There is no hint of areca safety in bulk areca shop near XiangTan Railway Station. In Changsha, almost all the smoke hotels, small supermarkets, convenience stores, the doorway of the door has a areca shelf, put all brands, various flavors of areca. In April 14th, the official website of the Xiangya Hospital said, in the 46 ward of oral and maxillofacial surgery, 45 of the 50 hospitalized patients suffer from oral cancer, and 44 of them have a long and large history of chewing areca. This news once again pushed areca to the top of the storm, triggering public doubts about arecas safety. In fact, controversy about areca and oral health has always existed. In 2003, WHO ranked areca as the first class carcinogen. In 2017, the State Food and Drug Administration issued a complete list of carcinogens. Areca fruit was also listed as a carcinogen. Related reports show that the incidence of oral cancer in Hunan is significantly higher than the national average level. In the past 12 years, the number of oral cancer patients in 5 hospitals in Changsha has increased rapidly. In December, the latest data on the registration of cancer in Hunan Province, issued by the Hunan provincial cancer prevention and Control Research Office, first entered the first ten of all cancers in Hunan province. In recent years, Hunan has become the largest areca processing and consumption base in mainland China, and areca has become an important source of Local Taxation. Some experts suggest that areca should be managed like cigarettes, highly taxed, restricted to buy people, and can not be advertised. It is also suggested that for the sake of public health, the areca industry should be banned directly. There is also a view that the areca industry is related to local economy and employment, and the areca carcinogenicity is doubtful, and can not establish a direct causal relationship between areca and oral cancer. The reporter learned that the safety of the suspicious and addictive areca, its food positioning is not clear, the State Health Planning Commission has not agreed to formulate areca food safety standards. Hunan Health Planning Commission said it would speed up the areca safety evaluation project and recommend areca to the management of hobby products. Under the dispute, the areca industry is still expanding, and the people who eat areca have spread from Hunan to the whole country. Oral cancer patients Wang Hao, 31, a 31 year old man who works in telephone service, is most often to speak to people, but it has become a more difficult thing to speak since he found a lump on the gums of the Spring Festival this year. At first a small blister, long on the right side of the gums, a touch of pain, the small blisters grew faster and bigger, no pain, and Wang Hao came to the Department of Stomatology, Xiangya No.2 Hospital, Central South University. The results were not less than a bolt from the blue - oral cancer. This is a malignant tumor that needs to be excised by surgery. In the face of the reporter, he squeezed a word from his teeth. Im afraid, you try to sleep every day, you cant eat, you want to do the operation quickly. Wang Hao, a resident of Loudi in Hunan next to the ward, is 49 years old and has been hospitalized for the second time. In March 23rd last year, as a result of the first operation of oral cancer in the second hospital of Xiangya, the Chinese army removed some of the soft palate and 2/3 of the tongue, and left a long and waking scar on the right side of the neck. Because the tongue function is limited after the operation, Jing Si Jun is often choked when eating and drinking, and his speech is ambiguous. You cant expectant sputum like a normal person. Every time you eat in, the phlegm gets stuck up. You have to wrap it up and buy the big cotton swab and put it in your mouth and pick up the sputum. Although there is no quality of life, but the family feel that, as long as the life of a life, other can bear, never thought, a year later, the tumor on the left side of the mouth again. After the two operation, the trachea was cut and he was lying on the bed. He couldnt move, could not speak, the stomach tube was inserted from his nose, and the fluid was slowly transported to his weak body. In the ward of oral and maxillofacial surgery of the Second Xiangya Hospital, there are also ten oral cancer patients like Wang Hao and Jing Si Jun. In 2017, the Chinese Journal of dental research published a paper predicting the number of oral cancer induced by areca in China and the burden of medical treatment in China, and collected data of oral cancer patients in five large comprehensive hospitals and special hospitals in Changsha, including Xiangya Hospital, Xiangya Second Hospital and Hunan cancer hospital. Zhang showed that in the past 12 years, oral cancer cases in 5 hospitals in Changsha showed a rapid growth trend. From 305 cases in 2005 to 2108 cases in 2016, the total number has reached 11882 cases. One of the authors, Tao