Biomedical subjects

Jung-Der Wang

Publications and source records attributed to Jung-Der Wang.

At least 37 records · Page 2Linked to original sources

PubMed2006

Life-expectancy estimations and the determinants of survival after 15 years of follow-up for 81 249 workers with permanent occupational disabilities.

OBJECTIVES: This study attempts to estimate life expectancy and explore the determinants of survival for workers with permanent occupational disabilities. METHODS: A database on permanent occupational disabilities occurring between 1986 and 2000 was linked with the national death registry database to construct the survival function. A method with Monte Carlo simulation was used to extrapolate survival for up to 600 months to derive the life expectancy for different disability grades (N=81249). A Cox (proportional hazard) regression was carried out to explore the determinants and to estimate the hazard ratios. Demographic variables, including age, gender, insured wage, severity of disability, injury causes, and organ-system disability, were included in the model as covariates. RESULTS: The results indicate that the survival period for workers suffering permanent occupational disabilities is shorter than that of the general population, amounting to an estimated loss of life expectancy ranging from 5 to 19 years. After adjustment for age and gender, a higher severity of disability, impairment of vital organs or lower extremities, and a lower insured wage had a significant association with shorter survival. Injury types, including transportation incidents, being struck by sliding objects, or a trip, slip or stumble, and collapse injury, indicated hazard ratios of between 1.24 and 1.34, as compared with injuries such as being trapped or caught in machinery. CONCLUSIONS: The findings identify major determinants for predicting survival for workers with permanent occupational disabilities; these determinants may be of use in improving the equity of the compensation system for workers.

Accidents, Occupational↗

PubMed2005

Homocysteine, circulating vascular cell adhesion molecule and carotid atherosclerosis in postmenopausal vegetarian women and omnivores.

Since the adoption of vegetarian diets as a healthy lifestyle has become popular, the cardiovascular effects of long-term vegetarianism need to be explored. The present study aimed to compare the presence and severity of carotid atherosclerosis (CA), and the blood levels of Vitamin B12, homocysteine (Hcy) and soluble vascular cell adhesion molecule-1 (sVCAM-1) between 57 healthy postmenopausal vegetarians and 61 age-matched omnivores. Carotid atherosclerosis, as measured by ultrasound, was found to be of no significant difference between the two groups. Yet, fasting blood glucose, low-density lipoprotein cholesterol, and Vitamin B12 were significantly lower, while Hcy and sVCAM-1 were higher in the vegetarians as comparing with the omnivores. Multivariate regression analysis showed that the level of Vitamin B12 was negatively associated with the level of Hcy. Vegetarianism itself and Hcy level were significantly associated with sVCAM-1 level in univariate analysis; however, after adjustment for covariates, we identified age but not vegetarianism as the determinant of sVCAM-1 level. Multiple linear regression analysis identified age and systolic blood pressure, but not vegetarianism, as determinants of common carotid artery IMT. In conclusion, there was no significant difference in CA between apparently healthy postmenopausal vegetarians and omnivores. The findings of elevated Hcy in vegetarians indicate the importance of prevention of Vitamin B12 deficiency.

Biomarkers↗

PubMed2005

Twenty-four-hour ambulatory blood pressure and duration of hypertension as major determinants for intima-media thickness and atherosclerosis of carotid arteries.

The relationship between time factors of elevated blood pressure (BP) and carotid atherosclerosis (CA) is still unclear. The associations between time-weighted average 24 h ambulatory systolic BP (TWA-SBP), duration of hypertension in years (hypertension-year), and CA were investigated in a petrochemical company sample of 95 executives and 91 gender- and age-matched non-executives employees. Intima-media thickness (IMT) and plaque scores of extracranial carotid artery (ECCA) were determined bilaterally by high-resolution B-mode ultrasound. The determinants of segment-specific carotid IMT and odds ratios for CA, in terms of thicker IMT (IMT > or = 75th percentile) and ECCA score > or = 3, were evaluated by multivariate regression analysis. Results revealed TWA-SBP and hypertension-year were two major determinants of IMT at common carotid artery (CCA) and carotid bulb by using mixed regression models. However, TWA-DBP was a negative determinant of IMT at CCA and carotid bulb. Meanwhile, the executives were found to be a negative association with IMT at carotid bulb. Measurements at both internal carotid artery and bulb identified duration of diabetes mellitus as significant determinant of IMT. After controlling covariates, multivariate logistic regression analysis identified TWA-SBP and hypertension-year as the important determinants for thicker IMT and ECCA > or = 3. And, TWA-DBP was found as a negative determinant for CA. In conclusion, both TWA-SBP and hypertension-year were two major determinants for carotid IMT and CA, which seem to imply that both short-term and long-term durations of elevated BP are probably crucial in the pathogenesis of CA.

