Japanese Workers Research Articles

Meiji Japan’s Path Towards Modernisation in the Nineteenth Century: A Reinterpretation of Japanese Policy of Hiring Foreign Workers in The Country

The study attempts to revisit the policy of hiring foreign experts and advisers in the Japanese public institution especially in the essential sectors such as bureaucracy, military, education, and economic sectors following the takeover of the Bakufu government by the Meiji leadership in 1868. This study also intends to investigate how successful such a policy was in paving the way for the modernization of the Japanese public institutions and economy as far as the Meiji leadership was concerned. In so doing, the study adopts a method of content analysis, deriving its observation from a wide range of archival and scholarly sources which are later selected for their relevance to the study. Eventually, the study demonstrates that the Meiji Government employed foreign experts, advisers, and employees in a way that would serve twofold purposes, namely of enforcing reforms in the country by having the Japanese workers acquire the know-how in related fields by working hand in hand with their foreign supervisors and co-workers. Soon thereafter, as the local Japanese workers were getting trained and later became experts by themselves, the Meiji Government had slowly reduced the number of foreign experts and advisers employed in the country.

Associations Between Consumption of Different Vegetable Types and Depressive Symptoms in Japanese Workers: A Cross-Sectional Study.

PurposeVegetable intake is an important part of our everyday diet and is associated with many positive health outcomes. Although previous studies have investigated the association between vegetable consumption and depressive symptoms among various populations, no study has examined this association in the adult working population. The present study investigated whether the frequency of consumption of a specific type of vegetable is associated with the prevalence of depressive symptoms in Japanese adult workers.Participants and MethodsThe final participants consisted of 1724 Japanese adults, and a cross-sectional study was conducted to analyze the results. The frequency of vegetable consumption and depressive symptoms was evaluated using a brief-type self-administered diet history questionnaire and the Zung Self-Rating Depression Scale (SDS), respectively. The association between the variables was examined using Poisson regression analysis. Age-stratified analysis was performed, and SDS cut-off values of 45 and 50 were used to perform a sensitivity analysis.ResultsAfter adjustment for covariates, including age, body mass index, sociodemographic and lifestyle-related variables, health condition, C-reactive protein, and other dietary variables, an inverse association was found between tomato product consumption and the prevalence of depressive symptoms among men (P for trend <0.01); however, no significant association was found for other vegetable types. For women, there was no association between the frequency of consumption of any of the vegetable types and the prevalence of depressive symptoms. The results were confirmed by the age-stratified analysis for both genders.ConclusionConsumption of tomato products may help alleviate depressive symptoms, regardless of differences in dietary culture among men.

Turnover in Japanese IT Professionals: Antecendants and Nuances

The Japanese information technology (IT) workplace is unique compared to that of other nations. IT represents a large sector of the country’s economy, and organizations need to develop proactive approaches to retain their IT workforce. In order to manage employee turnover, they need to understand the distinctive factors influencing employee turnover intention, as turnover intention is known to be a reliable predictor of actual turnover. In this study, a model was constructed and tested with data collected from 284 Japanese IT professionals. Our findings show that the effects of work exhaustion, personal accomplishment, and friendship networks on turnover intention are fully mediated through job satisfaction. Work-home conflict has no impact on job satisfaction. The strength of the relationships is stronger for younger than for older organizations. Furthermore, individualistic factors (i.e., work exhaustion and personal accomplishment) have a stronger impact on job satisfaction than collectivistic factors (i.e., work-home conflict and friendship networks). These results show the fragility of the notion of long-term employment, which is supposed to be embraced within the entire Japanese work culture.

Antibody response of smokers to the COVID-19 vaccination: Evaluation based on cigarette dependence.

Smokers may have lower antibody titers after vaccination with a coronavirus disease 2019 (COVID-19) mRNA vaccine. However, to the best of our knowledge, no study has evaluated antibody titers after COVID-19 vaccination based on the level of smokers' cigarette dependence. In this study, we measured the level of serum anti-severe acute respiratory syndrome coronavirus 2 (anti-SARS-CoV-2) spike protein receptor-binding domain (S-RBD) immunoglobulin-G (IgG) by enzyme linked immunosorbent assay of 55 actively smoking Japanese social workers (firefighters, paramedics, and rescue workers) who had received two doses of the BNT162b2 vaccine. Further, we assessed their cigarette dependence using the Fagerstrom Test for Nicotine Dependence (FTND), measured their serum cotinine levels, and tested for their correlation with anti-RBD IgG levels. Serum anti-SARS-CoV-2 S-RBD protein IgG levels after BNT162b2 vaccination showed a significant negative correlation with FTND (ρ = -0.426, p = 0.001). In addition, serum cotinine level showed a significant positive correlation with FTND (ρ = 0.470, p = 0.000). However, no significant negative correlation was noted between serum cotinine and serum anti-SARS-CoV-2 S-RBD protein IgG levels (ρ = -0.156, p = 0.256). Our results suggest that smokers with strong cigarette dependence have inadequate anti-SARS-CoV-2 S-RBD protein IgG levels after COVID-19 mRNA vaccination.

