We aimed to examine whether the number of types of hazardous operations at work experienced through a lifetime is associated with cancer incidence, and additionally examined the combined effects with ...lifestyle‐related factors. Using a nationwide, multicenter, hospital inpatient dataset (2005‐2015), we conducted a matched case‐control study with 1 149 296 study subjects. We classified the participants into those with none, 1, or 2 or more types of hazardous operation experience, based on information of special medical examinations taken, mandatory in Japan for workers engaged in hazardous operations. Using those with no experience as the reference group, we estimated the odds ratios for cancer incidence (all sites, lung, stomach, colon and rectum, liver, pancreas, bile duct, and bladder) by conditional logistic regression with multiple imputations. We also examined the effects of the combination with hazardous operations and lifestyle‐related factors. We observed increased risks for cancer of all sites, and lung, pancreas, and bladder cancer associated with the experience of hazardous operations. Multivariable‐adjusted ORs (95% CIs) of cancer incidence of all sites were 1 (reference), 1.16 (1.12, 1.21), and 1.17 (1.08, 1.27) for none, 1, and 2 or more types of hazardous operation experience, respectively (P for trend <.001). Potential combined associations of hazardous operations with smoking were observed for lung, pancreas, and bladder cancer, and with diabetes for pancreas cancer. Engaging in hazardous operations at work and in combination with lifestyle‐related factors may increase the risk of cancer. We highlight the potential for those engaged in hazardous work to avoid preventable cancers.
Compared with those with no experience of occupational hazardous operation, the incidence of total, lung, pancreas, and bladder cancer was clearly increased as the number of types of hazardous operation work experience increased. Potential combined associations of hazardous operations with smoking were also observed for lung, pancreas, and bladder cancer, and with diabetes for pancreas cancer.
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BFBNIB, FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SAZU, SBCE, SBMB, UL, UM, UPUK
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
The Inpatient Clinico-Occupational Survey collected data from 3.76 million patients, showing that the average length of stay declined by 16.1 d in FY2008 and by 14.1 d in FY2015. In this study, we ...assessed the length of hospital stay and readmission, stratified by ICD-10 and employment status. A cross-sectional study was conducted on data from FY2008, including those from 65,806 first hospitalizations and 16,653 readmissions in FY2008, where 62,260 first admissions and 29,242 readmissions in FY 2015. The length of hospital stay was longest in those admitted due to external influences (24.8 d), followed by musculoskeletal disorders (22.5 d). This remained unchanged in FY2015, however, lengths of stay of those were reduced by 20.1 and 20.0 d, respectively. The length of hospital stay for most diseases was longer upon readmission than on first admission, and longer for those who were unemployed. It is necessary to give attention to patients who need to be discharged early due to work, or plan for frequent hospitalization in order to reduce the length of each hospital stay because of the expected increase in the number of elderly workers brought on by a declining birth rate and an aging population.
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
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
An immediate ambulance call offers the greatest opportunity for acute stroke therapy. Effectively using ambulance services requires strengthening the association between knowledge of early stroke ...symptoms and intention to call an ambulance at stroke onset, and encouraging the public to use ambulance services.
The present study utilized data from the Acquisition of Stroke Knowledge (ASK) study, which administered multiple-choice, mail-in surveys regarding awareness of early stroke symptoms and response to a stroke attack before and after a 2-year stroke education campaign in two areas subject to intensive and moderate intervention, as well as in a control area, in Japan. In these three areas, 3833 individuals (1680, 1088 and 1065 participants in intensive intervention, moderate intervention, and control areas, respectively), aged 40 to 74 years, who responded appropriately to each survey were included in the present study.
After the intervention, the number of correctly identified symptoms significantly associated with intention to call an ambulance (P < 0.05) increased (eg, from 4 to 5 correctly identified symptoms), without increasing choice of decoy symptoms in the intensive intervention area. Meanwhile, in other areas, rate of identification of not only correct symptoms but also decoy symptoms associated with intention to call an ambulance increased. Furthermore, the association between improvement in the knowledge of stroke symptoms and intention to call an ambulance was observed only in the intensive intervention area (P = 0.009).
Our results indicate that intensive interventions are useful for strengthening the association between correct knowledge of early stroke symptoms and intention to call an ambulance, without strengthening the association between incorrect knowledge and intention to call an ambulance.
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FFLJ, NUK, ODKLJ, UL, UM, UPUK
Background and Purpose: This study aimed to examine the factors affecting the promotion or inhibition of return to work among stroke patients using a database of cases managed by the health and ...employment support coordinator. Methods: We analyzed 337 stroke patients out of 401 patients registered in the database between February 2017 and March 2019, excluding 64 cases of unknown outcomes, ongoing treatment, and non-stroke. The database consisted of 69 items belonging to six factors: patients, family, economy, workplace, medical care, and return to work, and each item was evaluated on a 2 to 5 scale. A univariate analysis was performed by the χ2 test to see if there was a difference between “return to work” and “non-return to work” for each variable. Results: The results revealed that the possibility of returning to work was influenced by physical functions, higher brain function, desire to return to work, self-management skills, and income; however, no significant effects of gender and age were found. The rate of return to work (67.7%) was considerably high. Conclusion: Functional improvement and psychological support are important for reinstatement support, and continuous rehabilitation and consultation support system construction are desired.
