Sangyo eiseigaku zasshi = Journal of occupational health最新文献

Objective: In occupational health activities in Japan, evaluating workers' fitness for work following health checkups is a primary task. Health checkups are used to identify workers at high risk of cerebrovascular and cardiovascular diseases and conduct fit-for-work evaluations. However, identifying high-risk individuals based on a single risk factor may overlook those with multiple risk factors who have a high risk of developing cerebrovascular and cardiovascular diseases. Presently, we aimed to investigate the atherosclerotic cardiovascular disease (ASCVD) risk score from a previous study by Hisayama (Hisayama study) and examine its use in the workplace.

Methods: Baseline data from health checkups conducted in 2010 of 41,815 employees (men; 34,024, women; 7,791) aged 19-64 years without previous cerebrovascular or cardiovascular disease were analyzed. The relationship between baseline ASCVD risk scores and the incidence of ASCVD > 10 years (2011-2020) was examined using Cox regression analysis with hazard ratios (HR). Receiver operating characteristic (ROC) analysis was conducted to evaluate the model's performance and determine optimal cut-off values for the identification of high-risk individuals in the workplace.

Results: The 10-year incidence of ASCVD was 2.6% (men; 3.0%, women; 0.8%). In men, each 1% increase in ASCVD risk score was associated with a 1.5-fold increase in ASCVD incidence (HR; 1.46, 95% confidence interval [CI]; 1.42-1.51, p < .001), which was observed from age 30 and even after multivariate adjustment. In women, univariate analysis showed an association between increased ASCVD risk score and incidence (HR; 3.19, 95% CI; 2.10-4.85, p < .001); however, this was not significant after adjustment. ROC analysis identified 1.62% as the optimal cut-off (sensitivity; 58.6%, specificity; 71.9%, positive predictive value [PPV]; 5.2%).

Conclusion: The ASCVD risk score is a useful tool for risk management and prevention in the workplace, particularly for men. In women, this association disappeared after age adjustment, possibly due to reduced estrogen effects with aging. Based on the ROC analysis, stratifying at ≥ 1.5% for intervention, ≥ 2.0% (top 20%) for "high risk," and ≥ 3.5% (PPV > 10%) for "extremely high risk" is advised. However, this study may have underestimated the risk levels; therefore, companies should adapt the use of ASCVD risk scores flexibly according to their circumstances.

Background: According to the gene-environment interactions concept, the mechanism of health impairment can be explained by genetic factors, environmental factors, or their interaction. Physical and mental health effects resulting from environmental exposure may be classified either as toxicity, immune response, and allergic reaction. Moreover, despite the already established therapeutic approaches to bronchial asthma and decreasing mortality due to bronchial asthma, patients with difficult and severe asthma are increasing in number. This review outlines recent topics in the field of allergies, focusing on asthma.

Results and discussion: Living environment-derived pollutants and their involvement in the pathogenesis of asthma and its exacerbation, referred to here as an exposome concept, comprises the three domains of internal, specific external, and general external. Living environment-derived pollutants include exposure to pollutants in workplaces, climate change, air pollution, microplastics, tobacco smoke, biodiversity change and loss, changing dietary habits, and the microbiome. These are associated with the modernization, urbanization, and globalization of human society. Although many novel compounds are currently available, their harmful health effects, such as allergy, are not thoroughly understood. Hence, the means to mitigate these are unknown. Dietary changes from a traditional diet rich in fish to a Western-style diet are considered critical environmental factors and therefore, associated with an increased prevalence of allergies. Cytokines, including thymic stromal lymphopoietin, IL-25, and IL-33, released from the airway epithelium in response to various triggers (exposure to diverse environmental factors) are known as alarmins. Anti-alarmin antibodies are a promising therapeutic approach against severe and difficult allergic disorders. Collaboration between hospitals and clinics and occupational and clinical medicine is imperative for treating and managing severe asthma. In addition to avoiding environmental exposure, understanding the pathogenesis and exacerbation of asthma is essential for future research in the field of allergy and immunotoxicology.

Objectives: Assessing the risk of employee health problems according to firm characteristics (e.g., industry) can be used by companies to identify groups of workers with health problems and develop health-related policies. Previous studies have examined differences in the prevalence of diseases across industries; however, studies using sickness absences, which reduce productivity, are scarce. The purpose of this study was to identify differences in sickness absence rates across industries.

