Faculty Profiles - TAKAO Soshi

Papers - TAKAO Soshi

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The role of medicine in the decline of post-War infant mortality in Japan Reviewed

Takashi Yorifuji, Shinichi Tanihara, Sachiko Inoue, Soshi Takao, Ichiro Kawachi

PAEDIATRIC AND PERINATAL EPIDEMIOLOGY 25 ( 6 ) 601 - 608 2011.11

Language：English Publishing type：Research paper (scientific journal) Publisher：WILEY-BLACKWELL

Yorifuji T, Tanihara S, Inoue S, Takao S, Kawachi I. The role of medicine in the decline of post-War infant mortality in Japan. Paediatric and Perinatal Epidemiology 2011; 25: 601-608.
The infant mortality rate (IMR) in Japan declined dramatically in the immediate post-War period (1947-60) in Japan. We compared the time trends in Growth Domestic Product (GDP) in Japan against declines in IMR. We then conducted a prefecture-level ecological analysis of the rate of decline in IMR and post-neonatal mortality from 1947 to 1960, focusing on variations in medical resources and public health strategies. IMR in Japan started to decline after World War II, even before the era of rapid economic growth and the introduction of a universal health insurance system in the 1960s. The mortality rates per 1000 infants in 2009 were 2.38 for IMR, 1.17 for neonatal mortality and 1.21 for post-neonatal mortality. The rate of decline in IMR and preventable IMR (PIMR) during the post-War period was strongly correlated with prefectural variations in medical resources (per capita physicians, nurses, and proportion of in-hospital births). The correlation coefficients comparing the number of physicians in 1955 with the declines in IMR and PIMR from 1947 to 1960 were 0.46 [95% confidence interval (CI) 0.19, 0.66] and 0.39 [95% CI 0.11, 0.61], respectively. By contrast, indicators of public health strategies were not associated with IMR decline. The IMR in Japan has been decreasing and seems to be entering a new era characterised by lower neonatal compared with post-neonatal mortality. Furthermore, the post-War history of Japan illustrates that improvement in infant mortality is attributable to the influence of medical care, even in the absence of rapid economic development.

DOI： 10.1111/j.1365-3016.2011.01216.x

Workplace Social Capital and Adherence to Antihypertensive Medication: A Cohort Study

Tuula Oksanen, Ichiro Kawachi, Anne Kouvonen, Etsuji Suzuki, Soshi Takao, Noora Sjosten, Marianna Virtanen, Jaana Pentti, Jussi Vahtera, Mika Kivimaki

PLOS ONE 6 ( 9 ) e24732 2011.9

Language：English Publishing type：Research paper (scientific journal) Publisher：PUBLIC LIBRARY SCIENCE

Background: While hypertension is a common and treatable health problem, adherence to antihypertensive medication remains a challenge. This study examines the hypothesis that workplace social capital may influence adherence to antihypertensive medication among hypertensive employees.
Methodology/Principal Findings: We linked survey responses to nationwide pharmacy records for a cohort of 3515 hypertensive employees (mean age 53.9 years, 76% women) who required continuous antihypertensive drug therapy (the Finnish Public Sector study). A standard scale was used to measure workplace social capital from co-workers' assessments and self-reports in 2000-2004. Non-adherence to antihypertensive medication was determined based on the number of days-not-treated at the year following the survey using comprehensive prescription records. Negative binomial regression models were conducted adjusting for socio-demographic characteristics, duration of hypertension, behaviour-related risk factors, and co-morbid conditions. The overall rate of days-not-treated was 20.7 per person-year (78% had no days-not-treated). Higher age, obesity, and presence of somatic co-morbidities were all associated with better adherence, but this was not the case for co-worker-assessed or self-reported workplace social capital. The rate of days-not-treated was 19.7 per person-year in the bottom fourth of co-worker-assessed workplace social capital, compared to 20.4 in the top fourth. The corresponding rate ratio from the fully-adjusted model was 0.95 (95% confidence interval (CI) 0.58-1.56). In a subgroup of 907 new users of antihypertensive medication this rate ratio was 0.98 (95% CI 0.42-2.29).
Conclusions/Significance: We found no consistent evidence to support the hypothesized effect of workplace social capital on adherence to drug therapy among employees with chronic hypertension.

