China

Focus: Cancer and environmental health

Affiliation: Chinese CDC and National Institute for Environmental Health, Yale School of Public Health

Contacts:Tongzhang Zheng, DSc, Susan Dwight Bliss Professor of Epidemiology (Environmental Health); Department Chair, Environmental Health Sciences; Min Dai, PhD, Professor, National Office of Cancer Prevention & Control, Cancer Institute & Hospital, Chinese Academy of Medical Sciences

Site and Background
The rapid economic development experienced in China during the past 3 decades has in turn led to dramatic changes in environmental conditions, dietary intakes, nutritional status, and lifestyle factors in the population. China today faces vast environmental pollution and deterioration which has resulted in sharp increases of frequency of cancers and other environmental and occupation-related diseases, injuries, and disabilities. During the past decade, Yale School of Public Health (YSPH) has been working, through a network of partners, with various Chinese government agencies, institutions and universities to conduct capacity building in identified national, occupational, and environmental health priority areas. NIH-sponsored Training Programs (Fogarty D43 TW 008323 and D43 TW 007864) have not only supported 33 trainees at Yale, the programs have also contributed to several trainee-oriented research projects listed below.

Projects

1. A prospective cohort study of metal exposures and human health in Jinchuan Industry (China Metal Cohort Study)The Jinchuan Group is the largest nickel, zinc, copper and cobalt producer in China. The specific aims of this study include 1) prospectively studying the mortality and incidence trends for various diseases by occupation, job title and type of exposures; 2) assessing the changes in disease biomarkers and exposure markers to assess the intervention effects through changes in working condition and health campaigns; and 3) investigating occupational and genetics as risk factors for various diseases observed in these workers through nested case-control studies. The Jinchuan study, launched in 2010, will include about 32,000 active and 19,000 retired workers.

2. A cohort study of health effects among 100,000 coal miners in China (China Coal Mine Cohort Study) Kailuan Coal Group is one of the largest state-run coal enterprises. The aims of the China Coal Cohort Study include 1) identifying the top cancers in Kailuan and carry out the screening and interventional programs for cancers targeting the high-risk subjects; 2) assessing the changes in cancer biomarkers and exposure markers to look for biomarkers for early detection of cancers and assess the intervention effects; and 3) investigating the role of occupational exposures and genetics on cancer risks observed in this population. The Kailuan Group has more than 100,000 workers (both active and retired workers). The cohort was launched in 2006, with three general check-ups and in-person interviews completed to date.

3. A prospective cohort study of human health in Dongfeng Automobile Enterprise (China Automobile Workers Cohort Study) Dongfeng is one of the largest auto manufacturers in China. This study, launched in 2008, has included 27,009 retired workers to date. In the short-term, the study will focus on the role of genetic and environmental factors in the development of obesity, metabolic syndrome, and type-2 diabetes. With long-term follow-up, the study will be able to investigate cardiovascular and cerebrovascular outcomes and cancer. Detailed information on occupational and environmental factors dating back to 1993 is available for the cohort and blood samples have been collected.

4. A birth cohort study of environmental exposures and adverse birth outcomes. China’s NIEHS is conducting this study in 8 Chinese cities. The main purpose of the on-going birth cohort study is to explore the role of environmental factors, endogenous hormones, and genes on the risk of adverse birth outcomes and children’s development. As of April 2012, a total of 13,000 mother-baby pairs have been included in the study.

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