This study aimed to investigate the performance of innovative and traditional cardiometabolic indices, including body mass index (BMI), waist circumference (WC), Chinese visceral adiposity index (CVAI), visceral adiposity index, lipid accumulation product, a body shape index (ABSI), body roundness index, conicity index (CI), triglyceride-glucose (TyG) index, TyG-BMI, and TyG-WC, in estimating atherosclerotic cardiovascular disease (ASCVD) risk in 3143 Taiwanese adults aged 20–79 years. Elevated 10-year ASCVD risk was defined as ≥7.5% using the Pooled Cohort Equations. The performance of different indices in estimating elevated ASCVD risk was assessed by receiver operating characteristic (ROC) curves. In multivariate-adjusted logistic regression analyses, all cardiometabolic indices (p-value < 0.001) were significantly associated with elevated ASCVD risk in both genders, except for ABSI and CI in women. In particular, CVAI had the largest area under the curve (AUC) in men (0.721) and women (0.883) in the ROC analyses. BMI had the lowest AUC in men (0.617), while ABSI had the lowest AUC in women (0.613). The optimal cut-off value for CVAI was 83.7 in men and 70.8 in women. CVAI performed best among various cardiometabolic indices in estimating elevated ASCVD risk. CVAI may be a reliable index for identifying people at increased risk of ASCVD.

N-Hexane is a well-known neurotoxicant. Polyneuropathy due to occupational n-hexane exposure has been reported worldwide, however, our case is the first report in the Chinese herb industry. A 25-year-old Asian man experienced progressive weakness and numbness in his hands and feet after working as an operator in a Chinese medicine pharmaceutical plant for the manufacture of Chinese herbal pain relief patches for 10 months. Electrophysiological studies indicated a reduction in nerve conduction velocity, prolongation of distal latencies, mildly positive sharp waves, and reduced recruitment with polyphasic potentials, particularly at distal sites. Demyelination with axonal degeneration caused by occupational n-hexane exposure was strongly suspected. Through investigation of our patient’s workplace, the ambient n-hexane concentration in air was found to considerably exceed the permissible exposure limit/time-weighted average for n-hexane in Taiwan. His symptoms were gradually relieved after 4 months of cessation of exposure to n-hexane. He was then confirmed as a case of occupational n-hexane intoxication. Further effective control measures should be implemented as soon as possible to prevent exposure of workers to n-hexane. Despite a typical clinical presentation, his exposure at workplace was appropriately investigated. Chemical exposure in Chinese medicine pharmaceutical plants could be an emerging issue that may affect workers’ health. The lack of knowledge and management of solvents could endanger the health of workers. This case has profound educational implications for occupational health and is worthy of further follow-up for improving hazards control.

Background: Metabolic Score for Visceral Fat (METS-VF) is a novel indicator for estimating intra-abdominal fat, yet its connection with coronary artery calcification (CAC) remains uncharted. Our research aims to explore the novel METS-VF indicator’s link to CAC while comparing its performance against relevant anthropometric indices. Methods: This study enrolled participants who underwent health checkups and computed tomography scans for categorizing severity of CAC using the coronary artery calcium score. The METS-VF was calculated and compared with anthropometric indices in estimating the presence of CAC and different CAC severity using receiver operating characteristic curves. Results: Overall, 1217 participants (mean age 50.7 ± 9.9, 53.8% male) were included. METS-VF (odds ratio [OR], 1.506; 95% confidence interval [CI], 1.181–1.921; p = 0.001) was positively associated with the presence of CAC, even after accounting for cardiometabolic factors. Notably, METS-VF was positively associated with mild (OR, 1.450; 95% CI, 1.115–1.886; p = 0.006), moderate (OR, 1.865; 95% CI, 1.137–3.062; p = 0.014), and severe (OR, 2.316; 95% CI, 1.090–4.923; p = 0.029) CAC. Moreover, METS-VF yielded the highest area under curve (AUC) value in the estimation of the CAC presence (AUC = 0.710), mild (AUC = 0.682), moderate (AUC = 0.757), and severe (AUC = 0.807) CAC when compared with body mass index, waist circumference, visceral adiposity index, triglyceride–glucose index, and metabolic score for insulin resistance. The optimal METS-VF cut-off value was 6.4 for predicting CAC. Conclusions: METS-VF emerged as a strong independent marker for detecting CAC presence across mild, moderate, and severe CAC categories, outperforming major anthropometric indices in accurately estimating the presence of CAC and different severity of CAC.

