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Background: Sensitivity to cold is associated with several factors, such as aging, sex, and body composition. However, no previous studies have examined the differences in sensitivity to cold in men and women or the association of hormonal levels with sensitivity to cold. Objective: The aim of the present study was to clarify both the change in sensitivity to cold with aging and the difference in sensitivity to cold between men and women. Associations were also examined between circulating hormonal concentrations and the changes with aging and differences in sensitivity. Methods: This population-based cohort study enrolled healthy Japanese men and women aged >/= 50 years. A standardized 210-item health questionnaire was used to obtain information on symp- toms of sensitivity to cold. Serum concentrations of luteinizing hormone, follicle-stimulating hor- mone (FSH), estradiol, testosterone, dehydroepiandrosterone sulfate, and sex hormone-binding globu- lin (SHBG) were measured. Results: Of the 154 men and 180 women enrolled in this study, more women than men had sensitivity to cold. Whereas the percentage of men who had sensitivity to cold significantly increased with aging (P < 0.05), the percentage of women who had sensitivity to cold was already high (23.7%) at 50 to 60 years of age and did not change with aging. In men, advancing age and low body mass index (BMI) were significantly associated with sensitivity to cold (P < 0.05); however, age and BMI in women were not similarly associated. In addition, the effect of sex after adjustment for age was significant (P < 0.05), and there was also a numeric but nonsignificant effect of sex after adjustment for BMI. In men, low serum levels of the gonadal hormone FSH were significantly associated with sensitivity to cold in logistic analysis, but this association was nonsignificant after multivariate analysis. Serum concentrations of gonadal hormones and SHBG in women were not associated with sensitivity to col. Conclusions: The association of age with sensitivity to cold was different in men and women; the association of BMI with sensitivity to cold might be different in men and women. In addition, these changes in sensitivity to cold were not associated with circulating hormonal concentrations. [ABSTRACT FROM AUTHOR]

After developing job-exposure matrices (JEMs) for screen and sedentary time, we aimed to assess the associations between the JEM-derived exposures and various ocular diseases. We collected data from patients hospitalized from 2005 to 2021. JEMs were developed from 41,718 patients with occupational information and screen and sedentary times. The adjusted means of screen and sedentary time were calculated for 143 occupational groups and categorized into three classes based on the tertiles. The associations between ocular diseases and these JEM-derived exposures were examined using multivariable conditional logistic regression for 727,589 patients. The odds ratios of the class with highest screen time were 1.05 (95% confidence interval, 1.01-1.09) for cataract, 1.24 (1.06-1.45) for primary open-angle glaucoma (POAG), 1.26 (1.06-1.49) for rhegmatogenous retinal detachment (RRD), 1.49 (1.26-1.76) for ptosis, and 0.39 (0.27-0.57) for pterygium. The odds ratios of the class with highest sedentary time were 1.05 (1.01-1.09) for cataract, 1.24 (1.05-1.46) for RRD, 1.68 (1.42-1.99) for ptosis, and 0.60 (0.42-0.84) for pterygium. Both screen and sedentary time were positively associated with cataract, RRD and ptosis. Interestingly, POAG had a positive association with only screen time. Please check and confirm that the authors and their respective affiliations have been correctly identified and amend if necessary."I have confirmed that the content is correct. No amendments are necessary.Please check article title if captured correctly."?>"I have confirmed that the content is correct. No amendments are necessary., (© 2024. The Author(s).)

Introduction: Allergic rhinitis (AR) is a chronic condition caused by an immunoglobulin E-mediated response to environmental allergens, which affects 10-40% of the global population. AR symptoms, such as nasal congestion and rhinorrhea, significantly reduce quality of life and are associated with sleep disturbances, further exacerbating the condition's burden. Despite the known impact of AR on sleep, the effects of intranasal corticosteroids on sleep quality have not been comprehensively reviewed. Therefore, this systematic review and meta-analysis aimed to investigate the efficacy of intranasal corticosteroids in improving sleep quality among patients with AR., Methods: This systematic review and meta-analysis followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The study protocol was registered with PROSPERO (CRD42023460698). A comprehensive search was conducted on PubMed, Cochrane Central Register of Controlled Trials, and Ichushi-Web. Randomized controlled trials (RCTs) comparing intranasal corticosteroids with placebos in patients with AR were included. Data extraction and risk of bias assessment were independently performed by two authors. The primary outcome was the improvement in sleep quality measured by standardized questionnaires. Meta-analyses were performed using a random-effects model. The risk of bias was assessed using the RoB2 tool., Results: Eighteen RCTs involving 6,019 participants were included. The meta-analysis of 12 comparisons from eight studies for the Rhinoconjunctivitis Quality of Life Questionnaire sleep domain showed significant improvement in sleep quality with a standardized mean difference (SMD) of 0.292 (95% confidence interval [CI]: 0.235-0.350, p < 0.0001, I2 = 0.0%). The Nocturnal Rhinoconjunctivitis Quality of Life Questionnaire also showed improvement with an SMD of 0.284 (95% CI: 0.164-0.404, p < 0.0001) based on two comparisons from one study. However, the Epworth Sleepiness Scale did not show significant results (SMD: 0.027, 95% CI: -0.429 to 0.483, p = 0.907) based on two comparisons from two studies. Sensitivity analysis, excluding two studies with high risk of bias according to RoB2, confirmed the robustness of these results. Subgroup analyses for patients with seasonal or perennial AR showed significant improvements in both groups., Conclusion: This study demonstrates that intranasal corticosteroids significantly improve sleep quality in patients with AR. These findings support the use of intranasal corticosteroids as a first-line treatment for AR, not only for managing daytime symptoms but also for enhancing sleep quality. Future research should focus on sleep quality changes as a primary outcome and incorporate both subjective and objective measures to better understand the relationship between sleep and AR symptoms., (© 2024 The Author(s). Published by S. Karger AG, Basel.)

