[Nihon koshu eisei zasshi] Japanese journal of public health最新文献

Objectives　The number of occupational injuries among migrant workers in Japan has increased. This increase corresponds with the increase in the number of migrant workers in Japan, which has more than doubled over the past 10 years, from approximately 720,000 in 2013 to a record high of over two million in 2023. There were 5,672 work-related deaths and injuries in 2023. To prevent occupational injuries, it is necessary to strengthen countermeasures, by considering the specific risks present in each industry. In this study, we conducted a scoping review to identify problems associated with occupational injuries for various industry types and examined preventive measures.Methods　The review targeted literature published from 1990 up to October 2023. Academic databases (CiNii Research, Ichushi Web, and PubMed) were searched, along with "Kakehashi" published by the Japan International Trainee & Skilled Worker Cooperation Organization (JITCO) and the official websites of the Ministry of Health, Labour and Welfare and JITCO. Two reviewers independently screened titles and abstracts and selected documents that mentioned occupational injuries among migrant workers. Subsequently, they independently reviewed the full text (or the abstract, if the full text was unavailable) to determine eligibility. The studies were categorized as case reports (based on a single-case analysis) or survey reports (based on multiple-case analyses). The industries addressed in the literature were classified according to the Japan Standard Industrial Classification.Results　Two reviewers screened 885 reports and selected 73 for review, including 37 survey reports and 36 case reports. Of the survey reports, three focused on "agriculture and forestry," two on "construction," three on "manufacturing," and one on "transport and postal services," while 28 did not focus on specific industries. The identified issues included insufficient understanding of machinery use and failure to retain operational skills, in the agriculture and forestry sector; inadequate knowledge of basic safety practices on construction sites in the construction sector; and malfunctioning safety devices on press machines, general machine malfunctions, and a lack of safety training in the manufacturing sector. Some efforts to address these problems through targeted measures were observed in the agriculture and forestry and construction sectors. Some industries did not exhibit industry-specific problems.Conclusion　To prevent occupational injuries among migrant workers, it is necessary to collect industry-specific information that is currently lacking.

Objective　This study investigated whether self-rated parent-child relationships are associated with self-esteem among elementary and junior high school students, after statistically adjusting for family economic status and young carer status.Methods　In 2024, 893 anonymous questionnaires were administered among fifth-grade elementary and second-grade junior high school students in Yurihonjo City, Japan. Exposure-defined as a "poor parent-child relationship"-was determined based on responses indicating "somewhat does not apply" or "does not apply" to one or more of six relevant items. Self-esteem was measured using the total score ranging from 3 to 12 on the Tokyo version of the Self-Esteem Scale. "Financial difficulties" were defined as responses indicating that the household's living conditions were "somewhat difficult" or "very difficult." Young carers were defined as children who provided care to family members in a manner that affected their daily lives. A linear regression model was used to examine the association between parent-child relationships and self-esteem. The total score on the self-esteem scale was treated as the dependent variable, whereas parent-child relationship (reference: good), household economic status (reference: sufficient), young carer status (reference: non-carer), and additional covariates were included as independent variables. Regression coefficients representing differences in self-esteem scores relative to the reference categories were estimated along with their 95% confidence intervals (CIs).Results　Among the participants, 49% were female, 52% were fifth-grade elementary school students, and 17% lived in single-parent households. A total of 23% participants reported poor parent-child relationships, 10% reported economic difficulties, 2% were young carers, and the median self-esteem score was 9.5. Regarding basic characteristics, children who reported poor parent-child relationships when compared to those with good relationships, exhibited the following features: a higher proportion of females, poorer self-rated health, and limited household economic status, while a lower proportion had someone to consult. After adjusting for covariates, the difference in self-esteem scores was -0.98 (95% CI: -1.19 to -0.77) for poor parent-child relationships. In addition, the total self-esteem scale score was -0.21 (95% CI: -0.50 to 0.09) among those experiencing poorer household economic status and 0.25 (95% CI: -0.26 to 0.75) among those identified as young carers.Conclusion　These findings suggest that parent-child relationships may serve as a key factor in fostering self-esteem among elementary and junior high school students.

