Publishing type：Research paper (scientific journal)  

Background: The modern 24/7 society demands night shift work, which is a possible risk factor for chronic diseases. This study aimed to examine the associations of rotating night shift work duration with tooth loss and severe periodontitis. Methods: This cross-sectional study used data from a self-administered questionnaire survey conducted among 3,044 permanent employees aged 20–64 years through a Japanese web research company in 2023. The duration of rotating night shift work was assessed using a question from the Nurses’ Health Study. Tooth loss was assessed based on self-reported remaining natural teeth count. Severe periodontitis was assessed using a validated screening questionnaire comprising four questions related to gum disease, loose tooth, bone loss, and bleeding gums. We employed linear regression models for tooth loss and Poisson regression models for severe periodontitis, adjusting for demographic, health and work-related variables and socioeconomic status. Results: Among participants included, 10.9% worked in rotating night shifts for 1–5 years, while 11.0% worked in such shifts for ≥6 years. In fully adjusted models, rotating night shift work duration of 1–5 years was associated with tooth loss (beta −0.74, 95% confidence interval (CI) [−1.55 to 0.08]) and severe periodontitis (prevalence ratio 1.80, 95% CI [1.33–2.43]); however, the association with tooth loss was not statistically significant. Conclusions: This study supports that employees who work short-term rotating night shifts may experience poor oral conditions. Further research is needed to determine whether long-term rotating night shift work is associated with deteriorated oral health.

DOI： 10.7717/peerj.17253

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Background: Physicians in public health administration agencies (public health physicians: PHP) play important roles in public health; however, there are not enough such physicians in Japan. This study aimed to elucidate the factors related to the resignation and migration of PHPs using nationwide survey data. Methods: Data from the Survey of Physicians, Dentists, and Pharmacists (2010, 2012, 2014, and 2016) were analyzed. The outcome was the resignation of PHPs or migration to public health administration agencies. The explanatory variables in the resignation analysis were age, sex, workplace, and board certification status. The type of work was added as an explanatory variable in the migration analysis, and clinical specialty was added to the clinical doctor-restricted analysis. The odds ratios (ORs) of the explanatory variables were calculated using generalized estimation equations. Results: In the resignation analysis among PHPs, women had a significantly lower OR, whereas younger PHPs and those with board certifications had significantly higher ORs. In the migration to public health administration agencies analysis among medical doctors, women and those aged between 35 and 39 years had significantly higher ORs, but those with board certifications had significantly lower ORs. Hospital/clinic founders or directors had significantly lower ORs, but the clinic staff and ‘others/not working’ had significantly higher ORs. In the migration to public health administration agencies analysis among clinical physicians, those aged between 35 and 39 years had significantly higher ORs. Still, those with two or more board certifications had significantly lower ORs. Hospital/clinic founders or directors had significantly lower ORs, but the clinic staff had significantly higher ORs. Clinical doctors specializing in surgery and other specialties had significantly lower ORs, but those specializing in pediatrics and psychiatry/psychosomatic medicine had significantly higher ORs. Conclusions: Having board certifications were significantly related to the resignation of PHPs and migration to public health administration agencies. Women migrated to public health administration agencies more than men and younger PHPs were more likely to resign. However, medical doctors aged between 35 and 39 years were more likely to migrate to public health administration agencies. Similarly, clinic staff, non-clinical physicians, and those whose specialties were pediatrics and psychiatry/psychosomatic medicine were more likely to migrate to public health administration agencies.

DOI： 10.1186/s12913-023-10085-7

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Background The government of Japan has spent a significant amount on dental healthcare, but it remains unknown how the spending varies across age, type of service, and time. This study describes trends in dental expenditures in Japan. Methods This descriptive study used two national data sources: Estimates of National Medical Care Expenditure and Survey on Economic Conditions in Health Care. We obtained annual total and average per capita dental expenditures by age in Japan from 1984 to 2020 and estimated the proportions of types of service from 1996 to 2021. All costs were adjusted for the 2020 Consumer Price Index (1 US dollar ≈ 100 yen in 2020). Results Total dental expenditures increased from 1.96 trillion yen in 1984 to 3.00 trillion yen in 2020. In particular, total and average per capita dental spending for older persons showed a rapid increase (total: from 185 billion yen in 1984 to 1.18 trillion yen in 2020; average per capita: from 15,500 yen in 1984 to 32,800 yen in 2020), contributing to the total amount increase. The crown restoration and prosthesis category amounted to 50.3% of the total expenditure in 1996, and this proportion declined to 32.4% by 2021. In 0-14 years persons, expenses on the crown restoration and prosthesis category decreased while the medical management category (mainly including fees for a management plan for oral diseases or oral functions) increased. In persons aged 65 years or older, expenses on the crown restoration and prosthesis category decreased, with increasing expenses in the medical management and athome treatment categories. Conclusion The amount of dental spending in Japan substantially increased from 1.96 trillion yen in 1984 to 3.00 trillion yen in 2020), a 1.53-fold increase. The observed changes in annual dental spending varied across age groups and types of service.

DOI： 10.1371/journal.pone.0292547

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Publishing type：Research paper (scientific journal)   Publisher：BMJ  

Objectives

Multimorbidity is defined as the coexistence of two or more chronic physical or psychological conditions within an individual. The association between maternal multimorbidity and adverse perinatal outcomes such as preterm delivery and low birth weight has not been well studied. Therefore, this study aimed to investigate this association.

Methods

We conducted a prospective cohort study using data from the Japan Environment and Children’s Study of pregnant women between 2011 and 2014. Those with data on chronic maternal conditions were included in the study and categorised as having no chronic condition, one chronic condition or multimorbidities. The primary outcomes were the incidence of preterm birth (PTB), low birth weight (LBW) and small for gestational age (SGA). Adjusted logistic regression was performed to estimate ORs (aORs) and 95% CIs.

Results

Of the 104 062 fetal records, 86 885 singleton pregnant women were analysed. The median maternal age and body mass index were 31 years and 20.5 kg/m², respectively. The prevalence of pregnant women with one or more chronic conditions was 40.2%. The prevalence of maternal multimorbidity was 6.3%, and that of PTB, LBW, and SGA were 4.6%, 8.1%, and 7.5%, respectively. Pre-pregnancy underweight women were the most common, observed in 15.6% of multimorbidity cases, followed by domestic violence from intimate partner in 13.0%. Maternal multimorbidity was significantly associated with PTB (aOR 1.50; 95% CI 1.33–1.69), LBW (aOR 1.49; 95% CI 1.35–1.63) and SGA (aOR 1.33; 95% CI 1.20–1.46).

Conclusion

Maternal multimorbidity was associated with adverse perinatal outcomes, including PTB, LBW and SGA. The risk of adverse perinatal outcomes tends to increase with a rise in the number of chronic maternal conditions. Multimorbidity becomes more prevalent among pregnant women, making our findings important for preconception counselling.

DOI： 10.1136/bmjopen-2022-069281

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Language：Japanese   Publisher：(一社)日本衛生学会  

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Language：English   Publishing type：Research paper (scientific journal)  

BACKGROUND: Internal medicine (IM) doctors in Japan play the role of primary care physicians; however, the shortage of rural physicians continues. This study aims to elucidate the association of age, sex, board certification, type of work, and main clinical work with the retention or migration of IM doctors to rural areas. METHODS: This retrospective cohort study included 82,363 IM doctors in 2010, extracted from the national census data of medical doctors. The explanatory variables were age, sex, type of work, primary clinical work, and changes in board certification status. The outcome was retention or migration to rural areas. The first tertile of population density (PD) of municipalities defined as rural area. After stratifying the baseline ruralities as rural or non-rural areas, the odds ratios (ORs) of the explanatory variables were calculated using generalized estimation equations. The analyses were also performed after age stratification (<39, 40-59, ≥60 years old). RESULTS: Among the rural areas, women had a significantly higher OR for retention, but obtaining board certification of IM subspecialties had a significantly lower OR. Among the non-rural areas, physicians who answered that their main work was IM without specific subspecialty and general had a significantly higher OR, but obtaining and maintaining board certification for IM subspecialties had a significantly lower OR for migration to rural areas. After age stratification, the higher OR of women for rural retention was significant only among those aged 40-59 years. Those aged under 40 and 40-59 years in the non-rural areas, who answered that their main work was IM without specific subspecialty had a significantly higher OR for migration to rural areas, and those aged 40-59 years in the rural areas who answered the same had a higher OR for rural retention. CONCLUSIONS: Obtaining and maintaining board certification of IM subspecialties are possible inhibiting factors for rural work, and IM doctors whose main work involves subspecialties tend to work in non-rural areas. Once rural work begins, more middle-aged female IM doctors continued rural work compared to male doctors.

DOI： 10.1265/ehpm.22-00169

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Language：English   Publishing type：Research paper (scientific journal)  

OBJECTIVE: This cross-sectional study aimed to examine factors potentially associated with psychological distress among undergraduate students during the coronavirus disease 2019 pandemic in Japan. METHODS: We analysed data of 958 undergraduates (median age 20 years; 56.8% women) from a web-based, self-administered questionnaire survey conducted from August to September 2020. Prevalence ratios (PRs) for psychological distress defined as 5 points or over of the Kessler Psychological Distress Scale (K6) were calculated by Poisson regression models. RESULTS: The proportion of psychological distress was 40.0%. In the mutually-adjusted model, the following were significantly associated with psychological distress: decreases in household income to 50-99% of the pre-pandemic amount compared to no change (PR = 1.48), newly experiencing unpaid wages compared to no experience (PR = 1.44), insufficient money to buy necessities compared to no shortage (PR = 1.45), receiving a student loan or scholarship compared to none (PR = 1.27), and communication one to three times a month compared to at least once a week (PR = 1.22). In contrast, school closure during the pandemic compared to no closure was inversely associated with psychological distress (PR = 0.78). CONCLUSIONS: Among undergraduate students in Japan, economic difficulties significantly predicted psychological distress.

DOI： 10.1017/dmp.2022.245

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Publishing type：Research paper (scientific journal)   Publisher：Springer Science and Business Media LLC  

<title>Abstract</title><sec>
<title>Background</title>
The extremes of maternal pre-pregnancy body mass index (BMI) are known to be risk factors associated with obstetric and adverse perinatal outcomes. Among Japanese women aged 20 years or older, the prevalence of underweight (BMI &lt; 18.5 kg/m²) was 11.5% in 2019. Maternal thinness is a health problem caused by the desire to become slim. This study aimed to investigate the association between the severity of maternal low pre-pregnancy BMI and adverse perinatal outcomes, including preterm birth (PTB), low birth weight (LBW), and small-for-gestational age (SGA).


</sec><sec>
<title>Methods</title>
We conducted a prospective cohort study using data from the Japan Environment and Children’s Study, which recruited pregnant individuals between 2011 and 2014. Pre-pregnancy BMI was categorized as severe-moderate underweight (BMI <underline>&lt;</underline> 16.9 kg/m²), mild underweight (BMI, 17.0–18.4 kg/m²), low-normal weight (BMI, 18.5–19.9 kg/m²), high-normal weight (BMI, 20.0–22.9 kg/m²), overweight (BMI, 23.0–24.9 kg/m²), and obese (BMI ≥ 25.0 kg/m²). The high-normal weight group was used as the reference for statistical analyses. Adjusted logistic regression was performed to evaluate the association between pre-pregnancy BMI and PTB, LBW, and SGA.


</sec><sec>
<title>Results</title>
Of 92,260 singleton pregnant individuals, the prevalence was 2.7% for severe-moderate underweight, 12.9% for mild underweight, and 24.5% for low-normal weight. The prevalence of adverse outcomes was 4.6% for PTB, 8.1% for LBW, and 7.6% for SGA. The adjusted odds ratios (aORs) for PTB were 1.72 (95% confidence interval [CI], 1.46–2.03) for severe-moderate underweight and 1.26 (95% CI, 1.14–1.39) for mild underweight. The aORs of LBW were 2.55 (95% CI, 2.27–2.86) for severe-moderate underweight, 1.64 (95% CI, 1.53–1.76) for mild underweight, and 1.23 (95% CI, 1.16–1.31) for low-normal weight. The aORs of SGA were 2.53 (95% CI, 2.25–2.84) for severe-moderate underweight, 1.66 (95% CI, 1.55–1.79) for mild underweight, and 1.29 (95% CI, 1.21–1.38) for low-normal weight.


</sec><sec>
<title>Conclusions</title>
A dose-response relationship was found between the severity of low pre-pregnancy BMI and PTB, LBW, and SGA. Even low-normal BMI (18.5–19.9 kg/m²) increased the risk of LBW and SGA. This study provides useful information for pre-conception counseling in lean individuals.


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DOI： 10.1186/s12884-022-04418-3

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Other Link： https://link.springer.com/article/10.1186/s12884-022-04418-3/fulltext.html

Publishing type：Research paper (scientific journal)   Publisher：SAGE Publications  

Although children with orofacial clefts have an increased risk for sleep-disordered breathing, no studies have examined the association of sleep duration. Thus, this study aimed to examine associations between orofacial clefts and sleep duration at 1 month, 6 months, 1 year, and 3 years of age in Japan.

A cohort study from the Japan Environment and Children's Study.

This study consisted of 91 497 children, including ones with isolated cleft lip and palate (n = 69), isolated cleft lip only (n = 48), and isolated cleft palate only (n = 37), for which recruitment was undertaken during 2011 to 2014.

Seep durations (hours per day) at 1 month, 6 months, 1 year, and 3 years of age, as reported by their mothers.

In the control group, mean sleep durations and standard deviations at 1 month, 6 months, 1 year, and 3 years of age were 15.2 (2.5), 13.6 (1.9), 12.9 (1.6), and 11.6 (1.2) h, respectively. Compared to the control group, linear regression models reported effect sizes and 95% confidence intervals shorter than 1 h for sleep duration of each type of isolated orofacial cleft at each time point.

This study suggested null associations between isolated orofacial clefts and sleep duration at 1 month, 6 months, 1 year, and 3 years of age. Children with isolated orofacial clefts had sufficient mean sleep duration.

DOI： 10.1177/10556656221128425

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Publishing type：Research paper (scientific journal)   Publisher：Wiley  

DOI： 10.1111/cga.12496

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Publishing type：Research paper (scientific journal)   Publisher：Elsevier BV  

Urinary cotinine concentration (UCC) reflects smoking status. However, in pregnant women, its association with adverse birth outcomes related to fetal growth is not widely known. Thus, we aimed to explore this relationship by focusing on dose–response relationships. We investigated 86,638 pregnant women enrolled between 2011 and 2014 in a prospective cohort study in Japan and observed three birth outcomes (preterm birth, low birth weight, and small-for-gestational age). We measured UCC in the second or third trimester, and categorized the participants using cut-off values (negative cotinine concentration, passive cotinine concentration, and active cotinine concentration corresponding to non-smokers, passive smokers, and active smokers, respectively). Logistic regression analyses were conducted to evaluate the risks, and dose–response relationships were visualized using restricted cubic spline curves. Analyses based on self-reported smoking status were also performed. We found that in low active and highly active cotinine concentrations, the adjusted odds ratios (aORs) of birth outcomes were significantly increased (preterm birth, 1.24 [95% CI 1.06–1.46], 1.39 [95% CI 1.19–1.62]; low birth weight, 1.40 [95% CI 1.24–1.58], 2.27 [95% CI 2.05–2.53]; small-for-gestational age, 1.35 [95% CI 1.19–1.52], 2.39 [95% CI 2.16–2.65]). Restricted cubic spline curves demonstrated risk elevations in the active cotinine concentration range. Our research revealed dose–response relationships between UCC during pregnancy and the risks of preterm birth, low birth weight, and small-for-gestational age. Measurement of UCC to ascertain smoking status during pregnancy may be a useful approach for predicting the risks of these birth outcomes.

DOI： 10.1016/j.envres.2022.114302

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Language：English   Publishing type：Research paper (scientific journal)  

OBJECTIVE: Previous studies have indicated that spatial variation in suicide mortality is associated with area-specific socioeconomic characteristics, such as socioeconomic deprivation and social fragmentation. However, most of these studies have been conducted in the West and findings from Asian countries are limited. This study aims to investigate associations between socioeconomic characteristics and suicide mortality rates across 1887 municipalities in Japan between 2009 and 2017. We also assessed these associations by gender and age group. METHODS: Suicide data were obtained from the suicide statistics of the Ministry of Health, Labour and Welfare in Japan and included information on the number of suicides by gender, age and municipality location. Social fragmentation, socioeconomic deprivation and urbanicity were used as socioeconomic characteristics in this study and were created from survey data obtained from the 2010 census. Bayesian hierarchical models were used to examine associations between socioeconomic characteristics and suicide risk. RESULTS: Suicide rates were significantly higher in municipalities with higher levels of deprivation, with a rate ratio of 1.13 (95% credible interval: 1.10 to 1.17) in the highest quartile compared with the lowest. Higher levels of urbanicity had significantly lower suicide rates, with a rate ratio of 0.79 (95% credible interval: 0.77 to 0.82) in the highest quartile compared with the lowest. However, associations between exposures and suicide varied considerably by gender and age. Among both men and women aged 0-39 years, fragmentation was significantly associated with suicide, with rate ratios of 1.07 and 1.15 for men and women, respectively, in the highest quartile compared with the lowest. CONCLUSION: Suicide prevention in Japan should particularly focus on areas with high levels of deprivation or low levels of urbanicity. Furthermore, young Japanese people residing in the most fragmented municipalities were also at high risk of suicide, and appropriate measures need to be taken.

DOI： 10.1136/bmjopen-2022-063255

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Language：English   Publishing type：Research paper (scientific journal)  

Background: The COVID-19 pandemic is negatively impacting mental health globally. While increased social cohesion may have initially decreased suicide risk, there are few reports on the long-term impact. We examined the impact of the pandemic on suicide by gender and age through December 2021 in Japan. Methods: We analyzed trends in monthly suicide rates by age and gender from January 2016 to December 2021 using provisional mortality data in an interrupted time series analysis. We also considered linear trends in the pre-pandemic period and seasonal variations. Pandemic onset was defined as from April 2020. Estimated excess deaths by suicide that occurred during the pandemic were calculated. Findings: Excess number of suicide deaths during the pandemic period was estimated to be 1208 for men and 1825 for women. While there was no statistically significant increase in suicide rates overall for both men and women during the pandemic compared to the pre-pandemic, age-specific analyses showed a statistically significant increase in men 20-29 and 40-49 years, and in women of all age groups, except those under 20, 40-49 and over 80 years. Interpretation: The COVID-19 pandemic has had a negative impact on suicide rates in Japan and the impact is most pronounced in women and younger age groups. Subgroup analyses are needed, with a particular focus on those considered to be vulnerable and at increased suicide risk. Funding: A Grant-in-Aid for scientific research from the Ministry of Education, Culture, Sports, Science and Technology of Japan (Award Number 21K10462).

DOI： 10.1016/j.lanwpc.2022.100480

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Language：Japanese   Publisher：北海道公衆衛生学会  

医師の出身地が地方であること、入試形態が地域枠であること、地方勤務の義務がある奨学金受給をしていることが地方勤務の意思と関連するのか明らかにすることを目的とした。旭川医科大学卒業生の質問票調査により、出身地が都市部か地方か、入試形態が地域枠入試であるか否か、地方勤務義務の義務がある奨学金の受給をしていたか否か、地方勤務の意思があるか否かを把握した。多変量ロジスティック回帰にて地方勤務の意思ありとなるオッズ比(OR)を算出した。都市部勤務者では地域枠入試のOR=3.11と有意に大きく、地方勤務者では地域枠入試のOR=0.17と有意に小さかった。北海道出身者のみに限定した場合、地域枠入試、地方勤務義務のある奨学金はORが有意に大きかった。さらに北海道出身者の都市部勤務者では、地域枠入試の地方勤務の意思ありに対するORが有意に大きかった。地域枠入学者と地方勤務の義務がある奨学金は地方勤務の継続につながる可能性が考えられた。(著者抄録)

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Publishing type：Research paper (scientific journal)   Publisher：Wiley  

This prospective cohort study aimed to examine the associations between mold growth, type of stoves, and fragrance materials and early childhood wheezing and asthma, using data from the Japan Environment and Children's Study. Mold growth at home, usage of kerosene/gas stove, wood stove/fireplace, and air freshener/deodorizer were surveyed using a questionnaire at 1.5-year-old, and childhood wheezing and doctor-diagnosed asthma during the previous year were obtained using a 3-year-old questionnaire. Multilevel logistic regression analysis was performed to evaluate the association between exposure to childhood wheezing and asthma. A total of 60 529 children were included in the analysis. In multivariate analyses, mold growth and wood stove/fireplace had significantly higher odds ratios (ORs) for wheezing (mold growth: 1.13; 95% CI, 1.06−1.22; wood stove/fireplace: 1.23; 95% CI, 1.03−1.46). All four exposures had no significant ORs for childhood doctor-diagnosed asthma; however, in the supplemental analysis of northern regions, wood stove/fireplace had a significantly higher OR for asthma. Mold growth and wood stove/fireplace had significant associations with childhood wheezing in the northern regions. Mold elimination in the dwellings and use of clean heating (no air pollution emissions) should be taken into consideration to prevent and improve childhood wheezing and asthma.

