Objectives: To clarify the priority given to periodical medical examination items among occupational physicians in Japan. Methods: Sixty-two occupational physicians who participated in this study selected statutory and non-statutory items within two types of budget plans: one lower (8,500 yen) than the total fee of statutory medical examinations (9,250 and 11,290 yen), and the other higher (12,000 yen) than the total fee. Medical fee points were used to set the cost of each medical examination item. A three round Delphi method was used from May to July 2016 to clarify the consensus opinion of occupational physicians. Results: The statutory items (selection rate: between 66 and 100%), except for waist circumference (15%) and sputum examination (0%), and serum creatinine (58%, non-statutory item) were included in the smaller budget plan (8,500 yen). In the larger budget plan (12,000 yen), the statutory items (selection rate: between 92 and 100%), except for waist circumference (39%) and sputum examination (0%), and some non-statutory items, namely serum creatinine (95%), leukocytes (92%), uric acid (89%), and fecal occult blood reaction (81%), had a selection rate over 80%. In addition, statutory items with higher accuracy were preferred, which included the following: air conduction pure-tone audiometry (92%), imaging diagnosis of thoracic X-ray examinations by a specialist (97%), glycated hemoglobin levels (98%), and electrocardiogram assessment by a specialist (100%). Conclusion: The statutory items, except for waist circumference and sputum examination, and some of the non-statutory items (e.g., serum creatinine) were given higher priority among occupational physicians in Japan.
Objectives:To identify what types of information were useful and/or difficult to obtain for occupational physicians during the COVID-19 epidemic, and how information should be provided to help occupational physicians in the event of future outbreaks of emerging infectious diseases. Methods: The list was developed by categorizing information about COVID-19 delivered by researchers to a group of occupational physicians after the COVID-19 outbreak. We created a survey and asked the group about the usefulness and ease of obtaining each type of information. Results: In total, 79.1-100% of the occupational physicians said that each type of information was "Useful". Information on the nature of the virus; clinical course, testing, and treatment; infection prevention measures; regulations in Japan; immigration restrictions in Japan; and guidelines were all considered useful by more than 95%, as was information about the introduction of information aggregation websites by public institutions, academic societies, experts, and others, and sharing of case studies by information distribution group members. These last two items also had a high percentage of respondents who said that they "only obtained the information because it was distributed this way". Conclusions: Constructing a system for automatic distribution of information that is useful to occupational physicians and difficult to obtain elsewhere may make it easier for occupational physicians to respond more smoothly to emerging infectious disease outbreaks within a company.
Objectives To elucidate the factors that influence occupational physicians’ decision to issue an employer warning. Methods The interview was conducted with 10 Japan Society for Occupational Health certified occupational physicians (COPs) and certified senior occupational physicians (CSOPs) to create nine fictive scenarios in which an occupational physician may need to consider issuing a warning. Sixteen CSOPs assessed the seriousness of the problem in each of nine scenarios where they may need to consider issuing an employer warning. Next, using a survey questionnaire, 597 COPs and CSOPs were asked to rate how likely they were to issue a warning in each of the nine scenarios, and answer items on their characteristics and number of previously issued warnings. A multilevel logistic regression analysis nested for various scenarios was used to assess the odds ratio (OR) of being likely to issue a warning. Results Valid questionnaires were obtained from 117 participants (19.6%). The ORs and 95% confidence intervals (CIs) were as follows: mean score of seriousness of the problem, 5.90 (4.50‐7.75); years of experience as occupational physician, 1.04 (1.02‐1.06); women, 1.75 (1.20‐2.54); being a part‐time occupational physician without in‐house experience, 2.08 (1.31‐3.29); and having previously issued two or more times warnings, 1.99 (1.29‐3.06), compared with those who had never issued a warning. Conclusions Occupational physicians’ likelihood to issue a warning was associated with the seriousness of the problem as assessed in various scenarios, years of experience as occupational physician, gender, employment type, experience as in‐house occupational physician, and number of past warnings.
Objectives: This study aimed to consider the appropriate occupational health system for Japanese enterprises in the Philippines based on information on the regulations and development of specialists.Methods: We collected information using an information-gathering checklist. Along with literature and internet surveys, we conducted interviews by visiting local business sites, central government agencies in charge of medical and health issues, and educational institutions with specialized occupational physician training curricula. Results: Occupational health administration in the Philippines is managed by the Department of Labor and Employment, which issues the Occupational Safety and Health Standards that specify the legal requirements for occupational health. A new law (Republic Act 11058), enacted in 2018 to strengthen the Occupational Safety and Health Standards, has newly established a penalty provision in case of violations. Professional personnel responsible for occupational health are grouped as safety officers and occupational health personnel, including occupational physicians and occupational nurses; training is conducted at the Occupational Safety and Health Center of the Department of Labor and Employment and educational institutions. The basic medical insurance system and the workers' compensation system are operated by the Philippine Health Insurance Corporation and Social Security Committee, respectively, both of which are government agencies. Conclusions: We confirmed that occupational health activities in the Philippines are based on government regulations, namely, the Occupational Safety and Health Standards. In addition, the enactment of a new law calls for strict compliance with corporate occupational health activities. To manage proper occupational health activities at overseas workplaces, Japanese corporations should clarify corporate-wide policies and support local employers in complying with regulations and utilizing highly specialized personnel.
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