Impact of Radiofrequency Exposure From Mobile Phones on the Risk of Developing Brain Tumors in Korean and Japanese Adolescents: A MOBI-Kids Case-control Study.

BACKGROUND: This study aimed to examine the association between risk of brain tumors and radiofrequency (RF) exposure from mobile phones among young people in Korea and Japan. METHODS: This case-control study of brain tumors in young people was conducted in Korea and Japan under the framework of the international MOBI-Kids study. We included 118 patients diagnosed with brain tumors between 2011 and 2015 and 236 matched appendicitis controls aged 10-24 years. Information on mobile phone use was collected through face-to-face interviews. A detailed RF exposure algorithm, based on the MOBI-Kids algorithm and modified to account for the specificities of Japanese and Korean phones and networks, was used to calculate the odds ratios (ORs) for total cumulative specific energy using conditional logistic regression. RESULTS: The adjusted ORs in the highest tertile of cumulative call time at 1 year before the reference date were 1.61 (95% confidence interval [CI], 0.72-3.60) for all brain tumors and 0.70 (95% CI, 0.16-3.03) for gliomas, with no indication of a trend with exposure. The ORs for glioma specifically, were below 1 in the lowest exposure category. CONCLUSION: This study provided no evidence of a causal association between mobile phone use and risk of brain tumors as a whole or of glioma specifically. Further research will be required to evaluate the impact of newer technologies of communication in the future.

Validation of mobile phone use recall in the multinational MOBI-kids study.

Potential differential and non-differential recall error in mobile phone use (MPU) in the multinational MOBI-Kids case-control study were evaluated. We compared self-reported MPU with network operator billing record data up to 3 months, 1 year, and 2 years before the interview date from 702 subjects aged between 10 and 24 years in eight countries. Spearman rank correlations, Kappa coefficients and geometric mean ratios (GMRs) were used. No material differences in MPU recall estimates between cases and controls were observed. The Spearman rank correlation coefficients between self-reported and recorded MPU in the most recent 3 months were 0.57 and 0.59 for call number and for call duration, respectively. The number of calls was on average underestimated by the participants (GMR = 0.69), while the duration of calls was overestimated (GMR = 1.59). Country, years since start of using a mobile phone, age at time of interview, and sex did not appear to influence recall accuracy for either call number or call duration. A trend in recall error was seen with level of self-reported MPU, with underestimation of use at lower levels and overestimation of use at higher levels for both number and duration of calls. Although both systematic and random errors in self-reported MPU among participants were observed, there was no evidence of differential recall error between cases and controls. Nonetheless, these sources of exposure measurement error warrant consideration in interpretation of the MOBI-Kids case-control study results on the association between children's use of mobile phones and potential brain cancer risk.

Length of employment in workplaces handling hazardous chemicals and risk of cancer among Japanese men.

OBJECTIVES: In Japan, the risk of developing cancer among workers employed in workplaces where chemical substances are handled is unclear. This study aimed to assess the association between cancer risk and employment in workplaces handling hazardous chemicals. METHODS: The Inpatient Clinico-Occupational Survey of the Rosai Hospital Group data of 120 278 male patients with incident cancer and 217 605 hospital controls matched for 5-year age group, hospital (34 hospitals) and year of admission (2005-2019) were analysed. Cancer risk in relation to lifetime employment in workplaces using regulated chemicals was assessed while controlling for age, region and year of diagnosis, smoking, alcohol consumption and occupation. Further analysis stratified by smoking history was performed to examine interaction effects. RESULTS: In the longest group of employment in tertiles, ORs were increased for all cancers (OR=1.13; 95% CI: 1.07 to 1.19) and lung (OR=1.82; 95% CI: 1.56 to 2.13), oesophageal (OR=1.73; 95% CI: 1.18 to 2.55), pancreatic (OR=2.03; 95% CI: 1.40 to 2.94) and bladder (OR=1.40; 95% CI: 1.12 to 1.74) cancers. Employment of 1+ years was associated with risk for lung cancer; 11+ years for pancreatic and bladder cancers; and 21+ years for all cancers and oesophageal cancer. These positive relationships were particularly obvious among patients with a history of smoking; however, no significant interaction between smoking and length of employment was observed. CONCLUSIONS: There is a high risk of cancer among workers, especially smokers, employed in workplaces handling regulated chemicals in Japan. Thus, future measures for chemical management in workplaces are needed to prevent avoidable cancers.

