Chinese Working Population Research Articles

Urban-rural differences in the association between occupational physical activity and mortality in Chinese working population: evidence from a nationwide cohort study

Despite emerging studies suggesting that occupational physical activity (OPA) might be harmful to health, the available evidence is not definitive. Most of these research studies were conducted in high-income Western countries or in urbanized setting. In China, where over one-third of the population resides in rural area, the impact of OPA on health is not well understood. The goal of this study is to investigate how the association between OPA and mortality vary by urban-rural settings. Baseline data on OPA was gathered using the Global Physical Activity Questionnaire from 30,650 urban and 49,674 rural working adults as part of the 2013-2014 China Chronic Disease and Risk Factor Surveillance. Participants were followed for a median of 6.2 years, and death records were retrieved from the National Mortality Surveillance System until December 31, 2019. The multivariable Cox proportional hazard model was used to examine urban-rural differences in the association between OPA and all-cause and cardiovascular disease (CVD) mortality. Subgroup analyses were performed by sex, socioeconomic status, leisure time, transportation, and non-occupational physical activity. During the study period, 1342 deaths were recorded, of which 426 were caused by CVD. In rural area, working adults engaging in occupational moderate-to-vigorous physical activity (MVPA) for ≥40h per week, compared to those without any, had an adjusted hazard ratio of 0.60 (95% CI: 0.49-0.73) for all-cause mortality and 0.55 (95% CI: 0.37-0.83) for CVD mortality. However, no significant association was found in urban area (0.84 [0.61-1.15] for all-cause mortality, Pinteraction=0.036; and 0.94 [0.53-1.66] for CVD mortality, Pinteraction=0.098). The negative associations of occupational MVPA with mortality were more pronounced in women, non-smokers, and those with less non-occupational physical activities. Hypertension, heart rate, and diabetes were important contributors to the relationship between occupational MVPA and mortality. The findings from the current study did not support the notion that high levels of OPA would induce harm. On the contrary, in rural setting, higher levels of OPA were associated with lower mortality risks. Furthermore, the observed urban-rural differences in the association between OPA and mortality underscored the need for context-specific public health guidelines on physical activities. R&D Program of Beijing Municipal Education Commission (KM202210025026),National Key Research and Development Program of China (2021YFC2500201), and Young Elite Scientist Sponsorship Program by BAST (BYESS2023385).

Predictors of cancer screening behavior of the working population in China based on the information-motivation-behavioral skills model.

The cancer screening rate in the working population is very low in China. Information-motivation-behavioral skills (IMB) model has been applied to elucidate screening behavior for various chronic diseases but has not been investigated in analyzing cancer screening behavior. This study aimed to examine factors influencing cancer screening behavior and their linkages based on the IMB model. A cross-sectional study was conducted in Shanghai, China from August to October 2021. Data were obtained through an anonymous questionnaire. Predictive relationships between variables in the IMB model and cancer screening behavior were evaluated. Structural equation modeling (SEM) was constructed to demonstrate the utility of the IMB model. Among the 556 participants included in the analysis, 34.4% of participants had ever done a cancer screening. The construct validation analysis supported that the measure items included were acceptable. SEM found that knowledge of cancer warning signs and symptoms (β = 0.563, p < 0.001) and cancer screening behavioral skills (β = 0.264, p = 0.003) were related to participation in cancer screening, whereas cancer screening motivation was not directly influenced the participation in cancer screening (β = - 0.075, p = 0.372). The cancer screening rate was found to be lower than expected in the working population. The IMB model could be used to make decisions in implementing behavioral interventions to participate in cancer screening among the Chinese working population. Enhancing the knowledge of cancer warning signs and symptoms and strengthening behavioral skills should be focused on to improve participation in cancer screening.