Methods: With permission for secondary use of archived data from the Japan Institute for Labor Policy and Training (JILPT), we obtained data from private companies with 50 or more regular employees nationwide. Negative binomial regression was conducted using the number of sickness absences attributed to mental health, cancer, lifestyle-related diseases (e.g., diabetes, hypertension, heart disease, cerebrovascular disease), and intractable diseases as the objective variables. The results were confirmed by an ordinal logistic regression. Firm characteristics other than industry were adjusted for firm size, age structure, medical examinations, labor unions, and flexible work systems.

Results: The incidence of sickness absences due to mental health was high in the information and communications, medical care/welfare, and education/learning support industries because of lifestyle-related diseases, and heart disease was high in the transportation/postal industry. Cancer was high in the medical care/welfare industry. While older worker age groups had a lower incidence of mental health issues, a higher incidence of physical illnesses, excluding intractable diseases, was observed. The presence of a labor union was associated with sickness absences due to mental health, cancer, and cerebrovascular disease, and the availability of a flexible work system was associated with sickness absences due to mental health and heart disease.

Conclusions: The three industries with a high incidence of mental health leave had a high percentage of professional/technical workers and a common background of heavy workloads. In addition, role ambiguity, particularly in the education and medical industries, could lead to stress. The association between the transportation/postal industry and sickness absences due to lifestyle-related diseases and heart disease was probably influenced by work style and lifestyle, whereas the association between the medical care/welfare industry and sickness absences due to cancer was probably influenced by the high percentage of women in this industry. This study could not be adjusted for several variables examined in other studies, such as sex, and caution should be exercised when interpreting the results, especially regarding absences due to cancer.

Objectives: This study examined the association between cooperative work climate and business owners' attitudes toward work climate and help-seeking intentions for balancing medical treatment and job (BTJ) by occupation among employees of small companies.

Methods: In January 2024, we conducted an online survey of 1,800 full-time employees aged 20-64 years with no work restrictions due to illness working in small companies. After participants were provided a leaflet regarding BTJ, they were asked to indicate their intention to seek help in an imaginary situation where they had been diagnosed with cancer. We conducted a multivariate logistic regression analysis using a combination of cooperative work climate (low or high) and business owners' attitudes toward work climate (low or high) as the primary explanatory variable and help-seeking intentions regarding BTJ as the dependent variable, adjusted for relevant job-related variables. As a subgroup analysis, logistic regression analyses by occupation (i.e., white- or blue-collar workers) were also conducted.

Results: Among the 1,800 participants (602 females and 1,198 males), 1,350 (75.0%) reported an active intention to seek help regarding BTJ. Those who reported higher levels of cooperative work climate and lower levels of business owners' positive attitudes toward work climate (odds ratio (OR) 1.5, 95% confidence interval (CI) 1.07-2.1), as well as those who reported higher levels of work climate and business owners' attitudes (OR 2.0, 95% CI 1.4-2.9), were significantly more likely to reveal help-seeking intentions regarding BTJ than those who reported lower levels of work climate and business owner attitudes. Analyses by occupation also showed that for both occupation categories, those who reported higher levels of cooperative work climate and business owner attitudes toward work climate more frequently revealed help-seeking intentions than those who reported lower levels of work climate and business owner attitudes.

Conclusions: Among participants working for small companies, regardless of occupation, those who reported higher levels of cooperative work climate and business owners' attitudes toward work climate were significantly more likely to reveal help-seeking intentions regarding BTJ. Our findings imply that (1) cooperative work climate has a stronger effect on help-seeking intentions regarding BTJ than business owners' attitudes toward work climate, and (2) both work climate and business owners' attitudes have a synergistic impact on help-seeking intentions regarding BTJ. Enhancing a cooperative work climate may promote help-seeking intentions among employees working for small companies, regardless of occupation.

Objective: This study aimed to investigate the performance of generative pre-trained transformer-4 (GPT-4) on the Certification Test for Mental Health Management and whether tuned prompts could improve its performance.

Methods: This study used a 3 × 2 factorial design to examine the performance according to test difficulty (courses) and prompt conditions. We prepared 200 multiple-choice questions (600 questions overall) for each course using the Certification Test for Mental Health Management (levels I-III) and essay questions from the level I test for the previous four examinations. Two conditions were used: a simple prompt condition using the questions as prompts and tuned prompt condition using techniques to obtain better answers. GPT-4 (gpt-4-0613) was adopted and implemented using the OpenAI API.