Occupational physical activity differentially affects the risk for developing later-onset Crohn's disease and ulcerative colitis among middle-aged and older populations.

BACKGROUND: A person's occupation may increase his/her risk for developing inflammatory bowel disease (IBD). This study investigated the association between risk for later-onset of IBD and both specific occupations and occupational physical activity (OPA) levels. MATERIALS AND METHODS: A multicenter hospital-based matched case-control study was conducted using the Inpatient Clinico-Occupational Survey database. Cases were patients with Crohn's disease (CD) and ulcerative colitis (UC) patients admitted for the first time between 2005 and 2015. Four controls matched by age, sex, admission year and hospital were selected for each case. Cases and controls were grouped into the longest-held occupations as classified by the Japanese Standard Occupational Classification and OPA levels. We conducted conditional logistic regressions to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for IBD, CD and UC adjusted for alcohol consumption and smoking status. RESULTS: There were 564 cases (172 CD, 392 UC) and 2086 controls. The risk for UC was higher among sales workers and carrying, cleaning and packing workers (ORs 2.62 [95%CIs 1.18-5.82], 2.52 [1.04-6.09]). There was no association between occupation type and CD risk. Higher OPA level decreased CD risk (OR 0.51 [95%CIs 0.26-1.00]) and increased UC risk (OR 1.53 [95%CIs 1.02-2.30]). CONCLUSIONS: Our study revealed that the risk for later-onset of UC, but not CD, was associated with longest-held 'service' and 'manufacture' work. The risk by OPA levels was inversely associated between CD and UC. Further studies are needed by follow-up method for long-term effects of physical activity.

Combined effects of occupational exposure to hazardous operations and lifestyle-related factors on cancer incidence.

We aimed to examine whether the number of types of hazardous operations at work experienced through a lifetime is associated with cancer incidence, and additionally examined the combined effects with lifestyle-related factors. Using a nationwide, multicenter, hospital inpatient dataset (2005-2015), we conducted a matched case-control study with 1 149 296 study subjects. We classified the participants into those with none, 1, or 2 or more types of hazardous operation experience, based on information of special medical examinations taken, mandatory in Japan for workers engaged in hazardous operations. Using those with no experience as the reference group, we estimated the odds ratios for cancer incidence (all sites, lung, stomach, colon and rectum, liver, pancreas, bile duct, and bladder) by conditional logistic regression with multiple imputations. We also examined the effects of the combination with hazardous operations and lifestyle-related factors. We observed increased risks for cancer of all sites, and lung, pancreas, and bladder cancer associated with the experience of hazardous operations. Multivariable-adjusted ORs (95% CIs) of cancer incidence of all sites were 1 (reference), 1.16 (1.12, 1.21), and 1.17 (1.08, 1.27) for none, 1, and 2 or more types of hazardous operation experience, respectively (P for trend <.001). Potential combined associations of hazardous operations with smoking were observed for lung, pancreas, and bladder cancer, and with diabetes for pancreas cancer. Engaging in hazardous operations at work and in combination with lifestyle-related factors may increase the risk of cancer. We highlight the potential for those engaged in hazardous work to avoid preventable cancers.

Exposure to Medical Radiation during Fetal Life, Childhood and Adolescence and Risk of Brain Tumor in Young Age: Results from The MOBI-Kids Case-Control Study.

BACKGROUND: We explored the association between ionizing radiation (IR) from pre-natal and post-natal radio-diagnostic procedures and brain cancer risk within the MOBI-kids study. METHODS: MOBI-kids is an international (Australia, Austria, Canada, France, Germany, Greece, India, Israel, Italy, Japan, Korea, New Zealand, Spain, The Netherlands) case-control study including 899 brain tumor (645 neuroepithelial) cases aged 10-24 years and 1,910 sex-, age-, country-matched controls. Medical radiological history was collected through personal interview. We estimated brain IR dose for each procedure, building a look-up table by age and time period. Lifetime cumulative doses were calculated using 2 and 5 years lags from the diagnostic date. Risk was estimated using conditional logistic regression. Neurological, psychological and genetic conditions were evaluated as potential confounders. The main analyses focused on neuroepithelial tumors. RESULTS: Overall, doses were very low, with a skewed distribution (median 0.02 mGy, maximum 217 mGy). ORs for post-natal exposure were generally below 1. ORs were increased in the highest dose categories both for post and pre-natal exposures: 1.63 (95% CI 0.44-6.00) and 1.55 (0.57-4.23), respectively, based on very small numbers of cases. The change in risk estimates after adjustment for medical conditions was modest. CONCLUSIONS: There was little evidence for an association between IR from radio-diagnostic procedures and brain tumor risk in children and adolescents. Though doses were very low, our results suggest a higher risk for pre-natal and early life exposure, in line with current evidence.

