[Association between subjective chewing conditions and dietary habits in Japanese workers].

OBJECTIVES: Previous studies on the elderly have reported that they avoid fiber-rich and hard foods in favor of softer foods as chewing ability declines. However, evidence of worker chewing conditions and dietary habits is scarce. This study aimed to clarify the association between chewing conditions and dietary habits in workers. METHODS: The subjects included 6,703 workers (45.6 ± 10.2 years, range 18-64 years) who underwent medical and dental check-ups from April 2018 to March 2019 with no missing data. We classified workers into two groups, those with good chewing conditions (GCC) and those with poor chewing conditions (PCC) according to their responses to the chewing condition item in our questionnaire. We performed logistic regression analysis using the questionnaire dietary habits item response as the objective variable and chewing conditions as the explanatory variable and adjusting for sex, age, number of present teeth, periodontal pocket depth, oral hygiene status, Body Mass Index, smoking habits, alcohol intake, exercise habits, history of present illness, and stages of transtheoretical model. Additionally, we performed subgroup analysis using a similar framework stratified by sex and age groups (under 40 or older). RESULTS: We found significant negative associations with PCC for the following dietary habits (p < .05): Awareness of balanced diet; Regular consumption of dark green and deep yellow vegetables; Eating slowly and chewing well; Frequent consumption of seaweed and small fish; Having three meals at almost at the same time every day; Having breakfast almost every day; Eating protein dishes with every meal; Frequently consuming dairy products; Finishing eating at least two hours before bedtime. Furthermore, we found significant positive associations with PCC for the following items (p < .05): Having on average two or more bottles/cans of juice or coffee a day; Frequently eating heavy meat dishes; Frequently eating deep-fried foods such as fried dishes and pork cutlets; Frequently having instant or processed foods; Eating two or more kinds of Western or Japanese confectioneries or snacks on average a day; Frequently eating salty food; Regularly having snacks or late-night meals. Additionally, similar trends were also observed following subgroup analysis, regardless of sex or age. CONCLUSIONS: This study suggests that workers with PCC may retain undesirable dietary habits, regardless of sex and age. Therefore, it is necessary to expand dental check-ups in the workplace and to promote dental health guidance that targets all workers.

[Evaluating the relationship between oral health status in male workers and question item regarding subjective chewing symptoms].

OBJECTIVES: In recent years, the relationship between oral health status and various diseases has been increasingly reported worldwide, leading to a growing understanding of the importance of oral health. This study aimed to investigate the relationship between oral health status, determined after a dental health check-up, and chewing condition, determined via a questionnaire for specific health check-ups with the newly added chewing condition item-When you chew your food, which most accurately describes your chewing-. METHODS: From 20,834 Japanese workers who underwent dental health check-ups and specific health check-ups from April 2018 to March 2019, 4,011 male workers (51.2 ± 6.1 years, range 40-64 years) were extracted for this study. Participants were divided into two groups, the good chewing condition group (GCG) and poor chewing condition group (PCG), according to their responses to a questionnaire regarding chewing conditions. We collected and compared data on subjects' age, smoking status, number of teeth present, number of filled teeth, number of decayed teeth, number of missing teeth with prosthetic treatment, periodontal pockets, gingival bleeding, oral hygiene status, and Eichner's classification. Additionally, to clarify the risk associated with chewing condition, we performed stepwise multiple logistic regression analysis with good chewing condition/poor chewing condition as the dependent variable, and age, smoking status, number of teeth present, number of filled teeth, number of missing teeth with prosthetic treatment, periodontal pockets, oral hygiene status, and Eichner's classification as the independent variables. RESULTS: The result of stepwise multiple logistic regression analyses, the odds ratio (OR) and 95% confidence interval (95% CI) of the factors that remained in the final model were as follows; the number of decayed teeth (OR = 1.18 [95% CI: 1.12-1.24]); periodontal pockets of 3 mm or less vs. 6 mm or more (OR = 1.63 [95% CI: 1.12-2.37]); Eichner's classification A1 vs. A2 (OR = 1.40 [95% CI: 1.08-1.82]), A3 (OR = 1.66 [95% CI: 1.09-2.52]), B1 (OR = 3.38 [95% CI: 2.04-5.61]), B2 (OR = 5.26 [95% CI: 2.46-11.2]), B3 (OR = 4.28 [95% CI: 1.20-15.2]), B4 (OR = 7.59 [95% CI: 1.06-54.5]). CONCLUSIONS: The results of this study suggest a significant association between the newly added "chewing condition" item in the questionnaire for specific health check-ups and oral status; the number of decayed teeth, periodontal pockets, Eichner's classification.

