Objectives: The purpose of this review is to summarize the current evidence on the economic impact of corporate wellness programs (CWPs) in Europe from the results of randomized controlled trials (RCTs) published up to 2013. Methods: A review was undertaken by searching for RCTs with key words in the following databases: PubMed, SPORT-Discus, and Business Source Premier. Only RCTs that evaluated the economic impact of CWPs, and included analyses performed in Europe with results converted into monetary values, were eligible for inclusion. An approach to economic analyses from both an employer's perspective and a societal perspective was also undertaken. Results: Eleven RCTs were identified, and review of these studies determined that the economic impact of the majority of CWPs analyzed was mostly negative. We discuss a possible explanation for these discrepancies with regard to prior reviews in this area. Despite the fact that the RCT is the “gold standard” for investigating without bias, several limitations to the methodology may have influenced the results of the studies in this review and suggested the use of caution in the interpretation of the results. Conclusions: The findings of this review could be a “wake up call” for companies regarding the high probability of bias from non-RCT studies, the majority of which report a positive economic impact of these programs, and the risk of taking inappropriate decisions based on the results of such studies.(J Occup Health 2015; 57: 201–211)
Objectives: The aim of this study was to identify whether arsenic (As) exposure could induce hippocampal neural apoptosis in vivo. Methods: Sixty-four mice were randomly divided into 4 groups of 16 each. Group 1 orally received drinking water alone as a control. Groups 2–4 were given arsenic trioxide (As2O3) orally at the doses of 1 ppm, 2 ppm and 4 ppm, respectively. All the treatments continued for 60 days. Morphological changes in the hippocampus were observed by HE staining. Apoptosis in the hippocampus was examined by TUNEL assay and transmission electron microscopy. The expression levels of Bcl-2 and Bax genes and their proteins in the hippocampus were determined by real-time PCR and Western blotting. The activity of caspase-3 was determined by spectrophotometry. Results: Abnormal histopathological changes and apoptosis were found in the hippocampus of As-exposed mice. The expressions of the Bcl-2 gene and its protein in the hippocampus of As-exposed mice were significantly lower than those in the control group (p<0.05). However, the expressions of the Bax gene and its protein, and the expression ratio of Bax/Bcl-2 in the hippocampus were significantly higher in the groups exposed to As than in the control group (p<0.05). Moreover, the activity of caspase-3 in the hippocampus of mice exposed to As was higher than that in the control (p<0.05). Conclusions: These results indicate that subchronic exposure to As induces apoptosis in the hippocampus of mice by disturbing normal Bax/Bcl-2 regulatory pathways. Meanwhile, it is suggested that the induced apoptosis in the hippocampus may be at least partly responsible for As-induced neurotoxicity.(J Occup Health 2015; 57: 212–221)
Objective: This study attempted to use the community health survey (CHS) to identify the effect of long working hours (long WHs) and night/shift work on suicidal ideation among the employed population of Korea. Methods: This study used data from 67,471 subjects who were administered the 2008 CHS which obtained information regarding sociodemographic characteristics, health behaviors and working environment, using structured questionnaires and personal interviews. We adopted multiple logistic regression models for gender and employment stratification. Results: Among male employees, suicidal ideation was significantly associated with only moderately long WHs (51–60 hours), after controlling covariates (adjusted odds ratio [aOR], 1.30; 95% confidence interval [95%CI], 1.07 to 1.57). Self-employed/male employer populations had higher suicidal ideation when they had moderately long WHs (aOR, 1.23; 95%CI, 1.01 to 1.50) and very long WHs (over 60 hours) (aOR, 1.31; 95%CI, 1.08 to 1.59). Among the female population, suicidal ideation was significantly association with moderately long WHs in the employee group (aOR, 1.31; 95%CI, 1.08 to 1.58) and moderately (aOR, 1.35; 95%CI, 1.08 to 1.69) and very (aOR, 1.33; 95%CI, 1.07 to 1.65) long WHs in the self-employed/employer group. Shift work was a significant predictor only in the female population in the employee groups (aOR, 1.45; 95%CI, 1.23 to 1.70). Conclusions: Long WHs and shift work were associated with suicidal ideation when taking into account gender and employment differences. The harmful effects of exceptionally long WHs in Korea, among other Organization for Economic Co-operation and Development (OECD) countries, raise concerns about public and occupational health. To address the issue of long WHs, labor policies that reduce maximum working hours and facilitate job stability are needed.(J Occup Health 2015; 57: 222–229)
