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Correction to: Associations of physical activity and sedentary time with psychological distress among Japan self-defense forces personnel dispatched overseas: a prospective cohort study. 更正:派驻海外的日本自卫队人员体力活动和久坐时间与心理困扰的关系:一项前瞻性队列研究。
IF 2.6 4区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2025-04-22 eCollection Date: 2025-01-01 DOI: 10.1093/joccuh/uiaf011

[This corrects the article DOI: 10.1093/joccuh/uiae069.].

[这更正了文章DOI: 10.1093/ jocch /uiae069.]。
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引用次数: 0
Association between health literacy and behaviors among shift workers: an observational cross-sectional study with mediation analysis. 轮班工人健康素养与行为的关系:一项具有中介分析的观察性横断面研究。
IF 2.6 4区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2025-03-09 eCollection Date: 2025-01-01 DOI: 10.1093/joccuh/uiae070
Yuko Morikawa, Keiko Teranishi, Masaru Sakurai, Masao Ishizaki, Teruhiko Kido, Hideaki Nakagawa

Objectives: Previous research has indicated that shift workers exhibit fewer healthy behaviors than those working regular daytime hours. Although health literacy influences health behaviors, studies comparing health literacy levels between shift and fixed-day workers and investigating whether differences in health behaviors between these 2 groups are mediated by health literacy are lacking.

Methods: This cross-sectional study used a self-administered questionnaire in a large-scale manufacturing company. Overall, 2152 manual workers aged 18-64 years were enrolled in this study (961 and 1191 fixed-day and shift workers, respectively). Logistic regression structural equation models were used for analyzing the mediating role of health literacy in the relationship between shift work and health behaviors.

Results: Shift and fixed-day workers did not show differences in age-adjusted health literacy. Compared with fixed-day workers, the odds ratios of shift workers for leisure time exercise, not currently smoking, having breakfast, brushing their teeth, and eating green and yellow vegetables were 0.85 (95% CI, 0.70-1.02), 0.68 (95% CI, 0.56-0.80), 0.63 (95% CI, 0.52-0.76), 0.79 (95% CI, 0.65-0.95), and 0.58 (95% CI, 0.48-0.70), respectively. Mediation analysis showed that the odds ratios of the direct effects of shift work on favorable habits were almost the same as the total effect.

Conclusions: This study observed that health literacy did not mediate health behavior and shift work. Further research is needed to clarify the causes of these differences.

目的:先前的研究表明,倒班工人比正常白天工作的人表现出更少的健康行为。虽然健康素养影响健康行为,但比较轮班和固定工作日工作者之间的健康素养水平以及调查这两组之间的健康行为差异是否由健康素养介导的研究缺乏。方法:本横断面研究采用某大型制造企业自填问卷。总共有2152名18-64岁的体力劳动者参加了这项研究(分别为961名和1191名固定日班工人)。采用Logistic回归结构方程模型分析健康素养在倒班工作与健康行为关系中的中介作用。结果:倒班和固定日工作者在年龄调整后的健康素养方面没有差异。与固定工作日工人相比,轮班工人在休闲时间锻炼、目前不吸烟、吃早餐、刷牙和吃绿色和黄色蔬菜的比值比分别为0.85 (95% CI, 0.70-1.02)、0.68 (95% CI, 0.56-0.80)、0.63 (95% CI, 0.52-0.76)、0.79 (95% CI, 0.65-0.95)和0.58 (95% CI, 0.48-0.70)。中介分析表明,轮班工作对良好习惯的直接影响的比值比与总影响的比值比几乎相同。结论:本研究观察到健康素养不调节健康行为和轮班工作。需要进一步的研究来澄清这些差异的原因。
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引用次数: 0
Health risks of N,N -dimethylacetamide (DMAC) in humans. N,N -二甲基乙酰胺(DMAC)对人体的健康风险
IF 2.6 4区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2025-02-07 DOI: 10.1093/JOCCUH/uiaf010
Tetsuo Nomiyama, Teruomi Tsukahara, Kohei Hasegawa

N,N-Dimethylacetamide (DMAC), which is widely used as an industrial solvent, can be absorbed via the respiratory tract and skin of humans exposed to DMAC. Hepatotoxicity is a main health risk of DMAC exposure in humans, and the relevant cases and epidemiological studies are reviewed herein. No hepatotoxicity was identified in workers exposed to approx. 3-ppm DMAC, and among workers exposed to > 9-ppm DMAC the DMAC exposure was not observed to contribute significantly to the liver damage. However, a case of liver damage was identified in which the calculated 8-hour weighted average was 12.8 mg/m3 (3.6 ppm). The skin absorption notation for DMAC is indicated based on human volunteer studies. The evidence regarding DMAC's potential carcinogenicity in humans is not sufficient, and our literature search identified no report of DMAC as a reproductive toxicant in humans. Further case reports and epidemiological studies are necessary to determine the acceptable DMAC exposure limit for workers and thus protect them from DMAC's toxicity.

