An Occupational Health Study of E m e r g e n c y P h y s i c i a n s i n J a p a n : H e a l t h Assessment by Immune Variables (CD4, CD8, CD56, and NK cell activity) at the Beginning of Work: Hiroteru OKAMOTO, et al. Department of Preventive Medicine and Public Health, School of Medicine, Kyorin University-This study was conducted to evaluate the occupational health of Japanese physicians in emergency medicine. Subjects participating in this study were eighty-nine physicians working at 12 medical facilities (10 critical care emergency centers) in Japan. Participants were asked to complete a questionnaire of work conditions and to provide blood samples for immune variable measurements (CD4, CD8, CD56 and natural killer cell (NK cell) activity) before commencing their work. The data collected from seventy-four of 89 participating physicians were analyzed. The traditional work group comprised of 39 emergency physicians, who were significantly overworked compared to other two groups: the shift work group and the day work group. Among these three groups, no immune variable was significantly different except lymphocyte, number of CD4, and NK cell activity; and the NK cell activity of the shift work group was significantly lower than those of the traditional work group (p<0.01) and the day work group (p<0.01) in terms of Bonferroni's multiple comparison, probably due to circadian rhythm. It was indicated that NK cell activity was significantly lower in samples collected at night versus in the morning (OR=8.34, 95%CI: 1.95-35.6, p<0.01) through multiple logistic regression analyses. NK cell activity was significantly lower in individuals taking 0-3 days off per month, as compared to those taking 4 or more days off (OR=4.65, 95%CI: 1.27-17.0, p=0.02), according to multiple logistic regression analyses. Therefore, the low NK cell activity appears to have reflected the extent of fatigue arising from physicians' overwork. Overwork would have been a potential risk for the physicians' health, resulting in a lower quality of Japanese emergency medical services than that which could have been achieved otherwise. This study suggests that it would be better for the Japanese emergency physicians to take 4 or more days off per month for their health and the quality of their services. (J Occup Health 2008; 50: 136-146)

Objectives The purpose of this study was to assess and compare the improvement in oral and systemic conditions and health-related quality of life in patients with missing teeth receiving dental implants and conventional treatment. Methods A total of 97 patients with missing teeth, of whom 59 received dental implants and 38 received conventional treatment, were included in this study. The patients were divided into two age groups for a more detailed analysis: a 30-to 59-year age group (young) and a [60-year age group. The changes in oral condition, mental health, and health utility level before and after (pre-and post-, respectively) the procedures were assessed using an original questionnaire,

Objectives Changes in B-type natriuretic peptide (BNP) and electrocardiographic (ECG) findings in an adult Japanese population were measured over a 5-year period, and the statistical relationships between these were evaluated. Methods This was a longitudinal analysis in which data were collected on 353 subjects (135 men and 218 women) who had undergone general health checks in 1998 and 2003. Results Data were examined by correlation coefficient and one-way analysis of covariance using repeated measurements. The correlation coefficient for BNP between 1998 and 2003 was 0.622 (P \ 0.0001) for the men and 0.557 (P \ 0.0001) for women. The changes in BNP over the same period were 13.71 ± 26.06 (P \ 0.0001) pg/ml in the men and 20.17 ± 32.01 (P \ 0.0001) pg/ml in the women. In 99 men and 145 women who had undergone ECG tests, with both normal and abnormal findings, visual inspections of changes in the ECG findings with respect to BNP changes were performed over the 5-year period. In men, both age and BNP significantly correlated with changes in ECG findings; however, in women, no significant correlation between BNP and changes in ECG findings was observed. Conclusions This regional longitudinal study revealed a gender difference in the relationship between long-term changes in BNP and ECG findings, suggesting that a 10 pg/ ml or more increase in BNP in men over a 5-year period may a indicate worsening of cardiac function and the need for intervention.

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