Objectives: We conducted a retrospective cohort study to examine the risk of bile duct cancer among current and former workers in the offset color proof printing department at a printing company in Osaka, Japan. Methods: Standardized incidence ratios (SIRs) between January 1, 1985, and December 31, 2012, were estimated for the cumulative years of exposure to two chemicals, dichloromethane (DCM) and 1,2-dichloropropane (1,2-DCP), using the national incidence level as a reference. In addition, we examined risk patterns by the calendar year in which observation started. Results: Among 106 workers with a total of 1,452.4 person-years of exposure, 17 bile duct cancer cases were observed, resulting in an estimated overall SIR of 1,132.5 (95% confidence interval (CI): 659.7–1,813.2). The SIR was 1,319.9 (95% CI: 658.9–2,361.7) for those who were exposed to both DCM and 1,2-DCP, and it was 1,002.8 (95% CI: 368.0–2,182.8) for those exposed to 1,2-DCP only. SIRs tended to increase according to years of exposure to 1,2-DCP but not DCM when a 5-year lag time was assumed. The SIRs were higher for the cohorts in which observation started in 1993–2000, particularly in cohorts in which it started in 1996–1999, compared with those in which it started before or after 1993–2000. Conclusions: We observed an extraordinarily high risk of bile duct cancer among the offset color proof printing workers. Elevated risk may be related to cumulative exposure to 1,2-DCP, but there remains some possibility that a portion of the risk is due to other unidentified substances.(J Occup Health 2015; 57: 230–236)
Objective: The aim of this study was to clarify whether there are differences in the circadian rhythms of shift-working nurses by assessing depression, fatigue and salivary cortisol levels. Methods: Forty nurses working in a two-shift system at “Hospital A”, Fukuoka City, Japan, used a self-rated depression scale (SDS) to assess their depression levels. Fatigue levels were measured with the visual analogue scale for fatigue (VAS-F); saliva was collected before and during shifts for three days. Results were analyzed with analysis of variance (ANOVA). Results: Thirty-six valid records were obtained, and subjects were classified according to SDS scores into a normal group (NG), moderate group (MG) and severe group (SG). There were no significant differences in the day shift salivary cortisol values of the three groups. However, the night shift salivary cortisol value for the SG was 0.132 µg/dl at 16:00, before starting the shift, and decreased to 0.036 µg/dl at 20:00. It increased slightly up to 0.057 µg/dl by 24:00 and formed a peak between 5:00 and 7:00, with the levels being 0.322 µg/dl and 0.305 µg/dl respectively. Meanwhile, the NG cortisol value was 0.154 µg/dl before the shift, decreased to 0.034 µg/dl by 20:00, slightly increased up to 0.093 µg/dl by 5:00 and presented its peak value, 0.253 µg/dl, at 7:00 next morning. Conclusions: SG nurses presented significantly increased salivary cortisol levels early in the morning during night shifts, showing a phase deviation in the circadian rhythm. Because subjective fatigue levels did not differ with time, SG nurses should understand and deal with physical changes in the early morning. This approach may reduce medical accidents and malpractice in the early morning.(J Occup Health 2015; 57: 237–244)
Objective: In several Japanese printing plants, printing workers have suffered from cholangiocarcinoma. 1,2-dichloropropane (1,2-DCP) is considered to be a causative agent, and whether or not other chemicals also contribute to the development of this disease has not been conclusively determined. This study aimed to identify the chemicals used by seven printing workers who developed cholangiocarcinoma, as well as to estimate the levels of chemical exposure among them. Methods: Information was obtained from the Ministry of Health, Labour and Welfare, Japan, to identify chemicals used by printing workers who developed cholangiocarcinoma and to estimate chemical exposure concentrations. Working environment concentrations of the chemicals in the printing rooms were estimated using a well-mixed model, and exposure concentrations during the ink removal operation were estimated using a near-field and far-field model. Shift time-weighted averages of exposure concentrations were also calculated. Results: Four of the seven printing workers were exposed to both 1,2-DCP and dichloromethane (DCM). The estimated maximum exposure concentrations for each of the four workers were 230 to 420 ppm for 1,2-DCP and 58 to 720 ppm for DCM, and the estimated shift average exposure concentrations were 0 to 210 ppm for 1,2-DCP and 15 to 270 ppm for DCM. The remaining three workers were exposed to DCM but not 1,2-DCP. The estimated maximum exposure concentrations of DCM for each of the three workers were 600 to 1,300 ppm, and the estimated shift average exposure concentrations were 84 to 440 ppm. Conclusions: Our findings suggest that DCM may contribute to the development of cholangiocarcinoma in humans.(J Occup Health 2015; 57: 245–252)
