Analysis of Japanese occupational health services for small-scale enterprises, in comparison with the recommendations of the Joint WHO/ILO Task Group

Objectives: To evaluate Japanese occupational health services (OHSs) for small-scale enterprises (SSEs). Methods: The current Japanese OHSs for SSEs were compared with 15 recommendations of the Joint WHO/ILO Task Group. The status of OHSs was analyzed using the published papers collected by means of a computerized literature search. Thirty-five papers were used in the analysis, which was first conducted by the four authors separately, followed by discussion among the authors. Evaluation was conducted by classifying the status of Japanese OHSs for SSEs into three classes (A: good, B: average, C: poor) based on comparison with each recommendation. Results: Six issues were evaluated as “A”: establishment of a national policy for the provision of OHSs for SSEs, occupational health and safety inspection for SSEs, legislation to ensure services for SSEs and provision of financial incentives, adoption of occupational health programs using multiple channels, training in occupational health issues, and establishment of national data collection and registration systems. Nine issues were evaluated as “B”: provision of OHSs for all SSEs as a part of the “national Health for ALL” strategy, intervention combining economic development and OHSs, extension of OHSs to vulnerable groups, coverage of migrant and seasonal workers by OHSs, the establishment of a national collaborative and coordinative body on OHSs, control of transfer of hazardous technology, encouragement of applied research, employers' commitment and worker participation, and integration of OHSs with primary health care. None of them was evaluated as “C”. Conclusions: Japanese OHSs for SSEs were fairly well established in terms of compliance with the recommendations of the Joint WHO/ILO Task Group, although evaluation may be somewhat subjective and rather qualitative.