2024/02/01 更新

写真a

ツダ トシヒデ
津田 敏秀
TSUDA Toshihide
所属
環境生命自然科学学域 教授
職名
教授
外部リンク

学位

  • 医学博士 ( 岡山大学 )

研究キーワード

  • 環境汚染における発がん

  • 医学情報の21世紀のあり方

  • 疫学理論

  • Causal Inference in Environmental Epidemiology

  • 根拠に基づく医学

  • 因果推論

  • Environmental Medicine

  • Epidemiology

  • 環境医学

  • 疫学

  • Evidence Based Medicine

  • Causal Inference

  • 数え上げ法と日本の医学研究方法論

研究分野

  • 環境・農学 / 放射線影響  / 環境汚染における発がん

  • 人文・社会 / 哲学、倫理学  / 環境疫学における因果推論

  • 人文・社会 / 科学社会学、科学技術史  / 医学的根拠に関する歴史的発展

  • ライフサイエンス / 衛生学、公衆衛生学分野:実験系を含まない  / フィールド疫学

  • ライフサイエンス / 生態学、環境学  / 医学における科学的根拠

  • 環境・農学 / 環境影響評価

  • 人文・社会 / 哲学、倫理学

  • 環境・農学 / 環境政策、環境配慮型社会

  • ライフサイエンス / 衛生学、公衆衛生学分野:実験系を含まない

  • ライフサイエンス / 衛生学、公衆衛生学分野:実験系を含む

  • ライフサイエンス / 医療管理学、医療系社会学

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学歴

  • 岡山大学   Graduate School, Division of Medicine   Department of Hygiene

    - 1989年

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  • 岡山大学    

    - 1989年

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    国名: 日本国

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  • 岡山大学   Medical School   Faculty of Medicine

    - 1985年

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    国名: 日本国

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  • 岡山大学   Faculty of Medicine   School of Medicine

    - 1985年

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経歴

  • 岡山大学大学院環境生命自然科学研究科   環境生態学講座   環境疫学   医学博士

    2022年4月 - 現在

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    国名:日本国

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  • - Occupational Physician,Occupational Safety and Health,Administrative Center,Okayama University

    2005年

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  • - 岡山大学 大学院環境学研究科 教授

    2005年

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  • - 岡山大学本部安全衛生委員会 産業医

    2005年

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  • - 岡山大学環境生命科学研究科 教授

    2005年

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  • - Professor,Okayama University The Graduate School of Environmental Science

    2005年

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  • - Professor,Graduate School of Environmental and life Science,Okayama University

    2005年

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  • - 岡山大学岡山大学病院治験審査委員会 治験審査委員

    2004年

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  • - Comittee Member of IRB,Institutional Review Board,University Hospital of Medicine and Dentistry,Okayama University

    2004年

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  • Professor,Department of Hygiene, Okayama University Graduate School of Medical and Dental Science

    2001年 - 2004年

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  • 岡山大学大学院医歯学総合研究科長寿社会医学専攻衛生学 講師

    2001年 - 2004年

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  • Senior Assistant Professor,Department of Hygiene, Okayama University School of Medicine

    1995年 - 2001年

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  • 岡山大学   Medical School

    1995年 - 2001年

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  • Assistant Professor,Okayama University School of Medicine

    1990年 - 1995年

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  • 岡山大学   Medical School

    1990年 - 1995年

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所属学協会

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委員歴

  • 日本精神神経学会   法委員会委員  

    1995年1月 - 2023年7月   

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    団体区分:学協会

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  • 日本衛生学会   エキスパート  

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    団体区分:学協会

    日本衛生学会

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論文

  • Demonstrating the undermining of science and health policy after the Fukushima nuclear accident by applying the Toolkit for detecting misused epidemiological methods. 査読

    Tsuda T, Miyano Y and Yamamoto E

    Environmental Health   21   77   2022年8月

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    担当区分:筆頭著者, 最終著者, 責任著者   記述言語:英語   掲載種別:研究論文(学術雑誌)  

    DOI: https://doi.org/10.1186/s12940-022-00884-6

  • 誤用された疫学的手法を検出するためのツールキットを適用することで、福島原発事故後の科学と保健政策が損なわれていることを実証する 査読

    津田敏秀, 宮野由美子, 山本英二

    環境保健   21 ( 1 )   1 - 22   2022年8月

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    担当区分:筆頭著者, 責任著者   記述言語:英語   掲載種別:研究論文(学術雑誌)  

    添付ファイル: Tsuda2022Environmental Health0f81e5bb-1669-40e1-ba1a-e2a35b1c1ba8.pdf

    DOI: 10.1186/s12940-022-00884-6

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    その他リンク: https://link.springer.com/article/10.1186/s12940-022-00884-6/fulltext.html

  • 誤った情報は、誤った結論と政策に導くだけである: Schüzらの反応についての解説 査読

    津田敏秀, 宮野由美子, 山本英二

    環境保健   22 ( 62 )   1 - 6   2023年11月

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    担当区分:筆頭著者, 責任著者   記述言語:英語   掲載種別:研究論文(学術雑誌)  

    添付ファイル: Tsuda2023EnvironmentalHealths12940-023-01013-7.pdf

    DOI: 10.1186/s12940-023-01013-7

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  • A population-based longitudinal study on glycated hemoglobin levels and new-onset chronic kidney disease among non-diabetic Japanese adults. 国際誌

    Yukari Okawa, Etsuji Suzuki, Toshiharu Mitsuhashi, Toshihide Tsuda, Takashi Yorifuji

    Scientific reports   13 ( 1 )   13770 - 13770   2023年8月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Chronic kidney disease (CKD) is a major global public health problem. Recent studies reported that diabetes and prediabetes are risk factors for developing CKD; however, the exact glycated hemoglobin (HbA1c) cut-off value for prediabetes remains controversial. In this study, we aimed to examine the relationship between HbA1c levels and subsequent CKD development in greater detail than previous studies. Longitudinal data of annual checkups of 7176 Japanese non-diabetic people (male: 40.4%) from 1998 to 2022 was analyzed. HbA1c values were categorized into < 5.0%, 5.0-5.4%, 5.5-5.9%, and 6.0-6.4%. CKD was defined as an estimated glomerular filtration rate < 60 ml/min/1.73 m2. The descriptive statistics at study entry showed that higher HbA1c values were associated with male, older, overweight or obese, hypertensive, or dyslipidemic people. During a mean follow-up of 7.75 person-years, 2374 participants (male: 40.0%) developed CKD. The Weibull accelerated failure time model was selected because the proportional hazards assumption was violated. The adjusted time ratios of developing CKD for HbA1c levels of 5.5-5.9% and 6.0-6.4% compared with 5.0-5.4% were 0.97 (95% confidence interval: 0.92-1.03) and 1.01 (95% confidence interval: 0.90-1.13), respectively. There was no association between HbA1c in the prediabetic range and subsequent CKD development.

    DOI: 10.1038/s41598-023-40300-8

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  • Preparedness for measles among Japanese travelers to India after the COVID-19 pandemic

    Michiyo Yamakawa, Yuko Tanaka, Akiko Tokinobu, Toshihide Tsuda

    Journal of Travel Medicine   2023年6月

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    掲載種別:研究論文(学術雑誌)   出版者・発行元:Oxford University Press (OUP)  

    Highlight

    After the COVID-19 pandemic, over half of Japanese budget travellers to India did not adequately prepare for measles. Most of those who visited a clinic for travel vaccination missed the opportunity to get vaccinated against measles. For the summer, urgent efforts to ensure travellers’ preparation for measles are required.

    DOI: 10.1093/jtm/taad086

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  • Diarrhea and related personal characteristics among Japanese university students studying abroad in intermediate- and low-risk countries

    Michiyo Yamakawa, Toshihide Tsuda, Keiko Wada, Chisato Nagata, Etsuji Suzuki

    PLOS ONE   18 ( 2 )   e0279426 - e0279426   2023年2月

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    掲載種別:研究論文(学術雑誌)   出版者・発行元:Public Library of Science (PLoS)  

    Despite an increasing number of students studying abroad worldwide, evidence about health risks while they are abroad is limited. Diarrhea is considered the most common travelers’ illness, which would also apply to students studying abroad. We examined diarrhea and related personal characteristics among Japanese students studying abroad. Japanese university students who participated in short-term study abroad programs between summer 2016 and spring 2018 were targeted (n = 825, 6–38 travel days). Based on a 2-week-risk of diarrhea (passing three or more loose or liquid stools per day) among travelers by country, the destination was separated into intermediate- and low-risk countries. After this stratification, the associations between personal characteristics and diarrhea during the first two weeks of their stay were evaluated using logistic regression models. Among participants in intermediate-risk countries, teenagers, males and those with overseas travel experience were associated with an elevated risk of diarrhea; the odds ratios (95% confidence intervals) were 2.42 (1.08–5.43) for teenagers (vs. twenties), 1.93 (1.08–3.45) for males (vs. females) and 2.37 (1.29–4.33) for those with overseas experience (vs. none). Even restricting an outcome to diarrhea during the first week did not change the results substantially. The same tendency was not observed for those in the low-risk countries. Teenage students, males and those with overseas travel experience should be cautious about diarrhea while studying abroad, specifically in intermediate-risk countries.

    DOI: 10.1371/journal.pone.0279426

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  • Physical activity and incident dementia in older Japanese adults: The Okayama Study 査読 国際誌

    Liu Y, Mitsuhashi T, Yamakawa M, Sasai M, Tsuda T, Doi H, Hamada J

    Int J Geriatr Psychiatry   34 ( 10 )   1429 - 1437   2019年10月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    DOI: 10.1002/gps.5135

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  • Alcohol consumption and incident dementia in older Japanese adults: The Okayama Study 査読

    Liu Y, Mitsuhashi T, Yamakawa M, Sasai M, Tsuda T, Doi H, Hamada J

    Geriatrics & Gerontology International   19 ( 8 )   740 - 746   2019年8月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    DOI: 10.1111/ggi.13694

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  • Japanese tourists travelling in India have poor pre-travel preparedness. 査読

    Tokinobu A, Yamakawa M, Tsuda T, Matsushita N, Hashizume M

    Travel medicine and infectious disease   33   101417 - 101417   2019年5月

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    掲載種別:研究論文(学術雑誌)  

    DOI: 10.1016/j.tmaid.2019.05.003

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  • Measles vaccination status among Japanese university students participating in short-term study abroad programs

    Michiyo Yamakawa, Megumi Sasai, Mayumi Ono, Toshihide Tsuda

    Travel Medicine and Infectious Disease   27   131 - 132   2019年1月

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    掲載種別:研究論文(学術雑誌)   出版者・発行元:Elsevier BV  

    DOI: 10.1016/j.tmaid.2018.10.008

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  • Combined effects of body mass index and unhealthy behaviors on disability in older Japanese adults: the Okayama study. 査読 国際誌

    Yangyang Liu, Toshiharu Mitsuhashi, Michiyo Yamakawa, Megumi Sasai, Toshihide Tsuda, Hiroyuki Doi, Jun Hamada

    PeerJ   7   e8146   2019年

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    記述言語:英語  

    Background: Body mass index (BMI) is a significant predictor of functional disability in older adults. However, when evaluated, the association between BMI and incident functional disability, considering behaviors only as covariates or not, may not be appropriate. The primary purpose of the study was to investigate the combined effects of BMI and unhealthy behaviors on the risk of incident functional disability. Methods: This was a retrospective cohort study that took place in Okayama City, Japan. Data on BMI and unhealthy behaviors were obtained using the health check-up questionnaire. The certification of Long-Term Care Insurance was used to measure functional disability. Cox proportional hazard models were used; adjusted hazard ratios (HRs) with 95% confidence interval (CI) were calculated for incidence of functional disability across categories of BMI and number of unhealthy behaviors. Results: The relationship between BMI and incident functional disability was U-shaped (HR = 1.18, 95% CI [1.11-1.25], among the underweight range; and 1.26 [1.19-1.34] among the obesity range), and its risk was significantly higher within the normal-to-overweight range of BMI values with co-occurring unhealthy behaviors (with normal weight range and one, 1.17 [1.01-1.21]; two, 1.29 [1.18-1.41]; and three or four unhealthy behaviors 1.38 [1.24-1.54]; as well as among overweight range and one, 1.16 [1.05-1.27]; two, 1.26 [1.15-1.38]; and three or four unhealthy behaviors, 1.47 [1.31-1.64]). In each BMI category, the risk of incident functional disability increased with increasing number of unhealthy behaviors (p < 0.05 for linear tread), with the highest risk (1.87 [1.58-2.20]) occurring in combination with at least three unhealthy behaviors with BMI ≥ 27.5, for both sexes (2.20 [1.64-2.92] in men and 1.66 [1.35-2.04] in women). Conclusion: It is necessary to consider the combined effects of BMI and behaviors on incident functional disability. Furthermore, interventions targeting multiple behaviors should be considered as such interventions may offer greater benefits than simple interventions.

    DOI: 10.7717/peerj.8146

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  • Association of early daycare attendance with allergic disorders in children: a longitudinal national survey in Japan. 査読 国際誌

    Tokinobu A, Yorifuji T, Yamakawa M, Tsuda T, Doi H

    Archives of environmental & occupational health   75 ( 1 )   1 - 9   2018年12月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    DOI: 10.1080/19338244.2018.1535481

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  • 肥満に対するアーユルヴェーダ療法の効果と安全性 システマティックレビューとメタアナリシスによる検討

    時信 亜希子, 関 隆志, 津田 敏秀

    日本統合医療学会誌   11 ( 2 )   249 - 249   2018年9月

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    記述言語:日本語   出版者・発行元:(一社)日本統合医療学会  

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  • 舌清掃による消化力改善効果の検討

    時信 亜希子, 頼藤 貴志, 津田 敏秀

    アーユルヴェーダ研究   ( 48 )   95 - 97   2018年4月

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    記述言語:日本語   出版者・発行元:(一社)日本アーユルヴェーダ学会  

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  • Effects of tongue cleaning on Ayurvedic digestive power and oral health-related quality of life: A randomized cross-over study 査読

    A. Tokinobu, T. Yorifuji, M. Sasai, H. Doi, T. Tsuda

    Complementary Therapies in Medicine   36   9 - 13   2018年2月

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    掲載種別:研究論文(学術雑誌)   出版者・発行元:Elsevier BV  

    DOI: 10.1016/j.ctim.2017.11.011

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  • Re: Associations between childhood thyroid cancer and external radiation dose after the Fukushima Daiichi Nuclear Power Plant accident 査読

    Tsuda T, Tokinobu A, Yamamoto E, Suzuki E

    Epidemiology   29 ( 6 )   e56 - e57   2018年

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    DOI: 10.1097/EDE.0000000000000898

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  • クルーズ旅行中に経験する健康問題に関する疫学研究 招待 査読

    佐才めぐみ, 山川路代, 葛西洋介, 津田敏秀

    日本渡航医学会誌   11 ( 2 )   81 - 88   2018年

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    記述言語:日本語   掲載種別:研究論文(学術雑誌)  

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  • Diarrhea and related factors among passengers on world cruises departing from Japan 査読

    Yamakawa M, Sasai M, Kasai Y, Tsuda T, Suzuki E

    Travel Med Infect Dis   23 ( May-Jun )   56 - 63   2018年

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    DOI: 10.1016/j.tmaid.2018.01.004

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  • Erratum to: Ethical Issues Related to the Promotion of a "100 mSv Threshold Assumption" in Japan after the Fukushima Nuclear Accident in 2011: Background and Consequences. 査読

    Tsuda T, Lindahl L, Tokinobu A

    Current environmental health reports   4 ( 3 )   383   2017年9月

  • Ethical Issues Related to the Promotion of a "100 mSv Threshold Assumption" in Japan after the Fukushima Nuclear Accident in 2011: Background and Consequences. 国際誌

    Toshihide Tsuda, Lena Lindahl, Akiko Tokinobu

    Current environmental health reports   4 ( 2 )   119 - 129   2017年6月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    PURPOSE OF REVIEW: This article describes the debates in Japan regarding the 100 mSv threshold assumption and ethical issues related to it, and explores the background to distorted risk information and absence of risk communication in Japan. Then we seek proper risk communication based on scientific evidence. RECENT FINDINGS: On March 11, 2011 an accident occurred at the Fukushima Daiichi Nuclear Power Plant due to the Great East Japan Earthquake. Since then a number of misunderstandings have become common in Japan as a result of public statements by the Japanese and local governments that have no basis in medical science or are contradictory to medical science. Consequently, not only the population of Fukushima Prefecture, but also others, have been subjected to unnecessary exposure to radiation, against the As Low As Reasonably Achievable (ALARA) principle. The number of cases of thyroid cancer has increased by one or two orders of magnitude since the accident in Fukushima. However, the population has hardly been given any correct information from the central and local governments, medical societies, and media. The center of this problem is a statement on radiation-induced cancer (including thyroid cancer) made by the Japanese Government and Japanese medical academic societies indicating that "exposure of less than 100 mSv gives rise to no excess risk of cancer, and even if there is some resulting cancer it will be impossible to detect it" (this will be referred to as "the 100 mSv threshold assumption" from now onward). They have been saying this since April 2011 and have made no effort to correct it. Many Japanese began to notice this but correct information on radiation protection has reached only one part of the population. Risk communication should be based on scientific evidence, and providing it as information for the public is a key element. In Japan, governments and academic societies tried to communicate with the public without doing it. Ethical problems after the accident in Fukushima can be understood from the consequences of the mistakes in both risk information and risk communication in Japan after 2011.

    DOI: 10.1007/s40572-017-0145-0

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  • A typology of four notions of confounding in epidemiology 査読

    Etsuji Suzuki, Toshiharu Mitsuhashi, Toshihide Tsuda, Eiji Yamamoto

    JOURNAL OF EPIDEMIOLOGY   27 ( 2 )   49 - 55   2017年2月

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    記述言語:英語   出版者・発行元:ELSEVIER SCIENCE INC  

    Confounding is a major concern in epidemiology. Despite its significance, the different notions of confounding have not been fully appreciated in the literature, leading to confusion of causal concepts in epidemiology. In this article, we aim to highlight the importance of differentiating between the subtly different notions of confounding from the perspective of counterfactual reasoning. By using a simple example, we illustrate the significance of considering the distribution of response types to distinguish causation from association, highlighting that confounding depends not only on the population chosen as the target of inference, but also on the notions of confounding in distribution and confounding in measure. This point has been relatively underappreciated, partly because some literature on the concept of confounding has only used the exposed and unexposed groups as the target populations, while it would be helpful to use the total population as the target population. Moreover, to clarify a further distinction between confounding "in expectation" and "realized" confounding, we illustrate the usefulness of examining the distribution of exposure status in the target population. To grasp the explicit distinction between confounding in expectation and realized confounding, we need to understand the mechanism that generates exposure events, not the product of that mechanism. Finally, we graphically illustrate this point, highlighting the usefulness of directed acyclic graphs in examining the presence of confounding in distribution, in the notion of confounding in expectation. (C) 2016 The Authors. Publishing services by Elsevier B.V. on behalf of The Japan Epidemiological Association.

    DOI: 10.1016/j.je.2016.09.003

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  • 福島県でのリスクコミュニケーションと健康対策の欠如

    津田 敏秀

    学術の動向   22 ( 4 )   4_19 - 4_27   2017年

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    記述言語:日本語   出版者・発行元:公益財団法人 日本学術協力財団  

    DOI: 10.5363/tits.22.4_19

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  • The authors respond 招待 国際誌

    Toshihide Tsuda, Akiko Tokinobu, Eiji Yamamoto, Etsuji Suzuki

    Epidemiology   27 ( 3 )   e21 - e23   2016年5月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:Ovid Technologies (Wolters Kluwer Health)  

    DOI: 10.1097/ede.0000000000000468

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  • アーユルヴェーダ・シローダーラー療法(頭部滴油療法)の睡眠改善効果を検討するパイロット研究

    時信 亜希子, 頼藤 貴志, 津田 敏秀, 土居 弘幸

    日本統合医療学会誌   8 ( 3 )   156 - 156   2015年11月

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    記述言語:日本語   出版者・発行元:(一社)日本統合医療学会  

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  • Intrauterine Exposure to Methylmercury and Neurocognitive Functions - Minamata disease – 査読 国際誌

    Takashi Yorifuji, Tsuguhiko Kato, Yoko Kado, Akiko Tokinobu, Michiyo Yamakawa, Toshihide Tsuda, Satoshi Sanada

    Archives of Environmental and Occupational Health   70, 297-302 ( 5 )   297 - 302   2015年6月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    DOI: 10.1080/19338244.2014.904268

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  • Cancer and non-cancer excess mortality resulting from mixed exposure to polychlorinated biphenyls and polychlorinated dibenzofurans from contaminated rice oil: “Yusho” 査読

    Kashima, Saori, Yorifuji, Takashi, Tsuda, Toshihide, Eboshida, Akira

    INTERNATIONAL ARCHIVES OF OCCUPATIONAL AND ENVIRONMENTAL HEALTH   88 ( 4 )   419 - 430   2015年5月

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    掲載種別:研究論文(学術雑誌)   出版者・発行元:SPRINGER  

    In 1968, rice oil contaminated with polychlorinated biphenyls and polychlorinated dibenzofurans caused a severe outbreak of food poisoning in Japan and was termed locally as Yusho&quot; (oil disease). In our previous study, we found that area-based standardize

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  • A simple example as a pedagogical device? 査読

    Etsuji Suzuki, Toshiharu Mitsuhashi, Toshihide Tsuda, Eiji Yamamoto

    ANNALS OF EPIDEMIOLOGY   24 ( 7 )   560 - 561   2014年7月

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    記述言語:英語   出版者・発行元:ELSEVIER SCIENCE INC  

    DOI: 10.1016/j.annepidem.2014.04.003

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  • Alternative Definitions of "Proportion Eliminated" 査読

    Etsuji Suzuki, Toshiharu Mitsuhashi, Toshihide Tsuda, Eiji Yamamoto

    EPIDEMIOLOGY   25 ( 2 )   308 - 309   2014年3月

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    記述言語:英語   出版者・発行元:LIPPINCOTT WILLIAMS & WILKINS  

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  • Minamata 査読

    T. Yorifuji, T. Tsuda

    Encyclopedia of Toxicology: Third Edition   340 - 344   2014年1月

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    記述言語:英語   掲載種別:論文集(書籍)内論文   出版者・発行元:Elsevier  

    The history of Minamata disease is presented in chronological order (from the first outbreak to the current situation). The history of the disease provides us with invaluable lessons for future public health strategies. First, prompt countermeasures should be taken when a cause is identified and should not be postponed until an etiologic agent is identified. Second, lack of investigation obscures the features as well as the expansion of the disease and unnecessarily confuses the situation. Third, the womb is the environment. Finally, social circumstances can induce disease.

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  • 在宅医療現場における心不全に伴う睡眠時無呼吸に対するASV治療 査読

    山崎賢士, 藤井基弘, 藤井弥子, 津田敏秀, 鈴木越治

    日本プライマリ・ケア連合学会誌   37 ( 4 )   342 - 345   2014年

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    記述言語:日本語   掲載種別:研究論文(学術雑誌)   出版者・発行元:一般社団法人 日本プライマリ・ケア連合学会  

    目的 : 在宅医療において, 新しい換気モードを搭載した人工呼吸器 (adaptive servo-ventilation (ASV) ) による心不全治療効果を評価する.<br>方法 : 心不全を有する後期高齢者の睡眠呼吸障害を簡易モニターにより診断し, 8名にASV治療を導入した. 心不全治療効果をNT-proBNPで評価し, 睡眠呼吸障害の改善を無呼吸低呼吸指数 (apnea hypopnea index (AHI) ) で評価した.<br>結果 : マスクをつけるのが怖いという理由で3名が脱落したため, 残りの5名について分析を行った. NT-proBNPの治療前後での平均変化率は-0.43[95%信頼区間 : -0.64, -0.22]と有意に改善した. AHIの平均変化量は-20.4回/時[95%信頼区間 : -41.2回/時, 0.4回/時]であった.<br>結論 : ASV治療は, 在宅医療現場における心不全治療に有効である.

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  • Regional impact of exposure to a polychlorinated biphenyl and polychlorinated dibenzofuran mixture from contaminated rice oil on stillbirth rate and secondary sex ratio 査読 国際誌

    Yorifuji, Takashi, Kashima, Saori, Tokinobu, Akiko, Kato, Tsuguhiko, Tsuda, Toshihide

    ENVIRONMENT INTERNATIONAL   59   12 - 15   2013年9月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:PERGAMON-ELSEVIER SCIENCE LTD  

    Yusho disease, a polychlorinated biphenyl (PCB) and polychlorinated dibenzofuran (PCDF) mixed poisoning caused by contaminated rice oil, occurred in Japan in 1968. The evidence on reproductive outcome is limited. We therefore evaluated the regional impact of the exposure to the PCB and PCDF mixture on stillbirth rate and secondary sex ratio among the residents in two severely affected areas. We selected the regionally-affected towns of Tamanoura (n = 4390 in 1970) and Naru (n = 6569) in Nagasaki Prefecture, Japan, for study. We obtained data on stillbirths (spontaneous/artificial) and live-born births (total/male/female) from 1958 to 1994. For a decade and a half after the exposure, an increase in the rate of spontaneous stillbirths coincided with a decrease in the male sex ratio. Compared with the years 1958-1967, the ratios for spontaneous stillbirth rates were 2.16 (95% confidence interval: 1.58 to 2.97) for 1968-1977 and 1.80(95% confidence interval: 1.25 to 2.60) for 1978-1987. The sex ratio (male proportion) was 0.483 (95% confidence interval: 0.457 to 0.508) in the first 10 years after exposure. Exposure to a mixture of PCBs and PCDFs affected stillbirth and sex ratio for a

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  • A counterfactual approach to bias and effect modification in terms of response types. 査読

    Suzuki E, Mitsuhashi T, Tsuda T, Yamamoto E

    BMC medical research methodology   13   101   2013年7月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    DOI: 10.1186/1471-2288-13-101

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  • Critical Appraisal of the 1977 Diagnostic Criteria for Minamata Disease 査読

    Takashi Yorifuji, Toshihide Tsuda, Sachiko Inoue, Soshi Takao, Masazumi Harada, Ichiro Kawachi

    ARCHIVES OF ENVIRONMENTAL & OCCUPATIONAL HEALTH   68 ( 1 )   22 - 29   2013年1月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:ROUTLEDGE JOURNALS, TAYLOR & FRANCIS LTD  

    Large-scale food poisoning caused by methylmercury was identified in Minamata, Japan, in the 1950s (Minamata disease). Although the diagnostic criteria for the disease remain current, few studies have been carried out to assess the diagnostic accuracy of the criteria. From a 1971 population-based investigation, data from 2 villages were selected: Minamata (high-exposure area; n = 779) and Ariake (low-exposure area; n = 755). The authors examined the prevalence of neurologic signs characteristic of methylmercury poisoning and the validity of the criteria. A substantial number of residents in the exposed area exhibited neurologic signs even after excluding officially certified patients. Using paresthesia of the extremities as the gold standard of diagnosis, the criteria had a sensitivity of 66%. The current diagnostic criteria as well as the official certification system substantially underestimate the incidence of Minamata disease.

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  • Asian dust and daily all-cause or cause-specific mortality in western Japan 査読

    Kashima, Saori, Yorifuji, Takashi, Tsuda, Toshihide, Eboshida, Akira

    OCCUPATIONAL AND ENVIRONMENTAL MEDICINE   69 ( 12 )   908 - 915   2012年12月

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    掲載種別:研究論文(学術雑誌)   出版者・発行元:BMJ PUBLISHING GROUP  

    Objective Desert dust, which is included in course particles, is considered to have potential toxicity. The effect modification of desert dust on associations between anthropogenic air pollution and mortality has been evaluated. However, the independent effects of Asian dust are less clear. Thus, we evaluated the effects of Asian dust on mortality independent of particulate matter (PM) in western Japan. Methods We obtained daily mean concentrations of Asian dust using Light Detection and Ranging measurements and suspended particulate matter (SPM) concentrations (approximately PM8) during March 2005 to December 2010. We then evaluated city-specific associations of Asian dust and SPM with daily mortality using a time-series analysis targeting 1 379 052 people aged 65 or above living in 47 cities. The city-specific results were then combined with a Bayesian-hierarchical model. Results Asian dust did not modify the effects of SPM on mortality. Meanwhile, Asian dust was adversely associated with mortality independent of SPM. The excess risk following a 10 mu/m(3) increase in mean of the current to the previous 2 days Asian dust concentration was 0.6% (95% CI 0.1 to 1.1) for heart diseas

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  • Influence of radiofrequency ablation of lung cancer on pulmonary function. 査読

    Tada A, Hiraki T, Iguchi T, Gobara H, Mimura H, Toyooka S, Kiura K, Tsuda T, Mitsuhashi T, Kanazawa S

    Cardiovascular and interventional radiology   35 ( 4 )   860 - 867   2012年8月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

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  • Does Open-air Exposure to Volatile Organic Compounds near a Plastic Recycling Factory Cause Health Effects? 査読

    Takashi Yorifuji, Miyuki Noguchi, Toshihide Tsuda, Etsuji Suzuki, Soshi Takao, Saori Kashima, Yukio Yanagisawa

    JOURNAL OF OCCUPATIONAL HEALTH   54 ( 2 )   79 - 87   2012年3月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:JAPAN SOC OCCUPATIONAL HEALTH  

    Does Open-air Exposure to Volatile Organic Compounds near a Plastic Recycling Factory Cause Health Effects?: Takashi YORIFUJI, et al. Department of Human Ecology, Okayama University Graduate School of Environmental Sciences-Objectives: After a plastic reprocessing factory began to operate in August 2004, the residents around the factory in Neyagawa, Osaka, Japan, began to complain of symptoms. Therefore, we conducted an exposure assessment and a population-based epidemiological study in 2006. Methods: To assess exposure, volatile organic compounds (VOCs) and total VOCs were measured at two locations in the vicinity of the factory. In the population-based study, a total of 3,950 residents were targeted. A self-administered questionnaire was used to collect information about subjects' mucocutaneous or respiratory symptoms. Using logistic regression models, we compared the prevalence of symptoms in July 2006 by employing the farthest area from the factory as a reference, and prevalence odds ratios (PORs) and their 95% confidence intervals (Cis) were estimated. Results: The concentration of total VOCs was higher in the vicinity of the factory. The prevalence of mucocutaneous and respiratory symptoms was the highest among the residents in the closest area to the factory. Some symptoms were significantly increased among the residents within 500 m of the factory compared with residents of an area 2800 m from the factory: e.g., sore throat (POR=3.2, 95% CI: 1.3-8.0), eye itch (POR=3.0, 95% CI: 1.5-6.0), eye discharge (POR=6.0, 95% CI: 2.3-15.9), eczema (POR=3.0, 95% CI: 1.1-7.9) and sputum (POR=2.4, 95% CI: 1.1-5.1). Conclusions: Despite of the limitations of this study, these results imply a possible association of open-air VOCs with mucocutaneous and respiratory symptoms. Because this kind of plasticre cycling factory only recently came into operation, more attention should be paid to the operation of plastic recycling factories in the environment. (J Occup Health 2012; 54: 79-87)

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  • Short-term effect of severe exposure to methylmercury on atherosclerotic heart disease and hypertension mortality in Minamata 査読

    Sachiko Inoue, Takashi Yorifuji, Toshihide Tsuda, Hiroyuki Doi

    SCIENCE OF THE TOTAL ENVIRONMENT   417   291 - 293   2012年2月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:ELSEVIER SCIENCE BV  

    Recent studies suggest potential adverse effects of methylmercury exposure on myocardial infarction and hypertension, although the evidence is still limited. We thus evaluated this association using age-standardized mortality ratios (ASMRs) in Minamata, where severe methylmercury poisoning had occurred. We obtained mortality data from annual vital statistics and demographic statistics from census. We then compared mortality of atherosclerotic heart disease including degenerative heart disease and hypertension in Minamatacity with those in Kumamoto Prefecture, which includes Minamata city, as a control. We estimated ASMRs and 95% confidence intervals (CIs) during the period from 1953 to 1970. ASMRs of atherosclerotic heart disease were continuously decreased during the period from 1953 to 1967. In contrast, the ASMR of hypertension was significantly elevated during the period from 1963 to 1967 (SMR= 1.38, CI; 1.06-1.80); but they decreased later. Although dilution is present in this ecological study, our study supports the notion that methylmercury exposure induces hypertension. (C) 2011 Elsevier B.V. All rights reserved.

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  • Residential proximity to major roads and placenta/birth weight ratio 査読

    Yorifuji, Takashi, Naruse, Hiroo, Kashima, Saori, Murakoshi, Takeshi, Tsuda, Toshihide, Doi, Hiroyuki, Kawachi, Ichiro

    SCIENCE OF THE TOTAL ENVIRONMENT   414   98 - 102   2012年1月

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    掲載種別:研究論文(学術雑誌)   出版者・発行元:ELSEVIER SCIENCE BV  

    Exposure to air pollution has been demonstrated to increase the risk of preterm birth and low birth weight. We examined whether proximity to major roads (as a marker of exposure to air pollution) is associated with increased placenta/birth weight ratio (as a biomarker of the placental transport function). Data on parental characteristics and birth outcomes were extracted from the database maintained by a major hospital in Shizuoka Prefecture, Japan. We restricted the analysis to mothers who delivered liveborn single births from 1997 to 2008 (n = 14,189). Using geocoded residential information, each birth was classified according to proximity to major roads. We examined the association between proximity to major roads and the placenta/birth weight ratio, using multiple linear regression. Proximity to major roads was associated with higher placenta/birth weight ratio. After adjusting for potential confounders, living within 200 m of a major road increased the ratio by 0.48% (95% CI = 0.15 to 0,80). In addition, proximity to major roads was associated with lower placenta weight and birth weight. These observed associations were stronger among participants living closer to major roads.

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  • Methyl Mercury Exposure at Niigata, Japan: Results of Neurological Examinations of 103 Adults 査読

    Kimio Maruyama, Takashi Yorifuji, Toshihide Tsuda, Tomoko Sekikawa, Hiroto Nakadaira, Hisashi Saito

    JOURNAL OF BIOMEDICINE AND BIOTECHNOLOGY   2012年

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:HINDAWI PUBLISHING CORPORATION  

    Background. Large-scale poisonings caused by methyl mercury (MeHg) have occurred in Japan (Minamata in the 1950s and Niigata in the 1960s) and Iraq (in the 1970s). The current WHO neurological risk standard for adult exposure (hair level: 50 mu g/g) was based partly on evidence from Niigata which did not consider any cases who were diagnosed later and/or exposed to low level of MeHg (hair mercury level less than 50 mu g/g). Methods. Early in the Niigata epidemic in June 1965 there were two extensive surveys. From these two surveys, we examined 103 adults with hair mercury measurement who consulted two medical institutions. We compared the prevalence and the distribution of neurological signs related to MeHg poisoning between exposure categories. Result. We found 48 subjects with neurological signs related to MeHg poisoning who had hair mercury concentration less than 50 mu g/g. Among the neurological signs, sensory disturbance of the bilateral distal extremities was observed more frequently, followed by disequilibrium, hearing impairment, and ataxia, in groups with hair MeHg concentration both below 50 mu g/g and over 50 mu g/g. Conclusion. The present study suggests the possibility that exposure to MeHg at levels below the current WHO limits could cause neurologic signs, in particular, sensory disturbance.

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  • Long-term exposure to methylmercury and psychiatric symptoms in residents of Minamata, Japan 査読

    Takashi Yorifuji, Toshihide Tsuda, Sachiko Inoue, Soshi Takao, Masazumi Harada

    ENVIRONMENT INTERNATIONAL   37 ( 5 )   907 - 913   2011年7月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:PERGAMON-ELSEVIER SCIENCE LTD  

    Introduction: It is well-known that prenatal or postnatal exposure to methylmercury can produce neurological signs in adults and children, exemplified by a case of large-scale poisoning in Minamata, Japan, in the 1950s. However, evidence regarding whether pre- or postnatal exposure to methylmercury causes psychiatric symptoms (e.g., impairment of intelligence and mood and behavioral dysfunction) is still limited-excluding cases of fetal Minamata disease patients.
    Methods: We evaluated the effects of pre- or postnatal exposure to methylmercury on psychiatric symptoms using data derived from a 1971 population-based survey in Minamata and neighboring communities. We adopted residential areas as an exposure indicator and psychiatric symptoms as the outcome. Then, we estimated the adjusted prevalence odds ratio (POR) and confidence interval (Cl) of psychiatric symptoms in relation to residential area.
    Results: There were 904 participants in Minamata (high exposure area), 1700 in Goshonoura (middle exposure area), and 913 in Ariake (low exposure area). Compared to the Ariake area, participants in the Minamata area manifested psychiatric symptoms more frequently: PORs for impairment of intelligence and mood and behavioral dysfunction were 5.2 (95% Cl: 3.7-7.3) and 4.4 (95% Cl: 2.9-6.7), respectively. Furthermore, participants with psychiatric symptoms in the Minamata area more frequently had neurological signs. Peaks in prevalence of psychiatric symptoms occurred around age 20 and in older age adults in the area. These findings did not change when we excluded those who had been officially certified as Minamata disease patients by that time.
    Conclusions: The present study suggests a relationship between pre- or postnatal exposure to methylmercury and psychiatric symptoms among the general population in Minamata even after excluding officially certified patients. (C) 2011 Elsevier Ltd. All rights reserved.

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  • Identification of operating mediation and mechanism in the sufficient-component cause framework 査読

    Etsuji Suzuki, Eiji Yamamoto, Toshihide Tsuda

    EUROPEAN JOURNAL OF EPIDEMIOLOGY   26 ( 5 )   347 - 357   2011年5月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:SPRINGER  

    The assessment of mediation and mechanism is one way to more deeply explore cause-effect relationships, providing a stronger test and explanation of the observed associations. Most previous studies have described direct and indirect effects in terms of potential outcomes and response types, exploring mediation analysis in the counterfactual (= potential-outcome) framework. A recent paper by Hafeman (Eur J Epidemiol 23(11):711-721, 2008) provided a conceptual description of mediation in the sufficient-component cause framework, and VanderWeele (Eur J Epidemiol 24(5):217-224, 2009) explored the distinctions and relationships between the concepts of mediation and mechanism. This study builds on this prior work and demonstrates that further insight can be given by elucidating the concepts of mediation and mechanism in the sufficient-component cause framework, distinguishing their operation from presence. The careful consideration of the concepts of mediation and mechanism can clarify the relationship between them. Then, the present article describes how investigators can identify mediation as well as mechanism by showing their correspondence with direct and indirect effects in the counterfactual framework. This study also demonstrates how a researcher can decompose the total effect into the effect due to mediated paths and the effect due to non-mediated paths in terms of the probabilities of background factors of sufficient causes.

