Background Few localized food frequency questionnaires (FFQ) have been developed and used in Chinese nutrition surveys despite China’s large population and diverse dietary habits. Method We analyzed data collected in two waves (six months apart) of the Shanghai Diet and Health Study in 2012–2013, from 1623 Shanghai residents (798 men and 825 women) older than 18 years. The results of 3-day 24-h dietary recalls (HDR) plus condiment weighing were used to evaluate the validity and reliability of the SDHS FFQ. Results The median and first and third quartiles for energy intake (in kcal) derived from the FFQ1 and FFQ2 were 1566.5 (1310.1–1869.6) and 1561.9 (1280.2–1838.4), respectively, of which protein (in g) was 54.3 (42.5–65.8) and 52.9 (42.4–64.5), fat (in g) was 49.8 (37.2–64.7) and 47.9 (34.9–61.9), and carbohydrates (in g) was 227.3 (180.8–277.9) and 228.1 (182.2–275.2) in the reliability analysis. The median and first and third quartiles for energy-intake differences between the FFQ1 and the 3-day 24-HDR with condiment weighing was 59.3 (− 255.5–341.6), of which protein was − 5.2 (− 18.7–7.8) and fat was − 11.2 (− 30.8–5.3). The adjusted Spearman’s correlations were 0.33–0.77 for validity and 0.46–0.79 for reliability. The intra-class correlation coefficients exceeded 0.46 (validity) and 0.47 (reliability) for macronutrient intake. The consistency between the same and adjacent quartiles was approximately 80% for various nutrients. Conclusion The reliability and comparative validity of the SDHS FFQ is similar to FFQs that are used worldwide. Electronic supplementary material The online version of this article (10.1186/s12937-019-0454-2) contains supplementary material, which is available to authorized users.

NHEXAS AZ is a multimedia, multipathway exposure assessment survey designed to evaluate metals and other analytes. This paper reports the analytespecific concentration distributions in each of the media examined (air, soil, house dust, food, beverage, and water), for various methodologies used (inductively coupled plasma-atomic emission spectroscopy and hydride generation-atomic absorption spectroscopy). Results are reported for the five primary metals (Pb, As, Cd, Cr, and Ni). Ingestion was the most important pathway of exposure. Metal concentrations in air were very low (ng / m 3 ) and found only above the 90th percentile. Metals were commonly found in house dust and soil. Exposure transfer coefficients minimize the importance of this component for those over the age of 6 years. When ranked by exposure, food, beverage, and water appeared to be the primary contributors of metal exposure in NHEXAS AZ. For instance, at the 90th percentile, Pb was undetected in air, found at 131 and 118 g / m 3 in floor dust and soil, respectively, and measured at 16 g / kg in food, 7.1 g / kg in beverage, and 2.0 and 1.3 g / l in drinking and tap water, respectively. We calculated preliminary estimates of total exposure (g /day) for each participant and examined them independently by age, gender, and ethnicity as reported by the subjects in the NHEXAS questionnaire. At the 90th percentile for Pb, total exposures were 64 g /day across all subjects (n =176); adult men (n = 55) had the greatest exposure (73 g /day) and children (n =35) the least (37 g /day). Hispanics (n = 54) had greater exposure to Pb (68 g /day) than non-Hispanics (n =119; 50 g /day), whereas non-Hispanics had greater exposure for all other metals reported. These results have implications related to environmental justice. The NHEXAS project provides information to make informed decisions for protecting and promoting appropriate public health policy.

