労研出版	労働の科学　　労働科学　　書籍・雑誌のご注文＆ご案内

勞働科学 82巻（2006年）

＜１号＞＜２号＞＜３号＞＜４号＞

　82巻１号

前原直樹、佐々木司、赤堀正成
アンケート調査による慢性疲労の出現頻度と特徴について
Maehara N et al. ：The Frequency of Occurrence and the Characteristics of Chronic Fatigue Studied by Questionnaire Surveys

労働科学,82(1),1〜13,(2006)

定義の違いによる慢性疲労の出現頻度の差異とその際の労働・生活及び健康状況の特徴について検討した。疲労が「休日にも回復していない」割合は11.1%であったが、月の残業が平均50時間以上で、しかも睡眠が平均7時間未満の対象者の中で、睡眠満足感が｢殆ど不足｣している条件で、疲労が「休日にも回復していない」割合は2.3%を示した。また20歳から40歳未満までの「編集職」でのこの割合は5.4%を示した。このような慢性疲労では、体調が悪くても休日が取れず、100時間以上の残業や5時間未満の睡眠という特徴や、いつも身体がだるく、疲れた感じ、いつも眠気がとれず寝つきが悪い、将来に健康不安を有するという特徴を示していた。（図2,表6）
キーワード：慢性疲労；週内性疲労；残業時間；睡眠時間；睡眠不足感

Naoki MAEHARA (Director, The Institute for Science of Labour), Tsukasa SASAKI (Work Stress Research Group, Research Department, The Institute for Science of Labour), Masashige AKAHORI(Work and Social LIfe Research Group, Research Department, The Institute for Science of Labour), ：The Frequency of Occurrence and the Characteristics of Chronic Fatigue Studied by Questionnaire Surveys
THE JOURNAL OF SCIENCE OF LABOUR, 82(1), 1〜13, (2006)

Based on questionnaire surveys of workers in publishing companies, differences in the frequencies of chronic fatigue symptoms were studied in relation to varied definitions of chronic fatigue. The features of their working and living conditions and their health status were also taken into account. The rate of workers complaining of "fatigue not recovering even on holidays" increased linearly from 6.0% in 1992 to 11.1% in 2004. The recovery process of fatigue was analyzed by taking into account the overtime hours and sleeping conditions. Among the workers who had the average overtime hours of 50 or more a month and the average sleeping time of less than 7 hours, those who complained of "fatigue not recovering even on holidays" were designated as chronic-fatigue group A and those who complained of both "serious lack of sleep" and "fatigue not recovering even on holidays" were designated as chronic-fatigue group B. Those of group A accounted for 2.9% whereas those of group B accounted for 2.3%. Among the editorial staff of age from 20 to less than 40, those in group B accounted for 5.4% (6.9% among male editors and 4.1% among female editors). It was revealed that those in chronic-fatigue group B were usually complaining of feeling unwell, not taking holidays, working 100 or more overtime hours and average sleep time of less than 5 hours. These group B workers were characterized by always feeling dull and tired, drowsiness and difficulty in falling asleep at all times and having strong anxiety about their health in the future.

Key words: Chronic fatigue; Fatigue within week; Over time; Sleep time; feeling of loss or lack of sleep


堀口俊一
平井毓太郎教授と乳幼児の鉛毒性脳膜炎に関する史的考察
Horiguchi, S:A Historical Study of Research by Ikutarou Hirai on Lead Encephalopathy of Infants
労働科学,82(1),14〜21,(2006)

京都大学小児科初代教授平井毓太郎博士は1923年、乳幼児の「仮称所謂脳膜炎」が母親の用いていた白粉中の鉛に起因することを明らかにした。原因究明のため、患児の臓器組織、脳脊髄液、尿･糞便等の鉛量の測定が行われた。平井教授の報告における鉛の定量法は当時にあって信頼できるもので、とくに、脳脊髄液中の鉛測定にいちはやくポーラログラフ法を用いたことは特筆すべきであると考える。例数や対照は十分ではないが、臓器中の鉛量の検出は所謂脳膜炎が鉛中毒症であることの根拠に寄与するところが大であった。ただし脳脊髄液中の鉛量については、その後の研究に照らして、必ずしも中毒診断の根拠とはならなかったと判断される。（表5）（自抄）
キーワード：　平井毓太郎, 乳幼児, 鉛中毒, 鉛毒性脳膜炎, 史的考察

Horiguchi, S（Osaka City University）
A Historical Study of Research by Ikutarou Hirai on Lead Encephalopathy of Infants
THE JOURNAL OF SCIENCE OF LABOUR, 82(1), 14〜21, (2006)

Ikutarou Hirai, the first professor of the Department of Pediatrics at Kyoto University, revealed in 1923 that "so-called meningitis named tentatively" of infants was caused by lead-contained face powder being used by mothers. In order to find the cause of the meningitis, he tried to determine the quantities of lead in organ-tissues, cerebrospinal fluid, urine and feces. The author considers the procedures used for determination of lead in Hirai's report to be reliable and agrees to highlight the early introduction of the polarographic method into the determination of lead in cerebrospinal fluid. While the number of examples and controls was not sufficient, the detection of lead in organ-tissues contributed largely to the clarification of the cause of so-called meningitis due to lead poisoning. On the other hand, the detection of lead in cerebrospinal fluid did not necessarily provide evidence for lead poisoning in view of subsequent studies.

Key words: Ikutarou HIRAI, Infant, Lead poisoning, Lead encephalopathy, Historical study


鈴木一弥,松元　俊
柔軟な床マットが８時間の模擬立ち作業における下腿周径の変化量と下肢違和感に及ぼす効果
Suzuki K et al. : Effects of a Soft Floor Mat on the Lower-Leg- Circumference and Discomfort in Simulated 8-Hour Standing Work
労働科学,82(1),22〜32,(2006)

発泡樹脂製の柔軟な床マット（マット条件）と、硬いマット（対照条件）とで、長時間の立ち作業における下肢の活動量、下腿の周径、インピーダンス法に基づく下腿の容積、および身体各部位の主観的な違和感を比較した。９名の男子大学生を被験者とし、10：00-18：10（休憩を含む）に立位作業（折り紙製作）を実施した。分析の結果、マット条件における下肢の活動量の増加が認められた。その際、下肢の違和感には条件間の差がなかった。下肢のうっ血の指標である下腿周径の平均値に２条件間の統計的な有意差はみられなかったが、午後の前半にマットの使用による下腿周径の増加速度が抑えられる傾向が有意な交互作用として認められた。下肢の活動量が少なく、条件間の変動も少ない被験者の方がマットの使用による下腿周径増加の抑制傾向にやや一貫性があった。床マットの有効な適用条件を探るためには、マットによる活動量の増加の原因や身体的活動の関与をさらに検討する必要がある。（図11）（自抄）
キーワード: 立ち作業、下肢のうっ血、床マット、下腿周径、インピーダンス法

