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Distinct differences exist between public-private sector organizations with respect to the market environment and operational objectives; furthermore, among private sector businesses, organizational structures and work conditions often vary between large- and small-sized companies. Despite these obvious structural distinctions, however, sectoral differences in employees' psychosocial risks and burnout status in national level have rarely been systematically investigated. Based on 2013 national employee survey data, 15,000 full-time employees were studied. Sector types were classified into "public," "private enterprise-large (LE)," and "private enterprise-small and medium (SME);" based on the definition of SMEs by Taiwan Ministry of Economic Affairs, and the associations of sector types with self-reported burnout status (measured by the Chinese version of Copenhagen Burnout Inventory) were examined, taking into account other work characteristics and job instability indicators. Significantly longer working hours and higher perceived job insecurity were found among private sector employees than their public sector counterparts. With further consideration of company size, greater dissatisfaction of job control and career prospect were found among SME employees than the other two sector type workers. This study explores the pattern of public-private differences in work conditions and employees' stress-related problems to have policy implications for supporting mechanism for disadvantaged workers in private sectors.

Noise, vibration, and low temperature render specific occupational hazards to labor employees. The purpose of this research was to investigate the combined effects of these three physical hazards on employees' physiological parameters. The Taguchi experimental method was used to simulate different exposure conditions caused by noise, vibration, and low temperature, and their effects on the physiological parameters of the test takers were measured. The data were then analyzed using statistical methods to evaluate the combined effects of these three factors on human health. Results showed that the factor that influenced the finger skin temperature, manual dexterity, and mean artery pressure (MAP) most was air temperature, and exposure time was the second most influential factor. Noise was found to be the major factor responsible for hearing loss; in this case, hand–arm vibration and temperature had no effect at all. During the study, the temperature was confined in the 5–25°C range (which was not sufficient to study the effects at extremely high- and low-temperature working conditions) because the combined effects of even two factors were very complicated. For example, the combined effects of hand–arm vibration and low temperature might lead to occupational hazards such as vibration-induced white finger syndrome in working labors. Further studies concerning the occupational damage caused by the combined effects of hazardous factors need to be conducted in the future.

To explore the effectiveness of exercise program for banking and insurance workers and clarify the association between exercise, burnout, and metabolic syndrome components. In the process of the study, a practicable worksite exercise program was developed for bank and insurance enterprises. A three-month (12-wk) exercise course was conducted, and its benefits evaluated. Levels of burnout and metabolic syndrome components were analyzed after exercise intervention. After intervention, the indicators of burnout and metabolic syndrome components were significantly improved in both low and high intensity groups, and the improvement were expressed in reduction of waist circumference, systolic blood pressure, person burnout and work-related burnout. A dose-response of burnouts and metabolic syndrome components with exercise intensity are shown (p

Endometriosis is an inflammatory disease associated with multiple pathogenic factors and studies regarding roles of trace metals in endometriosis have been inconsistent and limited. The aim of this cross-sectional study was to compare the blood levels of miscellaneous trace metals measured by inductively coupled plasma mass spectrometry in infertile women with and without endometriosis. Zinc level is associated with declining odds (adjusted OR=0.39, 95% CI=0.18-0.88) of endometriosis. By contrast, lead level is associated with increasing odds (adjusted OR=2.59, 95% CI=1.11-6.06) of endometriosis. The cadmium levels were higher in women with endometriosis, but the aOR was not significant. Zinc has anti-inflammatory characteristics and regulates homeostasis of zinc-containing superoxide dismutase. High lead levels might induce reactive oxygen species and deplete antioxidant defense mechanisms. Further prospective study is needed to test for their causal associations.

