著者

Ling-Chien Hung Sheng-Feng Sung Cheng-Yang Hsieh Ya-Han Hu Huey-Juan Lin Yu-Wei Chen Yea-Huei Kao Yang Sue-Jane Lin

出版者

Japan Epidemiological Association

雑誌

Journal of Epidemiology (ISSN:09175040)

巻号頁・発行日

vol.27, no.1, pp.24-29, 2017-01-05 (Released:2017-02-07)

参考文献数

36

被引用文献数

44

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Background: Stroke severity is an important outcome predictor for intracerebral hemorrhage (ICH) but is typically unavailable in administrative claims data. We validated a claims-based stroke severity index (SSI) in patients with ICH in Taiwan.Methods: Consecutive ICH patients from hospital-based stroke registries were linked with a nationwide claims database. Stroke severity, assessed using the National Institutes of Health Stroke Scale (NIHSS), and functional outcomes, assessed using the modified Rankin Scale (mRS), were obtained from the registries. The SSI was calculated based on billing codes in each patient's claims. We assessed two types of criterion-related validity (concurrent validity and predictive validity) by correlating the SSI with the NIHSS and the mRS. Logistic regression models with or without stroke severity as a continuous covariate were fitted to predict mortality at 3, 6, and 12 months.Results: The concurrent validity of the SSI was established by its significant correlation with the admission NIHSS (r = 0.731; 95% confidence interval [CI], 0.705–0.755), and the predictive validity was verified by its significant correlations with the 3-month (r = 0.696; 95% CI, 0.665–0.724), 6-month (r = 0.685; 95% CI, 0.653–0.715) and 1-year (r = 0.664; 95% CI, 0.622–0.702) mRS. Mortality models with NIHSS had the highest area under the receiver operating characteristic curve, followed by models with SSI and models without any marker of stroke severity.Conclusions: The SSI appears to be a valid proxy for the NIHSS and an effective adjustment for stroke severity in studies of ICH outcome with administrative claims data.

著者

Sayaka Adachi Norie Sawada Kenya Yuki Miki Uchino Motoki Iwasaki Kazuo Tsubota Shoichiro Tsugane

出版者

Japan Epidemiological Association

雑誌

Journal of Epidemiology (ISSN:09175040)

巻号頁・発行日

vol.31, no.1, pp.21-29, 2021-01-05 (Released:2021-01-05)

参考文献数

52

被引用文献数

6

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Background: Although the consumption of vegetables and fruits is reported to influence the risk of cataract, no prospective study of this association from Asia has yet appeared. Here, we investigated the association between vegetable and fruit intake and cataract incidence in a large-scale population-based prospective cohort study in Japan.Methods: This study included 32,387 men and 39,333 women aged 45–74 years who had no past history of cataract and had completed a dietary questionnaire of the Japan Public Health Center-based Prospective Cohort Study. The incidence of cataract was evaluated after 5-year follow-up. We used multiple logistic regression analyses to estimate the sex-specific odds ratios (ORs), with adjustment for confounding factors.Results: We identified 1,836 incident cataracts in 594 men and 1,242 women. In men, the OR for cataract was decreased with higher intake of vegetables (ORQ5 vs Q1, 0.77; 95% confidence interval [CI], 0.59–1.01; Ptrend across quartile categories = 0.03) and cruciferous vegetables (ORQ5 vs Q1, 0.74; 95% CI, 0.57–0.96; Ptrend = 0.02). In contrast, the OR for cataract was increased with higher intake of vegetables among women (ORQ5 vs Q1, 1.28; 95% CI, 1.06–1.53; Ptrend = 0.01). Green and yellow vegetable and fruit intake were not associated with cataract in either sex.Conclusions: This study suggests that vegetables may reduce the risk of cataract in men, but not in women.

