Environmental Health and Preventive Medicine最新文献

Background: This study examined the association between neurological symptoms and quality of life (QoL) in patients with neurofibromatosis type 2 (NF2) using a national database of all patients who newly claimed for medical expense subsidies in Japan from 2015 to 2019.

Methods: The Japanese Ministry of Health, Labour and Welfare provided access to the "National Database of Designated Intractable Diseases of Japan" containing the "Medical Certificates of Designated Intractable Diseases" of all patients with NF2. The database included information on five items of QoL: "mobility," "self-care," "usual activities," "pain/discomfort," and "anxiety/depression." To examine the association between the presence/absence of neurological symptoms and QoL, multivariable logistic regression analyses were performed, adjusted for potential confounders.

Results: Data from 187 patients (97 females and 90 males; mean (standard deviation) age, 43.1 (17.9) years) were analyzed. Overall, 31% to 55% of patients were recorded as having moderate/severe impairment of QoL. Spinal dysfunction was significantly associated with deterioration of all components of QoL, whereas speech dysfunction and hemiparesis were specifically associated with physical health-related components of QoL. Spinal dysfunction, facial nerve palsy, and age 25-64 years were significantly associated with "anxiety/depression."

Conclusions: In the present epidemiological study using a national database of NF2 in Japan, spinal dysfunction was significantly associated with deterioration of all components of QoL, including subjective and mental health-related components of QoL, whereas speech dysfunction and hemiparesis were specifically associated with physical health-related components of QoL.

Background: Identifying treatment targets for sarcopenia is a public health concern. This study aimed to examine the association of nocturnal sleep duration and midday napping with the presence of sarcopenia in middle-aged and older adults, utilizing data from the China Health and Retirement Longitudinal Study in 2011 and 2015.

Methods: A sum of 7,926 individuals (≥40 years) took part in this study. Sarcopenia was diagnosed according to the Asian Working Group for Sarcopenia. A self-reported questionnaire was used to collect data on nocturnal sleep duration and midday napping. Nocturnal sleep duration was categorized into three groups: short sleepers (<6 h), normal sleepers (6-8 h), and long sleepers (>8 h). Midday napping was coded as a dichotomous outcome (yes/no).

Results: The incidence of sarcopenia was 5.3% during the 4-year follow-up. Short sleep duration (<6 h) was substantially linked to an increased incidence of sarcopenia (OR: 1.50, 95% CI: 1.21-1.87) as compared to nocturnal sleep length (6-8 h). Adults with midday napping had a lower risk of developing sarcopenia than non-nappers (OR: 0.78, 95% CI: 0.63-0.95). We further found that short sleepers with midday napping did not have a significantly higher risk of subsequent diagnosis of sarcopenia compared to normal sleepers without midday napping.

Conclusion: These findings imply that short sleep duration in middle-aged and older persons is related to an increased incidence of sarcopenia. However, the adverse effect of short sleep duration on sarcopenia can be compensated by midday napping.

Background: Concerns regarding the impact of screen-based sedentary behavior on health have been increasing. Therefore, the present study investigated the longitudinal relationship between multiple screen time and nutrient intake in children and adolescents.

Methods: The present study was conducted utilizing 3 years longitudinal data. Study subjects were 740 Japanese children aged between 6 and 12 years at baseline and between 9 and 15 years in the follow-up. Screen-based sedentary behavior was assessed using screen time, including television (TV) viewing, personal computer (PC) use, and mobile phone (MP) use. The main outcomes were the intakes of nutrients. Mixed effect multivariate linear regression analyses were used to examine the longitudinal relationship between screen-based sedentary time and nutrient intake. Covariates included in the multivariable analysis consisted of sex, age, solitary eating, skipping breakfast, staying up late, and body weight status, as confounders, and physical inactivity, as mediator.

