Language：Japanese   Publisher：(一財)日本消化器病学会  

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Language：Japanese   Publisher：日本公衆衛生学会  

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Language：Japanese   Publisher：(公社)日本母性衛生学会  

本研究の目的は、女性が祖母になることで子どもとの関係がどのように変化したかについて、祖母になった年齢と子どもの性別に着目し、その違いを明らかにすることである。初孫をもって6年以内の女性を対象に自記式質問紙調査を行った。65名の回答者を祖母になった年齢が59歳以下・60歳以上の二群と、初孫の親である子どもの性別で二群に分け、日常的・精神的・経済的な支援量、支援への負担感と満足感、各支援量と支援への負担感と満足感の相関関係、孫が生まれる前後の子どもとの関係を比較した。子どもとの関係は娘の群に比べて息子の群で好転する傾向があり、祖母になった年齢で有意差はみられなかった。息子の群では3つ全ての支援量と負担感との間に正の相関を認め、娘の群では日常的および精神的な支援量、支援への負担感が有意に高かった。息子の群(父方祖母)では支援量はいずれも少ないが負担感となりやすく、娘の群(母方祖母)では日常的な支援量が多くなることが負担感の増大につながる傾向があった。母子保健に携わる専門職者には、祖母になる女性が自身の生き方に関心をもち、今後の子どもとの関係や支援のあり方を考えられる関わりが求められる。(著者抄録)

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Other Link： https://search.jamas.or.jp/default/link?pub_year=2019&ichushi_jid=J01362&link_issn=&doc_id=20190129050016&doc_link_id=%2Fcu2mater%2F2019%2F005904%2F017%2F0777-0785%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fcu2mater%2F2019%2F005904%2F017%2F0777-0785%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

Language：Japanese   Publishing type：Research paper (scientific journal)   Publisher：新潟大学医学部保健学科  

一般病棟に勤務する新卒看護師の終末期がん患者の看取りケアに対する困難感尺度の原案作成を目的とした。対象は全国のがん診療連携拠点病院に勤務する卒後2年目看護師とした。質問票の内容は、死別経験、文献レビューをもとに作成した困難感尺度55項目(5件法)、看取りケアに対する困難感のVisual Analogue Scale(VAS)とした。因子分析の結果、1.患者の死に対する恐怖・不安、2.患者とのコミュニケーションの難しさ、3.看取りケアに対する後悔、4.最期の時を話題にすることへの戸惑い、5.亡くなる間際のケアの悲しさ、6.看取りケアに関する能力の不足感の6因子21項目が採用された。採用された6因子は、患者の死に対して恐怖や不安を抱くという、新卒看護師の特徴的な困難感を表していた。今後は、尺度の信頼性・妥当性のさらなる検討および質問項目の修正・洗練を行い、新卒看護師の教育に活用できる尺度開発を行う。(著者抄録)

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Other Link： https://search-tp.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2019&ichushi_jid=J06421&link_issn=&doc_id=20190528370002&doc_link_id=1900536&url=https%3A%2F%2Fkango-sakuin.nurse.or.jp%2Fnid%2F1900536&type=%8D%C5%90V%8A%C5%8C%EC%8D%F5%88%F8Web&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00014_1.gif

Language：Japanese   Publishing type：Research paper (scientific journal)  

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Language：Japanese   Publishing type：Research paper (scientific journal)  

DOI： 10.11236/jph.64.12_718

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Other Link： http://hdl.handle.net/10191/47193

Language：Japanese   Publishing type：Research paper (scientific journal)  

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Language：Japanese   Publishing type：Research paper (scientific journal)   Publisher：Japanese Society of Public Health  

<p><b>Objective</b> We examined effective exercise adherence support methods for persons experienced in the Medical Fitness (MF) program to clarify the relation of personality traits with exercise adherence and the factors that improve exercise adherence.</p><p><b>Methods</b> Subjects were 283 adults who had registered as members in the MF program at an affiliate of Hospital A. We implemented an anonymous self-administered questionnaire by postal mail. Using the Japanese version of the Ten Item Personality Inventory (which contains 10 items that measure the Big Five personality traits), we evaluated the following characteristics: "Extraversion", "Agreeableness", "Conscientiousness", "Neuroticism", and "Openness". The subjects who reported exercising regularly at the time of survey were considered persons with subjective exercise adherence.</p><p><b>Results</b> In persons with subjective exercise adherence, "Conscientiousness" was significantly lower (<i>P</i>=0.003) among men and "Neuroticism" was significantly higher (<i>P</i>=0.018) among women when compared to persons with subjective exercise adherence. There was no correlation between the things that emphasize exercise adherence and "Conscientiousness" among men. There was a negative correlation between "can achieve goal" and "Neuroticism" among women.</p><p><b>Conclusions</b> It is essential to consider personality and gender differences when devising exercise adherence support measures for the MF program. Our results suggest that women with high neuroticism do not need "can achieve goal" to maintain their exercise habits; therefore, it is necessary to examine teaching methods that do not focus on only goal achievement as part of exercise adherence support for MF.</p>

DOI： 10.11236/jph.64.11_664

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Language：Japanese   Publishing type：Research paper (scientific journal)  

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Language：Japanese   Publishing type：Research paper (scientific journal)  

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Language：Japanese   Publisher：新潟青陵学会  

DOI： 10.32147/00001434

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：WILEY-BLACKWELL  

AimBoth being underweight and overweight can lead to reduced activity of daily living, which subsequently can require long-term care. The aim of the present study was to clarify the association between underweight/overweight and the subsequent risk of long-term care introduction.
MethodsWe tracked the data of long-term care insurance for 1580 men and women aged 65 years who had participated in the official population-based health check-up program in 2001 in Tsunan town and Sekikawa village, Japan. The health check-up data and medical expenditure data for the fiscal year 2001 were used as baseline data. Participants were classified into underweight (body mass index (BMI) &lt;18.5kg/m(2)), normal range (BMI=18.5 to &lt;25.0kg/m(2)) and overweight (BMI 25.0kg/m(2)); the normal range was used as a reference category in Cox proportional hazards models.
ResultsDuring the average 5.8 years of follow up, 156 participants were identified to start using long-term care services. Among the young-old elderly (65-74 years-of-age), underweight was significantly associated with the risk of long-term care introduction (multivariable-adjusted HR 4.26, 95% CI 1.69-10.72), whereas overweight was not (multivariable-adjusted HR 1.45, 95% CI 0.69-3.06). Neither underweight nor overweight were significantly associated with long-term care introduction among the old-old elderly (75 years-of-age).
ConclusionsUnderweight could be a good predictor of long-term care introduction in the young-old elderly. We should pay attention to underweight in the elderly, as it might be a manifestation of some physical or mental problems related to future long-term care introduction. Geriatr Gerontol Int 2014; 14: 328-335.

