A telephone survey of 986 Hong Kong households determined exposure and risk perception of avian influenza from live chicken sales. Householders bought 38,370,000 live chickens; 11% touched them when buying, generating 4,220,000 exposures annually; 36% (95% confidence interval [CI] 33%–39%) perceived this as risky, 9% (7%–11%) estimated >50% likelihood of resultant sickness, whereas 46% (43%–49%) said friends worried about such sickness. Recent China travel (adjusted odds ratio 0.35; CI 0.13–0.91), traditional beliefs (1.20, 1.06–1.13), willingness to change (0.29, 0.11–0.81) and believing cooking protects against avian influenza (8.66, 1.61-46.68) predicted buying. Birth in China (2.79, 1.43–5.44) or overseas (4.23, 1.43–12.53) and unemployment (3.87, 1.24–12.07) predicted touching. Age, avian influenza contagion worries, husbandry threat, avian influenza threat, and avian influenza anxiety predicted perceived sickness risk. High population exposures to live chickens and low perceived risk are potentially important health threats in avian influenza.

To assess the prevalence of the metabolic syndrome disease cluster in the Hong Kong Chinese population we applied the US National Cholesterol Education Programme Adult Treatment Panel III (NCEP ATP III) guidelines. This was present if > or =3 of the following conditions were present: Hypertension (> or =130/85 mmHg); fasting plasma glucose was > or =6.1 mmol/L; fasting plasma triglycerides > or =1.69 mmol/L; fasting HDL-cholesterol <1.04 or <1.29 mmol in males and females, respectively; or subjects were receiving treatment for their condition; waist circumference >88 or 102 cm (Asian WHO criteria > or =80 or 90 cm) in females and males, respectively. A total of 16.7% (17.1 (95%CI 15.7-18.5)% age and gender-adjusted) of the 2893 subjects had the metabolic syndrome. The prevalence of having at least 2, 3, 4 or 5 components was 34.5, 16.7, 6.4 and 1.4%, respectively. The prevalence increased from 3.1% in those aged 25-29 years to 41.0% in those aged over 70 years. Using the 2001 Census, 880,499 Hong Kong residents would have the metabolic syndrome. If the WHO recommended waist circumference for Asians is used, the age and gender-adjusted prevalence is significantly higher at 21.2% (21.9 (95%CI 20.4-23.4)%). In summary, the high prevalence of the metabolic syndrome in adult Hong Kong Chinese, particularly in the elderly, forewarns a rapidly increasing problem in Mainland China, and other Asian populations, which may have overwhelming public health ramifications.

(WC) and BMI], surrogate measures of insulin resistance (fasting plasma glucose and insulin, oral glucose tolerance test, 2 hours glucose and insulin), fasting lipids (total, low-density lipoprotein-cholesterol, high-density lipoprotein-cholesterol, and triglycerides) and systolic and diastolic blood pressure were measured. General obesity was classified as BMI Ն25.0 kg/m 2 and central obesity as a WC Ն80 or Ն90 cm in women and men, respectively. Results: A total of 39.2% of the population was found to be obese. Obesity per se increased the levels of the risk factors, but central adiposity contributed to a greater extent to adverse high-density lipoprotein-cholesterol, triglyceride, and insulin resistance levels. There was a continuous relationship between increasing obesity, both general and central, and cardiovascular risk, with lowest risk associated with the lowest indices of obesity. In the 1759 nonobese subjects divided into quartiles of BMI or WC, the levels of the cardiovascular risk factors still significantly increased with increasing quartiles of adiposity. Discussion: Central adiposity appears to contribute to a greater extent than general adiposity to the development of cardiovascular risk in this population. The relationship between obesity parameters and risk is a continuum, with risk factors significantly increasing even at levels usually considered nonobese. These observations support the proposed redefinition of overweight and obesity in Asian populations using lower cut-off points.

This guidance document is a reference for air quality policymakers and managers providing state-of-the-art, evidence-based information on key determinants of air quality management decisions. The document reflects the findings of five annual meetings of the NERAM (Network for Environmental Risk Assessment and Management) International Colloquium Series on Air Quality Management (2001-2006), as well as the results of supporting international research. The topics covered in the guidance document reflect critical science and policy aspects of air quality risk management including i) health effects, ii) air quality emissions, measurement and modeling, iii) air quality management interventions, and iv) clean air policy challenges and opportunities.

Influenza has been well documented to significantly contribute to winter increase of mortality in the temperate countries, but its severity in the subtropics and tropics was not recognized until recently and geographical variations of disease burden in these regions remain poorly understood. In this study, we applied a standardized modeling strategy to the mortality and virology data from three Asian cities: subtropical Guangzhou and Hong Kong, and tropical Singapore, to estimate the disease burden of influenza in these cities. We found that influenza was associated with 10.6, 13.4 and 8.3 deaths per 100,000 population in Guangzhou, Hong Kong and Singapore, respectively. The annual rates of excess deaths in the elders were estimated highest in Guangzhou and lowest in Singapore. The excess death rate attributable to A/H1N1 subtype was found slightly higher than the rates attributable to A/H3N2 during the study period of 2004-2006 based on the data from Hong Kong and Guangzhou. Our study revealed a geographical variation in the disease burden of influenza in these subtropical and tropical cities. These results highlight a need to explore the determinants for severity of seasonal influenza.