Through the use of epidemiological research methods and embracing the spirit of both bold speculation and cautious refutation, we aim to uncover new public health concerns, advance knowledge in public, environmental, and occupational health, and effectively disseminate my findings to promote public health advocacy. Our research focuses specifically on addressing new challenges in the fields of environmental and occupational medicine, reproductive and developmental epidemiology, children’s environmental health, and cancer causes and control. Initially, we established occupational cohorts using labor health insurance databases, which include the RCA corporation employees (1978-92; female, n=70,735; male, n=16,133), a semiconductor industry cohort (1980-2000; male, n=19,816; female, n=27,610), a Chinese herbalist cohort (1985-98; male, n=3,085; female, n=3,453), and a lead exposure cohort (1992-98; male, n=18,010; female, n=11,497). Our research primarily focused on examining the impact of occupational exposures on the risk of cancer and reproductive health in these occupational cohorts. (Academic Contributions: Please see Reproductive Hazards in the Workplace and Environment, Expert Witnesses for the RCA Corporation Employees Caring Association, and Preventive Actions of Banning Herbal Medicine Containing Aristolochic Acid)
Birth cohorts, which are based on recruiting and actively following mothers and children, allow for the collection of biological material, as well as specific clinical and genetic information, to determine the causal relationship between potential risk factors during the prenatal or postnatal period and the health status of the newborn up to childhood and potentially adulthood. I first used the Prospective Pregnancy Cohort in Taipei (PPCT, 1984-87, n=15,729) in my PhD dissertation to investigate the effects of biological, occupational, and social factors on birth outcomes. We then began conducting longitudinal birth cohort follow-up studies to investigate the environment, genetics, and children’s health issues, including the Taiwan Birth Cohort Study (TBCS, 2005, n=21,248), Taiwan Birth Panel Study (TBPS1, 2004-05, n=486), and Taiwan Birth Panel Study (TBPS2, 2011-12, n=1,012). We also co-established the Birth Cohort Consortium of Asia (BiCCA, 2012-now, 33 birth cohorts in 17 Asian countries, n=90,000) to investigate different environmental risks in Asian countries. To investigate the potential health effects of per-and polyfluoroalkyl substances (PFAS, endocrine disrupting chemicals, persistent organic pollutants) in adults, we also cooperated with hospital-based studies including the Young Taiwanese Cardiovascular Cohort Study (YTCC, Dr. Ta-Chen Su, 2006-08, n=790), Genetic and Biomarkers Study for Childhood Asthma (GBCA, Dr. Yungling Lee, 2009-10; cases, n=231; controls, n=225), and NTUH Breast Cancer Case-control Study (Dr. Ching-Hung Lin, 2013-15; cases, n=120; control, n=119). (Academic Contributions: Please see Children’s Environmental Health Based on Birth Cohort Studies and Birth Cohort Consortium of Asia (BiCCA))
Lastly, we utilized national health insurance databases to set up our population-based studies including studies of HBV-infected patients (1997-2010, n=802,642), HCV-infected patients (1997-2010, n=223,467), and type 2 diabetic patients (1997-2010; male, n=430,377; female, n=431,956) in relation to aristolochic acid-related cancers and cancer chemoprevention. In order to understand the distribution and trend of environmental chemicals in humans, we recently began conducting nation-wide representative population-based surveys, the Biomonitoring and Epidemiology Pilot Study in Taiwan (2019, n=1,584; 2020, n=1,748) to collect biological samples such as blood and urine. We will measure persistent organic pollutants, heavy metals, endocrine disrupting chemicals, volatile organic solvents, and pesticides, and compare them to the databases of the International Biomonitoring Network. The ultimate goal is to effectively assess and understand exposure and health effects in order to reduce or prevent adverse health effects in the population. (Academic Contributions: Please see Preventive Actions of Banning Herbal Medicine Containing Aristolochic Acid and Cancer Chemoprevention Based on Health Informatics Research)
Birth cohorts, which are based on recruiting and actively following mothers and children, allow for the collection of biological material, as well as specific clinical and genetic information, to determine the causal relationship between potential risk factors during the prenatal or postnatal period and the health status of the newborn up to childhood and potentially adulthood. I first used the Prospective Pregnancy Cohort in Taipei (PPCT, 1984-87, n=15,729) in my PhD dissertation to investigate the effects of biological, occupational, and social factors on birth outcomes. We then began conducting longitudinal birth cohort follow-up studies to investigate the environment, genetics, and children’s health issues, including the Taiwan Birth Cohort Study (TBCS, 2005, n=21,248), Taiwan Birth Panel Study (TBPS1, 2004-05, n=486), and Taiwan Birth Panel Study (TBPS2, 2011-12, n=1,012). We also co-established the Birth Cohort Consortium of Asia (BiCCA, 2012-now, 33 birth cohorts in 17 Asian countries, n=90,000) to investigate different environmental risks in Asian countries. To investigate the potential health effects of per-and polyfluoroalkyl substances (PFAS, endocrine disrupting chemicals, persistent organic pollutants) in adults, we also cooperated with hospital-based studies including the Young Taiwanese Cardiovascular Cohort Study (YTCC, Dr. Ta-Chen Su, 2006-08, n=790), Genetic and Biomarkers Study for Childhood Asthma (GBCA, Dr. Yungling Lee, 2009-10; cases, n=231; controls, n=225), and NTUH Breast Cancer Case-control Study (Dr. Ching-Hung Lin, 2013-15; cases, n=120; control, n=119). (Academic Contributions: Please see Children’s Environmental Health Based on Birth Cohort Studies and Birth Cohort Consortium of Asia (BiCCA))
Lastly, we utilized national health insurance databases to set up our population-based studies including studies of HBV-infected patients (1997-2010, n=802,642), HCV-infected patients (1997-2010, n=223,467), and type 2 diabetic patients (1997-2010; male, n=430,377; female, n=431,956) in relation to aristolochic acid-related cancers and cancer chemoprevention. In order to understand the distribution and trend of environmental chemicals in humans, we recently began conducting nation-wide representative population-based surveys, the Biomonitoring and Epidemiology Pilot Study in Taiwan (2019, n=1,584; 2020, n=1,748) to collect biological samples such as blood and urine. We will measure persistent organic pollutants, heavy metals, endocrine disrupting chemicals, volatile organic solvents, and pesticides, and compare them to the databases of the International Biomonitoring Network. The ultimate goal is to effectively assess and understand exposure and health effects in order to reduce or prevent adverse health effects in the population. (Academic Contributions: Please see Preventive Actions of Banning Herbal Medicine Containing Aristolochic Acid and Cancer Chemoprevention Based on Health Informatics Research)