Cross-sectional associations between lifestyle and serum lipid levels were examined in 1591 Japanese male office workers aged 35 to 59 years in Osaka, Japan. From multiple linear regression analyses, significant correlates with low-density lipoprotein (LDL) cholesterol, highdensity lipoprotein (HDL) cholesterol, and Log triglyceride levels and the ratio of LDL cholesterol to HDL cholesterol were, in the order of relative importance: BMI, alcohol intake (negative) and age for LDL cholesterol level; BMI (negative), cigarette smoking (negative), alcohol intake, consideration for nutritional balance, hours of brisk walking, hours of walking at an ordinary pace and physical exercise for HDL cholesterol level; BMI, cigarette smoking, consideration for nutritional balance (negative), hours of work (negative), alcohol intake and coffee drinking (negative) for Log triglyceride level; and BMI, alcohol intake (negative), cigarette smoking, consideration for nutritional balance (negative), age, hours of brisk walking (negative) and the frequency of snack intake between meals for the ratio of LDL cholesterol to HDL cholesterol. Our data suggest that obesity, cigarette smoking and snack intake between meals are atherogenic whereas alcohol consumption, consideration for nutritional balance and walking long hours, especially at a brisk pace, are anti-atherogenic in middle-aged Japanese men. J Epidemiol, 2000 ; 10 : 216-225.
The present study describes leisure-time physical activity status and related lifestyle factors in middle-aged Japanese. Data were obtained from 1, 893 (905 men, 988 women) participants aged 40-69 years who had either been selected from a public registry or who had visited a healthcare facility. Subjects responded to a self-administered questionnaire and were interviewed using an assessment method for leisure-time and on-the-job physical activity within the last 12 months by trained interviewers. According to the leisure-time physical activity score, men and urban residents tended to engage in more leisure-time physical activity than did women and rural residents, respectively. Leisure-time physical activity tended to be inversely associated with on-the-job physical activity in all cases aside from women in urban regions, and also to be associated with higher levels of education in rural regions. Subjects engaging in more leisuretime physical activity had higher odds ratios of certain lifestyle factors, indicating a healthy lifestyle that included a variety of foods in their diet and a subjective sense of wellness in both men and women, in addition to non-smoking and drinking milk in men. These results suggested that leisure-time physical activity is influenced by socio-environmental factors, and that it is accompanied by other healthy behavior. J Epidemiol, 2000 ; 10 : 226-233.
Study purpose: To evaluate the effect of interferon treatment for reducing the incidence of hepatocellular carcinoma among patients with type C chronic hepatitis. Methods: Retrospective cohort study was conducted on 923 patients with type C chronic hepatitis, who were identified through databases of Osaka Medical Center for Cancer and Cardiovascular Diseases. Two hundred and twenty-four of those had undergone interferon treatment, while the other 699 patients had not. Kaplan-Meier method and the proportional hazards model were used for statistical analysis. Results: Five-years' cumulative incidence of hepatocellular carcinoma was 2.2% among the interferon treated patients, while 9.5% among the interferon untreated. Difference between the 2 curves of the cumulative incidence was statistically significant (p=0.0015). After adjustment for possible confounders, hazard rate ratio of hepatocellular carcinoma was 0.31 in the interferon treated group, significantly lower than that in the untreated (p=0.015). Hazard rate ratio for death from causes other than hepatocellular carcinoma and liver diseases was also lower among the interferon treated group than that among the untreated, although not significant. Conclusions: Interferon treatment is suggested to reduce the risk of hepatocellular carcinoma among patients with type C chronic hepatitis, and not to increase the risk for death from causes other than hepatocellular carcinoma and liver diseases. J Epidemiol, 2000 ; 10 : 234-240.
In order to evaluate the characteristics of fatigue symptoms and their association with the life style and the health status, we examined using data accumulated by the longitudinal surveys from 1992 to 1998, in 118 six-year primary school children and 129 second-year junior high school children. The complaints of “Drowsiness and dullness”, such as “Become drowsy” (71 %), “Give a yawn”(59%) and “ Want to lie down”(51 %), respectively, were most frequently observed. The proportion of these complaints was high before the first morning class, but decreased when the children leave school. Notably, the complaints of “Difficulty in concentration” annually have increased. Children with undesirable eating habits, particularly those who often eat salty foods, or poor life style, such as staying up late at night tended to have more complaints of fatigue symptoms. By correlation analysis, these complaints were significantly related to the obesity degree, blood pressure, HDL cholesterol and atherogenic index. These results support the hypothesis that fatigue symptoms increase or are associated with life style and health status. Consequently, it is necessary to improve the life style such as dietary habits and rhythm of life for the reduction of fatigue symptom. J Epidemiol, 2000 ; 10 : 241-248.
We observed functional transitions in instrumental activities of daily living (IADL) over one year among older Japanese and examined factors influencing the deterioration of each IADL. The sources of the study were the first and second panel studies of the Saku Longitudinal Study on Aging, which were done in 1988 and 1989. The study subjects were those participants aged 70 or older. Five IADL items using public transportation, shopping for daily necessities, preparing meals, paying bills, and managing deposits were measured in each survey. Deterioration of each IADL item was examined in relation to demographic characteristics such as age, sex, occupational status, living arrangements, and educational status. Of the effective baseline cohort (n = 5, 559), 4, 892 responded in the second survey (response rate 88%). Over 80% of the respondents who were initially independent in each IADL item remained independent in the second survey. Multiple logistic regression analyses revealed that greater age, having no occupation, and living with children at the baseline were associated with deterioration in each item of IADL. Lower educational status was associated with deterioration in each item of IADL except preparing meals. This study indicates that being engaged in work, living separately from children, and having higher educational status are strongly correlated with remaining independent in IADL for older people aged 70 or older. J Epidemiol, 2000 ; 10 : 249-254.
