Journal of Epidemiology
Online ISSN : 1349-9092
Print ISSN : 0917-5040
ISSN-L : 0917-5040
Volume 29, Issue 12
Displaying 1-7 of 7 articles from this issue
Original Article
  • Akio Yagi, Shinya Hayasaka, Toshiyuki Ojima, Yuri Sasaki, Taishi Tsuji ...
    2019 Volume 29 Issue 12 Pages 451-456
    Published: December 05, 2019
    Released on J-STAGE: December 05, 2019
    Advance online publication: October 27, 2018
    Supplementary material

    Background: While bathing styles vary among countries, most Japanese people prefer tub bathing to showers and saunas. However, few studies have examined the relationship between tub bathing and health outcomes. Accordingly, in this prospective cohort study, we investigated the association between tub bathing frequency and the onset of functional disability among older people in Japan.

    Methods: We used data from the Japan Gerontological Evaluation Study (JAGES). The baseline survey was conducted from August 2010 through January 2012 and enrolled 13,786 community-dwelling older people (6,482 men and 7,304 women) independent in activities of daily living. During a 3-year observation period, the onset of functional disability, identified by new certification for need of Long-Term Care Insurance, was recorded. Tub bathing frequencies in summer and winter at baseline were divided into three groups: low frequency (0–2 times/week), moderate frequency (3–6 times/week), and high frequency (≥7 times/week). We estimated the risks of functional disability in each group using a multivariate Cox proportional hazards model.

    Results: Functional disability was observed in a total of 1,203 cases (8.7%). Compared with the low-frequency group and after adjustment for 14 potential confounders, the hazard ratios of the moderate- and high-frequency groups were 0.91 (95% confidence interval [CI], 0.75–1.10) and 0.72 (95% CI, 0.60–0.85) for summer and 0.90 (95% CI, 0.76–1.07) and 0.71 (95% CI, 0.60–0.84) for winter.

    Conclusion: High tub bathing frequency is associated with lower onset of functional disability. Therefore, tub bathing might be beneficial for older people’s health.

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  • Atsushi Hozawa, Takumi Hirata, Hiroshi Yatsuya, Yoshitaka Murakami, Sh ...
    2019 Volume 29 Issue 12 Pages 457-463
    Published: December 05, 2019
    Released on J-STAGE: December 05, 2019
    Advance online publication: November 03, 2018
    Supplementary material

    Background: We sought to investigate the optimal values of BMI for the lowest risk of all-cause death and whether the optimal BMI differs according to smoking status in large-scale pooled analysis of 13 Japanese cohorts.

    Methods: Data from 179,987 participants of 13 well-qualified cohort studies conducted throughout Japan were used for our analysis. A cohort-stratified Cox proportional hazard model was used. P values for interactions were calculated based on the cross product of BMI and age, sex, or smoking status.

    Results: In the entire study population, all-cause mortality risk was lowest when the BMI was 22.0–24.9 kg/m2. This was also the case for selected healthy participants (never smoked, baseline total cholesterol level ≥4.1 mmol/L; the first 5 years of follow-up data were excluded). No effect modification of age, sex, or smoking status was observed. Regardless of their BMI, never smokers always had a lower all-cause mortality risk than did current smokers even with an ideal BMI in terms of mortality risk.

    Conclusion: A BMI of 22–24.9 kg/m2 correlated with the lowest risk of mortality, regardless of whether all participants or selected healthy participants were analyzed. The fact that smoking was more strongly associated with mortality than obesity emphasizes the urgency for effective anti-smoking programs.

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  • Truong-Minh Pham, Tatsuhiko Kubo, Yoshihisa Fujino, Naohiro Fujimoto, ...
    2019 Volume 29 Issue 12 Pages 464-470
    Published: December 05, 2019
    Released on J-STAGE: December 05, 2019
    Advance online publication: November 24, 2018

    Background: In the present study, we examined the trends of premature mortality due to kidney and bladder cancers among the Japanese population from 1980 through 2010.

    Methods: Mortality data were obtained from the World Health Organization mortality database. Years of life lost (YLL) was estimated using Japanese life tables. Average lifespan shortened (ALSS) was calculated and defined as the ratio of years of life lost relative to the expected lifespan.

    Results: Over the study period, the age-standardized rates to the World Standard Population for deaths from kidney and bladder cancers were stable. The average years of life lost (AYLL) measure shows decreases of about 4 and 6 years of life for kidney cancer in men and women, respectively, and decreases of about 2 years of life for bladder cancer in both sexes. The ALSS shows that patients with kidney cancer lost 21.0% and 24.7% of their lifespan among men and women in 1980, whereas respective losses were 15.3% and 15.8% in 2010. Also, patients with bladder cancer on average lost 13.5% in men and 14.2% in women in 1980 and 10.8% in men and 11.1% in women in 2010.

    Conclusions: Our study shows favorable trends in premature mortality for kidney and bladder cancers in Japan over a 30-year period; however, patients with bladder cancer on average lost a smaller proportion of their lifespan compared to those with kidney cancer. The development of a novel ALSS measure is convenient in examination of the burden of premature mortality over time.

