National occupational health research priorities,agenda and strategy of Japan: invited report in NORA symposium 2001, USA

An invited report on national occupational health research priorities, agenda and strategy of Japan was delivered in the NORA (National Occupational Research Agenda) Symposium 2001, USA. The third NORA Symposium was held by the US National Institute for Occupational Safety and Health (NIOSH) in Washington DC on June 27, 2001. The national conference in Japan entitled "Conference on Occupational Health Research Strategies in the 21st Century" was organized by the Japanese Ministry of Labour (Currently, Ministry of Health, Labour and Welfare) in the years 1998-2001, and the national occupational health research agenda and strategy for the next decade in Japan was identified. A total of 50 Conference members, i.e., representatives from various fields of occupational health in Japan, ranked 58 comprehensive research topics, yielding short-term (5-year) and long-term (6-10 year) priority research topics. Overall (10-year) priority research topics were calculated by combining the short-term and long-term priority scores. Together with the ranking by 145 extramural occupational health specialists, it was identified that work stress (i.e., one of the 58 research topics) was the first overall priority research topic for the next 10 years in Japan. Three other topics, i.e., elderly workers, women workers and maternity protection, and mental health and quality of work and life, were the second group of priority topics; and hazard and risk assessment and biological effect index were the third priority group. Based on the scores for the short-term and long-term priority research topics, all 58 research topics were classified into three key research areas with 18 key research issues (National Occupational Health Research Agenda, NOHRA). Finally, eight implementation measures of national strategy for the Japanese Government to promote occupational health research were introduced.     

Development of carcinogenicity classifications and evaluations: the case of formaldehyde

In this paper carcinogenicity classification and evaluations case of formaldehyde made by national and international agencies and organizations (such as European Union, International Agency for Research on Cancer, World Health Organization) both in occupational (such as American Conference of Government Industrial Hygienists, National Institute of Occupational Safety and Health and Occupational Health and Safety Administration) and non occupational environment (such as United States Environmental Protection Agency) are proposed. The differences in the database and consequently in the conclusion are described in a short historical review since formaldehyde was considered for the first time as regard as health effects.     

Initial results from the European Network of Health Promoting Schools program on development of health education in Finland

The European Network of Health Promoting School (ENHPS) program aims to foster healthy lifestyles for school populations by developing supportive teaching and learning environments conducive to promotion of health. Most European countries have joined the network since its organization in 1993. This paper describes how the European, national, and local aims of the ENHPS program have been realized in Finnish schools during the first year of the second triennium (1997-1999). Substantial development related to health promotion has occurred in the Finnish ENHPS schools. A safe school environment was emphasized, and networking with other schools was encouraged at the international and national levels. Attitudes toward the ENHPS program generally were positive. However, Finnish schools have emphasized developing "structures" for health promotion. In the future, efforts should concentrate on students' active participation in the activities of health promotion in everyday teaching and learning situations.     

Occupational health: a classic example of class conflict

The history of class conflict in occupational health in the United States is illustrated by the current Pittston Company attack on coal miners' health benefits, the silicosis and asbestosis controversies, the corporate restrictions on state workers' compensation laws, and the unremitting management opposition to the federal Coal Mine Health and Safety Act of 1969 and the Occupational Health and Safety Act of 1970. A positive action program is presented as the basis for convening the long-overdue White House Conference on Occupational Health and Safety. Mining engineers are urged to support that action program to prevent unnecessary work-related death and disability.     

Workers' health in Israel.

BACKGROUND: Occupational hazards are important causes of morbidity, mortality, and disability in the community. This article presents a review of workers' health in Israel. METHODS: Data were collated from the Occupational Health Institute of the University of Tel Aviv, the National Insurance Institute, the Occupational Health Departments of the General Sick Fund, and the Institute of Safety and Hygiene of the Ministry of Labor and Welfare. International comparisons are based on data derived from the WHO Health for All database for the European region. RESULTS: Levels of most biological and chemical exposures in 1996 were found to be in accordance with the standards, except for dust, gases, pesticides, and noise exposure. In 1996, 4.3% of the working population received injury compensation from the National Insurance Institute. 78% of workers' claims approved in 1992-1994 were for injuries to the back and spine. 93% of new cases of occupational diseases and injuries reported in 1996 by the occupational health service of the largest Health Fund were due to noise-induced hearing impairments. In 1996, there were 87 reported deaths following work accidents; about 50% of them were falls that occurred in the construction industry, and 26% of fatalities were among foreign workers. Rates of work accidents, average days of incapacity per accident, and fatalities have been increasing since 1991. Rates of occupational accidents and of occupational fatalities are higher than the European Community average. CONCLUSIONS: Rates of occupational diseases and of injury compensation among workers are increasing, despite the efforts and resources invested in the prevention of work accidents and the promotion of workers' health. These findings indicate the necessity for further research and efforts toward the prevention of injuries and the promotion of occupational health in Israel.     