N,N-二甲基乙酰胺(DMAC)是一种广泛使用的工业溶剂,暴露于DMAC的人体可通过呼吸道和皮肤被吸收。肝毒性是人类接触DMAC的主要健康风险,本文综述了相关病例和流行病学研究。未发现工人暴露于约。在暴露于3-ppm DMAC的工人中,没有观察到DMAC暴露对肝损伤有显著影响。然而,确定了一个肝损伤病例,其中计算的8小时加权平均值为12.8 mg/m3 (3.6 ppm)。DMAC的皮肤吸收表示法是根据人体志愿者研究得出的。关于DMAC对人类潜在致癌性的证据并不充分,我们的文献检索没有发现DMAC作为人类生殖毒物的报告。需要进一步的病例报告和流行病学研究来确定工人可接受的DMAC暴露限值,从而保护他们免受DMAC的毒性。
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引用次数: 0
Health risks of N,N -dimethylacetamide (DMAC) in humans. N,N -二甲基乙酰胺(DMAC)对人体的健康风险
IF 2.6 4区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2025-02-07 DOI: 10.1093/joccuh/uiaf010
Tetsuo Nomiyama, Teruomi Tsukahara, Kohei Hasegawa

N,N-Dimethylacetamide (DMAC), which is widely used as an industrial solvent, can be absorbed via the respiratory tract and skin of humans exposed to DMAC. Hepatotoxicity is a main health risk of DMAC exposure in humans, and the relevant cases and epidemiological studies are reviewed herein. No hepatotoxicity was identified in workers exposed to approx. 3-ppm DMAC, and among workers exposed to > 9-ppm DMAC the DMAC exposure was not observed to contribute significantly to the liver damage. However, a case of liver damage was identified in which the calculated 8-hour weighted average was 12.8 mg/m3 (3.6 ppm). The skin absorption notation for DMAC is indicated based on human volunteer studies. The evidence regarding DMAC's potential carcinogenicity in humans is not sufficient, and our literature search identified no report of DMAC as a reproductive toxicant in humans. Further case reports and epidemiological studies are necessary to determine the acceptable DMAC exposure limit for workers and thus protect them from DMAC's toxicity.

N,N-二甲基乙酰胺(DMAC)是一种广泛使用的工业溶剂,暴露于DMAC的人体可通过呼吸道和皮肤被吸收。肝毒性是人类接触DMAC的主要健康风险,本文综述了相关病例和流行病学研究。未发现工人暴露于约。在暴露于3-ppm DMAC的工人中,没有观察到DMAC暴露对肝损伤有显著影响。然而,确定了一个肝损伤病例,其中计算的8小时加权平均值为12.8 mg/m3 (3.6 ppm)。DMAC的皮肤吸收表示法是根据人体志愿者研究得出的。关于DMAC对人类潜在致癌性的证据并不充分,我们的文献检索没有发现DMAC作为人类生殖毒物的报告。需要进一步的病例报告和流行病学研究来确定工人可接受的DMAC暴露限值,从而保护他们免受DMAC的毒性。
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引用次数: 0
Health risks of N,N-dimethylacetamide (DMAC) in humans. N,N-二甲基乙酰胺(DMAC)对人体的健康风险。
IF 2 4区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2025-02-07 eCollection Date: 2025-01-01 DOI: 10.1093/joccuh/uiaf010
Tetsuo Nomiyama, Teruomi Tsukahara, Kohei Hasegawa

N,N-Dimethylacetamide (DMAC), which is widely used as an industrial solvent, can be absorbed via the respiratory tract and skin of humans exposed to it. Hepatotoxicity is a main health risk of DMAC exposure in humans, and the relevant cases and epidemiological studies are reviewed herein. No hepatotoxicity was identified in workers exposed to ~3 ppm DMAC, and among workers exposed to >9 ppm DMAC the DMAC exposure was not observed to contribute significantly to liver damage. However, a case of liver damage was identified in which the calculated 8-hour weighted average was 12.8 mg/m3 (3.6 ppm). The skin absorption notation for DMAC is indicated based on human volunteer studies. The evidence regarding DMAC's potential carcinogenicity in humans is not sufficient, and our literature search identified no report of DMAC as a reproductive toxicant in humans. Further case reports and epidemiological studies are necessary to determine the acceptable DMAC exposure limit for workers and thus protect them from DMAC's toxicity.

