Papers by Yoshihisa Fujino
Cancer Causes & Control, 2008
This prospective cohort study examined the association between educational level and breast cance... more This prospective cohort study examined the association between educational level and breast cancer incidence in Japan. A baseline survey was conducted between 1988 and 1990 among 110,792 residents of 45 areas, aged 40-79 years. Data were restricted to 24 areas where incidence registry data were available, and to subjects which provided information on educational level (32,646). The subjects were assigned to three groups according to their level of education (<16, 16-18, 18<). During 13 years of follow-up (328,931 person-year), 169 cases of breast cancer were newly diagnosed. Women with a high level of education had an increased risk of breast cancer (HR = 1.93, 95 percent confidence interval (95% CI): 1.18, 3.16, in women with the highest educational level) compared with women with the lowest educational level. Adjustment for lifestyle and reproductive factors did not substantially change the results. In addition, when analyses were stratified by age subgroups, the educational difference in breast cancer incidence was more evident among the younger than the elder subgroup. The present results suggested that cancer prevention strategies should recognize women with a higher educational level as a high risk group for breast cancer.
BMC Public Health, 2011
Background: A body of research has shown that neighborhood environment may have an effect on a va... more Background: A body of research has shown that neighborhood environment may have an effect on a variety of health outcomes, including cardiovascular disease. One explanation for the mechanism of the effect of neighborhood on cardiovascular disease is psychosocial pathways. Direct evidence for an effect of neighborhood on cardiovascular disease with adjustment for perceived stress at the individual level has not been obtained, however. The Japan Collaborative Cohort Study for the Evaluation of Cancer Risk provides a unique dataset which has aggregated area-based cohorts from 45 areas throughout Japan. The purpose of the present study was to examine the contextual effect of area-level stress on ischemic heart disease using data from a large prospective cohort in Japan.
Preventive Medicine, 2011
In Japan, screening programmes have been widely implemented as a public health practice. We inves... more In Japan, screening programmes have been widely implemented as a public health practice. We investigated the effect of the area-level interest in health screening on mortality using data from a large cohort in Japan.A baseline survey was conducted between 1988 and 1990 among 110,792 residents of 45 areas, aged 40–79 years. Area-level interest in health screening was defined as the proportion of people with high and moderate interest in health screening in an area. Multilevel Poisson regression was employed in a two-level structure of individuals nested within the areas. During 15 years of follow-up (1,035,617 person-years), 13,184 deaths were observed.The reduction in mortality rate was (a) 2% in both men (p = 0.009) and women (p = 0.038) for each percent increase in area-level interest in screening, and (b) 10% in men (p = 0.001) and 9% in women (p = 0.001) for individual attendance to screening in the year before follow-up. There was no interaction between area-level interest in screening, individual-level attendance at screening and overall mortality.Area-level and individual interest for health screening appear to be independent predictor of 15-year mortality in this national Japanese study. The present findings may support public health practices to promote knowledge and participation in screening programmes.
Sangyo Eiseigaku Zasshi, 2007
This work conducted a health impact assessment (HIA) of the Japanese Government&a... more This work conducted a health impact assessment (HIA) of the Japanese Government's proposal concerning the introduction of so called "white-collar exemption" into the Japanese labor market. We adopted the Merseyside model and performed a rapid health impact assessment to assess the potential health effects of white-collar exemption. In this HIA, several health determinants which may possibly be affected, both positively and negatively, were identified based on experts' judgments. Literature evidence was assessed using PubMed and other databases. In addition, we searched for the opinions of those affected by white-collar exemption from internet web sites, and six concerns were identified. Long working hours were identified as the most serious concern by both experts and those affected. White-collar exemption may increase irregular working patterns which may be related to sleep disorder, stress, and cardiovascular disease. Family function and social participation will also be affected by irregular working patterns. On the other hand, in terms of stress, white-collar exemption may benefit from a higher degree of job control. There are possibilities that white-collar exemption may enable an improved work-life balance and enable access of some groups of the population, such as people with disabilities or parents looking after children, greater access to the labour market. However, it is uncertain whether the benefits of white-collar exemption would overcome those of the current free-time or flex-time systems. The present work provides a wide range of health impacts of white-collar exemption, and will hopefully attract the attentions of decision-makers and those likely to be affected in order to contribute to policy-making.