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  • Residential Proximity to Major Roads and Preterm Births 査読

    Yorifuji, Takashi, Naruse, Hiroo, Kashima, Saori, Ohki, Shigeru, Murakoshi, Takeshi, Takao, Soshi, Tsuda, Toshihide, Doi, Hiroyuki

    EPIDEMIOLOGY   22 ( 1 )   74 - 80   2011年1月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:LIPPINCOTT WILLIAMS & WILKINS  

    Background: Preterm births cause a large public-health burden, and air pollution is considered to be a potential risk factor. We evaluated the association between proximity to major roads (as an index for air pollution) and preterm births, classified by gestational age and specific clinical manifestations. Methods: Data on parental information and birth outcomes were extracted from the database maintained by the perinatal hospital in Shizuoka, Japan. We restricted the analysis to mothers who delivered liveborn single births from 1997 to 2008 (n = 14,226). Using the geocoded residential information, each birth was classified on its proximity to major roads. We estimated the multivariate-adjusted odds ratios and their 95% confidence intervals (CIs) for the association of proximity to major roads with preterm births, using logistic regression. Results: We found positive associations between proximity to major roads and preterm births at all gestational ages. Living within 200 m increased the risk of births before 37 weeks by 1.5 times (95% CI = 1.2-1.8), birth before 32 weeks by 1.6 times (1.1-2.4), and births before 28 weeks by 1.8 times (1.0-3.2). Proximity specifically increased th

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  • Environmental factors and seasonal influenza onset in Okayama city, Japan: case-crossover study

    Tsuchihashi Y, Yorifuji T, Takao S, Suzuki E, Mori S, Doi H, Tsuda T

    Acta Medica Okayama   65 ( 2 )   97 - 103   2011年

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    記述言語:英語   出版者・発行元:Okayama University Medical School  

    Seasonal influenza infection is a major challenge in public health. The term "seasonal influenza" refers to the typical increase in the number of influenza patients in the winter season in temperature zones. However, it is not clear how environmental factors within a single flu season affect influenza infection in a human population. Therefore, we evaluated the effects of temperature and humidity in the 2006-7 flu season on the onset of seasonal influenza using a case-crossover study. We targeted patients who attended one pediatric clinic in Okayama city, Japan and who were diagnosed as being infected with the seasonal influenza virus. Using 2 references (time-stratified and symmetric bidirectional design), we estimated the effects of average temperature and relative humidity from the onset day (lag0) to 10 days before (lag10). The total number of subjects was 419, and their onset days ranged from 26 December 2006 to 30 April 2007. While the onset was significantly associated with lower temperature, relative humidity was not related. In particular, temperatures before the 3-day incubation period had higher-magnitude odds ratios. For example, the odds ratio and 95% confidence interval for average temperature at time lag 8 was 1.12 (1.08-1.17) per 1.0℃ decrease. Low environmental temperature significantly increased the risk of seasonal influenza onset within the 2006-7 winter season.

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  • On the link between sufficient-cause model and potential-outcome model

    Suzuki E, Yamamoto E, Tsuda T

    Epidemiology   22 ( 1 )   131 - 132   2011年

  • Outbreak of Salmonella Braenderup infection originating in boxed lunches in Japan in 2008

    Mizoguchi Y, Suzuki E, Tsuchida H, Tsuda T, Yamamoto E, Nakase K, Doi H

    Acta Medica Okayama   65 ( 2 )   63 - 69   2011年

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    記述言語:英語   出版者・発行元:Okayama University Medical School  

    There have been only 2 reports of a large-scale foodborne outbreak arising from Salmonella enterica serotype Braenderup infection worldwide. On August 9, 2008, an outbreak originating in boxed lunches occurred in Okayama, Japan. We conducted a cohort study of 786 people who received boxed lunches from a particular catering company and collected 644 questionnaires (response rate:82%). Cases were defined as those presenting with diarrhea (≧4 times in 24h) or fever (≧38℃) between 12 am on August 8 and 12 am on August 14. We identified 176 cases (women/men:39/137);younger children (aged<10 years) appeared to more frequently suffer severe symptoms. Three food items were significantly associated with higher risk of illness;tamagotoji (soft egg with mixed vegetables and meat) (relative risk (RR):11.74, 95% confidence interval (CI):2.98-46.24), pork cooked in soy sauce (RR:3.17, 95% CI:1.24-8.10), and vinegared food (RR:4.13, 95% CI:1.60-10.63). Among them, only the RR of tamagotoji was higher when we employed a stricter case definition. Salmonella Braenderup was isolated from 5 of 9 sampled cases and 6 food handlers. It is likely that unpasteurized liquid eggs contaminated by Salmonella Braenderup and used in tamagotoji caused this outbreak.

    DOI: 10.18926/AMO/45264

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  • Oseltamivir and Abnormal Behavior response

    Takashi Yorifuji, Etsuji Suzuki, Toshihide Tsuda

    EPIDEMIOLOGY   21 ( 6 )   916 - 916   2010年11月

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    記述言語:英語   出版者・発行元:LIPPINCOTT WILLIAMS & WILKINS  

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  • 給食弁当を原因食品とするSalmonella Braenderupによる食中毒

    溝口 嘉範, 山本 英二, 津田 敏秀, 土居 弘幸, 中瀬 克己

    日本公衆衛生学会総会抄録集   69回   546 - 547   2010年10月

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    記述言語:日本語   出版者・発行元:日本公衆衛生学会  

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  • Increased risk of lung cancer mortality among residents near an asbestos product manufacturing plant. 査読

    Kumagai S, Kurumatani N, Tsuda T, Yorifuji T, Suzuki E

    International journal of occupational and environmental health   16 ( 3 )   268 - 278   2010年7月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

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  • Factors Affecting Appropriate Management of Patients with Sexually Transmitted Infections in Japan 査読

    Tomoe Kodama, Katsumi Nakase, Toshihide Tsuda, Takashi Yorifuji, Hiroyuki Doi

    ACTA MEDICA OKAYAMA   64 ( 3 )   171 - 179   2010年6月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:OKAYAMA UNIV MED SCHOOL  

    Physicians should educate patients with sexually transmitted infections (STIs) on measures to prevent reinfection and should also undertake human immunodeficiency virus (HIV) testing after diagnosis of STIs. These preventive measures are important, but it is not known to what extent these procedures are followed in Japan. We conducted a cross-sectional study to investigate the proportion of patients with STIs who received appropriate management from physicians, namely recommendation of HIV testing, encouragement of condom use and examination and/or treatment of sexual partners, to elucidate the factors affecting institution of each measure. From a mailshot of 566 physicians, 409 (72.3%) responded, with 176 diagnosing an STI in 967 patients. The proportions applying the 3 measures were low (recommendation of HIV testing: 27.0%; encouragement of condom use: 64.8%; examination of sexual partners: 17.5%), and were related to the sex of the patients and numbers of patients diagnosed by the physicians. Female patients received better care than male patients, particularly with respect to recommendation of HIV testing (odds ratio: 2.82). Physicians who diagnosed more than 20 STI patients tended not to provide appropriate management. These findings suggest the necessity for better physician management of patients for effective prevention of STIs.

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  • Effects of traffic-related outdoor air pollution on respiratory illness and mortality in children, taking into account indoor air pollution, in Indonesia 査読

    Kashima S, Yorifuji T, Tsuda T, Ibrahim J, Doi H

    Journal of Occupational and Environmental Medicine   52 ( 3 )   340 - 345   2010年3月

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    掲載種別:研究論文(学術雑誌)  

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  • Long-term exposure to methylmercury and its effects on hypertension in Minamata 査読

    Yorifuji T, Tsuda T, Kashima S, Takao S, Harada M

    Environmental Research   110 ( 1 )   40 - 46   2010年1月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    DOI: 10.1016/j.envres.2009.10.011

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  • Total mercury content in hair and neurologic signs: historic data from Minamata

    Yorifuji T, Tsuda T, Takao S, Suzuki E, Harada M

    Epidemiology   20 ( 2 )   188 - 193   2009年

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    DOI: 10.1097/EDE.0b013e318190e73f

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  • Long-Term Exposure to Particulate Matter and All-Cause and Cause-Specific Morality in Japan: Shizuoka Study 査読

    Takashi Yorifuji, Saori Kashima, Etsuji Suzuki, Soshi Takao, Toshihide Tsuda, Hiroyuki Doi

    The journal of obstetrics and gynaecology research   19 ( 6 )   S195   2008年11月

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    掲載種別:研究論文(学術雑誌)  

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  • Health impact assessment of particulate matter in Tokyo, Japan 査読

    Takashi Yorifuji, Eiji Yamamoto, Toshihide Tsuda, Norito Kawakami

    Archives of Environmental and Occupational Health   60 ( 4 )   179 - 185   2005年

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:Taylor and Francis Inc.  

    Among industrialized countries, Japan still maintains an old set of guidelines for particulate matter (PM)
    therefore, we assessed the public health impacts of PM exposure in various situations using data from the Tokyo metropolitan area. Subjects were 7.8 million people aged older than 30 years. Based on a linear relationship between exposure and health effects, we estimated attributable cases of mortality caused by PM. Even at the recent exposure level, the number of deaths will occur after both short- and long-term exposure. When the guideline for PM2.5 (particles &lt
    2.5 μm in diameter) long-term exposure was set at 12 μg/m3, we could prevent 8% of all causes mortality or 6,700 deaths in the Tokyo metropolitan area per year. This assessment shows that guidelines for long-term exposure, especially for PM 2.5, should be recommended in Japan. Copyright © 2006 Heldref Publications.

    DOI: 10.3200/AEOH.60.4.179-185

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  • F305 原因確率とAction・Lnaction・Causal lnference

    津田 敏秀, 大津 忠弘, 高尾 総司, 茂見 潤, 馬場 園明, 三野 善央

    産業衛生学雑誌   44   516 - 516   2002年

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    記述言語:日本語   出版者・発行元:公益社団法人 日本産業衛生学会  

    DOI: 10.1539/sangyoeisei.KJ00003947921

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  • Does smoking cessation improve mental health? 査読

    Yoshio Mino, Jun Shigemi, Tadahiro Otsu, Toshihide Tsuda, Akira Babazono

    Psychiatry and Clinical Neurosciences   54 ( 2 )   169 - 172   2000年4月

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    There is a possibility that cessation of smoking improves mental health, but there are no studies that have demonstrated this. A cohort study was performed for 1 year in 18 males who spontaneously stopped smoking (cessation group) and 173 who continued to smoke (smoking group). The mental health state was evaluated using the Japanese version of the 30-item General Health Questionnaire (GHQ-30) before the cessation of smoking and 6 months and 1 year after smoking cessation. Changes in the GHQ score were compared between the cessation and smoking groups. In order to control the effects of confounding factors, multiple regression analyses were performed using the GHQ score after 6 months and 1 year as dependent variables. The GHQ score in the cessation group significantly decreased 6 months and 1 year after smoking cessation (P &lt
    0.04 and 0.01, respectively, by paired t-test). In the smoking group, the GHQ score slightly decreased. Repeated measure analysis of variance revealed that the decrease in the GHQ score in the cessation group was significantly larger than in the smoking group. Multiple regression analysis revealed significant effects of smoking cessation on mental health after controlling for other confounding factors. It can be concluded that smoking cessation may improve mental health.

    DOI: 10.1046/j.1440-1819.2000.00654.x

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  • Recovery from mental ill health in an occupational setting: A cohort study in Japan 査読

    Yoshio Mino, Jun Shigemi, Toshihide Tsuda, Nobufumi Yasuda, Akira Babazono, Paul Bebbington

    Journal of Occupational Health   42 ( 2 )   66 - 71   2000年

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    Objectives: The purpose of this study is to clarify the degree of recovery from mental ill health in occupational settings and the nature of perceived job stress associated with recovery. Methods: A 1-year cohort study was carried out in 287 of 763 workers who scored 8 or more on the General Health Questionnaire (GHQ-30), and the proportion recovering during the year was compared according to the presence of individual perceived job stress items. To control confounding factors, multiple logistic analysis was used. Results: Recovery from mental ill health was observed in 48.7% after the first 6 months and in 66.1% after 1 year. During the first 6-month period, no identified job stress item was associated with recovery. During the second 6- month period, however, the odds ratio (95% confidence interval) between recovery and the absence of perceived job stress was 4.2 (1.3-13.1) for 'Too much responsibility', even after controlling for sex, age, the degree of family life satisfaction, physical health state, and the initial GHQ score. Conclusion: Relief from excessive responsibility might promote recovery in mentally ill workers.

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  • Stability of factor structure and correlation with perceived job stress in general health questionnaire: A three-wave survey over one year in Japanese workers 査読

    Jun Shigemi, Yoshio Mino, Toshihide Tsuda

    Journal of Occupational Health   42 ( 6 )   284 - 291   2000年

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:Japan Society for Occupational Health  

    A cross-sectional study was conducted to examine psychological symptoms and job stress in Japanese workers. To assess the stability of the relationship between the parameters for perceived job stress and mental health, two additional surveys were carried out six months and one year later. The surveys included demographic questions, the General Health Questionnaire (GHQ), and questions relating to perceived job stress to measure the worker's mental health and job stress. Factor analyses were conducted to clarify the factor structure of mental health. As for the GHQ, the 6 dominant factors were interpreted. These factors involved "Anxiety and depression", "Severe depression", "Lack of interpersonal network or social support", "Poor social activity", "Insomnia", and "Lack of a positive attitude". This structure was stable in the 2 follow up surveys. A multiple regression analysis was used to examine the relationship between extracted factors of the GHQ and job stress. The analysis showed that the factor "Anxiety and depression" had a significantly stable relationship with "Too much responsibility at work" and "Cannot keep up with new technology".

    DOI: 10.1539/joh.42.284

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  • The Role of Perceived Job Stress in the Relationship between Smoking and the Development of Peptic Ulcers

    SHIGEMI Jun, MINO Yoshio, TSUDA Toshihide

    Journal of epidemiology   9 ( 5 )   320 - 326   1999年11月

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    記述言語:英語   出版者・発行元:日本疫学会  

    Although smoking has been considered a risk factor in causing pepticulcers, no study has examined the effects of job stress on the relationship between peptic ulcers and smoking.To establish a link between gastric or duodenal ulcers over two years and a state of perceived job stress, a questionnaire, including questions on demographics, smoking, history of peptic ulcer and perceived job stress was conducted. Follow-up surveys were carried out every six months to accumulate the data for this analysis and the time span of this follow up study was two years. To examine the role of perceived job stress on the relationship between smoking and peptic ulcers, stratified analyses were performed.Some specific causes of perceived job stress such as "Too much competition, " "Schedule is too tight or pressed to work too hard" had high estimated relative risks: 2.13 with 95% confidence interval (CI) of 1.09 -4.16 and 2.50 with 95%Cl of 0.98 - 6.40, respectively. Stratified analyses suggested an effect-measure modification of perceived job stress in the relationship between peptic ulcers and smoking. Multiplicative and additive models suggest positive interaction between perceived job stress and smoking. These results suggest that specific perceived job stress is an effect modifier in the relationship between the history of the peptic ulcer and smoking. J Epidemiol, 1999 ; 9 : 320-326

    DOI: 10.2188/jea.9.320

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  • Perceived job stress and mental health in precision machine workers of Japan: A 2 year cohort study 査読

    Yoshio Mino, Jun Shigemi, Toshihide Tsuda, Nobufumi Yasuda, Paul Bebbington

    Occupational and Environmental Medicine   56 ( 1 )   41 - 45   1999年

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:BMJ Publishing Group  

    Objectives. To determine whether perceived job stress affects mental health in occupational settings. Methods. A 2 year cohort study was conducted. Initially, a survey including the general health questionnaire (GHQ) and a questionnaire about perceived job stress was carried out. Of 462 workers who initially showed a GHQ score of ≤ 7 310 were successfully followed up for 2 years. The 2 year risks of developing mental ill health (a GHQ score ≥ 8) were assessed relative to perceived job stress. To control for potential confounding factors, multiple logistic regression analyses were conducted. Results. The overall 2 year risk for developing mental ill health was high at 57.7%. Workers who reported aspects of perceived job stress showed a greater 2 year risk than those without stress. Multiple logistic regression analyses showed that some components of perceived job stress were associated with a higher 2 year risk, among which 'not allowed to make mistakes' showed the largest adjusted odds ratio (OR) (95% confidence interval (95% CI)) of 2.37 (1.32 to 4.29). 'Poor relationship with superior' had a significant effect on mental health only in women, with an adjusted OR (95% CI) of 3.79 (1.65 to 8.73). Conclusions. Certain specific items of perceived job stress seem to be associated with mental ill health in workers. These could broadly be described as job strain, or job demand items. The type of job stress that predicts mental health may be dependent on the characteristics of the workplace investigated.

    DOI: 10.1136/oem.56.1.41

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  • 23. 耐火煉瓦工場集積地域における肺癌の疫学調査について (平成10年度中国四国合同地方会)

    大津 忠弘, 津田 敏秀, 三野 善央, 茂見 潤, 青山 英康, 馬場園 明

    産業衛生学雑誌   41 ( 2 )   35 - 35   1999年

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    記述言語:日本語   出版者・発行元:公益社団法人 日本産業衛生学会  

    DOI: 10.1539/sangyoeisei.KJ00002552120

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  • J306 粉じん曝露およびじん肺と肺がんの関連に関する症例対照研究

    津田 敏秀, 三野 善央, 茂見 潤, 大津 忠弘, 馬場 園明

    産業衛生学雑誌   41   638 - 638   1999年

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    記述言語:日本語   出版者・発行元:公益社団法人 日本産業衛生学会  

    DOI: 10.1539/sangyoeisei.KJ00001991392

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  • Expressed emotion of families and negative/depressive symptoms in schizophrenia: A cohort study in Japan 査読

    Yoshio Mino, Shimpei Inoue, Shinji Shimodera, Shuichi Tanaka, Toshihide Tsuda, Eiji Yamamoto

    Schizophrenia Research   34 ( 3 )   159 - 168   1998年11月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    This study investigated whether the Expressed Emotion (EE) status of families is associated with an increased risk of negative and depressive symptoms in schizophrenia. The subjects were 52 schizophrenic patients from mental hospitals in Kochi, Japan, who satisfied the DSM-III-R or ICD-9 criteria for schizophrenia. The Japanese version of the Camberwell Family Interview was administered to 73 key relatives of the patients within 2 weeks after admission. A certified rater evaluated the EE's status of each family, using an audiotaped interview and its transcript. Using cohort study design, the subjects were followed for 9 months after their discharge and were monitored for negative and depressive symptoms. Trained psychiatrists who were blind to the EE status of the patients' households administered the Brief Psychiatric Rating scale (BPRS) at discharge, and 9 months after discharge. Repeated-measures analyses of variance showed that EE effects were significant in Emotional withdrawal in all subjects, Depressive mood and Total depressive symptoms in non-relapsers. A multiple regression analyses revealed that EE's effect was significant only in Depressive mood in non- relapsers controlling confounding factors. In non-relapsers in positive symptoms, high EE families could make patients depressed. EE's effect on negative symptoms remains to be established.

    DOI: 10.1016/S0920-9964(98)00091-7

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  • 集団食中毒事件における疫学調査方法に関する研修会

    津田 敏秀, 三野 善央, 茂見 潤, 荒木 英俊, 大津 忠弘, 岩浅 祐二郎, 中瀬 克己, 馬場園 明

    日本公衆衛生学会総会抄録集   57回   658 - 658   1998年10月

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    記述言語:日本語   出版者・発行元:日本公衆衛生学会  

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  • The effect of a redistribution system for health care for the elderly on the financial performance of health insurance societies in Japan

    Akira Babazono, Janet Weiner, Toshihide Tsuda, Yoshio Mino, Alan L. Hillman

    International Journal of Technology Assessment in Health Care   14 ( 3 )   458 - 466   1998年

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    掲載種別:研究論文(学術雑誌)  

    Health care for the elderly in Japan is financed through a pool to which all insurers contribute. We analyzed insurers' financial data to evaluate this redistribution system. Cost sharing affected financial performance substantially. The current formula for cost-sharing redistributes elderly health care costs unequally and should be changed.

    DOI: 10.1017/S0266462300011430

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  • 疫学から見た作業関連性疾患と職業病:再論 (話題)

    津田 敏秀, 馬場園 明, 三野 善央, 松岡 宏明

    産業衛生学雑誌   40 ( 3 )   A52 - A55   1998年

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    記述言語:日本語   出版者・発行元:公益社団法人 日本産業衛生学会  

    DOI: 10.1539/sangyoeisei.KJ00001989796

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  • 職場における主観的ストレス度の変化が精神の健康状態に与える影響

    馬場園 明, 津田 敏秀, 三野 善央, 畝 博

    産業衛生学雑誌   40   153 - 153   1998年

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    記述言語:日本語   出版者・発行元:公益社団法人 日本産業衛生学会  

    DOI: 10.1539/sangyoeisei.KJ00001989982

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  • An epidemiological study on silica, silicosis, and lung cancer in the south east of Okayama Prefecture, Japan 査読

    T Tsuda, Y Mino, A Babazono, J Shigemi, T Otsu, E Yamamoto

    ADVANCES IN THE PREVENTION OF OCCUPATIONAL RESPIRATORY DISEASES   1153   211 - 215   1998年

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    記述言語:英語   掲載種別:研究論文(国際会議プロシーディングス)   出版者・発行元:ELSEVIER SCIENCE BV  

    Background. In the south east of Okayama Prefecture, Japan, there have been reports on the high prevalence of silicosis among refractory brick production workers, and excess risk of lung cancer among the residents. Therefore, a population-based case-control study was conducted on the relationship between silica, silicosis, and lung cancer.
    Method. Cases and controls were obtained from death certificates from 1986 to 1993 in the area. The four control groups were the series of deaths from stomach cancer, liver cancer, colon cancer, and the other cancers. 186 lung cancer cases and 477 controls were analyzed. Age and smoking habits were adjusted by stratified analysis using the Mantel-Haenszel odds ratio estimates.
    Results. The age- and smoking-adjusted odds ratios were 1.72 (95% C.I. 0.95-3.17) for stomach cancer control, 1.84 (0.96-3.59) for liver cancer, 1.70 (0.81-3.89) for colon cancer, and 2.34 (1.35-4.25) for the other cancer on silica exposure, and 2.23 (1.14-4.16), 2.43 (1.17-5.37), 3.11 (1.26-10.34), and 2.68 (1.47-5.18) on silicosis, respectively.
    Conclusions. The results indicate the causal relationship between silica exposure and lung cancer. The excess risk of lung cancer in the area can partly be explained by the relationship.

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  • Expressed emotion among families and course of schizophrenia in Japan: A 2-year cohort study 査読

    Yoshio Mino, Shimpei Inoue, Shuichi Tanaka, Toshihide Tsuda

    Schizophrenia Research   24 ( 3 )   333 - 339   1997年4月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    A 2-year cohort study was conducted to determine whether expressed emotion (EE) in families is associated with relapse of schizophrenia in Japan. Key relatives of 52 schizophrenic patients were interviewed using the Camberwell Family Interview (CFI) and the patients were classified into high and low EE groups. The 2-year relapse risks were 71% (17/24) in the, high EE group and 37% (10/27) in the low EE group. The risk ratio was 1.9 and the 95% confidence interval (CI) ranged from 1.1 to 3.3. In the multiple logistic regression analysis, the odds ratio between families' EE and schizophrenic relapse was 4.6, controlling for other potential confounding factors. It was concluded that, in Japan, the families' EE is a good predictor for schizophrenic relapse within 2 years. This association between EE and relapse could be due to the strong difference in the first 9 months. The period during which EE's predictive validity for schizophrenic relapse is applicable may vary according to the society to which the patients and their families belong.

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  • The relationship between job stress and mental health at work 査読

    J Shigemi, Y Mino, T Tsuda, A Babazono, H Aoyama

    INDUSTRIAL HEALTH   35 ( 1 )   29 - 35   1997年1月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:NATL INST INDUSTRIAL HEALTH  

    In order to evaluate the relationship between job stress and mental health, a cross-sectional study was conducted using a questionnaire relating to demographics, subjective job stress and mental health state, The questionnaire consisted of a 30-item Japanese version of the General Health Questionnaire (GHQ) developed by Goldberg in addition to questions about subjective Job stress, to measure mental health and job stress conditions, respectively, All subjects were employees of an electronic company in Japan, Among 782 workers, 763 workers responded to the questionnaire satisfactorily (response rate was 97.6%), People whose GHQ score was more than 7 were classified as having psychiatric problems, while the remaining respondents were considered as having no mental health problems, We employed a multiple logistic regression analysis to estimate the relationship between subjective job stress and mental health, adjusting for gender, age, marital state, familial stress, and physical health state, Subjective job stress was significantly associated with the state of mental health, In particular, the items of ''too much trouble at work,'' ''too much responsibility,'' ''are not allowed to make mistakes,'' ''poor relationship with superiors,'' and ''cannot keep up with technology'' were significantly related to mental health.

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  • Causal inference in medicine: A reaction to the report, 'Incidence of Minamata Disease in Communities along the Agano River, Niigata, Japan - Patterns of the exposure and official diagnosis of patients' 査読

    Toshihide Tsuda, Yoshio Mino, Eiji Yamamoto, Hiroaki Matsuoka, Akira Babazono, Jun Shigemi, Masaya Miyai

    Japanese Journal of Hygiene   52 ( 2 )   511 - 526   1997年

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    記述言語:日本語   掲載種別:研究論文(学術雑誌)   出版者・発行元:Japanese Society for Hygiene  

    Kondo's 'Incidence of Minamata Disease in Communities along the Agano River, Niigata, Japan (Jap. J. Hyg. 51:599-611
    1996)' is critically reviewed. The data of the article were obtained from most of the residents living in the Agano river villages where Minamata disease was discovered in June, 1965. However, sampling proportions were much different between in the population base and in the cases. The method of identification of cases from the data and the reason for the difference were not clearly demonstrated. The citations of reference articles are insufficient despite the fact that other epidemiologic studies on methyl-mercury poisoning have been reported not only in Japan, but also around the world. His 'analysis of the recognized patients' is erroneous. Both the sampling scheme of information of hair mercury and the modeling of the analysis are based on Kondo' s arbitrary interpretation, not on epidemiologic theory. His 'analysis of the rejected applicants' is also erroneous. His calculations of the attributable proportion are incorrect and self-induced in both the assignments of data and analysis of data. Kondo has failed to study the epidemiologic theories in light of changes in the field. Therefore, his article is lacking in epidemiologic theory, a logical base and scientific inference. In Japan, epidemiologic methodology has rarely been used in studies on Minamata Disease in either Kumamoto and Niigata. The government has used neurologically specific diagnosis based on combinations of symptoms to judge the causality between each of symptoms and methyl-mercury poisoning. Epidemiologic data obtained in Minamata, Kumamoto in 1971 indicate that the criteria set by the government in 1977 have produced much more false-negative patients than false-positive patients. As a result, a huge number of symptomatic patients, including those with peripheral neuropathy or with constriction of the visual field, did not receive any help or compensation until 1995. The authors emphasize that the causal relationship between each symptom and methyl- mercury exposure should be reevaluated epidemiologically in Japan.

    DOI: 10.1265/jjh.52.511

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  • Optimal Screening Interval for Gastric Cancer in Japan 査読

    Akira Babazono, Toshihide Tsuda, Yoshio Mino, Takanori Ogawa, Hideyasu Aoyama

    Journal of Epidemiology   5 ( 2 )   67 - 74   1995年

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Annual gastric cancer screening has been recommended for residents over the age of 40 in Japan. We conducted a cost-effectiveness study in order to determine an optimal screening interval in both genders using a cohort model. Hypothetical cohorts of 100,000 asymptomatic individuals aged 40 were assumed to have taken part in each strategy with a follow-up period of 20 years. In order to evaluate both the cost and effectiveness of the gastric cancer screening, a Markov modeling process was used. The incremental cost per year-of-life saved in gastric cancer screening, compared to no screening, illustrates a tendency toward a higher cost per year-of-life saved in both, shorter than and longer than 3-year screening intervals. Our results indicate that the recommended method of annual screening represents the least cost-effective option regarding both genders. The incremental cost per year-of-life saved of annual screening strategy was 2,764,000 yen ($25,127) for males and 3,753,000yen ($34,118) for females, compared to no screening. The figures of the incremental cost per year-of-life saved in the three year screening interval at 1,670,000 yen ($15,182) for males and 2,431,000yen ($22,100) for females clearly show this strategy as the most efficient solution in both genders, compared to no screening. However, the screening program on annual basis is not considered to be less efficient than other screening programs so far. The cost-effectiveness of gastric cancer is decreasing as its incidence decreases. It is very important for policy makers to pay attention to the incidence of diseases targeted by screening programs and to evaluate screening interval. J Epidemiol, 1995
    5: 67-74. © 1995, Japan Epidemiological Association. All rights reserved.

    DOI: 10.2188/jea.5.67

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  • 感情表出(Expressed Emotion)にもとづく分裂病の家族介入研究の効果判定-その技術と評価 査読

    三野善央, 津田敏秀, 茂見潤, 谷原真一, 青山英康, 馬場園明

    日本公衆衛生雑誌   42 ( 9 )   301 - 312   1995年

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    記述言語:日本語   掲載種別:研究論文(学術雑誌)   出版者・発行元:日本公衆衛生学会  

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    その他リンク: http://search.jamas.or.jp/link/ui/1996013461

  • 〈総説〉集団を対象とした観察研究におけるバイアス

    馬場園 明, 津田 敏秀, 三野 善央[他]

    健康科学   17   35 - 42   1995年

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    記述言語:日本語   出版者・発行元:九州大学  

    Avoiding bias is essential in an observational study on population since bias leads to a misinterpretation of the magnitude of the effect on a result. Bias is classified into three categories; selection bias, infomation bias and confounding. Selection bias refers to a distortion in the estimate of effect resulting from the manner in which subjects are selected for the study population. Information bias refers to a distortion in the estimate of effect due to measurement error or misclassification of subjects on one or more variables. Confounding is the bias that results when the study factor effect is mixed, in the data, with the effects of extraneous variables. We must maintain the specific characteristics of each of those biases in mind in order to control them. It is not fair to insist that a study result is incorrect because of a small bias since it is impossible to rule out any bias completely when data are collected by observation. Direction of bias is very helpful in judging the study result when some bias is noticed. Neither selection bias nor information bias can be controlled during the data analytic phase. Both selection bias and information bias should be minimized in the reseatch design. Confounding can be controlled in either the research design or the data analytic phase.バイアスは要因と結果の関連の指標の強さを真の値から歪めるものである。集団を対象とした観察研究においては,バイアスは選択バイアス,情報バイアス,交絡に分けられる。選択バイアスは対象の設定の問題から起こるバイアスで,情報バイアスは情報が誤っているために対象を誤分類してしまう問題である。交絡は,原因と結果の双方に関係する他要因によって因果関係が歪められるバイアスである。観察による方法でデータを集める場合には,バイアスを完全になくすことはできないため,バイアスがあるからといってその研究が誤っているという考え方は正しくはない。バイアスをできるだけ少なくする努力は必要であるが,その研究から起こって来る可能性のあるバイアスを考え,そのバイアスが結果を過大評価したのか過小評価したのかを考察し,そのバイアスがあったとしても研究結果を支持できるかどうかを考察することも重要である。また,バイアスを小さくする方法は,選択バイアス,情報バイアス,交絡それぞれについて検討されなければならない。選択バイアスと情報バイアスの対策は研究計画を立てる段階でしかおこなうことはできず,分析の段階で工夫することはできない。一方,交絡は研究計画をおこなう段階でも,分析の段階でも対策を立てることができる。

    DOI: 10.15017/626

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    その他リンク: http://hdl.handle.net/2324/626

  • Risk Factors for Low Birth Weight Infants in Japan 査読

    Akira Babazono, Toshihide Tsuda, Eiji Yamamoto, Yoshio Mino, Tsuneko Babazono, Yoshiki Kishi, Jun Sigemi, Takanori Ogawa, Hideyasu Aoyama

    Journal of Epidemiology   4 ( 2 )   91 - 98   1994年

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Prevalence of low birth weight infants in Japan has been increasing, although infant mortality is the lowest in the world. We conducted a population based case-control study to clarify risk factors for low birth weight infants in Japan. Information was obtained by questionnaire. The response rate was 78.9% from 402 cases and 804 controls. The majority of low birth weight infants belongs to full-term case group. This is considered to be an important factor for low infant mortality in Japan. We examined potential risk factors by a multiple logistic regression model. Lower maternal academic career and toxemia were identified as significant risk factors for pre-term low birth weight infants, while maternal shorter height, lower prepregnancy weight, maternal smoking and employment during pregnancy and hypertension were identified as significant risk factors for full-term low birth weight infants. The Japanese small physique and prevalent hypertension are considered to be causes for the high prevalence of low birth weight infants. J Epidemiol, 1994
    4: 91-98. © 1994, Japan Epidemiological Association. All rights reserved.

    DOI: 10.2188/jea.4.91

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  • The effect of a cost sharing provision in japan 査読

    Akira Babazono, Takanori Ogawa, Tsuneko Babazono, Hirohisa Hamada, Toshihide Tsuda, Hideyasu Aoyama

    Family Practice   8 ( 3 )   247 - 252   1991年

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Babazono A, Ogawa T, Babazono T, Hamada H, Tsuda T and Aoyama H. The effect of a cost sharing provision in Japan. Family Practice 1991
    8: 247-252. This study evaluated the effect of a 10% cost sharing provision, introduced in October 1984, on demand for medical services. We analysed the data of 1701 health insurance societies, all of which joined the National Federation of Health Insurance Societies between 1983 and 1985. The case rate (per 1000 persons) and the number of serviced days (per case) were analysed as indicators of demand for inpatient, outpatient and dental medical services. The case rate was considered to bean indicator of the patient's behaviour, while the number of serviced days was influenced by the doctor's behaviour. Multiple linear regression analysis was used with each indicator to isolate the effect of the cost sharing provision, adjusted for other variables which influenced demand for medical services. The case rate was reduced significantly in all medical services. This means that a patient was discouraged from using a medical facility by the cost sharing provision. There was little difference among medical services. The number of serviced days was also reduced significantly in all medical services. There was a large difference among medical services. The effect on outpatient service was much greater than that on any other service. © 1991 Oxford University Press.

    DOI: 10.1093/fampra/8.3.247

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書籍等出版物

  • 医学者は公害事件で何をしてきたのか

    岩波書店(岩波現代文庫)  2014年  ( ISBN:9784006003111

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  • 医学的根拠とは何か

    岩波書店(岩波新書)  2013年 

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  • Training Program on Food-Borne Disease Epidemiology

    Japan Food Hygiene Association  2012年 

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  • 食中毒の疫学講座.

    日本食品衛生協会  2012年 

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  • 新通史 日本の科学技術 第4巻: 世紀転換期の社会史/1995年~2011年

    原書房  2011年 

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  • 医学と仮説-原因と結果の科学を考える-

    岩波書店  2011年 

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  • The Science and Tchnology in Japan

    2011年 

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  • Medicine and Hypothesis -Science on cause and outcome-

    Iwanami co. Ltd.  2011年 

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  • 津田敏秀レビューアーの意見書と著者らの対応

    丸善  2009年 

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  • 医学における因果関係の推論と原因確率.法と経済学叢書 Ⅷ〕サナ・ルー著 『法,疫学,市民社会:法政策における科学的手法の活用』

    木鐸社  2009年 

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  • アスベストによる健康障害の疫学とリスクアセスメント―特に環境曝露による人体への影響に関して―.解説資料:石綿関係法施行状況調査.

    衆議院調査局環境調査室  2008年 

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  • 平成17年度厚生労働科学研究費補助金(食品の安心・安全確保研究事業)食品の安全施策等に関する国際協調のあり方に関する研究、研究報告書

    2007年 

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  • カネミ油症-過去・現在・未来-.

    緑風出版  2006年 

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  • 悪魔のマーケティング-タバコ産業の真実-

    日経BP社  2005年 

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  • 水俣学講義 第2集

    日本評論社  2005年 

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  • 悪魔のマーケティング-タバコ産業が語った真実-

    日経BP社  2005年 

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  • 医学者は公害事件で何をしてきたのか

    岩波書店  2004年 

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  • 厚生労働科学研究研究費補助金、長寿科学総合研究事業研究報告書「老人疾患患者に及ぼす家族の感情表出の影響に関する研究」

    2003年 

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  • 厚生労働科学研究研究費補助金、新興再興感染症研究事業研究報告書「経口細菌感染症の広域的・散発的発生時の実地疫学的・調査手法等の開発に関する研究」

    2003年 

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  • 医学大事典

    医学書院,東京  2003年 

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  • 市民のための疫学入門-医学ニュースから環境裁判まで-.

    緑風出版,東京  2003年 

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  • 交代勤務と心血管系疾患メカニズムのレビュー.

    自治体労働安全衛生研究会  2002年 

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  • 讀賣新聞

    2001年 

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  • 毎日新聞

    2001年 

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  • 筋骨格性障害と職場要因?アメリカ労働安全衛生研究所による腰部における職業関連性による筋骨格性障害に関する疫学的レビュー?