DOI： 10.1371/journal.pone.0024732

Regional disparities in compliance with tobacco control policy in Japan: an ecological analysis Reviewed

Takashi Yorifuji, Shinichi Tanihara, Soshi Takao, Ichiro Kawachi

TOBACCO CONTROL 20 ( 5 ) 374 - 379 2011.9

Language：English Publishing type：Research paper (scientific journal) Publisher：B M J PUBLISHING GROUP

Background The slow progress of tobacco control policy in Japan reflects the tension among the interests of the Finance Ministry (which remains the majority shareholder of Japan Tobacco, Inc), the Health Ministry, tobacco growers and consumers.
Methods We sought to examine regional disparities in compliance with national tobacco control legislation (the 2003 Health Promotion Law). Specifically, we sought to examine whether prefecture-level compliance with legislation was correlated with decreases in smoking prevalence, and decreases in lung cancer mortality rates. We also examined whether prefectural involvement in growing tobacco was associated with lower compliance with the law.
Results From 2001 to 2007, higher prefectural compliance with tobacco control laws was associated with decreased prevalence of smoking. Decreased tobacco consumption was in turn associated with declining lung cancer mortality. Prefectures involved in growing tobacco exhibited lower levels of compliance with national tobacco control laws. The same prefectures also exhibited the worst improvement in smoking prevalence.
Conclusions This study in Japan suggests that tobacco control policies are being unevenly implemented across prefectures, and that measures to counteract the influence of local tobacco culture are required to reduce the disparities in regional tobacco control outcomes in that country.

DOI： 10.1136/tc.2010.041442

Workplace Social Capital and All-Cause Mortality: A Prospective Cohort Study of 28043 Public-Sector Employees in Finland

Tuula Oksanen, Ichiro Kawachi, S. V. Subramanian, Mika Kivimaki, Jaana Pentti, Paula Salo, Marianna Virtanen, Jussi Vahtera, Soshi Takao, Etsuji Suzuki, Anne Kouvonen

AMERICAN JOURNAL OF PUBLIC HEALTH 101 ( 9 ) 1742 - 1748 2011.9

Language：English Publishing type：Research paper (scientific journal) Publisher：AMER PUBLIC HEALTH ASSOC INC

Objectives. We examined the association between workplace social capital and all-cause mortality in a large occupational cohort from Finland.
Methods. We linked responses of 28043 participants to surveys in 2000 to 2002 and in 2004 to national mortality registers through 2009. We used repeated measurements of self- and coworker-assessed social capital. We carried out Cox proportional hazard and fixed-effects logistic regressions.
Results. During the 5-year follow-up, 196 employees died. A 1-unit increase in the mean of repeat measurements of self-assessed workplace social capital (range 1-5) was associated with a 19% decrease in the risk of all-cause mortality (age- and gender-adjusted hazard ratio [HR]=0.81; 95% confidence interval [CI) =0.66, 0.99). The corresponding point estimate for the mean of coworker-assessed social capital was similar, although the association was less precisely estimated (age- and gender-adjusted HR=0.77; 95% CI=0.50, 1.20). In fixed-effects analysis, a 1-unit increase in self-assessed social capital across the 2 time points was associated with a lower mortality risk (odds ratio=0.81; 95% CI=0.55, 1.19).
Conclusions. Workplace social capital appears to be associated with lowered mortality in the working-aged population. (Am J Public Health. 2011;101: 1742-1748. doi:10.2105/AJPH.2011.300166)

DOI： 10.2105/AJPH.2011.300166

Diesel vehicle emission and death rates in Tokyo, Japan: A natural experiment

Takashi Yorifuji, Ichiro Kawachi, Mariko Kaneda, Soshi Takao, Saori Kashima, Hiroyuki Doi

SCIENCE OF THE TOTAL ENVIRONMENT 409 ( 19 ) 3620 - 3627 2011.9

Language：English Publishing type：Research paper (scientific journal) Publisher：ELSEVIER SCIENCE BV

