title: Environmental factors and risk of idiopathic dilated cardiomyopathy: a multi-hospital case-control study in Japan.
abstract: BACKGROUND
  Detailed epidemiological investigations on the relationship of environmental factors, especially occupational and microbiological factors, to the development of idiopathic dilated cardiomyopathy (IDC) are scarce.
  
  
  RESULTS
  A multi-hospital case-control study was conducted in 38 hospitals throughout Japan in order to survey IDC cases and age, sex-matched outpatient controls at each hospital. Crude and adjusted odds ratios (ORs) by various environmental factors were calculated in 135 pairs of cases and controls. Univariate analyses revealed significantly increased ORs for lower education, passive smoking in the workplace, cold and/or hot workplace, symptoms of fatigue and history of bacterial infection; in contrast, decreased ORs were associated with a history of rubella and gastroduodenal diseases. Based on multivariate adjusted analyses, lower education (OR 1.96, 95% confidence interval (CI) 1.13-3.40), cold or hot workplace (OR 1.84, 95%CI 1.08-3.12) and history of measles (OR 1.78, 95%CI 1.01-3.08) exhibited a significant positive relationship with IDC risk. History of rubella (OR 0.17, 95%CI 0.06-0.52) and gastroduodenal diseases (OR 0.14, 95%CI 0.07-0.29) were inversely related to the risk.
  
  
  CONCLUSIONS
  Some occupational and microbiological factors appear to relate independently to the development of IDC and further investigation is required to establish their respective mechanisms.
authors.affiliation: Department of Public Health, Kanazawa Medical University, 1-1 Daigaku, Uchinada, Ishikawa 920-0293, Japan. miura@kanazawa-med.ac.jp
authors.forename: Katsuyuki
authors.initials: K
authors.lastname: Miura
authors.forename: Hideaki
authors.initials: H
authors.lastname: Nakagawa
authors.forename: Hideaki
authors.initials: H
authors.lastname: Toyoshima
authors.forename: Kazunori
authors.initials: K
authors.lastname: Kodama
authors.forename: Masaki
authors.initials: M
authors.lastname: Nagai
authors.forename: Yuko
authors.initials: Y
authors.lastname: Morikawa
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Inaba
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Ohno
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001424:Bacterial Infections / Q000150:complications; D002311:Cardiomyopathy, Dilated / Q000209:etiology*; D016022:Case-Control Studies; D004493:Education; D004777:Environment; D005221:Fatigue / Q000150:complications; D005260:Female; D006801:Humans; D007564:Japan; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D016273:Occupational Exposure; D016017:Odds Ratio; D012307:Risk Factors; D013696:Temperature; D014028:Tobacco Smoke Pollution / Q000009:adverse effects
chemical_list: D014028:Tobacco Smoke Pollution