A sectoral network on occupational health and safety in agriculture has been established in Estonia as part of a project that provided support for Estonian accession into European Union. Participating organizations represent farmers' unions at county level, agricultural enterprises, workers' representatives, universities and agricultural expert institutions, and government agencies. The purpose is to provide a shared infrastructure that combines information and other capacities of several organizations and provides a platform for dialogue and co-operation in order to make a greater impact with available resources. The network has a decentralized architecture and is technically managed by an institutionalized secretariat. The network's task forces have compiled a network directory, summarised the capacities and interests of member organizations, made an inventory of existing information and training materials, developed an overall strategy for information management, established an information repository on the Internet, prepared promotional materials, and devised a protocol for agricultural walk-though assessment. A profile on occupational health and safety in Estonian agriculture has been compiled with a rapid assessment approach that collected both quantitative and qualitative information from secondary sources (statistics, documents) and from focus group discussions. The profile is used as an instrument for taking occupational health and safety needs in agriculture into discussion on political arena.

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The scientific literature regarding preventive occupational health and safety activities in small enterprises has been reviewed in order to identify effective preventive approaches and to develop a future research strategy. During the last couple of years, there has been a significant increase in the number of studies of small enterprises, but the research community is scattered between many different disciplines and institutions. There is a lack of evaluation of intervention studies, both in terms of effect and practical applicability. However, there is sufficiently strong evidence to conclude that employees of small enterprises are subject to higher risks than the employees of larger ones, and that small enterprises have difficulties in controlling risk. The most effective preventive approaches seem to be simple and low cost solutions, disseminated through personal contact. It is important to develop future intervention research strategies which study the complete intervention system: from the intermediaries through dissemination methods to the resulting preventive activities of the small enterprises.

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Information is needed in all activities aiming at the development and improvement of working conditions. The information and communication technology has made it possible to have information available 24 h a day, 360 d a year. The administrative structures in various countries also call for more information steering at the workplace level. This means that more web-based and other materials for small enterprises are needed in all countries in order to improve safety and health of the workers. Four different approaches to improve workplace level activities are described here to provide models for others to modify them to their local conditions. The networking of small workplaces supports the development of their safety and thereby also their productivity and possibilities to offer jobs also in the future.

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An intervention based on the methodology developed by the International Labour Office, the Work Improvement in Small Enterprises (WISE) was carried out to improve work condition of small-scale enterprises and the informal sector in the Philippines, Thailand and Japan. Through the evaluation of the efficacy of the approaches based on participatory methodology, it is concluded that the method is an efficient measure to improve work condition in small workplaces. It is also pointed out that the activities of supporting experts such as introduction of the methodology and evaluation of the activity are necessary. The important roles of the experts are 1) to encourage managers and workers to sustain the activities for work improvement, 2) to analyse the effectiveness and problems of the implemented improvements, 3) to give appropriate suggestions for the further improvement, and 4) to get materials for demonstrating the effectiveness of WISE activities on improving work conditions and productivity to other managers and workers who have not participated in the activity.

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Attention and assistance to enhance the role of small and medium scale enterprises (SMEs) by the government is more emphasized due to the success of SMEs in earning significant amount of foreign currency when Indonesia had to face economical crisis in 1997. This policy has been highly recognized again since the bombing tragedy in 2002; with the excellent evidence to show how important SMEs is in helping and maintaining the economic development of Bali. But in the implementation the assistance needs to be remanaged again in a more proper and appropriate way to attain the ultimate goals. The three economic potentials, agriculture in broad sense, tourism and SMEs (cottage industry included), must be developed in harmony, interdependence, support and complementary each other, if possible as synergist to obtain sustainable development of Bali. While assistance to SMEs must be done in a more coordinated way among the government technical offices, universities, NGOs, banking, and other social community institutions. By doing so, there would be no duplication or gap, nor creation of new disadvantageous problems. It could be in form of ergonomics, occupational health and safety impacts and problems in particular, and in adverse working conditions and environment in general. Therefore it is a must at this moment to carry out total approach in helping SMEs, by integrating the effort to improve their working conditions and environment, built-in within the effort to enhance SMEs'quality of life through economic assistance. In this process a total approach through SHIP approach and Appropriate Technology intervention must be done wisely and timely. By so doing, SMEs'sustainable working conditions and environment shall be attained.

