著者
Yuta Taniguchi Masao Iwagami Nobuo Sakata Taeko Watanabe Kazuhiro Abe Nanako Tamiya
出版者
Japan Epidemiological Association
雑誌
Journal of Epidemiology (ISSN:09175040)
巻号頁・発行日
pp.JE20200057, (Released:2020-06-13)
参考文献数
22

Background: With increasing age globally, more people may become vulnerable to food choking. We investigated the nationwide epidemiology of food choking deaths in Japan.Methods: Using Japanese Vital Statistics death data between 2006 and 2016, we identified food choking deaths based on the 10th revision of the International Statistical Classification of Diseases code W79 (Inhalation and ingestion of food causing obstruction of respiratory tract) as a primary diagnosis. We assessed the demographics of people with food choking deaths; temporal trends of food choking deaths by the year (overall and by age group), the day of year; and prefecture variations.Results: Overall, 52,366 people experienced food choking deaths (median age, 82 years, 53% were male, and 57% occurred at home). The highest numbers occurred January 1-3, and were lowest in June. Despite a stable total number of cases at around 4,000 yearly, from 2006 to 2016 the incidence proportion declined from 16.2 to 12.1 per 100,000 population among people aged 75-84 years. Among people ≥85 years, the incidence proportion peaked at 53.5 in 2008 and decreased to 43.6 in 2016. The number of food choking deaths varied by prefecture.Conclusions: There are temporal and regional variations of food choking deaths in Japan, possibly due to the consumption of Japanese rice cake (mochi), particularly over the New Year’s holiday.
著者
Kosuke Kiyohara Tomohiko Sakai Chika Nishiyama Tatsuya Nishiuchi Yasuyuki Hayashi Taku Iwami Tetsuhisa Kitamura
出版者
Japan Epidemiological Association
雑誌
Journal of Epidemiology (ISSN:09175040)
巻号頁・発行日
pp.JE20160179, (Released:2017-10-28)
参考文献数
25
被引用文献数
6

Background: Japanese rice cake (“mochi”) is a major cause of food-choking accidents in Japan. However, the epidemiology of out-of-hospital cardiac arrests (OHCAs) due to suffocation caused by rice cakes is poorly understood.Methods: OHCA data from 2005 to 2012 were obtained from the population-based OHCA registry in Osaka Prefecture. Patients aged ≥20 years who experienced OHCA caused by suffocation that occurred before the arrival of emergency-medical-service (EMS) personnel were included. Patient characteristics, prehospital interventions, and outcomes were compared based on the cause of suffocation (rice cake and non-rice-cake). The primary outcome was 1-month survival after OHCA.Results: In total, 46 911 adult OHCAs were observed during the study period. Of the OHCAs, 7.0% (3,294/46,911) were due to suffocation, with choking due to rice cake as the cause in 9.5% of cases (314/3,294), and of these, 24.5% (77/314) occurred during the first 3 days of the New Year. In crude analysis, 1-month survival was 17.2% (54/314) in those with suffocation caused by rice cake and 13.4% (400/2,980) in those with suffocation due to other causes. In the multivariable analysis for all-cause suffocation, younger age, arrest witnessed by bystanders, and earlier EMS response time were significantly related to better 1-month survival.Conclusion: Approximately 10% of OHCAs due to suffocation were caused by rice-cake choking, and 25% of these occurred during the first 3 days of the New Year. Further efforts for establishing preventive measures as well as improving the early recognition of choking and encouraging bystanders to call EMS sooner are needed.
著者
Seiji Yasumura Mitsuaki Hosoya Shunichi Yamashita Kenji Kamiya Masafumi Abe Makoto Akashi Kazunori Kodama Kotaro Ozasa
出版者
日本疫学会
雑誌
Journal of Epidemiology (ISSN:09175040)
巻号頁・発行日
vol.22, no.5, pp.375-383, 2012-09-05 (Released:2012-09-05)
参考文献数
37
被引用文献数
92 203 32

