著者

Ayaka Igarashi Jun Aida Toshimi Sairenchi Toru Tsuboya Kemmyo Sugiyama Shihoko Koyama Yusuke Matsuyama Yukihiro Sato Ken Osaka Hitoshi Ota

出版者

Japan Epidemiological Association

雑誌

Journal of Epidemiology (ISSN:09175040)

巻号頁・発行日

pp.JE20170330, (Released:2018-05-31)

参考文献数

20

被引用文献数

5

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Background: Annually, more than 1.2 million deaths due to road traffic accidents occur worldwide. Although previous studies have examined the association between cigarette smoking and injury death, the mortality outcome often included non-traffic accident-related deaths. This study aimed to examine the association between cigarette smoking and traffic accident death.Methods: We conducted a prospective cohort study using data from the Ibaraki Prefectural Health Study conducted between 1993 and 2013. The cohort included 97,078 adults (33,138 men and 63,940 women) living in Ibaraki Prefecture, who were aged 40–79 years at an annual health checkup in 1993. We divided participants into four smoking status groups: non-smokers, ex-smokers and current smokers who smoked <20 and ≥20 cigarettes per day. Hazard ratios (HRs) of traffic accident death were calculated using a Cox proportional hazards model.Results: During 20 years of follow-up, average person-year of follow-up were 16.8 and 18.2 in men and women, respectively. Among men, after adjusting for age and alcohol intake, compared to non-smokers, HRs for traffic accident death among current smokers of <20 cigarettes/day and ≥20 cigarettes/day were 1.32 (95% confidence interval (CI), 0.79–2.20) and 1.54 (95% CI, 0.99–2.39), respectively. In contrast, among women, we found no association between smoking status and traffic accident deaths.Conclusion: In this prospective cohort study, we found a positive association, though marginally significant, between smoking and traffic accident death among men in Japan. Among women, because smaller number of death among smokers, adequate estimation could not be obtained.

著者

Takaaki Ikeda Upul Cooray Toshifumi Yodoshi Makoto Kaneko Ken Osaka Masayasu Murakami

出版者

The Japanese Association of Rehabilitation Medicine

雑誌

Progress in Rehabilitation Medicine (ISSN:24321354)

巻号頁・発行日

vol.8, pp.20230033, 2023 (Released:2023-09-27)

参考文献数

41

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Objectives : There has been no analysis of the effects of in-hospital rehabilitation on adult patients with Down’s Syndrome (DS) after hospitalization for community-acquired pneumonia (CAP). Medical claims data retrospectively collected nationwide were used to examine outcomes at discharge.Methods : Hospitalization data were obtained from 440 Japanese hospitals for DS patients with CAP that were discharged between 1 June 2009 and 31 January 2022 (n=2897). After the exclusion of 2478 patients, mainly on the basis of age or type of admission, the records of 419 patients were extracted. The following were used as outcomes: (1) 30-day readmission, (2) 45-day readmission, (3) discharge Barthel Index (BI), (4) BI score gain, and (5) length of hospital stay. The targeted minimum loss-based estimator was used to examine effects of the average daily times of rehabilitation on outcomes at discharge.Results : Most patients had no in-hospital rehabilitation (73.5%). Provided that the average daily time of rehabilitation therapy was at least 20 min, BI scores were lower at discharge (coefficient, −15.91; 95% confidence interval, −30.07 to −1.75) and BI gain was lower (coefficient, −12.56; 95% confidence interval, −25.60 to 0.47) when compared with the use of no rehabilitation therapy.Conclusions : In-hospital rehabilitation medicine in DS patients with CAP provided by a therapist was not associated with improved activities of daily living at discharge. Future studies are warranted to develop systematic, efficient, and comprehensive rehabilitation medicine for DS patients suffering from CAP.

著者

Yukihiro Sato Richard G Watt Yasuaki Saijo Eiji Yoshioka Ken Osaka

出版者

Japan Epidemiological Association

雑誌

Journal of Epidemiology (ISSN:09175040)

巻号頁・発行日

pp.JE20190057, (Released:2019-08-31)

参考文献数

31

被引用文献数

8

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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 by the Kessler Psychological Distress Scale (K6: the cut-off point was 13/14). 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, respectively. 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.

