[Current status of occupational health activities and the way that occupational health services should be offered to small- and medium-scale enterprises]

Prevalence of coronary heart disease and its risk factors by working environment among Japanese male workers

Work is a major social determinant of health. We conducted a cross-sectional study to explore the association between coronary heart disease (CHD), its risk factors, and the working environment among Japanese male workers. We collected data from 10,572 workers (mean age 49.9 yr) who underwent annual medical check-ups in Toyama, Japan, in 2016. This study included data from health check-ups and questionnaires on medical history of CHD, hypertension, and diabetes, and the use of medication. The working environment included company size and industry categories. Company size was classified into 4 categories according to the number of full-time workers (1-20, 21-100, 101-300, 301-). The industry category was classified into 10 categories. Logistic regression analysis was performed to explore the association. In total, 1.5% of patients had a history of CHD and 31.5% and 11.0% of participants were suffering from hypertension and diabetes, respectively. Compared to workers in a large company, those in a smaller company were more likely to have CHD. Moreover, there was a significant association between CHD's risk factors and working in the transportation industry. Health providers, including medical doctors, should consider employee working environment as a potential risk factor for CHD.

The Impact of Diabetes Status on Presenteeism in Japan

OBJECTIVE

This study aimed to investigate the impact of diabetes status on presenteeism in companies in Japan.

METHODS

A cross-sectional study was conducted among workers aged 40 years or older. Using medical examination results and health insurance claims data, participants were classified as normal, borderline, or diabetic. The diabetic group was further classified as untreated or treated. The Quantity and Quality (QQ) method was used as an evaluation index of presenteeism. Logistic regression analysis was performed to predict presenteeism loss.

RESULTS

Data on 13,292 people were analyzed. Presenteeism loss was significantly higher in the diabetic group versus the normal group. The untreated group did not differ from the normal group, but presenteeism loss was significantly higher in the treated group.

CONCLUSIONS

Presenteeism loss may occur among diabetic workers in Japan and can be caused by diabetes treatment.

Social participation and mortality according to company size of the longest-held job among older men in Japan: A 6-year follow-up study from the JAGES

OBJECTIVES

The purpose of this study was to examine the relationship between social participation (type/pattern) and mortality according to company size of the longest-held job among older men in Japan who have worked in the company.

METHODS

Longitudinal data from the Japan Gerontological Evaluation Study were used in this study. Functionally independent individuals aged 65 years and older in Japan were surveyed. Work and community organizations (local community, hobbies, and sports) were used as social participation. A Cox proportional hazards model was used to calculate mortality hazard ratios.

RESULTS

Analysis was carried out on 19 260 participants. A total of 2870 deaths occurred during the 6-year follow-up period. Those in companies with 49 or fewer employees had the highest prevalence of work participation and the lowest participation in any community organization. Regardless of company size, the mortality risk was significantly lower for participants in any social participation (eg, the hazard ratio for participation in a hobby organization among those with a company size of 49 employees or fewer was 0.74, 95% CI: 0.65-0.85) compared to nonparticipants whose company size was 49 or fewer employees.

CONCLUSIONS

In Japan, although older men who have worked for small companies may have fewer benefits, their social participation may reduce their mortality risks. To avoid increasing health inequalities, it is necessary to create an environment in which they are more likely to participate in social activities.

Size of company of the longest-held job and mortality in older Japanese adults: A 6-year follow-up study from the Japan Gerontological Evaluation Study

OBJECTIVES

Very few longitudinal studies have investigated the question of whether differences in company size may give rise to health inequalities. The aim of this study was to examine the relationship between company size of the longest-held job and mortality in older Japanese adults.

METHODS

This study used longitudinal data from the Japan Gerontological Evaluation Study. Surveys were sent to functionally independent individuals aged 65 or older who were randomly sampled from 13 municipalities in Japan. Respondents were followed for a maximum of 6.6 years. The Cox proportional hazards model was used to calculate mortality hazard ratios (HRs) for men and for women. Analysis was carried out on 35 418 participants (197 514 person-years).

RESULTS

A total of 3935 deaths occurred during the 6-year follow-up period. Among men, in Model 1 that adjusted for age, educational attainment, type of longest-held job, and municipalities, mortality HRs decreased significantly with increasing size of company (P for trend = .002). Compared to companies with 1-9 employees, the mortality HR (0.78, 95% confidence interval: 0.68-0.90) was significantly lower for companies with 10 000 or more employees. However, there were no significant differences among women (P for trend = .41).

CONCLUSIONS

In men, mortality in old age may decrease with increasing size of company of the longest-held job. To reduce health inequalities in old age due to differences in size of company, studies should be conducted to determine the underlying mechanisms and moderating factors and those findings should be reflected in labor policies and occupational health systems.

Current Status and Issues for the Role of Occupational Health Physicians in Japan

This paper reviews the circumstances, current situation, and issues for Japanese occupational health physicians and discusses future developments. The Industrial Safety and Health Act requires workplaces that regularly employ 50 or more workers to appoint one occupational health physician. Their duties have been expanded by amendments to the Act, and they now have increased authority. Under these conditions, the occupational health physicians not only comply with laws and regulations but also follow a professional code of ethics. After the Act was amended in 1996, occupational health physicians had to complete additional training requirements. Basic training courses are provided by the Japan Medical Association (JMA) and the University of Occupational and Environmental Health, Japan. Most of the occupational health physicians certified by the JMA do not spend enough time on occupational health. Many Japanese occupational health work issues can be separated into issues of exposure, labor, and the occupational health system. Occupational health is characterized by changing needs because of new industrial structures and technological innovations. Given occupational health physicians’ expanding duties and professional development, they need to collaborate with one other and other occupational health staff to meet society’s expectations.