Akizumi Tsutsumi

The Japanese version of the Effort-Reward Imbalance Questionnaire: A study in dental technicians

To test the psychometric properties and criterion validity of the Japanese version of the EffortReward Imbalance (ERI) Questionnaire (Siegrist, 1996), a survey was conducted among 105 male dental technicians. The Japanese version of the questionnaire was developed through a backtranslation process. Internal consistency and factorial structure were tested and the criterion validity with respect to musculoskeletal symptoms was estimated with the help of a correlation matrix and logistic regression analysis. In psychometric terms, the factorial structure of the scales measuring the components of the theoretical concept was replicated satisfactorily, and internal consistencies of the scales measuring the extrinsic and intrinsic components of the model were appropriate. Significant associations between components of the ERI and musculoskeletal symptoms were found. Logistic regression analysis revealed a significantly elevated risk of musculoskeletal symptoms in participants scoring high on the scale measuring ...

Dietary patterns and levels of blood pressure and serum lipids in a Japanese population.

Background Associations between dietary patterns and cardiovascular disease risk factors remain unclear. The objective of this study was to evaluate the association between dietary patterns derived from factor analysis and the levels of blood pressure and serum lipids in a Japanese population. Methods We conducted a cross-sectional analysis among 6886 (in the analysis on blood pressure) and 7641 (in the analysis on serum lipids) Japanese subjects aged 40-69 years. Dietary patterns were identified from a food frequency questionnaire by factor analysis. Associations between dietary patterns and blood pressure and serum lipids were examined after taking potential confounders into account. Results Three dietary patterns were identified: vegetable, meat, and Western. In men, the meat pattern was associated with higher total, high-density lipoprotein (HDL), and low-density lipoprotein (LDL) cholesterol. The Western pattern was associated with higher total and LDL cholesterol. In women, the vegetable pattern was associated with lower systolic and diastolic blood pressure and pulse pressure, and higher HDL cholesterol. The meat pattern was associated with higher total and HDL cholesterol. The Western pattern was associated with higher total, HDL, and LDL cholesterol, and the least intake pattern of Western diet was associated with higher systolic and diastolic blood pressures. Conclusions Dietary patterns of a Japanese population were related to cardiovascular disease risk factors, especially in women.

Participatory Intervention for Workplace Improvements on Mental Health and Job Performance Among Blue-collar Workers: A Cluster Randomized Controlled Trial

Objective: To explore the effect of participatory intervention for workplace improvement on mental health and job performance. Methods: Eleven assembly lines were randomly allocated to six intervention and five control lines (47 and 50 workers, respectively). The primary outcome was defined as the improvement in the following measures during the intervention period: General Health Questionnaire and WHO Health and Work Performance Questionnaire. Results: General Health Questionnaire scores significantly deteriorated in the control lines, whereas the score remained at the same level in the intervention lines. Health and Work Performance Questionnaire scores increased in the intervention lines, but decreased in the control lines, yielding a significant intervention effect (P = 0.048). Conclusion: It is suggested that the participatory intervention for workplace improvement is effective against deterioration in mental health and for improving job performance.

Prospective Study on Occupational Stress and Risk of Stroke

BACKGROUND No prospective studies have examined the association between occupational stress according to the job demand-control model and the risk of stroke in Asian populations. METHODS We conducted a multicenter community-based prospective study of 6553 Japanese male and female workers. Occupational stress was evaluated using a Japanese version of the job demand-control model questionnaire. We used the Cox proportional hazards model to evaluate the association between occupational stress and stroke. RESULTS During a mean follow-up of 11 years, we identified 147 incident strokes. Multivariable analysis revealed a more than 2-fold increase in the risk of total stroke among men with job strain (combination of high job demand and low job control) (hazard ratio, 2.73; 95% confidence interval, 1.17-6.38) compared with counterpart men with low strain (combination of low job demand and high job control) after adjustment for age, educational attainment, occupation, smoking status, alcohol consumption, physical activity, and study area. Additional adjustments for biologic risk factors attenuated the hazard ratio, but there continued to be statistical significance (hazard ratio, 2.53; 95% confidence interval, 1.08-5.94). In women, no statistically significant differences were found for any stroke incidence among the job characteristic categories. CONCLUSION Occupational stress related to job strain was associated with incident strokes among Japanese men.

Comparison of acute and chronic impact of adaptive servo-ventilation on left chamber geometry and function in patients with chronic heart failure.

The aim of this study was to determine differences in the acute and chronic impact of adaptive servo‐ventilation (ASV) on left chamber geometry and function in patients with chronic heart failure (CHF).

Association between job characteristics and health behaviors in Japanese rural workers

Associations between job characteristics defined by the Karasek’s job demand-control model and health behaviors were investigated in a cross-sectional analysis of 6,759 Japanese rural workers. High psychological demands were associated with heavy smoking, exaggerated prevalence of alcohol drinking, and high work-related physical activity. Low job control was associated with lower consumption of vegetables, a smaller quantity number of cigarettes smoked, and a low level of work-related physical activity. Job strain, a combined measure obtained from the ratio of demands to control, was associated with lower vegetable consumption, low prevalence of smoking, and high prevalence of current alcohol drinking. Stratified analyses by occupations and gender provided some but not allof the explanations for the unexpected findings. The results indicate a possible association between psychosocial job characteristics and health behaviors. A few unexpected findings prevent complete support to one of the hypothetical pathways that the job characteristics lead to cardiovascular disease through behaviors.

