The study outcomes with regard to the basis of serum immunochemistry biomarkers and HRCT indicate that exposure to hardly soluble indium compound dust may represent a risk for interstitial lung damage.
Long-term follow-up of currently and formerly indium-exposed workers is essential not only to clarify the natural history of indium lung but also to trace the incidence of lung cancer. It is also necessary to elucidate the mechanism of indium lung and difference in clinical manifestations between Japanese and US cases.
Acceptability and Long‐Term Compliance with Drug Treatment for Hypercholesterolemia in Japanese Male Workers: 1. Acceptability of Drug Treatment: Masayuki Tatemichi, et al. Department of Environmental and Occupational Health, Toho University School of Medicine—We performed a prospective study to assess the acceptability and long‐ term compliance with drug treatment for hypercholesterolemia in Japanese male workers aged 40 to 57 yr with hypercholesterolemia detected in legally required periodical physical examinations. This paper describes the acceptability of statin‐based drug treatment. All eligible workers who had not improved after 3‐month diet therapy were recommended for drug treatment with simvastatin, a 3 hydroxy‐3‐ methylcoenzyme A reductase inhibitor. Subsequently, according to each individual preference, the subjects were divided to two groups: a group which accepted drug treatment (DT) and a group which rejected it. The subjects who did not accept drug treatment were further assigned to two groups according to their preference: a group which accepted only dietary intervention (Dl) and a non‐treatment group (NT). Among 1,278 workers recruited, 656 (51.3%) were placed in the DT group, 414 (32.4%) in the Dl group and 208 (16.3%) in the NT group. In the DT group, mean serum total cholesterol (TC) was the highest [272 ± 30 (SO) mg/dl]. The acceptability of drug treatment was significantly associated with the serum TC level, pre‐existing medical history of hypertension and a family history of ischemic heart disease (IHO). The occupational issues such as type of job, overtime worked, sleeping time and psychologicalstatus were different among the three groups, and habits of taking breakfast and daily exercise were associated with acceptability of drug treatment. These data suggest that acceptability of the drug treatment is low and associated with the work‐and lifestyle‐ related issues as well as IHO risk factors.
Acceptability and Long-Term Compliance with Drug Treatment for Hypercholesterolemia in Japanese Male Workers: II. Long-Term Compliance with Drug Treatment: Masayuki TATEMICHI, et at. undertook a prospective study to assess the long-term compliance of Japanese male workers with drug treatment for hypercholesterolemia. In workers who accepted treatment with simvastatin, an HMG-CoA reductase inhibitor, compliance was monitored every 6 months with an interview. Factors affecting compliance were identified by using the background characteristics of subjects and a self-administered questionnaire on their type of job, job style, private lifestyle and psychological status at work. Mean (SD) follow-up periods were 21.5 (10.6) months for 640 workers, and 240 noncompliant « 75 % of prescription) subjects were found. Of these 240, 23 (9.6%) were restored to be finally compliant at the last follow-up (re-compliant). We assessed the time-course rate of compliant subjects and factors affecting drug compliance using Cox proportional hazard model by setting occurrence of a noncompliant attitude to an endpoint. The cumulative compliance rate at 36 months was 0.508 when excluding 23 re-compliant subjects and 0.529 when considering them as compliant. Multivariate analysis showed that age and present medical illness with hypertension (HT) in background characteristics of subjects and the habit of having breakfast daily in factors related to private-lifestylewere significantly associated with compliance. Baseline lipid profiles and work related issues were not associated with compliance. The occurrence rate of side effects did was similar in compliant and noncompliant workers. In this study, even though considering the re-compliant subjects, the rate of compliant subjects over a 3-yr period was considerably low (around 50%). The factors related to compliance were age, present illness with HT and the habit of having breakfast daily. (J Occup Health 2002; 44: 307-314)
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