We aimed to investigate the risks of cardiovascular diseases associated with specific occupations, using a nation-wide, multicentre, hospital-based registry data from the Inpatient ...Clinico-Occupational Survey. The analysis included 539,110 controls (non-circulatory disease) and 23,792 cases (cerebral infarction, intracerebral/subarachnoid hemorrhage, acute myocardial infarction) aged ≥ 20 years who were initially hospitalized during 2005-2015. The participants' occupational and clinical histories were collected by interviewers and medical doctors. Occupations were coded into 81 categories according to the Japanese standard occupation classification. Multivariable logistic regression analysis adjusted for age, admission year and hospital, smoking, alcohol consumption, hypertension, and shift-work was conducted by sex using general clerical workers as the reference. Increased risks of cerebral infarction, intracerebral hemorrhage, subarachnoid hemorrhage, and acute myocardial infarction, were observed in 15, 20, 25, and 1 occupation(s) in men, and 9, 2, 2, and 10 occupations in women. Motor vehicle drivers, food and drink preparatory workers, fishery workers, cargo workers, civil engineer workers, and other manual workers in men and other manual workers in women faced increased risks of all three stroke subtypes. Our findings demonstrate associations between specific occupations and the risk of cardiovascular disease incidence and suggest that the risk may vary by occupation.
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IZUM, KILJ, NUK, PILJ, PNG, SAZU, UL, UM, UPUK
To examine the risk of incident cataract surgery associated with alcohol use patterns among Japanese adults. This was a case-control study evaluating 14,861 patients with incident cataract surgery ...and 14,861 matched controls. Subjects admitted to any of the 34 hospitals in Japan and aged between 40 and 69 years were included. Drinking patterns (drinking frequency, daily average drinks, and total amount of lifetime drinking), smoking history, lifestyle-related comorbidities, and occupational factors were surveyed by trained interviewers. Odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using conditional logistic regression models. For drinking frequency, ORs in the 1-3 days/week and 4-7 days/week groups were 1.10 (95% CI 1.03-1.17) and 1.30 (1.21-1.40), respectively. For average drinks, ORs in > 0-2 drinks/day, > 2-4 drinks/day, and > 4 drinks/day were 1.13 (1.06-1.20), 1.23 (1.12-1.35), and 1.16 (1.03-1.31), respectively. Both men and women had an increased risk of incident cataract surgery with increased total lifetime drinking, with a significant increase in risk occurring at > 90 drink-years for men and > 40 drink-years for women. A positive dose-response relationship was observed between alcohol consumption and cataract. Restricted drinking may help to reduce the progression of cataracts.
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IZUM, KILJ, NUK, PILJ, PNG, SAZU, UL, UM, UPUK
Telework has dramatically increased due to the coronavirus disease 2019 (COVID-19) pandemic, and the health impacts related to telework have become major concerns. Some studies have shown that ...telework has both positive and negative impacts. However, during the pandemic, the influence of COVID-19 is too strong to estimate the health effects of telework. Therefore, this scoping review investigated a comprehensive overview of those impacts based on studies conducted before the COVID-19 pandemic.
We searched keywords related to telework in five databases: PubMed, Scopus, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Cochrane Library, and Ichu-Shi Web. We included articles written in English and Japanese and published from January 2009 to December 2020. One author extracted data, and four authors were paired into two groups. All authors independently conducted the first and second screening and checked the results in pairs. Any disagreements were resolved by reaching a consensus among all authors. All screening and strategies were performed with the consent of all authors.
Twenty-nine quantitative studies published in 12 countries were extracted. The outcomes included 10 studies on physical and lifestyle outcomes, 25 studies on stress and mental health outcomes, and 13 studies on quality-of-life and wellbeing outcomes. Telework increased sitting time in one study, and two studies showed improvement in behavior, such as reducing smoking or drinking due to telework. While six studies reported subjective stress levels improved by telework, the results for depression, anxiety, and other disorders varied across those studies, and the social or individual factors further complicated the situation.
Telework is potentially associated with a shift to healthier lifestyles but also the potential for inverse correlation to extend sedentary time. Mental stress indicators depend on the social and individual situations, and very few intervention studies on teleworking existed prior to the COVID-19 pandemic. Our review identified a lack of intervention and comparative research on health problems with telework and revealed a need to conduct research with clear comparisons in post-COVID-19 studies.
https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021203104, identifier: CRD42021203104.
Fib4 index (Fib4) is clinically used as a noninvasive marker of liver fibrosis. In this study, we aimed to preliminarily investigate whether Fib4 can be used to detect individuals who need assessment ...for alcoholic liver disease (ALD) in the general population by clarifying the detailed association of Fib4 with alcohol consumption and gamma-glutamyl transferase (GGT) among male workers.
We analyzed data sets on the comprehensive medical examinations of male workers as cross-sectional and retrospectively longitudinal studies. We enrolled 10 782 males (mean age: 52.2 ± 10.2 years) in FY2019 and 7845 males (mean follow-up: 12.6 ± 6.7 years) who could be consecutively followed up for 20 years from FY2000 to FY2019. Data were evaluated using logistic regression and COX proportional analysis.