著者

Natsu Sasaki Reiko Kuroda Kanami Tsuno Kotaro Imamura Norito Kawakami

出版者

Japan Epidemiological Association

雑誌

Journal of Epidemiology (ISSN:09175040)

巻号頁・発行日

vol.31, no.1, pp.93-96, 2021-01-05 (Released:2021-01-05)

参考文献数

8

被引用文献数

13

著者

Tami Saito Tuula Oksanen Kokoro Shirai Takeo Fujiwara Jaana Pentti Jussi Vahtera

出版者

Japan Epidemiological Association

雑誌

Journal of Epidemiology (ISSN:09175040)

巻号頁・発行日

vol.30, no.10, pp.442-449, 2020-10-05 (Released:2020-10-05)

参考文献数

36

被引用文献数

1 3

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Background: While marriage and education help maintain older adults’ health, their joint association with mortality remains unclear. This cross-national study examined the combined effect of marriage and education on the mortality of older Japanese and Finnish adults.Methods: Data on 22,415 Japanese and 11,993 Finnish adults, aged 65–74 years, were obtained from the Japan Gerontological Evaluation Study of 2010–2012 and the Finnish Public Sector Study of 2008–2009 and 2012–2013. We followed up on respondents’ survival status for 5 years using public records. Marital status, educational level, and other variables in both datasets were harmonized.Results: The Cox proportional hazards model showed that unmarried men had a higher mortality risk than married men in both countries (hazard ratio [HR] 1.47; 95% confidence interval [CI], 1.21–1.79 for Japanese and HR 1.94; 95% CI, 1.29–2.91 for Finnish); no such difference was observed in women. The highest mortality risk was observed in unmarried men with tertiary education in both Japan (HR 1.85; 95% CI, 1.21–2.83) and Finland (HR 2.21; 95% CI, 1.26–3.89), when adjusted for baseline age, health-related behaviors, and illnesses.Conclusions: Our findings showed similarity in the combined effect of marriage and education between Japan and Finland, differing from observations in countries with more apparent socioeconomic health disparities. Further studies should examine the reasons for the excessive mortality risk in highly educated, unmarried men in both countries and consider whether selection bias led to underestimation of the true risk in unmarried older adults with lower education.

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

Akira Takagi Satoko Ohfuji Takashi Nakano Hideaki Kumihashi Munehide Kano Toshihiro Tanaka

出版者

Japan Epidemiological Association

雑誌

Journal of Epidemiology (ISSN:09175040)

巻号頁・発行日

pp.JE20200233, (Released:2020-10-24)

参考文献数

17

被引用文献数

9

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Background: Mumps deafness causes serious problems, and incidence data are needed to identify its disease burden. However, such data are limited, and the reported incidence is highly variable. Nationwide studies in Japan with a large age range are lacking.Methods: This was a retrospective observational investigation of the 2005–2017 mumps burden using employment-based health insurance claims data. Data were analyzed for 5,190,326 people aged 0–64 years to estimate the incidence of mumps deafness.Results: Of 68,112 patients with mumps (36,423 males; 31,689 females), 102 (48 males; 54 females) developed mumps deafness—an incidence of 15.0 per 10,000 patients (1 in 668 patients). Fifty-four (52.9%) patients had mumps deafness in childhood (0–15 years), and 48 (47.1%) had mumps deafness in adolescence and adulthood (16–64 years); most cases occurred in childhood, the peak period for mumps onset. The incidence of mumps deafness per 10,000 patients was 73.6 in adolescence and adulthood, 8.4 times higher than the incidence of 8.8 in childhood (P < 0.001). In childhood, the incidence of mumps deafness was 7.2 times higher among 6–15-year-olds (13.8 [95% CI, 10.2-18.2]) than among 0–5-year-olds (1.9 [95% CI, 0.6-4.5]), and this difference was statistically significant (P < 0.001). No sex difference was observed.Conclusions: The incidence of mumps deafness per 10,000 patients aged 0–64 years was 15.0 (1 in 668 patients). A secondary risk of deafness following mumps virus infection was identified not only for children, but also for adolescents and adults.

著者

Taiji Noguchi Fumi Kondo Takeshi Nishiyama Takahiro Otani Hiroko Nakagawa-Senda Miki Watanabe Nahomi Imaeda Chiho Goto Akihiro Hosono Kiyoshi Shibata Hiroyuki Kamishima Akane Nogimura Kenji Nagaya Tamaki Yamada Sadao Suzuki

出版者

Japan Epidemiological Association

雑誌

Journal of Epidemiology (ISSN:09175040)

巻号頁・発行日

pp.JE20200343, (Released:2020-10-17)