Association of domain-specific physical activity and sedentary behavior with cardiometabolic health among office workers.

Previous studies have reported opposite effects of occupational or non-occupational physical activity (PA) and sedentary behavior (SB) on health outcomes. However, no study has investigated the relationship between domain-specific movement behaviors and cardiometabolic health (CMH) among office workers, considering the compositional nature of time-use data. We investigated the associations of accelerometer-measured PA and SB for each domain (working time, non-working time on workday, and non-workday) with CMH indicators among office workers, using compositional data analysis. This cross-sectional study included 1258Japanese office workers. The time spent on SB, light-intensity PA (LPA), and moderate- to vigorous-intensity PA (MVPA) were assessed using an accelerometer. CMH indicators were retrieved from the annual health check-up data. Compositional multiple linear regression indicated that PA and SB during non-working time on workdays, but not working time or non-workdays, were significantly associated with CMH. In particular, during non-working time, time reallocations from SB to LPA and from SB to MVPA were associated with favorable changes in cardiometabolic risk score and lipid metabolism, respectively. Paradoxically, a greater proportion of LPA during non-working time was associated with favorable diastolic blood pressure (β=1.61; 95% confidence interval [CI]= 0.02, 3.19), whereas occupational LPA was detrimental (β=-2.48; 95% CI=-4.87, -0.09). Our results suggested that reducing SB and increasing PA during non-working time on workdays may be effective for managing CMH among office workers. Future longitudinal studies using compositional data analysis are required to confirm our results.

Sleep Satisfaction May Modify the Association between Metabolic Syndrome and BMI, Respectively, and Occupational Stress in Japanese Office Workers.

The association between obesity and psychological stress is ambiguous. The aim is to investigate the association between metabolic syndrome (MetS) and body mass index (BMI), respectively, with occupational stress among Japanese office workers. The study is a secondary analysis of the intervention group from a randomized controlled trial. There are 167 participants included in the analysis. Occupational stress is self-reported using the Brief Job Stress Questionnaire (BJSQ). BMI and the classification of MetS/pre-MetS was based on the participants’ annual health check-up data. The primary exposure is divided into three groups: no MetS, pre-MetS, and MetS in accordance with Japanese guidelines. The secondary exposure, BMI, remains as a continuous variable. Multiple linear regression is implemented. Sensitivity analyses are stratified by sleep satisfaction. Pre-MetS is significantly associated with occupational stress (7.84 points; 95% CI: 0.17, 15.51). Among participants with low sleep satisfaction, pre-MetS (14.09 points; 95% CI: 1.71, 26.48), MetS (14.72 points; 95% CI: 0.93, 28.51), and BMI (2.54 points; 95% CI: 0.05, 4.99) are all significantly associated with occupational stress. No significant associations are observed in participants with high sleep satisfaction. The findings of this study indicate that sleep satisfaction may modify the association between MetS and BMI, respectively, and occupational stress.

Association Between Loneliness and Sleep-Related Problems Among Japanese Workers During the COVID-19 Pandemic.

BackgroundThe coronavirus disease 2019 (COVID-19) pandemic has been linked to a rise in loneliness. Loneliness is associated with sleep-related problems, which in turn can be a risk factor for various psychiatric disorders. However, it is unclear whether loneliness is linked to sleep-related problems during the pandemic. Here, we studied the association between loneliness and sleep-related problems during the COVID-19 pandemic in Japan.MethodsA total of 33,302 individuals who indicated they were employed were surveyed online. The survey responses of 27,036 participants were analyzed. Odds ratios (ORs) were estimated using univariate and multiple logistic regression analyses.ResultsOf those analyzed, 2,750 (10.2%) experienced feelings of loneliness. Further, sleep-related problems were significantly more common among those who felt lonely both in the short term (more than 3 days) and the long term (more than 3 months). The ORs were much weaker after adjusting for factors related to interpersonal connections, such as family and friendships, than after adjusting for factors related to socioeconomic status.ConclusionLoneliness may be a risk factor for sleep-related problems in the COVID-19 pandemic. Having connections with family and friends may have a moderating effect on the occurrence of sleep-related problems.

