Fit For Work Service (FFWS) is a new occupational health delivery system in UK. The purpose of FFWS is to help people in the early stages of sickness absence to return to, and remain in, work more quickly after illness or when they develop a health condition or impairment. In UK the annual economic cost of sickness absence and worklessness among the working age is enormous reaching over £100 billion. FFW is expected to reduce this cost by supporting workers to continue to work. The core service is case management by multidisciplinary team composed by medical and social professionals. This service is very suggestive for the Japanese occupational health services in order to adapt to the highly ageing society. In this review, we outline the basic mechanism of FFWS and compare with the occupational health delivery system in Japan.

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Work can cause and cure ill-health of workers. The appropriate health support system will make it possible for the workers to act proactive for prevention and to return to work as early as possible. Wok is not merely a tool for live but also something for purpose and meaning of life. Although the previous literatures have clarified the importance of MSDs on nation's health and economy, these disorders have not been received enough attention as an important problem. In fact MSDs are common health disorders and one can continue to work with symptoms related MSDs. However, the European Trade Union Institute estimated that the cost of work related MSDs would be between 0.5 and 2.0% of gross domestic product (GDP). In Japan, ACCJ has estimated that the pain associated cost at the occupational setting is JPY88 million by absenteeism and JPY52.6 million by presenteeism. Regarding the above-mentioned situation, it is necessary to implement to appropriately support the workers with MSDs and other ill-health problem for return to work as early as possible. Fit for work (FFW) service is one of such solutions. For this purpose, our university is now organizing a FFW program targeting to RA and other MSDs.

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The French Labor law defines the role and its allocation criteria of occupational physician (OP) as like as in Japan. In France, the occupational medicine is one of the medical specialties. The OP resident must follow the 4 years clinical training before certificated. After finished their residency, they are entitled to work for the occupational health service office of company or company association (in the case of small and medium sized company). The most important characteristics of French system is that it covers all workers regardless of company size. The main role of OP is prevention of work related diseases and accidents. They are not allowed to do clinical services except for emergency cases. Their main activities are health examinations, health education, patrol and advice for better working condition. Formerly, it was rather difficult to attract the medical students for OP resident course because of its prevention oriented characteristics. A growing concern about the importance of health management at work site, however, has changed the situation, that is, the number of candidate for OP resident course is increasing. Their task has expanded to cover mental health and other life style related diseases. The 2011 modification of law redefines the role of OP as a director of occupational health service office who has a total responsibility of multidisciplinary services. The French and Japanese occupational health system has lots of similarities. It is expected to advance a series of comparative studies in order to ameliorate the quality of occupational health services of both countries.

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Along with the ageing of society, the social security expenditures continue to increase in Japan. In order to tackle this situation, the Japanese government intends to realize the active aged society where most of the 75 years old persons will be socially active. This requires a health related big data by which the government plans and evaluate the health programs. For this purpose, the authors have already constructed an integrated evaluation system of health data in the community setting. This system is now used among several local governments. Based on this experience, we have developed a similar system for the occupational setting. The present study has clarified the feasibility and utility of our data analyzing system. Using this analysis system, occupational health nurses of the insurer can extract the target of intervention. Furthermore, they can evaluate the compliance level of insured who were advised to have consultation by clinicians. The Japanese government has started the Data Health Plan in 2013. In this national project, the government intends to construct a big data that can be used for the health policy and the creation of new health related business. Our system can be one of the bases for this discussion.

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