Planting the Seed: The 2009 Midwest Rural Agricultural Safety and Health Forum (MRASH)

ABSTRACT

The annual Midwest Rural Agricultural Safety and Health Forum (MRASH) is produced by the combined efforts and resources of Iowa's Center for Agricultural Safety and Health (I-CASH), the Great Plains Center for Agricultural Health, and The Heartland Center for Occupational Health. There is a regional focus for the conference on agricultural health issues for the 11 states of the upper Midwest, thus the new name for conference (MRASH). The purpose of this conference is to “plant the seeds” for stimulating and strengthening collaborative efforts among researchers, practitioner, agricultural producers, and medical professionals. This is accomplished by sharing cutting edge research, reviewing intervention theory and methodologies, reviewing activities of regional academic, public health, and nonprofit farm health and safety organization. The 2009 conference included plenary and topical breakout sessions. The plenary sessions included topics that have a relevance to the theory and practice of health interventions in populations. The breakout sessions were quite varied, with topics of community prevention programs (including Certified Safe Farm for large farms), AgrAbility programs, exposures from noise, pesticides, needle sticks, and all-terrain vehicle operation. The largest breakout session was on methicillin-resistant Staphylococcus aureus (MRSA). Should there be further questions of authors or the organizing committee, contact information is available at the following Web site address: http://www.public-health.uiowa.edu/ICASH/programs/MRASH/2009/index.htm.     

环境与健康保护：从理论到行动的转化之路——“第六届环境与职业医学国际学术研讨会”纪要

＂第六届环境与职业医学国际学术研讨会暨《环境与职业医学》杂志创办30周年研讨会＂于2014年10月16—18日在上海市召开,会议的主题是＂环境与健康保护：从理论到行动＂。此次会议由上海市疾病预防控制中心、上海市预防医学研究院、上海市预防医学会、《环境与职业医学》杂志主办,复旦大学公共卫生学院、江苏省预防医学会、浙江省预防医学会协办。共有44位中外专家进行了报告,200余位参会者就＂环境相关疾病的预防与控制＂＂职业人群的健康保护＂＂环境与职业医学中的组学研究＂＂环境政策与公共卫生＂等内容展开讨论。本次会议收到中英文论文投稿近200篇,同时设置了壁报展示并评选出3份优秀壁报。在＂《环境与职业医学》编者、审者、作者交流会＂上,编委会成员和审稿专家共同回顾了杂志创办30年来的发展历程,为杂志的发展提出了缩短出版周期、提供增值服务、进入重要数据库等意见。本次会议的成功举办可望进一步加深加强上海与国际国内在相应领域的联系与合作,更好地促进环境与职业医学领域理论与实际的结合、基础与临床的整合、微观与宏观的融合,为环境健康研究注入新的活力。     

FIOH-sponsored newsletter misrepresents asbestos hazards in Zimbabwe

The Finnish Institute of Occupational Health (FIOH) has received support from the World Health Organization (WHO) and the International Labor Office (ILO) to publish the African Newsletter on Occupational Health and Safety. The African Newsletter on Occupational Health and Safety should not be a medium for industry propaganda, or the source of misinformation among the workers of Africa. Instead, FIOH should provide the same level of scientific information in Africa that it does in Finland and other developed countries.     

环境与人类和谐发展：公共卫生的重要角色——第五届环境与职业医学国际学术研讨会纪要

2010年4月7—10日,以“环境与健康——气候·城市·职业”为主题的“第五届环境与职业医学国际学术研讨会”在四川省都江堰市召开。此次国际研讨会由上海市疾病预防控制中心、上海市预防医学研究院和《环境与职业医学》杂志编委会主办,加州中国科研合作项目（美国国立卫生研究院资助）、美国疾控中心环境卫生中心、美国《环境与健康展望》杂志和四川省都江堰市卫生局合办,42位中外专家和200多名代表出席会议。与会者就“生态、气候与健康”、“城市与健康”、“职业与健康”、“暴露与评估”、“环境铅暴露与健康”等主题进行了深入交流。本次研讨会的顺利举行必将促进环境与职业医学乃至公共卫生学科的持续发展,为科技和经济发展、构建和谐社会服务。     