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There is increased attention to improving occupational health and safety in small to medium-sized Enterprises (SMEs). The Workers Health Centre, a not-for-profit OHS service in western Sydney, assessed workplace exposures in two SMEs following intervention by regulatory agencies. A low-cost monitoring program for noise, airbone dust, fibers and chemicals was conducted at these two metal working industry workplaces. Results showed that exposure to the hazards were above the statutory limits and there was generally an unhealthy access to OHS information by the predominantly immigrant or low literate worker population, were identified. The potential for using a program of low-cost exposure assessments, accompanied by a strategy to provide OHSs information for workers in small-scale enterprises, is discussed.

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Participatory programmes for occupational risk reduction are gaining importance particularly in small workplaces in both industrially developing and developed countries. To discuss the types of effective support, participatory steps commonly seen in our "work improvement-Asia" network are reviewed. The review covered training programmes for small enterprises, farmers, home workers and trade union members. Participatory steps commonly focusing on low-cost good practices locally achieved have led to concrete improvements in multiple technical areas including materials handling, workstation ergonomics, physical environment and work organization. These steps take advantage of positive features of small workplaces in two distinct ways. First, local key persons are ready to accept local good practices conveyed through personal, informal approaches. Second, workers and farmers are capable of understanding technical problems affecting routine work and taking flexible actions leading to solving them. This process is facilitated by the use of locally adjusted training tools such as local good examples, action checklists and group work methods. It is suggested that participatory occupational health programmes can work in small workplaces when they utilize low-cost good practices in a flexible manner. Networking of these positive experiences is essential.

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To meet diversified health needs in workplaces, especially in developed countries, occupational safety and health (OSH) activities should be extended. The objective of this study is to develop a new multi-dimensional action checklist that can support employers and workers in understanding a wide range of OSH activities and to promote participation in OSH in small and medium-sized enterprises (SMEs). The general structure of and specific items in the new action checklist were discussed in a focus group meeting with OSH specialists based upon the results of a literature review and our previous interviews with company employers and workers. To assure practicality and validity, several sessions were held to elicit the opinions of company members and, as a result, modifications were made. The new multi-dimensional action checklist was finally formulated consisting of 6 core areas, 9 technical areas, and 61 essential items. Each item was linked to a suitable section in the information guidebook that we developed concomitantly with the action checklist. Combined usage of the action checklist with the information guidebook would provide easily comprehended information and practical support. Intervention studies using this newly developed action checklist will clarify the effectiveness of the new approach to OSH in SMEs.

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Many workers in Asia are in the informal economy. They often work in substandard conditions, exposed to hazards in the workplace. Learning from the recent successes of participatory training programmes to improve safety and health in Asia, the ILO has strengthened its partnership efforts with local people to improve safety and health of informal economy workplaces. The target groups were: (1) home workplaces in Cambodia and Thailand, (2) salt fields and fishing villages in Cambodia where many young workers are working, and (3) small construction sites in Cambodia, Laos, Mongolia, Thailand and Vietnam. The walk-through survey results showed that the workers and owners in the target informal economy workplaces had the strong will to improve safety and health at their own initiatives and needed practical support. In the participatory, action-oriented training workshops carried out, the participated workers and owners were able to identify their priority safety and health actions. Commonly identified were clear and safe transport ways, safer handling of hazardous substances, basic welfare needs such as drinking water and sanitary toilets, and work posture. The follow-up visits confirmed that many of the proposed actions were actually taken by using low-cost available materials. These positive changes were possible by applying the participatory training tools such as illustrated checklists and extensive use of photographs showing local good examples and placing emphasis on facilitator roles of trainers. In conclusion, the target informal economy workplaces in Asia made positive changes in safety and health through the participatory, action-oriented training focusing on local initiative and low-cost improvement measures. Local network support mechanisms to share lessons from good practices played essential roles in encouraging the voluntary implementation of practical improvement actions. It is important to increase our joint efforts to reach more informal economy workplaces in industrially developing countries and provide practical support measures focusing on local self-help initiatives.

