related habits with coffee and tea consumption in free-living subjects examined in the Israeli CORDIS Study.

BACKGROUND. A positive association between coffee consumption and serum cholesterol levels has been demonstrated and recent results indicate that this may be due to a lipid-rich fraction present mainly in boiled coffee. The possible effects of tea consumption are less clear, although evidence has been presented which suggests that tea drinkers have lower cholesterol levels. The associations between serum lipids and lipoproteins and coffee and tea consumption were examined in the Israel CORDIS study. METHODS. Employees of 21 factories were screened for cardiovascular disease risk factors between 1985 and 1987. Detailed data on coffee and tea consumption and serum lipids and lipoproteins were available for 3,858 men and 1,511 women. RESULTS AND CONCLUSIONS. Consumption of five or more cups of coffee per day was reported by 10.1% of men and 8.7% of women, whereas only 3.4% of men and 2.2% of women consumed similar quantities of tea. After controlling for a number of potential confounders, coffee consumption (particularly "mud" coffee) was strongly and positively associated with higher serum total and low-density lipoprotein cholesterol levels in both sexes (consumers of five or more cups per day had cholesterol levels up to 18 mg/dl higher than abstainers) and with high-density lipoprotein cholesterol in women. There was a nonsignificant negative association between tea consumption and serum cholesterol (cholesterol levels about 5 mg/dl more in abstainers than in those consuming five or more cups per day). In general, more negative health-related habits were reported with increased coffee consumption, whereas this relationship was not found for tea drinking. The relatively small percentage of heavy tea drinkers limits the conclusions that one can draw from this study and controlled trials are needed to evaluate possible lipid-lowering effects of tea consumption.     

农村女性高血压危险因素研究

目的 找出农村成年女性高血压危险因素。方法 整群随机抽取4县24916名40岁以上农村女性进行问卷调查和体检。结果 经Logistic逐步回归分析发现,年龄、体重指数、生育次数、婚姻状况、父母高血压史、妇科疾病、饮酒、被动吸烟、食盐摄入9项为危险因素。而睡眠时间、饮绿茶、绿叶蔬菜摄入、其他蔬菜摄入、母乳喂养、油脂摄入的6项因素频度高,患高血压的概率低,即有保护作用。而未发现有统计学联系的有月经规律、性别、早餐习惯、饮红茶、肉类摄入、居住面积、饮水质量、吸烟、家庭结构、性格、业余爱好等11项因素。结论 应重视从饮食、行为等方面预防高血压。     

成都市区糖代谢障碍现状与相关因素的现况研究

目的 了解成都地区糖代谢障碍及有关因素的现状。方法 采取整群抽样方式调查成都市区人群7288例的人口统计学指标、社会经济因素、心血管危险因素、空腹血糖水平。结果 成都市区糖尿病知晓率22．55％，治疗率17．39％，控制率5．59％，血糖升高者约10．6万，糖尿病约6．82万，平均血糖水平女性有高于男性趋势(中年更明显)，血糖随年龄增高，≥6．1—7.0者患病率4．88％，＞7．0者患病率3．09％，血糖水平与血压、年龄、甘油三酯、胆固醇、体质指数、心率、尿酸明显相关，尤其收缩压及甘油三酯联系更强。与糖代谢障碍相关的高血压、高甘油三酯、高胆固醇及超重更为常见。结论 成都人群血糖水平、糖尿病患病率均有增高，而治疗及控制率低，血糖与多种危险因素有伴随关系，与高血压常共存，糖尿病的防治对心脑血管病防治有重大意义。     

Childhood Cognition and Risk Factors for Cardiovascular Disease in Midadulthood: The 1958 British Birth Cohort Study

