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Tai Hing Lam

Publications and source records attributed to Tai Hing Lam.

49 records · Page 3Linked to original sources

Prevalence and correlates of alcohol use: a population-based study in Hong Kong.

OBJECTIVE: To estimate the prevalence and pattern of alcohol use and to analyse the socio-demographic and biological correlates of alcohol drinking in Hong Kong Chinese. DESIGN: A population-based cross-sectional study conducted from December 1994 to October 1996. SETTING AND PARTICIPANTS: 2900 randomly selected subjects age 25-74 years who participated in the Cardiovascular Risk Factor Prevalence Study in Hong Kong. RESULTS: Alcohol consumers comprised 55.4% (95% CI: 52.8-58.0) of men and 19.4% (95% CI: 17.4-21.4) of women. The median weekly ethanol consumed by male and female drinkers were 9.6 g and 3.6 g, respectively. Beer was the main source of alcohol; 61.5% of drinkers consumed beer as their main drink. In stepwise multiple regression among drinkers, male sex, smoking, high density lipoprotein cholesterol, primary or below education, diastolic blood pressure and separated or widowed marital status were associated positively with weekly ethanol consumption. CONCLUSION: In this representative sample of Hong Kong adults, the majority were either non-drinkers or very light drinkers, which can be used as a benchmark to measure changes in drinking pattern in the future. The putative protective effect of alcohol on heart disease could be due to the higher level of HDL in moderate drinkers.

Adult↗

Preventing exposure to second-hand smoke.

OBJECTIVE: To report the effectiveness of a health education intervention provided by nurses to prevent second-hand smoke exposure in sick children in Hong Kong. DATA SOURCES: A clinical trial, international and national government reports, and research studies. CONCLUSION: Exposure to second-hand smoke is associated with significant morbidity and mortality. Nursing interventions to reduce exposure are critical and need further study. IMPLICATIONS FOR NURSING PRACTICE: Nurses are in a vital position to carry out health education about the health risks associated with second-hand smoke exposure and to protect the child from such exposure.

Adolescent↗

Voluntary HIV antibody testing amongst youth in Hong Kong.

We performed a study to estimate the prevalence of and factors associated with human immunodeficiency virus (HIV) antibody-testing behaviour among youth in Hong Kong. It was a population-based cross-sectional study. Questions on HIV testing were asked as part of a youth sexuality study conducted in July to December 1996 among young adults in Hong Kong. A total of 517 (53.6%) males and 447 (46.4%) females aged 17 to 28 years completed an anonymous structured self-administered questionnaire. Respondents had good knowledge about correct modes of HIV transmission and prevention. 9.4% (95% confidence interval [CI]: 7.0, 12.3) of males and 6.4% (95% CI: 4.3, 9.1) of females had been tested for HIV through blood donation. Excluding blood donation, 3.7% (95% CI: 2.2, 5.7) of males and 3.6% (95% CI: 2.1, 5.9) of females had been tested (voluntary testing). 47.5% (95% CI: 44.4, 50.7) of subjects reported at least one major risk factor for HIV infection. In multivariate analyses, factors independently associated with both voluntary HIV testing and HIV testing by blood donation were age and having had sex with multiple partners. A higher educational level was a predictor of HIV testing by blood donation. Self-assessment of having sufficient sex education was also significantly associated with voluntary HIV testing. HIV testing is not widespread in Hong Kong and those at risk are more likely to have been tested. It is of concern, however, that many of those reporting risk factors have not been tested.

AIDS Serodiagnosis↗

Lymphocyte DNA damage in elevator manufacturing workers in Guangzhou, China.