Lin, a professor of Dentistry at Illinois State University in the United States, said that the number would be higher if the people who gave up medical or conservative treatment for economic reasons, as well as doctors at grass-roots hospitals, or other provinces because they could not wait for a bed. Many media have called oral cancer a characteristic tumor in Hunan province. Last December 26th, the Hunan provincial cancer prevention and Control Research Office issued the latest data on the registration of cancer in Hunan. Among the 10 men before the onset of the disease, oral cancer ranked seventh, which was the first ten of all cancers in Hunan province for the first time. Liao Xianzhen, deputy director of the Hunan provincial cancer prevention and Control Research Office, said that the incidence of oral cancer in Hunan province was significantly higher than the national average, especially in urban areas, which was more likely to be related to the local eating habits of Hunan. Causality There are more people eating areca, and those who get OSF will naturally have more, while the rate of cancer of OSF patients is much higher than that of the normal population. Reporters interviewed found that most of these patients in Hunan had a common habit of chewing areca. Wang Hao came into contact with areca from junior high school. After working, he could eat three or four packs a day and a pack of more than a dozen bags of areca in Hunan. The areca could chew him from early to late. This malignant tumor is on the right gingiva that he chews. The history of arecas areca was longer, He Changhong said. In 90s of the last century, when areca was sold in Loudi, her husband began to eat, and at the most, it could eat four or five packs a day. Xiangya Second Hospital Oral and maxillofacial surgery director Wu Hanjiang introduced, at present Xiangya Second Hospital of oral cancer patients, about 80% of the accompanying areca eating habits. The proportion of Xiangya Hospital is higher. According to the Xiangya Hospital official network, 13-14 April, the Chinese Stomatological Association and other experts team went to the Department of Stomatology investigation in the Department of Stomatology. Roughly statistics, 45 people in the hospital of oral surgery now 50 patients have oral cancer, of which 44 have a long history of chewing areca disease, this proportion is very astonishing, the situation of tumor prevention and control is very strict. Stern. Chewing areca can cause oral submucosal fibrosis (hereinafter referred to as OSF), and OSF is a precancerous lesion, the president of the Hunan Stomatological Association and the director of the Institute of oral precancerous lesions, Central South University, in 2014, published in the International Journal of oral medicine. Chronic pathological processes over a long period of time are abominable to become oral cancers. The study of Professor Zhang Xiaolin of Peking University School of Stomatology at Peking University showed that the prevalence rate of OSF in Chinese chewing areca was about 0.9%-4.7%, most in the age group of 30-39, followed by the 40-49 year old group. Studies also show that the prevalence of OSF is younger. However, there is also a view that there is no direct causal relationship between areca and oral cancer. Yang Xun, President of the areca Food Industry Association of Hunan Province, provided a copy of the different opinions and information on the areca carcinogenesis by the areca Association of areca, which wrote that the WHO had identified the first class carcinogen as a first grade carcinogen, based on the situation in South Asia, Southeast Asia and the Taiwan region of China. Survey statistics or conclusions were not sampled in Hunan. In this report, areca Hunan is also carcinogenic. Yang Xun explained that the way Hunan people eat areca is different from other parts of the world where there are chewing areca habits. Southeast Asia is a fresh food of areca, which is eaten together with shellfish, and India is crushed by areca, wrapped in tobacco, and dipped in perfume and spices. The Hunan areca is drying the areca fresh fruit, slicing, removing nucleation, and brine. The edible part is the fiber shell of the dried fruit of areca. Yang Xun believes that Hunan areca does not add leaves or tobacco, and the food additives in processing are in line with the scope permitted by the national standard. Therefore, although the proportion of OSF in Chinese mainland to eat areca is high, the proportion of OSF to oral cancer is not high, only 1.2%-2.6%, which also shows that there is no direct causal link between cancer and Hunan areca. Tang Jieqing, director of Xiangtan stomatological hospital, supported Yangs view. He guessed whether areca Hunan had destroyed certain factors or even carcinogens in the process of processing. Tang Jieqing also said whether OSF or even oral cancer would be associated with individual sensitivity, who had been chewed for a long