Objectives　The prevalence of metabolic syndrome, a major risk factor for lifestyle-related diseases, varies across occupations. We aimed to clarify how employment type contributed to lifestyle differences among individuals covered by one health insurance society.Methods　Among 17,855 individuals covered by the health insurance society of a Japanese automobile manufacturer who had undergone specific health checkup, we analyzed 13,188 individuals aged 40-64 years, after excluding those with confounding prior medical histories or current medication use. The participants were classified into four groups: headquarter employees (including indirect corporate functions such as management, human resources, general affairs, public relations, and vehicle development), dealership employees (sales representatives, maintenance technicians, and clerical staff), factory employees (working in the company's production plants), and affiliated employees (e.g., component-manufacturing workers in medium-sized companies, real estate employees, and financial sector employees). Descriptive statistics were calculated by sex using responses to questionnaires collected during routine health checkup appointments. Univariate logistic regression analyses were then conducted, with each lifestyle factor as the dependent variable and employment type as the independent variable, followed by multivariable logistic regression adjusted for age (five strata). Odds ratios (ORs), and 95% confidence intervals (CIs) were calculated, with headquarter employees as the reference group.Results　Among men, the dealership employees had the highest prevalence of low physical activity, with 80.1% reporting exercising for ≥30 min only ≤1 day per week (OR: 1.97, CI: 1.77-2.20). Headquarter employees had the highest proportion of walking for ＜1 h per day (69.1%, reference). The factory employees reported the highest rate of slower walking speeds vs their peers (60.3%, OR: 1.60, CI: 1.45-1.77). The dealership employees also tended to have less healthy overall lifestyle behaviors: 43.4% smoked (OR: 2.55, CI: 2.29-2.83), 48.7% ate dinner within two hours of bedtime (OR: 1.73, CI: 1.57-1.91), 30.4% skipped breakfast ≥3 times per week (OR: 3.08, CI: 2.70-3.50), and 14.0% consumed ≥2 alcoholic drinks daily (OR: 1.95, CI: 1.63-2.34). The factory employees were less motivated to change their lifestyles (38.3%, OR: 2.29, CI: 2.05-2.57), and were less likely to participate in health guidance programs (85.7%, OR: 2.58, CI: 2.27-2.92).Conclusion　Employee lifestyles differed significantly by job type in our cohort, although all were covered by the same health insurance society. Employment type also associated with motivation to adopt healthier behaviors. Occupational characteristics should therefore be considered when designing interventions to promote lifestyle improvements using health-related guidance.

Objectives　The aim of this study was to analyze the association between employment status, family structure, and nutrient adequacy in working-age Japanese adults (aged 20-64 years).Methods　Data from the 2019 National Health and Nutrition Survey and the Comprehensive Survey of Living Conditions, conducted by the Ministry of Health, Labour and Welfare, were used to examine the associations between nutrient adequacy and employment status (full-time, part-time, unemployed, or not applicable) and family structure (single, couple only, two-parents and child [parent, child], single parent and child [parent, child], three-generations [parent, child], and other family structures). Logistic regression analysis was performed with nutrient deficiency as the dependent variable and employment status and family structure as independent variables, controlling for age, municipality size, and prefecture of residence.Results　The association between employment status and nutrient adequacy, as assessed by the chi-squared test, showed statistically significant differences in the percentage of nutrient inadequacy across employment status categories among women for three nutrients, but not among men. The chi-squared test between family structure and nutrient adequacy showed statistically significant differences for 10 nutrients for men and 14 nutrients for women. Among men, parents in three-generation families had higher inadequacy rates; among women, those living alone showed higher inadequacy rates. Logistic regression revealed that, compared with those in full-time employment, men in part-time employment had statistically higher inadequacy in total fiber, folic acid, potassium, and magnesium. For women, employment status was associated with inadequacy of n-6 fatty acids, total fiber, vitamin A, vitamin C, salt equivalents, and magnesium. Furthermore, nutrient inadequacy differed significantly by family structure for 14 nutrients in men and 16 nutrients in women. For men, single individuals, and parents in three-generation families showed statistically higher inadequacy rates for some nutrients, while for women, of the 16 nutrients showing statistically significant differences, children in "two-parent and child families" and women in "couple-only families" showed lower rates of nutrient inadequacy for 9 and 8 nutrients, respectively.Conclusion　Nutritional disparities among working-age adults are associated with employment patterns and family structure. In addition, nutrient excesses and deficiencies were identified in groups previously overlooked, such as parents in two-parent and child households and three-generation households, highlighting the need for policies that address these diverse factors.