Blood Pressure↗

PubMed2005

Predicting health-related quality of life in patients with low back pain.

STUDY DESIGN: Cross-sectional surveys of health-related quality of life (HRQOL) in patients with low back pain at ambulatory clinics plus 8 weeks of follow-up. OBJECTIVE: The objective of this study is to predict the HRQOL in patients with low back pain. SUMMARY OF BACKGROUND DATA: There is disagreement on the relative contribution of pain, physical impairment, functional status, and psychological factors on the disability and HRQOL in patients with low back pain. METHODS: Data were collected from 232 patients with low back pain who were consecutively recruited from several clinics of physical medicine and rehabilitation. Every patient received physical examination and completed a set of questionnaire, including the Taiwan version of the Brief Questionnaire of the World Health Organization on quality of life (WHOQOL-BREF), Modified Roland and Morris Disability Questionnaire, and visual analogue scale for pain intensity and for HRQOL. These patients were observed with a mail questionnaire 8 weeks later. The results of WHOQOL-BREF were also compared to those obtained from another 213 healthy volunteers who were accompanied persons with patients, volunteer workers in hospitals, and hospital employees. RESULTS: Results showed that there were significant correlations of HRQOL with pain intensity, disability scale, and disability days. Among the results of physical examination, lumbosacral radiculopathy was the only factor with moderate correlation with HRQOL. The significant predictors for HRQOL included physical domain, psychological domain, pain intensity, and family income. Among all the 232 study patients, 100 of them responded to the follow-up questionnaire. Changes in environmental domain, disability days, educational level, receiving herb drugs, and physiotherapy were the significant predictors for the changes of HRQOL. CONCLUSIONS: The HRQOL of patients with low back pain depended on functional status and psychological factors more than simple physical impairment. Future intervention may need to put more emphasis on improving functional status and psychological stress for these patients.

Adult↗

PubMed2005

Valuation of the risk of SARS in Taiwan.

Two surveys conducted in Taiwan during the spring 2003 severe acute respiratory syndrome (SARS) epidemic reveal a high degree of concern about the threat posed by SARS to Taiwan and its residents, although respondents believe they are knowledgeable about the risk of SARS and that it is susceptible to individual control. Willingness to pay (WTP) to reduce the risk of infection and death from SARS is elicited using contingent valuation methods. Estimated WTP is high, implying values per statistical life of US dollars 3 to 12 million. While consistent with estimates for high-income countries, these values are substantially larger than previous estimates for Taiwan and may be attributable to the high degree of concern about SARS at the time the data were collected.

Adult↗

PubMed2005

Comparison of WHOQOL-bREF and SF-36 in patients with HIV infection.

The purpose of the study was to evaluate the reliability and validity of the two generic instruments, the WHOQOL and the SF-36, for assessing health-related quality of life in 224 patients with HIV infection. The internal consistency ranged from 0.75 to 0.86 across the WHOQOL-BREF domains and from 0.72 to 0.93 across the SF-36 scales. The scores of all WHOQOL-BREF domains and SF-36 scales correlated positively with the measure of happiness, Sat-HRQOL and self-perceived health status, and correlated negatively with the number and intensity of symptoms. Patients with higher CD4 cell counts scored significantly higher on G4 (general health), three WHOQOL-BREF domains, seven SF-36 scales, and PCS (physical component summary). Patients with fewer symptoms and with less intensity of symptoms had significantly higher scores on all four domains of WHOQOL-BREF, eight scales, PCS, and MCS (mental component summary) of the SF-36 scale. The correlations between the physical, psychological, and social domains of the WHOQOL-BREF and PF (physical functioning), MH (mental health), and SF (social functioning) of the SF-36 were 0.51, 0.75, and 0.54, respectively. There is also good correlation between PCS of the SF-36 and the physical domain of the WHOQOL-BREF (r = 0.48), and between MCS and all four domains of the WHOQOL-BREF (r range = 0.60-0.75). The WHOQOL-BREF domains showed fewer floor or ceiling effect than the SF-36 scales. We concluded that both the WHOQOL-BREF and the SF-36 are reliable and valid health related quality-of-life instruments in patients with HIV infection.