DOI： 10.1111/ina.12931

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Publishing type：Research paper (scientific journal)   Publisher：National Institute of Industrial Health  

The association between oral diseases and work productivity loss remains unclear. This study examined whether dental caries, tooth loss, and poor periodontal status were associated with absenteeism and presenteeism. This cross-sectional study used two independent datasets: 184 employees at a medical university and 435 employees from among the registrants of an online research company. Absenteeism and presenteeism, according to the World Health Organization Health and Work Performance Questionnaire, were dependent variables. The independent variables were the number of decayed and filled teeth (DFT), missing teeth (MT), and selfreported periodontal status. Multivariable linear regression models were developed to estimate unstandardised coefficients with 95% confidence intervals (CIs) for absenteeism and presenteeism. After adjusting for covariates, among the 435 employees enrolled from among the registrants of an online research company, poor periodontal status was significantly associated with a 7.8% (95%CI = −14.5, −1.0) decline in presenteeism but not absenteeism. DFT and MT were not significantly associated with either absenteeism or presenteeism in both populations. Given that periodontal status was potentially associated with a 7.8% decline in work performance, occupational specialists, managers, and dental health professionals should be aware of the impact on work productivity.

DOI： 10.2486/indhealth.2021-0274

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Language：English   Publishing type：Research paper (scientific journal)  

Background: Psychological stress is a potential risk factor for oral diseases. However, evidence for the association between work stress and oral diseases is scarce. We aimed to examine the associations of work stress, according to the effort-reward imbalance model, with dental caries, periodontal status, and tooth loss. Methods: This cross-sectional study included 184 regular employees at a medical university and 435 registrants of a web research company. Work stress was assessed using the effort-reward imbalance (ERI) ratio. Dental caries and tooth loss were assessed according to the number of decayed, filled, and missing teeth (DMFT) among the set of 28 teeth. Periodontal status was assessed using a self-administered questionnaire. For the DMFT, a linear regression model was used to estimate the unstandardised coefficients. A Poisson regression model was used to estimate the prevalence ratios (PRs) of poor periodontal status. Results: Among medical university employees and employees enrolled from among the registrants of an online research company, a one-unit increase in the ERI ratio was associated with -2.81 (95% CI [-4.70 to -0.92]; p-value = 0.004) and -0.84 (95% CI [-1.80 to 0.12]; p-value = 0.085) changes in the DMFT from adjusted linear regression models, respectively. In employees enrolled from among the registrants of an online research company, a one-unit increase in the ERI ratio was also associated with 1.55 (95% CI [1.04-2.32]; p-value = 0.032) of the PR for poor periodontal status based on Poisson regression models. Conclusion: ERI at work was associated with an increased risk of poor periodontal status.

DOI： 10.7717/peerj.13792

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Publishing type：Research paper (scientific journal)   Publisher：Springer Science and Business Media LLC  

<title>Abstract</title><sec>
<title>Background</title>
The influence of maternal psychological distress on infant congenital heart defects (CHDs) has not been thoroughly investigated. Furthermore, there have been no reports on the combined effect of maternal psychological distress and socioeconomic status on infant CHDs. This study aimed to examine whether maternal psychological distress, socioeconomic status, and their combinations were associated with CHD.


</sec><sec>
<title>Methods</title>
We conducted a prospective cohort study using data from the Japan Environment and Children’s Study, which recruited pregnant women between 2011 and 2014. Maternal psychological distress was evaluated using the Kessler Psychological Distress Scale in the first trimester, while maternal education and household income were evaluated in the second and third trimesters. The outcome of infant CHD was determined using the medical records at 1 month of age and/or at birth. Crude- and confounder-adjusted logistic regression analyses were performed to evaluate the association between maternal psychological distress and education and household income on infant CHD.


</sec><sec>
<title>Results</title>
A total of 93,643 pairs of mothers and infants were analyzed, with 1.1% of infants having CHDs. Maternal psychological distress had a significantly higher odds ratio in the crude analysis but not in the adjusted analysis, while maternal education and household income were statistically insignificant. In the analysis of the combination variable of lowest education and psychological distress, the P for trend was statistically significant in the crude and multivariate model excluding anti-depressant medication, but the significance disappeared in the full model (P = 0.050).


</sec><sec>
<title>Conclusions</title>
The combination of maternal psychological distress and lower education may be a possible indicator of infant CHD.


</sec>

DOI： 10.1186/s12884-021-04001-2

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Language：Japanese   Publisher：日本公衆衛生学会  

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Language：Japanese   Publisher：日本公衆衛生学会  

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Language：Japanese   Publisher：日本公衆衛生学会  

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Language：Japanese   Publisher：日本公衆衛生学会  

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Language：English   Publishing type：Research paper (scientific journal)  

OBJECTIVES: Although psychological stress is a risk factor for oral diseases, there seems to be no review on work stress. This study aimed to review the evidence on the association between work stress and oral conditions, including dental caries, periodontal status and tooth loss. DESIGN: A systematic review of published observational studies. DATA SOURCES: A systematic literature search was conducted in PubMed and Scopus databases on 12 August 2020. STUDY SELECTION: Articles were screened based on the following inclusion criteria: published after 1966; in English only; epidemiological studies on humans (except case studies, reviews, letters, commentaries and editorials); and examined the association of work stress with dental caries, periodontal status and tooth loss. DATA EXTRACTION: Data were extracted from eligible studies. A quality assessment was conducted using the Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies. RESULTS: Of 402 articles identified, 11 met the inclusion criteria, and 1 study assessed the association of work stress with dental caries and periodontal status. Of 11 studies, 1 reported a non-significant association between work stress and dental caries; 8 of 9 studies reported a significant association between work stress and worse periodontal status; and 1 of 2 studies reported a significant association between work stress and tooth loss. Nine of 11 studies were cross-sectional, while the remaining 2 studies had unclear methodology. Only two studies were sufficiently adjusted for potential confounders. Eight studies assessed work stress but did not use the current major measures. Three studies were rated as fair, while eight studies had poor quality. CONCLUSIONS: There is a lack of evidence on the association of work stress with dental caries and tooth loss. Eight studies suggested potential associations between periodontal status and work stress. Cohort studies using the major work stress measures and adjusting for the potential confounders are needed.

DOI： 10.1136/bmjopen-2020-046532

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Publishing type：Research paper (scientific journal)   Publisher：Public Library of Science (PLoS)  

<sec id="sec001">
<title>Background</title>
The influence of mothers’ and fathers’ educational levels in separate evaluations of asthma has not been fully investigated. This study aims to examine the associations of the mother’s and fathers’ educational levels with childhood wheeze and asthma adjusting for crude and pre-and post-natal modifiable risk factors.


</sec>
<sec id="sec002">
<title>Methods</title>
We conducted a prospective cohort study using data from the Japan Environment and Children’s Study, which recruited pregnant women from 2011 to 2014. The mother’s and father’s educational levels were surveyed by a questionnaire during the pregnancy, and childhood wheezing and doctor-diagnosed asthma were estimated using a 3-year questionnaire. Multilevel logistic regression analysis was performed to evaluate the association between the mother’s and father’s educational levels and childhood wheezing and asthma, adjusted for pre-and post-natal factors.


</sec>
<sec id="sec003">
<title>Results</title>
A total of 69,607 pairs of parents and their single infants were analyzed. We found 17.3% of children had wheezing and 7.7% had asthma. In crude analyses, lower educational level of parents was associated with an increased risk of childhood wheezing and asthma. After full adjustment, a lower educational level of mothers was associated with an increased risk of childhood asthma (junior high school (reference: high school); odds ratio (OR): 1.17, 95% CI, 1.01–1.36), and higher educational level, especially the mother’s, was associated with an increased risk of childhood wheezing (technical junior college, technical/vocational college, or associate degree (ECD3); OR: 1.12, 95% CI, 1.06–1.18, bachelor’s degree, or postgraduate degree; OR: 1.10, 95% CI, 1.03–1.18), and asthma (ECD3; OR: 1.13, 95% CI, 1.04–1.21).


</sec>
<sec id="sec004">
<title>Conclusions</title>
Parents’ lower educational level was a crude risk factor for childhood wheezing and asthma. However, an increased risk of wheezing due to mothers’ higher educational level was found after adjusting for pre-and post-natal factors.


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DOI： 10.1371/journal.pone.0250255

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Language：Japanese   Publisher：北海道公衆衛生学会  

今後のかかりつけ医制度推進の資料となることを目的として、旭川医科大学病院に紹介状を持参して初診した患者に質問票調査を行った。対象者の50.9%が大学外来を継続している(逆紹介なし)状況であった。逆紹介なしを従属変数とする多変量ロジスティック回帰分析では、大学病院に入院した・予定、大学病院への通院時間が2時間以内、受診科が2科目以上に有意なオッズ比の上昇を得た。病状が安定した後の通院について地域のかかりつけ医等での受診が推奨されていることへの意見の自由記載では、患者にとって大病院・専門医レベルの治療が継続されることが重要と考えていることが示された。受診初期からの逆紹介を考慮した患者対応と、重症度や複数疾患を考慮し、患者の診療への希望に対して配慮した逆紹介先への適切な連携・調整が重要であると考えられた。(著者抄録)

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Language：Japanese   Publisher：(一社)日本衛生学会  

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Language：Japanese   Publisher：(一社)日本衛生学会  

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OBJECTIVE: This study examined psychological status trajectories of mothers of infants with nonsyndromic orofacial clefts in Japan. DESIGN: Prospective cohort study. SETTING: Data from the Japan Environment and Children's Study. PARTICIPANTS: Infants with a nonsyndromic cleft (N = 148) including cleft lip and palate (CLP; n = 72), cleft lip (CL; n = 46), and cleft palate (CP; n = 30). The control group included unaffected infants (N = 84 454). MAIN OUTCOME MEASURES: At 15 weeks and 27 weeks of pregnancy and 12 months after birth, the Kessler Psychological Distress Scale (clinical cutoff ≥5) was used. At 1 month and 6 months after birth, the Edinburgh Postnatal Depression Scale (clinical cutoff ≥9) was used. RESULTS: Prenatal diagnosis rates were unavailable. Mothers of infants with CLP had higher psychological distress than controls at 27 weeks of pregnancy (prevalence ratio [PR] = 1.36, 95% CI: 1.06-1.74) and postnatal depression at 1 month after birth (PR = 2.21, 95% CI: 1.53-3.19). Mothers of infants with CP showed heightened psychological distress at 27 weeks of pregnancy (PR = 1.62, 95% CI: 1.21-2.17) and postnatal depression 6 months after birth (PR = 1.86, 95% CI: 1.01-3.43). There was no significant association between CL and maternal psychological status. At 12 months after birth, no differences in distress were found between mothers of infants with a cleft and controls. CONCLUSIONS: Mothers of infants with orofacial clefts may need psychosocial support, particularly during pregnancy and the first year after birth.

DOI： 10.1177/1055665620951399

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BACKGROUND: Lower respiratory tract infections (LRTIs) are a cause of inpatient and outpatient care among children. Although orofacial clefts seem to be associated with LRTIs, epidemiological studies are scarce on this topic. This study aimed to examine whether infants with orofacial clefts were associated with LRTIs. METHODS: This prospective cohort study used data from the Japan Environment and Children's Study, whose baseline recruitment was conducted during 2011-2014. This study included 81,535 participants. The number of infants with cleft lip and palate (CLP), cleft lip (CL), and cleft palate only (CP) was 67, 49, and 36, respectively. We defined history of LRTIs until 12 months' age reported by their mothers as the dependent variable. Accumulated breastfeeding duration was used as potential mediators. RESULTS: The incidence proportion of LRTIs among the control group was 6.0%. The incidence proportion among infants with CLP, CL, and CP were 11.9%, 14.3%, and 5.6%, respectively. After adjusting for covariates, compared with the control group, infants with CLP and CL were associated with risk of LRTIs (incidence risk ratio [IRR] of CLP = 2.38 [95% confidence interval = 1.30, 4.36] and of CL = 2.73 [1.40, 5.33]) , but not ones with CP (1.08 [0.28, 4.15]). Accumulated breastfeeding duration decreased the IRR of CLP only (IRR of CLP = 2.16 [1.19, 3.93]). CONCLUSIONS: Infants with orofacial clefts aged 1 year have a potentially high incidence proportion of LRTIs. Accumulated breastfeeding duration might mediate the associations of CLP.

DOI： 10.2188/jea.JE20200438

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PURPOSE: There are notable geographic variations in incidence rates of suicide both in Japan and globally. Previous studies have found that rurality/urbanity shapes intra-regional differences in suicide mortality, and suicide risk associated with rurality can vary significantly by gender and age. This study aimed to examine spatial patterning of and rural-urban differences in suicide mortality by gender and age group across 1887 municipalities in Japan between 2009 and 2017. METHODS: Suicide data were obtained from suicide statistics of the Ministry of Health, Labour and Welfare in Japan. We estimated smoothed standardized mortality ratios for suicide for each of the municipalities and investigated associations with level of rurality/urbanity using Bayesian hierarchical models before and after adjusting for socioeconomic characteristics. RESULTS: The results of the multivariate analyses showed that, for males aged 0-39 and 40-59 years, rural residents tended to have a higher suicide risk compared to urban ones. For males aged 60+ years, a distinct rural-urban gradient in suicide risk was not observed. For females aged 0-39 years, a significant association between suicide risk and rurality was not observed, while for females aged 40-59 years and females aged 60 years or above, the association was a U-shaped curve. CONCLUSION: Our results showed that geographical distribution of and rural-urban differences in suicide mortality in Japan differed substantially by gender and age. These findings suggest that it is important to take demographic factors into consideration when municipalities allocate resources for suicide prevention.

DOI： 10.1007/s00127-020-01978-7

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BACKGROUND: Levels of student loan debt have been increasing, but very little research has assessed if this is associated with poor health. The aim was to examine the association between student loans and psychological distress in Japan. METHODS: We conducted a cross-sectional web-based self-administered questionnaire survey in 2017. The sample comprised of 4,149 respondents aged 20-34, with 3,170 graduates and 979 current university students. The independent variables were whether or not current students had student loans, and for graduates, the total amount of their student loan debt. The dependent variable was severe psychological distress assessed using the Kessler Psychological Distress Scale (K6; the cut-off point was 12/13). Covariates were demographic and parents' socioeconomic variables. A Poisson regression analysis with a robust error variance was conducted to estimate prevalence ratios (PRs) and 95% confidence intervals (CIs). Because there was a significant interaction between current student status and the status of borrowing student loans, stratified analyses were conducted. RESULTS: The percentage of those with student loans was 33.8% among graduates and 35.2% among current university students. Among graduates, student loan debt was significantly associated with a high possibility of having severe psychological distress after adjusting for covariates (PR of ≥4 million yen, 1.44; 95% CI, 1.02-2.03). Among current university students, there was no significant association (PR of borrowing student loans, 0.91; 95% CI, 0.60-1.37). CONCLUSIONS: There was a significant association between student loan debt and psychological distress among graduates but not current university students.

DOI： 10.2188/jea.JE20190057

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Language：Japanese   Publisher：日本公衆衛生学会  

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Poor accessibility to physicians might be linked to the inadequate control of cardiovascular risk factors. The aim of this study was to investigate whether the accessibility of primary care physicians was related to a lower incidence of ischemic heart disease and stroke mortality via ecological data analyses of both primary care facility density and internal physician density. The unit of observation was the Japanese secondary medical service area, the basic unit for healthcare planning and administration. A primary care facility was defined as a clinic or medical institution with less than 200 inpatient beds, whose specialty included internal medicine. The number of primary care facilities per 10,000 population and the number of internal physicians per 10,000 population were used as explanatory variables. Bayesian hierarchical models were used to analyze the relative risks (RR) of primary care facility density and internal physician density using the socioeconomic confounders of designated emergency hospitals, natural log-transformed population density, birth rate, secondary and tertiary industrial workers, and taxable income. In multivariate models for ischemic heart disease mortality, primary care facility density was significantly related to the total population (RR = 0.986, 95% credible interval [CrI]: 0.979-0.993), men (RR = 0.988, 95% CrI: 0.981-0.996), and women (RR = 0.986, 95% CrI: 0.979-0.993). No significant results were obtained for internal physician density. In the multivariate models for stroke mortality, neither primary care facility density nor internal physician density showed any significant effects. Increasing primary care facility density may reduce ischemic heart disease mortality.

DOI： 10.1620/tjem.251.217

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Background: Birch pollen allergy affects pregnant women, and such allergy may affect the development of allergic diseases in their children. Using nationwide birth cohort data, this study aimed to investigate the prevalence of birch pollen IgE positivity and to identify correlating factors in pregnant women in Hokkaido, Japan, a high-latitude island. Methods: Participants included 6856 pregnant women. Participants responded to questionnaires regarding lifestyle factors and history of allergies. Data regarding parity, height, and pre-pregnancy weight were collected from medical records. Blood samples were obtained from participants during the first trimester of pregnancy, and serum allergen-specific IgE titers were determined. Results: The serum of 30.2% participants was positive for birch pollen IgE (≥0.35 UA/mL). Such positivity significantly correlated with a history of other allergic diseases, particularly food allergy and allergic rhinitis/hay fever. In multivariate logistic regression analysis, pre-pregnancy high body mass index (BMI ≥ 25) significantly correlated with birch pollen IgE positivity [odds ratio (OR), 1.24; 95% CI, 1.05-1.47; reference BMI, 18.5-24.9] and higher income (≥10 million yen per year; OR,0.55; 95% CI, 0.37-0.81; reference, household income < 2 million yen per year), and second quintile level physical activity (OR,0.75; 95% CI, 0.63-0.88; reference, the first quintile of physical activity) had significant protective effects. Conclusions: Birch pollen IgE positivity in pregnant women was positively associated with food allergy, allergic rhinitis, pre-pregnant high BMI, and was negatively associated with light exercise and high household income in Hokkaido. Trial registration: UMIN000030786.

DOI： 10.1016/j.waojou.2020.100128

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BACKGROUND: Population impact of modifiable risk factors on orofacial clefts is still unknown. This study aimed to estimate population attributable fractions (PAFs) of modifiable risk factors for nonsyndromic cleft lip with or without cleft palate (CL±P) and cleft palate only (CP) in Japan. METHODS: We conducted a prospective cohort study using data from the Japan Environment and Children's Study, which recruited pregnant women from 2011 to 2014. We estimated the PAFs of maternal alcohol consumption, psychological distress, maternal active and passive smoking, abnormal body mass index (BMI) (<18.5 and ≥25 kg/m2), and non-use of a folic acid supplement during pregnancy for nonsyndromic CL±P and CP in infants. RESULTS: A total of 94,174 pairs of pregnant women and their single babies were included. Among them, there were 146 nonsyndromic CL±P cases and 41 nonsyndromic CP cases. The combined adjusted PAF for CL±P of the modifiable risk factors excluding maternal alcohol consumption was 34.3%. Only maternal alcohol consumption was not associated with CL±P risk. The adjusted PAFs for CL±P of psychological distress, maternal active and passive smoking, abnormal BMI, and non-use of a folic acid supplement were 1.4% (95% confidence interval = -10.7, 15.1), 9.9% (-7.0, 26.9), 10.8% (-9.9, 30.3), 2.4% (-7.5, 14.0), and 15.1% (-17.8, 41.0), respectively. We could not obtain PAFs for CP due to the small sample size. CONCLUSIONS: We reported the population impact of the modifiable risk factors on CL±P, but not CP. This study might be useful in planning the primary prevention of CL±P.