Clinical presentation of young people (10-24 years old) with brain tumors: results from the international MOBI-Kids study.

INTRODUCTION: We used data from MOBI-Kids, a 14-country international collaborative case-control study of brain tumors (BTs), to study clinical characteristics of the tumors in older children (10 years or older), adolescents and young adults (up to the age of 24). METHODS: Information from clinical records was obtained for 899 BT cases, including signs and symptoms, symptom onset, diagnosis date, tumor type and location. RESULTS: Overall, 64% of all tumors were low-grade, 76% were neuroepithelial tumors and 62% gliomas. There were more males than females among neuroepithelial and embryonal tumor cases, but more females with meningeal tumors. The most frequent locations were cerebellum (22%) and frontal (16%) lobe. The most frequent symptom was headaches (60%), overall, as well as for gliomas, embryonal and 'non-neuroepithelial' tumors; it was convulsions/seizures for neuroepithelial tumors other than glioma, and visual signs and symptoms for meningiomas. A cluster analysis showed that headaches and nausea/vomiting was the only combination of symptoms that exceeded a cutoff of 50%, with a joint occurrence of 67%. Overall, the median time from first symptom to diagnosis was 1.42 months (IQR 0.53-4.80); it exceeded 1 year in 12% of cases, though no particular symptom was associated with exceptionally long or short delays. CONCLUSIONS: This is the largest clinical epidemiology study of BT in young people conducted so far. Many signs and symptoms were identified, dominated by headaches and nausea/vomiting. Diagnosis was generally rapid but in 12% diagnostic delay exceeded 1 year with none of the symptoms been associated with a distinctly long time until diagnosis.

Computed tomography of the head and the risk of brain tumours during childhood and adolescence: results from a case-control study in Japan.

To clarify whether medical radiation exposure, especially from head computed tomography (CT), increases the risk of brain tumours in young patients in Japan, which ranks the second highest in the world in the number of paediatric CT examinations following the US. From 2011 to 2015, we performed a case-control study of 120 brain tumour patients and 360 appendicitis patients as controls. Reasons, the number of brain and head CT scans date were available from interviews. A cumulative radiation dose to the brain was calculated as a sum of doses received from head CT scans and from conventional X-rays and estimated using a reference table derived from a literature review of published studies. We performed conditional logistic regression to assess the risk of brain tumours from brain and head CT, and from conventional head X-ray procedures. The case group received on average 1.8 CTs to the brain area and 2.2 CTs to the whole head, with a mean estimated brain dose of 32 ±13 mGy. The odds ratio for developing a brain tumour from having a brain CT was 0.93 (95% confidence interval: 0.38-1.82). This was hardly altered when adjusting for parental educational history and for other diseases (history of neurological disease and attention-deficit disorder/attention-deficit hyperactivity disorder). Neither whole head CT nor cumulative brain dose to the brain increased the risk of glioma or of all brain tumours. Although this study conducted in Japan, where ranks second in the number of CT scans conducted in the world, did not show an increased risk of brain tumours related to CT scans, it should be taken with caution due to a case-control study with limited sample size.

Nonparticipation Selection Bias in the MOBI-Kids Study.

