Willingness to implement mental health measures among small-scale enterprise employers in Ohta ward, Tokyo, Japan]

Due to the increase in mental health problems among Japanese workers in recent years, effective approaches to address these problems are of growing concern. Although such an effort is now under way in largescale enterprises (LSEs), small-scale enterprises (SSEs) are lagging behind LSEs for a number of reasons. In the present study, to know the reason, the presidents of 263 SSEs (fewer than 50 employees) in the Ohta ward of Tokyo were surveyed with a self-administered questionnaire from October 1999 to March 2000 (response rate, 51.0%). The main business types were manufacturing (71.2%), transportation & storage (6.1%), and construction (5.3%). The results revealed that employers attribute the mental health problems of employees to "Job content/Aptitude for job (78.6%)", "Communication among employees (71.0%)", "Physical problems/Illness (50.4%)", "Family problems (33.6%)". These results are very similar to those obtained in the same enterprises employees survey in 1996, suggesting that employers perceive the factors responsible for employees' mental health problems with substantial accuracy. Sixty-nine point five percent of the employers answered that they need mental health measures for employees. And 62.7% of employers agreed to take mental health measures in their enterprises. Taken together, it is considered that employers are willing to improve their employees' mental health problems. Nevertheless, 95% of employers are doing nothing to improve the situation. The major reasons cited were 1) Cannot obtain a consultant or counselor (44.8%), 2) Lack of time (43.1%), 3) Manpower shortage (41.4%), 4) Difficulty in ensuring employees' privacy (36.2%), and 5) Lack of financial resources (30.2%). The results of the present study suggest that perception of the mental health problems among employers and employees of SSEs in the Ohta area were close to each other. Effective strategies are needed to improve mental health problems in SSEs.     

Actual conditions of occupational health activities in small-scale enterprises in Japan: system for occupational health, health management and demands by small-scale enterprises]

In order to clarify the real conditions of occupational health services (OHS) in small-scale enterprises (SSEs) in Japan, we analyzed questionnaires recovered from 765 SSEs in the area of a city neighboring Osaka City (recovery rate, 69.3%). The SSEs included 358 SSEs with 1 to 4 workers (46.8% of total SSEs), 203 with 5 to 9 (26.5%), 163 with 10 to 29 (21.3%) and 41 with 30 to 49 (5.4%). The main types of businesses were manufacturing (374, 48.9% of total SSEs), wholesale/retail trade/restaurants (153, 20.0%), community, social and personal services (132, 17.3%) and construction (72, 9.4%). Health examinations were performed in 47.7% of SSEs. The reason for the lack of examinations were "shortage of time" (33.3% of SSEs lacking health examination) and "employees do not want to be examined" (28.1%). Some health promotion measures were conducted in 29.2% of SSEs. Health examination (59.0% of SSEs), health promotion (36.5%), measure of mental health (25.9%) and information service for employers and employees (25.5%) were demanded by SSEs as OHS. Financial subsidies and economical incentives were demanded by 46.4% and 28.8% of SSEs, respectively. Regional occupational health center in this area was poorly known among SSEs (8.2%), but health examination (48.4%), information service (37.5%), assessment of work method and advice to improve (19.8%) and environment measurement (12.4%) are demanded of the center by SSEs.     

Occupational health services for small-scale enterprises in Korea

Korea needs national strategies to handle problems of Small Scale Enterprises (SSEs) systematically. Since 1993, the Korean government has begun to provide financial subsidy programs for Occupational Health Services (OHSs) in SSEs from Occupational Injury Prevention Fund. To identify the health care status in SSEs in Korea, 5,080 factories, which had participated in the Government-funded Subsidy Program in 1997, were surveyed. The overall morbidity of the workers in these SSEs was higher than the national average for both general and occupational diseases. Based on the health examinations for occupational disease of those workers exposed to occupational hazards such as noise, dust, or solvents, we could find the industry-specific occupational disease patterns. From this result, we would plan the targeted occupational health services to specific groups. In spite that the effectiveness of this program is not completely assessed, our results indicate that it is desirable for this program to be continued in Korea. In addition, this program may be a good model for rapidly developing countries.     

'Competition' among employers offering health insurance

Most employees contribute towards the cost of employer-sponsored insurance, despite tax laws that favor zero contributions. Contribution levels vary markedly across firms, and the average contribution (as a percentage of the premium) has increased over time. We offer a novel explanation for these facts: employers raise contribution levels to encourage their employees to obtain coverage from their spouses' employer. We develop a model to show how the employee contribution required by a given firm depends on characteristics of the firm and its work force, and find empirical support for many of the model's predictions.     