Background: The accidents that occurred at the Fukushima Daiichi Nuclear Power Plant after the Great East Japan Earthquake on 11 March 2011 have resulted in long-term, ongoing anxiety among the residents of Fukushima, Japan. Soon after the disaster, Fukushima Prefecture launched the Fukushima Health Management Survey to investigate long-term low-dose radiation exposure caused by the accident. Fukushima Medical University took the lead in planning and implementing this survey. The primary purposes of this survey are to monitor the long-term health of residents, promote their future well-being, and confirm whether long-term low-dose radiation exposure has health effects. This report describes the rationale and implementation of the Fukushima Health Management Survey.Methods: This cohort study enrolled all people living in Fukushima Prefecture after the earthquake and comprises a basic survey and 4 detailed surveys. The basic survey is to estimate levels of external radiation exposure among all 2.05 million residents. It should be noted that internal radiation levels were estimated by Fukushima Prefecture using whole-body counters. The detailed surveys comprise a thyroid ultrasound examination for all Fukushima children aged 18 years or younger, a comprehensive health check for all residents from the evacuation zones, an assessment of mental health and lifestyles of all residents from the evacuation zones, and recording of all pregnancies and births among all women in the prefecture who were pregnant on 11 March. All data have been entered into a database and will be used to support the residents and analyze the health effects of radiation.Conclusions: The low response rate (<30%) to the basic survey complicates the estimation of health effects. There have been no cases of malignancy to date among 38 114 children who received thyroid ultrasound examinations. The importance of mental health care was revealed by the mental health and lifestyle survey and the pregnancy and birth survey. This long-term large-scale epidemiologic study is expected to provide valuable data in the investigation of the health effects of low-dose radiation and disaster-related stress.
著者
Yasuyuki Okumura Nobuo Sakata Hisateru Tachimori Tadashi Takeshima
出版者
Japan Epidemiological Association
雑誌
Journal of Epidemiology (ISSN:09175040)
巻号頁・発行日
pp.JE20180066, (Released:2018-09-22)
参考文献数
35

Background: Understanding the area-specific resource use of inpatient psychiatric care is essential for the efficient use of the public assistance system. This study aimed to assess the geographical variation in psychiatric admissions and to identify the prefecture-level determinants of psychiatric admissions among recipients of public assistance in Japan.Methods: We identified all recipients of public assistance who were hospitalized in a psychiatric ward in May 2014, 2015, or 2016 using the Fact-finding Survey on Medical Assistance. The age- and sex-standardized number of psychiatric admissions was calculated for each of the 47 prefectures, using direct and indirect standardization methods.Results: A total of 46,559 psychiatric inpatients were identified in May 2016. The number of psychiatric admissions per 100,000 population was 36.6. We found a 7.1-fold difference between the prefectures with the highest (Nagasaki) and lowest (Nagano) numbers of admissions. The method of decomposing explained variance in the multiple regression model showed that the number of psychiatric beds per 100,000 population and the number of recipients of public assistance per 1,000 population were the most important determinants of the number of psychiatric admissions (R2 = 28% and R2 = 23%, respectively). The sensitivity analyses, using medical cost as the outcome and data from different survey years and subgroups, showed similar findings.Conclusions: We identified a large geographical variation in the number and total medical cost of psychiatric admissions among recipients of public assistance. Our findings should encourage policy makers to assess the rationale for this variation and consider strategies for reducing it.
著者
Akio Yagi Shinya Hayasaka Toshiyuki Ojima Yuri Sasaki Taishi Tsuji Yasuhiro Miyaguni Yuiko Nagamine Takao Namiki Katsunori Kondo
出版者
Japan Epidemiological Association
雑誌
Journal of Epidemiology (ISSN:09175040)
巻号頁・発行日
pp.JE20180123, (Released:2018-10-27)
参考文献数
40