Workplace-based primary prevention intervention reduces incidence of hypertension: a post hoc analysis of cluster randomized controlled study

BackgroundA workplace-based primary prevention intervention be an effective approach to reducing the incidence of hypertension (HTN). However, few studies to date have addressed the effect among the Chinese working population. We assessed the effect of a workplace-based multicomponent prevention interventions program for cardiovascular disease on reducing the occurrence of HTN through encouraging employees to adopt a healthy lifestyle.MethodsIn this post hoc analysis of cluster randomized controlled study, 60 workplaces across 20 urban regions in China were randomized to either the intervention group (n = 40) or control group (n = 20). All employees in each workplace were asked to complete a baseline survey after randomization for obtaining sociodemographic information, health status, lifestyle, etc. Employees in the intervention group were given a 2-year workplace-based primary prevention intervention program for improving their cardiovascular health, including (1) cardiovascular health education, (2) a reasonable diet, (3) tobacco cessation, (4) physical environment promotion, (5) physical activity, (6) stress management, and (7) health screening. The primary outcome was the incidence of HTN, and the secondary outcomes were improvements of blood pressure (BP) levels and lifestyle factors from baseline to 24 months. A mix effect model was used to assess the intervention effect at the end of the intervention in the two groups.ResultsOverall, 24,396 participants (18,170 in the intervention group and 6,226 in the control group) were included (mean [standard deviation] age, 39.3 [9.1] years; 14,727 men [60.4%]). After 24 months of the intervention, the incidence of HTN was 8.0% in the intervention groups and 9.6% in the control groups [relative risk (RR) = 0.66, 95% CI, 0.58 ~ 0.76, P < 0.001]. The intervention effect was significant on systolic BP (SBP) level (β = − 0.7 mm Hg, 95% CI, − 1.06 ~ − 0.35; P < 0.001) and on diastolic BP (DBP) level (β = − 1.0 mm Hg, 95% CI, − 1.31 ~ − 0.76; P < 0.001). Moreover, greater improvements were reported in the rates of regular exercise [odd ratio (OR) = 1.39, 95% CI, 1.28 ~ 1.50; P < 0.001], excessive intake of fatty food (OR = 0.54, 95% CI, 0.50 ~ 0.59; P < 0.001), and restrictive use of salt (OR = 1.22, 95% CI, 1.09 ~ 1.36; P = 0.001) in intervention groups. People with a deteriorating lifestyle had higher rates of developing HTN than those with the same or improved lifestyle. Subgroup analysis showed that the intervention effect of BP on employees with educational attainment of high school above (SBP: β = − 1.38/ − 0.76 mm Hg, P < 0.05; DBP: β = − 2.26/ − 0.75 mm Hg, P < 0.001), manual labor workers and administrative worker (SBP: β = − 1.04/ − 1.66 mm Hg, P < 0.05; DBP: β = − 1.85/ − 0.40 mm Hg, P < 0.05), and employees from a workplace with an affiliated hospital (SBP: β = − 2.63 mm Hg, P < 0.001; DBP: β = − 1.93 mm Hg, P < 0.001) were significantly in the intervention group.ConclusionsThis post hoc analysis found that workplace-based primary prevention interventions program for cardiovascular disease were effective in promoting healthy lifestyle and reducing the incidence of HTN among employees.Trial registrationChinese Clinical Trial Registry No. ChiCTR-ECS-14004641.

Using the experience of industrilized countries for reference to promote the prevention and control of occupational stress from research to practice

Occupational stress is one of the major occupational health problems in industrialized countries. In Europe, the United States, Japan, and other countries, occupational stress has been included in the prevention and control of occupational hazards in the workplace. This problem has also become a major risk factor affecting the physical and mental health of the working population in China. Over the last three decades, China had carried out a lot of research on occupational stress and made significant progress, but there is still a big gap between China and industrialized countries in terms of theoretical research on occupational stress, development of measurement tools, research topics and methods, formulation of regulations and standards, and practice of prevention and control. Articles in this key issue report the research on the core scale of occupational stress measurement for the Chinese working population, the scale scoring norm of manufacturing and medical personnel, the research on the relationship between positive psychology variables, and occupational stress and its role in the relationship between occupational stress and health outcomes.

