[Application of health questionnaires for health management in small- and medium-sized enterprises]

Two kinds of health questionnaires, the Todai Health Index (THI) and Cumulative Fatigue Index (CFI), were applied as a screening device for health management of workers belonging to small-medium sized enterprises. A total of 495 workers composed of 452 male workers of a glass-bottle manufacturing factory and 43 male workers of a soft-drink bottling factory were the subjects of the present study. It was found that the two kinds of health questionnaires were different from each other and have their own characteristics. Twelve scales of THI were grouped into two, the first consisting of ten scales (SUSY, RESP, EYSK, MOUT, DIGE, IMPU, MENT, DEPR, NERV, and LIFE) and the second consisting of two scales (AGGR and LISC). Nine categories of CFI were grouped into one by using principal factor analysis. It was confirmed that the twelve scale scores of THI obtained at small-medium sized factories differed from those scale scores of a reference group investigated at a large-sized enterprise. It is on the basis of the scales of aggressiveness and lies and also of the scale of mental unstability which characterizes workers, locality, job (clerical or field work), and size of industry (large or small sized) that the difference could be evaluated. Urban life characterized by a life style of staying up late at night and waking up late in the morning has been reflected on the scale of life irregularity. Irregularity of life induced by transformation of working schedule, such as two or three shifts of work and overtime, was also reflected on this scale. Two scales of THI test, i.e., many subjective symptoms and digestive organ complaints, seemed to be the representative scales indicating a close relation between work load and health level. The discriminant score for diagnosis of psychosomatic diseases is considered to be one of the most useful assessments of the individual's health condition. As mentioned above, THI is recommended as a convenient assessment method for health management of workers and for screening individuals or groups requiring health management from the total respondents belonging to small-medium sized enterprises where health administrators or professionals for health services are not available. A combined use of THI and CFI is more effective in evaluating health status of field workers than the independent use of one of these two tests, because the causal relationship between work load and health status cannot be satisfactorily observed, only through THI.