Environmental Health and Preventive Medicine最新文献

{"title":"A suspected case of \"itai-itai disease\" in a cadmium-polluted area in Akita prefecture, Japan.","authors":"Toru Sasaki, Hyogo Horiguchi, Takehisa Matsukawa, Momoko Kobayashi, Yuki Omori, Etsuko Oguma, Atsushi Komatsuda","doi":"10.1265/ehpm.24-00063","DOIUrl":"10.1265/ehpm.24-00063","url":null,"abstract":"<p><strong>Background: </strong>Itai-itai disease is the most severe case of chronic cadmium (Cd) toxicity, which was endemic in Cd-polluted areas in the Jinzu River basin in Toyama prefecture, Japan. Akita prefecture also has Cd-polluted areas, but there have been no cases of \"itai-itai disease\".</p><p><strong>Case presentation: </strong>An elderly female farmer with Cd nephropathy residing in a Cd-polluted area in the northern part of the Akita prefecture was identified through hospital-based screening at Akita Rosai Hospital in Odate city. She had chronic renal failure with a high Cd exposure level and advanced renal tubular dysfunction. The shortening of height, bone deformities and fractures, abnormal bone metabolism suggesting osteomalacia, and renal anemia were also noted. Therefore, \"itai-itai disease\", similar to cases in the Jinzu River basin, was suspected.</p><p><strong>Conclusion: </strong>This is the first case of \"itai-itai disease\" in a Cd-polluted area in Akita prefecture.</p>","PeriodicalId":11707,"journal":{"name":"Environmental Health and Preventive Medicine","volume":"29 ","pages":"40"},"PeriodicalIF":4.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11310559/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141901336","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Oral hygiene status and vascular aging in schoolchildren and their mothers.","authors":"Shogo Nakane, Yuki Ito, Kayo Kaneko, Sayaka Kato, Kyoko Minato, Takeshi Ebara, Shinji Saitoh, Mayumi Sugiura-Ogasawara, Yasuyuki Shibuya, Michihiro Kamijima","doi":"10.1265/ehpm.24-00093","DOIUrl":"10.1265/ehpm.24-00093","url":null,"abstract":"<p><strong>Background: </strong>Poor oral hygiene, generally manifesting as dental caries, gingivitis, or periodontitis, is a common chronic condition among both children and adults worldwide and has been reportedly associated with hypertension and arterial stiffness mainly in adult patients. However, these associations have not been well-studied in children and adults in the general population. Therefore, we conducted this cross-sectional study to clarify the associations between oral hygiene indices and high blood pressure (BP)/hypertension and arterial stiffness as assessed by the cardio-ankle vascular index (CAVI) in children along with their mothers. The association between maternal oral hygiene and high BP in children was also examined based on the hypothesis that maternal awareness of oral hygiene is related to their children's oral hygiene.</p><p><strong>Methods: </strong>This study was conducted as an Adjunct Study of the Aichi Regional Sub-Cohort of the Japan Environment and Children's Study. Participating children (n = 220, 85-104 months old) and their mothers (n = 217, 29-52 years old) underwent dental/intra-oral examination and BP and CAVI assessment. High BP in children and hypertension in mothers were diagnosed according to corresponding American guidelines. Logistic regression analysis or analysis of covariance was used to examine the associations of poor oral hygiene indices with BP and CAVI.</p><p><strong>Results: </strong>Maternal dental caries ≥1 was associated with their hypertension (adjusted odds ratio [aOR]: 2.72, 95% confidence interval (CI): 1.12-6.61). Maternal dental plaque ≥1/3 was associated with maternal hypertension and children's high BP (aOR, 95% CI: 4.71, 1.33-16.73 and 5.67, 1.22-25.04, respectively). Maximum pocket depth ≥4 mm was associated with children's high BP (aOR: 6.85, 95% CI: 1.24-38.01). No associations were observed between oral hygiene indices and CAVI in children; however, there was a significant association between dental plaque and CAVI in mothers (F = 5.62, p < 0.01).</p><p><strong>Conclusions: </strong>The small sample size, especially the case number, made it necessary to refrain from drawing unambiguous conclusion. The hypothesis that warrants further investigation based on the present study results is that poor oral hygiene is associated with high BP in children and hypertension and arterial stiffness in mothers, and maternal oral hygiene is associated with high BP in children.</p>","PeriodicalId":11707,"journal":{"name":"Environmental Health and Preventive Medicine","volume":"29 ","pages":"42"},"PeriodicalIF":4.