Objective To establish a new method for assessing the effects of environmental factors on human health.Methods Based on the environment part of the frame for comparative risk assessment(CRA) of WHO,the frame and index system for environmental contamination risk assessment which accorded with the situation in China was developed.With the prevalence of different exposure level,RR and the choice of counterfactual scenario,the potential impact fraction(PIF) was estimated.Then an example on the study of liver cancer related with water pollution was used to show the new frame.In this example,the contaminated water was regarded as the environmental factor,incidence of liver cancer was regarded as variable of health,and the analysis was performed with spatial interpolation,counterfactual analysis and CRA theory.Results The quantity of COD of river water in this area was estimated with ordinary Kriging interpolation,and the accumulated exposure of COD was calculated with the trend of annual COD,and the number of population exposed to COD was estimated at same time.In accordance with the different level of pollution and the RR relate to liver cancer,the trend with monotonically increasing showed.At same time,the values of PIF illuminated that 75.72% in male and 66.39% in female would avoid death for liver cancer if the level of contaminated water could be reduced to the level of the control areas.Conclusion The frame includes CRA,spatial analysis and counterfactual analysis is a good approach to assess the health effects of environmental factors.

When revising Advertisement Law ( AL) of People's Republic of China, a basic principal is the comprehensive banning of direct or indirect tobacco advertising and implementing the WHO Framework Conven-tion on Tobacco Control ( FCTC) . After comparing the AL Revised Draft ( ALRD) with the AL, the Interim Man-agement Regulation for Tobacco Advertisements ( IMRTA) , and FCTC article 13 and its implementation guide-line, we found that ALRD did not ban all kinds of the tobacco advertising in all public places by using different channels, couldn’t clearly define the covert and false advertisements on tobacco, so that the epidemic of tobacco advertising cannot be curbed in China. In addition, this ALRD still permits the tobacco advertising in some places, and this does not satisfy the FCTC requirement. Therefore, China cannot honor its commitments as a re-sponsible big country. According to above analysis, we proposed some suggestions on comprehensive banning all the direct and indirect tobacco advertisements.

Objective To investigate the contamination level of environmental tobacco smoke (ETS) in the public places and workplaces in Dongcheng district of Beijing and identify the influencing factors for ETS exposure. Methods The contamination level of ETS in 14 public places and workplaces of Dongcheng district were monitored with passive sampler of vapor-phase nicotine during Apr.-Feb.,2004. Results Nicotine was detected from all monitor sites at the 14 locations. The lowest air nicotine concentration was detected in no smoking places and the highest one was detected in non-regulation places. There were many factors which were found to influence the indoor air nicotine concentration,including legislation,the number of smokers and the room space,etc. The most significant factor was found to be the numbers of smokers. Conclusion Exposure to ETS in the pubic places and workplaces has become a major pubic and occupational health issue at present.

OBJECTIVETo assess the implementation of World Health Organization Framework Convention on Tobacco Control (WHO FCTC) by organizations in seven provinces/municipalities in China.

METHODSA total of 901 organizations, including hospitals, schools, government departments, health administrative departments and public transportation facilities, were selected by multistage sampling method in five provinces and two municipalities in China, 2010 and 2012. Key informant interview and observation survey were conducted to collect data on implementation of WHO FCTC. Analysis was performed among three clusters of indexes, which were establishment of smoke-free environment, education and training on tobacco control, and tobacco cessation measures.

RESULTSThe five types of organizations performed differently in creating smoke-free environment. The ratios of conducting complete smoke-free policy in hospitals, health administrative departments and schools were separately 83.3% (111/192), 81.6% (146/179) and 66.5% (121/182) in 2012, which were comparatively higher than those in governments (32.4%, 33/102) and public transport facilities (25.0%, 27/108) (χ(2) = 174.93, P < 0.01) . As for promotion and training programs of tobacco control information, the ratio of health administrative departments raised from 78.1% (150/192) to 100.0% (192/192), and the difference showed statistical significance (χ(2) = 42.00, P < 0.01). But those departments who provide training to social media only accounted for 11.8% (22/187), which was substantially lower than the percentage of those providing training to themselves (67.7%, 128/189) (χ(2) = 413.99, P < 0.01). Three indexes of tobacco cessation related work--offering help in tobacco use quitting, providing health workers with training on tobacco cessation skills and establishing tobacco cessation clinics, only reached as low as 41.1% (312/760) , 55.6% (104/187) and 45.9% (89/194), respectively. Among the seven provinces/municipalities, Shanghai did better than the others on most of the indexes. 27 out of 28 schools in Shanghai implemented complete smoke-free policy, which was the best among the seven, while only 3 out of 26 in Jiangxi, as the poorest (χ(2) = 47.63, P < 0.01). Meanwhile, all of the 24 schools in Shanghai had health education classes on tobacco control, followed by Zhejiang (23 out of 29), while Jiangxi was also the poorest, only 12 out of 26 (χ(2) = 17.95, P < 0.01).

CONCLUSIONThe implementation of WHO FCTC by the five types of organizations in the seven provinces/municipalities has improved to various degrees. Nevertheless, further actions should be taken to promote smoke-free environment especially in certain circumstances such as public transport facilities, to strengthen training programs of tobacco control for social media, and to enhance hospitals' abilities in providing tobacco cessation services.