Background: While bathing styles vary among countries, most Japanese people prefer tub bathing to showers and saunas. However, few studies have examined the relationship between tub bathing and health outcomes. Accordingly, in this prospective cohort study, we investigated the association between tub bathing frequency and the onset of functional disability among older people in Japan.Methods: We used data from the Japan Gerontological Evaluation Study (JAGES). The baseline survey was conducted from August 2010 to January 2012 and enrolled 13,786 community-dwelling older people (6,482 men and 7,304 women) independent in activities of daily living. During a 3-year observation period, the onset of functional disability, identified by new certification for need of Long-Term Care Insurance, was recorded. Tub bathing frequencies in summer and winter at baseline were divided into 3 groups: low frequency (0-2 times/week), moderate frequency (3-6 times/week), and high frequency (≥ 7 times/week). We estimated the risks of functional disability in each group using a multivariate Cox proportional hazards model.Results: Functional disability was observed in a total of 1,203 cases (8.7%). Compared with the low-frequency group and after adjustment for 14 potential confounders, the hazard ratios (95% confidence intervals) of the moderate- and high-frequency groups were 0.91 (0.75-1.10) and 0.72 (0.60-0.85) for summer and 0.90 (0.76-1.07) and 0.71 (0.60-0.84) for winter.Conclusion: High tub bathing frequency is associated with lower onset of functional disability. Therefore, tub bathing might be beneficial for older people’s health.
著者
Akira Sakai Tetsuya Ohira Mitsuaki Hosoya Akira Ohtsuru Hiroaki Satoh Yukihiko Kawasaki Hitoshi Suzuki Atsushi Takahashi Gen Kobashi Kotaro Ozasa Seiji Yasumura Shunichi Yamashita Kenji Kamiya Masafumi Abe
出版者
日本疫学会
雑誌
Journal of Epidemiology (ISSN:09175040)
巻号頁・発行日
pp.JE20140092, (Released:2014-10-11)
参考文献数
8
被引用文献数
3 5

Background: Lymphocytes are susceptible to damage from radiation, and the white blood cell (WBC) count, including counts of neutrophils and lymphocytes, is a useful method of dosimetry. According to the basic survey of the Fukushima Health Management Survey (FHMS), among 13 localities where evacuation was recommended, Iitate and Namie had more individuals with external radiation exposure of more than 5 mSv than the other evacuation areas. We analyzed whether or not WBC, neutrophil, and lymphocyte counts decreased after the disaster.Methods: The subjects of this study were 45 278 men and women aged 20 to 99 years (18 953 men and 26 325 women; mean age 56 years) in the evacuation zone who participated in the Comprehensive Health Check (CHC) from June 2011 to the end of March 2012.Results: Significant differences were detected in the mean values of WBC, neutrophil, and lymphocyte counts, and for the proportion of individuals under the minimum standard for WBC and neutrophil counts, among the 13 localities. However, the distribution of individuals at each 200-cell/µL increment in lymphocyte count were similar in these areas, and the WBC, neutrophil, and lymphocyte counts did not decrease in Iitate or Namie specifically.Conclusions: No marked effects of radiation exposure on the distribution of WBC counts, including neutrophil and lymphocyte counts were detected within one year after the disaster in the evacuation zone.
著者
Yasuyuki Okumura Naoya Sugiyama Toshie Noda Hisateru Tachimori
出版者
Japan Epidemiological Association
雑誌
Journal of Epidemiology (ISSN:09175040)
巻号頁・発行日
pp.JE20180096, (Released:2018-09-15)
参考文献数
27
被引用文献数
5

Background: A better understanding of resource use of new psychiatric admissions is important for healthcare providers and policymakers to improve psychiatric care. This study aims to describe the pattern of new psychiatric admissions and length of stay in Japan.Methods: A retrospective cohort study was conducted using data from the National Database of Health Insurance Claims and Specific Health Checkups of Japan (NDB). All patients newly admitted to psychiatric wards from April 2014 through March 2016 were included and followed up until discharge to the community.Results: Our sample included 605,982 admissions from 1,621 hospitals over 2 years. The average monthly number of admissions was 25,024 in fiscal year 2014 and 25,475 in fiscal year 2015. There was a seasonal trend in the number of admissions, with a peak in summer (in July). The discharge rates within 90 days and 360 days were 64.1% and 85.7%, respectively, and varied by type of hospital fee and by hospital. For example, the range of hospital-level discharge rate within 90 days in psychiatric emergency units was 46.0–75.3% in the 1st (lowest) quintile, while it was 83.6–96.0% in the 5th (highest) quintile. The prefecture-level indicators in the NDB and the 630 survey had correlations of >0.70.Conclusions: Our study provides fundamental information on resource use of new psychiatric admissions in Japan. Although using the NDB has substantial benefits in monitoring resource use, the results should be interpreted with some caution owing to methodological issues inherent in the database.
著者
Etsuji Suzuki Tomohiro Shinozaki Eiji Yamamoto
出版者
Japan Epidemiological Association
雑誌
Journal of Epidemiology (ISSN:09175040)
巻号頁・発行日
pp.JE20190192, (Released:2020-02-01)
参考文献数
70
被引用文献数
1

