A case control study on male primary hepatocellular carcinoma(HCC) and hepatitis B or C virus and some potential risk factors, e.g. blood transfusion, aldehyde dehydrogenase 2(ALDH2) genotype and drinking habits, was performed using two controls, i.e. a hospital control(HC) and a community control(CC) in Fukuoka and Saga Prefectures. Cases were obtained from the Second Department of Internal Medicine, Kurume University Hospital. The HCs were obtained from inpatients of two general hospitals in Kurume and the CCs were randomly sampled from the Kurume citizens being matched with age and sex to each case. Based on the HCs, odds ratios(ORs) of developing male HCC were statistically significant due to HBsAg or anti-HCV antibody positive status. Some discrepancies were observed between the two controls, i.e. higher proportions of past histories of diabetes or hypertension, of ALDH2 typical homozygote(ALDH21/ALDH21), and of heavy drinkers among the HCs, suggesting slight deviation of the HCs from the CCs in alcohol related aspects. Although ORs regarding accumulated amount of alcohol intake by age 40 based on the HCs were insignificant, two of the three corresponding ORs based on the CCs were statistically significant. Judging from alcohol related aspects between the two controls, the ORs for alcohol based on the HCs seems to be underestimated. J Epidemiol, 1998 ; 8 : 1-5.
The importance of the major risk and protective factors for cervical cancer in women by age group was evaluated with the use of data from the Hospital-based Epidemiologic Research Program at Aichi Cancer Center (HERPACC), Japan. This study included 416 cervical cancer cases and 20, 985 referents confirmed as free of cancer. Cases and referents were divided into three age groups: the younger, middle and older age groups (30-44, 45-54 and 55-69 years old, respectively). Logistic model was applied separately to the three groups to estimate odds ratios (ORs) of smoking, beverage and dietary habits with adjustment for marital and reproductive factors. The elevated OR of current smokers was observed consistently in all age groups, while alcohol intake did not show any increased ORs. Dietary control for health lowered ORs for all three age groups, and the effect appeared to be more pronounced among the older age group (OR=0.49, 95% confidence interval: 0.30-0.80). Higher frequency intake of green-yellow vegetables consistently afforded lower ORs among all three age groups. This risk increment of smoking and risk reduction by dietary control were consistent in all age groups. These findings suggested practicable prevention strategy for the cervical cancer by modifying general life style. J Epidemiol, 1998 ; 8 : 6-14.
STUDY OBJECT: to reveal the relationship between regular exercise and physical fitness, life style, mental health, and other cardiovascular risk factors among the Japanese. DESIGN: cross- sectional study. SUBJECTS: Three thousands, one hundred and thirty-two individuals (1, 795 men and 1, 336 women) over 40 years old who were examinees at one of seven centers for health promotion. METHODS: a questionnaire survey on the life style, a physical fitness tests and clinical laboratory tests were performed. RESULTS: Continuing regular exercise was associated with high levels of physical strength and their odds ratio (OR) was 2.09 (95% confidence interval(CI) 1.74 - 2.50). Many individuals in this group had good mental health: the OR for their sensation of fatigue (swift recovery) was 1.40(95%Cl;1.17 - 1.68) and that for mood recovery (fast) was 1.44(95%CI;1.20 - 1.72). Thinness and obesity were scarce in this group. CONCLUSIONS: high physical fitness level, good mental health, standard body weight are more common in regular exercise group. J Epidemiol, 1998 ; 8 : 15-23.
It is difficult to conduct the epidemiological survey with accurate statistical theory in the developing countries due to the problems especially emerged in the developing countries such as no availability of the accurate population data, limitation of the time for survey, geographical obstacle and financial problems. In the consideration of the health needs in those countries, results of the epidemiological survey should be reflected in the present health projects as rapidly as possible. The authors conducted the survey for the immunization coverage of oral poliomyelitis vaccine( OPV) in China by the questionnaire and interview. The data was analyzed by using the Hayashi's quantification theory type 2 and made clear about the relationship between the health behaviors for immunization among residents and several factors. It is considered that this theorem can provide the obvious numeral materials about multi-factorial cause effect relationship for the decision making and is useful for the rapid assessment or initial survey in the developing countries. J Epidemiol, 1998 ; 8 : 24-27.
