Search

Objectives: We developed a standardized cost estimation method for occupational health (OH) services. The purpose of this study was to set reference OH services costs and to conduct OH services cost management assessments in two workplaces by comparing actual OH services costs with the reference costs., Methods: Data were obtained from retrospective analyses of OH services costs regarding 15 OH activities over a 1-year period in three manufacturing workplaces. We set the reference OH services costs in one of the three locations and compared OH services costs of each of the two other workplaces with the reference costs., Results: The total reference OH services cost was 176,654 Japanese yen (JPY) per employee. The personnel cost for OH staff to conduct OH services was JPY 47,993, and the personnel cost for non-OH staff was JPY 38,699. The personnel cost for receipt of OH services-opportunity cost-was JPY 19,747, expense was JPY 25,512, depreciation expense was 34,849, and outsourcing cost was JPY 9,854. We compared actual OH services costs from two workplaces (the total OH services costs were JPY 182,151 and JPY 238,023) with the reference costs according to OH activity. The actual costs were different from the reference costs, especially in the case of personnel cost for non-OH staff, expense, and depreciation expense., Conclusions: Using our cost estimation tool, it is helpful to compare actual OH services cost data with reference cost data. The outcomes help employers make informed decisions regarding investment in OH services.

Objectives: The aim of the present study was to develop standardized cost estimation tools that provide information to employers about occupational safety and health (OSH) activities for effective and efficient decision making in Japanese companies., Methods: We interviewed OSH staff members including full-time professional occupational physicians to list all OSH activities. Using activity-based costing, cost data were obtained from retrospective analyses of occupational safety and health costs over a 1-year period in three manufacturing workplaces and were obtained from retrospective analyses of occupational health services costs in four manufacturing workplaces. We verified the tools additionally in four workplaces including service businesses., Results: We created the OSH and occupational health standardized cost estimation tools. OSH costs consisted of personnel costs, expenses, outsourcing costs and investments for 15 OSH activities. The tools provided accurate, relevant information on OSH activities and occupational health services., Conclusions: The standardized information obtained from our OSH and occupational health cost estimation tools can be used to manage OSH costs, make comparisons of OSH costs between companies and organizations and help occupational health physicians and employers to determine the best course of action.

To investigate the effects of sleep hygiene education for workers of an information technology (IT) company, we conducted a controlled clinical trial providing 581 workers one-hour sleep hygiene education. The contents of the sleep hygiene education program were a review of sleep habits, provide sleep hygiene education, and the establishment of sleep habit goals. A self-report questionnaire was used to measure outcomes including the Pittsburgh Sleep Quality Index (PSQI), Karolinska Sleepiness Scale (KSS), Checklist Individual Strength (CIS), Center for Epidemiologic Studies for Depression (CES-D), and mean sleep duration on weekdays before and 4 wk after the intervention. A total of 391 participants were included in the analysis, with 214 participants in the sleep hygiene education group and 177 in the waiting list group. KSS score at 2 P.M. decreased by 0.42 points in the sleep hygiene education group, but increased by 0.08 points in the waiting list group, showing a significant effect size of 0.50 (95%CI, -0.97 to -0.04, p<0.05). PSQI score also improved, but the inter-group difference was not statically significant. The present study provides preliminary evidence that brief sleep hygiene education may improve afternoon sleepiness at work, but not sleep at night for IT workers.

Background: Maternity blues and postpartum depression are common complications of childbearing. However, few studies have shown the relationship between the severity of maternity blues and the risk of postnatal depression. We carried out a longitudinal study among Japanese women to show that maternity blues is a useful factor for predicting postpartum depression., Methods: Two hundred and thirty-five women completed questionnaires before delivery, and five days, one month, and three months after delivery. They were required to answer the Stein's Blues Scale and Edinburgh Postnatal Depression Scale and other variables. A sequential logistic regression analysis was performed to estimate the association of maternity blues with postpartum depression. The stratum-specific likelihood ratio was then calculated., Results: The prevalence of postpartum depression was 12.8%. A Stein's Blues Scale of eight or above was significantly associated with postnatal depression. Likelihood ratios (95% CI ) for the Stein's Blues Scale of 0 to 3, 4 to 7, 8 to 11 and 12 or more were 0.33 (0.16-0.65), 1.06 (0.60-1.88), 3.42 (1.64-7.12) and 9.57 (3.41-26.86), respectively., Conclusions: These findings suggest that maternity blues is a strong predictor of postpartum depression. The higher the blues score, the higher the risk of postpartum depression.

Sleep-disordered breathing (SDB) is the major determinants of hypertension. Recent studies indicated sleep duration, in addition to shift work, were also associated with hypertension. But very little attention has been paid to these two factors when looking at the effects of SDB on blood pressure. We conducted the present study to evaluate the relationship between SDB and hypertension adjusting for sleep duration and shift work in a sample of Japanese steel workers. In this cross-sectional study, we measured blood pressure and oxygen desaturations index (ODI) by nocturnal pulse oximetry of 249 male workers aged 20 to 65 yr. SDB was defined by 3%ODI level of 15 or more events per hour. Logistic regression analyses were performed to estimate the associations of SDB with hypertension after adjustment for age, body mass index, alcohol intake, smoking, usual sleep duration, shift work, and occupation. The prevalence of SDB was 18.1%. The adjusted odds ratio of hypertension for high (> or =15) vs. low (<15) category of 3%ODI level was 2.86 (95% confidence interval, 1.23-6.66). The significant association between SDB and hypertension suggests that screening for SDB among steel workers is useful for prevention of hypertension.