Kazuya SUZUKI （Human Technology Interaction Reseach Group, Reseach Department, The Institute for Science of Labour）, Shun MATSUMOTO（Work Stress Reseach Group, Reseach Department, The Institute for Science of Labour）
Effects of a Soft Floor Mat on the Lower-Leg- Circumference and Discomfort in Simulated 8-Hour Standing Work
THE JOURNAL OF SCIENCE OF LABOUR, 82(1), 22〜32, (2006)

The effects of a soft floor mat on the swelling of the lower legs and subjective discomfort were examined in prolonged standing work. Nine young male subjects participated in simulated handcraft work (folding paper) in a standing posture. The work started at 10:00 and lasted for 8 hours including two breaks of 10 minutes each and a lunch-break of 50 minutes. Changes in the circumference and the volume of the lower leg were measured repeatedly at intervals of 20 minutes by means of a tape measure and an apparatus based on the impedance method. Subjective ratings in physical discomfort were recorded. Leg movements were also recorded by measuring the acceleration of the ankle. Results showed significant increases in leg activities when a soft floor mat was used. Reduction in the mean circumference was not significant. However, significant time-floor condition interaction was noted in the first half of the afternoon session. This indicated that changes in the leg circumference were delayed in the condition using a soft floor mat.

Key words: Standing Work, Leg Swelling, Floor Mat, Lower Leg Circumference, Impedance Plethysmograph


内藤堅志
中規模な地域一般病院での看護実践にあった効果的な医療事故防止教育（注射・与薬教育）プログラムの開発 　-実態の把握と教育内容の提案-
Naito K: Development of an Education Program for Preventing Injection and Medication Accidents in Nursing Practices in a District General Hospital: Actual Conditions and the Proposed Content of Education
労働科学,82(1),33〜44,(2006)

地域一般病院における看護実践に即した注射与薬事故防止の教育プログラムを開発するために、看護師と研究者が合同の研究委員会を設立し、会議での報告・議論、看護師長への面接調査などにより院内教育や看護実践などを把握した。そして、教育・研修の現状、コミュニケーション教育、事故防止活動の現状、不安全行動、看護師管理（労務管理）について、それぞれの実状と教育項目に関する解析、考察を試みた。その結果、院内教育の対象に偏りがみられた。コミュニケーション能力の不足によりインシデントが発生していた。病棟では同様な内容のインシデントが発生している。業務中に不安全な行動がみられたことや看護師が水薬を軽視していた。病棟の役職が新人看護師の言動の理解に苦しむ状況が伺えた。などの実情が明確となった。以上のことから、教育内容の再検討と共に、アサーションの理論、QC手法、KYT教育、リスナー教育等が必要であると考えられた。(図1,表3)（自抄）
キーワード：地域一般病院, 看護実践, 医療事故防止, 教育プログラム, 研究委員会

Kenshi NAITO (Work Stress Reseach Group, Reseach Department, The Institute for Science of Labour)
Development of an Education Program for Preventing Injection and Medication Accidents in Nursing Practices in a District General Hospital: Actual Conditions and the Proposed Content of Education
THE JOURNAL OF SCIENCE OF LABOUR, 82(1), 33〜44, (2006)

The purpose of the study was to develop an education program for preventing accidents due to injection and medication tasks by improving nursing practices at a district-level general hospital. A nursing mentor and a researcher established a joint study committee, and educational and nursing practices in the hospital were investigated by examining existing reports, discussions at meetings and interview results of the nurse heads. Then, the programs for education and training of nurses, communication training and accident prevention were analyzed. Unsafe behaviour of nurses and management practices of work assignments for nurses were also analyzed. Further, subjects for educational programs were looked into. The results indicated that the subjects for education had not been selected consistently and that young nurses had not adequately acquired communication skills. This situation seemed to have led to increased rates of incidents among the nurses. Unsafe practices were also noted in conducting nursing work. It was revealed that the nurse heads of the hospital wards experienced at times difficulty in understanding the behavior of newcomer nurses. It appeared urgent to reorient the educational programs for the nurses including their contents. In rearranging the programs, it is suggested to take into account the assertion theory, quality control methods, danger prediction training methods and a listener training program.

Key words: General hospital, Nursing practice, Prevention of a medical accident, Education program, Research committee

82巻2号

鈴木　安名
単一企業分散型小規模事業場における業務管理実態の調査を通じたメンタルヘルス対策の立案
Suzuki , Y. : Planning of Mental Health Care Measures Based on the Analysis of the Production Control in Small-Scale Offices Geographically Distributed
労働科学,82(2),51〜69,（2006）

　製造業の分散型小規模事業場において、保健職ではない要員によるメンタルヘルスケアに必要な条件を検討した。法律と業務管理実態調査により労務指揮のあり方を明らかにし、安全配慮義務を履行する管理職とこれを支援する組織を抽出した。この保健活動にふさわしい知識を選定し、総務課社員による講話と討論、標語、ポスター、社内イントラネット、社内報などによる知識の普及を行った。方法の特徴はストレス調査を行わず業務管理実態調査により施策を立案することであり、保健職がいない事業所でも最小限の２、３次予防が可能となるが、それには現場を熟知した人事部門の存在が必要である。(図4,表2)（自抄）
キーワード：メンタルヘルス対策；分散型小規模事業場；業務管理；ヒアリング調査；安全配慮義務

Yasuna, SUZUKI （Mental Health Research Group, Department, The Institute for Science of Labour）
Planning of Mental Health Care Measures Based on the Analysis of the Production Control in Small-Scale Offices Geographically Distributed
THE JOURNAR OF SCIENCE OF LABOUR,82（2）,51〜69,（2006）

In geographically distributed offices of the manufacturing industry, various support measures for mental health care are conducted by personnel not necessarily specialized in health care. Conditions required for such personnel in taking effective support measures were examined. By means of a survey on laws and business management, the common practices in personnel management were studied. Based on the results of the survey, managerial positions in charge of safety control duties and the internal organizations supporting the execution of these duties were extracted. Measures suitable for supporting mental health care activities were then identified, including lectures by personnel management staff, discussion sessions, safety slogans, posters, in-house intranet activities and newsletters. These measures were characterized by their planning processes by means of investigations through business management and local experiences. While these processes did not involve stress surveys, they were found to lead to meaningful secondary and tertiary preventive measures even in offices not directly served by health care specialists. An important requisite for the planning of effective support measures was found be the presence of a personnel section expert knowledgeable about production job sites.