DOI： 10.1111/ggi.12102

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：PUBLIC LIBRARY SCIENCE  

Background: Japan has implemented various school actions during seasonal influenza outbreaks since the 1950's under the School Health Law. However, the effective duration, extent, and timing of closures remain unresolved.
Materials and Methods: We conducted a retrospective study on the relationship between elementary class closures and influenza outbreak control during four consecutive influenza seasons from the 2004-2005 to 2007-2008 school years in Joetsu, Niigata, Japan. Among a total of 1,061 classes of 72 schools, 624 cases of influenza outbreaks were documented among 61 schools.
Results: Class closures were carried out in a total of 62 cases in response to influenza outbreak, which was defined as a student absentee rate of greater than 10% due to influenza or influenza-like illness. Of these cases, two-day class closures were conducted the day after reaching a 10% student absentee rate in 28 cases and other types of closures were initiated in 34 cases. A markedly higher number of outbreak cases ended within one week for two-day class closures compared to the other types of closures (82.1% vs. 20.6%, respectively). The significant association between two-day class closures and interruption of an outbreak within one week was confirmed using a multivariable model adjusted for the season, grade, day of the week of an outbreak start, and absentee rate on the day of an outbreak start (OR, 3.18; 95% CI, 1.12-9.07; p = 0.030).
Conclusions: Our results suggest that a two-day class closure carried out the day after reaching a 10% absentee rate is an effective approach for mitigating influenza outbreaks in elementary schools.

DOI： 10.1371/journal.pone.0074716

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Language：Japanese   Publisher：日本公衆衛生学会  

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Language：English   Publishing type：Research paper (international conference proceedings)  

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Objectives Point-of-purchase (POP) information at food stores could help promote healthy dietary habits. However, it has been difficult to evaluate the effects of such intervention on customers' behavior. We objectively evaluated the usefulness of POP health information for vegetables in the modification of customers' purchasing behavior by using the database of a point-of-sales (POS) system. Methods Two supermarket stores belonging to the same chain were assigned as the intervention store (store I) and control store (store C). POP health information for vegetables was presented in store I for 60 days. The percent increase in daily sales of vegetables over the sales on the same date of the previous year was compared between the stores by using the database of the POS system, adjusting for the change in monthly visitors from the previous year (adjusted Dsales). Results The adjusted Dsales significantly increased during the intervention period (Spearman's q = 0.258, P for trend = 0.006) at store I but did not increase at store C (q = -0.037, P for trend = 0.728). The growth of the mean adjusted Dsales of total vegetables from 30 days before the intervention period through the latter half of the intervention period was estimated to be greater at store than at store C by 18.7 percentage points (95% confidence interval 1.6-35.9). Conclusions Health-related POP information for vegetables in supermarkets can encourage customers to purchase and, probably, consume vegetables. © The Japanese Society for Hygiene 2011.

DOI： 10.1007/s12199-010-0192-8

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Language：Japanese   Publisher：日本公衆衛生学会  

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：LIPPINCOTT WILLIAMS & WILKINS  

Objective Major disasters can affect the health status of the victims. However, the effects on the health status of those involved in disaster relief operations are unclear. The aim of this study was to clarify how disaster-related administrative workloads affect the cardiovascular risk factors of local governmental staff.
Methods A big earthquake struck the central area of Niigata Prefecture, Japan, in October 2004. Thereafter, the Niigata Prefectural Government was engaged in intensive disaster relief operations until March 2005. We compared the changes in the cardiovascular risk factor measurements of 4035 governmental staff members across this period in terms of their workloads due to the relief operations.
Results Compared with the staff having the lowest workloads, those with the highest workloads showed significantly greater increases of BMI, systolic blood pressure (SPB) and serum total cholesterol for men as well as SBP and diastolic blood pressure for women even after cessation of the intensive operations. They had an approximately two-fold higher risk of SBP elevation by 10 mmHg than those with the lowest workloads; the age-adjusted odds ratio (95% confidence interval) was 2.02 (1.47-2.79) for men and 1.82 (1.21-2.75) for women.
Conclusion Workloads during disaster relief operations can cause prolonged worsening of blood pressure levels and some other cardiovascular risk factors among local governmental staff. Therefore, when a disaster occurs, health management should be considered not only for the victims, but also for the local governmental staff. J Hypertens 28: 695-702 (C) 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins.

DOI： 10.1097/HJH.0b013e328336ed70

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：TOHOKU UNIV MEDICAL PRESS  

Retaining experienced nurses is an indispensable part of securing the safety and reliability of medical care. In this study, we investigate how the working conditions affect staff nurses' intention to remain in their current employment positions (intention to remain employed). A total of 319 staff nurses working for three private hospitals were given a questionnaire in order to evaluate their working conditions. A stepwise multiple logistic regression analysis selected 5 out of 44 question items as significant independent variables for their intention to remain employed; they were assumed to directly affect their intentions (direct modulators). From the remaining 39 items, seven meaningful factors were extracted via factor analysis. We constructed a path network model so that these factors would indirectly affect the intention to remain employed via any of the five direct modulators (indirect modulators). In this network, the factor, "Rapport with coworkers" had the strongest positive effect on three of the five direct modulators (beta = 0.28-0.55, p &lt; 0.05). According to factor loadings, positive teamwork together with appropriate supervision and recognition from superiors and colleagues seems to characterize this factor, and therefore, may play a key role in retaining staff nurses in their current positions. Two indirect modulators related to "Management by Objectives" (MBO)- "Understanding MBO" and "Clear personal objectives" also played negligible roles in this path model. These findings could be helpful in improving management systems of the nursing sections of hospitals, which could contribute to retaining staff nurses in their current employment positions.

DOI： 10.1620/tjem.220.191

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：OXFORD UNIV PRESS  

Background Daytime napping is associated with elevated risk of all-cause mortality in the elderly. However, the association with cardiovascular disease (CVD) risk is inconsistent.
Methods From 1988 to 1990, a total of 67 129 Japanese non-workers or daytime workers (27 755 men and 39 374 women) aged 40-79 years, without a history of stroke, heart disease or cancer, completed a lifestyle questionnaire. They were followed for mortality until the end of 2003.
Results During the 879 244 person-year follow-up, 9643 deaths (2852 from CVD, 3643 from cancer, 2392 from other internal causes, 738 from external causes and 18 from unspecified causes) were observed. After adjustment for possible confounders, subjects with a daytime napping habit had elevated hazard ratios (HRs) for mortality from all causes [HR 1.19, 95% confidence interval (CI) 1.14-1.24, P &lt; 0.001], CVD (HR 1.31, 95% CI 1.22-1.42, P &lt; 0.001), non-cardiovascular/non-cancer internal diseases (HR 1.26, 95% CI 1.16-1.37, P &lt; 0.001) and external causes (HR 1.28, 95% CI 1.10-1.50, P = 0.001), but not for cancer death (HR 1.03, 95% CI 0.96-1.10, P = 0.400). The risk of CVD mortality associated with daytime napping was diminished among overweight subjects, but pronounced in those with weight loss after age 20 years, with non-regular employment, with lower education level and with a follow-up period &lt; 5 years.
Conclusions Daytime napping is associated with elevated risk of CVD mortality as well as non-cardiovascular/non-cancer and external deaths. Daytime napping may elevate risk of CVD death through some biological effects but, to a larger extent, some comorbid disorders causing weight loss or associated with non-regular employment and low education level could explain this association.

DOI： 10.1093/ije/dyp327

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Language：Japanese   Publishing type：Research paper (scientific journal)  

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：CENTERS DISEASE CONTROL  

Guidelines available to school administrators to support school closure decisions during influenza outbreaks are usually not evidence based. Using empirical data on absentee rates of elementary school students in Japan, we developed a simple and practical algorithm for determining the optimal timing of school closures for control of influenza outbreaks.