Objective: To develop a job-exposure matrix for sedentary behavior and assess its relationship with non-communicable diseases., Methods: We constructed a job-exposure matrix using occupational and industry classifications combined with data on daily average sitting durations from 41,718 individuals. This matrix was then applied to a cohort of 706,939 participants in a case-control study to explore the link between sedentary behavior and non-communicable disease risks., Results: The matrix effectively identified sedentary behavior across different occupational groups. Using the matrix to assess sedentary behavior, associations were found between increased sedentary activity and heightened risks of diabetes, acute myocardial infarction, and endometrial cancer, while a reduced risk was observed for stroke., Conclusions: The job-exposure matrix provides valuable insights into the health impacts of sedentary behavior in the workplace, underscoring significant disease risks associated with prolonged inactivity., Competing Interests: Conflicts of interest: N.K. received grant from the Industrial Disease Clinical Research Grants from the Ministry of Health, Labour and Welfare (No. 170201-01). M.T. received founding from the Ministry of Health, Labour and Welfare in Japan., (Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American College of Occupational and Environmental Medicine.)

Potential differential and non-differential recall error in mobile phone use (MPU) in the multinational MOBI-Kids case-control study were evaluated. We compared self-reported MPU with network operator billing record data up to 3 months, 1 year, and 2 years before the interview date from 702 subjects aged between 10 and 24 years in eight countries. Spearman rank correlations, Kappa coefficients and geometric mean ratios (GMRs) were used. No material differences in MPU recall estimates between cases and controls were observed. The Spearman rank correlation coefficients between self-reported and recorded MPU in the most recent 3 months were 0.57 and 0.59 for call number and for call duration, respectively. The number of calls was on average underestimated by the participants (GMR = 0.69), while the duration of calls was overestimated (GMR = 1.59). Country, years since start of using a mobile phone, age at time of interview, and sex did not appear to influence recall accuracy for either call number or call duration. A trend in recall error was seen with level of self-reported MPU, with underestimation of use at lower levels and overestimation of use at higher levels for both number and duration of calls. Although both systematic and random errors in self-reported MPU among participants were observed, there was no evidence of differential recall error between cases and controls. Nonetheless, these sources of exposure measurement error warrant consideration in interpretation of the MOBI-Kids case-control study results on the association between children's use of mobile phones and potential brain cancer risk., (© 2024 The Author(s). Bioelectromagnetics published by Wiley Periodicals LLC on behalf of Bioelectromagnetics Society.)

Background: This study aimed to examine the association between risk of brain tumors and radiofrequency (RF) exposure from mobile phones among young people in Korea and Japan., Methods: This case-control study of brain tumors in young people was conducted in Korea and Japan under the framework of the international MOBI-Kids study. We included 118 patients diagnosed with brain tumors between 2011 and 2015 and 236 matched appendicitis controls aged 10-24 years. Information on mobile phone use was collected through face-to-face interviews. A detailed RF exposure algorithm, based on the MOBI-Kids algorithm and modified to account for the specificities of Japanese and Korean phones and networks, was used to calculate the odds ratios (ORs) for total cumulative specific energy using conditional logistic regression., Results: The adjusted ORs in the highest tertile of cumulative call time at 1 year before the reference date were 1.61 (95% confidence interval [CI], 0.72-3.60) for all brain tumors and 0.70 (95% CI, 0.16-3.03) for gliomas, with no indication of a trend with exposure. The ORs for glioma specifically, were below 1 in the lowest exposure category., Conclusion: This study provided no evidence of a causal association between mobile phone use and risk of brain tumors as a whole or of glioma specifically. Further research will be required to evaluate the impact of newer technologies of communication in the future.

