Gender differences in the occurrence of nonfatalagricultural injuries among farmers in Fukuoka, Japan.

BACKGROUND: The lack of information regarding nonfatal agricultural injuries has been recognized as an obstacle for effective injury prevention. The aim of this study was to describe gender differences in the pattern of nonfatal agricultural injuries between the years 2008 and 2009. METHODS: Farmers' compensation injury claims were utilized to determine the mechanisms involved (machinery, non-machinery, and traffic), types of accident, sources of injury, kinds of injury, body parts affected place of injury, work being performed at the time of injury, and length of hospitalization. Agricultural injuries were identified using the International Classification of External Causes of Injury (ICECI). The Statistical Analysis System (SAS) software was used for all statistical analyses. Study variables were compared using the Mantel-Haenszel chi-square test. RESULTS: A total of 2,729 (1,921 males) farmers' compensation injury claims were analyzed. There were approximately 9 times as many nonfatal agricultural machinery injuries in males compared with females. The most common machinery injuries were cuts resulting from a rotary blade (31%) for males and injuries caused by being struck by a machine (24%) for females in the 65-89 years of age group. The male:female ratio of non-machinery injuries averaged 2:1 (actual numbers of 1,293 and 676, respectively), but the percentage was higher for females (83.7%) than males (67.3%). For both males and females in the 65-89 years of age group, the main source of non-machinery injuries was slopes, the main type of accident was falling/slipping, the leading kind of injury was fracture, and the main work being performed was harvesting. Female farmers had a greater risk of prolonged hospitalization (more than 30 days) compared with males (p < 0.05). CONCLUSIONS: Gender is an important factor to consider in the interpretation of nonfatal agricultural injuries. A greater number of males had machinery injuries than females; however, a higher percentage of females had non-machinery injuries than males. Further research will be needed to understand the role of differential job tasks within agriculture in explaining the difference in risk.

Reasons for smoking cessation attempts among Japanese male smokers vary by nicotine dependence level: a cross-sectional study after the 2010 tobacco tax increase.

OBJECTIVES: To examine the association between smoking cessation attempts during the previous 12 months, motivators to quit smoking and nicotine dependence levels among current male smokers after Japan's massive 2010 tobacco tax increase. DESIGN: Cross-sectional study. SETTING: A self-reported questionnaire about smoking habits, nicotine dependence levels and factors identified as motivators to quit smoking was administered to 9378 employees working at a company located in Fukuoka Prefecture in Japan (as of 1 October 2011). PARTICIPANTS: A total of 2251 male current smokers 20-69 years old. PRIMARY AND SECONDARY OUTCOME MEASURES: Nicotine dependence level assessed by Fagerström Test for Cigarette Dependence (FTCD), smoking cessation attempts during the previous 12 months and motivators for smoking cessation. RESULTS: The proportion of current smokers who had attempted to quit smoking within the previous 12 months was 40.6%. Nicotine dependence level of current smokers was negatively associated with cessation attempts during the previous 12 months. Motivators for smoking cessation differed by nicotine dependence levels. 'The rise in cigarette prices since October 2010' as a smoking cessation motivator increased significantly at the medium nicotine dependence level (OR 1.44, 95% CI 1.09 to 1.90); however, this association was not statistically significant for individuals with high nicotine dependence (OR 1.24, 95% CI 0.80 to 1.92). 'Feeling unhealthy' was significantly negatively associated for medium (OR 0.42, 95% CI 0.27 to 0.65) and high (OR 0.31, 95% CI 0.14 to 0.71) nicotine dependence levels. Trend associations assessed by assigning ordinal numbers to total FTCD score for those two motivators were statistically significant. CONCLUSIONS: The efficacy of smoking cessation strategies can be improved by considering the target group's nicotine dependence level. For smokers with medium and high nicotine dependence levels, more effective strategies aimed at encouraging smoking cessation, such as policy interventions including increasing tobacco taxes, are needed.

