title: Trends in cause specific mortality across occupations in Japanese men of working age during period of economic stagnation, 1980-2005: retrospective cohort study.
abstract: OBJECTIVE
  To assess the temporal trends in occupation specific all causes and cause specific mortality in Japan between 1980 and 2005.
  
  
  METHODS
  Longitudinal analysis of individual death certificates by last occupation before death. Data on population by age and occupation were derived from the population census.
  
  
  METHODS
  Government records, Japan.
  
  
  METHODS
  Men aged 30-59.
  
  
  METHODS
  Age standardised mortality rate for all causes, all cancers, cerebrovascular disease, ischaemic heart disease, unintentional injuries, and suicide.
  
  
  RESULTS
  Age standardised mortality rates for all causes and for the four leading causes of death (cancers, ischaemic heart disease, cerebrovascular disease, and unintentional injuries) steadily decreased from 1980 to 2005 among all occupations except for management and professional workers, for whom rates began to rise in the late 1990s (P<0.001). During the study period, the mortality rate was lowest in other occupations such as production/labour, clerical, and sales workers, although overall variability of the age standardised mortality rate across occupations widened. The rate for suicide rapidly increased since the late 1990s, with the greatest increase being among management and professional workers.
  
  
  CONCLUSIONS
  Occupational patterns in cause specific mortality changed dramatically in Japan during the period of its economic stagnation and resulted in the reversal of occupational patterns in mortality that have been well established in western countries. A significant negative effect on the health of management and professional workers rather than clerks and blue collar workers could be because of increased job demands and more stressful work environments and could have eliminated or even reversed the health inequality across occupations that had existed previously.
authors.affiliation: Department of Public Health, Kitasato University School of Medicine, 1-15-1 Kitasato Minami-ku Sagamihara, Kanagawa 252-0374, Japan. kwada-sgy@umin.ac.jp
authors.forename: Koji
authors.initials: K
authors.lastname: Wada
authors.forename: Naoki
authors.initials: N
authors.lastname: Kondo
authors.forename: Stuart
authors.initials: S
authors.lastname: Gilmour
authors.forename: Yukinobu
authors.initials: Y
authors.lastname: Ichida
authors.forename: Yoshihisa
authors.initials: Y
authors.lastname: Fujino
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Satoh
authors.forename: Kenji
authors.initials: K
authors.lastname: Shibuya
mesh_terms: D000328:Adult; D000367:Age Factors; D002318:Cardiovascular Diseases / Q000401:mortality; D002423:Cause of Death / Q000639:trends*; D003644:Death Certificates; D057172:Economic Recession / Q000639:trends*; D004651:Employment / Q000523:psychology / Q000639:trends; D005260:Female; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000401:mortality; D009790:Occupations / Q000639:trends*; D012189:Retrospective Studies; D012959:Socioeconomic Factors; D013315:Stress, Psychological / Q000453:epidemiology; D013405:Suicide / Q000639:trends*