AIMS: To study the effect of smoking, passive smoking, alcohol drinking, and occupational exposure to low level of benzene on DNA strand breaks in elevator manufacturing workers in Guangzhou, China. METHODS: Three hundred and fifty-nine workers (252 men and 107 women) of a modern elevator manufacturing factory, 205 were from production departments and 154 from managerial department. Information on the workers' health conditions, smoking, passive smoking, alcohol consumption and occupational exposure history was collected by personal interview. Lymphocyte DNA damage was measured by the Comet assay. RESULTS: None of the women smoked and 20.6% of the men were daily smokers. In non-smokers, the prevalence of passive smoking at work was 25% for men and 11.2% for women, and at home, 37.8 and 48.6%, respectively. Smoking significantly increased tail moment (P<0.001). Daily smokers had the largest tail moment (geometric mean, 95% CI) (0.93 microm (0.81-0.94)), followed by occasional smokers (0.76 microm (0.59-0.95)), ex-smokers (0.70 microm (0.58-0.85)), and never smokers (0.56 microm (0.53-0.60)). Tail moment increased significantly with daily tobacco consumption (cigarettes per day) (r=0.26, P<0.001) after adjusting for age, gender, occupational exposure, passive smoking, and drinking. Analysis of covariance (ANCOVA) showed that smoking (P<0.001), passive smoking at home (P=0.026), occupational exposure (P<0.001), male gender (P<0.001), and age (P=0.001) had independent effects on tail moment, whereas passive smoking at work and alcohol drinking had no significant effect. CONCLUSIONS: Smoking, passive smoking at home, male gender, age and occupational exposure independently increased lymphocyte DNA strand breaks. The presence of excess DNA damage under low level of occupational exposure to benzene or other solvents suggest that the current allowance concentrations may not be safe to prevent genotoxicity.

Adult↗

Breast-feeding and its relation to smoking and mode of delivery.

OBJECTIVE: To examine the effects of cesarean and forceps or vacuum delivery and parental smoking habits on the initiation and duration of breast-feeding. METHODS: We conducted a prospective, population-based birth cohort study in 1997. Data were collected on breast-feeding history, household smoking habits, method of delivery, and other demographic, obstetric, behavioral, and potential confounding variables via a standardized self-administered questionnaire. Multivariable logistic regression was used to examine the association between method of birth (cesarean versus forceps or vacuum delivery versus normal vaginal birth) and either not initiating breast-feeding or doing so for less than 1 month. Among women who breast-fed for 1 month or more, multivariable survival analysis was employed to study the relationship between method of delivery and breast-feeding duration. We repeated these analyses to examine the link between parental smoking habits and breast-feeding initiation and duration. RESULTS: A total of 7825 mother-infant pairs were followed up for 9 months. Cesarean delivery was a risk factor for not initiating breast-feeding, for breast-feeding less than 1 month, and remained a significant hazard against breast-feeding duration. Assisted delivery with forceps or vacuum, although not associated with breast-feeding initiation, was a significant risk against breast-feeding duration. Conversely, current parental smoking habits only affected breast-feeding initiation but were unrelated to breast-feeding duration. CONCLUSION: This study indicates a possible effect of forceps or vacuum delivery on breast-feeding and of cesarean on long-term breast-feeding duration. The findings provide additional evidence in support of the avoidance of unnecessary obstetric interventions.

Breast Feeding↗

Smoking, quitting, and mortality in a Chinese cohort of retired men.

PURPOSE: To examine the relationship between smoking, quitting, and mortality in older Chinese men. DESIGN AND METHODS: A cohort analytic study was carried out in Xi'an, China. A total of 1268 retired male military cadres aged 60 or older were examined in 1987 and followed for 12 years. RESULTS: At baseline, 388 men were never-smokers, 461 were former smokers, and 419 were current smokers. Through May 1999, a total of 299 had died. The relative risks [95% confidence intervals (CI)] for ever-smoking, after adjusting for age, blood pressure, body mass index, total cholesterol, triglycerides, alcohol drinking, exercise and existing diseases, for deaths resulting from all causes, chronic obstructive pulmonary disease (COPD), lung cancer, and coronary heart disease (CHD) were, respectively, 1.34 (1.02-1.76), 3.23 (0.95-10.91), 2.31 (0.95-5.61), and 1.60 (0.81-3.19). The risks increased significantly with increasing amount and duration of smoking. Compared with current smokers, former smokers had lower risks of total mortality (excess risk reduction of 56%) and from CHD death, but had higher risks for COPD death. CONCLUSIONS: Smoking is a major cause of death in older Chinese and quitting can save lives. Early recognition of the significance of COPD symptoms followed by prompt quitting should be emphasized in the control of the growing tobacco epidemic.

Aged↗

Smoking, alcohol drinking and non-fatal coronary heart disease in Hong Kong Chinese.

