Shintaro Takeda

Exercise BP response in subjects with high-normal BP: exaggerated blood pressure response to exercise and risk of future hypertension in subjects with high-normal blood pressure.

OBJECTIVES This study was designed to assess the clinical usefulness of an exaggerated blood pressure (BP) response to exercise (EBPR) in predicting the development of hypertension from a high-normal state. BACKGROUND Exaggerated BP response during both dynamic and isometric exercises are associated with increased risk of future hypertension, while the significance of these responses concerning the identification of individuals with high-normal BP who are prone to develop hypertension is unknown. METHODS The study population comprised a sample of 239 men with high-normal BP (aged 42.3 +/- 5.9 years) who underwent a symptom-limited bicycle ergometer exercise testing at baseline and then were followed for 5.1 years. RESULTS The Kaplan-Meier survival analysis showed that the subjects in the upper quartile of BP response to exercise had a significantly higher cumulative incidence of hypertension on follow-up than those in the middle two and lower quartiles (log-rank test, p < 0.05). Multivariate analysis using the Cox proportional hazards survival model showed that the EBPR was significantly and independently associated with the risk of developing hypertension after adjustment for some traditional risk factors for hypertension (RR = 2.31, 95% confidence interval = 1.45 to 6.25). CONCLUSIONS These findings suggest that an EBPR is an important risk factor for new-onset hypertension from a high-normal state and, thus, exercise testing can provide valid information that may help identify individuals with high-normal BP at a greater risk of future hypertension.

Symptoms of contruction workers exposed to whole body vibration and local vibration

SummaryTo study the effects of construction machinery operation on subjective symptoms, a questionnaire survey was caried out among construction machinery operators by a self-reporting method. Subjects were 184 power shovel operators, 127 bulldozer operators, 44 forklift operators as operator groups, and 44 office workers as a control. Their ages were in a range of 30–49 years. The questionnaire contained 20 symptoms referring to fatigue, digestive problems, and upper or lower limbs or back problems. The prevalence rate and symptom characteristics were examined. The dominant symptoms of the operator groups were stiff shoulder, low back pain, and stomack symptoms. The prevalence rate of low back pain was significantly different between forklift operators and controls. No significant differences were found in the symptoms of upper limbs and fingers between operator groups and controls. The prevalence of Raynauds phenomenon was 0.5%–2.3% in the operator groups and 2.3% in the control group.

Evaluation of organic solvent ototoxicity by the upper limit of hearing.

To clarify the effects of organic solvents on hearing, we measured the upper limit of hearing in 93 male workers exposed to organic solvents in 7 factories that produced plastic buttons or baths. Medical examinations, environmental monitoring (i.e., concentration in breathing-zone air), and biological monitoring (i.e., concentration in urine) of the organic solvents were also done. Although the organic solvent concentrations in the environmental monitoring were lower than the occupational exposure limit, the upper limit of hearing was reduced in workers who were exposed for 5 y or more. This reduction was dose-dependent and was related to styrene concentrations in breathing-zone air and mandelic acid concentrations in urine. Even individuals who had normal medical examinations showed a reduced upper limit of hearing. The upper limit of hearing may serve as an early detection indicator of health effects in workers constantly exposed to styrene.

The influence of obesity and metabolic risk variables on brachial-ankle pulse wave velocity in healthy adolescents.

Measurement of brachial-ankle pulse wave velocity (baPWV) is recognized as a simple and practical method for assessing arterial stiffness. We determined whether the baPWV of adolescents is affected by obesity and its associated metabolic risk variables. A cross-sectional sample of 754 apparently healthy adolescents (383 men and 371 women), aged 15–17 years, was recruited for this study. baPWV was measured by a simple automatic oscillometric technique. Adiposity measures, blood pressure, serum lipoproteins, fasting glucose and insulin were evaluated. The baPWV of the adolescents was significantly higher in men than in women and increased with age in both genders. After being statistically adjusted for age and gender, baPWV was significantly correlated with body mass index, percent body fat, waist-to-height ratio, systolic and diastolic blood pressures, mean arterial pressure, triglycerides, high-density lipoprotein cholesterol (HDL-C), atherogenic index, glucose, insulin, and homoeostasis model assessment of insulin resistance (HOMA-IR). In the multivariate regression analysis, mean arterial pressure, atherogenic index, HOMA-IR, systolic blood pressure and age were found to be significant determinants of baPWV (P<0.001). An increasing number of clustered risk variables, including high values (>gender-specific top quartiles) of waist-to-height ratio, mean arterial pressure, atherogenic index and HOMA-IR showed a graded association with baPWV (P<0.001 for trend). These results suggest that obesity and its associated metabolic abnormalities are important factors in the increased baPWV of adolescents and that baPWV may be useful in investigating early arterial wall changes in this population.

Hearing impairment among young Chinese in a rural area

To evaluate hearing levels in Chinese young people, audiometry was carried out at a rural village in Shandong Prefecture. The subjects were 282 healthy school children and students ranging in age from 7-17 y. All subjects were asked to complete a brief questionnaire on otological symptoms, personal histories and use of noisy playthings. Audiometric threshold testing was performed at the audiometric frequencies of 0.5, 1, 2, 4 and 8 kHz. Cluster analysis was used to estimate the associations between questions in the questionnaire and hearing impairment. Fifty-six subjects (20% subjects) were excluded from the normal groups. Twenty-two ears of the excluded subjects showed 4 kHz-dip and 38 ears showed high frequency hearing loss. An increased prevalence of hearing impairment was found when compared with young Japanese (1% from the nationwide school health survey) and with young Chinese in Shandong Prefecture (0.5%). In the questionnaire, 4 questions on dizziness, head trauma, aminoglycoside administration, and suspicion of Menieres syndrome, were included in the cluster of hearing impairment. The cause of this hearing impairment was proposed to be the potentiating effects of aminoglycoside antibiotics and exposure to noise.

