Article

Bathing in a bathtub and health status: A cross-sectional study

Authors:
To read the full-text of this research, you can request a copy directly from the authors.

Abstract

Bathing, or soaking, in a bathtub is a popular and often habitual pastime that has its roots in the culture of the Japanese people. The purpose of this study was to examine the effects of such bathing on health status. We conducted a population-based cross-sectional study involving 617 Japanese participants who took routine medical checkups. The frequency of bathing in a bathtub was categorized into two levels: "less than seven times a week" (less frequent bathing group) and "seven or more times a week" (frequent bathing group). We compared the following characteristics between the two groups: age, body mass index, blood pressure, blood chemistry findings, self-rated health, and sleep quality. The frequent bathing group reported better self-rated health and sleep quality than the less frequent bathing group, with age- and sex-adjusted odds ratios (95% confidence interval) of 2.11 (1.28-3.48) for self-rated health and 1.55 (0.98-2.44) for sleep quality. Other survey items were similar between the two groups. The findings of this study suggested that bathing in a bathtub every day or more frequently was associated with a good state of self-rated health and sleep quality.

No full-text available

Request Full-text Paper PDF

To read the full-text of this research,
you can request a copy directly from the authors.

... 1,2 The main purposes of bathing are relaxation, relieving fatigue, and warming the body, whereas showering is mainly for washing and cleaning the body. 1,3 This custom is also considered essential even at the end of life. Skaczkowski et al. 4 reported that spa baths improved palliative care patients' self-reported pain, anxiety, and well-being, which may improve quality of life. ...
... There have been some international studies, some of which have reported the safety and efficacy of bathing for terminally ill patients. 3,4,[6][7][8][9][10][11][12][13][14] Fujimoto reported that bathing was a safe and comfortable care practice for terminally ill patients, because it did not cause significant fluctuations in circulatory dynamics, and it reduced anxiety. 11 In the author's preliminary study, a comparison of before and after bathing for terminal cancer patients showed that it was safe and reduced fatigue. ...
... This is consistent with the previous reports that Japanese people have a high need for bathing. 1,3,6,[9][10][11]15,16 However, it is often difficult for terminally ill patients, especially in their last month, to bathe independently because of their severe symptoms and decreased ADL, because they require the assistance of two or more nurses to take a bath. 4,11,14,16,22,23 Although there is a high need for bathing even among terminally ill cancer patients, in this study, only 40% (n = 353) of the patients could actually bathe. ...
Article
Background: Bathing in a tub is integral to Japanese culture. It improves palliative care patients' symptoms and may improve quality of life. Objectives: This study aimed to determine the prevalence and impressions of bathing for terminally ill cancer patients and its relations to the evaluations of perceived end-of-life care and achievement of a good death. Design: This was a cross-sectional, anonymous, self-report questionnaire survey. Setting/subjects: The questionnaire for this study was sent to bereaved family members who had lost loved ones in 14 general hospitals and 187 palliative care wards in Japan. Measurements: The bereaved family members of the patients who had actually bathed were asked about their impression of bathing. The short version of the Good Death Inventory (GDI) and the Care Evaluation Scale were used to evaluate "achievement of a good death." In total, 1819 surveys were sent between July and September 2018 to bereaved family members of patients who had died between February 2014 and January 2018 in 14 general hospitals and 187 palliative care wards in Japan. Overall 885 questionnaires (valid response rate 48%) returned by bereaved family members were analyzed. Results: Overall, 85% of bereaved family members of patients who bathed evaluated the experience positively, 86% reported that the patient's face seemed to become calm after the bath, and 28% of bereaved family members whose loved one had not bathed reported regretting it. The total GDI score for the bereaved family's desired death was 82.7 ± 13.0 for the bathing group and 75.4 ± 15.7 for the no bathing group, a significant difference (effect size = 0.52, p < 0.01). Conclusions: Bathing before death was evaluated positively and was associated with the achievement of a good death.
... There are, however, many research reports on the beneficial effects of JSB on sleep [54][55][56][57][58][59][60][61], self-rated health [58,59,62], rehabilitation [63,64], fatigue [60,62,65], depression [66,67], and BP [68]. ...
... There are, however, many research reports on the beneficial effects of JSB on sleep [54][55][56][57][58][59][60][61], self-rated health [58,59,62], rehabilitation [63,64], fatigue [60,62,65], depression [66,67], and BP [68]. ...
... JSB can also ameliorate sleep disturbances in patients with insomnia [80,81] and dementia [56]. JSB habits appear to have led to improvements in self-rated health [58,59] and depressive symptoms [62,66,67,87]. In an epidemiological study, Aritake-Okada et al. [57] investigated the relationship between daytime sleepiness and coping with regular behavior (having a bath, reading or listening to music, eating and drinking, etc.) to obtain adequate sleep in 24,686 general adults in Japan. ...
Article
Full-text available
Japanese-style bathing (JSB), which involves soaking in hot water up to the shoulders in deep bathtubs for a long time in the evening to night, is unique. Many experimental and epidemiological studies and surveys have shown that JSB improve sleep quality, especially shortens sleep onset latency in winter. In addition, repeated JSB lead the improvement of depressive symptoms. JSB is a simple and low-cost non-pharmacological measure to sleep difficulty in winter and mental disorders, especially for the elderly. On the contrary, drowning, while soaking in a bathtub, is the most common of accidental death at home in Japan. It is estimated that approximately 19,000 Japanese individuals die annually while taking a bath, mostly during winter, and most victims are elderly people. Elderly Japanese people tend to prefer a higher-risk JSB because the temperature inside the house during winter, especially the dressing room/bathroom temperature, is very low. Since the physiological thermal effect of the elderly associated with bathing is relatively lower among the elderly than the young, the elderly prefer to take a long hot bath. This elderly’s favorite style of JSB results in larger increased blood pressure in dressing rooms and larger decreased in blood pressure during hot bathing. A sudden drop in blood pressure while immersed in the bathtub leads to fainting and drowning. Furthermore, elderly people are less sensitive to cold air or hot water, therefore, it is difficult to take appropriate measures to prevent large fluctuations in blood pressure. To ensure a safe and comfortable winter bathing, the dressing room/bathroom temperature needs to be maintained at 20 °C or higher, and several degrees higher would be recommended for the elderly.
... A cross-sectional study in Japan demonstrated that bathing in a bathtub every day or more frequently was associated with a good state of self-rated health and sleep quality. 31 On the other hand, a recent cross-sectional study in Japan reported that approximately 70% of people take a bath every day (seven times a week), but the rest do not utilize bathing, and approximately 3% actually have no bathing habit. 32 The effectiveness of regular HWB on glycemic control has not been thoroughly investigated in epidemiological (observational) studies. ...
... 54,55 WB is considered to promote health in a highly safe and very low-cost manner, which is acceptable to many people in countries and regions where there is no traditional bathing culture. 19,31,[56][57][58][59][60] Bathing every day was found to be associated with self-rated good health and sleep quality. 31 A single-arm intervention study outlined how a-12 day balneotherapy program improved pain, depression, mood, quality of life, and sleep in healthy elderly people. ...
... 19,31,[56][57][58][59][60] Bathing every day was found to be associated with self-rated good health and sleep quality. 31 A single-arm intervention study outlined how a-12 day balneotherapy program improved pain, depression, mood, quality of life, and sleep in healthy elderly people. 45 Moreover, the combination of exercise and HWB had a significant effect on pain relief and quality of life for patients with bone and joint diseases, especially those who were middle-aged and elderly. ...
Article
Full-text available
Purpose: To clarify the relationship between daily hot water bathing (HWB) at home and glycemic control in middle-aged and elderly ambulatory patients with type 2 diabetes mellitus (T2DM). Methods: We defined hemoglobin A1c (HbA1c) as the main outcome. We set 7.0% based on the mean value of the dependent variable as the cut-off point for analysis. Frequency of HWB was an explanatory variable. A two-sample t-test was used to compare between groups with continuous variables. Multiple logistic regression analysis was performed for frequency, adjusted age, sex, BMI, T2DM duration (Model 1), and other confounding factors (Model 2). Odds ratio (OR) and 95% confidence interval (95% CI) were calculated. Results: Among 838 patients, there was a significant difference (p<0.001) in age between males (n=528, 62.8±8.7 years) and females (n=310, 65.0±8.1 years). In Model 1, compared with participants who used HWB more than seven times a week, those with poorly controlled HbA1c were significantly associated with low frequency of HWB: four to six times a week (OR 1.32, 95% CI 0.87-1.99) and less than three times a week (OR 1.43, 95% CI 0.98-2.10); p-value for overall trend was 0.041. In Model 2, p-value for overall trend was 0.138. Conclusion: A higher frequency of HWB was moderately associated with a decreased risk of poor glycemic control in middle-aged and elderly ambulatory patients with T2DM.