    2001年 

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  • Chapter 15 Epidemiological Studies of Cancer in Arsenic Poisoning Patients

    Encyclopedis of Environmental Control Technology, Volume 7 High-Hazard Pollutants 

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  • Chapter 15 Epidemiological Studies of Cancer in Arsenic Poisoning Patients

    Encyclopedis of Environmental Control Technology, Volume 7 High-Hazard Pollutants 

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MISC

  • Is there an obesity paradox in the Japanese elderly population? A community-based cohort study of 13 280 men and women

    Kenji Yamazaki, Etsuji Suzuki, Takashi Yorifuji, Toshihide Tsuda, Toshiki Ohta, Kazuko Ishikawa-Takata, Hiroyuki Doi

    GERIATRICS & GERONTOLOGY INTERNATIONAL   17 ( 9 )   1257 - 1264   2017年9月

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    記述言語:英語   出版者・発行元:WILEY  

    AimDespite increased interest in an obesity paradox (i.e. a survival advantage of being obese), evidence remains sparse in Japanese populations. We aimed to verify this phenomenon among community-dwelling older adults in Japan.
    MethodsOlder adults aged 65-84 years randomly chosen from all 74 municipalities in Shizuoka Prefecture completed questionnaires including body mass index information. Participants were followed from 1999 to 2009. Following World Health Organization guidelines, participants were classified using an appropriate body mass index for Asian populations as follows: &lt;18.5 kg/m(2) (underweight), 18.5-23.0 kg/m(2) (normal weight), 23.0-27.5 kg/m(2) (overweight) and 27.5 kg/m(2) (obesity). We estimated hazard ratios and their 95% confidence intervals for all-cause mortality, controlling for sex, age, smoking status, alcohol consumption, physical activity, hypertension and diabetes mellitus.
    ResultsCompared with normal-weight participants, overweight/obese participants tended to have lower hazard ratios; the multivariate hazard ratios (95% confidence interval) were 0.86 (0.62-1.19) for obesity, 0.83 (0.73-0.94) for overweight and 1.60 (1.40-1.82) for underweight. In subgroup analyses by sex and age, the hazard ratios tended to be lower among obese men, albeit not significantly; hazard ratios (95% confidence interval) were 0.56 (0.25-1.27) in men aged 65-74 years, and 0.78 (0.41-1.45) in men aged 75-84 years.
    ConclusionsThe present study provides evidence of a conservative obesity paradox among older Japanese people, using the appropriate body mass index cut-off points for Asian populations. In particular, obese older men tend to have a lower risk of all-cause mortality. Geriatr Gerontol Int 2017; 17: 1257-1264.

    DOI: 10.1111/ggi.12851

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  • Correlation between infectious disease and soil radiation in Japan: an exploratory study using national sentinel surveillance data

    S. Inaida, T. Tsuda, S. Matsuno

    EPIDEMIOLOGY AND INFECTION   145 ( 6 )   1183 - 1192   2017年4月

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    記述言語:英語   出版者・発行元:CAMBRIDGE UNIV PRESS  

    We investigated the relationship between epidemics and soil radiation through an exploratory study using sentinel surveillance data (individuals aged &lt;20 years) during the last three epidemic seasons of influenza and norovirus in Japan. We used a spatial analysis method of a geographical information system (GIS). We mapped the epidemic spreading patterns from sentinel incidence rates. We calculated the average soil radiation [dm (mu Gy/h)] for each sentinel site using data on uranium, thorium, and potassium oxide in the soil and examined the incidence rate in units of 0.01 mu Gy/h. The correlations between the incidence rate and the average soil radiation were assessed. Epidemic clusters of influenza and norovirus infections were observed in areas with relatively high radiation exposure. A positive correlation was detected between the average incidence rate and radiation dose, at r = 0.61-0.84 (P &lt;0.01) for influenza infections and r = 0.61-0.72 (P &lt;0.01) for norovirus infections. An increase in the incidence rate was found between areas with radiation exposure of 0 &lt;dm &lt;0.01 and 0.154dm &lt;0.16, at 1.80 [95% confidence interval (CI) 1.47-2.12] times higher for influenza infection and 2.07 (95% CI 1.53-2.61) times higher for norovirus infection. Our results suggest a potential association between decreased immunity and irradiation because of soil radiation. Further studies on immunity in these epidemic-prone areas are desirable.

    DOI: 10.1017/S0950268816003034

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  • Evaluating the Effects of Air Pollution from a Plastic Recycling Facility on the Health of Nearby Residents

    Xin Zhao, Toshihide Tsuda, Hiroyuki Doi

    ACTA MEDICA OKAYAMA   71 ( 3 )   209 - 217   2017年

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    記述言語:英語   出版者・発行元:OKAYAMA UNIV MED SCHOOL  

    We evaluated how exposure to airborne volatile organic compounds emitted from a plastic recycling facility affected nearby residents, in a cross-sectional study. Individuals&gt; 10 years old were randomly sampled from 50 households at five sites and given questionnaires to complete. We categorized the subjects by distance from the recycling facility and used this as a proxy measure for pollutant exposure. We sought to improve on a preceding study by generating new findings, improving methods for questionnaire distribution and collection, and refining site selection. We calculated the odds of residents living 500 or 900 m away from the facility reporting mucocutaneous and respiratory symptoms using a reference group of residents 2,800 m away. Self-reported nasal congestion (odds ratio=3.0, 95% confidence interval=1.02-8.8), eczema (5.1, 1.1-22.9), and sore throat (3.9, 1.1-14.1) were significantly higher among residents 500 m from the facility. Those 900 m away were also considerably more likely to report experiencing eczema (4.6, 1.4-14.9). Air pollution was found responsible for significantly increased reports of mucocutaneous and respiratory symptoms among nearby residents. Our findings confirm the effects of pollutants emitted from recycling facilities on residents' health and clarify that study design differences did not affect the results.

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  • Covariate balance for no confounding in the sufficient-cause model 国際誌

    Etsuji Suzuki, Toshihide Tsuda, Eiji Yamamoto

    Annals of Epidemiology   28 ( 1 )   111 - 113   2017年

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  • Maternal smoking location at home and hospitalization for respiratory tract infections among children in Japan

    Michiyo Yamakawa, Takashi Yorifuji, Tsuguhiko Kato, Toshihide Tsuda, Hiroyuki Doi

    ARCHIVES OF ENVIRONMENTAL & OCCUPATIONAL HEALTH   72 ( 6 )   343 - 350   2017年

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    記述言語:英語   出版者・発行元:ROUTLEDGE JOURNALS, TAYLOR & FRANCIS LTD  

    We examined the effects of maternal smoking location at home on hospitalization for respiratory tract infections among young children in Japan. We used the large nationwide population-based longitudinal survey and restricted study participants to children born after 37 gestational weeks and singleton births (n = 43,851). We evaluated the associations among children between the ages of 6 and 18months and between the ages of 18 and 30months, respectively. After adjusting for potential confounders, both maternal outdoor and indoor smoking were associated with the elevated risk. The adjusted odds ratios (95% confidence intervals) of maternal outdoor and indoor smoking (vs nonsmoking mothers) were 1.21 (1.01-1.44) and 1.18 (1.04-1.33), respectively, in children between the ages of 6 and 18months. We thus encourage a smoke-free home policy to protect children from second- and third-hand smoke exposure.

    DOI: 10.1080/19338244.2016.1255582

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  • 大学生が海外留学時に経験した症状とその関連要因の検討

    山川路代, 鈴木越治, 鈴木越治, 佐才めぐみ, 小野真由美, 津田敏秀, 中瀬克己

    日本熱帯医学会大会プログラム抄録集   58th(Web)   2017年

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  • Errors in causal inference: an organizational schema for systematic error and random error

    Etsuji Suzuki, Toshihide Tsuda, Toshiharu Mitsuhashi, Mohammad Ali Mansournia, Eiji Yamamoto

    ANNALS OF EPIDEMIOLOGY   26 ( 11 )   788 - 793   2016年11月

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    記述言語:英語   出版者・発行元:ELSEVIER SCIENCE INC  

    Purpose: To provide an organizational schema for systematic error and random error in estimating causal measures, aimed at clarifying the concept of errors from the perspective of causal inference.
    Methods: We propose to divide systematic error into structural error and analytic error. With regard to random error, our schema shows its four major sources: nondeterministic counterfactuals, sampling variability, a mechanism that generates exposure events and measurement variability.
    Results: Structural error is defined from the perspective of counterfactual reasoning and divided into nonexchangeability bias (which comprises confounding bias and selection bias) and measurement bias. Directed acyclic graphs are useful to illustrate this kind of error. Nonexchangeability bias implies a lack of "exchangeability" between the selected exposed and unexposed groups. A lack of exchangeability is not a primary concern of measurement bias, justifying its separation from confounding bias and selection bias. Many forms of analytic errors result from the small-sample properties of the estimator used and vanish asymptotically. Analytic error also results from wrong (misspecified) statistical models and inappropriate statistical methods.
    Conclusions: Our organizational schema is helpful for understanding the relationship between systematic error and random error from a previously less investigated aspect, enabling us to better understand the relationship between accuracy, validity, and precision. (C) 2016 Elsevier Inc. All rights reserved.

    DOI: 10.1016/j.annepidem.2016.09.008

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  • Aflatoxins in Rice Artificially Contaminated with Aflatoxin-producing Aspergillus flavus under Natural Storage in Japan

    Satoshi Sugihara, Hiroyuki Doi, Masahiko Kato, Yoshihiro Mitoh, Toshihide Tsuda, Satoru Ikeda

    ACTA MEDICA OKAYAMA   70 ( 3 )   167 - 173   2016年6月

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    記述言語:英語   出版者・発行元:OKAYAMA UNIV MED SCHOOL  

    Aflatoxin (AFT) contamination is frequent in foods grown in tropical regions, including rice. Although AFTs are generally not found in temperate-region foods, global warming has affected typical temperate-region climates, potentially permitting the contamination of foods with AFT-producing Aspergillus flavus (A. flavus). Here we investigated the AFT production in rice during storage under natural climate conditions in Japan. We examined AFTs in brown rice and rough rice artificially contaminated with A. flavus for 1 year in Japan, and we subjected AFTs in white rice to the same treatment in airtight containers and examined the samples in warm and cold seasons, simulating the storage of white rice in general households. In the brown rice, AFTs increased after 2 months (March) and peaked after 9 months (October). The AFT contamination in the rough rice was minimal. After the polishing and cooking of the brown rice, AFTs were undetectable. In the white rice stored in airtight containers, AFTs increased after 1 month (August) and peaked after 2 months (September). Minimal AFTs were detected in the cold season. Thus, AFT contamination in rice may occur in temperate regions following A. flavus contamination. The storage of rice as rough rice could provide be useful for avoiding AFT contamination.

    DOI: 10.18926/AMO/54415

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  • Thyroid Cancer Detection by Ultrasound Among Residents Ages 18 Years and Younger in Fukushima, Japan: 2011 to 2014

    Toshihide Tsuda, Akiko Tokinobu, Eiji Yamamoto, Etsuji Suzuki

    EPIDEMIOLOGY   27 ( 3 )   316 - 322   2016年5月

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    記述言語:英語   出版者・発行元:LIPPINCOTT WILLIAMS & WILKINS  

    Background: After the Great East Japan Earthquake and Tsunami in March 2011, radioactive elements were released from the Fukushima Daiichi Nuclear Power Plant. Based on prior knowledge, concern emerged about whether an increased incidence of thyroid cancer among exposed residents would occur as a result.
    Methods: After the release, Fukushima Prefecture performed ultrasound thyroid screening on all residents ages 18 years. The first round of screening included 298,577 examinees, and a second round began in April 2014. We analyzed the prefecture results from the first and second round up to December 31, 2014, in comparison with the Japanese annual incidence and the incidence within a reference area in Fukushima Prefecture.
    Results: The highest incidence rate ratio, using a latency period of 4 years, was observed in the central middle district of the prefecture compared with the Japanese annual incidence (incidence rate ratio = 50; 95% confidence interval [CI] = 25, 90). The prevalence of thyroid cancer was 605 per million examinees (95% CI = 302, 1,082) and the prevalence odds ratio compared with the reference district in Fukushima Prefecture was 2.6 (95% CI = 0.99, 7.0). In the second screening round, even under the assumption that the rest of examinees were disease free, an incidence rate ratio of 12 has already been observed (95% CI = 5.1, 23).
    Conclusions: An excess of thyroid cancer has been detected by ultrasound among children and adolescents in Fukushima Prefecture within 4 years of the release, and is unlikely to be explained by a screening surge.

    DOI: 10.1097/EDE.0000000000000385

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  • Rejoinder: The Authors Respond

    Markku Sallmen, Jens Peter Bonde, Marja-Liisa Lindbohm, Petter Kristensen

    EPIDEMIOLOGY   27 ( 3 )   462 - 463   2016年5月

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    記述言語:英語   出版者・発行元:LIPPINCOTT WILLIAMS & WILKINS  

    DOI: 10.1097/EDE.0000000000000458

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  • Re: Thyroid Cancer Among Young People in Fukushima Response

    Toshihide Tsuda, Akiko Tokinobu, Eiji Yamamoto, Etsuji Suzuki

    EPIDEMIOLOGY   27 ( 3 )   E21 - E23   2016年5月

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    記述言語:英語   掲載種別:速報,短報,研究ノート等(学術雑誌)   出版者・発行元:LIPPINCOTT WILLIAMS & WILKINS  

    DOI: 10.1097/EDE.0000000000000468

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  • 岡山市健康寿命に関連する要因分析業務

    山川路代, 佐才めぐみ, 津田敏秀

    受託事業報告書   2016年3月

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    記述言語:日本語  

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  • Effects of Ayurvedic Oil-Dripping Treatment with Sesame Oil vs. with Warm Water on Sleep: A Randomized Single-Blinded Crossover Pilot Study

    Akiko Tokinobu, Takashi Yorifuji, Toshihide Tsuda, Hiroyuki Doi

    JOURNAL OF ALTERNATIVE AND COMPLEMENTARY MEDICINE   22 ( 1 )   52 - 58   2016年1月

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    記述言語:英語   出版者・発行元:MARY ANN LIEBERT, INC  

    Objectives: Ayurvedic oil-dripping treatment (Shirodhara) is often used for treating sleep problems. However, few properly designed studies have been conducted, and the quantitative effect of Shirodhara is unclear. This study sought to quantitatively evaluate the effect of sesame oil Shirodhara (SOS) against warm water Shirodhara (WWS) on improving sleep quality and quality of life (QOL) among persons reporting sleep problems. Methods: This randomized, single-blinded, crossover study recruited 20 participants. Each participant received seven 30-minute sessions within 2 weeks with either liquid. The washout period was at least 2 months. The Shirodhara procedure was conducted by a robotic oil-drip system. The outcomes were assessed by the Pittsburgh Sleep Quality Index (PSQI) for sleep quality, Epworth Sleepiness Scale (ESS) for daytime sleepiness, World Health Organization Quality of Life 26 (WHO-QOL26) for QOL, and a sleep monitor instrument for objective sleep measures. Changes between baseline and follow-up periods were compared between the two types of Shirodhara. Analysis was performed with generalized estimating equations. Results: Of 20 participants, 15 completed the study. SOS improved sleep quality, as measured by PSQI. The SOS score was 1.83 points lower (95% confidence interval [CI], -3.37 to -0.30) at 2-week follow-up and 1.73 points lower (95% CI, -3.84 to 0.38) than WWS at 6-week follow-up. Although marginally significant, SOS also improved QOL by 0.22 points at 2-week follow-up and 0.19 points at 6-week follow-up compared with WWS. After SOS, no beneficial effects were observed on daytime sleepiness or objective sleep measures. Conclusions: This pilot study demonstrated that SOS may be a safe potential treatment to improve sleep quality and QOL in persons with sleep problems.

    DOI: 10.1089/acm.2015.0018

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  • Epidemiological studies of neurological signs and symptoms and blood pressure in populations near the industrial methylmercury contamination at Minamata, Japan

    Takashi Yorifuji, Toshihide Tsuda

    ARCHIVES OF ENVIRONMENTAL & OCCUPATIONAL HEALTH   71 ( 4 )   231 - 236   2016年

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    記述言語:英語   出版者・発行元:ROUTLEDGE JOURNALS, TAYLOR & FRANCIS LTD  

    Severe methylmercury exposure occurred in Minamata, Japan. Only a limited number of epidemiological studies related to that exposure have been carried out. The evidence that methylmercury is cardiotoxic is very limited, and these studies provide only minimal support for that hypothesis. We therefore analyzed the data both from an investigation in Minamata and neighboring communities in 1971 and an investigation in 1974 in another area simultaneously. We included a total of 3,751 participants. We examined the association of residential area with neurological signs or blood pressure using logistic regression or multiple linear regression models, adjusting for sex and age. We found that the prevalence of neurological signs and symptoms was elevated in the Minamata area (high-exposure), followed by the Goshonoura area (medium-exposure). Moreover, blood pressure was elevated in residents of the Minamata area.

    DOI: 10.1080/19338244.2015.1084261

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  • 記述統計の結果を報告する際の検定の扱いについて CONSORT 2010声明とSTROBE声明を踏まえて

    鈴木 越治, 三橋 利晴, 高尾 総司, 津田 敏秀

    産業衛生学雑誌   57 ( 臨増 )   466 - 466   2015年5月

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    記述言語:日本語   出版者・発行元:(公社)日本産業衛生学会  

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  • Health impact assessment of PM10 and PM2.5 in twenty-seven Southeast and East Asian cities

    Takashi Yorifuji, Sanghyuk Bae, Saori Kashima, Toshihide Tsuda, Hiroyuki Doi, Yasushi Honda, Ho Kim, Yun-Chul Hong

    Journal of Occupational and Environmental Medicine   57 ( 7 )   e007184 - 756   2015年

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    記述言語:英語   出版者・発行元:Lippincott Williams & Wilkins  

    Objective: We aimed to evaluate the annual health impacts of particulate matter (PM) less than 10 μm diameter (PM10) and less than 2.5-μm diameter (PM2.5) in 27 cities in Southeast and East Asian countries (Japan, the Philippines, the Republic of Korea, Singapore, and Vietnam) for the year 2009 (n = 50,756,699).Methods: We estimated the number of cases attributable to long-term exposure. We used a scenario that reduced the annual mean values for PM10 and PM2.5 to 20 and 10 μg/m3, respectively.Results: A reduction in long-term exposure to PM10 and PM2.5 would have postponed 8% to 9% of all-cause mortality or about 37,000 deaths. One third of them were associated with cardiopulmonary mortality and one ninth of them were associated with lung cancer mortality.Conclusions: Current air pollution levels in Southeast and East Asian countries have a nonnegligible public health impact.

    DOI: 10.1097/JOM.0000000000000485

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  • Long-term effects of breastfeeding on children's hospitalization for respiratory tract infections and diarrhea in early childhood in Japan. 国際誌

    Michiyo Yamakawa, Takashi Yorifuji, Tsuguhiko Kato, Sachiko Inoue, Akiko Tokinobu, Toshihide Tsuda, Hiroyuki Doi

    Maternal and Child Health Journal   19 ( 9 )   196 - 201   2015年

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  • EXTENDED CAUSAL DIAGRAMS INTEGRATING RESPONSE TYPES AND OBSERVED VARIABLES.

    Etsuji Suzuki, Toshiharu Mitsuhashi, Toshihide Tsuda, Eiji Yamamoto

    AMERICAN JOURNAL OF EPIDEMIOLOGY   177   S100 - S100   2013年6月

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    記述言語:英語   掲載種別:研究発表ペーパー・要旨(国際会議)   出版者・発行元:OXFORD UNIV PRESS INC  

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  • 100 mSv以下の被ばくでは発がん影響がないのか-統計的有意差の有無と影響の有無

    津田敏秀, 山本英二, 鈴木越治

    科学   83 ( 7 )   735 - 742   2013年

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    記述言語:日本語   出版者・発行元:岩波書店  

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  • Long-term exposure to traffic-related air pollution and the risk of death from hemorrhagic stroke and lung cancer in Shizuoka, Japan

    Yorifuji T, Kashima S, Tsuda T, Ishikawa-Takata K, Ohta T, Tsuruta K, Doi H

    Sci Total Environ.   443   397 - 402   2013年

  • Study on the factors determining home death of patients during home care: A historical cohort study at a home care support clinic.

    Kawagoe Seiji, Tsuda Toshihide, Doi Hiroyuki

    Geriatrics & Gerontology Internationa   13 ( 4 )   874 - 880   2013年

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    記述言語:英語  

    AimAssociations between markedly low activities of daily living (ADL) at the start of home visit care and patient home death were analyzed using data from a home care support clinic in Japan that has a low rate of home deaths.MethodsThe study was a historical cohort study. It involved patients who began to receive home visit care from a home visit care support clinic between 1 April 2006 and 31 March 2011. Using home death as a dependent variable and presence/absence of markedly low ADL and other parameters (cancer, the patient's desire for home death, etc.) as independent variables, the adjusted hazard ratio and 95% confidence interval (CI) were calculated using the Cox proportional hazards model.ResultsMarkedly low ADL were associated with home death even after adjustment for factors that influence home death (adjusted hazard ratio 4.40; 95% CI 2.37–8.16). Cancer and the patient's desire for home death were statistically significant factors involved in home death. In a subgroup analysis according to the presence/absence of cancer, the association between markedly low ADL and home death was stronger in the cancer-free group (adjusted hazard ratio 10.78; 95% CI 2.89–40.26) than in the cancer group (adjusted hazard ratio 5.58; 95% CI2.39–13.05).ConclusionPatients' desire for home death could be fulfilled if home care support clinics provide home visit services to not only terminal-stage cancer patients, but also bedridden cancer-free patients. We must establish systems for older adults to remain at home during the terminal period of their lives. Geriatr Gerontol Int 2012; ●●: ●●–●●.

    DOI: 10.1111/ggi.12018

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  • Is there a carcinogenic effect from exposure to less than 100 mSv? Presence or absence of statistical significance and effect

    Tsuda T, Yamamoto E, Suzuki E

    Science Journal KAGAKU   83 ( 7 )   735 - 742   2013年

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  • 中国地方5県における男女別の黄砂の死亡への影響評価

    鹿嶋小緒里, 頼藤貴志, 津田敏秀, 村上玄樹, 烏帽子田彰

    日本公衆衛生学会総会抄録集   71st   578 - 578   2012年10月

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    記述言語:日本語   出版者・発行元:日本公衆衛生学会  

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  • Frequency of Antenatal Care Visits and Neonatal Mortality in Indonesia

    Juliani Ibrahim, Takashi Yorifuji, Toshihide Tsuda, Saori Kashima, Hiroyuki Doi

    JOURNAL OF TROPICAL PEDIATRICS   58 ( 3 )   184 - 188   2012年6月

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    記述言語:英語   出版者・発行元:OXFORD UNIV PRESS  

    Objective: To examine the relationship between frequency of antenatal care visits, as a whole and in each trimester, and neonatal mortality in Indonesia. Subjects: 13 055 single births from the fifth Indonesia Demographic Health Survey in 2006-07. Methods: Estimate adjusted odds ratios (ORs) and their 95% confidence intervals (95% CIs). Results: Pregnant women who had more antenatal care visits experienced a lower risk of neonatal mortality and more benefit in the last trimester: the ORs against the 0-1 visit group, were 0.76 (95% CI 0.45-1.29) for 2 visits group, 0.54 (95% CI 0.33-0.87) for 3 visits group and 0.31 (95% CI 0.17-0.57) for 4 visits group, respectively. Individual ORs as a whole period were not significant, but ORs declined markedly at 7 visits or more. Conclusion: The results may provide a valuable recommendation for the care of pregnant women in Indonesia.

    DOI: 10.1093/tropej/fmr067

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  • Does Open-air Exposure to Volatile Organic Compounds near a Plastic Recycling Factory Cause Health Effects? (vol 54, pg 79, 2012)

    Takashi Yorifuji, Miyuki Noguchi, Toshihide Tsuda, Etsuji Suzuki, Soshi Takao, Saori Kashima, Yukio Yanagisawa

    JOURNAL OF OCCUPATIONAL HEALTH   54 ( 3 )   254 - 254   2012年5月

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    記述言語:英語   出版者・発行元:JAPAN SOC OCCUPATIONAL HEALTH  

    DOI: 10.1539/joh.11-0202-OA

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  • 母親の労働時間と小児の過体重の関連 追加報告

    三橋 利晴, 鈴木 越治, 高尾 総司, 津田 敏秀, 土居 弘幸

    産業衛生学雑誌   54 ( 臨増 )   362 - 362   2012年5月

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  • On the Relations Between Excess Fraction, Attributable Fraction, and Etiologic Fraction

    Etsuji Suzuki, Eiji Yamamoto, Toshihide Tsuda

    AMERICAN JOURNAL OF EPIDEMIOLOGY   175 ( 6 )   567 - 575   2012年3月

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    記述言語:英語   出版者・発行元:OXFORD UNIV PRESS INC  

    It has been noted that there is ambiguity in the expression "attributable fraction," and epidemiologic literature has drawn a distinction between "excess fraction" and "etiologic fraction." These quantities do not necessarily approximate one another, and the etiologic fraction is not generally estimable without strong biologic assumptions. In previous studies, researchers have explained the relations between excess and etiologic fractions in the potential-outcome framework, and few authors have explained the relations between these concepts by showing the correspondence between the potential-outcome model and the sufficient-cause model. In this article, the authors thoroughly clarify the conceptual relations between excess, attributable, and etiologic fractions by explicating the correspondence between these 2 models. In so doing, the authors take into account the potential completion time of each sufficient cause, which contributes to further insight to clarify the 2 types of etiologic fraction, i.e., accelerating etiologic proportion and total etiologic proportion. These 2 measures cannot be distinguished in epidemiologic data, and the differences might be subtle. However, they are closely related to a very fundamental issue of causal inference, that is, how researchers define etiology. Further, the authors clarify the relation between 3 distinct assumptions-positive monotonicity, no preventive action (or sufficient-cause positive monotonicity), and no preventive sequence.

    DOI: 10.1093/aje/kwr333

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  • 肺と心臓の共通の敵,タバコの害について識る.

    Heart View   16 ( 3 )   58(266)-63(271)   2012年

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  • Adverse effects of cigarette smoking - The common enemy against lung and heart in humans.

    16 ( 3 )   58(266)-63(271)   2012年

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  • 日本における大気汚染の健康影響評価と政策評価研究

    頼藤貴志, 鹿嶋小緒里, 津田敏秀, 土居弘幸

    環境と公害   42 ( 2 )   65 - 69   2012年

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  • Acute non-cancer mortality excess after polychlorinated biphenyls and polychlorinated dibenzofurans mixed exposure from contaminated rice oil: Yusho

    Saori Kashima, Takashi Yorifuji, Toshihide Tsuda

    SCIENCE OF THE TOTAL ENVIRONMENT   409 ( 18 )   3288 - 3294   2011年8月

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    記述言語:英語   出版者・発行元:ELSEVIER SCIENCE BV  

    In Japan in 1968, rice-oil contaminated by polychlorinated biphenyls and polychlorinated dibenzofurans caused severe food poisoning, termed "Yusho" (oil disease). Several previous studies attempted to evaluate the effects targeting officially-certified Yusho patients. However, these studies have several limitations such as the left-truncated nature of the registry or residual confounding arising from the referent population selection. We thus conducted an area-based standardized mortality ratios (SMRs) study using vital statistics. A severely affected area (Tamanoura area) was adopted as the exposure group, with a reference population from Nagasaki prefecture in Kyushu, which included the Tamanoura. A large number of residents in Tamanoura were exposed to the rice-oil (28% of all the certified cases as of 2009). We estimated SMRs of non-cancer and cancer diseases for the years 1968-2002. Shortly after the exposure, SMRs of all causes, diabetes mellitus, cardiovascular disease, pneumonia/bronchitis, and bronchus/lung cancer were elevated. In particular, SMRs of heart disease were 1.97 [95% confidence intervals (CI): 1.09-3.56] in 1968, 2.05 (95% Cl: 1.16-3.60) in 1969, and 1.89 (95% CI: 1.05-3.41) in 1975. However, we did not observe clear increase in SMRs more than 10 years after the exposure. This study provides further evidence in Yusho, especially on acute effects on non-cancer mortality. (C) 2011 Elsevier B.V. All rights reserved.

    DOI: 10.1016/j.scitotenv.2011.05.038

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  • Environmental Health Research Implications of Methylmercury

    Toshihide Tsuda, Takashi Yorifuji, Masazumi Harada

    ENVIRONMENTAL HEALTH PERSPECTIVES   119 ( 7 )   A284 - A284   2011年7月

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    記述言語:英語   掲載種別:速報,短報,研究ノート等(学術雑誌)   出版者・発行元:US DEPT HEALTH HUMAN SCIENCES PUBLIC HEALTH SCIENCE  

    DOI: 10.1289/ehp.1103580

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  • IDENTIFICATION OF OPERATING MEDIATION AND MECHANISM IN THE SUFFICIENT-COMPONENT CAUSE FRAMEWORK

    E. Suzuki, E. Yamamoto, T. Tsuda

    AMERICAN JOURNAL OF EPIDEMIOLOGY   173 ( 5 )   S184 - S184   2011年6月

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    記述言語:英語   掲載種別:研究発表ペーパー・要旨(国際会議)   出版者・発行元:OXFORD UNIV PRESS INC  

    DOI: 10.1007/s10654-011-9568-3

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  • Cancer excess after arsenic exposure from contaminated milk powder

    YORIFUJI Takashi, TSUDA Toshihide, DOI Hiroyuki, GRANDJEAN Philippe

    Environmental health and preventive medicine   16 ( 3 )   164 - 170   2011年5月

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  • 日本の病院におけるソーシャル・ネットワークと看護師の主観的不健康

    岩瀬 敏秀, 三橋 利晴, 高尾 総司, 津田 敏秀, 土居 弘幸

    産業衛生学雑誌   53 ( 臨増 )   500 - 500   2011年5月

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    記述言語:日本語   出版者・発行元:(公社)日本産業衛生学会  

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  • 母親の就業時間と小児の肥満の関連

    三橋 利晴, 鈴木 越治, 高尾 総司, 津田 敏秀

    産業衛生学雑誌   53 ( 臨増 )   552 - 552   2011年5月

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  • Residential proximity to heavy traffic and birth weight in Shizuoka, Japan

    Saori Kashima, Hiroo Naruse, Takashi Yorifuji, Shigeru Ohki, Takeshi Murakoshi, Soshi Takao, Toshihide Tsuda, Hiroyuki Doi

    ENVIRONMENTAL RESEARCH   111 ( 3 )   377 - 387   2011年4月

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    記述言語:英語   出版者・発行元:ACADEMIC PRESS INC ELSEVIER SCIENCE  

    An association between exposure to traffic-related air pollution and reduced birth weight has been suggested. However, previous studies have failed to adjust for maternal size, which is an indicator of individual genetic growth potential. Therefore, we evaluated the association of air pollution with birth weight, term low birth weight (term-LBW), and small for gestational age (SGA), with adjustment for maternal size. Individual data were extracted from a database that is maintained by a maternal and perinatal care center in Shizuoka, japan. We identified liveborn singleton births (n=14,204). Using geocoded residential information, each birth was assigned a number of traffic-based exposure indicators: distance to a major road; distance-weighted traffic density; and estimated concentration of nitrogen dioxide by land use regression. The multivariate adjusted odds ratios and their 95% confidence intervals (CIs) for the associations between exposure indicators and outcomes were then estimated using logistic regression models. Overall, exposure indicators of air pollution showed no clear pattern of association. Although there are many limitations, we did not find clear associations between birth-weight-related outcomes and the three markers of traffic-related air pollution. (C) 2011 Elsevier Inc. All rights reserved.

    DOI: 10.1016/j.envres.2011.02.005

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  • The History of Minamata Disease and Public Health Policy

    Toshihide Tsuda, Takashi Yorifuji

    EPIDEMIOLOGY   22 ( 1 )   S99 - S99   2011年1月

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    記述言語:英語   掲載種別:研究発表ペーパー・要旨(国際会議)   出版者・発行元:LIPPINCOTT WILLIAMS & WILKINS  

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  • Increased Risk of Lung Cancer Mortality Among Residents Who Had Lived Near an Asbestos Product Manufacturing Plant

    Shinji Kumagai, Norio Kurumatani, Toshihide Tsuda, Takashi Yorifuji, Etsuji Suzuki

    EPIDEMIOLOGY   22 ( 1 )   S75 - S76   2011年1月

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    記述言語:英語   掲載種別:研究発表ペーパー・要旨(国際会議)   出版者・発行元:LIPPINCOTT WILLIAMS & WILKINS  

    DOI: 10.1097/01.ede.0000391894.33567.9c

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  • Epidemiology of Congenital Minamata Disease Patients

    Masazumi Harada, Takashi Yorifuji, Toshihide Tsuda

    EPIDEMIOLOGY   22 ( 1 )   S100 - S100   2011年1月

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    記述言語:英語   掲載種別:研究発表ペーパー・要旨(国際会議)   出版者・発行元:LIPPINCOTT WILLIAMS & WILKINS  

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  • Recent Findings in Minamata Disease From a Population-based Study Conducted in 1971

    Takashi Yorifuji, Toshihide Tsuda, Masazumi Harada

    EPIDEMIOLOGY   22 ( 1 )   S99 - S100   2011年1月

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    記述言語:英語   掲載種別:研究発表ペーパー・要旨(国際会議)   出版者・発行元:LIPPINCOTT WILLIAMS & WILKINS  

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  • Acute and Long-term Excess Mortality After Polychlorinated Biphenyls and Polychlorinated Dibenzofurans Mixed Exposure From Contaminated Rice Oil: Yusho

    Saori Kashima, Takashi Yorifuji, Toshihide Tsuda

    EPIDEMIOLOGY   22 ( 1 )   S239 - S239   2011年1月

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    記述言語:英語   掲載種別:研究発表ペーパー・要旨(国際会議)   出版者・発行元:LIPPINCOTT WILLIAMS & WILKINS  

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  • Environmental Exposure to Asbestos and Pleural Plaques Among Retirees in a Factory Without Asbestos Use in H City, Japan

    Takashi Yorifuji, Etsuji Suzuki, Toshihide Tsuda, Yuji Natori, Eisuke Matsui

    EPIDEMIOLOGY   22 ( 1 )   S76 - S76   2011年1月

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    記述言語:英語   掲載種別:研究発表ペーパー・要旨(国際会議)   出版者・発行元:LIPPINCOTT WILLIAMS & WILKINS  

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  • An epidemiological study of children with status epilepticus in Okayama, Japan: incidence, etiologies, and outcomes

    Nishiyama I, Ohtsuka Y, Tsuda T, Kobayashi K, Inoue H, Narahara K, Shiraga H, Kimura T, Ogawa M, Terasaki T, Ono H, Tanaka T

    Epilepsy Res   96 ( 1-2 )   89 - 95   2011年

  • The authors respond

    Takashi Yorifuji, Etsuji Suzuki, Toshihide Tsuda

    Epidemiology   21 ( 6 )   916   2010年11月

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    記述言語:英語   掲載種別:速報,短報,研究ノート等(学術雑誌)  

    DOI: 10.1097/EDE.0b013e3181f32842

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  • Unusual Cancer Excess After Neonatal Arsenic Exposure From Contaminated Milk Powder

    Takashi Yorifuji, Toshihide Tsuda, Philippe Grandjean

    JOURNAL OF THE NATIONAL CANCER INSTITUTE   102 ( 5 )   360 - 361   2010年3月

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    記述言語:英語   掲載種別:速報,短報,研究ノート等(学術雑誌)   出版者・発行元:OXFORD UNIV PRESS INC  

    DOI: 10.1093/jnci/djp536

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  • Long-term exposure to traffic-related air pollution and mortality in Shizuoka, Japan

    Takashi Yorifuji, Saori Kashima, Toshihide Tsuda, Soshi Takao, Etsuji Suzuki, Hiroyuki Doi, Masumi Sugiyama, Kazuko Ishikawa-Takata, Toshiki Ohta

    OCCUPATIONAL AND ENVIRONMENTAL MEDICINE   67 ( 2 )   111 - 117   2010年2月

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    記述言語:英語   出版者・発行元:B M J PUBLISHING GROUP  

    Objectives The number of studies investigating the health effects of long-term exposure to air pollution is increasing, however, most studies have been conducted in Western countries. The health status of Asian populations may be different to that of Western populations and may, therefore, respond differently to air pollution exposure. Therefore, we evaluated the health effects of long-term exposure to traffic-related air pollution in Shizuoka, Japan.
    Methods Individual data were extracted from participants of an ongoing cohort study. A total of 14 001 older residents, who were randomly chosen from all 74 municipalities of Shizuoka, completed questionnaires and were followed from December 1999 to March 2006. Individual nitrogen dioxide exposure data, as an index for traffic-related exposure, were modelled using a land use regression model. We assigned participants an estimated concentration of nitrogen dioxide exposure during 2000-2006. We then estimated the adjusted HR and their Cl for a 10 mu g/m(3) increase in exposure to nitrogen dioxide for all-cause or cause-specific mortality.
    Results The adjusted HR for all-cause mortality was 1.02 (95% Cl 0.96 to 1.08). Regarding cause-specific mortality, the adjusted HR for cardiopulmonary mortality was 1.16 (95% Cl 1.06 to 1.26); in particular the adjusted HR for ischaemic heart disease mortality was 1.27 (95% Cl 1.02 to 1.58) and for pulmonary disease mortality it was 1.19 (95% Cl 1.02 to 1.38). Furthermore, among non-smokers, a 10 mu g/m(3) increase in nitrogen dioxide was associated with a higher risk for lung cancer mortality (HR 1.30, 95% Cl 0.85 to 1.93).
    Conclusion Long-term exposure to traffic-related air pollution, indexed by nitrogen dioxide concentration, increases the risk of cardiopulmonary mortality, even in a population with a relatively low body mass index and increases the risk of lung cancer mortality in nonsmokers.

    DOI: 10.1136/oem.2008.045542

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  • Training Program on Food-Borne Disease Epidemiology 19. Case-Control Study (3). Multi-Prefectural Disease Outbreaks which are Difficult to be Investigated by a Classical Method

    Food Sanitation Research   60 ( 4 )   29 - 38   2010年

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  • Training Program on Food-Borne Disease Epidemiology 18. "Cause" of Food Borne Disease and Recall

    Food Sanitation Research   60 ( 3 )   37 - 46   2010年

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  • Training Program on Food-Borne Disease Epidemiology 17. Bias in Epidemiology: Type, Magnitude, Direction, and its Countermeasure

    Food Sanitation Research   60 ( 2 )   39 - 46   2010年

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  • 食中毒の疫学研修講座(16)疫学研究におけるバイアスの種類等とその対策(前編)

    津田 敏秀, 槌田 浩明, 中瀬 克己

    食品衛生研究   60 ( 1 )   47 - 55   2010年

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    記述言語:日本語   出版者・発行元:日本食品衛生協会  

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  • 食中毒の疫学研修講座(20)記述疫学と地理情報システム(GIS)

    鹿嶋 小緒里, 土橋 酉紀, 頼藤 貴志

    食品衛生研究   60 ( 5 )   47 - 56   2010年

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    記述言語:日本語   出版者・発行元:日本食品衛生協会  

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    その他リンク: http://search.jamas.or.jp/link/ui/2010214186

  • 食中毒の疫学研修講座18.食中毒の「原因」と回収問題.食品衛生研究2010;60(3):37-46.