DOI： 10.2188/jea.JE20190347

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Language：Japanese   Publisher：(一社)日本衛生学会  

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Oral diseases produce enormous productivity loss. However, epidemiological evidence of work stress and tooth loss is scarce. The aim of this study was to examine the association of work stress, according to effort-reward imbalance (ERI), with tooth loss. We conducted a cross-sectional study using data obtained between 2010 and 2011 in Japan. This study included 1,195 employees aged 25-50 years old (response rate=32%). The dependent variable was self-reported tooth loss (having or not). The independent variable was a dichotomized ERI ratio (>1.4 and ≤1.4). Age, sex, sociodemographic variables, work-related factors, and health-related variables were adjusted. Psychological distress was used as a potential mediator. We also examined an additive interaction between support from supervisors and ERI. The median age was 37, and 48% were women. After adjusting for the covariates, ERI was still associated with tooth loss (prevalence ratio=1.20 [95% confidence interval=1.01, 1.42] from Poisson regression models with a robust error variance). Psychological distress partially explained the association, and support from supervisors significantly attenuated the association. In conclusion, high ERI ratio was still associated with an increased risk of tooth loss among working adults.

DOI： 10.2486/indhealth.2018-0226

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Public smoke-free legislation has been in place since July 2016 in a small city (Bibai) in Hokkaido (Japan); the effects of public smoke-free legislation in small cities in Japan on cardiovascular and cerebrovascular events have not been fully investigated. Monthly numbers of acute myocardial infarctions (AMIs) and stroke admissions were obtained from medical records, and the adjacent area, Naka-Sorachi, was used as a control region. According to the results of the Poisson regression, significant direct outcomes after the enactment of smoke-free legislation in Bibai city were not observed. After the implementation of the smoke-free legislation, the average monthly admission rates per population and risk ratios for AMI, stroke, and the combined outcome (AMI plus stroke) decreased in the Bibai region but increased in the control region (Naka-Sorachi), although there was no statistically significant difference between the two regions. However, significant interactions between the region (Bibai or Naka-Sorachi) and period (before or after the legislation) for stroke and the combined outcome were noted. Although a direct admission effect was not observed, the significant interaction indicated that Bibai had a decreasing trend in emergency admissions compared with the control region (Naka-Sorachi). Public smoke-free legislation in small cities may also decrease cardiovascular events.

DOI： 10.1038/s41440-019-0299-2

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Language：Japanese   Publisher：(公社)日本産業衛生学会  

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This study aimed to construct a childhood obesity risk index based on predictors identified in pregnant women and 1-yr-old infants. The primary outcome was an identified obesity index of > 20% at 6-8 yr of age. Of a total sample size of 6,846 mother-child pairs, 80% and 20% were randomly allocated to the derivation and validation cohorts, respectively. For the derivation cohort, univariate and multivariate logistic regression analyses of data were conducted to identify the final predictors to determine the childhood obesity risk score algorithm. These included pre-pregnancy body mass index (BMI), child's gender, smoking during pregnancy, education, and obesity index at one yr of age. The β coefficients for categories of predictor variables were each divided by the smallest value among them. The quotient was rounded off to the integer and assigned to the risk score, and a value of zero was assigned to reference categories. A total risk score was calculated for each individual. A cutoff point ≥ 16 had 22.2% and 21.8% positive predictive values in the derivation and validation cohorts, respectively. In conclusion, the childhood obesity risk score algorithm was constructed based on generic predictors that can be easily obtained from maternal and child health handbooks.

DOI： 10.1297/cpe.28.81

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BACKGROUND: Prenatal psychological stress may increase the risk of placental abruption (PA). This study aimed to clarify the effects of psychological distress during pregnancy and exposure to stressful life events in the year before or during pregnancy on the occurrence of PA in Japanese women. METHODS: Using a nationwide prospective birth cohort study, we obtained data from 103,099 women between January 2011 and March 2014. Information on exposure to 14 stressful life events and psychological distress (Kessler 6 scale) was collected using a self-administered questionnaire during pregnancy. Clinical diagnoses of PA were obtained from medical records. A total of 80,799 women with singleton births were analyzed using logistic regression models that adjusted for possible confounders. RESULTS: PA was diagnosed in 335 (0.4%) women. There was no significant difference in the Kessler 6 score during pregnancy between the PA group and non-PA group. Exposure to the death of a child in the year before or during pregnancy was significantly associated with PA in multigravid women (adjusted odds ratio [aOR] 3.57; 95% confidence interval [CI] 1.50-8.34). A spouse's loss of employment was significantly associated with PA in parous women (aOR 3.25; 95% CI 1.40-7.56). CONCLUSIONS: This study identified the possible effects of exposure to the death of a child on PA occurrence that adjusted for important confounding factors.

DOI： 10.1371/journal.pone.0219379

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Authorship：Lead author   Language：English   Publishing type：Research paper (scientific journal)   Publisher：Cambridge University Press ({CUP})  

DOI： 10.1017/S2045796018000410

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Shortage of healthcare workers is a global problem. It is important to clarify factors, including job stress, that influence workplace resignation and factors that cause burnout among rural physicians. The study was designed as a cross-sectional questionnaire survey. We sent questionnaires to town or village hospitals and clinics (n = 1,898) in Hokkaido, Tohoku, Shikoku, and Kyushu and Okinawa. The number of participants was 509. Of these 7.7% were female and 21.6% were < 50 years. Internal or general medicine physicians were asked about personal and job factors, job stress based on the demand-control-support model, intention to resign from current position, and burnout evaluated using the Maslach Burnout Inventory-General Survey. Overall, 10.4% of the participants intended to resign, and 21.8% was defined as burnout positive. In the multivariate logistic regression analysis, dissatisfaction with income (OR, 3.63; 95% CI, 1.63-8.10), having one's hometown in another town or village in the same prefecture (OR, 3.53; 95% CI, 1.18-10.62) were significantly related to intention to resign, while high job control (OR, 0.72; 95% CI, 0.58-0.88) had a significantly protective effect. In the multivariate analysis, high job demand (OR, 1.48; 95% CI, 1.28-1.72) was significantly related to burnout, and high job control (OR, 0.66; 95% CI, 0.55-0.78) and high support from co-workers (OR 0.88, 95% CI, 0.78-1.00) had a significantly protective effect. Improving job stress factors, especially job control, and taking into consideration physicians' hometown and income may be important factors to prevent resignation from a current position and burnout among Japanese rural physicians.

DOI： 10.1620/tjem.245.167

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：PERGAMON-ELSEVIER SCIENCE LTD  

Sick house syndrome (SHS) derived from sick building syndrome (SBS) is used to describe symptoms that inhabitants experience due to indoor environment and personal factors, and children might be more susceptible to the effects of SHS than adults. However, there have been no comprehensive studies on effects of indoor pollutants exposure in relation to SHS. Thus, the aim of this study is to examine the association between indoor pollutants and SHS in children and adults who live in the same dwelling. This is a cross-sectional study on 184 elementary school children and 273 adults/adolescents in Sapporo, Japan. Indoor pollutants were measured in air and dust collected from 128 dwellings. Results showed children (20.6%) have higher prevalence of any symptoms than adults/adolescents (15.1%). Among SHS, mucosal symptoms were the most common in both children and adults/adolescents. Doctor diagnosed allergies, building age, dampness, and ventilation system showed significant association with prevalence of SHS. Formaldehyde, di(isobutyl) phthalate (DiBP), di(2-ethylhexyl) phthalate (DEHP), di(isononyl) phthalate (DiNP), endotoxin, and 13-glucan were detected in all dwellings. Any symptoms and mucosal symptoms were significantly associated with the exposure to 2-ethyl-1-hexanol (2E1H). Floor dust DiNP, multi-surface dust Tris(2-butoxyethyl) phosphate with mucosal symptoms and endotoxin with dermal symptoms were inversely associated in adults/adolescent. Multi-surface dust DiBP also showed inverse association with mucosal symptoms in children. 2E1H emission increased with dampness in the dwellings thus, eliminating dampness in the dwellings may reduce the emissions of 2E1H and the risk of SHS in residents.

DOI： 10.1016/j.buildenv.2018.03.056

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PURPOSE: The role of insomnia in chronic kidney disease (CKD) is controversial. To date, there have been no prospective studies investigating insomnia, CKD and the effect of shift work. We assessed insomnia and CKD risk in a prospective, occupational cohort study. METHODS: A total of 3600 participants with normal kidney function were followed for an average of 4.4 years. Insomnia was assessed using the Athens Insomnia Scale (AIS). CKD was defined as an estimated glomerular filtration rate of <60 mL/min/1.73 m2 at the first health examination. Cox proportional hazard regression models were used to estimate hazard ratios with 95% confidence intervals of insomnia for CKD development. RESULTS: A total of 182 CKD cases were identified. After adjustment for potential confounders, we did not observe an association between insomnia (AIS score ≥6) and CKD. However, the AIS item of awakening during the night was associated with a significantly increased CKD risk (hazard ratio = 3.10, 95% confidence interval 1.68-5.30). In further analyses, having difficulty with sleep induction was associated with an increased CKD risk among shift workers (hazard ratio = 3.34, 95% confidence interval 1.22-8.31). This association was not present among non-shift workers. CONCLUSIONS: Awakening during the night is associated with a moderately increased CKD risk.

DOI： 10.1007/s11325-017-1508-3

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Polychlorinated dibenzo-p-dioxins (PCDDs), dibenzofurans (PCDFs) and biphenyls (PCBs) are persistent organic pollutants that are universally detected. Some congeners of PCDDs, PCDFs or PCBs have dioxin-like toxicity, whereas non-dioxin-like PCBs are considered to have different toxicity. Reports of the relationships between prenatal exposure to PCDDs, PCDFs or PCBs and thyroid homeostasis in pregnant women and infants have been inconsistent. The aim of this study was to investigate the effect of maternal serum PCDD/F or PCB levels on maternal and neonatal thyroid hormone (TH) levels in a prospective cohort. Of the 514 subjects in the prospective cohort, 386 mothers and 410 infants were included for analysis. Fifteen dioxins and seventy PCBs in maternal blood collected between 23 and 41weeks of gestation were measured using high-resolution gas chromatography and high-resolution mass spectrometry. Blood samples to measure thyroid stimulating hormone (TSH) and free thyroxine (FT4) levels were obtained from mothers at an early gestational stage (median ten weeks), and from infants between four and seven days of age, respectively. Multiple linear regression analysis was conducted. Median concentration of total PCBs, PCB 153 were 104,700, and 20,500pg/g lipid, respectively. Median total dioxin-TEQ was 13.8pg/g lipid. Total dioxin-TEQ, coplanar PCBs were positively associated with neonatal FT4 (beta=0.224, 0.206, respectively). The association was stronger in boys (beta=0.299, 0.282, respectively). Several PCDD/F and PCB isomers were also positively associated with neonatal FT4. Total PCBs or non-dioxin-like PCBs were not associated with any maternal or neonatal THs. No DLC grouping or congeners were associated with neonatal TSH. Non-ortho PCBs were positively associated with maternal FT4. Three PCB congeners had significant positive association(s) with maternal THs. In conclusion, the results of our study suggest that perinatal exposure to background-level DLCs increases neonatal FT4, especially in boys.

DOI： 10.1016/j.scitotenv.2017.09.038

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Language：Japanese   Publisher：(公社)日本産科婦人科学会  

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Objective: Poor access to a primary care physician may lead to poor control of risk factors for disease. This study investigated whether geographic access to a primary care physician was related to ischemic heart disease and stroke mortality. Methods: Road-distances from the centroids of the basic unit blocks of the 2010 Japanese Census to the nearest primary care facilities in Hokkaido, northern Japan, were measured using geographic information system (GIS) software. Next, block population-weighted mean road-distances to primary care facilities in all municipalities were calculated. The numbers of deaths from ischemic heart disease and stroke were obtained from the Vital Statistics Bureau. A Bayesian spatial conditional autoregressive (CAR) model was used to analyze relative risk (RR) by road-distance with the numbers of physicians in the municipality included as a covariate. Results: Relative risk (per 1 kilometer increased) of death from ischemic heart disease to road-distance to the nearest primary care facility was not significantly higher in men (1.108: 95% credible interval [CI] 0.999-1.037) and women (1.023: 95% CI 1.000-1.046). However, RR of death from stroke was significantly higher in men (1.019: 95% CI 1.005-1.032) and women (1.019: 95% CI 1.006-1.033). Conclusion: Longer road-distance to a primary care facility may increase the risk of stroke mortality.

DOI： 10.1002/jgf2.140

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© 2017 Tomoyuki Hanaoka et al. Background: Prevalence rates of all anomalies classified as birth defects, including those identified before the 22nd gestational week, are limited in published reports, including those from the International Clearinghouse for Birth Defects Surveillance and Research (ICBDSR). In our birth cohort study, we collected the data for all birth defects after 12 weeks of gestation. Methods: Subjects in this study comprised 19,244 pregnant women who visited one of 37 associated hospitals in the Hokkaido Prefecture from 2003 through 2012, and completed follow-up. All birth defects after 12 weeks of gestation, including 55 marker anomalies associated with environmental chemical exposures, were recorded. We examined parental risk factors for birth defects and the association between birth defects and risk of growth retardation. Results: Prevalence of all birth defects was 18.9=1,000 births. The proportion of patients with birth defects delivered between 12 and 21 weeks of gestation was approximately one-tenth of all patients with birth defects. Among those with congenital malformation of the nerve system, 39% were delivered before 22 weeks of gestation. All patients with anencephaly and encephalocele were delivered before 22 weeks of gestation. We observed different patterns of parental risk factors between birth defect cases included in ISBDSR and cases not included. Cases included in ISBDSR were associated with an increased risk of preterm birth. Cases not included in ISBDSR were associated with an increased risk of being small for gestational age at term. Conclusions: Data from our study complemented the data from ICBDSR. We recommend that birth defects not included in ICBDSR also be analyzed to elucidate the etiology of birth defects.

DOI： 10.2188/jea.JE20160108

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OBJECTIVES: To elucidate the impact of social support and its interrelations with other demand-control-support (DCS) model factors on presenteeism and absenteeism, and to determine which DCS factors were most influential. METHODS: Questionnaires from 2535 local government employees were analyzed. The Brief Job Stress Questionnaire (BJSQ) was used to assess DCS factors including job demand, job control, and social support from supervisors and coworkers. The Stanford Presenteeism Scale 13-item version (SPS-13) was used to evaluate both absenteeism (absent days) and presenteeism. For the latter, the Work Impairment Score (WIS) and the Work Output Score (WOS) were also used. Possible confounder-adjusted logistic and negative binomial regression analyses were performed to obtain odds ratios (ORs) for WIS and WOS and relative risks (RRs) for absenteeism according to DCS factors. RESULTS: Higher job control had a significantly protective effect on higher WIS in both males and females and a lower WOS in males. Based on a point estimate of an OR per 1 standard deviation change of each DCS factor, job control had the strongest effect on higher WIS in both males and females and a lower WOS in males. Higher job demand resulted in significantly higher ORs for both male and female WIS, and a lower WOS in females. Support from supervisors had a significantly protective effect on higher WIS in females and a lower WOS in males. Support from coworkers had a significantly protective effect on higher WIS in males. Higher support from coworkers had a significantly protective effect on absenteeism among both males and females, and higher job control had a significantly protective effect in females. The combination of high job strain and low support from supervisors had a significantly worsening effect, except for absenteeism in females. High job strain and low support from coworkers had a significantly worsening effect except for WOS in males. CONCLUSIONS: The results suggest job control was the DCS factor most related to presenteeism. Higher support from supervisors and coworkers had a protective effect on presenteeism, and higher job demand had a worsening effect. Higher support from coworkers had a protective effect on absenteeism among both males and females. Interventions should focus on improving job control as a possible countermeasure to presenteeism, and encouraging support from coworkers as a possible countermeasure to absenteeism.

DOI： 10.1007/s00420-017-1218-y

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AIM: The aim of this study was to elucidate the relation between premorbid personality traits and behavioral and psychological symptoms in dementia (BPSD) in dementia with Lewy bodies (DLB) and Alzheimer's disease (AD) patients. METHODS: Forty-one DLB patients and 98 AD patients were assessed for BPSD using the Neuropsychiatric Inventory (NPI). Each patient's midlife personality traits were rated by a family member using the NEO Five-Factor Inventory (NEO-FFI) questionnaire. RESULTS: In multiple regression analyses for DLB patients, NPI total score and anxiety were significantly associated with premorbid openness, delusion with premorbid agreeableness, and agitation with premorbid conscientiousness. In AD patients, depression was significantly associated with premorbid neuroticism, and agitation, apathy, and irritability with premorbid agreeableness. CONCLUSION: Premorbid personalities affected BPSD differently in DLB and AD. Given the differences in the effects of premorbid personalities on BPSD, additional studies are needed to develop interventions to reduce these symptoms.

DOI： 10.1111/pcn.12511

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BACKGROUND: In Japan, a dramatic rise in suicide rates was observed in the 1950s, especially among the younger population, and then the rate decreased rapidly again in the 1960s. The aim of this study was to assess secular trends in method-specific suicides by gender and age in Japan between 1950 and 1975. We paid special attention to suicides by poisoning (solid and liquid substances), and their contribution to dramatic swings in the overall suicide rate in Japan during the 1950s and 1960s. METHODS: Mortality and population data were obtained from the Vital Statistics of Japan and Statistics Bureau, Ministry of Internal Affairs and Communications in Japan, respectively. We calculated method-specific age-standardized suicide rates by gender and age group (15-29, 30-49, or 50+ years). RESULTS: The change in the suicide rate during the research period was larger in males than females in all age groups, and was more marked among people aged 15-29 years compared to those aged 30-49 years and 50 years or over. Poisoning by solid and liquid substances overwhelmingly contributed to the dramatic change in the overall suicide rates in males and females aged 15-49 years in the 1950s and 1960s. For the peak years of the rise in poisoning suicides, bromide was the most frequently used substance. CONCLUSIONS: Our results for the 1950s and 1960s in Japan illustrated how assessing secular trends in method-specific suicides by gender and age could provide a deeper understanding of the dramatic swings in overall suicide rate. Although rapid increases or decreases in suicide rates have been also observed in some countries or regions recently, trends in method-specific suicides have not been analyzed because of a lack of data on method-specific suicide in many countries. Our study illustrates how the collection and analysis of method-specific data can contribute to an understanding of dramatic shifts in national suicide rates.

DOI： 10.1186/s12963-017-0131-7

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DOI： 10.1186/s12199-017-0654-3

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Phthalates are widely used as plasticizers in household products. Several studies have reported an association between phthalate exposure and an increased risk of allergies. The present study estimated phthalate exposure in children aged 6-12years and assessed potential correlations with allergies. House dust samples were collected from floors and multi-surface objects >35cm above the floor. Urine samples were collected from the first morning void of the day. Daily phthalate intake (DIdust and DI) was estimated using both house dust and urinary metabolite concentrations. Exposure to di-2-ethylhexyl phthalate (DEHP) in floor dust was associated with parental-reported rhino-conjunctivitis. After stratification by gender, this trend was found to only occur in boys. Furthermore, urinary mono-isobutyl phthalate was inversely associated with parental-reported wheeze in boys. DIdust of benzyl butyl phthalate (BBzP) and DEHP were significantly correlated with DI_BBzP and DI_DEHP, respectively. These correlations were stronger with floor than with multi-surface dust. Our results suggest that, among Japanese children, house dust from low surfaces, such as living room floors, might play a meaningful role in the indoor environmental exposure pathway for BBzP and DEHP.