Foreign coworker nationality, cultural distance, and perception of cultural diversity in the workplace

PurposeAs Japan has been slowly opening up to foreign workers to supplement its shrinking workforce, local employees have had to deal with increased diversity at work, owing to the presence of foreign coworkers. This paper aims to investigate the relationship between foreign coworkers’ nationality (specifically Chinese, Korean and those from Western countries) and the perception of the benefits and threats of cultural diversity in the workplace by Japanese employees.Design/methodology/approachA sample of Japanese employees working in Japan, half of which working with foreigners, was used, focusing on those Japanese employees who reported working with foreign coworkers of a single nationality.FindingsThe authors found that Japanese workers’ perceived benefits of cultural diversity at work, but not perceived threats, are significantly impacted by the unique nationality of their foreign coworkers. Specifically, the effect of coworker nationality is most apparent for the two benefits of “understanding of diverse groups in society” and “social environment,” whereby cultural distance is significantly and positively related to these perceived benefits. And more benefits from cultural diversity at work are perceived by Japanese employees in the presence of Western or Chinese, rather than South Korean coworkers.Practical implicationsIn the Japanese context, hiring employees from certain distant and heterogeneous cultures and nationalities could increase the positive perception of multiculturalism at work, therefore facilitating diversity management and fostering inclusion in the culture of the firm.Originality/valueVery little research in Japan has examined perception biases among native employees based on the nationality of their foreign coworkers, which is critical as globally minded Japanese firms are trying to increase their level of internal internationalization.

Reproduction of Haruki Murakami's Writing Style Based on the English Translation of 1Q84

Haruki Murakami is a well-known Japanese writer living in the United States, deeply influenced by Western writers and works; and even many of his English novels have been translated back into Japanese. Taking Jay Rubin's English version of 1Q84 as an example, this paper discusses the difficulties and strategies of translating Haruki Murakami's near-English-styled Japanese works into English. This study applies the famous British translation theorist Tytler's three principles of translation, specifically analyzes the typical sentences in the English translation, mainly from the perspective of linguistic expression, then examines the translator's translation strategy from the cultural level, comprehensively examines the translation's communication effect. The study finds that Jay Rubin's translation faithfully reproduces the original ideas and style and has its own unique way of dealing with Murakami's special genre. There are few studies on the English translation of 1Q84, most of which focus on the literary exploration of 1Q84 and the development of the meaning of the work, so this study can be said to be a cutting-edge study in the analysis of the translation of the work at present. It not only verifies whether Murakami's work leaves more room for the translator when translated back into English but also gives some insight into translation study and practice.

INVESTIGATION OF THE THERMAL COMFORT AND PRODUCTIVITY IN JAPANESE MIXED-MODE OFFICE BUILDINGS

This study investigates the overall comfort and productivity of Japanese office workers in mixed-mode office buildings. The indoor thermal environment is adjusted using the air-conditioning in Japanese office buildings to maintain thermal comfort and productivity. Thus, it is necessary to research thermal comfort and productivity to understand how occupants prepare themselves to be at a comfortable temperature and perform their daily tasks under mixed-mode (MM) and free-running (FR) modes. Environmental parameters such as air temperature, relative humidity, and so on were measured in 17 Japanese office buildings with the help of digital instruments, and thermal comfort transverse surveys were conducted for two years in Tokyo, Yokohama, and Odawara of Japan. The data were collected every once a month for a day visiting each building with the measurement instruments, together with the questionnaires. Almost 3000 votes were collected. This paper evaluates the overall comfort discussions followed by how the occupant could achieve their productivity. The occupants were found to be thermally comfortable and productive in the office. The most suitable comfortable temperature range for MM mode was found to be 22–26 °C and 23–25 °C for FR mode. The workers' productivity range is defined by the globe temperature range of 21–27 °C for MM and 20–27 °C for FR mode. The findings should be useful to suggest that whenever new office buildings are designed, these factors always need to be taken into consideration.

Cognitive complaints mediate childhood parental bonding influence on presenteeism.