A cohort study was conducted to explore the tracking stability of cardiovascular risk factors and relative risk (RR) of factors relating hyperlipidemia in children. The percentages of children remaining persistently at high risk over a four-year tracking were as follows: body mass index (BMI) 65.0%, total cholesterol (T-c) 60.6%, atherogenic index (Al) 56.4%, high density lipoprotein cholesterol (HDL-c) 50.7%, systolic blood pressure (SBP) 44.2% and diastolic blood pressure (DPB) 39.6%. The order of correlation coefficients over four years was BMI > Al > HDL-c > T-c > SBP > DBP and these coefficients in boys were slightly higher than those in girls. The relative risk (RR) of BMI for Al 3 was elevated (RR=4.36, 95%Cl: 1.3-14.1). The incidence and RR for Al 3 increased along with the addition of the selected risk factor number. The RR in children with three selected risk factors rose to 8.39 (95% Cl: 1.2-38.7 ). The stability of tracking was better for BMI, T-c, Al and HDL-c. As the number of multiple factors increased, so did the RR of higher Al in childhood. These results suggest that preventive activities for hyperlipidemia should be focused on children with multiple cardiovascular risk factors. J Epidemiol, 2000 ; 10 : 255-261.
A national survey of polychlorinated dibenzo-p-dioxins (PCDD) and dibenzofurans (PCDF) in emission gases from the municipal waste incinerators in 1997 revealed that the Nose Bika Center was heavily contaminated by PCDF. Ninety-four workers underwent a physical examination, and blood biochemistry, lymphocyte marker, and NK activity studies were carried out, along with blood dioxin measurements. Information on working history, life-style, and dietary habits was obtained by questionnaire and interview. The blood dioxin levels were as follows. The median TEQ of dioxins was 39.7 pg I-TEQ/g lipid, and the range was 13.3 to 805.8. The median 2, 3, 7, 8-TCDD concentration was 3.9 pg TEQ/g lipid, and the range was <1 pg TEQ/g lipid (one case) to 13.4 pg TEQ/g lipid. The median TEQ of coplanar PCB was 10.8 pg I-TEQ/g lipid, and the range was 3.1 to 54.2 pg TEQ/g lipid. The congener-specific distribution was quite similar to that in soil around incinerator and waste in the factory. The relationship between dioxin concentrations and work history in the factory showed that the fluidized incinerator and fly ash treatment areas were high-risk work areas. Correlation analyses between body burden, PCDD/PCDF TEQ, Co-PCB TEQ and various laboratory data showed significant positive correlations between dioxin levels and GGT, total protein, uric acid and calcium, and a negative correlation with Fe. However, these correlations disappeared as a result of multivariate analysis adjusted for age, smoking status, and alcohol drinking. Increased NK activity and lower response to PHA stimulation remained significant even after adjusting for age. History of hyperlipidemia and allergy had significantly increased odds ratios. A study on the risk to other workers in the same type of incinerators is under way. Health effects of chronic exposure mainly to PCDF will be clarified by follow-up. J Epidemiol, 2000 ; 10 : 262-270.
To investigate the psychological characteristics of smoking and tobacco dependence, a questionnaire survey was conducted of 2, 051 consenting adults aged 21 to 65 years from the total population of a town in Akita Prefecture. Valid responses were received from 673 men and 818 women, for a total of 1, 491 (72.7%). The questionnaires used were a tobacco dependence questionnaire, a personality questionnaire (the NEO Five-Factor Inventory: NEO-FFI), the WHO Subjective Well-being Inventory (SUBI), and the 12-Item General Health Questionnaire (GHQ-12). Subjects who responded that they had smoked daily for more than one month before the day of the survey were considered smokers. There were 400 male (59.8%) and 39 female (4.8%) smokers. Both male and female smokers were more extroverted than nonsmokers. Among smokers, there were 166 (41.5%) men and 19 (49%) women diagnosed as having a tobacco dependence of ICD-10. Among men, dependent smokers had a significantly higher score for Openness of the NEO-FFI and a lower score for Perceived III Health on the SUBI than nondependent smokers. Among smokers, 128 (32.0%) men and 13 (33%) women met the ICD-10 criteria for tobacco withdrawal. Among male smokers, those with tobacco withdrawal had a significantly higher score for Neuroticism and Openness on the NEO-FFI and a lower score for Negative Affect on the SUBI than those with no withdrawal. These results suggest that there is a relationship between tobacco dependence and personality or negative emotions. J Epidemiol, 2000 ; 10 : 271-279.
In eastern Indonesia, malaria control activities mainly depend on residual spraying but the situation is almost unchanged since the past decade. Understanding the socioeconomic and human behavior determinants is needed to implement an effective malaria control in accordance with the local condition and development. Hence we conducted an unmatched case control study. Two hundred samples were recruited from all, 11 villages surrounding the centre in Bacan island, Maluku. For children aged 0 to 15 years old, the association of socioeconomic determinants: crowding and poor type of houses with malaria remained significant in the multivariate analysis. Meanwhile for persons above 15 years old, younger persons and regular going outside at night remained significant in the multivariate analysis. And for persons above 15 years old, a higher proportion of controls (14%) than cases (4%) slept under mosquito net regularly. The Indonesia Family Program should be promoted. There was a better quality of life in small family. For persons above 15 years old, going outside at night should be discouraged because exposed to mosquito bites. The malaria control strategy use of effective personal, regular use of mosquito net could be used as a completion for the present activities. Considering the low malaria knowledge among samples, inhabitants should be enhanced the malaria knowledge on causation, transmission, prevention and to provide proper knowledge on residual spraying. J Epidemiol, 2000 ; 10 : 280-289.