N,N-二甲基乙酰胺(DMAC)是一种广泛使用的工业溶剂,接触它的人可以通过呼吸道和皮肤吸收。肝毒性是人类接触DMAC的主要健康风险,本文综述了相关病例和流行病学研究。在暴露于~ 3ppm DMAC的工人中未发现肝毒性,在暴露于bbb90ppm DMAC的工人中,未观察到DMAC暴露对肝损伤有显著影响。然而,确定了一个肝损伤病例,其中计算的8小时加权平均值为12.8 mg/m3 (3.6 ppm)。DMAC的皮肤吸收表示法是根据人体志愿者研究得出的。关于DMAC对人类潜在致癌性的证据并不充分,我们的文献检索没有发现DMAC作为人类生殖毒物的报告。需要进一步的病例报告和流行病学研究来确定工人可接受的DMAC暴露限值,从而保护他们免受DMAC的毒性。
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引用次数: 0
Increased risk of proximal tubular dysfunction due to occupational cadmium exposure: a survival analysis study. 职业性镉暴露增加近端肾小管功能障碍的风险:一项生存分析研究。
IF 2.6 4区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2025-01-07 DOI: 10.1093/joccuh/uiaf016
Kento Hoshino, Satoko Iwasawa, Noriyuki Yoshioka, Satoko Suzuki, Itsumi Hashimoto, Shoko Ukita, Genta Toshima, Kengo Nagashima, Toru Takebayashi, Masashi Tsunoda

Objectives: The objective of the current study was to elucidate the relationship between blood cadmium (Cd-B) levels and proximal tubular dysfunction using urinary β2-microglobulin (B2M-U) as an indicator among workers in nickel-cadmium battery plants in Japan.

Methods: Medical check-up data from 338 workers exposed to cadmium at 2 plants were collected from 1997 through 2020. Workers with at least 2 check-ups were included, excluding those with other renal dysfunctions. Proximal tubular dysfunction was defined as a B2M-U of 300 μg/g creatinine or higher in 2 or more consecutive check-ups. A multivariable Cox proportional-hazards regression model with time-dependent covariates was performed to analyze the relationship between Cd-B levels and the time to onset of proximal tubular dysfunction, adjusting for age, sex, and smoking history.

Results: Of the 338 workers, 238 met the study eligibility criteria for the analyses. The geometric mean of Cd-B was 1.97 μg/L. The Cox proportional hazards analysis demonstrated that higher time-dependent Cd-B levels were significantly associated with an increased risk of proximal tubular dysfunction, with a hazard ratio of 1.17 (95% CI: 1.06-1.29).

Conclusions: Higher Cd-B levels are associated with an increased risk of proximal tubular dysfunction in workers exposed to cadmium, indicating an increased risk of renal disease under the current industrial health management in Japan. Continuous monitoring and improved management of cadmium exposure are necessary to protect workers' health even in developed countries such as Japan.

目的:本研究以尿β2-微球蛋白(bm2 - u)为指标,探讨日本镍镉电池厂工人血镉(Cd-B)水平与近端肾小管功能障碍的关系。方法:收集1997 ~ 2020年2个镉暴露厂338名工人的体检资料。包括至少2次检查的工人,不包括其他肾功能不全的工人。近端肾小管功能障碍定义为连续检查2次及以上B2M-U≥300 μg/g肌酐。采用含时间相关协变量的多变量Cox比例风险回归模型分析Cd-B水平与近端肾小管功能障碍发病时间之间的关系,并对年龄、性别和吸烟史进行校正。结果:338名工人中,238人符合研究分析的资格标准。Cd-B的几何平均值为1.97 μg/L。Cox比例风险分析显示,时间依赖性较高的Cd-B水平与近端小管功能障碍风险增加显著相关,风险比(HR)为1.17(95%可信区间[CI]: 1.06-1.29)。结论:较高的Cd-B水平与接触镉的工人近端肾小管功能障碍的风险增加有关,表明在日本目前的工业健康管理下,肾脏疾病的风险增加。即使在日本等发达国家,也必须对镉接触进行持续监测和改进管理,以保护工人的健康。
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引用次数: 0
Occupational health topics series on the effects of chemicals: epidemiological and toxicological risk assessments of ortho-toluidine for bladder cancer. 关于化学品影响的职业健康专题系列:邻甲苯胺对膀胱癌的流行病学和毒理学风险评估。
IF 2.6 4区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2025-01-07 DOI: 10.1093/joccuh/uiaf005
Makiko Nakano, Min Gi, Tatsushi Toyooka, Shugo Suzuki, Hideki Wanibuchi, Toru Takebayashi

Objectives: Our aim was to report integrative evidence for the health risk assessment of ortho-toluidine (OT) in bladder cancer in a mini-review of the recent studies of humans, experimental animals, and OT skin permeability.