Effect of a Workplace-Based Multicomponent Intervention on Hypertension Control

A workplace-based intervention could be an effective approach to managing high blood pressure (BP). However, few studies to date have addressed hypertension control among the Chinese working population. To assess the effect of a workplace-based, multicomponent intervention strategy on improving BP control. A cluster randomized clinical trial of a hypertension management program was conducted from January 2013 to December 2014 in 60 workplaces across 20 urban regions in China. Workplaces were randomized to either the intervention group (n = 40) or control group (n = 20). Employee participants in each workplace were asked to complete a cross-sectional survey. Data analysis on an evaluable population was conducted from January 2016 to January 2017. The 2-year intervention included 2 components: (1) a workplace wellness program for improving employees' cardiovascular health and (2) a guidelines-oriented hypertension management protocol with a community health center intervention accompanied by monthly visits for achieving BP control over a period of 24 months. The primary outcome was the change in BP control rate from baseline to 24 months among employees with hypertension in the intervention and control groups. The secondary outcomes were the changes in BP level and lifestyle factors by the end of the trial. Overall, 4166 participants (3178 in the intervention group and 988 in the control group) were included (mean [SD] age, 46.3 [7.6] years; 3451 men [82.8%]). Blood pressure control rate at baseline was 19.5% in the intervention group and 20.1% in the control group. After 24 months of the intervention, the BP control rate for the intervention group compared with the control group was significantly higher (66.2% vs 44.0%; odds ratio, 1.77; 95% CI, 1.58-2.00; P < .001). The intervention effect on systolic BP level was -5.8 mm Hg (95% CI, -6.8 to -4.9 mm Hg; P < .001) and on diastolic BP level was -3.6 mm Hg (95% CI, -4.4 to -2.9 mm Hg; P < .001). The BP control rate showed a gradual increment throughout the whole duration in the intervention group. Moreover, greater reduction was reported in the rates of drinking (-18.4%; 95% CI, -20.6% to -16.2%; P < .001), perceived stress (-22.9%; 95% CI, -24.8% to -21.1%; P < .001), and excessive use of salt (-32.0%; 95% CI, -33.7% to -30.4%; P < .001). This trial found that a workplace-based, multicomponent intervention appeared to be more effective than usual care, leading to measurable benefits such as lower blood pressure, improved hypertension control, and adoption of healthy lifestyle habits. The intervention can therefore be considered for large-scale use or inclusion in hypertension control programs in workplaces in China and other countries. Chinese Clinical Trial Registry No. ChiCTR-ECS-14004641.

Prevalence, awareness, treatment, and control of hypertension among Chinese working population: results of a workplace-based study

We investigated the prevalence, awareness, treatment, and control of hypertension and the related risk factors among Chinese working population. From 2012 to 2013, a total of 37,856 employees aged 18–60 years from 61 workplaces were sampled. Standard questionnaire surveys and physical examinations were undertaken. Multilevel logistic regression models were performed to identify the risk factors. Overall, the age-standardized prevalence of hypertension was 23.3% (95% confidence interval [CI]: 22.9%–23.7%). Among the hypertensives, 47.8% (95% CI: 46.8%–48.8%) were aware of their condition, 20.6% (95% CI: 19.8%–21.4%) were in treatment, but only 8.5% (95% CI: 7.9%–9.1%) had controlled hypertension. White-collar employees had a lower odds of hypertension compared with the blue-collar (odds ratio: 0.77, 95% CI: 0.71–0.84), whereas the state-owned enterprise employees had a higher odds compared with their private enterprise counterparts (odds ratio: 1.69, 95% CI: 1.07–2.65). Lower awareness and treatment were associated with being younger, higher education, and those from workplace without affiliated hospital. Higher occupation status individuals were more likely to be treated but no sign of better control. There is substantial room for improvement in hypertension diagnosis and treatment among the employees. Effective intervention programs are urgently needed at the workplaces.

Innovative non-invasive model for screening reduced estimated glomerular filtration rate in a working population.