Key words :Mental health care ;Small-scale office distributed broadly ;Production control ; interview; dｕｔｙ ｔｏ ｃａｒｅ ｆｏｒ ｓａｆｅｔｙ

堀口俊一・西尾久英・林　千代
平井毓太郎教授記念碑「平井乃梅」とその行方
Horiguchi ,S., Nishio, H., Hayashi, C. A　　Monument　in　the　Memory　of　Ikutarou　Hirai　,　"Hirai　no Ume" and its Whereabouts
労働科学,82(2),70〜76,（2006）

　1950年1月、神戸市にある廣厳寺（楠寺）境内に、京都大学医学部小児科の初代教授平井毓太郎博士の記念碑が建立され、傍らに梅一樹が植えられ、碑の表面に「平井乃梅」と刻まれた。その後、1992年、北村晋吾博士が楠寺を訪れたとき、焼失した本堂は未だ再建されておらず、台座から壊された碑が境内の片隅に、生い茂る夏草の間に打ち捨てられてあり、梅の木の所在は分からなかったと、著書「平井毓太郎伝」に記している。著者らはさらに12年後、2004年に楠寺を訪れ、阪神大震災の改修工事の進む中で碑を探索した。数回の現地調査の結果、漸く12月11日、未整理の石碑類の中に件の碑を見付けることができた。建立50年余にして忘れ去られようとしている記念碑を修復して後世に伝えることを提唱する。(写真4)
キーワード: 平井毓太郎; 記念碑; 平井乃梅; 乳幼児; 鉛毒性脳膜炎

Shunichi　HORIGUCHI（Osaka City University） Hisahide　NISHIO( Department of Public Health, Faculty of Medical Sciences, Kobe University Graduate School of Medicine) Chiyo HAYASHI (Department of Public Health, Faculty of Medical Sciences, Kobe University Graduate School of Medicine) A　　Monument　in　the　Memory　of　Ikutarou　Hirai　,　"Hirai　no Ume" and its Whereabouts
THE JOURNAR OF SCIENCE OF LABOUR,82（2）,70〜76,（2006）

Lead poisoning is one of the most important industrial poisoning due to metals. Ikutarou Hirai, the first professor of the Department of Pediatrics at Kyoto University, made an important contribution to the study of lead poisoning by finding the cause of "so-called meningitis named tentatively" of infants in 1923. To commemorate the achievements of Ikutarou Hirai (1865-1945), a monument was built on the ground of Kogen (Kusunoki) Temple in Kobe, January 1950. Beside the monument, an ume tree (a Japanese apricot) was planted and four letters in Kanji (Chinese character), "hirai no ume (ume laid down by Hirai), were inscribed on the surface of the monument. About 40 years after that, Shingo Kitamura, a pediatrician, visited the Kusunoki Temple in 1992. He found the main hall of the temple had been destroyed by fire, and saw the monument without a pedestal left in a corner of precincts densely covered with summer grass. There was no memorial ume tree. He has described this scene in his book " A biography of Ikutarou Hirai". The present authors, twelve years after Kitamura's visit, traced the whereabouts of the monument. The temple suffered from Hanshin great earthquake disaster and was under repair. After several attempts of field surveys, the authors finally found the monument among a pile of stones and monuments on December 11, 2004. The authors make a proposal to restore the monument to its former condition over 50 years ago, and earnestly hope the monument will be preserved for posterity.
Key words : Ikutarou　HIRAI; Monument; Hirai no ume; Infant; Lead encephalopathy

菅沼　崇・細田　聡・井上枝一郎・施　桂栄・奥村隆志・余村朋樹
組織事故モデルによる事例分析の試み
Suganuma T.et al.: A Trial of Case Analysis Based on the Organizational Accident Model
労働科学，82(2)，77〜95，(2006)

　本研究では，組織事故モデル（菅沼ら, 2002）に対する妥当性検証の一貫として，某産業組織で発生した死亡事故を対象にモデルによる事例分析を試みた。その結果，モデルにおける要因設定の適切性が確認されるとともに，組織事故の2段階プロセスとして位置づけられる「リスク事象の発生プロセス」と「リスク事象の継続プロセス」の双方が見出された。しかし，後者のプロセスにおける「リスク事象の潜伏経路」を説明する6段階リスク情報処理ステップのうち，潜伏経路として確認されたのは第1ステップ（事象認知ステップ）のみであったことから，モデルの妥当性は部分的に検証されるに留まった。（図5，表2）
キーワード：組織事故；事例分析；組織内要因；組織外要因；リスク事象

Takashi SUGANUMA(Sagami Women's University), Satoshi HOSODA(Kanto-Gakuin University; The Institute for Science of Labour), Shiichiro INOUE(Kanto-Gakuin University; The Institute for Science of Labour), Guirong SHI(System Safety Research Group, ; The Institute for Science of Labour), Takashi OKUMURA(System Safety Research Group, ; The Institute for Science of Labour), Tomoki YOMURA(System Safety Research Group, ; The Institute for Science of Labour), A Trial of Case Analysis Based on the Organizational Accident Model
THE JOURNAR OF SCIENCE OF LABOUR,82（2）,77〜95,（2006）

The purpose of this study was to test the validity of the Organizational Accident Model (Suganuma et al., 2002) by analyzing an accident case using the model. A fatal accident at an industrial organization was adopted as the case, and we had interviews with 71 employees of the organization in order to obtain information concerning the accident. The case analysis based on the model revealed that (a) all of the intra- and extra-organizational factors identifisd in the case were included in the model, and (b) that the case comprised both a risk-event generating process and a risk-event maintaining (incubating and reinforcing) process. These two processes were characterized as two-stage processes of the organizational accident. The relevance of the six-step risk information processing corresponding to incubation routes in the risk-event maintaining process of the model was then examined. It was shown that the risk event in this case had been incubated only in the first step (the event-perception step). These results suggest that the validity of the model was partially verified.

Key words: Organization accident; Case analysis; Intra-organization factors; Extra- organization factors; Risk event

82巻3号

福原　驍、辻　克彦
プッシュプル型換気装置の汚染物捕集効率　−吹出し開口部の大きさが捕集効率に及ぼす影響−
Fukuhara I et al.: Capture efficiency of push-pull ventilation systems
−Influence of air supply opening on capture efficiency−
労働科学，82（3），105〜111，（2006）

　近年、プッシュプル型換気装置が労働衛生関係法令の中にとり込まれたことにより、今後ますます各種作業環境の改善のために普及するものと考えられる。プッシュプル型換気装置の必要排気風量についてはこれまでに流量比法による方法が発表されているが、吹出し開口の大きさが排風量に及ぼす影響についての定量的なデータは見当たらない。そこで、本報では吹出し開口の大きさがプッシュプル流れに及ぼす影響を調べるために、吹出し風量と吸込み風量を等しくしたプッシュプル型換気装置において、吹出し開口の大きさを変化させた場合の流れの中で発生した汚染物の捕集効率について実験的に検討した。（図８、表１）（自抄）
キーワード：ッシュプル型換気装置；捕集効率；吹出し開口；乱流強度；排風量

Isamu FUKUHARA, Katsuhiko TSUJI
Capture efficiency of push-pull ventilation systems
ﾑInfluence of air supply opening on capture efficiencyﾑ
労働科学，82（3），105〜111，（2006）