... La pratique d'un ou plusieurs bains par jour est culturelle au Japon. Une étude portant sur 617 Japonais bénéficiant d'un bilan médical de routine ad é montré que le groupe des personnes qui prenaient un bain chaud (40 à 42°C) au moins 7f ois par semaine rapportait un ressenti de bonne santé et une meilleure qualité de sommeil [17]. Plusieurs études ont montré que les bains hyperthermiques amélioraient le sommeil chez les sujets sains et les personnes insomniaques [17][18][19][20]. ...
... Une étude portant sur 617 Japonais bénéficiant d'un bilan médical de routine ad é montré que le groupe des personnes qui prenaient un bain chaud (40 à 42°C) au moins 7f ois par semaine rapportait un ressenti de bonne santé et une meilleure qualité de sommeil [17]. Plusieurs études ont montré que les bains hyperthermiques amélioraient le sommeil chez les sujets sains et les personnes insomniaques [17][18][19][20]. ...
... Cette action est associée à des modifications électro-encéphalographiques qui consistent en une augmentation significatived us ommeil à ondes lentes (ondes delta), d'un plus grand accès au stade 4d u sommeil et d'une diminution du sommeil paradoxal [16][17][18][19]. ...
... Thermal bathing is an ancient tradition in some countries as a standard health activity: sauna in Finland, steam bath in Turkey, hot water bath in Japan are very popular practices to relax and recover from both physical and mental fatigue [1][2][3][4]. These treatments are well tolerated by healthy people and have been documented to be safe also for most patients, including chronic heart failure and hypertensive subjects [5][6][7]. ...
... A subjective experience of relaxation and well-being is often reported after thermal bathing, whatever the characteristics [1,3]. After 1 h of spa bathing at 40°C, the reduced self-reported stress has been found to be associated with a decrease in salivary cortisol and chromogranin A, that are considered physiological stress markers [8]. ...
... After 1 h of spa bathing at 40°C, the reduced self-reported stress has been found to be associated with a decrease in salivary cortisol and chromogranin A, that are considered physiological stress markers [8]. Thermal bathing would induce a deeper and more relaxing sleep [1,9]. These treatments have been found to induce improvement in muscle stiffness and joint mobility [6], thus relieving related symptoms such as tension headache and arthro-muscular pain [3,9]. ...
Article
Purpose Heart rate variability (HRV) was analyzed after a spa-course to test the hypothesis that cardiac autonomic modulation can reflect the feeling of relaxation and well-being induced by the treatment. Methods Twenty healthy males were administered a spa-course, consisting in classic sauna (15 min), steam bath (10 min), and soft sauna (10 min), each of them followed by a cooling-off and a rest period. Heart rate (HR) and blood pressure (BP) were measured at rest in supine position before and after the treatment. HRV was analyzed in time and frequency domains and by Poincaré plot. Results After the treatment, systolic and diastolic BPs were decreased by about 13 and 6 mmHg, respectively (p < 0.05 vs. before), while HR was unchanged (55 ± 7 b/min). HRV time domain and Poincaré parameters were significantly higher after than before the spa-course: SDNN, rMSSD, SD1 and SD2 increased by 31–35 %, NN50 and pNN50 by 64 %. The ratio SD1/SD2 was 0.6 ± 0.1 in both conditions. No modification was found in normalized power of spectral component and in their ratio (LF/HF = 1.3 ± 1.1, overall mean). Conclusions The increase in HRV with no change in markers of sympatho-vagal interaction observed after the spa-course would suggest an enhanced vagal modulation of HR, possibly reflecting the relaxing effect of the treatment. HRV analysis could be a useful tool to monitor changes in individual psychophysiological condition.
... La pratique d'un ou plusieurs bains par jour est culturelle au Japon. Une étude portant sur 617 Japonais bénéficiant d'un bilan médical de routine ad é montré que le groupe des personnes qui prenaient un bain chaud (40 à 42°C) au moins 7f ois par semaine rapportait un ressenti de bonne santé et une meilleure qualité de sommeil [17]. Plusieurs études ont montré que les bains hyperthermiques amélioraient le sommeil chez les sujets sains et les personnes insomniaques [17][18][19][20]. ...
... Une étude portant sur 617 Japonais bénéficiant d'un bilan médical de routine ad é montré que le groupe des personnes qui prenaient un bain chaud (40 à 42°C) au moins 7f ois par semaine rapportait un ressenti de bonne santé et une meilleure qualité de sommeil [17]. Plusieurs études ont montré que les bains hyperthermiques amélioraient le sommeil chez les sujets sains et les personnes insomniaques [17][18][19][20]. ...
... Cette action est associée à des modifications électro-encéphalographiques qui consistent en une augmentation significatived us ommeil à ondes lentes (ondes delta), d'un plus grand accès au stade 4d u sommeil et d'une diminution du sommeil paradoxal [16][17][18][19]. ...
Article
Sleep Disorders and Crenotherapy The crenotherapy uses for therapeutic purposes the natural mineral waters at their place of emergence. In France, spa treatments are organized on the basis of a package of 18 days of care. They are conventionally covered by medical insurance on prescription. Spa treatments are prescribed and monitored by a specialized doctor in three consultations dedicated to the beginning, during and at the end of the course. Sleep disorders can evolve in the context of psychic and / or somatic affections. The thermal treatment has demonstrated a beneficial effect on sleep in healthy subjects and in various indications, rheumatological in particular. Specific treatments are proposed for the treatment of sleep disorders associated with anxiety, burnout, depression and for the withdrawal of benzodiazepines. Their effectiveness has been demonstrated on the basis of studies that meet the requirements of evidence-based medicine. The mechanisms of action of crenotherapy are plural: hyperthermic baths, climate, analgesia, muscular relaxation, regulation of the mood, reduction of the stress. The spa resort is a particularly well-adapted structure for the implementation of non-drug treatment of sleep disorders and the withdrawal of benzodiazepines.
... 1-12 Such bath-related deaths comprise >10% of all sudden deaths, 8 and most victims are ≥65 years. [1][2][3][4][5][6][7][9][10][11][12] This phenomenon is unique to Japan and is not seen in other developed countries, such as the USA, UK, Germany or France. 9 According to Japanese Government Vital Statistics, in 2011 there were 7,536 unexpected deaths due to drowning (International Classification of Diseases [ICD]-10, W65-74). ...
... Climate, living environment or bathing customs in those areas might contribute to mortality. 4 We conducted this study in Tokyo, and in northern and western regions in Japan. The regional fire departments in Tokyo, Yamagata and Saga cooperated in this study. ...
Article
Background: Bath-related sudden cardiac arrest frequently occurs in Japan, but the mortality data have not been sufficiently reported.Methods and Results:This prospective cross-sectional observational study was conducted in the Tokyo Metropolis, Saga Prefecture and Yamagata Prefecture between October 2012 and March 2013 (i.e., in winter). We investigated the data for all occurrences in these areas for which the emergency medical system needed to be activated because of an accident or acute illness related to bathing. Emergency personnel enrolled the event when activation of the emergency medical system was related to bathing. Of the 4,599 registered bath-related events, 1,527 (33%) were identified as bath-related cardiac arrest events. Crude mortality (no. deaths per 100,000) during the observational period was 10.0 in Tokyo, 11.6 in Yamagata and 8.5 in Saga. According to the mortality data for age and sex, the estimated number of bath-related deaths nationwide was 13,369 in winter, for the 6 months from October (95% CI: 10,862-16,887). Most cardiac arrest events occurred in tubs filled with water with the face submerged in the water. This suggests that drowning plays a crucial role in the etiology of such phenomena. Conclusions: The estimated nationwide number of deaths was 13,369 (95% CI: 10,862-16,887) in winter, for the 6 months from October. Crude mortality during the winter season was 10.0 in Tokyo, 11.6 in Yamagata and 8.5 in Saga.