Most of the existing risk scores for identifying people with reduced estimated glomerular filtration rate (eGFR) involve laboratory-based factors, which are not convenient and cost-effective to use in a large population-based screening programme. We aimed at using non-invasive variables to identify subjects with reduced eGFR in a Chinese working population. Two study populations were recruited in 2012 and 2015, respectively. The 2012 study population (n=14374) was randomly separated as the training dataset (n=9621) or the internal testing dataset (n=4753) at a ratio of 2:1, and the 2015 study population (n=4371) was used as the external testing dataset. Stepwise logistic regression analysis with age, gender, hypertension and body mass index (BMI) status were first performed in the training dataset and then validated in both internal and external testing dataset. A nomogram was further developed based on the final model. Results showed that older females with higher BMI status were more likely to have reduced eGFR. The model had excellent discrimination (AUC: 0.887 [95%CI: 0.865, 0.909] in the internal validation and 0.880 [95%CI: 0.829, 0.931] in the external validation) and calibration (Hosmer-Lemeshow test, P=0.798 and 0.397 for internal and external dataset, respectively). The probability of having reduced eGFR increased gradually from <0.1% at a total score of 0 to 26% at a total score of 58 shown in the nomogram. Non-invasive variables could help identify individuals at high risk of reduced eGFR for further kidney function testing or intervention, aiding in decision-making and resource allocation in large population screening.

Effects of long-term psychological intervention on blood pressure and health-related quality of life in patients with hypertension among the Chinese working population.

The aim of this study was to analyze the effects of psychological intervention on blood pressure, health-related quality-of-life (HRQOL), and stroke prevalence in patients with hypertension among the Chinese working population. Cluster sampling was conducted in September 2013 at the Shaanxi Jinduicheng Molybdenum Group General Hospital (intervention group) and the Shaanxi Province Hancheng Mining Bureau General Hospital (control group). The intervention group received regular psychological intervention for 2 years, including cognitive, emotional, and behavioral interventions. HRQOL was measured with the Spanish Hypertension Quality of Life Questionnaire (MINICHAL). We analyzed the data from a total of 409 subjects. After 2 years of psychological intervention, systolic blood pressure (SBP) and diastolic blood pressure (DBP) in the non-anxiety subgroup, and the anxiety subgroup were lower than baseline levels and lower than those in the control group. Post intervention, the mental state, somatic symptoms, and total MINICHAL scores were significantly below baseline levels, and the stroke morbidity was lower than that in the control group. Post intervention, SBP, DBP, and the MINICHAL scores in the intervention group were lower than those in the control group. SBP, DBP, and the MINICHAL scores were lower in the intervention group after 1 and 2 years of psychological intervention, as compared with the control group. Long-term psychological intervention can thus be used as an adjunctive therapy for patients with hypertension among the Chinese working population to improve their blood pressure, HRQOL and stroke prevalence.

Gender disparity in the associations of overweight/obesity with occupational activity, transport to/from work, leisure-time physical activity, and leisure-time spent sitting in working adults: Across-sectional study.

BackgroundThe associations of occupational activity (OA), commuting, leisure-time physical activity (LTPA), and sitting with overweight/obesity in working adults are controversial. This study explored these factors with the risk of overall and abdominal overweight/obesity in a Chinese working population and whether these associations differ by gender.MethodsA cross-sectional study was conducted. Data analysis was done among 6739 employed participants. Multivariate logistic regression was used to estimate the odds ratios (ORs) and 95% confidence intervals (CIs) for the studied associations.ResultsFor male employees, those with heavy OA had a lower overall (OR 0.76; 95% CI, 0.62–0.93) and abdominal (OR 0.76; 95% CI, 0.62–0.93) overweight/obesity risk than those with light OA. Those with LTPA ≥150 min/week had a lower risk of overall (OR 0.73; 95% CI, 0.56–0.96) and abdominal (OR 0.70; 95% CI, 0.53–0.91) overweight/obesity than those with LTPA <150 min/week. Men with leisure-sitting time <2.5 h/day had a significantly lower risk of abdominal overweight/obesity than those sitting ≥4 h/day (OR 0.80; 95% CI, 0.65–0.99). And men who cycled to/from work had a lower risk of overall (OR 0.69; 95% CI, 0.53–0.90) and abdominal overweight/obesity (OR 0.71; 95% CI, 0.54–0.92) than passive transports. However, the above significant associations disappeared among female employees.ConclusionsHeavy OA, cycling to/from work, and LTPA were associated with lower risk of overall or abdominal overweight/obesity in male employees. Reducing leisure sitting time can also help male employees reduce the risk of abdominal overweight/obesity. More research on gender disparity in the risk of overweight and obesity should be done.