Results: In boys, a longer total screen time longitudinally correlated with higher intake of energy and lower intakes of protein, dietary fiber, minerals, and vitamins. In girls, longer total screen time longitudinally associated with higher intake of sucrose and lower intakes of protein, minerals, and vitamins. In boys, a longer TV viewing time was associated with higher intake of sucrose and lower intakes of protein, minerals, and vitamins. In girls, a longer TV viewing time was associated with higher intake of carbohydrates and lower intakes of protein, fat, minerals, and vitamins. In boys, relationships were observed between a longer PC use time and higher intakes of energy as well as lower intakes of protein, minerals, and vitamins. Relationship was observed between longer PC use time and lower intakes of minerals in girls. An increased MP use time was associated with higher intakes of energy, and lower intakes of protein, sucrose, dietary fiber, minerals, and vitamins in boys. A longer MP use time was associated with higher intakes of fat, and salt as well as lower intakes of carbohydrates, protein, minerals, and vitamins in girls.

Conclusions: The present results revealed that longer screen-based sedentary behaviors were longitudinally associated with nutrient intake in children and adolescents. Future study is needed to elucidate these relationships.

Background: Although social interaction and social support during the "new normal" due to coronavirus disease 2019 (COVID-19) may be related to presenteeism, the effect between these factors has not been clear for Japanese workers. The aim of this study was to describe the presenteeism of Japanese workers with reference to social interaction and social support following the lifestyle changes due to COVID-19 and to assess whether social interaction and social support affected their presenteeism.

Methods: The data were obtained from internet panel surveys from October 2020. Descriptive statistics were calculated, and multiple linear regression was conducted using the data from the first, fourth and fifth surveys, which were conducted during October to November 2020, July to August 2021, and September to October 2021, respectively. To measure presenteeism, questions from "absenteeism and presenteeism questions of the World Health Organization's Heath and Work Performance Questionnaire", short version in Japanese was utilized. Multiple linear regressions were conducted to investigate the effects of social interaction and social support-related factors on presenteeism.

Results: A total of 3,407 participants were included in the analysis. The mean score of absolute presenteeism from the fifth survey was 58.07 (SD = 19.71). More time spent talking with family, a larger number of social supporters and a higher satisfaction level for social support were associated with a higher absolute presenteeism score.

Conclusions: Our results suggested that social support reduced the presenteeism of the Japanese workers during the "new normal" due to the COVID-19 pandemic. Social interaction with family also relieved presenteeism.

Background: Social relationships are essential in maintaining the physical and mental health of mothers and their children. However, there is limited evidence on how social support provided to the mother during pregnancy could impact child development. Herein, we examined whether maternal social support levels during pregnancy was associated with the risk of developmental delay in 3-year-old children.

Methods: Overall, 68,442 mother-child pairs completed questionnaires on maternal social support during pregnancy and development delay in 3-year-old children. The maternal social support level was evaluated using four items. The risk of development delay was evaluated using the Japanese version of the Ages and Stages Questionnaire-3 (ASQ-3) with five domains of communication, gross motor, fine motor, problem-solving, and personal-social. Odds ratios (OR) and 95% confidence intervals (CI) were calculated using logistic regression according to the quintiles of maternal social support levels after adjusting for potential confounding factors.

Results: Social support during pregnancy was associated with a lower risk of development delay at 3 years of age. Beneficial effects were detected in all domains of the ASQ-3 (p for trend <0.001). Multivariable ORs (95% CIs) for the highest versus lowest quartiles of maternal social support level were 0.57 (0.50-0.65) for communication, 0.49 (0.43-0.55) for gross motor delay, 0.58 (0.53-0.64) for fine motor delay, 0.56 (0.51-0.62) for problem-solving delay, and 0.52 (0.45-0.60) for personal social delay. The associations remained unchanged when stratified by maternal education level, paternal education level, living with children, household income, and postpartum depression.

Conclusion: Maternal social support during pregnancy was inversely associated with the risk of developmental delay at 3 years of age.

Background: The developing brains are sensitive to methylmercury (MeHg). However, the exposure to MeHg in baby foods and toddler meals remains unknown. This study aimed to determine MeHg intake from baby food or toddler meals, and to investigate the relationship with child hair total mercury (THg).

Methods: A total of 3 days of 24-hour dietary diet and hair samples were collected from 260 consenting children aged 0-5 years. We measured the concentrations of THg and MeHg in the diet and THg in the hair.