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11341943/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141970860","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Seasonal variation in vascular dehydration risk: insights from the Kobe Orthopedic and Biomedical Epidemiologic (KOBE) study.","authors":"Tomofumi Nishikawa, Naomi Miyamatsu, Aya Higashiyama, Yoshimi Kubota, Yoko Nishida, Takumi Hirata, Aya Hirata, Junji Miyazaki, Daisuke Sugiyama, Kazuyo Kuwabara, Sachimi Kubo, Yoshihiro Miyamoto, Tomonori Okamura","doi":"10.1265/ehpm.24-00132","DOIUrl":"10.1265/ehpm.24-00132","url":null,"abstract":"<p><strong>Background: </strong>Dehydration, a risk factor for ischemic cerebrovascular diseases, is common in summer; however, the incidence of ischemic diseases is not necessarily higher in summer. Therefore, this study aimed to clarify the relationships between serum osmolarity, hematocrit, daily non-alcohol drink (NAD) intake and factors such as season and age as risk factors for dehydration.</p><p><strong>Method: </strong>Participants (703 women and 306 men) in the follow-up survey, in 2012 and 2013, of the Kobe Orthopedic and Biomedical Epidemiologic (KOBE) Study, consisting of healthy individuals living in Kobe, Japan, were categorized into two groups based on the examination month: the warmer and colder seasons. Multivariate analyses were conducted to examine disparities in serum osmolarity, hematocrit, and NAD intake between these two groups.</p><p><strong>Results: </strong>The colder season was found to be negatively correlated with serum osmolarity and NAD intake, but positively correlated with hematocrit, even after adjusting for relevant factors. Age was independently associated with serum osmolarity, but not with hematocrit and NAD intake.</p><p><strong>Conclusions: </strong>This study suggests that intra-vascular volume depletion is more likely in the colder season despite lower serum osmolarity compared to the warmer season. Age-related increases in serum osmolarity without a corresponding rise in water intake may contribute to this. These findings support the importance of addressing dehydration in the colder season, particularly in older adults.</p>","PeriodicalId":11707,"journal":{"name":"Environmental Health and Preventive Medicine","volume":"29 ","pages":"62"},"PeriodicalIF":4.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11551438/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142575808","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relationship between working hours and sleep quality with consideration to effect modification by work style: a community-based cross-sectional study.","authors":"Aya Yoshida, Keiko Asakura, Haruhiko Imamura, Sachie Mori, Minami Sugimoto, Takehiro Michikawa, Yuji Nishiwaki","doi":"10.1265/ehpm.23-00252","DOIUrl":"10.1265/ehpm.23-00252","url":null,"abstract":"<p><strong>Background: </strong>Although longer working hours are associated with lower sleep quality, it is still necessary to work a certain number of hours to make a living. In this study, we investigated the relationship between working hours and sleep quality in a community setting. We then explored how to manage work style while maintaining the sleep quality of workers without markedly reducing working hours.</p><p><strong>Methods: </strong>4388 day-time workers in various occupations living in Ota ward in Tokyo were included in the analysis. The relationship between working hours and sleep quality measured by the Athens Insomnia Scale was examined by ANOVA and linear regression models. Effect modification by work style (work end time, shift in working start and end time, current work from home status, change in work place) on the relationship between working hours and sleep quality was investigated by multivariate linear regression models.</p><p><strong>Results: </strong>Longer working hours were significantly associated with lower sleep quality. The magnitude of the relationship between long working hours and low sleep quality was significantly larger when work end time was later (p for trend of interaction < 0.01) and when working start and end time were shifted later (vs no change, p for interaction = 0.03). The relationship was marginally greater when the proportion of work from home was increased (vs no change, p for interaction = 0.07).</p><p><strong>Conclusions: </strong>A relationship between longer working hours and lower sleep quality was observed among workers. Leaving work earlier or optimizing the work environment at home may diminish the adverse effect of long working hours on sleep quality.</p>","PeriodicalId":11707,"journal":{"name":"Environmental Health and Preventive Medicine","volume":"29 ","pages":"19"},"PeriodicalIF":4.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10965413/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140179477","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gabapentin improves neuropathic pain in Minamata disease model rats.","authors":"Masatake Fujimura","doi":"10.1265/ehpm.24-00035","DOIUrl":"10.1265/ehpm.24-00035","url":null,"abstract":"<p><strong>Background: </strong>Methylmercury (MeHg), the causative agent of Minamata disease, damages the cranial nervous system and causes specific sensory disturbances, especially hypoesthesia, in the extremities. However, recent reports demonstrate that patients with chronic Minamata disease conversely develop neuropathic pain in the lower extremities. Studies on our established Minamata disease model rats showed that MeHg-mediated neurodegeneration might induce neuropathic pain by over time through inducing rewiring with neuronal activation in the somatosensory cortex via microglial activation in the spinal dorsal horn.