BackgroundChildhood parental bonding and cognitive complaints (CCs) affect a worker’s mental health (MH), and CCs affect presenteeism. However, the impact of childhood parental bonding on presenteeism and the mediating effect of CCs with respect to the association among childhood parental bonding and presenteeism remain poorly understood.AimWe aimed to investigate the mediating role of CCs on the relationship between childhood parental bonding and presenteeism to better understand the influence of childhood parental bonding on adulthood presenteeism.SettingA total of 440 Japanese adult workers recruited using convenience sampling were evaluated.MethodsThe Parental Bonding Instrument, Cognitive Complaints in Bipolar Disorder Rating Assessment and Work Limitations Questionnaire 8 were used to assess childhood parental bonding, CCs, and presenteeism, respectively. We performed Spearman’s correlation analysis and path analysis to investigate the relationship among the variables.ResultsPath analysis revealed that childhood parental bonding and CCs significantly affected presenteeism. More specifically, CCs fully and partially mediated the effect of paternal and maternal care on presenteeism, respectively. Moreover, CCs partially mediated the effects of both paternal and maternal overprotection on presenteeism.ConclusionThe mediating role of CCs on the relationship between childhood parental bonding and presenteeism was shown in this study. In occupational MH, evaluating the mediating effect of CCs may be useful for addressing adulthood presenteeism associated with childhood parental bonding.

Maoto, a traditional herbal medicine, for post-exposure prophylaxis for Japanese healthcare workers exposed to COVID-19: A single center study

BackgroundLittle research has been done on post-exposure prophylaxis (PEP) for COVID-19. This study was done to determine if maoto, a traditional herbal medicine commonly used for diseases with symptoms similar to those of COVID-19, can be repurposed for post-exposure prophylaxis to prevent the spread of nosocomial infection with SARS-CoV-2. MethodsA cohort analysis was done of the data of 55 health care workers (HCWs) whether to get infected with SARS-CoV-2 in a Japanese hospital experiencing a COVID-19 cluster in April of 2021. Of these subjects, maoto granules for medical use were prescribed for PEP to 42 HCWs and taken for three days in mid-April. Controls were 13 HCWs who rejected the use of maoto. Polymerase chain reaction was performed routinely once or twice a week or when a participant presented with symptoms of COVID-19. ResultThere were no background differences between the maoto and control groups by profession, sex, or mean age. No severe adverse reactions were observed. During the observation period of 1 week, significantly fewer subjects were diagnosed with COVID-19 in the maoto group (N = 3, 7.1%) than in the control group (N = 6, 46.2%). The prophylactic effectiveness of maoto was 84.5%. ConclusionOral administration of maoto is suggested to be effective as PEP against nosocomial COVID-19 infection.

Working Conditions and Fatigue in Japanese Shift Work Nurses: A Cross-sectional Survey

This study aimed to identify the working conditions (working hours, overtime work, number of night shifts, number of holidays, and work intervals) associated with fatigue, based on the shift patterns, and determine their thresholds. From January to February 2020, a web-based questionnaire was sent to 4601 shift work nurses at 47 hospitals in Japan. The multivariate logistic analysis was conducted to predict high- and low-fatigue groups by working conditions, and receiver operating characteristic analysis was performed to clarify the high-fatigue thresholds by shift pattern. A total of 386 shift work nurses participated in this study. The threshold (fatigue was 3.0 or higher) of the two-shift rotation was 9hours 50minutes for daily working hours during day shifts (Odds ratio [OR]=1.57, p<.01), 17hours 15minutes for daily working hours during night shifts (OR=1.20, p<.01), and 8.0days for the number of night shifts (OR=1.09, p=.02). The threshold of the three-shift rotation was 9hours 45minutes (OR=1.59, p<.01), 2.9days for the number of midnight shifts (OR=1.53, p<.01), and 2.0 times for the interval between day-shift and night-shifts within 12hours (OR=1.39, p<.01). Working hours and the number of night shifts are important for two-shift rotation, and working hours for the assignment of midnight shift are important for three-shift rotations. Nurse managers should manage shifts according to nurses' shift patterns.

Time expressions in Vietnamese in relation to tenses in Japanese

In Vietnamese, time expressions are not determined by the suffixes in languages with clear temporal references. Expression of time in Vietnamese is a lexical-grammatical category that operates in the "implicit" and "thrifty" mechanism. This mechanism lies first in the general and universal linguistic thinking. Through a survey on several Japanese works translated into Vietnamese and Vietnamese works translated into Japanese, this study points out certain characteristics related to the time expression of the Japanese and the corresponding relationship in terms of tenses between the two distinct languages: Japanese and Vietnamese. The research findings contribute to the improvement of learning and more effective use of the Japanese language.