BACKGROUND: MOBI-Kids is a 14-country case-control study designed to investigate the potential effects of electromagnetic field exposure from mobile telecommunications devices on brain tumor risk in children and young adults conducted from 2010 to 2016. This work describes differences in cellular telephone use and personal characteristics among interviewed participants and refusers responding to a brief nonrespondent questionnaire. It also assesses the potential impact of nonparticipation selection bias on study findings. METHODS: We compared nonrespondent questionnaires completed by 77 cases and 498 control refusers with responses from 683 interviewed cases and 1501 controls (suspected appendicitis patients) in six countries (France, Germany, Israel, Italy, Japan, and Spain). We derived selection bias factors and estimated inverse probability of selection weights for use in analysis of MOBI-Kids data. RESULTS: The prevalence of ever-regular use was somewhat higher among interviewed participants than nonrespondent questionnaire respondents 10-14 years of age (68% vs. 62% controls, 63% vs. 48% cases); in those 20-24 years, the prevalence was ≥97%. Interviewed controls and cases in the 15- to 19- and 20- to 24-year-old age groups were more likely to have a time since start of use of 5+ years. Selection bias factors generally indicated a small underestimation in cellular telephone odds ratios (ORs) ranging from 0.96 to 0.97 for ever-regular use and 0.92 to 0.94 for time since start of use (5+ years), but varied in alternative hypothetical scenarios considered. CONCLUSIONS: Although limited by small numbers of nonrespondent questionnaire respondents, findings generally indicated a small underestimation in cellular telephone ORs due to selective nonparticipation.

Simulation of the incidence of malignant brain tumors in birth cohorts that started using mobile phones when they first became popular in Japan.

Over 20 years have passed since the initial spread of mobile phones in Japan. Epidemiological studies of mobile phone use are currently being conducted around the world, but scientific evidence is inconclusive. The present study aimed to simulate the incidence of malignant brain tumors in cohorts that began using mobile phones when they first became popular in Japan. Mobile phone ownership data were collected through an Internet-based questionnaire survey of subjects born between 1960 and 1989. The proportion of mobile phone ownership between 1990 and 2012 was calculated by birth cohort (1960s, 1970s, and 1980s). Subsequently, using the ownership proportion, the incidence of malignant brain tumors was calculated under simulated risk conditions. When the relative risk was set to 1.4 for 1,640 h or more of cumulative mobile phone use and the mean daily call duration was 15 min, the incidence of malignant brain tumors in 2020 was 5.48 per 100,000 population for the 1960s birth cohort, 3.16 for the 1970s birth cohort, and 2.29 for the 1980s birth cohort. Under the modeled scenarios, an increase in the incidence of malignant brain tumors was shown to be observed around 2020. © 2019 Bioelectromagnetics Society.

Epidemiology of Pediatric Out-of-Hospital Cardiac Arrest at School　- An Investigation of a Nationwide Registry in Japan.

BACKGROUND: A better understanding of the epidemiology of pediatric out-of-hospital cardiac arrest (OHCA) occurring in school settings is important to establish an evidence-based strategy for prevention and better prognosis.Methods and Results:The Stop and Prevent cardIac aRrest, Injury, and Trauma in Schools (SPIRITS) is a nationwide prospective observational study linking databases from 2 nationally representative registries, the Injury and the Accident Mutual Aid Benefit System of The Japan Sport Council and the All-Japan Utstein Registry of the Fire and Disaster Management Agency. Using these databases, we described the detailed characteristics and outcomes of pediatric OHCAs that occurred in school settings in Japan between 2009 and 2014. During the 6-year study period, 295 OHCA cases were confirmed. Overall incidence rate was 0.4 per 100,000 students per year. The majority of OHCA cases had a cardiac origin (71%), occurred during exercise (65%), were witnessed by bystanders (70%), and received bystander-initiated cardiopulmonary resuscitation (73%). In approximately one-third of cases the student was defibrillated by public-access automated external defibrillator (38%). The proportion of patients with 1-month survival and a favorable neurological outcome was 34% among all OHCAs and 43% among OHCAs of cardiac origin. CONCLUSIONS: In Japan, approximately 50 pediatric cases of OHCA consistently occur yearly in school settings. The majority of students received basic life support from bystanders, and patients with OHCA of cardiac origin had a relatively good prognosis.

Recall of mobile phone usage and laterality in young people: The multinational Mobi-Expo study.

