Background:Early detection of esophageal squamous cell carcinoma (ESCC) may improve survival, but universal screening is not feasible. This study aimed to develop and validate a model for identifying individuals at high absolute risk of ESCC in a high-risk Chinese population. Methods:The model was developed by using data from a case-control study in Yanting County, Sichuan, China between 2011 and 2013, including 942 ESCC cases and 942 age- and sex-matched control participants. Conditional logistic regression and the Gail algorithm were used to construct the model. Model performance was assessed by using the area under the receiver-operating characteristic curve (AUC) with 10-fold cross-validation. External validation was performed in two independent populations, i.e. another Chinese case-control study and the UK Biobank cohort. Results:The model included six risk factors: education level, marital status, tobacco smoking, alcohol consumption, body mass index (overweight status), and family history of cancer. The model incorporated age- and sex-specific incidence rates in the population to estimate the 5-year absolute risk. The AUC was 0.72 (95% confidence interval [CI] 0.69-0.74) in the derivation dataset and 0.68 (95% CI, 0.67-0.69) after cross-validation. In external validation, the AUC was 0.65 (95% CI, 0.61-0.69) in the independent Chinese case-control study and 0.66 (95% CI, 0.56-0.75) in UK Biobank. The estimated 5-year absolute risk of ESCC in the population in Yanting ranged from 0.0005% to 18.2%. In the group at the highest predicted risk, six individuals would need to undergo screening to detect one ESCC case within 5 years. Conclusion:The developed model demonstrated acceptable performance and has the potential to identify high-risk individuals for targeted prevention and early detection in the studied high-risk population.

Background and aims: Experimental studies showed that carotenoids had anti-carcinogenic properties, but epidemiological studies on the association between dietary carotenoids and esophageal squamous cell carcinoma (ESCC) risk were limited, and the findings were inconsistent. This study aimed to investigate the roles of intake of dietary carotenoids in the development of ESCC among a rural Chinese population. Methods: A population-based case-control study was conducted in Southwest China. A total of 915 incident ESCC cases and 925 community-based controls were included. A validated food frequency questionnaire with 76-item was adopted to collect information about dietary consumption. Intake of dietary calories and each carotenoid was calculated according to the China food composition tables. Odds ratios (OR) with 95% confidence intervals (CI) were calculated by a logistic regression model, with adjustments for age, gender, body mass index, family cancer history, cigarette smoking, alcohol drinking, education, marital status, prudent pattern score, and total calories. Results: In comparison to the highest with lowest intake quartiles, intake of total carotenes (OR: 0.70, 95% CI: 0.52-0.96, Ptrend: 0.024), α-carotene (OR: 0.62, 95% CI: 0.46-0.83, Ptrend: 0.014), β-carotene (OR: 0.63, 95% CI: 0.46-0.86, P-trend: 0.005), and the sum of lutein and zeaxanthin (OR: 0.41, 95% CI: 0.29-0.56, Ptrend<0.001) was significantly associated with a decreased risk of ESCC after adjustment for confounders. Conclusions: The results indicated that a higher intake of total carotene, α-carotene, β-carotene, and the sum of lutein and zeaxanthin was associated with a lower risk of ESCC.

