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The purpose of this study was to investigate the relationship between insomnia and future risk of developing depression. This was a 6-year cohort survey from 2011 to 2017. A questionnaire was conducted with male workers in a manufacturing industry. The questions included the Center for Epidemiologic Studies Depression Scale (CES-D) for evaluating depression and the Athens Insomnia Scale (AIS) for rating insomnia. Data from 1,332 daytime workers aged less than 60 years who had no depressive symptoms at baseline were analyzed. The risk of developing depression in the future was associated with insomnia at baseline, after adjusting for age (hazard ratio [HR] 1.64). Even after adjusting for the covariances of job type, living with family, sleeping time, and undergoing treatment or taking medication, insomnia was associated with the onset of future depression (HR 1.58). In addition, the HR increased as the total AIS score increased: total AIS score 1-3 points (HR 1.99; 95% CI 1.23-3.22), 4-5 points (HR 3.58; 95% CI 2.18-5.89), and 6 points and above (HR 4.24; 95% CI 2.49-7.21). The risk of developing depression in the future increased in correlation with greater severity of insomnia at baseline, suggesting that even slight insomnia can be a risk of future developing depression. It may be important to measure the level of insomnia using an indicator such as AIS, and to improve sleep quality in workers to prevent depression.

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OBJECTIVES: The Industrial Safety and Health Law implemented in December 2015 mandates that workplaces with more than 50 employees should perform annual stress checks on their employees; workplace with fewer than 50 employees are required only to make an effort to perform such checks. Notably, more than half of all workers in Japan work for workplaces with fewer than 50 employees. Therefore, the effectiveness of this legislation is compromised by its limited applicability to small-scale workplace. This research examined the extent to which workplaces with 30-49 employees provide mental health measures and stress checks, and considered the effective types of taking to promote the implementation of stress checks in a small-scale workplaces. METHODS: Questionnaires were mailed to workplaces in Aichi Prefecture with 30-49 employees. Data from independent companies were compared with those from branch offices of larger businesses, whereas data from workplaces with and without an individual charged with promoting mental health were also compared. RESULTS: The number of workplaces in the independent group was 290, whereas that in the branch group was 331. In the independent group, 55 workplaces appointed an individual to promote mental health, whereas 235 did not; in the branch group, 102 offices appointed an individual to promote mental health, whereas 229 did not. Compared with independent workplaces, a greater proportion of branch offices not only appointed individuals to promote mental health but also actively engaged in efforts to promote mental health. Indeed, stress checks had been performed in almost half of the branch offices surveyed. The workplaces in both groups that appointed an individual to promote mental health reported more positive efforts in this regard and were more likely to implement stress checks. Our data also suggest that the success of extending mandatory stress checks to workplaces with fewer than 50 employees would be facilitated by appointing skilled individuals to promote the mental health of employees in both groups. Such efforts by independent workplaces could be facilitated by an adequate budget, whereas the availability of experts would be of assistance to branch offices. However, public support for use of such services was low in both groups, and this was especially pronounced in independent workplaces. CONCLUSIONS: A smaller proportion of independent workplaces, compared with branch offices, engaged in not only efforts to promote mental health but also the implementation of stress checks. However, groups with an individual promoting the mental health of employees reported more positive efforts. Encouraging the appointment of individuals charged with promoting employee mental health is expected to lead to a positive approach to stress checking.

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OBJECTIVES: This 3-year cohort study was conducted to investigate the relation between insomnia and development of depression in male workers, and to clarify the association between the severity of insomnia and the onset of depression. METHODS: Self-administered questionnaire surveys on depression and insomnia were conducted on male workers for 3 years. Depression was assessed with the Center for Epidemiologic Studies Depression Scale (CES-D), and insomnia was examined using the Athens Insomnia Scale (AIS). The analysis was done with 840 men who had no depression at baseline. RESULTS: Depression symptoms were newly found in 113 men during this study. Cox regression analyses showed that people with insomnia (AIS score of ≥ 1) at baseline had about a 7 times greater risk for onset of depression. Furthermore, compared with those with AIS score of 0 (no insomnia), people with AIS score of 1-3 had a 5.2-fold greater risk of depression and those with a score of 4 or higher indicated about tenfold greater risk. CONCLUSIONS: A new finding was that the risk for onset of depression increased with the severity of insomnia.