Digital health technology has been widely applied to mental health interventions worldwide. Using digital phenotyping to identify an individual's mental health status has become particularly important. However, many technologies other than digital phenotyping are expected to become more prevalent in the future. The systematization of these technologies is necessary to accurately identify trends in mental health interventions. However, no consensus on the technical classification of digital health technologies for mental health interventions has emerged. Thus, we conducted a review of systematic review articles on the application of digital health technologies in mental health while attempting to systematize the technology using the Delphi method. To identify technologies used in digital phenotyping and other digital technologies, we included 4 systematic review articles that met the inclusion criteria, and an additional 8 review articles, using a snowballing approach, were incorporated into the comprehensive review. Based on the review results, experts from various disciplines participated in the Delphi process and agreed on the following 11 technical categories for mental health interventions: heart rate estimation, exercise or physical activity, sleep estimation, contactless heart rate/pulse wave estimation, voice and emotion analysis, self-care/cognitive behavioral therapy/mindfulness, dietary management, psychological safety, communication robots, avatar/metaverse devices, and brain wave devices. The categories we defined intentionally included technologies that are expected to become widely used in the future. Therefore, we believe these 11 categories are socially implementable and useful for mental health interventions., (© The Author(s) [2024]. Published by Oxford University Press on behalf of Journal of Occupational Health.)

The effect of maternal occupational non-ionizing radiation (NIR) exposure from MRI on premature birth and low birth weight delivery was analyzed based on questionnaire survey (263 employees, 443 births). Although the highest occurrence rates of both outcomes were observed in the group whose NIR exposure occurred only before pregnancy, no statistical significance was detected.

Background: Long-term cancer prognosis after initial surgical procedures is an unlikely endpoint for clinical trials. Medical claim databases may aid in addressing this issue regardless of limited information on disease and patient background. However, the long-term prognosis (especially regarding long-term care needs) following surgical procedures remains unclear. This study aimed to assess whether long-term outcomes, such as the exacerbation of long-term care needs and mortality, differ with surgical methods., Methods: Using a longitudinal study with linkage between medical claim and long-term care database, patients with primary colorectal cancer who underwent initial colonoscopies were identified through anonymized data in Japan (Shizuoka Kokuho Database, 2012-2018). Odds ratios (ORs) for long-term outcomes (long-term care needs and all-cause mortality during a 6.5-year follow-up period) were analyzed using logistic regression to compare laparoscopy and endoscopic surgery to laparotomy., Results: Overall, 3,744 primary colorectal cancer cases (822 laparotomies, 705 laparoscopies, and 2,217 endoscopic surgeries) were included. Compared to the laparotomy group, the crude OR for exacerbation of long-term care needs in the laparoscopic surgery group was 0.376 (95% confidence interval, 0.227, 0.624), while the OR for all-cause mortality was 0.22 (0.329, 0.532)., Conclusion: This is the first study to analyze long-term prognosis after surgery for patients with colorectal cancer to combine medical and long-term needs data. As the national health insurance claim database rarely includes information on cancer stage and comorbidities, better prognosis on endoscopic surgery may need careful interpretation. Therefore, laparoscopy has superior outcomes in terms of long-term care needs and mortality compared to those of laparotomy., Competing Interests: The authors have declared that no competing interests exist., (Copyright: This is an open access article, free of all copyright, and may be freely reproduced, distributed, transmitted, modified, built upon, or otherwise used by anyone for any lawful purpose. The work is made available under the Creative Commons CC0 public domain dedication.)

The number of devices that generate intermediate-frequency electromagnetic fields (IF-EMFs) in the living environment has been increasing. As the public has vague concerns about new devices, it is necessary to clarify the safety of IF-EMFs. Therefore, the present study aimed to examine the possible health effects of IF-EMFs by clarifying the relationship between the use of induction heating (IH) cookers and delivery outcomes. The study participants were pregnant women over the age of 20 years who were registered in panels with an Internet research firm. A total of 8920 pregnant women participated in the baseline survey. Of those who responded to the follow-up survey, 5022 who had a singleton birth were included in the analysis. We then examined the relationship between the use of IH cookers and gestational week at delivery (<37th/⩾37th week) or birth weight (<2500/⩾2500 g) using logistic regression models. No association was found between the use of IH cookers and birth weight, but weak associations were found between the use of stationary- and tabletop-type IH cookers and gestational week at delivery. After all considerations, we determined that the observed increased odds ratio did not indicate an increased risk of premature birth., Competing Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2023.)

Prcis: In this case-control study of the Japanese population, including 3207 glaucoma cases, alcohol consumption patterns such as frequency and quantity showed a positive association with glaucoma prevalence., Purpose: To examine the association between alcohol consumption patterns and glaucoma., Subjects and Methods: This case-control study evaluated 3207 cases with glaucoma and 3207 matched controls. Patients over 40 years of age were included from 1,693,611 patients admitted to 34 hospitals in Japan. Detailed alcohol consumption patterns (drinking frequency, average daily drinks, and total lifetime drinks) were obtained, as well as various confounding factors, including smoking history and lifestyle-related comorbidities. Conditional logistic regression models were used to calculate odds ratios (ORs) and 95% CIs for glaucoma prevalence., Results: Drinking frequency showed an association with glaucoma for "a few days/week" (OR, 1.19; 95% CI, 1.03-1.38) and "almost every day/week" (OR, 1.40; 95% CI, 1.18-1.66). Average daily drinks showed an association for ">0-2 drinks/day" (OR, 1.16; 95% CI, 1.03-1.32). Total lifetime drinks showed an association for ">60-90 drink-year" (OR, 1.23; 95% CI, 1.01-1.49) and ">90 drink-year" (OR, 1.23; 95% CI, 1.05-1.44). As alcohol consumption levels differed considerably between men and women, additional analyses were conducted separately for men and women. Among men, drinking frequency of "a few days/week" and "almost every day/week," average daily drinks of ">0-2 drinks/day" and ">2-4 drinks/day," and total lifetime drinks of ">60-90 drink-year" and ">90 drink-year" had an association with glaucoma. Conversely, among women, neither drinking frequency, average daily drinks, nor total lifetime drinks were associated., Conclusions: Both the frequency and quantity of alcohol consumption were associated with glaucoma. Further research on gender differences is warranted., Competing Interests: Disclosure: The authors declare no conflict of interest., (Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc.)