... In an aging society, the burden imposed by lifethreatening conditions increases. Sudden death during bathing frequently occurs in Japan (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13). Such bath-related deaths have been reported as exceeding 10% of all sudden deaths (8), and most victims are ! ...
... Such bath-related deaths have been reported as exceeding 10% of all sudden deaths (8), and most victims are ! 65 years of age (1)(2)(3)(4)(5)(6)(7)(9)(10)(11)(12)(13). This phenomenon is unique to Japan and is not seen in other developed countries, including the US, UK, Germany, and France (9). ...
Article
Full-text available
Objective Bath-related sudden cardiac arrests occur frequently in Japan. Although previous studies have reported that most fatal events occurr in winter, the reason why such events exhibit a seasonal variation has not been elucidated. In this study, we hypothesized that the occurrence of bath-related deaths was correlated with a low air temperature. Method This prospective cross-sectional observational study was conducted in the Tokyo Metropolitan area between October 2012 and March 2013. Data were collected for all cases involving the activation of the emergency medical system because of an accident or acute illness related to bathing that occurred in Tokyo during the study period. In particular, elderly (≥65 years) cardiac arrest victims who had been found in a bathtub filled with water were enrolled. The relationship between the daily number of cardiac arrest events and the lowest daily air temperature in Tokyo was studied using a nonlinear regression model. Results A total of 3,624 bath-related events were registered in this study. Among these events, 1,081 deaths of elderly individuals who had been found in a bathtub filled with water were recorded. A close correlation was observed between the daily number of events and the lowest daily air temperature. This correlation was described by the following equation: y=8.38e-0.07x, where y was the daily number of cardiac arrests and x was the lowest daily air temperature. Conclusion A low air temperature was closely correlated with the occurrence of bath-related cardiac arrest.
... Cultures such as the Scandinavians and Japanese have known this for many years. Ofuro bathing is a component of Japan"s national culture and identity, and it is believed that healthy persons may benefit from the physiological effects of hot-water immersion on the body"s homeostatic systems (Becker, 2009;Choukroun & Varene, 1990;Hayasaka et al. 2010;Kataoka & This article is protected by copyright. All rights reserved. ...
... Unlike their European and American counterparts [2], many Japanese are thought to bathe in a bathtub almost daily [3]. Bathing, or soaking, in a bathtub is a popular and often habitual pastime that has its roots in the culture of the Japanese people [4]. In general, it is well-known that Japanese people prefer bathing for recovery from fatigue as well as to ensure cleanliness [5]. ...
Article
Full-text available
Background Recently, mist saunas have been used in the home as a new bathing style in Japan. However, there are still few reports on the effects of bathing methods on recovery from muscle fatigue. Furthermore, the effect of mist sauna bathing on human physiological function has not yet been revealed. Therefore, we measured the physiological effects of bathing methods including the mist sauna on recovery from muscle fatigue. Methods The bathing methods studied included four conditions: full immersion bath, shower, mist sauna, and no bathing as a control. Ten men participated in this study. The participants completed four consecutive sessions: a 30-min rest period, a 10-min all out elbow flexion task period, a 10-min bathing period, and a 10-min recovery period. We evaluated the mean power frequency (MNF) of the electromyogram (EMG), rectal temperature (Tre), skin temperature (Tsk), skin blood flow (SBF), concentration of oxygenated hemoglobin (O2Hb), and subjective evaluation. Results We found that the MNF under the full immersion bath condition was significantly higher than those under the other conditions. Furthermore, Tre, SBF, and O2Hb under the full immersion bath condition were significantly higher than under the other conditions. Conclusions Following the results for the full immersion bath condition, the SBF and O2Hb of the mist sauna condition were significantly higher than those for the shower and no bathing conditions. These results suggest that full immersion bath and mist sauna are effective in facilitating recovery from muscle fatigue.
... Bathtub bathing (BB) has also been reported to affect mental health. For example, Ishizawa et al. [4] reported that frequent BB improves the mental health of middle-aged Japanese individuals, and Hayasaka et al. [5] reported similar results for elderly Japanese individuals. Additionally, bathing with herbal extracts increases peripheral blood circulation, helping to maintain body warmth after bathing, and providing a feeling of relief among middle-aged Japanese individuals [6]- [9]. ...
Article
Full-text available
Frequent bathtub bathing (BB) improves the mental health of middle-aged and older Japanese in-dividuals. This study investigated the chronic mental health effects of BB, maintaining warmth using an insulating sheet and sleeping bag after bathtub bathing (BBW), and bathtub bathing with herbal extracts (BBH) in healthy young adults. The study involved healthy young adults who habitually showered, as opposed to bathing. In the first experiment, 18 participants were randomly assigned to either the BB or BBW groups for 14 consecutive nights. After a 2-week washout period, the participants were asked to switch their bathing styles (a cross-over design). In the second experiment, 20 participants were randomly assigned to the BB or BBH group. The herbal extracts for the BBH group contained angelicae radix, aurantii nobilis pericarpium, chamomile, and zingiberis rhizoma. After a 2-week washout period, these participants also switched to the other bathing style. The participants’ mental conditions pre- and post-intervention were assessed using the Profile of Mood States-Brief Form questionnaire, Japanese version, and were statistically analyzed. The participants’ Anger-Hostility score converged to an average (50 points) in the post-BBW and post-BBH participants, and there were no significant differences in BB. The Confusion change rate was significantly different in the first experiment (BB versus BBW). The Depression-Dejection and Fatigue change rates were significantly different in the second experiment (BB versus BBH). Our findings suggest that changing bathing style from showering to BBW or BBH improves the POMS Anger-Hostility scores of healthy young adults.
... It is believed that healthy persons may benefit from the physiological effects of hot-water immersion (HWI) on the body's homeostatic systems (16,25,48,53,81,118). People may sit and soak up to the shoulders or neck in deep hot (38-43°C) tubs for 5-15 min (96,118). The high incidence of Japanese hot-water tub fatalities suggests that HWI may lead to drowning (2,109,175,191,211,291). ...
Article
Drowning physiology relates to two different events: immersion (upper airway above water) and submersion (upper airway under water). Immersion involves integrated cardiorespiratory responses to skin and deep body temperature, including cold shock, physical incapacitation, and hypovolemia, as precursors of collapse and submersion. The physiology of submersion includes fear of drowning, diving response, autonomic conflict, upper airway reflexes, water aspiration and swallowing, emesis, and electrolyte disorders. Submersion outcome is determined by cardiac, pulmonary, and neurological injury. Knowledge of drowning physiology is scarce. Better understanding may identify methods to improve survival, particularly related to hot-water immersion, cold shock, cold-induced physical incapacitation, and fear of drowning.
... In Japan, daily immersion to the neck in a warm bath is linked to the calming and cleansing of the inner self with cultural significance far beyond mere hygiene ( Traphagan, 2004 ). Daily tub baths are also associated with a good state of self-rated health by the Japanese ( Hayasaka et al., 2010 ). Shared cultural attitudes, values and practices may influence the acceptance and use of interventions such as ancient Chinese medicine ( Cai et al., 2018 ) or bathing. ...
Article
Objective: Though bathing (hydrotherapy) is widely used during labor to decrease anxiety and pain and to promote relaxation, the influence of cultural beliefs about bathing by parturients is virtually unknown. This pilot study explored pregnant women's experiences of bathing, bathing in labor, and cultural beliefs about bathing. Design: An exploratory, descriptive design. Setting: Low risk obstetrical clinics. Participants: Healthy Hispanic, Black, White, American-Indian and Asian women (N = 41) at >37 weeks gestation. Methods: During a routine prenatal visit women responded to a brief openended questionnaire on the use of bathing. Data was captured using a modified ethnographic method involving observation and note taking with thematic analysis and quantification of percent response rates. Findings: Forty-six percent (N = 41) of women used bathing for purposes other than hygiene but only 4.9% (N = 41) of these women bathed during a previous labor. The women described bathing as relaxing, easing, calming, and efficacious for relief of menstrual cramps and labor contractions. Ten percent of women reported cultural beliefs about bathing. Conclusions: Women who bathe, report relief of anxiety, menstrual and labor pain and promotion of mental and physical relaxation. The findings do not support the view that bathing is associated with identifiable cultural beliefs; rather, they suggest that bathing is a self-care measure used by women. This practice is likely transmitted from generation to generation by female elders through the oral tradition. Assumptions that race or ethnicity precludes the use of bathing may be faulty. Cautionary instructions should be given to pregnant women who are <37 completed weeks of gestation, to avoid bathing for relief of cramping or contractions and to seek immediate health care evaluation. Study of culturally intact groups may uncover additional themes related to bathing in labor and as a self-care measure for dysmenorrhea.