    津田 敏秀, 槌田 浩明, 中瀬 克己, 溝口 嘉範, 山本 英二, 土居 弘幸, 土橋 酉紀, 頼藤 貴志, 鈴木 越治, 鹿嶋 小緒里, 岡山食中毒の疫学研修プログラム研究会

    食品衛生研究   60 ( 3 )   37 - 46   2010年

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    記述言語:日本語   出版者・発行元:(公社)日本食品衛生協会  

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  • 食中毒の疫学研修講座17.疫学研究におけるバイアスの種類、その影響の程度と方向、およびその対策:後編.

    津田 敏秀, 槌田 浩明, 中瀬 克己, 溝口 嘉範, 山本 英二, 土居 弘幸, 土橋 酉紀, 頼藤 貴志, 鈴木 越治

    食品衛生研究   60 ( 2 )   39 - 46   2010年

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    記述言語:日本語   出版者・発行元:(公社)日本食品衛生協会  

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  • 食中毒の疫学研修講座16.疫学研究におけるバイアスの種類、その影響の程度と方向、およびその対策:前編.

    津田 敏秀, 槌田 浩明, 中瀬 克己, 溝口 嘉範, 山本 英二, 土居 弘幸, 土橋 酉紀, 頼藤 貴志, 鈴木 越治, 岡山食中毒の疫学研修プログラム研究会

    食品衛生研究   60 ( 1 )   47 - 55   2010年

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  • Training Program on Food-Borne Disease Epidemiology 21: Closing Remarks on the Serial

    Food Sanitation Research   60 ( 6 )   33 - 44   2010年

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  • 食中毒の疫学研修講座21.連載を終わるにあたって.食品衛生研究2010;60(6):33-44.

    中瀬 克己, 槌田 浩明, 溝口 嘉範, 山本 英二, 津田 敏秀, 鹿嶋 小緒里, 土橋 酉紀, 頼藤 貴志, 鈴木 越治, 土居 弘幸, 岡山食中毒の疫学研修プログラム研究会

    食品衛生研究   60 ( 6 )   33 - 44   2010年

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    記述言語:日本語   出版者・発行元:(公社)日本食品衛生協会  

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  • 記述疫学と地理情報システム

    鹿嶋 小緒里, 土橋 酉紀, 頼藤 貴志, 鈴木 越治, 土居 弘幸, 槌田 浩明, 中瀬 克己, 溝口 嘉範, 山本 英二, 津田 敏秀, 岡山食中毒の疫学研修プログラム研究会

    食品衛生研究   60 ( 5 )   47 - 56   2010年

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    記述言語:日本語   出版者・発行元:(公社)日本食品衛生協会  

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  • 食中毒の疫学研修講座19.古典的調査法では対応できない広域散発事例.

    中瀬 克己, 槌田 浩明, 溝口 嘉範, 津田 敏秀, 山本 英二, 土居 弘幸, 土橋 酉紀, 頼藤 貴志, 鈴木 越治, 岡山食中毒の疫学研修プログラム研究会

    食品衛生研究   60 ( 4 )   29 - 38   2010年

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    記述言語:日本語   出版者・発行元:(公社)日本食品衛生協会  

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  • Does tumor type affect local control by radiofrequency ablation in the lungs? 国際誌

    Hiraki T, Gobara H, Mimura H, Sano Y, Tsuda T, Iguchi T, Fujiwara H, Kishi R, Matsui Y, Kanazawa S

    Eur J Radiol.   74巻 ( 1号 )   136 - 141   2010年

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  • What has methylmercury in umbilical cords told us? - Minamata disease

    Takashi Yorifuji, Saori Kashima, Toshihide Tsuda, Masazumi Harada

    SCIENCE OF THE TOTAL ENVIRONMENT   408 ( 2 )   272 - 276   2009年12月

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    記述言語:英語   出版者・発行元:ELSEVIER SCIENCE BV  

    Severe methylmercury poisoning occurred in Minamata and neighboring communities in the 1950s and 1960s. The exposed patients manifested neurological signs, and some patients exposed in utero were born with so-called congenital Minamata disease. In a previous report, Nishigaki and Harada evaluated the methylmercury concentrations in the umbilical cords of inhabitants and demonstrated that methylmercury actually passed through the placenta (Nishigaki and Harada, 1975). However, the report involved a limited number of cases (only 35) and did not quantitatively evaluate the regional differences in the transition of methylmercury exposure. Therefore, in the present study, we evaluated the temporal and spatial distributions of methylmercury concentrations in umbilical cords, with an increased number of participants and additional descriptive analyses. Then, we examined whether the methylmercury concentrations corresponded with the history of the Minamata disease incident. A total of 278 umbilical cord specimens collected after birth were obtained from babies born between 1925 and 1980 in four study areas exposed to methylmercury. Then. we conducted descriptive analyses, and drew scatterplots of the methylmercury concentrations of all the participants and separated by the areas. In the Minamata area, where the first patient was identified in 1956, the methylmercury concentration reached a peak around 1955. Subsequently, about 5 years later, the concentrations peaked in other exposed areas with the expected exposure distribution corresponding with acetaldehyde production (the origin of methylmercury). This historical incident several decades ago in Minamata and neighboring communities clearly shows that regional pollution affected the environment in utero. Furthermore, the temporal and spatial distributions of the methylmercury concentrations in the umbilical cords tell us the history of the Minamata disease incident. (C) 2009 Elsevier B.V. All rights reserved.

    DOI: 10.1016/j.scitotenv.2009.10.011

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  • Oseltamivir and Abnormal Behaviors True or Not?

    Takashi Yorifuji, Etsuji Suzuki, Toshihide Tsuda

    EPIDEMIOLOGY   20 ( 4 )   619 - 621   2009年7月

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    記述言語:英語   出版者・発行元:LIPPINCOTT WILLIAMS & WILKINS  

    Oseltamivir is a neuraminidase inhibitor that inhibits influenza virus proliferation, and is used as an antiviral drug against influenza A and B viruses. Recently, concerns have been raised about hallucinations, delirium, and abnormal activity after administration of oseltamivir for treatment of infection with influenza virus. A large epidemiologic study was conducted in Japan in the winter of 2006-2007 to assess the relationship between oseltamivir intake and adverse behaviors, and an interim report was released on 10 July 2008. In the report, the research group concluded that no positive associations were detected between oseltamivir intake and abnormal behaviors. However, the analytic method used in the study was flawed. A correct analysis (based on person-time) shows a rate ratio of 1.57 (95% confidence interval = 1.34-1.83). This example clearly illustrates the importance of person-time in the analysis of cohort studies.

    DOI: 10.1097/EDE.0b013e3181a3d3f6

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  • UNSCEAR 2006 inadequately cited “A case control study of multiple myeloma at four nuclear facilities” .

    Tsuda Toshihide, Yamamoto Eiji, Yorifuji Takashi

    Ann Epidemiol   19 ( 7 )   519 - 519   2009年7月

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    記述言語:英語   掲載種別:速報,短報,研究ノート等(学術雑誌)  

    DOI: 10.1016/j.annepidem.2009.02.007

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  • Minamata Disease. –A catastrophic poisoning due to failure of appropriate public health response.

    Tsuda Toshihide, Yorifuji Takashi, Takao Soshi, Miyai Masaya, Babazono Akira

    Journal of Public Health Policy   30 ( 1 )   54 - 67   2009年4月

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  • Application of land use regression to regulatory air quality data in Japan

    Saori Kashima, Takashi Yorifuji, Toshihide Tsuda, Hiroyuki Doi

    SCIENCE OF THE TOTAL ENVIRONMENT   407 ( 8 )   3055 - 3062   2009年4月

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    記述言語:英語   出版者・発行元:ELSEVIER SCIENCE BV  

    A land use regression (LUR) model has been used successfully for predicting traffic-related pollutants, although its application has been limited to Europe and North America. Therefore, we modeled traffic-related pollutants by LUR then examined whether LUR models could be constructed using a regulatory monitoring network in Shizuoka, Japan. We used the annual-mean nitrogen dioxide (NO(2)) and suspended particulate matter (SPM) concentrations between April 2000 and March 2006 in the study area. SPM accounts for particulate matter with an aerodynamic diameter less than 8 mu m (PM8). Geographic variables that are considered to predict traffic-related pollutants were classified into four groups: road type, traffic intensity, land use, and physical component. Using geographical variables, we then constructed a model to predict the monitored levels of NO(2) and SPM. The mean concentrations of NO(2) and SPM were 35.75 mu g/m(3) (standard deviation of 11.28) and 28.67 mu g/m(3) (standard deviation of 4.73), respectively. The final regression model for the NO(2) concentration included five independent variables. R(2) for the NO(2) model was 0.54. On the other hand, the regression model for the SPM concentration included only one independent variable. R(2) for the SPM model was quite low (R(2) = 0.11). The present study showed that even if we used regulatory monitoring air quality data, we could estimate NO(2) moderately well. This result could encourage the wide use of LUR models in Asian countries. (C) 2008 Elsevier B.V. All rights reserved.

    DOI: 10.1016/j.scitotenv.2008.12.038

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  • Minamata disease: Catastrophic poisoning due to a failed public health response

    Toshihide Tsuda, Takashi Yorifuji, Soshi Takao, Masaya Miyai, Akira Babazono

    Journal of Public Health Policy   30 ( 1 )   54 - 67   2009年4月

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    記述言語:英語  

    We present the history of Minamata disease in a chronological order from the public health point of view. Because the appropriate public health response - to investigate and control the outbreak - as set out in the Food Sanitation Act was not conducted, no one knew how many became ill following the outbreak. Exposure could not be stopped. In our discussion, we offer two reasons as to why the Japanese public health agencies did not apply the Act: social circumstances in the 1950s and 1960s that placed emphasis on industrial development, and the Japanese medical communitys lack of knowledge about the Act. The history of Minamata disease shows us the consequences when public health responses are not implemented. Minamata disease should be an invaluable lesson for future public health responses. © 2009 Palgrave Macmillan.

    DOI: 10.1057/jphp.2008.30

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  • ANALYSIS OF FACTORS ASSOCIATED WITH RADIATION-INDUCED BRONCHIOLITIS OBLITERANS ORGANIZING PNEUMONIA SYNDROME AFTER BREAST-CONSERVING THERAPY

    Norihisa Katayama, Shuhei Sato, Kuniaki Katsui, Mitsuhiro Takemoto, Toshihide Tsuda, Atsushi Yoshida, Tsuneharu Morito, Tomio Nakagawa, Akifumi Mizuta, Takahiro Waki, Harutaka Niiya, Susumu Kanazawa

    INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS   73 ( 4 )   1049 - 1054   2009年3月

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    記述言語:英語   出版者・発行元:ELSEVIER SCIENCE INC  

    Purpose: To evaluate factors associated with radiation-induced bronchiolitis obliterans organizing pneumonia (BOOP) syndrome after breast-conserving therapy.
    Methods and Materials: A total or 702 women with breast cancer who received radiotherapy after breast-conserving surgery at seven institutions between July 1995 and December 2006 were analyzed. In all patients, the whole breast was irradiated with two tangential photon beams. The criteria used for the diagnosis of radiation-induced BOOP syndrome were as follows: (1) radiotherapy to the breast within 12 months, (2) general and/or respiratory symptoms lasting for 2 weeks, (3) radiographs showing lung infiltration outside the radiation port, and (4) no evidence of a specific cause.
    Results: Radiation-induced BOOP syndrome was seen in 16 patients (2.3%). Eleven patients (68.8%) were administered steroids. The duration of steroid administration ranged from 1 week to 3.7 years (median, 1.1 years). Multivariate analysis revealed that age ( &gt;= 50 years; odds ratio [OR] 8.88; 95% confidence interval [CI] 1.16-67.76; P = 0.04) and concurrent endocrine therapy (OR 3.05; 95% CI 1.094.54; p = 0.03) were significantly associated with BOOP syndrome. Of the 161 patients whose age was :50 years and who received concurrent endocrine therapy, 10 (6.2%) developed BOOP syndrome.
    Conclusions: Age (&gt;= 50 years) and concurrent endocrine therapy can promote the development of radiation-induced BOOP syndrome after breast-conserving therapy. Physicians should carefully follow patients who received breast-conserving therapy, especially those who are older than 50 years and received concurrent endocrine therapy during radiotherapy. (C) 2009 Elsevier Inc.

    DOI: 10.1016/j.ijrobp.2008.05.050

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  • 食中毒の疫学研修講座13.症例対照研究(1):対照の取り方と食中毒事件対策.

    津田 敏秀, 槌田 浩明, 中瀬 克己, 溝口 嘉範, 山本 英二, 土居 弘幸, 土橋 酉紀, 頼藤 貴志

    食品衛生研究   59 ( 10 )   25 - 33   2009年

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    記述言語:日本語   出版者・発行元:(公社)日本食品衛生協会  

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  • 食中毒の疫学研修講座12.統計疫学入門:補足編.

    津田 敏秀, 槌田 浩明, 溝口 嘉範, 中瀬 克己, 山本 英二, 土橋 酉紀, 頼藤 貴志, 土居 弘幸, 岡山食中毒の疫学研修プログラム研究会

    食品衛生研究   59 ( 9 )   41 - 45   2009年

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    記述言語:日本語   出版者・発行元:(公社)日本食品衛生協会  

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  • 食中毒の疫学研修講座11.統計疫学入門:信頼区間と検定.

    津田 敏秀, 槌田 浩明, 溝口 嘉範, 中瀬 克己, 山本 英二, 土橋 酉紀, 頼藤 貴志, 土居 弘幸

    食品衛生研究   59 ( 8 )   53 - 61   2009年

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    記述言語:日本語   出版者・発行元:(公社)日本食品衛生協会  

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  • 食中毒の疫学研修講座10.実地疫学専門家養成コースFETP-Jと自治体でのアウトブレイク調査.

    土橋 酉紀, 土居 弘幸, 頼藤 貴志

    食品衛生研究   59 ( 7 )   53 - 59   2009年

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    記述言語:日本語   出版者・発行元:日本食品衛生協会  

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    その他リンク: http://search.jamas.or.jp/link/ui/2009272239

  • 食中毒の疫学研修講座14.メディアとの連携-食中毒疫学調査と対策は疫学と調査法の理解だけではできない-.食品衛生研究2009;59(11):29-38.

    津田 敏秀, 槌田 浩明, 中瀬 克己, 溝口 嘉範, 山本 英二, 土居 弘幸, 土橋 酉紀, 頼藤 貴志

    食品衛生研究   59 ( 11 )   29 - 39   2009年

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    記述言語:日本語   出版者・発行元:(公社)日本食品衛生協会  

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  • 食中毒の疫学研修講座5.疫学統計ソフトEpi InfoTM日本語版の紹介,インストールおよび基礎.

    山本 英二, 中瀬 克己, 槌田 浩明

    食品衛生研究   59 ( 2 )   17 - 26   2009年

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    記述言語:日本語   出版者・発行元:日本食品衛生協会  

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    その他リンク: http://search.jamas.or.jp/link/ui/2009149150

  • Implications for future adverse effect studies of neuraminidase inhibitors (Rapid response to Neuraminidase inhibitors for preventing and treatinginfluenza in healthy adults: systematic review and meta-analysis byJefferson et al. BMJ 2009; 339: b5106).

    Yorifuji T, Tsuda T, Kashima S, Suzuki E, Doi H

    BMJ   2009年

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  • Total hair mercury content and neurological signs in Minamata and neighboring communities.

    Takashi Yorifuji, Toshihide Tsuda, Soshi Takao, Etsuji Suzuki, Masazumi Harada

    Epidemiology   2009年

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  • 医学における因果推論 第一部 -研究と実践での議論を明瞭にするための反事実モデル-.

    鈴木越治, 小松裕和, 頼藤貴志, 山本英二, 土居弘幸, 津田敏秀

    日本衛生学雑誌   64 ( 4 )   786 - 795   2009年

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    記述言語:日本語   出版者・発行元:日本衛生学会  

    A central problem in natural science is identifying general laws of cause and effect. Medical science is devoted to revealing causal relationships in humans. The framework for causal inference applied in epidemiology can contribute substantially to clearly specifying and testing causal hypotheses in many other areas of biomedical research. In this article, we review the importance of defining explicit research hypotheses to make valid causal inferences in medical studies. In the counterfactual model, a causal effect is defined as the contrast between an observed outcome and an outcome that would have been observed in a situation that did not actually happen. The fundamental problem of causal inference should be clear; individual causal effects are not directly observable, and we need to find general causal relationships, using population data. Under an "ideal" randomized trial, the assumption of exchangeability between the exposed and the unexposed groups is met; consequently, population-level causal effects can be estimated. In observational studies, however, there is a greater risk that the assumption of conditional exchangeability may be violated. In summary, in this article, we highlight the following points: (1) individual causal effects cannot be inferred because counterfactual outcomes cannot, by definition, be observed; (2) the distinction between concepts of association and concepts of causation and the basis for the definition of confounding; (3) the importance of elaborating specific research hypotheses in order to evaluate the assumption of conditional exchangeability between the exposed and unexposed groups; (4) the advantages of defining research hypotheses at the population level, including specification of a hypothetical intervention, consistent with the counterfactual model. In addition, we show how understanding the counterfactual model can lay the foundation for correct interpretation of epidemiologic evidence.<br>

    DOI: 10.1265/jjh.64.786

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  • 医学における因果推論 第一部 -研究と実践での議論を明瞭にするための反事実モデル-.

    鈴木 越治, 小松 裕和, 頼藤 貴志, 山本 英二, 土居 弘幸, 津田 敏秀

    日本衛生学雑誌2009;64:786-795.   64 ( 4 )   786 - 795   2009年

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    記述言語:日本語   出版者・発行元:日本衛生学会  

    A central problem in natural science is identifying general laws of cause and effect. Medical science is devoted to revealing causal relationships in humans. The framework for causal inference applied in epidemiology can contribute substantially to clearly specifying and testing causal hypotheses in many other areas of biomedical research. In this article, we review the importance of defining explicit research hypotheses to make valid causal inferences in medical studies. In the counterfactual model, a causal effect is defined as the contrast between an observed outcome and an outcome that would have been observed in a situation that did not actually happen. The fundamental problem of causal inference should be clear; individual causal effects are not directly observable, and we need to find general causal relationships, using population data. Under an "ideal" randomized trial, the assumption of exchangeability between the exposed and the unexposed groups is met; consequently, population-level causal effects can be estimated. In observational studies, however, there is a greater risk that the assumption of conditional exchangeability may be violated. In summary, in this article, we highlight the following points: (1) individual causal effects cannot be inferred because counterfactual outcomes cannot, by definition, be observed; (2) the distinction between concepts of association and concepts of causation and the basis for the definition of confounding; (3) the importance of elaborating specific research hypotheses in order to evaluate the assumption of conditional exchangeability between the exposed and unexposed groups; (4) the advantages of defining research hypotheses at the population level, including specification of a hypothetical intervention, consistent with the counterfactual model. In addition, we show how understanding the counterfactual model can lay the foundation for correct interpretation of epidemiologic evidence.<br>

    DOI: 10.1265/jjh.64.786

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  • 昭和52年判断条件と認定問題と原因確率.

    津田敏秀

    法と民主主義   2009年

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  • 食中毒の疫学研修講座9.調査デザインと調査方針.

    槌田浩明, 中瀨克己, 溝口嘉範, 山本英二, 津田敏秀, 土居弘幸, 土橋酉紀

    食品衛生研究   59 ( 6 )   33 - 41   2009年

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    記述言語:日本語   出版者・発行元:(公社)日本食品衛生協会  

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  • 食中毒の疫学研修講座4.調査票作成およびデータ収集の留意点.

    槌田浩明, 中瀬克巳, 溝口嘉範, 山本英二, 津田敏秀, 土橋酉紀, 土居弘幸

    食品衛生研究   59 ( 1 )   47 - 55   2009年

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    記述言語:日本語   出版者・発行元:(公社)日本食品衛生協会  

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  • 食中毒の疫学研修講座15.症例対照研究(2):スギヒラタケによる脳症の発生.食品衛生研究2009;59(12):55-66.

    津田敏秀, 津田敏秀, 槌田浩明, 槌田浩明, 中瀬克己, 中瀬克己, 溝口嘉範, 溝口嘉範, 山本英二, 山本英二, 土居弘幸, 土居弘幸, 土橋酉紀, 土橋酉紀, 頼藤貴志, 頼藤貴志

    食品衛生研究   59 ( 12 )   55 - 66   2009年

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  • 食中毒の疫学研修講座 8.観光船での汚染された弁当による集団食中毒事例(後編).

    山本英二, 中瀬克巳, 槌田浩明, 溝口嘉範, 津田敏秀, 土橋酉紀, 土居弘幸

    食品衛生研究   59 ( 5 )   41 - 48   2009年

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  • 食中毒の疫学研修講座 7.観光船での汚染された弁当による集団食中毒事例(前編).

    山本英二, 中瀬克巳, 槌田浩明, 溝口嘉範, 津田敏秀, 土橋酉紀, 土居弘幸

    食品衛生研究   59 ( 4 )   29 - 37   2009年

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  • 食中毒の疫学研修講座6.疫学統計ソフトEpi InfoTMの使い方.

    山本英二, 中瀬克巳, 槌田浩明, 溝口嘉範, 津田敏秀, 土橋酉紀, 土居弘幸

    食品衛生研究   59 ( 3 )   35 - 43   2009年

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  • 食中毒の疫学研修講座5.疫学統計ソフトEpi InfoTM日本語版の紹介,インストールおよび基礎.

    山本英二, 中瀬克巳, 槌田浩明, 溝口嘉範, 津田敏秀, 土橋酉紀, 土居弘幸

    食品衛生研究   59 ( 2 )   17 - 26   2009年

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  • 食中毒の疫学研修講座15.症例対照研究(2):スギヒラタケによる脳症の発生.

    津田敏秀, 槌田浩明, 溝口嘉範, 中瀬克巳, 山本英二, 土居弘幸, 土橋酉紀, 頼藤貴志

    食品衛生研究   59 ( 12 )   2009年

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  • 食中毒の疫学研修講座14.メディアとの連携-食中毒疫学調査と対策は疫学と調査法の理解だけではできない-.

    津田敏秀, 槌田浩明, 溝口嘉範, 中瀬克巳, 山本英二, 土居弘幸, 土橋酉紀, 頼藤貴志

    食品衛生研究   59 ( 11 )   29 - 39   2009年

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    記述言語:日本語   出版者・発行元:日本食品衛生協会  

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  • 食中毒の疫学研修講座10.実地疫学専門家養成コースFETP-Jと自治体でのアウトブレイク調査.

    土橋酉紀, 土居弘幸, 頼藤貴志, 中瀬克巳, 槌田浩明, 溝口嘉範, 山本英二, 津田敏秀

    食品衛生研究   59 ( 7 )   53 - 59   2009年

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  • 医学における因果推論 第二部 -交絡要因の選択とバイアスの整理および仮説の具体化に役立つDirected Acyclic Graph-.

    鈴木越治, 小松裕和, 頼藤貴志, 山本英二, 土居弘幸, 津田敏秀

    日本衛生学雑誌   64 ( 4 )   796 - 805   2009年

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    記述言語:日本語   出版者・発行元:日本衛生学会  

    Confounding is frequently a primary concern in epidemiological studies. With the increasing complexity of hypothesized relationships among exposures, outcomes, and covariates, it becomes very difficult to present these hypotheses lucidly and comprehensively. Graphical models are of great benefit in this regard. In this article, we focuse on directed acyclic graphs (DAGs), and review their value for confounder selection, categorization of potential biases, and hypothesis specification. We also discuss the importance of considering causal structures before selecting the covariates to be included in a statistical model and the potential biases introduced by inappropriately adjusting statistical models for covariates. DAGs are nonparametric and qualitative tools for visualizing research hypotheses regarding an exposure, an outcome, and covariates. Causal structures represented in DAGs will rarely be perfectly "correct" owing to the uncertainty about the underlying causal relationships. Nevertheless, to the extent that using DAGs forces greater clarity about causal assumptions, we are able to consider key sources of bias and uncertainty when interpreting study results. In summary, in this article, we review the following three points. (1) Although researchers have not adopted a consistent definition of confounders, using DAGs and the rules of d-separation we are able to identify clearly which variables we must condition on or adjust for in order to test a causal hypothesis under a set of causal assumptions. (2) We also show that DAGs should accurately correspond to research hypotheses of interest. To obtain a valid causal interpretation, research hypotheses should be defined explicitly from the perspective of a counterfactual model before drawing DAGs. A proper interpretation of the coefficients of a statistical model for addressing a specific research hypothesis relies on an accurate specification of a causal DAG reflecting the underlying causal structure. Unless DAGs correspond to research hypotheses, we cannot reliably reach proper conclusions testing the research hypotheses. Finally, (3) we have briefly reviewed other approaches to causal inference, and illustrate how these models are connected.<br>

    DOI: 10.1265/jjh.64.796

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  • 医学における因果推論 第二部 -交絡要因の選択とバイアスの整理および仮説の具体化に役立つDirected Acyclic Graph-.

    鈴木 越治, 小松 裕和, 頼藤 貴志, 山本 英二, 土居 弘幸, 津田 敏秀

    日本衛生学雑誌2009;64:796-805.   64 ( 4 )   796 - 805   2009年

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    記述言語:日本語   出版者・発行元:日本衛生学会  

    Confounding is frequently a primary concern in epidemiological studies. With the increasing complexity of hypothesized relationships among exposures, outcomes, and covariates, it becomes very difficult to present these hypotheses lucidly and comprehensively. Graphical models are of great benefit in this regard. In this article, we focuse on directed acyclic graphs (DAGs), and review their value for confounder selection, categorization of potential biases, and hypothesis specification. We also discuss the importance of considering causal structures before selecting the covariates to be included in a statistical model and the potential biases introduced by inappropriately adjusting statistical models for covariates. DAGs are nonparametric and qualitative tools for visualizing research hypotheses regarding an exposure, an outcome, and covariates. Causal structures represented in DAGs will rarely be perfectly "correct" owing to the uncertainty about the underlying causal relationships. Nevertheless, to the extent that using DAGs forces greater clarity about causal assumptions, we are able to consider key sources of bias and uncertainty when interpreting study results. In summary, in this article, we review the following three points. (1) Although researchers have not adopted a consistent definition of confounders, using DAGs and the rules of d-separation we are able to identify clearly which variables we must condition on or adjust for in order to test a causal hypothesis under a set of causal assumptions. (2) We also show that DAGs should accurately correspond to research hypotheses of interest. To obtain a valid causal interpretation, research hypotheses should be defined explicitly from the perspective of a counterfactual model before drawing DAGs. A proper interpretation of the coefficients of a statistical model for addressing a specific research hypothesis relies on an accurate specification of a causal DAG reflecting the underlying causal structure. Unless DAGs correspond to research hypotheses, we cannot reliably reach proper conclusions testing the research hypotheses. Finally, (3) we have briefly reviewed other approaches to causal inference, and illustrate how these models are connected.<br>

    DOI: 10.1265/jjh.64.796

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  • 水俣病における医学的問題と日本精神神経学会の取り組み.第104回日本精神神経学会総会教育講演.

    津田敏秀

    精神神経学雑誌   2009年

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  • 食中毒の疫学研修講座13.症例対照研究(1):対照の取り方と食中毒事件対策.

    津田敏秀, 槌田浩明, 溝口嘉範, 中瀬克巳, 山本英二, 土居弘幸, 土橋酉紀, 頼藤貴志

    食品衛生研究   59 ( 10 )   25 - 33   2009年

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    記述言語:日本語   出版者・発行元:(公社)日本食品衛生協会  

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  • 食中毒の疫学研修講座12.統計疫学入門:補足編.食

    津田敏秀, 槌田浩明, 溝口嘉範, 中瀬克巳, 山本英二, 土橋酉紀, 頼藤貴志, 土居弘幸

    食品衛生研究   59 ( 9 )   41 - 45   2009年

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  • 食中毒の疫学研修講座11.統計疫学入門:信頼区間と検定.

    津田敏秀, 槌田浩明, 溝口嘉範, 中瀬克巳, 山本英二, 土橋酉紀, 頼藤貴志, 土居弘幸

    食品衛生研究   59 ( 8 )   53 - 61   2009年

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  • Minamata Disease. –A catastrophic poisoning due to failure of appropriate public health response.

    Tsuda Toshihide, Yorifuji Takashi, Takao Soshi, Miyai Masaya, Babazono Akira

    Journal of Public Health Policy   2009年

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  • Minamata disease: Catastrophic poisoning due to a failed public health response.

    Toshihide Tsuda, Takashi Yorifuji, Soshi Takao, Masaya, Miyai, Akira Babazono

    Journal of Public Health Policy 2009; 30: 54-67.   2009 ( 30 )   54 - 67   2009年

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  • 食中毒の疫学研修講座 7.観光船での汚染された弁当による集団食中毒事例(前編).

    山本 英二, 中瀬 克己, 槌田 浩明, 溝口 嘉範, 津田 敏秀, 土橋 酉紀, 土居 弘幸, 岡山食中毒の疫学研修プログラム研究会

    食品衛生研究   59 ( 4 )   29 - 37   2009年

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  • 食中毒の疫学研修講座(8)観光船内の仕出し弁当による食中毒事例(後編)

    山本 英二, 中瀬 克己, 槌田 浩明

    食品衛生研究   59 ( 5 )   41 - 48   2009年

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    記述言語:日本語   出版者・発行元:日本食品衛生協会  

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  • 食中毒の疫学研修講座(7)観光船内の仕出し弁当による食中毒事例(前編)

    山本 英二, 中瀬 克己, 槌田 浩明

    食品衛生研究   59 ( 4 )   29 - 37   2009年

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    記述言語:日本語   出版者・発行元:日本食品衛生協会  

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  • Training Program on Food-Borne Epidemiology 6. Introduction to Japanese Version of Epi InfoTM Software for Epidemic Studies

    Food Sanitation Research   59 ( 3 )   35 - 43   2009年

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  • 食中毒の疫学研修講座(4)質問票作成およびデータ収集の留意点

    槌田 浩明, 中瀬 克己, 溝口 嘉範

    食品衛生研究   59 ( 1 )   47 - 55   2009年

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    記述言語:日本語   出版者・発行元:日本食品衛生協会  

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  • 食中毒の疫学研修講座(11)疫学統計入門--信頼区間と検定

    津田 敏秀, 槌田 浩明, 溝口 嘉範

    食品衛生研究   59 ( 8 )   53 - 61   2009年

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    記述言語:日本語   出版者・発行元:日本食品衛生協会  

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    その他リンク: http://search.jamas.or.jp/link/ui/2009301051

  • Training Program on Outbreak Epidemiology 10. Field Epidemiology Training Program-Japan.

    Food Sanitation Research   59 ( 7 )   53 - 59   2009年

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  • 食中毒の疫学研修講座(5)疫学統計ソフトEpi Info日本語版の紹介,インストールおよび基礎

    山本 英二, 中瀬 克己, 槌田 浩明

    食品衛生研究   59 ( 2 )   17 - 26   2009年

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    記述言語:日本語   出版者・発行元:日本食品衛生協会  

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    その他リンク: http://search.jamas.or.jp/link/ui/2009149150

  • Training Program on Food-Borne Epidemiology 9. Study Designs and Practices

    Food Sanitation Research   59 ( 6 )   33 - 41   2009年

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  • Traing Program on Food-Borne Disease Epidemiology 14. Media and the Public. -Strategies for Outbreak Investigation and Countermeasure othe than Epidemiology-

    Food Sanitation Research   59 ( 11 )   29 - 39   2009年

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  • 食中毒の疫学研修講座(13)症例対照研究(1)対照のとり方と食中毒事件対策

    津田 敏秀, 槌田 浩明, 中瀬 克己

    食品衛生研究   59 ( 10 )   25 - 33   2009年

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    記述言語:日本語   出版者・発行元:日本食品衛生協会  

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    その他リンク: http://search.jamas.or.jp/link/ui/2010007445

  • 食中毒の疫学研修講座(12)疫学統計入門:補足編

    津田 敏秀, 槌田 浩明, 溝口 嘉範

    食品衛生研究   59 ( 9 )   41 - 45   2009年

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    記述言語:日本語   出版者・発行元:日本食品衛生協会  

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    その他リンク: http://search.jamas.or.jp/link/ui/2009322057

  • Total hair mercury content and neurological signs in Minamata and neighboring communities.

    Takashi Yorifuji, Toshihide Tsuda, Soshi Takao, Etsuji Suzuki, Masazumi Harada

    Epidemiology   in press   2009年

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  • 食中毒の疫学研修講座6.疫学統計ソフトEpi InfoTMの使い方.

    山本 英二, 中瀬 克己, 槌田 浩明, 溝口 嘉範, 津田 敏秀, 土橋 酉紀, 土居 弘幸, 岡山食中毒の疫学研修プログラム研究会

    食品衛生研究   59 ( 3 )   35 - 43   2009年

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    記述言語:日本語   出版者・発行元:(公社)日本食品衛生協会  

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  • 食中毒の疫学研修講座4.調査票作成およびデータ収集の留意点.

    槌田 浩明, 中瀬 克己, 溝口 嘉範, 山本 英二, 津田 敏秀, 土居 弘幸, 土橋 酉紀, 岡山食中毒の疫学研修プログラム研究会

    食品衛生研究   59 ( 1 )   47 - 55   2009年

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    記述言語:日本語   出版者・発行元:(公社)日本食品衛生協会  

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  • Training Program on Food-Borne Disease Epidemiology 15. Case-Control Study (2): Encephalopahy Induced by Ingesting Pleurotus Mashroom

    Food Sanitation Research   59 ( 12 )   55 - 66   2009年

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  • 食中毒の疫学研修講座9.調査デザインと調査方針.

    槌田 浩明, 中瀬 克己, 溝口 嘉範, 山本 英二, 津田 敏秀, 土居 弘幸, 土橋 酉紀

    食品衛生研究   59 ( 6 )   33 - 41   2009年

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    記述言語:日本語   出版者・発行元:(公社)日本食品衛生協会  

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  • 食中毒の疫学研修講座 8.観光船での汚染された弁当による集団食中毒事例(後編).

    山本英二, 山本英二, 中瀬克己, 中瀬克己, 槌田浩明, 槌田浩明, 溝口嘉範, 溝口嘉範, 津田敏秀, 津田敏秀, 土橋酉紀, 土橋酉紀, 土居弘幸, 土居弘幸

    食品衛生研究   59 ( 5 )   41 - 48   2009年

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  • Factors affecting the choice of suicide method in Okayama: A database analysis from a forensic perspective.

    Eigo Kamizato, Kei Yoshitome, Yuji Yamamoto, Toshihide Iwase, Toshihide Tsuda, Satoru Miyaishi, Hiroyuki Doi

    Acta Medica Okayama   63 ( 4 )   177 - 186   2009年

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    記述言語:英語   出版者・発行元:Okayama University Medical School  

    <p>The annual number of suicides in Japan increased sharply in 1998, and since that time it has consistently exceeded 30,000 per year. In this study, we analyze a database of personal and background characteristics of 824 cases (605 men, 219 women) who completed suicide in Okayama Prefecture in 2002 and 2003. The data were obtained with cooperation from the police. Using the methodologies in a previous European study as a model, we classified the suicide methods into 8 categories. To examine the generational and regional differences in the choice of methods, we stratified the sample into 4 age groups (<-24, 2544, 4564, and >-65) and 2 regional groups (Okayama/Kurashiki vs. other areas). Our results on gender differences in 7 of the suicide methods were mostly similar to the European data. However, our data showed a remarkably higher proportionate male-to-female mortality ratio for poisoning by other substances (ICD-10, X65-X69 codes) (1.83, 1.15-2.92). In terms of generational differences in the choice of suicide methods, the Mantel-Haenszel test of homogeneity was significant for most of the categories in our study, suggesting an impact of age on how people commit suicide. There were no remarkable regional differences in our sample. An epidemic curve for suicides via carbon monoxide poisoning using charcoal briquets revealed a trend of time clustering not observed in the other 6 means. The database constructed and used in this study contains richer information than conventional death statistics and is expected to provide helpful knowledge and insights for future epidemiological studies.</p>

    DOI: 10.18926/AMO/31815

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  • Implications for future adverse effect studies of neuraminidase inhibitors

    Yorifuji T, Tsuda T, Kashima S, Suzuki E, Doi H

    British Medical Journal   2009年

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  • 大気汚染疫学の最新知見

    頼藤貴志, 浦久保雄介, 津田敏秀

    環境と公害   38 ( 3 )   11 - 16   2009年

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  • Preliminary retrospective investigation of FDG-PET/CT timing in follow-up of ablated lung tumor

    Fumiyo Higaki, Yoshihiro Okumura, Shuhei Sato, Takao Hiraki, Hideo Gobara, Hidefumi Mimura, Shiro Akaki, Toshihide Tsuda, Susumu Kanazawa

    ANNALS OF NUCLEAR MEDICINE   22 ( 3 )   157 - 163   2008年4月

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    記述言語:英語   出版者・発行元:SPRINGER  

    Objective The aim of this study was to clarify the most appropriate follow-up initiation time point for positron emission tomography (PET)/computed tomography (CT) following radio frequency ablation (RFA) of lung tumors, and the cutoff values of maximum standard uptake value (SUVmax) to evaluate local tumor progression.
    Methods We enrolled 15 patients (8 men, median age 62 years) with 60 tumors, who were treated with RFA of lung tumors and underwent fluorodeoxyglucose (FDG)-PET/CT following RFA. Local tumor progression was assessed by periodic chest CT images prior to and following intravenous administration of a contrast medium. The SUVmax of three periods, namely, 03 months, 3-6 months, and 6-9 months after RFA, was evaluated. The appropriate time point for follow-up initiation and the cutoff value of SUVmax were determined using receiver-operating characteristic (ROC) analysis.
    Results The median follow-up period was 357 days. Of 60 tumors, 10 showed local progression. The area under the ROC curve (Az) for the 6-9 months (P = 0.044) was the largest and almost equal to that of the 3-6 months (P = 0.024). Az for the 0-3 months was the smallest and statistically insignificant (P = 0.705). The cutoff value of 1.5 of SUVmax at 3-9 months after RFA showed 77.8% sensitivity and 85.7-90.5% specificity.
    Conclusions The appropriate follow-up initiation time point is at least 3 months following RFA. Thus, SUVmax is a useful and reliable predictive indicator.