Methods: Bladder cancer cases were identified in workers in Japan who were occupationally exposed in 2014-2017 to aromatic amines, primarily to the human carcinogen OT.

Results: A key epidemiological study of 98 aromatic amine-exposed workers in Japan showed a clear OT exposure-response relationship with a standardized incidence ratio. A rat model experimental study also indicated that OT and acetoaceto-o-toluidine are potent bladder carcinogens. Multiple mechanisms of OT-related bladder cancer have been proposed: metabolic activation to reactive metabolites that bind DNA and proteins, mutagenicity, oxidative DNA damage, chromosomal damage, and cytotoxicity by OT. Recent comprehensive analyses of DNA adducts in rats identified a number of common oxidative DNA adducts, including 8-OHdG, in the rat urothelium and indicated that oxidative stress may play a crucial role in the development of urinary cancer caused by OT. The skin permeability of 6 aromatic amines (o-toluidine, aniline, p-toluidine, o-anisidine, 2,4-dimethylaniline, and o-chloroaniline) was examined with the use of a 3-dimensional (3D) reconstructed human skin model; ~70%-80% of the 6 aromatic amines had permeated through the 3D skin within 8 hours. Genotoxic potency testing in a human urothelial cell line using γ-H2AX, a marker of DNA damage, suggested that OT exhibited strong γ-H2AX generation.

Conclusions: Prolonged dermal exposure to OT along with other genotoxic aromatic amines over many years may contribute to the development of bladder cancer.

背景:2014-2017 年,在日本发现了职业暴露于芳香胺(主要是人类致癌物邻甲苯胺(OT))的工人患膀胱癌的病例:2014-2017年,日本发现了职业暴露于芳香胺(主要是人类致癌物邻甲苯胺(OT))的工人罹患膀胱癌的病例:我们通过对近期有关人类、实验动物和 OT 皮肤渗透性的研究进行微型综述,报告了 OT 在膀胱癌中的健康风险评估的综合证据:结果:对日本 98 名接触过芳香胺的工人进行的一项重要流行病学研究显示,OT 暴露与标准化发病率比率之间存在明确的反应关系。大鼠模型实验研究也表明,OT 和乙酰乙酰甲苯胺是强效的膀胱致癌物。与 OT 有关的膀胱癌有多种发生机制:代谢活化生成与 DNA 和蛋白质结合的活性代谢物、诱变性、DNA 氧化损伤、染色体损伤以及 OT 的细胞毒性。最近对大鼠 DNA 加合物的综合分析发现,大鼠尿路上皮细胞中存在一些常见的氧化 DNA 加合物,其中包括 8-OHdG,这表明氧化应激可能在 OT 导致的泌尿系统癌症的发生中起着至关重要的作用。利用三维(3D)重建人体皮肤模型对六种芳香胺(邻甲苯胺、苯胺、对甲苯胺、邻甲氧基苯胺、2,4-二甲基苯胺和邻氯苯胺)的皮肤渗透性进行了检测,结果表明在 8 小时内,约 70%-80% 的六种芳香胺渗透过三维皮肤。使用 DNA 损伤标记物 γ-H2AX 对人类尿道细胞系进行的遗传毒性测试表明,OT 具有很强的 γ-H2AX 生成能力:结论:OT 和其他具有遗传毒性的芳香胺多年来长期通过皮肤接触可能会导致膀胱癌的发生。
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引用次数: 0
Effect of perceived workplace health support on absenteeism and presenteeism among Japanese workers: a prospective cohort study. 感知工作场所健康支持对日本员工旷工和出勤的影响:一项前瞻性队列研究。
IF 2.6 4区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2025-01-07 DOI: 10.1093/joccuh/uiaf018
Kazushirou Kurogi, Kazunori Ikegami, Hajime Ando, Akira Ogami

Objectives: This study aimed to investigate the impact of perceived workplace health support (PWHS) on absenteeism and presenteeism among Japanese workers to determine the significance of health and productivity management in improving labor productivity.