DOI： 10.1016/j.envint.2016.08.025

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BACKGROUND: The impact of long working hours on diabetes is controversial; however, shift work is known to increase the risk of diabetes. This study aimed to investigate the association between long working hours and diabetes among civil servants in Japan separately by shift work schedules. METHODS: A prospective cohort study was conducted from April 2003 to March 2009. A total of 3195 men aged ≥35 years who underwent an annual health checkup at baseline were analyzed by shift work schedules (2371 non-shift workers and 824 shift workers). Self-reported working hours were categorized as 35-44 and ≥45 hours per week. The incidence of diabetes was confirmed by fasting plasma glucose concentration ≥126 mg/dL and/or self-reported medical diagnosis of diabetes at the annual checkup. A Cox proportional model was used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) for developing diabetes associated with long working hours. RESULTS: The median follow-up period of non-shift and shift workers was 5.0 and 4.9 years, respectively. During this period, 138 non-shift workers and 46 shift workers developed diabetes. A decreased HR was found among non-shift workers working ≥45 hours per week (HR 0.84; 95% CI, 0.57-1.24); however, shift workers working ≥45 hours per week had a significantly increased risk of diabetes (HR 2.43; 95% CI, 1.21-5.10) compared with those working 35-44 hours per week. An analysis restricted to non-clerical workers also showed similar results. CONCLUSIONS: The risk of diabetes associated with long working hours differed by shift work schedules.

DOI： 10.2188/jea.JE20150155

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PURPOSE: An epidemic of carbon monoxide poisoning suicide by burning charcoal occurred in Hong Kong and Taiwan. An epidemic also emerged in Japan from February 2003 and resulted in an increase of 10-20 % in overall suicide rates in younger adults (aged <45 years) in the mid-2000s. We investigated the spatial and temporal evolution of the epidemic to assess its impact on the epidemiology of suicide in Japan. METHODS: Mortality data were obtained from the official vital statistics of Japan. Smoothed standardized mortality ratios of charcoal-burning and non-charcoal-burning suicide were estimated for the period 2003-2013 using Bayesian hierarchical models. Joinpoint regression analysis was performed to analyze secular trends in suicide rates by gender, method used and geographic location between 1999 and 2013. RESULTS: Suicide by burning charcoal rose sharply in the mid-2000s and was not accompanied by a simultaneous decline in alternative methods. The epidemic of charcoal-burning suicide in Japan showed a pronounced spatial pattern, being concentrated in rural prefectures particularly among males. For men but not women, the epidemic contributed to the widening of urban-rural disparities in suicide rates (higher rates in rural areas). CONCLUSIONS: Our results differ from previous research in other Asian countries (e.g., Taiwan), where the epidemic of charcoal-burning suicide emerged more prominently in urban areas. In Japan, the introduction and diffusion of charcoal burning contributed to a real excess in suicide rates, as well as a widening of the urban/rural disparity in suicide.

DOI： 10.1007/s00127-016-1172-0

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：CAMBRIDGE UNIV PRESS  

The International Clearinghouse for Birth Defects, Surveillance and Research reports a rise in the prevalence rate of spina bifida in Japan. We determined first-trimester folate status of Hokkaido women and identified potential predictors. Participants were 15 266 pregnant women of the Hokkaido Study on Environment and Children's Health Cohort. Data were extracted from self-reported questionnaires and biochemical assay results. Demographic determinants of low folate status were younger maternal age (adjusted OR (AOR) 1.48; 95% CI 1.32, 1.66), lower educational level (AOR 1.27; 95% CI 1.17, 1.39) and lower annual income (AOR 1.11; 95% CI 1.01, 1.22). Plasma cotinine concentrations of 1.19-65.21 nmol/l increased the risk of low folate status (AOR 1.20; 95% CI 1.10, 1.31) and concentrations > 65.21 nmol/l further increased the risk (AOR 1.91; 95% CI 1.70, 2.14). The most favourable predictor was use of folic acid (FA) supplements (AOR 0.19; 95% CI 0.17, 0.22). Certain socio-demographic factors influence folate status among pregnant Japanese women. Modifiable negative and positive predictors were active and passive tobacco smoking and use of FA supplements. Avoiding both active and passive tobacco smoking and using FA supplements could improve the folate status of Japanese women.

DOI： 10.1017/S0007114516001628

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：CAMBRIDGE UNIV PRESS  

Background. Little is known about whether particular suicide methods have contributed differently to the recent unfavourable suicide mortality trends in Japan. Analysing such trends may shed light on the effect of potentially preventable factors, such as the impact of restricting access to certain popular suicide methods, on overall rates. Therefore, we assessed recent trends in method-specific suicide by gender and age in Japan.
Method. Suicide mortality and population data between 1990 and 2011 were obtained from the Vital Statistics of Japan and used to calculate method-specific mortality rates. Suicide methods were divided into seven groups: overdose, gases, hanging, drowning, cutting, jumping and other means. Age was divided into four groups: 15-24, 25-44, 45-64 and 65+ years. We applied joinpoint regression to the data and quantified the observed changes.
Results. The results of the joinpoint regression analyses showed a sharp increase in overall suicide rates for males and females of all ages until the late 1990s. Suicide from hanging and jumping, in particular, contributed to this increase. After 2000, an increasing trend in overall suicide rates in both males and females aged 15-24 and 25-44 years was observed, with overdose, gases and hanging contributing to this increasing trend.
Conclusions. Our findings revealed that different suicide methods varied in their contribution to the recent overall suicide transition in Japan. Regarding factors associated with the recent increase in suicides by overdose, gases, hanging and jumping, further research is needed in order to promote and implement effective means restriction strategies.

DOI： 10.1017/S2045796014000675

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This study aims to elucidate the relationships among the factors of the demand-control-support model (DCS) on the intention to leave a hospital job and depressive symptoms. Participants included 1,063 nurses. Job demand, job control, and support from supervisors were found to be significantly related to both the intention to leave and depressive symptoms. Based on the odds ratios per 1 SD change in the DCS factors, low support from supervisors was found to be most related to the intention to leave, and low job control was found to be most related to depressive symptoms. In models that did not include "job demand" as an independent variable, 60-h working weeks were found to have a significantly higher odds ratio for depressive symptoms. Support from supervisors is more important in preventing intention to leave and depressive symptoms among nurses than is support from co-workers. Improving job control and avoiding long working hours may be important to prevent depressive symptoms.

DOI： 10.2486/indhealth.2015-0083

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DOI： 10.2188/jea.JE20160082

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INTRODUCTION: While the beneficial effects of prenatal yoga have been reported in recent years, little is known about its effectiveness in pregnant Japanese women. Despite several adverse effects, ritodrine hydrochloride is frequently prescribed to suppress preterm labor in Japan, and its usage may therefore indicate cases of preterm labor. This study aimed to clarify the association between prenatal yoga and ritodrine hydrochloride use during pregnancy. METHODS: An observational study was conducted as an adjunct study by the Hokkaido unit of the Japan Environment and Children's Study. Information on prenatal yoga practice was collected using a self-questionnaire between March 21, 2012, and July 7, 2015, targeting women who had recently delivered. Ritodrine hydrochloride use was identified from medical records. A total of 2,692 women were analyzed using logistic regression models that adjusted for possible confounders. RESULTS: There were 567 (21.1%) women who practiced prenatal yoga, which was associated with a lower risk of ritodrine hydrochloride use (adjusted odds ratio [OR] 0.77; 95% CI 0.61-0.98). This was especially evident in women with a total practice duration that exceeded 900 minutes throughout their pregnancy (adjusted OR 0.54; 95% CI 0.38-0.76). A sensitivity analysis that excluded patients with threatened abortion during the study period produced similar results. CONCLUSIONS: Prenatal yoga was associated with a lower risk of ritodrine hydrochloride use, particularly in women with more than 900 minutes of practice time over the course of their pregnancy. Prenatal yoga may be a beneficial option for pregnant women in the selection of alternative therapies.

DOI： 10.1371/journal.pone.0158155

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：ELSEVIER GMBH, URBAN & FISCHER VERLAG  

We measured urinary phthalate metabolites, including di-n-butyl phthalate (DnBP), di-isobutyl phthalate, benzyl butyl phthalate (BBzP), and di(2-ethylhexyl) phthalate (DEHP), from 178 school-aged children and their 284 family members using gas chromatography-mass spectrometry, and we calculated daily phthalate intakes. The highest median levels of phthalate metabolites were for mono-isobutyl phthalate in all participants except schoolchildren, where the highest levels were for mono-(2-ethyl-5-oxohexyl) phthalate (MEOHP). Comparing the schoolchildren with their parents, the schoolchildren had significantly higher urinary metabolites for MEOHP, mono-(2-ethyl-5-carboxypentyl) phthalate, and EDEHP. Regarding daily intakes, the schoolchildren had significantly higher daily intakes of DnBP, BBzP, and EDEHP. All phthalate metabolite and sums of metabolite levels in the schoolchildren were positively correlated with their mothers' levels, except for MEHP, whereas fathers were less correlated with their children. The DEHP intake in this study was higher than that of most other studies. Moreover, 10% of the children and 3% of the adults exceeded the Reference Dose (RfD) value (20 mu g/kg/day) of the U.S. Environmental Protection Agency, which indicates that it is important to focus on children's DEHP exposure because the children exceeded the RID more than adults among the same families who shared similar exposure sources. Our results will contribute to considerations of the regulations for some phthalates and the actual phthalate exposure levels in the Japanese population. (C) 2015 Elsevier GmbH. All rights reserved.

DOI： 10.1016/j.ijheh.2015.03.013

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：ELSEVIER SCIENCE INC  

DOI： 10.1016/S0140-6736(15)61152-7

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Language：Japanese   Publisher：(一社)日本衛生学会  

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PURPOSE: To elucidate whether low job control and low social support at work have synergistic interaction on mental health. The synergistic interaction was also analyzed after stratification by high and low job demands. METHODS: Participants were 2,121 local government employees in Asahikawa city, Japan. The Brief Job Stress Questionnaire was used to assess job demands, job control, and social support. Depression was assessed using the Patient Health Questionnaire-9. The Maslach Burnout Inventory-General Survey was used to assess burnout. Insomnia was assessed using the Athens Insomnia Scale. Possible confounder-adjusted logistic regression analyses were performed to obtain odds ratios for depression, burnout, and insomnia, and synergy indices between job control and social support at work were assessed. RESULTS: The synergy indices among men and women, respectively, were 2.08 (80 % confidence interval: 1.01, 4.27) and 1.98 (0.67, 5.89) for depression, 1.79 (1.28, 2.51) and 2.62 (1.07, 6.40) for burnout, and 1.92 (1.22, 3.02) and 2.77 (0.43, 18.01) for insomnia. Men with high job demands had higher synergistic interaction on depression and burnout, compared to men with low job demands, and women with low job demands had higher synergistic interaction between job control and social support at work on burnout and insomnia, compared to women with high job demands. CONCLUSIONS: There were more-than-additive interactions of job control and social support at work on depression, burnout, and insomnia. After stratification by job demands, the synergistic interaction may be different between men and women. To assess job stress, it is necessary to consider the interactive effect of not only job demands and job control but also job control and social support at work.

DOI： 10.1007/s00420-014-0945-6

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Language：Japanese   Publishing type：Research paper (scientific journal)  

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Language：Japanese   Publishing type：Research paper (scientific journal)   Publisher：Japanese Society of Public Health  

<b>Objectives</b> While several studies on the preventive and therapeutic effects of prenatal yoga (maternity yoga) have been reported in recent years, there has been no systematic review on the effects of prenatal yoga based on randomized controlled trials (RCT). The purpose of this study, therefore, was to systematically review the literature to clarify the effects of prenatal yoga in RCT focusing on the contents of the intervention, the intervention means, and the frequency of practice.<br/><b>Methods</b> The literature search was performed using the electronic database, PubMed. The inclusion criteria were RCT, pregnant women, and yoga intervention.<br/><b>Results</b> In total, 54 citations were found; of these, eight studies (10 reports) were included in the final analysis. In four studies on healthy pregnant women, significant improvement in pain and pleasure at delivery, duration of delivery, perceived stress levels during pregnancy, anxiety levels, depression, pregnancy-related experiences, quality of life, and interpersonal relationships were compared to those in the control group. In two studies on depressed pregnant women, one reported that depression, anxiety levels, anger levels, leg pain, and back pain significantly improved with yoga, while the other found no differences from the control group. In one study of high-risk pregnant women with morbidity factors such as obesity or advanced age, yoga resulted in significantly fewer cases of pregnancy-induced hypertension, gestational diabetes, and intrauterine growth restriction, as well as a decrease in perceived stress levels. In one study on pregnant women with pelvic pain, the median pain score was lower in the yoga group. Regarding the contents of the intervention, while the two studies for depressed pregnant women only included physical postures, the remaining six studies also included breathing technique and meditation. Interventions were performed using lectures by instructors alone or together with self-teaching. The frequency of the intervention varied within each study.<br/><b>Conclusion</b> The findings suggest that prenatal yoga may help reduce pelvic pain. It may also improve mental condition (stress, depression, anxiety, etc.), physical condition (pain and pleasure at the delivery, etc.), and perinatal outcomes (obstetrical complications, delivery time, etc.). However, further studies are needed. The contents of the intervention, the intervention means, and the frequency varied with each study. Thus, it is necessary to further examine the content of effective interventions, intervention means, and frequency that suit participant's characteristics and each outcome. Further research in this field, particularly randomized controlled trials, is merited.

DOI： 10.11236/jph.62.5_221

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Other Link： http://amcor.asahikawa-med.ac.jp/modules/xoonips/detail.php?id=2015289038

Language：English   Publishing type：Research paper (scientific journal)  

OBJECTIVES: Days off, on call, night duty, working hours and job stress can affect physicians' mental health, and support from supervisors and co-workers may have a buffering effect. This study elucidates whether job strain and job factors affect physicians' mental health, and whether support from supervisors and co-workers has a protective effect on their mental health. MATERIAL AND METHODS: The subjects included 494 physicians. The Brief Job Stress Questionnaire (BJSQ) was used to evaluate job demand, job control and support. High job strain was defined as a combination of high job demand and low job control. Depressive symptoms were assessed using the Patient Health Questionnaire-9. The Maslach Burnout Inventory-General Survey was used to evaluate burnout. Possible confounder adjusted logistic regression analyses were performed to obtain odds ratios for depressive symptoms and burnout. RESULTS: As per the analysis, high job strain had significantly higher odds ratios, and support from co-workers had significant protective odds ratios for depressive symptoms. High job strain and having only 2-4 days off per month (compared to > 8 days off per month) had significantly higher odds ratios, and support from co-workers had significant protective odds ratios for burnout. CONCLUSIONS: High job strain was related to depressive symptoms and burnout, and support from co-workers had a buffering effect on depressive symptoms and burnout. An inadequate number of days off was related to burnout. Assessment of job strain may be a good tool to measure physicians' mental health, and a sufficient number of days off may be needed to prevent burnout.

DOI： 10.2478/s13382-014-0324-2

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OBJECTIVE: To investigate the association of sleep duration and shift work with development of chronic kidney disease (CKD) in Japanese workers. METHODS: A total of 3600 participants without CKD were observed for an average of 4.4 years. The Cox proportional-hazards regression model was used to estimate hazard ratios and 95% confidence intervals of the risk of CKD associated with sleep duration and shift work. RESULTS: Sleep duration and shift work showed no significant association with the risk of CKD. Nevertheless, when the results were stratified by shift work status, short sleep duration was associated with a significantly higher risk of CKD among shift workers (hazard ratio = 3.60; 95% confidence interval: 1.52 to 10.68). CONCLUSIONS: Short sleep duration was a risk factor for early CKD but only among shift workers.

DOI： 10.1097/JOM.0000000000000322

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Language：Japanese   Publisher：日本公衆衛生学会  

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Language：Japanese   Publisher：(一社)日本衛生学会  

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Language：Japanese   Publisher：(公社)日本産業衛生学会  

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：ELSEVIER  

The demand for phosphorus flame retardants (PFRs) has recently increased as an alternative to polybrominated diphenyl ether (PBDE). PFRs have been detected in house dust, but little is known about the concentrations of PFRs in private homes and the effects on human health. We measured the levels of 10 PFRs in indoor floor dust and upper surface dust from 128 Japanese dwellings of families with children in elementary school. The median (min-max) concentrations (mu g/g) of PFRs were as follows: tris(2-butoxyethyl) phosphate (TBOEP), 30.88 (<0.61-936.65); tris(2-chloro-iso-propyl) phosphate (TCIPP), 0.74 (<0.56-392.52); and triphenyl phosphate (TPHP), 0.87 (<0.80-23.35). These values exceeded 50% detection rates, and the rates are median over the LOD in floor dust. The concentrations (wig) of TBOEP 26.55 (<0.61-1933.24), TCIPP 2.23 (<0.56-621.23), TPHP 3.13 (<0.80-27.47), tris(2-chloroethyl) phosphate (TCEP) 1.17 (<0.65-92.22), and tributyl phosphate (TNBP) 0.74 (<036-60.64) exceeded 50% detection rates in the upper surface dust. A significant positive correlation (P<0.05) between the concentrations of TCIPP and TBOEP was shown in floor dust and upper surface dust (n=48). Estimated median and 95th percentile daily intake was calculated for toddlers and elementary school children and was compared with reference dose values (RfD) from the literature. For TBOEP, the estimated 95th percentile intake from floor dust was 14% of RfD for toddlers and 4% for school children. The estimated intake from upper surface dust was somewhat lower. Estimated median intake of TBOEP and median intake for the other PFRs were less than 1% of the RfD. TBOEP, TCIPP and TPHP were the main PFRs in the dust. The median levels of PFRs are well below the RfD values. (C) 2014 Elsevier B.V. All rights reserved.

DOI： 10.1016/j.scitotenv.2013.12.121

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：ELSEVIER SCIENCE BV  

Phthalates are widely used as plasticizers in numerous products. However, there has been some concern about the various effects they may have on human health. Thus, household phthalate levels are an important public health issue. While many studies have assessed phthalate levels in house dust, the association of these levels with building characteristics has scarcely been examined. The present study investigated phthalate levels in house dust samples collected from the living areas of homes, and examined associations between these phthalate levels and the interior materials. Dust was collected from two portions of the living area: floor dust from the entire floor surface, and multi-surface dust from objects more than 35 cm above the floor. The levels of seven phthalates were measured using gas chromatography/mass spectrometry in selective ion monitoring mode. Phthalate levels were higher in multi-surface dust than in floor dust Among floor dust samples, those from dwellings with compressed wooden flooring had significantly higher levels of di-iso-butyl phthalate compared to those with other floor materials, while polyvinyl chloride (PVC) flooring was associated with higher di-2-ethylhexyl phthalate (DEHP) levels. Among multi-surface dust samples, higher levels of DEHP and di-iso-nonyl phthalate (DINP) were found in samples from homes with PVC wallpaper than without The number of PVC interior materials was significantly positively correlated with the levels of DEHP and DINP in multi-surface dust. The phthalate levels in multi-surface dust were associated with the interior surface materials, and those in floor dust were directly related to the flooring materials. Our findings show that when using house dust as an exposure assessment, it is very important to note where the samples were collected from. The present report provides useful information about the association between phthalates and dust inside dwellings, which will assist with establishing public health provisions. (C) 2013 Published by Elsevier B.V.

DOI： 10.1016/j.scitotenv.2013.07.107

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：SPRINGER  

To examine the association between antenatal depression and infant development after controlling for confounding factors.A hospital-based prospective cohort study (Hokkaido Study on Environment and Children's Health) was conducted between July 2002 and October 2005 in Sapporo, Japan. Of 309 mothers who delivered at Sapporo Toho Hospital during the study period and who agreed with the clinical assessment of depression, 154 mother-infant pairs were eligible for analysis. Antenatal depression was assessed between the second and third trimesters using the Edinburgh Postnatal Depression Scale (EPDS), and infant development was assessed at 6 months by the Bayley Scales of Infant Development II (BSID-II). Data on potential confounders, including socioeconomic status, birth complications, postnatal depression and child care environment, were obtained from medical records and self-administered questionnaires. Univariable and multivariable analyses were conducted in which the EPDS score was entered as an independent variable and the BSID-II scores as a dependent variable, adjusting for confounders.Although the antenatal EPDS score tended to be related to the BSID-II score in the univariable analysis, this correlation was lost in the multivariable analysis. However, based on a series of linear regression analyses, antenatal depression was found to be significantly related to shorter gestational age (beta = -0.25, 95 % confidence interval (CI) [-1.20, -0.17]), and shorter gestational age was significantly related to a lower BSID-II (mental development) score (beta = 0.23, 95 % CI [0.00, 0.00]).Gestational age is an important confounder in the association between maternal antenatal depression and infant development. A delay in infant development may be related to a shorter gestational period caused by maternal depression during pregnancy.