Evidence linking air pollution with adverse cardiopulmonary outcomes is accumulating. However, few studies have been conducted to evaluate whether vehicle emission control improves public health. We thus evaluated the effect of a diesel emission control law on mortality rates in 23 wards of Tokyo metropolitan area, Japan. We obtained daily counts of mortality and concentrations of nitrogen dioxide (NO2) and particulate matter less than 2.5 mu m in diameter (PM2.5) from April 2003 to December 2008. Time-series and interrupted time-series analysis were employed to analyze the data in two periods: prior to the introduction of tighter restrictions (April 2003 to March 2006) and after the enforcement (April 2006 to December 2008). Concentrations of air pollutants gradually decreased during the study period: from 36.3 ppb (NO2) and 22.8 mu g/m(3) (PM2.5) to 32.1 ppb and 20.3 mu g/m(3), respectively. Air pollutants were positively associated with circulatory and pulmonary disease mortality, especially cerebrovascular disease. Each same-day PM2.5 increase of 10 mu g/m(3) was associated with a 1.3% increase in cerebrovascular mortality rate (95% confidence interval: 0.2-2.4). Rate ratios were attenuated after the enforcement in most of the outcomes, probably due to reduced toxicity of the pollutants. In the crude interrupted time-series analysis, reductions of standardized mortality rates after the enforcement were the greatest in high traffic areas. Even after adjustment of longer-time trend, mortality rate from cerebrovascular disease was reduced by 8.50% (p<.001) with dose-response relationship. However, the declines in other cause-specific mortality became equivocal. This natural experiment in Tokyo suggests that emission controls improved air quality. Although suggestive, further data are needed to conclusively demonstrate an impact on mortality rates. (C) 2011 Elsevier B.V. All rights reserved.

DOI： 10.1016/j.scitotenv.2011.06.002

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

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

ENVIRONMENT INTERNATIONAL 37 ( 5 ) 907 - 913 2011.7

Language：English Publishing type：Research paper (scientific journal) Publisher：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.

DOI： 10.1016/j.envint.2011.03.008

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

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

ENVIRONMENTAL RESEARCH 111 ( 3 ) 377 - 387 2011.4

Language：English Publishing type：Research paper (scientific journal) Publisher：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

Residential Proximity to Major Roads and Preterm Births

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

EPIDEMIOLOGY 22 ( 1 ) 74 - 80 2011.1

Language：English Publishing type：Research paper (scientific journal) Publisher：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 the risk of preterm births with preterm premature rupture of the membranes and with pregnancy hypertension.Conclusions: This study demonstrates that exposure to traffic-related air pollution increases even the risk of preterm births of less than 30 weeks' gestational age and proposes a possible mechanism.

DOI： 10.1097/EDE.0b013e3181fe759f

Environmental Factors and Seasonal Influenza Onset in Okayama City, Japan: Case-Crossover Study

Yuuki Tsuchihashi, Takashi Yorifuji, Soshi Takao, Etsuji Suzuki, Shigeru Mori, Hiroyuki Doi, Toshihide Tsuda

ACTA MEDICA OKAYAMA 65 ( 2 ) 97 - 103 2011

Language：English Publishing type：Research paper (scientific journal) Publisher：OKAYAMA UNIV MED 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 degrees C decrease. Low environmental temperature significantly increased the risk of seasonal influenza onset within the 2006-7 winter season.

DOI： 10.18926/AMO/45268

Multi-level, cross-sectional study of workplace social capital and smoking among Japanese employees

Etsuji Suzuki, Takeo Fujiwara, Soshi Takao, S. V. Subramanian, Eiji Yamamoto, Ichiro Kawachi

BMC PUBLIC HEALTH 10 2010.8

Language：English Publishing type：Research paper (scientific journal) Publisher：BMC

Background: Social capital is hypothesized to be relevant to health promotion, and the association between community social capital and cigarette smoking has been examined. Individual-level social capital has been found to be associated with smoking cessation, but evidence remains sparse on the contextual effect of social capital and smoking. Further, evidence remains sparse on the association between smoking and social capital in the workplace, where people are spending an increasing portion of their daily lives. We examined the association between workplace social capital and smoking status among Japanese private sector employees.Methods: We employed a two-stage stratified random sampling procedure. Of the total of 1,800 subjects in 60 companies, 1,171 (men/women; 834/337) employees (65.1%) were identified from 46 companies in Okayama in 2007. Workplace social capital was assessed in two dimensions; trust and reciprocity. Company-level social capital was based on inquiring about employee perceptions of trust and reciprocity among co-workers, and then aggregating their responses in order to calculate the proportion of workers reporting mistrust and lack of reciprocity. Multilevel logistic regression analysis was conducted using Markov Chain Monte Carlo methods to explore whether individual-and company-level social capital was associated with smoking. Odds ratios (ORs) and 95% credible intervals (CIs) for current smoking were obtained.Results: Overall, 33.3% of the subjects smoked currently. There was no relationship between individual-level mistrust of others and smoking status. By contrast, one-standard deviation change in company-level mistrust was associated with higher odds of smoking (OR: 1.25, 95% CI: 1.06-1.46) even after controlling for individual-level mistrust, sex, age, occupation, educational attainment, alcohol use, physical activity, body mass index, and chronic diseases. No clear associations were found between lack of reciprocity and smoking both at the individual-and company-level.Conclusions: Company-level mistrust is associated with higher likelihood of smoking among Japanese employees, while individual perceptions of mistrust were not associated. The link between lack of reciprocity and smoking was not supported either at the individual-or company-level. Further studies are warranted to examine the possible link between company-level trust and smoking cessation in the Japanese workplace.