time and didnt get OSF, and the time for someone to chew was not long. Although not all people chewing areca will get OSF, not all people who have OSF will suffer from oral cancer, but there are more people who eat areca, more people who have OSF, and the cancer rate of OSF patients is far higher than that of normal people, said he Zhi Jing, chief physician of oral and maxillofacial surgery in the second hospital of Xiangya, to make this part of the people aware. The severity of the problem. The inseparable areca It is addictive. You always think of this thing, as long as there is a areca to the mouth, there is a sense of satisfaction. In recent years, Wang Hao has discovered some of his changes. As a native of Changsha, he used to eat spicy and how to taste it, but as he chewed areca for a long time, he ate chili, and his mouth was hot and hot. I havent eaten chili for years. He Zhijing, the chief physician of oral and maxillofacial surgery in Xiangya Second Hospital, says OSF patients are more sensitive to pain and chili, because their oral cavity is not only mucous fibrosis, but there are some epithelial lesions, local inflammation, and stimulation of nerve endings to make the nerve more sensitive. Can not eat spicy, can not eat cold, mouth can not open, say more pain, mucous membrane bleeding...... With more and more abnormal symptoms, Wang Hao suspected the areca head, thinking of the areca quit, but do not eat heart is very difficult, quit several times to quit. When you see someone else will eat, you will buy it. Changsha people Cheng Yu (the pseudonym) is also a heavy areca addict, he described to the new Beijing newspaper reporters after the feeling of his addiction, if you do not eat areca, it feels that the six gods, it is addictive. You always think of this thing, as long as there is a areca into the mouth, there is a sense of satisfaction, but as long as you eat one, you will have the desire to continue to eat, depending on your own control is difficult to solve this problem. Cheng Yu has 20 years of areca history, when more than 6-8 bags a day to eat, one day to buy areca will spend 200 yuan, after eating, teeth completely loose still can not stop. Professor Yan Wansen of the medical psychology teaching and Research Department of Guizhou Medical University told the new Beijing News reporter that areca is the fourth most common type of psychoactive substances in the world after tobacco, alcohol and caffeine, and the incidence of areca addiction is up to 50% in the chewing areca population. Xiangtan CDC had carried out an epidemiological survey on the situation of chewing areca in urban and rural residents in Hunan province. The results showed that the rate of chewing areca in Hunan was 38.40%, of which 42.65% in urban areas and 34.12% in rural areas. Xiangtan is higher. The chewing rate of Xiangtan people is 58.81%, of which the masticatory rate of male areca is 62.45%. In Xiangtan, chewing areca has a long history. The chronicles of Xiangtan county records that during the Qing Emperor Qianlong period, the Xiangtan epidemic and people suffered from bulging. Bai Jingan, a county magistrate, distributed areca to patients for chewing, and the disease and disease disappeared. Since then, Xiangtan people chewing areca has gradually become a habit. Xiangtan citizen Hu Yiming (pseudonym) said, in Hunan, especially in Xiangtan, the atmosphere of chewing areca is very strong, everyone together, there is that atmosphere in, you do too alternative is not ah. He thinks areca is a bit like smoking in social functions, but its different from smoking, because smoking is harmful to health is now popular. If you dont smoke, people will feel normal, but if you dont chew on areca, people will feel you dont fit in. Hu Yiming introduced, Xiangtan area marriage and funeral marriage can not be separated from the areca, who works, the door two plates, a plate is scattered smoke, the other plate is the bulk of areca, the guests take their own. Wu Xianhua, director of the law teaching and Research Department of the Party School of Changsha Municipal Committee, believes that the overwhelming areca advertisement is also an important reason to induce the public to eat areca. Areca advertising makes people feel we have such wonderful things around us. If you dont enjoy it, its a waste of life! Reporters noted that in Hunan, areca advertising is very common, subway stations, bus stops, building elevators are everywhere. There are some areca brand advertisements on the highway leading to Zhangjiajie on Changshas high-speed rail line to Beijing. On the packaging bags of some areca brands, the no chewing, not burning the mouth, the foot of the foot, fear of challenge, and innate character are on the advertising language. The family members of an oral cancer patient in Xiangya Hospital say that the advertisements of some brands of areca are very fashionable. It seems that you are behind the times if you dont eat. A areca