参考文献数

37

被引用文献数

1

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Background: Marital transitions are associated with adverse health events, such as mortality and cardiovascular disease. Since marital transitions (e.g., becoming widowed) are unavoidable life events, it is necessary to identify modifiable intermediate outcomes. Thus, we examined the association between marital transitions and vegetable intake among middle-aged and older Japanese adults.Methods: This longitudinal study included Japanese adults aged 40–79 years who received an annual health checkup between 2007 and 2011 (baseline) and five years later (follow-up). Marital transitions were classified as whether and what type of transition occurred during the five-year period and comprised five groups: consistently married, married to widowed, married to divorced, not married to married, and remained not married. Changes in total vegetable, green and yellow vegetable, and light-colored vegetable intake from baseline to follow-up were calculated using the Food Frequency Questionnaire.Results: Data from 4813 participants were analyzed (mean age: 59.4 years; 44.1% women). Regarding marital transitions, 3,960 participants were classified as “consistently married,” 135 as “married to widowed,” 40 as “married to divorced,” 60 as “not married to married,” and 529 as “remained not married.” Multivariable linear regression analysis revealed that compared to consistently married, married to widowed was inversely associated with the change in total vegetable intake (β = -16.64, SE = 7.68, p = 0.030) and light-colored vegetable intake (β = -11.46, SE = 4.33, p = 0.008).Conclusion: Our findings suggest that being widowed could result in a reduced intake of vegetables. Hence, dietary counseling according to marital situation is necessary.

著者

Masamitsu Kamada Jun Kitayuguchi I-Min Lee Tsuyoshi Hamano Fumiaki Imamura Shigeru Inoue Motohiko Miyachi Kuninori Shiwaku

出版者

Japan Epidemiological Association

雑誌

Journal of Epidemiology (ISSN:09175040)

巻号頁・発行日

vol.24, no.6, pp.474-483, 2014-11-05 (Released:2014-11-05)

参考文献数

56

被引用文献数

18 26

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Background: Both little and excessive physical activity (PA) may relate to chronic musculoskeletal pain. The primary objective of this study was to characterize the relationship of PA levels with chronic low back pain (CLBP) and chronic knee pain (CKP).Methods: We evaluated 4559 adults aged 40–79 years in a community-based cross-sectional survey conducted in 2009 in Shimane, Japan. We used self-administered questionnaires to assess sociodemographics and health status: PA was assessed by the International Physical Activity Questionnaire, and CLBP and CKP were assessed by a modified version of the Knee Pain Screening Tool. We examined relationships of PA with prevalence of CLBP and CKP using Poisson regression, controlling for potential confounders.Results: CLBP and CKP were both prevalent (14.1% and 10.7%, respectively) and associated with history of injury, medication use, and consultation with physicians. PA was not significantly related to CLBP or CKP (P > 0.05) before or after adjustment for potential confounders. For example, compared with adults reporting moderate PA (8.25–23.0 MET-hours/week), prevalence ratios for CKP adjusted for sex, age, education years, self-rated health, depressive symptom, smoking, chronic disease history, and body-mass index were 1.12 (95% confidential interval [CI] 0.84–1.50) among those with the lowest PA and 1.26 (95% CI 0.93–1.70) among those with the highest PA (P quadratic = 0.08). The prevalence ratios were further attenuated toward the null after additional adjustment for history of injury, medication use, and consultation (P quadratic = 0.17).Conclusions: This cross-sectional study showed that there were no significant linear or quadratic relationships of self-reported PA with CLBP and CKP. Future longitudinal study with objective measurements is needed.

著者

Yuri Yaguchi-Tanaka Takahiro Tabuchi

出版者

Japan Epidemiological Association

雑誌

Journal of Epidemiology (ISSN:09175040)

巻号頁・発行日

pp.JE20200266, (Released:2020-07-11)

参考文献数

33

被引用文献数

8

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Background: Few longitudinal studies have examined the association between skipping breakfast and overweight/obesity in pre-elementary school children. Furthermore, this association may differ between boys and girls. The main objective of this study was to assess whether skipping breakfast in early childhood was associated with later incidence of overweight/obesity with stratification by gender, using data on children aged 2.5 to 13 years old in The Longitudinal Survey of Newborns in the 21st century.Methods: We examined the associations between skipping breakfast at 2.5 years old and overweight/obesity at 2.5 (n=34,649), 4.5 (n=35,472), 7 (n=31,266), 10 (n=31,211), and 13 (n=28,772) years old. To estimate adjusted odds ratios (ORs) with 95% confidence intervals (CIs) of overweight/obesity by each age (2.5, 4.5, 7, 10, 13 years), a multivariate logistic regression was used adjusting for time-invariant and time-varying covariates.Results: At the age of 2.5 years, 11.0% of boys and 12.2% of girls were skipping breakfast. In fully adjusted models, skipping breakfast at 2.5 years old was not significantly associated with overweight/obesity at 2.5 and 4.5 years old, but was significantly associated with overweight/obesity at 7 and 10 years old, in both sexes. Skipping breakfast at 2.5 years old was significantly associated with overweight/obesity at 13 years old in boys (OR=1.38, 95% CI=1.17-1.62), but not in girls (OR=1.21, 95% CI=0.98-1.49).Conclusions: Skipping breakfast in early childhood increased overweight/obesity in later childhood, but there may be gender differences in the association.