Adult↗

PubMed2005

Stated preferences for the removal of physical pain resulting from permanently disabling occupational injuries. A contingent valuation study of Taiwan.

Within the process of calculating the true costs of illness, physical pain is a component of intangible, or human, costs. One method of estimating the monetary value of such costs is the 'contingent valuation method' (CVM), a stated preference method based upon the elicitation of levels of willingness to pay (WTP) facilitated through surveys. This study is amongst the first of its kind to apply CVM to the estimation of the cost of the removal of physical pain resulting from permanently disabling occupational injuries. We assume that a painkilling drug has been invented to mitigate physical pain with the advantages of validity and instantaneity, and without any side effects. The WTP of each of the respondents is determined by a two-step sequential-bidding process. The maximum WTP under log normal distribution was NT 1791 US dollars/day (65.1 US dollars), whilst under Weibull distribution it was NT 1913 US dollars/day (69.6 US dollars). Older respondents, those with higher household income, fall injuries, longer periods of hospitalization, or with a perceived demand for the painkilling drug in excess of one day, displayed a positive independent effect on the eliciting of their WTP. In addition, respondents with higher 'out-of-pocket' expenses, or where the interview took place 2 years or more after the injury occurred, responded with a lower WTP.

Adult↗

PubMed2005

Reduction of post-shift traffic injuries among gasoline station workers: Are they related to the reduction of occupational gasoline vapor exposure?

AIMS: Solvents exposure is known to impair psychomotor performances. With gasoline vapor recovery devices (GVRD) installed, this study should observe a decrease of traffic injuries after shift among gasoline workers. METHODS: The occupational injury registry data of 1991-2000 in a petrochemical company containing 20,000 workers were analyzed. Cumulative injury rate (CIR) was calculated to estimate lifetime risk. The potential workday loss (PWDL) and the potential salary loss (PSL), which summed up the expected workdays and salary loss assuming a uniform retirement age of 65, were calculated for traffic injuries. Workers of gasoline sales were compared with those without gasoline exposure for commuting traffic injuries. The rate ratio (RR) was calculated based on a person-time data. RESULTS: The CIR dropped 3.14 times during 1997-2000 for commuting accidents on the way back home compared with that during 1991-1992, and the PWDL and PSL dropped 25.2 and 21.5 times, respectively, which corresponded with the time of installments of GVRD. The RRs of commuting accidents on the way back home in the exposed group significantly decreased from 2.15 to 0.53. CONCLUSIONS: The decrease of commuting injuries on journey back home for gasoline workers were probably related to the effective reduction of solvent exposure.

Accidents, Traffic↗

PubMed2005

Return to work after spinal cord injury in Taiwan: the contribution of functional independence.

OBJECTIVE: To study the employment rate and determinants of return to work for persons with traumatic spinal cord injury (SCI) in Taiwan. DESIGN: Cross-sectional. SETTING: Taiwan community. PARTICIPANTS: One hundred sixty-nine people who had sustained traumatic SCI, had been completely rehabilitated in a university hospital between 1989 and 2002, and who were between 18 and 60 years of age at the time of interview in 2003. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: A structured questionnaire was used to identify demographic and injury-related status, functional status, and pre- and postinjury work-related information. RESULTS: At the time of survey, only 47% of the participants were engaged in remunerative employment. Cox regression analysis, with time elapsed between injury and survey as the underlying time axis, showed that education and functional independence were associated with employment. Subjects with a high school education had a 2.2-fold higher chance (95% confidence interval [CI], 1.3-3.8) of returning to work than those without. Subjects with higher scores on the Barthel Index and ability to use public or private transport independently had a 2.7-fold higher chance (95% CI, 1.5-4.9) of returning to work than those unable to travel independently. Other factors significantly associated with employment included marital status, with marriage having a favorable influence; age at injury, with age below 25 years being favorable; preinjury occupation; and vocational training after injury. The importance of functional independence training in rehabilitation is stressed. CONCLUSIONS: Functional independence was a strong factor predicting return to work. Rehabilitation focused on education, vocational training, self-care ability, community mobility, and environmental modifications could improve employability after SCI.

Adult↗

PubMed2005

Health related quality of life in adult patients with epilepsy compared with a general reference population in Taiwan.