Objectives: In 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., Methods: The 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., Results: In 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., Conclusions: There 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., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Background: 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., Methods: 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., Results: 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)., Conclusions: 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., Competing Interests: Conflict of interest None declared., (Copyright © 2022 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

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., (© 2022. The Author(s).)

Objective: To assess exposure levels to electromagnetic fields (EMFs) among library workers in Japan, focusing on co-exposure to intermediate-frequency EMF (IF-EMF) and pulsed EMF, to propose a new epidemiological research methodology., Methods: The evaluated exposure sources were an electromagnetic type-electronic article surveillance gate (EM-EAS, IF-EMF (operating frequency 220 Hz-14 kHz)) and an activator/deactivator of anti-theft tags termed as "book check unit" (BCU, pulsed EMF). Short-term exposures were: (E1) whole-body exposure from the EAS gate when sitting within 3 m; (E2) local exposure to transient IF-EMF while passing through or beside the EAS gate; and (E3) local exposure to a pulsed magnetic field on BCU use. E1-E3 were evaluated based on exposure levels relative to magnetic flux density at the occupational reference level (RL; E1) or as per occupational basic restrictions (BR; E2 and E3) delineated by the International Commission on Non-Ionizing Radiation Protection (ICNIRP) 2010 guidelines. Exposure indices based on mid-term exposure (D1-D3), assuming exposure according to employment on a weekly basis, were used to assess exposure in actual working conditions. D1 represents continuous exposure from an EAS gate when sitting within 3 m of the gate. D2 and D3 represent repeated transient exposures occurring during gate pass or on the operation of a BCU. A link to a web-based questionnaire was distributed to librarians working at all libraries where the authors had mailed institutional questionnaires (4,073 libraries). Four exposure patterns were defined according to various exposure scenarios., Results: We obtained information on exposure parameters and working conditions from the 548 completed questionnaires. The ICNIRP guideline levels were not exceeded in any of the E1-E3 scenarios. Median of the D1 (% ICNIRP RL × hour/week) was 1, and >85% respondents had values <10. However, the maximum value was 513. Altogether, these results indicate that continuous exposure was low in most cases. The same tendency was observed regarding repeated transient exposure from EM-EAS gates (i.e., the median value for D2 (% ICNIRP BR × gate pass) was 5). However, there were several cases in which D1 and D2 values were >10 times the median. The median of D3 (% ICNIRP BR × BCU operation) was 10, and most respondents' D3 values were greater than their D2 values, although the derived results depended on the assumptions made for the estimation., Conclusion: We conducted an assessment of combined exposures to IF-EMF and pulsed EMF among library workers in Japan by evaluating both short-term exposures (E1-E3) and exposure indices based on mid-term exposures (D1-D3) assuming actual working conditions per questionnaire results. These results provide useful information for future epidemiological studies., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Yamaguchi-Sekino, Taki, Ikuyo, Esaki, Aimoto, Wake and Kojimahara.)

Exposure to magnetic fields from the electronic article surveillance (EAS) gate was evaluated in consideration of the application to epidemiological studies of library workers who are exposed continually to intermediate frequency magnetic fields from the EAS gate. Two types of exposures were investigated. One was transient exposure due to passing through or beside the gate and another was chronic exposure in the room. We measured magnetic fields from five EAS gate models which were commonly used in libraries in Japan. Detailed measurements were performed for two of them in consideration of the phase difference of vector components of magnetic flux density. The polarization of the magnetic field in the gate was investigated with the index of ellipticity. The induced electric field in a human body was numerically calculated for exposures to magnetic fields of the two gate models. The results provide a quantitative understanding of exposures during passing through or by the EAS gate. Magnetic field distribution was measured in a large room for one gate model to quantify the chronic exposure of library workers during the work at the desk. It was found that the magnetic field was distributed as a function of the horizontal distance to the nearest gatepost. The 45-point average value B IEC defined by the IEC standard was suggested to be a useful quantity to characterize the magnitude of the magnetic field from the EAS gate. Exposures to different EAS gates are expected to be compared through this quantity without detailed measurements. These results are expected to provide useful means for exposure assessment of epidemiological studies on the association between the IF-EMF exposure and possible health outcomes., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Ikuyo, Esaki, Aimoto, Wake, Yamaguchi-Sekino, Kojimahara, Suzuki and Taki.)