    DOI: 10.1007/s12149-007-0113-0

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  • Preliminary retrospective investigation of FDG-PET/CT timing in follow-up of ablated lung tumor

    Fumiyo Higaki, Yoshihiro Okumura, Shuhei Sato, Takao Hiraki, Hideo Gobara, Hidefumi Mimura, Shiro Akaki, Toshihide Tsuda, Susumu Kanazawa

    ANNALS OF NUCLEAR MEDICINE   22 ( 3 )   157 - 163   2008年4月

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    記述言語:英語   出版者・発行元:SPRINGER  

    Objective The aim of this study was to clarify the most appropriate follow-up initiation time point for positron emission tomography (PET)/computed tomography (CT) following radio frequency ablation (RFA) of lung tumors, and the cutoff values of maximum standard uptake value (SUVmax) to evaluate local tumor progression.
    Methods We enrolled 15 patients (8 men, median age 62 years) with 60 tumors, who were treated with RFA of lung tumors and underwent fluorodeoxyglucose (FDG)-PET/CT following RFA. Local tumor progression was assessed by periodic chest CT images prior to and following intravenous administration of a contrast medium. The SUVmax of three periods, namely, 03 months, 3-6 months, and 6-9 months after RFA, was evaluated. The appropriate time point for follow-up initiation and the cutoff value of SUVmax were determined using receiver-operating characteristic (ROC) analysis.
    Results The median follow-up period was 357 days. Of 60 tumors, 10 showed local progression. The area under the ROC curve (Az) for the 6-9 months (P = 0.044) was the largest and almost equal to that of the 3-6 months (P = 0.024). Az for the 0-3 months was the smallest and statistically insignificant (P = 0.705). The cutoff value of 1.5 of SUVmax at 3-9 months after RFA showed 77.8% sensitivity and 85.7-90.5% specificity.
    Conclusions The appropriate follow-up initiation time point is at least 3 months following RFA. Thus, SUVmax is a useful and reliable predictive indicator.

    DOI: 10.1007/s12149-007-0113-0

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  • Preliminary retrospective investigation of FDG-PET/CT timing in follow-up of ablated lung tumor

    Fumiyo Higaki, Yoshihiro Okumura, Shuhei Sato, Takao Hiraki, Hideo Gobara, Hidefumi Mimura, Shiro Akaki, Toshihide Tsuda, Susumu Kanazawa

    ANNALS OF NUCLEAR MEDICINE   22 ( 3 )   157 - 163   2008年4月

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    記述言語:英語   出版者・発行元:SPRINGER  

    Objective The aim of this study was to clarify the most appropriate follow-up initiation time point for positron emission tomography (PET)/computed tomography (CT) following radio frequency ablation (RFA) of lung tumors, and the cutoff values of maximum standard uptake value (SUVmax) to evaluate local tumor progression.
    Methods We enrolled 15 patients (8 men, median age 62 years) with 60 tumors, who were treated with RFA of lung tumors and underwent fluorodeoxyglucose (FDG)-PET/CT following RFA. Local tumor progression was assessed by periodic chest CT images prior to and following intravenous administration of a contrast medium. The SUVmax of three periods, namely, 03 months, 3-6 months, and 6-9 months after RFA, was evaluated. The appropriate time point for follow-up initiation and the cutoff value of SUVmax were determined using receiver-operating characteristic (ROC) analysis.
    Results The median follow-up period was 357 days. Of 60 tumors, 10 showed local progression. The area under the ROC curve (Az) for the 6-9 months (P = 0.044) was the largest and almost equal to that of the 3-6 months (P = 0.024). Az for the 0-3 months was the smallest and statistically insignificant (P = 0.705). The cutoff value of 1.5 of SUVmax at 3-9 months after RFA showed 77.8% sensitivity and 85.7-90.5% specificity.
    Conclusions The appropriate follow-up initiation time point is at least 3 months following RFA. Thus, SUVmax is a useful and reliable predictive indicator.

    DOI: 10.1007/s12149-007-0113-0

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  • Causal interpretation based on DAGs

    Etsuji Suzuki, Hirokazu Komatsu, Takashi Yorifuji, Toshihide Tsuda,

    EPIDEMIOLOGY   19 ( 2 )   361 - 361   2008年3月

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    記述言語:英語   掲載種別:速報,短報,研究ノート等(学術雑誌)   出版者・発行元:LIPPINCOTT WILLIAMS & WILKINS  

    DOI: 10.1097/EDE.0b013e31816379b1

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  • Causal interpretation based on DAGs

    Etsuji Suzuki, Hirokazu Komatsu, Takashi Yorifuji, Toshihide Tsuda,

    EPIDEMIOLOGY   19 ( 2 )   361 - 361   2008年3月

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    記述言語:英語   掲載種別:速報,短報,研究ノート等(学術雑誌)   出版者・発行元:LIPPINCOTT WILLIAMS & WILKINS  

    DOI: 10.1097/EDE.0b013e31816379b1

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  • Causal interpretation based on DAGs

    Etsuji Suzuki, Hirokazu Komatsu, Takashi Yorifuji, Toshihide Tsuda,

    EPIDEMIOLOGY   19 ( 2 )   361 - 361   2008年3月

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    記述言語:英語   掲載種別:速報,短報,研究ノート等(学術雑誌)   出版者・発行元:LIPPINCOTT WILLIAMS & WILKINS  

    DOI: 10.1097/EDE.0b013e31816379b1

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  • Long-term exposure to methylmercury and neurologic signs in Minamata and neighboring communities

    Takashi Yorifuji, Toshihide Tsuda, Soshi Takao, Masazumi Harada

    EPIDEMIOLOGY   19 ( 1 )   3 - 9   2008年1月

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    記述言語:英語   出版者・発行元:LIPPINCOTT WILLIAMS & WILKINS  

    Background: It is well known that large-scale poisonings caused by methylmercury occurred in Japan (Minamata, in the 1950s) and Iraq. However, in contrast to Iraq, there have been few sound epidemiologic studies in Minamata. We evaluated the effect of methylmercury on neurologic signs using data from a 1971 population-based study.
    Methods: Villages in 3 areas were selected for study: the Minamata area (a high-exposure area), the Goshonoura area (a medium-exposure area), and the Ariake area (a low-exposure area). We used place of residence as the-exposure indicator. We examined associations between methylmercury exposure and the following neurologic signs measured on clinical examination: paresthesia of whole body, paresthesia of extremities, paresthesia around the mouth, ataxia, dysarthria, tremors, and pathologic reflexes.
    Results: Total population was 1120 in the high-exposure villages, 1845 in the medium-exposure villages, and 1165 in the low-exposure villages. In the Minamata area, 87% (n = 833) of the eligible population (age 10 years and older) participated in the 1971 investigations, in the Goshonoura area, 93% (n = 1450), and in the Ariake area, 77% (n = 755). Compared with subjects in the Ariake area, the subjects in the Minamata area manifested neurologic signs more frequently. The highest prevalence odds ratio was observed for paresthesia around the mouth (110; 95% confidence interval = 16-820). Although residents in the Goshonoura area had been exposed less heavily than those in the Minamata area, Goshonoura residents also had increased prevalence of neurologic signs.
    Conclusion: Long-term exposure to methylmercury has a strong adverse impact on neurologic signs among residents in a local community.

    DOI: 10.1097/EDE.0b013e31815c09d2

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  • Long-term exposure to methylmercury and neurologic signs in Minamata and neighboring communities

    Takashi Yorifuji, Toshihide Tsuda, Soshi Takao, Masazumi Harada

    EPIDEMIOLOGY   19 ( 1 )   3 - 9   2008年1月

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    記述言語:英語   出版者・発行元:LIPPINCOTT WILLIAMS & WILKINS  

    Background: It is well known that large-scale poisonings caused by methylmercury occurred in Japan (Minamata, in the 1950s) and Iraq. However, in contrast to Iraq, there have been few sound epidemiologic studies in Minamata. We evaluated the effect of methylmercury on neurologic signs using data from a 1971 population-based study.
    Methods: Villages in 3 areas were selected for study: the Minamata area (a high-exposure area), the Goshonoura area (a medium-exposure area), and the Ariake area (a low-exposure area). We used place of residence as the-exposure indicator. We examined associations between methylmercury exposure and the following neurologic signs measured on clinical examination: paresthesia of whole body, paresthesia of extremities, paresthesia around the mouth, ataxia, dysarthria, tremors, and pathologic reflexes.
    Results: Total population was 1120 in the high-exposure villages, 1845 in the medium-exposure villages, and 1165 in the low-exposure villages. In the Minamata area, 87% (n = 833) of the eligible population (age 10 years and older) participated in the 1971 investigations, in the Goshonoura area, 93% (n = 1450), and in the Ariake area, 77% (n = 755). Compared with subjects in the Ariake area, the subjects in the Minamata area manifested neurologic signs more frequently. The highest prevalence odds ratio was observed for paresthesia around the mouth (110; 95% confidence interval = 16-820). Although residents in the Goshonoura area had been exposed less heavily than those in the Minamata area, Goshonoura residents also had increased prevalence of neurologic signs.
    Conclusion: Long-term exposure to methylmercury has a strong adverse impact on neurologic signs among residents in a local community.

    DOI: 10.1097/EDE.0b013e31815c09d2

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  • Long-term exposure to methylmercury and neurologic signs in Minamata and neighboring communities

    Takashi Yorifuji, Toshihide Tsuda, Soshi Takao, Masazumi Harada

    Epidemiology   19 ( 1 )   3 - 9   2008年1月

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    記述言語:英語  

    BACKGROUND: It is well known that large-scale poisonings caused by methylmercury occurred in Japan (Minamata, in the 1950s) and Iraq. However, in contrast to Iraq, there have been few sound epidemiologic studies in Minamata. We evaluated the effect of methylmercury on neurologic signs using data from a 1971 population-based study. METHODS: Villages in 3 areas were selected for study: the Minamata area (a high-exposure area), the Goshonoura area (a medium-exposure area), and the Ariake area (a low-exposure area). We used place of residence as the exposure indicator. We examined associations between methylmercury exposure and the following neurologic signs measured on clinical examination: paresthesia of whole body, paresthesia of extremities, paresthesia around the mouth, ataxia, dysarthria, tremors, and pathologic reflexes. RESULTS: Total population was 1120 in the high-exposure villages, 1845 in the medium-exposure villages, and 1165 in the low-exposure villages. In the Minamata area, 87% (n=833) of the eligible population (age 10 years and older) participated in the 1971 investigations, in the Goshonoura area, 93% (n = 1450), and in the Ariake area, 77% (n = 755). Compared with subjects in the Ariake area, the subjects in the Minamata area manifested neurologic signs more frequently. The highest prevalence odds ratio was observed for paresthesia around the mouth (110
    95% confidence interval = 16-820). Although residents in the Goshonoura area had been exposed less heavily than those in the Minamata area, Goshonoura residents also had increased prevalence of neurologic signs. CONCLUSION: Long-term exposure to methylmercury has a strong adverse impact on neurologic signs among residents in a local community. © 2008 Lippincott Williams &amp
    Wilkins, Inc.

    DOI: 10.1097/EDE.0b013e31815c09d2

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  • Long-term exposure to methylmercury and neurologic signs in Minamata and neighboring communities

    Takashi Yorifuji, Toshihide Tsuda, Soshi Takao, Masazumi Harada

    EPIDEMIOLOGY   19 ( 1 )   3 - 9   2008年1月

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    記述言語:英語   出版者・発行元:LIPPINCOTT WILLIAMS & WILKINS  

    Background: It is well known that large-scale poisonings caused by methylmercury occurred in Japan (Minamata, in the 1950s) and Iraq. However, in contrast to Iraq, there have been few sound epidemiologic studies in Minamata. We evaluated the effect of methylmercury on neurologic signs using data from a 1971 population-based study.
    Methods: Villages in 3 areas were selected for study: the Minamata area (a high-exposure area), the Goshonoura area (a medium-exposure area), and the Ariake area (a low-exposure area). We used place of residence as the-exposure indicator. We examined associations between methylmercury exposure and the following neurologic signs measured on clinical examination: paresthesia of whole body, paresthesia of extremities, paresthesia around the mouth, ataxia, dysarthria, tremors, and pathologic reflexes.
    Results: Total population was 1120 in the high-exposure villages, 1845 in the medium-exposure villages, and 1165 in the low-exposure villages. In the Minamata area, 87% (n = 833) of the eligible population (age 10 years and older) participated in the 1971 investigations, in the Goshonoura area, 93% (n = 1450), and in the Ariake area, 77% (n = 755). Compared with subjects in the Ariake area, the subjects in the Minamata area manifested neurologic signs more frequently. The highest prevalence odds ratio was observed for paresthesia around the mouth (110; 95% confidence interval = 16-820). Although residents in the Goshonoura area had been exposed less heavily than those in the Minamata area, Goshonoura residents also had increased prevalence of neurologic signs.
    Conclusion: Long-term exposure to methylmercury has a strong adverse impact on neurologic signs among residents in a local community.

    DOI: 10.1097/EDE.0b013e31815c09d2

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  • 食中毒の疫学研修講座3.疫学調査の流れと基本-納豆オクラ事例 2-.

    溝口嘉範, 中瀬克巳, 槌田浩明, 山本英二, 土橋酉紀, 土居弘幸, 津田敏秀

    食品衛生研究   58 ( 12 )   33 - 42   2008年

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    記述言語:日本語   出版者・発行元:(公社)日本食品衛生協会  

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  • Mecal Issues in the Minamata Disease Incident, and the Approach by the Japanese Society for Psyciatry and Neurology

    Psychiatria et Neurologia Japonica   110 ( 11 )   1120 - 1125   2008年

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  • Training Program on Food-Borne Disease Epidemiology 1. Introdution of the Course Program and its Importance

    Food Sanitation Research   58 ( 10 )   7 - 15   2008年

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  • Electromagnetic Field and high-voltage transmission line- What is the problem? - WHO's Recommendation and the Japanese Bureaucracy

    The World   779 ( 5 )   185 - 194   2008年

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  • アスベストによる健康障害の疫学とリスクアセスメント―特に環境曝露による人体への影響に関して―.

    津田敏秀

    衆議院調査局環境調査室、解説資料:石綿関係法施行状況調査.   2008年

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  • アスベストによる健康障害の疫学とリスクアセスメント―特に環境曝露による人体への影響に関して―.

    津田敏秀

    衆議院調査局環境調査室、解説資料:石綿関係法施行状況調査.   2008年

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  • Training Program on Food-Borne Disease Epidemiology 3. Flow and Base of Epidemiologic Investigation- the Natto-Okra Incident 2

    Food Sanitation Research   58 ( 12 )   33 - 42   2008年

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  • Training Program on Food-Borne Disease Epidemiology 2. Flow and Base of Epidemiologic Investigation- the Natto-Okra Incident 1.

    Food Sanitation Research   58 ( 11 )   49 - 60   2008年

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  • 電磁波と高圧送電線・何が問題なのか-WHOの勧告と日本政府の対応.

    世界   779 ( 5 )   185 - 194   2008年

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  • Analysis of factors associated with radiation-induced bronchiolitis obliterans organizing pneumonia (BOOP) syndrome after breast-conserving therapy

    N. Katayama, S. Sato, K. Katsui, M. Takemoto, A. Yoshida, T. Morito, T. Nakagawa, A. Mizuta, H. Niiya, S. Kanazawa

    INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS   72 ( 1 )   S188 - S188   2008年

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    記述言語:英語   掲載種別:研究発表ペーパー・要旨(国際会議)   出版者・発行元:ELSEVIER SCIENCE INC  

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  • 食品衛生法を眠らせるな.

    津田敏秀

    朝日新聞   2008年

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  • 食中毒の疫学研修講座2.疫学調査の流れと基本-納豆オクラ事例 1-.

    溝口 嘉範, 中瀬 克己, 槌田 浩明

    食品衛生研究   58 ( 11 )   49 - 60   2008年

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    記述言語:日本語   出版者・発行元:日本食品衛生協会  

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    その他リンク: http://search.jamas.or.jp/link/ui/2009023272

  • 水俣病における医学的問題と日本精神神経学会の取り組み.第104回日本精神神経学会総会教育講演.

    精神神経学雑誌   110 ( 11 )   1120 - 1125   2008年

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  • 食中毒の疫学研修講座1.研修の現状と必要性-連載をはじめるにあたって-.

    中瀬 克己, 槌田 浩明, 溝口 嘉範

    食品衛生研究   58 ( 10 )   7 - 15   2008年

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    記述言語:日本語   出版者・発行元:日本食品衛生協会  

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    その他リンク: http://search.jamas.or.jp/link/ui/2008352817

  • 食品衛生法を眠らせるな.

    津田敏秀

    朝日新聞   2008年

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  • 食中毒の疫学研修講座3.疫学調査の流れと基本-納豆オクラ事例 2

    溝口 嘉範, 中瀬 克己, 槌田 浩明, 山本 英二, 津田 敏秀, 土居 弘幸, 土橋 酉紀, 岡山食中毒の疫学研修プログラム研究会

    食品衛生研究   58 ( 12 )   33 - 42   2008年

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    記述言語:日本語   出版者・発行元:(公社)日本食品衛生協会  

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  • 電磁波と高圧送電線・何が問題なのか-WHOの勧告と日本政府の対応.

    津田敏秀

    世界   ( 779 )   185 - 194   2008年

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    記述言語:日本語   出版者・発行元:岩波書店  

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  • 食中毒の疫学研修講座2.疫学調査の流れと基本-納豆オクラ事例 1-.

    溝口嘉範, 中瀬克巳, 槌田浩明, 山本英二, 土橋酉紀, 土居弘幸, 津田敏秀

    食品衛生研究   58 ( 11 )   49 - 60   2008年

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    記述言語:日本語   出版者・発行元:(公社)日本食品衛生協会  

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  • 食中毒の疫学研修講座1.研修の現状と必要性-連載をはじめるにあたって-.

    中瀬克巳, 槌田浩明, 溝口嘉範, 山本英二, 土橋酉紀, 津田敏秀

    食品衛生研究   58 ( 10 )   7 - 15   2008年

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    記述言語:日本語   出版者・発行元:(公社)日本食品衛生協会  

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  • 電磁波と高圧送電線・何が問題なのか-WHOの勧告と日本政府の対応.

    津田敏秀

    世界   2008年

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  • 電磁波と高圧送電線・何が問題なのか-WHOの勧告と日本政府の対応.

    津田敏秀

    世界   2008年

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  • EBMにおいてエビデンスを吟味する.

    津田敏秀

    大阪保険医雑誌   2008年

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  • 22pTV-5 環境科学における因果関係と科学哲学 : 医学者はどんな役割を果たしてきたのか?(領域13,領域1,領域2,領域10,領域12合同シンポジウム:環境科学リテラシー確立の今日的意義,領域13,物理教育,物理学史,環境物理)

    津田 敏秀

    日本物理学会講演概要集   62 ( 2 )   413 - 413   2007年8月

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    記述言語:日本語   出版者・発行元:一般社団法人日本物理学会  

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  • Age standardized cancer mortality ratios in areas heavily exposed to methyl mercury

    Takashi Yorifuji, Toshihide Tsuda, Norito Kawakami

    INTERNATIONAL ARCHIVES OF OCCUPATIONAL AND ENVIRONMENTAL HEALTH   80 ( 8 )   679 - 688   2007年8月

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    記述言語:英語   出版者・発行元:SPRINGER  

    Objective Methyl-mercury (MeHg) was discharged from a chemical factory in Minamata, and consequently spread throughout the Shiranui Sea in Kumamoto, Japan. Although many studies have focused on MeHg-induced neurological disorders, the association between MeHg and malignant neoplasms has not been adequately investigated. Therefore, we explored this association using the age standardized mortality ratio (ASMR) in an ecologic study over a wide area allowing for a long empirical induction period.
    Methods The subjects were residents in areas around the Shiranui Sea. We divided these areas into exposure groups 1 (Minamata and Ashikita regions) and 2 (Amakusa region). Exposure group 1 was contaminated from the late 1930s, and exposure group 2 was contaminated from the late 1950s. In addition, exposure group 1 was contaminated more heavily than exposure group 2. There were 92,525 and 152,541 residents in each group in 1960, respectively. We analyzed the cancer ASMR in both exposure groups using data from two reference populations (Japan and Kumamoto prefecture) from 1961 to 1997. There were 94,301,494 and 1,856,192 people in each reference group in 1960, respectively. We abstracted population and mortality data from the censuses and the vital statistics of the prefecture and Japan.
    Results An increased leukemia ASMR and a decreased gastric cancer ASMR were observed in both exposure groups, while other ASMRs were around unity and less precise. Furthermore, the leukemia ASMRs were elevated differently between the two exposure groups: the leukemia ASMR was already elevated early in the study period in exposure group 1 and increased gradually in exposure group 2.
    Conclusion While the negative association between MeHg and gastric cancer might be explained by salt intake, the positive association between MeHg and leukemia could not be explained by potential confounders. Despite some limitations mainly due to its ecologic design, this study indicates the necessity of an individual-level study evaluating the association between MeHg and leukemia in regions with exposure to MeHg.

    DOI: 10.1007/s00420-007-0179-y

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  • An epidemiological study of children with status epilepticus in Okayama, Japan

    Itsuko Nishiyama, Yoko Ohtsuka, Toshihide Tsuda, Hideo Inoue, Taiji Kunitomi, Hiroshi Shiraga, Takafumi Kimura, Kiyoshi Fujimoto

    EPILEPSIA   48 ( 6 )   1133 - 1137   2007年6月

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    記述言語:英語   出版者・発行元:BLACKWELL PUBLISHING  

    Background: The incidence of status epilepticus (SE) in Asian children, including Japanese, has not been reported.
    Methods: In 2003, we performed an epidemiological study of SE on Japanese children (31 days or older to &lt; 15 years of age) in Okayama City by ascertaining all lifetime first episodes of SE.
    Results: Thirty-seven patients (22 males and 15 females) were identified. The annual incidence of SE was 38.8 per 100,000 population (95% CI: 24.5-49.5). Febrile SE in the absence of CNS infection accounted for 17. Acute symptomatic etiologies other than febrile SE were observed in eight patients, including three cases of influenza encephalitis/encephalopathy. Five were classified as remote symptomatic and the remaining seven as cryptogenic. The highest incidence (155.1/100,000) was seen in the age range of 31 days or older to &lt; 1 year, followed by 101.5/100,000 in the age range of one year, and the incidence decreased after eight years. In 26 of the 37 patients, SE was their first seizure. As for seizure types, 32 had convulsive SE, including tonic status in one. Five others showed nonconvulsive SE, including complex partial SE in four and absence status in one. No one died of SE. Two patients who brought on SE because of influenza encephalitis/encephalopathy suffered from motor disturbance with or without mental disturbance after SE.
    Conclusions: The incidence of SE tended to be higher in Japanese children than reported in Caucasians. The Japanese had an age-specific incidence pattern similar to that of Caucasians.

    DOI: 10.1111/j.1528-1167.2007.01106.x

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  • 論文の批判的吟味・長期間の携帯電話使用と脳腫瘍.

    津田敏秀

    物性研究   2007年

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  • Standardized cancer mortality ratios in areas heavily exposed to methyl mercury.

    Yorifuji T, Tsuda T, Kawakami N

    Int Arch Occup Environ Health 2007   80、679-688.   2007年

  • 論文の批判的吟味・長期間の携帯電話使用と脳腫瘍.

    津田敏秀

    物性研究   2007年

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  • Risk factors for local progression after percutaneous radiofrequency ablation of lung tumors - Evaluation based on a preliminary review of 342 tumors

    Takao Hiraki, Jun Sakurai, Toshihide Tsuda, Hideo Gobara, Yoshifumi Sano, Takashi Mukai, Soichiro Hase, Toshihiro Iguchi, Hiroyasu Fujiwara, Hiroshi Date, Susumu Kanazawa

    CANCER   107 ( 12 )   2873 - 2880   2006年12月

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    記述言語:英語   出版者・発行元:JOHN WILEY & SONS INC  

    BACKGROUND. The purpose of the study was to retrospectively evaluate the risk factors for local progression after percutaneous radiofrequency (AF) ablation of lung tumors.
    METHODS. The study included 128 patients (77 men, 51 women; mean age, 61.3 years) with 342 tumors (25 primary and 317 metastatic lung neoplasms; mean long-axis diameter, 1.7 cm) treated with RF ablation. The overall primary, and secondary technique effectiveness rates were estimated using Kaplan-Meier analysis. Multiple variables were analyzed using the log-rank test, followed by multivariate multilevel analysis to determine independent risk factors for local progression. The primary and secondary technique effectiveness rates were again estimated when considering only tumors without independent risk factors.
    RESULTS. The median follow-up period was 12 months (range, 6-47 months). The overall primary and secondary technique effectiveness rates were 72% and 84% at 1 year, 60% and 71% at 2 years, and 58% and 66% at 3 years, respectively. Larger turner size (hazard ratio [HR], 1.97; 95% confidence interval [95% CI], 1.47-2.65; P &lt;.00001) and the use of an internally cooled electrode (HR, 2.32; 95% CI, 1.10-4.90; P=.027) were assessed as independent risk factors for local progression. The primary and secondary technique effectiveness rates when considering tumors smaller than 2 cm and treated with a multitined expandable electrode were 89% and 89% at 1 year and 66% and 78% at 2 years, respectively.
    CONCLUSIONS. Larger tumor size and the use of an internally cooled electrode were independent risk factors for local progression after RF ablation of lung tumors.

    DOI: 10.1002/cncr.22333

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  • A reason why the number of patients of Minamata disease is still unknown - The 50th year of Minamata disease since the first notification in 1956

    T. Tsuda, M. Harada, M. Miyai, A. Babazono, E. Yamamoto, H. Matsuoka, T. Yorifuji, Y. Mino

    EPIDEMIOLOGY   17 ( 6 )   S494 - S494   2006年11月

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    記述言語:英語   掲載種別:研究発表ペーパー・要旨(国際会議)   出版者・発行元:LIPPINCOTT WILLIAMS & WILKINS  

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  • Effects of stress management at workplace on depressive symptoms, a randomized controlled trial

    Y Mino, S Shimodera, A Babazono, T Tsuda, N Yasuda

    JOURNAL OF AFFECTIVE DISORDERS   91   S81 - S81   2006年3月

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    記述言語:英語   掲載種別:研究発表ペーパー・要旨(国際会議)   出版者・発行元:ELSEVIER SCIENCE BV  

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  • 産業医と疫学.認定産業医9.

    津田敏秀

    日本医事新報   ( 4283 )   43 - 45   2006年

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    記述言語:日本語   出版者・発行元:日本医事新報社  

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    その他リンク: http://search.jamas.or.jp/link/ui/2006252948

  • Can stress management at the workplace prevent depression? A randomized controlled trial

    Y Mino, A Babazono, T Tsuda, N Yasuda

    PSYCHOTHERAPY AND PSYCHOSOMATICS   75 ( 3 )   177 - 182   2006年

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    記述言語:英語   出版者・発行元:KARGER  

    Background. Stress, mental health and depression at the workplace have emerged as common and significant problems. The effectiveness of a stress-management program at the workplace was investigated. Methods: The effectiveness of a stress-management program was examined in workers at a highly stressful workplace using a randomized controlled trial. The 58 workers in the office were randomly assigned into a stress-management group (n = 28) and a control group (n = 30). The stress-management program included lectures on the perception of stress, measures to cope with it, stress-management recording sheets, and e-mail counseling. This program was based on the cognitive behavioral approach. The stress-management program was carried out for 3 months, and perceived work-related stress and psychological symptoms were evaluated using: General Health Questionnaire (GHQ)-30, Center for Epidemiologic Study for Depression (CES-D), the Questionnaire of Work-Related Stress and the Effort-Reward Imbalance Questionnaire. Twenty-one out of the 28 in the stressmanagement group and all in the control group were successfully followed up. Results: In the stress-management group, a significant improvement in the depressive symptoms was observed, compared with the control group in CES-D (p = 0.003 by two-tailed paired t-test, and p = 0.042 by repeated measure analysis of variance). In the multiple regression analysis, the effect of stress management on depressive symptoms at follow-up was significant (p = 0.041), controlling for potential confounding factors. However, the alleviation of perceived occupational stress was limited. Conclusions:A stress-management program based on the cognitive behavioral approach at the workplace may have potential for the prevention of depression.

    DOI: 10.1159/000091775

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  • 水俣病事件における医学的問題の概略

    津田敏秀

    解説資料:水俣病問題の概要An outline of the Minamata Disease Problem   2006年

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  • 認定制度は崩壊.水俣病公式確認50年.

    津田敏秀

    朝日新聞   2006年

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  • 食中毒だ!!とわかるまで.

    津田敏秀

    食と健康   2006年

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  • Understanding the impact of health policy: 10% co-payments for medical services reduce complaiance with necessary care among elderly patients with chronic disease in Japan.

    Akira Babazono, Motonobu Miyazaki, Hiroshi Une, Eiji Yamamoto, Toshihide Tsuda, Yoshio Mino, Alan L Hillman

    Journal of Health Science   28   15 - 23   2006年

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    記述言語:英語   出版者・発行元:九州大学  

    Co-payments help determine how expensive an individual health service is both to payers and to enrollees. The Japanese government had provided its elderly with first dollar coverage, including pharmaceuticals, until January 2001 when it introduced 10% co-payments in an effort to contain costs. We evaluated whether the Japanese increase in co-payments reduced compliance with necessary care, including prescription pharmaceuticals, in elderly patients with chronic illness. Subjects were members of the Health Care System for the Aged (persons age 70 or older) who belonged to a health insurance society located in Fukuoka Prefecture continuously from January 2000 to December 2001. We defined 234 highly compliant patients with hypertension and 35 with diabetes mellitus who visited physicians at least once per month during every month of the 6-month period from January to June 2000. We used time series analyses to compare medical service use during 6 months before and 12 months after the 10% co-payments were introduced. During this study, medical visits were necessary to obtain prescriptions for pharmaceuticals in Japan. Compliance decreased significantly for both hypertension and diabetes mellitus patients after the introduction of 10% co-payments, controlling for the possible impact of secular trends. The impact on necessary pharmaceutical use was likewise affected. However, the impact on costs was not as marked. Co-payments have a major impact on patient compliance and recommended medical service use (but perhaps not on costs), especially in the elderly with chronic diseases.

    DOI: 10.15017/10769

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    その他リンク: http://hdl.handle.net/2324/10769

  • Health care policy-making in Japan: The Impact of the increase co-payments on use of services by patients with chronic illness

    Babazono A, Miyazaki M, Une H, Yamamoto E, Tsuda T, Mino Y, Hillman AL

    Japanese Journal of Health Promotion   8   89 - 96   2006年

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  • A prospective study on the influences of workplace stress on mental health

    A Babazono, Y Mino, J Nagano, T Tsuda, T Araki

    JOURNAL OF OCCUPATIONAL HEALTH   47 ( 6 )   490 - 495   2005年11月

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    記述言語:英語   出版者・発行元:JAPAN SOC OCCUPATIONAL HEALTH  

    The purpose of this study was to clarify the influences of subjective stress in the workplace on mental health according to work contents in subjects without mental health problems. In a survey in fiscal 1997, 1,246 (84.6%) of all 1,363 workers of a manufacturing company in Japan, responded to a questionnaire including questions on subjective stress and GHQ60, and 1,135 workers answered all questions (effective response rate, 83.3%). In fiscal 1997, there were 705 "mentally healthy" workers with a GHQ score of &lt;= 16. Of the 705 workers, 603 (85.5%) could be followed up by another survey 2 yr later (fiscal 1999). According to the contents of the work, multiple logistic regression analysis was performed using the status of mental health in fiscal 1999 as a dependent variable and subjective workplace stress, sex, age, smoking, and alcohol usage in fiscal 1997 as explanatory variables. The statistically significant items relating to problematic mental health for "factory work" were "too much competition", "feel pressed for time", and "cannot keep up with new technology" (Table 4). For "too much competition", the odds ratios (95% CI) of "always" and "sometimes" to "do not feel" were 4.04 (1.39-11.76) and 1.85 (0.92-3.70), respectively. For "feel pressed for time", the odds ratios (95% CI) of "always" and "sometimes" to "do not feel" were 2.40 (1.08-5.35) and 0.98 (0.46-2.06), respectively. For "cannot keep up with new technology", the odds ratio (95% CI) of "always" and "sometimes" to "do not feel" were 6.54 (0.37-116.36) and 2.52 (1.34-4.77), respectively. The statistically significant items relating to problematic mental health for "research and development or office work" were "too much trouble at work" and "feel pressed for time". For "too much trouble at work", the odds ratios (95% CI) of "always" and "sometimes" to "do not feel" were 3.92 (1.41-10.93) and 1.44 (0.67-3.09), respectively. For "feel pressed for time", the odds ratios (95% CI) of "always" and "sometimes" to "do not feel" were 2.69 (1.04-6.93) and 2.09 (0.94-4.67), respectively. Our study suggests that subjective stress items aggravating mental health are different among work contents. If we could identify items of workplace stress influencing mental health by work contents, we could utilize the results for a mental health promotion program.

    DOI: 10.1539/joh.47.490

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  • Health impact assessment of particulate matter in Tokyo, Japan

    Takashi Yorifuji, Eiji Yamamoto, Toshihide Tsuda, Norito Kawakami

    ARCHIVES OF ENVIRONMENTAL & OCCUPATIONAL HEALTH   60 ( 4 )   179 - 185   2005年7月

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    記述言語:英語   出版者・発行元:HELDREF PUBLICATIONS  

    Among industrialized countries, Japan still maintains an old set of guidelines for particulate matter (PM); therefore, we assessed the public health impacts of PM exposure in various Situations using data from the Tokyo metropolitan area. Subjects were 7.8 million people aged older than 30 years. Based on a linear relationship between exposure and health effects, we estimated attributable cases of mortality caused by PM. Even at the recent exposure level, the number of deaths will occur after both short- and long-term exposure. When the guideline for PM2.5 (particles &lt; 2.5 mu m in diameter) long-term exposure was set at 12 mu g/m3, we could prevent 8% of all causes mortality or 6,700 deaths in the Tokyo metropolitan area per year. This assessment shows that guidelines for long-term exposure, especially for PM2.5, should be recommended in Japan.

    DOI: 10.3200/AEOH.60.4.179-185

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  • Effects of the increase in co-payments from 20 to 30 percent on the compliance rate of patients with hypertension or diabetes mellitus in the Employed Health Insurance System

    Akira Babazono, Motonobu Miyazaki, Takuya Imatoh, Hiroshi Une, Eiji Yamamoto, Toshihide Tsuda, Kiyoshi Tanaka, Shinichi Tanihara

    International Journal of Technology Assessment in Health Care   21 ( 2 )   228 - 233   2005年3月

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    記述言語:英語  

    Objectives: How to contain medical expenditures is a universal problem. The Japanese government has increased patient co-payments to control it. The purpose of this study is to clarify whether the increase in co-payments to 30 percent prevented patients with hypertension or diabetes mellitus from receiving necessary care in the Employee Health Insurance System. Methods: The subjects were 211 patients with hypertension and 66 patients with diabetes mellitus who regularly visited physicians from October 2001 to March 2002 and were defined as a cohort that needed health care, and their medical indicators were examined between April and September 2002 (prestage) and between April and September 2003 (poststage). Results: In the hypertensive patients with no complications, the compliance rate was 89.9 percent and 88.0 percent in the prestage, and poststage, respectively, showing no significant change. In the hypertensive patients with complications, the compliance rate was 90.5 percent and 92.1 percent in the prestage and poststage, respectively, showing no significant change. In the diabetic patients with complications, the compliance rate was 77.5 percent and 79.2 percent, in the prestage and poststage, respectively, with no significant change. In the diabetic patients with no complications, however, the compliance rate was 83.7 percent and 66.7 percent, in the prestage and poststage, respectively. A significant decrease was observed among diabetic patients without complications. Conclusions: Increasing co-payments reduced necessary preventive care in diabetic patients without complications. Copyright © 2005 Cambridge University Press.

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  • The relationship between epidermal growth factor receptor mutations and clinicopathologic features in non-small cell lung cancers

    M Tokumo, S Toyooka, K Kiura, H Shigematsu, K Tomii, M Aoe, K Ichimura, T Tsuda, M Yano, K Tsukuda, M Tabata, H Ueoka, M Tanimoto, H Date, AF Gazdar, N Shimizu

    CLINICAL CANCER RESEARCH   11 ( 3 )   1167 - 1173   2005年2月

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    記述言語:英語   出版者・発行元:AMER ASSOC CANCER RESEARCH  

    Purpose: Recent studies reported that clinical responsiveness to gefitinib was associated with somatic mutation of epidermal growth factor receptor (EGFR) gene in non-small cell lung cancers (NSCLC). Here, we investigated the relationship between EGFR mutation and clinicopathologic features.
    Experimental Design: EGFR mutational status of 120 NSCLCs was determined mainly in EGFR exons 18 to 21 by direct sequence and correlated with clinicopathologic parameters.
    Results: EGFR mutations were present in 38 cases (32%) and the majority of mutations were in-frame deletions of exon 19 (19 cases) and a missense mutation in exon 21 (18 cases). EGFR mutations were frequently associated with adenocarcinoma (P &lt; 0.0001), never smoker (P &lt; 0.0001), and female gender (P = 0.0001). Of interest, increasing smoke exposure was inversely related to the rate of EGFR mutation (P &lt; 0.0001). Multivariate analysis showed that smoking and histology were independent variables. Furthermore, gender difference was observed for the mutational location (P = 0.01) dominance of exon 19 for males and exon 21 for females. Twenty-one cases were treated with gefitinib and found that EGFR mutation was significantly related to gefitinib responsiveness (P = 0.002). In addition, median survival times of patients with and without EGFR mutations treated with gefitinib were 25.1 and 14.0 months, respectively. Patients with EGFR mutations had approximately 2-fold survival advantage; however, the difference was not significant.
    Conclusions: We show that EGFR mutations were significantly related to histology and smoke exposure and were a strong predictive factor for gefitinib responsiveness in NSCLC.