... The etiology of such fatal events has never been elucidated. All of the studies investigating bath-related accidents only considered sudden deaths (1,(3)(4)(5)(6)(7)(8)(9)(10). Most cases of sud-den death have been found in tubs without any traumatic injuries (2). ...
Article
Objectives Bath-related sudden cardiac arrests frequently occur in Japan. This study aimed to describe the actual incidence and characteristics of bath-related accidents, including non-fatal events, and to establish the etiology of bath-related sudden cardiac arrest. Methods This prospective cross-sectional observational study was conducted in Tokyo Metropolis and Saga and Yamagata Prefectures between October 2012 and March 2013. Emergency personnel enrolled events in this study when they recognized that activation of the emergency medical system was related to bathing. Surveillance cards were delivered and collected from the emergency personnel and attending physicians. Results In total, 4,593 events were enrolled (1,528 cardiac arrests, 935 survivors in need of help, 1,553 patients with acute illnesses, and 577 patients with injuries) in this study. In the group of survivors in need of help and with acute illness, consciousness disturbance and lethargy without any organic disease were recognized as the main symptoms. Acute coronary syndrome and stroke were infrequently diagnosed. Of the survivors, 30% had a body temperature above 38°C. Their consciousness level significantly correlated with their body temperature. Emergency personnel reported that 79% of sudden cardiac arrests were from victims whose faces were submerged in the tub water, while 18% of survivors had their faces submerged in the tub water. Conclusions This study revealed that accidents, including non-lethal events, frequently occur. The key symptoms were consciousness disturbance and lethargy characterized as a functional disorder and accompanied by an elevated body temperature. Those findings suggest that heat illness during hot water immersion causes drowning.
... In cross-sectional studies, tub bathing frequency was reported to be associated with good sleep quality, low perceived stress, and good self-rated health. [10][11][12] Only one longitudinal study in Japan, with a 5-year observational period, has examined this issue, 13 finding that tub bathing frequency was inversely associated with the onset of functional disability. However, that study was limited in generalizability because it specifically enrolled outpatients and had a relatively small sample size (n = 610). ...
Article
Full-text available
Background: While bathing styles vary among countries, most Japanese people prefer tub bathing to showers and saunas. However, few studies have examined the relationship between tub bathing and health outcomes. Accordingly, in this prospective cohort study, we investigated the association between tub bathing frequency and the onset of functional disability among older people in Japan. Methods: We used data from the Japan Gerontological Evaluation Study (JAGES). The baseline survey was conducted from August 2010 to January 2012 and enrolled 13,786 community-dwelling older people (6,482 men and 7,304 women) independent in activities of daily living. During a 3-year observation period, the onset of functional disability, identified by new certification for need of Long-Term Care Insurance, was recorded. Tub bathing frequencies in summer and winter at baseline were divided into 3 groups: low frequency (0-2 times/week), moderate frequency (3-6 times/week), and high frequency (≥ 7 times/week). We estimated the risks of functional disability in each group using a multivariate Cox proportional hazards model. Results: Functional disability was observed in a total of 1,203 cases (8.7%). Compared with the low-frequency group and after adjustment for 14 potential confounders, the hazard ratios (95% confidence intervals) of the moderate- and high-frequency groups were 0.91 (0.75-1.10) and 0.72 (0.60-0.85) for summer and 0.90 (0.76-1.07) and 0.71 (0.60-0.84) for winter. Conclusion: High tub bathing frequency is associated with lower onset of functional disability. Therefore, tub bathing might be beneficial for older people’s health.
... It has been suggested that, as compared with bathtub bathing, the lower water pressure used during showering imposes a lower burden on the body. 12 However, as habitual bathing is reported to be associated with good self-rated health and sleep quality, 13 it would not be wise to suggest that bathtub bathing is, in general, more hazardous to general health than showering. ...
Article
Full-text available
Bathing is a deeply ingrained custom among Japanese; however, data on the incidence rate of symptoms and accidents during bathing have not yet been reported for the Japanese general public. We conducted a population-based cross-sectional study of 617 Japanese adults who attended a specialized health checkup. Participants completed a self-administered questionnaire to assess weekly frequencies of bathtub bathing and showering and the frequency of symptoms/accidents (falling, loss of consciousness, and other) during these activities in the past year. We calculated the incidence rates of accidents per 10 000 baths/showers and 95% confidence intervals (CIs) and compared the clinical characteristics of participants who had symptoms/accidents with those who did not. The incidence rates of accidents per 10 000 bathtub baths and showers were 0.43 (95% CI: 0.22-0.84) and 0.24 (95% CI: 0.04-1.37). Although these rates are low, there were 740 000 bathtub bathing-related accidents in Japan, due to the fact that bathing is an almost-daily habit. There was no significant difference in clinical characteristics between groups. We collected basic information on the incidence of bathing-related accidents in Japan. Falls and loss of consciousness during bathing or showering can potentially lead to a serious accident, so the general public should be educated about the possibility of such accidents during bathing.
... Hsieh et al. 36 reported that the unintentional drowning mortality rates for older people in Japan were highest among 31 Organization for Economic Co-operation and Development (OECD) countries, and over 70% of deaths involved bathtubs in 2014. We speculated the high RR of drowning for cold can be explained by Japan's unique bathing manner, 36,37,38 characterized by head-out water immersion and high frequency of bathing. One potential explanation could be that older people generally have a weaker thermoregulatory system than younger people and that some underlying diseases or etiologies (e.g., acute ischemic heart failure, heatstroke, and blood pressure fluctuation) triggered during bathing in winter could induce a higher risk of drowning. ...
Article
Background: Although substantial evidence suggests that high and low temperatures are adversely associated with nonaccidental mortality, few studies have focused on exploring the risks of temperature on external causes of death. Objectives: We investigated the short-term associations between temperature and external causes of death and four specific categories (suicide, transport, falls, and drowning) in 47 prefectures of Japan from 1979 to 2015. Methods: We conducted a two-stage meta-regression analysis. First, we performed time-stratified case-crossover analyses with a distributed lag nonlinear model to examine the association between temperature and mortality due to external causes for each prefecture. We then used a multivariate meta-regression model to combine the association estimates across all prefectures in Japan. In addition, we performed stratified analyses for the associations by sex and age. Results: A total of 2,416,707 external causes of death were included in the study. We found a J-shaped exposure-response curve for all external causes of death, in which the risks increased for mild cold temperatures [20th percentile; relative risk (RR)=1.09 (95% confidence interval [CI]: 1.05,1.12)] and extreme heat [99th percentile; RR=1.24 (95% CI: 1.20, 1.29)] compared with those for minimum mortality temperature (MMT). However, the shapes of the exposure-response curves varied according to four subcategories. The risks of suicide and transport monotonically increased as temperature increased, with RRs of 1.35 (95% CI: 1.26, 1.45) and 1.60 (95% CI: 1.35, 1.90), respectively, for heat, whereas J- and U-shaped curves were observed for falls and drowning, with RRs of 1.14 (95% CI: 1.03, 1.26) and 1.95 (95% CI: 1.70, 2.23) for heat and 1.13 (95% CI: 1.02, 1.26) and 2.33 (95% CI: 1.89, 2.88) for cold, respectively, compared with those for cause-specific MMTs. The sex- and age-specific associations varied considerably depending on the specific causes. Discussion: Both low and high temperatures may be important drivers of increased risk of external causes of death. We suggest that preventive measures against external causes of death should be considered in adaptation policies. https://doi.org/10.1289/EHP9943.
