Intervention of Hypertension by Occupational Health Management Among Dock Workers — Shenzhen City, Guangdong Province, China, 2020–2024

Naixing Zhang^1,#; Wei Zhou¹; Jinlin Wang¹; Wenting Feng¹; Qiujie Sheng¹; Aipin Xiao²; Dafeng Lin^1,2; Shaofan Weng¹

1. Shenzhen Prevention and Treatment Center for Occupational Diseases, Shenzhen City, Guangdong Province, China;

2. Southern Medical University, Guangzhou City, Guangdong Province, China.

^# Corresponding author: Naixing Zhang, zhangnx@wjw.sz.gov.cn.

Hypertension predisposes dock workers to high health risks in their work environments. This study explored occupational health management in hypertension among dock workers. In 2020, 1,145 dock workers from a port company in Shenzhen, China, were enrolled via cluster sampling for an intervention trial over the following 4 years. Annual blood pressure (BP) monitoring and questionnaires regarding basic characteristics and work information were administered. The occupational health management measures for hypertension intervention included daily pre-shift BP monitoring and hierarchical management, regular health training, dietary management, and exercise promotion. Annual BP values and hypertension incidence and prevalence were analyzed to evaluate the outcomes. Results showed that the median age of the cohort was 46 years, with a median body mass index of 25.08 kg/m² at baseline. The median diastolic BP remained ≥80 mmHg for 5 consecutive years, indicating that more than half of the cohort required long-term intervention. The median systolic and diastolic BP values of patients with baseline hypertension were significantly reduced during the intervention period (all P<0.001), showing downward trends (both P_trend<0.001). Although higher than the baseline levels (all P<0.05), the median BP values of participants without baseline hypertension were all lower than the hypertension diagnostic criteria during the intervention period. The incidence of hypertension in the cohort showed a decreasing trend during the intervention period (P_trend<0.001), and the incidence in the last 2 years of intervention was significantly lower than that in the first 2 years (all P<0.001). Although the prevalence of hypertension increased annually during the intervention (P_trend<0.001), its growth rate decreased annually. The intervention measures helped control BP and reduce the incidence of hypertension in dock workers, which should be promoted in similar occupational environments.

运用职业健康管理对码头工人高血压进行干预 — 深圳市，广东省，中国，2020–2024年

张乃兴^1,#；周伟¹；王金林¹；冯文艇¹；盛秋洁¹；肖爱拼²；林大枫^1,2；翁少凡¹

1. 深圳市职业病防治院，深圳市，广东省，中国；

2. 南方医科大学，广州市，广东省，中国。

^# 通信作者：张乃兴，zhangnx@wjw.sz.gov.cn。

患高血压的码头工人在工作环境中面临高健康风险。本研究在码头工人中探讨高血压的职业健康管理。2020年，通过整群抽样法纳入中国深圳某港口公司的1,145名码头工人作为研究对象，在随后4年中开展干预试验。研究期间每年进行血压监测，并对研究对象的基本特征与工作信息进行问卷调查。用于高血压干预的职业健康管理措施包括：每日班前血压监测与分级管理、定期健康培训、饮食管理及运动促进。通过比较分析队列人群在基线和干预期间的血压值、高血压发病率及患病率，评估干预效果。结果显示，队列人群基线中位年龄为46岁，体块指数中位数为25.08 kg/m²。舒张压中位数连续5年≥80 mmHg，表明该队列中超过半数人的血压需长期干预。基线高血压患者在干预期间收缩压和舒张压中位数均显著下降（P<0.001），且呈下降趋势（P_trend<0.001）。尽管基线非高血压人群的血压中位数在干预期间均高于基线水平（P<0.05），但却低于高血压诊断标准。队列人群的高血压发病率在干预期间呈下降趋势（P_trend<0.001），干预最后2年高血压发病率显著低于前2年（P<0.001）。尽管队列人群的高血压患病率在干预期间逐年增高（P_trend<0.001），但增高率却逐年下降。本研究采用的职业健康管理措施有助于控制码头工人的血压水平和降低高血压发病率，值得在类似职业环境中推广应用。

For more information: https://weekly.chinacdc.cn/en/article/doi/10.46234/ccdcw2026.024

Accessible Blood Based Biomarkers Reflecting Inflammation-Lipid Dysregulation in Silicosis Progression — Jiangsu Province, China, 2021–2024

Rong Jiang^1,&; Qianqian Gao^2,&; Lang Zhou²; Feng Shi¹; Yunfeng Hua¹; Feifei Wang¹; Zhen Hong^1,#; Lei Han^2,#

1 Jiangsu Health Vocational College, Nanjing City, Jiangsu Province, China;

2 Department of Occupation Disease Prevention and Cure, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing City, Jiangsu Province, China.