Editorial – News from Nairobi: Politics,technology and mainstreaming

If one thing can be said about political engagement, it is that the Kenyan's know how to do it very well. The World Health Organization's 7th Global Conference on Health Promotion (7th GCHP) was held in Nairobi, Kenya, from 26 to 30 October 2009. The conference was opened by the President of the Republic of Kenya, closed by the Vice President and attended by both the Minister for Public Health and Sanitation and the Minister for Medical Services. Not only did these Ministers attend to make speeches, they also listened, participated and learned along with the rest of us. The engagement of senior political figures in Kenya with health promotion was a demonstration of the commitment of WHO, local conference organisers and the Kenyan government to make Africa's first global conference on health promotion a success.     

Current status of occupational health in Japan

In Japan, the primary administrative authority of occupationalhealth is the Ministry of Labour, and its legislative basisis the Industrial Safety and Health Law (ISH law). Occupationalhealth is mandated by this law and its enforcement involvesthe appointment of an occupational health physician (OP) forworkplaces with 50 or more workers, and a full-time OP for workplaceswith 1000 or more workers. The actual percentage of appointmentsfilled for the former group is 83.4 per cent, compared with58.4 per cent for the latter. The estimated number of OPs is34000, of which 2000 work full time. Worker health examinationis mandatory for all workplaces and many OPs allocate considerabletime to its implementation. Occupational health organizationsprovide occupational health services such as worker health examinationsto meet the demand. Basic training courses for OPs are providedby the Japan Medical Association and advanced courses are providedby the University of Occupational and Environmental Health,Japan. The Ministry of Labour recently launched a plan to establishoccupational health centres to assist OPs at prefectural andregional levels. A network of such centres is planned to spanthe country within the next seven years.     

How can critical incidents be used to describe health promotion in the Finnish European Network of Health Promoting Schools?

The purpose of this study was to elicit critical incidents that illustrate the reality in which health promotion processes take place in the Finnish European Network of Health Promoting Schools (ENHPS). In this study, critical incidents were used as a data collection method. The data were collected by asking representatives (n = 30) of the schools to describe in writing both positive and negative critical incidents related to health promotion in their school community. Altogether 48 critical incidents were analysed using qualitative content analysis. The results show that collaboration in a network of participants from inside and outside the school community to plan and implement a special school health day was the most commonly described positive critical incident. In addition, the organizational culture of the schools seemed to improve in a positive way. The reorganization of resources for health promotion resulted in positive progress, whereas a lack of resources had a frustrating and negative effect. The most commonly described negative critical incident was a failure to discourage smoking by pupils.     

Intervention research in agriculture: Examples from the swine confinement and respiratory health project

The “Measurement and Analysis in Agricultural Interventions” workshop session of the “Intervention Research in Occupational Health and Safety: Science, Skills, Strategies” conference considered a variety of approaches to safety and health interventions in agriculture. The “Respiratory Health in Swine Confinement Project” in Iowa, an educational intervention to improve respiratory health and safety in swine confinement workers, was presented as a case study for the discussion. Results from the project were used to illustrate the advantages and disadvantages of a variety of research techniques in interventions and program evaluation, including specific issues related to measurement and analysis. The discussion reflects comments from workshop participants along with summary observations reported to conference attendees. Themes of the session include the complementary nature of quantitative and qualitative techniques, and the importance of developing interventions that are community based. © 1996 Wiley-Liss, Inc.     