To compare the health-related quality of life (HRQL) for patients with epilepsy and health subjects, we collected the clinical and demographic data and information on health states by using the Taiwan version of World Health Organization quality of life (WHOQOL)-BREF questionnaire in 296 patients (aged 19-73 years) with confirmed active epilepsy visiting the clinic of National Taiwan University Hospital, and 296 age-, gender-, municipal- and education-matched Taiwanese healthy subjects sampled from a national health interview survey. Multiple regression analyses with stepwise selection strategy were conducted to study risk factors for impairment of HRQL. Patients with epilepsy have poorer HRQL than the healthy population in physical, psychological and social domains but not in environment domain (p<0.005). Patients with less than 4 attacks during the previous 1 month had a better score in the availability and quality of health and social care in environment domain than healthy subjects (p<0.05). After controlling other determinants, seizure frequency, and comobid with other diseases are the important factors in predicting HRQL for epilepsy patients. Patients with employment and married had a significantly better HRQL. Effective control of seizure frequency and thoughtful promotion of positive attitudes in community are essential to improve the HRQL of epilepsy patients.

Adult↗

PubMed2005

Quality of life and its determinants of hemodialysis patients in Taiwan measured with WHOQOL-BREF(TW).

BACKGROUND: In 1991, the World Health Organization (WHO) initiated a cross-cultural project to develop a quality-of-life (QOL) questionnaire (WHOQOL); soon after this, the clinically applicable short form was developed and named WHOQOL-BREF, followed by a Taiwanese version (WHOQOL-BREF[TW]). METHODS: We first administered the WHOQOL-BREF(TW) and symptom/problem scale to 376 patients with end-stage renal disease on regular hemodialysis therapy in Taiwan. Analysis with multiple stepwise regressions was conducted to study determinants of QOL domains and items. RESULTS: The WHOQOL-BREF(TW) was reliable and valid from various validation studies. The 4 domains (physical, psychological, social relations, and environment) and global items (overall quality of life and general health) of the WHOQOL-BREF(TW) each differentiated symptoms/problems of hemodialysis patients from age-, sex-, and education-matched healthy referents. The 4 domains, except for environment and global items of the WHOQOL-BREF(TW), each differentiated erythropoietin dosage from age-, sex-, and education-matched healthy referents. After adjusting for age, sex, marriage, and education, the prominent associated factors of various QOL domains and items were age, area (Taipei or Keelung), hemoglobin level, normalized protein catabolic rate, and symptom/problem scale. CONCLUSION: The WHOQOL-BREF(TW) is reliable and valid for long-term study of hemodialysis patients, and hemodialysis had negative impacts on QOL, especially in patients with more severe disease with greater symptom/problem scores, lower hemoglobin levels, and lower normalized protein catabolic rates.

Adult↗

PubMed2005

Estimation of burden of lead for offspring of female lead workers: a quality-adjusted life year (QALY) assessment.

This study demonstrates an empirical example that uses quality-adjusted life year (QALY) as a common metric for occupational health assessment to measure the utility loss of potential lead-exposed children delivered by female lead-battery-exposed workers. A set of nationwide health examination data was used for 1726 lead workers. Among them, there were 649 female workers. The numbers of offspring from female lead workers were estimated by multiplying the age-specific fertility rate (ASFR) by the number of workers in each age stratum. The quality of life assessment for these offspring was assumed impaired by increased absorption of lead using a measure of utility for quality of life that was adapted from Rosser's index of health-related quality of life. The total utility loss was calculated by summing up the loss of QALY for these expected offspring. Dose-response and exposure assessments were based on their mothers' blood lead levels. It was estimated that more than 38 babies were delivered in 1 yr. There would be 19 babies born with blood lead levels over 30 microg/dl, and about 17 babies with blood lead between 10 and 29 microg/dl. The expected utility loss of the babies was estimated to be about 216 QALY, of which 51.6 QALY was attributed to the babies with moderate blood lead level, while that of high blood lead was 164.4 QALY. An effective industrial hygiene program to reduce blood lead to 5, 10, and 15 microg/dl in female lead-exposed workers would decrease the utility loss to 169.5, 126.8, and 92.3 QALY, respectively, in the offspring. An alternative policy of raising the age of female workers by 5 or 10 yr before employment would also reduce the loss to 174.6 or 107.4 QALY. Data suggest that an effective industrial hygiene program should be implemented, and the use of QALY as a common metric for comparative assessment of occupational health policy may be feasible.

Adult↗

PubMed2005

Finished herbal product as an alternative treatment for menopausal symptoms in climacteric women.