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Lots of chemicals are produced in chemical industry and used everywhere as convenient and indispensable materials in daily life and industry. Moreover, many new chemicals are needed to produce competitive new goods such as new medicines, new dyestuffs, new agricultural chemicals and others. Main chemicals used in industry have reached to more than 50,000 kinds. And many workers are exposed to chemicals and injured all over the world. To protect the workers in small workplaces against hazardous chemicals is one of the most important tasks of occupational health. n-Hexane, lead and 1-bromopropane poisoning are shown as examples for health hazards and preventive measures in small workplaces. Preventive measure such as TLV or OEL, Material Safety Data sheets, health check-up, comprehensive cooperation among employers, workers, researchers, industrial physicians and administrative officers, and information on toxicity are discussed.

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The aim of this study is to evaluate the effects of work improvements in small enterprises (WISE) on workloads and productivity, and managers' satisfaction with those projects. Participating in this study from 1994 to 1996 were 9 small enterprises, 3 metal industries, 1 car parts manufacturing, 1 garment manufacturing, 1 food processing, and a few others. Upon visiting these worksites, we carried out interviews on the implemented WISE improvements and made objective evaluations of their effect on workloads and productivity. Reductions in physical workloads were found in 4 of 6 enterprises where that factor was estimated. Productivity in most of the enterprises increased after WISE improvements. Managers' subjective satisfaction with WISE activity ranged between 50-80% on each technical item. More than 50 percent of managers came to understand the necessity of workers' involvement and understanding of the activities in order to sustain activity for improvement. WISE activity can exert a beneficial influence on workload and productivity. Most of the managers were satisfied with the results. It is presumed that follow-up visits with objective estimation will provide both managers and workers with encouragement to maintain their efforts.

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Researchers from the National Institute for Occupational Safety and Health (NIOSH) investigated occupational safety and health concerns in the small business wood pallet manufacturing industry because of an injury rate (2000) 226% greater than that for general industry¹⁾. NIOSH investigators conducted walk-through evaluations at seven wood pallet manufacturing companies, and returned to four of them to take environmental measurements. Carbon monoxide (CO) levels, noise levels, and total particulate were measured, ergonomic observations made, and occupational safety practices analyzed at each of the four facilities where measurements were taken. The focus of this study is the evaluation of airborne particulate and carbon monoxide exposures for the purpose of determining areas of potentially high exposures. This knowledge can guide the plant owner or health professional to determine whether further measurements are necessary and where they might be needed. Safety factors and physical stressors (noise and ergonomic stressors) were described in a previously published companion paper²⁾. Although we did not take 8 h samples, we did find certain exposures that were potentially of concern to the small business owner. The main findings of this investigation were as follows: 1) CO levels in three plants, for the time periods measured, were less than the OSHA permissible exposure limit (PEL) of 50 parts per million (ppm) for an 8-h TWA. Three measurements, all from one plant, were due to a older and defective forklift and were above 50 ppm. 2) Total dust measures ranged from 0.86 to 1.67 mg/m³, taken adjacent to an operating machine cutting hardwood and measured up to 6 min. The American Conference of Governmental Industrial Hygienists (ACGIH) guideline for hardwood dust is 1.0 mg/m³, again for an 8-h TWA.