Legal provisions relating to push-pull ventilation systems have been stipulated by the Ministry of Health, Labour and Welfare of Japan. Push-pull ventilation systems as well as local exhaust systems are expected to be widely applied for removing contaminated air from various working environments. In a local exhaust systems, the required exhaust flow rate increases sharply as the size of a contaminant source becomes larger. The extent of this increase for push-pull ventilation systems is notably less.
The capture efficiency of push-pull ventilation systems combining supply and exhaust flows was studied. A disturbance of supply flow greatly influenced the diffusion of contaminants in the push-pull flow. The diffusion was found to be restrained by decreasing the disturbance of the push-pull flow. This was consistent with our previous finding that the exhaust flow rate decreased by decreasing the disturbance of the flow. As the decrease in the disturbance of the flow required to lessen turbulent intensity of the flow at the supply opening and raise the uniformity of the supply flow, the sizes of supply and exhaust openings were considered to be one of primary factors affecting the push-pull flow.
The capture efficiency of contaminants in the push-pull ventilation systems was experimentally determined when the sizes of supply and exhaust openings were changed, with the supply flow rate being kept equal to the exhaust flow rate. The capture efficiency was higher when the size of the supply opening was larger. This was due to the decrease in the turbulent intensity of the supply flow. This influence of the supply opening size should be considered in designing push-pull ventilation systems.
Keyword: Push-pull ventilation; Capture efficiency; Supply opening; Turbulent intensity; Exhaust flow rate

前原直樹
中程度の筋労作による循環器負担について−主に重量物の挙上・運搬作業を対象に−
Maehara N: Ｃirculatory systeｍ load due to moderate physical work - mainly for handling and transportation of heavy materials-
労働科学，82（3），112〜135，（2006）

　職場には重筋作業には該当しないが、総じて作業強度が「中程度の筋労作」と評価できる状況が未だ数多く見られる。重量物の挙上・運搬などでの筋労作の健康リスク、とりわけ循環器系への影響での問題点も数多く指摘されているが、長期影響に関する疫学研究では明瞭な結論が出ていない。一方、「中程度の筋労作」を伴った際の過労死事例なども問題となっており、その予防策も急務といえる。体調不良や過労・睡眠不足時における「中程度の筋労作」での循環器負担の知見の一層の蓄積が求められている。
そこで、今回の論文では、運輸業と倉庫業務での製品取り扱いを例としながら、その筋作業の特徴を見ると共にその循環器系への負担の様相を検討した。（図19）（自抄）
キーワード：中程度の筋労作；循環器負担；過労死；運輸業；製造業

Naoki MAEHARA
Ｃirculatory systeｍ load due to moderate physical work - mainly for handling and transportation of heavy materials-
労働科学，82（3），112〜135，（2006）

There are many situations in which work intensity can be estimated as "the moderate degree of physical work" although it may not appear to correspond to heavy work. Although many problems are pointed out about the influence on health risks of physical work by handling and transportation of heavy materials, especially with respect to the circulatory system, clear conclusion has not been reached in the epidemiology research regarding the long-term influence. On the other hand, examples of "karoshi" (death by overwork) at the time of being engaged in "the physical work of the moderate degree" pose a problem, and necessary preventive measures become urgent. Much more accumulation related to findings of strains in the circulatory system during "physical work of the moderate degree" under the conditions of poorly maintained health, over-fatigue and loss of sleep.
In the present paper, the characteristics of physical work represented by the materials handling in transportation and warehouse businesses, were discussed, by examining the aspects of strain in the circulatory system.
Key word: physical work of the moderate degree; strains in the circulatory system; karoshi; transportation industry; manufacturing industry

82巻4号

吉川　徹，小木和孝
アジア地域医療従事者の安全と健康に関する特集号にあたって
労働科学，82（4），139〜142，（2006）
　アジア地域の医療現場で働く労働者の安全と健康について共通した課題が増えている1)．医療従事者は様々な場で医療サービスを提供しており，多様な安全・健康リスクに直面しているが，様々な医療事故の機会と針刺し切創，筋骨格系障害，アレルギー，暴力，職務ストレスなど広範囲の危険有害要因がアジア諸国で共通していることが報告されている1)．そこでは，これらの医療現場に働く医療従事者の安全と健康に関する多彩な予防活動が各国で取り組まれ，職場ごとの労働条件と医療慣行を十分考慮した「参加型の予防活動」が大きな進展をみせている。
　一方，アジア各国の医療現場に共通した労働安全衛生活動の普及とともに，地域内の交流，ネットワーク形成が進みつつある。その一つである「医療従事者の参加型労働環境改善研修ツール開発を通じたアジア地域ネットワーク構築」は，トヨタ財団の助成を受けて進められている。本プロジェクトでは医療従事者における医療災害と作業関連健康障害の防止を良好事例に学び職場改善する手法の共同開発を通じ，地域ネットワークの構築をめざしている。2006年3月にタイで第1回ワークショップが行われ，対策指向研修ツールの開発が進められている。また，2006年5月には日本産業衛生学会の研究会の一つとして「医療従事者のための産業保健研究会（世話人代表：織田進）」が発足した。
　 これらを背景として，日本産業衛生学会「医療従事者のための産業保健研究会」第2回研究会が，トヨタ財団助成によるアジア隣人ネットワークのプログラムと協力して，2006年10月に北九州・福岡地区でアジア地域ワークショップとして開催された。海外から7名の発表者を迎え3日間に及ぶ活発な意見交換が行われた。このワークショップでは，日本で行われている参加型職場改善プログラムの実地見学と各国の経験の交流を通じて，相互間のネットワークの強化が図られた。
　本特集号は2006年10月21日の上記第2回研究会で報告された演題をもとに各国からの投稿を集めて編集したものである。発表された演題の中から，3編の総説，8論文が掲載されている。本特集号がアジア地域を含む医療従事者の安全と健康に寄与することを願っている。
Toru Yoshikawa , Kazutaka Kogi
On the Special Issue concerning the Safety and Health of Health Case Workers in the Asian Region
THE JOURNAL OF SCIENCE OF LABOUR，82（4），143〜146，（2006）
There are an increasing number of tasks common to the safety and health of health care workers in the Asian region. Safety and health risks faced by health care workers engaged in human care services in varying situations are reported to be common in Asian countries, including medical accidents and needle stick injuries, infectious diseases, musculoskeletal disorders, allergies, violence and work-related stress. Various preventive activities addressing health care workers are reported from these countries. A growing trend is the progress in participatory preventive activities that take into account local workplace conditions and ongoing health care practices.
Along with the spread of occupational safety and health programs for health care workers in Asian countries, various attempts to promote cooperation and networking are in progress in the region. One of these attempts is represented by the new project on the establishment of an Asian regional network for developing participatory training tools in improving work environment of health care workers, undertaken with the support of the Toyota Foundation. Within this project, a regional network is being formed by means of jointly developing workplace improvement methods for preventing work-related accidents and diseases among health care workers based on good practices. The first workshop of the project was held in Thailand in March 2006, and the joint development of action-oriented training tools is proceeding. Within the Japan Society for Occupational Health (JSOH), a new research group on occupational health for health care workers started in May 2006 with Susumu Oda as the representative caretaker.
Backed by these collaborative activities, the second workshop on occupational health for health care workers was held by the JSOH research group from 19-21 October 2006 in the Kitakyushu-Fukuoka area in collaboration with the Asian Neighbours Network Program of the Toyota Foundation. Lively discussions took place for three days involving eight speakers from abroad and a number of Japanese participants. In the workshop, the networking arrangements evolving since the first workshop were strengthened through the visits to health care facilities conducting participatory workplace improvement programs and through the exchanges of positive experiences in the countries of the participants.
This special issue contains the papers selected from those presented at the workshop sessions on 21 October 2006. Of the papers of the sessions, three discussion articles and seven report papers are edited and included in this special issue. We hope that this issue will contribute to furthering the safety and health of health care workers in the Asian region and elsewhere.

