Objectives　Despite suggested associations among smoking exposures and the prevalence of allergic diseases in children, studies examining the effect of prenatal maternal smoking and secondhand smoking on the occurrence of these diseases in children are limited. Our study aimed to investigate the association between prenatal maternal smoking as well as secondhand smoking and the incidence of asthma or atopic dermatitis in children.

Methods　We included checkup data of a total of 53,505 children living in Kobe, Japan, without missing values for exposure or outcome, between April 1, 2004, and March 31, 2013. The exposure variables were prenatal maternal smoking, prenatal secondhand smoking, and postnatal secondhand smoking till 4 months, which were assessed by maternal notification form and exclusively classified into eight categories. The outcome variables were the incidence of asthma or atopic dermatitis in the respective children up to 3 years of age assessed by a checkup questionnaire. The association between the smoking exposures and the development of asthma or atopic dermatitis up to 3 years was examined using a generalized linear mixed model with odds ratios and 95% confidence intervals (CI). Additionally, multiple imputation methods were used for the missing covariates.

Results　Of the 53,505 children, 27,210 (50.9%) were males and 26,218 (49.0%) were females. In total, 5,810 (10.9%) children were diagnosed with asthma and 4,964 (9.3%) with atopic dermatitis up to 3 years of their age. Compared to the children born to nonsmoking mothers during pregnancy and those without exposure to postnatal secondhand smoking, the adjusted odds ratio for the incidence of asthma up to 3 years of their age was found to be 2.04 (95% CI: 1.38-3.01) in children exposed to prenatal maternal smoking. Similarly, the adjusted odds ratio for the incidence of asthma in children exposed to maternal secondhand smoking during pregnancy was 1.12 (95% CI: 1.01-1.25) when compared with children who were never exposed to any smoking. Additionally, the adjusted odds ratio increased to 1.86 (95% CI: 1.42-2.44) in children exposed to both prenatal maternal smoking and secondhand smoking. In contrast, no statistical significance was observed among the smoking exposures and the incidence of atopic dermatitis in the children.

Conclusions　Our study confirmed that prenatal maternal and secondhand smoking were associated with the incidence of asthma in children. These findings suggest a need to focus on smoking cessation by pregnant women as well as by family members living together to prevent the development of asthma in children.

Objectives　The proportion of Japanese women who maintain their employment during pregnancy and after delivery has been increasing. Previous studies from Western countries showed an association between the mother's occupation and birth outcomes; however, to the best of our knowledge, no epidemiological study has analyzed this association in Japan. Therefore, data from the national Vital Statistics: Occupational and Industrial Aspects were used to examine the association between the mother's occupation and (1) the risk of stillbirth at or after 12 weeks of gestation, and (2) the risk of infant death under 1 year of age after livebirth.

Methods　Data from the Vital Statistics: Occupational and Industrial Aspects (Live Birth Form, and Foetal Death Form) for fiscal years (FYs) 1995, 2000, 2005, 2010, and 2015 and Vital Statistics data files (Death Form) from FYs 1995-96, 2000-01, 2005-06, 2010-11, and 2015-16 were analyzed. The study population consisted of (1) 5,355,881 infants who were born during the survey period, with (2) 5,290,808 live birth excluding still birth during the same period. The odds ratios (ORs) were estimated for (1) stillbirth (without stillbirth = livebirth) and (2) infant death (without infant death = alive at 1 year of age) by mother's occupation (managers/specialist/technical workers, clerical workers, sales workers, service workers, blue collar workers, and not employed) using logistic regression. Blue collar workers included workers in security, agriculture/forestry/fishing, manufacturing process, transport, and machine operation. The population attributable risk (PAR) for stillbirth attributed to mother's occupation among employed mothers was also calculated.

Results　There were 61,179 (1.1%) stillbirths in the study population and 12,789 (0.2%) infant deaths among 5,290,808 live birth. Compared to managers/specialist/technical workers, the adjusted ORs (95% confidence interval) for stillbirth among clerical workers, sales workers, service workers, blue collar workers and not employed women were 1.24 (1.20-1.29), 1.48 (1.41-1.56), 1.76 (1.69-1.83), 1.54 (1.46-1.61), and 0.95 (0.92-0.98), respectively. There was no association between the mother's occupation and infant deaths. The PAR values for stillbirth among mothers employed as clerical workers and service workers were 7.4% and 12.3%.