BackgroundDentists are a high-risk population of work-related musculoskeletal disorders (WMSDs), where the body part with the highest prevalence is the neck. ObjectiveTo analyze potential influencing factors of neck pain among dentists, and explore a prediction model of neck pain in dentists. MethodsDentists from different hospitals in Fuzhou were selected as study subjects by stratified cluster sampling according to hospital characteristics (dental hospitals, general hospitals, and dental clinics). The basic information, presentation of WMSDs, and its influencing factors were investigated by using the Chinese version of Musculoskeletal Disorders Questionnaire and the Subjective Workload Assessment Technique. A total of 655 questionnaires were collected, of which 603 were valid, with an effective rate of 92.1%. Multiple logistic regression was used to analyze potential influencing factors of neck pain in dentists. A prediction model of neck pain of dentists was constructed by using neural network model, and the prediction efficiency of the model was evaluated. ResultsThe neck was the body part with the highest prevalence (43.8%, 264/603) of WMSDs among dentists. The results of multiple logistic regression analysis showed that female (OR=2.709, 95%CI: 1.852-3.962, P <0.001), working age of 10-<20 years (versus <10 years, OR=3.836, 95%CI: 2.471-5.957, P<0.001), keeping head up or down for a long time (OR=8.492, 95%CI: 2.203-32.731, P=0.002), holding head sideways for a long time (OR=2.210, 95%CI: 1.376-3.550, P<0.001), maintaining the same sitting spot for a long time (OR=4.336, 95%CI: 2.192-8.579, P<0.001), and psychological load value ≥70 (versus <40, OR=1.901, 95%CI: 1.038-3.480, P=0.037) increased the risk of neck pain in dentists. Sufficient operating space (OR=0.507, 95%CI: 0.302-0.850, P=0.010) and doing some exercise during work break (OR=0.670, 95%CI: 0.453-0.991, P=0.045) reduced the risk of reporting neck pain among dentists. A neural network prediction model of dentists' neck pain was constructed with 1 hidden layer and 6 hidden layer neurons. The percentage of correct prediction of training set was 89.6%, and the percentage of correct prediction of test set was 83.9%. The order of importance of the independent variables included in the model were working age, holding head sideways for a long time, psychological load, etc. The result of neural network model of neck pain among dentists showed that the area under the curve of receiver operator characteristic (ROC) was 0.940 (95%CI: 0.922-0.958, P<0.001). When the maximum diagnostic value was determined by the ROC curve, the sensitivity was 84.8%, the specificity was 91.2%, and the Youden Index was 0.760. ConclusionNeck pain of dentists is affected by many factors, such as individual factors (gender and working age), ergonomic factors (keeping various postures and operations for a long time, operating space, etc.), psychological factors (different levels of psychological load) and so on. The neural network model can be used as a prediction tool to explore the risk of reporting neck pain among dentists.

Background This study aimed to assess the reproducibility and validity of a food frequency questionnaire (FFQ) developed for diet-related studies in a rural population. Methods One hundred fifty-four healthy residents were interviewed with a 76-item FFQ at baseline (FFQ1) and 1 month later (FFQ2) to assess reproducibility, and required to complete two three-day dietary recalls (DRs) between two FFQs to determine the validity by comparing DRs with FFQ1. Results Crude Spearman correlation coefficients between FFQ1 and FFQ2 ranged from 0.58 to 0.92 and energy-adjusted coefficients ranged from 0.62 to 0.92; weighted kappa statistic covered a spectrum from 0.45 to 0.81, depicting moderate to good agreements. For validity, there were moderate to strong associations (0.40–0.68) in most nutrients and food between FFQ1 and DRs; weighted kappa statistic demonstrated fair to moderate agreements for nutrients and food (0.21–0.49). Conclusions The results suggest that the FFQ has reasonably reproducibility and validity in measuring most nutrients and food intake, and it can be used to explore the dietary habits in studying the diet-disease relationship in Chinese rural populations.

OBJECTIVES:This study is to evaluate the efficacy of participatory ergonomic (PE) intervention on musculoskeletal disorders (MSDs) and work ability among young dental professionals in China.METHODS:A cluster randomized controlled trail was conducted during 2015-2016. Twenty-nine departments from five hospitals in the South of China were randomized into intervention (14 departments) and control (15 departments), with individuals of 125 and 138 dental professionals, respectively. Main participatory ergonomic interventions involved work posture, repetitive motions, tool usage, work break relaxation and work time re-arrangement with total 235 ergonomic changes in the trail. Individual ergonomic risk exposure was assessed by investigator's observation using quick exposure check (QEC). Work ability index (WAI) and MSDs were collected by questionnaires at baseline, and every 3 months during the 1-year follow-up.RESULTS:Follow-up rate was 91% and 96% for the intervention and control group, respectively. Significant reductions in ergonomic risk exposure and MSD prevalence on six anatomic sites were found in the PE group during the different follow-up stages. WAI scores improved by 1.1 (95% CI 0.43, 1.89) after the 9-month intervention. Compared to the control, the PE participants significantly reduced MSDs on neck (OR = 2.93, 95% CI: 1.25, 4.03) and wrists/hands (OR = 2.33, 95% CI: 1.08, 4.21), marginally increased WAI scores by 0.53 (95% CI: -0.02, 1.56) due to the interventions.CONCLUSION:PE intervention is effective in reducing ergonomic risk exposure and MSDs on neck and wrists/hands among young dental professionals. PE ought to be offered in the early dental career for preventing MSDs.

