Symptoms related to glaucomatous visual field abnormalities among male Japanese workers in a population-based setting.

PURPOSE: To identify symptoms potentially related to glaucomatous visual field abnormalities (VFAs) in a population-based setting, and to assess the applicability of using these symptoms to identify persons at risk of developing glaucoma. METHODS: In this study, 10,214 Japanese male general workers (mean age, 45.3±8.8 years) filled out a self-administered questionnaire and underwent frequency doubling technology (FDT) perimetry testing. The questionnaire inquired about whether the participant was suffering from any of nine symptoms, with scores for each response graded on a four-item Likert scale: 0 (none), 1 (rarely), 2 (sometimes), and 3 (always). Results from the questionnaire were compared among three groups: participants without any VFAs (9767), participants with VFAs as determined by the FDT test (FDT-VFA; 447), and 227 participants (of the 447 FDT-VFA participants) with glaucomatous VFAs who were newly diagnosed by ophthalmologic examinations. RESULTS: The mean summed scores for the total items were significantly (p<0.01) higher in FDT- and glaucomatous VFA groups than in normal subjects. In particular, responses citing the symptoms 'feeling of something in the front of the eye' and 'feeling of hardness to see in dark places' were significantly (p<0.05) more frequent in subjects with FDT- and glaucomatous VFAs than among normal participants. However, the respective areas under the receiver operating characteristic curve of summed scores for the nine total items and for the two items which showed significant differences for the glaucoma groups were 0.57 (95% confidence interval=0.53-0.60) and 0.58 (95% confidence interval=0.54-0.61). CONCLUSION: Although the symptoms 'feeling of hardness to see in dark places' and 'feeling of something in the front of the eye' could be associated with glaucomatous VFA in a population-based setting, inquiring about symptoms is of little aid in identifying subjects with glaucomatous VFA as a strategy for public health.

Effect of a group health education program in the workplace at the age of 35: a population approach.

Using a population approach, we investigated whether a group health education program exerted a preventive effect on checkup items at five years later. Workers turning 35 years old before the initial implementation of the program were entered in the control group (n = 422) and those turning 35 years on this date or after were entered in the intervention group (n = 206). These groups were compared using data obtained from routine health checkups at 35 and 40 years of age. In the intervention group, self-management ability prior to and after completion of the program was compared using a 2 item questionnaire based on the General Self-Efficacy Scale (GSES) and the Health Locus of Control (HLC). In males, the intervention group showed significant inhibition of increases in body mass index (BMI), systolic and diastolic blood pressure (SBP and DBP), and gamma-glutamyl transpeptidase (gamma-GTP) compared to the control group. In females, however, a similar outcome was seen for gamma-GTP only. The evaluation index of self-management ability for both GSES and HLC significantly improved among males but did not significantly change among females at five years post-completion of the program. In particular, the group with a high GSES evaluation index experienced significant inhibition of weight gain. As a population approach, adoption of this program in the workplace for males aged 35 years may have an inhibitory effect on five-year weight gain. Further, programs which improve GSES appear effective in inhibiting weight gain.