Objectives. We sought to establish whether associations between childhood cognition and risk factors for cardiovascular disease in adulthood are explained by common causes, or adult social position or health behavior.Methods. We analyzed associations between cognition at age 11 and cardiovascular disease risk factors at age 45 in the 1958 British birth cohort (n = 9377), with and without adjustment for covariates.Results. General ability was inversely associated with systolic and diastolic blood pressure, glycosylated hemoglobin, triglycerides (in women), body mass index, and waist circumference. Systolic blood pressure decreased by 0.47 mm Hg (95% confidence interval [CI] = −0.90, –0.05) for a 1-standard-deviation increase in ability. Separate adjustment for social class at birth, education level by adulthood, adult social class, and health behaviors reduced the associations respectively by 14% to 34%, 36% to 50%, 14% to 36%, and 24% to 73%. Full adjustment reduced associations between ability and risk factors at age 45 years by 43% to 92%, abolishing all associations.Conclusions. Increments across the distribution of childhood cognition are associated with improvements in cardiovascular risk profile in midlife, with associations primarily mediated through adult health behavior and social destinations.Individuals with a higher IQ in the first 2 decades of life have been found to have lower death rates from all causes in mid- to late adulthood, as reported in a systematic review of 9 prospective studies.¹ Associations between childhood cognition and mortality were not caused by confounding, reverse causality, or selection bias; hence, work directed at understanding the association is needed.Knowledge of the specific diseases associated with childhood cognition may yield clues about the likely explanations. Recent studies have investigated relationships between childhood cognition and intermediate risk factors for later cardiovascular disease. For example, higher childhood cognition has been associated with lower systolic and diastolic blood pressure in the Midspan cohorts of Scottish adults,² although another Scottish study found no association for self-reported hypertension.³ Prevalence of self-reported diabetes was reduced in adults with higher childhood cognition in a US but not a Scottish population.^3,4 Associations between higher childhood cognition and lower levels of adiposity have been observed, with some studies investigating mediation of factors such as adult education.^5–8Explanations have been proposed for associations between childhood cognition and adult mortality or morbidity: first, there may be common causes of cognition and adult disease, including childhood socioeconomic position; second, childhood cognition predicts later educational and occupational attainment, which in turn influences exposure to hazardous environments that affect risk of adult disease; and third, childhood cognition affects the extent to which individuals acquire or act on knowledge about protective or health-damaging behaviors linked to disease.⁹ Few studies have examined explanations in detail, largely because of limited data availability on relevant factors.We, therefore, examined associations between childhood cognition and several risk factors for cardiovascular disease (CVD) in a large population-based sample of men and women. Our primary aim was to establish whether childhood cognition is associated with blood pressure, lipids, glycosylated hemoglobin (HbA_1c), and total or central adiposity in midlife. We sought to determine whether associations between childhood cognition and risk factors for CVD are explained by (1) early life factors, such as birthweight and social origins, which could act as common causes of both cognition and CVD risk; (2) adult social position; or (3) health behaviors. We studied a prospective birth cohort, followed to age 45 years, in which we have previously shown lower birthweight and less-advantaged social origins to be associated with poorer childhood cognition.¹⁰ In turn, poorer cognition was found in this cohort to increase the risk of behaviors, such as abstaining from alcohol and binge drinking¹¹ and smoking,¹² linked to adverse health outcomes.     

Association between Nutritional Awareness and Diet Quality: Evidence from the Observation of Cardiovascular Risk Factors in Luxembourg (ORISCAV-LUX) Study