Methods: This prospective cohort study, using data from the Work Systems & Health Internet Research (WSHIR) study, involved 1879 Japanese workers aged 20-69 years. The intensity of PWHS was assessed using self-administered questionnaires. The participants were followed up from October 2021 to October 2022 to evaluate the incidence of absenteeism and presenteeism based on the level of PWHS.

Results: The study findings revealed that higher PWHS significantly correlated with lower presenteeism, indicating better work productivity. Conversely, the relationship between PWHS and absenteeism was less clear, with no consistent trend observed across different levels of PWHS intensity.

Conclusions: Enhanced PWHS was associated with reduced presenteeism among Japanese workers, underscoring the importance of workplace health support for improving employee productivity. This finding emphasizes the need for companies to focus on health promotion activities and recognize the potential of PWHS as a performance indicator in corporate health management.

目的:本研究旨在探讨工作场所健康支持对日本员工旷工和出勤的影响,以确定健康和生产力管理对提高劳动生产率的意义。方法:这项前瞻性队列研究使用来自工人健康互联网调查研究的数据,涉及1879名年龄在20-69岁之间的日本工人。使用自我管理的问卷评估工作场所健康支持的感知强度。从2021年10月到2022年10月,研究人员对参与者进行了随访,以评估基于感知的工作场所健康支持水平的缺勤和出勤发生率。结果:研究发现,高感知的工作场所健康支持与低出勤率显著相关,表明更高的工作效率。相反,感知工作场所健康支持与缺勤之间的关系不太清楚,在感知工作场所健康支持强度的不同水平之间没有观察到一致的趋势。结论:“工作场所健康支持的增强与日本工人出勤率的降低有关,强调了工作场所健康支持对提高员工生产力的重要性。这一发现强调,公司需要注重健康促进活动,并认识到工作场所健康支持作为公司健康管理绩效指标的潜力。
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引用次数: 0
Association between health literacy and behaviors among shift workers: an observational cross-sectional study with mediation analysis. 轮班工人健康素养与行为的关系:一项具有中介分析的观察性横断面研究。
IF 2.6 4区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2025-01-07 DOI: 10.1093/joccuh/uiae070
Yuko Morikawa, Keiko Teranishi, Masaru Sakurai, Masao Ishizaki, Teruhiko Kido, Hideaki Nakagawa

Objectives: Previous research has indicated that shift workers exhibit fewer healthy behaviors than those working regular daytime hours. Although health literacy influences health behaviors, studies comparing health literacy levels between shift and fixed-day workers and investigating whether differences in health behaviors between these 2 groups are mediated by health literacy are lacking.

Methods: This cross-sectional study used a self-administered questionnaire in a large-scale manufacturing company. Overall, 2152 manual workers aged 18-64 years were enrolled in this study (961 and 1191 fixed-day and shift workers, respectively). Logistic regression structural equation models were used for analyzing the mediating role of health literacy in the relationship between shift work and health behaviors.

Results: Shift and fixed-day workers did not show differences in age-adjusted health literacy. Compared with fixed-day workers, the odds ratios of shift workers for leisure time exercise, not currently smoking, having breakfast, brushing their teeth, and eating green and yellow vegetables were 0.85 (95% CI, 0.70-1.02), 0.68 (95% CI, 0.56-0.80), 0.63 (95% CI, 0.52-0.76), 0.79 (95% CI, 0.65-0.95), and 0.58 (95% CI, 0.48-0.70), respectively. Mediation analysis showed that the odds ratios of the direct effects of shift work on favorable habits were almost the same as the total effect.

Conclusions: This study observed that health literacy did not mediate health behavior and shift work. Further research is needed to clarify the causes of these differences.