Few studies have explored the different lineages of influenza B viruses, which cause excessive fatalities. This study aimed to estimate age-and sex-specific excessive mortality associated with influenza subtypes/lineages in Shanghai, during 2010-2015. Methods: We used quasi-Poisson regression models to fit weekly numbers of deaths from various causes by adjusting long-term trend, seasonal trend, and absolute humidity as confounding factors. The mortality burden associated with influenza subtypes/lineages was estimated by age and sex. Results: The average influenza-associated excessive mortality rate in deaths coded as all-cause was 27.66 (95%CI: 22.30-33.88) per 100,000 person-years. The excessive deaths from six underlying causes in people aged !65 years weight heavily. Compared to influenza B(Victoria) lineage, influenza B(Yamagata) lineage had more effect on the influenza-associated disease burden, particularly in patients with respiratory and circulatory diseases. There was no statistical significance of sex in the mortality burden associated with influenza. Conclusion: Disproportionate mortality associated with influenza B virus is dominated by B(Yamagata) lineage in Shanghai, and the evidence for sex differences in the influenza-associated mortality burden for respiratory and circulatory diseases is limited. Improving the vaccination of the elderly and strengthening laboratory-based surveillance of influenza B lineages in Shanghai are needed to reduce this influenza's disease burden.

Within the context of the National Human Exposure Assessment Survey (NHEXAS), metals were evaluated in the air, soil, dust, water, food, beverages, and urine of a single respondent. Potential doses were calculated for five metals including arsenic. In this paper, we seek to validate the potential dose calculations through spatial analysis of the data. Others report elevated arsenic concentrations in biological and environmental samples from residents of mining towns, particularly Ajo, Arizona. These reports led us to expect potential arsenic doses above the 90th percentile of the NHEXAS exposure distribution to be from residents of mining communities. Arsenic dose was calculated using media concentrations, time activity patterns, and published exposure factors. Of the 179 homes evaluated, 54 were in mining communities; 11 of these were considered separately for reasons of population bias. Of the 17 homes with the greatest potential arsenic doses, almost half (47%) were in mining communities. We evaluated the potential doses by media from nonmining and mining areas using the nonparametric Mann±Whitney U test. Statistically significant ( p = 0.05) differences were found between mining (n = 43) and nonmining sites (n = 122) for total exposure and for each of the following media: house dust, yard soil, outdoor air, beverage consumed, and water consumed. No differences were found in either food or indoor air of mining and nonmining areas. We eliminated outliers and repeated the test for all media; significance increased. Dietary, organic arsenic from fish consumption contributed to elevated arsenic exposure among people from nonmining communities and acted as an initial confounder. When controlling for fish consumption, we were able to validate our potential dose model using arsenic, particularly in Ajo. Further, we identified three mining communities lacking elevated arsenic exposure. Additional work is needed speciating the arsenic and evaluating health risks. The utilization of Geographic Information System facilitated spatial this project and paves the way for more sophisticated future spatial analyses.

Background Rheumatoid arthritis (RA) is a chronic inflammatory and destructive arthritis. Understanding the incidence and prevalence of RA within the province facilitates appropriate health care resource planning. Objective To estimate the incidence/prevalence of RA over time for the overall provincial population, for specific age range categories, and for gender. Methods Saskatchewan Provincial Administrative Health Databases (2001–2014) were utilized as data sources. Two RA case-definitions were employed: 1) > three physician billing diagnoses, at least one of which was submitted by a specialist (rheumatologist, general internist or orthopedic surgeon) within 2 years; 2) > one hospitalization diagnosis (ICD-9-CM code-714, and ICD-10-CA code-M05). Data from these definitions were combined to identify incident and prevalent RA cases. Using this data, annual incidence and prevalence rates were calculated for the provincial population, specified age range categories and gender categories. Results The number of RA cases meeting the case definition increased from 3731 to 6223 over the study period. The incidence of RA disease demonstrated variation within the study period with age and sex adjusted incidence ranging from 33.6 (95% CI 29.9–37.6) per 100,000 to 73.1 (95% CI 67.6–79.0) per 100,000. The prevalence of RA increased over time from 482 (95% CI 466.7–497.7) per 100,000 in 2001–2002 to 683.4 (95% CI 666.6–700.6) per 100,000 in 2014–2015. Both incidence and prevalence rates rose with increasing age. Women were found to have higher incidence and prevalence rates compared to men. Conclusion In Saskatchewan, the overall prevalence of RA is rising while there has been variability in the incidence.