Conclusion　The risk of stillbirth differed according to the mother's occupation in our study. The OR and PAR of stillbirth were the highest for service workers. Mother's occupation was not associated with the risk of infant death; therefore, the mothers' occupation is likely to affect the children's condition only during pregnancy. Our study suggests the importance of understanding the causal linkage between pregnant women's occupation and birth outcomes.

Objective　In Japan, the revised Health Promotion Act and the Tokyo Metropolitan Ordinance to Prevent Exposure to Second-hand Smoke have been in place since April 1, 2020. However, regional differences in the prohibition of smoking in restaurants have raised concerns that some restaurants are not regulated by the smoke-free legislation. In addition, outdoor smoking rules have been in place in municipalities prior to the smoke-free legislation, so smoking outside restaurants may occur, and this may obstruct progress in the prohibition of smoking. In this study, we examined the indoor smoking rules before and after the enforcement of the smoke-free legislation, as well as what influenced the changes in these rules.

Methods　We conducted a self-administered questionnaire survey in 6,000 restaurants in Tokyo, Osaka, and Aomori prefectures from February to March 2020. We examined the indoor smoking rules before and after the enforcement of the smoke-free legislation and calculated the proportion of change by categorizing the indoor smoking rules into “smoking prohibited,” “smoking permitted in separate area,” and “smoking permitted.”

Results　Of the 879 restaurants that responded, 603 indicated that they were not regulated by the smoke-free legislations. The percentage of restaurants that switched from “smoking permitted in separate area” and “smoking permitted” to “smoking prohibited” was 5.2% (3/58) in Tokyo, 23.1% (31/134) in Osaka, and 17.2% (57/326) in Aomori. In addition, when we included restaurants that were already “smoking prohibited” before the enforcement and did not plan to change the rules after the enforcement, the percentage was 46.6% (55/118) in Tokyo, 49.6% (113/228) in Osaka, and 48.6% (125/257) in Aomori.

Conclusion　In total, 17.6% (91/518) of the restaurants that were not regulated by the smoke-free legislations would plan to change their indoor smoking rules from “smoking permitted in separate area” and “smoking permitted” to “smoking prohibited.” There is a concern regarding the reduction in customers and sales due to the prohibition of smoking, and the existence of outdoor smoking rules prior to the smoke-free legislation may obstruct progress in the prohibition of smoking. It will be important to examine changes in the number of customers and sales resulting from changes to the indoor smoking rules to deal with smokers when smoking is prohibited, and to improve environments set as public smoking spaces in Japan.

Objectives　The purpose of this study was to assess the situation of regional cancer screening of individuals in Sapporo city through an independent survey and to identify groups with low cancer screening rates.

Methods　We conducted a self-administered questionnaire survey on 3,000 men aged 40 to 69 years and 4,000 women aged 20 to 69 years living in Sapporo (response rate = 32.4%). The contents of the survey were quoted from the health slips of the Comprehensive Survey of Living Conditions related to cancer screening, as well as basic and cancer-related attributes. We analyzed the relationship between cancer screening participation rate, basic attributes, and cancer-related attributes using the χ² test or logistic regression analysis.

Results　The screening rates recorded in this study for gastric, colon, and lung cancers were 67.4%, 59.2%, and 66.1%, respectively in men, and 48.7%, 47.7%, and 53.4%, respectively in women. The screening rates were 52.7% and 56.1% for uterine and breast cancers, respectively.

　The participation rate of non-working individuals and those who had National Health Insurance was significantly lower for all cancer types among both men and women. Regarding attributes and cancer screening, the odds ratio of working to non-working individuals was 3.00 to 3.09 in men and 1.41 to 2.46 in women. The odds ratio of non-National Health Insurance individuals was 3.47 to 4.26 in men and 1.47 to 2.52 in women. In addition, there was a significant association between awareness and rates of Sapporo city cancer screening in both men and women, with the exception of stomach cancer screening in women. Furthermore, the odds ratio of awareness was 1.41 to 1.74 in men and 1.24 to 1.48 in women.

Conclusion　The cancer types with screening rate below 50% were gastric and colon cancers in women. In men, the screening rate for gastric, colon, and lung cancers exceeded 50%. The cancer-screening rate was found to be low among both non-working men and women, those with national health insurance, or those who do not recognize the Sapporo city cancer screening (regional screening). The characteristics of the group with low participation status in Sapporo city, which was the only parameter not reported in the Comprehensive Survey of Living Conditions, has been clarified.