DOI： 10.1007/s12199-013-0353-7

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：ASIAN PACIFIC ORGANIZATION CANCER PREVENTION  

Background: No studies on male attitudes towards HPV and HPV vaccination have been conducted in Japan, and little is known globally whether attitudes of single fathers differ to those living with a female partner. This exploratory study assessed whether Japanese fathers were likely to have their daughter vaccinated against HPV in a publically funded program and whether any differences existed regarding attitudes and knowledge about HPV according to marital status. Materials and Methods: Subjects were 27 fathers (16 single; 11 married) who took part in a study on HPV vaccine acceptability aimed at primary caregivers of girls aged 11-14 yrs in three Japanese cities between July and December 2010. Results: Knowledge about HPV was extremely poor (mean score out of 13 being 2.74 +/- 3.22) with only one (3.7%) participant believing he had been infected with HPV and most (81.4%) believing they had no or low future risk. No difference existed regarding knowledge or awareness of HPV according to marital status. Concerning perceived risk for daughters, single fathers were significantly more likely to believe their daughter was at risk for both HPV (87.5% versus 36.4%; p=0.01) and cervical cancer (75.0% versus 27.3%; p=0.02). Acceptability of free HPV vaccination was high at 92% with no difference according to marital status, however single fathers were significantly more likely (p=0.01) to pay when vaccination came at a cost. Concerns specific to single fathers included explaining the sexual nature of HPV and taking a daughter to a gynecologist to be vaccinated. Conclusions: Knowledge about HPV among Japanese fathers is poor, but HPV vaccine acceptability is high and does not differ by marital status. Providing sexual health education in schools that addresses lack of knowledge about HPV as well as information preferences expressed by single fathers, may not only increase HPV vaccine acceptance, but also actively involve men in cervical cancer prevention strategies. However, further large-scale quantitative studies are needed.

DOI： 10.7314/APJCP.2014.15.4.1837

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：ROYAL COLL PSYCHIATRISTS  

BACKGROUND: The charcoal burning suicide epidemics in both Hong Kong and Taiwan have been well documented. However, little is known about the situation in Japan. AIMS: To examine the impact of charcoal burning suicide on the overall and other method-specific suicide rates between 1998 and 2007 in Japan. METHOD: Using data obtained from the Vital Statistics of Japan, negative binomial regression analyses were performed to investigate the impact of the charcoal burning method. RESULTS: In males and females aged 15-24 and 25-44 years, the charcoal burning epidemic led to a substantial increase in overall suicides, without a decrease in other methods. In all other age groups, no such trend was observed. CONCLUSIONS: In young Japanese, the charcoal burning method may have appealed to individuals who might not have chosen other highly or relatively lethal methods, and consequently led to an increase in overall suicides.

DOI： 10.1192/bjp.bp.113.135392

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Epidemiological data indicate the existence of a J-shaped association between alcohol consumption and cardiovascular mobility and mortality. However, studies assessing the relationship between alcohol consumption and pulse wave velocity (PWV) as a marker of arterial stiffness have provided inconsistent results. In addition, data regarding the effect of alcohol on arterial stiffness in women has been limited. This study aimed to clarify the relationship between alcohol consumption and PWV among female and male workers in Japan. Study participants were local government employees in Hokkaido, Japan, who underwent annual health check-ups. All data were collected using self-administered questionnaires. The average daily alcohol consumption of the previous month, based on the alcohol concentration of each beverage type (g/day, ethanol equivalent), was estimated according to the frequency and amount of consumption. Data from 3893 participants (812 women and 3081 men) were analyzed. In women, non-drinkers had significantly higher PWV than women who consumed <10 g/day of alcohol. In men, compared with those who reportedly drank 20-39 g/day, non-drinkers and those who drank <20 g/day and ≥60 g/day had significantly higher PWV. Alcohol consumption showed a J-shaped association with PWV in men (p for quadratic term < 0.036) and marginally in women (p < 0.056). The results of stratified analyses by age groups showed a significant J-shaped association, which was most notable for men ≥45 years (p < 0.005). In middle-aged Japanese women and men, light-to-moderate alcohol consumption is associated with lower PWV, which in turn correlates with a reduction in vascular stiffness.

DOI： 10.1016/j.alcohol.2013.10.003

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：ROUTLEDGE JOURNALS, TAYLOR & FRANCIS LTD  

Background: Only a few studies have specifically considered the role of caregiver characteristics in the presence of behavioral and psychological symptoms of dementia (BPSD). The aim of this study was to determine whether there were differences in the presence of individual BPSD between community-dwelling dementia care recipients with spouse caregivers and those with non-spouse caregivers.Methods: Care recipients (n = 109) and their primary caregivers were recruited from memory clinic outpatients at the public psychiatric hospital in Sapporo City, Japan. Data were collected by questionnaire. Relationship with the care recipient was categorized as either spouse' or non-spouse.' The frequency of BPSD occurrence observed by the caregiver was assessed using the Troublesome Behavior Scale (TBS). Logistic regression analyses were performed to examine whether there were differences with regard to each of the 14 TBS items between spouse and non-spouse caregivers.Results: The number of spouse caregivers was 47 (43.1%). TBS items presented by >50% care recipients were repetition and/or clinging' and ill-natured denial and/or distortion.' After adjustment for the characteristics of caregivers and care recipients, non-spouse caregivers were found to be significantly associated with the presence of hiding and/or losing things,' rummaging,' crying and/or screaming,' and interfering with a happy home circle,' compared with spouse caregivers.Conclusions: Our results suggest that non-spouse caregivers need more support with regard to certain symptoms of individual BPSD compared with spouse caregivers. Identifying caregiver characteristics that are independently associated with each individual BPSD may help customize interventions for caregivers with specific characteristics.

DOI： 10.1080/13607863.2013.790927

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：SPRINGER  

Little is known about the combined risk of socioeconomic status and psychosocial environment for insomnia.The purpose of this study was to investigate the combined risk of employment level and psychosocial work environment for insomnia in a large Japanese male working population.We investigated 5,951 male employees aged 34-59 years from two local governments in Japan. Data were obtained from a questionnaire distributed in advance of their annual health check-up. Employment level was categorized as higher-level non-manual workers, lower-level non-manual workers, and manual workers. Psychosocial work environment was assessed using the Demand-Control Model and the Effort-Reward Imbalance Model (ERI). Insomnia was assessed using the Athens Insomnia Scale.The results showed that 1,382 (23.2 %) participants suffered from insomnia. Lower employment level was significantly associated with a higher risk of insomnia. Job strain (ratio of job demand to job control), E/R (ratio of job effort to job reward), and OC (over commitment) were also significantly associated with insomnia. The relative excess risk due to the interaction between employment level and psychosocial environment (job strain, E/R, and OC) was 0.09 (95 % CI -0.57 to 0.76), 2.61 (0.74 to 4.48), and 3.14 (0.82 to 5.45), respectively; synergy index = 1.07 (0.66 to 1.74), 1.99 (1.37 to 2.90), and 2.25 (1.46 to 3.46), respectively.We found supra-additive interactions between employment level and psychosocial environment, assessed by the ERI (E/R and OC). Our findings suggested that lower level workers are more vulnerable to an adverse psychosocial environment than those at a higher level.

DOI： 10.1007/s12529-012-9230-9

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OBJECTIVE: To elucidate the differences in job stress and burnout status of Japanese hospital physicians between large cities, small cities, and towns and villages. DESIGN: Cross-sectional study. SETTING: Postal self-administered questionnaires were distributed to 2937 alumni of Asahikawa Medical University. PARTICIPANTS: Four hundred and twenty-two hospital physicians. MAIN OUTCOME MEASURES: The Brief Job Stress Questionnaire was used to evaluate job demand, job control and social support. The Japanese version of the Maslach Burnout Inventory-General Survey (MBI-GS) was used to evaluate burnout. An analysis of covariance was conducted on the mean scores on the Brief Job Stress Questionnaire and the MBI-GS scales after adjusting for sex, age and specialties. RESULTS: In adjusted analyses, the job demand score was significantly different among physicians in the three areas. In Bonferroni post-hoc tests, scores in large cities was significantly higher than those in small cities and towns and villages. The job control score showed a significant difference and a marginally significant trend, with large cities associated with lower job control. There were significant differences in support from supervisors and that from family/friends, and scores in large cities was significantly higher than those in small cities in the post-hoc test. There was a significant effect on the exhaustion scale of the MBI-GS, with large cities associated with higher exhaustion, and scores in large cities was significantly higher than those in small cities. CONCLUSIONS: Urban hospital physicians had more job demand, less job control and exhaustion caused by burnout, and rural hospital physicians had less social support.

DOI： 10.1111/ajr.12040

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Dioxins are metabolized by cytochrome P450, family 1 (CYP1) via the aromatic hydrocarbon receptor (AHR). We determined whether different blood dioxin concentrations are associated with polymorphisms in AHR (dbSNP ID: rs2066853), AHR repressor (AHRR; rs2292596), CYP1 subfamily A polypeptide 1 (CYP1A1; rs4646903 and rs1048963), CYP1 subfamily A polypeptide 2 (CYP1A2; rs762551), and CYP1 subfamily B polypeptide 1 (CYP1B1; rs1056836) in pregnant Japanese women. These six polymorphisms were detected in 421 healthy pregnant Japanese women. Differences in dioxin exposure concentrations in maternal blood among the genotypes were investigated. Comparisons among the GG, GA, and AA genotypes of AHR showed a significant difference (genotype model: P=0.016 for the mono-ortho polychlorinated biphenyl concentrations and toxicity equivalence quantities [TEQs]). Second, we found a significant association with the dominant genotype model ([TT+TC] vs. CC: P=0.048 for the polychlorinated dibenzo-p-dioxin TEQs; P=0.035 for polychlorinated dibenzofuran TEQs) of CYP1A1 (rs4646903). No significant differences were found among blood dioxin concentrations and polymorphisms in AHRR, CYP1A1 (rs1048963), CYP1A2, and CYP1B1. Thus, polymorphisms in AHR and CYP1A1 (rs4646903) were associated with maternal dioxin concentrations. However, differences in blood dioxin concentrations were relatively low.

DOI： 10.1016/j.toxlet.2013.03.013

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：ELSEVIER IRELAND LTD  

Dioxins are metabolized by cytochrome P450, family 1 (CYP1) via the aromatic hydrocarbon receptor (AHR). We determined whether different blood dioxin concentrations are associated with polymorphisms in AHR (dbSNP ID: rs2066853), AHR repressor (AHRR; rs2292596), CYP1 subfamily A polypeptide 1 (CYP1A1; rs4646903 and rs1048963), CYP1 subfamily A polypeptide 2 (CYP1A2; rs762551), and CYP1 subfamily B polypeptide 1 (CYP1B1; rs1056836) in pregnant Japanese women. These six polymorphisms were detected in 421 healthy pregnant Japanese women. Differences in dioxin exposure concentrations in maternal blood among the genotypes were investigated. Comparisons among the GG, GA, and AA genotypes of AHR showed a significant difference (genotype model: P = 0.016 for the mono-ortho polychlorinated biphenyl concentrations and toxicity equivalence quantities [TEQs]). Second, we found a significant association with the dominant genotype model ([TT + TC] vs. CC: P = 0.048 for the polychlorinated dibenzo-p-dioxin TEQs; P = 0.035 for polychlorinated dibenzofuran TEQs) of CYP1A1 (rs4646903). No significant differences were found among blood dioxin concentrations and polymorphisms in AHRR, CYP1A1 (rs1048963), CYP1A2, and CYP1B1. Thus, polymorphisms in AHR and CYP1A1 (rs4646903) were associated with maternal dioxin concentrations. However, differences in blood dioxin concentrations were relatively low. (C) 2013 Elsevier Ireland Ltd. All rights reserved.

DOI： 10.1016/j.toxlet.2013.03.013

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：WILEY-BLACKWELL  

Aim: This study aimed to determine the effect of a home visit program using a Functioning Improvement Tool (FIT) compared with a home visit using conversation alone. Methods: Twenty-eight participants (mean age, 78.6 +/- 7.5 years) were randomly assigned to an intervention (n = 13) or control (n = 15) group for 3 months. The intervention group received a 60-minute FIT home visit program; the control group received a 30-minute home visit using common conversational techniques. Measures were Mini-Mental State Examination, Frontal Assessment Battery (FAB) and Geriatric Depression Scale. Results: The FAB score was significantly improved in the intervention group compared with the control group (2.5 vs -0.5, P = 0.02). Conclusions: Our FIT home visit program improved cognitive function. Further studies with larger samples and longer follow-up periods are needed to assess the long-term effectiveness of a FIT home visit program on cognition.

DOI： 10.1111/j.1741-6612.2012.00589.x

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：ELSEVIER SCI LTD  

To better understand how to achieve high uptake rates of human papillomavirus (HPV) vaccination in Japan, we investigated acceptance of and attitudes towards HPV vaccination in 2192 mothers of girls aged 11-14 yrs. A school-based survey was conducted in five elementary and fourteen junior high schools in Sapporo, Japan. Responses from 862 participants were analyzed. Ninety-three percent of mothers would accept the vaccine for their daughter if free, but only 1.5% was willing to pay the minimum recommended price of (sic)40,000. Vaccine acceptance was higher in mothers who had heard of HPV vaccine (adjusted odds ratio, aOR = 2.58, confidence interval, Cl = 1.47-4.53), and who believed susceptibility to (aOR = 2.30, Cl = 1.34-3.92) and severity of (aOR = 3.73, Cl = 1.41-9.88) HPV to be high. Recommendations from a doctor (aOR = 12.60, Cl = 7.06-21.48) and local health board (aOR 27.80, Cl = 13.88-55.86) were also positively associated with increased HPV vaccine acceptance. Concerns about side effects of both the HPV vaccine (aOR = 0.03, Cl - 0.01-0.08) and routine childhood vaccines in general (aOR = 0.11, CI = 0.02-0.78) emerged as barriers to vaccination. Not participating in routine cervical screening also emerged as a deterrent (aOR = 0.49, Cl = 0.27-0.91). While most mothers (66.8%) agreed that 10-14 yr was an appropriate age for vaccination, a further 30.6% believed &gt;15 yr to be more appropriate.
In conclusion, attitudes of Japanese mothers toward HPV vaccination are encouraging. While lower vaccine acceptance in mothers who do not undergo regular cervical screening needs further investigation, this study indicates that high uptake may be possible in a publically funded HPV vaccination program if physicians actively address safety concerns and justify why the vaccine is needed at a particular age. (C) 2012 Elsevier Ltd. All rights reserved.

DOI： 10.1016/j.vaccine.2012.07.003

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The aim of this study was to document the exposure levels of pregnant women in Hokkaido to persistent organochlorine (POC) pesticides and the relationship between the body burdens of these pesticides and the study population's characteristics, such as age, pre-pregnancy body weight and calendar year in which blood was collected. From 2002 to 2005, whole blood samples were obtained from 186 pregnant women (aged 17 to 47 years) from the population of 514 women registered with the Sapporo Toho hospital cohort of the Hokkaido Study. Blood samples were analyzed by GC/NCIMS and GC/HRMS to quantify 29 POC pesticides. The subjects' demographic details were obtained from medical records and self-administered questionnaires. The Jonckheere-Terpstra test was used to determine relevant trends in the chemical concentrations of these pesticides and their relationship to the subjects' demographic details. Twenty-one of the 29 targeted compounds (including pesticides that have never been used in Japan, such as Mirex, Parlar-26 and Parlar-50) were detected in whole blood samples, and their log-transformed concentrations were found to significantly correlate with each other. The concentrations of p,p'-DDD, o,p'-DDE, p,p'-DDE, Parlar-26 and Parlar-50 declined from 2002 to 2005 (p<0.05). The pesticide concentrations appeared to have stronger associations with past conception than with parity, with most pesticide concentrations declining in a manner that appeared inversely related to past conceptions (p<0.05). Maternal age was positively associated with the following pesticide concentrations: p,p'-DDE, chlordanes group, cis-heptachlorepoxide, β-HCH and mirex. Maternal pre-pregnancy body weight was positively associated with the concentrations of dieldrin, HCB, β-HCH, Parlar-26 and Parlar-50, and appeared to be more strongly related to the body burdens of POC pesticides when compared with BMI associations. Further studies are required to evaluate the effects of POC pesticides on human health with regard to reproductive outcomes and child development.

DOI： 10.1016/j.scitotenv.2012.02.073

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：WILEY  

Objective: The aim was to determine whether mini mental state examination (MMSE) scores improved in older participants of a Functioning Improvement Tool (FIT) home-visit program. Methods: Two hundred fifty-two participants aged 65 years or older living at home and receiving preventive services or a community long-term care prevention project according to the Japanese social long-term care insurance system were enrolled and randomly assigned to an intervention group (n = 128) or a control group (n = 124). Intervention group subjects received a 60-min FIT home-visit program for 3 months, which included guidance, assistance, and help in writing and teaching calculation in order to complete the FIT. Control subjects did not receive any home visits. Cognitive function was evaluated by MMSE. Analysis of covariance was used to examine the effects of the FIT adjusting for baseline MMSE scores, age, and sex. Results: Fifty-three subjects were excluded because of withdrawal, hospitalization, death, relocation, or missing data of MMSE; 199 subjects (60 men, 139 women; age 78.6 +/- 7.4 years) were analyzed. The baseline MMSE scores did not differ between the intervention and control groups (24.2 +/- 4.3 vs. 24.1 +/- 4.7, p = 0.90). After the study period, the change in the MMSE score was significantly better in the intervention group than in the control group (0.8 +/- 0.3 vs. -0.1 +/- 0.2, p = 0.04). Stratified analyses showed that the intervention strategy was most effective in subjects with mild cognitive decline, with baseline MMSE scores from 18 to 23 points (1.9 +/- 0.5 vs. -0.1 +/- 2.8, p = 0.04). Conclusions: Our FIT home-visit program improved MMSE scores in older participants with mild cognitive decline. Copyright (C) 2011 John Wiley & Sons, Ltd.

DOI： 10.1002/gps.2753

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DOI： 10.1111/j.1442-200X.2011.03513.x

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：SPRINGER HEIDELBERG  

A higher prevalence of insomnia in females has been consistently demonstrated across countries and cultures. The aim of this study was to clarify whether gender differences in insomnia could be explained by gender differences in paid work and family responsibilities.Participants were employees at two local governments in Hokkaido, Japan, who underwent annual health checkups from April 2003 to March 2004. All data were obtained via self-administered questionnaires. Insomnia was evaluated by the Athens Insomnia Scale. For work and family characteristics, occupation, working hours, days off, shift work, visual display terminal (VDT) work, occupational stress, marital status, hours spent on household tasks, childcare, and caregiving were chosen. Data from 7,451 participants (5,951 men and 1,500 women) were analyzed. Logistic regression analysis examined how much paid work and family responsibilities explained gender differences in insomnia.The prevalence of insomnia in female subjects (31.0%) was significantly larger than in males (23.2%), but the gender difference disappeared after adjustment for paid work and family responsibilities. The results of stratified analyses revealed that significant gender differences were found only among workers with comparatively favorable work and family conditions, such as non-shift work, less than 6 h/day of VDT work, exposure to low levels of occupational stress, household tasks for less than 1 h/day, and not living with persons who needed care and support.These results suggest that gender differences in insomnia are explained, in the main, by gender differences in work and family characteristics.