... Such advice largely derives from findings of questionnaire and observation-based investigations. For example, Aritake-Okada et al. [29] found bathing to be an effective means of improving nighttime sleep and decreasing excessive daytime sleepiness; Ojima et al. [30] reported good subjective sleep quality of persons who regularly bathe; Hayasaka et al. [31] detected positive relationship between frequent bathing and self-assessed sleep quality and Goto et al. [32] likewise demonstrated positive association between frequent bathing combined with onsen (hot springs) facilities and self-rated sleep quality; and Camilleri and Barrett [33] observed better sleep of seniors with late-day bathing. Findings of objective laboratory studies complement the positive effects of PBH WB inferred by subjective measures. ...
Article
Water-based passive body heating (PBHWB) as a warm shower or bath before bedtime is often recommended as a simple means of improving sleep. We searched PubMed, CINAHL, Cochran, Medline, PsycInfo, and Web of Science databases and extracted pertinent information from publications meeting predefined inclusion and exclusion criteria to explore the effects of PBHWB on sleep onset latency (SOL), wake after sleep onset, total sleep time, sleep efficiency (SE), slow wave sleep, and subjective sleep quality. The search yielded 5322 candidate articles of which 17 satisfied inclusion criteria after removing duplicates, with 13 providing comparable quantitative data for meta-analyses. PBHWB of 40 to 42.5oC was associated with both improved self-rated sleep quality and SE, and when scheduled 1-2 hours before bedtime for little as 10 min significant shortening of SOL. These findings are consistent with the mechanism of PBHWB effects being the extent of core body temperature decline achieved by increased blood perfusion to the palms and soles that augments the distal-to-proximal skin temperature gradient to enhance body heat dissipation. Nonetheless, additional investigation is required because the findings regarding PBHWB are limited by the relative scarcity of reported research, especially its optimal timing and duration plus exact mechanisms of effects.
... 7 It is also associated with good sleep quality and self-rated health. 8 Conversely, it may be associated with sudden death, particularly in the elderly, by accidental drowning or heart attack triggered by a rapid change in body temperature, 9 or by heatstroke in which the increased body temperature cannot be controlled by diaphoresis, while such a risk has not been reported for sauna bathing. 6 10 Tub bathing is common in Japan, and frequent tub bathing may be related with Japanese people's longevity, but no evidence has been available on its long-term effect on risk of CVD. ...
Article
Full-text available
Objective Tub bathing is considered to have a preventive effect against cardiovascular disease (CVD) by improving haemodynamic function. However, no prospective studies have investigated the long-term effects of tub bathing with regard to CVD risk. Methods A total of 30 076 participants aged 40–59 years with no history of CVD or cancer were followed up from 1990 to 2009. Participants were classified by bathing frequency: zero to two times/week, three to four times/week and almost every day. The HRs of incident CVD were estimated using Cox proportional hazards models after adjusting for traditional CVD risk factors and selected dietary factors. Results During 538 373 person-years of follow-up, we documented a total of 2097 incident cases of CVD, comprising 328 coronary heart diseases (CHDs) (275 myocardial infarctions and 53 sudden cardiac deaths) and 1769 strokes (991 cerebral infarctions, 510 intracerebral haemorrhages, 255 subarachnoid haemorrhages and 13 unclassified strokes). The multivariable HRs (95% CIs) for almost daily or every day versus zero to two times/week were 0.72 (0.62 to 0.84, trend p<0.001) for total CVD; 0.65 (0.45 to 0.94, trend p=0.065) for CHD; 0.74 (0.62 to 0.87, trend p=0.005) for total stroke; 0.77 (0.62 to 0.97, trend p=0.467) for cerebral infarction; and 0.54 (0.40 to 0.73, trend p<0.001) for intracerebral haemorrhage. No associations were observed between tub bathing frequency and risk of sudden cardiac death or subarachnoid haemorrhage. Conclusion The frequency of tub bathing was inversely associated with the risk of CVD among middle-aged Japanese.
... A maior temperatura encontrada para uso de água quente em terapia está relacionada a sua ingestão a 50 o C, onde ensaio clínico de 2 dias e com 12 pacientes demonstrou efeitos positivos para casos de distúrbios funcionais do esôfago ou acalásia (Ren et al., 2012). (Hayasaka et al., 2010). Tais temperaturas são também confirmadas em estudo que recomenda manter a ar dos ambientes destes banhos ao menos a 25 o C (Hashiguchi et al., 2002). ...
Thesis
Full-text available
BRAZILIAN FOUNTAINS, BIOLOGICALLY ACTIVE COMPOUNDS. The natural surrounds and resources wrapping hot or mineral springs belong to sustainable matter involving governance and strategic planning of public health, environment, welfare, tourism and mining sectors. Noted it, through the current Brazilian policy demand: social thermalism/hydrotherapy/crenotherapy selected like complementary alternative medicine (CAM) by health ministry law MS 971/2006 (PNPIC), hydro-thermal therapy qualifying DNPM (MME Ordinance 127/2011 and MME 337/2002), health and wellness tourism formally oriented by tourism ministry and environmental management groundwater resources (Resolution MME / CONAMA 396/2008 and MME / CNRH 107/2010). Whereas as fresh potable reserves or potential mineral aquatic strategic deposits, the main biologically active components (BAC) were identified, with their minimum levels needed to related health benefits. Similar to conventional mining prospection, these “cut off grade” detection, at natural occurrences from Brazil, was the major goal in this work. The bibliographic systematic review allowed identify the main bioactive substances (BAC) related to springs sources of elements enougth or proven as health beneficial and at which indications. Wards after, it was performed a georeferenced database with these same variables (BAC) from Brazilian springs. Overlays all through thematic maps assisted in geographical and geological evaluations, whereas, at the end, statistical comparisons filtered target selection at all. The total 60 possible natural BAC and its minimum values for efficacy globally reviewed and established were detected at least one BAC occurrence from 703 mineral springs at 525 Brazilian cities. The arguments utilized were important in demonstrating the abundant and diverse existence of this endowment, where its potential health applications are virtually unknown today.
Article
The purpose of this study was to clarify the relationship of daily hot water bathing at home (DHW) and hot water spa bathing (HSPA) with the number of underlying diseases in middle-aged and elderly ambulatory patients. We defined the number of underlying diseases as the main outcome and dependent (criterion) variable. The frequency and time of DHW and the frequency of HSPA were set as explanatory variables. Multiple logistic regression analysis was performed for each frequency and time, adjusted age and sex. Odds ratio (OR) and 95% confidence interval (95% CI) were calculated. Among the 1261 patients who participated, there was no significant difference in age between males (n = 508, 72.8 ± 6.8 years) and females (n = 753, 73.5 ± 6.9 years). There was also no significant age difference between males (number of diseases: 2.7 ± 2.0 pts.) and females (number of diseases: 2.7 ± 2.1 pts.) in the occurrence of underlying diseases. Frequency and time of DHW were not associated with the occurrence of underlying diseases. However, compared with participants who utilized hot water spa at least once a week, the occurrence of underlying diseases was significantly associated with bathing frequency: one to three times per month (OR 2.72, 95% CI 1.63–4.52); twice or five times a year (OR 1.92, 95% CI 1.25–2.94). In conclusion, lower frequency of HSPA was significantly associated with increased risk of the occurrence of underlying diseases in middle-aged and elderly ambulatory patients. However, the relationship between proactive use of hot water spa and patients’ mental and physical support should be clarified by well-designed cohort studies. The present study was registered as UMIN000033018 by the University Hospital Medical Information Network Clinical Trials Registry (UMIN-CTR) in Japan (refer: https://upload.umin.ac.jp/cgi-open-bin/ctr/ctr_view.cgi?recptno=R000037643).