manufacturer also named the two Hunan satellite TV Spring Festival Gala and the Lantern Festival. More areca brand has invited some entertainment and sports stars to speak. In Changsha, almost all the smoke hotels, small supermarkets, convenience stores, the doorway of the door has a areca shelf, put all brands, various flavors of areca. From time to time, you can see chewing areca on the street, sending out a middle-aged areca man with a sweet taste. An awkward identity The safety and location of food areca is not clear in China at present, and requires Hunan to suspend the revision of all food safety standards related to areca consumption. Hunans areca food industry association president Yang Xuns top priority is to win a clear food status for areca in Hunan. If areca is able to make local standards for food safety, it means that areca can get a clear food identity, which is more conducive to arecas sales outside Hunan. Yang Xun said that before the production of areca was in accordance with the Hunan provincial standard? Food areca issued by the Hunan provincial quality and Technical Supervision Bureau in 2004, after the introduction of the food safety law, the management of areca standards was responsible for the health department, and the standard should be reformulated as the local standard for food safety. Since 2009, Hunans health authorities have been hoping to set up arecas local standards for food safety, but they have been frustrated at the level of expert proof and the National Health Planning Commission. In May 20, 2015, the State Health Planning Commission wrote a written reply to the Hunan Provincial Health Planning Commission: in May 20, 2015, the international cancer research center ranked areca as the first class carcinogen. The fifth article of local standards for food safety standards stipulates that the establishment of local food safety standards should be aimed at ensuring the health of the public and on the basis of the results of the risk assessment of food safety, taking full consideration of the local food characteristics and eating habits. In view of the fact that the international authoritative medical institutions have been settled, you should make decisions in accordance with the law and prudence. At the end of 2016, the national food safety assessment center told the Hunan provincial Wei Planning Commission that the safety and positioning of food in our country are not clear at present, and that Hunan is required to suspend the revision of all food safety standards related to the consumption of areca. In November 15, 2017, the Hunan Provincial Planning Commission responded to the proposal of a deputy to the NPC, saying: arecas food location and safety are not clear. According to the provisions of the food safety law, food should be non-toxic, harmless, meet the needs of nutrition, and do not cause any acute, subacute or chronic harm to human health. The state is currently placing areca as a drug into the Peoples Republic of China Pharmacopoeia, and does not include areca in the catalogue of articles that are traditionally both food and Chinese medicine. According to Guangming Daily, the total output value of Hunans areca industry has exceeded 30 billion yuan, accounting for 3/4 of the total output value of areca. The Xiangtan County Peoples governments opinion on supporting the development of areca industry in August 2017 said that it is necessary to build a famous areca cultural city in China to make the areca industry bigger and stronger, to ensure that the sales revenue of the areca industry will achieve 30 billion yuan after three years, and to achieve the target of 50 billion yuan in five years. Yang Xun introduced that in recent 20 years, the areca industry in Hunan has been expanding. At present, there are 300 thousand industrial workers, forming a whole industry chain including processing, logistics, warehousing, marketing and other links. Product market is also expanding, our Hunan areca, our country in addition to the Taiwan region, everywhere else. The expanding areca industry has brought a lot of tax revenue to local governments. Yang Xun said that Xiangtan, Yiyang and other places, areca enterprises are important tax revenue. But there are studies showing that the economic contribution of areca industry will be offset by the medical burden it causes. A paper, entitled predicting the number and burden of oral cancer induced by areca in China, is mentioned. According to the current trend, by 2030, areca related oral cancer cases may accumulate more than 300 thousand in Hunan, the national conservative estimate may exceed 1 million, the medical burden caused by areca related oral cancer in the country, With a conservative estimate of 200 thousand yuan per case, the cumulative total may exceed RMB 200 billion yuan, which is enough to offset its economic contribution to the society. Advice and sound Hunan Health Planning Commission said that it would speed up the