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There is clear evidence that high sodium intake is associated with many health issues including hypertension and cardiovascular diseases (CVDs). Several national and worldwide studies have estimated deaths from CVDs attributable to high sodium. But how to evaluate the impact of high sodium intake on diseases using regional routine monitoring and investigation data is necessary and important. Our study aimed to quantitatively evaluate the high sodium intake attributed to CVDs deaths based on the routine monitoring data from China National Nutrition and Health Survey (CNNHS) in Tianjin, China. The population attributable fractions (PAF) were calculated by comparing the observed systolic blood pressure (SBP) distribution with the theoretical minimum or counterfactual distribution by sex and age groups. The results showed that CVDs deaths due to elevated SBP were 22728 (95% uncertainty intervals: 22679-23050), accounting for 62.8% of total CVDs deaths. According to sodium intake recommended by World Health Organization (WHO), PAF of CVDs deaths attributable to high sodium diet in our study was 14.6% of total CVDs deaths, accounting for 5228 (95% UI: 5005-5998) cases. The dietary sodium intake of residents is nearly three times than sodium intake recommended by WHO. If sodium intake was reduced to reference level, the potential avoidable CVD deaths attributable to the SBP-raising effect were more than 5200 among adults 25 aged and over in Tianjin. This evaluation method can be extended to other cities.

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INTRODUCTION: We conducted a mortality case-control study to assess the risks of all-cause and major causes of death attributable to smoking in Tianjin from 2010 through 2014. The death registry-based study used data from The Tianjin All Causes of Death Surveillance System, which collects information routinely on smoking of the deceased in the death certificate of Tianjin Centers for Disease Control and Prevention. METHODS: Cases (n = 154,086) and controls (n = 25,476) were deaths at 35 to 79 years from smoking-related and nonsmoking-related causes, respectively. Mortality rate ratios (RRs) for ever smokers versus never smokers, with adjustment for sex, 5-year age group, education, marital status, and year of death, and smoking-attributed fractions were calculated. RESULTS: The RRs in men were 1.38 (95% confidence interval [CI], 1.33-1.43) for all causes and 3.07 (95% CI, 2.91-3.24) for lung cancer, and in women were 1.46 (95% CI, 1.39-1.54) and 4.07 (95% CI, 3.81-4.35). The smoking-attributed fractions for all causes and for lung cancer in men were 15.4% and 50.2%, respectively, and in women were 7.3% and 32.7%, respectively. Smoking annually caused an average of 3,756 (9.4%) deaths, mostly from lung cancer in men (47.4%) and women (66.9%). Women who started smoking before 30 had a higher RR (1.79; 95% CI, 1.63-1.97) than men who did so (1.48; 95% CI, 1.41-1.56). CONCLUSION: Lung cancer was the main cause of smoking-induced deaths in both sexes. Tobacco use is a major cause of premature deaths in men aged 35 to 79 years. Young women must be urged to not start smoking because they could have greater risk of all-cause and lung cancer deaths than men do.

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Cohort evidence that links long-term exposures to air pollution and mortality comes largely from the United States and European countries. We investigated the relationship between long-term exposures to particulate matter <10µm in diameter (PM10), nitrogen dioxide (NO2), and sulfur dioxide (SO2) and mortality of lung cancer in Northern China. A cohort of 39,054 participants were followed during 1998-2009. Annual average concentrations for PM10, NO2, and SO2 were determined based on data collected from central monitoring stations. Lung cancer deaths (n=140) were obtained from death certificates, and hazard ratios (HRs) were estimated using Cox proportional hazards models, adjusting for age, gender, BMI, education, marital status, smoking status, passive smoking, occupation, alcohol consumption, etc. Each 10mg/m(3) increase in PM10 concentrations was associated with a 3.4%-6.0% increase in lung cancer mortality in the time-varying exposure model and a 4.0%-13.6% increase in the baseline exposure model. In multi-pollutant models, the magnitude of associations was attenuated, most strongly for PM10. The association was different in men and women, also varying across age categories and different smoking status. Substantial differences exist in the risk estimates for participants based on assignment method for air pollution exposure.