Development of occupational health in Japan

This paper was presented as a Lucas Lecture 1990 before the Faculty of Occupational Medicine, Royal College of Physicians, United Kingdom. It describes the development of occupational health in Japan including primitive industrialization (mining, smelting and others) back as far as the 8th century. The modern industrialization of Japan began slightly over one hundred years ago, i.e. from the beginning to the middle of the Meiji era. Before World War II, Japanese workers in industry suffered terrible working conditions, represented by a booklet published in 1925 entitled "The Tragic History of Female Workers" by Wakizo Hosoi. At that time a pioneer named Dr. Gito Teruoka was hard at work. He literally became the "Father of Occupational Health" in Japan. He established the Kurashiki Institute of Science of Labour in 1921 in Kurashiki City located in western Honshu, which is the main island of Japan. At the beginning of the Showa era, from 1930 to 1950, various types of occupational diseases were reported and the situation was overviewed by Dr. Juko Kubota. The rapid industrialization immediately after World War II during which workers were exposed to chromium, benzidine, beta 2-naphthylamine, arsenic, vinyl chloride monomer, asbestos, bischloromethyl ether and other chemicals gave rise to occupational cancer. The Ministry of Labour (MOL) was established in 1947 and the Labour Standard Law enacted. As a result, the incidence of tuberculosis decreased rapidly and occupational health emphasized the early detection of tuberculosis. After tuberculosis was nearly eradicated, more complicated working conditions developed in various industries. MOL enacted the Industrial Safety and Health Law in 1972 and occupational health practices improved greatly. Furthermore, in 1988 MOL amended the Law and announced guidelines on maintenance and promotion of health for the work population. However, there is a great disparity in occupational health services between large establishments and small factories. The University of Occupational and Environmental Health, Japan, (UOEH) was established in 1978 to promote occupational health sciences as well as to train and foster occupational health personnel to meet the short supply of occupational health physicians. However, there is no authority that establishes standards for occupational health physicians and nurses. The urgent necessity of establishing an authorized institution for the qualification of occupational health personnel is emphasized.     

Requirements for occupational medicine training in Europe: a Delphi study

OBJECTIVES—To identify the common core competencies required for occupational physicians in Europe.
METHOD—A modified Delphi survey was conducted among members of the European Association of Schools of Occupational Medicine (EASOM), the Occupational Medicine Section of the Union of European Medical Specialities (UEMS), and of the European Network of Societies of Occupational Physicians (ENSOP). An initial questionnaire based on the training syllabus of the United Kingdom Faculty of Occupational Medicine was circulated and respondents were asked to rate the importance of each item. The results were discussed at a conference on the subject of competencies. A further questionnaire was developed and circulated which asked respondents to rank items within each section.
RESULTS—There was a 74% response in the first round and an 80% response in the second. Respondents' ratings from most important to least important were; occupational hazards to health, research methods, health promotion, occupational health law and ethics, communications, assessment of disability, environmental medicine, and management. In the second round, among those topics ranked most highly were; hazards to health and the illnesses which they cause, control of risks, and diagnoses of work related ill health. Topics such as principles of occupational safety and selection of personal protection equipment were of least importance. Although the assessment of fitness was regarded as important, monitoring and advising on sickness absence were not highly rated. Management competency was regarded as of low importance.
CONCLUSION—This survey identified that respondents had traditional disease focused views of the competencies required of occupational physicians and that competencies were lagging behind the evolving definition of occupational health.


Keywords: competencies; Delphi study; occupational medicine training     

Continuous medical education (CME): do we need CME for paediatric environmental medicine in Europe?

The knowledge about the influence of environmental hazards on children's health is increasing enormously. European Ministers of Health and Environment, like many other stakeholders, identified the environmental hazards in Europe for the health of children as so serious, that they called for a "Children's Environment and Health Action Plan for Europe (CEHAPE)" approved in June 2004. The knowledge of paediatricians and other health care providers on children's health and environment in Europe is insufficient, due to the lack of training in environmental medicine for medical students, clinical trainees and postgraduates. Only continuous medical education in environmental medicine can help to fill this gap of knowledge and is thereby urgently needed. The World Health Organization developed a training package for health care providers for children's health and environment, containing excellent material for paediatric training events. The International Network on Children's Health, Environment and Safety (INCHES) developed additional training material for paediatricians within the Children's Health, Environment and Safety Training (CHEST) project. The German Network Children's Health and Environment offers training for paediatric doctors' assistants in primary prevention. To improve knowledge about children's health and environment at all levels in paediatric settings, greater efforts of national institutions, paediatric associations and other institutions are necessary. It is time to strengthen existing structures and to introduce, where necessary, new structures for training in environmental medicine.     

International School Health Network: an informal network for advocacy and knowledge exchange