Results: The results of measuring THg were below both the method detection and method quantification limits or either of both in powdered milk (93.8%), 5-6 months (53.3%), and 7-8 months (39.5%). The median daily THg intake was 20.3 (95% confidence interval 0.72-232.5) ng/kgbw. MeHg was not detected in 213 samples with dietary THg concentrations below 1 ng/g. The MeHg concentration with THg concentrations of 1 ng/g or higher was 1.70 (0.87-6.21) ng/g, and MeHg percentage in THg was 90.0%. To estimate MeHg intake, we multiplied the THg concentration by 90.0%, resulting in an estimated MeHg intake of 18.3 (0.65-209.2) ng/kgbw/day. The THg in children's hair was 1.05 (0.31-3.96) ppm, and a weak positive correlation was observed between hair THg and dietary MeHg (r = 0.170).

Conclusions: This study highlights the accurate estimation of MeHg intake in children using a duplicate method. Japanese children consume fish, the MeHg intakes exceeded the reference dose and/or provisional tolerable weekly intake in several children. Further discussion based on epidemiological data is required.

Background: Both metabolic syndrome (MetS) and depression are high priority health problems, especially for working age. Numerous studies have explored the link between metabolic syndrome and depression; however, not all of them have consistently demonstrated an association. The objective of this study was to determine whether there is an association between MetS and depression by analyzing extensive real-world data (RWD).

Methods: Our data was drawn from insurance claims and health checkups of local government officials across all prefectures in Japan except for Tokyo in the 2019 fiscal year. According to the number of months with diagnosis of depression and prescription of antidepressants, the study participants were classified into the following categories: Certainly not Depression (CN), Possibly not Depression (PN), Possible Depression (PD), and Certain Depression (CD). Associations between MetS and its components-visceral obesity, hypertension, hyperlipidemia, and diabetes- and these categories of depression were analyzed by logistic regression.

Results: The depression categories of the 130,059 participants were as follows: CN 85.2%; PN 6.9%; PD 3.9%; and CD 4.1%. For men, the adjusted odds ratio (AOR) for MetS were PN 0.94 (95% CI: 0.86-1.02), PD 1.31 (1.19-1.43), and CD 1.63 (1.50-1.76), with reference to CN. For women, AOR of MetS were PN 1.10 (0.91-1.32), PD 1.54 (1.24-1.91), and CD 2.24 (1.81-2.78). Among the MetS components, visceral obesity, hyperlipidemia, and diabetes were significantly associated with depression categories.

Conclusions: In this study, we found a significant association between MetS and depression, this association being similar to that previously reported. Our findings provide robust evidence for linkage between MetS and depression, suggesting that analysis of RWD is useful for providing concrete evidence.

Background: Exposure to fine particulate matter (PM_2.5) has been associated with allergic diseases, including asthma. However, information about the effects of specific PM_2.5 components is limited. This study aimed to investigate the relationship of exposure to chemical components of PM_2.5 during pregnancy and early childhood with the development of asthma, allergies, and sensitization in school-age children.

Methods: This study included 2,408 children in the second grade of elementary school. Questionnaire surveys of respiratory/allergic symptoms and measurements of serum total IgE and specific IgE levels to house dust mite (HDM) and animal proteins were conducted. Exposures to ambient PM_2.5 mass, sulfate (SO₄^2-), nitrate (NO₃^-), ammonium (NH₄⁺), elemental carbon (EC), and organic carbon (OC) of PM_2.5 in participants' residences from conception to age six were estimated using predictive models. Multiple logistic regression analysis was used to analyze the association of respiratory/allergic symptoms and allergen sensitization with estimated exposure concentrations, after adjustment for survey year, sex, season of birth, feeding method during infancy, presence of siblings, history of lower respiratory tract infection, use of childcare facilities, passive smoking, presence of pets, mother's age, history of allergic diseases, smoking during pregnancy, and annual household income.

