Association between self-reported stressful feeling by SACL and mortality in a Japanese community.

A cohort study consisting of 4,291 residents of a Japanese community has been conducted since 1987. The associations between stressful feelings measured by Stress Arousal Checklist (SACL) and mortality of all causes and cancer were examined. The relative risks (RRs) for mortality for 7 years for high stressful state (SACL score: 7-17) and moderate stressful state (3-6) subjects compared with low stressful state subjects (0-2) were 1.1 (95% CI = 0.69-1.68), 1.3 (95% CI = 0.85-2.00) for all causes and 1.5 (95% CI = 0.80-2.99), 1.3 (95% CI = 0.67-2.61) for cancer respectively, after being adjusted for sex, age, smoking, drinking, exercise and medical-care use. When each item of the SACL was examined independently, six out of 17 items of SACL which were "not comfortable", "not contented", "not cheerful", "dejected", "nervous", "not pleasant" showed elevated RRs for all causes of mortality with statistical significance (RRs: 1.4, 1.4, 1.7, 1.7, 1.5, 1.5, respectively), after being adjusted for the possible confounding factors stated above. Especially, the adjusted RRs of "not cheerful" and "dejected" for all causes was 1.7 (95% CI = 1.20-2.33), 1.7 (95% CI = 1.17-2.46), respectively. The results suggested that stressful feelings of "not cheerful" and "dejected" might increase mortality.

[Occupational dangers to health of nursing staffs in hemodialysis units].

Since hemodialysis patients are at high risk for blood-borne viral infection such as hepatitis B and C virus infection, nursing staffs of the hemodialysis units have a significant occupational exposure to blood-borne virus infection. Furthermore, they are in danger of contacting occupational low back-pain because they have to take care of patients in a half-rising position. In addition, they may also suffer from burned-out syndrome because they have to look after all the chronic renal failure patients as well as run machines during the hemodialysis procedure. In this paper, we describe occupational danger to health of nursing staffs working in hemodialysis units.

[The association of self-rated health and mortality--a 7-year follow-up study of a Japanese community].

This study aims to examine whether self-rated health is an independent predictor of cause-specific mortality even after the influence by a variety of factors in relation to mortality reported by previous studies have been excluded. This study included randomly selected 4,259 inhabitants (1,827 men and 2,432 women) in Y city, Fukuoka prefecture, Japan, aged from 30 to 79 in 1987. These subjects were surveyed in 1987 by self-administered questionnaires regarding self-rated health as well as life habits, and followed up for their vital status and underlying causes of death. After excluding the individuals who were lost to follow up or who didn't respond to the question on self-rated health, 4,046 individuals were analysed to see the relationship between self-rated health and cause-specific mortality by Cox proportional hazard models, controlling for sex, age, smoking, BMI, medical care use and ADL. It was shown that relative risks for all causes, cancer, circulatory disease and other causes among the unhealthy group were 2.95 (95% CI: 1.93-4.50), 2.96 (1.53-5.73), 2.32 (0.86-6.26) and 4.09 (2.12-7.89), relatively. In the analyses of the subgroup (subjects without diseases in 1987 or subjects excluding deceased cases within first 3 years after follow-up), to avoid selection bias, the association between self-rated health and mortality was substantially similar to the results obtained in the former analysis, even the association was weakened. Even after excluding both of the subjects with diseases in 1987 and the subjects who died in the first 3 years after follow-up, self-rated health could be associated with mortality from all causes (RR = 1.89, 95%CI; 0.91-3.94). From the results it is suggested that self-rated health itself can be the independent predictor of mortality.

[A sero-epidemiological study on atrophic gastritis and Helicobacter pylori infection].

The aim of this study is to clarify the relationship between the incidence of atrophic gastritis and Helicobacter pylori infection. A case control study was conducted in 1995. Cases and controls were selected among those who took an annual health examination in a rural area of Fukuoka Prefecture. Cases are those who were not diagnosed as having atrophic gastritis in 1991 or 1992 but were diagnosed as having atrophic gastritis in 1995 by the examination of serum pepsinogens. Controls are those who were not diagnosed as having atrophic gastritis between 1991, or 1992 and 1995. Helicobacter pylori infection was evaluated by anti Helicobacter pylori IgG in 1995. The odds ratio for atrophic gastritis was calculated using Logistic regression analysis. The odds ratio of age and sex was not significant, but the odds ratio of Helicobacter pylori infection was significantly elevated (5.2, 95% confidence interval: 2.08-13.17). As for the influence of sex difference on the incidence of atrophic gastritis by Helicobacter pylori infection, the odds ratio among males was not significant (1.4, 95% confidence interval: 0.30-6.10), but the odds ratio among females was significantly high (9.8, 95% confidence interval: 2.82-34.11). These results suggest that Helicobacter pylori infection is associated with the incidence of atrophic gastritis. There may be a risk difference between males and females in the incidence of atrophic gastritis caused by Helicobacter pylori infection.