Does difficulty in chewing induce subjective musculoskeletal symptoms? A case-control study.

OBJECTIVES: Risk factors associated with the development of musculoskeletal disorders and symptoms remain an important issue worldwide. This study aimed to investigate the relationship between oral health problems such as difficulty chewing and the occurrence of stiff neck/shoulders (SN/S) and low back pain (LBP). DESIGN: Case-control study. SETTING AND PARTICIPANTS: This study was conducted from 1 April 2018 to 31 March 2020. The subjects were 77 341 workers among 646 281 workers from several employers in Japan. OUTCOME MEASURES: Participants were asked to evaluate their subjective SN/S and LBP symptoms using a self-administered questionnaire. METHODS: We defined the chewing condition using a questionnaire, and workers who responded with 'I can chew anything' were classified as the good condition group (GCG), and those who responded with 'Sometimes I have difficulty chewing due to problems with the teeth, gums, or bite' or 'I can hardly chew' were classified as the poor condition group (PCG). Setting the year 2018 as the baseline, we performed a logistic regression model using propensity score and inverse probability weighting (IPW) methods and chewing condition groups as explanatory variables and SN/S and LBP as objective variables. RESULTS: The IPW-adjusted logistic regression model showed that the OR of SN/S was approximately 1.25 (95% CI 1.17 to 1.33) times higher in the PCG than that in the GCG (p<0.001). Similarly, the OR of LBP was about 1.37 (95% CI 1.27 to 1.48) times higher in the PCG than that in the GCG in the IPW-adjusted logistic regression model (p<0.001). CONCLUSIONS: Our study suggests that the occurrence of SN/S and LBP symptoms in workers could be predicted depending on the presence of difficulty in chewing. Therefore, oral health and health guidance are gaining importance for the prevention of subjective musculoskeletal symptoms.

Fitting the task to a person with disabilities: A case of return-to-work support for a patient due to left-sided poststroke hemiplegia using tailor-made jigs-and-tools.

BACKGROUND: A 45-year-old Japanese male pharmacist developed a stroke in December 2018; hence, he had left-sided hemiplegia due to the after-effects of cerebral stroke. This paper reports the return-to-work (RTW) and after RTW support for poststroke patients from a combined ergonomic and rehabilitation perspective. METHODS: From April 2019 to July 2020, we visited hospitals and workplaces multiple times, making various preparations for workplace accommodation and exchanging information as follows: allowing staggered working hours; securing the flow routes in the back room; equipping a cane holder on his working desk; and adjusting the position of the work tablet. In August 2020, after RTW, we conducted a brief evaluation of residual motor function and an on-site task analysis, and we subsequently made a support tool. RESULTS: In July 2020, his RTW was eventually realized. Moreover, as a result of introducing the tailor-made support tool, the duration of certain tasks that he had been claiming to be difficult was reduced when compared to that before support-tool use, and the average task duration before and after support-tool use was 32.8 s and 10 s, respectively (reduced by approximately 69.5%). CONCLUSION: To augment our efforts, hospital staff, support staff in his workplace, and his employer collaborated to make various workplace accommodations for the smooth realization of RTW before and after RTW. In the present case, the ergonomic and rehabilitation approach after RTW might have contributed to ease of task, work efficiency, and the potential for future job retention.

[Verification of the effects of three percent weight loss at 6 months and application possibility of assessment at 3 months after the specific health guidance for male workers].

