Journal of Epidemiology最新文献

{"title":"A Principal Component Analysis of Metabolome and Cognitive Decline Among Japanese Older Adults: Cross-sectional Analysis Using Tohoku Medical Megabank Cohort Study Data.","authors":"Sakura Kiuchi, Kumi Nakaya, Upul Cooray, Kenji Takeuchi, Ikuko N Motoike, Naoki Nakaya, Yasuyuki Taki, Seizo Koshiba, Shunji Mugikura, Ken Osaka, Atsushi Hozawa","doi":"10.2188/jea.JE20240099","DOIUrl":"10.2188/jea.JE20240099","url":null,"abstract":"<p><strong>Background: </strong>Dementia is the leading cause of disability and imposes a significant burden on society. Previous studies have suggested an association between metabolites and cognitive decline. Although the metabolite composition differs between Western and Asian populations, studies targeting Asian populations remain scarce.</p><p><strong>Methods: </strong>This cross-sectional study used data from a cohort survey of community-dwelling older adults aged ≥60 years living in Miyagi, Japan, conducted by Tohoku Medical Megabank Organization between 2013 and 2016. Forty-three metabolite variables quantified using nuclear magnetic resonance spectroscopy were used as explanatory variables. Dependent variable was the presence of cognitive decline (≤23 points), assessed by the Mini-Mental State Examination. Principal component (PC) analysis was performed to reduce the dimensionality of metabolite variables, followed by logistic regression analysis to calculate odds ratios (ORs) and 95% confidence intervals (CIs) for cognitive decline.</p><p><strong>Results: </strong>A total of 2,940 participants were included (men: 49.0%, mean age: 67.6 years). Among them, 1.9% showed cognitive decline. The first 12 PC components (PC1-PC12) accounted for 71.7% of the total variance. Multivariate analysis showed that PC1, which mainly represented essential amino acids, was associated with lower odds of cognitive decline (OR 0.89; 95% CI, 0.80-0.98). PC2, which mainly included ketone bodies, was associated with cognitive decline (OR 1.29; 95% CI, 1.11-1.51). PC3, which included amino acids, was associated with lower odds of cognitive decline (OR 0.81; 95% CI, 0.66-0.99).</p><p><strong>Conclusion: </strong>Amino acids are protectively associated with cognitive decline, whereas ketone metabolites are associated with higher odds of cognitive decline.</p>","PeriodicalId":15799,"journal":{"name":"Journal of Epidemiology","volume":" ","pages":"39-46"},"PeriodicalIF":3.7,"publicationDate":"2025-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11637816/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141554945","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Income Dynamics and Risk of Colorectal Cancer in Individuals With Type 2 Diabetes: A Nationwide Population-based Cohort Study.","authors":"Yong-Moon Mark Park, Benjamin C Amick Iii, Pearl A McElfish, Clare C Brown, Mario Schootman, Marie-Rachelle Narcisse, Seong-Su Lee, Yoon Jin Choi, Kyungdo Han","doi":"10.2188/jea.JE20230310","DOIUrl":"10.2188/jea.JE20230310","url":null,"abstract":"<p><strong>Background: </strong>Individuals with type 2 diabetes mellitus (T2DM) have increased colorectal cancer (CRC) risk, but it is unknown whether income dynamics are associated with CRC risk in these individuals. We examined whether persistent low- or high-income and income changes are associated with CRC risk in non-elderly adults with T2DM.</p><p><strong>Methods: </strong>Using nationally representative data from the Korean Health Insurance Service database, 1,909,492 adults aged 30 to 64 years with T2DM and no history of cancer were included between 2009 and 2012 (median follow-up of 7.8 years). We determined income levels based on health insurance premiums and assessed annual income quartiles for the baseline year and the four preceding years. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated after adjusting for sociodemographic factors, CRC risk factors, and diabetes duration and treatment.</p><p><strong>Results: </strong>Persistent low income (ie, lowest income quartile) was associated with increased CRC risk (HR_{5 years vs 0 years} 1.11; 95% CI, 1.04-1.18; P for trend = 0.004). Income declines (ie, a decrease ≥25% in income quantile) were also associated with increased CRC risk (HR_{≥2 vs 0 declines} 1.10; 95% CI, 1.05-1.16; P for trend = 0.001). In contrast, persistent high income (ie, highest income quartile) was associated with decreased CRC risk (HR_{5 years vs 0 years} 0.81; 95% CI, 0.73-0.89; P for trend < 0.0001), which was more pronounced for rectal cancer (HR 0.64; 95% CI, 0.53-0.78) and distal colon cancer (HR 0.70; 95% CI, 0.57-0.86).