著者

Toshihiro TERUI Kazuki YOSHIDA Mie SASAKI Michio MURAKAMI Aya GOTO

出版者

Japan Epidemiological Association

雑誌

Journal of Epidemiology (ISSN:09175040)

巻号頁・発行日

pp.JE20200108, (Released:2020-08-29)

参考文献数

36

被引用文献数

5

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Background: Discrepancies between parents’ reports of paternal parenting have been gaining attention, but epidemiological evidence is scarce in Asia. This study aimed to clarify agreement/discrepancy between paternal and maternal recognition of paternal parenting, and the association between actual paternal parenting time and background factors.Methods: Data from couples whose children attended 4-month-child health check-ups in Fukushima City were analyzed (N = 509). Based on paternal recognition of paternal parenting (PRPP) and maternal recognition of paternal support (MRPS), couples were classified into four groups. Each group’s paternal household work and parenting time were analyzed. Univariable and multivariable analysis were performed to investigate the association between agreement/discrepancy and background factors of children and parents.Results: Frequency of positive agreement (PRPP+ and MRPS+) was 83.9%, whereas negative agreement (PRPP- and MRPS-) was 2.6%. As for discrepancy, PRPP+ and MRPS- was 8.4% and PRPP- and MRPS+ was 5.1%. Fathers’ total median parenting time was 2 (weekdays) and 6 (weekends) hours, and showed significant differences among the four groups. Multivariable analysis revealed that compared to positive agreement, maternal mental health condition and pregnancy intention were significantly associated with the discrepancy PRPP+ and MRPS−, paternal mental health condition and marital satisfaction with the discrepancy PRPP−and MRPS+, and maternal mental health condition with negative agreement.Conclusions: We identified differences in parenting time and mental health characteristics among couples depending on agreement/discrepancy in recognition of paternal parenting. Assessing both parents’ profiles is necessary in clinical practice to promote paternal participation in childcare.

著者

Masaaki Yamada Michikazu Sekine Takashi Tatsuse Yukiko Asaka

出版者

Japan Epidemiological Association

雑誌

Journal of Epidemiology (ISSN:09175040)

巻号頁・発行日

pp.JE20200214, (Released:2020-08-08)

参考文献数

32

被引用文献数

7

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Background: Little is known about pathological Internet use (PIU) and online risky behaviors among elementary school children. We aimed to investigate the prevalence and factors associated with PIU and online risky behaviors.Methods: A school-based cross-sectional study was conducted in Toyama, Japan in 2018. The study included 13,413 children in the 4th-6th grades (mean, 10.5 years old) from 110 elementary schools (61.1% of elementary schools in Toyama). We assessed PIU by Young’s Diagnostic Questionnaire (YDQ) and risky behaviors. Poisson regression analysis was conducted.Results: Totally, 13,092 children returned questionnaires (response rate 97.6%). The prevalence of PIU was 4.2% and that of each risky behavior was as follows: 21.6% in spending money online, 6.6% in uploading personal movies, 5.2% in interpersonal issues, and 2.4% in having met strangers. PIU was significantly associated with boys (prevalence ratio, PR=1.26; 95% confidence interval, CI: 1.04-1.52), skipping breakfast (PR=1.43; 95% CI: 1.14-1.79), Internet time (for 2~3h; PR=3.49, 95% CI: 2.63-4.65, for 3~4h; PR=4.45, 95% CI: 3.27-6.06, and for ≥4h; PR=8.25, 95% CI: 6.45-10.55), physical inactivity (PR=2.63; 95% CI: 2.00-3.47), late bedtime (PR=1.86; 95% CI: 1.45-2.39 for ≥11p.m.), no rules at home (PR=1.22; 95% CI: 1.01-1.46), no child-parent interaction (PR=1.37; 95% CI: 1.06-1.77), no close friends in real life (PR=1.69; 95% CI: 1.30-2.19).Conclusions: PIU and risky behaviors were not rare among the elementary school children. Besides unhealthy lifestyles, social and family environments were associated with PIU. Having child-parent interaction and helping children develop close friendships in real life are effective deterrents to PIU.