Low Control at Work and the Risk of Suicide in Japanese Men: A Prospective Cohort Study

Background: Although adverse psychosocial job characteristics are suspected predictors of suicide death, prospective studies based on established stress instruments are limited. Methods: In a multicenter community-based Japanese cohort study, we prospectively investigated the association between psychosocial job characteristics and the risk of death from suicide among male workers. Baseline examination was conducted from 1992 to 1995 to determine the socioeconomic, behavioural and biological variables in addition to the psychosocial job characteristics of 3,125 male workers aged 65 and under and free from major illness. Low job control and high job demands were measured as adverse psychosocial job characteristics according to a job demand-control model questionnaire. Suicide deaths were identified using the Cause-of-Death Register. Results: During the 9-year follow-up, 14 suicides were identified. The suicide death rate was 48.1 per 100,000 person years. Multivariate analysis revealed a more than fourfold increase in the risk of suicide among men with low control at work (relative risk: 4.10; 95% confidence interval: 1.31–12.83) compared with counterpart men after adjustment for age, marital status, educational attainment, occupation, smoking status, alcohol consumption, total cholesterol level, and study area. Job demands were not associated with risk of death from suicide. Conclusions: By using a job demand-control model questionnaire, low control at work was revealed as a predictor of suicide death among Japanese male workers. The finding implies that job redesign aimed at increased worker control could be a worthwhile strategy in preventing, or at least reducing, the risk of suicide death.

Incidence of total stroke, stroke subtypes, and myocardial infarction in the Japanese population: the JMS Cohort Study.

Background Previous reports indicated that the incidence rate of stroke was higher in Japan than in Western countries, but the converse was true in the case of myocardial infarction (MI). However, few population-based studies on the incidence rates of stroke and MI have been conducted in Japan. Methods The Jichi Medical School (JMS) Cohort Study is a multicenter population-based cohort study that was conducted in 12 districts in Japan. Baseline data were collected between April 1992 and July 1995. We examined samples from 4,869 men and 7,519 women, whose mean ages were 55.2 and 55.3 years, respectively. The incidence of stroke, stroke subtypes, and MI were monitored. Results The mean follow-up duration was 10.7 years. A total of 229 strokes and 64 MIs occurred in men, and 221 strokes and 28 MIs occurred in women. The age-adjusted incidence rates (per 100,000 person-years) of stroke were 332 and 221 and those of MI were 84 and 31 in men and women, respectively. In the case of both sexes, the incidence rates of stroke and MI were the highest in the group of subjects aged > 70 years. Conclusion We reported current data on the incidence rates of stroke and MI in Japan. The incidence rate of stroke remains high, considerably higher than that of MI, in both men and women. The incidence rates of both stroke and MI were higher in men than in women.

Psychosocial job characteristics and insomnia: A prospective cohort study using the Demand-Control-Support (DCS) and Effort–Reward Imbalance (ERI) job stress models

OBJECTIVE To examine the prospective effects of psychosocial job characteristics evaluated with the Demand-Control-Support (DCS) and Effort-Reward Imbalance (ERI) models on insomnia. METHODS A prospective cohort study with a two-year observation was performed. The subjects were 1022 middle-aged (>or= 39 years) Japanese workers. The following associations were analyzed: high job strain, low social support, effort-reward imbalance, and overcommitment to work at the baseline with self-reported persistence and future onset of insomnia. RESULTS Among those who were insomniacs at the baseline (N=292), low social support [adjusted odds ratio (95% CI): 2.00 (1.18, 3.40)] and effort-reward imbalance [2.40 (1.13, 5.10)] at the baseline had a significant relationship to insomnia at the follow-up. Among those who were not insomniacs at the baseline (N=730), overcommitment to work [1.75 (1.16, 2.66)] and high job strain [1.72 (1.06, 2.79)] at the baseline were associated with insomnia at follow-up. CONCLUSIONS Prospective effects of psychosocial job characteristics on insomnia differed between its persistence and future onset. Proportionate reward for work effort and sufficient support at work assist recovery from insomnia, while overcommitment to work and high job strain cause future onset of insomnia.

The Effort-reward Imbalance Model : Experience in Japanese Working Population

The Effort‐reward Imbalance Model: Experience in Japanese Working Population: Akizumi Tsutsumi, et al. Okayama University Graduate School of Medicine and Dentistry—The validity of Siegrists effort‐reward imbalance model was examined in Japanese workers: 105 dental technicians, 902 employees of production companies, and 2,827 selected from staff of hospitals. After controlling for possible confounders, levels of the two stress measures, ‘effort‐reward imbalance’ and ‘overcommitment’, were similar for both genders. The effort‐reward imbalance was most prevalent in the 25‐ 30 age employees and then decreased with age, but the level of overcommitment increased with age. Those with lower educational attainment and others who reported working long hours were more often exposed to effort‐reward imbalance and those in the private sector reported higher overcommitment levels than their respective counterparts. Hospital staff (predominantly nurses) had almost twice as high a level of effort‐reward imbalance as production workers. A review of empirical studies confirmed validity of the criterion with respect to a self‐reported health outcome and the responsiveness of the measures to organizational changes. Nevertheless, the low prevalence of an effort‐reward imbalance (originally formulated by Siegrists group on European samples) in Japanese employees seemed to reduce the statistical power of these tests. A subsequent change in exposure prevalence by defining the top quintile of the distribution of the logarithmic‐transformed effort‐ reward ratio resulted in an improvement in the statistical fit. The Japanese evidence indicates promising applicability of the effort‐reward imbalance model, particularly if statistical approaches that measure the models core notion are extended, and recommendation of repeated measures for exposure. Cross‐cultural research on occupational stress is instructive in terms of health science.