Prevalence and risk factors associated with hypertension and prehypertension in a working population at high altitude in China: a cross-sectional study

BackgroundLittle information is available on the epidemiology of hypertension and prehypertension at high altitude in China, the aim of this study was to determine the prevalence of hypertension, prehypertension and their risk factors among Chinese working population at high altitude regions.MethodsA cross-sectional survey was performed in an occupational sample of 4198 employees aged 20–59 years on Qinghai-Tibet Plateau between May to July 2013. Information from a self-administered questionnaire, physical examinations and laboratory measurements were obtained from each participant. Multivariable analysis was performed to determine the association of various risk factors with hypertension and prehypertension.ResultsThe total crude prevalence of hypertension and prehypertension was 28.1 and 41.5%, respectively; the overall standardized prevalence of hypertension and prehypertension was 26.7 and 41.3%, respectively. Multivariate logistic regression showed that age, sex, ethnicity, job position, overweight or obesity, frequent drinking, family history of hypertension, diabetes and hyperuricemia were risk factors for hypertension, and age, sex, education, job position, overweight or obesity, current smoking and family history of hypertension were risk factors for prehypertension. Among the hypertensives, 36.5% were aware of their condition, 19.4% were being treated and 6.2% had their blood pressure (BP) controlled; among the treated hypertensives, 31.9% had their BP under control.ConclusionsThere is a high prevalence of hypertension and prehypertension in the working population at high altitude in China, but with very low awareness, treatment and control rates. Workplace-based BP screening and intervention programs that aim to modify risk factors such as high BMI, tobacco use, alcohol consumption and inappropriate use of antihypertensive medicine are urgently needed.

Anthropometric parameters and their associations with cardio-metabolic risk in Chinese working population.

BackgroundThere remains controversy regarding which of the anthropometric indicators best defines obesity. In this study, we compared the efficacy of using body mass index (BMI), waist circumference (WC) and waist-to-hip ratio (WHR) in the diagnosis of obesity and assessed their associations with diabetes, hypertension, and dyslipidemia in an urban working population in China.MethodsAnthropometric measurements, blood pressure, plasma lipids, fasting and 2-hour plasma glucose (PG) levels by a 75 gram oral glucose tolerance test (OGTT) were obtained from 2603 working Chinese who had no history of cardiovascular diseases or diabetes. Cardio-metabolic risk factors including high blood pressure, dyslipidemia, and glucose intolerance were evaluated. The diagnoses of overweight and obesity were based on the WHO definitions with BMI for general obesity and WC and WHR for central obesity.ResultsBased on BMI, WC and WHR, there were 31.3%, 16.6%, 35.2% of the studied subjects, respectively, being overweight and 2.0%, 5.6%, 9.2% being obese. Among women but not men, more overweight and obese subjects were diagnosed using WHR and WC. The number of cardio-metabolic risks was higher by WC criterion than BMI and WHR in the whole group (p <0.05) and female subjects (p <0.01). Comparing the three anthropometric indexes predicting hypertension, hyperglycemia, dyslipidemia and multiple cardio-metabolic risks, for women, it was WC having the largest areas under ROC curves (0.759, 0.746, 0.701 and 0.773 respectively); while in men, it was WC for hypertension, WHR for hyperglycemia, BMI for dyslipidemia and WC for multiple cardio-metabolic risks (areas under ROC curves were 0.658, 0.686, 0.618 and 0.695 respectively).ConclusionsAmong Chinese working population, the need of lower cutoff values to define overweight and obesity were observed. Central obesity indicator (WC) is the preferred measure to predict the presence of cardio-metabolic risk in Chinese female subjects.