Background/Objectives This prospective cohort study was to assess the association of pre-diagnostic dietary intake and dietary pattern with the survival of esophageal squamous cell carcinoma (ESCC) patients. Subjects/Methods 855 patients were recruited and successfully followed. Information on diet over past five years before diagnosis was collected using a food frequency questionnaire, and dietary patterns were extracted using principal component analysis. Hazard ratio (HR) with 95% confidence interval (95% CI) was calculated using the Cox proportional hazard model. Results 164 (19.18%) ESCC patients survived during the follow-up. Every 25-g increment intake of pickled vegetables was associated with a 6.0% (HR: 1.060, 95% CI: 1.003-1.121) increased risk of death after adjustment for covariates. When comparing the highest with lowest tertiles of energy-adjusted intake, pickled vegetables intake was associated with a 21.9% elevated risk of death (HR: 1.219, 95% CI: 1.014-1.465), while fish and shrimp intake was associated with a 19.4% (HR: 0.816, 95% CI: 0.675-0.986) reduced risk of death. Three dietary patterns were defined and labeled as patterns I, II, and III. Every 10-score increment of dietary pattern II, characterized with a higher loading of preserved vegetables, pickled vegetables, and salted meat, was associated with a 1.7% (HR: 1.017, 95% CI: 1.003-1.032) increased risk of death. Conclusions A diet characterized with higher loading of preserved vegetables, pickled vegetables, and salted meat, was negatively associated with death risk among ESCC patients. Prospective studies concerning the role of post-diagnosis dietary intake in ESCC prognosis are needed.

This study was to evaluate the associations of dietary intake of total and specific phytosterols and risk of esophageal squamous cell carcinoma (ESCC) and to explore their joint effects with PLCE1 rs2274223 polymorphisms. A population-based case–control study was conducted in a Chinese rural population and 856 eligible incident ESCC cases and 856 controls were included. A validated food frequency questionnaire was used to collect dietary consumption and PLCE1 rs2274223 polymorphisms were genotyped. Unadjusted and adjusted odds ratios (ORs) with 95% confidence interval (CI) were assessed via logistic regression model. When comparing the highest with lowest intake quartiles, β-sitosterol, campesterol, stigmasterol, β-sitostanol, campestanol, and total phytosterols were all associated with a decreased risk of ESCC, with adjusted ORs being 0.32 (95% CI 0.20–0.48), 0.18 (95% CI 0.11–0.27), 0.45 (95% CI 0.29–0.70), 0.13 (95% CI 0.08–0.20), 0.14 (95% CI 0.09–0.22) and 0.28 (95% CI 0.18–0.43), respectively. An exposure—response relationship was also observed for both total and five specific phytosterols (all P for trend < 0.001). In comparison to rs2274223 AA genotype, both GA genotype (OR: 1.47, 95% CI 1.16–1.85) and GG genotype (OR: 2.13, 95% CI 1.20–3.84) were associated with an increased risk of ESCC. However, no interaction was observed between total/specific phytosterols intake and rs2274223 polymorphisms. Higher dietary intake of total and five specific phytosterols was associated with a lower risk of ESCC, and the risk of ESCC increased with the increment of rs2274223 G allele. The negative association between phytosterols and ESCC risk was not modified by rs2274223 polymorphisms. Foods or supplements rich in phytosterols are a promising source for chemoprevention of ESCC, and still, clinical trials will be required in any specific case.

Objectives: The aim of this population-based case-control study was to investigate the association between dietary consumption of the total flavonoids, subclasses, and specific flavonoids and the risk of esophageal squamous cell carcinoma (ESCC) among adults in a high-risk area of China. Methods: We recruited 820 ESCC participants and 863 control participants from Yanting County. Dietary flavonoids were assessed using a validated 76-item food frequency questionnaire. Odds ratios (ORs) with 95% confidence intervals (CIs) were estimated using logistic regression after considering potential confounders. Results: Comparing the highest and lowest intake quartiles, we observed a negative association of ESCC risk with consumption of isoflavones (OR = 0.34, 95% CI = 0.23-0.50, P for trend < 0.001), daidzein (OR = 0.31, 95% CI = 0.21-0.45, P for trend < 0.001), genistein (OR = 0.34, 95% CI = 0.23-0.50, P for trend < 0.001), and glycitein (OR = 0.32, 95% CI = 0.22-0.48, P for trend < 0.001) after adjustment for potential confounders. A more pronounced negative association was observed when comparing the third quartile, rather than the fourth, with the lowest quartile for consumption of anthocyanidins (OR = 0.58, 95% CI = 0.42-0.80, P for trend = 0.004), delphinidin (OR = 0.57, 95% CI = 0.41-0.78, P for trend = 0.004), and cyanidin (OR = 0.48, 95% CI = 0.35-0.66, P for trend = 0.003) after considering potential confounders. Consumption of total flavonoids, flavones, flavonols, and six other specific flavonoids (quercetin, myricetin, kaempferol, luteolin, apigenin, and peonidin) was not associated with ESCC risk. Conclusions: The results suggest that increased dietary intake of isoflavones and moderate consumption of anthocyanidins were associated with a decreased risk of ESCC. Future nutritional guidelines may emphasize foods or supplements rich in specific isoflavones and anthocyanidins for ESCC chemoprevention. (c) 2021 Elsevier Inc. All rights reserved.