</p><p><strong>Conclusion: </strong>Our findings underscore the need for increased public policy awareness of the association between income dynamics and CRC risk in adults with T2DM.</p>","PeriodicalId":15799,"journal":{"name":"Journal of Epidemiology","volume":" ","pages":"30-38"},"PeriodicalIF":3.7,"publicationDate":"2025-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11637811/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141554948","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Methodological Tutorial Series for Epidemiological Studies: Confounder Selection and Sensitivity Analyses to Unmeasured Confounding From Epidemiological and Statistical Perspectives.","authors":"Kosuke Inoue, Kentaro Sakamaki, Sho Komukai, Yuri Ito, Atsushi Goto, Tomohiro Shinozaki","doi":"10.2188/jea.JE20240082","DOIUrl":"10.2188/jea.JE20240082","url":null,"abstract":"<p><p>In observational studies, identifying and adjusting for a sufficient set of confounders is crucial for accurately estimating the causal effect of the exposure on the outcome. Even in studies with large sample sizes, which typically benefit from small variances in estimates, there is a risk of producing estimates that are precisely inaccurate if the study suffers from systematic errors or biases, including confounding bias. To date, several approaches have been developed for selecting confounders. In this article, we first summarize the epidemiological and statistical approaches to identifying a sufficient set of confounders. Particularly, we introduce the modified disjunctive cause criterion as one of the most useful approaches, which involves controlling for any pre-exposure covariate that affects the exposure, outcome, or both. It then excludes instrumental variables but includes proxies for the shared common cause of exposure and outcome. Statistical confounder selection is also useful when dealing with a large number of covariates, even in studies with small sample sizes. After introducing several approaches, we discuss some pitfalls and considerations in confounder selection, such as the adjustment for instrumental variables, intermediate variables, and baseline outcome variables. Lastly, as it is often difficult to comprehensively measure key confounders, we introduce two statistics, E-value and robustness value, for assessing sensitivity to unmeasured confounders. Illustrated examples are provided using the National Health and Nutritional Examination Survey Epidemiologic Follow-up Study. Integrating these principles and approaches will enhance our understanding of confounder selection and facilitate better reporting and interpretation of future epidemiological studies.</p>","PeriodicalId":15799,"journal":{"name":"Journal of Epidemiology","volume":" ","pages":"3-10"},"PeriodicalIF":3.7,"publicationDate":"2025-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11637813/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141554947","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"New Special Article Series: \"Methodological Tutorial Series for Epidemiological Studies\".","authors":"Yuri Ito","doi":"10.2188/jea.JE20240387","DOIUrl":"https://doi.org/10.2188/jea.JE20240387","url":null,"abstract":"","PeriodicalId":15799,"journal":{"name":"Journal of Epidemiology","volume":"35 1","pages":"1-2"},"PeriodicalIF":3.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142931444","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Community social capital and all-cause mortality in Japan: Findings from the Adachi Cohort Study.","authors":"Hiroshi Murayama, Mika Sugiyama, Hiroki Inagaki, Ayako Edahiro, Fumiko Miyamae, Chiaki Ura, Keiko Motokawa, Tsuyoshi Okamura, Shuichi Awata","doi":"10.2188/jea.JE20240277","DOIUrl":"https://doi.org/10.2188/jea.JE20240277","url":null,"abstract":"<p><strong>Background: </strong>Community social capital is associated with various health outcomes; however, its impact on mortality is not fully understood, particularly in non-Western settings. This study examined the association between community-level social capital and all-cause mortality among community-dwelling older Japanese adults.</p><p><strong>Methods: </strong>The baseline data were obtained from a 2015 questionnaire survey for all 132,005 residents aged ≥65 years without long-term care insurance certification in Adachi Ward (consisting of 262 small districts) of the Tokyo metropolitan area. We measured two aspects of social capital: neighborhood cohesion as cognitive social capital and neighborhood network as structural social capital. For district-level social capital, we aggregated the individual responses of neighborhood cohesion and neighborhood network in each district.