DOI： 10.1007/s00127-011-0370-z

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：JAPAN EPIDEMIOLOGICAL ASSOC  

Background: Intracellular folate hemostasis depends on the 5,10-methylenetetrahydrofolate reductase (MTHFR) gene. Because 5,10-MTHFR 677TT homozygosity and tobacco smoking are associated with low folate status, we tested the hypothesis that smoking in mothers with 5,10-MTHFR C677T or A1298C polymorphisms would be independently associated with lower birth weight among their offspring.Methods: We assessed 1784 native Japanese mother-child pairs drawn from the ongoing birth cohort of The Hokkaido Study on Environment and Children's Health. Data (demographic information, hospital birth records, and biological specimens) were extracted from recruitments that took place during the period from February 2003 to March 2006. Maternal serum folate were assayed by chemiluminescent immunoassay, and genotyping of 5,10-MTHFR C677T/A1298C polymorphisms was done using a TaqMan allelic discrimination assay.Results: The prevalence of folate deficiency (< 6.8 nmol/L) was 0.3%. The 5,10-MTHFR 677CT genotype was independently associated with an increase of 36.40 g (95% CI: 2.60 to 70.30, P = 0.035) in mean infant birth weight and an increase of 90.70 g (95% CI: 6.00 to 175.50, P = 0.036) among male infants of nonsmokers. Female infants of 677TT homozygous passive smokers were 99.00 g (95% CI: -190.26 to -7.56, P = 0.034) lighter. The birth weight of the offspring of smokers with 5,10-MTHFR 1298AA homozygosity was lower by 107.00 g (95% CI: -180.00 to -33.90, P = 0.004).Conclusions: The results suggest that, in this population, maternal 5,10-MTHFR C677T polymorphism, but not the 5,10-MTHFR A1298C variant, is independently associated with improvement in infant birth weight, especially among nonsmokers. However, 5,10-MTHFR 1298AA might be associated with folate impairment and could interact with tobacco smoke to further decrease birth weight.

DOI： 10.2188/jea.JE20110039

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OBJECTIVE: To investigate whether a difference in the risk for diabetes exists in Japanese workers with regard to sleep duration/quality and the presence or absence of a family history of diabetes (FHD). RESEARCH DESIGN AND METHODS: The researchers conducted a prospective, occupational-based study of local government employees in Sapporo, Japan. Between April 2003 and March 2004, 3,570 nondiabetic participants, aged 35-55 years, underwent annual health checkups and completed a self-administered questionnaire that included information on sleep duration/quality and FHD at baseline. Having diabetes was defined as taking medication for diabetes or a fasting plasma glucose level of ≥126 mg/dL at follow-up (2007-2008). RESULTS: A total of 121 (3.4%) new cases of diabetes were reported. In multivariate logistic regression models of workers without an FHD, and after adjustment for potential confounding factors, the odds ratio (95% CI) for developing diabetes was 5.37 (1.38-20.91) in those with a sleep duration of ≤5 h compared with those with a sleep duration of >7 h. Other risk factors were awakening during the night (5.03 [1.43-17.64]), self-perceived insufficient sleep duration (6.76 [2.09-21.87]), and unsatisfactory overall quality of sleep (3.71 [1.37-10.07]). In subjects with an FHD, these associations were either absent or weaker. CONCLUSIONS: The current study shows that poor sleep is associated with a higher risk of developing diabetes in workers without an FHD. Promoting healthy sleeping habits may be effective for preventing the development of diabetes in people without an FHD.

DOI： 10.2337/dc11-1455

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：ROYAL SOC CHEMISTRY  

Exposure to various chemicals can cause adverse effects to health, such as asthma and allergies, especially in children. Data on personal exposure levels in children are scarce, thus small lightweight diffusive mini-samplers for aldehydes and volatile organic compounds (VOCs) were designed to measure the exposure level of children to these chemicals. The aim of the study was to validate and examine the applicability of these mini-samplers for measuring daily chemical exposure. The diffusive mini-samplers are 20 mm in length, 11 mm in diameter, and 1.67 g in weight. The devices are cylindrically shaped with polytetrafluoroethylene membrane filters placed at each end. To measure aldehydes and acetone, 20 mg of 2,4-dinitrophenylhydrazine was used as an absorbent. To measure VOCs, a carbon molecular sieve was used. The sampling rate for each chemical was determined by parallel sampling with active samplers in a closed exposure bag. The blank levels of the chemicals and the storage stability of the device were tested. The mini-samplers were compared to commercially available diffusive samplers. To examine the applicability of the samplers, 65 elementary school children carried them for 24 h. The sampling rates for formaldehyde, acetaldehyde, and acetone were 20.9, 22.9, and 19.7 mL min(-1), respectively. The limits of quantification (LOQ) for the 24-hour sampling by high-performance liquid chromatography/ultraviolet (HPLC/UV) analysis were 8.3, 7.6, and 8.8 mu g m(-3) for formaldehyde, acetaldehyde, and acetone, respectively. The sampling rates for the 11 VOCs were determined and ranged from 3.3 mL min(-1) for styrene and 2-ethyl-1-hexanol to 11.7 mL min(-1) for benzene. The LOQ for the 24-hour sampling by gas chromatography-mass spectrometry (GC-MS) analysis ranged from 5.9-105.2 mu g m(-3), 1.1-24.7 parts per billion. The storage stability after 5 days ranged from 94.8 to 118.2%. Formaldehyde, acetone, benzene, and toluene were detected above the LOQ in more than 90% of the children, and the median concentrations were 21.7, 20.9, 10.1, and 21.5 mu g m(-3), respectively. This study shows that the diffusive samplers developed were suitable for children to carry and were capable of measuring the children's daily chemical exposure.

DOI： 10.1039/c1em10624d

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Language：Japanese   Publisher：The Japanese Society of Toxicology  

Background: Reported evidence regarding relationships between PCBs at low exposure levels and thyroid homeostasis in adults and neonates has been considered contradictory.Objectives: To investigate the relationship between maternal specific PCB congener levels and maternal and neonatal thyroid hormone (TH) levels.Methods: We conducted a prospective cohort study of pregnant women from 2002 to 2005 in Sapporo, Japan. Maternal blood samples for measurement of PCBs were collected between 23 weeks of gestation and one week after delivery. Congener-specific analysis of PCBs was conducted using HRGC/HRMS. Maternal (n = 386) and infant (n = 411) blood samples for measurement of THs were obtained between 7 and 20 gestational weeks and between 4 and 7 days of age after birth, respectively. THs were measured by enzyme-linked immunosorbent assay as public screening program. Characteristics of mothers and their neonates were obtained from self-administered questionnaires and medical records. Results: Maternal fT4 increased significantly with high non-ortho PCB concentrations. There were no significant associations among PCB levels and maternal TSH or neonatal TSH or fT4. Stratified analysis by neonatal gender showed no associations.

DOI： 10.14869/toxpt.39.2.0.AP-107.0

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We measured the concentrations of polychlorinated dibenzo-p-dioxins (PCDDs), polychlorinated dibenzofurans (PCDFs), dioxin-like polychlorinated biphenyls (PCBs), and non-dioxin-like PCBs in paired samples of blood and breast milk collected from 67 secundiparas in Sapporo City, Japan, and combined this data with those of the 30 secundiparas previously measured. The arithmetic mean total toxic equivalents (TEQ-WHO) concentrations of PCDDs, PCDFs, non-ortho PCBs, and mono-ortho PCBs in blood and breast milk of the 97 secundiparous subjects were 3.0-23 (mean: 13, median: 14) and 2.7-20 (mean: 8.6, median: 8.5) pg TEQ g(-1) lipid, respectively. The sums of the concentrations of 56 non-dioxin-like PCB congeners that were measured in the subjects' blood and breast milk were 16-326 (mean: 107, median: 100) and 12-252 (mean: 73, median: 67) ng g(-1) lipid, respectively. The partitioning ratios of individual congeners of PCDDs, PCDFs, dioxin-like PCBs, and non-dioxin-like PCBs from blood to breast milk in secundiparas were almost the same as those of primiparas that have been recently reported, suggesting that the partitioning ratios of these compounds from maternal blood to breast milk in women is little affected by delivery. Furthermore, the partition of PCB congeners with chlorine at the 2-, 3-, 4'-, and 5-positions or the 2-, 4-, 4'-, and 5-positions of the biphenyl ring from the blood to the breast milk tended to occur at a higher level than that of other congeners. In particular, the levels of tetraCB-74 and hexaCB-146 in the breast milk for both primiparous and secundiparous mothers were slightly higher than those in the blood.

DOI： 10.1016/j.chemosphere.2011.09.014

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：ELSEVIER SCIENCE BV  

Maternal smoking is a critical public health concern requiring the establishment of its prevalence rate and clinical impact. Maternal self-reported information of tobacco smoke exposure requires validation using accurate biochemical analysis. This study examined the association between self-reported exposure to tobacco smoke and plasma cotinine level in Japanese pregnant women. We collected information about smoking and secondhand smoke (SHS) exposure during pregnancy from 5128 pregnant women in a prospective cohort design, and analyzed biochemically maternal blood samples using the enzyme-linked immunosorbent assay (ELISA) technique. Based on self-reports, the subjects were classified into three groups: 650 smokers, 728 ex-smokers and 3750 non-smokers. Using the receiver operating characteristic (ROC) curve, plasma cotinine cut-off value of 11.48 ng/mL was established for separating smokers from non-smokers, resulting in a smoking prevalence of 14%. A cotinine cut-off value of 0.21 ng/mL for discriminating exposed and unexposed nonsmokers resulted in a 63% prevalence of exposure to tobacco smoke among nonsmokers. Cotinine biomarker analysis proved accurate in validating self-reported smoking information in the subjects. Lower validity of SHS exposure suggests a need to confirm questionnaire information with biochemical analysis. (C) 2011 Elsevier B.V. All rights reserved.

DOI： 10.1016/j.scitotenv.2011.10.019

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：OXFORD UNIV PRESS INC  

Objectives: The aim of this study is to examine the relationship between self-reported sleep duration and arterial stiffness in a large-scale Japanese study.Design: Cross-sectional study.Setting: Sapporo City, Hokkaido, Japan.Participants: Local government employees aged 35-62 years, who underwent annual health checkups from April 2003 to March 2004. After excluding those with incomplete data, data from 4,268 employees (males: 3,410) participants were analyzed.Interventions: N/A.Measurements and Results: Brachial-ankle pulse-wave velocity (baPWV) was investigated as an indicator of arterial stiffness. We used a self-administered questionnaire, which included items on daily sleep duration, lifestyle factors, and occupational factors. Sleep duration was classified into 5 categories; "<= 5 h," "6 h," "7 h," "8 h," and ">= 9 h." Results of multiple linear regression analysis after fully adjusting the model revealed that subjects with = 9 h of daily sleep had significantly elevated baPWV values compared with the reference group with 7 h of sleep. Stratified analyses by sex showed that there was a significant association among male subjects only.Conclusions: Daily sleep duration = 9 h was found to be associated with elevated values of baPWV. This suggests that there is an association between long sleep duration and arterial stiffness.

DOI： 10.5665/sleep.1434

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DOI： 10.1093/ije/dyq071

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Language：Japanese   Publishing type：Research paper (scientific journal)   Publisher：The Japanese Society for Hygiene  

Objectives: This study was performed to evaluate the levels of exposure to persistent organochlorine pesticides in pregnant women in Hokkaido.<br> Methods: Whole-blood samples were obtained from 70 pregnant women aged 17 to 39 years in Hokkaido and analyzed to quantify 29 organochlorine pesticides by gas chromatography/negative ion chemical ionization mass spectrometry and gas chromatography/high-resolution mass spectrometry.<br> Results: Among 29 target compounds, 20 were detected in the whole-blood samples. Mirex, Parlar-26, and Parlar-50, which have never been used in Japan, were identified in all samples, as well as 11 compounds that have been used in Japan. Log-transformed concentrations of compounds with detection rates above 60% linearly correlated with each other (p<0.01). <i>p,p</i>′-DDE exhibited the highest concentration, with a geometric mean of 730 pg/g wet weight. From the results of the Jonckheere-Terpstra trend test, body weight or age was positively associated with the concentrations of several compounds.<br> Conclusions: We detected 22 organochlorine pesticides including pesticides with no history of use in Japan in the whole-blood samples from pregnant women in Hokkaido. Through long-distance transport mechanisms, these pollutants may distribute widely, and further surveillance of human blood, in addition to foods and the environment, should be conducted.<br>

DOI： 10.1265/jjh.66.95

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Other Link： https://jlc.jst.go.jp/DN/JALC/00363866664?from=CiNii

Language：English   Publisher：LIPPINCOTT WILLIAMS & WILKINS  

DOI： 10.1097/01.ede.0000392424.44805.25

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Language：English   Publisher：LIPPINCOTT WILLIAMS & WILKINS  

DOI： 10.1097/01.ede.0000392447.84581.fc

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AIM: Helicobacter Pylori infection was associated with the risk of cardiovascular disease; however, the relation between Helicobacter Pylori infection and the lipid profile has not been fully established. METHODS: We measured anti-Helicobacter Pylori antibody concentration and lipid profiles in 6,289 Japanese subjects aged 21-64 years (5,077 male and 1,212 female). RESULTS: The prevalence of Helicobacter Pylori-seropositive subjects was 46.8% and 39.6% in men and women, respectively. Adjusted mean values of low-density lipoprotein (LDL) cholesterol and high-density lipoprotein (HDL) cholesterol in men were significantly higher and lower in Helicobacter Pylori-seropositive than-negative subjects, respectively, (LDL-cholesterol: 129.0±0.8 vs. 125.3±0.7 mg/dL, p< 0.001, HDL-cholesterol: 54.6±0.3 vs. 56.6±0.3 mg/dL, p< 0.01), whereas these associations were not significant in female subjects. Moreover, the odds ratio of Helicobacter Pylori infection for high LDL-cholesteremia and low HDL-cholesteremia in male subjects was 1.23 (95% CI (confidence interval): 1.08-1.40, p< 0.05) and 1.29 (95% CI: 1.03-1.59, p< 0.05), respectively. Female subjects did not have such associations. CONCLUSIONS: The present study demonstrates that Helicobacter Pylori infection is significantly associated with high LDL-cholesteremia and low HDL-cholesteremia in Japanese male subjects.

DOI： 10.5551/jat.5157

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Language：Japanese   Publisher：(一社)日本衛生学会  

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We measured the concentrations of polychlorinated dibenzo-p-dioxins (PCDDs), polychlorinated dibenzofurans (PCDFs), dioxin-like polychlorinated biphenyls (PCBs), and non-dioxin-like PCBs in paired samples of blood and breast milk collected from 89 primiparous mothers in Sapporo City, Japan, and studied the relationships of these compounds between blood and breast milk for these women plus 30 primiparous mothers in whom these data had been previously reported. The present study is one of the few studies in which the concentration distributions of PCDDs, PCDFs, dioxin-like PCBs, and non-dioxin-like PCBs have been investigated in blood and breast milk collected from the same mothers. The arithmetic mean TEQ concentrations of PCDDs, PCDFs, non-ortho PCBs, and mono-ortho PCBs in blood and breast milk of these 119 subjects were 8.2, 2.9, 5.1, and 0.4 pg TEQ g(-1)lipid, respectively, and 4.8, 2.0, 4.0, and 0.4 pg TEQ g(-1)lipid, respectively, with the total TEQ concentrations of these dioxin-like compounds being 7.0-36 (mean: 17, median: 14) and 5.7-41 (mean: 11, median: 10) pg TEQ g(-1)lipid, respectively. The sums of the concentrations of 56 non-dioxin-like PCB congeners that were measured in the subjects' blood and breast milk were 43-445 (mean: 120, median: 106) and 34-366 (mean: 90, median: 81) ng g(-1)lipid, respectively, indicating that the total TEQ concentration and the total concentration of 56 non-dioxin-like PCB congeners in the maternal blood were notably higher than those in the breast milk. Statistically significant correlations were observed between maternal age and the total TEQ concentration of PCDDs, PCDFs, and dioxin-like PCBs or the total concentration of 56 non-dioxin-like PCB congeners in maternal blood, and significant correlations were also observed between maternal age and the total TEQ concentration of these dioxin-like compounds or the total concentration of 56 PCB congeners in breast milk. The total TEQ concentration of PCDDs, PCDFs, and dioxin-like PCBs in maternal blood showed a close correlation to that in subjects' breast milk, and there was also good correlation between the total concentration of 56 non-dioxin-like PCB congeners in maternal blood and that in subjects' breast milk. Pearson and Spearman correlation analyses showed a relationship between the total TEQ concentration of PCDDs, PCDFs, and dioxin-like PCBs and the total concentration of 56 non-dioxin-like PCB congeners in maternal blood, and also showed an association between the total TEQ concentration of these dioxin-like compounds and the total concentration of 56 PCB congeners in breast milk. The concentration of hexaCB-153 in maternal blood showed significant correlations to the total TEQ concentration of PCDDs, PCDFs, and dioxin-like PCBs or the total concentration of 56 non-dioxin-like PCBs in that sample. Moreover, the concentration of hexaCB-153 in breast milk also showed significant correlations to the total TEQ concentration of these dioxin-like compounds or the total concentration of 56 PCB congeners in that sample. These findings suggested that hexaCB-153 may be an indicator of total TEQ concentrations of PCDDs, PCDFs, and dioxin-like PCBs and total concentrations of 56 non-dioxin-like PCB congeners in blood and breast milk of primiparous mothers.

DOI： 10.1016/j.chemosphere.2009.09.047

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The aim of this study was to examine the effects of a stress inoculation training program for civil servants through a non-randomized trial. We divided 140 civil servants into two groups (an intervention group and a waiting list control group), and carried out three sessions with the intervention group at intervals of four weeks. The sessions included lectures on responses to stress and coping skills, problem-solving training, group discussions and self-monitoring. Data from 65 subjects in the intervention group and 63 subjects in the waiting list group were analyzed using two-way analysis of covariance (ANCOVA). The intervention group showed statistically significant development of problem-solving skills and positive cognition, with a significant effect remaining one month after the intervention. The effect sizes in the intervention group showed a small-to-medium change in problem-solving coping and small changes in positive cognitive coping. However, no interventional effects were seen in terms of response to stress and health competence. As the number of existing studies on job stress management for workers is limited, further research in this field is necessary, including examination of the frequency and methods of intervention sessions, the effects of intervention by gender, etc.

DOI： 10.2486/indhealth.47.173

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：SPRINGER  

Numerous studies have reported the relationships between job characteristics and coronary heart diseases. However, there are only a few reports on the association between occupational stresses and arterial stiffness as a marker of early stage arthrosclerosis. The aim of this study was to clarify the relationship between occupational stress models-Siegrist's effort reward imbalance and Karasek's demand control model (DCM)-and arterial stiffness using brachial-ankle pulse-wave velocity (baPWV).The participants were local government employees (3,412 men and 854 women) aged 35 and over who had their annual health checkups. The associations between occupational stress questionnaires of the two theoretical models and a risk of increased arterial stiffness using baPWV were examined.On performing multiple linear regression analysis after fully adjusting the model, high strain, which was defined as a combination of both low job control and high job demands in the DCM, was found to be significantly associated with a high risk of arterial stiffness (P = 0.027) in women. However, in men, although low job control was positively significant with a high value of baPWV adjusted for each step, modest but not significant association was found after adjustment for all covariates.In conclusion, the present study indicates that high strain indicated by high demands and low control is associated with increased arterial stiffness in women. The types of job stress associated with a high risk of arterial stiffness may differ by gender.

DOI： 10.1007/s00420-008-0319-z

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：ELSEVIER IRELAND LTD  

The purpose of this study wits to determine the changes with time lapse in the influences of social relationship factors, in relation to mortality in the elderly. A baseline investigation was conducted in 1992 and survival conditions of 637 subjects aged 68-82 years were followed up for 12 years. The associations of social relationships with mortality were compared between the first and later half periods. The results showed that for men, close friends, group membership and finding life worth living were significantly associated with mortality in the first half period and the association disappeared in the later half; also in men, providing instrumental support was significantly associated in the 12-year period. In the first half, living arrangement was not significantly associated with mortality for men, and marital status and job were not for women, but in the later half, the association of those became apparent. The present study suggests that for men, the association of close friends, group membership and finding life worth living with mortality decreased with the passage of time while providing instrumental support had positive effects throughout the long term. The association of living arrangement increased for men, and marital status and job for women. (C) 2007 Elsevier Ireland Ltd. All rights reserved.