目的:先前的研究表明,倒班工人比正常白天工作的人表现出更少的健康行为。虽然健康素养影响健康行为,但比较轮班和固定工作日工作者之间的健康素养水平以及调查这两组之间的健康行为差异是否由健康素养介导的研究缺乏。方法:本横断面研究采用某大型制造企业自填问卷。总共有2152名18-64岁的体力劳动者参加了这项研究(分别为961名和1191名固定日班工人)。采用Logistic回归结构方程模型分析健康素养在倒班工作与健康行为关系中的中介作用。结果:倒班和固定日工作者在年龄调整后的健康素养方面没有差异。与固定工作日工人相比,轮班工人在休闲时间锻炼、目前不吸烟、吃早餐、刷牙和吃绿色和黄色蔬菜的比值比分别为0.85 (95% CI, 0.70-1.02)、0.68 (95% CI, 0.56-0.80)、0.63 (95% CI, 0.52-0.76)、0.79 (95% CI, 0.65-0.95)和0.58 (95% CI, 0.48-0.70)。中介分析表明,轮班工作对良好习惯的直接影响的比值比与总影响的比值比几乎相同。结论:本研究观察到健康素养不调节健康行为和轮班工作。需要进一步的研究来澄清这些差异的原因。
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引用次数: 0
Comparative evaluation of FIB-3 and FIB-4 indices for liver fibrosis screening in workplace-based health checkups. FIB-3和FIB-4指标在工作场所健康检查中筛查肝纤维化的比较评价
IF 2 4区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2025-01-07 DOI: 10.1093/joccuh/uiaf038
Kota Fukai, Shoko Nakazawa, Kosuke Sakai, Yuko Furuya, Yuya Watanabe, Toru Honda, Takeshi Hayashi, Toru Nakagawa, Masaaki Korenaga, Masayuki Tatemichi

Objectives: To examine the utility of the FIB-3 index as a secondary screening tool for liver fibrosis in workplace-based health checkups, by comparing its concordance and negative predictive values (NPVs) with those of the FIB-4 index.

Methods: This cross-sectional study included 12 622 workers from the Hitachi Cohort Study who underwent workplace-based health checkups between April 2021 and March 2022. FIB-4 was calculated using age, aspartate aminotransferase (AST), alanine aminotransferase (ALT), and platelet count, whereas FIB-3 used the same components except age. To evaluate the utility of FIB-3 in excluding liver fibrosis, NPVs were calculated using FIB-4 thresholds (1.30, 2.01, and 2.67) as references. Concordance between FIB-3 and FIB-4 was examined across different age groups. In addition, multivariate logistic regression analysis was conducted to identify factors associated with false-positive FIB-3 results.

Results: The FIB-3 index demonstrated high NPVs for excluding liver fibrosis, with values of 99.9% at FIB-4 ≥ 1.30 and 98.2% at FIB-4 ≥ 2.67. Strong concordance between FIB-3 and FIB-4 was observed consistently across different age groups. Among participants with elevated ALT (>30 IU/L), FIB-3 consistently ruled out fibrosis, whereas FIB-4 positivity increased with advancing age. Multivariate analysis indicated that higher AST levels and increased alcohol intake were significantly associated with false-positive FIB-3 results.

Conclusions: The FIB-3 index demonstrated stable performance across age groups while maintaining high concordance and NPV relative to FIB-4. These findings suggest that FIB-3 may serve as a practical screening tool in routine workplace-based health checkups, particularly in mitigating age-related overestimation observed with the FIB-4 index.

目的:通过比较FIB-3指数与FIB-4指数的一致性和阴性预测值(NPVs),研究FIB-3指数在工作场所健康检查中作为肝纤维化二级筛查工具的效用。方法:这项横断面研究包括来自日立队列研究的12,622名工人,他们在2021年4月至2022年3月期间接受了基于工作场所的健康检查。FIB-4采用年龄、天冬氨酸转氨酶(AST)、丙氨酸转氨酶(ALT)和血小板计数计算,而FIB-3采用除年龄外的相同成分。为了评估FIB-3在排除肝纤维化方面的效用,以FIB-4阈值(1.30、2.01和2.67)为参考计算npv。FIB-3和FIB-4之间的一致性在不同年龄组中进行了检查。此外,还进行了多变量logistic回归分析,以确定与FIB-3结果假阳性相关的因素。结果:FIB-3指数在排除肝纤维化方面表现出较高的npv值,FIB-4≥1.30时为99.9%,FIB-4≥2.67时为98.2%。FIB-3和FIB-4之间的强烈一致性在不同年龄组中一致观察到。在ALT升高(30 IU/L)的参与者中,FIB-3一致地排除了纤维化,而FIB-4阳性随着年龄的增长而增加。多因素分析表明,AST水平升高和酒精摄入量增加与FIB-3假阳性结果显著相关。结论:FIB-3指数在各年龄组表现稳定,同时相对于FIB-4保持较高的一致性和NPV。这些发现表明FIB-3可以作为工作场所常规健康检查的实用筛查工具,特别是在减轻FIB-4指数观察到的与年龄相关的高估方面。
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引用次数: 0
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Journal of Occupational Health
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