</p><p><strong>Results: </strong>A total of 75,338 were analyzed. A multilevel survival analysis with an average follow-up of 1,656 days showed that higher district-level neighborhood cohesion was associated with a lower risk of all-cause mortality in men (hazard ratio [95% confidence interval]: 0.92 [0.84-0.99] for the highest quintile and 0.91 [0.82-0.99] for the second, compared to the lowest), not in women. This association was more pronounced in men aged 65-74 years.</p><p><strong>Conclusions: </strong>This study provides valuable insights from the Asian population. Men, who typically have fewer social networks and support systems than women, could receive more benefits from residing in a cohesive community, which may contribute to their longevity. These findings support public health strategies that bolster community social capital as a means of archiving longevity among older men, underscoring the importance of social integration in aging societies.</p>","PeriodicalId":15799,"journal":{"name":"Journal of Epidemiology","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2024-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142877393","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of serum retinol-binding protein 4 levels in late pregnancy on the incidence of small/large for gestational age infants among 11,854 pregnant women: A retrospective study.","authors":"Bin Zhang, Zhaolong Zhan, Sijie Xi, Feng Wang, Xiaosong Yuan","doi":"10.2188/jea.JE20240275","DOIUrl":"https://doi.org/10.2188/jea.JE20240275","url":null,"abstract":"<p><strong>Background: </strong>There is still uncertainty regarding the association between maternal serum levels of retinol-binding protein 4 (RBP4) and pregnancy outcomes. This study aimed to determine the association between RBP4 levels and incidence of small/large for gestational age (SGA/LGA) infants among the Chinese population.</p><p><strong>Methods: </strong>This was a retrospective study of 11,854 pregnant women who delivered at Changzhou Maternal and Child Health Care Hospital between 2016 and 2017 and whose serum RBP4 levels were measured at the time of admission. The incidence of SGA/LGA deliveries was retrieved from the medical records of the participants.</p><p><strong>Results: </strong>Maternal RBP4 levels in the second, third and fourth quartiles (28.8-34.0, 34.1-40.0, and >40.0 mg/L, respectively) were associated with lower birthweights relative to those in the first quartile (<28.8 mg/L), with estimated average decreases of 51.30 g (95% CI: -70.51, -32.10), 86.86 g (95% CI: -106.50, -67.22) and 124.08 g (95% CI: -144.51, -103.64), respectively (P for trend <0.01). Pregnant women in the fourth quartile for RBP4 levels had a greater SGA risk (OR: 2.14, 95% CI: 1.72, 2.65) and lower LGA risk (OR: 0.53, 95% CI: 0.45, 0.63) than those in the first quartile after controlling for demographic variables, gestational age, pregnancy complications and other laboratory results. The sensitivity analysis indicated the consistency of these findings.</p><p><strong>Conclusion: </strong>High RBP4 levels in late pregnancy are associated with an increased SGA risk and decreased LGA risk, indicating that serum RBP4 levels at the time of admission for delivery could be a promising predictor of SGA/LGA delivery.</p>","PeriodicalId":15799,"journal":{"name":"Journal of Epidemiology","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2024-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142877413","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Validity of a self-administered food frequency questionnaire for genomic and omics research among pregnant women: the Tohoku Medical Megabank Project Birth and Three-Generation Cohort Study.","authors":"Keiko Murakami, Misako Nakadate, Taku Obara, Misato Aizawa, Ippei Takahashi, Mami Ishikuro, Aoi Noda, Hisashi Ohseto, Noriyuki Iwama, Masatoshi Saito, Ribeka Takachi, Shiori Sugawara, Yudai Yonezawa, Takahiro Yamashita, Shigenori Suzuki, Junko Ishihara, Masayuki Yamamoto, Shinichi Kuriyama","doi":"10.2188/jea.JE20240293","DOIUrl":"https://doi.org/10.2188/jea.JE20240293","url":null,"abstract":"<p><strong>Background: </strong>The Tohoku Medical Megabank Project has initiated the Birth and Three-Generation Cohort Study (TMM BirThree Cohort Study) including genomic and omics investigations, and conducted a self-administered food frequency questionnaire with the response option \"constitutionally unable to eat or drink it\" for individual food items (TMM-FFQ) for pregnant women. This study evaluated the validity of the TMM-FFQ among pregnant women.