Musculoskeletal symptoms and associated risk factors in a large sample of Chinese workers in henan province of China

To investigate the one-year prevalence of musculoskeletal symptoms and associated risk factors in a large sample of Chinese workers in various industrial settings. A total of 5,338 (3,632 males and 1,706 females) workers from 13 companies participated in this study. Musculoskeletal symptoms in different body regions in the previous year and their risk factors were assessed by a self-reported questionnaire. Logistic regression analyses were performed to estimate the individual, work-related physical and psychosocial risk factors for the musculoskeletal symptoms. The most commonly affected body regions among the workers were lower back (59.7%), neck (48.6%), shoulders (38.8%), and wrists (33.5%). Female workers had greater prevalence of musculoskeletal symptoms in the neck, shoulders, and wrists than male workers. Results of multivariate analyses indicated that individual, work-related physical and psychosocial factors were associated with the musculoskeletal symptoms. The results suggest that interventions aimed at reducing musculoskeletal symptoms in the Chinese working population should take into account multiple risk areas including individual, physical job characteristics and work-related psychosocial factors.

Associations between dietary habits and risk factors for cardiovascular diseases in a Hong Kong Chinese working population--the "Better Health for Better Hong Kong" (BHBHK) health promotion campaign.

Diet and nutritional status have been shown to play pivotal roles in the occurrence of many chronic diseases. In this study, we examined the patterns of dietary habits and their relationships with risk factors for cardiovascular and chronic diseases in Hong Kong working populations. In April 2000, a 5-year territory-wide health promotion campaign supported by the Li Ka Shing Foundation was launched in Hong Kong by the Health InfoWorld of Hospital Authority. Between July 2000 and March 2002, 4841 Chinese subjects [2375 (49.1%) men and 2466 (50.9%) women, mean age: 42.4 +/- 8.9 years (median: 43.0 years, range: 17-83 years)] from the general working class were recruited. Subjects were randomly selected using computer generated codes according to the distribution of occupational groups. A dietary questionnaire was used to assess 6 core dietary habits: daily fruit intake, vegetable intake, fluid intake, sugary drinks, regularity of daily meals and number of dining out each day. Overall, men had a worse cardiovascular risk profile and less desirable dietary habits than women. Those who had more unhealthy dietary habits were more likely to be obese and current smokers. Using logistic regression analysis with the dietary habits as independent variables, we found that obesity, smoking and constipation were independently associated with various unhealthy dietary patterns. In conclusion, there were close associations between dietary habits and risk factors for cardiovascular diseases in Hong Kong. More effective community education about healthy lifestyle is required in Hong Kong.

Doubling over ten years of central obesity in Hong Kong Chinese working men

Obesity is now an epidemic in most parts of the world. In this cross sectional study, we report the most recent data on obesity in Hong Kong Chinese working population and compare the changes over 10 years. Between July 2000 and March 2002, 5882 adult subjects from the working class in Hong Kong were recruited (2716 men (46.2%) and 3166 women (53.8%)). They were randomly selected using computer generated codes according to the distribution of occupational groups. Results of this study were compared with the data collected from a prevalence survey for cardiovascular risk factors in a Hong Kong Chinese working population conducted in 1990 (1513 subjects, 910 men (60.1%) and 603 women (39.9%)). Standardized percentages of overweight, obesity, and central obesity, in Hong Kong Chinese working population were 59.7%, 35.0%, 26.7% in men and 32.0%, 21.7%, 26.7% in women. Compared to the data collected in 1990, the percentage of obesity increased by 5% in men and reduced by 6% in women. The percentage of central obesity doubled in men (from 12.2% to 26.7%) but remained stable in women. There is a doubling of the percentage of central obesity in Hong Kong Chinese working men over previous decade. Education and proper lifestyle modification program to tackle this social health issue are urgently indicated.

Reliability and Validity of Job Content Questionnaire in Chinese Petrochemical Employees

To evaluate psychometric properties the Chinese (mainland) version of the 30-item Job Content Questionnaire was administered to 889 employees in 4 industries of PetroChina. A retest at 3 months with 296 randomly chosen employees showed reliabilities ranged from .76 to .93. Cronbach coefficients alpha for the 8 dimensions ranged from .43 to .88, indicating that the Job Insecurity subscale had low internal consistency. Exploratory factor analysis showed 8 meaningful factors corresponding to the 8 theoretical dimensions of this questionnaire. This version has variable a but suitable retest to be a reliable and valid measure of job strain, applicable to the Chinese industrial working population of PetroChina.