This study examined the association between nutritional awareness and diet quality, as indicated by energy density, dietary diversity and adequacy to achieve dietary recommendations, while considering the potentially important role of socioeconomic status (SES). Data were derived from 1351 subjects, aged 18–69 years and enrolled in the ORISCAV-LUX study. Energy density score (EDS), dietary diversity score (DDS) and Recommendation Compliance Index (RCI) were calculated based on data derived from a food frequency questionnaire. Nutritional awareness was defined as self-perception of the importance assigned to eating balanced meals, and classified as high, moderate, or of little importance. Initially, a General Linear Model was fit that adjusted for age, sex, country of birth, and body mass index (BMI). Furthermore, simultaneous contributions to diet quality of individual-level socioeconomic factors, education, and household income were examined across levels of nutritional awareness. Attributing high importance was associated inversely with energy density (p = 0.02), positively with both dietary diversity (p < 0.0001), and adequacy to dietary recommendations (p < 0.0001), independent of demographic factors, weight status and SES. Further adjustment for household income in the EDS-related multivariable model, reduced the β coefficient by 47% for the “moderate importance” category and 36% for the “high importance” category. Likewise, the β coefficient decreased by 13.6% and 10.7% in the DDS-related model, and by 12.5%, and 7.1% in the RCI-related model, respectively, across awareness categories. Nutritional awareness has a direct effect on diet quality, with a minor component of variance explained by improved income. The impact of nutritional awareness on diet quality seems to be a promising area for both health promotion and health policy research.     

铁路工伤危险因素的控制及评价

[目的]预防和控制铁路运输工伤事故。[方法]运用流行病学调查方法和SPSS FOR WINDOWS 12．0软件，分析工伤事故发生原因，建立事前预防控制体系并在试点区实施干预。[结果]铁路运输工伤事故发生率为23．68／10万，违章操作是其主要原因（61．3％）。文化程度较低、工龄较短、吸烟、安全意识不强、违规操作、机器异常均可使职业伤害发生的危险性增高。实施干预后工伤事故发生率有所下降。[结论]工伤是可以预防和控制的。只要领导重视，以人为本，采取有效的工伤事故预防控制体系，完全可以减少工伤事故发生率，从而达到保护职工健康、推动运输经济可持续发展的目的。     

工作中缺乏体力活动(静坐工作)与心血管疾病的职业流行病学

西方许多大型心血管病流行病学研究资料表明，缺乏体力活动与冠心病之间有病因联系，并承认体力活动是心血管疾病的一个保护因素。经济技术的飞速发展，静坐式工作普遍增多。静坐式工作或工作中缺乏体力活动与心血管病的关系受到重视。影响职业人群心血管病的危险因素众多，如何控制多种混杂因素、分离出体力活动的独立作用较难，而且心血管病危险因素：血压、血脂、心率等都可能受到体力活动的影响而改变，静坐工作可否能成为职业人群心血管病的一个独立危险因素等问题尚需进一步精深的流行病学研究来解决。     

Impact of Meat Consumption on Nutritional Quality and Cardiovascular Risk Factors in Young Adults: The Bogalusa Heart Study

Objective To document the contribution of meat consumption to the overall nutritional quality of the diet and assess its impact on cardiovascular risk factors in young adults.Objective To document the contribution of meat consumption to the overall nutritional quality of the diet and assess its impact on cardiovascular risk factors in young adults.Design and setting A cross-sectional survey of young adults in Bogalusa, La.Subjects We collected 24-hour dietary recalls from 504 19- to 28-year-olds from 1988 through 1991.Statistical analyses We examined dietary composition by meat consumption quartiles. Analysis of variance and Newman-Keuls range tests were performed.Results Young adults consume an average of 6.5 oz meat daily; whites most often consumed beef and blacks most often consumed pork and poultry. Persons in the <25th percentile for meat consumption consumed a diet closest to recommended levels — with 11% of energy from protein, 55% from carbohydrate, 32% from fat, 11% from saturated fatty acids, and 264 mg dietary cholesterol. In contrast, persons in the >75th percentile for meat consumption consumed a diet with 18% of energy from protein, 40% from carbohydrate, 41% from fat, 13% from saturated fatty acids, and 372 mg dietary cholesterol. Intakes of heme iron and phosphorus were lower and calcium intake higher in persons in the <25th percentile compared with those in the >75th percentile for meat consumption. The percent of persons meeting two thirds of the Recommended Dietary Allowances for vitamin B-12, niacin, and zinc was greater in the >75th percentile for meat consumption compared with the <25th percentile for meat consumption. We noted no differences across meat consumption quartiles in blood lipids and lipoproteins, anthropometric measurements, and hemoglobin levels.Applications/conclusions Consumption of moderate amounts of lean meat, along with healthier choices in other food groups, may be necessary to meet the current dietary recommendations. J Am Diet Assoc. 1995; 95:887-892.     

