Journal of Epidemiology最新文献

Background: The potential impacts of polygenic scores (PGS) on health-behavior changes are not fully understood. The Iwate PGS Assessment and Risk Communication Study aims to investigate the effects of reporting PGS-based risk for ischemic stroke on health behaviors.

Methods: Participants wishing to know their PGS-based ischemic stroke risk were recruited from health checkup venues for workers in Iwate Prefecture in 2023. Health checkup data, biospecimens, and questionnaire responses were collected for biochemical testing, genotyping, and storage in the Tohoku Medical Megabank integrated biobank. The risk was calculated using an integrative PGS model for East Asians. Participants were randomly assigned to two groups, and one group received their risk report as the intervention group. The impacts of the risk notification will be investigated in follow-up surveys.

Results: Of 3,599 workers, 2,088 participated in the study (consent rate, 58.0%). The demographic profile of the eligible 2,083 participants was as follows: 80.7% males, and dominance of participants aged 18-29 years (25.2%), in their 30's (25.3%), and in their 40's (24.7%). Two hundred participants (9.7%) had a risk of 1.0 as the reference; 57 (2.7%), 927 (44.7%), and 888 (42.9%) participants had 2.1-3.4-, 1.4-1.9-, and <1.0-fold that risk, respectively.

Conclusion: We collected health information and biospecimens from over 2,000 workers, and disclosed the PGS-based ischemic stroke risk. Behavioral effects will be evaluated 1 year after disclosure, with follow-up until 2030. As Japan's first large-scale PGS risk communication study, it will provide initial insights for implementing PGS in personalized preventive medicine.

BackgroundIn 2023, a collaborative UNICEF-WHO group introduced the concept of small vulnerable newborns (SVNs) to improve the identification of newborns at increased risk of adverse outcomes and to guide more effective preventive strategies. However, global data on the prevalence of SVNs remains scarce. This study aimed to examine secular trends in the prevalence of SVNs and their three subgroups, namely term small for gestational age (SGA), preterm SGA, and preterm non-SGA, in the Japanese population.MethodsWe analyzed data from vital statistics including livebirths and stillbirths between 1997 and 2021. Secular trends in the prevalence of SVNs and their subgroups were assessed. In addition, we conducted regional analyses to explore associations with the distribution of medical resources.ResultsA total of 26,172,760 newborns were included. The overall prevalence of SVNs was 7.8% in 1997, peaked at 8.7% in 2005, and declined to 7.7% by 2021. This decline was primarily attributed to a reduction in term SGA births. In contrast, the prevalence of preterm SGA and preterm non-SGA remained largely unchanged. In 2021, the prevalence of term SGA, preterm SGA, and preterm non-SGA was 2.0%, 0.44%, and 5.3%, respectively. No significant association was found between the regional variation in the prevalence of SVNs and the distribution of medical resources.ConclusionThe prevalence of SVNs in Japan has declined since 2005, mainly due to reduced term SGA births. Persistent rates of preterm subgroups highlight the ongoing burden of prematurity, underscoring the need for targeted strategies to improve neonatal outcomes.

Background: Brief measures of 24-hour movement behaviors are needed to easily evaluate their durations. The present study investigated the criterion validity and test-retest reliability of a brief self-report instrument to assess 24-hour movement behaviors.

Methods: A paper-based self-administered questionnaire was used to assess sleep, sedentary behavior (SB), light-intensity physical activity (LPA), and moderate-to-vigorous physical activity (MVPA) with four items in 35 healthy adults. Participants wore a tri-axial accelerometer and answered the questionnaire on the final day of the accelerometry assessment and after 14 days. Spearman's correlations of self-reported measures with their accelerometer-derived counterparts were assessed and median values compared by Mann-Whitney U-tests. Bland-Altman plots were employed to characterize differences in self-reported and device-measured time in the behaviors and their limits of agreement. Test-retest reliability was assessed using Intra-class correlation coefficients (ICCs).

Results: Moderate correlations with device measures for sleep, SB, and LPA for a typical and the past week (rho = 0.46 to 0.60) and low correlations for MVPA (rho = 0.33 to 0.47) were observed. Less duration of sleep and MVPA were reported compared with accelerometer-derived durations for the three recall periods (z = -3.9 to -2.5 and -4.0 to -3.5, respectively). The test-retest reliability for a typical week was fair-to-good or excellent for all the four behaviors (ICCs = 0.72 - 0.90).

Conclusion: Findings show acceptable validity and reliability of this questionnaire measure of 24-hour movement behaviors for typical week, past week and previous day recall periods.

The Iodine Status in Pregnancy and Offspring Health Cohort (ISPOHC) was initiated in Shanghai to address the need for a comprehensive and longitudinal study on iodine nutrition and its effects on maternal and offspring health. The findings based on the Shanghai population can serve as a reference for other megacities experiencing significant dietary changes simultaneously. ISPOHC utilized a stratified cluster random sampling design, enrolling 5,099 pregnant women from all 16 districts of Shanghai. The survey has been conducted in three phases. Data collected at different time points include health status, living habits, dietary intake, birth, feeding, early development, anthropometric measurements, and biomarkers, allowing for an in-depth evaluation of iodine nutrition's impact on offspring development. Data were collected through a combination of questionnaires, home visits, anthropometric measurements, and biological sample collection. The integration of detailed food investigation and on-site weighing of household seasonings provides a more precise assessment of dietary iodine intake, particularly iodized salt consumption, distinguishing this study. The study has provided significant insights into the relationship between iodine nutrition during pregnancy and various health outcomes.