</p><p><strong>Methods: </strong>In this study, the effects of gabapentin, a potentially effective treatment for neuropathic pain, was evaluated using this Minamata disease model rats. To further elucidate the mechanism of its medicinal effects, histochemical and biochemical analyses of the nervous system of Minamata disease model rats were conducted.</p><p><strong>Results: </strong>Gabapentin treatment restored the reduction in the pain threshold caused by MeHg exposure in rats. Histochemical and biochemical analyses revealed that gabapentin showed no effect on MeHg-induced neurodegeneration in entire nervous system and microglial activation in the spinal dorsal horn. However, it was shown that gabapentin may reduce excessive synaptogenesis through its antagonist action on the alpha2-delta-1 subunit of calcium channels in the somatosensory cortex.</p><p><strong>Conclusions: </strong>These results indicate that gabapentin may alleviated neuropathic pain in MeHg poisoning, as typified by Minamata disease, by reversibly modulation synaptic rewiring in the somatosensory cortex.</p>","PeriodicalId":11707,"journal":{"name":"Environmental Health and Preventive Medicine","volume":"29 ","pages":"31"},"PeriodicalIF":4.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11157338/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141199749","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lower regional urbanicity and socioeconomic status attenuate associations of green spaces with hypertension and diabetes mellitus: a national representative cross-sectional study in China.","authors":"Wanzhou Wang, Chao Yang, Jinwei Wang, Fulin Wang, Ze Liang, Yueyao Wang, Feifei Zhang, Chenyu Liang, Chenshuang Li, Yiqun Lan, Shuangcheng Li, Pengfei Li, Ying Zhou, Luxia Zhang, Lieyun Ding","doi":"10.1265/ehpm.24-00121","DOIUrl":"10.1265/ehpm.24-00121","url":null,"abstract":"<p><strong>Background: </strong>High blood pressure (HBP) and diabetes mellitus (DM) are two of the most prevalent cardiometabolic disorders globally, especially among individuals with lower socio-economic status (SES). Studies have linked residential greenness to decreased risks of HBP and DM. However, there has been limited evidence on whether SES may modify the associations of residential greenness with HBP and DM.</p><p><strong>Methods: </strong>Based on a national representative cross-sectional study among 44,876 adults, we generated the normalized difference vegetation index (NDVI) at 1 km spatial resolution to characterize individuals' residential greenness level. Administrative classification (urban/rural), nighttime light index (NLI), individual income, and educational levels were used to characterize regional urbanicity and individual SES levels.</p><p><strong>Results: </strong>We observed weaker inverse associations of NDVI with HBP and DM in rural regions compared to urban regions. For instance, along with per interquartile range (IQR, 0.26) increment in residential NDVI at 0∼5 year moving averages, the ORs of HBP were 1.04 (95%CI: 0.94, 1.15) in rural regions and 0.85 (95%CI: 0.79, 0.93) in urban regions (P = 0.003). Along with the decrease in NLI levels, there were continuously decreasing inverse associations of NDVI with DM prevalence (P for interaction <0.001). In addition, weaker inverse associations of residential NDVI with HBP and DM prevalence were found among individuals with lower income and lower education levels compared to their counterparts.</p><p><strong>Conclusions: </strong>Lower regional urbanicity and individual SES could attenuate the associations of residential greenness with odds of HBP and DM prevalence.</p>","PeriodicalId":11707,"journal":{"name":"Environmental Health and Preventive Medicine","volume":"29 ","pages":"47"},"PeriodicalIF":4.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11391273/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142153375","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between temperature and mortality: a multi-city time series study in Sichuan Basin, southwest China.","authors":"Yizhang Xia, Chunli Shi, Yang Li, Shijuan Ruan, Xianyan Jiang, Wei Huang, Yu Chen, Xufang Gao, Rong Xue, Mingjiang Li, Hongying Sun, Xiaojuan Peng, Renqiang Xiang, Jianyu Chen, Li Zhang","doi":"10.1265/ehpm.23-00118","DOIUrl":"10.1265/ehpm.23-00118","url":null,"abstract":"<p><strong>Background: </strong>There are few multi-city studies on the association between temperature and mortality in basin climates. This study was based on the Sichuan Basin in southwest China to assess the association of basin temperature with non-accidental mortality in the population and with the temperature-related mortality burden.