ObjectivesPrevious studies have reported that displacement from one’s own home after a natural disaster is associated with a higher degree of psychological distress. The present study investigated the longitudinal association between the period of residence in prefabricated temporary housing and psychological distress after the Great East Japan Earthquake.Design, setting and participantsWe conducted a longitudinal observation of 284 adults (aged ≥18 years) who had lived in prefabricated temporary housing in Miyagi, Northeastern Japan. The period of residence in prefabricated temporary housing was classified into three categories: <3, 3–4 and >4 years (ie, still living in prefabricated temporary housing).OutcomesThe Kessler 6-item Psychological Distress Scale (K6) was assessed in both a baseline survey (2011) and a follow-up survey (2016). Higher psychological distress was defined by a K6 score of ≥5. We used Firth’s penalised likelihood method in the multivariate logistic regression model to estimate the adjusted ORs and 95% CIs.ResultsAmong the total participants, the proportion of individuals with higher psychological distress at the follow-up survey was significantly higher in the >4 years category (multivariate OR=4.00, 95% CI 1.67 to 10.16) than in the <3 years category. Among participants who had a lower degree of psychological distress at the baseline, the proportion of those whose psychological distress deteriorated was significantly higher in the >4 years category (multivariate OR=4.87, 95% CI 1.26 to 20.28) than in the <3 years category. On the other hand, among the participants who had a higher degree of psychological distress at the baseline, the proportion of those whose psychological distress ameliorated was significantly lower in the >4 years category (multivariate OR=0.26, 95% CI 0.06 to 0.85) than in the <3 years category.ConclusionsThe proportion of individuals with more severe psychological distress was higher among participants who had lived in prefabricated temporary housing for a long period.

Although cigarette smoking is a well-known risk factor for lung cancer, histology-specific risk has not been fully clarified in Japan. This case-control study evaluated the associations between smoking and lung cancer risk according to sex and histologic type. From among patients aged 30 years and over admitted to a single hospital in Japan between 1997 and 2009, 1670 lung cancer cases and 5855 controls were selected. History of smoking, quantity and duration of smoking, and passive smoking from spouses were assessed using a self-administered questionnaire. Odds ratios (ORs) and 95% confidence intervals (CIs) for each exposure were estimated by unconditional logistic regression. Ever-smoking was significantly associated with a higher risk of squamous cell and small cell carcinoma. The OR for these two histologic types combined was larger in women (OR = 24.98, 95% CI: 13.50-46.23) than in men (OR = 9.43, 95% CI: 5.73-15.51). Analysis of the quantity and duration of smoking showed that the OR for each exposure level tended to be larger in women than in men. For adenocarcinoma, clear positive associations with quantity and duration-related factors were observed among men, and a significant positive association with passive smoking from spouses was found among non-smoking women (OR = 1.44, 95% CI: 1.06-1.95). These results suggest sex-and histologic type-differences in the association of smoking with lung cancer risk. Although smoking control should be continued to prevent lung cancers, further studies are required to better clarify differences in smoking-related lung cancer risk between the sexes and histologic types. (Cancer Sci 2013; 104: 1515-1522 D uring the past several decades, trends in cancer incidence have changed in Japan. Lung cancer has been the leading site in male cancer mortality since 1993, although it has the second highest incidence after stomach cancer.(1) For women, lung cancer is the fifth leading-site in cancer incidence and is expected to continuously increase. Additionally, the patterns of lung cancer incidence according to histologic type have also changed, (2) the incidence of adenocarcinoma having increased and that of both squamous cell carcinoma and small cell carcinoma having decreased.Cigarette smoking has been regarded as the most important risk factor for lung cancer.(3) Smoking control would undoubtedly be the most effective method for prevention of lung cancer. However, risk estimates for cigarette smoking appear to vary according to sex and histologic type.(3-5) Thus, it seems difficult to precisely predict the overall effect of smoking control on lung cancer morbidity. In a previous case-control study, we analyzed lung cancer risk of cigarette smoking according to histologic type.(6) However, that study was unable to clarify any histology-specific risk in relation to the quantity and duration of smoking. Also, the risk of lung cancer according to histologic type could not be fully evaluated in women, due to the small number of cases of female squamous cell and small cell carcino...

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It has already been established that severe psychological distress is a major risk factor for completed suicide. However, the impact (population attributable fraction; PAF) of moderate psychological distress on completed suicide has not been clarified. The present study investigated the association between various severities of psychological distress and completed suicide. We analyzed follow-up data covering a 7.3-year period (2006-2014) for 43,473 adults (aged ≥ 40 years) participating in a community-based, prospective cohort study. Psychological distress was measured using the K6 psychological distress scale at the baseline. Participants were classified into three groups according to their K6 score (low: 0-4; moderate: 5-12; severe: 13-24). Completed suicide was determined from a Japanese national database. The Cox model was used to estimate hazard ratios (HRs) for completed suicide. The PAFs of moderate and severe psychological distress for completed suicide were also estimated. The multivariate-adjusted HRs (95% confidence interval) for completed suicide were 2.37 (1.49-3.78) among participants with moderate psychological distress, and 4.16 (2.13-8.15) among those with severe psychological distress, relative to those with low psychological distress (P for trend < 0.001). The PAF of the moderate group for completed suicide was 26.8%, whereas that of the severe group was 10.9%. Not only severe but also moderate psychological distress was significantly associated with an increased risk of completed suicide. The PAF of moderate psychological distress for completed suicide was larger than that of severe psychological distress. Public health actions for suicide prevention should focus on moderate as well as severe psychological distress.

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