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Physical inactivity and sleep disturbance are more problematic in patients with chronic obstructive pulmonary disease (COPD) than in healthy individuals. The purpose of the study was to identify impacts of nighttime sleep on next-day physical activity in COPD patients. The study included 52 COPD patients reporting disturbed sleep. Sleep and physical activity were measured using an accelerometer for 5 days. Increased sleep latency was associated with less next-day physical activity during the afternoon (4-6 p.m.). Greater waking duration/times were associated with less next-morning (6-8 a.m.) physical activity. Greater total sleep time was associated with less next-morning (12-9 a.m.) physical activity, and greater sleep efficiency was associated with less next-morning (1-3 a.m.) and more next-evening (6-7 p.m.) physical activity. Results suggest that sleep disturbance had varying influences on next-day hourly physical activity. These results support the potential value of sleep management in promoting physical activity in COPD patients.

The “fourth industrial revolution” (FIR) is an age of advanced technology based on information and communication. FIR has a more powerful impact on the economy than in the past. However, the prospects for the labor environment are uncertain. The purpose of this study is to anticipate and prepare for occupational health and safety (OHS) issues.In FIR, nonstandard employment will be common. As a result, it is difficult to receive OHS services and compensation. Excessive trust in new technologies can lead to large-scale or new forms of accidents. Global business networks will cause destruction of workers' biorhythms, some cancers, overwork, and task complexity. The social disconnection because of an independent work will be a risk for worker's mental health. The union bonds will weaken, and it will be difficult to apply standardized OHS regulations to multinational enterprises.To cope with the new OHS issues, we need to establish new concepts of ''decent work” and standardize regulations, which apply to enterprises in each country, develop public health as an OHS service, monitor emerging OHS events and networks among independent workers, and nurture experts who are responsible for new OHS issues. Keywords: Fourth industrial revolution, Occupational health and safety, Workers' compensation, Workers' health

Fatigability is defined as the extent of fatigue in the context of activity and differs from the term used in exercise literature to describe muscle endurance characteristics. Many fatigability measures are available, but no studies have thoroughly evaluated them for adequate incorporation of fatigability concepts. This integrative review provides an overall assessment of existing fatigability measures and then evaluates each in depth. A database search and hand search produced 14 studies for review. Fatigability measurement took three forms: self-reported fatigability, perceived fatigability (self-reported fatigue following a defined performance test), and performance fatigability (performance deterioration). Of 17 measures identified, validity and/or reliability was reported for six (35.3%), and no measure was used in more than one study. Fatigability measures have been correlated with clinical measures, indicating that fatigability should be measured during routine clinical health screening. Refinement of measures and additional fatigability data collection will improve understanding and treatment of fatigue.

Here, we present a case of lung cancer in a 48-year-old male horse trainer. To the best of our knowledge, this is the first such case report to include an exposure assessment of respirable crystalline silica (RCS) as a quartz. The trainer had no family history of lung cancer. Although he had a 15 pack/year cigarette-smoking history, he had stopped smoking 12 years prior to his diagnosis. For the past 23 years, he had performed longeing, and trained 7-12 horses per day on longeing arena surfaces covered by recycled sands, the same surfaces used in race tracks. We investigated his workplace RCS exposure, and found it to be the likely cause of his lung cancer. The 8-hour time weight average range of RCS was 0.020 to 0.086 mg/m3 in the longeing arena. Horse trainers are exposed to RCS from the sand in longeing arenas, and the exposure level is high enough to have epidemiological ramifications for the occupational risk of lung cancer.

In the absence of existing research, we examined the association between longitudinal changes in serum gamma-glutamyltransferase (GGT) levels and the risk for metabolic syndrome (MetS). A MetS-free cohort of 9148 healthy male workers, who had participated in a health checkup program in 2002, was followed until September 2007. Metabolic syndrome was defined according to the modified National Cholesterol Education Program, using body mass index instead of waist circumference. Standard Cox proportional hazards and time-dependent Cox models were performed. During 37 663.4 person-years of follow-up, 1056 men developed MetS. The risk of incident MetS increased across the baseline GGT quartiles, even after further updating GGT values during the follow-up. A longitudinal increase in GGT as a time-dependent variable as well as a non-time-dependent variable was significantly related to MetS after adjusting for age plus the elapsed time from visit 1 to visit 2, baseline MetS traits, uric acid, regular exercise, alcohol consumption, and smoking. Even within the GGT reference interval (