DOI： 10.3201/eid1511.090798

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Language：Japanese   Publishing type：Research paper (scientific journal)  

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：TOHOKU UNIV MEDICAL PRESS  

Knee pain is extremely common among the elderly, particularly women. Hence, there is an urgent need for applicable community-based intervention models for halting the progression of knee pain and related disabilities in elderly women. We aimed to assess the efficacy of home-visit physiotherapy as a new intervention model. This non-randomized 5-month-long controlled trial enrolled elderly community-dwelling women (aged 60-83 years) with mild knee pain. The intervention consisted of two home visits by a physiotherapist, with instructions on routinely performing muscle-strengthening exercises at home and implementing simple environmental modifications when necessary. Outcome measures were assessed at baseline and 5 months later. The primary outcomes were measured as the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and a newly devised seiza-style sitting score. People in Japan, especially elderly women, are accustomed to seiza-style sitting that involves kneeling on one's lower legs while resting the buttocks on the heels. The secondary outcomes included quadriceps isometric strength, knee alignment in the frontal and sagittal planes, and passive knee extension range. Forty-two subjects (20 in the intervention group and 22 in the control group) completed the study. At baseline, characteristics and the primary outcomes did not significantly differ between the 2 groups. At 5 months, the primary outcomes improved significantly in the intervention group. Estimated differences in the change from baseline for each outcome between the 2 groups were computed, adjusting for outcome variables imbalanced at baseline. Even after the adjustment, the home-visit physiotherapy regimen provides favorable improvement in the seiza-style sitting score.

DOI： 10.1620/tjem.219.91

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Language：Japanese   Publisher：日本公衆衛生学会  

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Language：Japanese   Publishing type：Research paper (other academic)  

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Objectives There is a growing need to evaluate the performance status of the activities of daily living (ADL) of the elderly in the rapidly aging Japanese society. The purpose of this study was to verify the usefulness of our new scoring sheet for assessing present ADL status and to clarify whether or not the assessed ADL status can predict the future risk of adverse conditions related to falls. Methods The validation study was performed using 116 non-handicapped community-dwelling Japanese elderly at least 60 years of age. Of those subjects, 44 were also analyzed for the relationship between baseline ADL status and subsequent risk of adverse conditions related to falls. Results The daily living performance score sheet had good internal consistency, with a Cronbach's alpha of 0.82 and a sequential hierarchical structure that reflected the difficulty of the activities. The total score was significantly and positively associated with six of eight subscale scores on the Short-Form 36-Item Health Survey (P\\0.01). In the follow-up study, every one-point decrease in total score was significantly associated with a 39% elevated risk of a stumble or fall (P = 0.022) and also borderline signifi- cantly associated with higher risks of a fall, anxiety while walking indoors, and anxiety while walking outdoors (P\\0.10). Conclusion Our new scoring sheet can reliably and comprehensively assess present ADL status. The assessed ADL could predict the future risk of adverse conditions related to falls. © The Japanese Society for Hygiene 2009.

DOI： 10.1007/s12199-008-0066-5

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：JAPAN SOC INTERNAL MEDICINE  

Objective To find useful indices to identify subjects at high risk for developing diabetes.
Methods We retrospectively reviewed 75-g oral glucose tolerance test (OGTT) surveys conducted during 1980 to 2001 in a Japanese community. Using personal charts of the surveys, 230 non-diabetics were followed for progression to type 2 diabetes. The usefulness of HbA(1C), fasting (Glucose(0)) and 1-hour (Glucose60) glucose levels during OGTT, and indices for insulin resistance and/or secretion to identify high risk subjects for diabetes were then analyzed.
Materials Data described in personal charts of the OGTT program for residents of Nishikawa Town, Niigata Prefecture, Japan.
Results During the 4.3 +/- 2.7 years of follow-up, 52 subjects progressed to type 2 diabetes. Assessing glucose and insulin levels during OGTT, Glucose(0), Glucose(60), "Insulin Response Ratio" (IRR(30), Insulin at 30 minutes / Fasting insulin; IRR(60), insulin at 60 minutes / fasting insulin), and insulin secretion / insulin resistance index (ISIRI(30)) were significantly associated with progression to type 2 diabetes even after the result for OGTT, body mass index, and familial history of diabetes were adjusted. These were also able to identify still higher risk subjects for type 2 diabetes from those with impaired glucose tolerance (IGT) although other indices for insulin resistance or secretion and hemoglobin A(1C) were less contributable for this purpose.
Conclusion A combination of Glucose(0) and Glucose(60) can most cost effectively identify high risk subjects for type 2 diabetes from IGT. IRR(30), IRR(60) and ISIRI(30) can also be used for such identification. However, further studies are needed to clarify whether these indices are superior to Glucose(0) and Glucose(60).

DOI： 10.2169/internalmedicine.48.1325

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：WILEY-BLACKWELL  

Aim: To elucidate the role of tobacco smoking and polymorphisms of carcinogen metabolism genes in cervical carcinogenesis.
Methods: We analyzed genotypes of nine genes, 11 polymorphisms encoding carcinogen metabolizing enzymes, information on smoking, and the presence of human papillomavirus in 124 Japanese cervical cancer patients and 125 healthy controls.
Results: The incidence of human papillomavirus infection (95.5% vs 9.9%; P &lt; 0.001; odds ratio (OR), 231.98; 95% confidence interval [CI], 57.17-941.22), and smoking (41.1% vs 18.4%; P &lt; 0.001; OR, 3.40; 95% CI, 1.88-6.17) were both significantly higher in patients than in controls. The genotype distributions of CYP1A1, CYP2E1, CYP2A6, NQO1, NAT2, mEH, MPO and GSTT1 genes were not statistically different; however, the ratio of the GSTM1 null genotype was significantly higher in patients than in controls (62.1% vs 47.2%; P = 0.019; OR, 1.83; 95% CI, 1.11-3.04). The incidence of GSTM1 null was significantly higher in the non-smoking group (63.0% vs 47.1%; P = 0.038; OR, 1.92; 95% CI, 1.04-3.54), and not in the smoking group (60.8% vs 47.8%; P = 0.300; OR, 1.69; 95% CI, 0.63-4.56).
Conclusions: In the current study, risk factors for developing cervical cancer were tobacco smoking and GSTM1 null; however, no association was observed between these two factors. We could not prove that smoking-GSTM1 null interaction was responsible for the increase in cervical cancer among young Japanese, and further studies with more detailed smoking status, not only active but passive smoking, will be required.

DOI： 10.1111/j.1447-0756.2008.00798.x

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：OXFORD UNIV PRESS  

Background and purpose Green tea consumption is inversely associated with death from stroke. The purpose of the present study was to assess whether it is inversely associated with subsequent stroke incidence and whether this association is preserved even with roasted tea leaves.
Methods In 1998, 6358 Japanese adults (2087 men and 4271 women) aged 4089 years without a history of stroke or heart disease completed a lifestyle questionnaire, including consumption of green tea or roasted tea. By the end of 2003, 110 stroke events (59 cerebral infarction events, 34 cerebral haemorrhage events, 15 subarachnoidal haemorrhage events and two stroke events of unspecified subtype) had been documented. Cox proportional hazards regression analysis was used to calculate the multivariable-adjusted hazard ratios (HRs) and 95% confidence intervals (95% CIs) for total stroke events, cerebral infarction events and cerebral haemorrhage events according to consumption categories of green tea and roasted tea.
Results A considerably lower risk was observed for total stroke incidence in both the middle (multivariable HR, 0.43; 95% CI, 0.25-0.74; P = 0.002) and the high (multivariable HR, 0.41; 95% CI, 0.24-0.70; P = 0.001) categories of green tea consumption. This inverse association was consistent even when cerebral infarction and cerebral haemorrhage were analysed separately. The consumption of roasted tea was not associated with stroke risk.
Conclusions Green tea consumption is associated with a reduced risk of total stroke incidence, cerebral infarction and cerebral haemorrhage.