Occupational factors and mortality were assessed in the Japan Collaborative Cohort Study for eval... more Occupational factors and mortality were assessed in the Japan Collaborative Cohort Study for evaluation of cancer. Overall an elevated risk of death from all causes, all cancers and circulatory disease, particularly in males, was found for those who were unemployed or to a lesser extent, self-employed. Certain cancers also showed links. There was no difference in the risk of total death or death due to cancers between office workers and manual workers. However, manual workers of both sexes have a decreased risk of death due to colon cancer and of breast in females. In males, rotating shift work increased risk of total death and ischemic heart diseases. Slight increase overall with dusty and noisy environments, perceived stress linked with IHD and CVD.
This study prospectively examined the association between shift work and the risk of ischemic hea... more This study prospectively examined the association between shift work and the risk of ischemic heart disease among Japanese male workers. A baseline survey, which involved 110,792 inhabitants (age range: 40-79 years) from 45 areas throughout Japan, was conducted between 1988 and 1990. The causes of death were identified from death certificates. The analysis was restricted to 17,649 men (age range: 40-59 years) who were employed at the time of the baseline survey. All subjects were asked to indicate the most regular shift work that they had undertaken previously: day work, rotating-shift work, or fixed-night work. The Cox proportional hazards model was used to estimate the risks of shift work for ischemic heart disease. During the 233,869 person-years of follow-up, a total of 1,363 deaths were recorded, 86 of which were due to ischemic heart disease. Compared with the day workers, the rotating-shift workers had a significantly higher risk of death due to ischemic heart disease (relative risk ¼ 2.32, 95% confidence interval: 1.37, 3.95; p ¼ 0.002), whereas fixed-night work was not associated with ischemic heart disease (relative risk ¼ 1.23, 95% confidence interval: 0.49, 3.10; p ¼ 0.658). In addition, subjects with coronary risk factors, such as hypertension, overweight, habitual alcohol consumption, and smoking, were highly susceptible to the effect of rotating-shift work on the risk of death due to ischemic heart disease.
Journal of Epidemiology, 2005
Several epidemiologic studies reported the positive association between cigarette smoking and sto... more Several epidemiologic studies reported the positive association between cigarette smoking and stomach cancer. The prevalence of smoking in men remains high in Japan compared to other developed countries. It is therefore of great importance to determine the impact of cigarette smoking on stomach cancer among the Japanese population. The Japan Collaborative Cohort Study (JACC Study) provided an opportunity to examine the association between smoking and the risk of mortality due to stomach cancer. A baseline survey was conducted throughout Japan from 1988 through 1990 among 110,792 inhabitants of 45 areas. Data retrieved for 98,062 participants (43,482 male and 54,580 female) who provided sufficient information about their smoking habits, without any history of caner at the baseline. Of total 970,251 person-years, 757deaths due to stomach caner were identified. Current smokers were at a higher risk of death due to stomach cancer than non-smokers (Hazard ratio=1.36; 95% confidence interval [CI]: 1.07, 1.73). The risk of stomach cancer for men who smoked 15 or more cigarettes per day was approximately 1.4-fold greater than that of non-smokers, and those who smoked 35 or more cigarettes per day had an approximately 1.7-fold higher risk of stomach cancer, although the dose-response trend among men was unclear (p for trend=0.063). No associations between smoking and stomach cancer were detected among women. The present results, together with previous findings, strongly support a hypothesis that cigarette smoking increases the risk of stomach cancer in Japanese men.
Preventive Medicine, 2005
This prospective cohort study examined the association between educational level and major causes... more This prospective cohort study examined the association between educational level and major causes of death in Japan.A baseline survey was conducted between 1988 and 1990 among 110,792 inhabitants of 45 areas aged 40–79 years. Follow-up surveys were conducted annually and causes of death were identified from death certificates. The analysis was restricted to 16,715 men and 23,284 women.During the follow-up period (377,139 person-years), 6628 deaths were recorded. Individuals with low levels of education had an increased overall risk of death [relative risk (RR) = 1.16, 95% confidence interval (CI): 1.08, 1.25, in men; RR = 1.26, 95% CI: 1.14, 1.39, in women], cancers (RR = 1.17, 95% CI: 1.04, 1.32, in men; RR = 1.10, 95% CI: 0.93, 1.30, in women), and death from external causes (RR = 1.81, 95% CI: 1.29. 2.54, in men; RR = 1.78, 95% CI: 1.18, 2.70, in women). Ischemic heart disease risk was marginally reduced in men with low levels of education (RR = 0.77, 95% CI: 0.58, 1.01).These results show that health inequalities exist in Japan, even though wealth inequalities are relatively low. Social and political initiatives will be needed to correct these inequities between different socioeconomic statuses.
