Asbestos is a carcinogen that causes diseases such as mesothelioma and lung cancer in humans. There was a sharp increase in the use of asbestos in Korea in the 1970s as Korea's economy developed rapidly, and asbestos was only recently banned from use. Despite the ban of its use, previously applied asbestos still causes many problems. A series of asbestos-related events that recently occurred in Korea have caused the general public to become concerned about asbestos. Therefore, it is necessary to take proper action to deal with asbestos-related events, such as mass outbreaks of mesothelioma among residents who lived near asbestos textile factories or asbestos mines. Although there have been no rapid increases in asbestos-related illnesses in Korea to date, such illnesses are expected to increase greatly due to the amount of asbestos used and long latency period. Decreasing the asbestos exposure level to levels as low as possible is the most important step in preventing asbestos-related illnesses in the next few decades. However, there is a lack of specialized facilities for the analysis of asbestos and experts to diagnose and treat asbestos-related illnesses in Korea; therefore, national-level concern and support are required.
Asbestos/*toxicity ; Asbestosis/*epidemiology/etiology/mortality ; Environmental Exposure/prevention & control ; Humans ; Korea ; Lung Neoplasms/*chemically induced ; Mesothelioma/*chemically induced/epidemiology

OBJECTIVETo investigate the relationship between silica or silicosis and lung cancer in a large cohort of silicotic workers in Hong Kong.

METHODSAll workers with silicosis in Hong Kong diagnosed between 1981 and 1998 were followed up till the end of 1999 to ascertain their vital status and causes of death, using the corresponding mortality rates of Hong Kong males of the same period as external comparison. Standardized mortality ratios (SMR) for lung cancer and other major causes of death were calculated. Person-year method was used. Axelson's indirect method was performed to adjust for the confounding effect of smoking. Penalized smoothing spline (p-spline) models were used to evaluate the exposure-response relationship between silica dust exposure and lung cancer mortality.

RESULTSA total of 2789 newly diagnosed cases of silicosis were included in the cohort, with an overall 24 992.6 person-years of observations. The loss-to-follow-up rate was only 2.9%. Surface construction workers (51%) and underground caisson workers (37%) constituted the major part of the cohort. There were 853 silicotics observed with an average age at death of 63.8 years. The SMR for all causes and all cancers increased significantly. The leading cause of death was non-malignant respiratory diseases. About 86 deaths were from lung cancer, giving a SMR of 1.69 (95% CI: 1.35 approximately 2.09). The risk of lung cancer death among workers in surface construction, underground caisson, and entire cohort was reduced to 1.12 (95% CI: 0.89 approximately 1.38), 1.09 (95% CI: 0.82 approximately 1.42) and 1.56 (95% CI: 0.98 approximately 2.36) respectively, after indirectly adjusting for smoking.

RESULTSfrom P-spline model did not show a clear exposure-response relationship between silica dust (CDE and MDC) and lung cancer mortality.

CONCLUSIONThis cohort study did not show an increased risk of lung cancer mortality among silicotic workers. P-spline model does not support an exposure-response relationship between silica dust exposure and lung cancer mortality.

Adult ; Aged ; Dust ; Follow-Up Studies ; Hong Kong ; epidemiology ; Humans ; Lung Neoplasms ; etiology ; mortality ; Male ; Middle Aged ; Occupational Exposure ; adverse effects ; Retrospective Studies ; Silicosis ; complications ; mortality

OBJECTIVETo understand the smoking-attributed mortality by inclusion of smoking information into all causes of death surveillance.

METHODSSince 2010, the information about smoking status, smoking history and the number of cigarettes smoked daily had been added in death surveillance system. The measures of training, supervision, check, sampling survey and telephone verifying were taken to increase death reporting rate and reduce data missing rate and underreporting rate. Multivariate logistic regression analysis was conducted to identify risk factors for smoking-attributed mortality.

RESULTSDuring the study period (2010-2014), the annual death reporting rates ranged from 6.5‰ to 7.0‰. The reporting rates of smoking status, smoking history and the number of cigarettes smoked daily were 95.53%, 98.63% and 98.58%, respectively. Compared with the nonsmokers, the RR of males was 1.38 (1.33-1.43) for all causes of death and 3.07 (2.91-3.24) for lung cancer due to smoking, the RR of females was 1.46 (1.39-1.54) for all causes of death and 4.07 (3.81-4.35) for lung cancer due to smoking, respectively.

CONCLUSIONThe study of smoking attributed mortality can be developed with less investment by using the stable and effective all causes of death surveillance system in Tianjin.

