Long working hours and risk of hypertensive intracerebral haemorrhage among Japanese workers claiming compensation for overwork-related intracerebral haemorrhage: an unmatched case-control study.

OBJECTIVES: Overwork-related cerebrovascular and cardiovascular diseases (CCVDs) constitute a major occupational and public health issue worldwide. However, to our knowledge, few studies have reported the underlying pathophysiological mechanisms. We aimed to determine whether patients with extreme workload have a greater risk of developing hypertensive intracerebral haemorrhage (ICH) located in the deep brain areas than patients without extreme workload. We also determined the association between the number of hours of overtime work and the risk of developing hypertensive ICH. DESIGN: Unmatched case-control study. SETTING: Database of patients claiming compensation for overwork-related CCVDs in Japan. PARTICIPANTS: A total of 1215 patients who claimed overwork-related ICH in Japan, of whom 621 had their compensation claim approved (patients with extreme workload) and 622 did not. PRIMARY AND SECONDARY OUTCOME MEASURES: Logistic regression analysis was performed to calculate the risk of developing hypertensive ICH in patients with extreme workload compared with those without extreme workload, adjusted for confounders such as age, occupation, smoking status, alcohol consumption and medical history. We also calculated the risk of developing hypertensive ICH in compensated patients by average monthly overtime working hours. RESULTS: Patients with extreme workloads had a significantly higher odds ratio (OR) for developing hypertensive ICH (1.44, 95% CI: 1.10 to 1.88) than those without extreme workloads. ORs for developing hypertensive ICH according to overtime working hours showed a dose-response relationship; an overtime of 100 hours/month was associated with a significantly higher OR (1.31, 95% CI: 0.89 to 1.91; 1.41, 95% CI: 0.95 to 2.11; and 1.50, 95% CI: 1.01 to 2.22 for 60-79.9, 80-99.9 and≥100 hours/month, respectively) than that for workloads of less than 60 hours/month. CONCLUSIONS: Regarding Japanese workers, overtime work could be associated with the risk of developing hypertensive ICH, and hypertension may play an important role in overwork-related ICH.

Relationship between occupational injury and gig work experience in Japanese workers during the COVID-19 pandemic: a cross-sectional internet survey.

This study evaluated the relationship between occupational injury risk and gig work, which included the exchange of labor for money between individuals or companies via digital platforms. As Japan has experienced a severe economic decline during the coronavirus disease 2019 (COVID-19) pandemic, an increasing number of individuals have engaged in gig work. While few studies have evaluated occupational risks in gig work, several traffic accidents associated with food delivery gig work have been reported in the mass media. In this study, 18,317 individuals completed an internet survey that collected information pertaining to their involvement in gig work and experience of related occupational injuries; data regarding several confounding factors were also recorded. Multiple logistic regression analysis showed that workers involved in gig work had a greater risk of any minor occupational injuries (odds ratio, 3.68; 95% confidence interval, 3.02-4.49) and activity-limiting injuries (odds ratio, 9.11; 95% confidence interval, 7.03-11.8) than those not involved in gig work, after adjusting for age, sex, household income, lifestyle factors, and work-related factors. The results of this study indicate that gig workers are exposed to greater occupational hazards during the COVID-19 pandemic. Additional studies are warranted to clarify the causal mechanism for this relationship.

Outcomes of a telemedicine smoking cessation programme for heated tobacco product users in Japan: a retrospective cohort study.

OBJECTIVES: Japan is one of the largest markets for heated tobacco products (HTPs), and the number of HTP users, including dual users, is growing. However, it is not yet clear whether a telemedicine smoking cessation programme is effective for nicotine-dependent HTP users to quit smoking. We assessed the outcomes of a telemedicine smoking cessation programme in terms of continuous smoking cessation among smokers who had used HTPs compared with those who used exclusively cigarettes. DESIGN: A retrospective cohort study to assess the outcomes of the telemedicine smoking cessation programme provided by Linkage, Japan, comparing the success rates of smoking cessation between exclusively cigarette group (as reference) and HTP user groups (exclusively HTPs or dual use of both cigarettes and HTPs). SETTING: Linkage telemedicine smoking cessation programme database, covering programme participants in Japan. PARTICIPANTS: Programme participants from between August 2018 and October 2020. OUTCOME MEASURES: Continuous abstinence rates (CARs) from 9 to 24 weeks (CAR9-24) and 9 to 52 weeks (CAR9-52). Adjusted ORs (aORs) with 95% CIs for CAR were calculated to compare the exclusively cigarette group with exclusively HTP and dual use groups. RESULTS: We analysed 733 telemedicine smoking cessation programme participants. Exclusively HTP users had higher CARs than the exclusively cigarette group for CAR9-24 (aOR 1.12, 95% CI 1.02 to 1.23; p=0.02) and CAR9-52 (1.09, 0.99 to 1.19; p=0.08). Conversely, dual users had lower CARs than the exclusively cigarette group for CAR9-24 (0.85, 0.76 to 0.95; p=0.004) and CAR9-52 (0.88, 0.79 to 0.97; p=0.01). CONCLUSIONS: Exclusive HTP users achieved higher CARs, whereas dual users had lower CARs than exclusively cigarette users over short-term and long-term periods. A telemedicine smoking cessation programme may be a reasonable option for exclusive HTP users.

Relationship Between Nicotine Dependency and Occupational Injury in a Japanese Large-Scale Manufacturing Enterprise: A Single-Center Study.