DOI： 10.1186/1471-2458-10-489

Does low workplace social capital have detrimental effect on workers' health?

Etsuji Suzuki, Soshi Takao, S. V. Subramanian, Hirokazu Komatsu, Hiroyuki Doi, Ichiro Kawachi

SOCIAL SCIENCE & MEDICINE 70 ( 9 ) 1367 - 1372 2010.5

Language：English Publishing type：Research paper (scientific journal) Publisher：PERGAMON-ELSEVIER SCIENCE LTD

While the majority of studies of social capital and health have focused on conceptualizing social capital at the geographic level, evidence remains sparse on workplace social capital. We examined the association between workplace social capital and health status among Japanese private sector employees in a cross-sectional study. By employing a two-stage stratified random sampling procedure, 1147 employees were identified from 46 companies in Okayama in 2007. Workplace social capital was measured based on two components; trust and reciprocity. Company-level social capital was based on aggregating employee responses and calculating the proportion of workers reporting mistrust and lack of reciprocity. Multilevel logistic regression analysis was conducted using Markov Chain Monte Carlo methods to explore whether individual- and company-level mistrust and lack of reciprocity were associated with poor self-rated health. Odds ratios (ORs) and 95% credible intervals (as) for poor health were obtained for each variable. Workers reporting individual-level mistrust and lack of reciprocity had approximately double the odds of poor health even after controlling for sex, age, occupation, educational attainment, smoking, alcohol use, physical activity, body mass index, and chronic diseases. While we found some suggestion of a contextual association between company-level mistrust and poor health, no association was found between company-level lack of reciprocity and health. Despite the thorough examination of cross-level interaction terms between company-level social capital and individual characteristics, no clear patterns were observed. Individual perceptions of mistrust and lack of reciprocity at work have adverse effects on self-rated health among Japanese workers. Although the present study possibly suggests the contextual effect of workplace mistrust on workers' health, the contextual effect of workplace lack of reciprocity was not supported. (C) 2010 Elsevier Ltd. All rights reserved.

DOI： 10.1016/j.socscimed.2010.01.014

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

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

Environmental Research 110 ( 1 ) 40 - 46 2010.1

Language：English Publishing type：Research paper (scientific journal) Publisher：ACADEMIC PRESS INC ELSEVIER SCIENCE

Recent studies suggest potential adverse effects of methylmercury exposure on cardiovascular disease, although the evidence of association with hypertension is still inconsistent. Therefore, we evaluated the effects of methylmercury exposure on hypertension in Minamata. We used data derived from the 1971 population-based survey in Minamata and neighboring communities. We also utilized data on hair mercury content of the participants (derived from a 1960 investigation). We adopted two exposure indices (residential area and hair mercury content) and two hypertension outcomes (past history of hypertension and hypertension defined by measurements in the examination). Then, we estimated the adjusted prevalence odds ratio (POR) and its confidence interval (CI) of both hypertension outcomes in relation to residential area and hair mercury content. In the Minamata area (high exposure area), 87% (833) of the eligible population (aged >= 10 years) participated in the 1971 investigations. In the Goshonoura area (middle exposure area) and the Ariake area (low exposure area), 93% (1450) and 77% (755), respectively, of the eligible population participated. Compared with subjects in the Ariake area, the subjects in the Minamata area manifested hypertension more frequently, and PORs observed for two hypertension outcomes were 1.6 (95% CI: 1.2-2.1) and 1.4 (95% CI: 1.1-1.9), respectively. Furthermore, dose-response trends with hair mercury content were observed for both hypertension outcomes. The present finding supports the causal relationship between methylmercury exposure and hypertension. (C) 2009 Elsevier Inc. All rights reserved.