Inequality in the health status of workers in small-scale enterprises

BACKGROUND: Small-scale enterprises (SSEs) usually share poorer resources for promoting occupational health. AIM: To investigate inequality of health status among SSEs in Japan. METHOD: A cross-sectional, multiple-centred study was carried out using the periodical health check-up data for the fiscal year 2000 to compare the age-adjusted proportions of workers with hypertension (HT), hyperlipidaemia, impaired glucose tolerance (IGT) and obesity and of current smokers by size of enterprise, i.e. or=1000 employees in Japan. RESULTS: From five leading occupational health organizations, data were collected for 9833 enterprises with a total of 436 729 subjects, 302 383 males and 134 346 females. The proportions of workers in SSEs with or=50 male employees. The prevalence of smokers in SSEs with or=50 male employees. These proportions showed a significantly increasing tendency with decreasing size of male workforce. CONCLUSION: Despite the cross-sectional design and only adjusting age as a potential confounder, higher proportions of HT, IGT, obesity and smoking in male workers were found in SSEs compared to larger organizations.     

Nationwide survey of occupational health activities in small-scale enterprises in Japan

OBJECTIVES: In order to clarify the real condition of occupational health (OH) activities in small-scale enterprises (SSEs) at the nationwide level, we conducted a questionnaire study sent to SSEs. We selected SSEs according to their employee numbers published in the in "Census of Workplaces in 1999". SUBJECTS AND METHODS: About 2000 establishments were selected from the list in the "Census" describing the names and addresses of enterprises with 5 or more employees. The questionnaire included type of business, number of employees, independence, OH competent person, conduction of health examination, potential hazardous works and countermeasures (chemicals handling, computer work, etc), committee or other types of organizations for OH, and others. RESULTS: Two hundred eleven establishments with 1-4 employees, 779 establishments with 5-9 employees, 681 establishments with 10-49 employees, 300 establishments with 50-99 employees, and 57 establishments with more than 100 employees, a total of 2,029 establishments responded to the questionnaire. The types of businesses (the number of establishments) were construction (216 establishments), manufacturing (604), transportation and communication (216), wholesale and restaurants (390) and services (602). The rate of independent enterprises was 54.1% and branches 45.9%. Indicators of OH activities including selection of OH competent person, enforcement of OH guideline for computer work, OH education about the occupational health risks, enforcement of special health examinations and general health examinations in SSEs with 1-4 and 5-9 employees were worse than SSEs with 10 or more employees. CONCLUSIONS: The differences of OH activities by scale of number of employees were clarified at a nationwide level. However, OH activities in SSEs with 1-4 employees were not clarified sufficiently. Various policies and methods should be established and implemented to improve the low level of OH activities in SSEs.     

Multiple channels for occupational health services to small-scale enterprises in Japan

This study was performed to clarify the characteristics of multiplechannels for occupational health services (OHS) to small-scaleenterprises (SSEs) in Japan employing less than 50 workers byreviewing relevant research papers. OHS were provided to SSEsby both government organizations and non-government organizations.Government organizations included the Japanese Industrial Safety& Health Association, regional occupational health centres,prefectural occupational health promotion centres, and otherhealth centres. Non-government organizations were parent companies,occupational health organizations, hospitals, medical associations,trade associations and health insurance societies. The qualityof OHS in terms of provision of health personnel and the natureof their services differed greatly between the organizations.Health care programmes were more popular than management ofthe work environment or working practices in OHS to SSEs. Feworganizations provided comprehensive OHS to SSEs. At present,parent companies and occupational health organizations appearto provide the best OHS available to SSEs in Japan.     

我国50家大型企业员工健康相关知信行及健康现状调查

目的了解大型企业员工的健康相关知识、信念和行为现状,为企业制定健康管理措施提供依据。方法本次调查利用整群抽样的方法对参加企业行现场活动的50家大型企业的员工进行问卷调查。结果共发放4697份问卷,有效问卷4574份,有效率为97.4%;有24.4%的受访员工认为男性成人一天酒精用量不应超过25 g;对健康的食盐摄入量的知晓率为56%。调查人群的总体吸烟率为29.6%,35.6%的受访员工称自己没有时间做运动,65.4%的受访员工不知道或不清楚本企业是否有专门的健康管理部门,不同类型企业间部分结果差异有统计学意义。结论 50家大型企业的员工基本的健康知识知晓情况较好,但部分重要健康问题认识仍有偏差,健康行为形成率低,部分企业忽视对员工健康管理的日常工作。     

