Objectives: This retrospective cohort study evaluated the impact of the Stress Check Program, a recently introduced national policy and program aimed at reducing psychological distress among Japanese workers.
Methods: A baseline survey was conducted from November 2015 to February 2016, the period when Japan began enforcing the Stress Check Program. A one-year follow-up survey was conducted in December 2016. In the follow-up survey, two exposure variables were collected: having taken the annual stress survey, and experiencing an improvement in the psychosocial work environment. Psychological distress was assessed using the Brief Job Stress Questionnaire (BJSQ) at baseline and 1-year follow-up. The two exposure variables were used to define four groups: "Neither", "Stress survey (SS) only", "Psychosocial work environment improvement (WI) only", and "Both". BJSQ results were analyzed using repeated measures general linear modeling (GLM).
Results: The study included 2,492 participants: 1,342 in the "Neither" group, 1,009 in the "SS only" group, 76 in the "WI only" group, and 65 in the "Both" group. Overall time-group interaction effects were not significant. The "Both" group showed significantly greater improvements in psychological distress than the "Neither" group (p = 0.02) at the 1-year follow-up, although the effect size was small (d = -0.14).
Conclusions: Combination of the annual stress survey and improvement in psychosocial work environment may have been effective in reducing psychological distress in workers, although the effect size was small.
Objectives: Rotating shift work has been reported to increase the risk of cardiovascular diseases. Vascular endothelial dysfunction and platelet activation are among the leading causes of thrombus formation in patients with myocardial infarction or stroke. Endothelial function has been shown to be impaired immediately after night-shift work; however, it is not known whether platelets are also activated. The aim of this study was to investigate the acute impact of night-shift work on platelet function.
Methods: This observational study included 11 healthy medical staff members (seven women, median age 32 years). We examined each subject's platelet aggregation rates and the serum concentrations of eicosanoid mediators after night-shift work and on day-shift work without preceding night-shift work (baseline).
Results: Platelet aggregation did not differ from baseline levels after night-shift work. However, serum cyclooxygenase (COX)-metabolized eicosanoid mediators, particularly thromboxane (Tx) B2 (a stable metabolite of TxA2 and the most important marker of platelet activation), were significantly higher after the night-shift than at baseline (median 65.3 vs 180.4 ng/ml).
Conclusions: Although platelet aggregation did not increase, there was an increase in serum COX-metabolized eicosanoid mediators such as TxB2 in healthy medical staff after night-shift work. This platelet hypersensitivity may be one of the mechanisms underlying the significant association between night-shift work and adverse cardiovascular outcomes.
This Document, "Guidelines for personal exposure monitoring of chemicals" ("this Guideline"), has been prepared by "The Committee for Personal Exposure Monitoring" ("the Committee") of the Expert Division of Occupational Hygiene & Ergonomics, Japan Society for Occupational Health. Considering the background of the growing importance of personal exposure monitoring in risk assessment and the need to prepare for the introduction of monitoring using personal samplers from an administrative perspective in recent years, the Committee was organized in November 2012. The Committee has prepared this Guideline as a "practical guideline" for personal exposure monitoring, so as to offer proposals and recommendations to the members of the Japan Society for Occupational Health and to society in general. The scope of this Guideline covers all chemical substances and all related workplaces regarded as targets for general assessment and the management of risk. It thus is not to be considered to comment on legal regulations and methodology. The main text provides the basic methods and concepts of personal exposure monitoring, while 31 "Appendices" are provided in this Guideline throughout the series; technical descriptions, statistical bases, and actual workplace examples are provided in these appendices, to assist better understanding. The personal exposure monitoring described as per this Guideline is equivalent to an "expert-centered basic method to reasonably proceed with the assessment and management of risk at workplaces." It is considered that practicing and expanding on this method will significantly contribute in reforming the overall framework of occupational hygiene management in Japan.
Objectives: To evaluate the effects of a 2-month lifestyle intervention for dry eye disease in office workers.