織田　進
医療従事者のための産業保健の挑戦
労働科学，82（4），143〜146，（2006）
　医療従事者は多様な健康障害リスクに直面している。また，人員不足による過重労働，病院間競争の激化，医療電子カルテの導入等により医療従事者のストレスは増大している。医療労働における健康障害予防活動を狙いとした連続ワークショップが開催され，労働時間管理，医療関連器材と有害化学物質の適切な取り扱い，情報過多，夜勤交代制，暴力・ハラスメント，筋骨格系障害，感染症，移住労働者とメンタルヘルス対策の重要性が指摘された。これらは医療従事者のチームワークによる良好実践例を学ぶ課題として特に重要で，多面的な新しい試みが報告されつつある。2006年から「医療従事者のための産業保健研究会」が日本産業衛生学会の科学委員会として発足しており，今後の発展が期待される。（自抄・英文）
キーワード：医療従事者；過労；ワクチン接種；メンタルヘルス；グローバリゼーション

Susumu ODA
The Challenges of Occupational Health for Health Care Workers
THE JOURNAL OF SCIENCE OF LABOUR，82（4），143〜146，（2006）
Health care workers in the workplace are commonly exposed to a range of hazardous agents including harmful substances (glutaraldehyde, formaldehyde, etc.), needle stick injuries and risks of musculoskeletal illnesses. Moreover, overwork due to shortage of health care staff, intensifying competition among hospitals and the introduction of electronic medical charts are increasing the stress for health care workers. Various new attempts are reported for improving working conditions and the working environment of health care workers exposed to these risks. The Scientific Committee in Occupational Health for Health Care Workers of the Japan Society for Occupational Health has launched in 2006 a new initiative for promoting occupational health activities for health care workers through the international exchange of these positive experiences. Serial workshops have been held by the initiative to address the need for preventive measures in health care work. These workshops have pointed out, as key issues, managing work hours, proper handling of medical instruments and chemicals, information overload, shift systems, harassment, musculoskeletal illnesses, infections, migrant workforce and mental health. It is important to address, these issues by learning good practices achieved by teamwork of health care workers.
Key words: Health care workers; Overwork; Vaccination; Mental health; Globalization

小木和孝，吉川 徹
保健医療におけるリスクマネジメントに関する参加型対策指向トレーニングの役割
労働科学，82（4），147〜150，（2006）
保健医療におけるリスクマネジメントにおける参加型ステップの役割を検討した。参加型対策指向トレーニングは産業安全保健改善の最近の動向を反映しており、チーム作業を主体とする医療労働に特に有用である。職場良好実践に基づく多面の作業関連リスク低減策の提案と実施に参加型ステップが役立つ。アクションチェックリストや低コスト改善手引きなど職場に適合したツールの利用により、改善事例の学習と改善への取り組みが促進される。こうした参加型研修は、針刺し切創、ストレス関連健康障害，不規則勤務制などの多様な医療関連リスクを低減する上で効果的である。医療労働における多面な視点から多数の職場改善事例が報告されており、これらのリスクを扱う参加型プログラムの普及が勧められる。（図1・表2）（自抄・英文）
キーワード：医療労働者；参加型活動；アクチョンチェックリスト；職場改善事例；低コスト改善

Kazutaka KOGI, Toru YOSHIKAWA
The Role of Participatory Action-Oriented Training in Risk Management in Health Care
THE JOURNAL OF SCIENCE OF LABOUR，82（4），147〜150，（2006）
　The role of participatory steps in risk management in health care is discussed. These steps reflect recent advances in participatory action-oriented training programs commonly undertaken for improving occupational safety and health in various sectors. In health care, participatory training is particularly useful as it is suited to the teamwork style characteristic to health care work. Serial group work sessions are generally effective in human care teamwork situations. It is important that participatory steps taken by health care workers as a rule emphasize reduction of multiple work-related risks through building on local good practices. Team learning of local good practices is found to be facilitated by the use of locally adjusted group work tools such as action checklists and low-cost improvement guides. The positive role of the participatory training is thus recognized in reducing various care-related risks, including needle stick injuries, stress-induced disorders and irregular work hours. It is encouraging that participatory programs dealing with these risks have demonstrated numerous workplace improvements achieved in these different aspects of health care work.
Key words: Health care workers; Participatory action-oriented training; Action-checklist; Local good practices; Low-cost improvements

医療従事者における筋骨格障害予防のための参加型対策指向アプローチプログラム(PAOAP)の応用経験
丘　貞完，鄭　銀姫，金　亨烈，鄭　惠先，金　順禮 ，李　宗恩，朴　映惠，朴　正鮮，禹　克鉉，金　龍奎
労働科学，82（4），151〜156，（2006）
　カソリック大学議政府聖母病院で医療従事者の筋骨格障害予防のための参加型対策指向アプローチプログラム(PAOAP)を実施した。2005年7月にファシリテーター育成ワークショップを開催し，予行演習と医療従事者向けのアクションチェックリストの開発を行った。8月に看護師・10月にコメディカル向けの参加型対策指向型研修を実施し，その後，病院管理者向けフォローアップ活動，2週間毎に各自が提案した職場解決策の支援を行った。2006年3・5月に開催した改善結果報告会では，看護12部門とコメディカル6部門から自職場の改善事例が数多く報告された。明確な職場改善の指向をもつPAOAP実践ファシリテーターが育ち，PAOAPの実施は病院における筋骨格系障害(WRMSD)予防活動の極めて有用であることが示唆された。（図6）（自抄・英文）
キーワード: 参加型対策指向アプローチプログラム(PAOAP); 医療従事者; 筋骨格系障害；ファシリテーター；職場改善