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  • Takehiro Michikawa, Kayo Ueda, Akinori Takami, Seiji Sugata, Ayako Yos ...
    2019 Volume 29 Issue 12 Pages 471-477
    Published: December 05, 2019
    Released on J-STAGE: December 05, 2019
    Advance online publication: October 27, 2018
    Supplementary material

    Background: From around 2012, the use of automated equipment for fine particulate matter (PM2.5) measurement with equivalence to a reference method has become popular nationwide in Japan. This enabled us to perform a national health effect assessment employing PM2.5 concentrations based on the standardized measurement method. We evaluated the association between non-accidental mortality and short-term exposure to PM2.5 and coarse particulate matter (PM), with the latter estimated as the difference between suspended particulate matter and PM2.5, for the fiscal years 2012–2014.

    Methods: This was a time-stratified case-crossover study in 100 highly-populated Japanese cities. Mortality data was obtained from the Ministry of Health, Labour and Welfare. City-specific estimates of PM-mortality association were calculated by applying a conditional logistic regression analysis, and combined with a random-effects meta-analysis.

    Results: The respective averages of daily mean concentration were 14.6 µg/m3 for PM2.5 and 6.4 µg/m3 for coarse PM. A 10 µg/m3 increase in PM2.5 concentrations for the average of the day of death and the previous day was associated with an increase of 1.3% (95% confidence interval (CI), 0.9–1.6%) in total non-accidental mortality. For cause-specific mortality, PM2.5 was positively associated with cardiovascular and respiratory mortality. After adjustment for PM2.5, we observed a 1.4% (95% CI, 0.2–2.6%) increase in total mortality with a 10 µg/m3 increase in coarse PM.

    Conclusion: The study revealed that short-term exposure to PM2.5 had adverse effects on total non-accidental, cardiovascular, and respiratory mortality in Japan. Coarse PM exposure also increased the risk of total mortality.

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  • Mayumi Tsuji, Chihaya Koriyama, Yasuhiro Ishihara, Megumi Yamamoto, Ki ...
    2019 Volume 29 Issue 12 Pages 478-486
    Published: December 05, 2019
    Released on J-STAGE: December 05, 2019
    Advance online publication: January 12, 2019
    Supplementary material

    Background: Metal exposures could possibly affect allergic responses in pregnant women, although no studies have yet shown a clear relationship between the two, and such exposures might also affect the development of allergic diseases in children.

    Methods: We investigated the relationship between metal concentrations in whole blood and immunoglobulin E (IgE; total and specific) in 14,408 pregnant women who participated in the Japan Environment and Children’s Study. The subjects submitted self-administered questionnaires, and blood samples were collected from them twice, specifically, during the first trimester and again during the second/third trimester. Concentrations of the metals Cd, Pb, Hg, Se, and Mn, as well as serum total and allergen-specific IgEs for egg white, house dust-mites (HDM), Japanese cedar pollen (JCP), animal dander, and moth, were measured. Allergen-specific IgE(s) were divided based on concentrations <0.35 or ≥0.35 UA/mL, and the metal levels were divided into quartiles.

    Results: Multivariable logistic regression analysis showed that there was a significant negative correlation between HDM- and animal dander-specific IgEs and Hg and Mn concentrations. Conversely, there was a significant positive relationship between JCP-specific IgE and Hg and Se concentrations.

    Conclusions: Metal exposures may be related to both increases and decreases in allergen-specific IgEs in pregnant women.

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Short Communication
  • Ryota Sakurai, Hisashi Kawai, Hiroyuki Suzuki, Susumu Ogawa, Hunkyung ...
    2019 Volume 29 Issue 12 Pages 487-490
    Published: December 05, 2019
    Released on J-STAGE: December 05, 2019
    Advance online publication: December 08, 2018

    Background: Considering the rate of growth of the older population in several countries, accidental falls in older cyclists are expected to increase. However, the prevalence and correlates of bicycle-related falls (BR-falls) are unknown. The aim of the present study was to explore the characteristics of BR-falls, focusing on the risk factors.

    Methods: Seven-hundred and ninety-one older adults participated in a comprehensive baseline assessment that included questions on bicycle use, BR-falls, lifestyle, and physical and cognitive evaluations. A cyclist was defined as a person who cycled at least a few times per month. The incidence of BR-falls in participants who did not report BR-falls at baseline was again ascertained 3 years later. Logistic regression analyses examined the predictors of BR-falls incidence.

    Results: At baseline, 395 older adults were cyclists and 45 (11.4%) of them had experienced BR-falls. Adjusted regression analysis showed that slower gait velocity, shorter one-leg standing time, and experience of falls (ie, non-BR-falls) were associated with BR-falls. Among the 214 cyclists who did not report BR-falls at baseline and who participated in both baseline and follow-up assessments, 35 (16.4%) cyclists experienced BR-falls during the 3-year follow-up. Adjusted regression analysis revealed that higher body mass index and non-BR-falls were predictors of future incidence of BR-falls, independent of physical function.

    Conclusions: Our results showed that experience of falls, irrespective of bicycling, is an independent correlate and risk factor of BR-falls. This suggests that experience of falls and BR-falls may share the same risk factors.

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