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  • Clostridium perfringens foodborne outbreak due to braised chop suey supplied by chafing dish

    H Ochiai, T Ohtsu, T Tsuda, H Kagawa, T Kawashita, S Takao, A Tsutsumi, N Kawakami

    ACTA MEDICA OKAYAMA   59 ( 1 )   27 - 32   2005年2月

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    記述言語:英語   出版者・発行元:OKAYAMA UNIV MED SCHOOL  

    On February 13, 2002, a public health center in Hiroshima Prefecture, Japan, was notified that many individuals living at the Japan Maritime Self-Defence Force base had symptoms resembling those of food poisoning. Self-administered questionnaires requesting information regarding meal consumption and symptoms were distributed to all 281 members at the base. A case of the illness was defined as a member who had had watery or mucousy stool, or loose stool with abdominal cramps, more than twice a day after consuming dinner on February 12. Control of the illness was defined as a member with no symptoms. The dinner on February 12 was significantly associated with the illness (Mantel-Haenszel odds ratio: 3.59, 95% confidence interval: 1.06-12.20). A case-control study showed that, among the food supplied at dinner on February 12, the braised chop suey was significantly associated with the illness (odds ratio: 12.30, 95% confidence interval: 1.90-521.00). The braised chop suey had been stored in a chafing dish. An environmental investigation indicated that Clostridium perfringens (C. perfringens) in the chafing dish proliferated under an inappropriate heat-retention temperature, and the contaminated braised chop suey could have caused the food poisoning. This study demonstrated that the recommended heat-retention temperature (over 65 degreesC) should be confirmed thoroughly.

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  • 「関西水俣病訴訟」上告審判決.

    津田敏秀

    科学   75 ( 1 )   7 - 9   2005年

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    記述言語:日本語   出版者・発行元:岩波書店  

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  • 大食中毒事件と病因物質.

    津田敏秀

    メディカル朝日   2005年

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  • 日本の医学医療の現状と科学.

    津田敏秀

    科学   2005年

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  • 人体への影響調査は被害拡大防止に有効.

    津田敏秀

    建築ジャーナル   2005年

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  • 日本の医学医療と公害事件-認定審査会は原理的に個人の「認定」に関する新しい知見をもたらさない.

    津田敏秀

    科学   75 ( 5 )   586 - 591   2005年

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    記述言語:日本語   出版者・発行元:岩波書店  

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  • 解決に、疫学が役立つ課題は数多い.

    津田敏秀

    メディカル朝日   2005年

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  • アスベストと疫学、応用科学の存在考え直す時.

    津田敏秀

    朝日新聞   2005年

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  • Dose effect of smoking on aberrant methylation in non-small cell lung cancers

    S Toyooka, M Suzuki, T Tsuda, KO Toyooka, R Maruyama, K Tsukuda, Y Fukuyama, T Iizasa, T Fujisawa, N Shimizu, JD Minna, AF Gazdar

    INTERNATIONAL JOURNAL OF CANCER   110 ( 3 )   462 - 464   2004年6月

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    記述言語:英語   掲載種別:速報,短報,研究ノート等(学術雑誌)   出版者・発行元:WILEY-LISS  

    DOI: 10.1002/ijc.20125

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  • 小学校で発生した麻疹集団感染事例

    大津忠弘, 万代素子, 二宮忠矢, 松下明, 高尾総司, 落合裕隆, 津田敏秀, 中瀬克己

    日本衛生学雑誌   59 ( 2 )   145   2004年3月

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    記述言語:日本語  

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  • ウエルシュ菌による食中毒アウトブレイク事例についての疫学調査

    落合裕隆, 大津忠弘, 香川治子, 河下寿昭, 津田敏秀, 高尾総司, 堤明純, 中瀬克己, 川上憲人

    日本衛生学雑誌   59 ( 2 )   146   2004年3月

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  • Prognosis after withdrawal of antiepileptic drugs in childhood-onset cryptogenic localization-related epilepsies

    H Ohta, Y Ohtsuka, T Tsuda, E Oka

    BRAIN & DEVELOPMENT   26 ( 1 )   19 - 25   2004年1月

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    記述言語:英語   出版者・発行元:ELSEVIER SCIENCE BV  

    The purpose of this study was to clarify the risk factors of relapse following discontinuation of AEDs in patients with childhood-onset cryptogenic localization-related epilepsies. The subjects were 82 patients who fulfilled the following criteria: (1) age at first visit of less than 15 years, (2) follow-up period of more than 5 years, (3) suffering from cryptogenic localization-related epilepsies, and (4) the patient underwent AED withdrawal during the follow-up period. As a basic principle, we decided to start withdrawing AEDs when both of the following two conditions were met: (1) the patient had a seizure-free period of 3 years or more, and (2) there were no epileptic discharges on EEGs just prior to the start of withdrawal. Seizures recurred in eight of the 82 patients (9.8%). Univariate analysis revealed that the following factors were correlated with higher rates of seizure relapse: 6 years of age or higher at onset of epilepsy; 15 years of age or higher at the start of AED withdrawal, 5 years or more from the start of AED treatment to seizure control; five or more seizures before seizure control; and two or more AEDs administered before seizure control. Among these risk factors, 6 years of age or higher at onset and 5 years or more from the start of AED treatment to seizure control were determined by multivariate analysis to be independent risk factors for relapse. Thus, we conclude that the physician should be more careful in discontinuing AEDs in these higher-risk patients groups, and more generous in discontinuing AEDs in lower-risk groups. (C) 2003 Elsevier B.V. All rights reserved.

    DOI: 10.1016/S0387-7604(03)00089-5

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  • A study on a reduction in visits to physicians after introduction of 30% co-payments in the employee health insurance in Japan

    A Babazono, M Miyazaki, H Une, E Yamamoto, T Tsuda, Y Mino

    INDUSTRIAL HEALTH   42 ( 1 )   50 - 56   2004年1月

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    記述言語:英語   出版者・発行元:NATL INST OCCUPATIONAL SAFETY & HEALTH, JAPAN  

    The purpose of the study is to evaluate influences of the introduction of 30% co-payments on potential visit behavior using a questionnaire in order to determine whether "employment state of the spouse" and "number of dependent children", as indicators of economic backgrounds, affect visits to physicians in a health insurance society. The subjects were 1,674 insured consisting of 1,165 males and 509 females, who underwent a regular health examination in July 2002, in a health insurance society. In the survey, they were asked whether the subject "will reduce" or "will not reduce" visits to physicians due to the increase in co-payments in the health insurance system scheduled in 2003. Multivariate analyses showed that "employment state of the spouse" was significantly related to the reduction in visits for myocardial infarction or stroke, cancer or heart disease, and hypertension and diabetes mellitus. Concerning "number of dependent children", it was related to the risk of reducing visits to physicians for myocardial infarction or stroke, trauma or fracture, cancer or heart disease, and low back pain or knee pain. Finally, upper limit expenditures of co-payments of physicians to visits due to hypertension and diabetes mellitus were related to "number of dependent children". The study results suggest that "employment state of the spouse" and "number of dependent children" are significant factors to affect potential visits to physicians after the introduction of 30% co-payments.

    DOI: 10.2486/indhealth.42.50

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  • Does seropositivity for Helicobacter pylori antibodies increase outpatient costs for gastric and duodenal ulcer or inflammation?

    A Babazono, M Miyazaki, H Une, E Yamamoto, T Tsuda, Y Mino, AL Hillman

    PHARMACOECONOMICS   22 ( 15 )   975 - 983   2004年

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    記述言語:英語   出版者・発行元:ADIS INT LTD  

    Background: Helicobacter pylori is regarded as an important cause of both peptic ulcer and chronic gastritis. in particular, seropositivity is highest in patients with duodenal ulcer. No studies have determined whether there are differences in the direct medical costs associated with gastric/duodenal ulcer or inflammation, between seropositive and seronegative patients.
    Objective: To examine the relationship between seropositivity for H. pylori and outpatient visits and direct medical costs for gastric/duodenal ulcer or inflammation in Japan from the perspective of the payor and patients.
    Methods: Participants were males (n = 653) who worked for an agricultural co-operative in Fukuoka Prefecture, attended an annual health examination (including a written lifestyle and medical survey), belonged to the same health insurance society consistently for 4 years from April 1996 to March 2000, and provided a blood sample. The survey asked about lifestyle, including smoking and drinking, and past medical history. We retrospectively analysed the annual number of outpatient visits per person and outpatient medical cost (Yen [] 2000 values) per person for visits relating to gastric or duodenal ulcer or inflammation using International Classification of Diseases (9th edition) - Clinical Modification codes. We assessed for potential confounding factors using analysis of covariance and the chi-square test.
    Results: The annual outpatient incidence of disease, the number of visits to physicians, and the medical costs for gastric or duodenal ulcer or inflammation were about 2-fold greater in individuals with antibodies to H. pylori compared with those without antibodies.
    Conclusion: Population-based studies and/or randomised controlled clinical trials that target high-risk groups and account for the unique way in which data are collected in Japan are needed to determine whether medical costs for gastric and duodenal ulcer might be reduced by treating asymptomatic patients who have antibodies to H. pylori.

    DOI: 10.2165/00019053-200422150-00002

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  • 食中毒事件としての水俣病事件.

    津田敏秀

    環境と公害   2004年

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  • 関西水俣病訴訟・最高裁判決を考える.

    津田敏秀

    神戸新聞   2004年

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  • 食中毒事件にあたり患者数の年次推移に関する一考察

    谷原真一, 山部清子, 大津忠弘, 津田敏秀, 中村好一, 藤田委由

    経口細菌感染症の広域的・散発的発生時の実地疫学的・調査手法等の開発に関する研究平成15年度総括・分担研究報告書   203-206   2004年

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    記述言語:日本語   掲載種別:研究発表ペーパー・要旨(全国大会,その他学術会議)  

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  • 福山市における麻疹流行と予防接種実施状況について 第1報・その2

    大津忠弘, 吉井健哲, 田中知徳, 高尾総司, 落合裕隆, 谷原真一, 津田敏秀, 中瀬克己

    日本公衆衛生学会総会抄録集   62nd   818   2003年10月

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  • 福山市における麻疹流行と予防接種実施状況について 第1報・その1

    吉井健哲, 大津忠弘, 田中知徳, 高尾総司, 落合裕隆, 谷原真一, 津田敏秀, 中瀬克己

    日本公衆衛生学会総会抄録集   62nd   818   2003年10月

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  • Stress management in an occupational setting: a randomized controlled trial

    Y Mino, A Babazono, T Tsuda, N Yasuda, Y Yonekura

    JOURNAL OF PSYCHOSOMATIC RESEARCH   55 ( 2 )   149 - 149   2003年8月

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    記述言語:英語   掲載種別:研究発表ペーパー・要旨(国際会議)   出版者・発行元:PERGAMON-ELSEVIER SCIENCE LTD  

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  • Effects of an increase in patient copayments on medical service demands of the insured in Japan

    Akira Babazono, Toshihide Tsuda, Eiji Yamamoto, Yoshio Mino, Hiroshi Une, Alan L. Hillman

    International Journal of Technology Assessment in Health Care   19 ( 3 )   465 - 475   2003年6月

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    記述言語:英語   掲載種別:書評論文,書評,文献紹介等  

    Objectives: To examine quantitatively the effects of an increase in patient copayments from 10% to 20% on the demand for medical services in Japan. Methods: The subjects of the study were the employees insured by the 1,797 health insurance societies, belonging to the National Federation of Health Insurance Societies, in 1996 and 1998. Indicators of medical service demands analyzed include the inpatient, outpatient, and dental case rates, the number of serviced days per case, the medical cost per day and the medical cost per insured. Results: When the effects of an increase in patient copayments from 10% to 20% were evaluated, taking into account the average age, the average monthly salary, the total number, the gender (male-to-female) ratio and the dependent ratio of the insured, the estimated change in the case rate was -6. 96% for inpatient, -4.79% for outpatient, and -5.77% for dental care. The estimated change in the number of serviced day per case was -4.66% for inpatient, -5.67% for outpatient, and -1.82% for dental care. The estimated change in the medical cost per day was -3.15% for inpatient, -13.00% for outpatient, and -11.48% for dental care. The estimated change in the medical cost per insured was -14.08% for inpatient, -21.54% for outpatient, and -18.11% for dental care. Conclusions: The increase in patient copayments from 10% to 20% enabled insurers to substantially reduce medical costs by cost shifting from the insurer to the insured, with resultant changes in the case rate and the number of service days per case.

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  • Comparison of Tc-99m-GSA scintigraphy with hepatic fibrosis and regeneration in patients with hepatectomy

    T Iguchi, S Sato, Y Kouno, Y Okumura, S Akaki, T Tsuda, K Kobayashi, S Kanazawa, Y Hiraki

    ANNALS OF NUCLEAR MEDICINE   17 ( 3 )   227 - 233   2003年5月

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    記述言語:英語   出版者・発行元:JAPANESE SOCIETY NUCLEAR MEDICINE  

    Objective: Liver regeneration after hepatectomy is correlated with liver fibrosis. Retrospectively, we compared three quantitative indices (HH15, LHL15 and LU15) of Technetium-99m-diethylenetriaminepentaacetic acid-galactosyl-human serum albumin (Tc-99m-GSA) liver scintigraphy with liver fibrosis; in particular, we compared the HH15 index and the rate of remnant liver regeneration. Methods: Fifty-three patients who had undergone hepatectomy were enrolled in this study. The non-neoplastic parts of their resected. specimens were divided into 5 groups (F0-F4) according to the degree of liver fibrosis, as determined using the New Inuyama classification system: F0, no fibrosis (n = 12); F1, portal fibrosis widening (n = 12); F2, portal fibrosis widening with bridging fibrosis (n = 14); F3, bridging fibrosis plus lobular distortion (n = 7); F4, liver cirrhosis (n = 8). Results: When the cases were divided into a no or mild fibrosis group (170 and F1) and a moderate or severe fibrosis or cirrhosis group (F2, F3 and F4), all of the indices were significantly different between the two groups. In this analysis, the areas (Az) under the receiver operating characteristic (ROC) curves for the HH15 and LHL15 indices were very similar, while the Az for the LU15 index was smaller. An HH15 index equal to 0.52 was the most accurate, producing a 79.3% sensitivity and a 75.0% specificity rating. When 18 patients that had received a CT scan one month after hepatectomy were divided into 2 groups according to their HH15 value (group A, HH15 less than or equal to 0.52; group B, HH15 &gt; 0.52), group A exhibited a better regeneration rate. Conclusion: Tc-99m-GSA scintigraphy is well correlated with liver fibrosis and may be useful for non-invasive, preoperative evaluations of liver fibrosis. The HH15 index, in particular, may be useful for predicting the rate of liver regeneration after hepatectomy.

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  • 職業がんとイニシエーター・プロモーター

    津田 敏秀, 大津 忠弘, 高尾 総司, 茂見 潤, 馬場園 明, 三野 善央

    産業衛生学雑誌 = Journal of occupational health   45   603 - 603   2003年3月

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  • The TP53 gene, tobacco exposure, and lung cancer

    S Toyooka, T Tsuda, AF Gazdar

    HUMAN MUTATION   21 ( 3 )   229 - 239   2003年3月

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    記述言語:英語   掲載種別:書評論文,書評,文献紹介等   出版者・発行元:WILEY-LISS  

    Of the various genetic alterations in lung cancer, the abnormalities of the TP53 gene (p53) are among the most frequent and important events. Because of its importance, many aspects of TP53 have been studied, including preneoplastic lesions and TP53 as a marker for early detection and prognosis and as a therapeutic option. We summarize recent knowledge of TP53 in lung cancer with a special emphasis on the relationship between smoking exposure (e.g, cigarette, etc.) and specific mutational pattern of TP53 by analyzing the latest version of the International Agency for Research on Cancer (IARC) database on TP53 mutations in human cancer. Our analysis confirmed several other studies showing significant differences in the frequencies of G:C to T:A transversions between ever-smokers and never-smokers. Furthermore, when comparing the mutational spectrum by gender, important differences were noted between male and female never smokers. We concluded that the previously noted G:C to T.A transversions were mainly due to female smokers having a high frequency of these changes compared to female never smokers. There was no relationship between adenocarcinomas and squamous cell carcinomas independent of gender. We also examined the seven codons which have been previously identified as hot spots, that is, the sites of frequent G:C to TA transversions in smoking,related lung cancers. However, there was no specific codon which was strongly related to smoke exposure despite a moderate relationship. We considered the term "warmspot" may be more appropriate. While mutations of TP53 are frequent in lung cancers, further investigation is necessary to understand their role for lung carcinogenesis, especially as they relate to gender differences, and to translate our laboratory knowledge to clinical applications.

    DOI: 10.1002/humu.10177

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  • 食中毒事件当たり患者数の年次推移に関する一考察.

    谷原真一, 山部清子, 大津忠弘, 津田敏秀, 中村好一, 藤田委由

    厚生の指標   2003年

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  • A case-control study of lung cancer in relation to silica exposure and silicosis in a rural area in Japan

    T Tsuda, Y Mino, A Babazono, J Shigemi, T Otsu, E Yamamoto, S Kanazawa

    ANNALS OF EPIDEMIOLOGY   12 ( 5 )   288 - 294   2002年7月

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    記述言語:英語   出版者・発行元:ELSEVIER SCIENCE INC  

    PURPOSE: In southeast Okayama Prefecture, Japan, there have been reports of a high prevalence of silicosis among refractory brick production workers. Recently, a high mortality rate of lung cancer among the local residents has been observed. Therefore, a population based case-control study was conducted concerning the relationship between silica, silicosis, and lung cancer using multiple cancer controls.
    METHODS: Cases and controls were restricted to male subjects and information was obtained from death certificates from 1986 to 1993 in the area. Three categories of deceased control groups were selected: a series of deaths from liver cancer, colon cancer, and cancers of other organs, which was assumed not to be related to silica exposure. Age and smoking habits were adjusted by stratified analysis using the Mantel-Haenszel odds ratio estimates. Unconditional logistic regression analysis was also conducted to control potential confounding factors; such as age and smoking habits.
    RESULTS: The age-, smoking-adjusted odds ratios were 1.94 (0-94-4-43) for the colon cancer control group, 2.13 (1.19-3.85) for the other cancer control group related to silica exposure, and 2.94 (1.30-8.90) and 2.69 (1.43-5.37) related to silicosis, respectively. The direct weighted average using the estimates for colon and the other cancer controls was 2.06 (1.29-3.29) for silica exposure, and 2.77 (1.60-4.77) for silicosis. Histological or cytological types of lung cancer cases were obtained from 64.1% of the subjects (118/ 184). As for the histologic type of lung cancer, small cell carcinoma was higher among those who had been silica-exposed workers than the unexposed lung cancer cases and the data from the general Japanese population. On chest x-ray findings, elevated lung cancer mortality compared with cancers other than lung cancer was demonstrated among patients without large opacities.
    CONCLUSIONS: Silica exposure increased the lung cancer mortality in the area. A high lung cancer mortality rate in the area could be explained by silica exposure and silicosis prevalence in this area. Ann Epidemiol 2002; 12:288-294. (C) 2002 Elsevier Science Inc. All rights reserved.

    DOI: 10.1016/S1047-2797(01)00271-X

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  • P329禁煙支援・事例報告 その1

    高尾 総司, 大津 忠弘, 太田 充彦, 茂見 潤, 津田 敏秀, 堤 明純, 三野 善央, 川上 憲人

    産業衛生学雑誌   44 ( 0 )   689 - 689   2002年3月

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    記述言語:日本語   出版者・発行元:公益社団法人日本産業衛生学会  

    DOI: 10.1539/sangyoeisei.KJ00003948091

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  • 疫学と行政判断-サリドマイド事件を例にして-.

    津田敏秀

    薬のチェックは命のチェック   2 ( 7 )   69 - 73   2002年

  • 疫学と根拠に基づく医学(EBM)から見た「脳死」問題

    津田敏秀, 大津忠弘, 茂見潤

    健康支援   4,2,107-110   2002年

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  • PearlのCausalityと行政判断

    山本英二, 津田敏秀

    岡山理科大学紀要   38,71-76   2002年

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  • 疫学と根拠に基づく医学(EBM)から見た「脳死」問題.

    津田敏秀, 大津忠弘, 茂見潤

    健康支援   2002年

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  • P330禁煙支援・事例報告 その2

    大津 忠弘, 高尾 総司, 太田 充彦, 茂見 潤, 津田 敏秀, 堤 明純, 三野 善央, 川上 憲人

    産業衛生学雑誌   44 ( 0 )   690 - 690   2002年

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    記述言語:日本語   出版者・発行元:公益社団法人 日本産業衛生学会  

    DOI: 10.1539/sangyoeisei.KJ00003948092

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  • PearlのCausalityと行政判断

    "山本 英二, 津田 敏秀", "ヤマモト エイジ, ツダ トシヒデ", Eiji "Yamamoto, Toshihide" Tsuda

    岡山理科大学紀要. A, 自然科学   38   71 - 76   2002年

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  • Effects of a one-hour educational program on medical students' attitudes to mental illness

    Y Mino, N Yasuda, T Tsuda, S Shimodera

    PSYCHIATRY AND CLINICAL NEUROSCIENCES   55 ( 5 )   501 - 507   2001年10月

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    記述言語:英語   出版者・発行元:BLACKWELL PUBLISHING ASIA  

    A new 1-h educational program was developed to change attitudes towards mental illness, and was conducted on 95 first-year medical students in order to investigate its effects on their attitudes towards mental illness, using a pre- and postquestionnaire study design. A similar study without the program was conducted on 94 first-year medical students as controls. After the program, more students replied that they would accept former patients on relatively close social distance items. Favorable attitudinal changes were observed in terms of 'psychiatric services', 'human rights of the mentally ill', 'patients' independence in social life', and 'cause and characteristics of mental illness'. In contrast, no significant change was observed in the control group. These results suggest that attitudes towards mental illness could be changed favorably by this program.

    DOI: 10.1046/j.1440-1819.2001.00896.x

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  • 福山市内小学校での小型球形ウイルスによる胃腸炎集団発生事例

    吉井 健哲, 大津 忠弘, 津田 敏秀, 茂見 潤, 太田 充彦, 三野 善央, 川上 憲人, 青山 英康

    日本衞生學雜誌   56 ( 1 )   344 - 344   2001年4月

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  • Smoking and mental health: Cross-sectional and cohort studies in an occupational setting in Japan

    Y Mino, J Shigemi, T Otsu, A Ohta, T Tsuda, N Yasuda, A Babazono, E Yamamoto

    PREVENTIVE MEDICINE   32 ( 4 )   371 - 375   2001年4月

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    記述言語:英語   出版者・発行元:ACADEMIC PRESS INC  

    Background The relationship between smoking and mental health remains unclear.
    Methods. We carried out a cross-sectional study and a cohort study on the possible association of smoking and mental health in 782 workers. Using a questionnaire including the 30-item General Health Questionnaire (GHQ-30) and items related to the smoking state, the association between smoking and mental health was evaluated separately in males and females. The subjects were classified into smokers and nonsmokers, and changes in the GHQ score during a 2-year followup period were evaluated. To control potential confounding factors, multiple regression analyses were performed.
    Results. The cross-sectional study showed mo difference in the GHQ score between smokers and nonsmokers among males but a significantly higher GHQ score for smokers than nonsmokers among females, This difference among females was confirmed to be significant by multiple regression analysis. The S-year cohort study showed a decrease in the GHQ score in each group and no reduction in the difference in the GHQ score between smokers and nonsmokers among females.
    Conclusions. No difference was observed in mental health between smokers and nonsmokers in males. However, in females, smokers showed poorer mental health than nonsmokers, and this difference remained unchanged even after 2 years. (C) 2001 American Health Foundation and Academic Press.

    DOI: 10.1006/pmed.2000.0803

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  • シリカ曝露と食道がん・胃がんに関する症例対照研究

    津田 敏秀, 大津 忠弘, 茂見 潤, 三野 善央, 馬場 園明

    産業衛生学雑誌 = Journal of occupational health   43   322 - 322   2001年3月

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  • 深夜勤務中に行う健康診断の有用性

    太田 充彦, 大津 忠弘, 茂見 潤, 津田 敏秀, 三野 善央, 川上 憲人, 山本 裕美, 石田 高男, 谷口 珪二

    産業衛生学雑誌 = Journal of occupational health   43   717 - 717   2001年3月

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  • A case-control study of the relationships among silica exposure, gastric cancer, and esophageal cancer

    T Tsuda, Y Mino, A Babazono, J Shigemi, T Otsu, E Yamamoto

    AMERICAN JOURNAL OF INDUSTRIAL MEDICINE   39 ( 1 )   52 - 57   2001年1月

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    記述言語:英語   出版者・発行元:WILEY-BLACKWELL  

    Background We examined the effect of silica exposure on gastric and esophageal cancer mortality using a cancer control series in a population setting.
    Methods Cases and controls were restricted to male subjects and were drawn from death certificates in the Tobi area of Japan. A control group was selected from a series of deaths due to colon cancer and cancers of other organs. The Japanese death certificate system is comprehensive because all deaths must be reported to the local office and death certificates are written by medical doctors. Age and smoking habits adjusted the Mantel-Haenszel odds ratios were estimated.
    Results For gastric cancer the age-, smoking-adjusted odds ratios were 1.22 (95% CI 0.74-2.01) for colon cancer and the other cancer control for silica exposure work, and 1.36 (95% CI 0.76-2.43) for silicosis. For esophageal cancel; the age- and smoking-adjusted odds ratios were 1.53 (95% CI 0.59-3.96) for the cancer control for silica exposure, and 2.33 (95% CI 0.87-6.23) for silicosis, respectively.
    Conclusions The results suggest that gastric and esophageal cancer were related to silica exposure and silicosis in the study area, although they did not reach a statistically significant level because of the small sample size. The estimated odds ratios were higher for esophageal cancer and silicotic patients. Am. J. Ind. Med. 39:52-57, 2001. (C) 2001 Wiley-Liss, Inc.

    DOI: 10.1002/1097-0274(200101)39:1<52::AID-AJIM5>3.0.CO;2-C

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  • 医学における因果関係の推論?意思決定?

    津田敏秀, 馬場園 明, 茂見 潤, 大津忠弘, 三野善央

    産業衛生学雑誌   43,161-173 ( 5 )   161 - 173   2001年

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    掲載種別:書評論文,書評,文献紹介等  

    DOI: 10.1539/sangyoeisei.KJ00001991709

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  • A case-control study of the relationships among silica exposure, gastric cancer, and esophageal cancer

    Toshihide Tsuda, Yoshio Mino, Akira Babazono, Jun Shigemi, Tadahiro Otsu, Eiji Yamamoto

    American Journal of Industrial Medicine   39 ( 1 )   52 - 57   2001年

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    記述言語:英語  

    Background: We examined the effect of silica exposure on gastric and esophageal cancer mortality using a cancer control series in a population setting. Methods: Cases and controls were restricted to male subjects and were drawn from death certificates in the Tobi area of Japan. A control group was selected from a series of deaths due to colon cancer, and cancers of other organs. The Japanese death certificate system is comprehensive because all deaths must be reported to the local office and death certificates are written by medical doctors. Age and smoking habits adjusted the Mantel-Haenszel odds ratios were estimated. Results: For gastric cancer, the age-, smoking-adjusted odds ratios were 1.22 (95% CI 0.74-2.01)for colon cancer and the other cancer control for silica exposure work, and 1.36 (95% CI 0.76-2.43) for silicosis. For esophageal cancer, the age- and smoking-adjusted odds ratios were 1.53 (95% CI 0.59-3.96) for the cancer control for silica exposure, and 2.33 (95% CI 0.87-6.23) for silicosis, respectively. Conclusions: The results suggest that gastric and esophageal cancer were related to silica exposure and silicosis in the study area, although they did not reach a statistically significant level because of the small sample size. The estimated odds ratios were higher for esophageal cancer and silicotic patients. © 2001 Wiley-Liss, Inc.

    DOI: 10.1002/1097-0274(200101)39:1<52::AID-AJIM5>3.0.CO;2-C

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  • A case-control study of the relationships among silica exposure, gastric cancer, and esophageal cancer

    Toshihide Tsuda, Yoshio Mino, Akira Babazono, Jun Shigemi, Tadahiro Otsu, Eiji Yamamoto

    American Journal of Industrial Medicine   39 ( 1 )   52 - 57   2001年

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    記述言語:英語  

    Background: We examined the effect of silica exposure on gastric and esophageal cancer mortality using a cancer control series in a population setting. Methods: Cases and controls were restricted to male subjects and were drawn from death certificates in the Tobi area of Japan. A control group was selected from a series of deaths due to colon cancer, and cancers of other organs. The Japanese death certificate system is comprehensive because all deaths must be reported to the local office and death certificates are written by medical doctors. Age and smoking habits adjusted the Mantel-Haenszel odds ratios were estimated. Results: For gastric cancer, the age-, smoking-adjusted odds ratios were 1.22 (95% CI 0.74-2.01)for colon cancer and the other cancer control for silica exposure work, and 1.36 (95% CI 0.76-2.43) for silicosis. For esophageal cancer, the age- and smoking-adjusted odds ratios were 1.53 (95% CI 0.59-3.96) for the cancer control for silica exposure, and 2.33 (95% CI 0.87-6.23) for silicosis, respectively. Conclusions: The results suggest that gastric and esophageal cancer were related to silica exposure and silicosis in the study area, although they did not reach a statistically significant level because of the small sample size. The estimated odds ratios were higher for esophageal cancer and silicotic patients. © 2001 Wiley-Liss, Inc.

    DOI: 10.1002/1097-0274(200101)39:1<52::AID-AJIM5>3.0.CO;2-C

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  • 喫煙とメンタルヘルスとの関連について-職域における調査より-

    大津忠弘, 三野善央, 茂見 潤, 太田充彦, 高尾総司, 津田敏秀, 安田誠史, 馬場園 明, 山本英二, 青山英康

    健康開発   2001年

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  • 健康保険組合における老人医療費の負担指標に関する研究

    馬場園 明, 山本英二, 津田敏秀, 三野善央

    医療経済研究   9   5 - 22   2001年

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    記述言語:日本語   出版者・発行元:医療経済研究機構  

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  • 保健医療における因果関係の推論-疫学の立場からの科学哲学的考察-

    津田敏秀, 茂見 潤, 大津忠弘, 馬場園 明

    健康支援   2001年

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  • 根拠に基づく医学(EBM)の根拠

    津田敏秀

    月刊保団連   ( 698 )   6 - 10   2001年

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    記述言語:日本語   出版者・発行元:全国保険医団体連合会  

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  • Predictors and underlying causes of medically intractable localization-related epilepsy in childhood

    Ohtsuka Y, Yoshinaga H, Kobayashi K, Murakami N, Yamatogi Y, Oka E, Tsuda T

    Pediatric Neurol   24   209 - 213   2001年

  • 医学における因果関係の認識と合意

    津田 敏秀, 馬場園 明

    健康支援   2 ( 1 )   38 - 53   2000年9月

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    記述言語:日本語   出版者・発行元:日本健康支援学会  

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  • 我が国の社会医学における因果関係論の構築を目指して

    津田 敏秀, 馬場 明園, 三野 善央, 山本 英二, 宮井 正弥, 茂見 潤

    日本衛生学雑誌   55 ( 2 )   462 - 473   2000年7月

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    記述言語:日本語   出版者・発行元:日本衛生学会  

    As a condition to achieving an agreement of recognition on the causal relationship in medicine, we firstly explained Hume's problem and counterfactual model. We, however, emphasized that we believe in the existence of causality on medical issues in our daily lives. Therefore, we illustrated conditions when we usually believe in causality. On the other hand, we criticized two well-known key phrases, "lack of mechanism in epidemiology" and "black box in epidemiology", which have often been used in Japan for skeptic viewpoints against epidemiologic methods even if epidemiology is often used to elucidate a causal effect in medicine in the world. We emphasized that a priori determinations of levels for inference of mechanism is necessary. And, the level and feature of mechanism should be defined in concrete expressions. After explanation of these basic concepts, we mentioned a classic view on specific diseases and non-specific diseases which have not been sufficiently discussed enough yet in Japan. As an example, we used the statements in the Japanese Compensation Law for the Health Effect by Environmental Pollution. In Japan, the classification of these diseases has been confused with that between manifestational criteria of diseases and causal criteria of them. We described the basic concepts to illustrate the causal relationship between non-specific disease and its exposure by using attached figures. Actually, we cannot recognize disease occurrence as a specific disease for several reasons. We indicated that we can recognize the magnitude of effect by causal relationships in medicine as a quantitative continuous variable.

    DOI: 10.1265/jjh.55.462

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  • 我が国の社会医学における因果関係論の構築を目指して

    津田 敏秀, 馬場 明園, 三野 善央, 山本 英二, 宮井 正弥, 茂見 潤

    日本衞生學雜誌   55 ( 2 )   462 - 473   2000年7月

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    記述言語:日本語   出版者・発行元:日本衛生学会  

    As a condition to achieving an agreement of recognition on the causal relationship in medicine, we firstly explained Hume's problem and counterfactual model. We, however, emphasized that we believe in the existence of causality on medical issues in our daily lives. Therefore, we illustrated conditions when we usually believe in causality. On the other hand, we criticized two well-known key phrases, "lack of mechanism in epidemiology" and "black box in epidemiology", which have often been used in Japan for skeptic viewpoints against epidemiologic methods even if epidemiology is often used to elucidate a causal effect in medicine in the world. We emphasized that a priori determinations of levels for inference of mechanism is necessary. And, the level and feature of mechanism should be defined in concrete expressions. After explanation of these basic concepts, we mentioned a classic view on specific diseases and non-specific diseases which have not been sufficiently discussed enough yet in Japan. As an example, we used the statements in the Japanese Compensation Law for the Health Effect by Environmental Pollution. In Japan, the classification of these diseases has been confused with that between manifestational criteria of diseases and causal criteria of them. We described the basic concepts to illustrate the causal relationship between non-specific disease and its exposure by using attached figures. Actually, we cannot recognize disease occurrence as a specific disease for several reasons. We indicated that we can recognize the magnitude of effect by causal relationships in medicine as a quantitative continuous variable.

    DOI: 10.1265/jjh.55.462

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  • Achievement of Causal Inference in the Social Medicine in Japan

    津田 敏秀, 馬場 明園, 三野 善央, 山本 英二, 宮井 正弥, 茂見 潤

    Japanese Journal of Hygiene   55 ( 2 )   462 - 473   2000年7月

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    記述言語:日本語   出版者・発行元:日本衛生学会  

    As a condition to achieving an agreement of recognition on the causal relationship in medicine, we firstly explained Hume's problem and counterfactual model. We, however, emphasized that we believe in the existence of causality on medical issues in our daily lives. Therefore, we illustrated conditions when we usually believe in causality. On the other hand, we criticized two well-known key phrases, "lack of mechanism in epidemiology" and "black box in epidemiology", which have often been used in Japan for skeptic viewpoints against epidemiologic methods even if epidemiology is often used to elucidate a causal effect in medicine in the world. We emphasized that a priori determinations of levels for inference of mechanism is necessary. And, the level and feature of mechanism should be defined in concrete expressions. After explanation of these basic concepts, we mentioned a classic view on specific diseases and non-specific diseases which have not been sufficiently discussed enough yet in Japan. As an example, we used the statements in the Japanese Compensation Law for the Health Effect by Environmental Pollution. In Japan, the classification of these diseases has been confused with that between manifestational criteria of diseases and causal criteria of them. We described the basic concepts to illustrate the causal relationship between non-specific disease and its exposure by using attached figures. Actually, we cannot recognize disease occurrence as a specific disease for several reasons. We indicated that we can recognize the magnitude of effect by causal relationships in medicine as a quantitative continuous variable.

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  • 職場における精神の健康度の変化に影響を与える要因

    馬場園 明, 津田 敏秀, 三野 善央

    産業衛生学雑誌 = Journal of occupational health   42   546 - 546   2000年3月

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  • Effects of perceived job stress on mental health. A longitudinal survey in a Japanese electronics company

    Jun Shigemi, Yoshio Mino, Tadahiro Ohtsu, Toshihide Tsuda

    European Journal of Epidemiology   16 ( 4 )   371 - 376   2000年

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    記述言語:英語  

    We conducted a cohort study for 2 years to examine the causal relationship between perceived job stress and mental health. Questionnaire surveys, including a 30-item General Health Questionnaire (GHQ) and a questionnaire on perceived job stress were carried out every 6 months for 2 years. To clarify the causal relationship between job stress and mental health, we followed a group of workers who initially had a GHQ score ≤7. Out of 462 workers who were thought to be in a healthy mental state, 282 were successfully followed for 2 years. We considered subjects who developed unhealthy mental health states (GHQ score ≥8) as hazardous cases. To control potential confounding factors, proportional hazard analysis was done. The overall proportion hazardous cases detected in the development of an unhealthy mental health state over two years was 55.7%. Using Cox's proportional hazard model, workers who complained of perceived job stress had a greater hazard than those without job stress. In particular, the item 'poor relationship with superior' showed the largest adjusted hazard ratio [95% confidence interval (CI)] of 1.51 (1.06 - 2.15). The item 'too much trouble at work' also had a significant hazardous effect on mental health with an adjusted hazard ratio (95% CI) of 1.43 (1.00-2.04). Some specific items of perceived job stress could cause mental ill health in workers.

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  • Effects of perceived job stress on mental health. A longitudinal survey in a Japanese electronics company

    Jun Shigemi, Yoshio Mino, Tadahiro Ohtsu, Toshihide Tsuda

    European Journal of Epidemiology   16 ( 4 )   371 - 376   2000年

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    記述言語:英語  

    We conducted a cohort study for 2 years to examine the causal relationship between perceived job stress and mental health. Questionnaire surveys, including a 30-item General Health Questionnaire (GHQ) and a questionnaire on perceived job stress were carried out every 6 months for 2 years. To clarify the causal relationship between job stress and mental health, we followed a group of workers who initially had a GHQ score ≤7. Out of 462 workers who were thought to be in a healthy mental state, 282 were successfully followed for 2 years. We considered subjects who developed unhealthy mental health states (GHQ score ≥8) as hazardous cases. To control potential confounding factors, proportional hazard analysis was done. The overall proportion hazardous cases detected in the development of an unhealthy mental health state over two years was 55.7%. Using Cox's proportional hazard model, workers who complained of perceived job stress had a greater hazard than those without job stress. In particular, the item 'poor relationship with superior' showed the largest adjusted hazard ratio [95% confidence interval (CI)] of 1.51 (1.06 - 2.15). The item 'too much trouble at work' also had a significant hazardous effect on mental health with an adjusted hazard ratio (95% CI) of 1.43 (1.00-2.04). Some specific items of perceived job stress could cause mental ill health in workers.