DOI： 10.1016/j.archger.2007.08.015

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This study investigates whether the two socioeconomic status indicators, educational level and employment grade, are associated with C-reactive protein (CRP) levels and arterial stiffness among Japanese urban civil servants. Brachial-ankle pulse-wave velocity (baPWV) as an indicator of arterial stiffness, CRP, occupational stress and conventional risk factors were evaluated in 3412 men and 854 women. Although the socioeconomic gradient showed a significant association with the CRP levels in men after adjustment for age, the significance disappeared after multivariate adjustment, whereas in women, the socioeconomic gradient showed no significant association with the CRP levels. In men, educational level was significantly associated with the baPWV value after adjustment for conventional risk factors, CRP and occupational stress (P for trend <0.0001). With regards to employment grade, only low-level non-manual workers had a significantly lower baPWV value as compared to manual workers at a fully adjusted model, and trend significance disappeared. However, in women, neither educational level nor employment grade was associated with the baPWV value. In summary, the socioeconomic gradient, especially the educational level, was significantly inversely related to the baPWV value in men. In women, the socioeconomic gradient was not related to the baPWV value. An inverse relationship between the socioeconomic gradient and CRP levels was found in men only after age adjustment. We suggest that because the educational level is an important aspect in the adolescent environment and hence might influence the future lifestyle, early health education should be provided to prevent an unfavourable lifestyle and atherosclerotic diseases in later life.

DOI： 10.1016/j.socscimed.2008.06.014

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BACKGROUND AND AIMS: The relationships between gamma-glutamyltransferase (GGT), C-reactive protein (CRP), and arterial stiffness have not been fully investigated. The aim of this study was to clarify whether serum GGT is related to CRP and arterial stiffness estimated using brachial-ankle pulse wave velocity (baPWV). METHODS AND RESULTS: The subjects were 3412 males and 854 females. GGT, CRP, baPWV, and conventional risk factors were evaluated. On multiple regression analysis, after adjustment for the conventional risk factors, log GGT was significantly associated with log CRP in male and female subjects (male subjects: beta=0.168, p<0.0001; female subjects: beta=0.098, p<0.05). After adjustment for the conventional risk factors, log GGT was significantly associated with PWV in male subjects (beta=0.060, p<0.0001), but in female subjects, no significant relationships were found after adjustment (beta=0.007, p=0.82). CONCLUSION: These results suggest that GGT is independently associated with an increased level of CRP in both males and females. In addition, in males, GGT is related to an increased level of arterial stiffness.

DOI： 10.1016/j.numecd.2006.10.002

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Language：Japanese   Publisher：(一社)日本衛生学会  

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Other Link： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2008&ichushi_jid=J01030&link_issn=&doc_id=20080313390242&doc_link_id=%2Fch4eisei%2F2008%2F006302%2F254%2F0495-0495%26dl%3D0&url=http%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fch4eisei%2F2008%2F006302%2F254%2F0495-0495%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

Language：English   Publishing type：Research paper (scientific journal)   Publisher：WILEY  

Background Visual display terminal (VDT) work has become very common among office workers in developed countries; however, studies investigating the association between the duration of daily VDT work and insomnia are limited.Methods The aim of this study was to clarify the association between the duration of daily VDT work and sleep disturbances. We investigated 2,417 clerks (men, 2,030; women, 387) at local government offices. Sleep disturbances were evaluated using the Athens Insomnia Scale (AIS).Results VDT work of 6 hr or more per day was significantly associated with insomnia (odds ratio = 1.62, 95% confidence interval: 1.16-2.27) and, in particular, caused problems with "total sleep duration" and "sleepiness during the day" among sleep-related symptoms, even after adjusting for possible confounding factors.Conclusions Our study suggested that VDT work of 6 hr or longer per day was related to insomnia.

DOI： 10.1002/ajim.20543

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There is increasing evidence from epidemiological studies that genetic susceptibilities may modify the teratogenic effects of toxic chemicals. However, in contrast to tobacco smoke, few epidemiological studies have addressed environmental chemicals, such as polychlorinated dibenzo-p-dioxins, polychlorinated dibenzofurans and polychlorinated biphenyls in regard to genetic susceptibility. Recent studies, including the Hokkaido Study of Environments and Children's Health, have investigated the impacts of both environmental and genetic factors on children's development. Several xenobiotic-metabolizing genes have been reported to confer genetic susceptibility to low birth weight. These genes seem to be influenced functionally by maternal smoking during pregnancy, itself a significant risk factor. In our study, we found that birth weight was significantly lower among infants born to smoking women having the specific AHR, CYP1A1, GSTM1, CYP2E1 and NQO1 genotypes. When combinations of these genotypes were considered, birth weight was even lower. On the other hand, congenital anomalies such as hypospadias seemed to be caused by environmental factors in conjunction with genetic predisposition as suggested by linkage in several case-control studies reported to low birth weight. We have found an association between maternal CYP1A1 genotype or low birth weight and the risk of hypospadias irrespective of smoking. At the same time, birth weight was negatively correlated with maternal blood concentrations of polychlorinated dibenzofurans. Further studies should elucidate the impact of genetic factors on adverse effects of exposures to dioxin-related chemicals.

DOI： 10.1111/j.1742-7843.2007.00201.x

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：WILEY  

There is increasing evidence from epidemiological studies that genetic susceptibilities may modify the teratogenic effects of toxic chemicals. However, in contrast to tobacco smoke, few epidemiological studies have addressed environmental chemicals, such as polychlorinated dibenzo-p-dioxins, polychlorinated dibenzofurans and polychlorinated biphenyls in regard to genetic susceptibility. Recent studies, including the Hokkaido Study of Environments and Children's Health, have investigated the impacts of both environmental and genetic factors on children's development. Several xenobiotic-metabolizing genes have been reported to confer genetic susceptibility to low birth weight. These genes seem to be influenced functionally by maternal smoking during pregnancy, itself a significant risk factor. In our study, we found that birth weight was significantly lower among infants born to smoking women having the specific AHR, CYP1A1, GSTM1, CYP2E1 and NQO1 genotypes. When combinations of these genotypes were considered, birth weight was even lower. On the other hand, congenital anomalies such as hypospadias seemed to be caused by environmental factors in conjunction with genetic predisposition as suggested by linkage in several case-control studies reported to low birth weight. We have found an association between maternal CYP1A1 genotype or low birth weight and the risk of hypospadias irrespective of smoking. At the same time, birth weight was negatively correlated with maternal blood concentrations of polychlorinated dibenzofurans. Further studies should elucidate the impact of genetic factors on adverse effects of exposures to dioxin-related chemicals.

DOI： 10.1111/j.1742-7843.2007.00201.x

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Language：Japanese   Publishing type：Research paper (scientific journal)  

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AIM: To investigate whether the pro- and anti-inflammatory cytokine gene polymorphisms, IL1B-511C/T, IL1B-31C/T, IL6-634C/G, TNF-1031T/C, TNF-857C/T, and IL10-1082A/G, interact with smoking and drinking habits to influence infection with H pylori. METHODS: The subjects were 410 Japanese transit company employees. C-reactive protein and conventional cardiovascular risk factors were evaluated. Serum anti-H pylori antibodies were measured. The genotypes of IL1B-511C/T, IL1B-31C/T, IL6-634C/G, TNF-1031T/C, TNF-857C/T, and IL10-1082A/G polymorphisms were determined by allelic discrimination using fluorogenic probes and a 5' nuclease assay. RESULTS: In gender- and age-adjusted logistic analyses, the subjects with TNF-857T/T had a significantly lower odds ratio (OR) for H pylori seropositivity (reference -857C/C; OR = 0.15, 95% CI: 0.03-0.59, P = 0.007). After stratification according to smoking and drinking status, among never-smokers, the subjects with IL1B-511C/T had a significantly lower OR (reference -511C/C; OR = 0.30, 95% CI: 0.10-0.90, P = 0.032). Among drinkers in the 1-5 times/wk category, the subjects with IL1B-511T/T had a significantly lower OR (reference C/C; OR = 0.38, 95% CI: 0.16-0.95, P = 0.039), and the subjects with IL1B-31C/T and T/T had a significantly higher OR (reference C/C; C/T: OR = 2.59, 95% CI, P = 0.042: 1.04-6.47; C/C: OR = 3.17, 95% CI: 1.23-8.14, P = 0.017). Among current smokers, the subjects with IL6-634C/G had a significantly higher OR (reference C/C; OR = 2.28, 95% CI: 1.13-4.58, P = 0.021). However, the interactions terms between the aforementioned genotypes and lifestyles were not statistically significant. CONCLUSION: Contrary to previous findings, the results herein suggest that the TNF-857T/T genotype may be protective against chronic infection with H pylori. Drinking and smoking habits may influence the effect of cytokine gene polymorphisms. Further studies are required to clarify the effects of the pro- and anti-inflammatory cytokine polymorphisms and gene-environmental interactions on H pylori infection.

DOI： 10.3748/wjg.v13.i33.4445

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：W J G PRESS  

AIM: To investigate whether the pro- and anti-inflammatory cytokine gene polymorphisms, IL1B-511C/T, IL1B-31C/T, IL6-634C/G, TNF-1031T/C, TNF-857C/T, and IL10-1082A/G, interact with smoking and drinking habits to influence infection with Hpylori.METHODS: The subjects were 410 Japanese transit company employees. C-reactive protein and conventional cardiovascular risk factors were evaluated. Serum anti-H pylori antibodies were measured. The genotypes of IL1B-511C/T, IL1S-31C/T, IL6-634C/G, TNF-1031T/C, TNF-857C/T, and IL10-1082A/G polymorphisms were determined by allelic discrimination using fluorogenic probes and a 5' nuclease assay.RESULTS: In gender- and age-adjusted logistic analyses, the subjects with TNF-857T/T had a significantly lower odds ratio (OR) for H pylori seropositivity (reference -857C/C; OR = 0.15, 95% CI: 0.03-0.59, P = 0.007). After stratification according to smoking and drinking status, among never-smokers, the subjects with IL1B-511C/T had a significantly lower OR (reference -511C/C; OR = 0.30, 95% CI: 0.10-0.90, P = 0.032). Among drinkers in the 1-5 times/wk category, the subjects with IL1B-511T/T had a significantly lower OR (reference C/C; OR = 0.38, 95% CI: 0.16-0.95, P = 0.039), and the subjects with IL1B-31C/T and T/T had a significantly higher OR (reference C/C; C/T: OR = 2.59, 95% CI, P = 0.042: 1.04-6.47; C/C: OR = 3.17, 95% CI: 1.23-8.14, P = 0.017). Among current smokers, the subjects with IL6-634C/G had a significantly higher OR (reference C/C; OR = 2.28, 95% CI: 1.13-4.58, P = 0.021). However, the interactions terms between the aforementioned genotypes and lifestyles were not statistically significant.CONCLUSION: Contrary to previous findings, the results herein suggest that the TNF-857T/T genotype may be protective against chronic infection with H pylori. Drinking and smoking habits may influence the effect of cytokine gene polymorphisms. Further studies are required to clarify the effects of the pro- and anti-inflammatory cytokine polymorphisms and gene-environmental interactions on Hpylori infection. (c) 2007 WJG. All rights reserved.

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Smoking and interleukin-6 (IL-6) are major factors in inflammation. The aim of this study was to investigate whether or not the IL6 -634C/G polymorphism (rs1800796) and its interaction with smoking influence serum C-reactive protein (CRP) concentrations. The subjects were 347 Japanese male employees of a transit company. CRP and conventional cardiovascular risk factors were evaluated. IL6 -634C/G polymorphisms were genotyped by allelic discrimination using fluorogenic probes and the 5' nuclease assay. The mean values of CRP were significantly higher in current smokers than in nonsmokers after adjustment for age, body mass index (BMI), systolic blood pressure, total cholesterol, log triglycerides, high-density lipoprotein cholesterol (HDL-C), fasting glucose, and drinking habit (p=0.011). Comparison of three genotypes revealed significant interaction between smoking and the IL6 -634C/G genotype manifested by CRP concentrations (p=0.007) after the adjustments cited above. After stratification by smoking status, CRP differed significantly among IL6 -634C/G genotypes groups in nonsmokers (p=0.010, p for trend=0.007), whereas no significant difference was found in current smokers. Comparison between -634C/C and C/G+G/G groups revealed also a significant interaction between smoking and the IL6 -634C/G genotype (p=0.007). These findings suggest that the impact of the -634G allele on CRP elevation is greater in nonsmokers than in current smokers. Since gene-environment interactions have been insufficiently examined, further studies are required to clarify their effect on inflammation, including CRP elevation.

DOI： 10.1291/hypres.30.593

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The aim of the present study was to identify relations between occupational stress and occupational class in Japanese civil servants, using two occupational stress models-the Effort-Reward Imbalance (ERI) Model and the Job Demand-Control (JDC) Model. The subjects were employees of three local public organizations. We distributed self-administered questionnaires and assessed occupational stress by ERI and JDC. We used seven occupational categories based on the Standard Occupational Classification for Japan. The data of 6,423 male and 1,606 female subjects were analyzed by logistic regression analysis to obtain odds ratios (OR) for relations between occupational stress and occupational class. In JDC, male clerical workers, transport/communication workers and protective service workers showed a significantly higher OR of being in the high occupational stress group, compared to managers. In ERI, male professionals/technicians, transport/communication workers, clerical workers and protective service workers showed a significantly higher prevalence OR, compared to managers, the two models giving different results. In ERI, female production workers/laborers and clerical workers had a significantly lower prevalence OR, compared to managers. The results of this study showed that occupational stress differed by occupational class and the two occupational stress models gave different results for occupational classes with high occupational stress.

DOI： 10.2486/indhealth.45.247

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Language：Japanese   Publisher：(一社)日本衛生学会  

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Other Link： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2007&ichushi_jid=J01030&link_issn=&doc_id=20070314480227&doc_link_id=%2Fch4eisei%2F2007%2F006202%2F248%2F0558-0558%26dl%3D0&url=http%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fch4eisei%2F2007%2F006202%2F248%2F0558-0558%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

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The aim of this study was to investigate whether the metabolic syndrome (MS) was associated with an elevated level of C-reactive protein (CRP) and increased arterial stiffness, and to clarify whether combined MS and CRP data had a stronger relation to arterial stiffness than did MS data alone. Brachial-ankle pulse wave velocity (baPWV), CRP, and conventional risk factors were evaluated in 3,412 men and 854 women. Adjusted mean values of baPWV in men with 0, 1, 2, and > or = 3 components were 1,309, 1,372, 1,422, and 1,462 cm/s, respectively (p for trend <0.001). Adjusted mean values of baPWV in women with 0, 1, 2, and > or =3 components were 1,212, 1,292, 1,357, and 1,391 cm/s, respectively (p for trend <0.001). Adjusted geometric mean concentrations of CRP in men with 0, 1, 2, and > or = 3 components were 0.036, 0.049, 0.059, and 0.076 mg/dI, respectively (p for trend <0.001). Adjusted geometric mean concentrations of CRP in women with 0, 1, 2, and > or = 3 components were 0.023, 0.030, 0.057, and 0.077 mg/dI, respectively (p for trend <0.001). In analyses of adjusted mean values of baPWV according to the number of MS components and according to CRP levels within or without top quartile levels, the p value for the trend was significant (<0.001) in both men and women but, in post hoc analyses, comparing high and low CRP levels in each MS component-number group, no significant difference was found. These results suggest that, for prediction of increased arterial stiffness, combining MS and CRP data has little additive effect compared to the use of MS data alone.

DOI： 10.1291/hypres.29.589

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Language：Japanese   Publisher：Japan Society for Occupational Health  

DOI： 10.1539/sangyoeisei.KJ00004429816

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：NATURE PUBLISHING GROUP  

The relationships between C-reactive protein (CRP), uric acid (UA), glomerular filtration rate (GFR), and arterial stiffness have not been fully investigated. The aim of this study was to clarify whether CRP, UA, and estimated GFR are related to arterial stiffness estimated using brachial-ankle pulse wave velocity (baPWV). The subjects were local government employees (3412 men and 854 women). baPWV, CRP, UA, GFR, and conventional risk factors were evaluated. Multiple linear regression analyses revealed that CRP and UA were significantly related to an elevation of PWV in male and female subjects, and that the estimated GFR was significantly related to an elevation of PWV in male subjects. Significant progressive increases in baPWV were observed across the quartiles of CRP in male subjects and for UA in male and female subjects. In female subjects, the relationship of quartile CRP to baPWV had marginal significance (P=0.055). But, in male and female subjects, quartile of estimated GFR had no significant association with PWV. These results suggest that CRP and UA are associated with an increase of arterial stiffness in male and female subjects, and that estimated GFR is possibly related to arterial stiffness in male subjects.

DOI： 10.1038/sj.jhh.1001913

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STUDY OBJECTIVE: The aims of this study were to (a) examine the association between occupational stress and insomnia and short sleep in Japanese workers and (b) demonstrate the difference between 2 occupational stress models-Effort Reward Imbalance and the Demand Control Model. DESIGN: All data were obtained via self-administrated questionnaires and annual health checkups. Insomnia was evaluated by the Athens Insomnia Scale, and short sleep was defined as less than 6 hours sleep per day. SETTING: Employees at local governments and a transit company who had annual health checkups during the period from April 2003 to March 2004. PARTICIPANTS: After excluding participants without complete data, data from 6,997 men and 1,773 women were analyzed. INTERVENTION: N/A. MEASUREMENTS AND RESULTS: In men, high occupational stresses were significantly associated with insomnia, especially a high level of Effort Reward Imbalance (defined as the presence of high effort and low reward), had a remarkably higher odds ratio. In women, high occupational stresses were significantly associated with insomnia as well. High occupational stresses were significantly associated with short sleep in men. However, in women, only Effort Reward Imbalance showed a significant association with short sleep. CONCLUSIONS: This study suggested that occupational stress is a possible risk factor for insomnia and short sleep.

DOI： 10.1093/sleep/28.6.728

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Beta2-Microglobulin (beta2m) is related to inflammatory diseases, but there have been few reports of a relationship between beta2m and atherosclerosis. We have examined the influence of beta2m on brachial-ankle pulse wave velocity (baPWV) to clarify whether it is related to arterial stiffness. baPWV, beta2m, C-reactive protein (CRP), and conventional risk factors were measured in 614 males and 158 females. The adjusted means of baPWV were compared with the quartiles of beta2m, and significant differences in baPWV were observed across the quartiles of beta2m (p = 0.037). After being adjusted for potential confounders, quartile 4 of beta2m, quartile 4 of CRP, and the combination of high beta2m plus high CRP were significantly associated with a high value of PWV (quartile 4 of beta2m: odds ratio [OR] 2.53, 95% confidence interval [CI], 1.31-4.89; quartile 4 of CRP: OR 2.27, 95% CI, 1.18-4.34; high beta2m plus high CRP: OR 5.60, 95% CI, 2.38-13.2). These results suggest that beta2m is associated with an increase of arterial stiffness. Further studies are needed to clarify whether beta2m is related to atherosclerotic diseases, and whether the combination of beta2m and CRP measurement is a useful predictor for the development of atherosclerosis.

DOI： 10.1291/hypres.28.505

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The role of Helicobacter pylori in the pathogenesis of atherosclerosis remains controversial, and the relationship between H. pylori and the early stage of atherosclerosis has not been fully investigated. We investigated the influence of H. pylori infection on arterial stiffness to clarify whether H. pylori infection is related to early-stage atherosclerosis. The subjects were 3,412 males and 854 females. Anti-H. pylori antibody and C-reactive protein (CRP) level were measured. Arterial stiffness was evaluated using the brachial-ankle pulse wave velocity (PWV). In multivariate logistic repression analyses of male subjects, H. pylori seropositivity (odds ratio [OR] 1.27 [95% confidence interval, 1.05-1.52]) and H. pylori seropositivity with a high CRP value (>0.045 mg/dl) (OR 1.50 [1.14-1.98]) were significantly related to a high value of PWV. In the analyses of male subjects aged < or = 49 years, H. pylori seropositivity (OR 1.40 [1.04-1.88]) and H. pylori seropositivity with a high CRP value (OR 1.81 [1.16-2.80]) were also significantly related to a high value of PWV. However, in male subjects aged > or = 50 years and female subjects, no associations were found. These results suggest that inflammation following H. pylori infection contributes to the early stage of atherosclerosis in younger males.