</p><p><strong>Methods: </strong>Daily mortality data, meteorological and air pollution data were collected for four cities in the Sichuan Basin of southwest China. We used a two-stage time-series analysis to quantify the association between temperature and non-accidental mortality in each city, and a multivariate meta-analysis was performed to obtain the overall cumulative risk. The attributable fractions (AFs) were calculated to access the mortality burden attributable to non-optimal temperature. Additionally, we performed a stratified analyses by gender, age group, education level, and marital status.</p><p><strong>Results: </strong>A total of 751,930 non-accidental deaths were collected in our study. Overall, 10.16% of non-accidental deaths could be attributed to non-optimal temperatures. A majority of temperature-related non-accidental deaths were caused by low temperature, accounting for 9.10% (95% eCI: 5.50%, 12.19%), and heat effects accounted for only 1.06% (95% eCI: 0.76%, 1.33%). The mortality burden attributable to non-optimal temperatures was higher among those under 65 years old, females, those with a low education level, and those with an alternative marriage status.</p><p><strong>Conclusions: </strong>Our study suggested that a significant association between non-optimal temperature and non-accidental mortality. Those under 65 years old, females, and those with a low educational level or alternative marriage status had the highest attributable burden.</p>","PeriodicalId":11707,"journal":{"name":"Environmental Health and Preventive Medicine","volume":"29 ","pages":"1"},"PeriodicalIF":4.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10788187/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139466333","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The global burden of vascular intestinal diseases: results from the 2021 Global Burden of Disease Study and projections using Bayesian age-period-cohort analysis.","authors":"Xiqiang Zhang, Longchao Wu, Yu Li, Ze Tao, Na Li, Haoyang Zhang, Ming Ren, Kexin Wang","doi":"10.1265/ehpm.24-00206","DOIUrl":"10.1265/ehpm.24-00206","url":null,"abstract":"<p><strong>Background: </strong>Vascular intestinal disease is a major health concern that often requires emergency surgery in patients with intestinal obstruction, perforation, or bowel necrosis. We aimed to provide data on the incidence, prevalence, mortality and disability-adjusted life years (DALYs) of vascular intestinal diseases from 1990 to 2021, thereby contributing to the development of health policies.</p><p><strong>Methods: </strong>Using standardized methods from the 2021 Global Burden of Disease study, we analyzed the incidence, prevalence, mortality, and DALYs of vascular intestinal disease from the perspectives of the sociodemographic index (SDI), regional, and country, along with the corresponding estimated annual percentage changes. Additionally, we used join-point regression to identify the key time points for disease burden changes.</p><p><strong>Results: </strong>In 2021, a total of 169,432 cases [95% uncertainty interval (UI): 155,127-185,189] of vascular intestinal disease were identified worldwide. The age-standardized incidence rate decreased from 18.81 (95% UI: 16.07-21.73) in 1990 to 15.98 (95% UI: 13.99-19.10) in 2021. In 2021, the age-standardized mortality rate was 1.12/100,000 people (95% UI: 1.00-1.21). Over the 32-year period, the global DALYs rate declined by 1.44 (95% Confidence Interval: -1.55 to -1.34). Within the five SDI regions, the high-middle SDI areas recorded the peak standardized mortality rates in 2021. Regionally, the greatest increase in incidence occurred in North Africa and the Middle East. Canada recorded the greatest national incidence rate [58.35 (95% UI: 50.05-67.37)] in 2021 among 204 countries, while Russia exhibited the highest related mortality [5.64/100,000 people (95% UI: 5.19-6.11)] and DALYs rate [101.48/100,000 people (95% UI: 93.83-109.66)].</p><p><strong>Conclusions: </strong>Despite a global decline in the burden of vascular intestinal disease from 1990 to 2021, significant regional and national disparities persist and the disease burden among the elderly has increased.</p>","PeriodicalId":11707,"journal":{"name":"Environmental Health and Preventive Medicine","volume":"29 ","pages":"71"},"PeriodicalIF":4.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11653002/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142812508","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ethylene oxide exposure increases impaired glucose metabolism in the US general population: a national cross-sectional study.","authors":"Yuqi Zhao, Deliang Liu, Xiaogao Pan, Yuyong Tan","doi":"10.1265/ehpm.24-00199","DOIUrl":"10.1265/ehpm.24-00199","url":null,"abstract":"<p><strong>Background: </strong>Current experimental evidence supports that ethylene oxide (EO) exposure-related pathophysiologies may affect glucose metabolism, but few population-based studies have explored the potential links.</p><p><strong>Methods: </strong>This study used cross-sectional data from 15560 participants in the National Health and Nutrition Examination Survey (NHANES) from 2017 to 2020. EO exposure levels were calculated by testing hemoglobin adducts of EO (HbEO) via a modified Edman reaction. We focused on the association of EO exposure with prediabetes and diabetes as well as indicators of impaired glucose metabolism and further analyzed the potential pathogenic mechanisms. Statistics included logistic regression, generalized additive model fitting, penalized spline method, two-piecewise linear regression, recursive algorithm, mediation analysis, and Pearson's analysis.