OBJECTIVES: Although several studies have shown the association between smoking and occupational injury, the exact mechanism by which smoking contributes to occupational injury remains unclear. We conducted a 5-year case-control study in a population of Japanese large-scale enterprise workers aimed to verify the hypothesis that nicotine dependency is positively associated with occupational injury. METHODS: A total of 3179 to 3574 male workers annually participated in this study conducted from 2008 to 2012. Employees who had an occupational injury as detailed in the company records were included in the case group, while employees who did not have any occupational injury were included in the control group. Information on smoking status, nicotine dependency [assessed according to time to first cigarette (TTF) and cigarette per day (CPD)], and potential confounders were obtained via questionnaires administered during periodic health checkups. Odds ratios (ORs) were estimated via multiple logistic regression analysis and integrated using the general variance-based fixed effects model. RESULTS: The overall adjusted OR of occupational injury in smokers was 1.71 [95% confidence interval (95% CI): 1.10 to 2.66]. The OR for low and high nicotine dependency according to TTF was 1.52 (95% CI: 0.92 to 2.51) and 1.98 (95% CI: 1.15 to 3.41), respectively. CONCLUSION: Nicotine dependency was related to an increased risk of occupational injury. These findings support the hypothesis that smoking is associated with occupational injury.

Effects of bench step exercise intervention on work ability in terms of cardiovascular risk factors and oxidative stress: a randomized controlled study.

Work ability is partly determined by physical and mental fitness. Bench step exercise can be practiced anywhere at any time. The aim of this study was to determine the effects of a bench step exercise on work ability by examining cardiovascular risk factors and oxidative stress. Thirteen volunteers working in a warehousing industry comprised the bench step exercise group (n=7) and the control group (n=6). The participants in the step exercise group were encouraged to practice the step exercise at home for 16 weeks. The step exercise improved glucose metabolism and antioxidative capacity and increased work ability by reducing absences from work and improving the prognosis of work ability. The improvement in work ability was related to a reduction in oxidative stress. These results suggest that a bench step exercise may improve work ability by reducing cardiovascular risk factors and oxidative stress.

The relationship between work ability and oxidative stress in Japanese workers.

Work ability is based on the balance between personal resources and work demand. This study focused on the personal resources component of work ability. The aims of this study were to elucidate the association between work ability and cardiovascular (CV) risk factors, particularly oxidative stress, and to estimate the effect of a community-implemented lifestyle modification programme on work ability and CV risk factors. Urinary 8-iso-prostaglandin F2α (PGF2α), a biomarker of oxidative stress, was negatively correlated with psychological resources, as measured by the Work Ability Index (WAI). Overall WAI score was unchanged following the programme, while CV risk factors and antioxidative activity improved. A reduction in PGF2α levels was correlated with an improvement in subjective work ability relative to job demands, as assessed by a WAI item. Taken together, the results suggest that lifestyle modification programmes enhance the personal resources component of work ability and are associated with a reduction in oxidative stress.

Sense of coherence is significantly associated with both metabolic syndrome and lifestyle in Japanese computer software office workers.

OBJECTIVES: Sense of coherence (SOC) is an individual characteristic related to a positive life orientation, leading to effective coping. Little is known about the relationship between SOC and metabolic syndrome (MetS). This cross-sectional study aimed at testing the hypothesis that workers with a strong SOC have fewer atherosclerotic risk factors, including MetS, and healthier lifestyle behaviors. MATERIAL AND METHODS: One hundred and sixty-seven computer software workers aged 20-64 years underwent a periodical health examination including assessment of body mass index, waist circumference, blood pressure, blood lipid levels, fasting blood sugar (FBS) levels and lifestyle behaviors (walking duration, smoking status, nutrition, alcohol consumption, and sleep duration). During this period, the participants also completed a 29-item questionnaire of SOC and the Brief Job Stress Questionnaire to assess job stressors such as job strain and workplace social support. RESULTS: Our results showed that the participants with a stronger SOC were likely to walk for at least 1 h a day, to eat slowly or at a moderate speed, and to sleep for at least 6 h. Compared with the participants with the weakest SOC, those with the strongest SOC had a significantly lower odds ratio (OR) for being overweight (OR = 0.31; 95% confidence interval (CI): 0.11-0.81), and having higher FBS levels (OR = 0.11; 95% CI: 0.02-0.54), dyslipidemia (OR = 0.29; 95% CI: 0.09-0.84), and MetS (OR = 0.12; 95% CI: 0.02-0.63), even after adjusting for age, gender and job stressors. CONCLUSIONS: High SOC is associated with a healthy lifestyle and fewer atherosclerotic risk factors, including MetS.

Effects of transitory stimulation interval exercise on physical function: a randomized controlled pilot study among Japanese Subjects.

Interval training is effective for promoting aerobic capacity and general health. However, it involves repeated high-intensity activity, which could pose cardiovascular risks for the elderly or people who are less fit. We developed a transitory stimulation interval exercise (TSIE) in which the duration of strenuous exertion was reduced to 30 seconds at 75% VO2max of intensity. This pilot study aims to explore the effects of this mode of exercise. Thirty women were randomized and stratified into the TSIE group, the continuous moderate exercise (CME) group, or the no-exercise (NE) group. The two exercise groups performed exercises for 12 weeks. Significant positive changes were observed in the TSIE group compared with the NE group in the relative change ratio from baseline in body weight and VO2max, but no significant differences were observed between the CME group and the NE group. Glycated hemoglobin A1c (HbA1c) decreased significantly in both exercise groups compared with the NE group. Overall, there were few significant differences between the CME group and the TSIE group. There might not be any differences between the TSIE and the CME in a long term intervention with equalized training volumes.