耶鲁公卫郑教授武汉讲座(中国环境与健康培训项目简介)

MajorTraining/ResearchProgramsforEnvironmentandHumanHealthinChinaTongzhangZheng,M.D.,Sc.D.,Sc.MProfessorandHeadDivisionofEnvironmentalHealthSciencesYaleUniversitySchoolofPublicHealthGrandNationalTheatreofChina,BeijingAdvancedMediaWatchMONDAY,30MARCH2009NEVERMINDTHEG20,ITSCHINATHATCANSAVETHEWORLD居大的成就和沉重的代价•人民•国土arenowat:HuangshanTour-HuangshanGallery-Mt.Huangshan-MountainScenery-AbruptPeakCrystalclearwatersIIPhotoEutrophicationinTaihulake这里的孩子遭受铅中毒的速度极端的高北京科技报：我国精子库精源紧张(图)北京科技报2009年3月9日封面南京精子庫入不敷出千對夫妻排隊等精子僑報【僑報訊】“不等了，我們離婚吧！”當29歲的張玉（化名）在江蘇省醫院得知，該院的精子庫有2000多人在排隊，自己要想懷上孩子，最起碼要等兩年，絕望的張玉迸出了離婚的念頭。有關專家不無擔憂地指出，“精子荒”已經成為一個社會問題。《南京晨報》3月1日報導，目前中國男性因為無精、少精、弱精、精子畸形導致的不育症越來越多，其中，無精子症的男性占到男性不育的20%左右，對于他們來說，想要孩子就只能寄希望于精子庫了。江蘇省醫院近日透露，目前該院精子庫入不敷出，排隊等待精子的夫妻達到了1000對以上。“最起碼要等兩年才能輪到，現在我們已經不接受登記了。”該庫一位負責人說。“精子緊缺已不再是純醫學問題，而成為一個社會問題，捐精和捐血已經變得同樣重要。”BreastCancerincidenceinShanghai,China,1973-200005101520253035401973197619791982198519881991199419972000YearofdiagnosisRateper100,000云南水富12名返乡农民工病死续:副县长承诺维权在水富家中养病的刘树祥记者张友平/摄昭通市水富县向家坝镇3个偏僻的村寨，当地50多名从安徽省滁州市一砂石厂打工返乡的男子，共同患上了一种“怪病”。两年多的时间，3个村相继死了12名青壮年男子。江西小山村癌魔橫行已有49人患癌去世村民恐懼鳳凰衛視USOlympiccyclistssaysorryforsmogmasksMajorChallenges•Chinafacesmanychallengesinconfrontingthecrucialenvironmentalhealthissues•Majorchallenge:lackoftrainedpersonnelinallmajorareasofenvironmentalhealthsciencesResearchTrainingforStudyofAirPollutionandHumanHealthinChina(AnintegratedtrainingprogramwasproposedandfundedbyUSNIH)PI:TongzhangZhengYaleUniversitySchoolofPublicHealthCo-PI:JinYinlongChinaNationalInstituteofEnvironmentalHealthSciencesPurposes–ToincreaseChineseexpertisetorespondtothisunprecedentedchallengeinenvironmentalhealth–IncreasethecapacityofIEHSasacenterofexcellenceinChinaforresearchrelatedtoenvironmentalhealthsciencesthroughaconsortedtrainingplanTrainingActivities•TraineestrainedatYSPH•WorkshopsheldinChina•Mentoredtraineeresearchprojects–(8CityStudyofAirPollutionandHumanHealth)–(BirthCohortStudyofEnvironment/Gene/Health)Whyareweinterestedinbirthcohort?WorldwidedecreaseinageatpubertyWorldwidedecreaseinageatmenarcheManycancersareestablishedinuteroManychronicdiseasesareoriginatedinuteroFetalOriginHypothesisBirthWeightandBreastCancerMichelsandXueInt.J.Cancer.119:2007-29BirthWeightandBreastCancer-PremenopausalMichelsandXueInt.J.Cancer.119:2007-29Thequestiontobeaskedis:IfprenatalexposuresindeedareresponsiblefortheseconditionsThen,whatfactorsandatwhichtrimesterarecriticforthesubsequentconditions?ThatiswhyareweinterestedinbirthcohortstudyEligibleSubjects1.Collectbaselineinformation2.Collectexposureinformationduringthefirsttrimester3.Collectbloodandurinesamples1.Updateexposureinformationduringthesecondtrimester2.Collectbloodandurinesamples1.Collectcordblood,andplacentasample2.Collectinformationonbirthoutcomes1.Before/at13thweekofpregnancy2.Agesbetween20-45yearsold3.Willingtocarrytoterm4.ResidentObtainingwrittenconsentParticipantsNon-participantsCollectingbriefinformationoneducationlevel,Age,&reasonfornonparticipationParticipantsat13thweekofpregnancyParticipantsat26thweekofpregnancyParticipantsat35thweekofpregnancyParticipantsatDelivery(Goaln=500/city)1.Updateexposureinformationduringthethirdtrimester2.CollectbloodandurinesamplesOverviewoftheBirthCohortEstablishmentinChina中國‧死因調查報告顯示‧癌症成中國首號殺手星洲日報中國衛生部早前發佈的第3份全國死因調查報告（2006-08年）顯示，癌症及中風是中國的頭號及次號殺手，呼吸道毛病及心臟病則是3號及4號殺手。至於損傷及中毒則是第5大死因。SameMajorChallenges•Chinafacesmanychallengesinconfrontingtherapidincreaseinhumancancerrisk•Majorchallenge:lackoftrainedpersonnelinallmajorareasofcancerpreventionandcontrolResearchTrainingforStudyofCancerEpidemiologyandEtiologyinChina(AnintegratedtrainingprogramwasproposedandfundedbyUSNIH)PI:TongzhangZhengYaleUniversitySchoolofPublicHealthCo-PI:PinZhaoDirectorChinaNationalCancerCenterPurposes–ToincreaseChineseexpertisetorespondtothisrapidincreaseincancerburden–IncreasethecapacityofChinaNCIasacenterofexcellenceinChinaforresearchrelatedtocancerepidemiologyandetiologyTrainingActivities•TraineestrainedatYSPH•WorkshopsheldinChina•Mentoredtraineeresearchprojects(HohhotProspectiveCohortStudy)GOALS•GoaloftheCohortStudy–Tostudyenvironmentalandgeneticandepigeneticriskfactorsformajordiseasesthroughacohortstudyinarelativelystablemultipleethnicpopulation•NestedGoaloftheCohortStudy–TosearchandidentifyearlydiseasebiomarkersfromearlydetectedpatientsamonghighriskpopulationinthecohortCross-sectionalStudyEstablishthecohortCase-controlstudyIdentifymajorriskfactorsforselecteddiseasesModelingIdentifyhighrisksubjectsofthecohortScreeningDetectearlydiseasesLabanalysesSearchearlydiseasebiomarkersCohortStudyIdentifyriskfactorsfordiseasesHohhotProspectiveCohortStudyChinaPhysicianandNursesCohortStudy•Establishingacohortofhealthprofessionalstostudyvariousenvironmentfactors,geneticandepigeneticfactorsanddiseaserelationshipsinChinaCONDITIONSTOESTABLISHCHINAP/NCOHORT•Computerizedsystem•MOHleadership•Expertiseofthestudyteam•Physiciansandnursesarewelltrainedinmed