Graphical models are useful tools in causal inference, and causal directed acyclic graphs (DAGs) are used extensively to determine the variables for which it is sufficient to control for confounding to estimate causal effects. We discuss the following ten pitfalls and tips that are easily overlooked when using DAGs; 1) Each node on DAGs corresponds to a random variable, and not its realized values; 2) The presence or absence of arrow in DAGs corresponds to the presence or absence of individual causal effect in the population; 3) “Non-manipulable” variables and their arrows should be drawn with care; 4) It is preferable to draw DAGs for the total population, rather than for the exposed or unexposed groups; 5) DAGs are primarily useful to examine the presence of confounding in distribution in the notion of confounding in expectation; 6) Although DAGs provide qualitative differences of causal structures, they cannot describe details of how to adjust for confounding; 7) DAGs can be used to illustrate the consequences of matching and the appropriate handling of matched variables in cohort and case-control studies; 8) When explicitly accounting for temporal order in DAGs, it is necessary to use separate nodes for each timing; 9) In certain cases, DAGs with signed edges can be used in drawing conclusions about the direction of bias; and 10) DAGs can be (and should be) used to describe not only confounding bias but also other forms of bias. We also discuss recent developments of graphical models and their future directions.
著者
Daisuke Yoneoka Takayuki Kawashima Yuta Tanoue Shuhei Nomura Keisuke Ejima Shoi Shi Akifumi Eguchi Toshibumi Taniguchi Haruka Sakamoto Hiroyuki Kunishima Stuart Gilmour Hiroshi Nishiura Hiroaki Miyata
出版者
Japan Epidemiological Association
雑誌
Journal of Epidemiology (ISSN:09175040)
巻号頁・発行日
pp.JE20200150, (Released:2020-05-30)
参考文献数
23
被引用文献数
1

BackgroundThe World Health Organization declared the novel coronavirus outbreak (COVID-19) to be a pandemic on March 11, 2020. Large-scale monitoring for capturing the current epidemiological situation of COVID-19 in Japan would improve preparation for and prevention of a massive outbreak.MethodsA chatbot-based healthcare system named COOPERA (COvid-19: Operation for Personalized Empowerment to Render smart prevention And care seeking) was developed using the LINE app to evaluate the current Japanese epidemiological situation. LINE users could participate in the system either though a QR code page in the prefecture’s website, or a banner at the top of the LINE app screen. COOPERA asked participants questions regarding personal information, preventive actions, and non-specific symptoms related to COVID-19 and their duration. We calculated daily cross correlation functions between the reported number of infected cases confirmed by PCR and the symptom-positive group captured by COOPERA.ResultsWe analyzed 206,218 participants from three prefectures reported between March 5 and 30, 2020. The mean (standard deviation) age of participants was 44.2 (13.2). No symptoms were reported by 96.93% of participants, but there was a significantly positive correlation between the reported number of COVID-19 cases and self-reported fevers, suggesting that massive monitoring of fever might help to estimate the scale of the COVID-19 epidemic in real time.ConclusionsCOOPERA is the first real-time system being used to monitor trends in COVID-19 in Japan, and provides useful insights to assist political decisions to tackle the epidemic.
著者
Kota Katanoda Tomomi Marugame Kumiko Saika Hiroshi Satoh Kazuo Tajima Takaichiro Suzuki Akiko Tamakoshi Shoichiro Tsugane Tomotaka Sobue
出版者
Japan Epidemiological Association
雑誌
Journal of Epidemiology (ISSN:09175040)
巻号頁・発行日
vol.18, no.6, pp.251-264, 2008 (Released:2008-12-17)
参考文献数
40
被引用文献数
91 94