Objective: Adiponectin plays a role in obesity, lipid metabolism, and anti-inflammation. Women with polycystic ovary syndrome (PCOS) are also at risk for dyslipidemia. Therefore, we investigated the association between adiponectin levels and the lipid profile including high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), and triglycerides (TGs) in women with PCOS and contemplated what role adiponectin might play in dyslipidemia with PCOS. Materials and Methods: We recruited 118 young Taiwanese women with PCOS. The women enrolled were not taking any medication and those with other systemic diseases of nonovarian origin, which could have affected the hypothalamic–pituitary–ovarian axis, were excluded. The serum lipid profile, metabolic and hormonal parameters, and adiponectin were measured. The lipid profile and adiponectin were analyzed and adjusted for age, body mass index (BMI), homeostasis model assessment-insulin resistance (HOMA-IR), and sex hormone-binding globulin (SHBG). Results: In a simple linear regression, adiponectin was significantly inversely related to LDL-C and TGs, but positively related to HDL-C (all p

Background/Purpose: Taiwan experienced a rapid surge in human immunodeficiency virus (HIV) among injection drug users (IDUs) from 2003 to 2005. The male-to-female ratio of HIV cases decreased from 20:1 in 2003 to 6:1 in 2006. This change is primarily due to increasing numbers of female injection drug users in Taiwan. Our primary objective was to identify the risk factors associated with HIV infection among incarcerated female drug users. Methods: A case-control design involved recruitment of all eligible HIV-infected female inmates from all 24 prisons in Taiwan from November to December, 2007. Eligible HIV seronegative controls were chosen within the same prison and matched to the cases by age (within 3 years) and by history of illicit drug use. A subsample of these matches was randomly selected since there were many more eligible controls than HIV-infected cases. An anonymous self-administered questionnaire was completed with assistance from trained research assistants. Results: A total of 114 cases and 149 control participants were recruited, with a response rate of 82% and 54%. Injectable heroin use was significantly greater (p = 0.02) among HIV-infected cases (93.0%) than uninfected controls (84.6%). Compared to seronegative controls, HIV-infected cases were more likely to share drug paraphernalia and have drug-using sexual partners. Multiple logistic regression analysis revealed that the number of imprisonments (between 2-5 times; OR = 5.23), sharing mainly dilutes (OR = 63.47), and sharing dilutes concurrently with needles (OR = 127.33) significantly predicted HIV seroconversion, after controlling for age and years of education. Conclusion: Sharing needles/dilutes and practicing unsafe intercourse with drug-using sexual partners places female drug users at considerable risk. © 2011 Elsevier & Formosan Medical Association.

Meconium is a matrix that can be obtained easily and noninvasively and is useful for detecting antenatal fetal exposure to environmental toxins. Taiwan is an island with high fish consumption, and many pregnant women would like to enjoy the benefits of fish without jeopardizing their health or that of their child. The aim of this study is to assess the mercury concentration in meconium in relation to the health risk of mercury exposure. A total of 198 mother-infant pairs residing in the city of HsinChu were recruited for the study between January 2007 and June 2007. The average mean concentration of mercury in meconium was 79.2+/-7.3 ng g(-1) dry wt We use the Monte Carlo technique to assess the uncertainty in risk assessment and the impact of these uncertainties on the estimation of expected risk of mercury intake from fish in mothers. Based on the FAO/WHO's tolerable daily intake of methylmercury (0.23 microg kg(-1)d(-1)), we found that 17.3% and 14.0% of the daily mercury exposure estimated exceeded the reference dose for foreign-born and Taiwan-born mothers, respectively. We found that the mercury concentration in meconium was much higher than in other studies, except for one study done in Tagum in the Philippines where mercury is used in gold mining. This may be because Asia is the largest emitter of anthropogenic mercury, accounting for 53% of worldwide emissions. Sensitivity analysis suggests that mercury concentration in fish and the rate of ingesting fish may be the key parameters for governments offering risk management guidance to protect the health of mothers and unborn babies.