Application of Participatory Action-Oriented Approach Program (PAOAP) for Preventing Musculoskeletal Disorders in Health Care Workers
Jung-Wan KOO, Eunhee JEONG, Hyoung-Roul KIM, Hye Sun JUNG, Soon Lae KIM, Jong-Eun LEE, Young Hae PARK, Jungsun PARK, Kuck Hyeun WOO, Yong-Kyu KIM
THE JOURNAL OF SCIENCE OF LABOUR，82（4），151〜156，（2006）
We conducted serial workshops as participatory action oriented approach programs (PAOAP) for health care workers at Uijeongbu St. Mary's hospital. This was held subsequent to the analysis of job-related musculoskeletal disorder. A facilitator training workshop was held on July 6, 2005 and a rehearsal was done on July 14, 2005 for developing an action checklist for health care workers. The participant education workshop was held on August 31, 2005 for nurses and on October 26, 2005 for health care workers except nurses. After these PAOAP workshops, the health manager of the hospital conducted follow-up activities every 2 weeks to encourage the application of their own solutions. These solutions were presented separately for nurses on March 20, 2006 and for health care workers except nurses on May 29, 2006. The participants accomplished the action plans for the improvement of their own workplace with PAOAP. And they kept their positive thinking for improving their workplace and became good facilitators to be able to perform PAOAP. The presentations of improvements done following the PAOAP workshops were conducted with 12 departments of nurses and 6 departments of medical assistance personal. After participating in the workshops, a number of work improvements were achieved on the basis of the workers' ideas. Many of these improvements were helpful for preventing musculoskeletal disorders. The results showed that the implementation of the PAOAP had high potentials as a useful means of preventing work-related musculoskeletal disorders (WRMSD) in hospitals.
Key words: Participatory action-oriented approach program (PAOAP); Health care workers; Musculoskeletal disorders; Facilitators; Work improvements

プラムック・オシリ，ドゥシット・スリララート，吉川　徹，チャラムチャイ・チャイキットポーン
医療従事者における健康リスク認識
労働科学，82（4），157〜160，（2006）
自記式質問紙により医療従事者に影響する健康リスクを調査した。質問項目は生物学的，身体的，化学的，人間工学，心理社会的，機械的要因に関連した6領域とした。病院部門長を通じ調査の趣旨が説明され用紙を配布し，534人の回答があった。医員と非医員の間の健康リスク認識をMann-Whitney U testにより検定した。 6つのリスク領域の中で職務ストレスが最も著明に認識されていた(97%以上)。医員は非医員より有意に鋭利器材による傷害を健康上のリスクとして認識していた。また， HIVやB/C型肝炎，結核等に関連した健康リスクも非医員より医員に極めてよく認識されていた。一方，鳥インフルエンザと重症急性呼吸器症候群(SARS)に関する認識の差異はなかった。（表2）（自抄・英文）
キーワード：健康リスク，医療従事者，病院有害要因，医員，非医員

Pramuk OSIRI, Dusit SUJIRARAT, Toru YOSHIKAWA, Chalermchai CHAIKITTIPORN
Recognition of Health Risks among Health Care Workers
THE JOURNAL OF SCIENCE OF LABOUR，82（4），157〜160，（2006）
This study conducted an investigation of health risks affecting health care workers by applying a self-administered questionnaire. These questionnaires comprised 6 categories relating to biological, physicals, chemicals, ergonomics, psychosocial, and mechanical risks at work. The explanation of the questionnaire was provided to the heads of units in a hospital and requested them to distribute the questionnaire to their staff members. The study employed the Mann-Whitney U test to analyze the recognition in health risks between medical staff and non-medical staff. Questionnaire replies were received from 534 health care workers. It was revealed that stress was the most prominently recognized among the six risk categories by over 97%. The health risk related to sharp injuries was more strongly noted by medical staff than by non-medical staff at the significance level of 0.001. The health risks related to HIV, hepatitis B, C, and tuberculosis were similarly more explicitly recognized by medical staff than non-medical staffs at the significant level of 0.001 while there were no significant differences about avian influenza and severe acute respiratory syndrome (SARS).
Key workds: Health risk; Health care workers; Hospital hazards; Medical staff member; Non-medical staff member

ワンペン・ソンカーム，チャワポーンパン・チャンプラシット，ルジパス・プーサワング，タニー・カエウタンマヌクル，ウィーラポーン・スタコーン
医療従事者のための産業安全保健プログラム: 産業看護モデルの応用
労働科学，82（4），161〜164，（2006）
　チェンマイ大学看護学部は2002年にタイ国内で初めて産業看護修士課程を設立した。この修士課程では就労世代に医療サービスを提供する専門的技術を持った看護師を養成している。本課程の主要な科目の1つに産業看護実践の習得がある。この実習科目では学生はアセスメント，計画，実施および評価の4つの段階をもつ産業看護モデルを産業安全保健プログラムに応用している。これまでの労働現場における産業看護実践の応用経験から，本モデルが適切で，修士学生が実践全課程を習得する必要なガイドラインとして役立った。本論文では産業看護モデルを医療従事者のための産業安全保健プログラムに応用する過程について概説し，その有効性と制約について検討した。（図1）（自抄・英文）
キーワード: 産業保健プログラム; 安全管理計画; 医療従事者; 産業看護モデル;　修士課程

Occupational Health and Safety Programs for Health Care Workers: An application of an Occupational Health Nursing Model
Wanpen SONGKHAM, Chawapornpan CHANPRASIT, Rujipas POOSAWANG, Thanee KAEWTAMMANUKUL, Weeraporn SUTHAKORN
THE JOURNAL OF SCIENCE OF LABOUR，82（4），161〜164，（2006）
　The Faculty of Nursing, Chiang Mai University, Thailand firstly established a master's program in occupational health nursing (OHN) in 2002. The program is to prepare nurses for acquiring expertise in the delivery of health services to working populations. One of the major requirements of the program is the completion of OHN practices. This practicum required students to develop an occupational health and safety (OHS) program that can be used in a specific workplace. Students have to adopt an OHN model into the OHS program. The model applied includes four stages: assessment, planning, implementation and evaluation. We have learned that the model is applicable for OHN practice in real work settings. It could serve as a guideline for master students to complete the full process of the practice. This paper describes the process of applying the OHN model in an OHS program for health care workers. Students were provided with a tool model to establish an OHS program in order to solve occupational health related-problems and to meet their needs. The effectiveness of using the tool and the model was discussed.
Key words: Occupational health program; Safety program; Health care workers; Occupational health nursing model; Master's programs

舟越光彦
医療機関におけるメンタルヘルス対策の経験
労働科学，82（4），165〜171，（2006）
　ある医療機関グループにおけるメンタルヘルス対策の経験を紹介し，その効果について検討した。この施設では，1999年にメンタルヘルス教育，2002年から職業性ストレス簡易調査票を用いてサーベイランス調査が実施され，2003年からカウンセリングサービスが開始された。2005年には，｢心の健康づくり計画｣が策定され，PDCAサイクルで組織的で継続的なメンタルヘルス対策が実施された。対策の結果，健康リスク指数は2003年以降は減少した。精神疾患による延べ休業日数も2005年に減少した。「働きがい」も同様に改善した。これらの結果は，健康リスク指数を低減するための包括的なメンタルヘルス対策の重要性を示すとともに，組織的に対策を継続する必要性を示していると考えられた。（図1・表4）（自抄）
キーワード:メンタルヘルス対策; 医療労働者; 働きがい; 休業日数; 職業性ストレス簡易調査票