Background: Quantitative measures of the burden of tobacco smoking in Asian countries are limited. We estimated the population attributable fraction (PAF) of mortality associated with smoking in Japan, using pooled data from three large-scale cohort studies.Methods: In total, 296,836 participants (140,026 males and 156,810 females) aged 40-79 years underwent baseline surveys during the 1980s and early 1990s. The average follow-up period was 9.6 years. PAFs for all-cause mortality and individual tobacco-related diseases were estimated from smoking prevalence and relative risks.Results: The prevalence of current and former smokers was 54.4% and 25.1% for males, and 8.1% and 2.4% for females. The PAF of all-cause mortality was 27.8% [95% confidence interval (CI): 25.2-30.4] for males and 6.7% (95% CI: 5.9-7.5) for females. The PAF of all-cause mortality calculated by summing the disease-specific PAFs was 19.1% (95% CI: 16.0-22.2) for males and 3.6% (95% CI: 3.0-4.2) for females. The estimated number of deaths attributable to smoking in Japan in 2005 was 163,000 for males and 33,000 for females based on the former set of PAFs, and 112,000 for males and 19,000 for females based on the latter set. The leading causes of smoking-attributable deaths were cancer (61% for males and 31% for females), ischemic heart diseases and stroke (23% for males and 51% for females), and chronic obstructive pulmonary diseases and pneumonia (11% for males and 13% for females).Conclusion: The health burden due to smoking remains heavy among Japanese males. Considering the high prevalence of male current smokers and increasing prevalence of young female current smokers, effective tobacco controls and quantitative assessments of the health burden of smoking need to be continuously implemented in Japan.
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

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
Hiroshi Hirai Masao Ichikawa Naoki Kondo Katsunori Kondo
出版者
Japan Epidemiological Association
雑誌
Journal of Epidemiology (ISSN:09175040)
巻号頁・発行日
pp.JE20180260, (Released:2019-06-22)
参考文献数
26
被引用文献数
2

BackgroundPopulation ageing and stringent licensing policies will increase the number of older drivers who stop driving. Adverse health outcomes owing to driving cessation and their prevention are emerging concerns. Therefore, we longitudinally examined the impact of driving cessation and alternative transportation use after cessation on the risk of functional limitations in a cohort of community-dwelling people (65 years and older) in Japan.MethodsUsing cohort data of those who drove as of 2006/07, we compared the risk of functional limitations between 2,704 current drivers and 140 former drivers (who stopped driving by 2010). Of the former drivers, 77 did not use public transportation or bicycles after driving cessation (thus losing independent mobility). We calculated the hazard ratios (HR) for the incidence of functional limitations with 95% confidence intervals (CI) based on the Cox proportional hazards model with the covariates influencing the functional limitations.ResultsFrom 2010 to 2016, 645 people had functional limitations, which included 38, 82, and 119 per 1,000 person-years among current drivers, former drivers who used public transportation or bicycles, and former drivers who were only driven by others, respectively (HR: 1.69, 95% CI: 1.15–2.49; HR: 2.16, 95% CI: 1.51–3.10, relative to current drivers).ConclusionDriving cessation is associated with an increased risk of functional limitations among older adults, but this risk might be alleviated if they are able to maintain independent mobility by using public transportation or bicycles after driving cessation.
著者
Aya Goto Yusuke Tsugawa Keiya Fujimori
出版者
Japan Epidemiological Association
雑誌
Journal of Epidemiology (ISSN:09175040)
巻号頁・発行日
pp.JE20180015, (Released:2018-12-15)
参考文献数
25
被引用文献数
1