Biological monitoring and possible health effects in workers occupationally exposed to methyl methacrylate

SummaryMonitoring by means of blood and urine analysis for methanol was successfully applied in 32 male workers who were exposed to methyl methacrylate (MMA) monomer at 6 ppm as a geometric mean and at 112 ppm as the maximum. Measurement of time-weighted average (TWA) intensity of the vapor exposure was successfully conducted with a diffusive sampler with activated carbon cloth as an adsorbent. Methanol concentrations in whole blood, serum, and urine samples were measured by headspace gas chromtography. The methanol concentrations in the three biological samples collected at the end of 8-h workshifts related linearly with the TWA MMA vapor concentrations, with correlation coefficients of 0.8–0.9. Quantitative evaluation of MMA in vapor and of methanol in urine suggests that only 1.5% of MMA inhaled will be excreted in urine as methanol. There were no significant clinical symptoms or abnormal hematological or serum biochemical findings at this exposure level, except that some workers complained throat irritation and frequent cough and sputa. The results indicate that biological monitoring by analysis for methanol is sensitive enough to detect MMA exposure at levels at which no serious health effects are to be expected.

Evaluation of noise-induced hearing loss by reference to the upper limit of hearing.

We have defined the upper limit of hearing as the maximum audible frequency measured with fixed intensity and changing frequency. We have previously established the standard upper limit ageing curves from the normal age variation in the upper limit of hearing. In the present study, we sought to clarify the effects of occupational noise on the upper limit of hearing. We measured the upper limit of hearing in 239 healthy male workers (478 ears) exposed to intensive occupational noise. Their age variation in the upper limit of hearing was compared with the standard upper limit ageing curves in males. There were statistically significant deteriorations. Even if the ears that had normal hearing levels (35 dB or less) were selected, deterioration in the upper limit of hearing was noticeable. The upper limit of hearing may serve as clinically useful information on the hearing impairment that precedes noticeable hearing impairment in conventional audiometry for workers exposed to intensive occupational noise.

Noise-Induced Hearing Loss in Working Environment and its Background

Noise‐Induced Hearing Loss in Working Environment and its Background: Ikuharu Morioka, et at. Department of Hygiene, School of Medicine, Wakayama Medical University—The excessive exposure to noise results in temporary and/or permanent changes in hearing ability in both human and animal subjects. The noise‐induced hearing loss in workers was previously known as industrial deafness and it is still an important problem in occupational health. The purpose of this review is to describe the major findings obtained in epidemiological and experimental studies on the effects of noise in the working environment on man. The discussion begins with a classification of noise‐induced hearing loss and the background of hearing impairment in workers. The degree of noise‐induced hearing loss depends on both the characteristics of noise and the individual sensitivity to noise. Factors related to noise‐induced hearing loss are reviewed. When the hearing ability is evaluated among aged workers, presbycusis cannot be ignored. Important new evidence is reviewed on hearing impairment caused by both aging and noise‐induced hearing loss. Exposure to intensive noise changes the structure and function of the basilar membrane, sensory hair cells, the tectorial membrane and tip links, and the cochlear blood flow. The pathology and pathophysiology of noise‐induced hearing loss are also explored. Relation between exposure to noise and hearing impairment is discussed to predict the effects of longterm exposure. Finally, the diagnosis and prevention of noise‐induced hearing loss are reviewed.

Age-specific nomogram of brachial-ankle pulse wave velocity in Japanese adolescents.

To obtain data on the brachial-ankle pulse wave velocity (baPWV) distribution during adolescence, a total of 3215 Japanese adolescents ranging from 12 to 18 years of age were studied. The brachial-ankle pulse wave velocity increased substantially with age and was significantly higher in males than in females. Multivariate regression analysis revealed that age, weight, and systolic and diastolic blood pressures were the major determinants of baPWV for both genders. Age-specific centile curves of baPWV were constructed for males and females by regression curve analysis. The proposed distribution curves of baPWV and its derived cutoff values may allow the atherosclerotic risk profile among adolescents of different ages to be more precisely estimated.

Effects of infrasound on gastric mucosal blood flow in rats

To clarify the effects of infrasound on gastric mucosal blood flow, rats were exposed to infrasound for 20 minutes. The sounds were pure tones of 8, 16 and 32 Hz, at sound levels ranging from 80 dB to 130 dB. Gastric mucosal blood flow was determined by the inhaled hydrogen gas clearance method. Norepinephrine and epinephrine concentrations in the plasma were also measured. The exposed rats showed decreased gastric mucosal blood flow with increasing sound levels of infrasound at each octave-band frequency. To significantly decrease the gastric mucosal blood flow, infrasound at 32, 16 and 8 Hz needed sound levels of 100, 110 and 130 dB, respectively. These findings suggest that, as the frequency of infrasound decreases, an increased sound level is necessary to decrease the gastric mucosal blood flow. The norepinephrine and epinephrine concentrations in the plasma were 0.65±0.47n.g/ml and 0.35±0.43 ng/ml, respectively, in the control rats, while the corresponding values were 0.91±0.87 ng/ml and 0.74±0.81 ng/ml, respectively, in the exposed rats. There were significant increases (p>0.05) in norepinephrine and epinephrine. Thus, it is probable that exposure to infrasound stimulates the sympathetic nervous system and causes a decrease in gastric mucosal blood flow.