Environmental Health Perspectives is an Open Access journal published by the National Institute of Environmental Health Sciences. Environmental Health Perspectives is an Open Access journal published by the National Institute of Environmental Health Sciences.

Limited evidence is available on the health effects of particulate matter with an aerodynamic diameter of <1 μm (PM1), mainly due to the lack of its ground measurement worldwide. To identify and examine the mortality risks and mortality burdens associated with PM1, PM2.5, and PM10 in Zhejiang province, China. We collected daily data regarding all-cause (stratified by age and gender), cardiovascular, stroke, respiratory, and chronic obstructive pulmonary disease (COPD) mortality, and PM1, PM2.5, and PM10, from 11 cities in Zhejiang province, China during 2013 and 2017. We used a quasi-Poisson regression model to estimate city-specific associations between mortality and PM concentrations. Then we used a random-effect meta-analysis to pool the provincial estimates. To show the mortality burdens of PM1, PM2.5, and PM10, we calculated the mortality fractions and deaths attributable to these PMs. Daily concentrations of PM1, PM2.5, and PM10 ranged between 0-199 μg/m3, 0-218 μg/m3, and 0-254 μg/m3, respectively; Mortality effects were significant in lag 0-2 days. The relative risks for all-cause mortality were 1.0064 (95% CI: 1.0034, 1.0094), 1.0061 (95% CI: 1.0034, 1.0089), and 1.0060 (95% CI: 1.0038, 1.0083) associated with a 10 μg/m3 increase in PM1, PM2.5, and PM10, respectively. Age- and gender-stratified analysis shows that elderly people (aged 65+) and females are more sensitive to PMs. The mortality fractions of all-cause mortality were estimated to be 2.39% (95% CI: 1.28, 3.48) attributable to PM1, 2.53% (95% CI: 1.42, 3.63) attributable to PM2.5, and 3.08% (95% CI: 1.95, 4.19) attributable to PM10. The ratios of attributable cause-specific deaths for PM1/PM2.5, PM1/PM10, and PM2.5/PM10 were higher than the ratios of their respective concentrations. PM1, PM2.5 and PM10 are risk factors of all-cause, cardiovascular, stroke, respiratory, and COPD mortality. PM1 accounts for the vast majority of short-term PM2.5- and PM10-induced mortality. Our analyses support the notion that smaller size fractions of PM have a more toxic mortality impacts, which suggests to develop strategies to prevent and control PM1 in China, such as to foster strict regulations for automobile and industrial emissions.

Electronic cigarettes (e-cigarettes) use is becoming increasingly common, especially among adolescents and young adults, and there is little evidence on the impact of e-cigarettes use on never-smokers. With a meta-analysis method, we explore the association between e-cigarettes use and smoking intention that predicts future cigarette smoking. Studies were identified by searching three databases up to January 2016. The meta-analysis results were presented as pooled odds ratio (OR) with 95% confidence interval (CI) calculated by a fixed-effects model. A total of six studies (91,051 participants, including 1452 with ever e-cigarettes use) were included in this meta-analysis study. We found that never-smoking adolescents and young adults who used e-cigarettes have more than 2 times increased odds of intention to cigarette smoking (OR = 2.21, 95% CI: 1.86–2.61) compared to those who never used, with low evidence of between-study heterogeneity (p = 0.28, I² = 20.1%). Among never-smoking adolescents and young adults, e-cigarettes use was associated with increased smoking intention.

Obesity has been identified as a major risk factor for a large number of chronic diseases. Understanding factors related to adolescent obesity is critical for prevention of chronic diseases. The associations between sleep duration and obesity among adolescents in the existing literature are controversial. Our study was designed to determine the prevalence of short sleep duration, and assess the association of sleep duration and obesity, among middle and high school students in Zhejiang, China. 18,403 Students in 442 schools were recruited and surveyed using an anonymous, self-administered questionnaires. Weighted multivariable logistic regression models were used for data analyses. The mean (SD) age of the students was 15.9 (1.8) years. 49.7% of students were girls. The mean (SD) height and weight were 166.2 (8.5) cm and 54.6 (11.1) kg, respectively. The overall prevalence of obesity and overweight were 3.4% (95% CI: 3.0–3.8) and 7.8% (95% CI: 7.4–8.3), respectively. The overall prevalence of short sleep duration among students was 66.0% (95% CI: 63.8–68.1), higher among girls than boys (69.8% vs. 62.1%) (P < 0.0001). The figures for middle school, academic high school, and vocational high school were 59.0, 82.4 and 59.7%, respectively (P < 0.0001). As compared with girls who sleep 8 h per day (reference), the odds ratios (95% CI) of obesity for girls who sleep < 7 h, 7 h, 9 h and ≥ 10 h were 1.97 (1.15–3.38), 1.90 (1.18–3.04), 1.38 (0.86–2.20) and 2.12 (1.22–3.67) respectively, after adjustment for socio-demographic status, lifestyle factors, and mental health. The corresponding figures among boys were 1.45 (0.97–2.16), 1.13 (0.81–1.57), 1.25 (0.89–1.74), and 1.12 (0.81–1.54), respectively. Insufficient sleep is prevalent among students in Zhejiang China. A U-shaped relationship was found between sleep duration and obesity risk among girls, with the lowest risk among those who slept for 8 h, but not among boys. Adequate sleep duration may be an important component of obesity prevention initiatives among adolescents.

