Background: Many previous studies have reported COVID-19 vaccine effectiveness, but there are few studies in Japan. This community-based, retrospective observational study investigated the association between vaccination status and COVID-19-related health outcomes in COVID-19 patients by SARS-CoV-2 variant type.
Methods: The study participants were 24,314 COVID-19 patients aged 12 or older whose diagnoses were reported to the Nara Prefecture Chuwa Public Health Center from April 2021 to March 2022, during periods when the alpha, delta, and omicron variants of COVID-19 were predominant. The outcome variables were severe health consequences (SHC) (i.e., ICU admission and COVID-19-related death), hospitalization, and extension of recovery period. The explanatory variable was vaccination status at least 14 days prior to infection. Covariates included gender, age, population size, the number of risk factors for aggravation, and the number of symptoms at diagnosis. The generalized estimating equations of the multivariable Poisson regression models were used to estimate the adjusted incidence proportion (AIP) and 95% confidence interval (CI) for each health outcome. We performed stratified analyses by SARS-CoV-2 variant type, but the association between vaccination status and COVID-19-related health outcomes was stratified only for the delta and omicron variants due to the small number of vaccinated patients during the alpha variant.
Results: Of the 24,314 participants, 255 (1.0%) had SHC; of the 24,059 participants without SHC, 2,102 (8.7%) were hospitalized; and of the 19,603 participants without SHC, hospitalization, and missing data on recovery period, 2,960 (15.1%) had extension of recovery period. Multivariable Poisson regression models showed that regardless of SARS-CoV-2 variant type or health outcome, those who received two or more vaccine doses had significantly lower risk of health outcomes than those who did not receive the vaccine, and there was a dose-response relationship in which the AIP for health outcomes decreased with an increased number of vaccinations.
Conclusion: A higher number of vaccinations were associated with lower risk of COVID-19-related health outcomes, not only in the delta variant but also in the omicron variant. Our findings suggest that increasing the number of COVID-19 vaccine doses can prevent severe disease and lead to early recovery of patients not requiring hospitalization.
Background: Congenital heart disease (CHD) is one of the most common congenital malformations in humans. Inconsistent results emerged in the existed studies on associations between air pollution and congenital heart disease. The purpose of this study was to evaluate the association of gestational exposure to air pollutants with congenital heart disease, and to explore the critical exposure windows for congenital heart disease.
Methods: The nested case-control study collected birth records and the following health data in Tianjin Women and Children’s Health Center, China. All of the cases of congenital heart disease from 2013 to 2015 were selected matching five healthy controls for each case. Inverse distance weighting was used to estimate individual exposure based on daily air pollution data. Furthermore, the conditional logistic regression with distributed lag non-linear model was performed to identify the association between gestational exposure to air pollution and congenital heart disease.
Results: A total of 8,748 mother-infant pairs were entered into the analysis, of which 1,458 infants suffered from congenital heart disease. For each 10 µg/m3 increase of gestational exposure to PM2.5, the ORs (95% confidence interval, 95%CI) ranged from 1.008 (1.001–1.016) to 1.013 (1.001–1.024) during the 1st–2nd gestation weeks. Similar weak but increased risks of congenital heart disease were associated with O3 exposure during the 1st week and SO2 exposure during 6th–7th weeks in the first trimester, while no significant findings for other air pollutants.
Conclusions: This study highlighted that gestational exposure to PM2.5, O3, and SO2 had lag effects on congenital heart disease. Our results support potential benefits for pregnancy women to the mitigation of air pollution exposure in the early stage, especially when a critical exposure time window of air pollutants may precede heart development.
Background: Weather conditions are a possible contributing factor to age-related macular degeneration (AMD), a leading cause of irreversible loss of vision. The present study evaluated the joint effects of meteorological factors and fine particulate matter (PM2.5) on AMD.
Methods: Data was extracted from a national cross-sectional survey conducted across 10 provinces in rural China. A total of 36,081 participants aged 40 and older were recruited. AMD was diagnosed clinically by slit-lamp ophthalmoscopy, fundus photography, and spectral domain optical coherence tomography (OCT). Meteorological data were calculated by European Centre for Medium-Range Weather Forecasts (ECMWF) reanalysis and were matched to participants’ home addresses by latitude and longitude. Participants’ individual PM2.5 exposure concentrations were calculated by a satellite-based model at a 1-km resolution level. Multivariable-adjusted logistic regression models paired with interaction analysis were performed to investigate the joint effects of meteorological factors and PM2.5 on AMD.
Results: The prevalence of AMD in the study population was 2.6% (95% CI 2.42–2.76%). The average annual PM2.5 level during the study period was 63.1 ± 15.3 µg/m3. A significant positive association was detected between AMD and PM2.5 level, temperature (T), and relative humidity (RH), in both the independent and the combined effect models. For PM2.5, compared with the lowest quartile, the odds ratios (ORs) with 95% confidence intervals (CIs) across increasing quartiles were 0.828 (0.674,1.018), 1.105 (0.799,1.528), and 2.602 (1.516,4.468). Positive associations were observed between AMD and temperature, with ORs (95% CI) of 1.625 (1.059,2.494), 1.619 (1.026,2.553), and 3.276 (1.841,5.830), across increasing quartiles. In the interaction analysis, the estimated relative excess risk due to interaction (RERI) and the attributable proportion (AP) for combined atmospheric pressure and PM2.5 was 0.864 (0.586,1.141) and 1.180 (0.768,1.592), respectively, indicating a synergistic effect between PM2.5 and atmospheric pressure.