Cause of Death ; China ; epidemiology ; Female ; Humans ; Logistic Models ; Lung Neoplasms ; etiology ; mortality ; Male ; Multivariate Analysis ; Population Surveillance ; methods ; Risk Factors ; Smoking ; adverse effects ; mortality

OBJECTIVETo calculate the latent period of lung cancer induced by air pollution.

METHODSThe degree of grey incidence (DGI) between the concentrations of TSP or SO(2) and the mortality of lung cancer were assessed through a grey system model. According to the maximum values of DGI, the total latent period of lung cancer was calculated. Data was collected in H city.

RESULTSThe maximum DGI value of TSP was 0.886 while the relationship between the comparison sequence from 1985 to 1989 and the reference sequence from 1994 to 1998 was greatly correlated. The maximum DGI value of SO(2) was 0.919 while the relationship between the comparison sequence from 1986 to 1990 and the reference sequence from 1994 to 1998 was most correlated.

CONCLUSIONSThe latent periods of lung cancer induced by TSP and SO(2) were 7 and 8 years respectively in H city. The model of grey system was less affected by the confounding factors, and the calculation process was relatively simple. A feasible and useful new way was provided by the model of grey system for quantitative analysis of the latent period of lung cancer induced by air pollutants.

Air Pollutants ; adverse effects ; China ; epidemiology ; Humans ; Lung Neoplasms ; epidemiology ; etiology ; mortality ; Models, Biological ; Particle Size ; Risk Factors ; Sulfur Dioxide ; adverse effects

Radon is likely the second most common cause of lung cancer after smoking. We estimated the lung cancer risk due to radon using common risk models. Based on national radon survey data, we estimated the population-attributable fraction (PAF) and the number of lung cancer deaths attributable to radon. The exposure-age duration (EAD) and exposure-age concentration (EAC) models were used. The regional average indoor radon concentration was 37.5 95 Bq/m3. The PAF for lung cancer was 8.3% (European Pooling Study model), 13.5% in males and 20.4% in females by EAD model, and 19.5% in males and 28.2% in females by EAC model. Due to differences in smoking by gender, the PAF of radon-induced lung cancer deaths was higher in females. In the Republic of Korea, the risk of radon is not widely recognized. Thus, information about radon health risks is important and efforts are needed to decrease the associated health problems.
Adult ; Demography ; *Environmental Exposure ; Female ; Humans ; Lung Neoplasms/*epidemiology/etiology/mortality ; Male ; Models, Theoretical ; Neoplasms, Radiation-Induced/*epidemiology/etiology ; Radon/*toxicity ; Republic of Korea/epidemiology ; Risk Assessment ; Smoking ; Survival Analysis

The purpose of this study was to investigate risk factors of postoperative pneumonia (POP) after lung cancer surgery. The 417 lung cancer patients who underwent surgical resection in a tertiary referral hospital were included. Clinical, radiological and laboratory data were reviewed retrospectively. Male and female ratio was 267:150 (median age, 65 yr). The incidence of POP was 6.2% (26 of 417) and in-hospital mortality was 27% among those patients. By univariate analysis, age > or = 70 yr (P < 0.001), male sex (P = 0.002), ever-smoker (P < 0.001), anesthesia time > or = 4.2 hr (P = 0.043), intraoperative red blood cells (RBC) transfusion (P = 0.004), presence of postoperative complications other than pneumonia (P = 0.020), forced expiratory volume in 1 second/forced vital capacity (FEV1/FVC) < 70% (P = 0.002), diffusing capacity of the lung for carbon monoxide < 80% predicted (P = 0.015) and preoperative levels of serum C-reactive protein > or = 0.15 mg/dL (P = 0.001) were related with risk of POP. Multivariate analysis showed that age > or = 70 yr (OR = 3.563, P = 0.014), intraoperative RBC transfusion (OR = 4.669, P = 0.033), the presence of postoperative complications other than pneumonia (OR = 3.032, P = 0.046), and FEV1/FVC < 70% (OR = 3.898, P = 0.011) were independent risk factors of POP. In conclusion, patients with advanced age, intraoperative RBC transfusion, postoperative complications other than pneumonia and a decreased FEV1/FVC ratio have a higher risk for pneumonia after lung cancer surgery.
Adult ; Age Factors ; Aged ; Aged, 80 and over ; C-Reactive Protein/analysis ; Carbon Monoxide/metabolism ; Erythrocyte Transfusion ; Female ; Forced Expiratory Volume ; Hospital Mortality ; Humans ; Incidence ; Logistic Models ; Lung Neoplasms/pathology/*surgery ; Male ; Middle Aged ; Neoplasm Staging ; Odds Ratio ; Pneumonia/epidemiology/*etiology/mortality ; *Postoperative Complications ; Retrospective Studies ; Risk Factors ; Vital Capacity