[The present state and forthcoming problems in the work of occupational health physicians engaged in the workplace]

The authors conducted a survey in July 2001 to examine the present state and forthcoming problems facing occupational health physicians (OHPs). The establishments investigated were those which employed 1,000 or more workers and had consulted us for the employment of OHPs. The number of establishments chosen was 1,658. A questionnaire was sent to the division chiefs responsible for the health management of the establishments, and those who supervised the OHPs engaged in the establishments were asked to complete the questionnaire. The questionnaire included items about the attributes of the perspective establishments, the work of OHPs and the personnel management system for the OHPs. Four hundred and forty-seven establishments (27.0%) out a total of 1,658 returned eligible responses for further analysis, and the major results were as follows: First, 79.2% of the manufacturing establishments which responded comprised those which employed 1,000 or more workers, even though the percentage of companies which employ 1,000 or more workers throughout Japan is 62.5%. The percentage of the establishments which employed full time OHPs was 64.2% in secondary industries (mining, constructing and manufacturing), and higher than the 40.8% in tertiary industries (other than farming, forestry, fishing and secondary industries). Second, although OHPs properly coped with the obligatory issues regulated by the related laws, the OHPs who routinely consulted with workers about their work-related health problems were few (36.7%). Third, despite the low percentage of the establishments (23.5%) which had recognized OHPs' work to be part of enterprise management, the budget of the health care section was kept unchanged (55.0%). And, in 49.0% of the establishments, the nomination of OHPs was recognized to be necessary irrespective of the presence of the related laws, and OHPs were expected to cope with the work-related health problems of workers (62.9%). On the other hand, the personnel management system for OHPs was insufficient, and the performance rating for OHPs' activity was prepared for only 50.3% of the establishments. In addition, when the subjects were confined to regular OHPs, they were allowed to attend internal training courses for regular employees in only 25.0% of the establishments. Taking the above into account, the activity of OHPs has to be developed more in tertiary industries. OHPs may also be asked to positively cope with workers' work-related health problems. Simultaneously, the personnel management system for OHPs has to be arranged properly.