DOI： 10.1093/ije/dyn211

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Language：Japanese   Publisher：日本公衆衛生学会  

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Other Link： http://search.jamas.or.jp/link/ui/2008277267

Language：Japanese   Publishing type：Research paper (scientific journal)  

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Language：Japanese   Publisher：日本公衆衛生学会  

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：SPRINGER  

To determine the relationship of body mass index (BMI) and BMI changes during adulthood to lung cancer mortality in a large-sized Japanese cohort.
We followed 29,350 men for a maximum of 11 years in the Japan Collaborative Cohort Study for Evaluation of Cancer Risk (JACC Study), which was initiated from 1988 to 1990. Complementary log-log modeling was employed with age, smoking status, and family history of lung cancer as covariates. Anthropometric measurements used were BMI at baseline, BMI around age 20, and adulthood BMI loss defined between the two measurements. Independent effects of these three measurements on lung cancer mortality were evaluated by applying the method of generalized estimation equations to the model for adjustment of intra-individual correlation.
Never smokers showed that high BMI both at baseline and around age 20 significantly predict lung cancer mortality (P &lt; 0.05). Adulthood BMI loss significantly (P &lt; 0.05) elevated the risk for lung cancer mortality among current smokers, implying their enhanced vulnerability to lung cancer risk among smokers.
The risk for lung cancer mortality is elevated by a mechanism related to smoking-induced weight loss during adulthood.

DOI： 10.1007/s10552-006-0069-8

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DOI： 10.5105/jse.26.111

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Language：Japanese   Publisher：日本公衆衛生学会  

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Chronic inflammation contributes to the process of carcinogenesis, but few epidemiologic studies have examined associations with risk of lung cancer. Relationships between lung cancer risk and serum levels of both heat shock protein 70 (Hsp70) and high-sensitivity C-reactive protein (hsCRP) were investigated in a case-control study nested in the Japan Collaborative Cohort Study for Evaluation of Cancer Risk. Serum samples and lifestyle information were collected at baseline from 39,242 men and women between 1988 and 1990. Of these, 240 deaths from lung cancer were identified through 1999, and 569 controls were matched for sex, age, and study area. Serum levels were measured in 189 cases and 377 controls for Hsp70 and in 209 cases and 425 controls for hsCRP. Odds ratios (95% confidence intervals) across quartiles, adjusted for confounding factors, including smoking habits, were 0.83 (0.44-1.58), 1.41 (0.77-2.60), and 1.84 (0.92-3.71) for Hsp70 (Ptrend = 0.042) and 1.13 (0.67-1.91), 0.66 (0.38-1.16), and 1.19 (0.70-2.02) for hsCRP (P trend = 0.941). In males, odds ratios (95% confidence intervals) across quartiles were 1.30 (0.59-2.84), 1.74 (0.83-3.67), and 2.49 (1.06-5.85) for Hsp70 (Ptrend = 0.029). High levels of serum Hsp70 might thus be associated with increased risk of lung cancer among Japanese males, although further studies are needed to clarify associations between chronic inflammation and lung cancer. Copyright © 2006 American Association for Cancer Research.

DOI： 10.1158/1055-9965.EPI-06-0005

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Background: The relationship between alcohol consumption and increased risk of lung cancer is controversial. This study was set up to investigate the association between alcohol consumption and death from lung cancer in a large Japanese cohort. Methods: The subjects comprised 28,536 males, aged 40-79 years, living throughout Japan. During 268,464 person-years of follow-up, 377 lung cancer deaths were recorded. The hazard ratio (HR) of alcohol consumption for lung cancer mortality was calculated using the Cox proportional hazards model after adjustment for age, smoking and family history of lung cancer. Results: There was no association between increased mortality from lung cancer and alcohol consumption among current drinkers. Compared with subjects who had never drunk alcohol, the HRs (95% confidence interval [Cl]) of death from lung cancer for light (consuming &lt
25.0 g ethanol per day), moderate (25.0-49.9 g per day) and heavy (≥50 g per day) drinkers were 0.81 (95% Cl=0.61-1.07), 0.82 (0.61-1.11) and 0.97 (0.66-1.43), respectively. Further adjustment for fruit and vegetable intake did not change the results, and there was no change in HR materially after excluding those patients who died during the first 5 years of follow-up. Conclusions: These findings indicate that alcohol consumption was not associated with increased lung cancer mortality in this population of Japanese men. © 2006 by the Japan Epidemiological Association.

DOI： 10.2188/jea.16.49

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Language：Japanese   Publishing type：Research paper (scientific journal)  

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Language：Japanese   Publishing type：Research paper (scientific journal)  

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Language：Japanese   Publisher：日本公衆衛生学会  

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Language：Japanese   Publisher：日本公衆衛生学会  

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The present study investigated smoking prevalence and attitudes toward smoking in student and staff nurses, and activities to promote tobacco intervention by staff nurses. A total of 743 student nurses in 2 colleges and one university and 490 staff nurses in the university hospital in Niigata, Japan participated in the study and filled in self-administered anonymous questionnaires focused on smoking habits, attitudes toward smoking, and activities to promote tobacco intervention. The smoking prevalence among student nurses was 6% and increased with the year of study, whereas that of among staff nurses was 16% and increased by employment up to 3-5 years. Almost half of the student nurse smokers started the habit before admission to higher education facilities, and more than half of staff smokers also started smoking in their school years, in high school or college. Nicotine dependence, as defined by over 11 cigarettes per day and the first cigarette within 30 min after getting up, was high in smokers who started smoking before admission to college or university, but not in those who took up the habit thereafter. Thirty-six percent of student nurses and 25% of staff nurses agreed with the statement that "nurses should not smoke." Only 12% of staff nurses were involved in anti-tobacco interventions routinely, partly due to lack of broad knowledge and the necessary skills. Greater efforts are needed as a high priority to educate student and staff nurses systematically and comprehensively about the range of tobacco interventions available in Japan. © 2005 Tohoku University Medical Press.