Job stress among workers who telecommute during the coronavirus disease (COVID-19) pandemic in Japan: a cross-sectional study.

The work system reform and the COVID-19 pandemic in Japan have prompted efforts toward telecommuting in Japan. However, only a few studies have investigated the stress and health effects of telecommuting. Therefore, this study aimed to clarify the relationship between telecommuting and job stress among Japanese workers. This was a cross-sectional study. In December 2020, during the "third wave" of the COVID-19 pandemic, an Internet-based nationwide health survey of 33 087 Japanese workers (The Collaborative Online Research on Novel-coronavirus and Work, CORoNaWork study) was conducted. Data of 27 036 individuals were included after excluding 6051 invalid responses. The authors analyzed a sample of 13 468 office workers from this database. The participants were classified into 4 groups according to their telecommuting frequency, while comparing scores on the subscale of the Job Content Questionnaire (JCQ) and subjective job stress between the high-frequency, medium-frequency, low-frequency, and non-telecommuters groups. A linear mixed model and an ordinal logistic regression analysis were used. A significant difference in the job control scores of the JCQ among the 4 groups was found, after adjusting for multiple confounding factors. The high-frequency telecommuters group had the highest job control score. Further, after adjusting for multiple confounding factors, the subjective job stress scores of the high- and medium-frequency telecommuters groups were significantly lower than those of the non-telecommuters group. This study revealed that high-frequency telecommuting was associated with high job control and low subjective job stress. The widespread adoption of telecommuting as a countermeasure to the public health challenges associated with the COVID-19 pandemic may also have a positive impact on job stress. Int J Occup Med Environ Health. 2022;35(3):339-51.

Dynamics of anti-Spike IgG antibody level after the second BNT162b2 COVID-19 vaccination in health care workers

IntroductionMany countries are administering a third dose of COVID-19 vaccines, but the evaluation of vaccine-induced immunity is insufficient. In addition, there are few reports of long-term observation of anti-spike IgG antibody titers after the vaccination in the Japanese population. This study aimed to evaluate anti-spike IgG levels in the Japanese health care workers six months after the BNT162b2 vaccination. MethodsDynamics of anti-spike IgG levels were assessed over a six-month period following the second vaccination in 49 participants (Analysis-1). A cross-sectional assessment of anti-spike IgG levels six months after the second vaccination was performed in 373 participants (Analysis-2). ResultsIn Analysis-1, the geometric mean titer of anti-spike IgG was lower in the older age group and decreased consistently after the second vaccination regardless of age. In Analysis-2, the anti-spike IgG level was significantly negatively associated with age (r = −0.35, p < 0.01). This correlation remained statistically significant (r = −0.28, p < 0.01) after adjustment for sex, BMI, smoking habits, alcohol drinking habits, allergies, and fever or other adverse reactions at the time of vaccination. Additionally, participants who drank alcohol daily had significantly lower anti-spike IgG levels than participants who had never drunk alcohol. Sex, smoking habits, allergy, and fever and other side effects after vaccination did not show a significant association with anti-spike IgG levels. ConclusionsSix months post-vaccination, the anti-spike IgG level was substantially lower in older persons and daily alcohol drinkers. This may be an indication for an additional vaccine dose for these at-risk categories.

Gender Differences in the Contribution of Anger Components to Depressive Symptomatology

Objective: The present study examined the association of anxiety- and anger-related components to depressive symptomatology for men and women. Methods: The study relied on a cross-sectional design. of 2,054 Japanese workers affiliated with two occupational settings, complete responses on measures for depression, anxiety, and anger, were obtained from 1,862 workers (90.7%: 1,521 men, 341 women). A stepwise regression analysis was executed by gender and age group. Results: Stepwise regression analysis revealed that main components were almost the same for both genders, i.e., trait anxiety, state anger and anger suppression. However, the explaining variances of anger were much larger for men, whereas those of state anxiety were larger for women. Anger expression outward was selected for men, but not for women. Conclusions: Depressive symptomatology was largely explained by trait anxiety, state anger, and anger expression style. For men, state anger and either expression of feelings of anger inward or outward were exacerbating their depression as compared to women. This could explain in part the gender differences in depression.