Article
Objective: Sudden death in the bathtub occurs relatively frequently in Japan, particularly among elderly people. We hypothesize that sudden death in epilepsy occurring in the bathtub (SDEPB) can be distinguished from sudden death in nonepilepsy occurring in the bathtub (SDnonEPB), but is identical to sudden unexpected death in epilepsy (SUDEP). Methods: Tokyo Medical Examiner's Office conducts postmortem examinations for all sudden and unexpected deaths in Tokyo. Clinical, social, and autopsy findings of 43 SDEPB were compared with 76 SDnonEPB, 50 SUDEP outside the bathtub, and Japanese forensic autopsy data as controls. Results: Extension of the leg(s) outside the bathtub was seen in 33% of SDEPB, but none of SDnonEPB. Sitting position was seen less frequently in SDEPB (37%) than in SDnonEPB (64%). Lung weight and pleural effusion volume were significantly lower in SDEPB than in SDnonEPB. Age at death in SDEPB was significantly younger than that in SDnonEPB. Sudden death in epilepsy occurring in the bathtub showed no differences in lung weight and pleural effusion volume from SUDEP. Living with family was more frequent in SDEPB (73%) than in SUDEP (48%). Few antiepileptic drugs, infrequent seizures, and low rate of mental retardation were identical between SDEPB and SUDEP. Lung weight was significantly heavier in all three groups than in age- and sex- matched autopsy controls. Conclusions: Leg extension outside the bathtub, lower lung weight, and absence of pleural effusion distinguish SDEPB from SDnonEPB in elderly people. Sudden death in epilepsy occurring in the bathtub may represent a form of SUDEP occurring in the bathtub, rather than drowning despite submergence in the bathtub at discovery. Conditions for bathing require careful attention from physicians and relatives, even for patients with epilepsy with few medications and infrequent seizures, and without mental retardation.
Article
The incidence of death by drowning greatly varies among different prefectures in Japan, mainly due to climate difference. However, there could be other factors affecting the incidence of deaths besides climate, for example, differences in regional death investigation systems. Here, we aimed to elucidate other such factors affecting the mortality data of drowning in the bathtub, especially the effects of discontinuing the medical examiner system. Police data in Kyoto and ambulatory care information in Yokohama were used. Data on cases of elderly individuals found dying or dead in the bathtub at home in winter 2014–2015 were obtained. The following data were collected for each case: age, gender, presence/absence of ambulatory transport, performance of autopsy, and cause of death. The autopsy and drowning rates in Kyoto were 0%, whereas both values in Yokohama were significantly higher at 93.1% and 89.4%, respectively (the denominator of each of the rates is the total number of elderly (aged 65 or over) individuals found dying or dead in the bathtub at home in each city during each winter). Despite no significant difference of incidence of total bath‐related death, the proportion of drowning‐related deaths was overwhelmingly higher in Yokohama than in Kyoto. The difference can be attributed to the difference in autopsy rates between the two cities, mainly caused by the presence/absence of a medical examiner system. Therefore, we should pay careful attention to future changes in autopsy/drowning rates in Yokohama, and ascertain whether the change might be continuously influenced by the abolishment of this system.
Article
Background: There is no consensus on the use of soap in skin care for atopic dermatitis in Japan. Thus, this study aimed to evaluate the efficacy of soap to maintain eczema remission in atopic dermatitis patients during the fall-winter period in Japan. Methods: This assessor-blinded, pragmatic randomized, non-inferiority study enrolled atopic dermatitis patients whose eczema was controlled by regular steroid ointment application within 2 days/week (tacrolimus ointment was permitted). For 8±3 weeks, participants washed their upper and lower limbs on one side with soap (soap side) and on the other side with water alone (water side). The primary outcome was the Eczema Area and Severity Index score at week 8±3. Results: Twenty-nine participants were analyzed. The Eczema Area and Severity Index scores at week 8±3 of the water and soap sides were 0.0 (0.0-0.4) and 0.0 (0.0-0.4), respectively (p=0.18). The difference between both sides was -0.02 (-0.11-0.08), and the limits of the 95% confidence interval did not reach the prespecified noninferiority margin. The average Patient-Oriented Eczema Measure score was 1.27±1.7 and 1.32±1.8 for the water and soap sides, respectively (p=0.92). The total number of additional steroid ointment applications was 4 (0-20) times and 6 (0-23) times, respectively (p=0.98). Participants were categorized according to self-assessments of the usefulness of soap, with 2, 24, and 3 participants in the water-effective, invariant, and soap-effective groups, respectively. Conclusions: For children with controlled atopic dermatitis, washing with water alone was not inferior to washing with soap for maintaining remission of eczema during the fall-winter period in Japan.
Article
Full-text available
Background:Characteristics and outcomes of emergency patients with bath-related sudden cardiac arrest in prehospital settings have not been sufficiently investigated. Methods and Results:From a prospective population-based registry, which covers all out-of-hospital cardiac arrests (OHCAs) in Osaka City, a total of 642 patients who had a bath-related OHCA from 2012 to 2014 were enrolled in the analyses. The characteristics and outcomes of OHCA were compared by three locations of arrest: home baths (n=512), public baths (n=102), and baths in other public institutions (n=28). Overall, bath-related OHCAs mainly occurred in winter (December–February, 48.9%, 314/642). The proportion of OHCAs that were witnessed by bystanders was 6.4% (33/512) in home baths, 17.6% (18/102) in public baths, and 25.0% (7/28) in baths in other public institutions. The proportion of public-access automated external defibrillator pad application was 0.8% (4/512) in home baths, 6.9% (7/102) in public baths, and 50.0% (14/28) in baths in other public institutions. Only 1 survivor with a favorable neurologic outcome was observed in a home bath, whereas there were no patients who survived with favorable neurologic outcomes in public baths and baths in other public institutions. Conclusions:Bath-related OHCAs mainly occurred in winter, and the outcome of victims was exceedingly poor, irrespective of location of arrest. The establishment of preventive measures as well as earlier recognition of cardiac arrest by bystanders are needed.
Article
Japan is an exceptionally healthy East Asian country with extended longevity. In addition, the typical levels of several proinflammatory proteins, including both C-reactive protein (CRP) and interleukin-6 (IL-6), are often reported to be low when compared to American and European populations. This analysis determined if blood levels of CRP and IL-6 were associated with 4 cultural practices reflective of Japanese behavior and customs -- drinking tea, eating seafood, consuming vegetables, and partaking in relaxing baths regularly – among 382 adults living in Tokyo. Regression models controlled for demographic factors, adiposity (BMI), physical exercise, smoking, alcohol use, and chronic illness (e.g., diabetes). Consuming a Japanese diet was associated with significantly lower CRP and IL-6 levels. More frequent bathing was associated with lower IL-6, but not specifically predictive of low CRP. This study has confirmed prior evidence for low inflammatory activity in Japanese adults and its association with several behavioral practices common in Japan.
Article
Purpose: The preference for dialysis modalities is not well understood in Japan. This study explored the subjective views of Japanese patients undergoing dialysis regarding their treatments. Methods: The participants were receiving in-center hemodialysis (CHD) or continuous ambulatory peritoneal dialysis (CAPD). In Study 1, 34 participants (17 CHD and 17 CAPD) were interviewed about the advantages and disadvantages of dialysis modalities. In Study 2, 454 dialysis patients (437 CHD and 17 CAPD) rated the advantages and disadvantages of CHD and CAPD in a cross-sectional survey. Results: Interviews showed that professional care and dialysis-free days were considered as advantages of CHD, while independence, less hospital visits, and flexibility were considered as advantages of CAPD. Disadvantages of CHD included restriction of food and fluids and unpleasant symptoms after each dialysis session. Catheter care was an additional disadvantage of CAPD. Survey showed that the highly ranked advantages were professional care in CHD and less frequent hospital visits in CAPD, while the highly ranked disadvantages were concerns about emergency and time restrictions in CHD, and catheter care and difficulty in soaking in a bath in CAPD. The total scores of advantages and disadvantages showed that CHD patients subjectively rated their own modality better CHD over CAPD, while CAPD patients had the opposite opinion. Conclusions: The results of this study indicate that the factors affecting the decision-making process of Japanese patients are unique to Japanese culture, namely considering the trouble caused to the people around patients (e.g., families, spouses, and/or caregivers).