Aim: Investigating the risks of diabetes complications among inpatients with diabetes associated with longest-held and current occupations., Method: Using a Japanese nationwide, multicenter, hospital inpatient dataset (2005-2015), a matched case-control study with 39,550 inpatients with diabetes was conducted. We considered both the longest-held and current occupations of the study subjects., Result: Diabetes complications such as retinopathy, nephropathy, neuropathy, and peripheral vascular complications occur more often in managers, sales workers, service workers, transportation workers, construction and mining workers and carrying, cleaning and packing workers. Among these occupations, particularly the service workers indicated consistently significant increased risks (OR = 1.36 (1.23-1.51)) in developing all the considered subtypes of diabetes complications, and the performed sensitivity analysis confirmed this conclusion. Moreover, among service workers, cooks, waiters, building service staff and other service workers were identified as having the highest risks in developing diabetes complications (ORs = 1.30 (1.12-1.51), 1.63 (1.36-1.95), 1.79 (1.21-2.67), and 2.05 (1.30-3.22), respectively)., Conclusions: Our study's potential translational impact should lead to subsequent investigations on the causes connected to certain occupations of various diabetes complications and particularly to more carefully dealing with patients with diabetes who work in the identified occupational areas and their health risks., (Copyright © 2022 The Authors. Published by Elsevier B.V. All rights reserved.)

Background: 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., Materials and Methods: 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., Results: 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])., Conclusions: 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.

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., (© 2021. The Author(s).)

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.

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., (© 2020 The Authors. Cancer Science published by John Wiley & Sons Australia, Ltd on behalf of Japanese Cancer Association.)

To clarify whether medical radiation exposure, especially from head computed tomography (CT), increases the risk of brain tumours in young patients in Japan, which ranks the second highest in the world in the number of paediatric CT examinations following the US. From 2011 to 2015, we performed a case-control study of 120 brain tumour patients and 360 appendicitis patients as controls. Reasons, the number of brain and head CT scans date were available from interviews. A cumulative radiation dose to the brain was calculated as a sum of doses received from head CT scans and from conventional X-rays and estimated using a reference table derived from a literature review of published studies. We performed conditional logistic regression to assess the risk of brain tumours from brain and head CT, and from conventional head X-ray procedures. The case group received on average 1.8 CTs to the brain area and 2.2 CTs to the whole head, with a mean estimated brain dose of 32 ±13 mGy. The odds ratio for developing a brain tumour from having a brain CT was 0.93 (95% confidence interval: 0.38-1.82). This was hardly altered when adjusting for parental educational history and for other diseases (history of neurological disease and attention-deficit disorder/attention-deficit hyperactivity disorder). Neither whole head CT nor cumulative brain dose to the brain increased the risk of glioma or of all brain tumours. Although this study conducted in Japan, where ranks second in the number of CT scans conducted in the world, did not show an increased risk of brain tumours related to CT scans, it should be taken with caution due to a case-control study with limited sample size., (Creative Commons Attribution license.)

In recent years, equipment that generates intermediate-frequency electromagnetic fields (IF-EMFs) has become increasingly prevalent, and the influence of IF-EMFs on human health is thus attracting increasing attention. The present study was conducted with the aim of analyzing whether there is a relationship between the penetration of induction heating cookers and birth outcomes using an ecological study design at the prefectural level. We created data sets for all 47 prefectures in Japan using previously published statistics. Spontaneous fetal death rate, fetal death rate after 22 weeks of pregnancy, perinatal mortality rate, and proportion of newborns weighing less than 2500 g were used as birth outcomes in correlation analysis. A weak positive association was observed between the penetration of induction heating cookers and the fetal death rate after the 22nd week of pregnancy (r = 0.27, p = 0.07), but it was not statistically significant. In addition, a weak negative association was observed between the penetration of induction heating cookers and the spontaneous fetal death rate (r = -0.27, p = 0.07), but it was not statistically significant. In the present ecological study, no statistically significant association were shown between the penetration of induction heating cookers and birth outcomes. To demonstrate further the safety of induction heating cooker use, observations in epidemiological studies of other designs should be considered., Competing Interests: Conflict of interest: All authors declare no conflicts of interest in this paper., (© 2020 the Author(s), licensee AIMS Press.)

Introduction: We used data from MOBI-Kids, a 14-country international collaborative case-control study of brain tumors (BTs), to study clinical characteristics of the tumors in older children (10 years or older), adolescents and young adults (up to the age of 24)., Methods: Information from clinical records was obtained for 899 BT cases, including signs and symptoms, symptom onset, diagnosis date, tumor type and location., Results: Overall, 64% of all tumors were low-grade, 76% were neuroepithelial tumors and 62% gliomas. There were more males than females among neuroepithelial and embryonal tumor cases, but more females with meningeal tumors. The most frequent locations were cerebellum (22%) and frontal (16%) lobe. The most frequent symptom was headaches (60%), overall, as well as for gliomas, embryonal and 'non-neuroepithelial' tumors; it was convulsions/seizures for neuroepithelial tumors other than glioma, and visual signs and symptoms for meningiomas. A cluster analysis showed that headaches and nausea/vomiting was the only combination of symptoms that exceeded a cutoff of 50%, with a joint occurrence of 67%. Overall, the median time from first symptom to diagnosis was 1.42 months (IQR 0.53-4.80); it exceeded 1 year in 12% of cases, though no particular symptom was associated with exceptionally long or short delays., Conclusions: This is the largest clinical epidemiology study of BT in young people conducted so far. Many signs and symptoms were identified, dominated by headaches and nausea/vomiting. Diagnosis was generally rapid but in 12% diagnostic delay exceeded 1 year with none of the symptoms been associated with a distinctly long time until diagnosis.