^& Joint first authors.

^# Corresponding author: Zhen Hong, 20091039@jshvc.edu.cn; Lei Han, hanlei@jscdc.com.

The activation of inflammatory cells and lipid metabolism disorder initiated by silica are key pathological mechanisms of silicosis. This study aims to analyze easily accessible blood biomarkers that reflect this inflammation-lipid imbalance and improve disease monitoring and management. A cross-sectional investigation was conducted in 160 male patients with silicosis and 123 silica-exposed control workers (male ceramic workers without silicosis). Neutrophil-to-HDL ratio (NHR) and Platelet-to-HDL ratio (PHR) were calculated from routine blood counts and high-density lipoprotein (HDL). Pulmonary function parameters (FVC%, FEV₁%, FEV₁/FVC) were evaluated by pulmonary function test. We studied group differences and correlations using statistical analysis. The NHR and PHR of patients in the silicosis group were significantly higher than those in the control group, with the highest levels in advanced stages (Stage II–III). All lung function parameters were significantly reduced in patients with silicosis. NHR and PHR showed significant negative correlations with lung function decline (FVC%, FEV₁%, FEV₁/FVC), and these correlations strengthened in patients with advanced silicosis. NHR and PHR are elevated and inversely correlate with worsening lung function in patients with silicosis, especially in advanced disease. These ratios are readily available, cost-effective biomarkers for monitoring inflammation-lipid dysregulation and functional decline during the progression of silicosis. Incorporating NHR and PHR into routine occupational health screening for workers exposed to silica could help in risk stratification and disease management.

便捷的血液生物标志物在评估矽肺炎症-脂质代谢失调中的应用 — 江苏省，中国，2021–2024年

蒋荣^1,&，高茜茜^2,&，周琅²，施凤¹，华云峰¹，王菲菲¹，洪震^1,#，韩磊^2,#

1.  江苏卫生健康职业学院，南京市，江苏省，中国；

2.   职业病防治所，江苏省疾病预防控制中心，南京市，江苏省，中国。

^& 共同第一作者。

^# 通信作者：洪震, 20091039@jshvc.edu.cn; 韩磊, hanlei@jscdc.com。

目前已有研究证实炎症细胞激活与脂质代谢紊乱是矽肺发生的关键病理机制。本研究的目标是分析易获取的并且能反映矽肺中炎症-脂质失衡状态的血液学生物标志物，用于疾病的监测与管理。采用横断面调查，纳入160例男性矽肺患者及123例有二氧化硅暴露史但无矽肺的男性陶瓷工人作为对照。通过血常规及高密度脂蛋白（HDL）的检测结果，计算中性粒细胞-高密度脂蛋白比值（NHR）与血小板-高密度脂蛋白比值（PHR）。通过肺功能检查评估用力肺活量占预计值百分比（FVC%）、第1秒用力呼气容积占预计值百分比（FEV₁%）及FEV₁/FVC比值。采用统计学方法分析组间的差异及相关性。矽肺组患者的NHR与PHR均显著高于对照组，且在矽肺晚期（II-III期）患者中，NHR与PHR水平最高。矽肺患者中三种反映肺功能的参数均显著降低。NHR、PHR与肺功能参数呈显著负相关，且在晚期矽肺患者中，这种负相关性显著增强。NHR与PHR在矽肺中升高，并与肺功能参数呈负相关，且在晚期中尤为明显。这两种比值指标是易于获取，且检测便宜的生物标志物，可用于监测矽肺进展过程中的炎症-脂质代谢失调与肺功能减弱。将NHR与PHR纳入对二氧化硅暴露工人的常规职业健康筛查，有助于进行风险分层与疾病管理。