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A 7-yr study was conducted to evaluate the respiratory effects of fluorine compounds on exposed workers in a small-scale enamel enterprise. Air monitoring was done and 75 pairs, exposed and non-exposed workers were examined. The applied tests were: an epidemiological questionnaire, the bronchitis record, clinical examinations and urinary fluorine. Linear regression analysis was done. The values of fluorine in the air of workplaces ranged from 0.1 to 3.7 mg/m³ air during the study. Twenty five point and seven percent of exposed workers presented chronic rhinitis, laryngotracheitis and bronchitis. The smoking habit was similar in both groups. The incidence of chronic bronchitis was significantly higher in exposed workers compared to the non-exposed ones. The values of urinary fluorine were higher in the exposed versus the control group. Linear regression analysis has shown positive correlations between the fluorine exposure and incidence of chronic bronchitis (r=0.75), as well as the incidence of chronic respiratory diseases (r=0.71). Fluorine exposure may be responsible for the high incidence of chronic irritative respiratory diseases, especially for chronic bronchitis in exposed workers. For diseases prevention it is advisable to reduce the levels of fluorine in the air of workplaces and to decrease the concentration of fluorine compounds in the composition of enamel.

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The cohort of 768 workers who were actively employed for a minimum of 6 months and died was retrospectively followed from 1 January 1953 to 31 December 2000. There were 328 women and 440 men observed. Proportionate mortality ratios (PMRs) were calculated using the Minsk-city population mortality proportions to generate expected numbers. The significant excess of pancreatic cancer (PMR=366%; 95%CI=134-800) and melanoma and skin cancer (PMR=455%; 95%CI=123-1,164) in women-workers of Dyeing and stuffing workshops was shown. The significantly high mortality from pancreatic cancer among Dyeing and stuffing workshops' female workers hired and discharged between 1958 and 1984 (PMR=1,024%; 95%CI=11-2,109), melanoma and skin cancer (PMR=440%; 95%CI=240-2,327) among Dyeing and stuffing workshops female workers who started before 1970, lip and buccal cavity among men who began working within 1974-1978 (PMR=1,071%; 95%CI=220-3,128), cervix and corpus uteri cancer among workers employed before1960 was found. It should be noted that the significantly high mortality from above noted cancers was indicated for Dyeing and stuffing workshops female workers with seniority more than 10 yr. Thus it was shown for pancreatic cancer (PMR=418%; 95%CI=136-975), for melanoma and skin cancers (PMR=497%; 95%CI=102-1,450), for uterus cancers (PMR=269%; 95%CI=130-496).

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Micro-scale enterprises (MSEs) with less than 5 employees are subject to be covered by the scheme of the regular workplace environmental inspection and medical health examination from 2002 in Korea. Due to limited resources as well as vast number of enterprises to be covered, there is an urgent need to focus these efforts to only those high-risk MSEs. To identify them, a qualitative risk assessment methodology was developed combining the hazardous nature of chemicals and exposure potentials as modeled by the HSE and the risk categorization technique by the AIHA. Risk Index (RI) was determined by combining characteristics specific to chemicals and scale of use of the chemicals. The method was applied to 514 MSEs that were selected from a random sample of 4000 MSEs. A total of 170 out of 514 MSEs studied were included in the final analysis. Current status and characteristics of MSEs were identified and RI was assigned to chemicals in each industry. Based on the distribution of RIs, the high-risk MSEs were selected. These include: wood and products of wood, chemicals and chemical products, basic metals, other machinery and equipment, motor vehicles, trailer and semi-trailer manufacturing, and furniture manufacturing. Since these MSEs are high-risk ones, more attentions should be focused on them. This method can be applied to other workplaces with no previous history of quantitative workplace inspections.