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

Ami Fukunaga Yosuke Inoue Takeshi Kochi Huanhuan Hu Masafumi Eguchi Keisuke Kuwahara Takako Miki Kayo Kurotani Akiko Nanri Isamu Kabe Tetsuya Mizoue

出版者

Japan Epidemiological Association

雑誌

Journal of Epidemiology (ISSN:09175040)

巻号頁・発行日

vol.30, no.7, pp.288-294, 2020-07-05 (Released:2020-07-07)

参考文献数

45

被引用文献数

7

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Background: While a growing body of research suggests a protective role of healthy lifestyle against depression, evidence from prospective studies is scarce. We constructed a healthy lifestyle index (HLI) and examined its prospective association with depressive symptoms in a Japanese working population.Methods: Participants were 917 employees (19–68 years old) who were free from depressive symptoms at baseline in 2012–2013 and attended the 3-year follow-up survey. The HLI (range: 0–7 points) was constructed by assigning 1 point to each healthy lifestyle factor, namely, (1) normal body mass index (18.5–24.9 kg/m2), (2) non-smoking, (3) no or moderate alcohol intake (≤23 g ethanol/day), (4) adequate physical activity (≥7.5 metabolic equivalent-hours/week), (5) high vegetable intake (≥350 g/day), (6) high fruit intake (≥200 g/day), and (7) adequate sleep duration (6–8.9 hours/day), which was categorized into three groups (low: 0–2 points; middle: 3–4 points; and high: 5–7 points). Depressive symptoms were assessed using the Center for Epidemiologic Studies Depression Scale.Results: A total of 155 incident cases (17.0%) of depressive symptoms were identified at the follow-up survey. Compared with the low HLI group, multivariable-adjusted odds ratios of depressive symptoms were 0.74 (95% confidence interval, 0.48–1.15) and 0.55 (95% confidence interval, 0.31–0.99) for the middle and high HLI groups, respectively (P-trend = 0.041).Conclusion: The present study suggests the importance of adherence to multiple healthy lifestyle factors in prevention of depressive symptoms.

著者

Manami Ochi Aya Isumi Tsuguhiko Kato Satomi Doi Takeo Fujiwara

出版者

Japan Epidemiological Association

雑誌

Journal of Epidemiology (ISSN:09175040)

巻号頁・発行日

pp.JE20190177, (Released:2020-03-21)

参考文献数

39

被引用文献数

29

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Background: The Adachi Child Health Impact of Living Difficulty (A-CHILD) study has been conducted since 2015 to clarify the associations between socioeconomic factors and child health, as well as to accumulate data for political evaluation of the child-poverty agenda. This paper describes the purpose and research design of the A-CHILD study and the baseline profiles of participants, together with the future framework for implementing this cohort study.Methods: We have conducted two types of continuous survey: a complete-sample survey started in 2015 as a first wave study to target first-grade children in all public elementary schools in Adachi City, Tokyo, and a biennial fixed grade observation survey started in 2016 in selected elementary and junior high schools. Questionnaires were answered by caregivers of all targeted children and also by the children themselves for those in the fourth grade and higher. The data of A-CHILD also combined information obtained from school health checkups of all school-grade children, as well as the results from blood test and measurement of blood pressure of eight-grade children since 2016.Results: The valid responses in the first wave were 4,291 (80.1%). The number of households in “living difficulties”, such as low household income or material deprivation, stood at 1,047 (24.5%).Conclusions: The A-CHILD study will contribute to the clarification of the impact of poverty on children’s health disparities and paves the way to managing this issue in the community.