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  • 研究と人権問題委員会報告 昭和60年10月15日付「水俣病の判断条件に関する医学専門家会議の意見」に対する見解

    中島豊爾, 石井一, 衛藤俊邦, へぎ祐二, 津田敏秀, 名村出, 星野征光, 丸井規博, 山田了士

    精神神経学雑誌   101 ( 6 )   539 - 558   1999年6月

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  • 後天性水俣病の判断条件に関する医学的検証

    津田 敏秀, 三野 善央, 茂見 潤, 山本 英二, 馬場 園明, 宮井 正彌

    日本衞生學雜誌   54 ( 1 )   129 - 129   1999年4月

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  • 病院でのO157集団感染の報告(その3) 原因調査について

    河本 幸子, 中瀬 克己, 津田 敏秀

    日本公衆衛生学会総会抄録集   57回   661 - 661   1998年10月

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    記述言語:日本語   出版者・発行元:日本公衆衛生学会  

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  • シリカ曝露は人体に肺がんを引き起こすか?--第9回国際職業性呼吸器疾患学術会議報告

    津田 敏秀

    労働の科学   53 ( 3 )   184 - 187   1998年3月

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    記述言語:日本語   出版者・発行元:労働科学研究所出版部  

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  • 散発事例及びさかのぼり調査の調査方法および食中毒患者の把握方法に関する研究

    柳川洋, 後藤敦, 津田敏秀, 土井由利子, 谷原真一

    食中毒予防方策のあり方に関する研究研究報告書   1-7   1998年

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    記述言語:日本語   掲載種別:研究発表ペーパー・要旨(全国大会,その他学術会議)  

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  • Health policy in transition terminal care and site of death in Japan 査読

    A. Babazono, J. Weiner, H. Hamada, T. Tsuda, Y. Mino, A. L. Hillman

    Journal of Health Services Research and Policy   3 ( 2 )   77 - 81   1998年

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    Objectives: In Japan, hospitals have replaced homes as the predominant site of death, especially for the elderly. Site of death is a reliable indicator of where older people receive care before they die. We conducted a population-based study to identify the factors that determine site of death in a typical rural area in Japan. Methods: Study subjects were residents of Kawakami town, aged 70 years or older, who died during 1981 and 1990. Death certificates provided information on age, gender, cause of death, duration of illness before death, family members, family occupation, and site of death. Results: Among 455 subjects, 52.7% died at home, while 47.3% died in hospital. Multiple logistic regression analyses indicated that subjects with cancer were 6.1 times more likely to die in hospitals than those with other diseases. Subjects who died in their seventies were 2.3 times more likely to die in hospital than older subjects. Members of non-farming families were 1.7 times more likely to die in hospital than members of farming families. Gender, duration of illness, and the presence of spouse or children in the household were not significantly related to site of death according to multivariate analyses, although trends did exist. Conclusion: This case study illustrates the importance of developing geriatric care systems in Japan, utilizing alternatives to hospitals, such as nursing homes and formal home care. This is particularly true for patients with cancer. As the older population rapidly increases in Japan, the need for alternatives in geriatric care grows more critical.

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  • 主観的職場のストレスと精神的健康との間の関連についてハザードモデルの観点から

    茂見 潤, 三野 善央, 津田 敏秀

    産業ストレス研究 = Job stress research   5   47 - 47   1997年12月

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  • 保健所における精神障害者家族教室

    三野 善央, 大島 巌, 後藤 雅博, 植木 ひろ子, 津田 敏秀, 松岡 宏明, 岡上 和雄

    日本公衆衛生雑誌   44 ( 5 )   364 - 371   1997年5月

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    記述言語:日本語   出版者・発行元:日本公衆衛生学会  

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  • 精神的保健度の疾病発性に与える影響

    馬場園 明, 津田 敏秀, 三野 全央

    産業衛生学雑誌 = Journal of occupational health   39   S195   1997年4月

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  • 疫学から見た作業関連性疾患と職業病

    津田 敏秀, 馬場 園明, 三野 善央, 松岡 宏明

    産業衛生学雑誌 = Journal of occupational health   39 ( 1 )   A19 - A20   1997年1月

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  • 水俣病の40年目の「解決」に根拠を与えた2論文 (<特集(2)>水俣病・残された問題)

    津田 敏秀, 三野 善央, 松岡 宏明

    環境と公害   26 ( 3 )   48 - 55   1997年1月

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    記述言語:日本語   出版者・発行元:岩波書店  

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  • A meta-analysis on the relationship between pneumoconiosis and lung cancer

    Toshihide Tsuda, Akira Babazono, Eiji Yamamoto, Yoshio Mino, Hiroaki Matsuoka

    Journal of Occupational Health   39 ( 4 )   285 - 294   1997年

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    記述言語:英語   出版者・発行元:Japan Society for Occupational Health  

    An excess of lung cancer deaths among pneumoconiosis patients has been noted for many years but there has not been agreement on the excess of lung cancer deaths among pneumoconiosis patients in Japan. A meta-analysis on the relationship between silicosis/pneumoconiosis and lung cancer mortality was conducted, by using 36 mortality studies published from 1950 to 1994. MEDICINE and other information sources were used for the information retrieval. After the critical appraisal, 32 eligible studies were identified. Study estimates were then pooled by using both the fixed effect model and the random effect model. An excess of lung cancer mortality among people with silicosis/pneumoconiosis was shown in all 32 studies. Although homogeneity among the studies was rejected (p&lt
    0.05) because the shape of the funnel plots assumed a symmetrical pyramidal shape, the summary rate ratio was estimated. The estimated rate ratio was 2.74 (95 percent confidence interval 2.60-2.90) in all 32 studies, and 2.77 (2.61-2.94) in 25 cohort studies. The random effect model results were almost the same as the fixed model results. The estimates in the Japanese studies were a little higher than the overall estimates, which indicated that lung cancer mortality was about three times higher among silicotic patients than among people in the control. This indicated a causal-relationship between silicosis and lung cancer. This means that lung cancer should be regarded as one of the important complications of silicosis/pneumoconiosis. We recommend further research on the relationship between silica exposure and lung cancer.

    DOI: 10.1539/joh.39.285

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  • A meta-analysis on the relationship between pneumoconiosis and lung cancer

    Toshihide Tsuda, Akira Babazono, Eiji Yamamoto, Yoshio Mino, Hiroaki Matsuoka

    Journal of Occupational Health   39 ( 4 )   285 - 294   1997年

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    記述言語:英語   出版者・発行元:Japan Society for Occupational Health  

    An excess of lung cancer deaths among pneumoconiosis patients has been noted for many years but there has not been agreement on the excess of lung cancer deaths among pneumoconiosis patients in Japan. A meta-analysis on the relationship between silicosis/pneumoconiosis and lung cancer mortality was conducted, by using 36 mortality studies published from 1950 to 1994. MEDICINE and other information sources were used for the information retrieval. After the critical appraisal, 32 eligible studies were identified. Study estimates were then pooled by using both the fixed effect model and the random effect model. An excess of lung cancer mortality among people with silicosis/pneumoconiosis was shown in all 32 studies. Although homogeneity among the studies was rejected (p&lt
    0.05) because the shape of the funnel plots assumed a symmetrical pyramidal shape, the summary rate ratio was estimated. The estimated rate ratio was 2.74 (95 percent confidence interval 2.60-2.90) in all 32 studies, and 2.77 (2.61-2.94) in 25 cohort studies. The random effect model results were almost the same as the fixed model results. The estimates in the Japanese studies were a little higher than the overall estimates, which indicated that lung cancer mortality was about three times higher among silicotic patients than among people in the control. This indicated a causal-relationship between silicosis and lung cancer. This means that lung cancer should be regarded as one of the important complications of silicosis/pneumoconiosis. We recommend further research on the relationship between silica exposure and lung cancer.

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  • Relation between the instrumental activities of daily living and physical fitness tests in elderly women

    H Uchida, Y Mino, T Tsuda, A Babazono, Y Kawada, H Araki, T Ogawa, H Aoyama

    ACTA MEDICA OKAYAMA   50 ( 6 )   325 - 333   1996年12月

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    記述言語:英語   出版者・発行元:OKAYAMA UNIV MED SCHOOL  

    A cross-sectional study was conducted to quantitatively evaluate the relationship between the instrumental activities of daily living (IADL) and various physical fitness tests in elderly women living at home. The study focused on the total population of those women aged 65 years and over living in Y Town, Hyogo Prefecture, Japan, who visited a nursing home for day services. A total of 128 subjects were divided into two groups: dependent in IADL group (n = 49) and independent in IADL group (n = 79). The magnitude of the relation was evaluated by the odds ratio (OR). The following tests showed a significant decrease in IADL: knee-raising test [age-adjusted OR = 4.23, 95% confidence interval (CI) 1.81-9.87], height (age-adjusted OR = 4.09, 95% CI 1.75-9.56), grip strength (age-adjusted OR = 3.68, 95% CI 1.57-8.60), sit-and-reach test (age-adjusted OR = 2.76, 95% CI 1.20-6.34), and standing on one leg with closed eyes (age-adjusted OR = 2.56, 95% CI 1.09-5.97). Multivariate analysis using Hayashi's quantification method I indicated that knee-raising was the test most highly correlated with decreased IADL. These results suggest that measurement of knee-raising ability, muscle strength of the lower extremities and flexibility of hip joint could be the most useful factors to assess the level of instrumental self-support ability.

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  • 職場における精神の健康度と医療機関利用との関連

    馬場園 明, 山田 裕章, 津田 敏秀, 三野 善央

    日本公衆衛生学会総会抄録集   55 ( 2 )   881 - 881   1996年10月

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  • 性行動を通じてのHIV感染予防のインディケーター

    中瀬 克己, 吉田 健男, 内野 英幸, 津田 敏秀

    日本公衆衛生学会総会抄録集   55 ( 3 )   515 - 515   1996年10月

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  • 水俣地域での四肢末梢感覚障害の期待数

    津田 敏秀, 三野 善央, 松岡 宏明, 田中 美紀, 茂見 潤, 宮井 正彌, 馬場園 明

    日本公衆衛生学会総会抄録集   55 ( 2 )   928 - 928   1996年10月

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  • 作業関連疾患の病因論-給食調理員の変形性手指間接症の例を用いて-

    津田 敏秀, 三野 善央, 松岡 宏明, 谷原 真一, 茂見 潤, 田島 隆興, 片岡 明彦, 馬場 園明

    産業衛生学雑誌 = Journal of occupational health   38   S423   1996年5月

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  • 精神の健康状態の変化に職場の主観的ストレス感が及ぼす影響に関する調査

    谷原 真一, 茂見 潤, 馬場園 明, 三野 善央, 津田 敏秀, 松岡 宏明, 小河 孝則, 青山 英康

    産業衛生学雑誌 = Journal of occupational health   38   S257   1996年5月

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  • Causal inference in medicine - A historical view in epidemiology

    Toshihide Tsuda, Akira Babazono, Yoshio Mino, Hiroaki Matsuoka, Eiji Yamamoto

    Japanese Journal of Hygiene   51 ( 2 )   558 - 568   1996年

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    記述言語:日本語   掲載種別:書評論文,書評,文献紹介等   出版者・発行元:Japanese Society for Hygiene  

    Changes of causal inference concepts in medicine, especially those having to do with chronic diseases, were reviewed. The review is divided into five sections. First, several articles on the increased academic acceptance of observational research are cited. Second, the definitions of confounder and effect modifier concepts are explained. Third, the debate over the so-called "criteria for causal inference" was discussed. Many articles have pointed out various problems related to the lack of logical bases for standard criteria, however, such criteria continue to be misapplied in Japan. Fourth, the Popperian and verificationist concepts of causal inference are summarized. Lastly, a recent controversy on meta-analysis is explained. Causal inference plays an important role in epidemiologic theory and medicine. However, because this concept has not been well-introduced in Japan, there has been much misuse of the concept, especially when used for conventional criteria.

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  • Causal inference in medicine - A historical view in epidemiology

    Toshihide Tsuda, Akira Babazono, Yoshio Mino, Hiroaki Matsuoka, Eiji Yamamoto

    Japanese Journal of Hygiene   51 ( 2 )   558 - 568   1996年

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    記述言語:日本語   掲載種別:書評論文,書評,文献紹介等   出版者・発行元:Japanese Society for Hygiene  

    Changes of causal inference concepts in medicine, especially those having to do with chronic diseases, were reviewed. The review is divided into five sections. First, several articles on the increased academic acceptance of observational research are cited. Second, the definitions of confounder and effect modifier concepts are explained. Third, the debate over the so-called "criteria for causal inference" was discussed. Many articles have pointed out various problems related to the lack of logical bases for standard criteria, however, such criteria continue to be misapplied in Japan. Fourth, the Popperian and verificationist concepts of causal inference are summarized. Lastly, a recent controversy on meta-analysis is explained. Causal inference plays an important role in epidemiologic theory and medicine. However, because this concept has not been well-introduced in Japan, there has been much misuse of the concept, especially when used for conventional criteria.

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  • 医学における因果関係の推論-疫学での歴史的流れ-

    日本衛生学雑誌   51 ( 2 )   558 - 568   1996年

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    記述言語:日本語   掲載種別:書評論文,書評,文献紹介等  

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  • 米国の医療精度とその改革

    馬場園 明, 津田 敏秀, 三野 善央

    日本衞生學雜誌   51 ( 3 )   666 - 676   1996年

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    記述言語:日本語   出版者・発行元:日本衛生学会  

    Securing access to medical services, controlling costs and improving quality are goals of health care system. Although they are all the same all over the country, each country has its own culture, health care system and health care problems. In the United States, employer-based and individual purchases of private health insurance coverage play a major role, although governmental programs such as Medicaid and Medicare exist for the poor and the elderly. Private health insurance had traditionally secured patients' freedom of choice of health care providers and physicians' professional freedom and had paid providers on a fee-for-service basis. Now, the U. S. has 40 million uninsured persons who do not have access to medical services, although it spends as much as its 14% of GNP on health care. In the early 1990s, this became a major political problem. President Clinton proposed the 'Health Security Act' which would enable any American to have access to comprehensive health care with managed competition to activate the health care market, but it was not enacted. Nevertheless, it is clear that managed care and managed competition will dominate and that traditional fee-for-service plan will be eroded in the health care market. Japan has a universal health care system. We do not have any uninsured or high medical costs. However, it is difficult to improve the quality of health care services within the present system. Japan can learn the system about disclosure of health care information from the managed care in the U. S.

    DOI: 10.1265/jjh.51.666

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  • 環境汚染による人体への影響の定量的評価―環境疫学の概念と最近の話題―

    津田 敏秀, 三野 善央, 松岡 宏明, 谷原 真一, 馬場園 明, 山本 英二

    環境制御   17   56 - 62   1995年12月

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    記述言語:日本語   出版者・発行元:岡山大学環境管理センター  

    Concept and recent topics on environmental epidemiology have been introduced in the article. First, the authors presented the basic concept on epidemiology. Answers to the question "Is a particular exposure influent to human health?" can be obtained only from studies of human beings, using an epidemiologic approach. Environmental epidemiology is an application of epidemiology to environmental problem. Then, we presented four examples on environmental epidemiologic research. The four recent topics are residential radon exposure and lung cancer, ingested arsenic and cancer, increase incidence of childhood leukaemia around the English neuclear reprocessing facilities, and magnetic field and excess incidence of childhood leukaemia near Swedish high-voltage power lines.

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  • AIDSに関するリスク認識とコンドーム常用との関連

    中瀬 克己, 津田 敏秀, 長井 勇

    日本公衆衛生学会総会抄録集   54   1258 - 1258   1995年10月

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  • 職場における精神の健康度に関する研究

    馬場園 明, 三野 善央, 津田 敏秀, 青山 英康

    日本公衆衛生学会総会抄録集   54   1406 - 1406   1995年10月

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  • 農村部の高齢者における医療費の決定に関する定量的研究

    谷原 真一, 馬場 園明, 津田 敏秀, 三野 善央, 三村 啓爾, 茂見 潤, 松岡 宏明, 小河 孝則, 青山 英康

    日本公衆衛生学会総会抄録集   54   1113 - 1113   1995年10月

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  • 産後の育児不安に関する調査

    谷名 菜穂子, 津田 敏秀, 三野 善央

    日本公衆衛生学会総会抄録集   54   987 - 987   1995年10月

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  • Training in evaluation of expressed emotion using the Japanese version of the Camberwell Family Interview 査読

    Y. Mino, S. Tanaka, T. Tsuda, A. Babazono, S. Inoue, H. Aoyama

    Acta Psychiatrica Scandinavica   92 ( 3 )   183 - 186   1995年9月

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    記述言語:英語   出版者・発行元:MUNKSGAARD INT PUBL LTD  

    To evaluate the effect of training in rating expressed emotion (EE) using the Japanese version of the Camberwell Family Interview (CFI), interrater reliability between a certified rater and a trainee was examined. The material was 65 CFI interviews with the families of 46 schizophrenic patients. The two raters independently rated EE status, critical comments (CC), hostility (H), emotional overinvolvement (EOI), warmth (W) and positive remarks (PR). The interrater reliability was satisfactory with regard to EE status, CC, H, EOI and PR. In the category of W, however, the results were unsatisfactory, as there was no positive development of agreement over time. In fathers, the interrater reliability of W was lower than in other relationships. Use of interview transcripts could contribute to a more satisfactory interrater agreement in EOI, and this is recommended as a useful training tool in EE evaluation. Copyright © 1995, Wiley Blackwell. All rights reserved

    DOI: 10.1111/j.1600-0447.1995.tb09565.x

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  • 職場の主観的ストレス感が精神の健康状態に及ぼす影響に関する追跡調査

    谷原 真一, 茂見 潤, 馬場 園明, 三野 善央, 津田 敏秀, 来住 由樹, 小河 孝則, 青山 英康

    産業衛生学雑誌 = Journal of occupational health   37   S384   1995年3月

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  • 日本病理剖検輯報を用いた塵肺と肺癌の関連の再評価

    馬場 園明, 津田 敏秀, 三野 善央, 小河 孝則, 青山 英康

    産業衛生学雑誌 = Journal of occupational health   37   S188   1995年3月

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  • 身体活動の労働社の体力に及ぼす影響

    佐々木 千恵, 馬場園 明, 津田 敏秀, 三野 善央

    日本衞生學雜誌   50 ( 4 )   876 - 885   1995年

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    記述言語:日本語   出版者・発行元:日本衛生学会  

    We conducted a cross-sectional study to clarify the effects of physical activity on physical fitness. Physical fitness tests were offered to workers of companies manufacturing automobile parts from December, 1992 to December, 1993. The subjects were 1, 217 male and 600 female workers who participated in the physical fitness test. From this group, we analyzed 1, 048 male and 522 female workers who answered a physical activity questionnaire. The questionnaire included age, sex, working posture, physical activity during working time and physical activity during leisure time. The physical fitness tests were composed of grip strength, standing trunk flexion, foot balance with closed eyes, jumping reaction time and step tests. We classified the subjects into low performance group and high performance group for each test. In addition, we classified the subjects into different groups by age (16-29 years old, 30-49 years old and 50-69 years old), by working posture (standing and sitting), as well as by activity levels during working time and leisure time physical activities (inactive and active). Thus, we examined potential risk factors for the physical fitness by a multiple logistic regression model.<br>The results were as follows:<br>1. Standing work was a significant risk factor for grip strength, foot balance with closed eyes and jumping reaction time in male workers, and standing trunk flexion, foot balance with closed eyes, jumping reaction time and the step test in female workers.<br>2. Physical activity during working time was not related to physical fitness in male and female workers.<br>3. Inactivity during leisure time was a significant risk factor for standing trunk flexion, foot balance with closed eyes, jumping reaction time and the step test in male workers, and grip strength and foot balance with closed eyes in female workers.<br>4. Young age (16-29 years old) was a significant risk factor for grip strength, standing trunk flexion, foot balance with closed eyes, jumping reaction time and the step test in male and female workers. Middle age (30-49 years old) was a significant risk factor for foot balance with closed eyes and jumping reaction time in male workers, and standing trunk flexion, foot balance with closed eyes, jumping reaction time and the step test in female workers.

    DOI: 10.1265/jjh.50.876

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  • Comparisons of survival time estimates for niigata prefecture (japan) residents exposed to ingested arsenic

    Toshihide Tsuda, Eiji Yamamoto, Akira Babazono, Yoshio Mino, Yoshiki Kishi, Norio Kurumatani, Takanori Ogawa, Hideyasu Aoyama

    Applied Organometallic Chemistry   8 ( 3 )   237 - 244   1994年

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    記述言語:英語  

    Survival analysis was used to analyze follow‐up data on an arsenic‐poisoned area, identified in 1959, in order to assess the effect of arsenic on survival time. The subjects were 443 residents of Namiki‐cho, Nakajo‐machi, Niigata Prefecture, Japan, who ingested well water contaminated with arsenic between 1955 and 1959. Their exposure to arsenic was only by ingestion of well water. We observed this historical cohort from October 1959 to February 1992. Survival time was calculated in two ways: from 1959 (the end of exposure) until death or until 1992 (the termination of follow‐up)
    or from birth until death or until 1992. The entire cohort was divided into two groups according to the arsenic concentration measured in the wells in 1959. Different survival curves of the two were drawn using the Kaplan–Meier method. The lifetime survival curves indicate that the lifetimes of arsenic‐exposed residents were significantly shorter than that of the low‐dose exposure group or of unexposed residents. From the differences in the estimated lifetime survival curves, the effect of arsenic on the mortality of the residents can be inferred. Copyright © 1994 John Wiley &amp
    Sons, Ltd.

    DOI: 10.1002/aoc.590080313

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  • An epidemiologic research design using the annual of the pathological autopsy cases in Japan

    T. Tsuda, E. Yamamoto, A. Babazono, Y. Mino, T. Ogawa, J. Shigemi, H. Aoyama

    Japanese Journal of Hygiene   49 ( 4 )   753 - 761   1994年

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    記述言語:日本語   掲載種別:書評論文,書評,文献紹介等   出版者・発行元:Japanese Society for Hygiene  

    Epidemiologic research designs using the Annual of the Pathological Autopsy Cases in Japan (APAC hereinafter) are discussed in this paper. The APAC data base has been recommended for use in epidemiologic research. However, it has not often been utilized for such research, even though it covers all pathological autopsy cases in Japan, perhaps because of different sampling proportions of each disease and because of the dead control series in APAC. First, we present epidemiologic measures in using the APAC. We show that the data base can be treated as a case-control design and that the magnitude of the exposure effect should be estimated by an odds ratio. Next, selection bias and information bias in using the APAC are discussed. The independence of the control series from the exposure is important in the determination of the control disease. Because this design is based on internal comparison, non-differential misclassification should be stressed more than differential misclassification.

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  • An epidemiologic research design using the annual of the pathological autopsy cases in Japan

    T. Tsuda, E. Yamamoto, A. Babazono, Y. Mino, T. Ogawa, J. Shigemi, H. Aoyama

    Japanese Journal of Hygiene   49 ( 4 )   753 - 761   1994年

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    記述言語:日本語   掲載種別:書評論文,書評,文献紹介等   出版者・発行元:Japanese Society for Hygiene  

    Epidemiologic research designs using the Annual of the Pathological Autopsy Cases in Japan (APAC hereinafter) are discussed in this paper. The APAC data base has been recommended for use in epidemiologic research. However, it has not often been utilized for such research, even though it covers all pathological autopsy cases in Japan, perhaps because of different sampling proportions of each disease and because of the dead control series in APAC. First, we present epidemiologic measures in using the APAC. We show that the data base can be treated as a case-control design and that the magnitude of the exposure effect should be estimated by an odds ratio. Next, selection bias and information bias in using the APAC are discussed. The independence of the control series from the exposure is important in the determination of the control disease. Because this design is based on internal comparison, non-differential misclassification should be stressed more than differential misclassification.

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  • Comparisons of survival time estimates for niigata prefecture (japan) residents exposed to ingested arsenic

    Toshihide Tsuda, Eiji Yamamoto, Akira Babazono, Yoshio Mino, Yoshiki Kishi, Norio Kurumatani, Takanori Ogawa, Hideyasu Aoyama

    Applied Organometallic Chemistry   8 ( 3 )   237 - 244   1994年

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    記述言語:英語  

    Survival analysis was used to analyze follow‐up data on an arsenic‐poisoned area, identified in 1959, in order to assess the effect of arsenic on survival time. The subjects were 443 residents of Namiki‐cho, Nakajo‐machi, Niigata Prefecture, Japan, who ingested well water contaminated with arsenic between 1955 and 1959. Their exposure to arsenic was only by ingestion of well water. We observed this historical cohort from October 1959 to February 1992. Survival time was calculated in two ways: from 1959 (the end of exposure) until death or until 1992 (the termination of follow‐up)
    or from birth until death or until 1992. The entire cohort was divided into two groups according to the arsenic concentration measured in the wells in 1959. Different survival curves of the two were drawn using the Kaplan–Meier method. The lifetime survival curves indicate that the lifetimes of arsenic‐exposed residents were significantly shorter than that of the low‐dose exposure group or of unexposed residents. From the differences in the estimated lifetime survival curves, the effect of arsenic on the mortality of the residents can be inferred. Copyright © 1994 John Wiley &amp
    Sons, Ltd.

    DOI: 10.1002/aoc.590080313

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  • 日本病理剖検輯報を用いた分析疫学研究方法-症例対照研究デザインを用いて-

    日本衛生学雑誌   49 ( 4 )   753 - 761   1994年

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    記述言語:日本語   掲載種別:書評論文,書評,文献紹介等  

    DOI: 10.1265/jjh.49.753

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  • Confounding Factors and Causal Relation in Environmental Problems

    TSUDA Toshihide, BABAZONO Akira, MINO Yoshie, TANIHARA Shinji

    Research on Environment Disruption   24 ( 3 )   61 - 65   1994年

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    記述言語:英語   出版者・発行元:学術雑誌目次速報データベース由来  

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  • 9.塵肺症における肺癌の多発 : 日本病理剖検輯データのMortality Odds Ratioを用いた分析(一般論演,第36回中国四国合同産業衛生学会)

    来住 由樹, 濱田 裕久, 小河 孝則, 津田 敏秀, 三野 善央, 青山 英康, 山本 英二

    産業医学   35 ( 3 )   221 - 221   1993年5月

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    記述言語:日本語   出版者・発行元:公益社団法人日本産業衛生学会  

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  • Depressive states in workers using computers

    Yoshio Mino, Toshihide Tsuda, Akira Babazono, Hideyasu Aoyama, Simpei Inoue, Hirotoshi Sato, Hirosh Ohara

    Environmental Research   63 ( 1 )   54 - 59   1993年

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    記述言語:英語  

    There have been few reports investigating the depressive states in workers using computers. We describe the depressive states observed in workers using computers and discuss the sources of their occupational stresses. The first subject is a 34-year-old male manager of a manufacturing company who had customarily worked until 9 PM. In 1985, it became necessary for him to work until midnight
    symptoms of depression began to appear during this period, exacerbated after trouble with a computer. In 1986, he visited a psychiatrist and his condition was diagnosed as Major Depression according to DSM-III. The second subject is a 26-year-old male VDT (visual display terminal) operator in a general hospital. Before the onset, he had had to work until 8 PM and, at the end of each month, until midnight. Two months later, he became depressed and his condition was diagnosed as Major Depression according to DSM-III. The third subject is a 32-year-old male chief in the computer programming section of a bank. He had had to work until 8 PM, became depressed, and visited a psychiatrist who diagnosed his condition as Major Depression according to DSM-III. The authors discuss these cases from the standpoint of occupational stresses, as they are associated with work overload, and the important role these stresses played in the onset of the workers’ depressive states. © 1993 Academic Press.

    DOI: 10.1006/enrs.1993.1126

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  • Depressive States in Workers Using Computers (共著)

    Environmental Research   63 ( 1 )   54 - 59   1993年

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    記述言語:英語  

    DOI: 10.1006/enrs.1993.1126

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  • Inorganic arsenic: A dangerous enigma for mankind

    Toshihide Tsuda, Akira Babazono, Takanori Ogawa, Hirohisa Hamada, Yoshio Mino, Hideyasu Aoyama, Norio Kurumatani, Tsuyoshi Nagira, Nobuyuki Hotta, Masazumi Harada, Shigemi Inomata

    Applied Organometallic Chemistry   6 ( 4 )   309 - 322   1992年

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    記述言語:英語   掲載種別:書評論文,書評,文献紹介等  

    Human being have been using inorganic arsenic for a long time. Many reports on arsenic poisoning have been published: eg case reports, examination reports, post mortem reports, and epidemiological studies. Several aspects and features of arsenic poisoning are discussed in this report. Methods of inferring arsenic‐related disease, disease classification according to acute or chronic criteria, exposure route, interaction, confounding factors, and the oxidation state of arsenic are all discussed. The effects of arsenic are classified into skin, respiratory system, gastrointestinal tract, liver, cardiovascular system, nervous system, and bone marrow effects. Carcinogenicity is an important chronic effect of arsenic poisoning, so special attention is paid to it in this review. In Japan, there have been many incidents of arsenic poisoning. In this review, we often use data from these cases, such as the Morinaga powdered‐milk poisoning case, the Ube soy‐sauce poisoning case, the Toroku mine incident, and the Nakajo well‐water poisoning case. We emphasize here the necessity of planning follow‐up studies and total health care for patients exposed to arsenic. Copyright © 1992 John Wiley &amp
    Sons Ltd.

    DOI: 10.1002/aoc.590060403

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  • Historical cohort studies in three arsenic poisoning areas in japan

    Toshihide Tsuda, Takanori Ogawa, Akira Babazono, Hirohisa Hamada, Susumu Kanazawa, Yoshio Mino, Hideyasu Aoyaam, Eiji Yamamoto, Norio Kurumatani

    Applied Organometallic Chemistry   6 ( 4 )   333 - 341   1992年

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    記述言語:英語  

    The results of historical cohort studies of three arsenic poisoning incidents in Japan are presented. The first episode was in a small mountainous community near an arsenic mine and refinery, at Toroku, where patients with chronic arsenism were certified by application of the Pollution Health Damage Compensation Law. The second area was in a small town, Namiki‐cho, near Nakajo‐machi, where wells were poisoned by arsenic produced in an arsenic(III) sulfide factory. As to the third cohort, eight residents of Nishikawa‐machi who ingested well‐water suffered arsenic poisoning about 35 years ago. The standardized mortality ratios were used in analyzing these data. Excesses of cancer mortality, especially lung cancer, were observed among the subjects in these areas. In Japan, there are many arsenic poisoning episodes, involving for example soy‐sauce poisoning, powdered‐milk poisoning and other incidents associated with arsenic mines. Thus it is necessary to clarify the chronic effects of arsenic in these areas. Copyright © 1992 John Wiley &amp
    Sons Ltd.

    DOI: 10.1002/aoc.590060405

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  • Historical cohort studies in three arsenic poisoning areas in japan

    Toshihide Tsuda, Takanori Ogawa, Akira Babazono, Hirohisa Hamada, Susumu Kanazawa, Yoshio Mino, Hideyasu Aoyaam, Eiji Yamamoto, Norio Kurumatani

    Applied Organometallic Chemistry   6 ( 4 )   333 - 341   1992年

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    記述言語:英語  

    The results of historical cohort studies of three arsenic poisoning incidents in Japan are presented. The first episode was in a small mountainous community near an arsenic mine and refinery, at Toroku, where patients with chronic arsenism were certified by application of the Pollution Health Damage Compensation Law. The second area was in a small town, Namiki‐cho, near Nakajo‐machi, where wells were poisoned by arsenic produced in an arsenic(III) sulfide factory. As to the third cohort, eight residents of Nishikawa‐machi who ingested well‐water suffered arsenic poisoning about 35 years ago. The standardized mortality ratios were used in analyzing these data. Excesses of cancer mortality, especially lung cancer, were observed among the subjects in these areas. In Japan, there are many arsenic poisoning episodes, involving for example soy‐sauce poisoning, powdered‐milk poisoning and other incidents associated with arsenic mines. Thus it is necessary to clarify the chronic effects of arsenic in these areas. Copyright © 1992 John Wiley &amp
    Sons Ltd.

    DOI: 10.1002/aoc.590060405

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  • Inorganic arsenic: A dangerous enigma for mankind

    Toshihide Tsuda, Akira Babazono, Takanori Ogawa, Hirohisa Hamada, Yoshio Mino, Hideyasu Aoyama, Norio Kurumatani, Tsuyoshi Nagira, Nobuyuki Hotta, Masazumi Harada, Shigemi Inomata

    Applied Organometallic Chemistry   6 ( 4 )   309 - 322   1992年

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    記述言語:英語   掲載種別:書評論文,書評,文献紹介等  

    Human being have been using inorganic arsenic for a long time. Many reports on arsenic poisoning have been published: eg case reports, examination reports, post mortem reports, and epidemiological studies. Several aspects and features of arsenic poisoning are discussed in this report. Methods of inferring arsenic‐related disease, disease classification according to acute or chronic criteria, exposure route, interaction, confounding factors, and the oxidation state of arsenic are all discussed. The effects of arsenic are classified into skin, respiratory system, gastrointestinal tract, liver, cardiovascular system, nervous system, and bone marrow effects. Carcinogenicity is an important chronic effect of arsenic poisoning, so special attention is paid to it in this review. In Japan, there have been many incidents of arsenic poisoning. In this review, we often use data from these cases, such as the Morinaga powdered‐milk poisoning case, the Ube soy‐sauce poisoning case, the Toroku mine incident, and the Nakajo well‐water poisoning case. We emphasize here the necessity of planning follow‐up studies and total health care for patients exposed to arsenic. Copyright © 1992 John Wiley &amp
    Sons Ltd.

    DOI: 10.1002/aoc.590060403

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  • Relationship between alcohol use and depressive/anxiety symptoms among a general population: A review of literature

    Y. Mino, T. Tsuda, H. Aoyama, H. Ohara

    Japanese Journal of Alcohol Studies and Drug Dependence   27 ( 3 )   242 - 253   1992年

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    記述言語:日本語   掲載種別:書評論文,書評,文献紹介等  

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  • Relationship between alcohol use and depressive/anxiety symptoms among a general population: A review of literature

    Y. Mino, T. Tsuda, H. Aoyama, H. Ohara

    Japanese Journal of Alcohol Studies and Drug Dependence   27 ( 3 )   242 - 253   1992年

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    記述言語:日本語   掲載種別:書評論文,書評,文献紹介等  

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  • 新潟県中条町における慢性ヒ素中毒症患者の悪性新生物に関する死亡調査

    津田敏秀

    医学のあゆみ   159 ( 2 )   125 - 126   1991年

  • AN EPIDEMIOLOGIC-STUDY ON CANCER IN CERTIFIED ARSENIC POISONING PATIENTS IN TOROKU

    T TSUDA, T NAGIRA, M YAMAMOTO, Y KUME

    INDUSTRIAL HEALTH   28 ( 2 )   53 - 62   1990年

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    記述言語:英語   出版者・発行元:NATL INST INDUSTRIAL HEALTH  

    DOI: 10.2486/indhealth.28.53

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  • AN EPIDEMIOLOGIC-STUDY ON CANCER IN CERTIFIED ARSENIC POISONING PATIENTS IN TOROKU

    T TSUDA, T NAGIRA, M YAMAMOTO, Y KUME

    INDUSTRIAL HEALTH   28 ( 2 )   53 - 62   1990年

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    記述言語:英語   出版者・発行元:NATL INST INDUSTRIAL HEALTH  

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  • Malignant neoplasms among residents who drank well water contaminated by arsenic from a King's Yellow factory

    T. Tsuda, T. Nagira, M. Yamamoto, N. Kurumatani, N. Hotta, M. Harada, H. Aoyama

    Journal of UOEH   11 ( Suppl. )   289 - 301   1989年

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  • Malignant neoplasms among residents who drank well water contaminated by arsenic from a King's Yellow factory

    T. Tsuda, T. Nagira, M. Yamamoto, N. Kurumatani, N. Hotta, M. Harada, H. Aoyama

    Journal of UOEH   11 ( Suppl. )   289 - 301   1989年

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  • 415. 新潟県中条町におけるヒ素中毒患者の悪性新生物に関する疫学調査(第2報)(変異原・発がん,一般講演,第61回日本産業衛生学会・第44回日本産業医協議会)

    津田 敏秀, 青山 英康, 山本 真, 柳楽 翼, 久米 行則

    産業医学   30 ( 7 )   695 - 695   1988年12月

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    記述言語:日本語   出版者・発行元:公益社団法人日本産業衛生学会  

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  • 416. 経口摂取によるヒ素中毒患者における肺癌症例の病理学的検討(変異原・発がん,一般講演,第61回日本産業衛生学会・第44回日本産業医協議会)

    柳楽 翼, 山本 真, 久米 行則, 津田 敏秀, 青山 英康, 能登原 憲司

    産業医学   30 ( 7 )   696 - 696   1988年12月

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    記述言語:日本語   出版者・発行元:公益社団法人日本産業衛生学会  

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  • Arsenic Poisoning Caused by Waste Water from an Orpiment Factory in Niigata-Re-Exmination After 28 Years

    HARADA Masazumi, HORITA Nobuyuki

    Research on Environmental Disruption   17 ( 3 )   58 - 65   1988年

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    記述言語:英語   出版者・発行元:学術雑誌目次速報データベース由来  

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  • Aresenic Poisoning Caused by Waste Water from an Orpiment Factory in Niigata--Re-examination after 28 Years

    HARADA Masazumi, HORITA Nobuyuki

    環境と公害 : 自然と人間の共生を求めて   17 ( 3 )   58 - 65   1988年

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    記述言語:英語   出版者・発行元:学術雑誌目次速報データベース由来  

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  • 520 土呂久における慢性ヒ素中毒認定者のガンについての疫学的研究(変異原・発がん,一般講演,第60回日本産業衛生学会・第42回日本産業医協議会)

    津田 敏秀, 青山 英康, 山本 真, 柳楽 翼, 久米 行則

    産業医学   29 ( 7 )   694 - 694   1987年12月

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  • Comparative study of subjective fatigue between automatic transmission bus drivers and manual transmission bus drivers.