Purpose: The aim of this study was to estimate the prevalence of dry eye disease (DED) in Japanese visual display terminal (VDT) workers and identify simple methods for screening DED during occupational health examinations. Methods: This study involved 369 (331 men and 38 women; mean age, 44.4 [8.8] years) workers engaged in PC development with approximately 6 hours of VDT use daily. The participants completed questionnaires on dry eye and physical symptoms affecting QoL, and their ability to keep their eyes open for 10 seconds was tested for DED screening. They also underwent assessment of conjunctival and corneal vital staining with lissamine green and fluorescein, measurement of tear film breakup time, and Schirmer's test for DED diagnosis. Sensitivity, specificity, and positive predictive value of the screening methods were assessed. Results: The DED group included 218 (definite, 14; probable, 204) participants. They had markedly high frequencies of 11 dry eye symptoms, especially ocular fatigue (OR, 17.1; 95% CI, 9.9 to 29.7) and dry sensation (OR, 8.2; 95% CI, 3.6 to 18.4), and were more often unable to keep their eyes open for 10 s. With either ocular fatigue or dry sensation as the cutoff criterion, the sensitivity, specificity, and positive predictive value were 89.9, 66.9, and 79.7%, respectively. Conclusions: Approximately 60% of the VDT workers were diagnosed with DED on the basis of diverse eye symptoms affecting their ability to work. The dry eye symptom questionnaire and 10-s eye-opening test are simple, noninvasive, and inexpensive methods for screening DED during occupational health examinations.(J Occup Health 2015; 57: 253–258)
Objectives: Although waged workers' working conditions have notably diversified in South Korea, there is little research addressing this issue. This study explores the relationship between working conditions and engagement in leisure-time physical activities (LTPA) among waged workers in South Korea. Methods: Data from 19- to 64-year-old waged workers (men=2,562, women=1,627) from the 11th wave of the Korean Income and Labor Panel Study were included in this study. Multiple logistic regression analyses were conducted to assess the association between LTPA and working conditions by gender. Results: More than 75% of employed persons did not participate in any type of LTPA. For male workers, those in manual, precarious, overtime, and non-shift positions were less likely to engage in LTPA, while for female workers, only manual and overtime work positions were significant factors influencing a low level of LTPA. Conclusions: Some negative work-related factors were associated with low LTPA, especially for male workers. Further studies should be conducted to clarify the pathways and barriers precluding engagement in LTPA due to work-related factors.(J Occup Health 2015; 57: 259–267)
Objectives: The importance of X-rays as a diagnostic medical tool cannot be denied. However, continuous exposure to X-rays can cause DNA damage. This study aimed to use the comet assay technique to investigate the level of DNA damage in lymphocytes due to X-rays in occupationally exposed personnel. Methods: Blood samples were collected from 74 exposed and 70 control subjects for analysis. A total of 100 randomly captured cells from each slide were examined using an epifluorescent microscope. The comets were analyzed by a visual scoring method according to comet tail length. Results: The results indicated a significant increase (p<0.05) in DNA damage in X-rays technicians (129.8 ± 17.2) as compared with the control group (53.0 ± 25.0). A significant increase (p<0.02) in DNA damage was also observed with an increase in exposure duration of technicians because of their service length. Conclusions: The present study suggests that the exposed radiology personnel should carefully comply with radiation protection procedures such as wearing of lead apron during diagnostic procedures and minimize radiation exposure where possible to avoid potential genotoxic effects due to X-rays.(J Occup Health 2015; 57: 268–274)
Background: Many employees working outside are exposed to the harmful effects of UV radiation. A growing problem is also sensitization to textile materials and allergic reactions to active compounds. Groups of inorganic UV blockers with nanoparticles may provide superior properties over organic UV absorbers with relatively less potential of provoking dermatitis. Objectives: To assess acute dermal irritation and sensitization of nano UV absorbers. Materials & Methods: Five UV absorbers with nano-sized particles (Z11, TiO2 − SiO2 [TDPK], TK44, TK11, A8G) and 2 vehicles (paste-based on 10% PEG, and dispersion with 1% HEC) were tested. Acute dermal irritation was tested using group of 3 rabbits for each absorber. The sensitization study was carried out on groups of 15 guinea pigs for each tested textile with a UV absorber showing an Ultraviolet Protection Factor (UPF)>40. This research was designed according to OECD Test Guideline No. 404 and 406, and 21 rabbits and 60 guinea pigs were used in the study. Results: In acute dermal irritation, Z11 and A8G modifiers and the analyzed paste gave results of 0.047 to 0.33 which classifies them as barely perceptible irritants, whereas the other analyzed modifiers and dispersion gave results of 0.00 and were classified as nonirritating. Only the textile with TK 11 did not have UPF>40. The analyzed barrier materials were classified as nonsenitizers (TDPK, A8G) or mild sensitizers (TK44, Z11). Conclusions: None of the analyzed materials or modifiers induced major skin reactions in animals. Therefore, they present low risk of provoking skin reactions in humans.(J Occup Health 2015; 57: 275–284)
