Workers' load and job-related stress after a reform and work system change in a hospital kitchen in Japan.

OBJECTIVES: Many kitchen work environments are considered to be severe; however, when kitchens are reformed or work systems are changed, the question of how this influences kitchen workers and environments arises. The purpose of this study is to examine whether there was a change in workload and job-related stress for workers after a workplace environment and work system change in a hospital kitchen. METHODS: The study design is a pre-post comparison of a case, performed in 2006 and 2008. The air temperature and humidity in the workplace were measured. Regarding workload, work hours, fluid loss, heart rate, and amount of activity [metabolic equivalents of task (METs)] of 7 and 8 male subjects pre- and post-reform, respectively, were measured. Job-related stress was assessed using a self-reporting anonymous questionnaire for 53 and 45 workers pre- and post-system change, respectively. RESULTS: After the reform and work system change, the kitchen space had increased and air-conditioners had been installed. The workplace environment changes included the introduction of temperature-controlled wagons whose operators were limited to male workers. The kitchen air temperature decreased, so fluid loss in the subjects decreased significantly. However, heart rate and METs in the subjects increased significantly. As for job-related stress, although workplace environment scores improved, male workers' total job stress score increased. CONCLUSIONS: These results suggest that not only the workplace environment but also the work system influenced the workload and job stress on workers.

School children's salt intake is correlated with salty taste preference assessed by their mothers.

Salt intake in childhood is a risk factor for developing hypertension later in life. As health education for children to decrease salt intake, it is important for them to know the relationship between salty taste preference and salt intake. The objective of this study was to investigate the relationship between children's salty taste preference and their salt intake. We employed a cross-sectional study design, and the subjects were 199 elementary school children (5th or 6th grade) and their mothers. The amount of salt intake was estimated by the amount of urinary sodium excretion. Children's salty taste preference was assessed 1) by asking children about their own salty taste preference as well as measuring their threshold level of salty taste, and 2) by their mothers' observation of their salt intake behavior using a questionnaire. The salt intake and salt taste threshold of children who liked a salty taste were similar to those in children who disliked it. No association was found between the threshold level of salty taste and sodium intake. Regarding the relationship between children's salt intake and their salt intake behavior score, assessed by their mothers using a questionnaire, the high score group had a higher estimated salt intake than the low score group. In conclusion, children's salt intake may be accurately assessed by their mother's observation rather than children's own salty taste preference. This study suggests the importance of a mother's role in salt restriction education for children.

[Efficacy of a community-based weight reduction program to improve exercise and diet behavior in overweight adults].

OBJECTIVE: The study was a non-randomized, parallel-group comparison to evaluate the efficacy of a community-based weight reduction program with exercise and diet modification for overweight adults using existing community health services. METHODS: The study population consisted of 1,115 community-dwelling people who underwent annual health checkups in 2002 and were screened by exclusion criteria (age> 65, body mass index (BMI) < 24.2). They received a mail request to select one of two courses; a usual single-session health instruction course (control group) or a 9-month weight management course (intervention group). Forty six patients registered in the intervention group, and fifty patients in the control group. The analyzed sample consisted of 76 participants (9 males and 67 females) excluding dropouts from November 2002 to July 2003. Intervention included monthly classes (2 hours per class, 9 classes) consisting of an individual support program for behavioral change and a community support program for continuation after the class. The control group participants received conventional instructions based on their health status. RESULTS: No significant inter-group differences were observed at baseline, except in age and height of females. The mean BMI decreased from 27.2 (SD = 2.8) kg m(-2) to 25.3(3.1) kg m(-2) in the intervention group, and 26.4 (1.7) kg m(-2) to 26.1(1.7) kg m(-2) in the control group. Repeated measures analysis of variance showed significant time and group interaction adjusted for gender and age. The proportion showing maintenance and action in stage of exercise behavior increased in the intervention group (31% to 60%), but remained stable in the control group (45% to 48%) . The proportion showing maintenance and action in stage of diet behavior increased in the intervention group (24% to 80%), but remained stable in the control group (29% to 26%). CONCLUSION: Community-based weight reduction programs may be effective to facilitate change in exercise and diet behavior for body weight reduction in overweight adults.

Burn and cut injuries related to job stress among kitchen workers in Japan.

To clarify the correlation between kitchen work-related burns and cuts and job stress, a self-administered questionnaire survey was conducted involving 991 kitchen workers among 126 kitchen facilities. The demographics, condition of burns and cuts, job stress with the Brief Job Stress Questionnaire (BJSQ), health condition, and work-related and environmental factors were surveyed. Multiple logistic regression models and trend tests were used according to quartiles (Q1, Q2, Q3, and Q4) of each sub-scale BJSQ. After adjustment for potential confounding variables, burns/cuts were associated with a higher score category (Q4) of job demands (OR: 2.56, 95% CI: 1.10-6.02/OR: 2.72, 95% CI: 1.30-5.69), psychological stress (OR: 4.49, 95% CI: 2.05-9.81/OR: 3.52, 95% CI: 1.84-6.72), and physical stress (OR: 2.41, 95% CI: 1.20-4.98/OR 2.16, 95% CI: 1.16-4.01). The ORs of the burn/cut injures increased from Q1 to Q4 with job demands (p for trend = 0.045/0.003), psychological stress (p for trend<0.001/0.001), and physical stress (p for trend = 0.006/0.005), respectively. These findings suggest that kitchen work-related burns and cuts are more likely to be correlated with job stress, and the higher the job stress score, the higher the frequency of burns and cuts among kitchen workers.

Risk factors for frequent work-related burn and cut injuries and low back pain among commercial kitchen workers in Japan.