Assessment of medical expenditures for sepsis:differentiating between cases with and without ruled-out diagnoses.

Setting public health priorities requires precise estimation of the burden of disease, including disease-specific medical expenditure. Information on multiple and ruled-out diagnoses on health insurance claims (HICs) has been ignored in traditional analyses of disease-specific medical expenditures in Japan. This study reviewed 448 inpatients with at least one diagnosis of sepsis on their HICs, who were insured by corporate health insurance organizations making claims on services provided from April 2006 to March 2007 in Japan. Subjects in whom sepsis-related diagnoses were specified as "ruled-out" were compared with subjects in whom sepsis-related diagnoses were classified as "not-ruled-out" (i.e., subjects in whom sepsis was considered possibly or likely present). Direct medical expenditure, length of stay (LOS), cost per day, cost of antibiotics, and proportion of administered cephalosporin and carbapenems were significantly higher in subjects classified as not-rule-out. When using health insurance claims in Japan, the statistics of medical expenditures and LOS are influenced by procedures performed to rule out a diagnosis, as well as those performed to treat a confirmed diagnosis of sepsis.

Retrospective longitudinal study on the relationship between 8-year weight change and current eating speed.

Most of the studies that have examined the relationship between the speed of eating and obesity have been cross-sectional. We investigated 529 male workers who received health check-ups provided by the employer in 2000 and 2008. We obtained information on the subjects' alcohol consumption, smoking status, self-reported speed of eating, and exercise in 2008, and height and weight in both 2000 and 2008. We compared weight change from 2000 to 2008 between 2 groups classified according to the speed of eating: a group of fast eaters, and a combined group of medium and slow eaters. The fast-eating group had a higher average weight gain (1.9 kg) than the medium and slow eating group (0.7 kg). Although statistically significant only for the 20-29-year age group, weight gain was greater in the fast-eating group for all age groups and was statistically significant when the age groups were combined. The relationship between eating fast and weight change was statistically significant even after adjusting for age and body mass index in 2000, drinking, smoking, and exercise. Our results suggested that the speed of eating is related to the rate of weight gain.

Inverse correlation between adiponectin and the risk of metabolic syndrome in middle-aged Japanese male workers.

Despite a close association between adiponectin and both hypertension and type 2 diabetes, the relationship between adiponectin and metabolic syndrome has not yet been well-investigated. To examine and evaluate the association between serum adiponectin levels and metabolic syndrome based on Japanese diagnostic criteria, we analyzed adiponectin and anthropometric parameters in 869 male employees aged 40-59 who belonged to a health insurance society in Fukuoka Prefecture and who underwent annual health check-ups from August 2006 to July 2007. Two hundred and thirty-two of the 869 subjects (26.7%) were diagnosed with metabolic syndrome. The serum adiponectin levels were significantly higher in the non-metabolic syndrome group. In a multiple logistic regression analysis, the subjects in the top quartile of serum adiponectin (adjusted odds ratio:0.36;95% confidence interval:0.21-0.63) and the second (adjusted odds ratio:0.51;95% confidence interval:0.31-0.84) quartile had a significantly decreased risk for metabolic syndrome in comparison to the bottom quartile. The dose-response relationship between serum adiponectin levels and metabolic syndrome was significant (p for trend 0.0001) after adjusting for age, body mass index, smoking status, and drinking status. The current findings suggest that hypoadiponectinemia is inversely correlated with the risk of metabolic syndrome in middle-aged Japanese male workers.

Hyperleptinemia is associated with hypertension in Japanese males.

Leptin is a hormone which is predominantly secreted by adipose tissue. Recent studies have shown that leptin increases arterial blood pressure. Although data from available animal studies clearly indicate an association between leptin and hypertension, results of human studies have been less definitive. We conducted a case-control study to examine the association between serum leptin levels and hypertension in 111 hypertensive subjects and 222 male controls, using conditional logistic regression analyses. Mean serum leptin levels were found to be marginally higher in the case subjects than in the control subjects (3.3 ng/ml versus 3.0 ng/ml), however, conditional logistic regression analysis revealed that subjects in the highest quartile had a significantly increased risk of hypertension compared with those in the lowest quartile, even after adjusting for drinking status and diabetes mellitus (adjusted OR, 2.11;95% CI, 1.01-4.39). Our findings suggest that leptin plays an important role in the development of hypertension.

