To examine the effectiveness of self-screening and self-educational materials of a brief alcohol intervention among working men. The research was conducted by a prospective cohort design with cluster sampling controls in a work place. A total 100 men who had consumed more than 60g of alcohol at least once in the past year and responded to the initial survey. They were allocated into an intervention group (n= 54) and a control group (n=46) by the location of working sites. After the initial survey with self-screening for alcohol use disorders, an intervention group received two kinds of simple self-educational leaflet. One was a knowledge about appropriate drinking, and the other was a work-sheet of target- behavior setting and self- monitoring. A control group was conducted only survey with the self-screening. The two groups were followed up at 1 month and 6 month later with the questionnaire. Main measurements were AUDIT score and the ratios of at-risk drinking (AUDIT≧8), hazardous drinking (AUDIT≧12), and weekly heavy drinking (pure alcohol ≧200 g / week). The collected data were assessed by intention to treat analysis. At 6 months, the ratio of hazardous drinking and the AUDIT score were significantly decreased in the intervention group. In the control group, these were not changed. Our findings indicate that self-screening and information of brief alcohol interven tion were effective on hazardous drinking reduction in the working men. It suggests that self-educational materials distribution have some potential to improve alcohol drinking behaviors.
In this article, we examined the development of a model for “karoshi” (death by cerebrovascular and cardiovascular diseases due to overwork) in terms of sleep architecture. The normal sleep architecture mainly consists of slow wave sleep (SWS) and rapid eye movement (REM) sleep which result in different time courses and functions. Slow wave sleep is associated with homeostatic regulation, and on the other hand, distribution of REM sleep is entrained by the circadian rhythm. In the normal sleep, the absolute amount of REM sleep is much higher than that of SWS. When working hours are prolonged and prior wakefulness duration increases, SWS pressure is estimated to simultaneously rise and then the amount of REM sleep will decrease and REM sleep pressure will be much higher. After that, REM latency could result in premature sleep-onset REM periods (SOREMPs). In this condition, homeostatic regulation in SWS and circadian regulation in REM sleep will be changed under further allostatic regulation (McEwen;1998). Therefore, we may hypothesize that if allostatic load continually repeats over time, then sympathetic nerves system activity during REM sleep will be elevated. This may result in increased brain and cardiovascular loads that will lead to a prodromal stage of karoshi.