establishment of areca safety assessment and recommend that areca be classified as a hobby product. Under the dispute, areca began to change. A senior areca executive in Xiangtan said long term chewing areca did have some effects on the teeth and the inner wall of the mouth, and the added brine alkalinity would have an impact on the mouth, so they were committed to softening the areca, reducing the alkalinity to a proper degree. The areca association is also in action. Yang Xun said they suggested that areca companies have chewing areca too much, harmful to oral health on arecas outer packaging, but he admits that the proposal is not mandatory. Yang Xun also suggested that they should not sell areca to minors. However, the Beijing News reporter visited a number of areca shops, the owners said they had not received such notice. According to media reports, 24 federations and 3 federal territories in 6 federal territories of 29 states in India have legislated against the sale of areca. Since November 2013, Papua and New Guinea have banned the sale and consumption of areca. In September 1996, the Xiamen municipal government issued the strictest areca ban in the world. In 1997, the Taiwan area will be designated as areca Prevention Day every December 3rd, vigorously publicizing its harm and calling on people not to chew areca. Tao Lin, a professor at the Illinois State University School of Dentistry, believes that there is a precedent for the ban on areca. However, taking into account the local economy and employment, areca can be managed by the government as a cigarette as a cigarette, limiting the age of the user, such as minors and pregnant women, and a moderate amount of food. The government has not lost taxes through high taxation, and areca manufacturers and a large number of practitioners can survive. In May 3rd, the comprehensive supervision department of the Hunan Provincial Health Planning Commission responded to the Beijing news report that the provincial government should lead the government to coordinate the relevant departments to start the research and evaluation of the safety of areca as soon as possible; to speed up the upgrading of enterprises upgrading technology and to explore ways and measures to reduce the physical and chemical damage to human body by eating areca. The use of areca is harmful to the pathogenic factors. Hunan Province Health Planning Commission believes that the safety assessment of areca has not been approved by the authority of the state, and the food location is not yet clear, and the food areca can not enter the food safety standard system to manage. On the premise of taking full consideration of the current situation of the industry, it is suggested to speed up the promotion of areca safety assessment on the one hand, and on the other hand, the areca industry association promotes the development of the industry standards for the consumption of areca. At the same time, according to expert advice, areca is classified as a hobby product. All day care for her husband on the bed, he Chang Hong feels exhausted. In April 18th, the army, who had been lying on the bed, was suddenly excited. He waved his hands, signaled his wife to bring his bedside notebook and wrote down a line of words - the government must strike for the quality of the whole people. He raised his book high in front of the reporter. Source: Beijing News Editor: Zhang Haitong _NN9053 In May 3rd, the comprehensive supervision department of the Hunan Provincial Health Planning Commission responded to the Beijing news report that the provincial government should lead the government to coordinate the relevant departments to start the research and evaluation of the safety of areca as soon as possible; to speed up the upgrading of enterprises upgrading technology and to explore ways and measures to reduce the physical and chemical damage to human body by eating areca. The use of areca is harmful to the pathogenic factors. Hunan Province Health Planning Commission believes that the safety assessment of areca has not been approved by the authority of the state, and the food location is not yet clear, and the food areca can not enter the food safety standard system to manage. On the premise of taking full consideration of the current situation of the industry, it is suggested to speed up the promotion of areca safety assessment on the one hand, and on the other hand, the areca industry association promotes the development of the industry standards for the consumption of areca. At the same time, according to expert advice, areca is classified as a hobby product. All day care for her husband on the bed, he Chang Hong feels exhausted. In April 18th, the army, who had been lying on the bed, was suddenly excited. He waved his hands, signaled his wife to bring his bedside notebook and wrote down a line of words - the government must strike for the quality of the whole people. He raised his book high in front of the reporter.