Introduction The Prolift system is an effective and safe procedure using mesh reinforcement for vaginal reconstruction of pelvic organ prolapse (POP), but its effect on sexual function is unclear. Aim To evaluate the impact of transvaginal pelvic reconstruction with Prolift on female sexual function at 6 months post‐operatively. Methods Thirty‐three sexually active women who underwent Prolift mesh pelvic floor reconstruction for symptomatic POP were evaluated before and 6 months after surgery. Their sexual function was assessed by using the short form of the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ‐12) before and after surgery. The quality of life was also evaluated with the short forms of the Urogenital Distress Inventory (UDI‐6) and the Incontinence Impact Questionnaire (IIQ‐7) as a control for efficacy of the procedure. The Pelvic Organ Prolapse Quantification system was used to evaluate the degree of prolapse. Main Outcome Measures PISQ‐12 scores at 6 months post‐operatively. Results The total PISQ‐12 score decreased from 29.5 ± 9.0 to 19.3 ± 14.7 ( P P = 0.016; 15.4 ± 4.7 vs. 10.4 ± 8.6, P = 0.001; 8.9 ± 3.8 vs. 6.4 ± 5.5, P = 0.01, respectively). UDI‐6 and IIQ‐7 scores were significantly improved at the 6‐month follow‐up, as was anatomic recovery. Of the 33 subjects, 24 (73%) had worse sexual function 6 months after the procedure. Conclusion The Prolift procedure provided an effective anatomic cure of POP, but it had an adverse effect on sexual function at 6 months after surgery. Su TH, Lau HH, Huang WC, Chen SS, Lin TY, Hsieh CH, and Yeh CY. Short term impact on female sexual function of pelvic floor reconstruction with the Prolift procedure.

INTRODUCTION In Taiwan, the Smoke-Free Restaurant Program (SFRP) was implemented from 2003 to 2005 as an initial phase before the introduction of restrictive legislation promoting smoke-free restaurants (SFRs). No studies have evaluated trends in public opinion before and after a national health promotion campaign for the introduction of SFRs on a voluntary basis. The present study investigated whether public opinion with respect to eliminating environmental tobacco smoke (ETS) in restaurants changed after implementation of the SFRP. METHODS Data were obtained from four large-scale, nationally representative surveys conducted in 2003-2005 before and after implementation of the SFRP. Weighted analyses were performed to obtain nationally representative results. RESULTS After a series of SFRP campaigns, reported exposure to ETS in restaurants by survey participants decreased by approximately 14%. Approximately 20% more people had heard of SFRs, and approximately 25% more had chosen to dine in a smoke-free restaurant. We found consistently high community support for SFRs (ca. 95%), and approximately 80% supported smoke-free restaurant legislation, although both rates dropped slightly in 2005. People aged 60 years or more, nonsmokers, and those who had greater knowledge of ETS hazards were more likely to support smoke-free restaurant legislation. DISCUSSION The SFRP was effective at promoting SFRs on a voluntary basis. Strong community endorsement has major implications for legislators who are considering the nature and extent of further smoke-free restaurant legislation in Taiwan and other countries.

Objective To determine the relationship between the 75-g oral glucose tolerance test and pregnancy outcome after women's first IVF cycle. Design Prospective study. Setting Infertility center at a private tertiary hospital in Taiwan. Patient(s) All 280 patients who went through their initial IVF cycle at the hospital between January 2004 and April 2005 were included in the study. Intervention(s) Two hundred eighty patients underwent an oral glucose tolerance test before entering an IVF cycle; all pregnancy outcomes and pregnancy complications were recorded. Main Outcome Measure(s) The relationships between glycemic parameters and insulin resistance and IVF pregnancy outcome were determined. Linear regression between birth weight and levels of preconception fasting insulin, 2-hour glucose, and 2-hour insulin was performed. Result(s) One hundred twenty patients conceived after their initial IVF cycle. Twenty-five of 89 ongoing pregnancies had various complications. The most common pregnancy complication was preterm birth (n = 11). These patients had higher body mass index (23.46 vs. 20.97 kg/m 2 ); higher fasting glucose (107.36 vs. 95.14 mg/dL), fasting insulin (10.55 vs. 6.20 μIU/mL), and 2-hour glucose (120.55 vs. 99.97 mg/dL) levels; and higher homeostatic model assessment of insulin resistance (3.43 vs. 1.45) than did patients with full-term pregnancies. Linear regression between birth weight and the fasting glucose level and between birth weight and the homeostatic model assessment of insulin resistance had positive correlations. Conclusion(s) Before proceeding with IVF, preconception oral glucose tolerance testing is suggested, especially in patients with higher body mass index, to help identify groups who are at high risk for preterm birth.