An epidemiological survey was conducted to clarify the relationship between bone mineral density(BMD) and exercise at 14 health centers in lbaraki Prefecture, Japan from September 1994 through March 1995. More than 5, 000 women participated in this survey. Second metacarpal BMD was measured by CXD(Computed X-ray Densitometry) method. Information about past history of exercise was obtained by questionnaire. *GS/D<2.3(*GS/D : a parameter of BMD) was used to estimate the suspicion of osteoporosis. Data on 5, 124 women aged 40 years and above were analyzed. Subjects were categorized into two groups according to the presence(n=1, 687) or absence(n=3, 437) of past history of regular exercise. ZGS/D values were significantly (ps0.05) higher in women who have had regular exercise in the past than those of the non-exercise group except those aged over 70 years. Ball game, foot sports and gymnastics were the main exercises. When osteoporosis was suspected based on the measurements of bone mineral density, the odds ratio (exercise present/absent) was 0.27 (95% confidence limits: 0.08-0.94), 0.82(0.65_??_1.04), 0.78 (0.61_??_ 0.99), and 1.25 (0.67-2.35) at 40 49, 50_??_59, 60_??_69, and over 70 years, respectively. The results of the present study suggest the beneficial influence of exercise on bone mineral density and its utility for preventing osteoporosis. J Epidemiol, 1998 ; 8 : 28-32.
On the night of June 27, 1994, about 12 liters of sarin were released by terrorists in Matsumoto City, Japan. In order to investigate the epidemic, community-based questionnaire surveys were conducted. The subjects were all inhabitants (2052 people) living and staying in an area of 1050 meters from north to south and 850 meters from east to west including the sarin release site. Participants included 1743 people who answered the questionnaire at the first survey; those with symptoms were contacted for follow-up at four months and one year after the episode. The number of sarin victims were 471 persons. Muscarinic signs were common to all victims; nicotinic signs were only seen in severely affected victims. The geographical distribution of sarin victims was closely related to the direction of the wind. Three weeks after the intoxication, 129 victims still had some symptoms such as dysesthesia of the extremities. At that time, many victims had begun to experience asthenopia, which was even more frequent at four months. Although victims who felt sarin-related symptoms had decreased by a year, some still had symptoms such as asthenopia. Sarin released in a suburban area affected approximately 500 inhabitants living nearby; some still had symptoms a year after the intoxication. J Epidemiol, 1998; 8 : 33-41.
Background: Many studies indicated that smokers have poor health habits such as high alcohol consumption and imbalanced nutrient intakes. These habits could affect the health- related behavior of smokers' families. Methods: To investigate the relationship between an individual's health-related behavior (nutrient intakes and participation in cancer screening) and their spouses' smoking status, we analyzed data collected using a self-administered questionnaire during a cohort study. We compared nutrient intakes and cancer screening participation rates between subjects grouped according to their spouses' smoking status, using a multivariate linear regression model to adjust for each subject's age and alcohol consumption. Results: There was an association between husbands' and wives' smoking status (never and current only). Poor micronutrient intakes and cancer screening participation rates were associated with both the subjects' and their spouses' smoking habits. This tendency was most apparent among male smokers and nonsmoking women. However, among nonsmoking men and female smokers, there were no statistically significant differences between groups classified according to their spouses' smoking status. Conclusion: Spouses' smoking habits were associated with poor health-related behavior in their partners. J Epidemiol, 1998; 8 : 42-46.