</p><p><strong>Methods: </strong>Participants comprised 122 pregnant women aged ≥20 years residing in Miyagi Prefecture who completed weighed food records (WFRs) for 3 days as reference intake and the TMM-FFQ during mid-pregnancy. Correlations between nutrient or food group intakes based on the WFR and the TMM-FFQ were calculated using Spearman's rank correlation coefficients (CCs), adjusting for energy intake and correcting for random within-individual variation of WFR. Cross-classification was also conducted according to quintiles using the WFR and TMM-FFQ data.</p><p><strong>Results: </strong>The percentages of participants who chose the \"constitutionally unable to eat or drink it\" option were >3% for seven food and drink items. CCs were >0.30 for 31 nutrients; the median across energy and 44 nutrients was 0.41. CCs were >0.30 for 14 food groups; the median across 20 food groups was 0.35. The median percentages of cross-classification into exact plus adjacent quintiles and extreme quintiles were 63.1% and 3.3% for energy and nutrients and 61.9% and 4.1% for food groups, respectively.</p><p><strong>Conclusions: </strong>The validity of the TMM-FFQ compared with the WFR was reasonable for certain nutrients and food groups among pregnant women in the TMM BirThree Cohort Study.</p>","PeriodicalId":15799,"journal":{"name":"Journal of Epidemiology","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2024-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142876464","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Three-year seroprevalence of SARS-CoV-2 nucleocapsid protein antibody among children, parental awareness, and contributors of infection: a single-school cohort study in Chiba, Japan.","authors":"Midori Yamamoto, Kenichi Sakurai, Rieko Takatani, Aya Hisada, Chisato Mori","doi":"10.2188/jea.JE20240284","DOIUrl":"https://doi.org/10.2188/jea.JE20240284","url":null,"abstract":"<p><strong>Background: </strong>Coronavirus disease 2019 (COVID-19) in children is often asymptomatic, posing challenges in detecting infections. Additionally, factors contributing to infection remain poorly understood. This study aimed to investigate trends in anti-severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) nucleocapsid antibody seroprevalence, the relationship between seroprevalence and parental perception of child infection, and factors related to COVID-19 in children.</p><p><strong>Methods: </strong>In December 2020, 355 children aged 6-12 years in one elementary school were enrolled in the study. The anti-SARS-CoV-2 nucleocapsid antibody seroprevalence was assessed, and questionnaires were administered annually for three years. Parents' perceptions of infection and factors contributing to infection were examined.</p><p><strong>Results: </strong>The seroprevalence was 0.6%, 2.2%, and 60.9% in the first, second, and third years, respectively. The third-year seroprevalence among children reported as 'infected,' 'not tested but had symptoms,' and 'not infected' by parents was 97.3%, 83.3%, and 35.7%, respectively. Increased odds of seropositivity at the third-year measurement were observed in lower grades (adjusted odds ratio [aOR]=2.79 compared with higher grades) and in children more likely to play with others (aOR=3.97 for 'somewhat' and 2.84 for 'often,' compared with 'rarely'). No significant associations with seropositivity were found for sex, siblings, body mass index, serum 25-OH vitamin D₃ concentration, or sleep duration.</p><p><strong>Conclusion: </strong>The Omicron variant outbreak from the end of 2021 led to a sharp increase in seroprevalence among children, with many unaware of their infection. Frequent play with others may facilitate transmission in children. These data provide useful information for developing countermeasures against COVID-19 and other future pandemics.