Methods: Prospective interventional study (randomized controlled study). Forty-one middle-aged Japanese office workers (men, 22; women, 19; 39.2 ± 8.0 years) with definite and probable dry eye disease were enrolled and randomized to an intervention group (n = 22) and a control group (n = 19). The intervention aimed at modifying diet, increasing physical activity, and encouraging positive thinking. The primary outcome was change in dry eye disease diagnoses. Secondary outcome was change in disease parameters, including dry eye symptoms, as assessed using the Dry Eye-Related Quality of Life Score, corneal and conjunctival staining scores, tear break-up time, and Schirmer test results.
Results: A total of 36 participants (intervention group, 17; control group, 19) completed the study. The number of definite dry eye disease diagnoses decreased from four to none (p =.05), and the dry eye symptom score showed a significant decrease in the intervention group (p =.03). In contrast, the corneal and conjunctival staining scores, tear break-up time, and Schirmer test results did not differ significantly between groups.
Conclusions: The 2-month lifestyle intervention employed in this study improved dry eye disease status among office workers, with a considerable decrease in subjective symptoms. Lifestyle intervention may be a promising management option for dry eye disease, although further investigation of long-term effects are required.
Objective: In this study, an experiment was conducted to examine whether noise exposure produced acute changes in cardiovascular responses, and whether these responses differed based on psycho-acoustic parameters to noises of low to high intensity. Methods: Thirty healthy subjects were enrolled. Three industrial noises were binaurally presented with a supra-aural earphone. The sound levels of noise were <55, 75, and 90 dB. Each noise was continued for 20 min and the electrocardiogram was simultaneously recorded. Results: The results showed a statistically significant increase in systolic blood pressure (SBP) at the 90 dB sound level. The study estimated a blood pressure increase of 0.85 mmHg/10 dB and 0.71 mmHg/10 dB in SBP and diastolic blood pressure (DBP), respectively. These results suggest that exposure to noise, particularly high-frequency noise, negatively impacts blood pressure. The tonality and fluctuation strength of noise especially impacts systolic blood pressure. Conclusions: The psycho-acoustic parameters of noise should be considered when evaluating the impact of noise exposure.
Objective: To investigate the extent of asbestos exposure among patients with primary lung cancer in Japan.
Methods: A retrospective estimation of potential asbestos-exposed individuals, as determined by the presence of pleural plaques identified on chest computed tomography (CT), was conducted on 885 pathologically confirmed primary lung cancer patients (mean age 71.3 years, 641 males). All patients were diagnosed at 29 hospitals across Japan between 2006 and 2007. Since these hospitals belong to the Japan Federation of Democratic Medical Institutions (MIN-IREN), an organization of medical institutions for workers, the study subjects may contain a higher proportion of workers than the general population.
Results: Pleural plaques were identified in 12.8% of subjects (15.8% in males and 4.9% in females), consisting exclusively of cases older than 50 years. They were found most frequently on the chest wall pleura (96.5%), followed by the diaphragm (23.9%) and mediastinum (9.7%). Calcifications were seen in 47 cases (41.6%). The highest prevalence of pleural plaques was seen among workers from construction-related fields (37.7%). No distinct lung cancer histology was observed in patients with pleural plaques. Coexistence of pleural plaques and small irregular opacities was observed in 2.5% of subjects.
Conclusion: In a Japanese population representing more workers than general Japanese, 12.8% of patients with primary lung cancer may have experienced asbestos exposure at some time in the past. Special medical attention should be paid to individuals with a history of employment in construction-related occupations, as workers in this sector showed the highest prevalence of pleural plaques.
Objectives: This study aimed to assess workers' exposure to indium and its compounds in 55 indium-handling operations among 13 Japanese plants. The surveyed plants were selected from indium-manufacturing plants whose annual indium production exceeded 500 kg.