The association between tea drinking and esophageal cancer is still contradictory. This study is to determine the association between tea drinking and esophageal squamous cell carcinoma focusing on drinking temperature and tea types. A population-based case-control study was conducted in a high esophageal squamous cell carcinoma risk area in China. A total of 942 incident esophageal squamous cell carcinoma cases with historical confirmation and 942 age- and sex- individually matched community controls were recruited from the study area. Trained interviewers using a structured questionnaire collected detailed information on tea drinking, diet, smoking and alcohol drinking habits. Habitual tea drinking temperature was measured with a thermometer during interviews. We analyzed the association between tea consumption, drinking temperature and esophageal squamous cell carcinoma, stratified by tea type, while adjusting for other potentially confounding factors. Drinking very hot tea (>65°C) was significantly associated with the increased risk of esophageal squamous cell carcinoma (odds ratio = 1.67, 95% confidential interval 1.25-2.24) relative to non-drinkers. Consumption of black tea, irrespective of the frequency, intensity and tea leaf amount, was significantly associated with a higher risk (P for trend <0.01). Compared to those who consumed <300 g/month tea leaves at ≤65°C, those who consumed more than 300 g/month tea leave at >65°C had a more than 1.8-fold higher risk of esophageal squamous cell carcinoma for both green tea and black tea. Our results provide more evidence that drinking very hot tea (above 65°C) are significantly associated with an increased risk of esophageal squamous cell carcinoma.

BACKGROUND:Exposure to high ergonomic risk resulted in an increasing prevalence of musculoskeletal disorders among dental professional. However, little is known about the high exposure risk impact on work ability among dental professionals.OBJECTIVE:We conducted a cross-sectional study to examine the association between ergonomic risk exposure and work ability among young dental professionals in their early careers.METHODS:A total of 230 dental professionals including dentists, dental assistants, and nurses were clustered sampled from three hospitals in Guangzhou, south of China. We used the Quick Ergonomic Check (QEC) to assess participants' ergonomic risk exposure and Work Ability Index (WAI) to evaluate their work ability. Demographics and other factors related with WAI were also included in the data collection. Multiple linear regression was applied to analyze the association between ergonomic exposure scores and WAI.RESULTS:A total of 218 participants (94.8%) had valid data and consent forms. The participants' average WAI was 39.6, of which the poor and moderate WAI composed 31%. High and very high ergonomic risk exposure level was 45.9% for the neck and 21.1% for the wrist/hand. In general, WAI decreased with higher ergonomic exposure level. With adjustment of other potential risk factors, the ergonomic scores for wrist/hand and total scores for the whole body were significantly associated with the decreased WAI.CONCLUSION:High ergonomic risk exposure might risk in reducing work ability among young dental professionals. Intervention measures toward ergonomic risk should be taken to prevent WAI from decreasing in their early careers.

目的 以表面擦拭采样评估新能源动力行业工作场所铅污染状况,并验证表面擦拭采样方法的信度与效度.方法 选择新能源动力行业某高效电池生产企业,以表面擦拭采样收集表面平行样品30对,对应定点采集13份空气样品,同时检查相应岗位作业工人47名的血铅水平;比较不同铅污染区域表面浓度的差异,分析同一表面相邻两次平行擦拭采样结果的一致性,分析血铅水平与表面擦拭采样铅浓度的相关.结果 表面擦拭采样可以区分出不同铅污染区表面铅的浓度(P＜0.01),其中炉前、出料口等重污染区表面铅浓度最高,而休息室和过磅处等表面铅浓度相对较低;比较同一表面相邻两次平行擦拭采样重量浓度,显示其间无显著差异(39.20 vs. 35.55 g/kg, P＞0.05),表面擦拭与空气采样结果有关联(P＜0.01),多元分析显示作业工人血铅水平与表面擦拭采样铅重量浓度呈正相关(P ＜ 0.05).结论 表面擦拭采样方法应用于新能源动力行业工作场所铅污染的暴露评估具有较好的信度与效度.