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OBJECTIVE: To quantitatively explore the effect of air pollution on coronary heart disease mortality in Tianjin. METHODS: Mortality data in 2001 - 2009 were from Tianjin mortality surveillance system operated by the Tianjin Centers for Disease Control and Prevention while data related to meteorology and air pollution were from the Tianjin Meteorological Bureau and Tianjin Environmental Monitoring Station, respectively. Generalized Additive Model (GAM) extended Poisson regression was used to examine the relationship between air pollution and mortality in Tianjin, under the controlling of time trends, weather, the day of week and population etc. RESULTS: The crude coronary heart disease mortality in Tianjin increased from year 2001 to 2009, from 105.12/100 000 to 167.03/100 000. The standardized mortality rate of 96.07/100 000 to 105.11/100 000. Air pollutants was more strongly associated with coronary heart disease mortality. By single GAM analysis, a 10 µg/m(3) increase in SO2, PM10 and NO2, which accounted for 1.25% (95%CI: 0.75% - 1.75%), 0.65% (95%CI: 0.51% - 0.79%) and 1.04% (95%CI: 0.52% - 1.55%) increased in daily mortality. By multiple GAM analysis, a 10 µg/m(3) increase in SO2 and PM10 which accounted for 0.86% (95%CI: 0.60% - 1.12%) and 0.40% (95%CI: 0.06% - 0.75%) increased the daily mortality. NO2 was not significantly associated with coronary heart disease mortality rates, but factors as low temperature, low wind speed and population size were (P < 0.05). CONCLUSION: from this study showed that air pollution was a risk factor for coronary heart disease mortality in Tianjin.

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OBJECTIVE: To investigate the effect of air pollution on stroke mortality in Tianjin, China, and to provide basis for stroke control and prevention. METHODS: Total data of mortality surveillance were collected by Tianjin Centers for Disease Control and Prevention. Meteorological data and atmospheric pollution data were from Tianjin Meteorological Bureau and Tianjin Environmental Monitoring Center, respectively. Generalized additive Poisson regression model was used in time-series analysis on the relationship between air pollution and stroke mortality in Tianjin. Single-pollutant analysis and multi-pollutant analysis were performed after adjustment for confounding factors such as meteorological factors, long-term trend of death, "days of the week" effect and population. RESULTS: The crude death rates of stroke in Tianjin were from 136.67 in 2001 to 160.01/100000 in 2009, with an escalating trend (P = 0.000), while the standardized mortality ratios of stroke in Tianjin were from 138.36 to 99.14/100000, with a declining trend (P = 0.000). An increase of 10 µg/m³ in daily average concentrations of atmospheric SO2, NO2 and PM10 led to 1.0105 (95%CI: 1.0060 ∼ 1.0153), 1.0197 (95%CI: 1.0149 ∼ 1.0246) and 1.0064 (95%CI: 1.0052 ∼ 1.0077), respectively, in relative risks of stroke mortality. SO2 effect peaked after 1-day exposure, while NO2 and PM10 effects did within 1 day. CONCLUSION: Air pollution in Tianjin may increase the risk of stroke mortality in the population and induce acute onset of stroke. It is necessary to carry out air pollution control and allocate health resources rationally to reduce the hazard of stroke mortality.

