[Public health: occupational health services without white uniforms].
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The U.S. Coast Guard has developed a Coast Guard-wide comprehensive system for surveillance of workplace diseases. The American Medical Association's fifth edition of the Current Medical Information and Terminology (CMIT) was used as a reference to expand the basic list of 50 Sentinel Health Events (Occupational) [SHE(O)] published by the National Institute of Occupational Health and Safety (NIOSH), September, 1983. The expanded list of 107 sentinel events serves as a framework for the development of a computerized system of occupational health surveillance in the U.S. Coast Guard. This application of SHE(O) surveillance can have application in the early detection and prevention of environmental diseases.
Occupational diseases are now being assessed at the cellular and molecular levels; this presents new opportunities for prevention and control [Calleman et al., 1978; Ong et al., 1987; Stejskal et al., 1989; Welch and Cullen, 1988; Garry et al., 1989]. The key to these opportunities is the ability to detect biological markers that reflect exposure, response, and susceptibility. Biological markers are not new, however. Biological markers such as blood lead, urinary phenol levels in benzene exposure, and liver function assays have long been used in occupational and public health research and practice. What distinguishes the current generation of markers from previous markers is a greater degree of analytical sensitivity and the ability to describe events that occur earlier in the progression between exposure and clinical disease. There are now new domains of response that were not known to exist 20 years ago. Accompanying this sensitivity is the increased requirement to consider the numerous factors that can influence the appearance of biological markers. It has been observed that all workers with similar exposures do not develop disease or markers indicative of exposure or disease. Various acquired and hereditary host factors are responsible for this variation in responses. The role of assessing the nature and degree of variation between individuals is of paramount importance. Finally, the use of biological markers in occupational health research and practice also brings new ethical and legal considerations into high profile. This paper presents my personal opinions on how biological markers can contribute to occupational health efforts and the new requirements that they bring to the field. As with any technological change, the more we can anticipate the impact, the better our ability to adjust.
The Study Model for Future Occupational Health (funded by a research grant from the Ministry of Health, Welfare and Labor) is a joint research project involving various organizations and agencies undertaken from 2002 to 2004. Society has undergone a dramatic transformation due to technological developments and internationalization. At the same time a low birth rate and an aging population have resulted in an increase in both the percentage of workers experiencing strong anxiety and stress in relation to their jobs and the working environment and the number of suicides. As a natural consequence, occupational health services are now expected to provide EAP, consulting and other functions that were formerly considered outside the realm of occupational health. In consideration of this background, the present study propose the following issues to provide a model for future occupational health services that meet the conditions presently confronted by each worker. 1. How to provide occupational health services and occupational physicians' services: 1) a basic time of 20 minutes of occupational health services per year should be allotted to each worker and to all workers; 2) the obligatory regulations should be revised to expand the obligation from businesses each with 50 or more employees under the present laws to businesses each with 30 or more employees. 2. Providers of occupational health services and occupational physicians' services: (1) reinforcement of outside occupational health agencies; (2) fostering occupational health consultant firms; (3) development of an institute of occupational safety and health; (4) support of activities by authorized occupational physicians in the field; (5) expanding of joint selection of occupational physicians including subsidy increase and the extension of a period of subsidy to five hears; (6) licensing of new entry into occupational health undertaking. 3. Introduction of new report system: (1) establishment of the obligation to submit reports on risk evaluation and improvement measures; (2) establishment of the obligation to prepare a report on results of medical examinations in all sizes of businesses. 4. Introduction of a merit system into businesses in establishment of a new system: the application of the special merit system of the workers' compensation insurance shall be revised to add occupational health activities, cover business with 20 or more to 100 or less employees and expand the period of application for three years under the present laws to five years. 5. Ensuring of international coordination: harmonization of standards of individual countries for occupational health and safety; thorough (1) ensuring of international agreement on high-level specialist qualifications; (2) mutual recognition of qualifications of occupational physician, nurse, occupational hygienist, ergonomist, and counselor; (3) preparation of guidelines for occupations relating to occupational health businesses.
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Comparing need between Health Occupation and Health Education Schools: Which students benefit most from the School Health Education Program? First-year medical students taught general health topics at public high schools. Pre-test and post-tests were given for each presentation. Health Education students had lower pre-test scores but showed greater improvement. With greater need and fewer resources, Health Education students benefit most.
1. Environmental hazards are ubiquitous. Many exist in the workplace or occur as a result of work process exposures. 2. Environmental health is a natural component of the expanding practice of occupational health nursing. 3. AAOHN's vision for occupational and environmental health will continue to set the standard and provide leadership in the specialty.
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We compared occupational health related laws and occupational health systems on ethics in Germany, France, USA, UK, and Japan, and reviewed them. The duties of appointment of occupational physicians, competence of occupational physicians, responsibility for maintaining the confidentiality of the medical records, professional independence of occupational physicians, employment and dismissal of occupational physicians, etc. were discussed. Concerning maintaining the medical privacy of workers, the Japanese law and system are thought to be different from those of other countries. Concerning the professional independence of occupational physicians, the Japanese law does not have this point of view. We hope that Japanese occupational physicians express their opinions on these issues.
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1. Although much work has been done to identify occupational risks to health care workers in institutions, little has been done to describe such risks in the growing home care industry. Changes in the nature of home care suggest the risks may be equivalent, with additional risks from the variable environment of the home. 2. Directors of home care agencies in Northern California were surveyed with respect to the nature of home care, workers, characteristics of occupational programs, and common illnesses and injuries. Musculoskeletal injuries were the most common occupational injuries reported. 3. Despite legislation and accreditation standards, occupational programs in home care agencies are incomplete. Further work is needed to determine the relationship between the presence of occupational health programs and home health care outcomes.
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