DOI： 10.1620/tjem.206.187

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Background: Lung cancer mortality is inversely associated with high serum carotenoid levels and high intake of vegetables and fruits rich in carotenoids. The Japan Collaborative Cohort (JACC) Study was conducted to investigate whether serum levels of carotenoids, retinol, tocopherols, and folic acid were associated with risk for lung cancer death with follow-up through 1997. To examine the association by sex, we extended the follow-up and analyzed additional serum samples. Methods: In the JACC Study, 39,242 subjects provided serum samples at baseline between 1988 and 1990. We identified 211 cases (163 men and 48 women) of death from lung cancer during about 10-year follow-up ending in 1999. Of the subjects who survived to the end of that follow-up, 487 controls (375 men and 112 women) were selected, and were matched to each case of lung cancer death for sex, age and participating institution. We measured serum levels of antioxidants in cases of lung cancer death and controls. Odds ratio (OR) for lung cancer death was estimated using conditional logistic models by sex. Results: For men, the risk of lung cancer death was significantly lower for the highest quartile of serum α- and β-carotenes, lycopene, and β-cryptoxanthin than for the lowest quartile: the OR adjusted for smoking and other covariates were 0.41, 0.28, 0.46, and 0.39, respectively. For women, serum levels of α-carotene and zeaxanthin/lutein were inversely associated with risk of lung cancer, but the association was not significant. No association between lung cancer and serum levels of β-carotene, β-cryptoxanthin, and retinol was appeared among women. There was a suggestion that association between lung cancer and high serum levels of these components might differ between men and women. Conclusions: Higher serum levels of carotenoids appear to play a role in preventing death from lung cancer among Japanese men. Relationships between lung cancer and serum levels of some carotenoids appear to differ between sexes, However, further study with a large number of women cases needs to clarify the discrepancy between sexes. Copyright © 2005 by Japan Epidemiological Association.

DOI： 10.2188/jea.15.S140

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Background: In Japan, lung cancer is the top cause of cancer death in men and the third leading cause in women. Updated information on risk factors for lung cancer, therefore, is of great importance. The Japan Collaborative Cohort Study, a large prospective study started in 1988, has provided such information. Methods: We reviewed published findings for lung cancer from the study. The endpoint was death from this cancer. Results: The major findings were as follows. (1) The relative risks in current smokers versus nonsmokers were 4.46 in men and 3.58 in women. (2) Cigarette smoking accounted for 67.0% of lung cancer deaths in men and only 14.6% in women. (3) More than 15 years of smoking cessation may be required to decrease the risk of lung cancer to the level of never smokers. (4) A reduced risk was associated with frequent intake of green-leafy vegetables and fruit in men but not in women. These foods seemed to decrease the risk in male current or former smokers more than in female nonsmokers. (5) Serum levels of α- and β-carotenes, β-cryptoxanthin, and lycopene were inversely correlated with the risk in men. (6) In a preliminary study, serum 8-hydroxy-deoxyguanosine was higher in current smokers than in nonsmokers. Conclusions: The relative and attributable risks of smoking were smaller in Japan than in Western countries. In addition to smoking habits, therefore, we must pay attention to other risk factors for lung cancer or factors that modify the adverse effects of smoking including dietary factors. Copyright © 2005 by Japan Epidemiological Association.

DOI： 10.2188/jea.15.S134

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DOI： 10.11236/jph.51.4_252

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：Niigata University  

The major concerns with immunization programs for disease control continue to be improving and sustaining immunization coverage, which can be monitored via the direct or indirect measurement of vaccination levels. We have developed a computerized program to monitor immunization coverage with diphtheria-pertussis-tetanus (DPT) and measles vaccines using registration books of immunization in 7 villages and towns in Niigata Prefecture, Japan, and analyzed 838 children who were born in the calendar year 2000. Immunization coverage for the third dose of DPT among infants aged 12 months ranged from 9.3% to 75%. Four places had introduced group immunization programs, and three had individual ones. Good coverage (37.7% to 75.0%) generally resulted when the first dose was given at 3 months of age, but where it was started at 5 or 7 months, values were quite low (9.3% to 28.0%) regardless of whether group or individual immunization programs were employed. However, when the first dose was given at 3 months of age, third dose vaccine coverage at 12 months was higher in the group immunization programs. Locales which arranged many immunization days achieved the best immunization coverage. Measles immunization coverage at 24 months of age was quite high at 86.6% to 94.6%, except in village G (75.5%) with both group and individual immunization programs. The present study leads us to conclude that this computerized system focusing on immunization activity is an effective tool to evaluate immunization programs.

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Other Link： http://search.jamas.or.jp/link/ui/2006219559

Language：Japanese   Publisher：日本公衆衛生学会  

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PURPOSE: To assess a smoking rate survey using the coming-of-age ceremony to examine the practicality for estimating the under twenties' smoking rate as a baseline and a long term assessment index for action plans to prevent smoking in the young. METHODS: We undertook the survey at village A (with a population of about 6,500) and town B (with about 12,000 residents) in Niigata Prefecture. Village A started a comprehensive anti-smoking policy featuring cooperation between schools and the community. Subjects were twenty-year young adults (69 in village A and 118 in town B) who attended rural coming-of-age ceremonies in 2002. The self-rated questionnaire included smoking habits, age of first smoking experience, and age of becoming a regular smoker (only in village A). RESULTS: Smoking rates were 68.0% for men and 48.6% for women in village A. Of these, approximately 90% smoked daily and more than 70% became regular smokers before the age of 20. Smoking rates in town B were similar. The results were about 20% higher than found by a smoking rate survey performed at high schools. CONCLUSION: Smoking rate surveys at coming-of-age ceremonies offer a practical and easy approach to estimate under twenties' smoking rate and assess the effects of smoking prevention strategies among the young.

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：Japan Epidemiological Association  

This study investigated the relationship between smoking habits and serum levels of 8-OHdG, oxi-dized LDL antibodies (oLAB), Mn-SOD, and carotenoids. Subjects were 79 males (mean age ± stan-dard deviation; 62.1 ±10.0 years) and 79 females (60.3±10.3 y) who attended a health examination screening in the town of Hokkaido, Japan. Serum 8-OHdG, Mn-SOD, and oLAB levels were measured by ELISA and serum carotenoids levels were measured by HPLC. Smoking habits were assessed by public health nurses using a questionnaire. Serum 8-OHdG levels were significantly higher in males than in females. On the other hand, serum levels of β-carotene, α-carotene, β-cryptoxanthin, and zeaxanthin and lutein were significantly lower in males than in females. Serum β-carotene, β-cryptox-anthin, and zeaxanthin and lutein were significantly lower in males who were en-aut-name=Junichi Ochiai, Kunio Aoki, Kenji Wakai, Akiko Tamakoshi, Masahiko Ando, Yoshiyuki Watanabe, Kotaro Ozasa, Nao Seki, Yoshikazu Nishino, Takaaki Kondo, Yoshiyuki Ohno3 for the JACC Study Groupcurrent smokers, com-pared to non-smokers. Serum 8-OHdG levels were also significantly higher in current smokers.Furthermore, in males, serum oLAB and β-carotene levels were significantly and negatively correlated with the number of cigarettes smoked per day. Serum Mn-SOD levels were unrelated to smoking habits in males. In conclusion, this preliminary study suggests that cigarette smoking increases serum 8-OHdG levels and reduces serum levels of oLAB and carotenoids, such as β-carotene, β-cryptoxan-thin, and zeaxanthin and lutein in healthy male subjects. Serum levels of 8-OHdG, oLAB, and carotenoids may be useful biomarkers of oxidative conditions affected by smoking. J Epidemiol2003;13:29-37.