Objectives　In most Japanese municipalities, the Questionnaire for Medical Checkup of Old-Old (QMCOO) is administered during annual health checkups for older adults aged ≥75 years to screen for frailty, whereas the Kihon Checklist (KCL) is used within the long-term care (LTC) system to identify individuals who may be eligible for services aimed at preventing loss of independence. Few studies have examined whether the combination of these two tools is associated with subsequent LTC certification. We examined the association between coexisting health risks identified by both tools and the onset of LTC certification.Methods　This retrospective cohort study used data from Chiyoda-ku, Tokyo, Japan. Fiscal year (FY) 2020-2021 data from the National Health Insurance's "Kokuho Database" were linked with FY2020 data from a postal survey that incorporated the KCL. The participants comprised individuals aged ≥75 years with no LTC certification at baseline, who had completed the annual health checkup (including the QMCOO) in FY 2020, and who had responded to the postal survey. Frailty risk was defined as ≥4 of 12 frailty-related QMCOO items, and individuals eligible for LTC prevention services were identified using the KCL's standard criteria. Participants were classified into four groups (QMCOO + or - /KCL + or -). Incident LTC certification cases were identified from the health checkup date until March 31, 2022. Cox proportional hazards analysis was performed to calculate the hazards for LTC certification across groups, with the QMCOO-/KCL- group as the reference.Results　Among the 527 participants (mean age: 80.6 years; men: 41.9%), 50 (9.5%) received LTC certification during the 1013.5 person-years of follow-up. The LTC certification incidence rate per 1000 person-years was 33.1 in the QMCOO-/KCL- group and 85.7 in the QMCOO+/KCL+ group (log-rank P = 0.006). Cox proportional hazards analysis that adjusted for covariates (sex, age groups, living arrangement, years of education, and medical history) showed that the hazard of incident LTC certification in the QMCOO+/KCL+ group was significantly higher than that of the QMCOO-/KCL- group (hazard ratio: 2.55, 95% confidence interval: 1.21-5.38). Neither the QMCOO+/KCL- nor QMCOO-/KCL+ groups were significantly associated with LTC certification.Conclusions　Using both tools to identify older adults at high risk of LTC certification may help improve the efficiency of preventive interventions within Japan's healthcare system for older adults.

Objectives　Various personal health record (PHR) services have been developed over recent years. However, academic evidence concerning PHR system use and its effects on behavioral change remains scarce. This umbrella review aimed to summarize current evidence regarding the factors associated with PHR service use and their association with patient outcomes.Methods　We searched PubMed, PsycInfo, and CINAHL databases and extracted review articles that reported factors associated with PHR service use and their association with patient outcomes. Three independent reviewers screened the titles and abstracts; one reviewer performed a primary assessment of the full texts, and two others confirmed the results.Results　Twelve studies were ultimately included in this review. A tethered PHR, or patient portal, represents an online tool that is connected to electronic medical records, whereas an untethered PHR represents a collection of health or wellness data concerning an individual's health. The former function includes viewing electronic medical records, contacting healthcare providers via messaging, refilling prescriptions, and scheduling appointments. In contrast, the monitoring and sharing of health statuses represent the primary functions of the latter. Male sex, younger age, higher education, higher income, Caucasian lineage, and insurance coverage were reported to represent the personal attributes associated with PHR service usage. Familiarity with the Internet and information was also associated with using PHR services. Some studies on tethered PHRs showed improved disease control and communication with healthcare providers, whereas others found no such association. Messaging with healthcare providers was associated with medication management, regular visits, and improved control of blood glucose and low-density lipoprotein levels. The associations among medication refilling with adherence, and health status monitoring/sharing with improved glycemic control and self-management were also reported. Certain PHR services have been specifically designed to support self-monitoring and disease control.Conclusion　We identified the concept of PHRs and the key terms that correspond to it. Few studies have examined the functions of untethered PHRs and their associations with patient outcomes compared with those of a tethered PHR. Further research is therefore warranted to clarify the effects of untethered PHR services.