Background: Little is known about the association between the anxiety toward the effects of radiation on reproduction caused by the Fukushima nuclear accident and the birth rate of people in Fukushima. Therefore, we examined changes and associated factors of future pregnancy intention among mothers in Fukushima Prefecture.Methods: Using data from three postal surveys among women who registered their pregnancies in the prefecture (N = 6,751 in 2012, N = 6,871 in 2013, and N = 6,725 in 2014), we analyzed the factors associated with women’s intention of future pregnancy using multivariable logistic regression models.Results: The proportion of mothers with pregnancy intention increased from 53.5% in 2012 to 57.9% in 2014, especially among multiparas (P for trend <0.001). Factors inversely associated with pregnancy intention of both groups were older maternal age (adjusted odds ratio [aOR] 0.92 for primipara and 0.87 for multipara), poor subjective health (aOR 0.75 and 0.81, respectively), and presence of depressive symptoms (aOR 0.71 and 0.79, respectively) (P < 0.01 for all items). In addition, not living with husband (aOR 0.24), dissatisfaction with obstetrical care (aOR 0.89) and child abnormalities (aOR 0.72) were inversely associated with pregnancy intention among primiparas, while receiving infertility treatment (aOR 2.05) was positively associated among multiparas (P < 0.01 for all items). A separate analysis of 2012 and 2013 data showed that concern about radiation contamination of breast milk was associated with pregnancy intention among primiparas (aOR 0.61, P < 0.001).Conclusions: Mothers’ concern about radiation was associated with lower pregnancy intention, especially among primiparas. Providing quality obstetrical and mental health care and parenting support may be the keys to maintaining the temporal increase in fertility.
著者
Kohta Suzuki Ryoji Shinohara Miri Sato Sanae Otawa Zentaro Yamagata
出版者
日本疫学会
雑誌
Journal of Epidemiology (ISSN:09175040)
巻号頁・発行日
pp.JE20150185, (Released:2016-02-20)
参考文献数
38
被引用文献数
30

Background: There has been no large nationwide population-based study to examine the effects of maternal smoking status during pregnancy on birth weight that simultaneously controlled for clinical information, socioeconomic status, and maternal weight. Thus, this study aimed to determine the association between maternal smoking status during pregnancy and birth weight, while taking these confounding factors into consideration.Methods: This study examined the first-year fixed dataset from a large nationwide birth cohort study that commenced in 2011. The dataset consisted of information on 9369 singleton infants born before December 31, 2011. Children were divided into 4 groups for statistical analysis: those born to mothers who did not smoke (NS), who quit smoking before pregnancy, who quit smoking during early pregnancy, and who smoked (SM). Multiple linear regression models were conducted for each sex to examine the association between maternal smoking status during early pregnancy and fetal growth. Birth weight was estimated using the least-squares method after controlling for covariates.Results: After controlling for potential confounding factors, maternal smoking status during pregnancy was significantly associated with birth weight. There was a significant difference in birth weight between NS and SM for both male and female infants (male infants, 3096.2 g [NS] vs 2959.8 g [SM], P < 0.001; female infants, 3018.2 g [NS] vs 2893.7 g [SM], P < 0.001).Conclusions: Using data from a large nationwide birth cohort study in Japan, we have shown that maternal smoking during pregnancy may reduce birth weight by 125–136 g.
著者
Yudai Tamada Kenji Takeuchi Chikae Yamaguchi Masashige Saito Tetsuya Ohira Kokoro Shirai Katsunori Kondo
出版者
Japan Epidemiological Association
雑誌
Journal of Epidemiology (ISSN:09175040)
巻号頁・発行日
pp.JE20200051, (Released:2020-05-16)
参考文献数
34

Background: While laughter is broadly recognized as a good medicine, a potential preventive effect of laughter on disability and death is still being debated. Accordingly, we investigated the association between the frequency of laughter and onset of functional disability and all-cause mortality among the older adults in Japan.Methods: The data for a 3-year follow-up cohort including 14,233 individuals (50.3% men) aged ≥ 65 years who could independently perform the activities of daily living and participated in the Japan Gerontological Evaluation Study were analyzed. The participants were classified into four categories according to their frequency of laughter (almost every day, 1–5 days/week, 1–3 days/month, and never or almost never). We estimated the risks of functional disability and all-cause mortality in each category using a Cox proportional hazards model.Results: During follow-up, 605 (4.3%) individuals developed functional disability, identified by new certification for the requirement of Long-Term Care Insurance, and 659 (4.6%) deaths were noted. After adjusting for the potential confounders, the multivariate-adjusted hazard ratio of functional disability increased with a decrease in the frequency of laughter (p for trend = 0.04). The risk of functional disability was 1.42 times higher for individuals who laughed never or almost never than for those who laughed almost every day. No such association was observed with the risk of all-cause mortality (p for trend = 0.39).Conclusions: Low frequency of laughter is associated with increased risks of functional disability. Laughter may be an early predictor of functional disability later on in life.
著者
Kaori Sakurada Tsuneo Konta Masafumi Watanabe Kenichi Ishizawa Yoshiyuki Ueno Hidetoshi Yamashita Takamasa Kayama
出版者
Japan Epidemiological Association
雑誌
Journal of Epidemiology (ISSN:09175040)
巻号頁・発行日
pp.JE20180249, (Released:2019-04-06)
参考文献数
23
被引用文献数
4