This retrospective cohort study describes the mortality pattern after retirement and examines associations of the last job position and work status immediately after retirement with the mortality for male employees who retired from Kochi prefectural government. The subjects include 514 retirees over the 1977-1981 period, who were followed for 9.8 years after retirement, and 721 retirees over the 1982-1986 period, who were followed for 5.8-9.8 years. All subjects were hypothesized to have retired at a normal retirement age. Mortality risk was stable through the follow-up period subdivided into two-year intervals in both cohorts of retirees. In both cohorts, men who did not work immediately after retirement had increased mortality within the first two years of retirement compared with those who worked immediately after retirement. This finding is consistent with the mortality pattern explained by health related selection into working after retirement. The present study does not show a meaningful mortality fluctuation over the post-retirement period among male employees of the local government. Lack of information on ages and health status at retirement of individual subjects hampers discussion about causality of observed associations between two study variables concerning pre- and post-retirement characteristics and post-retirement mortality. J Epidemiol, 1998 ; 8 : 47-51.
This paper aimed to explore descriptive epidemiological features of pancreatic cancer in Japan, by examining secular trends in mortality (1950-1995) and incidence rates (1975-1991), and also to discuss background factors possibly ascribable to the recent variation in mortality and incidence rates. The age-adjusted mortality rate (adjusted by the 1985 model population) has increased by approximately 9-fold in both males (from 1.4 to 12.5 per 100, 000 population) and females (from 0.8 to 6.8 per 100, 000 population) between 1950 and 1995. But it began to level off in both sexes since 1985. The age-adjusted incidence rate has remained plateau in both sexes, but likely showed a downward trend since 1988 in females. The older age groups showed the most steep increasing gradient in both age-specific mortality and incidence rates in both sexes, whereas a little or no apparent increase was observed in young age groups. Diagnostic improvement and increased cigarette consumption were believed to be the two major factors contributing to the increased mortality and incidence rates in Japan, but further epidemiological studies will be required to clarify possible background factors for the recent levelling-off of the mortality and incidence rates. J Epidemiol, 1998 ; 8 : 52-59.
This study was conducted to estimate true incidence of the total number of cancer cases and of cancers at selected sites in the population of Aichi Prefecture, Japan, using the degree of completeness of registration (CR). Information on incidence (I ), death (D), and cases first notified via death certificate (DCN) was based on the data from 1976 to 1993. Using this information, CR for each cancer site was calculated by gender and a 3-year period of diagnosis [CR=(1-PDCN I/D)/(1-PDCN), PDCN: proportion of DCN cases]. The true number of incident cases and incidence rates (estimated incidence rate: EIR) were then estimated from the number of cases observed and from CR. CR for all sites of cancer was 62-78 percent in males and 54-72 percent in females, and CR was higher in cancers with low I/D ratios than those with high I/D ratios. Annually, about 2, 500-3, 000 cases in each gender were unreported. The EIR of all sites was estimated at 252-280 in males and 213-207 in females compared with the incidence rates observed (observed Incidence rate: OIR) as 157.0-218.6 in males and 115.3-149.2 in females. OIR was closer to the EIR for cancers with low I/D ratios than those with high I/D ratios. These values are important for planning and evaluating cancer control strategies in the population. J Epidemiol, 1998; 8 : 60-64.
The objective of this study was to determine whether there is an association of mortality with the type of household in elderly people. A cohort of 1, 352 elderly people aged 65 years and over at baseline in October 1992 was followed for 42 months. Follow-up was completed for 1, 266 (93.6%) (172 deceased and 1, 094 alive). From the analysis using the Kaplan-Meier method and the log-rank test, male sex, older age group (75 years and over), no satisfaction with present dwelling, disability, no use of health checks, no practices of daily preventive health promotion, no participation in social activities, and no finding life worth living (no Ikigai)were univariately statistically significantly related to mortality. Furthermore, elderly people living with their spouse only or living alone had higher survival rates than those living with their spouse and children or living with their children, and the curves among the four subclasses of household were significantly different. From the Cox proportional hazards model, living with a spouse only remained as an independent predictor for survival, and living alone was not an increased risk factor for mortality, controlling for sex, age, housing conditions, disability, use of health management, and psychosocial conditions. J Epidemiol, 1998; 8 : 65-72.