Conclusions: This study is among the first to characterize the coordinated effects of meteorological factors and PM2.5 on AMD. The findings warrant further investigation to elucidate the relationship between ambient environment and AMD.
Background: Hand, foot and mouth disease (HFMD) is a serious infectious disease which has become a public health problem. A multi-regional study was conducted in this study to explore the relationship between temperature and HFMD in different regions and the source of heterogeneity, and further detect the effect modifiers such as socio-economic factors, medical and health factors and meteorological factors.
Methods: The data on daily reported HFMD cases and meteorological data from 2010 to 2019 in Chongqing were collected. Thirty-eight districts and counties of Chongqing were divided into 6 regions. The distributed lag nonlinear model (DLNM) was applied to assess the effect of daily mean temperature on HFMD at region level with the pooled effect estimates from multivariate meta-regression model analysis. Stratified analyses by gender, age and children’s type were also conducted. Potential modifiers were considered in meta regression to explore the source of heterogeneity.
Results: There were nonlinear relationships with an inverted V-shape between temperature and HFMD. A maximum cumulative relative risk (CRR) of 1.22 (95% confidence interval (CI): 1.12–1.34) peaked at 23.8 °C, and the risk appeared immediately and lasted for the whole 14 days. Compared with other groups, warm temperature had a stronger effect on children aged 0–1 and scattered children, while cold temperature had a stronger effect on female, children aged 3–6 and childcare children with an M-shape. We found that socio-economic factors, medical health factors and meteorological factors were significantly associated with heterogeneity. Density of medical technical personnel, urbanization rate and density of health care institutions were the main modifiers for explaining heterogeneity of 26.10%, 24.90% and 24.86% respectively which were revealed by meta-analysis.
Conclusions: There was a significant nonlinear correlation between temperature and HFMD. Compared with other groups, children aged 0–1 and scattered children were more susceptible to warm temperature, while female, children aged 3–6 and childcare children were more susceptible to cold temperature. Socio-economic factors, medical health factors and meteorological factors may be the source of the heterogeneity. Therefore, local governments should consider different temperature–HFMD relationships between different regions and populations when formulating appropriate preventive measures.
Background: Existing indicators for the ease of purchasing tobacco did not reflect the actual amount smoked and individual income, and did not assess heated tobacco products (HTPs). This study assessed the percentage of income spent on tobacco, including combustible cigarettes and/or HTPs, at the individual level and its relation to quit intention.
Methods: An internet-based self-reported questionnaire survey was conducted in 2020 as a part of the Japan Society and New Tobacco Internet Survey. A total of 954 smokers aged 15–72 years were analyzed. We calculated the percentage of income spent on tobacco according to income levels. A high percentage implies that tobacco is not easy to purchase. The odds ratios for quit intention according to three categories of percentage of income spent on tobacco (<1%, 1–5%, >5%) were calculated by multivariable logistic regression.
Results: The percentage of income spent on tobacco was higher as income level was lower, especially for dual cigarette and HTP users; the percentages in the lowest/highest income group were 7.1%/1.2% for exclusive combustible cigarette smokers; 6.5%/1.1% for exclusive HTPs users; and 9.2%/1.3% for dual users. The adjusted odds ratios (95% confidence intervals) of quit intention among the >5% of income spent on tobacco group compared with the <1% spent group were 0.43 (0.18–1.03) for exclusive combustible cigarette smokers, 0.71 (0.20–2.54) for exclusive HTPs users, and 0.11 (0.02–0.77) for dual users.
Conclusions: Higher tobacco expenditure was not associated with quit intention for all categories of tobacco product users, probably due to the low price of tobacco in Japan.
Conflict-related environmental damages on health: lessons learned from the past wars and ongoing Russian invasion of Ukraine
Released on J-STAGE: September 02, 2022 | Volume 27 Pages 35
Kouji H. Harada, Sani Rachman Soleman, Jeremy Sea Meng Ang, Antoine P. Trzcinski
Effects of forest environment (Shinrin-yoku/Forest bathing) on health promotion and disease prevention —the Establishment of “Forest Medicine”—
Released on J-STAGE: November 01, 2022 | Volume 27 Pages 43
Qing Li
Efficacy of personal protective equipment to prevent environmental infection of COVID-19 among healthcare workers: a systematic review
Released on J-STAGE: January 07, 2023 | Volume 28 Pages 1
Sani Rachman Soleman, Zhaoqing Lyu, Takuya Okada, Mariko Harada Sassa, Yukiko Fujii, Manal A.M. Mahmoud, Daniel K Ebner, Kouji H. Harada
The spread of heated tobacco product (HTP) use across various subgroups during 2015–16 and 2017–18 in Japan
Released on J-STAGE: January 18, 2023 | Volume 28 Pages 5
Ai Hori, Takahiro Tabuchi, Naoki Kunugita