Thesis
Full-text available
The natural surrounds and resources wrapping hot or mineral springs belong to sustainable matter involving governance and strategic planning of public health, environment, welfare, tourism and mining sectors. Noted it, through the current Brazilian policy demand: social thermalism/hydrotherapy/crenotherapy selected like complementary alternative medicine (CAM) by health ministry law MS 971/2006 (PNPIC), hydro-thermal therapy qualifying DNPM (MME Ordinance 127/2011 and MME 337/2002), health and wellness tourism formally oriented by tourism ministry and environmental management groundwater resources (Resolution MME / CONAMA 396/2008 and MME / CNRH 107/2010). Whereas as fresh potable reserves or potential mineral aquatic strategic deposits, the main biologically active components (BAC) were identified, with their minimum levels needed to related health benefits. Similar to conventional mining prospection, these “cut off grade” detection, at natural occurrences from Brazil, was the major goal in this work. The bibliographic systematic review allowed identify the main bioactive substances (BAC) related to springs sources of elements enougth or proven as health beneficial and at which indications. Wards after, it was performed a georeferenced database with these same variables (BAC) from Brazilian springs. Overlays all through thematic maps assisted in geographical and geological evaluations, whereas, at the end, statistical comparisons filtered target selection at all. The total 60 possible natural BAC and its minimum values for efficacy globally reviewed and established were detected at least one BAC occurrence from 703 mineral springs at 525 Brazilian cities. The arguments utilized were important in demonstrating the abundant and diverse existence of this endowment, where its potential health applications are virtually unknown today.
Article
To preliminarily assess the acute effects of a single warm-water bath (WWB) on serum adipokine activity, we measured serum adiponectin, leptin and other metabolic profiles before, immediately after and 30 minutes after WWB in seven healthy male volunteers (mean age, 39.7 ± 6.0 years; mean body mass index, 21.6 ± 1.8 kg/m(2)). The subjects were immersed in tap water at 41°C for 10 minutes. Two weeks later, the same subjects underwent a single WWB with a bath additive that included inorganic salts and carbon dioxide (WWB with ISCO(2)) by the same protocol as for the first WWB. Leptin levels significantly increased immediately after WWB with tap water and ISCO(2) (both P < 0.05), and remained significantly higher than those at baseline even 30 minutes after WWB with tap water (P < 0.05). Adiponectin levels showed a slight, but not significant, increase both immediately after and 30 minutes after WWB with tap water or ISCO(2). Some parameters, such as serum total cholesterol, red blood cell count, hemoglobin and hematocrit significantly increased immediately after WWB with tap water or ISCO(2) (all P < 0.05), but they all returned to the baseline levels 30 minutes after bathing under both conditions. The sublingual temperature rose significantly after 10 minutes of WWB with tap water (0.96 ± 0.16°C relative to baseline, P < 0.01) and after the same duration of WWB with ISCO(2) (1.24 ± 0.34°C relative to baseline, P < 0.01). These findings suggest that a single WWB at 41°C for 10 minutes may modulate leptin and adiponectin profiles in healthy men.
Article
Although majority of out-of-hospital cardiac arrests (OHCAs) occur in private residential locations, i.e., at home, the details of emergency patients with OHCAs occurring at home have not been sufficiently investigated at the national level. We obtained data of OHCA cases from the All-Japan Utstein Registry, including detailed information of the location of cardiac arrest. Cases of OHCA occurring at home from 2013 to 2015 were included. Patient characteristics and outcomes after OHCA were described based on the location of cardiac arrest. During the 3-year study period, a total of 212,722 cases of OHCA were documented at home (186,219 in detached houses and 26,503 in multiple dwelling houses), and it accounted for 65.0% of all OHCA cases in Japan. The majority of OHCAs occurred in the living room/bedroom (67.7%), followed by the bathroom (12.9%), entrance/corridor (5.3%), and toilet (4.8%). The characteristics of OHCA at home widely varied by location of cardiac arrest and residence type. The proportion of bystander-initiated cardiopulmonary resuscitations was less than half at all locations and ranged from 27.9% to 47.1%. The proportion of public-access defibrillation was also low regardless of the location of arrest and ranged from 0.0% to 0.2%. Consequently, the proportion of 1-month survival with favorable neurological outcome was low regardless of the location of arrest and ranged from 0.3% to 2.3%. In conclusion, OHCA occurrence at home accounted for approximately two-thirds of all OHCA cases in Japan, but their outcomes were extremely poor regardless of the location of cardiac arrest.
Article
Full-text available
浴槽のサイズにより入浴時のリラックス度が異なるかどうかを調べるため, 10名の健康男性(21-31歳)を対象に, 入浴中の脳波を記録しα波の出現頻度を調べた。被検者は朝より絶食とし, テレメトリー式の脳波計にて, 小浴槽での入浴前, 入浴中, 入浴後10分の脳波を連続記録した。別の日の同時刻に同一被検者が, 大浴槽にて同様の記録を行った。小浴槽として60×70×60cmの浴槽を, 大浴槽として327×595×107cmのプールを用い, 水温は両者とも39℃とした。入浴は胸骨柄の高さまでとし, プールでの水深はプール内の階段を用いて60cmとなるように工夫した。実験終了後全員に, どちらがより快適であったかの質問を行った。小浴槽での入浴中, α波の出現は有意に減少し(P<0.01), 出浴後には元に戻った。これに対し大浴槽では, 入浴中のα波の出現は入浴前と比べ変化がなく, 出浴後にはむしろ増加した。入浴中のα波の出現頻度は, 小浴槽に比べ大浴槽において有意に高かった(P<0.05)。実験終了後に行った質問では, 被検者全員が大浴槽の方が快適と答えた。以上より, リラックスする目的で入浴する場合には, より大きな浴槽での入浴が好ましいと考えられた。
A central feature of Japan's approach to community-based care of the elderly, including long-term home health care, is the emphasis on providing bath facilities. For mobile elders, senior centers typically provide a public bathing facility in which people can enjoy a relaxing soak along with friends who also visit the centers. In terms of in-home long-term care, visiting bath services are provided to assist family care providers with the difflcult task of bathing a frail or disabled elder--a task made more problematic as a result of the Japanese style of bathing. I argue that the bath, as social service, is a culturally shaped solution to a specific problem of elder care that arises in the Japanese context as a result of the importance of the bath in everyday life for Japanese. While the services may be considered specific to Japan, some aspects of bathing services, particularly the mobile bath service, may also have applicability in the United States.
Article
We studied the effects of bathing in warm water on cerebral blood flow (CBF). Seven healthy male volunteers were subjected to experiments. The subjects were bathed in warm water at 39°C for 20 minutes in a sitting position immersed up to the neck. Each subject received two CBF examinations: one under normal conditions and the other after taking a bath mentioned above. There was an interval of at least seven days between the two examinations. To measure CBF, we used the Patlak plot method with technetium- 99m ethyl cysteinate dimer (99m-Tc ECD). To examine CBF alter bathing, 99m- Tc ECD was injected within 10 minutes after bathing. Brain perfusion index (BPI) and regional CBF (rCBF) were used as indexes for evaluating CBF. The body temperature, pulse, blood pressure, arterial oxygen and carbon dioxide pressure, and hematocrit were also measured. Wilcoxon's signed rank test was used for statistical analyses. The following were observed: 1) BP1 increased significantly after bathing (p<0.05). 2) rCBF in the cerebral cortex, particularly in the frontal lobe, tended to increase after bathing (p<0.05). No definite changes were observed in the cerebellar cortex, caudate nucleus, or thalamus. 3) The body temperature and pulse increased significantly after bathing. No definite changes were observed in blood pressure, arterial oxygen and carbon dioxide pressure, or hematocrit. From the above, we conclude that bathing in warm water causes the cerebral blood flow to increase in healthy subjects.
Six healthy female volunteers (22–24 years), physically untrained (unfit), sat in baths of warm or cool water for 90 min, between 14.30 h and 17.30 h, on separate occasions. In the former condition (HOT), rectal temperature (Tr) rose by an average of 1.8°C, and in the latter (COOL), a thermoneutral condition, there was a nil Tr change. All-night sleep EEGs were monitored after both occasions and on baseline nights. Following COOL, there was no significant change in any sleep parameter. After HOT there were significant increases in: sleepiness at bed-time, slow wave sleep, and stage 4 sleep. REM sleep was reduced, particularly in the first REM sleep period.RésuméSix femmes volontaires, en bonne santé (22 à 24 ans), non entraînées physiquement, furent assises dans un bain d'eau chaude ou froide pour 90 min, entre 14 h 30 et 17 h 30, en 2 sessions distinctes. Dans la première situation (CHAUDE), la température rectale (Tr) s'élevait en moyenne de 1,8°C, alors que dans la seconde (FROIDE), une situation thermiquement neutre, il n'y avait pas de modification de la Tr. Les EEG de sommeil de la nuit complète furent suivis après les deux types de sessions ainsi que pendant des nuits témoins. Après une session FROIDE, il n'y avait pas de modification des paramètres du sommeil. Une augmentation significative était observée après une session CHAUDE: de l'endormissement à l'heure du coucher, du sommeil à ondes lentes et du stade 4 du sommeil. Le sommeil paradoxal était réduit, particulièrement dans sa première période d'apparition.