In the cross-sectional setting, the rate of Fib4 ≥ 2.67 in heavy drinkers (≥ 40 g of ethanol/day) was increased dose dependently in those over 65 years old, and that of body mass index ≥ 30 kg/m
was increased in those over 60 years old, but not in those with fatty liver. The odds ratio (OR) (95% confidence interval CI) for heavy drinking was 4.30 (95% CI = 1.90-9.72), and GGT ≥ 200 IU/L was considerably high (OR = 29.05 95% CI = 17.03-49.56). In the longitudinal setting, heavy drinkers and those with GGT ≥ 200 IU/L at 10 years after the baseline showed an increased risk for Fib4 ≥ 2.67 (hazard ratio = 2.17 95% CI = 1.58-2.98 and 7.65 95% CI 5.26-11.12, respectively).
The development of Fib4 ≥ 2.67 after 10 years was associated with heavy alcohol drinking and GGT level ≥ 200 IU/L. Therefore, Fib4 combined with GGT could indicate high risk of ALD. However, clinical examinations and course observations are essentially needed.
Occupational class, a proxy for socio-economic status, is a known factor for health disparities. However, no study has reported the association between occupational class and the risk of viral ...hepatitis B and C (HBV/HCV) infections. We investigated the effects of occupational class on the prevalence of HBV/HCV infections.
This is an unmatched hospital-based case-control study that included 12,101 patients who were diagnosed with HBV infection (ICD–10, B16.0, B16.1, B16.2, B16.9, B17.0, B18.0, B18.1) or HCV infection (ICD–10, B17.1, B18.2) and 698,168 controls (those with non-HBV/HCV-related diseases) aged ≥ 20 years who were initially hospitalized between 2005 and 2019. Patients were categorized according to occupational class (blue-collar, service, professional, and manager) and industrial sector (blue-collar, service, and white-collar). Managers in the blue-collar industry were set as the reference group, and the odds ratios (ORs) for the risk of HBV and HCV infections were calculated.
Occupational class was significantly associated with only HCV infection risk. Professionals in all industrial sectors showed the lowest risk for HCV (OR (95% confidence intervals CIs) = 0.69 0.58–0.82 in the blue-collar industry, 0.52 0.38–0.73 in the service industry, and 0.60 0.52–0.70 in the white-collar industry). Further, after adjusting for sex, age, and region of admitting hospital, all occupational classes in the white-collar industry showed lower risks of HCV than those in the other industries (ORs= 0.58 0.47–0.71 in blue-collar workers, 0.74 0.64–0.84 in service workers, 0.60 0.52–0.70 in professionals, and 0.81 0.64–1.02 in managers in white-collar industry).
Occupational class was closely associated with HCV infection risk only. Considering that blue-collar workers in the white-collar industry also showed a low risk, adequate measures should be taken against hepatitis, possibly because of the screening tests and cure implemented in that population.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
In Japan, health checkups for workers are legally compulsory. Considering legal health checkup items are important for Japanese workers' health problems. To date, the legal health checkup items for ...blood cell counts include only red blood cell counts and hemoglobin but not platelet counts. This study aimed to investigate the significance of measuring platelets in workers by showing the association between the FIB-4 index (FIB-4), which can be easily calculated from factors including platelet counts and viral hepatitis infection.
Both cross-sectional and longitudinal analyses were conducted on the comprehensive medical examinations of male workers. In fiscal year (FY) 2019, a logistic regression model was applied to 12,918 examinees. For 13,459 examinees (mean age = 47.5 ± 9.3 SD), FY2000 was set to be followed until FY2019. A total of 149,956 records between FY2000 and FY2019 were analyzed cross-sectionally, and 8,038 men who were consecutively examined to FY2019 at the longest were analyzed longitudinally. Receiver operating characteristic (ROC) curve-area under the ROC curve (ROC-AUC) and Cox proportional methods were used to examine the association between platelet-related indices and viral hepatitis infection.
Logistic regression showed that the risk of FIB-4 ≥ 2.67 was mostly associated with hepatitis C virus antibody (HCVAb) positivity odds ratio (OR) = 2.51, 95% confidence interval (CI) = 1.08-5.86, while negatively associated with body mass index (BMI) (OR = 0.54, 95% CI = 0.30-0.97), and not associated with the presence of fatty liver. To detect HVC Ab positivity, ROC-AUC showed more effectiveness in FIB-4 than in the AST/ALT ratio (0.776, 95% CI = 0.747-0.773 vs. 0.552; 95% CI = 0.543-0.561). The Cox analysis showed that the risk of FIB-4 ≥ 2.67 was closely associated with hepatitis B virus surface antigen (HBsAg) hazard ratio (HR) = 3.1, 95% CI = 2.0-4.6 and HCV Ab positivity (HR = 3.2, 95% CI = 2.0-5.0).
Our results suggest that it might be worth considering that usage of information on platelets in legal health checkups could be some help not to overlook workers with hepatitis virus carriers as a complementary countermeasure, although further investigations are needed into its practical application.
Pathophysiology of Functional Dyspepsia Futagami, Seiji; Shimpuku, Mayumi; Yin, Yan ...
