Japanese Journal of Hygiene最新文献

Objective: The confirmation of abnormal behavior during video monitoring in polysomnography (PSG) and the frequency of rapid eye movement (REM) sleep without atonia (RWA) during REM sleep based on physiological indicators are essential diagnostic criteria for the diagnosis of REM sleep behavior disorder (RBD). However, no clear criteria have been established for the determination of the tonic and phasic activities of RWA. In this study, we investigated an RWA decision program that simulates visual inspection by clinical laboratory technicians.

Methods: We used the measurement data of 25 men and women (average age±standard deviation: 72.7±1.7 years) who visited the Sleep Treatment Center for PSG inspection due to suspected RBD. The chin electromyography (EMG) during REM sleep was divided into 30 s intervals, and RWA decisions were made on the basis of visual inspection by a clinical laboratory technician. We compared and investigated two machine-learning methods namely support vector machine (SVM) and convolutional neural network (CNN) for RWA decisions.

Results: When comparing SVM and CNN, the highest discrimination accuracy for RWA decisions was obtained when using the average rectified value (ARV) processed chin EMG images using CNN as a feature. We also estimated the prevalence of RBD on the basis of the Mahalanobis distance measure using the frequency of occurrence of both tonic and phasic activities calculated from a total of 25 subjects in the patient and healthy groups. Consequently, estimation of RBD prevalence using CNN resulted in misclassification of none of the subjects in the patient group and two subjects in the healthy group.

Conclusions: In this study, we investigated the automatic analysis of PSG results focusing on RBD, which is a parasomnia. As a result, there were no misclassifications of patients in the 25 subjects in the patient or healthy groups based on the estimates of RBD prevalence using CNN. The prevalence estimation based on our proposed automated algorithm is considered effective for the primary screening for RBD.

Objective: In this study, we aimed to clarify the transition to the implementation of smoking prohibition at eating and drinking establishments one year before and after April 2020, the time when they became "nonsmoking" in principle following the implementation of the amendment bill for the Health Promotion Act of Japan.

Methods: The total number of nonsmoking/smoking eating and drinking establishments by industry were obtained using the data from "Tabelog^®." The number of people who tested positive for COVID-19 by the polymerase chain reaction test on the day of the survey nationwide and the bankruptcy status of the companies (eating and drinking establishments, etc.) for each month were ascertained.

Results: In 2020, a state of emergency was declared owing to the increase in the number of people positive for COVID-19, and many eating and drinking establishments went bankrupt. Despite these circumstances, the number of nonsmoking eating and drinking establishments exceeded that of smoking establishments in March 2020 and continued to increase thereafter. Additionally, the number of nonsmoking "restaurants" increased and exceeded that of smoking restaurants in June 2020. The number of nonsmoking "cafes" already exceeded that of smoking "cafes" at the beginning of this survey and continued to increase. The number of nonsmoking "bars" increased, but that of smoking "bars" remained high.

Conclusion: It is necessary to promote measures against passive smoking while paying attention to the trends for different types of eating and drinking establishments, rather than considering all establishments together.

Objectives: The aim of this study was to clearly identify the relationships among health literacy, social determinants of health, health behaviors, menopausal symptoms, lifestyle-related diseases, and depression in healthy menopausal women.

Method: A cross-sectional study was conducted using a questionnaire among menopausal women (45 to 60 years of age) who visited a facility offering various medical checkups to receive a specific medical checkup.Logistic regression was used to analyze the association of health literacy and social determinants of health with health behaviors for 162 subjects adjusted for age. Moreover, the association of several factors (health literacy, social determinants of health, and health behaviors) with menopausal symptoms, borderline zones for lifestyle-related diseases, and depression was also analyzed in the same way.

Results: It was shown that educational history was associated with smoking habit with an age-adjusted odds ratio OR of 3.23 (95% confidence interval [CI]: 1.103-9.443). It was shown that health literacy was associated with smoking habit, age-adjusted OR 4.07 (95% CI: 1.337-12.388), menopausal symptoms, age-adjusted OR 2.48 (95% CI: 1.177-5.235), and depression, age-adjusted OR 6.24 (95% CI: 2.421-16.092).

Conclusion: It was found that poor health literacy was associated with smoking habit and the severity of menopausal symptoms and depression.