擦拭采样方法具有快速简洁提供表面污染物信息的优点,其作为一种重要的采样技术手段,可用于评估各种污染沉积物的表面污染状况.目前,国外已经建立了针对不同污染物的擦拭采样方法.由于被擦拭污染物的理化性质不同,每种方法均具有其适用性和特殊性.美国主要将擦拭采样方法应用于环境监测、职业接触评估以及国家安全监控3大领域.但该方法亦存在一定的不足之处,如采样的可重复性、从表面移除的效率以及回收率等限制了该方法的广泛应用[1].

Background Cumulative fiber exposures, predominantly chrysotile, were estimated in a Chinese asbestos worker cohort and exposure–response relationships with lung cancer mortality and cumulative incidence of asbestosis were determined. Methods Individual time‐dependent cumulative exposures were estimated for 577 asbestos workers, followed prospectively for 37 years. Occupational history and smoking data were obtained from company records and personal interviews; vital status and causes of death were ascertained from death registries and hospital records. Hazard ratios were generated for disease outcomes, with adjustments for smoking and age. Results Median cumulative fiber exposure for the cohort was 132.6 fiber‐years/ml (IQR 89.3–548.4). Exposure–response relationships were demonstrated for both disease outcomes, with nearly sixfold and threefold increased risks seen at the highest exposure level for lung cancer deaths and asbestosis, respectively. Conclusion Evidence using quantitative exposure estimates was provided for increased risks of lung cancer mortality and development of asbestosis in a predominantly chrysotile‐exposed cohort. Am. J. Ind. Med. 59:369–378, 2016. © 2016 Wiley Periodicals, Inc.

Background & aims: Few studies were available in exploring the roles of dietary patterns in the development of esophageal cancer, especially in China. This study aimed to investigate the roles of dietary patterns in the risk of esophageal squamous cell carcinoma (ESCC) in a Chinese rural population.Methods: A population-based cases control study was designed and conducted in Yanting County, Sichuan Province of China during two years (between June 2011 and May 2013). A total of 942 pairs of ESCC cases and controls were recruited. A food frequency questionnaire was adopted to collect information of dietary consumption. Dietary patterns were extracted by using principle component and factor analysis based on 24 dietary groups. Odds ratios (ORs) with 95% confidence intervals (95% CI) were calculated by using logistic regression model, with adjustment for possible confounding variables.Results: Four major dietary patterns were identified, which were labeled as "prudent", "vegetable and fruits", "processed food" and "alcohol drinking". In comparison of the highest with the lowest quartiles of pattern scores, the processed food pattern (OR: 2.84, 95% CI: 2.13-3.80) and alcohol drinking pattern (OR: 2.69, 95% CI: 1.95-3.71) were significantly associated with an increased risk of ESCC, while the vegetable and fruit pattern (OR: 0.70, 95% CI: 0.53-0.92) was associated with reduced risk by 30%. The prudent pattern was associated with a reduced risk by 33% (OR: 0.67, 95% CI: 0.50-0.88) in a multivariate logistic regression model, but no statistical significance was reached in a composite model.Conclusions: The results suggest an important role of dietary patterns in ESCC. Diets rich in vegetables and fruits may decrease the risk of ESCC, whereas diets rich in processed food and drinking alcohol may increase the risk. (C) 2015 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