Association between Participation in the Short Version of a Workplace Oral Health Promotion Program and Medical and Dental Care Expenditures in Japanese Workers: A Longitudinal Study.

Studies suggest that intensive oral health promotion programs in the workplace reduce dental and medical care expenditures. The purpose of this longitudinal study was to evaluate the short version of an oral health promotion program in the workplace from the viewpoint of dental and medical care expenditures. Data for annual expenditures and number of days of dental, periodontal, and medical treatment in fiscal year 2018 and participation in the short version of a workplace oral health promotion program of 2545 workers (20–68 years old) in a company in fiscal year 2017 and prior were obtained. Zero-inflated negative binomial regression models or negative binomial regression models were used to evaluate the association between participation in the program and expenditures or number of days of treatment after adjusting for sex and age. Program participants were more likely than non-participants to visit dentists for dental and periodontal treatment. Those who participated twice or more spent less on dental, periodontal, and medical treatment and had fewer visits to dentists than non-participants. These results suggest that the short version of an oral health promotion program in the workplace decreases expenditures for dental, periodontal, and medical treatment.

Japanese Work Style Reformation and its impact on Large Japanese Companies

The labor shortage in Japan will be 6.4 million by 2030 due to a continuously declining birth rate and inadequate job opportunities for homemakers, retirees, and foreigners. The shortage will destroy the sustainability of the Japanese economy without prompt action. The Japanese government revised labor laws to let Japanese companies solve the future labor shortage. In 2020, large Japanese companies started following the revised laws. This paper analyzed the Japanese companies' reactions to the enforcement. Based on the analyses, we developed five suggestions that may be challenging but possible for Japanese companies to maintain competitive advantages and operational sustainability.

Abstract EP32: Low Density Lipoprotein Cholesterol Associations With The Risk Of Coronary Heart Disease And Stroke Among Middle-aged Japanese Workers: Analysis Using Inverse Probability Weighting

Introduction: Low density lipoprotein cholesterol (LDL-C) is an established causal factor for coronary heart disease (CHD) and ischemic stroke. A positive linear association between LDL-C and risk of CHD or ischemic stroke was reported from western populations but among Japanese the evidence still insufficient especially on the risk of ischemic stroke. This study used a longitudinal data from the Aichi Worker’s Cohort Study to explore the associations of LDL-C levels with the incidence of CHD, and stroke subtypes. Methods: Pooled data of 6325 adults (5001 men and 1324 women) who responded to the second (2002) and third (2007) wave surveys of the study were used for the current analysis. Propensity scores for LDL-C categories were generated using multinomial logistic regression that included age, sex, smoking, alcohol drinking, physical activity, body mass index, high-density lipoprotein cholesterol, triglycerides, history of diabetes and hypertension, antihypertensive medication, taking dyslipidemia medication and survey year. Hazard ratios (HRs) and the 95% confidence intervals (95% CIs) were estimated from inverse probability weighted (IPW) cox proportional hazards model for LDL-C categories associations with risks of CHD, stroke and its subtypes, and CVD. We also used restricted cubic spline to examine the possible nonlinear relationship. Results: During a median of 14 years of follow-up, 73 strokes (40 ischemic stroke, 30 hemorrhagic stroke and 3 unknown) and 60 CHD were observed. In comparison with LDL-C &lt; 120 mg/ dl, LDL-C ≥160 mg/dl was significantly associated with the increased risk of CVD (HR 1.79, 95% CI: 1.12-2.86) and CHD (HR 3.82, 95% CI: 1.80-8.06), but not with stroke (HR 1.05, 95% CI: 0.54-2.06), hemorrhagic stroke (HR 0.47, 95% CI: 0.13-1.67) or ischemic stroke (HR 1.56, 95% CI: 0.66-3.68). The results of restricted cubic spline analysis showed that the risks of CVD and CHD gradually increased from LDL-C of 120 mg/dl. On the other hand, the risk of ischemic stroke was flat until around LDL-C of 160 mg/dl and then increased afterward. The risk of hemorrhagic stroke was flat from LDL-C of 120 mg/dl or above, but showed an increased risk trend towards lower levels of LDL-C. Conclusions: Based on this recent, long-term prospective study among middle-aged Japanese workers and by applying the IPW method to adjust for several confounding variables, we found that LDL-C was linearly and positively associated with CHD incidence while higher LDL-C levels tended to be at an increased risk of ischemic stroke, though non-significant.