OBJECTIVE: To study recall of mobile phone usage, including laterality and hands-free use, in young people. METHODS: Actual mobile phone use was recorded among volunteers aged between 10 and 24 years from 12 countries by the software application XMobiSense and was compared with self-reported mobile phone use at 6 and 18 months after using the application. The application recorded number and duration of voice calls, number of text messages, amount of data transfer, laterality (% of call time the phone was near the right or left side of the head, or neither), and hands-free usage. After data cleaning, 466 participants were available for the main analyses (recorded vs. self-reported phone use after 6 months). RESULTS: Participants were on average 18.6 years old (IQR 15.2-21.8 years). The Spearman correlation coefficients between recorded and self-reported (after 6 months) number and duration of voice calls were 0.68 and 0.65, respectively. Number of calls was on average underestimated by the participants (adjusted geometric mean ratio (GMR) self-report/recorded = 0.52, 95% CI = 0.47-0.58), while duration of calls was overestimated (GMR=1.32, 95%, CI = 1.15-1.52). The ratios significantly differed by country, age, maternal educational level, and level of reported phone use, but not by time of the interview (6 vs. 18 months). Individuals who reported low mobile phone use underestimated their use, while individuals who reported the highest level of phone use were more likely to overestimate their use. Individuals who reported using the phone mainly on the right side of the head used it more on the right (71.1%) than the left (28.9%) side. Self-reported left side users, however, used the phone only slightly more on the left (53.3%) than the right (46.7%) side. Recorded percentage hands-free use (headset, speaker mode, Bluetooth) increased with increasing self-reported frequency of hands-free device usage. Frequent (≥50% of call time) reported headset or speaker mode use corresponded with 17.1% and 17.2% of total call time, respectively, that was recorded as hands-free use. DISCUSSION: These results indicate that young people can recall phone use moderately well, with recall depending on the amount of phone use and participants' characteristics. The obtained information can be used to calibrate self-reported mobile use to improve estimation of radiofrequency exposure from mobile phones.

Work Sustainability Among Male Cancer Survivors After Returning to Work.

BACKGROUND: Few studies have investigated the work continuance rate among cancer survivors after return to work (RTW). The objective of this study was to clarify work sustainability after RTW among Japanese male cancer survivors. METHODS: We collected data on male cancer survivors from an occupational health register. Inclusion criteria were as follows: employees who returned to work after an episode of sick leave due to clinically certified cancer diagnosed between January 1, 2000 and December 31, 2011. RESULTS: Of 1,033 male employees who were diagnosed with cancer, 786 employees (76.1%) returned to work after their first episode of sick leave due to cancer. Work continuance rates among all subjects were 80.1% 1 year after RTW and 48.5% 5 years after RTW. The mean duration of work after RTW was 4.5 years. The work continuance rates varied significantly by cancer type. The "Lung" and "Hepatic, Pancreatic" cancer groups had the shortest duration of work (0.9 year after RTW). CONCLUSIONS: Of workers who returned to work after their first episode of leave after cancer, 50% continued to work after 5 years in large-scale companies. There was a steep decrease in work continuance rates during the first year after RTW, with considerable differences according to cancer site.

Analysis of ear side of mobile phone use in the general population of Japan.

This study aimed to clarify the distribution of the ear side of mobile phone use in the general population of Japan and clarify what factors are associated with the ear side of mobile phone use. Children at elementary and junior high schools (n = 2,518) and adults aged ≥20 years (n = 1,529) completed an Internet-based survey. Data were subjected to a logistic regression analysis. In children, due to the tendency to use the dominant hand, we analyzed the factors associated with the use of right ear in right-handed people. Statistically significant differences were observed only in talk time per call (odds ratio (OR) = 2.17; 95% confidence interval (CI): 1.22-3.99). In adults, due to the tendency to use the left ear, we analyzed factors associated with the use of left ear in right-handed people. Significant differences were observed in those aged 30-39 years (OR = 2.55; 95% CI: 1.79-3.68), those aged 40-49 years (OR = 3.08; 95% CI: 2.15-4.43), those aged >50 years (OR = 1.85; 95% CI: 1.20-2.85), and in those with a percentage of total talk time when using mobile phones at work of 51-100% (OR = 1.75; 95% CI: 1.21-2.55). We believe that future epidemiological studies on mobile phone use can be improved by considering the trends in mobile phone use identified in this study. Bioelectromagnetics. 39:53-59, 2018. © 2017 Wiley Periodicals, Inc.

Employment sustainability after return to work among Japanese stroke survivors.