Background: Positive and negative psychological factors are associated with mortality and cardiovascular disease. This study prospectively investigated associations between daily frequency of laughter, and mortality and cardiovascular disease in a community-based population.Methods: This study included 17,152 subjects ≥40 years old who participated in an annual health check in Yamagata Prefecture. Self-reported daily frequency of laughter was grouped into 3 categories (≥1/week; ≥1/month but <1/week; <1/month). Associations between daily frequency of laughter and increase in all-cause mortality and cardiovascular disease incidence were determined using Cox proportional hazards modeling.Results: During follow-up (median, 5.4 years), 257 subjects died and 138 subjects experienced cardiovascular events. Kaplan-Meier analysis revealed that all-cause mortality and cardiovascular disease incidence were significantly higher among subjects with a low frequency of laughter (log-rank P<0.01). Cox proportional hazard model analysis adjusted for age, gender, hypertension, smoking, and alcohol drinking status showed that risk of all-cause mortality was significantly higher in subjects who laughed <1/month than in subjects who laughed ≥1/week (hazard ratio (HR) 1.95, 95% confidence interval (CI), 1.16-3.09). Similarly, risk of cardiovascular events was higher in subjects who laughed ≥1/month but < 1/week than in subjects who laughed ≥1/week (HR 1.62, 95% CI, 1.07-2.40).Conclusion: Daily frequency of laughter represents an independent risk factor for all-cause mortality and cardiovascular disease in a Japanese general population.
著者
Silvano GALLUS Alessandra LUGO Xiaoqiu LIU Panagiotis BEHRAKIS Roberto BOFFI Cristina BOSETTI Giulia CARRERAS Liliane CHATENOUD Luke CLANCY Xavier CONTINENTE Ruaraidh DOBSON Tobias EFFERTZ Filippos T. FILIPPIDIS Marcela FU Gergana GESHANOVA Giuseppe GORINI Sheila KEOGAN Hristo IVANOV Maria-José LOPEZ Angel LOPEZ-NICOLAS José PRECIOSO Krzysztof PRZEWOZNIAK Cornel RADU-LOGHIN Ario RUPRECHT Sean SEMPLE Joan B SORIANO Polina STARCHENKO Marta TRAPERO-BERTRAN Olena TIGOVA Anna S TZORTZI Constantine VARDAVAS Vergina K VYZIKIDOU Paolo COLOMBO Esteve FERNANDEZ the TackSHS Project Investigators
出版者
Japan Epidemiological Association
雑誌
Journal of Epidemiology (ISSN:09175040)
巻号頁・発行日
pp.JE20190344, (Released:2020-04-04)
参考文献数
35
被引用文献数
3