DOI： 10.1016/j.envres.2009.10.011

Green Tea Consumption and Mortality among Japanese Elderly People: The Prospective Shizuoka Elderly Cohort Reviewed

Etsuji Suzuki, Takashi Yorifuji, Soshi Takao, Hirokazu Komatsu, Masumi Sugiyama, Toshiki Ohta, Kazuko Ishikawa-Takata, Hiroyuki Doi

ANNALS OF EPIDEMIOLOGY 19 ( 10 ) 732 - 739 2009.10

Language：English Publishing type：Research paper (scientific journal) Publisher：ELSEVIER SCIENCE INC

PURPOSE: To investigate the association between green tea consumption and mortality from all causes, cancer, and cardiovascular disease (CVD) among elderly people.METHODS: In a population-based, prospective cohort study, a total of 14,001 elderly residents (aged 65-84 years), randomly chosen from all 74 municipalities in Shizuoka, Japan, completed questionnaires that included items about frequency of green tea consumption. They were followed for up to 6 years, from December 1999 to March 2006. Consequently, 12,251 subjects were analyzed to estimate the hazard ratios (HRs) for all-cause mortality, cancer, and CVD.RESULTS: Among 64,002 person-years, 1,224 deaths were identified (follow-up rate, 71.6%). The multivariate HRs and 95% confidence intervals (CIs) for CVD mortality compared those who consumed seven or more cups per day with those who consumed less than one cup per day, were 0.24 (0.14-0-40), 0.30 (0.15-0.61), and 0.18 (0.08-0.40) for total participants, men, and women, respectively. Although green tea consumption was not inversely associated with cancer mortality, green tea consumption and colorectal cancer mortality were inversely associated with a moderate dose-response relationship.CONCLUSIONS: Green tea consumption is associated with reduced mortality from all causes and CVD. This study also suggests that green tea Could have protective effects against colorectal cancer. Ann Epidemiol 2009; 19:732-739. (C) 2009 Elsevier Inc. All rights reserved.

DOI： 10.1016/j.annepidem.2009.06.003

Sleep duration, sleep quality and cardiovascular disease mortality among the elderly: A population-based cohort study Reviewed

Etsuji Suzuki, Takashi Yorifuji, Kazumune Ueshima, Soshi Takao, Masumi Sugiyama, Toshiki Ohta, Kazuko Ishikawa-Takata, Hiroyuki Doi

PREVENTIVE MEDICINE 49 ( 2-3 ) 135 - 141 2009.8

Language：English Publishing type：Research paper (scientific journal) Publisher：ACADEMIC PRESS INC ELSEVIER SCIENCE

Objective. To investigate the associations between sleep duration and mortality in the elderly by controlling for sleep quality.Method. Data were collected from participants in a cohort study in Shizuoka, Japan. A total of 14,001 elderly residents (aged 65-85 years), randomly chosen from all 74 municipalities in the prefecture. completed questionnaires that evaluated sleep duration, sleep complaints, and the use of hypnotics. Participants were followed from 1999 to 2006. We analyzed 11,395 subjects to estimate the hazard ratios (HR) for mortality from all causes and cardiovascular disease (CVD).Results. With 60,252 person-years, 1004 deaths were identified. While short sleep duration and mortality were not associated, longer sleep duration was associated with higher risk of mortality in both sexes. Compared with those who slept 7 h, the multivariate HR and 95% confidence interval of CVD mortality for those who slept >= 10 h was 1.95 (1.18-3.21) and, for those who slept <= 5 h, it was 1.10 (0.62-1.93). Although no clear association was found between sleep quality and mortality, long sleep duration was associated with higher risk of CVD mortality among those with poor sleep quality.Conclusion. Long sleep duration is associated with higher risk of CVD mortality among the elderly with poor sleep quality. (C) 2009 Elsevier Inc. All rights reserved.

DOI： 10.1016/j.ypmed.2009.06.016

Total Mercury Content in Hair and Neurologic Signs Historic Data From Minamata

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

EPIDEMIOLOGY 20 ( 2 ) 188 - 193 2009.3

Language：English Publishing type：Research paper (scientific journal) Publisher：LIPPINCOTT WILLIAMS & WILKINS

Background: Large-scale methylmercury poisonings have occurred in Japan (Minamata and Niigata) and in Iraq. The current WHO threshold for adult exposure (hair level: 50 mu g/g) was based on evidence from Niigata, which included only acute and severe cases. That study leaves open the possibility of more subtle effects at lower exposure levels.Methods: The Shiranui sea had been contaminated in the 1950s by the discharge of methylmercury from a factory near Minamata.In 1960, the hair mercury content of 1694 residents living on the coastline of the Shiranui sea was measured by researchers from the Kumamoto Prefecture Institute for Health Research. Independently, in 1971, a population-based study to examine neurologic signs was conducted in the Minamata and Goshonoura areas, on the coastline of the Shiranui Sea, and the Ariake area (reference), by researchers at Kumamoto University. We identified 120 residents from exposed areas who were included in both datasets, plus 730 residents of Ariake (an unexposed area) who were also examined for neurologic signs.Results: Hair mercury levels were associated with perioral sensory loss in a dose-response relationship. The adjusted prevalence odds ratios and 95% confidence intervals for perioral sensory loss, compared with the lowest exposure category (0-10 mu g/g), were 4.5 (0.5-44), 9.1 (1.0-83), and 10 (0.9-110), for the dose categories >10 to 20, >20 to 50, and >50 mu g/g, respectively. The prevalence of all neurologic signs was higher in the exposure area than in Ariake.Conclusions: An increased prevalence of neurologic signs, especially perioral sensory loss, was found among residents with hair mercury content below 50 mu g/g.