Association between sleeping hours, working hours and obesity in Hong Kong Chinese: the ‘better health for better Hong Kong’ health promotion campaign

To study the inter-relationships between sleeping hours, working hours and obesity in subjects from a working population. A cross-sectional observation study under the 'Better Health for Better Hong Kong' Campaign, which is a territory-wide health awareness and promotion program. 4793 subjects (2353 (49.1%) men and 2440 (50.9%) women). Their mean age (+/-s.d.) was 42.4+/-8.9 years (range 17-83 years, median 43.0 years). Subjects were randomly selected using computer-generated codes in accordance to the distribution of occupational groups in Hong Kong. The mean daily sleeping time was 7.06+/-1.03 h (women vs men: 7.14+/-1.08 h vs 6.98+/-0.96 h, P<0.001). Increasing body mass index (BMI) was associated with reducing number of sleeping hours and increasing number of working hours reaching significance in the whole group as well as among male subjects. Those with short sleeping hour (6 h or less) and long working hours (>9 h) had the highest BMI and waist in both men and women. Based on multiple regression analysis with age, smoking, alcohol drinking, systolic and diastolic blood pressure, mean daily sleeping hours and working hours as independent variables, BMI was independently associated with age, systolic and diastolic blood pressure in women, whereas waist was associated with age, smoking and blood pressure. In men, blood pressure, sleeping hours and working hours were independently associated with BMI, whereas waist was independently associated with age, smoking, blood pressure, sleeping hours and working hours in men. Obesity is associated with reduced sleeping hours and long working hours in men among Hong Kong Chinese working population. Further studies are needed to investigate the underlying mechanisms of this relationship and its potential implication on prevention and management of obesity.

Metabolic syndrome by the international diabetes federation definition in Hong Kong Chinese

In this report, we aimed to examine the impact of the new International Diabetes Federation (IDF) definition on the prevalence and clinical characteristics of subjects with metabolic syndrome (MES). Data were obtained from a prevalence survey for cardiovascular risk factors in a Hong Kong Chinese working population. There were 1513 subjects well representing all occupational groups from managers to general laborers [910 (60.1%) men and 603 (39.9%) women (mean age 37.5 ± 9.2, median 37.0, range 18–66 years)]. The crude prevalence of MES defined by the IDF criterion was 7.4% (compared to other criteria: NCEP, 9.6%; WHO, 13.4% and EGIR, 8.9%). The age-standardized prevalence of MES by the IDF criterion was 8.8% in women and 7.3% in men. Subjects with MES defined by IDF criterion had higher body mass index and waist compared to those with MES defined by NCEP or WHO criteria, and lower triglyceride compared to those with MES defined by NCEP criterion after adjustment for age, gender and smoking. Non-MES subjects defined by IDF criterion had higher 2 h glucose and insulin resistance compared to non-MES subjects defined by WHO. In conclusion, the new IDF criterion for MES is easy to implement in clinical practice. It may be potentially more ‘specific’ in identifying subjects with MES although compared to the NCEP criterion, it may have missed a proportion of subjects, especially men, who have metabolic derangement. Prospective and interventional studies are needed to validate the prognostic values of this new definition in comparison with other existing definitions.

High prevalence of metabolic syndrome in Hong Kong Chinese—comparison of three diagnostic criteria