著者

Sakura Kiuchi Taro Kusama Kemmyo Sugiyama Takafumi Yamamoto Upul Cooray Tatsuo Yamamoto Katsunori Kondo Ken Osaka Jun Aida

出版者

Japan Epidemiological Association

雑誌

Journal of Epidemiology (ISSN:09175040)

巻号頁・発行日

vol.32, no.7, pp.330-336, 2022-07-05 (Released:2022-07-05)

参考文献数

50

被引用文献数

2 13

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Background: Although the feasibility of randomized trials for investigating the long-term association between oral health and cognitive decline is low, deriving causal inferences from observational data is challenging. We aimed to investigate the association between poor oral status and subjective cognitive complaints (SCC) using fixed-effects model to eliminate the confounding effect of unobserved time-invariant factors.Methods: We used data from Japan Gerontological Evaluation Study (JAGES) which was conducted in 2010, 2013, and 2016. β regression coefficients and 95% confidence intervals [CIs] were calculated using fixed-effects models to determine the effect of deteriorating oral status on developing SCC. Onset of SCC was evaluated using the Kihon Checklist-Cognitive function score. Four oral status variables were used: awareness of swallowing difficulty, decline in masticatory function, dry mouth, and number of teeth.Results: We included 13,594 participants (55.8% women) without SCC at baseline. The mean age was 72.4 (standard deviation [SD], 5.1) years for men and 72.4 (SD, 4.9) years for women. Within the 6-year follow-up, 26.6% of men and 24.9% of women developed SCC. The probability of developing SCC was significantly higher when participants acquired swallowing difficulty (β = 0.088; 95% CI, 0.065–0.111 for men and β = 0.077; 95% CI, 0.057–0.097 for women), decline in masticatory function (β = 0.039; 95% CI, 0.021–0.057 for men and β = 0.030; 95% CI, 0.013–0.046 for women), dry mouth (β = 0.026; 95% CI, 0.005–0.048 for men and β = 0.064; 95% CI, 0.045–0.083 for women), and tooth loss (β = 0.043; 95% CI, 0.001–0.085 for men and β = 0.058; 95% CI, 0.015–0.102 for women).Conclusion: The findings suggest that good oral health needs to be maintained to prevent the development of SCC, which increases the risk for future dementia.

著者

Yusuke Matsuyama Toru Tsuboya Shun-ichiro Bessho Jun Aida Ken Osaka

出版者

Tohoku University Medical Press

雑誌

The Tohoku Journal of Experimental Medicine (ISSN:00408727)

巻号頁・発行日

vol.244, no.2, pp.163-173, 2018 (Released:2018-03-01)

参考文献数

29

被引用文献数

12

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Healthcare utilization after natural disasters remains understudied. In general, people in Japan pay 10%-30% of total amount of costs, according to their health insurance plan. A policy exempting survivors from copayments was introduced after the Great East Japan Earthquake in March 2011, which had a magnitude of 9.0 on the Richter scale and followed by devastating tsunamis. Among the disaster-affected areas, Miyagi prefecture experienced the largest number of deaths and the greatest extent of damage. However, the exemption was suspended in Miyagi prefecture from April, 2013, because of the huge governmental financial burden due to the immensity of damage from the disaster. Subsequently, in April 2014, the exemption was re-introduced, with smaller coverage. We, therefore, evaluated the influence of this policy change on monthly healthcare utilization in Miyagi prefecture between April 2008 and June 2015. We also evaluated the association between the proportion of people exempted from copayment in each municipality and the difference in healthcare utilization before and after the suspension using multivariable linear regression. Healthcare utilization in Miyagi increased immediately after the institution of the exemption policy and it peaked after one year. In March 2013, just before the suspension, a rapid increment in healthcare utilization was observed, suggesting that the copayment may be a barrier for people in the disaster-affected area to access to healthcare. The exemption policy did help the survivors to use healthcare utilization in Miyagi. After devastating natural disasters, policymakers should guarantee that all survivors can utilize healthcare services on demand.

著者

Yusuke Matsuyama Jun Aida Toru Tsuboya Shihoko Koyama Yukihiro Sato Atsushi Hozawa Ken Osaka

出版者

日本疫学会

雑誌

Journal of Epidemiology (ISSN:09175040)

巻号頁・発行日

pp.JE20160184, (Released:2017-10-28)

参考文献数

44

被引用文献数

9

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Background: Secondhand smoke (SHS) causes many deaths. Inequalities in SHS have been reported in several countries; however, the evidence in Asian countries is scarce. We aimed to investigate the association between socioeconomic status (SES) and SHS at home and the workplace/school among non-smoking Japanese adults.Methods: Cross-sectional data from the Miyagi Prefectural Health Survey 2014 were analyzed. Self-reported questionnaires were randomly distributed to residents ≥20 years of age and 2,443 (92.8%) responded. The data of the 1,738 and 1,003 respondents were included to the analyses for SHS in the past month at home and at the workplace/school, respectively. Ordered logistic regression models considering possible confounders, including knowledge of the adverse health effects of tobacco, were applied.Results: The prevalence of SHS at home and the workplace/school was 19.0% and 39.0%, respectively. Compared with ≥13 years of education, odds ratios (ORs) and 95% confidence intervals (CIs) for SHS at home were 1.94 (95% CI, 1.42–2.64) for 10–12 years and 3.00 (95% CI, 1.95–4.60) for ≤9 years; those for SHS at the workplace/school were 1.80 (95% CI, 1.36–2.39) and 3.82 (95% CI, 2.29–6.36), respectively. Knowledge of the adverse health effects of tobacco was significantly associated with lower SHS at home (OR 0.95; 95% CI, 0.91–0.98) but it was not associated with SHS at the workplace/school (OR 1.02; 95% CI, 0.98–1.06).Conclusions: Social inequalities in SHS existed among Japanese non-smoking adults. Knowledge about tobacco was negatively associated with SHS at home but not at workplace/school.