Methods: The Control of Substances Hazardous to Health (COSHH) Essentials control banding toolkit, which contains simple scales for hazard levels, quantities in daily use, and "dustiness" characteristics, was used to assess generic risks of indium-handling operations. The operations were then classified into one of four Control Approaches (CAs). Results: There were 35 indium-handling operations classified into CA4 (requires expert advice) and 16 grouped into CA3 (requires containment). There were three operations classified into CA2 (requires engineering controls) and only one into CA1 (requires good general ventilation (GV) and working practices). Of the 51 operations classified as CA4 and CA3, 36 were found to be improperly equipped with local exhaust ventilation, and the remaining 15 operations solely relied on GV practices. Respiratory protective equipment (RPE) used in the 13 indium plants was examined with reference to the recommendations of the COSHH Essentials and Japan's Technical Guidelines. Conclusions: Our findings suggest that stringent engineering control measures and respiratory protection from indium dust are needed to improve indium-handling operations. Our results show that the most common control approach for Japanese indium-handling operations is to require expert advice, including worker health checks for respiratory diseases and exposure measurement by air sampling.
Objective: In recent years, the Chinese government has attached great importance to occupational health under the guidance of people-oriented concept. This paper introduces the current status and future development of occupational health in China's Thirteenth Five-Year Plan (13th FYP) period (2016-2020) to promote the cooperation and exchange on occupational health between China and other countries.
Methods: We collected statistical data about occupational diseases and information addressing occupational diseases. We included all types of official reports, guidelines, policies, and relevant laws published by the Chinese government.
Results: China has carried out a series of strategies and measures to reduce the incidence of occupational diseases, and has made progress in occupational health protection. However, occupational health in China still faces severe conditions and challenges for occupational diseases that have not been prevented and controlled effectively. To actively promote the future development of occupational health during the 13th FYP period, China has issued a series of important policy documents (such as the Plan for a Healthy China 2030, the 13th FYP for Occupational Disease Prevention and Control, and the 13th FYP for Occupational Health Hazard Prevention and Control) in the last two years.
Conclusion: The overall situation condition of occupational health in China is still serious. Occupational health in China's 13th FYP period faces a series of challenges, future tasks include plans to add the employer and regulatory levels of occupational health management, and occupational health education and publicity to the current technology-dominated approaches.
Objective: The times spent in sedentary behavior (SB) and moderate-to-vigorous physical activity (MVPA) are independently associated with health outcomes; however, objective data on physical activity levels including SB among different occupations is limited. We compared accelerometer-measured times spent in SB, light-intensity physical activity (LPA), and MVPA, and the patterns associated with prolonged bouts of SB between white- and blue-collar workers.
Methods: The study population consisted of 102 full-time plant workers (54 white-collar and 48 blue-collar) who wore a triaxial accelerometer during waking hours for 5 working days. Accelerometer-measured activity levels were categorized as SB (≤1.5 metabolic equivalents (METs)), LPA (1.6-2.9 METs), and MVPA (≥3.0 METs). A sedentary bout was defined as consecutive minutes during which the accelerometer registered less than ≤1.5 METs. Accelerometer variables were compared between white- and blue-collar workers through analysis of covariance.
Results: During working hours, white-collar workers spent significantly more time in SB and less time in LPA than blue-collar workers (SB: 6.4 h vs. 4.8 h, 73% vs. 55% of total work time; LPA: 1.9 h vs. 3.5 h, 22% vs. 40% of total work time, p<.001), whereas the MVPA time was similar between the groups. White-collar workers spent significantly more SB time in prolonged sedentary bouts (≥30 min) compared to blue-collar workers. During leisure time the SB, LPA, and MVPA times were similar between the groups.
Conclusions: White-collar workers have significantly longer SB times than blue-collar workers during work hours, and do not compensate for their excess SB during work by reducing SB during leisure time.
Objectives: We examined the associations among job demands and resources, work engagement, and psychological distress, adjusted for time-invariant individual attributes.
Methods: We used data from a Japanese occupational cohort survey, which included 18,702 observations of 7,843 individuals. We investigated how work engagement, measured by the Utrecht Work Engagement scale, was associated with key aspects of job demands and resources, using fixed-effects regression models. We further estimated the fixed-effects models to assess how work engagement moderated the association between each job characteristic and psychological distress as measured by Kessler 6 scores.