For more information: https://weekly.chinacdc.cn/en/article/doi/10.46234/ccdcw2026.025

Classroom Environmental Determinants of Poor Vision in Chinese Schoolchildren — Guangdong Province, China, 2024

Jingxi Feng^1,2,&; Jing Jiang^2,&; Meng Li²; Rong Liu²; Qiuxia Chen²; Chengshu Yang²; Jiwei Niu²; Lin Xu¹; Yabin Qu^2,#

1 School of Public Health, Sun Yat-sen University, Guangzhou City, Guangdong Province, China;

2 Guangdong Provincial Center for Disease Control and Prevention, Guangzhou City, Guangdong Province, China.

^& Joint first authors.

^# Corresponding authors: Yabin Qu, gdsjkzx_yabinqu@gd.gov.cn.

The high prevalence and early onset of poor vision among school-aged children are major public health concerns, with classrooms being key settings for near-vision tasks. However, evidence on the prioritization of classroom environmental interventions in resource-limited areas remains scarce. This study used 2024 surveillance data from Guangdong Province, including 180,584 students and 3,905 classrooms, obtained via multistage stratified random sampling. Standardized measurements and assessments were conducted, with poor vision defined as an uncorrected visual acuity < 5.0. Multivariable logistic regression, Extreme Gradient Boosting (XGBoost) and Shapley Additive Explanations (SHAP) analyses were performed to explore the associations and factor importance. The rate of poor vision detection rate was 60.22%. Lower desk-chair allocation compliance, unqualified blackboard reflectance, and inappropriate desktop illuminance uniformity were significantly associated with an increased risk of poor vision. The SHAP analysis identified blackboard reflectance as the primary environmental factor, with stable effects across the subgroups. Differential effects were observed by educational stage, gender, and urban-rural setting. This study provides an empirical basis for targeted visual health interventions in schools in resource-limited areas. Future efforts should prioritize core environmental optimization and differentiated strategies alongside causal research that incorporates refractive examination data.

教室环境因素与中国学龄儿童视力不良的关联性研究 — 广东省，中国，2024年

冯靖浠^1,2,&，蒋静^2,&，李梦²，刘荣²，陈秋霞²，杨程舒²，牛计伟²，徐琳¹，曲亚斌^2,#

1 公共卫生学院，中山大学，广州市，广东省，中国；

2 广东省疾病预防控制中心，广州市，广东省，中国。

^& 共同第一作者。

^# 通信作者：曲亚斌，gdsjkzx_yabinqu@gd.gov.cn。

学龄儿童视力不良高发且低龄化已成为重要公共卫生问题，教室环境作为近距用眼核心场景，其与视力健康的关联及关键干预靶点尚需明确。本研究基于 2024 年广东省学生常见病监测数据，采用多阶段分层随机抽样纳入 180584 名中小学生及 3905 间教室，通过标准化检测与评估，结合多因素 logistic 回归、XGBoost 模型及 SHAP 分析，探究教室环境因素与视力不良的关联及相对重要性。结果显示，研究人群视力不良检出率为 60.22%；校正混杂因素后，课桌椅配置合格率低、黑板反射率不达标、桌面照度均匀度不合格均与视力不良风险升高显著相关。SHAP 分析表明黑板反射率是影响视力不良的首要环境因素。交互效应显示，不同学段、性别及城乡学生的部分环境暴露效应存在差异。本研究为资源有限地区制定靶向性校园视力健康干预策略提供实证依据，未来可优先优化核心环境指标、推进差异化干预，同时结合屈光检查数据开展更深入的因果关联研究。

For more information: https://weekly.chinacdc.cn/en/article/doi/10.46234/ccdcw2026.026

Prevalence and Influencing Factors of Myopia Among Primary and Secondary School Students — Zhejiang Province, China, 2023

Qinye Liu¹; Chengyong Liu²; Yingyun Shi¹; Xiaoyu Wei¹; Fen Chen¹; Yizhou Wei³; Mike Zhongyu He⁴; Fang Gu^5,#; Weina Liu¹^,#

1. Department of Nutrition and Food Hygiene, School of Public Health, Southeast University, Nanjing City, Jiangsu Province, China;

2. Affiliated Hospital of Nanjing University of Chinese Medicine, Liyang Branch of Jiangsu Province Hospital of Chinese Medicine, Nanjing City, Jiangsu Province, China;

3. School of Biomedical Engineering and Informatics, Nanjing Medical University, Nanjing City, Jiangsu Province, China;

4. Department of Environmental Medicine, Icahn School of Medicine at Mount Sinai, New York, NY,US;

5. Division of School Health, Department of Nutrition and Food Safety, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou City, Zhejiang Province, China.