The development of research on self-rated health in the United States was reviewed to elucidate the background of the research. The earliest studies utilized medical and objective health data to assess self-rated health. A lack of convenient and exact health measurements in the gerontological research field motivated the development of these early studies. These studies indicated that self-rated health could not serve as a substitute for physicians' ratings. On the other hand, studies of the relationship between psychosocial indices and self-rated health demonstrated that self-rated health was valid as a single measure of overall health, being related to physical, mental and social aspects of well-being. Recent epidemiological investigations have shown that self-rated health is a significant predictor of mortality and changes in activities of daily living. Most of these research studies on self-rated health utilized elderly populations for subjects.
Article
The acute hemodynamic effects of thermal vasodilation caused by exposure to hot water bath or sauna in chronic congestive heart failure were investigated in 32 patients (mean age 57 +/- 15 years old) with dilated cardiomyopathy (25 idiopathic and 7 ischemic). The clinical symptoms were New York Heart Association Class II in 2 patients, III in 17 and IV in 13, and the mean ejection fraction was 25 +/- 9% (9-44%). Exposure to hot water bath was for 10 minutes at 41 degrees C in a semi-sitting position, and to sauna for 15 minutes at 60 degrees C in a supine position using a special far infrared ray sauna chamber. Blood pressure, electrocardiogram, two-dimensional and Doppler echocardiograms, expiration gas, and intracardiac pressure tracings were recorded before (control), during, and 30 minutes after hot water bath or sauna. 1. The increase in oxygen consumption was only 0.3 Mets during hot water bath or sauna, and returned to the control level 30 minutes later. 2. The deep temperature in the main pulmonary artery increased by 1.0-1.2 degrees C on average at the end of hot water bath or sauna. 3. Heart rate increased significantly (p < 0.01) by 20-25/min during bathing and still increased 30 min later. 4. Systolic blood pressure did not change significantly during and after hot water bath or sauna, while, diastolic blood pressure decreased significantly during (p < 0.05) and after sauna (p < 0.01), and after hot water bath (p < 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)
To determine factors affecting self-rated health among the non-institutionalized elderly in Japan. In 20 municipalities in Japan, 6,094 persons aged 65 years and older who were not institutionalized were selected at random. A questionnaire survey was conducted from September through November 2000. The distribution of self-rated health was rated in terms of dependent variables, with odds ratios and their 95% confidence intervals calculated using unconditional logistic models. Of the study population, 5,565 persons (91.8%) responded to the survey. Of the respondents, 64.4% answered that they were healthy, while 28.8% were not. The necessity for periodical visit to hospitals and clinics, and lowering of the activity of daily living greatly lowered self-rated health. Compared with those who were 85 years of age or older, a high health status was observed among those aged between 75 and 84 years, but not those aged 65 to 74 years. Those who tried to have exercise periodically, who had a vice-leadership role in a group, who joined social activities, who lived what they considered a worthwhile life, and who had positive positive activities in daily life, had high levels of self-rated health. Joining social activities for passive reasons elevated the health as well as joining for active reasons such as "because it is fun." Even if the reason is passive, joining social activities may elevate the self-rated health levels of elderly people.
Article
The purpose of this study was to assess whether there is an enduring gender difference in the ability of self-rated health to predict mortality and investigate whether self-reported physical health problems account for this difference. Cox models for 4-year survival were fitted to data from successive cohorts aged 75-81 years registered with a primary care practice in the U.K. Midlands surveyed in 1981, 1988, and 1993-1995. Self-rated health was consistently a stronger predictor in men (hazard ratio [HR] = 2.7; 95% confidence interval [CI] = 2.1-3.5) than it was in women (HR = 1.9; 95% CI = 1.5-2.4). Women surveyed in 1993-1995 were more likely than men to report problems that were disabling but not life-threatening, whereas men were more likely to report potentially life-threatening problems. However, these differences did not explain the association of self-rated health with mortality. More than half of those who reported a potentially life-threatening problem said that their health was good. Self-rated health is more strongly associated with mortality in men, but this is unlikely to be explained by differences in the nature of their physical health problems.
Article
Several studies have demonstrated that the loss of a sense of one's own self-worth has an influence on the health status, psychological functioning, and quality of life in the aged. We used longitudinal data from 784 elderly residents (mean age = 73 years) to examine the relationship between subjective usefulness and 6-year mortality. We hypothesized that subjective usefulness is an important indicator of quality of life among the elderly population, and subsequently of mortality. We elicited information on subjective usefulness at baseline by using a self-administered questionnaire. Results of longitudinal analyses showed that subjective usefulness may be significantly associated with self-rated health and subsequent mortality. This indicates that subjective usefulness plays an important role in enhancing survival in the elderly population.
Article
In our medical and welfare facilities, many patients with senile dementia require aid in taking a bath. In most institutions, patients usually take a bath in the daytime within the working hours of the staff. However, most of these patients used to take a bath in the evening or at night at their homes. Some patients even fall asleep after daylight bathing. Thus, we studied the stabilizing effects of night-time spa bathing on symptoms associated with dementia. Ten patients (two male and eight females, aged 75-88) in special nursing institution for the aged, were enrolled in this study. They were all assessed as +4 on the Karasawa's clinical criteria for grading dementia. For 9 weeks, night-time spa bathing was performed at 18:00-19:00 twice a week. Except for the night-time spa bathing period, the bathing hour was 14:00-15:00 as usual. The observations of symptoms including restlessness, wandering and aggression were carried out ten times daily along with those on sleeping condition five times daily, to compare symptoms and conditions during 2 weeks of baseline daytime bathing periods, 9 weeks of night-time bathing periods and 2 weeks of daytime bathing periods, totaling 13 weeks. The results showed that sleeping conditions were ameliorated in more than 60-90% of the subjects. Their sleeping conditions began to improve 2 weeks after the start of night-time spa bathing with a remarkably improvement 4-6 weeks after the start. Restlessness was recognized in six subjects, wandering in eight and aggression in four at baseline, and 75-100% of the subjects with such symptoms improved markedly.
History of bath and spa. Taking the waters
  • A.L. Croutier
  • A.L. Croutier
The bath survey in Japan
  • N. Fukudome
  • N. Fukudome
Program for standard health checkup and health guidance
  • Japan Ministry of Health Labour and Welfare
  • Japan Ministry of Health Labour and Welfare
The bath survey in Japan and the United State (second report)
  • Y Ohta
  • Kimura
Ohta Y, Kimura Y. The bath survey in Japan and the United State (second report).
History of bath and spa. Taking the waters. Japanese edition. Tokyo: Sanseido
  • Al Croutier
Croutier AL. History of bath and spa. Taking the waters. Japanese edition. Tokyo: Sanseido; 1992.
Effects of assistance to elderly dementia patients on immune functions and stress (second report): change over time of saliva IgA and saliva cortisol with bathing care for elderly dementia patients
  • K Tozawa
  • M Itou
  • M Kawakami
  • M Aoyama
  • H Asada
  • C Meguro
Tozawa K, Itou M, Kawakami M, Aoyama M, Asada H, Meguro C, et al. Effects of assistance to elderly dementia patients on immune functions and stress (second report): change over time of saliva IgA and saliva cortisol with bathing care for elderly dementia patients. Bull Gumma Paz Coll 2008;6:35e43.
The bath survey in Japan. Tokyo: Urban Life Research Institute
  • N Fukudome
Fukudome N. The bath survey in Japan. Tokyo: Urban Life Research Institute; 1997.
Effects of assistance to elderly dementia patients on immune functions and stress (second report): change over time of saliva IgA and saliva cortisol with bathing care for elderly dementia patients
  • Tozawa