Results: The fixed-effects models showed that work engagement was positively associated with job resources, as did pooled cross-sectional and prospective cohort models. Specifically, the standardized regression coefficients (β) were 0.148 and 0.120 for extrinsic reward and decision latitude, respectively, compared to -0.159 and 0.020 for role ambiguity and workload and time pressure, respectively (p < 0.001 for all associations). Work engagement modestly moderated the associations of psychological distress with workload and time pressure and extrinsic reward; a one-standard deviation increase in work engagement moderated their associations by 19.2% (p < 0.001) and 11.3% (p = 0.034), respectively.
Conclusions: Work engagement was associated with job demands and resources, which is in line with the theoretical prediction of the job-demands-resources model, even after controlling for time-invariant individual attributes. Work engagement moderated the association between selected aspects of job demands and resources and psychological distress.
Objectives: Legionnaires' disease (LD), which is atypical pneumonia with a broad variety of clinical symptoms, can lead to death despite its low incidence. There are multiple risk factors for LD, yet little information is available concerning what kind of environmental factors are linked to higher risk of LD development. We have experienced a fatal case of LD, which occurred in a decontamination worker after the Fukushima nuclear disaster.
Case: A 53-year-old Japanese male visited our hospital with symptoms of fever, vomiting, diarrhea, and altered mental status, but not with respiratory manifestations. He was engaged in decontamination work, which generally includes operations such as the removal of topsoil in mountainous areas and cleaning roads and roofs of residential buildings with high-pressure water. He was required to wear specific equipment to prevent radiation exposure, and lived in a workers' dormitory or shared house, thereby sharing spaces with other workers.
Normal antibiotic therapy did not improve his symptoms following his diagnosis with pneumonia. A urinary antigen detection test was then conducted, leading to a diagnosis of LD. Despite the change of antibiotic to levofloxacin, multiple organ failure led to his death.
Conclusion: Decontamination workers may be at a high risk for developing LD and living and working conditions among them are possible contributors.
Objectives: This study aimed to describe the sleep quantity, sleep quality, and daily rest periods (DRPs) of Japanese permanent daytime workers.
Methods: Information about the usual DRP, sleep quantity, and sleep quality (Japanese version of the Pittsburgh Sleep Quality Index: PSQI-J) of 3867 permanent daytime workers in Japan was gathered through an Internet-based survey. This information was analyzed and divided into the following eight DRP groups: <10, 10, 11, 12, 13, 14, 15, and ≥16 h.
Results: The sleep durations for workers in the <10, 10, 11, 12, 13, 14, 15, and ≥16 h DRP groups were found to be 5.3, 5.9, 6.1, 6.3, 6.5, 6.7, 6.7, and 6.9 h, respectively. The trend analysis revealed a significant linear trend as the shorter the DRP, the shorter was the sleep duration. The PSQI-J scores for the <10, 10, 11, 12, 13, 14, 15, and ≥16 h DRP groups were 7.1, 6.7, 6.7, 6.3, 6.0 (5.999), 5.6, 5.2, and 5.2, respectively. The trend analysis revealed a significant linear trend as the shorter the DRP, the lower was the sleep quality.
Conclusions: This study described sleep quantity, sleep quality, and DRP in Japanese daytime workers. It was found that a shorter DRP was possibly associated with poorer sleep quantity as well as quality.
Background: It has been difficult to make reliable hazard assessments of manufactured nanomaterials, because the nanomaterials form large agglomerations in both in vitro and in vivo studies. Objective: A project by the New Energy and Industrial Technology Development Organization (NEDO) of Japan has succeeded in ensuring the stability of dispersion (nanoscale <100 nm) of manufactured nanomaterials, and is developing hazard assessments of manufactured nanomaterials. Results and Conclusion: Focusing on titanium dioxide, fullerenes and carbon nanotubes, we introduce findings made in inhalation and intratracheal installation studies overseas, and together with the findings made in the NEDO project, and also assess the hazards presented by manufactured nanoparticles.