著者

Yosuke Inoue Shuhei Nomura Chihiro Nishiura Ai Hori Kenya Yamamoto Tohru Nakagawa Toru Honda Shuichiro Yamamoto Masafumi Eguchi Takeshi Kochi Toshiaki Miyamoto Hiroko Okazaki Teppei Imai Akiko Nishihara Takayuki Ogasawara Naoko Sasaki Akihiko Uehara Makoto Yamamoto Makiko Shimizu Maki Konishi Isamu Kabe Tetsuya Mizoue Seitaro Dohi

出版者

Japan Epidemiological Association

雑誌

Journal of Epidemiology (ISSN:09175040)

巻号頁・発行日

pp.JE20190332, (Released:2020-07-25)

参考文献数

31

被引用文献数

6

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Background: While much effort has focused on quantifying disease burden in occupational health, no study has simultaneously assessed disease burden in terms of mortality and morbidity. We aimed to propose a new comprehensive method of quantifying the disease burden in the workplace.Method: The data were obtained from the Japan Epidemiology Collaboration on Occupational Health (J-ECOH) Study, a large-scale prospective study of approximately 80,000 workers. We defined disease burden in the workplace as the number of working years lost among the working population during a 6-year period (April 2012 to March 2018). We calculated the disease burden according to consequences of health problems (i.e., mortality, sickness absence [SA], and ill-health retirement) and disease category. We also calculated the age-group- (20–39 and 40–59 years old) and sex-specific disease burden.Results: The largest contributors to disease burden in the workplace were mental and behavioural disorders (47.0 person-years lost per 10,000 person-years of working years, i.e., per myriad [proportion]), followed by neoplasms (10.8 per myriad) and diseases of the circulatory system (7.1 per myriad). While mental and behavioural disorders made a greater contribution to SA and ill-health retirement compared to mortality, the latter two disorders were the largest contributors to the disease burden in the workplace due to mortality. The number of working years lost was greater among younger vs. older female participants, whereas the opposite trend was observed in males.Conclusions: Our approach is in contrast to those in previous studies that focused exclusively on mortality or morbidity.

著者

Yugo Shobugawa Hiroshi Murayama Takeo Fujiwara Shigeru Inoue

出版者

Japan Epidemiological Association

雑誌

Journal of Epidemiology (ISSN:09175040)

巻号頁・発行日

vol.30, no.7, pp.281-287, 2020-07-05 (Released:2020-07-07)

参考文献数

28

被引用文献数

15

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Background: Studies have shown that rural residents face disadvantages concerning medical access and socio-economic conditions. However, the social determinants of health among older people in rural areas are still unclear. The Neuron to Environmental Impact across Generations (NEIGE) study investigated the social determinants of health among older rural adults.Methods: A survey was conducted among the older residents of Tokamachi City, Japan. We randomly selected study participants (N = 1,346) from four stratified groups by age (65–74 and 75–84 years) and residential area (Tokamachi center [downtown] and Matsunoyama [mountain]). The survey collected data on socio-economic status, lifestyle, health, and neighborhood environment. Blood and urine sampling were also conducted, and physical activity was assessed. Magnetic resonance brain imaging (MRI) and Apo-E gene were also examined in the analysis.Results: In total, 527 people participated in the NEIGE study (participation rate: 39.2%). The average age of the participants was 73.5 (standard deviation, 5.6) years, and 47.3% were male. No differences in demographics were found between downtown and mountain residents, except for educational attainment, which was lower among mountain residents. Lifestyles were similar, except for the higher percentage of everyday drinkers (33.3–35.3%) in the mountain area. Concerning physical health, muscle mass, grip strength, and measured physical activity were significantly higher among mountain residents. However, gait speed and balance were better among downtown residents.Conclusion: The findings of the NEIGE study will help elucidate the social determinants of health in older rural adults in Japan, and emphasize the different outcomes between downtown and mountain areas.

著者

Takashi Yamauchi Machi Suka Hiroyuki Yanagisawa

出版者

Japan Epidemiological Association

雑誌

Journal of Epidemiology (ISSN:09175040)

巻号頁・発行日

vol.30, no.6, pp.237-243, 2020-06-05 (Released:2020-06-05)

参考文献数

23

被引用文献数

6

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Background: The present study aimed to examine the association between the presence/absence of help-seeking behavior (ie, behavior aimed at obtaining assistance from others to improve a situation or problem) and psychological distress among private and public employees by age group using a nationally representative sample of the Japanese population.Methods: The present study analyzed data obtained from the 2016 Comprehensive Survey of Living Conditions, a nationwide cross-sectional survey. Of 568,426 participants, 78,284 private and public employees aged 20 to 59 years, who were receiving no mental health services at the time of the survey and reported at least one stressor in daily life, were eligible. The primary outcome measure was self-rated psychological distress as measured by the Kessler Psychological Distress Scale. Multiple logistic regression analyses were carried out separately by age group, adjusting for sociodemographic and job/life-related factors.Results: The proportion of participants not showing help-seeking behavior was significantly higher among those aged 40–59 years compared to those aged 20–39 (30.5% and 22.7%, respectively; P < 0.001). Participants without help-seeking behavior had significantly higher odds ratios (ORs) for psychological distress, regardless of age group (OR = 1.9 [95% confidence interval (CI), 1.6–2.0] and OR = 1.6 [95% CI, 1.4–1.7] for the age 20–39 years and 40–59 years groups, respectively), compared to those showing help-seeking behavior.Conclusions: Participants not showing help-seeking behavior were more likely to have severe psychological distress, and this trend appeared to be slightly stronger among those aged 20–39 years. These findings suggest that promoting help-seeking behavior is important for improving mental health among workers.