All-trans retinoic acid (ATRA) stimulates platelet-derived growth factor (PDGF)-A expression and enhances alveolarization in rat lungs. On d 16 of gestation, pregnant Sprague-Dawley rats were randomly assigned to either a retinoic acid group (intragastric ATRA at 10 mg/kg body weight) or a vehicle group. We punctured each amniotic sac, and fetuses in the opposite uterine horn served as controls. On d 21 of gestation, the fetuses were delivered by cesarean section. Rats subjected to oligohydramnios exhibited significantly lower lung weights and lung/body weight ratios, and ATRA had no effects on the body or lung weights of oligohydramnios-exposed rats. Lung PDGF-A and -B mRNA expression was significantly lower in oligohydramnios-exposed rats compared with control littermates of maternal vehicle-treated dams. Maternal retinoic acid treatment significantly increased PDGF-A and -B mRNA expression in control and oligohydramnios-exposed rats compared with all rats and oligohydramnios-exposed rats of maternal vehicle-treated dams, respectively. Rats exposed to oligohydramnios exhibited a significantly lower generation of alveolar saccules than did control rats in the maternal retinoic acid- and vehicle-treated groups. In this model, maternal retinoic acid treatment showed no positive effects on oligohydramnios-induced pulmonary hypoplasia in the pseudoglandular stage.

OBJECTIVE The aim of this study was to examine relationships of organizational culture and health behaviors with presenteeism. METHOD Data of a self-reported questionnaire were collected from 816 employees, who joined the study on a voluntary basis, in seven enterprises in northern Taiwan. RESULTS Organizational culture and health behaviors were found to be significantly associated with presenteeism. After adjusting for confounding factors, the number of health complaints seemed to be more suitable than chronic diseases in predicting presenteeism. CONCLUSIONS This study result implied that advantage could be taken of organizational culture and employees' health behaviors to reduce presenteeism in the workplace.

SHIH, LING-YING, TSAN-HON LIOU, JANE C.-J. CHAO, HSIN-NUNG KAU, YI-JIUN WU, MING-JER SHIEH, CHING-YING YEH, AND BOR-CHENG HAN. Leptin, superoxide dismutase, and weight loss: initial leptin predicts weight loss. Obesity. 2006;14:2184–2192. Objective: Our goal was to study how plasma leptin concentration, superoxide dismutase (SOD) activity, and weight loss are related in obese adults. Research Methods and Procedures: Serum leptin concentration, SOD activities, general biochemical data, and body composition measurements were obtained for 62 overweight and obese subjects before and after an 8-week body weight reduction (BWR) regimen. The subjects were on dietary control, performed moderate aerobic and strength training exercises, and attended educational lectures. Results: The measurement results indicated that the following criteria were significantly reduced: body weight [84.4 17.0 vs. 79.3 16.1 (standard error) kg, p 0.001]; BMI (31.5 4.3 vs. 29.4 4.2 kg/m 2 , p 0.001), and fat mass (33.3 10.0 vs. 29.8 10.4 kg, p 0.001). Plasma leptin levels also significantly decreased from 31.5 17.6 to 26.5 17.2 ng/mL (p 0.001). Additionally, SOD activity was significantly increased from 261.4 66.0 to 302.7 30.9 U/mL (p 0.001). Based on linear regression analysis results, a 3.78- to 8.13-kg reduction in weight can be expected after the 8-week BWR regimen when initial leptin concentration was 5 to 30 ng/mL. Discussion: We found that an 8-week exercise and diet program was effective in reducing weight and fat mass and, notably, had further beneficial effects on leptin resistance and SOD activity. Additionally, this study demonstrated that initial plasma leptin concentration may be used as a predictor for weight loss outcome.