Financial assistance in promoting occupational health services for small-scale enterprises in Japan

In spite of the diversified views on the governmental financial assistance in promoting occupational health services (OHS) for small-scale enterprises (SSE), the issue has not been much studied. Considering the large differences between countries in the degree of governmental financial assistance, the international comparative research will provide insight into its advantages and disadvantages. In order to conduct such comparative research, the status of each country must first be clarified. This informative piece of study aims at stimulating researchers in other countries to share their experiences and facilitate future comparative studies. This study was conducted to clarify the financial assistance of the Japanese government for SSE. Published reports on financial assistance for SSE were collected and used for the study. The Ministry of Labor initiated the policy of subsidizing OHS for SSE in the early 1960s. Activities to be subsidized through four routes included primary and secondary prevention of occupational injuries and diseases. The amount of subsidy was limited from one-third to two-thirds of costs. There was a fourteen-fold increase in the amount of subsidies for SSE from US$ 7 million in 1986 to US$ 98 million in 1998. The long history of financial assistance for SSE and the increasing amount of subsidies suggest that the Ministry of Labor recognizes the importance of financial assistance in promoting OHS in small scale enterprises.     

Status of health promotion programme implementation in small-scale enterprises in Japan.

This study was conducted to determine the status of the implementation of health promotion programmes (HPPs) in Japanese small-scale enterprises (SSEs). A survey was conducted in 1996 using a questionnaire mailed to all the member construction companies (n = 772) of a health insurance society, and a response rate of 84% was obtained. Health examination was most frequently conducted (90%), followed by exercise/fitness programmes (17%), smoking measures (12%), health guidance (11%) and nutrition education (6%). Mental health programmes and the government-advocated Total Health Promotion Plan (THP) were implemented at less than 2% of SSEs. The implementation rates for these programmes, except for smoking measures and the THP, were higher at large enterprises than at SSEs. The employment rate for occupational physicians (OPs) was 9% and 49% at SSEs and large enterprises, respectively. The activity most frequently conducted by OPs was health examination, followed by curative services and health education. Advising employees to undergo re-examination or more valid examination after the annual health examination was most frequently conducted by non-health professionals.     

Survey of attitudes among general practitioners regarding the introduction of a personal computer medical network system in community health care]

General practitioners (GPs) play an important part in community health care. Their opinion regarding introduction of a medical information network system using a personal computer and factors influencing the decision to introduce such a system were surveyed among 977 randomly sampled GPs. A response from 727 GPs was obtained. Based on a two stage selection method, 20 factors were selected as effective factors among the 73 factors surveyed, with the following results: (1) Responses to the question concerning the approval of system introduction were classified into three groups: "not necessary + too early to make a decision (DA)" (DA group), "approve (A)" (A group) and "undecided (UD)" (UD group). Each group had nearly equal numbers of respondees. (2) Significant effective factors were "experience with personal computers", "a desire to use a personal computer", "a desire to use a computer-diagnosis-system", "cost", and "a volition to operate a computer by himself". (3) The "A group" had high experience and affirmative opinions, while the "DA group" had low experience and negative opinions. The "UD group" also tended to respond with "do not know" regarding the factors. (4) Approval of system introduction requires providing basic knowledge on computers, opportunities for positive experience with computers, and practical examples of problem solutions in a general practitioner's work.     

Association between attitudes toward health promotion and opinions regarding organ transplants in Japan

Health promotion activities to educate the public about health lifestyles have been performed widely in industrialized countries where chronic adult diseases have become prevalent. According to a basic principle of health promotion activities, the symptoms of many diseases are regarded as the result of inadequate health behavior, curable by modifying health behavior. It is thus possible that an exposure to health promotion activities might instill negative attitudes towards organ transplants, because program participants may conclude that persons who need an organ transplant have become unhealthy as the result of their own poor health habits. In this study, two types of surveys were undertaken to test this hypothesis. The subjects of the first cross-sectional study were 712 male and female Japanese citizens, and those of the second case-control study were 240 female company employees in Japan. In the first study, a logistic regression analysis was used and the following findings were obtained. (1) Compared with the persons who felt that they did not have enough practical knowledge about individual health practices, those who felt that they had adequate knowledge were 0.66 times less likely to support organ transplants. (2) Compared with those who were not willing to spend money on healthful things, the persons who were willing to do so were 0.51 times less likely to support organ transplants. In the second case-control study, it was revealed that the subjects who had negative attitudes towards organ transplants had consistently healthier lifestyles than did those who had positive attitudes towards organ transplants. Based upon the present findings and the nature of the basic principles of health promotion activities, we infer that community health promotion activities have a negative influence upon citizens' opinions of organ transplants. Since these findings have health policy implications, more studies are necessary to conclusively evaluate the effects of health promotion activities upon attitudes toward organ transplants.     