Results: The simple prompt condition scores were 74.5, 71.5, and 64.0 for levels III, II, and I, respectively. The tuned and simple prompt condition scores had no significant differences (Odds ratio = 1.03, 95% Confidence interval; 0.65-1.62, p = 0.908). Incorrect answers were observed in the simple prompt condition because of the inability to make choices, whereas no incorrect answers were observed in the tuned prompt condition. The average score for the essay questions under the simple prompt condition was 22.5 out of 50 points (45.0%).

Conclusion: GPT-4 had a sufficient knowledge network for occupational mental health, surpassing the criteria for levels II and III tests. For the level I test, which required the ability to describe more advanced knowledge accurately, GPT-4 did not meet the criteria. External information may be needed when using GPT-4 at this level. Although the tuned prompts did not significantly improve the performance, they were promising in avoiding unintended outputs and organizing output formats. UMIN trial registration: UMIN-CTR ID = UMIN000053582.

Purpose: The effects of lacking exercise due to increased sedentary behavior on physical and mental health are attracting attention. We developed an exercise program for sedentary behavior in desk workers and verified whether decreased body pain and weakness and improved subjective health are short-term effects.

Subjects and methods: We developed a 3-min exercise program comprising three among four types of exercises; standing on one leg (1 min on each side), squats (1 min), stretching (1 min), and deep breathing with eyes closed (1 min). The exercise program was performed in the morning and afternoon for 2 months (41 days) (3 types × twice daily × 41 days = 246 times) by 94 employees of University A. For easier implementation, radio exercises (part 1), widely recognized in Japan, were performed in the morning and afternoon before work. Participants were asked about their attributes, work situation, physical and mental conditions before and after implementation, and evaluation of the exercise program after implementation.

Results: Exercise records and questionnaire responses were collected from 87 participants. The median number of exercises was 83 (interquartile range; 16-128). The participants were divided into two groups based on the median values. The level of lower back pain and friendship scores had an interaction and improved in the group that performed the exercise more frequently. A receiver operating characteristic curve was drawn based on the relationship between the group whose level of lower back pain was reduced by at least 2 of 11 points and that who did not, and the number of exercises. The cutoff value was 70 times, suggesting that performing exercise ≥ 70 times for 41 days decreased lower back pain. To continue implementing the exercise program, it was necessary to use free time, maintain motivation, and create a sense of unity in the workplace.

Conclusions: We created an exercise program comprising four types of exercise for sedentary behavior in desk workers, which is performed in the morning and afternoon for 2 months. Improvements were seen in the degree of lower back pain and friendship score.

Objectives: This study aimed to elucidate the status of business continuity plan (BCP) formulation in businesses, focusing on different industries. It examined their preparation for natural disasters, such as earthquakes and tsunamis, and crisis events, such as emerging infectious diseases.

Methods: A total of 1,583 businesses in Wakayama Prefecture, Japan, were randomly selected from the Wakayama Occupational Health Support Center workplace list. Anonymous self-administered questionnaires were distributed by mail. The questionnaire comprised questions on the business, awareness and formulation status of BCP, and business continuity capabilities in preparation for natural disasters and crisis events. It also explored difficulties in progress in BCP formulation. Businesses were categorized into three groups based on the type of industry: manufacturing (114 companies), lifeline (66 companies), and others (207 companies).

Results: Questionnaires were collected from 412 businesses, and 387 of those that responded to the type of industry were analyzed (valid response rate: 24.3%). More than 50% of businesses in all industries were aware of BCP. Regarding the status of BCP formulation, 39.5% of the manufacturing, 34.8% of the lifeline, and 41.5% of others had already formulated or were formulating a BCP. Many lifeline businesses had not taken any measures to prepare facilities and allocate funds for emergencies. Additionally, 49% were at high risk of being forced to close down due to disasters. As the difficulties in progress in formulating a BCP, 60.9% of lifeline businesses did not know what to develop or how to consider it. In addition, 44.2% of others had to secure the time and human resources necessary for formulation.

Conclusions: Although awareness of BCPs is increasing, their formulation has not progressed significantly. In particular, BCP formulation has been delayed in lifeline industries, resulting in low business continuity capabilities. Given that many businesses do not know the contents or methods of formulating BCPs, it is suggested that educating relevant parties about using templates is necessary. This approach can reduce the time required for formulation and enable the creation of a BCP even without detailed human resources.