Objective This study was conducted to assess the reproducibility and validity of a food frequency questionnaire (FFQ) that was developed to assess the overall dietary consumption via dietary pattern method in a rural population in southwest China. Methods A total of 179 participants aged between 40 and 70 years old were included in this study. Participants administered FFQ at baseline (FFQ1) and one year later (FFQ2) to assess the reproducibility. Six 3-day 24-hour recalls (24HRs) were completed between the administrations of two FFQs to determine the validity. Dietary patterns from three separate dietary sources were derived by using principle component factor analysis. Comparisons between dietary pattern scores were made by using Pearson or intraclass correlation coefficient, cross-classification analysis, weighted kappa (κ) statistic and Bland-Altman analysis. The de-attenuated method was adopted to correct the monthly and seasonally variation and the partial correlation analysis was used correct the influence by total energy intake. Results Two major dietary factors, labeled as prudent pattern and processed food pattern, were identified. The prudent pattern was characterized by higher factor loadings of wheat, rice, fresh vegetables, bean products, nuts, red meat, white meat and fresh eggs; and the processed food pattern was characterized by higher factor loadings of pickled vegetables, preserved vegetables and salted meat. Between Two FFQs, intraclass correlation coefficients were 0.57 for prudent pattern and 0.55 for processed food pattern, partial Pearson correlation coefficients were 0.51 for the prudent pattern and 0.56 for the processed food pattern; weighted κ statistic ranged from 0.45 (for the prudent pattern) to 0.56 (for the processed food pattern). Between FFQs and 24HRs, de-attenuated correlation coefficients ranged from 0.54 to 0.78 for the prudent pattern and from 0.55 to 0.61 for the processed food pattern; partial Pearson correlation coefficients ranged from 0.41 to 0.56 for the prudent pattern and from 0.42 to 0.44 for the processed food pattern; weighted κ statistic ranged from 0.42 to 0.46 for prudent pattern and from 0.43 to 0.60 for processed food pattern. The Bland-Altman plots and limits of agreement indicated that the deviation/divergence was not obvious for both of the patterns between FFQ1 and FFQ2 and between FFQs and 24HRs. Conclusion The study suggests that the FFQ is reasonably reproducible and valid to assess the overall dietary consumption via dietary pattern methods in the Chinese rural population.

Objectives To assess the relationship between quantitative exposure levels and the development of asbestosis in a Chinese asbestos worker cohort. Method A cohort consisting of 577 male workers from an asbestos products factory in China was followed for 37-years. Personal information was collected, including date of hire, specific job types, duration of exposure, and smoking habits. There were 127 workers (22%) diagnosed as asbestosis by a specialised panel using Chinese radiographic Diagnostic Criteria for Pneumoconioses (GB5908–86). Individual cumulative fibre exposures (f-yrs/ml) were estimated based on periodic dust/fibre measurements from different workshops and years of working at specific workshops, and then categorised into four levels (quartile). The relationship between the exposure levels and cumulative incidence of asbestosis was assessed with Cox Proportional Hazard Model, adjusting for age and smoking. Results Workers at the four exposure levels were comparable in age at entry, exposure duration (around 25 yrs), and smoking rate. However, the proportion of asbestosis cases was grater with exposure levels, accounting for 9%, 27%, 29% and 36% from 1st quartile to 4th quartile, respectively. Hazard ratios for cumulative incidence of asbestosis showed a clear trend with the exposure levels, with a nearly three-fold increase (3.42. 95% CI 2.0, 5.9) at the highest exposure level, compared to at the lowest level. Conclusions The study using quantitative estimate of exposures, which was seldom available in China, provides additional evidence for the exposure-response relationship between chrysotile exposure and the development of asbestosis in asbestos workers.

Objective: Whether there is a difference in the exposure-response slope for lung cancer between mining workers and textile workers exposed to chrysotile has not been well documented. This study was carried out to evaluate exposure-specific lung cancer risks in Chinese chrysotile textile workers and mining workers.Subjects and methods: A chrysotile mining worker cohort and a chrysotile textile worker cohort were observed concurrently for 26 years. Information on workers' vital status, occupational history and smoking habits were collected, and causes and dates of deaths were verified from death registries. Individual cumulative fiber exposures were estimated based on periodic dust/fiber measurements from different workshops, job title and duration, and categorized into four levels (Q1-Q4). Standardized mortality ratios (SMRs) for lung cancer were calculated and stratified by industry and job title with reference of the national rates. Cox proportional hazard models were fit to estimate the exposure-specific lung cancer risks upon adjustment for age and smoking, in which an external control cohort consisting of industrial workers without asbestos exposure was used as reference group for both textile and mining workers.Results: SMRs were almost consistent with exposure levels in terms of job titles and workshops. A clear exposure-response relationship between lung cancer mortality and exposure levels was observed in both cohorts. At low exposure levels (Q1 and Q2), textile workers displayed higher death risks of lung cancer than mining workers. However, similarly considerably high risks were observed at higher exposure levels, with hazard ratios of over 8 and 11 at Q3 and Q4, respectively, for both textile and mining workers, after both age and smoking were adjusted.Conclusion: The chrysotile textile workers appeared to have a higher risk of lung cancer than the mining workers at a relatively low exposure level, but no difference was observed at a high exposure level, where both cohorts displayed a considerably high risk. (C) 2014 Elsevier Ireland Ltd. All rights reserved.