Mitsuhiko　FUNAKOSHI
Experience in Implementing Mental Health Measures in Health Care Institutions
THE JOURNAL OF SCIENCE OF LABOUR，82（4），165〜171，（2006）
Experiences in conducting mental health measures in a group of health care institutions consisting of acute-phase hospital, convalescent hospital and outpatient clinics located in Fukuoka City and its surrounding areas were discussed. In 2006, 864 regular and 195 non-regular employees were engaged in these institutions. In these institutions, mental health education started in 1999 and annual mental health surveys were conducted by means of brief job stress questionnaires in 2002. In 2003 they started counseling services for mental health care. In 2005, the new mental health promotion plan was established. According to this plan, systematic mental health measures were taken for all the health care workers through applying the Plan-Do-Check-Act cycle procedures. These measures addressed the job stress risks related to work demands, decision latitude and supervisor/co-worker support. The results of the job stress questionnaires revealed that the comprehensive health risks had reduced since 2003. In 2006, conditions related to work demands and supervisor/co-worker support were found to improve compared with those in 2003. The total days of absence per year were found to reduce only in 2005. Improvement in job satisfaction remained an important task in further extending the mental health measures for all the workers. The results confirm the importance of taking comprehensive anti-stress measures in reducing work-related mental health risks and the need to continue these measures in a systematic manner.
Key Words: Mental health measures; Health care workers; Job satisfaction; Days of absence; Brief job stress questionnaire

サラ・アーポーン，ノル・ハッシム・イスメイル，吉川　徹，ワンペン・トンサック
タイにおける医療従事者の労働安全衛生の促進
労働科学，82（4），172〜177，（2006）
　アジア地域の医療現場の労働安全衛生分野の経験の交流と安全衛生リスクの検討，対策の良好実践例を収集することを目的に，タイ国チャイナート県で 一日ワークショップを開催した。県内に勤務する医療従事者18名が参加し，グループ討議，事例発表，病院訪問を行った。その結果，医療現場では労働災害や事故がまれではなく，慢性と急性の健康影響がともに医療従事者にあることが確認された。職務ストレス，人間工学的リスク，生物学的リスクの3つが対策の優先度が高いとされた。また，医療サービスにおける労働条件改善の必要性が重視され，参加型アプローチ手法が医療従事者における安全と健康の促進に有用であることが示唆された。（図1，表2）（自抄・英文）
キーワード：医療従事者；参加型アプローチ；労働安全衛生；優先リスク対策；良好実践例

Sara ARPHORN , Noor Hassim ISMAIL, Toru YOSHIKAWA, Wanpen THONGSUK
The Promotion of Occupational Health and Safety for Health Care Workers in Thailand
THE JOURNAL OF SCIENCE OF LABOUR，82（4），172〜177，（2006）
　A one-day workshop on occupational health and safety of health care workers was held in Chainat Province, Thailand. Eighteen health care workers working in this province attended. The workshop consisted of group discussions and presentations and a hospital visit. The main objectives of the workshop were 1) to exchange experiences in the field of occupational safety and health in heath care settings, 2) to identify and discuss occupational health and safety risks among health care workers, 3) to collect good examples of existing working conditions, and 4) to draft a questionnaire for health care workers in Asia. The results showed that occupational injuries and accidents were not infrequent in health care settings. Both chronic and acute effects could be found among health care workers. Job stress, ergonomic risks and biological risks were prioritized to be the top three of occupational risks encountered by these workers. The need for improving working conditions in health care services was emphasized, while the participatory approach was found useful in promoting health and safety among health care workers.
Key words: Health care workers; Participatory approach; Occupational safety and health; Prioritized risk countermeasures; Good practices

ワンペン・トンスック、サラ･アーポーン，ネトナパン・サプチャローエン，スパンディ・マニーロック，ニパポーン・チャロエンリット
タイ国Phattalung県における医療従事者の労働安全衛生
労働科学，82（4），178〜181，（2006）
参加型対策指向型アプローチの方法論に基づき，医療専門スタッフや公衆衛生行政官，医療介護助手等を含む医療従事者向けのアクションチェックリスト(ACL)を開発し，実地利用を試みた。看護師8名，公衆衛生行政官19名，医療技術者1名と薬剤師2名により，地域病院への現地調査，産業保健リスクに関するグループ討議を通じて，生物学的要因，化学的要因，人間工学，職務ストレスの4領域と対応する31項目で構成されるACLが開発された。 ACL実地利用により，病院認証スキームは感染症管理において医療従事者の患者双方に有用と示唆された。しかし，化学物質，人間工学，職務ストレス対策等の他のリスク対策に対応していないとわかった。医療従事者の労働安全衛生の促進に参加型トレーニングは有用で，ACLは安全健康リスクの認識と普及に有用と思われた。（表2）（自抄・英文）
キーワード: 医療従事者; アクションチェックリスト; 産業保健リスク；グループワーク；病院認定

Wanpen THONGSUK, Sara ARPHORN, Netnaphang SAPCHAROEN, Supandee MANEELOK, Nipaporn CHAROENRIT
Occupational Safety and Health of Health Care Workers in Phattalung Province, Thailand
THE JOURNAL OF SCIENCE OF LABOUR，82（4），178〜181，（2006）
Health care workers are exposed to a wide range of occupational hazards, including biological, chemical, physical, ergonomic and psychosocial hazards. In addition to professional staff, these are many working as public health officers and health care assistants. The aim of this study was to develop an action checklist for these health care workers. The methodology used was based on the participatory action-oriented approach. The participants of the study were 8 nurses, 19 public health officers, a medical technician and 2 pharmacists. The participants performed group discussion on occupational health risk assessment of health care work and conducted a walk-through survey in a community hospital. The action checklist consisted of 31 items that were classified into four categories corresponding to biological, chemical and ergonomic hazards and job stress. The checklist was validated by the health care workers in Phattalung Province. It was found that the Hospital Accreditation scheme played an important role controlling infectious diseases among health care workers and patients. However, other potential hazards such as ergonomic and chemical hazards and job stress were not covered by the Hospital Accreditation activities. The results confirmed that the participatory training was useful for promoting occupational safety and health among health care workers. The action checklist would be a use tool for recognizing safety and health risks of health care workers and for facilitating the evaluation and control of their risks in the future.
Key words: Health care workers; Action checklist; Occupational health risk; Group work; Hospital accredition

吉川　徹　，小木和孝，川上　剛，プラムック・オシリ，サラ・アーポン，ノルハッシム・イスメイル，ファン・バンチン，トン・タット・カイ，丘　貞完，林　正鮮，外山尚紀，三橋　徹，堤　明純，長須美和子，松田文子，水野有希，酒井一博
医療従事者の安全保健のためのアジア地域ネットワーク構築における参加型対策指向型トレーニングの役割
労働科学，82（4），182〜187，（2006）
アジア地域ネットワーク構築における医療従事者の安全と健康リスクを減じる実践的な参加型対策指向型安全保健トレーニングの役割について検討した。近年の各領域での安全保健プログラムの進展から，1)各国の医療労働における職業性リスク低減良好実践例の収集，2)効果的研修手法の優先ニーズに関する現地調査の実施，3)参加型ステップを支援する研修ツールの開発が重要である。ネットワーク参加者はアクションチェックリスト，良好実践ガイド，イラスト入りマニュアル等の研修ツールの共同開発と良好実践例の経験交流を行う。アジア地域における医療従事者の良好実践ネットワーク構築により効果的な安全保健プログラムの持続開発を支援できる。（図1，表2）（自抄・英文）
キーワード：医療従事者; 参加型対策指向型トレーニング; アクションチェックリスト; 良好事例; アジアネットワーク