DOI： 10.1291/hypres.28.283

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Language：Japanese   Publisher：公益社団法人 日本産業衛生学会  

DOI： 10.1539/sangyoeisei.KJ00003804062

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Language：Japanese   Publisher：公益社団法人 日本産業衛生学会  

DOI： 10.1539/sangyoeisei.KJ00003803978

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Language：Japanese   Publishing type：Research paper (scientific journal)  

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Language：Japanese   Publishing type：Research paper (scientific journal)  

The effects of stressful life events which cause depression in the elderly and the role of the social support network--a longitudinal study in Hokkaido prefecture It has been reported that various stressful life events experienced by the elderly increase the risk of depression, and that a support network mitigates the effects. However, reports in our country are still lacking. This research was a longitudinal study in a former coal mining area, conducting a baseline survey on 1991. Every three to four years, we followed-up the elderly in the area. The questionnaire included :1) base attributes 2) stressful life events 3) networks, 4) instrumental/emotional support, support provided themselves, 4) Zung's Self Rating Depression Scale, 5) subjective health/number of illness/hospital admission/body aches/vision and hearing/urinary incontinence/signs of dementia, 6) hobbies and motivation in life/ADL/IADL. Whether male or female, SDS scores after three years were significantly high in cases of poor health, body aches, and signs of dementia. Females who did not participate in social activities scored significantly high after three years. In cross-sectional analysis, both males and females who were not working had significantly high scores. The effect of networks on SDS scores in females was significantly recognized for items regarding children living separately, neighborhood, close friends/relatives, and groups. However, it was not significant for males. Thus, a gender difference was found. In females, the level of depression was low when there were supports, though it was not significant in males. The subjective health condition was significantly different from SDS scores in both male and female groups. Admission to hospital, existence of body aches and vision disturbance were significantly different in females. Nevertheless, those were not significant in the male group. For social activity, whether the persons possessed hobbies and motivation in life or not created a significant difference in SDS scores. For stressful life events, both males and females had significantly high SDS scores caused by aggravation of health condition. In the female group, moving against the will, illness of spouse/family, and increased borrowing showed significance, and life events experienced within a year and SDS scores were significantly related. In multivariate analysis using parameters of males in 1995, only subjective health condition significantly increased the level of depression. In females, when the number of experienced life events was large, the level of depression was higher even when adjusted for the subjective health condition. Moreover, even then when "home visits by children separately living" were rare, the level of depression tended to be higher. As future issues, (1) adequate measures for evaluation of social support networks and (2) early preventive action in each community with validated scales for stressful life events are important.

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Authorship：Lead author   Language：Japanese   Publishing type：Research paper (scientific journal)  

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Language：Japanese   Publishing type：Research paper (scientific journal)  

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Language：Japanese   Publisher：(一社)日本衛生学会  

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Language：Japanese   Publisher：(一社)日本衛生学会  

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Language：Japanese   Publisher：(一社)日本疫学会  

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Language：Japanese   Publisher：北海道公衆衛生学会  

医師の出身地が地方であること、入試形態が地域枠であること、地方勤務の義務がある奨学金受給をしていることが地方勤務の意思と関連するのか明らかにすることを目的とした。旭川医科大学卒業生の質問票調査により、出身地が都市部か地方か、入試形態が地域枠入試であるか否か、地方勤務義務の義務がある奨学金の受給をしていたか否か、地方勤務の意思があるか否かを把握した。多変量ロジスティック回帰にて地方勤務の意思ありとなるオッズ比(OR)を算出した。都市部勤務者では地域枠入試のOR=3.11と有意に大きく、地方勤務者では地域枠入試のOR=0.17と有意に小さかった。北海道出身者のみに限定した場合、地域枠入試、地方勤務義務のある奨学金はORが有意に大きかった。さらに北海道出身者の都市部勤務者では、地域枠入試の地方勤務の意思ありに対するORが有意に大きかった。地域枠入学者と地方勤務の義務がある奨学金は地方勤務の継続につながる可能性が考えられた。(著者抄録)

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Language：Japanese   Publisher：日本公衆衛生学会  

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Language：Japanese   Publisher：(一社)日本衛生学会  

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Language：Japanese   Publisher：日本公衆衛生学会  

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Language：Japanese   Publisher：北海道公衆衛生学会  

地方で勤務する内科医による地方の医療を担う医師を増やす方策として有効と考える意見を質的に検討することを目的に、町・村の内科医・総合内科医への質問票調査を実施した。地方の医師を増やす有効な方法について自由記載で意見を求め、分析は自由記載データ(テクスト)を解釈するため、既存のカテゴリを使用する質的内容分析の手法を用いた。218人からの回答、総テクスト数335件が解析対象となった。テクスト数が最も多かったカテゴリは「負担軽減」、「金銭的インセンティブ」、「生活・福利面のサポート」の順であった。現在の医学部入試制度の強化や改革、地域医療を担当する事への義務化の意見も認めた。「負担軽減」では休日の確保や当直の負担軽減が重要と考えられ、また「金銭的インセンティブ」や「生活・福利面のサポート」があることも重要と考えられ、地方の医療担当医へのさらなるサポートも必要も考えられる。(著者抄録)

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Language：Japanese   Publisher：(一社)日本衛生学会  

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Language：Japanese   Publisher：(一社)日本衛生学会  

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Language：Japanese   Publisher：(一社)日本衛生学会  

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Language：Japanese   Publisher：環境ホルモン学会(日本内分泌撹乱化学物質学会)  

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Language：Japanese   Publisher：環境ホルモン学会(日本内分泌撹乱化学物質学会)  

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Language：Japanese   Publisher：日本公衆衛生学会  

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Language：Japanese   Publisher：(公社)日本生化学会  

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かかりつけ医制度の推進について北海道の内科医の意見を把握する目的で質問票調査を行った。かかりつけ医制度は、義務化すべき・推進すべきとの意見は合わせて51.7%であった。かかりつけ医制度を義務化・さらに推進するべきは、多変量解析にて50歳以上が有意に低いオッズ比であった。選定療養費対象病院を増やすべきは、70歳以上が有意に低いオッズ比であった。選定療養費を増額すべきは、院長・副院長・所長が有意に高いオッズ比であった。自由記載から、「かかりつけ医の役割強化」、「かかりつけ医の経営安定化」といった制度への期待を認めたが、「業務量増加」の懸念、「単なるかぜ診療とゲートキーパーになる恐れ」も認めた。高齢の医師が変革を望まず、院長クラスは収入増を期待している可能性が考えられるが、かかりつけ医制度をさらに推進するためには、担当する医師が不利益にならないよう配慮し、医療資源不足の地方に改革の重点を置くべきと考える。(著者抄録)

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Language：Japanese   Publisher：(一社)日本衛生学会  

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Language：Japanese   Publisher：(公社)日本産科婦人科学会  

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Language：Japanese   Publisher：日本公衆衛生学会  

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大病院受診の際に患者が紹介状を持参する要因と、患者側からの大病院受診の際の紹介状を必要とする制度への意見に関連する要因を検討し、今後の医療制度改革の資料となることを目的として、旭川医科大学病院を初診した患者について、アンケート調査を実施した。有効送付数1,264から621(49.1%の回収率)の回答があった。統計解析は多変量ロジスティック回帰を用いた。「紹介状持参なし」に有意に関連していたのは、入院した・する予定(オッズ比:0.24)、身内・友人のすすめ(4.36)、医大病院の設備が良い(1.68)、重い病気やけが(0.42)、別の医療機関に満足できない(2.20)であった。「紹介状にかかわらず大病院・専門医を自由に受診できるようにするべき」に有意に関連していたのは、学歴(中学・高校)(1.59)、紹介状あり(0.30)、入院した・する予定(0.55)、大きい病院が安心(1.72)であった。自由記載の質的検討では、かかりつけ医制度自体への不満や自由な受診を尊重すべきとの考えを認めた。かかりつけ医からの紹介がある場合のみ大病院・専門医を受診できるようになる制度の推進には、個人と社会への制度上のメリットについて十分な説明が必要である一方、日本のかかりつけ医機能と大病院の専門医機能に明確な線引きがないことが混乱を招いている可能性があり、それらの機能分担の明確化が必要ではないかと考えられた。(著者抄録)

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Language：Japanese   Publisher：(一社)日本衛生学会  

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Language：Japanese   Publisher：日本公衆衛生学会  

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Language：Japanese   Publisher：北海道母性衛生学会  

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Language：Japanese   Publisher：日本衛生学会  

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Authorship：Lead author   Language：Japanese   Publishing type：Article, review, commentary, editorial, etc. (trade magazine, newspaper, online media)   Publisher：日本医事新報  

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Language：Japanese   Publisher：北海道公衆衛生学会  

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Language：Japanese   Publisher：北海道公衆衛生学会  

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Language：Japanese   Publisher：北海道公衆衛生学会  

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Language：Japanese   Publisher：日本公衆衛生学会  

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Language：Japanese   Publisher：北海道母性衛生学会  

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Authorship：Lead author   Language：Japanese   Publishing type：Article, review, commentary, editorial, etc. (trade magazine, newspaper, online media)   Publisher：日本医事新報  

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Language：English   Publisher：ELSEVIER SCIENCE INC  

DOI： 10.1016/S0140-6736(15)61114-X

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Language：Japanese   Publisher：北海道産科婦人科学会  

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Language：English   Publishing type：Research paper, summary (international conference)   Publisher：OXFORD UNIV PRESS  

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Language：Japanese   Publisher：環境ホルモン学会(日本内分泌撹乱化学物質学会)  

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Language：Japanese   Publisher：北海道公衆衛生学会  

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Language：Japanese   Publisher：産業医学振興財団  

CiNii Books

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Language：Japanese   Publisher：北海道母性衛生学会  

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Language：Japanese   Publisher：(株)東京医学社  

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Language：Japanese   Publisher：日本成人病(生活習慣病)学会  

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Language：Japanese   Publisher：東北連合産科婦人科学会・北日本産科婦人科学会  

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Language：Japanese   Publisher：東北連合産科婦人科学会・北日本産科婦人科学会  

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Language：Japanese   Publisher：医学書院  

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Other Link： http://search.jamas.or.jp/link/ui/2013136993

Language：Japanese   Publisher：日本衛生学会  

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妊娠中の喫煙は，胎児の発育阻害など様々な悪影響がある．環境省「エコチル調査」北海道ユニットセンター登録の妊婦を対象に，喫煙実態を報告する．2011年1月の調査開始から，2013年7月までに妊娠中・後期調査票が登録された3901人の暫定データを集計した．平均年齢は30.9±4.8歳．喫煙経験者は1941人で，17.4%が16歳以下，25.4%が19歳以下で喫煙を開始していた．5.4%は妊娠後も喫煙を続け，15.1%は妊娠中に，30.0%は妊娠前に禁煙した．喫煙継続群は，妊娠中禁煙群，妊娠前禁煙群よりも喫煙開始年齢が早く，収入や学歴が低かった．喫煙継続群のパートナーの83.0%が喫煙していた．タバコは依存性があり家族の影響を受けやすい．家族やまわりの人々も含めて，受動喫煙を含む喫煙による胎児への影響に対する意識を高めていくこと，小児期から喫煙の害に関する組織的かつ継続的な啓発が必要である．

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Other Link： http://search.jamas.or.jp/link/ui/2014321475

Language：Japanese   Publisher：日本公衆衛生学会  

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Language：Japanese   Publisher：日本公衆衛生学会  

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Language：Japanese   Publisher：日本公衆衛生学会  

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Language：English   Publishing type：Research paper, summary (international conference)   Publisher：B M J PUBLISHING GROUP  

DOI： 10.1136/jech.2011.142976i.46

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Language：English   Publisher：OXFORD UNIV PRESS  

DOI： 10.1093/ije/dyq071

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Language：Japanese   Publisher：日本産業衛生学会-北海道地方会  

民間企業労働者における抑うつと首尾一貫感覚(SOC)の関連および首尾一貫感覚に影響を与える要因について検討した。年代が低くなるほど抑うつ得点が高かった。職位は、一般職と係長職の平均得点はほぼ同じであったが、課長代理以上は低い得点であった。抑うつとSOCの関連では、SOCの低い群の抑うつのオッズ比は、SOCの高い群と比較して有意に高かった。SOCと関連要因で、平均値に有意差のあったのは、性別、年齢、配偶者の有無、職種、職位、健康管理能力の高低であった。SOCを従属変数として、重回帰分析を行った結果、職位と健康管理能力の2つの変数が有意であった。

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Language：Japanese   Publisher：北海道公衆衛生学会  

札幌市の公立小学校に通う児童78名を対象に、自宅居間の床ダスト中における有機リン酸トリエステル類11化合物の測定を行い、シックハウス症候群(SHS)との関連について検討した。SHS有訴群(39名)と非有訴群(39名)とで11化合物の濃度を比較したところ、全ての化合物において有意な群間差は認められなかった。しかし、化合物のうちリン酸トリスブトキシエチルの濃度は、過去に欧米で報告された濃度に比べてかなり高かったことから、健康影響について更なる調査が必要であると考えられた。

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Language：Japanese   Publisher：北海道農村医学会  

先行研究で池野らは、北海道本別町と鷹栖町において75歳以上の高齢者36名を対象に「作業バランス自己診断」を用いた家庭訪問を実施し、生活機能や認知機能の改善に有効であったことを報告した。今回著者等は、池野らの「作業バランス自己診断」をもとに、高齢者がさらに理解しやすいよう改良した「在宅高齢者生活機能向上ツール」を作成し、これを用いた家庭訪問による介入が認知機能に与える影響について検討した。対象は北海道新ひだか町と日高町市街地に在住する65歳以上の高齢者で、[要支援1][要支援2][経過的要介護][要介護1]に認定されているか、または特定高齢者選定用スクリーニングの基本チェックリスト25項目のうち1項目以上チェックがついた人199名とした。介入群(99名)と非介入群(100名)に無作為に分け、Mini-Mental State Examinationの得点を比較しところ、介入群のほうが有意に高値であり、介入の効果が示された。

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Language：Japanese   Publisher：日本衛生学会  

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Language：Japanese   Publisher：日本公衆衛生学会  

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Language：Japanese   Publisher：(公社)日本産業衛生学会  

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Language：Japanese   Publisher：(公社)日本食品衛生学会  

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Inflammation and pulse wave velocity (PWV) are a potential risk factor and marker, respectively, for atherosclerosis in the primary prevention setting. Atherosclerosis is now generally accepted to be an inflammatory disorder of the arterial wall, and the high-sensitivity C-reactive protein (hs-CRP) level has been reported to be a strong predictor of cardiovascular events. High-sensitivity-CRP is associated with two factors related to inflammation: (1) the local production of CRP by atheromatous tissue or coronary artery smooth muscle cells and (2) adipose tissue as a potent source of inflammatory cytokines. Based on studies in North America and Europe, hs-CRP has been established as a cardiovascular risk factor and a cut-off value has been recommended. However, Japanese have lower hs-CRP values than their Western counterparts, partly because Japanese have a lower body mass index (BMI), which correlates positively to hs-CRP, and partly because lifestyle and genetic factors can affect hs-CRP values. Therefore, a cut-off value needs to be established by cohort studies for the Japanese population. Carotid-femoral PWV is most commonly measured by applanation tonometry, particularly in Europe, but this method is critically dependent upon the accurate placing of transducers over the arteries and is both time-consuming and complex. A novel device has been recently developed in Japan that measures brachial-ankle PWV (baPWV) using a volume-rendering method. Brachian-ankle PWV is a suitable screening method because of its technical simplicity and shorter measurement time. It is associated not only with conventional cardiovascular risk factors but also with new risk factors, such as inflammation, -glutamyltransferase, chronic kidney disease, and psychosocial factors. However, a suitable cut-off value has yet to be established. © 2009 The Japanese Society for Hygiene.

DOI： 10.1007/s12199-009-0080-2

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Language：Japanese   Publisher：日本産業衛生学会-北海道地方会  

職業性ストレスの1次予防対策として、認知行動療法を応用したストレスマネジメント教育を実施し、その効果を検討した。対象は、北海道の1公務職場に勤務する事務職員65名とした。ストレスマネジメントプログラムの内容は、認知行動療法の主要な理論の一つであるストレス免疫訓練の考え方に基づき、3回の講習会(4週間ごと、1回1時間)で構成した。教育効果を評価するため、1回目講習会の開始前と3回目の終了直後および1ヵ月後、6ヵ月後に質問紙調査を行い、「ストレス対処行動」「ストレス反応」「主観的健康管理能力」を測定した。その結果、「ストレス対処行動」の問題解決スコアの平均が講習会開始前に比べて終了直後・1ヵ月後・6ヵ月後に有意な高値を示した。

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Language：Japanese   Publisher：日本産業衛生学会-北海道地方会  

北海道に拠点を置く食品会社およびサービス業に勤務する社員212名(男性143名、女性69名)を対象に、日常生活習慣11項目と動脈硬化度(加速度脈波)との関連について統計学的に検討し、以下の結果を得た。1)日常的に緑黄野菜を摂取する者は動脈硬化度が低い。2)日常的に健康意識のある者は動脈硬化度が低い。3)睡眠時間が8時間以上の者は動脈硬化度が高い。

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Language：Japanese   Publisher：(公社)日本産業衛生学会  

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Language：Japanese   Publisher：北海道公衆衛生学会  

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Language：Japanese   Publisher：北海道公衆衛生学会  

J-GLOBAL

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Language：Japanese   Publisher：北海道公衆衛生学会  

J-GLOBAL

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Language：Japanese   Publisher：(公社)日本食品衛生学会  

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Language：Japanese   Publisher：日本衛生学会  

CiNii Books

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Language：Japanese   Publisher：日本衛生学会  

CiNii Books

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Language：Japanese   Publisher：(公社)日本産業衛生学会  

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Language：Japanese   Publisher：(公社)日本産業衛生学会  

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Language：English   Publisher：日本衛生学会  

CiNii Books

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Language：Japanese   Publisher：(公社)日本産業衛生学会  

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Language：Japanese   Publisher：日本老年社会科学会  

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Language：Japanese   Publisher：(公社)日本産業衛生学会  

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Language：Japanese   Publisher：(公社)日本産業衛生学会  

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Language：Japanese   Publisher：(公社)日本産業衛生学会  

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Language：Japanese   Publisher：日本衛生学会  

CiNii Books

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Language：Japanese   Publisher：日本衛生学会  

CiNii Books

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Language：Japanese   Publisher：日本公衆衛生学会  

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Language：Japanese   Publisher：(一社)日本老年医学会  

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Language：Japanese   Publisher：産業医学振興財団  

著者版日本の職域集団を対象として職業ストレスの心血管系への影響について上腕動脈足首動脈間法(baPWV)を用いて早期の動脈硬化への影響を検討した.定期職場健康診断を受診した35歳以上の地方自治体公務員(男3412,女854)を対象として,自記式質問紙調査票を用いた調査を行った.男性では,低仕事自由度が有意に脈波伝播速度(PWV)高値と関連した.女性では事要求度-コントロールモデル高ストレスが有意にPWV高値と関連した.努力報酬不均衡モデルとPWV高値の間には有意な関連は認めなかった

CiNii Books

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Other Link： http://amcor.asahikawa-med.ac.jp/modules/xoonips/detail.php?id=2006238449

Language：Japanese   Publisher：(公社)日本産業衛生学会  

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Language：Japanese   Publisher：日本衛生学会  

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Language：Japanese   Publisher：(公社)日本産業衛生学会  

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Language：Japanese   Publisher：日本衛生学会  

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Language：Japanese   Publisher：日本公衆衛生学会  

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Language：Japanese   Publisher：(公社)日本精神神経学会  

CiNii Books

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Other Link： http://search.jamas.or.jp/link/ui/2005183444

Language：Japanese   Publisher：日本衛生学会  

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Language：Japanese   Publisher：公益社団法人日本産業衛生学会  

CiNii Books

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Language：Japanese   Publisher：(公社)日本産業衛生学会  

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