Characteristics of lifestyle and health status of workers in small-scale enterprises in Japan

This study was conducted to clarify the characteristics of small-scale enterprises (SSEs) with fewer than 50 workers, which employ 62.2% of all Japanese workers. Subjects were 71,183 workers employed at 1,761 workplaces in Tochigi, Japan, in 2002. Frequencies of abnormal lifestyle and health check-up data were described according to the category of the enterprise. Adjusted odds ratios (ORs) of the abnormal findings were calculated by logistic regression analysis. Dose-response relationships were calculated by trend tests. The frequency of abnormal findings was higher in SSEs than in other categories of enterprises. The ORs of work intensity, alcohol consumption, current smoker, and the Brinkmann index were higher in SSEs than in large-scale enterprises (LSEs) and were also significant in trend tests. The ORs of audiometry, hypertension, glucose in urine and ECG in males and females, BMI, liver function, lipid metabolism, and blood sugar in females, chest X-ray, and anemia in males were higher in SSEs. Audiometry, hypertension, anemia, ECG in both males and females; chest X-ray, and glucose in urine in males, and liver function, lipid metabolism and blood sugar in females showed significant results in trend tests. Overall health and healthy lifestyle in SSEs were worse than in LSEs.     

广州市白云区中小微企业员工职业卫生知识认知情况调查

目的 了解中小微企业一线员工职业卫生知识认知情况, 探讨适合的健康教育模式, 更好地指导职业卫生工作。
方法 采用随机整群抽样的方法, 在广州市白云区随机抽取40家中小微企业, 自制调查问卷, 对513名员工进行职业卫生知识认知情况调查, 回收有效问卷468份。
结果 对《职业病防治法》有关知识的总知晓率为75.52%;对有机溶剂(苯、正己烷)、粉尘、噪声三大职业病危害因素知识的总知晓率为78.35%。不同性别、年龄、户籍、文化程度、工作岗位、企业规模的员工, 以及有无岗前培训企业员工之间职业卫生知识总得分差异有统计学意义(P < 0.01)。有74.79%员工能够主动去获取职业卫生知识, 获取途径多样。
结论 中小微企业内不同特征员工对职业卫生知识的知晓率各不相同, 应针对不同的人群, 采取不同的途径和内容, 宣传职业卫生知识。
     

即墨市三资企业职业卫生状况调查

为摸清即墨市三资企业职业危害状况,确定职业卫生监督管理工作的重点,我们于1998年3-12月对我市的67家三资企业进行了职业卫生调查,将调查结果报告如下。1内容与方法1.1调查内容对我市的三资企业职业卫生状况进行调查,内容包括企业行业分布,作业环境防护设施,职业病危害因素浓度(或强度),卫生知识培训,发放防护用品情况和健康查体情况等。     

食品出口企业员工食品安全KAP调查

目的了解食品出口企业员工的食品安全知识、态度、行为,为食品出口企业员工进行食品安全教育提供依据。方法采用整群抽样的方法,对360名出口食品企业员工进行食品安全知识和态度行为问卷调查,用SPSS统计软件进行统计分析。结果管理人员的食品安全知识得分高于食品加工人员,差别有统计学意义(P0.05);文化程度高或者工龄长的员工其食品安全知识得分也高,差别有统计学意义(P0.05);食品安全知识知晓水平高的员工食品安全态度、行为得分也高,差别有统计学意义(P0.05)。结论要加强对出口食品企业员工尤其是工龄短、文化程度低的食品加工人员食品安全知识教育。     

企业职工职业病防治知识知晓率调查

企业职工职业病防治知识的知晓程度对职业病防治工作起着至关重要的作用，只有企业职工了解工作场所存在的职业病危害因素的种类、危害性及如何防护，具备了相关职业病防治方面的知识，才能在工作中自觉按照操作规程进行操作，自觉使用防护用品及设施。为了解接触职业病危害作业职工对职业病防治知识的知晓程度，探讨行之有效的职业卫生健康教育的方法，太原市铁路中心卫生防疫站对273名接触职业病危害作业的职工进行了职业病防治知识知晓率调查。结果报告如下。