Background/Purpose Work-related fatigue among medical personnel is a major concern for patient safety, however heavy on-call duty is common in many hospitals. The purpose of this study was to investigate the prevalence of self-reported work-related fatigue and its associated factors. Methods A cross-sectional survey of 1833 participants was conducted in two hospitals in Taipei City, Taiwan, using a self-administered questionnaire. Participants reported their demographic characteristics, health-related behavior, health status and symptoms, and work-related fatigue during the past 3 months. Results The prevalence of work-related fatigue among the 1833 participants was 30.9%. Younger participants (20–29 years old) were more likely to report work-related fatigue than older participants (40–65 years old) [adjusted odds ratio (aOR) = 1.55, 95% confidence interval (CI) = 1.18–2.01]. Physicians, nurses, and medical technicians were more likely to report work-related fatigue symptoms than administrative personnel (aOR = 2.30, 95% CI = 1.57–2.79; aOR = 2.83, 95% CI = 1.87–3.99; and aOR = 2.01, 95% CI = 1.12–3.06, respectively). Those who drank coffee more than five times a week were more likely to report work-related fatigue than those who did not drink coffee at all (aOR = 2.53, 95% CI = 1.25–1.93). Participants with poor and very poor self-reported health were more likely to report work-related fatigue (aOR = 1.80, 95% CI = 1.26–2.38) than those who reported that their health was fair, good, or very good. Conclusion We identified factors associated with work-related fatigue among hospital workers in Taipei City. These findings can be applied toward on-the-job training and the development of preventive measures for occupational safety in general hospitals.

The aim of this study is to develop a practicable worksite physical fitness program for small and medium-sized enterprises (SMEs). Community-based intervention consisting of a three-month exercise course was conducted, and its benefits evaluated. A self-administrated structured questionnaire and physical fitness examination were designed to compare the difference between pre and post intervention. A total of 133 SME workers completed the lifestyle/exercise course and filled out the questionnaire, but 16 were excluded from the exercise group due to health reasons. After the intervention, health indicators such as weight, blood pressure, resting heart rate, waistline, BMI, front and back trunk flexibility, abdominal muscle durability and back muscle strength were significantly improved, and improvements in musculoskeletal disorders were seen in reduced neck pain (18.8%), wrist pain (17.4%), and upper/lower back pain (8.7% and 21.7%, respectively). Cardiovascular risk factors (BMI and resting heart rate) showed a significant improvement related to frequent participation in the program (p=0.02), and the exercise group reported a significant difference in overall health (p=0.02). This study has demonstrated an effective approach to community-based fitness intervention through SMEs.

ObjectiveAlthough teachers are the key participants in health-promoting schools (HPS) programme delivery, it is still unknown whether teachers are appropriate health information resources and role models for students with respect to healthy diets. The present study aimed to investigate the effects of implementing HPS programmes on teachers’ nutrition knowledge and diets.DesignOne HPS programme aiming at dietary intervention (HP-D) and one HPS not aiming at dietary intervention (HP-ND) were selected, along with two non-health-promoting (NHP) schools matched for school size and urbanization level with the two HPS. All 361 teachers in the four schools were invited to participate, yielding a 78·4 % overall valid response rate. A structured, self-reported questionnaire was administered, with regression models used for statistical analysis.ResultsTeachers in the HP-D group had a mean score of 21·1 on a range of 0–30 for nutrition knowledge, which was significantly higher than the mean scores of 18·5 in the HP-ND group and 19·1 in the NHP group (P< 0·001). Better dietary behaviours were also observed among HP-D teachers. Further, being a ‘health education’ course instructor was associated with significantly higher scores on nutrition knowledge (β= 2·6,P< 0·001) and vegetable and fruit consumption (β= 1·4,P= 0·02) in the HP-D group than in the NHP group. The HP-ND and NHP groups exhibited similar patterns of non-significant differences compared with the HP-D group.ConclusionsImplementation of a coordinated HPS framework on nutrition and diet was positively correlated with schoolteachers’ nutrition knowledge and dietary intake.