China ; Cities ; Data Collection ; Government Agencies ; Health Education ; Health Policy ; Hospitals ; Humans ; Schools ; Smoking ; Smoking Cessation ; Tobacco ; Tobacco Smoke Pollution ; World Health Organization

A substantial amount of data suggested that exposure to secondhand smoke (SHS) could cause cardiovascular diseases and acute coronary events in nonsmoking adults. In order to protect the public from SHS, more and more countries and regions across the world have enacted and implemented smoke-free legislations. Developed countries, such as USA, Canada, the Great Britain, Ireland, Italy and Spain, have carried out many studies to analyze the effects of smoke-free legislations on the hospital admission, incidence and mortality of cardiovascular diseases with the purpose of confirming the health benefits of the smoking ban and promoting the conduct of the ban. We searched PubMed, EMBASE, Web of Science, Cochrane Library,China National Knowledge Infrastructure(CNKI),WANFANG databaseto summarize the study designs, evaluating indicators, statistical methods and results of these studies to provide reference for evaluating smoke-free legislations in inland cities in China.

The paper summarized briefly the evidences for tobacco use as a cause of cancer based on hundreds of epidemiologic and biomedical studies carried out over the past 50-60 years, as well as overviewed the carcinogens in tobacco products and mechanisms of neoplasm induction by tobacco products. So, tobacco control is the important measure for cancer prevention.
Carcinogenesis ; Carcinogens ; Health Policy ; Humans ; Neoplasms ; prevention & control ; Smoking ; Tobacco ; Tobacco Use Disorder

The paper summarized briefly the evidences for tobacco use as a cause of cancer based on hundreds of epidemiologic and biomedical studies carried out over the past 50-60 years, as well as overviewed the carcinogens in tobacco products and mechanisms of neoplasm induction by tobacco products. So, tobacco control is the important measure for cancer prevention.

The paper summarized briefly the evidences for tobacco use as a cause of cancer based on hundreds of epidemiologic and biomedical studies carried out over the past 50-60 years, as well as overviewed the carcinogens in tobacco products and mechanisms of neoplasm induction by tobacco products. So, tobacco control is the important measure for cancer prevention.

OBJECTIVETo evaluate the completeness of the death registration system, so as to understand the death patterns in Xuanwei.

METHODSThe investigation on under-reported deaths was conducted in 30 villages selected with a multi-stage random sampling strategy. Participants were asked about changes of their family members (family members born or dead) during past 3 years with door to door visit. Then, death cases obtained in our investigation were matched with those from routine death registration system and under-reported rate of deaths during 2011-2013 was calculated employing capture-recapture method.

RESULTSTotal under-reported rate of deaths was 31.88%. For people aged between 0-14, 15-39, 40-69 and 60 above, under-reported rates of death were 33.35%, 34.93%, 29.10%, and 32.88%, respectively. And they were 31.72% and 32.02% for males and females, respectively. There was no significant difference shown in under-reported rates among deaths in different age groups (χ² = 7.24, P = 0.065) and genders (χ² = 0.06, P = 0.803). The under-reported rates in high-mortality, medium-mortality and low-mortality regions were 17.48%, 38.01%, and 36.22%, respectively with a significant difference (χ² = 213.25, P < 0.001). Death in local regions with mortality rate higher than 600.00/10(5), between 400.00/10⁵ and 600.00/10⁵ and lower than 400.00/10⁵ were adjusted with under-reported rates in three regions above respectively. The total adjusted morality rate in Xuanwei during 2011-2013 was 776.47/10⁵. For males and females, they were 918.73/10⁵ and 617.46/10⁵, respectively.

CONCLUSIONOverall under-reported rate of death was high in death registration system in Xuanwei. It was necessary to adjust mortality data reported with under-reported rate of death to estimate death patterns in this area.

China ; Data Accuracy ; Death Certificates ; Female ; Humans ; Male ; Mortality ; Registries

Background and objective Since 1970s, Xuanwei in Yunnan province has been one of the towns with highest lung cancer mortality in China. Moreover, the characters of high female lung cancer mortality and sub-regional clustering high lung cancer mortality have not changed. In this study, we further described the exposure situa-tion of risk factors of lung cancer in Xuanwei nowadays, in order to explore the trend of the distribution of lung cancer there.Methods Firstly we divided the 26 towns of Xuanwei city to high-, median- and low- lung cancer areas by the lung cancer mortality in 2010-2012. We chose 2 towns within each area according to topography and orientation, and randomly picked 4 villages in each town to be our study area. We did a questionnaire about lung cancer related risk factors upon the sample population in the study area. We calculated the exposure percentages of each risk factor, in whole sample population and subgroups, for nowadays and for 10 years ago (only living environmental risk factors), and compared them between areas or time points using standardized rates and the statistical test of standardized rate comparison, or chi-square test.Results 65%-80% male in the study area has a history of smoking; 60%-90% non-smoker has been exposed to second hand smoke. These situations are worse in high and median lung cancer areas. 50% male in median lung cancer area have coal mining work experience, which is 2 times of the percentages in the other two areas; while 15%-25% people in high lung cancer area have other occupational exposure history to particulate air pol-lution, which is 3-5 times of the percentages in the other two areas. From ten years ago until nowadays, 80% families in median lung cancer area use 2 tons or more smoky coal per year; more than 90% families burn coal for household heating; more than 60% families suffer from smog in the kitchen during cook; 60% families most frequently use stove in the ground with chimney. Only 20% families in high lung cancer area now use 2 tons or more smoky coal per year. Now 50%-75% families in the study area use 700 kilowatt-hours of electricity per year, much more than ten years ago. 80% residents in low lung cancer area eat fatty or pickled or smoked food at least 3 days per week; while in high and median lung cancer areas the percentages are 50%-60%.Conclusion According to data obtained in this survey, current distribution of smoky coal use has differed from the distribution of high-, median- and low- lung cancer areas. Tobacco use and second hand smoke, the use of smoky coal and occupational exposure to particulate matters could be the main risk factors for lung cancer in Xuanwei now. The relations between lung cancer and stove type, dietary habit and so on deserve further study.