Public health communication is an essential component of public health activities to protect and promote the health of all people in all communities. However, research is scarce on how to communicate public health issues effectively to the Japanese population. In this article, I outline the concept of public health communication, present our study findings, and discuss future challenges to developing public health communication programs. More studies are required to establish evidence-based practical guidelines on public health communication in Japan.

Objective: In this study, we aimed to clarify the relationship between workplace improvement and work engagement based on the level of sense of coherence.

Methods: An anonymous self-administered questionnaire survey was conducted on 1,845 regular employees in a financial industry (valid response rate, 78.5%). The questionnaire included the Japanese Sense of Coherence (SOC), Japanese Utrecht Work Engagement Scale (UWES-J), and Mental Health Improvement & Reinforcement Research of Recognition (MIRROR). Multiple linear regression analysis was performed with the total score of UWES-J as the dependent variable and the MIRROR items as the independent variables for each group with high and low SOC levels.

Results: Two MIRROR items namely, "It is easy to take a substitute vacation after work on holidays" and "In the workplace, the abilities and ingenuity of each person are utilized", were the negative factors common to the two groups. On the other hand, in the low-SOC-level group, the items "The work policy is decided in a way that everyone is satisfied with", "When the work breaks, I can go home without worrying about other people", and "The superior gives proper explanations about everything to his subordinates" showed negative relationships. In the high-SOC-level group, "The work environment (e.g., air conditioning and lighting) can be adjusted according to the wishes of workers", "No overtime day is set or utilized", "I am allowed to commute to work avoiding crowded times and routes", and "The superiors are trying to make everyone's work proceed smoothly" showed negative relationships.

Conclusions: Depending on the level of SOC, workers' desire for workplace improvement related to UWES-J scores differed.

Objectives: To identify the complex factors associated with anemia and overweight/obesity in pregnant Nepali women.

Methods: This study was conducted with 609 pregnant women who visited the Western Regional Hospital in Pokhara, Nepal, for maternal health checkups. We assessed their nutritional status on the basis of their responses to a questionnaire (socio-economic, demographic and health information using the Nepali version of the 14-item Health Literacy Scale), hemoglobin levels and body mass index (BMI). Data were analyzed and adjusted for confounding factors by binomial logistic regression analysis; this aided in identifying factors associated with anemia and overweight/obesity.

Results: The significant factor contributing to anemia is a low BMI (p=0.005, aOR=7.930, 95% CI=1.857, 33.870), followed by maternal age in the teens (p=0.000, aOR=3.018, 95% CI=1.852, 4.919). The significant factors contributing to overweight/obesity are household income, excluding the poorest (p=0.004, aOR=2.975, 95% CI=1.404, 6.303), followed by the presence of a nuclear family (p=0.000, aOR =2.156, 95% CI=1.493, 3.112). Functional literacy (p=0.005, aOR=1.045, 95% CI=1.013, 1.077) increases the risk of overweight/obesity, but critical literacy (p=0.009, aOR=0.819, 95% CI=0.705, 0.951) is a factor that buffers its onset.

Conclusions: The association of malnutrition with anemia and overweight/obesity has been confirmed in pregnant Nepali women, indicating the urgent need for new supports and improvements to nutrition. Nutrition education should be designed to take into consideration reproductive generation, as well as families with low health literacy.

Objectives: The purpose of this study was to clarify the relationship of the annual transition of implementation of nonsmoking at eating and drinking establishments with indices of population/household and economy/labor by prefecture.

Methods: The prefectural rates of eating and drinking establishments implementing nonsmoking (hereafter, nonsmoking rate) were computed in a year using the data from "Tabelog^®". Forty-seven prefectures were classified by hierarchical cluster analysis into "prefecture clusters" 1 to 5 in descending order of the median of nonsmoking rates. The indices of population/household (e.g., percentage of the population aged 65 years and over and percentage of nuclear family household) and economy/labor (e.g., prefectural income per capita and percentage of construction and mining workers) were classified by hierarchical cluster analysis into 11 "index clusters", and the representative index in each index cluster was extracted from the results of the Jonckheere-Terpstra test. An ordinal logistic regression analysis was performed using the numbers 1 to 5 of prefecture clusters as dependent variables and the indices representing the index clusters as independent variables.