Background: The interaction and substitution effects of physical activity (PA) and sitting time (ST) living in non-western countries have not been well investigated. This study aimed to examine the association of moderate-to-vigorous physical activity (MVPA) and ST with disability and mortality in older adults.

Methods: This prospective study analyzed data from 10,164 adults aged over 65 years who participated in the Kyoto-Kameoka study in Japan. We evaluated MVPA and ST using the validated International Physical Activity Questionnaire-Short Form. Participants were categorized into four groups based on their levels of MVPA (150 min/week) and ST (300 min/day): low MVPA/high ST, low MVPA/low ST, high MVPA/high ST, and high MVPA/low ST. Outcomes were gathered between July 30, 2011, and November 30, 2016.

Results: Over a median follow-up of 5.3 years (45,461 person-years), 2,273 disability cases were documented. The low MVPA/high ST groups were associated with higher disability risk than those in the high MVPA/low ST groups (hazard ratio [HR] 1.52; 95% confidence interval [CI], 1.31-1.75), and the interaction between MVPA and ST accounted for 48.5% of the relative excess risk of disability in the low MVPA/high ST group (P for interaction = 0.006). Daily replacement of 10 minutes of ST with 10 minutes of MVPA was associated with a reduced risk of disability (HR 0.980; 95% CI, 0.971-0.989) and all-cause mortality (HR 0.975; 95% CI, 0.962-0.988).

Conclusion: These findings indicate that even a small substitution of ST with MVPA could help lower both the risk of disability and mortality.

Background: We examined the association between the coronavirus disease 2019 (COVID-19)-specific prefectural bed utilization rate and in-hospital mortality during the first 3 years of the pandemic in Japan.

Methods: This nationwide study included 58,175 COVID-19 patients from the COVID-19 Registry Japan, hospitalized between May 1, 2020 and November 30, 2022. Based on the weekly COVID-19-specific bed utilization rate in each prefecture at diagnosis, patients were categorized into four groups (<25%, 25% to <50%, 50% to <75%, and ≥75%). Odds ratios (ORs) were estimated by fitting a generalized linear mixed model with prefecture as a random intercept and adjusting for covariates (age, gender, body mass index, smoking and drinking status, and comorbidities). Additional analyses according to age group, gender, and wave of the pandemic were conducted.

Results: We observed 2,312 (4.0%) all-cause in-hospital deaths. All-cause in-hospital mortality increased with higher COVID-19 bed utilization rates at diagnosis (OR for multivariable model 1.35; 95% confidence interval [CI], 1.19-1.54 for 25% to <50%; OR 1.89; 95% CI, 1.66-2.16 for 50 to <75%; OR 2.16; 95% CI, 1.80-2.58 for ≥75%; P for trend <0.0001). Stronger associations were noted among the younger population (aged <70 years: OR 3.18; 95% CI, 1.96-5.19) and during the fourth (March 1-June 30, 2021: OR 3.81; 95% CI, 2.13-6.80) and sixth pandemic waves (January 1-June 30, 2022: OR 2.67; 95% CI, 1.68-4.23).

Conclusion: Our results emphasize that preventing hospital bed shortages during outbreaks is an important public health strategy to reduce the associated mortality, particularly when new strains emerge and in younger people.

Background: The discomfort experienced due to residual tobacco smoke, a form of thirdhand smoke exposure brought into workplaces by smokers, and its health impacts on non-smokers have been inadequately investigated. This study explored associations between non-smokers' discomfort and work performance and mental health.

Methods: This observational internet-based survey was conducted in 2021 as part of the Japan Society and New Tobacco Internet Survey. Participants comprised 6,519 adult workers without firsthand or secondhand smoking. Work performance and mental health were evaluated using the Work Functioning Impairment Scale (WFun) and Kessler Psychological Distress Scale (K6), respectively. The proportion of participants who experienced discomfort from the residual tobacco smoke in their workplace by smokers in the previous year was calculated according to the workplace's smoke-free policy, and the difference was assessed using the χ² test. The association between such discomfort and WFun and K6 scores was examined using univariable and multivariable logistic regression analyses.

Results: Among respondents, 17.1% reported experiencing discomfort due to the residual tobacco smoke. A strict smoke-free workplace policy was associated with a lower proportion of respondents experiencing such discomfort (P < 0.001). Those who experienced discomfort more frequently had significantly higher scores on the WFun (15.5% "never", 21.3% "sometimes", 26.2% "frequently") and K6 (37.8% "never", 48.2% "sometimes", 50.8% "frequently"). Adjusting for potential covariates in multivariable analyses did not change these results.

Conclusion: Discomfort from thirdhand smoke was associated with worse work performance and mental health problems. Promotion of strict smoke-free workplace policies is required to reduce such experiences.