We attempted to clarify the severity of the risk of diabetes mellitus (DM) in the individuals who repeatedly fulfill the criteria for prediabetes in both fasting plasma glucose (FPG) and hemoglobin ...A1c (HbA1c). The subjects were 2347 individuals who underwent annual health checkup at our hospital. They were classified as normal glucose tolerance or prediabetes as their yearly status of glucose tolerance for three years; furthermore, the individuals classified as prediabetes were subclassified into 3 groups. Among them, we focused the individuals who fulfilled the criteria for prediabetes in both FPG and HbA1c, and this group was named as PD3. Similarly, all subjects were categorized into 4 groups by the frequency of the status of PD3 during three years. Moreover, all subjects were categorized into 8 patterns when PD3 status was positive. Then, we surveyed the development of diabetes for 5 years, and the incidence rates (IRs) and the age- and sex-adjusted odds ratios (ORs) were obtained. A total of 188 subjects developed diabetes. The individuals in the group of PD3 showed the highest IR of DM (33.6%). The values of ORs were 11.5, 20.0, and 63.5 when the frequencies of PD3 were one, two, and three, respectively. In the group whose frequency of PD3 was two, the individuals who had repeated the status of PD3 twice then moved to the status other than PD3 showed smaller risk of DM than the others in the same group. In conclusion, individuals who fulfill the criteria for prediabetes in both FPG and HbA1c were at a high risk of developing DM, and the risk was enhanced by repeating this status. On the other hand, changing the status from PD3 to others might reduce the risk of DM.
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FZAB, GIS, IJS, IZUM, KILJ, NLZOH, NUK, OILJ, PILJ, PNG, SAZU, SBCE, SBMB, UL, UM, UPUK
It is important that the general population be aware of the early symptoms, since it has been shown that early arrival to hospitals leads better prognosis of stroke patients. However, the general ...population is not well informed about the early symptoms of stroke. This study was conducted to clarify which stroke symptoms are less well known and which information sources are related to awareness of stroke symptoms.
A multiple-choice, mail-in survey involving 5,540 randomly selected residents, aged 40-74 years, of 3 cities in Japan was conducted. Their knowledge about stroke symptoms and their information sources were surveyed; information sources were classified as mass media (television/newspaper/radio) and personal communication sources (posters/leaflets/internet/health professionals/family and/or friends). 'Awareness' was defined as selecting all 5 of the correct stroke symptoms from among 10 listed symptoms with decoy choices. The estimated fraction of the possible impact due to each source on the whole population was also calculated by odds ratios (ORs) and the proportion of respondents who selected each source (Pe). The combined effects of mass media and personal communication sources on awareness were also assessed.
Of the 5,540 residents, only 23% selected all 5 correct symptoms. Visual disturbance was the least known of the 5 symptoms (35%). All sources were positively related to awareness, with ORs (Pe) of: television, 1.58 (72.5%); newspaper, 1.79 (48.0%); radio, 1.74 (13.3%); posters, 1.73 (7.6%); leaflets, 1.50 (24.7%); Internet, 1.66 (5.6%); health professionals, 1.33 (34.8%), and family/friends, 1.21 (44.6%). The estimated fraction of the possible impact due to each source was higher for mass media (television, 0.31 and newspaper, 0.28) than personal communication sources (Internet, 0.04 and leaflets, 0.12). Mass media only and mass media/personal communication sources were significantly associated (ORs: 1.66, 2.75, respectively).
As a single method of public education, television could be the most effective strategy. Moreover, the combined approach involving mass media and personal communication sources might have a synergistic effect. Less well-known symptoms, such as visual disturbances, should be noted in public education campaigns.
The return to work (RTW) rate of the stroke patient in our country is 30–50% and is not parallel with the predicted functional convalescent degree. The following thing is important for successful RTW ...that right assessment about patient's severity of disability and job description, patient's self-understanding, implementation of the rehabilitation which considered the work contents, co-operation of a medical person to restoration, information sharing with a workplace. Japan Organization of Occupational Health and Safety has begun to train the dual support coordinator compatible who does necessary evaluation and dissemination of information appropriate time while nestling close to a patient from fiscal year 2014. After I intervened in the stroke patient who agreed to intervention from the acute stage, about 70% of RTW rate is obtained. Understanding of a workplace and appropriate consideration are necessary for success of restoration. It is more important that the medical stuff who does stroke treatment concerns from the acute stage to stop leaving the job early.
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