This study investigated risk factors for frequent work-related burn and cut injuries and low back pain (LBP) among kitchen workers including personal, work-related and environmental factors. Subjects were 991 kitchen workers in 103 schools, 17 hospitals and nursing homes, and 6 restaurants in central Japan. A cross-sectional survey was carried out using a structured self-administered questionnaire. Logistic regression models were used to examine associations between frequent injuries/LBP and risk factors. The effective response rate was 75.1% (n=744), the mean age was 40.7 (SD 11.7) and 77.2% were female. Burn injury was associated with a smaller kitchen (OR 1.94; 95%CI, 1.13-3.33), and gas kitchens rather than electric kitchens (OR 2.30; 95%CI, 1.17-4.52). LBP was associated with female gender (OR 2.46; 95%CI, 1.37-4.43), high body height (>160 cm) (OR 2.03; 95%CI, 1.22-3.36), and large number of meals produced per person (≥ 150 meals) (OR 1.83; 95%CI, 1.12-3.00). The results of this study suggest that securing adequate work space and introducing electric kitchen systems may reduce the risk to kitchen workers, as well as the importance of adequate height of cooking equipment and selecting an appropriate volume of meals to produce per person to prevent LBP in kitchen workers.

The effects of work environments on thermal strain on workers in commercial kitchens.

The purpose of this study was to clarify the effect of working environments of different kinds of commercial kitchens on the thermal strain of kitchen workers. This study design was cross-sectional study, and data collection was performed during busy time in commercial kitchen from August to September 2006. The research subjects were 8 institutions, involving 7 cookers, and 16 men. Measured environmental variables were air temperature, radiant heat index, wet bulb globe thermometer index (WBGT) in front of the cookers, ambient temperature, and estimated ambient WBGT around the workers. The thermal strain on workers was evaluated by fluid loss, body temperatures, heart rate and amount of physical activity (METs). All average estimated ambient WBGTs in front of cookers were less than 27.5℃. The average heart rate was 107 ± 10 bpm, and average METs was 2.0 ± 0.6. The peak values of upper arm skin temperature and auditory canal temperature were less than 37.5℃. The work environments were affected by the kitchen spaces, cooling devices, heating methods, and heat sources. Even in the midsummer, if environmental temperatures were controlled adequately, estimated ambient WBGTs around workers were below the occupational exposure limit. Work environments and thermal strain on workers in commercial kitchen were not severe.

Evaluation of subjective thermal strain in different kitchen working environments using subjective judgment scales.

To elucidate the subjective thermal strain of workers in kitchen working environments, we performed a cross-sectional study involving 991 workers in 126 kitchen facilities in Japan, using a self-reporting questionnaire survey and subjective judgment scales (SJS). The ambient temperature, mean radiant temperature (MRT), and wet-bulb globe temperature (WBGT) index were measured in 10 kitchen facilities of the 126 kitchens. The association of SJS with the types of kitchen was estimated by multiple logistic regression models. Of the 991 kitchen workers, 809 (81%) responded to the questionnaire survey. Compared with the electric kitchens, the proportion of workers who perceived the room temperature as hot to very hot was significantly higher, and the ambient temperature, MRT, and WBGT were significantly higher in the gas kitchens. Compared with the electric kitchens, workers in gas kitchens had a more than fivefold (males) and tenfold (females) higher SJS adjusted for confounding factors (male odds ratio (OR), 5.13; 95% confidence interval (CI), 1.65-15.9; and female OR, 10.9; 95%CI, 3.89-30.5). Although SJS was affected by some confounding factors, our results suggest that workers in gas kitchens might be exposed to a higher heat strains than those in electric kitchens.

Effects of heating appliances with different energy efficiencies on associations among work environments, physiological responses, and subjective evaluation of workload.

To clarify the association between heat stress, physiological responses and subjective workload evaluations in kitchens using an induction heating stove (IH stove) or gas stove. The study design was an experimental trial involving 12 young men. The trial measured ambient dry-bulb temperature, globe temperature, wet-bulb globe temperature (WBGT) and relative humidity; the subjects' weight, heart rate, blood pressure, oxygen uptake, amount of activity, body temperature, subjective awareness of heat and workload before and after mock cooking for 30 min. The IH stove insignificantly increased heat indicators in the work environment and workers showed lower oxygen uptake, skin temperature, subjective awareness of heat and workload after heat exposure. Both physiological load and subjective awareness of heat and workload were slight in kitchens using the IH stove, which provided a better work environment.

Impact of lifestyle intervention on physical activity and diet of Japanese workers.

OBJECTIVE: To evaluate the effectiveness of the Life Style Modification Program for Physical Activity and Diet (LiSM-PAN) in comparison to a conventional healthcare program. METHOD: Subjects with risk factor(s) for chronic disease were allocated as a cluster to the LiSM group (n=92) or the Control group (n=85). The LiSM-PAN program consisted of counseling plus social and environment support, and the Control program consisted of written feedback for changing physical activity and dietary practice. Intervention was conducted for 6 months during 2001-2002 and with data analysis during 2003-2004 in Tokyo, Japan. The main outcomes were leisure time exercise energy expenditure (L.E.E.E.), maximum oxygen uptake (VO2max), dietary habits, body mass index (BMI), blood pressure, blood glucose, and lipid parameters. RESULTS: The LiSM group showed a significantly greater increase in L.E.E.E. than the Control group at the end of the intervention (mean inter-group difference: 400.6 kcal/week, 95% CI: 126.1, 675.0 kcal/week). No significant mean inter-group differences were observed in dietary habits. The LiSM group showed significantly greater decreases in BMI, systolic blood pressure, and LDL-cholesterol than the Control group. CONCLUSION: The LiSM-PAN program produced greater positive changes in L.E.E.E., dietary habits, and risk factors for cardiovascular diseases in high-risk middle-aged male workers compared to the Control program.