Objectives　The purpose of this study was to clarify smoking status and quit attempts among cigarette smokers after the release of heated tobacco products.Methods　We used data from the 2016, 2018, 2020, and 2022 waves of the Japan "Society and New Tobacco" Internet Survey (JASTIS), which aims to facilitate a better understanding of the current situation regarding new tobacco products in Japan. Participants were aged between 20 and 69 years in each wave and were regular cigarette smokers. Survey items included basic characteristics, smoking status, types of tobacco products smoked in the past year, and quit attempts and methods. We calculated the frequencies of basic characteristics, smoking status, and quit attempts for each survey year. Frequencies of quit attempt methods and overlapping status were also calculated. Chi-square tests were applied to each item, and significant differences were compared with the results from the previous year. The Cochran-Armitage trend test was applied to smoking status and quitting attempts.Results　There were 934 participants in 2016, 1,717 in 2018, 1,348 in 2020, and 4,117 in 2022. Most participants were in their 40s and 50s, and approximately 70% were male. The rate of cigarette-only smokers was 94.5% in 2016, dropping sharply to 60.3% in 2018 (P < 0.001). Conversely, the number of smokers who used cigarettes in combination with either heated tobacco products or e-cigarettes increased sharply from 4.0% to 37.3% within the same period (P < 0.001). The quit attempt rate was 16.0% in 2016, increasing annually and reaching 40.1% by 2022 (P < 0.001). The most common quit attempt method in 2016 was self-help, accounting for 71.8%, decreasing to 41.7% in 2018 (P < 0.001), while the use of heated tobacco products/e-cigarettes increased during the same period from 28.9% to 64.3% (P < 0.001). In 2016, smoking cessation treatments and nicotine preparations from pharmacies accounted for 18.1% and 26.2%, respectively, with both increasing since 2020.Conclusion　Since the launch of heated tobacco products, the number of smokers using cigarettes has decreased, whereas the number of smokers using heated tobacco products and/or e-cigarettes in combination with cigarettes has increased. Simultaneously, the rate of quit attempts has been steadily increasing, with growing preference for heated tobacco products/e-cigarettes as cessation methods. Emerging evidence indicates that heated tobacco products pose health risks and may also lower the success rate of quitting smoking, while increasing the relapse rate, making them an unsuitable cessation option.

Objectives　This study implemented nutritionally balanced meals (T-set meals) at a local restaurant, and nudged selection of those meals, to evaluate the changes in menu usage and clarify the reasons for customers' meal choices.Methods　This pre-post intervention study was conducted at the T Restaurant in Toda City over 8 weeks (September-October 2024). The interventions included: (1) provision of T-set meals based on the Smart Meal^® criteria (two types of meals offered over two 4-week phases); (2) information provision using menu displays. Weeks 1-2 and 5-6 constituted Intervention Period A, during which menus displayed only meal names and prices. Weeks 3-4 and 7-8 comprised Intervention Period B, during which photographs and menu details were added. Development of the T-set meals and menu displays was based on the CAN nudge framework (C = Convenient, A = Attractive, N = Normative). The primary outcome was a change in the number and composition ratio of meals sold by category, evaluated by (1) changes in the outcome in the month before and after the intervention; (2) comparing Intervention Periods A and B. To examine the reasons for selecting T-set meals, online surveys were conducted during weeks 5 and 7. Only first-time respondents were included in that analysis. The characteristics of respondents and reasons for their selection were compared. In a sub-analysis, the reasons for selecting T-set meals were compared between for week 5 (Period A) and week 7 (Period B).Results　During weeks 1-4, the composition ratio of all menu (except T-set meals) categories significantly decreased compared with the pre-intervention period. However, in weeks 5-8, the proportion of grand menu items (set meal) increased again, returning to the pre-intervention level (27.6% vs. 30.6%). The proportion of T-set meals significantly increased during Period B in weeks 1-4 but significantly decreased during Period B in weeks 5-8. During intervention Period B, more number of respondents cited reasons such as "collaboration with Kagawa Nutrition University," "contains a lot of vegetables," "looks tasty," and "affordable price" for selecting the T-set meals.Conclusion　These findings suggest that menu displays incorporating nudges, particularly those emphasizing visual appeal and pricing advantages, can positively influence meal selection. However, when a dish is unfamiliar or does not align with customer preferences, informational nudges alone may be insufficient to drive choice.