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OBJECTIVE: To study the association between sulphur dioxide, nitrogen dioxide and daily mortality in urban population from Tianjin. METHODS: Data on daily concentration of inhalable particulate matter, sulphur dioxide and nitrogen dioxide, daily mean temperature and relative humidity, daily cause-specific death counts were collected. Generalized additive models was used to explore the relationship between sulphur dioxide, nitrogen dioxide and daily mortality, after adjusting the effects of long-term and seasonal trend, weather conditions, and to analyze the potential effect of particulate matter and model parameters on relative risk estimates. RESULTS: Results showed that the daily concentrations of SO(2) and NO(2) were significantly associated with daily non-accidental and cardiovascular mortality but not associated with daily respiratory mortality. An increase of 10 µg/m(3) in SO(2) was associated with 0.56% (95%CI: 0.23% - 0.89%) non-accidental morality, 0.49% (0.06% - 0.93%) cardiovascular morality, respectively. An increase of 10 µg/m(3) in NO(2) was associated with 0.94% (95%CI: 0.17% - 1.70%) non-accidental morality, 1.29% (0.29% - 2.30%) cardiovascular morality, respectively. CONCLUSION: Our findings suggested that exposure to SO(2) and NO(2) was significantly associated with daily cardiovascular and respiratory mortality in urban population in Tianjin.

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OBJECTIVE: To study the association between particulate matter less than 10 micron in aerodynamic diameter (PM(10)) and daily mortality among urban population in Tianjin. METHODS: We collected data of air quality, daily mean temperature and relative humidity, and daily cause-specific death counts, and used generalized additive models to explore the relationship between ambient particulate matter and daily mortality, after adjusting the effects of long-term and seasonal trend, weather conditions and other gaseous pollutants, such as sulfur dioxide and nitrogen dioxide. RESULTS: An increase of 10 µg/m(3) in PM(10) was associated with 0.45% (95%CI: 0.21 - 0.69) non-accidental morality, 0.60% (0.29 - 0.91) circulatory morality and 0.82% (0.04 - 1.61) respiratory morality, respectively. CONCLUSION: Our findings indicated that the extent of exposure to PM(10) was significantly associated with daily mortality in urban population in Tianjin, especially with the mortality rates on circulatory and respiratory diseases.

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INTRODUCTION: To develop a model for forecasting the mortality of stroke in Tianjin, China. The time series of stroke mortality from 1999 Jan. to 2006 Dec. in Tianjin city were subjected. Circle distribution analysis was used to verify the trend of time concentration. Multiple seasonal autoregressive integrated moving average model [ARIMA (p, d, q) (P, D, Q) s], based on model identification, estimation and verification of parameter, and analysis of the fitting of model, was established. Most of the deaths from stroke occurred in January and had a cycle of 12 months. An ARIMA model (0, 1, 0) x (0, 1, 1)12 was established (1--B) (1-- B12) lnx(i) = 0.001 + (1--0.537 B12)epsilon(t). CONCLUSION: ARIMA & Circle Distribution analysis is an important tool for stroke mortality analysis. Potentially it has a high practical value on the surveillance, forecasting and prevention of stroke mortality.

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OBJECTIVE: To investigate pesticide abuse on fruits and vegetables in Tianjin Area, to detect pesticide residues in fruits and vegetables, to study the methods for reducing pesticide residues in fruits and vegetables. METHODS: (1) A questionnaire on the pesticide application during growing fruit and vegetable was administered to 185 farmers in Tianjin Area. (2) According to the information from the questionnaire survey, fruit and vegetable samples were collected in four seasons around the year and measured for organophosphorus pesticide residues by gas chromatography. (3) Fruit and vegetable samples contained pesticide residue were treated by scald, immersion in 0.15% and 0.30% detergent solution, immersion in pure water, peeling and cutting root and pesticide residues were measured before and after the treatment. RESULTS: The percentage of pesticide abuse in growing fruit and vegetable was 65.00% in Tianjin area, and 31.60% of the fruits and vegetable samples collected in summer were positive for high toxic organophosphorus pesticides. Significant decrease of pesticide residue in fruit and vegetable was found by scald, immersion in 0.15% and 0.30% detergent solution, as well as peeling and cutting root, and over 80.00% pesticide residue in the samples could be reduced by scald. CONCLUSIONS: It is necessary to strengthen pesticide abuse control and market surveillance and inspection, in order to reduce the harmful effects of pesticide residue in fruit and vegetables to human health.

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