Results: No significant association was found between PM_2.5 and its component concentrations and asthma. However, wheezing significantly increased with mean NO₃^- concentrations during pregnancy (odds ratio of 1.64 [95% confidence interval: 1.10, 2.47] for an interquartile range increase). Significant associations were also found between EC in the second trimester of pregnancy and PM_2.5, NO₃^-, EC, and OC concentrations in early childhood. Higher PM_2.5, SO₄^-, and NH₄⁺ concentrations during the second trimester increased the risk of rhinitis. Sensitizations to HDM and animal proteins were significantly associated with exposure to components such as SO₄^2- and NH₄⁺ during pregnancy but not with postnatal exposure.

Conclusions: Exposures to NO₃^-, EC, and OC during pregnancy and early childhood were associated with wheezing. SO₄^2- and NH₄⁺ exposures during pregnancy were associated with sensitization to HDM and animal proteins. Asthma was not associated with exposure to PM_2.5 and its main components at any period.

Background: In a study conducted in Kochi Prefecture, Shikoku, Japan, during the early stages of the pandemic in spring 2020, we found that emergency transportations due to acute alcohol intoxication decreased. We aimed to determine how the decline in the number of emergency transportations due to acute alcohol intoxication changed during the four years following the COVID-19 pandemic's onset.

Methods: This study used data of 107,013 emergency transportations from the Kochi-Iryo-Net database, Kochi Prefecture's emergency medical and wide-area disaster information system. We categorized emergency transportation cases according to the diagnoses entered into the system by the attending physician, which were then divided into alcohol- and non-alcohol-related intoxication cases based on the diagnostic codes in the International Classification of Diseases Manual, 10th edition, Clinical Modification. We performed chi-square tests and multiple logistic regression to examine the association between emergency transportations and acute alcohol intoxication.

Results: The number of emergency transportations due to acute alcohol intoxication was 412 (1.8%) in 2019, and it declined to 268 (1.4%), 248 (1.2%), 270 (1.2%), and 283 (1.3%) in 2020, 2021, 2022, and 2023, respectively. After adjusting for confounding factors such as fire department and age, a significant decrease was observed in the subsequent years compared with 2019 (2020: adjusted odds ratio, 0.79; 95% confidence interval, 0.68-0.93; 2021: adjusted odds ratio, 0.74; 95% confidence interval, 0.63-0.87; 2022: adjusted odds ratio, 0.73; 95% confidence interval, 0.62-0.85; 2023: adjusted odds ratio, 0.76; 95% confidence interval, 0.65-0.89).

Conclusions: This study examined changes in emergency transportation due to acute alcohol intoxication during and after the COVID-19 pandemic, especially when social events and other activities returned to "normal." Compared with 2021, which was when emergency transportations due to acute alcohol intoxication were at their lowest, a slight increase was observed in the number of transportations in subsequent years.

Background: The East Asian-specific genetic diversity, the rs671 variant of aldehyde dehydrogenase 2, causes the "Asian flush" phenomenon following alcohol consumption, resulting in an alcohol avoidance phenotype. The variant is suggested as a risk factor for Alzheimer's disease; however, its association with mild cognitive impairment (MCI), an effective target for secondary prevention of dementia, remains unclear.

Method: This cross-sectional study examined 430 individuals aged 60-80 years (251 women) without overt cognitive impairment in Yoshinogari, Japan. The effect of the rs671 variant on MCI, defined by scores <26 or <25 on the Japanese version of the Montreal Cognitive Assessment, was evaluated using multivariate logistic regression.

Results: The models included APOEε4, sex, age, education, history of habitual drinking, Brinkman index, hypertension, diabetes, and subclinical magnetic resonance imaging findings and consistently estimated the risk of the rs671 variant. Subsequently, stratified analyses by history of habitual drinking were performed based on an interactive effect between rs671 and alcohol consumption, and the rs671 variant significantly influenced MCI in participants who did not drink habitually, with odds ratios ranging from 1.9 to 2.1 before and after adjusting for covariates, suggesting an association independent of hippocampal atrophy and small vessel dysfunction. Conversely, no such association with the rs671 variant was observed in participants with a history of habitual alcohol use. Instead, hippocampal atrophy and silent infarcts were associated with MCI.

Conclusions: This is the first study to demonstrate an association between the rs671 variant and MCI morbidity. The findings highlight the need for race-specific preventive strategies and suggest potential unrecognized mechanisms in dementia development.