Background: We explored the association between ionizing radiation (IR) from pre-natal and post-natal radio-diagnostic procedures and brain cancer risk within the MOBI-kids study., Methods: MOBI-kids is an international (Australia, Austria, Canada, France, Germany, Greece, India, Israel, Italy, Japan, Korea, New Zealand, Spain, The Netherlands) case-control study including 899 brain tumor (645 neuroepithelial) cases aged 10-24 years and 1,910 sex-, age-, country-matched controls. Medical radiological history was collected through personal interview. We estimated brain IR dose for each procedure, building a look-up table by age and time period. Lifetime cumulative doses were calculated using 2 and 5 years lags from the diagnostic date. Risk was estimated using conditional logistic regression. Neurological, psychological and genetic conditions were evaluated as potential confounders. The main analyses focused on neuroepithelial tumors., Results: Overall, doses were very low, with a skewed distribution (median 0.02 mGy, maximum 217 mGy). ORs for post-natal exposure were generally below 1. ORs were increased in the highest dose categories both for post and pre-natal exposures: 1.63 (95% CI 0.44-6.00) and 1.55 (0.57-4.23), respectively, based on very small numbers of cases. The change in risk estimates after adjustment for medical conditions was modest., Conclusions: There was little evidence for an association between IR from radio-diagnostic procedures and brain tumor risk in children and adolescents. Though doses were very low, our results suggest a higher risk for pre-natal and early life exposure, in line with current evidence., (© 2020 S. Karger AG, Basel.)

Objective: To investigate the effect of guidelines for management of febrile seizures on the clinical practice, we conducted a nationwide survey in Japan., Methods: The Japanese guidelines for management of febrile seizures 2015 (GL2015) was released in 2015. In 2016, a questionnaire was sent to all 512 certified hospitals (3 pediatricians each) of the Japan Pediatric Society and all 47 prefecture Pediatric Associations (10 private pediatricians each) in Japan asking about management policies for febrile seizures (FSs) during 2013-2014 and 2016. The questionnaires were about the following procedures: (1) lumbar punctures, blood examinations, and diazepam suppositories for children after a first simple FS at emergency departments; and (2) prophylactic diazepam during febrile illnesses in children with two or three past simple FSs, with no known predictors of recurrence., Results: A total of 1327 pediatricians (66.2%) answered the questionnaire. Numbers of pediatricians performing lumbar punctures and blood examinations, and giving diazepam suppositories after a first simple FS were less in 2016 than in 2013-2014 (1.2% and 2.0%, 53.1% and 61.3%, and 36.7% and 51.9%, respectively). Pediatricians recommending prophylactic diazepam for children with two and three FSs decreased from 45.7% and 82.4% in 2013-2014 to 31.0% and 65.0% in 2016, respectively., Conclusion: GL2015 had an effect on the clinical practices of pediatricians. On the other hand, 65% recommended prophylactic diazepam to children with three simple FSs even though GL2015 did not recommend use of diazepam based on number of previous FS. Anxiety about frequent seizures may affect pediatricians' clinical practice., (Copyright © 2019 The Japanese Society of Child Neurology. Published by Elsevier B.V. All rights reserved.)

Over 20 years have passed since the initial spread of mobile phones in Japan. Epidemiological studies of mobile phone use are currently being conducted around the world, but scientific evidence is inconclusive. The present study aimed to simulate the incidence of malignant brain tumors in cohorts that began using mobile phones when they first became popular in Japan. Mobile phone ownership data were collected through an Internet-based questionnaire survey of subjects born between 1960 and 1989. The proportion of mobile phone ownership between 1990 and 2012 was calculated by birth cohort (1960s, 1970s, and 1980s). Subsequently, using the ownership proportion, the incidence of malignant brain tumors was calculated under simulated risk conditions. When the relative risk was set to 1.4 for 1,640 h or more of cumulative mobile phone use and the mean daily call duration was 15 min, the incidence of malignant brain tumors in 2020 was 5.48 per 100,000 population for the 1960s birth cohort, 3.16 for the 1970s birth cohort, and 2.29 for the 1980s birth cohort. Under the modeled scenarios, an increase in the incidence of malignant brain tumors was shown to be observed around 2020. © 2019 Bioelectromagnetics Society., (© 2019 Bioelectromagnetics Society.)