著者

Shingo Fukuma Tatsuyoshi Ikenoue Yukari Yamada Yoshiyuki Saito Joseph Green Takeo Nakayama Shunichi Fukuhara

出版者

Japan Epidemiological Association

雑誌

Journal of Epidemiology (ISSN:09175040)

巻号頁・発行日

pp.JE20200181, (Released:2020-07-04)

参考文献数

39

被引用文献数

3

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BackgroundBreaches of ethics undermine the practice of medicine. In Japan, two major scandals involving clinical research and drug marketing occurred after the publication of clinical trials. To study the effects of those scandals, we evaluated changes in the use of first-generation angiotensin II receptor blockers (ARBs) after publication of relevant clinical trials and also after the subsequent scandals.MethodsWe conducted a quasi-experimental design of an interrupted time series analysis (ITSA) on nationwide monthly drug-market data covering 12 years (2005 to 2017) in Japan. The main outcome was the use of first-generation ARBs (valsartan, candesartan, and losartan). The two exposures were the publication of ARB-related clinical-trial results (October 2006) and subsequent ARB-related scandals involving research and marketing (February 2013). A generalized estimating equation model was fitted for ITSA with a log link, Poisson distribution, robust variance estimators, and seasonality adjustment.ResultsThe publication of clinical trials was associated with 12% increase in the use of first-generation ARBs in Japan, and the subsequent ARB-related scandals was associated with 19% decrease. The decrease in the use of first-generation ARBs after the scandals was greater than the increase in their use after the publication of clinical-trial results. The net effect of the two exposures was a 9% decrease in the use of first-generation ARBs.ConclusionsThe scandals were associated with decrease in the use of first-generation ARBs, and that decrease was greater than the increase associated with the publication of “successful” clinical trials, making the net effect not zero but negative.

著者

Kenji Matsui Keiichiro Yamamoto Yusuke Inoue

出版者

Japan Epidemiological Association

雑誌

Journal of Epidemiology (ISSN:09175040)

巻号頁・発行日

pp.JE20200278, (Released:2020-07-04)

参考文献数

19

被引用文献数

2

著者

Kayo Ueda Makiko Yamagami Fumikazu Ikemori Kunihiro Hisatsune Hiroshi Nitta

出版者

Japan Epidemiological Association

雑誌

Journal of Epidemiology (ISSN:09175040)

巻号頁・発行日

vol.26, no.5, pp.249-257, 2016-05-05 (Released:2016-05-05)

参考文献数

32

被引用文献数

15 40

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Background: Seasonal variation and regional heterogeneity have been observed in the estimated effect of fine particulate matter (PM2.5) mass on mortality. Differences in the chemical compositions of PM2.5 may cause this variation. We investigated the association of the daily concentration of PM2.5 components with mortality in Nagoya, Japan.Methods: We combined daily mortality counts for all residents aged 65 years and older with concentration data for PM2.5 mass and components in Nagoya from April 2003 to December 2007. A time-stratified case-crossover design was used to examine the association of daily mortality with PM2.5 mass and each component (chloride, nitrate, sulfate, sodium, potassium, calcium, magnesium, ammonium, elemental carbon [EC], and organic carbon [OC]).Results: We found a stronger association between mortality and PM2.5 mass in transitional seasons. In analysis for each PM2.5 component, sulfate, nitrate, chloride, ammonium, potassium, EC, and OC were significantly associated with mortality in a single-pollutant model. In a multi-pollutant model, an interquartile range increase in the concentration of sulfate was marginally associated with an increase in all-cause mortality of 2.1% (95% confidence interval, −0.1 to 4.4).Conclusions: These findings suggest that some specific PM components have a more hazardous effect than others and contribute to seasonal variation in the health effects of PM2.5.