PURPOSE: To examine whether smoking, alcohol drinking and other risk factors were associated with non-fatal coronary heart disease (CHD) in Hong Kong Chinese. METHODS: A case control study was carried out with 598 CHD hospital cases (431 men, 167 women) and 1100 community controls (663 men, 437 women). Standardized questionnaires were used and blood lipids were measured using standard methods. RESULTS: Stepwise logistic regression models showed adjusted odds ratios (AOR) of 3.36 [95% confidence interval (CI): 2.35 to 4.81] for smoking and 0.32 (95% CI: 0.22 to 0.45) for alcohol drinking in men, and 6.50 (95% CI: 2.61 to 16.19) and 0.15 (95% CI: 0.08 to 0.30), respectively, in women. The OR increased with decreasing levels of high-density lipoprotein cholesterol (HDL) and increasing levels of triglycerides. No patterns were observed for body mass index (BMI), total and low-density lipoprotein cholesterol (LDL). The protective effect of drinking was observed for different types of drinks and frequency of drinking, although few drank alcohol more than 3 days per week. CONCLUSIONS: Smoking was a strong risk factor and moderate alcohol drinking was a protective factor for CHD, and low HDL and high triglyceride levels were important risk factors in Hong Kong Chinese.

Adult↗

Smoking, occupational exposure and mortality in workers in Guangzhou, China.

PURPOSE: To compare the mortality risk of smoking and overall occupational exposure in Guangzhou, China. METHODS: Baseline data on smoking and occupational exposure of 82159 workers aged 30+ were retrieved from medical records established in 1988-92. Vital status and causes of death were followed through 1998. RESULTS: During follow-up 1584 workers had died. Adjusted relative risks (RR) with 95% confidence intervals (95%CI) for ever-smoking in men was 1.23 (1.07-1.41) for total deaths, 1.43 (1.17-1.74) for all cancer, 3.77 (2.31-6.14) for lung cancer and 2.54 (1.09-5.92) for stomach cancer (all showing significant linear trends with amount and duration of smoking). The RR in women of 1.10 (0.59-2.06) for total deaths and 1.60 (0.65-3.92) for all cancer were positive but not significant. No significant excess mortality risk was observed for occupational exposure in each gender. In both genders combined, the RR for total deaths was 1.23 (1.08-1.40) for smoking and 1.07 (0.96-1.19) for occupational exposure. If the relationships were causal, 12% of all deaths could be attributed to smoking but only 3% to occupational exposure. CONCLUSION: Smoking was more predictive of premature deaths than overall occupational exposures in middle aged workers. Smoking cessation should be a top priority in occupational health practice.

Adult↗

Is the timing of exposure to infection a major determinant of acute lymphoblastic leukaemia in Hong Kong?

The hypothesis that protection of infants from exposure to infectious agents with delayed first exposure to one or more specific agents together contribute to the aetiology of childhood leukaemia, especially common acute lymphoblastic leukaemia (cALL), has substantial indirect support from descriptive epidemiology and case-control studies in developed Western countries. A case-control study of childhood leukaemia diagnosed at ages 2-14 years has now been conducted in Hong Kong. Cases (n=98) formed a consecutive series of Chinese children diagnosed with acute leukaemia; controls (n=228) were identified following a survey using random digit dialling and required to attend for medical examination by a paediatrician. Interviews with mothers were conducted in hospital by one trained interviewer using a structured questionnaire. Odds ratios (OR) and 95% confidence intervals (CI) are reported for exposure variables capable of serving as proxies for exposure to infection in two critical time periods: first year of life, year before reference date (diagnosis for cases, corresponding date for controls). Analyses used logistic regression with adjustment for appropriate confounders. Change of area of residence reduced risk if during the first time period (OR = 0.47 [95% CI 0.23, 0.98]) and increased risk if during the second (OR=3.92, [95% CI 1.47, 10.46]). Reported roseola and/or fever and rash in the first year of life reduced risk (OR=0.33 [95% CI 0.16, 0.68]) whereas tonsillitis in the period 3-12 months before reference date increased risk (OR=2.56 [95% CI 1.22, 5.38]). Some other proxies for exposure to infection at the critical times were associated with predicted patterns of risk but day-care attendance failed to show predicted associations. These results provide support for the delayed exposure hypothesis in an affluent geographical setting in which population exposure to infectious agents is quite distinct from the settings of previous case-control studies.

Adolescent↗

[An analysis of the main causes of death in different industrial systems in Guangzhou].