Background: Population data on tobacco use and its determinants require continuous monitoring and careful inter-country comparison. We aimed to provide the most up-to-date estimates on tobacco smoking from a large cross-sectional survey, conducted in selected European countries.Methods: Within the TackSHS Project, a face-to-face survey on smoking was conducted in 2017-2018 in 12 countries: Bulgaria, England, France, Germany, Greece, Ireland, Italy, Latvia, Poland, Portugal, Romania and Spain, representing around 80% of the 432 million European Union (EU) adult population. In each country, a representative sample of around 1,000 subjects aged 15 years and older was interviewed, for a total of 11,902 participants.Results: Overall 25.9% of participants were current smokers (31.0% among men and 21.2% among women, p<0.001), while 16.5% were former smokers. Smoking prevalence ranged from 18.9% in Italy to 37.0% in Bulgaria. It decreased with increasing age (compared to <45, multivariable odds ratio, OR, for ≥65 years was 0.31; 95% confidence interval, CI: 0.27-0.36), level of education (OR for low vs. high was 1.32; 95% CI: 1.17-1.48) and self-rated household economic level (OR for low vs. high was 2.05; 95% CI: 1.74-2.42). The same patterns were found in both sexes.Conclusions: These smoking prevalence estimates represent the most up-to-date evidence in Europe. From them it can be derived that there are more than 112 million current smokers in the EU-28. Lower socio-economic status is a major determinant of smoking habit in both sexes.
著者
Tatsuya Takahashi Minouk Schoemaker Klaus Trott Steven Simon Keisei Fujimori Noriaki Nakashima Akira Fukao Hiroshi Saito
出版者
日本疫学会
雑誌
Journal of Epidemiology (ISSN:09175040)
巻号頁・発行日
vol.13, no.2, pp.99-107, 2003 (Released:2007-11-30)
参考文献数
23
被引用文献数
18 32

The US nuclear weapons testing program in the Pacific conducted between 1946 and 1958 resulted in radiation exposure in the Marshall Islands. The potentially widespread radiation exposure from radioiodines of fallout has raised concerns about the risk of thyroid cancer in the Marshallese population. The most serious exposures and its health hazards resulted from the hydrogen-thermonuclear bomb test, the Castle BRAVO, on March 1, 1954. Between 1993 and 1997, we screened 3, 709 Marshallese for thyroid disease who were born before the BRAVO test. It was 60% of the entire population at risk and who were still alive at the time of our examinations. We diagnosed 30 thyroid cancers and found 27 other study participants who had been operated for thyroid cancer before our screening in this group. Fifty-seven Marshallese born before 1954 (1.5%) had thyroid cancer or had been operated for thyroid cancer. Nearly all (92%) of these cancers were papillary carcinoma. We derived estimates of individual thyroid dose proxy from the BRAVO test in 1954 on the basis of published age-specific doses estimated on Utirik atoll and 137Cs deposition levels on the atolls where the participants came from. There was suggestive evidence that the prevalence of thyroid cancer increased with category of estimated dose to the thyroid. J Epidemiol2003;13:99-107.
著者
Naoki Nago Shizukiyo Ishikawa Tadao Goto Kazunori Kayaba
出版者
日本疫学会
雑誌
Journal of Epidemiology (ISSN:09175040)
巻号頁・発行日
vol.21, no.1, pp.67-74, 2011-01-05 (Released:2011-01-05)
参考文献数
17
被引用文献数
24 49 23

Background: We investigated the relationship between low cholesterol and mortality and examined whether that relationship differs with respect to cause of death.Methods: A community-based prospective cohort study was conducted in 12 rural areas in Japan. The study subjects were 12 334 healthy adults aged 40 to 69 years who underwent a mass screening examination. Serum total cholesterol was measured by an enzymatic method. The outcome was total mortality, by sex and cause of death. Information regarding cause of death was obtained from death certificates, and the average follow-up period was 11.9 years.Results: As compared with a moderate cholesterol level (4.14–5.17 mmol/L), the age-adjusted hazard ratio (HR) of low cholesterol (<4.14 mmol/L) for mortality was 1.49 (95% confidence interval [CI]: 1.23–1.79) in men and 1.50 (1.10–2.04) in women. High cholesterol (≥6.21 mmol/L) was not a risk factor. This association was unchanged in analyses that excluded deaths due to liver disease, which yielded age-adjusted HRs of 1.38 (95% CI, 1.13–1.67) in men and 1.49 (1.09–2.04) in women. The multivariate-adjusted HRs and 95% CIs of the lowest cholesterol group for hemorrhagic stroke, heart failure (excluding myocardial infarction), and cancer mortality significantly higher than those of the moderate cholesterol group, for each cause of death.Conclusions: Low cholesterol was related to high mortality even after excluding deaths due to liver disease from the analysis. High cholesterol was not a risk factor for mortality.