Journal of Occupational Health, 2001
The user has requested enhancement of the downloaded file. All in-text references underlined in b... more The user has requested enhancement of the downloaded file. All in-text references underlined in blue are linked to publications on ResearchGate, letting you access and read them immediately. Abstract: Job Stress and Mental Health among Permanent Night Workers: Yoshihisa FUJINO, et al.
Journal of Exposure Analysis and Environmental Epidemiology, 2005
Objective: Recent studies have shown that generation of reactive oxidants during arsenic metaboli... more Objective: Recent studies have shown that generation of reactive oxidants during arsenic metabolism can play an important role in arsenic-induced injury. The purpose of this study was to examine the relationship between arsenic in drinking water and oxidative stress in humans by measuring 8-Hydroxy-2 0deoxyguanosine (8-OHdG). Methods: We performed a cross-sectional study in an arsenic-affected village in Hetao Plain, Inner Mongolia, China. A total of 134 of the 143 inhabitants (93.7%) of the village participated in the study. The levels of 8-OHdG, arsenic and its metabolites were measured in urine collected from the participants. Regression analyses were performed to investigate the relationship between arsenic species and 8-OHdG levels in urine. Results: In the polluted village, monomethylarsenic was significantly higher in subjects with arsenic dermatosis than those without dermatosis despite no difference in mean levels of arsenic in well water between both types of subject. For subjects with arsenic dermatosis, arsenic species and metabolites in urine are significantly associated with 8-OHdG, while there was no statistically significant relationship for subjects without arsenic dermatosis. For all residents of the polluted village, the levels of dimethylarsenic and 8-OHdG were significantly higher for those who had been exposed to well water for more than 12 years. Conclusions: These results provide evidence of a link between exposure to arsenic from drinking water and oxidative stress, which may play an important role in arsenic-involved injuries.
Preventive Medicine, 2002
Background. Different lifestyle choices are commonly regarded as a reflection of socioeconomic st... more Background. Different lifestyle choices are commonly regarded as a reflection of socioeconomic status, and the latter is inversely correlated with the risk of developing stomach cancer. However, the details of this association are still unclear in terms of the degree to which lifestyle factors are having impact. To explain the correlation between socioeconomic status and stomach cancer, we therefore examined the roles played by different lifestyle factors.Methods. A prospective cohort study of diet and cancer was initiated in Japan during 1988. Data were collected by means of a self-administered questionnaire. A follow-up survey was conducted annually, and the cause of death was recorded from the death certificate. The total of 127,477 study participants resided in 45 areas of Japan, and we retrieved data for 18,746 mend and 26,184 women for the present analysis. After 328,030 person-years of follow-up, 379 deaths from stomach cancer were detected: 261 in men and 118 in women.Results. For men, the age-adjusted relative risk was lowest in the highly educated group (relative risk = 0.72, 95% CI: 0.50–1.04). Relative risk after adjustment for age and dietary choices (including pickles, vegetables, fruit, green tea, and preference for salty foods) was the same as the age-adjusted relative risk (relative risk = 0.72, 95% CI: 0.50–1.04).Conclusion. The expected inverse correlation between education level and death from stomach cancer was observed in men. However, this association could not be explained by differences in dietary habits, smoking, or alcohol consumption associated with socioeconomic status.
BMC Public Health, 2007
Background: Several studies have indicated a significant association between marital status and m... more Background: Several studies have indicated a significant association between marital status and mortality risks. However, most of these studies have compared married and unmarried people without differentiating among single, divorced and widowed status. Moreover, gender differences in mortality rates associated with marital status have not been sufficiently clarified. With significant increases in the percentages of divorced and widowed people and a corresponding drop in the marriage rate in Japan during the past two or three decades, it can be expected that these changes will have a significant impact on mortality rates.