Objectives To examine mortality from digestive cancers in a Chinese miner cohort and to explore the exposure-response relationship between chrysotile mining dust and site-specific digestive cancers.Methods A cohort of 1539 asbestos miners was followed for 26years. Information on vital status and death causes was collected from personnel records and hospitals. Underlying causes of death from cancers were determined by combination of clinical manifestations and pathological confirmation. Individual cumulative dust exposures were estimated based on periodic dust measurements of different workshops, individuals' job title and employment duration, and treated as a time-dependent variable. Standardised mortality ratios (SMR) were calculated according to Chinese national data and stratified by exposure (levels 1-3, from low to high). Cox proportional hazard models were constructed to estimate HRs in relation to cumulative exposure with adjustment of smoking.Results Fifty-one deaths from digestive cancers were identified in the cohort, giving an SMR of 1.45 (95% CI 1.10 to 1.90). There was a clear exposure-response relationship between asbestos dust exposure and mortality from stomach cancer, with SMR of 2.39 (95% CI 1.02 to 5.60) and 6.49 (2.77 to 15.20) at exposure levels 2 and 3, respectively. The clear relationship remained in multivariate analysis, in which workers at the highest exposure level had HRs of 12.23 (95% CI 8.74 to 17.12). In addition, excess mortality from oesophageal and liver cancers was also observed at high exposure levels.Conclusions This study provides additional evidence for the association between exposure to chrysotile mining dust and excess mortality from digestive cancers, particularly stomach cancer.

To investigate the association between salt processed food and gastric cancer, a hospital based case-control study was conducted in a high risk area of China. One hundred and seven newly diagnosed cases with histological confirmation of gastric cancer and 209 controls were recruited. Information on dietary intake was collected with a validated food frequency questionnaire. Unconditional logistic regression was applied to estimate the odds ratios with adjustment for other potential confounders. Comparing the high intake group with never consumption of salt processed foods, salted meat, pickled vegetables and preserved vegetables were significantly associated with increased risk of gastric cancer. Meanwhile, salt taste preference in diet showed a dose-response relationship with gastric cancer. Our results suggest that consumption of salted meat, pickled and preserved vegetables, are positively associated with gastric cancer. Reduction of salt and salt processed food in diets might be one practical measure to preventing gastric cancer.

Etiology of esophageal cancer has not yet been clearly documented, especially in high-risk regions. To evaluate the association between salted meat intake and esophageal squamous-cell carcinoma (ESCC) and to explore its joint effects with alcohol drinking and smoking, a population-based case-control study was conducted in a high ESCC risk area in China, including 942 incident ESCC cases and 942 age- and sex-matching controls. A validated food frequency questionnaire was used to collect information on dietary factors, alcohol drinking and tobacco smoking. Conditional logistic regressions were applied to estimate the association between salted meat intake and ESCC and its interactions with alcohol drinking and smoking, with adjustment for other confounders, including total energy intake. Salted meat intake was associated with an increased risk of ESCC, showing an exposure-response relationship (p for trend <0.001). Consumption of 50 g salted meat per week was related to an increased risk by 18% (odds ratio=1.18, 95% confidence interval: 1.13-1.23). Salted meat in combination with either alcohol drinking or smoking had a greater risk than salted meat alone, which was more than additive. The strongest association was seen in the combination of all the three factors, particularly at the highest level of salted meat intake (odds ratio=29.27, 95% confidence interval: 13.21-64.89). Salted meat intake is strongly associated with ESCC and its interactions with alcohol drinking and/or smoking highlights the significance of reducing salted meat intake among smokers and drinkers with respect to ESCC prevention.What's new? Esophageal cancer has several known risk factors, including smoking, dietary factors, and alcohol consumption. In this paper, the authors asked whether eating lots of salted meat increases cancer risk, either alone or in combination with alcohol and smoking. They assessed the diet, tobacco, and alcohol use of nearly 2,000 cases and controls from a region of China known for high rates of esophageal cancer. Salted meat consumption, they found, accompanied an increase in esophageal cancer risk. And the addition of either alcohol or smoking produced an even larger boost in risk, more than would be expected from a simple additive effect.