^# Corresponding author: Weina Liu, weinaliu@seu.edu.cn; Fang Gu, fgu@cdc.zj.cn.

Myopia prevalence is rising globally, with particularly high rates observed in East Asia. This study evaluated the prevalence and associated factors of myopia among primary and secondary school students in Zhejiang Province, China. Using multistage stratified cluster sampling, 192,704 students from 521 schools participated in the School-Based Chinese Adolescents Health Survey (SCAHS) in 2023. Participants underwent ophthalmic examinations, and data on demographic characteristics, parental myopia status, visual and lifestyle behaviors, and dietary habits were collected through questionnaires. The overall myopia prevalence was 68.87%, with high myopia affecting 5.82% of students. Multilevel logistic regression analysis identified several risk factors significantly associated with increased myopia prevalence: female sex, parental myopia, higher body mass index (BMI), advanced school stage, homework duration ≥3 hours daily, and prolonged sedentary behavior. Conversely, protective factors included residence in suburban counties, outdoor rest during class breaks, ≥3 hours of daily outdoor activity, and vegetable consumption ≥twice daily. Notably, consuming a meat and egg-based breakfast demonstrated a protective effect (OR=0.96, 95% CI: 0.92, 0.99). Myopia prevalence remains critically high among primary and secondary school students in Zhejiang Province, China. Future public health initiatives should prioritize early screening programs and implement targeted interventions for high-risk populations.

中小学生近视率及其影响因素 — 浙江省，中国，2023年

刘沁烨¹，刘成勇²，石映鋆¹，魏小雨¹，陈芬¹，韦亦周³，Mike Zhongyu He⁴，顾昉^5,#，刘维娜^1,#

1. 营养与食品卫生学系，公共卫生学院，东南大学，南京市，江苏省，中国；

2. 南京中医药大学附属医院，江苏省中医院溧阳分院，南京市，江苏省，中国；

3. 生物医学工程与信息学院，南京医科大学，南京市，江苏省，中国；

4. 环境医学系，西奈山伊坎医学院，纽约市，纽约州，美国；

5. 营养与食品安全所学校卫生科，浙江省疾病预防控制中心，杭州市，浙江省，中国。

^# 通信作者: 刘维娜，weinaliu@seu.edu.cn；顾昉，fgu@cdc.zj.cn。

全球近视率快速上升，尤其在东亚地区。本研究旨在评估中国浙江省中小学生近视情况及其影响因素。2023年，通过多阶段分层整群随机抽样方法，共纳入浙江省521所中小学的192,704名学生。参与者均接受眼科检查，并通过问卷调查收集其人口统计学特征、父母近视情况、用眼及生活行为和饮食习惯。浙江省中小学生总体近视率为68.87%，高度近视率为5.82%。多水平Logistic回归分析显示，女性、父母近视、BMI较高、学段较高、写作业≥3小时和久坐时间较长均与近视风险升高相关。相反，郊县地区、课后在户外休息、户外活动≥3小时和蔬菜摄入≥2次/天均显著降低近视风险。值得注意的是，摄入肉蛋类早餐（OR=0.96，95% CI: 0.92，0.99）是近视的保护因素。中国浙江省中小学生近视率处于较高水平。未来应加强对近视易感儿童的早期识别与精准干预。

For more information: https://weekly.chinacdc.cn/en/article/doi/10.46234/ccdcw2026.023

Investigation of an Infectious Diarrhea Outbreak Associated with Direct Drinking Water in a High School — Baisha County, Hainan Province, China, November 2024

Faren Li^1,&; Li Qiu^2,&; Yan Jin²; Huiwen Gao¹; Jianhua Dong¹; Meirong Huang¹; Shennv Xue¹; Yunhui Su¹  Xianglin Huang²; Ren Qiu²; Shuyun Xie^2,3,#

1 Baisha County Center for Disease Control and Prevention, Baisha County, Hainan Province, China;

2 Hainan Provincial Center for Disease Control and Prevention, Haikou City, Hainan Province, China;

3 Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou City, Zhejiang Province, China.