DOI： 10.2188/jea.13.29

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：WILEY-LISS  

Estimating the proportion of lung cancer deaths that can be avoided is important in assessing the potential impact of anti-smoking efforts on the reduction of lung cancer deaths. We calculated the population attributable risk (PAR) and absolute risk of lung cancer death according to smoking status based on the Japan Collaborative Cohort (JACC) Study. The analytic cohort included 45,010 males and 55,724 females aged 40-79 years. Cox proportional hazards model was used to determine age-adjusted relative risks and PAR according to smoking status. We also computed lung cancer mortality according to age and smoking status. In males, 52.2% and 14.8% of lung cancer deaths were attributable to current and former cigarette smoking, respectively. In females, the corresponding figures were 11.8% and 2.8%. Among current male smokers, the relative risk was strongly correlated with the intensity and duration of cigarette smoking. In contrast, the PAR was associated with an intermediate level of smoking except for the years of smoking: the largest PARs were observed in those with 20-29 cigarettes per day, 40-59 pack-years and 20-22 years old at starting smoking. Absolute risks were estimated to increase with age and duration of smoking and not to decrease even after cessation. These findings suggest that avoidable lung cancer deaths are primarily among light to moderate smokers who are considered amenable to population-based antismoking strategies. For all current smokers, immediate cessation is encouraged because it offers the only realistic way to avoid a substantial increase in lung cancer mortality brought about by further continuation of smoking. (C) 2003 Wiley-Liss, Inc.

DOI： 10.1002/ijc.11043

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To investigate whether high serum levels of carotenoids, tocopherols, and folic acid decrease risk of lung cancer in Japanese, we conducted a case-control study nested in the Japan Collaborative Cohort (JACC) Study. A total of 39 140 subjects provided serum samples at baseline between 1988 and 1990. We identified 147 cases (113 males and 34 females) of death from lung cancer during an 8-year follow-up. Of the subjects who survived to the end of this follow-up, 311 controls (237 males and 74 females) were selected, matched to each case of lung cancer death for gender, age and participating institution. We measured serum levels of antioxidants in cases of lung cancer death and controls. Odds ratios (ORs) for lung cancer death were estimated using conditional logistic models. The risk of lung cancer death for the highest quartile of serum α-carotene, β-carotene, lycopene, β-cryptoxanthin, and canthaxanthin was significantly or marginally significantly lower than for the lowest quartile: the ORs, adjusted for smoking and other covariates, were 0.35 (95% confidence interval (Cl), 0.14-0.88), 0.21 (0.08-0.58), 0.46 (0.21-1.04), 0.44 (0.17-1.16) and 0.37 (0.15-0.91), respectively. The ORs for the highest serum levels of zeaxanthin/lutein and folic acid tended to be low, but the differences were not statistically significant. Serum total cholesterol was also inversely related to risk of lung cancer death: the OR for the highest vs. the lowest quartile was 0.39 (95% Cl, 0.19-0.79). Higher serum levels of carotenoids such as α- and β-carotenes may play a role in preventing death from lung cancer among Japanese.

DOI： 10.1111/j.1349-7006.2003.tb01352.x

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Mortality from coronary heart disease in Japan is the among lowest recorded in the industrialized nations
however, little is known about the rate of events including nonfatal cases. A survey of event registration and a review of death certificates was carried out to estimate event rates of acute myocardial infarction (AMI) and coronary deaths in the largest 2 cities of the Niigata prefecture where there are 480,720 residents aged between 15 and 65 years. The definitions for these cardiac events used for the WHO-MONICA project were: (1) 'definite AMI', (2) 'possible AMI or coronary death' (not including unclassifiable fatal events), and (3) 'unclassifiable fatal events'. Age-adjusted rates for AMI and coronary deaths (per 100,000/year) according to the registration survey were 54.6 for men and 7.2 for women according to definition 1 and 41.9 for men, and 5.3 for women according to definition 2. When data from the death certificate review were taken into account for the estimation, these rates increased to 80.6 for men and 14.2 for women according to definition 1, and 50.0 for men and 9.0 for women according to definition 2. These estimated rates are considerably lower than those in other industrialized nations surveyed in the WHO-MONICA project, and these findings are consistent with those from other studies conducted in Japan.

DOI： 10.1253/circj.67.40

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：WILEY  

To investigate whether high serum levels of carotenoids, tocopherols, and folic acid decrease risk of lung cancer in Japanese, we conducted a case-control study nested in the Japan Collaborative Cohort (JACC) Study. A total of 39 140 subjects provided serum samples at baseline between 1988 and 1990. We identified 147 cases (113 males and 34 females) of death from lung cancer during an 8-year follow-up. Of the subjects who survived to the end of this follow-up, 311 controls (237 males and 74 females) were selected, matched to each case of lung cancer death for gender, age and participating institution. We measured serum levels of antioxidants in cases of lung cancer death and controls. Odds ratios (ORs) for lung cancer death were estimated using conditional logistic models. The risk of lung cancer death for the highest quartile of serum alpha-carotene, beta-carotene, lycopene, beta-cryptoxanthin, and canthaxanthin was significantly or marginally significantly lower than for the lowest quartile: the ORs, adjusted for smoking and other covariates, were 0.35 (95% confidence interval (0), 0.14-0.88), 0.21 (0.08-0.58), 0.46 (0.21-1.04), 0.44 (0.17-1.16) and 0.37 (0.15-0.91), respectively. The ORs for the highest serum levels of zeaxanthin/lutein and folic acid tended to be low, but the differences were not statistically significant. Serum total cholesterol was also inversely related to risk of lung cancer death: the OR for the highest vs. the lowest quartile was 0.39 (95% Cl, 0.19-0.79). Higher serum levels of carotenoids such as alpha- and beta-carotenes may play a role in preventing death from lung cancer among Japanese.

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：BUSINESS CENTER ACADEMIC SOCIETIES JAPAN  

To elucidate the roles of insulin-like growth factors (IGFs) in the development of lung cancer, we conducted a case-control study nested within the Japan Collaborative Cohort Study. Serum samples were collected at baseline from 39 140 men and women between 1988 and 1990. We measured serum IGF-I, IGF-II, and IGF-binding protein-3 (IGFBP-3) in 194 case subjects who subsequently died from lung cancer during an 8-year follow-up and in 9351 controls. The odds ratios (ORs), adjusted for smoking and other covariates, were smaller with higher levels of IGF-II and IGFBP-3. The ORs across quartiles were 0.41 (95% confidence interval [CI], 0.27-0.63), 0.47 (0.31-0.71), and 0.67 (0.46-0.98) for IGF-II (trend P=0.018), and 0.55 (95% CI, 0.37-0.81), 0.54 (0.36-0.82), and 0.67 (0.45-1.01) for IGFBP-3 (trend P=0.037). These peptides were not independently related to lung cancer risk when mutually adjusted. The risk was increased in the highest vs. the lowest quartile of IGF-I only after controlling for IGFBP-3 (OR, 1.74; 95% CI, 1.08-2.81). Limiting subjects to those followed for greater than or equal to3 years strengthened the negative associations of IGF-II and IGFBP-3, whereas the ORs for IGF-I generally decreased. A higher level of circulating IGFBP-3 and/or IGF-II may decrease lung cancer risk. Elevated serum IGF-I may increase the risk, but this could partly be attributable to latent tumors.