In Canada, researchers, policy-makers and non-governmental organisations have re-conceptualized the school setting as being an ecological entity, linked to parallel ecologies of the homes and the community it serves. The school, public health and other systems that seek to deliver programs in that setting are open, loosely coupled and bureaucratic. This reconceived view of the school as a setting for health promotion leads to an emphasis on building organizational, system, professional and community capacity. One of the most effective ways of building such capacities when resources are scarce is to invest in a variety of formal and informal networks that can sustain themselves with little or no external resources. A number of recognised researchers from the health and education sectors have emphasized this systems-based approach and the need to build supportive, small-scale networks or learning communities. In recent health promotion research, networking at various levels, across sectors and within communities is viewed as a key strategy within new, more effective health promotion strategies. In education, the notion of networking for educational change has been described as "learning communities" for continuous school improvement. The authors suggest that this strategy of networking be used at the international level to address several global challenges: There is no single, convenient way to obtain basic information about the status and nature of national and state/provincial school health programs around the world. There is no global research agenda in school health promotion, despite the obvious value of sharing such research and knowledge. There is no global mechanism to facilitate the development of common or shared tools for surveillance of child/youth health and monitoring of school health policies and programs, despite the excellent work being done in individual countries and by the European Network of Health Promoting Schools. There is no international mechanism with a focus on school health that brings together the following stakeholders: educational organisations with public health organisations; researchers with government officials and practitioners; those who work in Spanish, English, French and other languages; issue-specific networks with health generalists. An invitation is given to government officials, researchers and national school health associations to join an informal International School Health Network (ISHN) (soon available at: www.internationalschoolhealt.org). Discussions about the formation of the ISHN have been held with a number of participants at several international meetings and have culminated in a fledgling network that will focus on electronic and web-based exchanges of information, developing a global school health research agenda, exchanging effective materials and tools, informing policy-makers about effective practices, policies and programs. This network would build on and not duplicate the work of existing networks and include participation from WHO, OECD, UNESCO, the IUHPE and the World Bank. The next large meeting of the ISHN will occur at the IUHPE 2007 Conference in Vancouver, Canada (www.iuhpe conference.org). Before then the ISHN will organise several on-line projects and teleconferences. For more information, contact dmccall@jcsh-cces.ca.     

Report on the International Conference on Emergency Health Care Development

Emergency medical services (EMS) provide rescue, field stabilization, transportation to medical facilities, and definitive care for persons experiencing medical emergencies. In order to advance worldwide development and refinement of EMS systems, and their integration with emergency preparedness and response programs, the International Conference on Emergency Health Care Development was held in Crystal City, Arlington, VA, August 15-19, 1989. The conference was supported by the Department of Health and Human Services and its Health Resources and Services Administration; the Department of Transportation and its National Highway Traffic and Safety Administration; and the Pan American Health Organization. Objectives of the conference were to clarify linkages between various levels of emergency response, to present methods for developing or improving EMS systems within societies with different resources, to demonstrate processes by which EMS systems have been developed, and to propose international emergency health care development goals. Topics included development of services in developing nations, case studies of underdeveloped countries' responses to natural disasters, and a method for updating disaster response through use of available medical resources.     

Agricultural medicine core course: building capacity for health and safety professionals

In 1987 the University of Iowa began training health care professionals to care for farmers' occupational health needs. The training enables health professionals from various disciplines to function in the anticipation, diagnosis, treatment, and prevention of occupational illnesses and injuries in the farm community. A grant from National Institute for Occupational Safety and Health (NIOSH) entitled "Building Capacity for Health and Safety Professionals" allowed for the expansion of this training to other states. This paper describes the challenges, successes, and lessons learned from dissemination of Agricultural Medicine Core Course.     

Exposure-related health effects of silver and silver compounds: a review

A critical review of studies examining exposures to the various forms of silver was conducted to determine if some silver species are more toxic than others. The impetus behind conducting this review is that several occupational exposure limits and guidelines exist for silver, but the values for each depend on the form of silver as well as the individual agency making the recommendations. For instance, the American Conference of Governmental Industrial Hygienists has established separate threshold limit values for metallic silver (0.1 mg/m3) and soluble compounds of silver (0.01 mg/m3). On the other hand, the permissible exposure limit (PEL) recommended by the Occupational Safety and Health Administration and the Mine Safety and Health Administration and the recommended exposure limit set by the National Institute for Occupational Safety and Health is 0.01 mg/m3 for all forms of silver. The adverse effects of chronic exposure to silver are a permanent bluish-gray discoloration of the skin (argyria) or eyes (argyrosis). Most studies discuss cases of argyria and argyrosis that have resulted primarily from exposure to the soluble forms of silver. Besides argyria and argyrosis, exposure to soluble silver compounds may produce other toxic effects, including liver and kidney damage, irritation of the eyes, skin, respiratory, and intestinal tract, and changes in blood cells. Metallic silver appears to pose minimal risk to health. The current occupational exposure limits do not reflect the apparent difference in toxicities between soluble and metallic silver; thus, many researchers have recommended that separate PELs be established.