OBJECTIVE: To study the main causes of death in workers from different industries in Guangzhou. METHODS: The industrial systems in Guangzhou were classified into six categories according to the Chinese Public Health Inspection Statistical Report. Baseline data on 79,547 workers, age > or = 35, were retrieved from individual health records under the Guangzhou Occupational Health Surveillance Record System established in 1989-1992. In this prospective cohort study, the workers' vital status and causes of death were followed up until 31 December 1998. Using SPSS 10.0, crude death rates were calculated and relative risks(RR) (95% CI) were estimated using Cox proportional-hazard models. RESULTS: (1) Among 79,547 workers were 49,355 men and 30,192 women, with mean age of (43.8 +/- 6.5) years, and 64% were aged 35-44. The mean age difference of workers in different industries was +/- 1 year. At baseline, 41% had been exposed to occupational hazards. Exposure was most prevalent in petroleum chemical industry(53.9%), followed by metallurgical industry, and the lowest exposure was in mechanical industry (30.2%). (2) The mean follow-up period was (8.0 +/- 1.3) years with 633,510 person-years. 1,577 workers had died with a total death rate of 248.9 per 100,000 person-years. The death rate in rubber industry was the highest, followed by metallurgical and petroleum chemical industries. Malignant neoplasms, vascular and respiratory diseases were most common, constituting 80.3% of all causes of death. (3) For all causes of death and the three main categories, the top three crude death rates were observed in rubber and petroleum chemical industries, and in the metallurgical industry except for vascular causes. The rubber industry had the highest crude death rate for all and vascular causes, and the metallurgical industry for malignant neoplasms and respiratory causes. (4) With the light industry as a reference (RR = 1.0), the metallurgical industry had the highest adjusted relative risks (RR) (95% CI) of 1.62(1.20-2.18) and 7.42(3.38-16.31) for malignant neoplasms and respiratory causes, respectively. The rubber industry had the highest RR of 1.69(1.40-2.04) for all causes. A significant RR of 2.03(1.43-2.88) for vascular causes was observed only in the rubber industry. CONCLUSIONS: The main causes of death varied from industry. Malignant neoplasms and respiratory diseases were the leading causes in metallurgical and petroleum chemical industries. In rubber industry, vascular and respiratory causes were most common. Preventive measures for disease control should be tailor-made for each industry.

Adult↗

[A prospective cohort study on the effect of occupational dust exposure and smoking on mortality].

OBJECTIVE: To study the effect of dust exposure and smoking on mortality. METHODS: Based on the Guangzhou Occupational Health Surveillance Record System established in 1989-1992, 61,648 factory workers, aged > or = 30, occupationally exposed to dust and non-exposure to dust or any other hazardous substances(controls), were included in a prospective cohort study. RESULTS: (1) 28 were lost to follow-up. Malignant neoplasm was most common among 1,186 deaths. (2) Most subjects were male workers, aged 35 to 44, with secondary education, and married. 42.2% had ever smoked and 32.8% were ever-drinkers. (3) To compare with non-exposure, non-smoking + non-smoking and non-exposure respectively, the adjusted RR of death from all causes, malignant neoplasm and respiratory diseases were 1.24, 1.34 and 1.96 respectively for dust exposed workers(compared to control, P < 0.01), 1.16, 1.37 and 1.63 respectively for those smoking(compared to non-smoker except RR of death from respiratory diseases, P < 0.01), and 1.48, 1.85 and 3.12 respectively for those smoking and dust exposure, which were far greater than those either smoked or exposed to dust alone(P < 0.01). (4) The influence of dust exposure on death was mainly showed in occupational exposure to silica dust and wood dust. CONCLUSION: Both dust exposure and smoking may increase the mortality, and they had synergistic effect.

Adult↗

The impact of work-related risk on nurses during the SARS outbreak in Hong Kong.

Severe acute respiratory syndrome (SARS) is a highly infectious disease, with high potential for transmission to close contacts, particularly among healthcare workers. This is the first systematic study investigating hospital nurses' physical and psychological health status and the kinds of healthcare used-stratified by the level of contact with SARS patients-during the 2003 outbreak in Hong Kong. Nurses in moderate-risk areas appeared to have more stress symptoms than those working in high-risk areas. It is essential to design hospital support systems and occupational health policy to promote the psychological well-being of nurses during future outbreaks of emerging infections.

Adolescent↗