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Serial participatory action programs for reducing occupational safety and health risks were undertaken to know the types of support suited for small-scale industries. Working groups were formed with workplace people and occupational safety and health experts. It was agreed to develop an action-oriented strategy focusing on improving both work environment and productivity by making low-cost improvements through group work. Many workplace improvements achieved by participating enterprises and the group work procedures taken were analyzed. As supporting tools for effectively implementing the workplace improvement action programs, we developed action checklists according to industry and workplace implementation guides. Collections of local good examples also served as part of these support tools. These experiences show that keys to the sustainable action in small-scale industries are: (1) mobilization of the industry-wise network by trade associations, (2) an output-oriented strategy based on interactive group work and (3) the effective use of support tools such as low-cost action checklists and group work methods.

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The POSITIVE (Participation-oriented safety improvement by trade union initiative) programme was introduced into the Philippines in 1995. The monitoring of activities was carried out in 2004 among core trainers who had been trained before. The results of the questionnaire survey showed that the core trainers evaluated their activities satisfactory in general, and particularly the training activities were considered excellent. Also, the union workers who had been trained by the POSITIVE programme implemented improvements at the rate of around 5 examples a year on average. It was of note that the installation ratio (the number of installations/that of plans) was higher in small- and medium-sized enterprises than in larger companies, although the numbers of plans and installations of improvements were greater in large enterprises. Together with the previous findings, the present results suggest that the POSITIVE-style participatory training program is effective and efficient for workers to take actions for the OSH in not only larger enterprises but also small enterprises.

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A cross-sectional study was conducted in 25 spray painters and 35 control subjects to evaluate neurobehavioral function, and thyroid and reproductive hormones profile. This study indicated higher prevalence of psychological and neurological symptoms, and clinical findings among spray painters when compared with controls. Levels of TSH were significantly (p<0.01) elevated in spray painters over the control group (3.04 ± 1.53 vs 1.88 ± 1.07 μIU/ml, mean ± SD), respectively. Two of the 25 spray painters acquired sub-clinical hypothyroidism, and one subject was detected with overt hypothyroidism. T₄ levels were significantly (p<0.05) suppressed in spray painters while T₃ was not changed significantly in both the groups. Reproductive hormones (LH, FSH, and testosterone) showed no significant changes in control and spray-painting group. However, two spray painters had abnormally high level of LH (26.43 and 12.22 IU/l; normal range 0.5-10 IU/l). These subjects were also found to have abnormally higher level of FSH (38.63 and 14.11 IU/l; normal range 1.3-11.5 IU/l). An isolated higher level of FSH (39.94 IU/l) was also observed in one spray painter. No abnormality in the level of LH was observed in control group while 3 subjects from this group had abnormally high level of FSH. Testosterone levels were under the normal range (3-12 ng/ml) in both the groups. This study might suggest that spray painters are at risk of developing neurobehavioral, thyroid and reproductive problems.

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The high rates of occupationally related injuries, accidents, and deaths in rural Thailand are of particular concern to public health officials, as well as the residents and workers living in these areas. In response to specific concerns raised by local residents and local health officials in Chainat Province, Thailand, the Work Improvement in Neighborhood Development (WIND) programme was introduced and implemented by means of the local Primary Care Unit (PCU). The objective was to improve farmers' knowledge of methods to improve occupational safety and to reduce the occurrence of occupationally related injuries, accidents, and deaths in the area. Local farmers, public health officers, and health volunteers from the PCU played a primary role in the programme, serving as trainers in the initial training of trainer session. Major activities included visiting a local farm to carry out a check-list improvement activity and active discussion among participants about potential improvements. Following the implementation of WIND in Chainat, a number of significant improvements in work conditions were noted, including construction of resting corners, plans to build toilets in the fields, improved knowledge about the dangers of chemical fertilizers and pesticides, and increased use of personal protective equipment. Furthermore, participants began making organic fertilizer and had independently developed an organic anti-snail pesticide. This integrative approach, achieved by including many different members of the community, in combination with government support and diligent follow-up, has proved to be particularly successful.