The Role of Participatory Action-oriented Training in Building an Asian Network for Occupational Safety and Health of Health Care Workers
Toru YOSHIKAWA , Kazutaka KOGI , Tsuyoshi KAWAKAMI, Pramuk OSIRI ,Sara ARPHORN ,
Noor Hassim ISMAIL , Phan VAN CHIN , Ton That KHAI ,
Jung-Wan KOO , Jung-Sun PARK , Naoki TOYAMA , Toru MITSUHASHI, Akizumi TSUTSUMI, Miwako NAGASU, Fumiko MATSUDA, Yuki MIZUNO, Kazuhiro SAKAI
THE JOURNAL OF SCIENCE OF LABOUR，82（4），182〜187，（2006）
The role of participatory action-oriented training in building a new network of collaboration for improving occupational safety and health of health care workers in Asia is discussed. The emphasis of the network is placed on the development of effective training tools for planning and implementing practical workplace improvements that can reduce safety and health risks in health care work. Learning from recent achievements in networking arrangements for work improvement in different settings, the new network aims at applying locally adjusted participatory training methods that address priority risks among health care workers. The collaborative activities of the network thus focus on 1) collecting good examples of occupational risk reduction in health care work in each country, 2) conducting field investigations of priority needs for effective training methods and 3) developing training tools facilitating participatory steps leading to concrete results. Joint efforts of the network partners are made to develop action-checklists, good practice guides and illustrated training manuals. Roving workshops are planned for testing the jointly developed tools and exchanging positive experiences. The project is aimed at setting up a good practice network for health care workers in Asia with a view to supporting sustainable development of effective occupational safety and health programs for health care workers in Asia.
Key words: Health care workers; Participatory action-oriented training; Action-checklist; Good examples; Asian network

チャンタナー・ピンチャン，バンポット・ピンチャン，ウィラワン・ヴィーチェンチョット，アモーンラット・パッダム
タイ国Chainat県，Manorom病院における5S活動優良職場賞受賞への取り組み
労働科学，82（4），188〜191，（2006）
　本プロジェクトは医療従事者の作業関連健康障害や労働上災害を減らし，安全・清潔な病院労働環境の維持改善を目的として実施された。5S活動は院内の系統的品質管理システムの一部として2005年12月から2006年2月の58日間に行われた。5S活動の実施ステップには目標設定，5S方針の設定，5S教育，清掃日の実行，成功病院へのスタディツアー，専門家による監査が含まれた。院内の部門間訪問と労働者参加による経験交流は，劇的な効果をもたらした。当院は5S活動優良職場賞を受賞した。取り組みの全過程は医療サービスの継続的発展と良好実践を示し，患者への良好・安全な医療サービスの提供に繋がった。参加型5S活動を通じた段階的発展から，清潔で安全，便利な医療サービスセンターとしての継続的改善が促進されることが確認された。（図6）（自抄・英文）
キーワード: 病院労働環境; 5S活動; 労働者参加; 労働災害; 外部監査

Chantana PINITCHAN, Banphot PINITCHAN , Wilawan WICHIENCHOT , Amornrat PATDAM .
5S Best Workplace Award at the Manorom Hospital in Chainat Province, Thailand
THE JOURNAL OF SCIENCE OF LABOUR，82（4），188〜191，（2006）
This project was aimed at improving the working environment in a hospital for safety and cleanness in order to reduce accidents at work. The protection from work-related diseases among health care workers was taken into account. The health care workers were trained concerning health promotion behavior. The training was undertaken as part of the systematic quality management system in the hospital. The 5S activities were used as a means for this purpose. They were implemented from 28 December 2005 until 23 February 2006, for 58 days. The operation steps included the goal setting, 5S policy issuing, 5S training, implementation of a cleaning day, a study tour to a successful hospital, auditing by experts, and serving as the learning hospital for 5S activities. The exchanges of experiences among the visited organizations and the participating workers took place in a dramatic manner. The 5S Best Workplace Award was gained as a result. The whole process demonstrated a sustainable development and good practices for health care services. The patients could achieve good and safe access for all provided services. The stepwise progress gained through the participatory 5S activities proved to promote continual improvement as a clean, safe and convenient health care service center.
Key words: working environment on hospital; 5S activity; Worker participation; Occupational accidents; External audit

坂田知子，石橋静香，吉川　徹，堤　明純，小木和孝，長見まき子，織田　進
医療機関におけるメンタルヘルス対策に重点をおいた参加型職場環境改善
労働科学，82（4），192〜200，（2006）
600床の地域中核総合病院でメンタルヘルス対策に重点をおいた参加型職場環境改善プログラムを開発・実施し，評価した。改善点を挙げたアクションチェックリストと良好実践例を用いて医療従事者のグループ討議方式による改善活動を病棟ごとに行った。対象職場への介入11ヶ月後に，1)安全確保対策・人間工学的改善，2)労働時間・勤務時間の再検討，3)職場内外コミュニケーションの促進など85件以上の改善が行われた。改善プロセス評価では，段階を追った支援，多面的な低コスト改善とツール提供，現場の自主性重視が重要なステップと認められた。検討課題として自主的改善へのイニシアティブ支援のための時間の確保，事例報告会の定期開催，担当者の負担感軽減を伴う手順の標準化などがあげられた（図3，表2）。（自抄）
キーワード: 参加型職場環境改善; メンタルヘルス; アクションチェックリスト; 良好実践例; 医療従事者

Tomoko SAKATA, Shizuka ISHIBASHI, Toru YOSHIKAWA, Akizumi TSUTSUMI, Kazutaka KOGI,
Makiko　NAGAMI，Sususmu ODA
Participatory Workplace Improvement for Managing Mental Health in a Hospital
THE JOURNAL OF SCIENCE OF LABOUR，82（4），192〜200，（2006）
This study was aimed at developing participatory work environment improvement program that gave for prioritizing mental health measures in a 600-bed general hospital in Japan. Workplace improvements were conducted by health care workers' group work by using a mental health action checklist and local examples of good practices. We evaluated the process of the participatory steps and improvements in health care work. Over eighty-five improvements were reported that included 1) safety improvements for both patients and health care worker relying on ergonomic rules, 2) work time and organization and 3) better work environment with improved preparedness and mutual support measures following 11-month interventions. Most employees who participated in these improvement activities favorably evaluated the activities. By the evaluation of the program, it was found important to focus on 1) multi-step supports, 2) locally practicable low-cost improvement with the support of action tools and good examples and 3) support for voluntary actions of each ward. The need of standardization of the execution technique and securing time for group work was pointed out. It was also suggested to ensure the support from the top management.
Key words: Participatory workplace improvement; Mental health; Action checklist; Good practices; Health care workers