Zhang Wen, Ohira Tetsuya, Yasumura Seiji, Maeda Masaharu, Otsuru Akira, Harigane Mayumi, Horikoshi Naoko, Suzuki Yuriko, Yabe Hirooki, Nagai Masato, Nakano Hironori, Hirosaki Mayumi, Uemura Mayu, Takahashi Hideto, Kamiya Kenji, Yamashita Shunichi, Abe Masafumi
Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima, Japan.
Department of Epidemiology, School of Medicine, Fukushima Medical University, Fukushima, Japan.
BMJ Open. 2017 Jun 23;7(6):e014077. doi: 10.1136/bmjopen-2016-014077.
To investigate the association between socioeconomic factors and the exacerbation of cardiovascular symptoms among evacuees after the Great East Japan Earthquake.
A sample of 73 433 individuals was included in the Fukushima Health Management Survey. Self-report questionnaires were used to determine the influence of socioeconomic factors including living arrangements, loss of employment and decreased income on the exacerbation of headache, dizziness, palpitations and shortness of breath. Odds ratios (ORs) and 95% CIs of the effect of socioeconomic factors were estimated for each symptom using multiple logistic regression analyses.
Exacerbation of headaches was reported by 1893 individuals, dizziness by 1229, palpitations by 1085 and shortness of breath by 626 individuals. Evacuation accommodation was associated with all of these symptoms. Compared with participants living in their own home (OR=1.00), individuals living in relatives' homes had increased probability of experiencing exacerbation of headache (1.58; 95% CI 1.19 to 2.09) and dizziness (1.42; 95% CI 1.02 to 1.98); those living in rental housing or apartments experienced exacerbation of headache (1.54; 95% CI 1.32 to 1.80), dizziness (1.45; 95% CI 1.20 to 1.75), palpitations (1.25; 95% CI 1.03 to 1.51) and shortness of breath (1.76; 95% CI 1.35 to 2.28); participants living in evacuation shelters experienced exacerbation of headache (1.80; 95% CI 1.09 to 2.96); and refugees living in temporary housing also experienced exacerbation of headache (1.42; 95% CI 1.15 to 1.72), dizziness (1.40; 95% CI 1.09 to 1.79) and shortness of breath (1.49; 95% CI 1.07 to 2.08). Compared with the evacuees who retained their jobs, unemployed individuals showed increased probability of exacerbation of headache (1.28, 95% CI 1.12 to 1.46), dizziness (1.26, 95% CI 1.07 to 1.48) and palpitations (1.21, 95% CI 1.01 to 1.45). Decreased income was associated with exacerbation of headache (1.39, 95% CI 1.22 to 1.60).
After the earthquake, living in non-home conditions was more likely to result in exacerbated cardiovascular symptoms among evacuees. Loss of employment was another risk factor related to exacerbated headache and dizziness.
调查东日本大地震后撤离人员的社会经济因素与心血管症状加重之间的关联。
福岛健康管理调查纳入了73433名个体样本。采用自填式问卷来确定包括居住安排、失业和收入减少等社会经济因素对头痛、头晕、心悸和呼吸急促加重的影响。使用多元逻辑回归分析估计社会经济因素对每种症状影响的比值比（OR）和95%置信区间（CI）。
报告头痛加重的有1893人，头晕加重的有1229人，心悸加重的有1085人，呼吸急促加重的有626人。疏散安置与所有这些症状都有关联。与住在自己家中的参与者相比（OR = 1.00），住在亲戚家的个体头痛加重（1.58；95%CI 1.19至2.09）和头晕加重（1.42；95%CI 1.02至1.98）的可能性增加；住在出租房屋或公寓的个体头痛加重（1.54；95%CI 1.32至1.80）、头晕加重（1.45；95%CI 1.20至1.75）、心悸加重（1.25；95%CI 1.03至1.51）和呼吸急促加重（1.76；95%CI 1.35至2.28）；住在疏散避难所的参与者头痛加重（1.80；95%CI 1.09至2.96）；住在临时住房的难民也有头痛加重（1.42；95%CI 1.15至1.72）、头晕加重（1.40；95%CI 1.09至1.79）和呼吸急促加重（1.49；95%CI 1.07至2.08）。与仍有工作的撤离人员相比，失业个体头痛加重（1.28，95%CI 1.12至1.46）、头晕加重（值为1.26，95%CI 1.07至1.48）和心悸加重（1.21，95%CI 1.01至1.45）的可能性增加。收入减少与头痛加重（1.39，95%CI 1.22至1.60）有关。
地震后，撤离人员居住在非自家环境中更有可能导致心血管症状加重。失业是与头痛和头晕加重相关的另一个风险因素。
