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Iwami O.,Iwami Neurological Clinic | Ikeda M.,Kyoto Industrial Health Association
Environmental Health and Preventive Medicine | Year: 2013

Objectives: Many traditionally established medical interventions are not examined with randomized trials especially in emergency medicine. We researched what is the scientific basis of the measurement of the causal effect in these interventions and proposed another trial to measure causal effects. Methods: We deduced steady state trials from the counterfactual model and used Bayesian approaches to estimate causal effects statistically. Results: When the state of the observed person is fairly steady before an exposure, the ratio of the after-period to the before-period of the exposure is sufficiently small, and changes are obtained in relatively short time, it is possible to postulate that the state of the counterfactual person to be compared is almost equal to the state of the real person before the exposure. Bayesian approaches show that the causal effect of the exposure is estimated even in only one-person steady state trials, when large changes are observed. Conclusions: Steady state trials are valid methods to measure causal effects and can measure causal effects even in one-person trials. When we can measure the causal effect of interventions with steady state trials, these interventions should be regarded as scientific without use of randomized trials. © 2012 The Author(s). Source


Moon C.-S.,Catholic University of Pusan | Lee C.K.,Institute of Environmental and Occupational Medicine | Hong Y.S.,Dong - A University | Ikeda M.,Kyoto Industrial Health Association
Asia Pacific Journal of Clinical Nutrition | Year: 2014

This survey was initiated to examine possible coastal-inland differences in cadmium (Cd) burden in general Korean populations. In total, 268 healthy non-smoking middle-aged women (30 to 49 years; 88 residents in 8 coastal areas and 180 residents in 15 inland areas) participated in the study. They offered peripheral blood and spot urine samples so that cadmium in blood (Cd-B) and urine (Cd-U) were taken as exposure markers. Determination of Cd-B and Cd-U was carried out by graphite furnace atomic absorption spectrophotometry. With regard to Cd burden, geometric means for the coastal and inland residents were 1.70 and 1.72 μg/L for Cd-B, 1.54 and 1.00 μg/L for Cd-U as observed (Cd-U), 2.59 and 1.81 μg/g creatinine for Cd-U as corrected for creatinine (Cd-Ucr), respectively. Cd-U and Cd-Ucr were higher in the coastal areas than in inland areas. Reasons for higher Cd-U in the coastal areas than in the inland areas were are discussed in relation to major sources of Cd in daily life of the residents. Attention was paid to consumption of fish and shellfish in the coastal areas as major sources of dietary Cd intake. This study shows that Cd burdens were higher in coastal areas than in inland areas in Korea. Source


Moon C.-S.,Catholic University of Korea | Yang H.-R.,Seoul Metropolitan Government Research Institute of Public Health and Environment | Nakatsuka H.,Miyagi University | Ikeda M.,Kyoto Industrial Health Association
Environmental Health and Preventive Medicine | Year: 2016

Objectives: The aim of this study was to elucidate past and current levels of cadmium (Cd) intake among the general populations in Korea. Methods: For this purpose, publications reporting dietary intake of cadmium (Cd-D), cadmium concentration in blood (Cd-B) and that in urine (Cd-U) in Korea were retrieved through literature survey for a period from 1975 to 2015. Results: In practice, 9, 21 and 14 articles were available on Cd-D, Cd-B and Cd-Ucr (Cd-U as corrected for creatinine concentration), respectively. Linear regression analyses of the reported values as a function of years (i.e., the year when each survey was conducted) showed steady decreases in all of the three exposure markers of Cd-D, Cd-B and Cd-Ucr. Factors possibly contributing for the reduction were discussed including the government-set guideline of 0.2 mg/kg for rice and changes in food habits among general populations. Conclusions: There have been steady decreases in Cd-D, Cd-B and Cd-Ucr. The current estimates for Cd-D, Cd-B and Cd-Ucr were 6.0–7.4 μg/day, 0.73–0.83 μg/L and 0.60–0.95 μg/g cr, respectively. © 2016 The Japanese Society for Hygiene Source


Kawai T.,Osaka Occupational Health Service Center | Mitsuyoshi K.,Osaka Occupational Health Service Center | Ikeda M.,Kyoto Industrial Health Association
Journal of Occupational Health | Year: 2015

Objectives: The aim of this study was to examine the applicability of urinalysis for unmetabolized solvent to biomonitor 1,2-dichloropropane (1,2-DCP) exposure. Methods: Thirty three male printers exposed to 1,2-DCP and 5 nonexposed male controls participated in the study. The 8-hr average levels of exposure to 1,2-DCP in air and 1,2-DCP in the end-of-shift urine samples were measured with capillary FID-GC. Results: The geometric mean (the maximum) concentrations was 7.1 ppm (23.1 ppm) for 1,2-DCP in air, and the level in urine (without correction for urine density) was 77 μ g/l (247 μ g/l). A regression analysis showed a correlation coefficient of 0.909 (p<0.01). No 1,2-DCP was detected in the urine samples from nonexposed subjects. Conclusions: The high correlation and low background (essentially zero) showed that urinalysis for unmetabolized 1,2-DCP is a promising tool for biomonitoring of occupational exposure to this carcinogenic solvent at lower levels (e.g. <1 ppm). © 2015. Japan Society for Occupational Health. Source


Joosen M.C.W.,University of Tilburg | Brouwers E.P.M.,University of Tilburg | Van Beurden K.M.,University of Tilburg | Terluin B.,VU University Amsterdam | And 9 more authors.
Occupational and Environmental Medicine | Year: 2015

Background: We compared available guidelines on the management of mental disorders and stress-related psychological symptoms in an occupational healthcare setting and determined their development and reporting quality. Methods: To identify eligible guidelines, we systematically searched National Guideline Clearinghouse, Guidelines International Network Library and PubMed. Members of the International Commission on Occupational Health (ICOH), were also consulted. Guidelines recommendations were compared and reporting quality was assessed using the AGREE II instrument. Results: Of 2126 titles retrieved, 14 guidelines were included: 1 Japanese, 2 Finnish, 2 Korean, 2 British and 7 Dutch. Four guidelines were of high-reporting quality. Best described was the Scope and Purpose, and the poorest described were competing interests (Editorial independence) and barriers and facilitators for implementation (Applicability). Key recommendations were often difficult to identify. Most guidelines recommend employing an inventory of symptoms, diagnostic classification, performance problems and workplace factors. All guidelines recommend specific return-to-work interventions, and most agreed on psychological treatment and communication between involved stakeholders. Discussion: Practice guidelines to address work disability due to mental disorders and stress-related symptoms are available in various countries around the world, however, these guidelines are difficult to find. To promote sharing, national guidelines should be accessible via established international databases. The quality of the guideline's developmental process varied considerably. To increase quality and applicability, guideline developers should adopt a common structure for the development and reporting of their guidelines, for example Appraisal of Guidelines for Research and Evaluation (AGREE) criteria. Owing to differences in social systems, developers can learn from each other through reviews of this kind. Source

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