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The first phase of this study was undertaken using Participatory Action Research (PAR) to identify the factual situations of fabric-weaving women working in the informal sector in Thailand. The aims were to enhance the mutual understanding of the women and researchers concerning the problems faced by these women and to establish an action plan to address these problems. The participant group consisted of 107 women working in the informal sector from three local villages who voluntarily took part in the study. Data were collected using quantitative and qualitative methods through structured questionnaires, focus groups, in-depth interviews, participant observations, and field notes. The results of the study revealed that the women learned their health problems were related to work and their labor potentially placed them at a risk for illness. When the women realized the gravity of their situation, they attained a sense of empowerment and took the initiative in establishing action plans to address their problems.

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The major problems of small enterprises include unfavourable working conditions and environment that affect safety and health of workers. The WISE (Work Improvement in Small Enterprises) methodology developed by the ILO has been widely applied to improve occupational safety and health in small enterprises in Thailand. The participatory methods building on local good practices and focusing on practicable improvements have proven effective in controlling the occupational hazards in these enterprises at their sources. As a result of applying the methods in small-scale industries, the frequency of occupational accidents was reduced and the working environment actually improved in the cases studied. The results prove that the participatory approach taken by the WISE activities is a useful and effective tool to make owner/managers and workers in small enterprises voluntarily improve their own working conditions and environment. In promoting a healthy work life at small enterprises in Thailand, it is important to further develop and spread the approach.

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Occupational Noise exposure has been linked with a range of negative health effects by various researchers. The resulting injury of occupational hearing loss is also a well recognized and global problem. To protect workers from hearing damage due to noise exposure and other related health effects, a vast store of knowledge has been accumulated till date about its nature, etiology and time course. There is still ignorance, amongst majority of people working in industries in developing and third world countries including India about ill effects of exposure to high values of noise. The study being reported here has been carried out in two textile plants located in Northern Indian state of Punjab. Equivalent sound pressure level L_eq has been measured in various sections of these plants with the help of a Class-I type digital sound level meter. The noise spectrum has been evaluated with the help of 1/3 octave filter set. A cross sectional study involving 112 workers exposed to different levels of occupational noise has been conducted. The results of the study establish the fact that noise level in certain sections of the plants i.e Loom Shed, Spinning, Ring Frame, TFO Area is more than the acceptable limit of 90 dBA for 8 h exposure stipulated by OSHA. The noise level in other sections like carding, blow room, combing etc., although is less than 90 dB(A) , but is quite higher than limits used for assessment of noise for community response. Octave band analysis of the noise shows the presence of high sound level in 4,000 Hz frequency range, which can be a major reason for causing occupational hearing loss. The results of the interview questionnaire which included a number of parameters reveal the following; (i) only 29% workers are aware about the effects of noise on health (ii) 28% workers are using ear protectors (iii) the satisfaction with the working environment is related to noise level, as workers exposed to comparatively less noise level report better satisfaction (iv) 70% of the workers reported that high noise level causes speech interference (v) 42% workers report the noise to be annoying. The study thus demonstrates the presence of gross occupational noise exposure in both the plants and the author believes that occupational noise exposure and the related effects in India is a widespread problem.

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The aim of this research was to clarify improvements in the occupational health management of small-scale enterprises by introducing the use of a checklist for organic solvents. We studied 25 small-scale enterprises producing lacquerware in Wakayama Prefecture, Japan. We specifically designed a manual for checking the occupational health management that included a checklist for self-evaluation. The survey using the manual led us to find that the median of workers was 4. All workshops were equipped with local exhaust ventilators for spraying work. Overall recognition of a need for the occupational safety and health by managers was not particularly high. The need was found for producing a documented work standard, properly dealing with or controlling organic solvents, thus preventing workers from exposure to organic solvents. Eighteen small-scale enterprises answered yes to more than 50 percent of items on the checklist. The results of the checklist exercise revealed some problems in spraying workshops, such as no documented work standard, no inspection of tools or local exhaust ventilators before work, no prevention against exposure to organic solvents, and insufficient measures taken for occupational health education. The results in this research pointed out some need to improvements in the occupational health management.