BACKGROUND: There is a paucity of scientific evidence supporting the efficacy of herbal medicines in treating menopausal symptoms. OBJECTIVE: The aim of this study was to evaluate safety and efficacy of the finished herbal product TMN-1 in the treatment of menopausal symptoms in climacteric women. DESIGN AND SETTING: A multicenter, prospective, observational follow-up study was conducted from July 2003 to December 2004 in four hospitals in Taiwan. PARTICIPANTS: Initially, 126 women were included who were between 45 and 55 years of age, were experiencing hot flashes, and were without hormone replacement therapy. Women were excluded if they had any signs of active cancer. Of the participants, 82% completed the study. The reasons for withdrawal included adverse effects (n = 7), failed to return (n = 7), lack of efficacy (n = 6), and from protocol deviation (n = 3). INTERVENTION: Every participant received TMN-1 treatment 4 g, 3 times per day, for 12 weeks. MAIN OUTCOME MEASURE: Primary measures were change in frequency of hot flashes and severity of menopausal symptoms measured by Kupperman Index (KI). Secondary outcomes included changes in quality of life and adverse events. RESULTS: Significant improvement in scores of hot flashes and KI were found at weeks 4 and 12 in the 50 peri- and 53 postmenopausal women who completed this study (p < 0.001). Logistic regression analyses showed that perimenopausal women with hot flashes had sevenfold (95% confidence interval [CI], 1.8-28.0) odds of improvement in favor of treatment, whereas that of the postmenopausal group was 1.5 (95% CI, 0.5 to 4.2). Further analyses showed that TMN-1 produced superior benefit in women with moderate and severe menopausal symptoms (KI > or = 21), compared to those with mild symptoms. It also improved symptoms of insomnia, nervousness, melancholia, and palpitation in perimenopausal women. Five (5) adverse drug reactions were detected: three single events of nausea, abdominal pain, and abdominal fullness; and two events of diarrhea. CONCLUSIONS: This study provides evidence that 12 weeks of TMN-1 therapy is a viable alternative treatment to consider in perimenopausal women with hot flashes, particularly in those with palpitations, emotional disturbance, and insomnia.

Drug Administration Schedule↗

PubMed2005

Saved by a material safety data sheet.

BACKGROUND: We present the case of a young female laboratory worker who developed acute hepatic encephalopathy. OBJECTIVE: To show that knowledge of occupational exposures to causative agents can alter therapeutic management. METHODS: Although the patient was in a deep coma, her family members examined the workplace material safety data sheet, revealing exposure to chloroform. Since most chemical-induced hepatitis is self-limiting, a scheduled liver transplantation was postponed. RESULTS: The patient recovered. Subsequent air sampling suggested that the patient had been exposed to chloroform at a concentration of more than 15 ppm for 2 weeks. CONCLUSION: Our case report demonstrates the importance of obtaining an occupational history and how the patient's family can be important in this process.

Adult↗

PubMed2005

Prevalence and psychosocial risk factors of upper extremity musculoskeletal pain in industries of Taiwan: a nationwide study.

Prevalence of upper extremity disorders and their associations with psychosocial factors in the workplace have received more attention recently. A national survey of cross-sectional design was performed to determine the prevalence rates of upper extremity disorders among different industries. Trained interviewers administered questionnaires to 17,669 workers and data on musculoskeletal complaints were obtained along with information on risk factors. Overall the 1-year prevalence of neck (14.8%), shoulder (16.6%), and hand (12.4%) disorders were higher than those of the upper back (7.1%) and elbow (8.3%) among those who sought medical treatment due to the complaint. Workers in construction and agriculture-related industries showed a higher prevalence of upper extremity disorders. After multiple logistic regression adjusted for age, education, and employment duration, we found job content, physical working condition, a harmonious interpersonal relationship at the workplace and organizational problems were significant determinants of upper extremity disorders in manufacturing and service industries. Male workers in manufacturing industries showed more concern about physical working conditions while female workers in public administration emphasized problems of job content and interpersonal relationships. We concluded that these factors were major job stressors contributing to musculoskeletal pain of the upper extremity.

Adult↗

PubMed2005

Stress, insomnia, and chronic idiopathic urticaria--a case-control study.