DOI： 10.1111/j.1349-7006.2002.tb01235.x

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：Slack Incorporated  

OBJECTIVE: To, evaluate the effectiveness of influenza vaccines against influenza-like illness (ILI) among nursing home residents. DESIGN: Prospective, nonrandomized, cohort study. SETTING: Nine nursing homes during the 1998-1999 influenza season and 11 nursing homes during the 1999-2000 influenza season in Niigata Prefecture, Japan. PARTICIPANTS: Six hundred ninety-nine residents and 440 healthcare workers (HCWs) during the first season, and 930 residents and 517 HCWs during the second season, with vaccination rates ranging from 0% to 97.7%. RESULTS: Overall, ILI decreased from 24.3% during the 1998-1999 season to 8.8% during the 1999-2000 season. Multivariate analysis adjusted for. several factors, including gender, age, underlying diseases, and resident and HCW vaccination rates, failed to demonstrate clear individual protection of residents (relative risk [RR], 1.42
P =.2 for the first season
RR, 0.95
P = .9 for the second season). However, vaccination rates of 60% or greater for residents and HCWs reduced the risk of ILI, and also could prevent outbreaks during the 2 seasons. Highly impaired activities of daily living and chronic respiratory diseases were significantly associated with increased ILI. CONCLUSIONS: A high vaccination rate for both residents and HCWs may reduce the risk of ILI and institutional outbreaks in nursing homes.

DOI： 10.1086/502011

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Language：Japanese   Publishing type：Research paper (scientific journal)  

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：BUSINESS CENTER ACADEMIC SOCIETIES JAPAN  

Lung cancer has increased and is the leading cause of cancer death among Japanese males. The associations of dietary habits with the risk of lung cancer death were evaluated by sex and smoking habits in this study. In the Japan Collaborative Cohort (JACC) Study, a cohort established in 1988-90 and consisting of 42 940 males and 55 308 females was observed for lung cancer deaths up to the end of 1997. During the observation period, 446 males and 126 females died of lung cancer. A self-administered food frequency questionnaire was used as the baseline survey. Hazard ratios for dietary factors were calculated by Cox's proportional hazards model. Among males, a high intake of ham and sausages, cheese, green-leafy vegetables, oranges, and other fruits significantly and dose-dependently decreased the risk of lung cancer death. Among females, a high intake of miso-soup, ham and sausages, and liver significantly and almost dose-dependently increased the risk. Vegetables and fruits rich in antioxidative and carcinogenic agents reduced the risk of lung cancer deaths among male smokers more than among female nonsmokers. The results among female nonsmokers were partially consistent with the hypothesis that high fat consumption increases the risk of lung cancer, especially that of adenocarcinoma.

DOI： 10.1111/j.1349-7006.2001.tb02148.x

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：Japan Epidemiology Association  

The Japan Collaborative Cohort Study for Evaluation of Cancer Risk Sponsored by Monbusho (JACC Study) included in its self-administered questionnaires some single-item questions concerning physical activity. We examined the validity of the questions among 1,730 Japanese adults and the reliability of the questions among 1,075 Japanese adults. The validity of the sports and physical exercise questions was estimated by comparing the self-administered questionnaire responses with the time spent on the activity and the energy expenditure index for the previous 12-month period, elicited by the interviewing method used in the Japan Lifestyle Monitoring Study with a minor modification. The Spearman's rank correlation coefficients ranged from 0.43 to 0.60, showing moderate correlations. On the other hand, test-retest reliability was estimated by comparing the responses from two separate surveys conducted roughly one year apart. Weighted kappa coefficients of sports and physical exercise questions, classified according to sex and age, ranged from 0.39 to 0.56, showing moderate reliability
and those of a question about walking ranged from 0.25 to 0.39, showing fair reliability. We suggest that measuring physical activity level with these single-item questions may be appropriate for establishing baseline data that reflects long-term physical activity in a large-scale cohort study targeting lifestyle-related diseases. validity, reliability, physical activity, single-item question, lifestyle-related disease.

DOI： 10.2188/jea.11.211

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：Japanese Society for Hygiene  

The purpose of this study was to determine lifestyle factors in the elderly that affected longevity, using a population-based prospective study. The participants were 440 men and 625 women aged 60 to 74 living in a rural Japanese community. The baseline data such as age, sex, present illness, walking hours per day, sleeping hours per day, alcohol consumption, a history of smoking, and "ikigai" (meaningfulness of life) were collected in July 1990. During 90 months of follow-up from July 1990 to December 31 1997, there were 123 deaths. By Cox's multivariate hazard model adjusted age, sex, and medical histories, walking ≧hour/day (HR=0.63,95%CI 0.44-0.91) and an "ikigai" (HR=0.66, 95%CI 0.44-0.99) lowered the risk for all-cause mortality independently. In regard to hours of sleep, the cumulative survival curve showed that 7 hours/day was the border and sleeping ≧7 hours/day lowered the risk (HR=0.49 95%CI 0.33-0.74). Based on the findings in this study, walking ≧1hour/day, sleeping ≧7 hours/day, and "ikigai" are important factors for longevity in the elderly.

DOI： 10.1265/jjh.56.535

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To evaluate the impact of smoking cessation in individuals and populations, we examined the decrease in risk of lung cancer death in male ex-smokers by age at quitting in the Japan Collaborative Cohort Study for Evaluation of Cancer Risk Sponsored by Monbusho (JACC Study), which was initiated from 1988 to 1990 in Japan. For simplicity, subjects were limited to male non-smokers, and former/current smokers who started smoking at ages 18-22, and 33 654 men aged 40-79 years were included. We modeled the mortality rates in non-smokers and current smokers, and compared the rates in ex-smokers with those expected from the model if they had continued smoking. During the mean follow-up of 8.0 years, 341 men died from lung cancer. The mortality rate ration for current smokers, compared to non-smokers, was 5.16, and those for ex-smokers who had quit smoking 0-4, 5-9, 10-14, 15-19 and ≥20 years before were 4.84, 3.19, 2.03, 1.29 and 0.99, respectively. The functions of 3.20×10-7×(age)4.5 and 1.96×10-5×(age-29.6)4.5 fitted the observed mortality rates (per 100 000 person-years) in non-smokers and continuing smokers, respectively. A greater decrease in lung cancer mortality was estimated among those who quit smoking at younger ages. Stopping smoking earlier in life appears preferable to keep the individual risk low. The absolute rate, however, substantially decreased after smoking cessation even in those who quit at ages 60-69, reflecting the high mortality rate among continuing smokers in the elderly.

DOI： 10.1111/j.1349-7006.2001.tb01167.x

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：SLACK INC  

Surveys on influenza vaccination and illness in longterm-care facilities in Niigata Prefecture during an influenza A (H3N2) epidemic revealed that &gt;20% of facilities had outbreaks and &gt;10% of residents experienced influenza. Outbreaks and number of cases were significantly reduced by vaccination, which should be strongly recommended for institutionalized elderly people.

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To identify life-related factors causing increased mortality, 2,769 rural residents aged 29-77 were investigated through a self-administered questionnaire in 1990. Death certificates and migration information were inspected during the 4.5-year follow-up period. Age, obesity, life attitude, job, marital status, drinking and smoking habits, previous or current illness, and frequency of participation in health examinations were checked during the baseline survey. The person-year mortality rate was higher among irregular participants in health examinations than among regular participants both among males and females. From Cox's multiple regression analysis, factors with a significantly high hazard ratio (HR) for mortality were irregular participation (HR=2.05), increase of age (HR=1.54, for 10 years), previous or current illness (HR=2.44), unemployment (HR=l.95), and living without a spouse (HR=2.61) for males
and for females they were having previous or current illness (HR=15.21) and living without a spouse (HR=2.94). Thus, irregular participation in health examinations, unemployment and aging showed a relationship with a higher mortality only in males. A previous or current illness and living without a spouse were related in both sexes.

