歴史的にみる「産業医」

事業場における医師の選任については、労働安全衛生法の制定以前から、

 

工場法に基づく「工場医」の選任と、労働基準法に基づく医師である衛生管理者

 

の選任が定められていました。

 

 

その後、1972年の労働安全衛生法の制定時に、医師の専門的立場を明確にするため、その呼称を「産業医」と定めました。

 

産業医は労働者の健康管理等に当たるとともに、事業者または総括安全衛生管理者に対し指導助言する等専門家として活動するものとされました。

 

 

その後、脳・心臓疾患などにつながる所見を有する労働者の増加、仕事や職場生活で悩みやストレス等を感じる労働者の増加などを背景として、

 

1996年に、労働者の健康管理等を行うのに必要な医学に関する知識について一定の要件を備えた者でなければならないとする等の法改正が行われました。

 

 

そして、この年より、産業医の資格というものが始まりました。

 

日本医師会認定産業医という資格を持っている人間が産業医をできます。

 

2006年8月現在、産業医の有資格者数は、合計で約7万人超となっています。

 

 

一方、現行法令に基づき産業医を選任する義務のある50人以上の規模の事業所数は全国で約14万事業所となっています(総務省「事業所・企業統計調査2004年」)。


Causes of Mental Stress

Common reasons of employee mental stress and disease are

 

nHis/her work reasons

 

nFailure at work

 

nAn increase of his/her responsibility

 

nOvertime works

 

nChanges in quality and amount (time) of work

 

nChanges in his/her position, (forcing him/ her to retire)

 

 

nPersonal reasons

 

nDivorce, separation

 

nFamily’s death


Company Structure against “Mental Stress”

Mental Stress causes the performance down.

Company needs to make a good structure against Mental Stress.

 

Company Structure which facilitates prevention and treatment of mental stress

 

1. For Individual

 

nIndividual – maintain physical wellbeing.

 

nCompany – provide professional healthcare services by offering consultations and education and raise awareness for opportunities and materials available.

 

 

2. Managers

 

nManager – acknowledge employee’s physical wellbeing and facilitate necessary actions i.e. consultations if necessary.

 

nCompany – provide managers healthy and safe education.

 

 

3. Health and Safety personal on site

 

nCompany doctor – consultation and follow up

 

nCompany – Provide company doctor consultation and held Hygiene Committee


Three levels of prevention against “Mental Stress”

nFirst Level

 

nPrevention

 

nIndividuals: Actions against stress

 

nEnvironment: Removal and reduction of stressor

 

 

nSecond level

 

nEarly stage detection and action

 

nAvoid accidents and troubles

 

nRisk management, CSR

 

nIncrease consultation opportunity

 

 

nThird level

 

nRecovery and relapse prevention

 

nCare for a reinstatement person


Actions of prevention against “Mental Stress”

nIndividual

 

nPrevention by assessment of; Environment & Self check

 

 

nMangers

 

nEarly detection

nEncourages professional advice from qualified physician. i.e. company doctor

 

 

nMedical Support

 

nRecovery

nAssistance and follow up


Mental Stress Self check list

This check list measures your level of stress from physical and mental symptoms.

 

Please check if your experience symptoms below.

 

 

p      Neck and shoulder tension (often)  

p      Fatigue

p      Lower back pain

p      Dizzy

p      Constipation

p      Chest pains

p      Dry throat

p      Numbness of the hand and feet

p      Trembling of the hands and feet

p      Trembling of the hands and feet

p      Wake up at early hours

p      Depression in the morning

p      Lack of focus at work

p      No stamina

p      Indecisiveness

p      Anxiety

p      Feel disconnected from society

p      Have a lack of confidence for the future

p      Unsociable

 

 

Checked

 1-4 items – No issues, 

 5-9 items – Need a actions, 

 10 or more items – Warning


Overtime Work Measures in Japan

lMinistry of Health, Labor and Welfare takes overtime seriously and recently, the control of the labor standards inspection office is getting strict in Japan.

 

 

lEmployers are required to monitor track of employee’s working hours because the level of tiredness is commonly estimated by overtime work hours.

 

ØRelationship between overtime work hours and brain / heart disease;

²        >100 hrs, within 1 month          Strong relationship!!

²        >80 hrs, within 2-6 months         Strong relationship

²        >45 hrs                         Relationship exists

²        <45hrs, within 6months           Weak relationship

 

 

l It is the company’s responsibility to acknowledge employees’ health situation and excessive working hours.


Managing Overtime & Excessive Working Employees in Japan

nOn an employee request bases, company must give company doctor’s consultations to employees who’s overtime working hours exceed 100 hours per month and show signs of fatigue.

 

nAlso, for employees who’s average overtime working hours are 80 to 100 hours (in past 2 to 6 months), company must try to give  company doctor’s consultations on an employee request bases (努力義務).

 

 

nCompany doctors will provide consultation and recommendation report to employers and the record must be kept for 5 years.

 

 

nEmployers must make actions when recommended by company doctor.

 

ne.g. Working hour limitations, Replacement, Report to Hygiene Committee Meeting.


General Actions against Overtime and Excessive Working Hours

nOvertime work managements.

n<45 hrs a month.

nTime card, online time management application.

 

nAnnual vacation.

 

n Carrying out annual health check-up and its follow up.

 

nAsking for a doctor’s opinion for a person with abnormal findings and act.

 

nCarrying out health check-up semiannually for employees with late-shift work.

 

nWorking hour limitations.


Company Doctor Consultations with Employees with Overtime Working Hours

nCompany doctor would;

 

1. Analyze data of his/her periodic health check-up report and search for signs of lifestyle diseases and abnormal readings.

 

 

2. Check whether an employee has a high chance of developing depression.

 

ü  A loss of interest or pleasure?

ü   A feeling of depression?

 

Ø  If Both answers are Yes.”⇒  Sensitivity for depression is 90%.

 

 

3.  Ask about his/her ;

 

ü         Appetite

ü         Body weigh

ü         Mental statement

ü         Tiredness

ü         Responsibility

ü         Desire to suicide

ü         Decrease in thought and concentration

ü         Sleeping patterns