OBJECTIVES: This study aimed to evaluate the effects of ≥ 3% body weight loss at 6 months in male workers and verify the application possibility of assessment at 3 months after specific health guidance. METHODS: We recruited 5,031 Japanese male workers (aged 40-64 years) who had undergone health checkups and completed specific health guidance from 2008 to 2017. Participants were divided into three groups according to the percentage of weight reduction (≥ 3%, 0%-3%, ≤ 0%) after 6 months of health guidance. We compared the body weight, waist circumference, and blood pressure at 3- and 6-months with baseline data within and between groups. Similarly, in the medical examination of the next fiscal year (n = 2,889), body weight, waist circumference, blood pressure, triglyceride levels, high-density lipoprotein-cholesterol (HDL-C) levels, plasma glucose levels, and the prevalence and improvement rates of metabolic syndrome (MetS) of specific health checkups were also compared. Furthermore, we calculated the weight reduction target after 3 months to arrive at a ≥ 3% weight reduction for 6 months. Based on the target, we investigated the prevalence and improvement rates of MetS in the next fiscal year. RESULTS: A total of 1,349 (26.8%) participants had a ≥ 3% weight reduction, 2,059 (40.9%) had a < 3% weight reduction, and 1,623 (32.3%) had no weight reduction. At the 6-month follow-up, waist circumference and blood pressure levels had increasingly improved with greater reductions in weight. The following year, body weight, waist circumference, blood pressure, triglyceride levels, HDL-C levels, and plasma glucose levels had improved in the ≥ 3% weight loss group, whereas plasma glucose levels had not improved in the 0-3% weight loss group. Additionally, only triglyceride levels and diastolic blood pressure had improved in the no weight reduction group. In the ≥ 3% weight loss group, the prevalence rate of MetS was the lowest (7.6%), and the improvement rate of MetS was the highest (70.7%). Furthermore, the weight reduction target after 3 months to arrive at a ≥ 3% body weight reduction at 6 months was 2.0% weight reduction. Those who reduced weight ≥ 2.0% had better prevalence and improvement rates of MetS than those who reduced weight < 2.0%. CONCLUSIONS: Our findings indicated that the objective of losing ≥ 3% of body weight at 6 months in male workers after completing specific health guidance was effective and that assessment after 3 months based on setting a 2.0% weight reduction target was applicable.

Lifestyle and subjective musculoskeletal symptoms in young male Japanese workers: A 16-year retrospective cohort study.

This longitudinal study was conducted from 2002 to 2018 and aimed to investigate predictive lifestyle factors for the occurrence of subjective musculoskeletal symptoms. The participants came from several employers in Japan. Setting 2002 as the baseline, we performed logistic regression analyses using lifestyle questionnaire items as explanatory variables and Stiff neck/shoulders (SN/S) and Lower back pain (LBP) as objective variables (n = 16,748). Workers who responded positively to good lifestyle items with an odds ratio < 1.0 and those who did not were classified in the Good (GL) and Poor lifestyle groups (PL), respectively. The survival period between the groups was compared using the log-rank test and Cox hazard regression analysis with propensity score matching (n = 3,593). Based on the Cox hazard regression analysis results, the risk of SN/S was about 2.54 (95% confidence interval [CI]: 1.80-3.59) times higher for PL than for GL (p < 0.001). Similarly, after propensity score matching, the risk was about 2.33 (95% CI: 1.07-5.10) times higher for PL than for GL (p < 0.05). Further, LBP risk was about 2.45 (95% CI: 1.67-3.58) times higher for PL than for GL (p < 0.001). Similarly, after propensity score matching, the risk was about 3.50 (95% CI: 1.60-7.68) times higher for PL than for GL (p < 0.01). This study highlighted that workers with four good lifestyle factors (life satisfaction, hours of sleep, exercise habits, and physical fitness) presented reduced risk of subjective musculoskeletal symptom occurrence. To prevent musculoskeletal symptoms, physicians and occupational health staff should advise on workers' individual lifestyle.