PURPOSE: Few studies have investigated the work continuance rate among stroke survivors who return to work (RTW). The objective of this study was to investigate work sustainability after RTW and the causes of recurrent sickness absence (RSA) among Japanese stroke survivors. METHODS: Data on stroke survivors were collected from an occupational health register. The inclusion criteria were as follows: employees who were aged 15-60 years old and returned to work after an episode of sick leave due to a clinically certified stroke that was diagnosed during the period from 1 January 2000 through 31 December 2011. RESULTS: 284 employees returned to work after their first episode of stroke-induced sick leave. The work continuance rate for all subjects was 78.8 and 59.0% at one and 5 years after the subjects' RTW, respectively. After returning to work, the subjects worked for a mean of 7.0 years. Of 284 employees who returned to work, 86 (30.3%) experienced RSA. The RSA were caused by recurrent strokes in 57.0% (49/86) of cases, mental disorders in 20.9% (18/86) of cases, and fractures (often due to accidents involving steps at train stations or the subject's home) in 10.5% (9/86) of cases. 21 employees resigned after returning to work. The resignation rates at 1 and 5 years were 4.9 and 7.6%, respectively. According to the multivariate analysis including all variables, the subjects in the ≥ 50 year group were at greater risk of work discontinuation than the ≤ 49 year (reference) age group (HR: 2.26, 95% CI 1.39-3.68). CONCLUSIONS: Occupational health professionals need to provide better RTW support to stroke survivors and should pay particularly close attention to preventing recurrent strokes, mental disorders, and fractures.

Association between climatic elements and acute appendicitis in Japan.

BACKGROUND: In Japan, it has been reported that an increase in atmospheric pressure is associated with a higher incidence of acute appendicitis. The aim of this epidemiologic study was to investigate the association between climatic elements and the incidence of acute appendicitis. MATERIALS AND METHODS: A case-crossover design was used in the present study. Two wk before diagnosis was used for the target period. The same 2-wk period, but 1, 2, and 3 y before diagnosis, was used for the control period. The study participants were patients with acute appendicitis (10-29 y) from 14 facilities in the Greater Tokyo Area. Mean of the observed values for atmospheric pressure, temperature, relative humidity, and hours of sunshine calculated for each target and control period were used as climatic elements to investigate trends 1 and 2 wk before diagnosis. RESULTS: The year of diagnosis, a statistically significant moderate upward trend in atmospheric pressure was observed during the 2-wk period before diagnosis of acute appendicitis (tau = 0.47; P = 0.0213), whereas a weak nonsignificant downward trend was observed 1 y before diagnosis (tau = -0.29; P = 0.1596), and weak nonsignificant upward trends were observed 2 (tau = 0.24; P = 0.2505) and 3 y (tau = 0.28; P = 0.1634) before diagnosis. CONCLUSIONS: An association was found between atmospheric pressure and the incidence of acute appendicitis. However, no significant differences were found in relation to sex or age. These findings suggest that changes in atmospheric pressure are associated with the likelihood of patients visiting the hospital.

Analysis of mobile phone use among young patients with brain tumors in Japan.

The purpose of this study was to clarify ownership and usage of mobile phones among young patients with brain tumors in Japan. The subjects of this study were patients with brain tumors diagnosed between 2006 and 2010 who were between the ages of 6 and 18 years. The target population for the analysis was 82 patients. Patients were divided into two groups: 16 patients who were mobile phone owners 1 year before diagnosis, and 66 patients who did not own mobile phones (non-owners). Using data on the mobile phone ownership rate obtained from three general-population surveys, we calculated the expected number of mobile phone owners. The three age-adjusted standardized ownership ratios were 0.83 (95% confidence interval [CI]: 0.56-1.22), 0.51 (95% CI: 0.24-1.04), and 0.75 (95% CI: 0.42-1.32). The mobile phone ownership prevalence among the young Japanese patients with brain tumors in the current study does not differ from available estimates for the general population of corresponding age. However, since the use of mobile phones among children is increasing annually, investigations into the health effects of mobile phone use among children should continue. Bioelectromagnetics. 38:349-355, 2017. © 2017 Wiley Periodicals, Inc.

Time trend in incidence of malignant neoplasms of the central nervous system in relation to mobile phone use among young people in Japan.