    Ueno Mitsuo, Ieyasu Hidetaka, Tsuda Toshihide, Ogawa Takanori, Adachi Masamitsu

    Acta Medica Okayama   41 ( 5 )   229 - 232   1987年10月

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    記述言語:英語   出版者・発行元:Okayama University Medical School  

    <p>The difference in the physiological condition of drivers of manual transmission buses (MTB) and automatic transmission buses (ATB) was examined from the viewpoint of occupational health. This study was based on a self-administered questionnaire which involved items concerning subjective fatigue complaints. No differences in the mental fatigue and stress between MTB drivers and ATB drivers were observed. Although ATB drivers tended to feel less physical fatigue than MTB drivers, the difference was not statistically significant. From these results, it was suggested that there was little difference in the subjective fatigue between ATB drivers and MTB drivers.</p>

    DOI: 10.18926/AMO/31751

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  • Comparative Study of Subjective Fatigue between Automatic Transmission Bus Drivers and Manual Transmission Bus Drivers (共著)

    Ueno Mitsuo, Ieyasu Hidetaka, Tsuda Toshihide, Ogawa Takanori, Adachi Masamitsu

    Acta Medica Okayama   41 ( 5 )   229 - 232   1987年10月

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    記述言語:英語   出版者・発行元:Okayama University Medical School  

    <p>The difference in the physiological condition of drivers of manual transmission buses (MTB) and automatic transmission buses (ATB) was examined from the viewpoint of occupational health. This study was based on a self-administered questionnaire which involved items concerning subjective fatigue complaints. No differences in the mental fatigue and stress between MTB drivers and ATB drivers were observed. Although ATB drivers tended to feel less physical fatigue than MTB drivers, the difference was not statistically significant. From these results, it was suggested that there was little difference in the subjective fatigue between ATB drivers and MTB drivers.</p>

    DOI: 10.18926/AMO/31751

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  • A Case of Lung Cancer Associated with Chronic Arsenic Poisoning Caused by Neighborhood Exposure of As2O3 from Toroku Mine

    Toshihide Tsuda, Hideyasu Aoyama, Yufcinori Kume, Makoto Yamamoto, Tsuyosi Nagira

    Japanese Journal of Industrial Health   29 ( 3 )   222 - 223   1987年

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  • A Case of Lung Cancer Associated with Chronic Arsenic Poisoning Caused by Neighborhood Exposure of As2O3 from Toroku Mine

    Toshihide Tsuda, Hideyasu Aoyama, Yufcinori Kume, Makoto Yamamoto, Tsuyosi Nagira

    Japanese Journal of Industrial Health   29 ( 3 )   222 - 223   1987年

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  • An Epidemiological Study on Cancer in Certified Arsenic Poisoning Patients in Toroku

    Toshihide Tsuda, Yukinori Kume, Hideyasu Aoyama, Makoto Yamamoto, Tsuyoshi Nagira

    Japanese Journal of Industrial Health   29 ( 6 )   496 - 497   1987年

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  • An Epidemiological Study on Cancer in Certified Arsenic Poisoning Patients in Toroku

    Toshihide Tsuda, Yukinori Kume, Hideyasu Aoyama, Makoto Yamamoto, Tsuyoshi Nagira

    Japanese Journal of Industrial Health   29 ( 6 )   496 - 497   1987年

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  • 土呂久鉱山からの近隣暴露による慢性ヒ素中毒症に合併した肺癌の1例

    産業医学   29 ( 3 )   222 - 223   1987年

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  • 536 土呂久鉱山周辺住民において発生したボーエン病および肺癌を合併した慢性砒素中毒の一例(その他の金属,一般講演,第59回日本産業衛生学会・第40回日本産業医協議会)

    山本 真, 津田 敏秀, 柳楽 翼, 久米 行則

    産業医学   28 ( 7 )   673 - 673   1986年12月

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    記述言語:日本語   出版者・発行元:公益社団法人日本産業衛生学会  

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  • 309 ずい道掘削作業におけるディーゼル排気ガスの状況(粉塵・じん肺,一般講演,第9回日本産業衛生学会・第40回日本産業医協議会)

    山本 真, 津田 敏秀, 柳楽 翼, 久米 行則

    産業医学   28 ( 7 )   600 - 600   1986年12月

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    記述言語:日本語   出版者・発行元:公益社団法人日本産業衛生学会  

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▼全件表示

Works(作品等)

  • A Report on the Indicators of Maternal and Child health in Okayama Prefecture

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    作品分類:芸術活動  

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  • A Report on Methods for the Investigation on the Causal Relationship between Air Pollution and Respiratory Diseases

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    作品分類:芸術活動  

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  • 精神疾患のプライマリ・ケア・サーベイ(平成4〜6年度科学研究費補助金(一般研究(A))研究成果報告書,課題番号:04404039,研究代表者:青山英康)

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  • A Report on the Indicators of Maternal and Child health in Okayama Prefecture

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    作品分類:芸術活動  

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  • A Report on Methods for the Investigation on the Causal Relationship between Air Pollution and Respiratory Diseases

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    作品分類:芸術活動  

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  • Epidemiologic Investigation on Food Poisoning - Seminar of Okayama City on Outbreak Investigation

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    作品分類:芸術活動  

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  • Epidemiologic Evidence of Infectious Disease and Food Poisoning - Public Health Seminar of Sakai City

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    作品分類:芸術活動  

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  • 岡山県母子保健指標に関する報告書

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    作品分類:芸術活動  

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  • 大気汚染と呼吸器疾器との関連についての調査方法検討報告書

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    作品分類:芸術活動  

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  • Epidemiologic Investigation on Food Poisoning - Seminar of Okayama City on Outbreak Investigation

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    作品分類:芸術活動  

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  • Epidemiologic Evidence of Infectious Disease and Food Poisoning - Public Health Seminar of Sakai City

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    作品分類:芸術活動  

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  • 岡山市食中毒疫学調査研修会 食中毒の疫学調査

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  • 堺市保健婦研修 感染症の疫学的検証

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  • 健康増進活動のための健康外来システムの開発とその評価(厚生科学研究費補助金健康科学総合研究事業研究報告書,主任研究者:馬場園明)

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    作品分類:芸術活動  

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  • 岡山県東南部地域に多発した肺癌に関する疫学的研究 (平成8〜10年度科学研究費補助金(基盤研究(C)(2))研究成果報告書,課題番号:08670393,研究代表者:津田敏秀)

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  • 職場のストレスのメンタルヘルスに及ぼす影響の定量的評価(平成7〜9年度科学研究費補助金(基盤研究(B))研究成果報告書,課題番号:07457095,研究代表者:三野善央)

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受賞

  • 新潟水俣 環境賞

    1999年  

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    受賞国:日本国

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共同研究・競争的資金等の研究

  • 水俣病における胎児期メチル水銀曝露の健康影響の全貌の解明

    研究課題/領域番号:23K09714  2023年04月 - 2026年03月

    日本学術振興会  科学研究費助成事業  基盤研究(C)

    津田 敏秀, 頼藤 貴志, 加戸 陽子, 櫻田 泰江

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    配分額:4550000円 ( 直接経費:3500000円 、 間接経費:1050000円 )

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  • 21世紀型放射能被害など蓄積的損害・大災害の居住福祉救済システムの学際的構築

    研究課題/領域番号:19H01433  2019年04月 - 2023年03月

    日本学術振興会  科学研究費助成事業  基盤研究(B)

    吉田 邦彦, 辻内 琢也, 今野 正規, 津田 敏秀, 成 元哲, 窪田 亜矢, 淡路 剛久, 今中 哲二

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    配分額:16900000円 ( 直接経費:13000000円 、 間接経費:3900000円 )

    福島の原発事故による放射能被害を皮切りに、蓄積的損害に関わる被害者救済の学際的考察を幅広く行うことを目指してリセットをかけた本研究だが、原発事故の被害者救済について、定期的な実務家との研究会にもかかわらず、関連の裁判例は芳しくなく(とくに放射能被害の知見が問われる『自主被害者(区域外被害者)』の問題)、非力を感じ、更なる学際的研究の詰めを求めたい。
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    災害復興との関係で、否応なく地球温暖化問題(水害、森林火災、熱帯雨林の破壊)に直面することとなり、その関連場所の訪問や会議報告を行った。東南アジア、南アメリカ(とくにブラジル)などにおける自然環境破壊は、先住民族問題も関係し、自然災害難民も生んでいて、グローバルな経済、資本主義権力とも深く関わり、21世紀の難問で打開策は急務なのだが緒はつかみがたく、因果関係の立証も難しく、不法行為救済を超える枠組み作りに苦慮している。さらに世界はコロナウィルスウイルス災害に席巻されるようになり、感染防止の点から身動きがとれなくなり、現場主義的研究・実証的(経験的)研究をモットーとしている本研究の手法は、同様に求められるだろう。
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    これらの課題との関係で、本年度は、別素材で視野拡大を試みた。例えば、沖縄ないし琉球弧の島々における米軍基地・軍事基地の環境悪化の調査に努め、これに関して、フランス・マルセイユのIUCN世界会議の場で、世界自然遺産(沖縄北部のやんばるの森など)との関係での環境問題を指摘し、地元紙でも注目された。軍事基地が急激に増強される宮古島における環境悪化の問題についても、「国防と居住福祉」の問題提起をした。そうこうするうちに、ウクライナ戦争が始まり、究極の環境破壊である戦争問題、核汚染危機も考察対象になりつつある。不実情報や補償・平和問題(関係修復)に真っ向から背を向ける行動様式にどう対処するかという難題に対峙することになっている。

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  • 安心・安全の確保を目的とした日本人旅行者のリスク行動に関する実証研究

    研究課題/領域番号:17K02111  2017年04月 - 2023年03月

    日本学術振興会  科学研究費助成事業  基盤研究(C)

    山川 路代, 田中 優子, 津田 敏秀, 小野 真由美, 中瀬 克己

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    配分額:4290000円 ( 直接経費:3300000円 、 間接経費:990000円 )

    日本人旅行者における感染症罹患にかかわる行動のメカニズムを解明することは、旅行者を行動変容に導くリスク情報の提示方法を知る上で不可欠と考えられる。そこで、本研究は、①個人特性とリスク認知・リスク行動との関連性、②リスク認知とリスク行動との関連性、③リスク行動と疾病発症との関連性、という3つの観点から検討を進めている。2016年から2018年に大学主催の語学研修に参加した日本人学生825名を対象に、渡航前と渡航後に質問紙調査を実施した。渡航前に、渡航歴やリスク認知、既往歴などについて情報収集した。渡航後に、リスク行動や疾病発症、渡航時に携帯した医薬品類などについて情報収集した。渡航先でのリスク行動(衛生、食事・生活習慣、アクティビティなど)は、本人の心理的な要因の関与が示唆されている。今年度は、②について、渡航先での手指衛生の実施状況をアウトカムとし、リスク認知・不安が渡航先での手指衛生の実施状況にどのような影響を及ぼしているか検討した。結果として、性別や年齢、渡航歴、渡航年を調整しても、衛生に対する不安が少ないほど、渡航先で手指衛生を実施しない傾向が見られた。一方で、リスク認知については、有意な関連性は見られなかった。得られた結果は、国内学会で発表するとともに、国際誌に投稿した。また、渡航先や旅行目的によってリスク行動にどのような違いが生じるか、リスク行動に関連する要因にどのような違いがあるか知ることを目的とし、感染リスクの高い地域(インド)を個人旅行する日本人を対象に、2020年度にWebアンケートによる横断調査を実施した。得られたデータをもとに、今年度はリスク行動と関連する要因について分析を進めた。

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  • 大気汚染の疾病罹患・死亡・出生児アウトカムに与える影響の検討

    研究課題/領域番号:26460746  2014年04月 - 2017年03月

    日本学術振興会  科学研究費助成事業  基盤研究(C)

    津田 敏秀, 頼藤 貴志, 土居 弘幸, 鹿嶋 小緒里

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    配分額:4680000円 ( 直接経費:3600000円 、 間接経費:1080000円 )

    国内では大気汚染の健康影響を評価した疫学研究は依然として少ない為、下記目的を達成するために研究を行った。①短期曝露と疾病罹患の関連評価、②短期曝露と疾病別死亡の関連評価、③大気汚染曝露と周産期指標の関連評価、④大気汚染曝露と児の疾病罹患との関連評価。結果として、①では短期曝露により、循環器疾患、呼吸器疾患、心停止による救急搬送のリスクが上昇していた。②においては、日々の二酸化硫黄の濃度と疾病別死亡との関連を認めた。③に関しては、曝露モデルの検討を行っており、更なるデータ蓄積と解析を行う予定である。④に関しては、妊娠中の曝露は満期低出生体重児を増加させ、発達にも影響を及ぼしていた。

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  • 日本とアジア各国での大気汚染による健康影響に関する包括的研究

    研究課題/領域番号:24510033  2012年04月 - 2015年03月

    日本学術振興会  科学研究費助成事業  基盤研究(C)

    土居 弘幸, 津田 敏秀, 鹿嶋 小緒里, 頼藤 貴志

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    配分額:5460000円 ( 直接経費:4200000円 、 間接経費:1260000円 )

    大気汚染による健康影響は甚大であり、アジアでの影響が大きいと考えられている。我々は、国内や東南アジア諸国で様々な研究を行った。アジア各国での研究としては、大気汚染による余剰死亡数推計、大気汚染の短期影響評価、黄砂の健康影響評価を行った。また、国内での研究として大気汚染の短期曝露による脳梗塞や呼吸器系疾患・心停止などへの影響や慢性曝露による心肺血管系・肺がん死亡への影響の評価、大気汚染の周産期指標(母体合併症、出生時体重)への影響評価、東京都のディーゼル車排出ガス規制の政策評価を行った。

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  • 活動の必要性と成果を住民と意志決定者に「見せる公衆衛生看護技術」の構築

    研究課題/領域番号:23390517  2011年04月 - 2015年03月

    日本学術振興会  科学研究費助成事業  基盤研究(B)

    岡本 玲子, 鳩野 洋子, 岩本 里織, 小出 恵子, 草野 恵美子, 津田 敏秀, 浜田 淳, 北脇 知己, 芳我 ちより, 合田 加代子, 山川 路代, 岡本 里香, 福川 京子, 長野 扶佐美

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    配分額:18330000円 ( 直接経費:14100000円 、 間接経費:4230000円 )

    本研究の目的は、住民と意思決定者に活動の必要性と成果を見せる公衆衛生看護技術を構築し、それを習得する学習プログラムを開発することである。
    2011年度は、「見せる公衆衛生看護技術」を定義し、①活動の必要性を見せる技術、②活動の成果を見せる技術、③保健師の存在価値を見せる技術について内容を体系化、2012年度はそれをもとにテキスト「見せる公衆衛生看護技術」を作成、2013年5月に出版(岡山大学出版会)。2013年度はテキストを用いた教育プログラムを検討・試行した。2014年度には成果普及に向けたWEB教材を作成・公開した(http://wwwmiseru.fhs.okayama-u.ac.jp)。

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  • 発達期の粉乳によるヒ素曝露の臨床的慢性影響評価(パイロット研究)

    研究課題/領域番号:23790662  2011年 - 2012年

    日本学術振興会  科学研究費助成事業  若手研究(B)

    頼藤 貴志, 津田 敏秀

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    配分額:4290000円 ( 直接経費:3300000円 、 間接経費:990000円 )

    1955年夏、ヒ素を混入したミルクによる食中毒が西日本中心に発生した。しかしながら、疫学的検証は充分には行われていない。その為、ヒ素曝露を受けた集団を対象として、ミルク飲用と健診所見、神経学的所見やがん関連のマーカーとの関連を検討するパイロット研究を行った。50名(飲用群27名、非飲用群23名)を対象とし、2012年4月24日から2013年2月26日の間に調査を行った。結果、飲用群において非飲用群に比べ、いくつかの自覚症状が多く見られた。神経認知行動学的検査においては、フィンガータッピングは差が認められなかったが、その他の検査項目で差が認められた。また、健診所見において差を認めた項目があった。

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  • 気候変動による健康ハイリスク集団の特定と効果的な予防・適応策の構築

    研究課題/領域番号:22390124  2010年 - 2012年

    日本学術振興会  科学研究費助成事業  基盤研究(B)

    津田 敏秀, 山本 英二, 土居 弘幸, 頼藤 貴志, 鹿嶋 小緒里, 鈴木 越治

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    配分額:7410000円 ( 直接経費:5700000円 、 間接経費:1710000円 )

    気温変化と疾病罹患の関連を評価するため、岡山市における平成 18年から平成 22 年の救急搬送データを用いて、65 歳以上の救急搬送患者全員を対象とした時系列分析を実施した。大気汚染やオゾン濃度などを調整して解析した結果、暑い環境下では呼吸器系疾患(特に肺炎・インフルエンザ)による救急搬送率が上昇する一方で、寒冷な環境下では心血管系疾患(特に一過性脳虚血発作)による救急搬送率が上昇することが示唆された。

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  • 全自殺事例報告に基づく自殺予防対策の提示と比較対照研究の実施

    研究課題/領域番号:21590695  2009年 - 2011年

    日本学術振興会  科学研究費助成事業  基盤研究(C)

    浜田 淳, 津田 敏秀, 瀬藤 貴志, 宮石 智

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    配分額:3380000円 ( 直接経費:2600000円 、 間接経費:780000円 )

    岡山県の全自殺例の分析を行い、練炭自殺が30~ 40代の男性を中心にある時期に集中して発生することを明らかにした。厚労省の人口動態統計のデータセットを構築して分析を行い、不況などの社会経済状況からみてハイリスク集団を同定し、この集団に対して適切な時期に予防的な介入を実施し、自殺を減少させることができないかを検討した。秋田県、岩手県、足立区など自殺予防の先進地域の取り組みを分析し、「ヘルスプロモーション・アプローチ」という総合的な取り組みを都市部を中心に浸透させることの重要性を明らかにした。

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  • 職業性ストレスとがん罹患の関連性およびそのメカニズムに関する疫学的研究

    研究課題/領域番号:16390170  2004年 - 2007年

    日本学術振興会  科学研究費助成事業  基盤研究(B)

    川上 憲人, 堤 明純, 島津 明人, 廣川 空美, 高尾 総司, 津田 敏秀, 中田 光紀

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    配分額:15130000円 ( 直接経費:14500000円 、 間接経費:630000円 )

    本研究では、職業性ストレスとがん罹患との関連性とそのメカニズムを明らかにすることを目的として、2つの前向きコホート研究(既存コホートデータと新規コホート)および職業性ストレスとがん罹患の媒介要因(免疫機能、抗酸化能などの生理指標および食事等のがん関連保健行動)との関係についての小規模な追跡研究を実施した。
    特に本研究では以下の3点を検討した。(1)2大職業性ストレス理論である「要求度-コントロール-社会的支援モデル」および「努カ-報酬不均衡モデル」に基づく職業性ストレスと全がんの罹患(および部位別のがん罹患)との関連性、(2)これ以外の職場の社会心理的な要因とがん罹患との関連性、(3)職業性ストレスとがん関連の生理指標(免疫機能および抗酸化能マーカー)および保健行動(喫煙、飲酒、栄養)との関連性。
    結果として、職業性ストレスは全がんの罹患リスクを増加させる可能性があることが示唆された。そのメカニズムの一部として、職業性ストレスによるDNA酸化があると考えられた。一方、食事や生活習慣は、職業性ストレスとがん罹患をつなぐ媒介変数としては大きな役割を果たしていないと推測された。

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  • 職場における精神の健康度が疾病発生に及ぼす影響

    研究課題/領域番号:14570340  2002年 - 2004年

    日本学術振興会  科学研究費助成事業  基盤研究(C)

    馬場園 明, 三野 善央, 津田 敏秀, 永野 純

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    配分額:3900000円 ( 直接経費:3900000円 )

    我々はH県に所在する製造業の企業の健康管理を行っており、職場の自覚的ストレスに関する調査を1995年から2年おきに行っている。1997年2月の調査では、全従業員1,363名に対し、回答者数は1,246名(84.6%)であった。そのうち2年後の調査で追跡できた者は1,036名(83.1%)であった。職場の自覚的ストレスに関する調査票は上畑のものに準じ、各項目について、"いつも"、"ときどき"、"感じない"からひとつを選択するものであった。疾病の発生についてはストレス関連疾患について1年間の受診の状況を聞いた。この職場のストレス関連疾患としては、この調査で罹患率が高かった胃・十二指腸潰瘍、腰痛症、頸肩腕症候群、不眠症を選択した。1999年2月の調査で得られた各疾病に関する受診の有無を目的変数、1997年2月の調査で得られた自覚的ストレス度、性、年齢、飲酒、喫煙、職種を説明変数とする多重logistic回帰分析を行った。胃・十二指腸潰瘍については、女性の男性に対するオッズ比(95%CI)は0.28(0.10-0.81)、年齢のオッズ比(95%CI)は1歳につき1.05(1.02-1.09)、工場勤務の研究開発・事務他に対するオッズ比(95%CI)は2.38(1.21-4.69)、「仕事が暇すぎる」のオッズ比は2.00(1.02-3.94)であった。腰痛と関連した要因については、工場勤務の研究開発・事務他に対するオッズ比(95%CI)は3.94(1.69-9.15)、「仕事が暇すぎる」のオッズ比は2.29(1.12-4.68)であった。頸肩腕症候群については、工場勤務の研究開発・事務他に対するオッズ比(95%CI)は2.18(1.08-4.39)、「時間に追われている感じがする」のオッズ比(95%CI)は2.47(0.94-6.50)であった。不眠症については、「仕事の拘束時間が長すぎる」のオッズ比(95%CI)は2.56(1.00-6.51)であった。

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  • 一般住民の精神健康に関する社会・心理・生理・分子遺伝疫学的研究

    研究課題/領域番号:13470082  2001年 - 2003年

    日本学術振興会  科学研究費助成事業  基盤研究(B)

    川上 憲人, 大津 忠弘, 津田 敏秀, 堤 明純, 尾崎 紀夫, 高尾 総司, 三野 善央

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    配分額:13500000円 ( 直接経費:13500000円 )

    平成13〜14年度には、調査票日本語版の訳語の確認と本調査用面接用プログラム(CAPI)の準備、面接員トレーニングの実施、データの収集とクリーニングを行った。岡山市住民から無作為に抽出したサンプル(1607名)に対して調査依頼し、27名の面接員が最終的に925名に面接を実施した(転居、死亡など調査対象外の者を除く回収率66%)。岡山市におけるDSM-IVおよびICD-10診断基準による主要な精神障害の有病率では、大うつ病(うつ病)、特定の恐怖症、アルコール乱用が比較的多く、うつ病(DSM-IV大うつ病、ICD-10うつ病エピソード)はこれまでに7〜8%の者が、過去12ヶ月間に2.5-2.6%の者がこれを経験していた。平成15年7月3〜10日には世界精神保健調査研究者会議(フランス)に出席し、面接調査データの予備的な解析結果を報告し、解析計画について専門家のレビューを受けるとともに、研究打ち合わせを行った。
    平成15年度には、上記面接調査への回答者から精神障害該当者及び非該当者(1/3の確率で選ばれた者)からそれぞれ採血および生理心理学的調査の対象者合計260名を選び、調査への参加を依頼し、同意した者について採血と生理心理学的測定を実施した。この調査は岡山大学医学部ヒトゲノム・遺伝子解析研究倫理審査委員会で承認された手続きにより書面で同意を得た上で実施された。全血サンプルは一時岡山大学に凍結保存した後、藤田保健衛生大に搬送され、遺伝マーカーの測定を行った。精神障害および自殺行動に影響する社会心理的要因の解析、社会機能およびQOLを含む社会心理的要因の解析、職業性因子の解析を実施した。また遺伝マーカーおよび生理学的要因と精神障害との関連性を解析した。

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  • 健康保険制度における定率2割負担導入による受診行動への影響

    研究課題/領域番号:11670373  1999年 - 2001年

    日本学術振興会  科学研究費助成事業  基盤研究(C)

    馬場園 明, 津田 敏秀

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    配分額:3000000円 ( 直接経費:3000000円 )

    1997年9月に行われた被用者健康保険における被保険者に対する定率2割負担の導入の影響を評価した。対象は1996年度および1998年度に健康保険組合連合会に所属する全組合1797組合とした。受診の指標としては、入院、外来、歯科の受診率、1件当たり診療日数、1日当たり医療費、1人当たり医療費とした。被保険者の平均年齢、平均標準報酬月額、被保険者総数、性比、扶養率を考慮して、定率負担導入の影響を評価した結果、受診率の変化の推定値(95%CIl)は、受診率の変化の推定値(95%CI)は、入院が-6.96%(-8.23%〜-5.66%)、外来が-4.79%(-5.56%〜-4.01%)、歯科が-5.77%(-6.37%〜-5.17%)であった。1件当たり日数の変化の推定値(95%CI)は、入院が-4.66%(-5.40%〜-3.92%)、外来が-5.67%(-6.07%〜-5.28%)、歯科が-1.82%(-2.22%〜-1.42%)であった。1日当たり医療費の変化の推定値(95%CI)は、入院が-3.15%(-4.01%〜-2.28%)、外来が-13.00%(-13.86%〜-12.14%)、歯科が-11.48%(-11.85%〜-11.11%)であった。被保険者1人当たり医療費の変化の推定値(95%CI)は、入院が-14.08%(-15.51%〜-12.64%)、外来が-21.54%(-22.26%〜-20.82%)、歯科が-18.11%(-18.70%〜-17.51%)であった。組合特性との関連では、定率1割負担導入の時には、外来受診率と歯科受診率に関しては平均報酬月額と関係はなかったが、今回の定率2割負担導入の分析では関連が認められた。また、入院、外来、歯科ともに1件あたり診療日数と平均報酬月額とは負の関係があった。このことは、平均報酬月額の低い人程、受診率が低いが、受診すると受診日数を多く要すということである。これは所得効果(income effect)により、所得の低い人は早期に受診することが妨げられている結果である可能性があり、定率負担導入は早期受診の保障という観点からも再検討される必要があろう。

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  • うつ病をはじめとする気分障害と家族の感情表出に関する研究

    研究課題/領域番号:10470108  1998年 - 2000年

    日本学術振興会  科学研究費助成事業  基盤研究(B)

    三野 善央, 下寺 信次, 青木 省三, 井上 新平, 大津 忠弘, 津田 敏秀

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    配分額:6600000円 ( 直接経費:6600000円 )

    日本人の気分障害の患者の家族を対象として,カンバウェル家族面接(Camberwell Family Interview,CFI)を用いたEE(expressed emotion)評価の信頼性を評価し,そのEEの特徴を明らかにする目的で研究を行った.研究対象は27名の気分障害患者とその家族31名だった.家族とのCFI面接を行った.2名の評価者がそれぞれ独立にEE評価を行い,2者間の信頼性をスピアマン順位相関係数(Spearman's correlation coefficient by ranks),カッパ値(kappa value)などで評価した.その結果,気分障害におけるEE評価の評価者間信頼性を再検討する必要があること,気分障害患者家族の感情表出は分裂病患者家族と比較して抑制されたものであること,日本人の感情表現は欧米人よりも控えめであることが明らかとなった.
    また,気分障害と診断された32名の患者と36名のその主要な家族が研究対象として,9カ月間および2年間追跡するコホート研究を行った.その結果,批判3個以上あるいはE0I3点以上を高EE群,それ以外を低EEとしての9カ月再発リスクはそれぞれ83.3%(5/6),19.2%(5/26)であり,再発リスク比(95%信頼区間)は4.3(1.8-12.2)であった.この分け方での,妥当性の指標の値が最良であった.多重ロジスティック分析の結果でも,EEの影響は有意であった.また,2年間のコホート研究においても,同様の結果が得られた.したがって,日本においてもCFIによるEEは再発と関連していると結論できる.

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  • 岡山県東南部地域に多発した肺癌に関する疫学的研究

    研究課題/領域番号:08670393  1996年 - 1998年

    日本学術振興会  科学研究費助成事業  基盤研究(C)

    津田 敏秀, 三野 善央, 松岡 宏明, 青山 英康

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    配分額:2400000円 ( 直接経費:2400000円 )

    岡山県の東南部を調査対象地域とした。この地域では耐火煉瓦製造労働者にじん肺の多発が報告され、近年では肺癌の多発も報告されていた。研究デザインはpopulation-basedの症例対照研究で、1地域の1986年から1993年の間に40歳以上で死亡した全男性症例を分析対象として、粉じん曝露・じん肺と肺癌の因果関係について検証した。症例は肺癌症例とし、対照群は肝癌・大腸癌と、粉じん曝露との関連が報告されていないその他の癌とした。曝露の指標は、喫煙歴、年齢、粉じん曝露歴、じん肺所見、肺癌のリスクファクターとなる職業歴とした。影響の指標はオッズ比とし、交絡要因についてはマンテルヘンツェル法もしくは多変量解析法で調整した。病理所見とシリカ曝露、じん肺の胸部X線写真の所見とシリカ曝露についてもデータを収集しているので、分析の対象として分析を試みた。
    性年齢調整オッズ比は、粉じん曝露に関しては、肝癌対照を取ったとき1.59(0.87-3.03)、大腸癌対照を取ったとき1.94(0.94-4.43)、その他の癌を対照としたとき2.13(1.19-3.85)であった。じん肺症に罹患している人の肺癌に関する性年齢調整オッズ比は、粉じん曝露に関しては、肝癌対照を取ったとき2.45(1.22-5.34)、大腸癌対照を取ったとき2.94(1.30-8.90)、その他の癌を対照としたとき2.69(1.43-5.37)であった。肺癌の組織型は、日本一般人口の肺癌の組織型と比較すると小細胞癌がやや多かったが、その他の特徴はなかった。胸部X線上のじん肺所見との比較では、大陰影がないじん肺患者にも肺癌の多発が認められた。
    これらの知見は、シリカ曝露を人体における肺癌の発癌物質に分類したIARCの決定を支持するもである。今後は、食道癌・胃癌・肝癌・造血器系癌など、肺癌以外でシリカ曝露との関係が報告さている癌についての調査と検証が必要となるであろう。

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  • 職場のストレスのメンタル・ヘルスに及ぼす影響の定量的評価

    研究課題/領域番号:07457095  1995年 - 1997年

    日本学術振興会  科学研究費助成事業  基盤研究(B)

    三野 善央, 松岡 宏明, 津田 敏秀, 青山 英康

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    配分額:6800000円 ( 直接経費:6800000円 )

    2年間にわたって800名の労働者を対象に,職場ストレスとメンタルヘルスに関するコホート研究を行った.質問紙の内容は全般健康調査票(General Health Questionnaire,GHQ),職場ストレスに関する14項目などとし,主観的職場ストレスとメンタルヘルスとの関連を検討した.メンタルヘルス上の不健康状態の2年リスクは58%にもおよび,ストレスあり群のなし群に対する2年リスク比の大きかった主観的ストレス項目は,「トラブルが多すぎる」,「上司との関係が悪い」,「責任が重すぎる」,「技術の進歩についていけない」であった.多重ロジスティック分析の結果では,他の交絡要因を調整しての上記ストレス項目のリスクオッズ比(95%信頼区間)はそれぞれ,2.1(1.3-3.6),2.1(1.2-3.7),2.1(1.3-3.4),2.0(1.1-3.4)であった.また,コックス比例ハザードモデルを用いた分析でも,「仕事のトラブルが多すぎる」,「責任が重すぎる」についての罹患率比が2を越え,有意であった.したがって特定の職場ストレスと精神的不健康との間の因果関係が強く示唆された.また,当初メンタルヘルス上問題のあったケースの回復を見るための1年間のコホート研究では,最初の6カ月間で49%の者が回復し,1年間で68%が回復していた.多重ロジスティック分析のよって交絡要因をコントロールしての,回復と「責任が重すぎる」という主観的ストレスとのオッズ比(95%信頼区間)は4.2(1.3-13)であった.職場におけるメンタルヘルス上の問題からの回復には,罹患とは異なる特定の主観的職場ストレスが関わっていることが明らかとなった.また,3回の調査に関してGHQとストレス項目の因子分析を行ったが,それぞれの因子構造は経時的に安定したものであった.

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  • 塵肺症及び粉塵暴露と肺癌の多発に関する研究

    研究課題/領域番号:06770260  1994年

    日本学術振興会  科学研究費助成事業  奨励研究(A)

    津田 敏秀

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    配分額:900000円 ( 直接経費:900000円 )

    近年、岡山県の東南部、東備地域では、肺癌の過剰死亡が報告されている(昭和61年から平成2年までの5年間の市町村別標準化死亡比で、備前市・1.22、日生町・1.80)。そこで岡山県保健福祉部、厚生省統計情報部、岡山県東備保健所の協力を得て、この地域(備前市・日生町・佐伯町・和気町・吉永町)の死亡小票を調査し、肺癌発生に及ぼすじん肺症の影響の程度の推定を症例対照研究の手法で試みた。
    死亡小票は上記5市町の昭和63年から平成5年までのものを利用した。症例対照研究は、肺癌死亡症例を症例群とし、対照群に胃癌とその他の癌による死亡症例を選んだ。暴露の指標はじん肺所見の記載を採用した。分析対象は、40才以上の男性に限った。死亡時の年齢で層別し、各々の層をマンテル・ヘンツェル法で統合し、調製オッズ比を求めた。
    胃癌を対照疾患としたときの年齢調整オッズ比は1.41(95%信頼区間0.57-3.52)、胃癌と肺癌以外の癌を対照疾患としたときには2.22(同1.63-4.65)、肺癌以外の全癌を対照疾患としたときには1.97(同0.99-3.89)であった。いずれも、じん肺患者における肺癌の過剰死亡を示唆し、これまでの日本でのコホート研究の結果に一致している。しかし、今回は暴露の指標を、死亡小票のじん肺所見の記載に頼っているため、Nondifferential misclassificationなどのバイアスが考えられ、今後より良い推定値を得るためにさらに研究が必要であると考える。また、今回は年齢以外の交絡要因の情報、例えば喫煙歴に関する情報などは得られていないので、この点に関しても、今後更に検討が必要である。

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  • 精神疾患のプライマリ・ケア・サーベイ

    研究課題/領域番号:04404038  1992年 - 1994年

    日本学術振興会  科学研究費助成事業  一般研究(A)

    青山 英康, 津田 敏秀, 青木 省三, 三野 善央, 馬場園 明, 甲田 茂樹

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    配分額:12000000円 ( 直接経費:12000000円 )

    プライマリ・ケアのうつ病に関しては、3日間に地域診療所を受診した患者全員を対象に質問紙調査を実施した。質問紙はうつ病を診断するための日本語版うつ病診断調査表(Inventory to Diagnose Depression, IDD)、身体的健康状態把握のための健康機能評価票(Dartmouth COOP Functional Health Assessment Charts)日本語版などとした。対象者302名の内275名より有効回答が得られ、大うつ病有病率は6%であり、小うつ病まで含めたうつ病有病率は13%であった。うつ病と身体的健康状態、社会活動、痛み症状などは明らかに関連していた。6カ月間追跡したところ、大うつ病と診断された16名の内13名が追跡可能で、その54%は回復していた。米国、イスラエルで同様の研究を行ったところ大うつ病有病率は米国13%、イスラエル3%であった。うつ病と健康機能はいずれの国でも関連していたが関連の仕方が異なっていた。プライマリ・ケアにおけるメンタル・ヘルスへの配慮が重要であることを示す結果であった。
    分裂病の経過と家族の感情表出(EE)との関連については、52名の分裂病者を2年間追跡するコホート研究を行った。家族のEEはカンバウェル家族面接によって評価した。高EEの家族とともに生活していた分裂病者24名の9カ月再発リスクは58%であり、低EEの家族と生活した28名の再発リスクは21%であった。多変量解析を用いてBPRSでの精神症状、薬物療法、罹病期間などをコントロールしても、家族のEEは最も強く再発と関連していた。また、2年間の追跡でもEEと再発は関連していた。日本におけるEEのあり方を国際的に比較検討し、わが国におけるEE研究に基づく家族介入が我が国における分裂病の地域ケアを促進するための大きな役割を果たしうることを明確にした。

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  • 健康保険組合における保健施設事業の評価

    研究課題/領域番号:01440036  1989年 - 1991年

    日本学術振興会  科学研究費助成事業  一般研究(A)

    青山 英康, 内田 勇人, 津田 敏秀, 馬場園 明, 甲田 茂樹, 井谷 徹, 三野 善央, 竹内 研

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    国際的に他に例を見ない急速な高齢化社会を迎えているわが国は、急増する医療費と負担者の減少に直面し、国民の創意と工夫によって対応しなければならない情況にある。
    WHO憲章によって国際的に確認された「健康権」を社会的に保障するために、各国で多種多様の方策が講じられているが、わが国では国民皆保険制度の発足によって、医療保険による医療受診を保障している。
    財源を被保険者が拠出する保険料に求めて、一切の国庫補助もなく、自主的な財政運営をしている健康保険組合こそは、医療保険の基本であり、「効果な医療費の活用によって、豊かな給付」を被保険者とその家族に保障する決め手は「効果的な保健施設事業の展開」以外に方策はない。
    このような考えの下に、第150号通達が出され、健康保険組合の主要な役割りを「医療費の補償から、医療の保障へ」の転換が図られることになった。
    このような状況下、本研究は第150号通達が出される以前と以後の健康保険組合の財政運営の推移を科学的に評価する中で、効果的な保健施設事業の方策を明らかにする目的で取り組んだ。
    まず、保健施設事業費については、財政窮迫組合も含めて、保険料収入の中に占める保健施設事業費の割合は、1985年以降の5年間に急増しており、行政通達の5%を上迴って年々増大しているのが認められた。さらに、保健施設事業費の中での体育奨励費が占める割合は、逆に固定施設の充実によって延びは小さかった。
    このような財政運営のもとで、各健康保険組合で実施可能な企業フィットネスの展開方法を検討し、マニュアルの作成を幅広い分野の専門家による協力を得て作成した。

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社会貢献活動

  • 医学裁判での証言(水俣病)

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    種別:その他

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