Research has shown that long-term exposure to lead harms the hematological system. The homeostatic iron regulator HFE (hemochromatosis) mutation, which has been shown to affect iron absorption and iron overload, is hypothesized to be related to lead intoxication in vulnerable individuals. The aim of our study was to investigate whether the HFE genotype modifies the blood lead levels that affect the distributions of serum iron and other red blood cell indices. Overall, 121 lead workers and 117 unexposed age-matched subjects were recruited for the study. The collected data included the blood lead levels, complete blood count, serum iron, total iron binding capacity, transferrin, and ferritin, which were measured during regular physical examinations. All subjects filled out questionnaires that included demographic information, medical history, and alcohol and tobacco consumption. HFE genotyping for C282Y and H63D was determined using polymerase chain reaction and restriction fragment length polymorphism (PCR/RFLP). The mean blood lead level in lead workers was 19.75 µg/dL and was 2.86 µg/dL in unexposed subjects. Of 238 subjects, 221 (92.9%) subjects were wild-type (CCHH) for HFE C282Y and H63D, and 17 (7.1%) subjects were heterozygous for a H63D mutation (CCHD). Multiple linear regression analysis showed that blood lead was significantly negatively associated with hemoglobin (Hb), mean corpuscular hemoglobin concentration (MCHC), and mean corpuscular volume (MCV), whereas the HFE variant was associated negatively with MCV and positively with ferritin. An interactive influence on MCV was identified between blood lead and HFE variants. Our research found a significant modifying effect of the HFE variant, which possibly affected MCV. The HFE H63D heterozygous (CCHD) variant seemed to provide a protective factor against lead toxicity. Future studies should focus on competing binding proteins between iron and lead influenced by gene variation.

Shift work (SW) is the main working schedule worldwide, and it may cause sleep disorders, breast cancer, and cardiovascular disease. Low back pain (LBP) is a common problem in the workplace; however, the association between LBP and SW remains unclear. Therefore, we conducted a meta-analysis to determine the association between SW and LBP. This study was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The PubMed, Embase, and Web of Science databases using a set of associated keywords were queried. The inclusion criteria were as follows: (1) adult employees hired by a company or organization; (2) SW exposure; and (3) the outcome of LBP according to examination or assessment. A total of 40 studies were included that met the inclusion criteria for the meta-analysis. SW was significantly associated with LBP (odds ratio [OR]: 1.31, 95% confidence interval [CI]: 1.18–1.47, p < 0.00001). Furthermore, it was observed that LBP was significantly associated with night shift (NS) (OR: 1.49, 95% CI: 1.24–1.82, p < 0.0001) but not with rotating shift (RS) (OR: 0.96, 95% CI: 0.76–1.22, p = 0.49). Moreover, LBP was significantly associated with SW in health care workers (HCWs) (OR: 1.40, 95% CI: 1.20–1.63, p < 0.0001) but not in non-HCWs (OR: 1.19, 95% CI: 0.94–1.50, p = 0.14). SW was significantly associated with LBP. Furthermore, the subgroup analysis showed that NS, but not RS, was associated with LBP. Compared with SW in non-HCWs, SW in HCWs was significantly associated with LBP.

Background: Lead inhibits the enzymes in heme biosynthesis, mainly reducing δ-aminolevulinic acid dehydratase (ALAD) activity, which could be an available biomarker. The aim of this study was to detect the threshold of δ-aminolevulinic acid dehydratase activity reduced by lead exposure. Methods: We collected data on 121 lead workers and 117 non-exposed workers when annual health examinations were performed. ALAD activity was determined by the standardized method of the European Community. ALAD G177C (rs1800435) genotyping was conducted using the polymerase chain reaction and restricted fragment length polymorphism (PCR-RFLP) method. In order to find a threshold effect, we used generalized additive models (GAMs) and scatter plots with smoothing curves, in addition to multiple regression methods. Results: There were 229 ALAD1-1 homozygotes and 9 ALAD1-2 heterozygotes identified, and no ALAD2-2 homozygotes. Lead workers had significantly lower ALAD activity than non-exposed workers (41.6 ± 22.1 vs. 63.3 ± 14.0 U/L, p < 0.001). The results of multiple regressions showed that the blood lead level (BLL) was an important factor inversely associated with ALAD activity. The possible threshold of BLL affecting ALAD activity was around 5 μg/dL. Conclusions: ALAD activity was inhibited by blood lead at a possible threshold of 5 μg/dL, which suggests that ALAD activity could be used as an indicator for lead exposure regulation.