Backgrounds: Cancer is one of the main causes of death worldwide, seriously threatening human health and life expectancy. We aimed to analyze the cancer incidence and mortality rates during 2016 in Zhejiang Province, Southeast China. Methods: Data were collected from 14 population-based cancer registries across Zhejiang Province of China. Cancer incidence and mortality rates stratified by sex and region were analyzed. The crude rate, age-standardized rate, age-specific and region-specific rate, and cumulative rate were calculated. The proportions of 10 common cancers in different groups and the incidence and mortality rates of the top five cancers in different age groups were also calculated. The Chinese national census of 2000 and the world Segi population was used for calculating the age-standardized incidence and mortality rates. Results: The 14 cancer registries covered a population of 14,250,844 individuals, accounting for 29.13% of the population of Zhejiang Province. The total reported cancer cases and deaths were 55,835 and 27,013, respectively. The proportion of morphological verification (MV%) was 78.95% of the population, and percentage of incident cases identified through death certificates only (DCO%) was 1.23% with a mortality-to-incidence ratio (M/I ratio) of 0.48. The crude incidence rate in Zhejiang cancer registration areas was 391.80/10⁵; the age-standardized incidence rate of the Chinese standard population (ASIRC) and the age-standardized incidence rate of the world standard population (ASIRW) were 229.76/10⁵ and 220.96/10⁵, respectively. The incidence rate in men was higher than that in women. The incidence rate increased rapidly after 45 years of age and peaked in individuals aged 80 to 84 years. The top 10 incidence rates of cancers were lung cancer, female breast cancer, thyroid cancer, colorectal cancer, stomach cancer, liver cancer, prostate cancer, cervical cancer, esophageal cancer, and pancreatic cancer (from highest to lowest). The crude mortality rate in Zhejiang cancer registration areas was 189.55/10⁵; the age-standardized mortality rate of the Chinese standard population (ASMRC) and the age-standardized mortality rate of the world standard population (ASMRW) were 94.46/10⁵ and 93.42/10⁵, respectively. The mortality rate in men was higher than that in women, and the male population in rural areas was higher than that in urban areas. The cancer mortality rate increased rapidly after 50 years of age and peaked in individuals aged 85+ years. The top 10 mortality rates of cancers were lung cancer, liver cancer, stomach cancer, colorectal cancer, pancreatic cancer, esophageal cancer, female breast cancer, prostate cancer, lymphoma, and leukemia (from highest to lowest). Conclusions: Lung cancer, female breast cancer, thyroid cancer, colorectal cancer, prostate cancer, liver cancer, and stomach cancer were the most common cancers in Zhejiang Province. Effective prevention and control measures should be established after considering the different characteristics of cancers in urban and rural areas.

Evidence indicates that breakfast consumption is associated with a cluster of health-related behaviors, yet studies in mainland China are scarce. This study is conducted to describe the frequency of breakfast consumption among Chinese adolescents and examine its associations with other dietary, physical activity, sedentary, sleep, cigarette-smoking, and alcohol-drinking behaviors. Breakfast consumption and other health-related behaviors data was collected via a self-administered questionnaire in a cross-sectional study in Zhejiang Province, China. A total of 19,542 school-aged adolescents were recruited in this survey. The associations between breakfast consumption and other health-related behaviors were examined using logistic regression models. A significantly higher prevalence of daily breakfast consumption was found among students who were younger (p for trend <0.001), from urban schools (p < 0.001), and academic high schools (p < 0.001). More frequent vegetable and milk consumption, greater physical activity, and longer sleep duration were positively associated with daily breakfast consumption, while soft drinks and fast food consumption, computer use, cigarette-smoking and alcohol-drinking behaviors were inversely associated. The prevalence of irregular breakfast consumption was relatively high among Chinese adolescents in Zhejiang Province. Daily breakfast consumption was associated with a constellation of health-related behaviors.