Genetic C677T and A1298C polymorphisms in 5,10-methylenetetrahydrofolate reductase (MTHFR) and levodopa therapy in Parkinson's disease (PD) may increase homocysteine (Hcy) level. We examined whether connecting both polymorphisms influences the effect of levodopa on Hcy. MTHFR genotypes and Hcy, vitamin B(12), and folate levels were determined in 48 levodopa-treated PD patients (PD-L), 28 non-treated PD patients (PD-N) and 110 controls. Hcy was remarkably higher in PD-L than in PD-N and controls (p0.001); similarly, the differences were seen in different age subgroups and in both genders. Furthermore, Hcy differences between PD-L and PD-N were evident in 677C/T, T/T, C/T + A/A, T/T + A/A (all p0.05), and 1298A/A (p0.001), but not in others such as 677C/C, and C/C + A/A. Hcy in PD-N and controls was comparable for all genotypes. In PD-L, Hcy was the highest in 677T/T, then in C/T, and in C/C with a significant difference from T/T (p=0.014), but was not different among A1298C genotypes. Likewise, Hcy was the highest in 677T/T+1298A/A, intermediate in C/T+A/A, and the lowest in C/C+A/A. In PD-N, Hcy was similar among all genotypes. In conclusion, Hcy elevation may be caused by levodopa administration, and further promoted by 677C/T and T/T, but not by A1298C genotypes. The promoting elevation in 1298A/A is attributed to combining the 677T allele. Neither C677T nor A1298C genotypes contribute to elevating Hcy in PD-N.

Objective To determine the prevalence of abnormalities in glucose metabolism in patients with polycystic ovary syndrome (PCOS) and control infertility patients in Taiwan, and to determine the predictive risk factors for PCOS. Design Cross-sectional study. Setting Infertility Center, Taiwan Adventist Hospital. Patient(s) Three hundred fifty-six patients with PCOS and 974 control infertility patients. Intervention(s) None. Main Outcomes Measure(s) Hormone assay and 75-g oral glucose tolerance test. Result(s) Patients with PCOS were younger (32.7 vs. 35.3 years) with a higher body mass index (BMI) (22.4 vs. 20.6 kg/m 2 ) than controls. Even after BMI adjustment, patients with PCOS still had significantly higher fasting glucose (97.2 vs. 94.4 mg/dL), fasting insulin (5.6 vs. 4.1 μIU/mL), 2-hour glucose (108.1 vs. 96.0 mg/dL), and 2-hour insulin levels (38.0 vs. 27.0 μIU/mL), and higher homeostasis model assessment of insulin resistance (HOMA-IR) values (1.3 vs. 1.0) than control patients. The prevalence of impaired glucose tolerance and diabetes mellitus in patients with PCOS was 7.6% and 3.1%, respectively, compared with 2.9% and 0.2% in the control group, respectively. Only fasting glucose and insulin, 2-hour insulin, HOMA-IR, age, androstenedione, and status (PCOS vs. control) had a significant impact on 2-hour glucose level. However, BMI and waist/hip ratio did not show a significant impact on 2-hour glucose level. Conclusion(s) Chinese women with PCOS are at increased risk for insulin resistance and glucose intolerance compared with controls. Body mass index failed to show significant impact on 2-hour glucose levels in our infertility patients.

Streptococcus iniae, a common fish pathogen, rarely infects humans. In this report, a case of invasive S. iniae infection in a 51-year-old woman with diabetes mellitus and hepatitis C-related liver cirrhosis is described. The isolate was identified by 16S rDNA sequencing. The patient recovered after 1 week of treatment with ampicillin.