BACKGROUND AND PURPOSE: There is growing evidence that stress might play a crucial role in the pathogenesis of urticaria. This study examined the association between chronic idiopathic urticaria and stress from major life events and explored the validity of the biopsychosocial model of stress as it relates to urticaria. METHODS: A total of 75 consecutive cases with chronic idiopathic urticaria and 133 controls with tinea pedis who visited a dermatologic clinic for treatment were recruited for participation in this study. Subjects in both groups were assessed with a semi-structured questionnaire to determine the number and subjective weighting of major life events, somatic symptoms, insomnia, irregularity of daily life, perceived family support, ego-function, positive coping, and negative coping. Structural equation modeling was used to examine the influence of biologic, psychologic, and social factors on the development of urticaria. Cluster analysis was used to classify subjects according to risk of developing urticaria. RESULTS: In the 6 months preceding disease onset, patients with chronic idiopathic urticaria had significantly more life events, higher subjective weighting of impacts from life events, more somatic symptoms, more severe insomnia, less family support, more negative coping tendencies, and were younger in age. Good ego-function, coping strategies and family support were associated with decreased frequency of urticaria. CONCLUSIONS: Stress is an important risk factor for the development of chronic idiopathic urticaria while positive coping tendencies and good family support appear to have preventative effects. Insomnia might be the most important psychosomatic symptom that is a predisposing factor for chronic urticaria.

Adaptation, Psychological↗

PubMed2004

Decreased HIV transmission after a policy of providing free access to highly active antiretroviral therapy in Taiwan.

BACKGROUND: Taiwan established a nationwide surveillance system for human immunodeficiency virus (HIV) infection in 1989 and adopted a policy to provide all HIV-infected citizens with free access to highly active antiretroviral therapy (HAART) beginning in April 1997. This provided an opportunity to determine the effect of the widespread use of HAART on the evolution of the HIV epidemic. METHODS: We analyzed national HIV surveillance data. The HIV transmission rate was estimated by use of an exponential model of HIV epidemic evolution, with statistical projection over the interval between infection and detection to fit the surveillance data. RESULTS: By the end of 2002, the cumulative number of HIV-infected citizens in Taiwan had reached 4390 (0.019% of the total population). After free access to HAART was established, the estimated HIV transmission rate decreased by 53% (0.391 vs. 0.184 new cases/prevalent case-year [95% confidence interval, 31%-65%]). There was no statistically significant change in the incidence of syphilis, in the general population or among HIV-positive patients, during the same period. CONCLUSION: Providing free HAART to all HIV-infected citizens was associated with a 53% decrease in the HIV transmission rate and contributed to the control of the HIV epidemic in Taiwan.

Adult↗

PubMed2004

Transition of cord blood lead level, 1985-2002, in the Taipei area and its determinants after the cease of leaded gasoline use.

Lead has long been of concern for its toxicity, impairment of neurobehavioral and cognitive development, and electrophysiological deficits in children, even at levels less than 10 microg/dL. The present study was conducted to elucidate the extent of cord blood lead level decline in the Taipei area from 1985 to 2002 and to explore the factors affecting the cord blood lead level after the cease of leaded gasoline use. In the current study period of 2001-2002, 184 of 1310 newborns delivered in the Taipei Municipal Women and Children Hospital between September 2001 and August 2002 were eligible and randomly selected to participate in this study. Neither of their parents had an occupational lead exposure history. At each delivery, a sample of 5-10 mL umbilical cord blood was collected for lead determination by graphite furnace atomic absorption spectrometry. The cord blood lead level of the newborns in the current study period averaged 2.35 +/- 1.12 microg/dL. Together with the cord blood lead averages of 7.48 +/- 2.25 and 3.28 +/- 1.52 microg/dL obtained from two previous surveys conducted in 1985-1987 and 1990-1992, respectively, the cord blood lead level was significantly decreased (P < 0.005). It is estimated that such a reduction in cord blood lead from 7.48 to 2.35 microg/dL for each year's cohort of 260,000 newborns in Taiwan might benefit the economics, ranging from US$8.9 billion to US$12.1 billion by improving the worker productivity. For the time period from 1985 to 2002, there were consistent transition patterns among the yearly fluctuations of air lead level, leaded gasoline consumption, lead content in gasoline, estimated lead amount emitted from the consumed leaded gasoline, and average cord blood lead levels of the three respective study periods. Additionally, every 0.1-g/L reduction in lead content in gasoline might lead to a lowering of cord blood lead level by 1.78 microg/dL. Furthermore, at low level of around 2 microg/dL, a multiple regression analysis demonstrated that economic status was the most influential factor for cord blood lead variation (P = 0.0061) while the maternal working month during her pregnancy was retained in the model with borderline effect (P = 0.0625). After accounting for the effect of leaded gasoline on the cord blood lead level, future study to differentiate the primary contributors for the low-level cord blood lead variation around 1-2 microg/dL is warranted.

Adult↗