Objective　Given the declining birthrate and aging society, extending healthy life expectancy by improving lifestyle habits to prevent metabolic syndrome (MetS) and maintain health-related quality of life (HR-QOL) has become a critical public health priority. Guided by the PRECEDE-PROCEED model, this study examined the relationships among lifestyle habits, MetS status, and HR-QOL.Methods　Participants included 1,393 workers (1,077 males, mean age 48.7 ± 9.2 years; 316 females, mean age 45.4 ± 8.6 years). HR-QOL was assessed using the SF-12 questionnaire, yielding the physical component summary (PCS), mental component summary (MCS), and role/social component summary scores. Relationships between HR-QOL, MetS classification, and related indicators (body mass index, abdominal circumference, blood pressure, fasting blood glucose, hemoglobin A1c (HbA1c), triglycerides (TG), high-density lipoprotein cholesterol, and low-density lipoprotein cholesterol) were analyzed. Additionally, associations between HR-QOL and lifestyle habits, such as weight gain since age 20, eating habits (eating speed, snacking, dinner within 2 h before bedtime, skipping breakfast), chewing conditions, physical activity/exercise habits (sweating-inducing exercise, daily walking, walking speed), and sleep quality were examined. Furthermore, the relationships between lifestyle habits, MetS classification, and related indices were assessed.Results　PSC and MSC scores of HR-QOL were significantly influenced by MetS classification, abdominal circumference, HbA1c, and TG levels. Lifestyle habits, including weight gain since age 20, eating habits, chewing conditions, and physical activity/exercise habits, were significantly associated with MeS classification and/or MetS-related indicators. While lifestyle habits were primarily associated with PCS and MCS, some of these associations ceased to be significant when Met classification or related indicators were included as intermediate variables.Conclusions　Our findings suggest that both MetS status and lifestyle habits are associated with HRQOL. Lifestyle habits may influence HR-QOL indirectly through their effects on MetS status. Therefore, improving lifestyle behaviors may be an effective strategy to enhance HR-QOL and promote healthy longevity.

Objectives　Employment in old age serves multiple purposes beyond economic independence. It helps maintain physical and mental health, fosters social connections, and provides a sense of purpose in life. Promoting employment among older adults requires an understanding of their preferred working styles. However, employment needs are multifaceted and aggregated needs have not yet been fully clarified. This study aimed to categorize older adults' employment needs based on multiple factors and to show the characteristics of each type.Methods　Data were drawn from the Wako Cohort Study of men and women aged 65 and older residing in Wako, Saitama Prefecture, Japan. Of the 6,429 valid respondents to the mail survey, 1,053 individuals who have expressed a desire to work were included in the analysis. Participants were classified through non-hierarchical cluster analysis, based on desired working days and hours, preferences for physical work and simple tasks, and factors they prioritized when choosing a job (i.e., salary, use of experience and skills, and sense of social contribution). Subsequently, chi-square test was performed to compare the three groups, and multiple comparisons were performed for sex, age group, living arrangements, longest-held job, current employment status, frailty, and desired job type.Results　Cluster analysis identified three types of employment needs based on the participants' characteristics. The "Minimal-schedule Skill-utilizing Employment Type" (35.2%) preferred working one to four days per week and one to less than four hours per day, with an emphasis on their capacity to use their experience and skills and being useful to others and society, rather than on physical or simple tasks. This group had a higher proportion of individuals with adequate living conditions and former professional/technical workers than other groups. The "Minimal-schedule Manual Employment Type" (25.6%) preferred simple tasks and working one to four days per week for one to less than four hours per day. The prevalence of unemployment and frailty was higher in this group. The "Moderate-schedule Physical Employment Type" (39.1%) preferred physical work of four to less than seven hours per day, three to four days per week. They comprised a higher percentage of men, individuals aged 65-69, current workers, and former blue-collar workers than the other groups.Conclusions　This study clarified three types of employment needs among older adults and identified the background factors associated with each. These findings can be used to develop employment opportunities and job-matching.