Journal of Nippon Medical School,
2011, Volume:
78, Issue:
5
Journal Article
Peer reviewed
Open access
Functional dyspepsia is a highly prevalent and heterogeneous disorder. Functional dyspepsia involves many pathogenic factors, such as gastric motility disorders, visceral hypersensitivity, ...psychological factors, Helicobacter pylori infection, and excessive gastric acid secretion. The present article provides an overview of pathogenetic factors and pathophysiologic mechanisms.
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IZUM, KILJ, NUK, PILJ, PNG, SAZU, UL, UM, UPUK
ObjectivesIn Japan, the risk of developing cancer among workers employed in workplaces where chemical substances are handled is unclear. This study aimed to assess the association between cancer risk ...and employment in workplaces handling hazardous chemicals.MethodsThe Inpatient Clinico-Occupational Survey of the Rosai Hospital Group data of 120 278 male patients with incident cancer and 217 605 hospital controls matched for 5-year age group, hospital (34 hospitals) and year of admission (2005–2019) were analysed. Cancer risk in relation to lifetime employment in workplaces using regulated chemicals was assessed while controlling for age, region and year of diagnosis, smoking, alcohol consumption and occupation. Further analysis stratified by smoking history was performed to examine interaction effects.ResultsIn the longest group of employment in tertiles, ORs were increased for all cancers (OR=1.13; 95% CI: 1.07 to 1.19) and lung (OR=1.82; 95% CI: 1.56 to 2.13), oesophageal (OR=1.73; 95% CI: 1.18 to 2.55), pancreatic (OR=2.03; 95% CI: 1.40 to 2.94) and bladder (OR=1.40; 95% CI: 1.12 to 1.74) cancers. Employment of 1+ years was associated with risk for lung cancer; 11+ years for pancreatic and bladder cancers; and 21+ years for all cancers and oesophageal cancer. These positive relationships were particularly obvious among patients with a history of smoking; however, no significant interaction between smoking and length of employment was observed.ConclusionsThere is a high risk of cancer among workers, especially smokers, employed in workplaces handling regulated chemicals in Japan. Thus, future measures for chemical management in workplaces are needed to prevent avoidable cancers.
A person's occupation may increase his/her risk for developing inflammatory bowel disease (IBD). This study investigated the association between risk for later-onset of IBD and both specific ...occupations and occupational physical activity (OPA) levels.
A multicenter hospital-based matched case-control study was conducted using the Inpatient Clinico-Occupational Survey database. Cases were patients with Crohn's disease (CD) and ulcerative colitis (UC) patients admitted for the first time between 2005 and 2015. Four controls matched by age, sex, admission year and hospital were selected for each case. Cases and controls were grouped into the longest-held occupations as classified by the Japanese Standard Occupational Classification and OPA levels. We conducted conditional logistic regressions to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for IBD, CD and UC adjusted for alcohol consumption and smoking status.
There were 564 cases (172 CD, 392 UC) and 2086 controls. The risk for UC was higher among sales workers and carrying, cleaning and packing workers (ORs 2.62 95%CIs 1.18-5.82, 2.52 1.04-6.09). There was no association between occupation type and CD risk. Higher OPA level decreased CD risk (OR 0.51 95%CIs 0.26-1.00) and increased UC risk (OR 1.53 95%CIs 1.02-2.30).
Our study revealed that the risk for later-onset of UC, but not CD, was associated with longest-held 'service' and 'manufacture' work. The risk by OPA levels was inversely associated between CD and UC. Further studies are needed by follow-up method for long-term effects of physical activity.
Abstract Introduction This study investigates the association of occupational class with Parkinson’s disease (PD). Methods This was a nationwide, multicenter, hospital-based matched case-control ...study included patients with PD (ICD–10, G20) and controls without mental/ behavioral disorders or nervous system diseases (ICD–10, F, G), aged ≥ 20 years who were initially hospitalized between 2005 and 2020. 10 controls matched by age, sex, admission year and hospital were selected for each case. Participants were grouped into the 12 longest-held occupational class by the Japanese Standard Occupational Classification and Japanese Standard Industrial Classification. We conducted conditional logistic regressions to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for risks of PD adjusted for alcohol consumption and smoking status. Results There were 2,077 cases and 20,368 controls. Service workers in service industry were set as reference. Professionals in service industry and white-collar industry showed higher risk of PD (ORs=2.35 (1.48–3.73) and 1.35 (1.15–1.59)). Stratified with smoking status, professionals in service industry remained an increased risk of PD in current smokers. Current and former smokers had lower risks of PD (0.36 (0.30–0.43) and 0.73 (0.66–0.80)). Furthermore, researchers (2.97 (1.06–8.28)), doctors/ dentists/veterinarians/ pharmacists (1.84 (1.17–2.87)), religious workers (2.31 (1.09–4.91)), musicians and stage designers (4.55 (1.39–14.8)) showed higher risk of PD. Discussion Although smoking had an inhibitory effect on PD, there were risk in specific professionals. It is significant to clarify the occupational factors that increase risk of PD. Conclusion Occupational class was possibly associated with PD risk.
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