Betel quid chewing has been associated with several human cancers. However, the role of betel quid in carcinogenesis remains uncertain. Piper betel contains high concentrations of safrole (an inducer of DNA oxidative damage). Safrole may be metabolized by hepatic sulfotransferase 1A1 (SULT1A1), or glutathione S-transferases (GSTM1, GSTT1, and GSTP1). Thus, we investigated the association of genetic polymorphisms of SULT1A1, GSTM1, GSTT1, and GSTP1 with DNA oxidative damage among betel quid chewers. A biomarker for oxidative stress, urinary 8-hydroxy-2'-deoxyguanosine (8-OHdG) level, was analyzed using isotope-dilution LC-MS/MS in 64 betel quid chewers and 129 non-betel quid chewers. Data on demographics and habits (smoking, alcohol drinking, and betel quid chewing) were obtained from questionnaires. Our results revealed that urinary 8-OHdG level was higher in chewers with SULT1A1 Arg-His genotype than in chewers with SULT1A1 Arg-Arg genotype. Urinary 8-OHdG level was also higher in chewers with GSTP1 Ile-Ile genotype. Furthermore, the combined effect of SULT1A1 and GSTP1 genotypes on urinary 8-OHdG was evaluated. Non-chewers with both SULT1A1 Arg-Arg and GSTP1 Val-Val/Ile-Val (reference group) had the lowest mean level (3.6 ng/mg creatinine), whereas chewers with either SULT1A1 Arg-His or GSTP1 Ile-Ile had the highest 8-OHdG mean level (6.2 ng/mg creatinine; vs. reference group, P = 0.04). Chewers with both of SULT1A1 Arg-Arg and GSTP1 Val-Val/Ile-Val (4.6 ng/mg creatinine), and non-chewers with either SULT1A1 Arg-His or GSTP1 Ile-Ile (4.7 ng/mg creatinine) had a moderately increased 8-OHdG level. Thus, the susceptible SULT1A1 and GSTP1 genotypes may modulate increased DNA oxidative stress elicited by betel-quid chewing.

The US Food and Drug Administration (USFDA) and Environmental Protection Agency (USEPA) are advising women and young children to avoid eating fish that contain high levels of mercury (Hg). However in Taiwan, the annual Black Fin Tuna Festival encourages the public to consume fish. The aim of this study was to assess fish intake in relation to the health risks of mercury exposure and calculate the acceptable and safe intake of fish in children and women of childbearing age. From the Monte Carlo simulation, based on USEPA's reference dose (0.1 microgkg(-1)d(-1)), we found that 21.6%-24.3% and 45.6%-57.4% of the daily mercury dose estimates exceeded the reference dose for typical and high-seafood consumers. The acceptable ingestion rates are

The aim of this study was to assess the total concentration and health risk to infants of breast milk mercury in urban mothers and mothers married to fishermen in relation to fish intake in Taiwan. A total of sixty-eight healthy mothers were recruited for the study. The breast milk mercury geometric mean concentration was 2.02 microgl(-1) (n=56, range: 0.24-9.45 microgl(-1)) for the city group and 2.04 microgl(-1) (n=12, range: 0.26-8.62 microgl(-1)) for the fishermen's group. Of the three sources of mercury exposure (i.e., ingestion (breast milk), inhalation (ambient air), and dermal exposure (shower)), breast-feeding was found to be the largest (96.3-99.6% of the total). From a Monte Carlo simulation, in which methyl mercury accounted for about 50% of total mercury, the hazard quotient (exposure estimate/oral minimal risk level or target organ toxicity dose) exceeded 1.0 for 12.9% of urban babies and 18.8% of fishermen's babies (chronic oral minimal risk level and target organ toxicity dose: 3 x 10(-4)mgkg(-1)d(-1)). The calculated mercury exposure was 3.02 x 10(-1) microgkg(-1)d(-1) for a 3.49 kg urban baby boy and 3.06 x 10(-1) microgkg(-1)d(-1) for a 3.44 kg urban baby girl. These results suggest the life style of mothers (eating raw fish and shellfish such as used in "Sashimi" and "Sushi," and vitamin supplementation) may influence the mercury concentration in breast milk.