Diabetes-metabolism Research and Reviews, 2001
BackgroundPrevious studies have identified the association between diabetes mellitus and liver ca... more BackgroundPrevious studies have identified the association between diabetes mellitus and liver cancer. However, the detail of this association is still unclear, in terms of confounding factors, the trend according to the duration of diabetes, and the interaction between diseases associated with the liver cancer and this association. The purpose of the present study was to examine the association between diabetes and liver cancer in view of the trend and the interaction.Previous studies have identified the association between diabetes mellitus and liver cancer. However, the detail of this association is still unclear, in terms of confounding factors, the trend according to the duration of diabetes, and the interaction between diseases associated with the liver cancer and this association. The purpose of the present study was to examine the association between diabetes and liver cancer in view of the trend and the interaction.MethodsThe baseline survey was conducted during the period 1986–1989 among the general population of Fukuoka Prefecture, Japan (15 417 persons aged 30–79 years). The respondents were assessed for history of diabetes, age at which they had had diabetes, and other covariates by means of a baseline questionnaire. A total of 7308 persons aged 40–79 years were retrieved for the main analysis and 4902 persons for a subcohort from which the information on history of diseases associated with liver cancer were obtained. The relative risks (RRs) and their 95% confidence intervals (CIs) were estimated using the Cox proportional hazards model.The baseline survey was conducted during the period 1986–1989 among the general population of Fukuoka Prefecture, Japan (15 417 persons aged 30–79 years). The respondents were assessed for history of diabetes, age at which they had had diabetes, and other covariates by means of a baseline questionnaire. A total of 7308 persons aged 40–79 years were retrieved for the main analysis and 4902 persons for a subcohort from which the information on history of diseases associated with liver cancer were obtained. The relative risks (RRs) and their 95% confidence intervals (CIs) were estimated using the Cox proportional hazards model.ResultsAfter adjustment for smoking, alcohol and the diseases associated with liver cancer, the RR for liver cancer was 2.06 (95% CI=1.01–4.19). Diabetes increased the risk of liver cancer in persons with hepatitis and/or cirrhosis (RR=2.90, 95% CI=1.13–7.41). However, the RR of diabetes for liver cancer was 1.35 (95% CI=0.41–4.43) in persons without hepatitis and cirrhosis. The trend according to the duration of diabetes was not seen.After adjustment for smoking, alcohol and the diseases associated with liver cancer, the RR for liver cancer was 2.06 (95% CI=1.01–4.19). Diabetes increased the risk of liver cancer in persons with hepatitis and/or cirrhosis (RR=2.90, 95% CI=1.13–7.41). However, the RR of diabetes for liver cancer was 1.35 (95% CI=0.41–4.43) in persons without hepatitis and cirrhosis. The trend according to the duration of diabetes was not seen.ConclusionsA significant association between diabetes and liver cancer was observed. Moreover, this association was modified by hepatitis and cirrhosis. Copyright © 2001 John Wiley & Sons, Ltd.A significant association between diabetes and liver cancer was observed. Moreover, this association was modified by hepatitis and cirrhosis. Copyright © 2001 John Wiley & Sons, Ltd.
British Journal of Cancer, 2002
The present study examined the relationship between stomach cancer and the low intake of fresh fr... more The present study examined the relationship between stomach cancer and the low intake of fresh fruit and vegetables and/or a high intake of pickled, preserved or salted foods and frequent use of cooking oil. During 139 390 person -year of follow-up of over 13 000 subjects, 116 died from stomach cancer. Using a Cox proportional hazards -regression analysis of relative risk (RR, 95% CI) controlling for age, sex, smoking and other dietary factors, a significant decline was found with a high consumption of green and yellow vegetables (RR=0.4, 95% CI=0.2 -0.9). Reductions of between 40 and 50% were also observed with a high consumption of fresh foods (fruit, cuttle fish, tofu, and potatoes), but these associations were not statistically significant. The risk was significantly increased by the high consumption of processed meat (RR=2.7, 95% CI=1.0-7.4) and by the frequent use of cooking oil (RR=4.0, 95% CI=1.3-11.8). The high consumption of pickled food and traditional soups also increased risk, but not significantly. The findings suggest that a diet high in salt and low in vitamins may be associated with an increase in stomach cancer.
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Papers by Yoshihisa Fujino