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OBJECTIVES: Mental disorders are increasing and their influence on productivity is a concern in the workplace. However, few studies have investigated depression among blue-collar and white-collar workers in the manufacturing industry. The purpose of this study was to clarify the factors associated with depressive symptoms, focusing on lifestyles and insomnia. METHODS: A self-administered questionnaire survey was conducted of 1,963 workers at an annual health checkup in a manufacturing company. Of the 1,712 respondents (response rate: 87%), 1,258 male worker subjects (blue-collar 674; white-collar 584) were analyzed after excluding those with mental diseases. The questionnaire included items on basic attributes and lifestyle. The Athens Insomnia Scale (AIS) and The Center for Epidemiologic Studies for Depression Scale (CES-D) were used to evaluate insomnia and depressive symptoms. RESULTS: The incidence of depressive symptoms with CES-D scores of ≥16 was 15.1% in both the blue-collar and the white-collar workers. Insomnia with AIS scores of ≥6 were encountered in 18.8% of the blue-collar workers and 18.3% of the white-collar workers. Multiple logistic regression analyses showed that for the blue-collar workers, depressive symptoms were associated with "AIS scores ≥6" (Odds ratio (OR): 10.93; 95% confidence interval (CI): 6.12-19.15), "not get rid of fatigue with sleep" (OR: 3.36; 95%CI: 1.85-6.09), "skip breakfast over 3 times a week" (OR: 3.10; 95%CI:1.42-6.76), "no family living together" (OR: 2.08; 95%CI: 1.05-4.12), and "commuting time" (OR: 1.01; 95%CI: 1.00-1.02). For the white-collar workers, depressive symptoms were related to "AIS scores ≥6" (OR: 14.91; 95%CI: 7.54-29.49), and "no family living together" (OR: 2.54; 95%CI: 1.27-5.09). Sleep time was not associated with depression in both blue- and white-collar workers. Depressive symptoms were found in 51.6% of the blue-collar workers with insomnia with AIS scores ≥6 and 53.8% of white-collar workers. CONCLUSIONS: Depressive symptoms were found at the same prevalence rate in both blue-collar and white-collar workers, which suggests that health measures for depression are necessary for both types of worker. Depressive symptoms were significantly associated with insomnia. Health advice focusing on insomnia as well as lifestyle may be important for workers.

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Relationships between work-related psychological and physical stress responses and counts of white blood cells (WBCs), neutrophils, and lymphocytes were investigated in 101 daytime workers. Counts of WBCs and neutrophils were positively associated with smoking and inversely correlated with high density lipoprotein (HDL)-cholesterol levels. Additionally, general fatigue score as measured by the profile of mood state was positively correlated with WBC and neutrophil counts whereas lymphocyte counts was not significantly associated with fatigue score. Multiple regression analysis showed that WBC count was significantly related to general fatigue, age, and HDL-cholesterol levels. Neutrophil count was significantly related to HDL-cholesterol levels and fatigue score. Among various psychological stress response variables, general fatigue may be a key determinant of low-grade inflammation as represented by increases of WBC and neutrophil counts.

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We divided subjects into hs-CRP of ≤1.0 mg/l and >1.0 mg/l, and investigated the relationship between hs-CRP and basic attributes, lifestyle and health checkup test results. In particular, hs-CRP increased significantly as BMI increased, and hs-CRP of >1.0 mg/l was seen in about 40% of people with BMI of ≥25 kg/m(2) and 75% with BMI of ≥ 30 kg/m(2). Persons with 3 or more abnormalities in BMI, blood pressure, serum lipid and glucose were found in 20.0% of those with hs-CRP >1.0 mg/l, while 4.3% in hs-CRP ≤ 1.0 mg/l. The present findings have suggested that hs-CRP > 1.0 mg/l can be an indicator for obesity-related risks in male Japanese.

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OBJECTIVE: To clarify the relation between short sleeping time, obesity and eating behaviors in male workers. METHODS: A self-completed questionnaire survey of 680 male daytime workers (age 19-60 years, mean age 42.9 ± 12.5 years) at a manufacturing plant was conducted in 2005. Subjects were divided into two groups by body mass index (BMI): 480 non-obese men with BMI of <25.0 kg/m(2) (mean age 42.8 ± 12.8 years) and 200 obese men with BMI of ≥25.0 kg/m(2) (mean age 43.3 ± 11.7 years). Basic attributes and living habits were then investigated, and the relation of eating behavior to each BMI level was analyzed. BMI and eating behaviors were also investigated in relation to sleeping time. RESULTS: Sleeping time was significantly shorter in obese men than in non-obese men. Multiple regression analysis showed that sleep time as well as living with family were independent factors for greater BMI. BMI increased as sleeping hours became shorter in the order of ≥9 h, 8 h, 7 h, and ≤6 h. With shorter sleeping time, the mean eating behaviors scores also increased for cognition of constitution, substitution eating and drinking, feeling of satiety, meal contents, eating rhythm abnormalities, and eating style. The mean scores for these eating behaviors all increased with level of obesity, and these behaviors were characteristic of the obese men. CONCLUSIONS: This study showed that people with short sleeping times tended to have eating behaviors of eating more, which can lead to obesity. Short sleeping time may contribute to eating much and then obesity.