Objectives: This study aimed to explore potential risk factors for work-related stress by, detailing working conditions and subjective hardship according to occupational category in health-care staff working with elderly patients. Methods: A cross-sectional descriptive survey was conducted in 105 nursing homes for the elderly in France. Data on nursing home working conditions were collected by occupational physicians. The study population was limited to those in direct contact with the elderly, who were divided into 3 occupational groups defined by qualifications and tasks: housekeepers (HKs), nursing assistants (NAs) and nurses (Ns). Employees answered a questionnaire on their perceived working conditions and vocational training courses. Psychosocial stress was assessed with the Siegrist questionnaire. Results: The subjects included 706 HKs, 1,565 NAs and 378 Ns, and the findings showed confusion of tasks and responsibilities in the study population. Verbal abuse by residents was reported by 60.9% of HKs (versus 76.2% of NAs and 76.7% of Ns, p<0.001). Physical attack by residents was more frequently reported by NAs (59.1%) than Ns (52.8%) or HKs (38.0%) (p<0.001). Nearly 10% of employees reported clear effort/reward imbalance (10.4% of NAs, 9.2% of Ns and 7.0% of HKs, p=0.059). Great hardship related to proximity to death was reported by 40.5% of HKs (versus 37.3% of NAs and 22.6% of Ns; p<0.001). Conclusions: To prevent stress related to insufficient ability, nursing home workers should be encouraged to attend job training courses, which should cover knowledge of the specific care needs of elderly patients and of the authority/responsibility required to do their job.(J Occup Health 2015; 57: 285–296)
Objectives: In the occupational health field, it is important to know how workload influences mental health. Overtime work and job strain appear to affect the mental health status of workers. Sense of coherence (SOC) may mediate the relationship between work stress and mental health. Since SOC represents a personal ability to manage psychological stressors, we hypothesized that a strong SOC would modify the adverse effect of an objective measure of overtime work on mental health. Methods: A total of 1,558 Japanese workers employed in an information technology company were asked to complete a 3-item SOC Questionnaire and 28-item General Health Questionnaire (GHQ) to assess mental health status. Workload was assessed by the actual amount of overtime work hours recorded by the company. Results: Multiple regression analysis revealed a main effect of overtime work (β=0.08, p=0.0003) and SOC scores (β=0.41, p <0.0001) on GHQ scores. There was a tendency toward interaction between overtime work and SOC scores (β=0.05, p=0.051). Simple slope analysis supported this association (−1 SD below the mean, simple slope=0.04, SE=0.01, p <0.0001; +1 SD above the mean, simple slope=0.01, SE=0.01, p=0.188). Conclusions: These results suggest that SOC buffers the mental health impacts of workload as measured by an objective index of overtime work, and should be considered when assessing the effects of workload on mental health.(J Occup Health 2015; 57: 297–301)
Objectives: The present study was initiated to examine if application of the same biological occupational exposure limits (BOELs) for organic solvents is applicable across the sexes. Methods: A survey was conducted in 69 micro-scale enterprises in a furniture-producing industrial park. In practice, 211 men and 52 women participated in the survey. They worked in a series of production process, and were exposed to solvent vapor mixtures. The exposure intensities were monitored with two types of diffusive samplers, one with carbon cloth (for solvents in general) and the other with water (for methyl alcohol) as adsorbents. Solvents in the adsorbents and head-space air from urine samples were analyzed with capillary FID-GC. The measured values were subjected to linear regression analysis followed by statistical evaluation for possible sex-related differences in slopes. Results: Essentially no significant difference was detected between men and women in regression line parameters including slopes. Possible differences in the cases of acetone and toluene were discussed and excluded. Conclusions: With the exceptions for acetone and toluene, the present study did not detect any clear differences between men and women. In examinations of past reports, no support for the observed differences was found. The present findings deserve further study so that a solid conclusion can be formed.(J Occup Health 2015; 57: 302–305)
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