DOI： 10.1265/ehpm.2000.66

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Language：Japanese   Publisher：日本公衆衛生学会  

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Language：Japanese   Publishing type：Research paper (scientific journal)   Publisher：The Japanese Association for Cerebro-cardiovascular Disease Control  

We assessed the role of abnormal glucose metabolism as a risk factor for atherosclerosis in the cardiovascular system through two studies we performed.<BR>1. A case-control study of coronary heart disease<BR>In this study, high serum fructosamine concentration (≥285μmol/l) was used as an index for abnormal glucose metabolism. The prevalence of high serum fructosamine was compared by age categories between 130 male patients with atherosclerotic coronary heart disease (CHD) aged 60 years or younger (the case) and 260 age matched male subjects without CHD (the control). The prevalence among the young group aged 40years or younger was 41.9% for cases and 5.8% for controls, while that among the middle-aged group, 41-60 years, was 33.3% for cases and 19.5% for controls. Although the differences between cases and controls were statistically significant (p < 0.01) in both age groups, the difference was greater in the young than in the middle-aged. As the result, odds ratio for CHD was high in the young (odds ratio : 18.70, 95% confidence interval : 3.34104.64) in comparison with that in the middle-aged (odds ratio : 2, 51, 95% confidence interval : 1.225.18) in a multivariate logistic regression analysis in which effects of other coronary risk factors were adjusted.<BR>2. A study of carotid atherosclerosis by ultrasonography<BR>Carotid arteries of 8lpatients with DM were examined by ultrasonography, and the prevalence of carotid atherosclerotic plaque (CAP) was compared with that in two community basedcontrol groups categorized by sex and age.<BR>More than half of the DM patients had CAP in every age group in both sexes. Although the prevalence in the controls did not differ from that in DM patients in the group aged 65years or over, that in the controls became lower and the difference with that for DM patients became greater at lower ages.<BR>From the results of the two studies, abnormal glucose metabolism represented by high serum fructosamine and DM was suggested to be an important risk factor for early development of atherosclerosis in the cardiovascular system. In view of the prevention of atherosclerotic deseases, prevention of DM would be important especially in the young.

DOI： 10.11381/jjcdp1974.33.151

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Language：Japanese   Publisher：公益社団法人 日本産業衛生学会  

DOI： 10.1539/sangyoeisei.KJ00001989841

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PURPOSE: We investigated familial aggregation as well as familial covariation of diseases by means of a questionnaire survey dealing with family histories of stomach cancer, stroke, hypertension, diabetes and tuberculosis as well as life style among 2,769 inhabitants of a rural community (84% of census population). METHODS: The strength of familial aggregation was shown by an odds ratio (OR) that compared the number of families in which siblings suffered from one of the above diseases among families in which at least one parent suffered from it, and among families in which neither did. Probands were divided into two groups for analysis: an under-55 'young group,' and a 55-and-older 'old group.' RESULTS: The OR for stomach cancer was lowest and insignificant in the young group, and significant (2.2, p &lt
0.05) only in the old group. The OR for stroke, hypertension, and tuberculosis was 4.5-5.1 (p &lt
0.05) in the young group but decreased to 2.3-3.2 in the old group. Diabetes increased from 3.9 to 5.7 (p &lt
0.05) with advancing age. Age-related OR trends were not affected by exposure to cigarette smoke in the past. Stomach cancer showed a borderline familial covariation with diabetes and a borderline inverse covariation with hypertension. Hypertension showed a familial covariation with stroke and diabetes. CONCLUSIONS: Among the investigated diseases, familial aggregation was weakest for stomach cancer. The results suggest that stomach cancer may share a common familial etiologic factor with diabetes and hypotension.

DOI： 10.1016/S1047-2797(97)00077-X

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To examine the relationship between overwork and the occurrence of sudden death, the relation between occupation and seasonal variation in sudden death was studied. A total of 8481 cases of sudden death (among subjects aged over 24 years) were selected from all deaths between 1984 and 1986 in the Niigata Prefecture, Japan, based on a death certificate survey. Sudden death was defined as death within 24 h of the onset of the underlying disease. We divided subjects into 4 groups according to the occupation of the householder: Agricultural workers, employees, the self-employed, and other occupations. As the incidence of sudden death in the ‘other occupation’ group did not show any significant seasonal variation, this group was considered to be a control group. Among young to middle-aged men (25-65 year old), the incidence of sudden death was higher than in the control group for agricultural workers in April and September and for employees in March and September. However, in older men (over 65) the incidence for agricultural workers was higher only in April. Among women, there was no such spring rise in the incidence of sudden death in any occupational group. The months featuring a high incidence of sudden death coincided with the busiest occupational months only for people who were actually working and not for those who had already retired. © 1997, The Japanese Circulation Society. All rights reserved.

DOI： 10.1253/jcj.61.814

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To investigate triggers for the occurrence of acute myocardial infarction (AMI) and sudden cardiac death (SCD), we examined the activities immediately before the time of onset in 149 cases of non-fatal AMI and 110 cases of SCD. All of the cases in which death occurred within 24 h from the onset of the underlying cause were considered SCD as long as the cause of death was of cardiac origin or unknown. We calculated the average time which is spent on each activity in the life cycle of Japanese people and estimated the number of incidence of each activity assuming a uniform distribution. Estimated values and actual values were compared. The results were as follows: 1) The incidence of non-fatal AMI and SCD was low while sleeping or resting or doing light work, and was high while using the toilet or doing sport or heavy work. 2) The incidence of SCD was also high even during moderate exertion, such as taking a bath or, walking or cycling, and it was significantly higher than that in the group of non-fatal AMI. 3) The incidence of non-fatal AMI was high while eating or drinking. 4) Many of the patients with SCD had past histories of circulatory diseases, compared to those with non-fatal AMI. This difference in past histories may account for the high incidence, of SCD during moderate exertion. © 1996, The Japanese Circulation Society. All rights reserved.

DOI： 10.1253/jcj.60.947

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Language：English   Publisher：JAPAN SOC INTERNAL MEDICINE  

DOI： 10.2169/internalmedicine.48.E001

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Language：Japanese  

J-GLOBAL

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Language：English   Publisher：日本癌学会  

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Language：Japanese   Publisher：公益社団法人日本産業衛生学会  

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Language：Japanese   Publisher：公益社団法人日本産業衛生学会  

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Language：Japanese   Publisher：(公社)日本小児科学会  

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Language：Japanese   Publisher：Niigata University  

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Other Link： http://search.jamas.or.jp/link/ui/2002147977

Language：Japanese   Publishing type：Article, review, commentary, editorial, etc. (scientific journal)   Publisher：Niigata University  

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Other Link： http://search.jamas.or.jp/link/ui/2000024697

Language：Japanese   Publisher：社団法人日本循環器学会  

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Language：Japanese   Publisher：新潟医学会  

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