Adiponectin levels associated with the development of hypertension: a prospective study.

Adiponectin is a recently discovered protein that seems to be exclusively secreted by adipocytes and is the most abundant adipose tissue-derived protein. While some recent studies have demonstrated an association between adiponectin levels and hypertension, these studies were cross-sectional in design, and the results have been inconsistent. Therefore we performed a prospective study to elucidate the role of adiponectin in the development of hypertension. The results of this study showed that serum adiponectin levels were significantly lower in hypertensive subjects than in normotensive subjects. Moreover, in logistic regression analysis, the subjects in the lowest quartile had a 3.72-fold higher risk than those in the highest quartile. Even after adjusting for potential confounding factors, this association was found to be significant. Low serum adiponectin levels were found to be independently associated with a higher risk for the development of hypertension. Our results therefore suggest that hypoadiponectinemia is a novel predictor of hypertension.

Effects of low body mass index and smoking on all-cause mortality among middle-aged and elderly Japanese.

To investigate effects of low body mass index (BMI) and smoking on all-cause mortality among middle-aged and elderly Japanese, we conducted a community-based prospective study. A mail survey was conducted in 1987-1990 in four towns, western Japan. A cohort of 7,301 Japanese men and 8,825 Japanese women was followed up from the date of the mail survey to 1995 in three of the towns and 1998 in the fourth town. We investigated the effect of BMI and smoking on all-cause mortality by using Cox's proportional hazards model. The relationship between BMI and all-cause mortality was a reverse J-shape with minimal mortality in 24 < or = BMI < 26 in men and a U-shape with minimal mortality in 22 < or = BMI < 24 in women, after adjusting for age and smoking. The lowest BMI category (BM < 20) had the highest all-cause mortality in men and also in women. Taking only never-smokers, the highest risk for all-cause mortality was observed in the lowest BMI category for men and for women. This does not seem to be explained by smoking and pre-existing diseases. More attention should be paid to persons with low BMI.

[Effects of cytotoxin-associated gene a (CagA) antibodies with Helicobacter pylori infection and lifestyle on chronic atrophic gastritis].

OBJECTIVE: We conducted a population-based study to examine differences in risk of developing chronic atrophic gastritis in association with Helicobacter pylori (H. pylori) infection, with and without the presence of cytotoxin-associated gene A (CagA) antibodies, as well as to determine associations with the lifestyle factors. METHOD: Seventy hundred and thirty eight residents (295 men and 443 women) aged 30-64 living in a village in the southern part of Fukuoka Prefecture had an annual health checkup, and all participated in our study. We obtained information on their lifestyle with informed consent and measured the levels of serum pepsinogen I (PGI) and pepsinogen II (PGII), H. pylori and CagA antibodies. Chronic atrophic gastritis was defined as both PGI < 70 micrograms/l and PGI/PGII < 3.0. RESULTS: The odds ratios for development of chronic atrophic gastritis were 4.26 (95% CI, 2.22-8.17) for CagA-positive H. pylori infection and 3.87 (95% CI, 1.95-7.68) for CagA-negative H. pylori infection in males, and 4.92 (95% CI, 3.06-7.92) and 3.02 (95% CI, 1.69-5.41) respectively for females, as compared with H. pylori-negative subjects. Regarding the relationship between chronic atrophic gastritis and lifestyle factors, high consumption of green tea was found to be negatively associated with risk, particularly with CagA-positive H. pylori infection. CONCLUSIONS: Our results suggest that a CagA-positive H. pylori infection is associated with an elevated risk for developing chronic atrophic gastritis as compared with Cag-negative H. pylori infection.