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The objective of this study is to clarify the prevalence of and risk factors for low back pain (LBP) in schools for physically and mentally handicapped children. This study design is a cross-sectional study. The subjects included were 1,869 staff members from 19 prefectural schools for children in Shizuoka Prefecture, Japan, which included schools for the blind, deaf-mutes, physically handicapped, and mentally retarded children. A total of 975 subjects completed two postal questionnaires which included morbidity, demographic factors, nursing activity, and psychosocial factors. The answer rate was 52%. The one-month prevalence of LBP was 45%. According to the classification of nursing activity, assistance in movement 1.67 (95% CI 1.27-2.14), excretory function 1.45 (1.11-1.88), and feeding 1.44 (1.10-1.90) showed significant increases in the odds ratio. The adjusted odds ratio significantly increased by 2.35 (1.78-3.11) in the group with depression symptoms as well as in the group with job stressors such as quantitative, qualitative, and physical work loads, job control, utilization of technique, interpersonal conflicts, and degree of satisfaction with their work/home life.

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The number of nursing home has increased largely in Japan since 1990. The Long-term Care Insurance in 2000 has accelerated the increase of nursing homes. The care giving and cooking in nursing homes have high risk factors of muscle-skeletal diseases (MSDs). However, the working conditions have not yet been improved. Thus, the incidence of low back pain and cervico-brachial disorder is very high among the care workers and cooks. Therefore, it is important to prevent the MSDs among the care workers and cooks. This study has been conducted to make a model of the participatory improvement focusing on low back pain in a nursing home for three years. As a result of the study, many improvements have been implemented and the incidence of low back pain has been reduced.

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The main purpose of this study was to assess some of the individual and occupational risk factors contributing to induction or intensification of LBP among the employees suffering from this problem in four small size factories in Ardabil, Iran. This study was a cross-sectional study that was conducted among the personnel of four industrial companies. Interview, questionnaire survey, medical examination (Lasegue test), radiographic evaluation, and ergonomic survey (using the NIOSH checklist) were the methods to collect data. The result of the study was divided into two parts: individual factors and work-related factors. The highest frequency of low back pain was observed in the age of 30-34 years old, medium height and heavy weight with 34.4, 84.4, and 33.0 percent, respectively. With regard to work-related factors, load lifting with 44.7 and body posture with 18.4 percent contributed to low back pain as the most important occupational causes among the patients. Observing recommended regulations and limitations of load lifting, modifying and optimizing ergonomic conditions in the workplace, selecting workers with suitable body strength on the basis of a pre-employment examination and implementing a continuous educational program for employees were the most important methods recommended to prevent low back pain.

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The improvement of occupational health conditions in Small- and medium-scale enterprises (SMEs ) is the most crucial issue in occupational health in Japan today. Improvement will depend on how occupational health services are provided to SMEs. Recently, Occupational Health Service Centers (OHSCs) providing occupational health services for SMEs have become more firmly established and expectations for further improvement in quality and quantity are high. In this way it is hoped that the challenges of providing "occupational health for all" can be met.

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In Japan, the accident rate for seamen is 5 times higher than that for all other industries. Many maritime work accidents are related to the poor ergonomic conditions of the working environment. It is particularly important to examine seamen safety in terms of vessel type and seamen age, as these factors are related to various sorts of accidents. In this paper, maritime work accidents were analyzed according to fundamental factors including vessel type, seamen age, and seamen rank. It is suggested that safety education should be provided according specifically to seamen age and vessel type, as they are revealed to be strong factors relating to maritime work accidents. Such education and further research may also lead to improvements in maritime equipment in relation to worker safety.