</p>","PeriodicalId":15799,"journal":{"name":"Journal of Epidemiology","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2024-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142876405","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association Between Introduction of the 23-valent Pneumococcal Polysaccharide Vaccine (PPSV23) and Pneumonia Incidence and Mortality Among General Older Population in Japan: A Community-Based Study.","authors":"Aya Sugiyama, Masaaki Kataoka, Kentaro Tokumo, Kanon Abe, Hirohito Imada, Bunlorn Sun, Golda Ataa Akuffo, Tomoyuki Akita, Shingo Fukuma, Noboru Hattori, Junko Tanaka","doi":"10.2188/jea.JE20240285","DOIUrl":"https://doi.org/10.2188/jea.JE20240285","url":null,"abstract":"<p><p>BackgroundWith global aging, especially in Asia, preventing pneumonia among seniors is vital. The necessity of introducing pneumococcal vaccines among the elderly has been highlighted but there is a paucity of community-based real-world evidence on their effect. Sera Town in Hiroshima Prefecture, a super-aged community, launched a distinctive pneumococcal vaccination support project for elderly residents and conducted a 5-year follow-up survey. This study evaluates the effectiveness of this vaccination initiative.MethodsFrom October 2010 to March 2015, Sera Town recruited elderly residents for PPSV23 vaccination with partial cost subsidies. Participants were surveyed annually for five years post-vaccination to assess pneumonia incidence, calculated on a person-years basis. Using vital statistics from 2000 to 2016, we quantified changes in mortality rates associated with the vaccination support project through interrupted time series analysis.ResultsOf approximately 7,900 residents aged 65 and older, 3,422 (43%) participated in the project (median age: 84 years; range: 70-114 years; 56.7% female). Over 14,559 person-years of observation, 295 participants developed pneumonia. The post-vaccination incidence rate was 20.3 per 1,000 person-years (95% CI: 18.0-22.7). Interrupted time series analysis indicated a 25% reduction in Sera Town's pneumonia mortality rate post-project, reversing an annual increase of 0.23 per 1,000 population pre-project to an annual decrease of 0.04 per 1,000 population post-project.ConclusionThis study provided real-world evidence on the association with PPSV23 vaccination on the general elderly through a community-based study. The results may be particularly useful for regions where PPSV23 serotypes are prevalent, offering insights for areas facing aging challenges.</p>","PeriodicalId":15799,"journal":{"name":"Journal of Epidemiology","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2024-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142794780","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The condition of subjective daytime sleepiness and its related decline in work productivity among daytime workers.","authors":"Yuta Takano, Toshiyuki Hirasawa, Yuichi Inoue","doi":"10.2188/jea.JE20240295","DOIUrl":"https://doi.org/10.2188/jea.JE20240295","url":null,"abstract":"<p><strong>Background: </strong>Few have examined the condition of subjective daytime sleepiness in workers and its relation to their work productivity. This study aimed to clarify the association between the presence of subjective daytime sleepiness and work productivity measures, including presenteeism and absenteeism, as well as factors related to the presence of the symptom in daytime workers.</p><p><strong>Methods: </strong>This cross-sectional study included 17963 daytime workers who attended the annual medical check-up. They were categorized into four groups; the daytime sleepiness group was defined as having only subjective daytime sleepiness, the insomnia group as having only insomnia symptoms, the combination group as having both subjective daytime sleepiness and insomnia symptoms, and the healthy group as having no sleep complaints. This study used demographics, health status, workplace, work productivity, and sleep items included in the self-reported medical check-up questionnaire.</p><p><strong>Results: </strong>The combination group had significantly worse presenteeism than other groups. The daytime sleepiness and insomnia groups had significantly worse presenteeism than the healthy group. The results of absenteeism were the same as presenteeism. Factors related to the positivity for subjective daytime sleepiness were presence of psychiatric disease, the positivity for habitual snoring and/or witnessed apnea, shorter sleep duration on workdays, long working hours, female sex, living alone, the amount of social jetlag, and younger age.</p><p><strong>Conclusions: </strong>Subjective daytime sleepiness, not just insomnia symptoms, has a significant negative impact on work productivity, and both workplace and individual approaches should not be ignored for addressing subjective daytime sleepiness among daytime workers.</p>","PeriodicalId":15799,"journal":{"name":"Journal of Epidemiology","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2024-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142794794","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}