著者

Takaaki Ikeda Noriko Cable Masashige Saito Shihoko Koyama Taishi Tsuji Taiji Noguchi Katsunori Kondo Ken Osaka Jun Aida

出版者

Japan Epidemiological Association

雑誌

Journal of Epidemiology (ISSN:09175040)

巻号頁・発行日

vol.31, no.10, pp.523-529, 2021-10-05 (Released:2021-10-05)

参考文献数

39

被引用文献数

3 14

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Background: Existing evidence suggest that those who are socially isolated are at risk for taking up or continuing smoking. This study investigated country-based differences in social isolation and smoking status.Methods: We performed a repeated cross-sectional study using two waves of data from two ongoing aging studies: the English Longitudinal Study of Ageing and the Japan Gerontological Evaluation Study. Participants from both studies aged ≥65 years were included. We applied a multilevel Poisson regression model to examine the association between social isolation and smoking status and adjusted for individual sociodemographic characteristics. We used the social isolation index which comprises the following domains: marital status; frequency of contact with friends, family, and children; and participation in social activities. Interaction terms between each country and social isolation were also entered into the mode.Results: After exclusion of never smokers, we analyzed 75,905 participants (7,092 for ELSA and 68,813 for JAGES, respectively). Taking ex-smokers as the reference, social isolation was significantly associated with current smoking; the prevalence ratios (PRs) were 1.06 (95% credible interval [CrI], 1.05–1.08) for men and 1.08 (95% CrI, 1.04–1.11) for women. Taking Japan as a reference, the interaction term between country and social isolation was significant for both sexes, with increased PRs of 1.32 (95% CrI, 1.14–1.50) for men and 1.30 (95% CrI, 1.11–1.49) for women in England.Conclusions: Older people who were less socially isolated were more likely to quit smoking in England than in Japan, possibly explained by the strict tobacco control policies in England.

著者

Yukihiro Sato Richard G. Watt Yasuaki Saijo Eiji Yoshioka Ken Osaka

出版者

Japan Epidemiological Association

雑誌

Journal of Epidemiology (ISSN:09175040)

巻号頁・発行日

vol.30, no.10, pp.436-441, 2020-10-05 (Released:2020-10-05)

参考文献数

31

被引用文献数

1 8

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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.

著者

Takaaki Ikeda Noriko Cable Masashige Saito Shihoko Koyama Taishi Tsuji Taiji Noguchi Katsunori Kondo Ken Osaka Jun Aida

出版者

Japan Epidemiological Association

雑誌

Journal of Epidemiology (ISSN:09175040)

巻号頁・発行日

pp.JE20200138, (Released:2020-08-08)

参考文献数

39

被引用文献数

14

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Background: Existing evidence suggest that those who are socially isolated are at risk for taking up or continuing smoking. This study investigated country-based differences in social isolation and smoking status.Methods: We performed a repeated cross-sectional study using two waves of data from two ongoing aging studies: the English Longitudinal Study of Ageing and the Japan Gerontological Evaluation Study. Participants from both studies aged ≥65 years old were included. We applied a multilevel Poisson regression model to examine the association between social isolation and smoking status and adjusted for individual sociodemographic characteristics. We used the social isolation index which comprises the following domains: marital status; frequency of contact with friends, family, and children; and participation in social activities. Interaction terms between each country and social isolation were also entered into the mode.Results: After exclusion of never smokers, we analyzed 75,905 participants (7,092 for ELSA and 68,813 for JAGES, respectively). Taking ex-smokers as the reference, social isolation was significantly associated with current smoking; the prevalence ratios (PRs; 95% credible intervals [CrIs]) were 1.06 (1.05–1.08) for men and 1.08 (1.04–1.11) for women. Taking Japan as a reference, the interaction term between country and social isolation was significant for both sexes, with increased PRs (95% CrIs) of 1.32 (1.14–1.50) for men and 1.30 (1.11–1.49) for women in England.Conclusions: Older people who were less socially isolated were more likely to quit smoking in England than in Japan, possibly explained by the strict tobacco control policies in England.

著者

Yukihiro SATO Toru TSUBOYA Jun AIDA Yasuaki SAIJO Eiji YOSHIOKA Ken OSAKA

出版者

National Institute of Occupational Safety and Health

雑誌

Industrial Health (ISSN:00198366)

巻号頁・発行日

pp.2018-0226, (Released:2019-05-17)

被引用文献数

1

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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.