^& Joint first authors.

^# Corresponding authors: Shuyun Xie, shyxie@cdc.zj.cn.

This study investigated the causes and transmission pathways of an infectious diarrhea outbreak at a high school in Baisha County during November 2024 to inform response strategies for similar outbreaks. Field epidemiological methods were employed to investigate and characterize the outbreak's epidemic features, while risk factors were analyzed through a case-control study. Case specimens underwent multipathogen PCR chip screening combined with real-time fluorescent PCR to identify the causative pathogen. Cafeteria reserved food samples were tested for diarrheagenic Escherichia coli (DEC)-specific virulence genes using real-time fluorescent PCR. Environmental water samples were analyzed by culture method to quantify total bacterial count, total coliforms, and Escherichia coli. A total of 344 cases were identified, yielding an attack rate of 11.44%. The most common clinical manifestations were diarrhea (80.23%) and abdominal pain (76.74%). Attack rates showed no statistically significant differences by gender or between boarding and day students (P>0.05). Case-control analysis demonstrated that consumption of school-provided direct drinking water was the primary risk factor for illness (odds ratio=3.87, 95% confidence interval: 1.18, 12.68). Laboratory testing identified DEC in both patient specimens and inlet tap water samples from the dispensers; the DEC positivity rate in patient specimens reached 63.3% (19/30), with escV and pic+astA as the predominant virulence genes (either singly or in combination). Hygienic surveys revealed that the school's direct drinking water dispensers failed to meet required standards; after these dispensers were deactivated, the incidence of new cases declined markedly. This outbreak was caused by DEC. The primary transmission route was consumption of direct drinking water supplied by substandard dispensers using contaminated source water, with person-to-person transmission occurring during the later stages of the outbreak.

某高中一起直饮水引起的感染性腹泻暴发调查 — 白沙县，海南省，中国，2024年11月

李发仁^1,&，邱丽^2,&，靳妍²，高慧文¹，董建华¹，黄媚蓉¹，薛深女¹，苏运辉¹，黄湘麟²，邱仁²，谢淑云^2,3,#

1. 白沙黎族自治县疾病预防控制中心，白沙黎族自治县，海南省，中国；

2. 海南省疾病预防控制中心，海口市，海南省，中国；

3. 浙江省疾病预防控制中心，杭州市，浙江省，中国。

^& 共同第一作者。

^# 通信作者：谢淑云, shyxie@cdc.zj.cn。

调查2024年11月白沙县某高中一起感染性腹泻暴发的原因与传播模式，为防控类似疫情提供依据。采用现场流行病学方法开展调查，描述暴发疫情的流行病学特征；运用病例对照研究分析危险因素。采集病例标本，通过多病原PCR芯片初筛与实时荧光PCR技术验证以确定致病病原体；对食堂留样食品采用实时荧光PCR检测DEC特异性毒力基因；对环境水样采用培养法检测细菌总数、总大肠菌群和大肠埃希菌。共发现344例病例，罹患率为11.44%，主要临床表现为腹泻(80.23%)和腹痛(76.74%)，不同性别、寄宿生与走读生的罹患率差异无统计学意义（P >0.05）。病例对照研究显示，饮用学校提供的直饮水是发病的主要危险因素（OR=3.87, 95% CI: 1.18, 12.68）。实验室检测发现，在患者标本和直饮机进水口水样均检出DEC，其中患者标本阳性率为63.3%（19/30），毒力基因以escV、pic+astA单种及多种组合为主。卫生学调查发现该校使用的直饮机未达标，停用直饮机后，新发病例显著减少。本起疫情由DEC引起，暴发的主要原因与饮用不合格的水源经不达标的直饮机供应的直饮水有关，疫情后期存在人际传播。

For more information: https://weekly.chinacdc.cn/en/article/doi/10.46234/ccdcw2026.026