With rapid aging of the world's population, the demand for research, for a better understanding of aging and aging-related disorders, is increasing. Ideally, such research should be conducted on human subjects. However, due to ethical considerations, animals such as rodents and monkeys are used as alternatives. Among these alternative models, non-human primates are preferred because of their similarities with humans. The small South American common marmoset (Callithrix jacchus) may offer several advantages over other non-human primates in terms of its smaller size, shorter life-span, and dental anatomy identical to humans. The purpose of this study was to determine the viability of using the marmoset as a human oral disease model. We collected saliva samples from eight marmosets and eight human subjects. Prokaryotic DNA was extracted from the saliva samples, and 16S bacterial rRNA gene sequencing was performed on each of the samples. Our results indicated that the types of oral microbiomes detected among human and marmoset samples were nearly indistinguishable. In contrast, the oral microbiomes of our human and marmoset subjects were distinctly different from those reported for rats and dogs, which are currently popular research animals. The oral microbiomes of marmosets showed greater diversity than those of humans. However, the oral microbiota of marmosets exhibited less variation than those of humans, which may be attributed to the fact that the marmoset subjects were kept in a controlled environment with identical lifestyles. The characteristics of its oral microbiota, combined with other technical advantages, suggest that the marmoset may provide the best animal model thus far for the study of oral health. This study characterized the oral microbes of the marmoset, thereby providing information to support future application of the marmoset as a model for age-related oral disease., Competing Interests: The following authors are affiliated with CLEA Japan, Inc.: KK and KF. The commercial affiliation with CLEA Japan, Inc. does not alter our adherence to PLOS ONE policies on sharing data and materials.

Background: MOBI-Kids is a 14-country case-control study designed to investigate the potential effects of electromagnetic field exposure from mobile telecommunications devices on brain tumor risk in children and young adults conducted from 2010 to 2016. This work describes differences in cellular telephone use and personal characteristics among interviewed participants and refusers responding to a brief nonrespondent questionnaire. It also assesses the potential impact of nonparticipation selection bias on study findings., Methods: We compared nonrespondent questionnaires completed by 77 cases and 498 control refusers with responses from 683 interviewed cases and 1501 controls (suspected appendicitis patients) in six countries (France, Germany, Israel, Italy, Japan, and Spain). We derived selection bias factors and estimated inverse probability of selection weights for use in analysis of MOBI-Kids data., Results: The prevalence of ever-regular use was somewhat higher among interviewed participants than nonrespondent questionnaire respondents 10-14 years of age (68% vs. 62% controls, 63% vs. 48% cases); in those 20-24 years, the prevalence was ≥97%. Interviewed controls and cases in the 15- to 19- and 20- to 24-year-old age groups were more likely to have a time since start of use of 5+ years. Selection bias factors generally indicated a small underestimation in cellular telephone odds ratios (ORs) ranging from 0.96 to 0.97 for ever-regular use and 0.92 to 0.94 for time since start of use (5+ years), but varied in alternative hypothetical scenarios considered., Conclusions: Although limited by small numbers of nonrespondent questionnaire respondents, findings generally indicated a small underestimation in cellular telephone ORs due to selective nonparticipation.

Objectives: We are responsible for answering the research question, "Does a return-to-work program improve the returning outcome?" This is one of the six research questions in the evidence-based "Return-to-work Guidance in Occupational Health 2017" developed by the Kanto branch of the Japanese Society of Occupational Health. This study aimed to integrate the effectiveness of the return-to-work program to improve the state of sick-listed employees suffering from cardiovascular disease, cancer, and musculoskeletal and mental health problems., Methods: Three different databases, PubMed, Cochrane Library, and Ichushi-Web were searched. Based on the results of a systematic review, the guidance developing group created the draft of the recommendations with evidence to decision framework and used a poll to determine the recommendations. We integrated the evidence from a systematic review and meta-analysis at the disease level. This study protocol was registered with PROSPERO (the registration number is: CRD42016048937)., Results: A total of five articles on musculoskeletal diseases and six on mental health problems were retrieved. No articles in the cardiovascular and cancer areas matched the eligibility criteria. When workers suffered from musculoskeletal disorders, the rehabilitation group statistically returned to work earlier than the usual care group did [HR 1.58 (95% CI 1.26-1.97), -40.71days (95% CI -60.69--20.72) ]. In the mental health problems group, the psychological intervention program group had statistically less days of sick leaves as compared to that in the usual care group [-18.64 days (95% CI -27.98--9.30) ]., Conclusions: It might be suggested that work environment management, work management, tackling psychological problems, cognitive behavioral approach, and several meetings with supervisors and occupational health staff, in addition to a direct focus on backache contributed to the early return-to-work of workers suffering from musculoskeletal disease. Regarding mental health problems, interviews with a psychological approach and consultations with psychologists and psychiatrists might be effective in reducing the days of sick leaves. However, because these methods were investigated in Europe, we need to be careful when introducing these practises in Japan due to the differences in the occupational health support systems. Further, high quality evidence level studies are needed in Japan.