The aim of this study was to examine whether incidence of malignant neoplasms of the central nervous system from 1993 to 2010 has increased among young people in Japan, and whether the increase could be explained by increase in mobile phone use. Joinpoint regression analysis of incidence data was performed. Subsequently, the expected incidence rate was calculated assuming that the relative risk was 1.4 for those who used mobile phones more than 1640 h cumulatively. Annual percent change was 3.9% (95% confidence interval [CI], 1.6-6.3) for men in their 20s from 1993 to 2010, 12.3% (95% CI, 3.3-22.1) for women in their 20s from 2002 to 2010, 2.7% (95% CI, 1.3-4.1) for men in their 30s from 1993 to 2010, and 3.0% (95% CI, 1.4-4.7) for women in their 30s from 1993 to 2010. Change in incidence rates from 1993 to 2010 was 0.92 per 100,000 people for men in their 20s, 0.83 for women in their 20s, 0.89 for men in their 30s, and 0.74 for women in their 30s. Change in expected incidence rates from 1993 to 2010 was 0.08 per 100,000 people for men in their 20s, 0.03 for women in their 20s, 0.15 for men in their 30s, and 0.05 for women in their 30s. Patterns in sex-, age-, and period-specific incidence increases are inconsistent with sex-, age-, and period-specific prevalence trends, suggesting the overall incidence increase cannot be explained by heavy mobile phone use. Bioelectromagnetics. 37:282-289, 2016. © 2016 Wiley Periodicals, Inc.

What digital health technology types are used in mental health prevention and intervention? Review of systematic reviews for systematization of technologies.

Digital health technology has been widely applied to mental health interventions worldwide. Using digital phenotyping to identify an individual's mental health status has become particularly important. However, many technologies other than digital phenotyping are expected to become more prevalent in the future. The systematization of these technologies is necessary to accurately identify trends in mental health interventions. However, no consensus on the technical classification of digital health technologies for mental health interventions has emerged. Thus, we conducted a review of systematic review articles on the application of digital health technologies in mental health while attempting to systematize the technology using the Delphi method. To identify technologies used in digital phenotyping and other digital technologies, we included 4 systematic review articles that met the inclusion criteria, and an additional 8 review articles, using a snowballing approach, were incorporated into the comprehensive review. Based on the review results, experts from various disciplines participated in the Delphi process and agreed on the following 11 technical categories for mental health interventions: heart rate estimation, exercise or physical activity, sleep estimation, contactless heart rate/pulse wave estimation, voice and emotion analysis, self-care/cognitive behavioral therapy/mindfulness, dietary management, psychological safety, communication robots, avatar/metaverse devices, and brain wave devices. The categories we defined intentionally included technologies that are expected to become widely used in the future. Therefore, we believe these 11 categories are socially implementable and useful for mental health interventions.

Changes in COPD mortality rate after amendments to the Preventive Vaccination Law in Japan.

BACKGROUND: The Japanese government amended the Preventive Vaccination Law in November 2001 to specify elderly people aged ≥ 65 years as the target population for influenza vaccinations. The vaccine coverage among this age group rapidly increased thereafter. Our goal was to evaluate how this amendment affected the nationwide mortality rate of chronic obstructive pulmonary disease (COPD). METHODS: The number of monthly COPD deaths by gender and age was obtained from the Monthly Vital Statistics Reports of the Ministry of Health, Labour and Welfare. Data between January 1995 and December 2009 were used for analyses. The COPD mortality rate for each month was calculated separately for the two age groups: age <65 years and age ≥ 65 years. Changes in the COPD mortality rates after amendment were evaluated each month using the Poisson regression analysis to calculate risk ratios (RRs) and to compute 95% confidence intervals (95% CIs) adjusting for gender, age, trend and seasonal variations. RESULTS: After amendments to the law, a statistically significant reduction in the COPD mortality rates were observed in January (RR 0.84; 95% CI 0.81-0.88), February (RR 0.85; 95% CI 0.81-0.89) and March (RR 0.92; 95% CI 0.88-0.96) among the population aged ≥ 65 years. However, in the population aged <65 years, statistically no significant changes in the COPD mortality rate were found in any month after the amendments were made. CONCLUSION: A legal approach to improving influenza vaccine coverage for the elderly population would contribute to the risk reduction of COPD deaths during the influenza season.