Egg Consumption,Cardiovascular Disease and Cardiometabolic Risk Factors: The Interaction with Saturated Fatty Acids. Results from the ATTICA Cohort Study (2002–2012)

Purpose: To examine the association of egg intake with 10-year risk of cardiovascular disease (CVD) and other cardiometabolic risk factors in a sample of individuals of Mediterranean origin. Methods: In 2001–2002, n = 1514 men and n = 1528 women (>18 years old) from the greater Athens area, Greece, were enrolled. Information on any egg intake, eaten as a whole, partly or in recipes was assessed via a validated semi-quantitative food frequency questionnaire. Follow-up for CVD evaluation (2011–2012) was achieved in n = 2020 participants (n = 317 CVD cases). Results: Ranking from lowest (<1 serving/week) to intermediate (1–4 servings/week) and high (4–7 servings/week) egg consumption tertiles, lower CVD incidence was observed (18%, 9% and 8%, respectively, p-for-trend = 0.004). Unadjusted analysis revealed that 1–3 eggs/week and 4–7 eggs/week were associated with a 60% and 75%, respectively, lower risk of developing CVD compared with the reference group (<1 egg/week). When adjusting for sociodemographic, lifestyle and clinical factors, significance was retained only for 1–3 eggs/week (hazard ratio (HR) = 0.53, 95% confidence interval (95% CI) = 0.28, 1.00). When total saturated fatty acid (SFA) intake was taken into account, this inverse association was non-significant. Multi-adjusted analysis revealed that in participants of low SFA intake, 1 serving/day increase in egg intake resulted in 45% lower risk of developing CVD. In the case of higher SFA consumption, only 1–3 eggs/week seemed to protect against CVD (HR = 0.25, 95% CI = 0.07, 0.86). In the case of intermediate cardiometabolic disorders, no significant trend was observed. Conclusions: Overall dietary habits principally in terms of SFA intake may be detrimental to define the role of eggs in cardiac health.     

Urinary 1-hydroxypyrene (1-HP) in environmental and occupational studies--a review

A total of 132 studies were identified, of which 25 studies addressed environmental exposure to polycyclic aromatic hydrocarbons (PAHs) in the general population. Of these 9 studies included children. Of 101 studies among workers in various occupations, 32 studies were in petrochemical industries, 29 studies in foundries, 14 studies in asphalt work, 21 studies working in urban air, 6 studies in combustion, 3 studies in soil remediation, and 2 studies in printing. Environmental and occupational studies were identified through an extensive search of the PubMed database up to November 2006. The aim of this review was to provide an overview of studies using urinary 1-hydroxypyrene (1-HP) as a biomarker of environmental and occupational exposure to PAHs. Hereby, we aim to support the current validation of 1-HP by summarizing the evidence of specific PAH exposure and1-HP associations in humans. Urine from more than 7000 children from 8 countries and 3400 adults from 9 countries were included in the 25 studies assessing environmental exposure to PAH. Among the occupational studies 7500 men and women gave urine samples to assess occupational PAH exposure. When measuring biomarkers in urine, volume (and time) or concentrations of creatinine are often used to standardize for diuresis. To be able to compare the included studies we recalculated the given concentrations to mumol 1-HP/mol creatinine. In conclusion, the highest concentrations of urinary 1-HP are found among workers in petrochemical industries among coke-oven workers. Occupational PAH exposure was the major factor determining high urinary concentration of 1-HP. The highest concentrations were observed among workers in the petrochemical industry at work places in Taiwan and China. To evaluate environmental and low-level occupational exposure to PAH it is crucial to provide knowledge on intra- and inter-individual variation in the evaluation of 1-HP. The highest contribution originates from environmental tobacco smoke, but also different country, cooking culture, and behavior influences urinary of 1-HP.