Objective: "Return-to-work Guidance in Occupational Health 2017 (RTW Guidance 2017) " is the first occupational health guide in Japan that evaluates the quality of evidence and offers recommendations based on results of the systematic review of randomized controlled trials. Details of the systematic review of each review question (RQs) will be described separately. This article presents an overview of the method and process of developing the "RTW Guidance 2017.", Materials and Methods: The guidance was developed following the previously-published "Method for developing evidence based occupational health guidance," which included the composition of a highly-transparent guidance developing group as well as the recruitment and selection of RQs. Using the Cochrane Library, PubMed, and Ichushi-Web, a literature search for the six RQs was conducted in January 2016 by partly modifying the search terms of the existing systematic review. Articles were selected according to the inclusion criteria, and the quality of evidence was evaluated using the GRADE approach. Meta-analysis was conducted for RQ2 and RQ4, and a qualitative systematic review was conducted for RQ5, RQ6, and cost-effectiveness. Recommendations were subsequently made after a thorough consideration for feasibility in Japan by examining the costs and available resources., Results: Based on a comprehensive literature search, eleven RQ2, four RQ4, one RQ5, and three RQ6 were selected. Support program for returning to work, such as "Re-work" for those who are temporarily not working due to musculoskeletal disorders or mental health disorder, was recommended based on moderate evidence (RQ2). For RQ4, the collaboration between occupational health practice and clinical practice was weakly recommended based on low evidence. For RQ5 that evaluated the usefulness of social support, intervention by the manager/co-worker was proposed as a "best practice statement" without indicating it as a recommendation. Work accommodation was weakly recommended based on low evidence in RQ6., Discussion and Conclusion: From the result of systematic reviews, it was recommended for workers on sick leave more than four weeks regardless of sick leave and sickness absence that interventions during leave would improve work-related outcomes, such as earlier reinstatement. Although there is limited evidence regarding occupational health in Japan, it is important for many occupational health professionals to learn the method of developing guidance and to identify issues for future studies with priority in Japan.

The effectiveness of dissemination of public-access automated external defibrillators (AEDs) has been well established for adults, but not for children at the population level. We obtained out-of-hospital cardiac arrest (OHCA) data between January 2005 and December 2014 from a nationwide OHCA registry of Japan. Our study subjects were OHCA cases aged 6 to 17, involving attempted resuscitation by emergency medical service personnel or by bystanders. The primary outcome measure was 1-month survival with favorable neurological outcome after OHCA. We evaluated trends in the proportion of OHCA cases receiving shocks by a public-access AED and outcomes after OHCA over the 10-year study period. Prehospital factors associated with 1-month survival with favorable neurological outcome were also evaluated. During the 10-year study period, a total of 5,899 OHCAs occurred in school-age children, and 1,452 (24.6%) were of cardiac origin. The overall OHCA incidence rate in school-age children was 4.2 per 100,000 people per year. The proportion of patients with OHCA who received shocks by a public-access AED increased significantly during the study period (0.1% in 2005 and 6.4% in 2014, p for-trend <0.001). Accordingly, the 1-month survival with favorable neurological outcome improved significantly (5.3% in 2005 and 9.0% in 2014, p for-trend <0.001). In multivariable analysis, receiving shocks by a public-access AED was significantly associated with improved outcomes (adjusted odds ratio 2.13, 95% confidence interval 1.43 to 4.15; p <0.001). In conclusion, the significant increase in receiving shocks by a public-access AED was followed by a substantial improvement in patient outcomes after OHCA in school-age children in Japan., (Copyright © 2018 Elsevier Ltd. All rights reserved.)

Purpose: Few studies have investigated the work continuance rate among stroke survivors who return to work (RTW). The objective of this study was to investigate work sustainability after RTW and the causes of recurrent sickness absence (RSA) among Japanese stroke survivors., Methods: Data on stroke survivors were collected from an occupational health register. The inclusion criteria were as follows: employees who were aged 15-60 years old and returned to work after an episode of sick leave due to a clinically certified stroke that was diagnosed during the period from 1 January 2000 through 31 December 2011., Results: 284 employees returned to work after their first episode of stroke-induced sick leave. The work continuance rate for all subjects was 78.8 and 59.0% at one and 5 years after the subjects' RTW, respectively. After returning to work, the subjects worked for a mean of 7.0 years. Of 284 employees who returned to work, 86 (30.3%) experienced RSA. The RSA were caused by recurrent strokes in 57.0% (49/86) of cases, mental disorders in 20.9% (18/86) of cases, and fractures (often due to accidents involving steps at train stations or the subject's home) in 10.5% (9/86) of cases. 21 employees resigned after returning to work. The resignation rates at 1 and 5 years were 4.9 and 7.6%, respectively. According to the multivariate analysis including all variables, the subjects in the ≥ 50 year group were at greater risk of work discontinuation than the ≤ 49 year (reference) age group (HR: 2.26, 95% CI 1.39-3.68)., Conclusions: Occupational health professionals need to provide better RTW support to stroke survivors and should pay particularly close attention to preventing recurrent strokes, mental disorders, and fractures.