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The aim of the present study was to examine the relation of insomnia with job stress factors, stress response, and social support. A self-completed questionnaire survey was conducted in 212 male Japanese workers at a synthetic fiber plant. With regard to insomnia, subjects were asked the first 5 of the 8 questions on the Athens Insomnia Scale (AIS). Job stress factors, stress response and social support were assessed using the Job Stress Questionnaire. Multiple regression analyses showed that psychological job stress factors of poor appropriateness of work and high qualitative workload were associated with insomnia. The psychological stress response of depression and physical stress responses were also related with insomnia. Depression was also related to appropriateness of work. The present results showed that insomnia was closely related with the psychological job stress factor of appropriateness of work and the psychological response of depression. These mutual relationships between insomnia and poor mental health need be investigated further.

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OBJECTIVE: We examined a possible relation among obesity, eating behavior, and job stress in male Japanese workers. METHODS: A questionnaire survey on lifestyle, eating behavior, and job stress was conducted with 595 male daytime workers (19-60 y of age, mean +/- SD 41.8 +/- 12.6 y of age) in a synthetic-fiber manufacturing plant. The 431 non-obese men (body mass index <25.0 k/m(2), mean age 41.7 +/- 12.9 y) and 164 obese men (body mass index > or = 25.0 k/m(2), mean age 42.0 +/- 11.9 y) were examined in relation to obesity, eating behavior, and job stress. Body mass index was calculated from height and weight measured in an annual health check. RESULTS: Obesity was associated with eating behaviors such as eating to satiety, eating fast, and substitution eating from irritability. These eating behaviors were related to high job demands of quantitative workload. The eating behaviors were also correlated with psychological stress responses of fatigue, tension/anxiety, and depression, which were associated with quantitative workload. CONCLUSION: The present study suggests that high job demands of quantitative workload may be a factor related to eating behavior to eat a lot among male Japanese workers. Increased workplace stress from job strain may affect the workers through eating behaviors to eat a lot that contribute to obesity.

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Sleep deprivation has been shown to be associated with an increase in inflammatory makers such as interleukin-6 and C-reactive protein. The purpose of the present study was to investigate the relation between subjective poor sleep and white blood cell (WBC) count, an inflammatory marker. The subjects were 208 male Japanese workers in a synthetic fiber-manufacturing plant, who responded to a cross-sectional survey of a questionnaire on basic attributes, life style, and sleep. All male workers in the plant took an annual health checkup. WBC count was also examined in the checkup. The WBC count was greater in shift workers than in daytime workers. Shift workers complained of poor sleep more frequently, though their sleeping hours were longer. Multiple regression analysis showed that poor sleep as well as smoking habit, BMI and age were independent factors for an increase in WBC count, while sleeping hours and work pattern (shift work) were not significant factors. The present finding that poor sleep was associated with higher WBC count in male workers might suggest the importance of quality of sleep, particularly among shift workers.

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OBJECTIVE: To clarify the relation of weight gain to eating behavior and job stress through a 2-year cohort study of non-obese male Japanese workers. METHOD: A survey of life style, eating behavior, and job stress was conducted in 2003 and 2005 using the same questionnaire. The subjects were 122 non-obese (BMI ≤ 24.9 kg/m(2)) male workers aged 21-60 years (mean age 35.3 ± 12.2 (S.D.) years) in a manufacturing industry in 2003. BMI was calculated from height and weight obtained from health examinations in 2003 and 2005. BMI changes over the 2 years were classified into three groups: decrease; no change or increase of BMI < 1 kg/m(2); and increase of BMI ≥ 1 kg/m(2). RESULTS: Weight gain over the 2 years was associated with the eating behavior of 'eating to satiety'. In the workers who gained BMI ≥ 1 kg/m(2), the score for 'eating to satiety' category increased over the 2 years, while no such trend was found in the subjects who lost weight or gained <1 kg/m(2). The score of eating to satiety in those who gained ≥1 kg/m(2) was also correlated with the psychological stress responses of tension/anxiety and depression, which were related to job demands positively and job latitudes negatively. CONCLUSIONS: The present study suggests that eating to satiety is a key eating behavior for weight gain in non-obese male Japanese workers. The eating behavior can be affected by psychological job stress responses such as tension/anxiety and depression. Workers feeling stressed may be more likely to develop their eating behavior to eat much and gain weight.