Health-related quality of life (HRQL) is an important measure of health outcome in working and healthy populations. Here, we investigated the impact of effort-reward imbalance (ERI), a representative work-stress model, on HRQL of Japanese working men. The study targeted 1,096 employees from a manufacturing plant in Japan. To assess HRQL and ERI, participants were surveyed using the Japanese version of the Short-Form 8 Health Survey (SF-8) and effort-reward imbalance model. Of the 1,096 employees, 1,057 provided valid responses to the questionnaire. For physical summary scores, the adjusted effort-reward imbalance odds ratios of middle vs. bottom and top vs. bottom tertiles were 0.24 (95% confidence interval, 0.08-0.70) and 0.09 (95% confidence interval, 0.03-0.28), respectively. For mental summary scores, ratios were 0.21 (95% confidence interval, 0.07-0.63) and 0.07 (95% confidence interval, 0.02-0.25), respectively. These findings demonstrate that effort-reward imbalance is independently associated with HRQL among Japanese employees.

The purpose of this study was to determine the associations of effort-reward imbalance and social support with chronic fatigue among medical residents in Japan. A total of 104 men and 42 women at 14 teaching hospitals participated in this study. Chronic fatigue was measured by the checklist individual strength questionnaire. Effort, reward and overcommitment were determined by the effort-reward questionnaire developed by Siegrist. Social support was determined by a visual analog scale. Sleeping hours for the last 30 days were estimated based on the number of overnight shifts worked, the average number of sleeping hours, and the number of hours of napping during overnight work. Multiple regression analysis was used to examine the multivariate relationship between these variables and chronic fatigue. In both men and women, effort-reward imbalance was positively associated, and higher social support was negatively associated with chronic fatigue. In men, higher overcommitment was positively associated with chronic fatigue. In women, longer sleeping hours was negatively associated with chronic fatigue and an interaction between sleeping hours and social support was found. The adjusted variance in fatigue explained by the exposure variables was 34% in men and 51% in women. The result of this study suggested that it is desirable to take these factors into consideration in the management of chronic fatigue among medical residents.

The effort-reward imbalance is an important psychosocial factor which is related to poor health among employees. However, there are few studies that have evaluated effort-reward imbalance among medical residents. The present study was done to determine the association between psychosocial factors at work as defined by the effort-reward imbalance model and depression among Japanese medical residents. We distributed a questionnaire to 227 medical residents at 16 teaching hospitals in Japan at the end of August 2005. We asked participants to answer questions which included demographic information, depressive symptoms, effort-reward imbalance, over-commitment and social support. Depression was evaluated using the Japanese version of the Center for Epidemiologic Studies-Depression (CES-D) scale. The effort-reward imbalance and over-commitment were assessed by the Effort-Reward Imbalance (ERI) questionnaire which Siegrist developed. Social support was determined on a visual analog scale. Logistic regression analysis was performed to determine the associations between effort-reward imbalance and depressive symptoms. Depressive symptoms were found in 35 (29.2%) 1st-year residents and 21 (27.6%) 2nd-year residents. The effort-reward ratio >1 (OR, 8.83; 95% CI, 2.87-27.12) and low social support score (OR, 2.77, 95% CI, 1.36-5.64) were associated with depressive symptoms among medical residents. Effort-reward imbalance was independently related to depression among Japanese medical residents. The present study suggests that balancing between effort and reward at work is important for medical residents' mental health.

The aims of the present study were to develop and validate the Japanese version of the checklist individual strength questionnaire (CIS) which is used to measure prolonged fatigue not only in the general population but also in the working population. We obtained permission to use CIS from its author and translated the questionnaire into Japanese. Then, the Japanese version of the questionnaire was translated back into English by a bilingual person. The author of the original version agreed that the back-translated version was conceptually and linguistically equivalent to the original CIS. To validate CIS, 399 workers (66.7% were men) from different companies answered the Japanese version of the CIS (CIS-J), Maslach burnout inventory-general survey (MBI-GS), Beck Depression Inventory-II (BDI-II), visual analogue scale (VAS) questionnaires for subjective fatigue, number of overtime hours and number of hours of sleep. Cronbach's alpha for the total CIS-J score was 0.91. The test-retest reliability assessed with an intra-class correlation coefficient was 0.82. Although confirmatory factor analysis did not show an ideal model fit, the correlation coefficients between the total CIS score and the MBI-GS exhaustion score, the BDI-II score and the VAS score were 0.58 (p<0.01), 0.66 (p<0.01) and 0.63 (p<0.01), respectively. The less workers slept and the longer they worked, the higher their total CIS score became. CIS-J showed good reliability and acceptable validity in the working population. Thus, it could be useful for studying fatigue among Japanese working populations.

Background: Effects of overtime work on health is a controversial issue., Aims: To determine the effects of overtime work on blood pressure and body mass index (BMI) for male workers in Japan., Methods: Participants were 323 male participants of three companies. Data were collected by occupational physicians at periodic physical examinations and additional examinations. The time courses for the development of definite hypertension and an increase in BMI were recorded. The Kaplan-Meier method was used to estimate the cumulative incidence rates of developing definite hypertension and increasing BMI, and the Cox proportional hazard model was used to determine the adjusted relative hazard of overtime work., Results: The age-adjusted incidence rates of developing definite hypertension and increasing BMI were significantly lower among the participants whose mean overtime was > or =50 h than among those whose mean overtime was <50 h/month (log-rank P < 0.05). The Cox proportional hazard model indicated that those who worked a mean overtime of > or =50 h/month had lower risks of developing definite hypertension (hazard ratio, 0.36; 95% CI, 0.15-0.88; P < 0.05) and increasing their BMI (hazard ratio, 0.44; 95% CI, 0.31-0.63; P < 0.01) after adjusting for age., Conclusions: The results of this study indicate that workers whose mean overtime was > or =50 h have lower risks of developing definite hypertension and increasing their BMI.