DOI： 10.1097/EDE.0b013e318190e73f

Impact of Breastfeeding on Body Weight of Preschool Children in a Rural Area of Japan: Population-based Cross-sectional Study Reviewed

Hirokazu Komatsu, Takashi Yorifuji, Toshibide Iwase, Ayako Sasaki, Soshi Takao, Hiroyuki Doi

ACTA MEDICA OKAYAMA 63 ( 1 ) 49 - 55 2009.2

Language：English Publishing type：Research paper (scientific journal) Publisher：OKAYAMA UNIV MED SCHOOL

To investigate the effect of exclusive breastfeeding on the likelihood of Japanese preschool children being overweight, population-based cross-sectional survey data from M town in Japan were used. Using the population registry of this town, all 616 preschool children were identified, and a self-administered questionnaire was sent to their parents. The exposure variable of interest was exclusive breastfeeding from. birth to 6 months, and the outcome variable of interest was the children being overweight at preschool age. Statistical analyses used included logistic regression and sensitivity analyses. In the final analyses, we included 448 preschool children. Although all point estimates indicated a protective effect, logistic regression analyses showed no significant reduction in being overweight due to exclusive breastfeeding in the unadjusted model (odds ratio (OR)= 0.70, 95% confidence intervals: 0.30-1.64), the model adjusted for birth weight (OR = 0.70, 95% CI: 030-1.63), the model adjusted for child lifestyle (OR = 0.71, 95% CI: 0.30-1.67), or the model adjusted for parental factors (OR=0.46, 95% CI: 0.15-1.37). In sensitivity analyses, point estimates were not significant, but a protective effect was observed. In conclusion, our results suggest that breastfeeding might have a protective effect on Japanese preschool children against being overweight, although statistical significance was not observed due to the limitation of the statistical power of the findings.

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

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

The journal of obstetrics and gynaecology research 19 ( 6 ) S195 2008.11

[Utilization, needs, and related factors for e-learning and its application to education and training in occupational safety and health among enterprises in Japan]. Reviewed

Toshiharu Mitsuhashi, Soshi Takao, Akizumi Tsutsumi, Norito Kawakami

Sangyo eiseigaku zasshi = Journal of occupational health 48 ( 5 ) 183 - 91 2006.9

Language：Japanese Publishing type：Research paper (scientific journal)

In order to know utilization, needs, and related factors for e-learning and its application to education and training in occupational safety and health (OSH) among enterprises in Japan, a questionnaire survey was conducted of enterprises randomly selected from those with 1,000 or more employees and those with 999 or less (500 for each). Data from 134 (56 and 78, respectively) enterprises were analyzed (response rate, 13%). Among total enterprises, 19% had introduced and 16% planned to introduce e-learning. However, only 7% of larger enterprises and less than 3% of smaller enterprises used e-learning for education and training in OSH. On the other hand, 80-90% of enterprises responded positively to considering the use of e-learning for education and training on various OSH topics for various users. Highly rated merits of e-learning were "can use whenever", "can use anywhere"; and its highly rated obstacles were "cost", "individual PC not available", "insufficient information on efficacy". However, the merit "can monitor training" was significantly associated with the use/plan of e-learning. "Good contents not available" was more frequent among enterprises which used/planned e-learning. The study indicated a greater need for e-learning based OSH education and training, despite a currently low rate of its use. Improvement of e-learning platforms and contents, reduction of cost, and improvement of e-learning infrastructure at work may be needed to facilitate the use of e-learning in OSH.

職場における管理監督者メンタルヘルス研修前後の知識・態度・行動の変化 Reviewed

西内恭子, 高尾総司, 峰山幸子, 堤明純, 川上憲人

産業衛生学雑誌 46 ( 臨増 ) 323 - 323 2004.3

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