Infant exposure to lead through breast milk is of special concern because breast milk is considered the best food source for infants under 6 months. In this study, a total of the mothers provided colostrum samples once in the early postpartum period, but only 16 of them provided breast milk weekly at 1-60 days postpartum. The geometric mean of lead concentrations in all colostrum samples (n=72) was 7.68+/-8.24 microg/L. The concentration of lead in the breast milk of the consumption group (the mothers who consumed traditional Chinese herbs) was 8.59+/-10.95 microg/L, a level significantly higher than the level of 6.84+/-2.68 microg/L found in the control group (mothers who did not consume traditional Chinese herbs). In the consumption group (n=9), the mean concentration of lead in the breast milk decreased with days postpartum, from 9.94 microg/L in colostrum to 2.34 microg/L in mature milk. We found the highest daily lead intake in infants at birth, and the level gradually decreased after the first month. We used an estimation of the hazard index (HI) to analyze the health risk of infants. In total, 5.7% (2 out of 35) of the HI estimates exceed 1.0 for the consumption group. In conclusion, the consumptions of traditional Chinese herbs by the mothers in this study significantly affected the body burden of lead in their infants.

Background There is limited information regarding the associations of lifestyle factors and sex with HDL subclasses containing apolipoprotein (apo) A-I (Lp A-I) and both apo A-I and apo A-II (Lp A-I:A-II). Objective We sought to examine the relations between 2 major HDL subclasses and sex, menopausal status, nutrient intakes, and adiposity. Design We conducted interviews and measured blood variables in 409 government employees aged 40-59 y in Taiwan. Results Women (n = 203) had significantly higher concentrations of HDL cholesterol, Lp A-I, and Lp A-I:A-II than did men (n = 206). Postmenopausal women (n = 72) had higher concentrations of HDL cholesterol, Lp A-I, and Lp A-I:A-II than did premenopausal women (n = 131). Body mass index and waist-to-hip ratio were strong predictors of and exerted an independent additive effect on Lp A-I concentrations in both men and women. However, body adiposity was associated with Lp A-I:A-II concentrations only in men. Waist-to-hip ratio was an independent determinant of Lp A-I but not of Lp A-I:A-II in men and postmenopausal women after adjustment for age, body mass index, smoking, and diet. Although there were relatively weak associations between dietary factors and both HDL subclasses (r = 0.01-0.26) in men and women according to bivariate analyses, multiple regression models showed that total fat, saturated fat, and cholesterol intakes were significantly correlated with HDL cholesterol and both Lp A-I and Lp A-I:A-II in men, but not in women. Conclusion Our data suggest that body adiposity and dietary fat consumption affect 2 major HDL subclasses differently depending on subject sex and menopausal status.

Objective To evaluate the effect on decrease in blood pressure of modifying risk factors for stroke, such as blood lipid profiles, diet habits and indices of body weight, through a family-based nutrition health education programme among hypertensive patients and pre-hypertensive subjects without taking any antihypertensive drugs. Design and setting This was a community-based prospective study. The study population was randomly selected from communities in Taipei; potential subjects were invited by telephone to participate. Subjects After excluding subjects whose blood pressure was normal and those using antihypertensive drugs, there were 390 participants included in the study. Subjects in the intervention group ( n 293) received nutrition health education on blood pressure control and stroke-related risk factor modification at each visit. Non-intervention subjects ( n 97) only acquired a general education sheet available in clinics. The blood pressure of study subjects was measured at baseline and 6-month follow-up to evaluate the intervention’s effect on decrease in blood pressure. Results Significant decreases of 2·0 mmHg and 5·9 mmHg in systolic blood pressure were observed both in pre-hypertensive and hypertensive subjects in the intervention group. Additionally, intervention subjects with improvement of total cholesterol and LDL cholesterol, decrease in indices of body weight and increase in consumption of fruit and vegetables also had significant lowering of blood pressure. Conclusions The present study provided evidence that the blood pressure of pre-hypertensive and hypertensive subjects could decrease significantly, without taking antihypertensive drugs, after modifying blood lipid profiles and waist by dietary habits changed through a family-based nutrition heath education programme, resulting in a significant effect on stroke risk reduction.