The World Health Organisation (WHO), European Group for the Study of Insulin Resistance (EGIR) and National Cholesterol Education Program (NCEP) Expert Panels had introduced definitions for the metabolic syndrome (MES). We aimed to estimate the prevalence of MES in a working population in Hong Kong using the three definitions for MES and compare their relative significance. The data are obtained from a prevalence survey for glucose intolerance and lipid abnormality in a Hong Kong Chinese working population. The distribution of occupational groups in these subjects was similar to that recorded in the Hong Kong Census (1991) and representative of the Hong Kong working population. Definition of obesity was modified using the Asian criterion of body mass index (BMI) ≥ 25 kg/m 2, waist circumference > 80 cm in women and >90 cm in men. Of the 1513 subjects, 910 (60.1%) were men and 603 (39.9%) were women. The mean age was 37.5 ± 9.2 (median 37.0 years, range 18–66 years). Using the Asian definition for obesity, the prevalence of MES using the WHO criterion was the highest (WHO versus EGIR versus NCEP—overall: 13.4% versus 8.9% versus 9.6%, p < 0.001; under age of 40 years: 7.9% versus 4.9% versus 5.4%, p = 0.017; age of 40 years or above: 21.9% versus 14.9% versus 16.0%, p = 0.003). The prevalence of different components of the MES ranged from 6 to 38%. In subjects aged less than 50 years, there was a male preponderance for MES (male versus female—WHO: 9.5% versus 6.2%, p = 0.007; EGIR: 7.9% versus 6.2%, p = 0.235; NCEP: 9.5% versus 6.2%, p = 0.030) but this trend was reversed after the age of 50 years (WHO: 29.3% versus 31.9%, p = 0.721; EGIR: 13.1% versus 34.8%, p = 0.001; NCEP: 19.2% versus 23.2%, p = 0.533). The prevalence of MES in Hong Kong Chinese of working age ranges from 6.1 to 13.4% depending on various diagnostic criteria. There was a male preponderance before the age of 50 years and a female-preponderance after the age of 50 years. The inclusion of albuminuria and insulin resistance by the WHO has made it the most discriminative criterion in identifying at risk individuals in all age groups.

Measurement of psychosocial factors in work environment: application of two models of occupational stress

To test the reliability and validity of the Chinese version of Job Content Questionnaire (JCQ) and Effort-Reward Imbalance Questionnaire (ERI) based on the Job Demand-Control Model and Effort-Reward Imbalance Model respectively. 928 health care workers in hospitals were investigated in this study. The self-administered questionnaires were used to assess the psychosocial work environment, including job demand, control, social support, extrinsic effort, reward, and overcommitment. Mean while, the internal consistency reliability, construct validity and criterion validity were evaluated. The Cronbach's alpha coefficients for 6 scales were acceptable (0.56 approximately 0.82); factor analysis showed the close fitness with the theoretical constructs, though the "job demand" and "overcommitment" scales were still questioned; moreover, both demand-control and effort-reward imbalance were independently related to depressive symptom (OR: 1.63 approximately 2.64, P < 0.01), indicating the satisfactory criterion validity. Both Job Demand-Control Model and Effort-Reward Imbalance Model, with their relevant questionnaires were reliable and valid methods for measuring the psychosocial work environment and assessing the occupational stress among Chinese working population and further revision is necessary.

Prediction of hypertension, diabetes, dyslipidaemia or albuminuria using simple anthropometric indexes in Hong Kong Chinese

It is important to determine what values of simple anthropometric measurements are associated with the presence of adverse cardiovascular risk factors such as diabetes or hypertension to provide an indication for further detailed investigations. In this analysis, we aimed to assess which anthropometric cutoff values are best at predicting the likelihood of diabetes, hypertension, dyslipidaemia and albuminuria in Hong Kong Chinese. The data were obtained from a previously reported prevalence survey for glucose intolerance in a representative Hong Kong Chinese working population. 1513 subjects (910 men and 603 women) with mean age+/-s.d. 37.5+/-9.2 y. We examined the likelihood ratios of having diabetes, hypertension, dyslipidaemia and albuminuria in subjects with various cutoff values of the four simple anthropometric indexes, namely, body mass index, waist-hip ratio, waist circumference and the ratio of waist-to-height. We developed a nomogram to show the predictive values of different indexes for the cardiovascular risk factors using likelihood ratio analysis. Using Caucasian mean levels of the simple anthropometric indexes to predict diabetes or hypertension in Hong Kong Chinese gave a high likelihood ratio of 2:3:5. Higher levels of body mass index, waist-hip ratio, waist circumference and the ratio of waist-to-height are associated with risk of having diabetes mellitus or hypertension in Hong Kong Chinese as in Caucasians. However, the cutoff values of those anthropometric indexes to define obesity used in Caucasians may not be applicable to Chinese.