</p><p><strong>Results: </strong>EO exposure was associated with changes in glucose metabolic indicators and increased prevalence of prediabetes and diabetes, showing age-consistency and being more pronounced in obese and non-smoking populations. For each one pmol/g Hb, one SD, or two-fold SD increase in log2-HbEO, the risk of prediabetes increased by 12%, 16%, and 33%, with an increased risk of diabetes by 18%, 26%, and 61%, respectively. Dose-response curves revealed that this positive correlation was approximately linear with prediabetes and \"J\" shaped with diabetes. When log2-HbEO > 8.03 pmol/g Hb, the risk of diabetes would be further increased. Pearson's correlation revealed that EO exposure was associated with reduced fasting insulin and elevated HbA1c in the prediabetic stage. While in the diabetes stage, EO exposure was correlated with elevated fasting glucose, HbA1c, and HOMA-IR, suggesting an exacerbation of diabetes progression by EO exposure. A potential mechanism that the early stages of impaired glucose metabolism may be initiated by EO-related inflammation and oxidative stress damaging pancreatic β-cells, resulting in decreased insulin secretion. These speculations were partially supported by mediation analysis and mediators' Pearson analysis.</p><p><strong>Conclusion: </strong>Elevated ethylene oxide exposure increases the incidence of impaired glucose metabolism in the general U.S. population and a potential intervention may be to effectively suppress inflammation and oxidative stress imbalances.</p>","PeriodicalId":11707,"journal":{"name":"Environmental Health and Preventive Medicine","volume":"29 ","pages":"68"},"PeriodicalIF":4.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11631556/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142794633","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk of severe COVID-19 in unvaccinated patients during the period from wild-type to Omicron variant: real-world evidence from Japan.","authors":"Kimiko Tomioka, Kenji Uno, Masahiro Yamada","doi":"10.1265/ehpm.23-00274","DOIUrl":"10.1265/ehpm.23-00274","url":null,"abstract":"<p><strong>Background: </strong>Many studies have reported that the Omicron variant is less pathogenic than the Delta variant and the wild-type. Epidemiological evidence regarding the risk of severe COVID-19 from the wild-type to the Omicron variant has been lacking.</p><p><strong>Methods: </strong>Study participants were COVID-19 patients aged 18 and older without previous COVID-19 infection who were notified to the Nara Prefecture Chuwa Public Health Center from January 2020 to March 2023, during the periods from the wild-type to the Omicron variant. The outcome variable was severe COVID-19 (i.e., ICU admission or COVID-19-related death). The explanatory variable was SARS-CoV-2 variant type or the number of COVID-19 vaccinations. Covariates included gender, age, risk factors for aggravation, and the number of general hospital beds per population. The generalized estimating equations of negative binomial regression models were used to estimate the adjusted incidence proportion (AIP) with 95% confidence interval (CI) for severe COVID-19.</p><p><strong>Results: </strong>Among 77,044 patients included in the analysis, 14,556 (18.9%) were unvaccinated and 520 (0.7%) developed severe COVID-19. Among unvaccinated patients, the risk of severe COVID-19 increased in the Alpha/Delta variants and decreased in the Omicron variant compared to the wild-type (AIP [95% CI] was 1.55 [1.06-2.27] in Alpha/Delta and 0.25 [0.15-0.40] in Omicron), but differed by age. Especially in patients aged ≥80, there was no significant difference in the risk of severe COVID-19 between the wild-type and the Omicron variant (AIP [95% CI] = 0.59 [0.27-1.29]). Regarding the preventive effect of vaccines, among all study participants, the number of vaccinations was significantly associated with the prevention of severe COVID-19, regardless of variant type. After stratified analyses by age, patients aged ≥80 remained a significant association for all variant types. On the other hand, the number of vaccinations had no association in Omicron BA.5 of patients aged 18-64.</p><p><strong>Conclusions: </strong>Patients aged ≥80 had less reduction in risk of severe COVID-19 during the Omicron variant period, and a greater preventive effect of vaccines against severe COVID-19, compared to younger people. Our findings suggest that booster vaccination is effective and necessary for older people, especially aged ≥80.</p>","PeriodicalId":11707,"journal":{"name":"Environmental Health and Preventive Medicine","volume":"29 ","pages":"10"},"PeriodicalIF":4.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10937246/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140049069","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}