Results: The percentage of the population aged 65 years and over and the percentage of construction and mining workers were positively related to the order of prefectural clusters.

Conclusions: To promote implementation of nonsmoking in eating and drinking establishments in prefectures especially in those with larger numbers of elderly people and construction and mining workers, it is important to inform the persons in charge that implementation of nonsmoking does not affect the number of customers.

Objectives: Traffic noise exposure is associated with adverse health effects such as environmental sleep disorder, ischaemic heart disease (IHD), stroke and diabetes. The health risks posed by traffic noise were estimated to be quite high in European countries. However, in Japan, no estimation has ever been conducted. In the present study, we estimated the health risk posed by road traffic noise in Japan.

Methods: We estimated the risks of environmental sleep disorder (high sleep disturbance) and IHD caused by road traffic noise in Japan as of 2015 on the basis of existing noise-exposure estimates, vital statistics of deaths, and patient survey with exposure-response relationships proposed by the Environmental Noise Guidelines for the European Region issued in 2018. We employed old information on noise exposure in 1994 because it is the only information currently available in Japan. We also estimated the health risks of noise exposure levels that were equivalent to the Japanese environmental quality standards.

Results: The estimated numbers of patients with environmental sleep disorder and IHD caused by road traffic noise were approximately 1,200,000 and 9,000, respectively. The estimated number of mortalities from IHD was approximately 1,700. The noise exposure level equivalent to the Japanese noise standards caused a lifetime mortality rate of more than 10^-2, which was extremely high as an environmental health risk.

Conclusions: As in European countries, road traffic noise was one of the most important environmental risk factors in Japan. However, the current Japanese noise standards are insufficient for the protection of public health.

Objectives: Recently, attention has been paid to the impact of cigarette smoking on skeletal muscles, as its underlying pathophysiological mechanism has been gradually elucidated. In this study, we aimed to examine whether cigarette smoking is associated with muscle mass reduction and low muscle strength in elderly men.

Methods: The study participants comprised 417 community-dwelling elderly men (aged 73±6 years) without severe glucose intolerance, chronic kidney disease, or liver disease. Bioelectrical impedance analysis was performed to estimate appendicular skeletal muscle mass (ASM), which was normalized for height (ASM index, kg/m²). Handgrip strength (HGS) was measured using a Smedley grip dynamometer. Cumulative smoking exposure level during a lifetime was expressed in pack-years, which is a product of the average number of packs of cigarettes smoked per day and smoking duration in years.

Results: When the participants were stratified on the basis of cumulative smoking exposure (<10 pack-years, 10-39 pack-years, ≥40 pack-years), the ASM index and HGS progressively decreased with increasing exposure level (P for trend <0.01). In multiple regression analysis, heavy smoking (defined as ≥40 pack-years) was found to be a significant determinant of the ASM index and HGS, independent of potential confounding factors. Among former smokers, the subgroup that quit smoking for ≥20 years had a significantly higher ASM index and HGS than the subgroup that quit smoking for <10 years. The duration of smoking cessation was significantly associated with the ASM index and HGS, even after adjusting for cumulative smoking exposure.

Conclusions: These findings suggest that cigarette smoking contributes to the loss of muscle mass and function in elderly men and that smoking cessation could reverse the impact of cigarette smoking on skeletal muscles.

Environmental problems are closely related to human activities, especially economic activities. Nevertheless, on a personal level, we do not face these problems and seem to avoid them. Why are environmental problems not taken seriously despite their urgency? As economic activities for self-profit, including money, are the essence of human behavior, we have hypothesized that, "selfishness and endless desire are the essence of human beings' instinct for survival, and as a result, environmental destruction occurs". In this paper, first, we describe through the prism of evolution how the "selfish gene" affects the survival of cells, individuals, and human society. At the same time, we detail how humans have developed the cerebrum, acquired intelligence, and developed science. Second, we describe the mechanism of modern capitalism and the global environmental situation at present. Third, we consider the relationship between human selfishness and environmental problems from three viewpoints: game theory, behavioral economics, and sociology. Finally, we propose countermeasures to environmental problems from three perspectives: social psychology, social system, and new technologies.