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Objectives: In order to clarify the real condition of occupational health (OH) activities in small-scale enterprises (SSEs) at the nationwide level, we conducted a questionnaire study sent to SSEs. We selected SSEs according to their employee numbers published in the in "Census of Workplaces in 1999". Subjects and Methods: About 2000 establishments were selected from the list in the "Census" describing the names and addresses of enterprises with 5 or more employees. The questionnaire included type of business, number of employees, independence, OH competent person, conduction of health examination, potential hazardous works and countermeasures (chemicals handling, computer work, etc), committee or other types of organizations for OH, and others. Results: Two hundred eleven establishments with 1-4 employees, 779 establishments with 5-9 employees, 681 establishments with 10-49 employees, 300 establishments with 50-99 employees, and 57 establishments with more than 100 employees, a total of 2,029 establishments responded to the questionnaire. The types of businesses (the number of establishments) were construction (216 establishments), manufacturing (604), transportation and communication (216), wholesale and restaurants (390) and services (602). The rate of independent enterprises was 54.1% and branches 45.9%. Indicators of OH activities including selection of OH competent person, enforcement of OH guideline for computer work, OH education about the occupational health risks, enforcement of special health examinations and general health examinations in SSEs with 1-4 and 5-9 employees were worse than SSEs with 10 or more employees. Conclusions: The differences of OH activities by scale of number of employees were clarified at a nationwide level. However, OH activities in SSEs with 1-4 employees were not clarified sufficiently. Various policies and methods should be established and implemented to improve the low level of OH activities in SSEs.

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Compared to workers on land, seamen working on the ocean are given only limited disease treatment. The aim of this paper is to clarify the actual condition of diseases among such seamen in an effort to improve measures that promote their health. We analyzed 51,641 cases of diseases that were reported to the Ministry of Land, Infrastructure and Transport from 1986 to 2000. The most prevalent diseases included disorders of the digestive system, followed by those of the musculoskeletal and the circulatory systems. The proportions of the three disease types were shown to vary by the type of work, ship, and occupation. One of the reasons for the variation in incidence between type of work and ship might result from differences in the voyage period in the given year. In explaining the varied incidences between occupations we hypothesize that differences in work systems and contents may be important variables to consider. It will be necessary to clarify the lifestyle and living environment of seamen to suggest appropriate measures for combating diseases prevalent in this population.

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This study was conducted to clarify the characteristics of small-scale enterprises (SSEs) with fewer than 50 workers, which employ 62.2% of all Japanese workers. Subjects were 71,183 workers employed at 1,761 workplaces in Tochigi, Japan, in 2002. Frequencies of abnormal lifestyle and health check-up data were described according to the category of the enterprise. Adjusted odds ratios (ORs) of the abnormal findings were calculated by logistic regression analysis. Dose-response relationships were calculated by trend tests. The frequency of abnormal findings was higher in SSEs than in other categories of enterprises. The ORs of work intensity, alcohol consumption, current smoker, and the Brinkmann index were higher in SSEs than in large-scale enterprises (LSEs) and were also significant in trend tests. The ORs of audiometry, hypertension, glucose in urine and ECG in males and females, BMI, liver function, lipid metabolism, and blood sugar in females, chest X-ray, and anemia in males were higher in SSEs. Audiometry, hypertension, anemia, ECG in both males and females; chest X-ray, and glucose in urine in males, and liver function, lipid metabolism and blood sugar in females showed significant results in trend tests. Overall health and healthy lifestyle in SSEs were worse than in LSEs.

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Health and safety professionals and organizations have often suggested that promoting and improving health and safety in the workplace will improve business success. We conducted a study of all new small businesses that registered with the Workers' Compensation Board of British Columbia (WCB of BC) in the years 1993, 1995, 1996 and 1997, assessing their injury rate in the first 5 complete years of business. The data set represents 53,913 new businesses and 19,332 claims. Businesses were grouped by the number of years between registering for WCB coverage and termination of coverage. Injury rates were determined for each calendar year for each industry sector as injuries per 100 person-years, based on payroll information provided by the businesses. Across all industries, businesses that failed between 1 and 2 yr of start-up had an average injury rate of 9.71 while businesses that survived more than 5 yr had an average injury rate of only 3.89 in their first year of business (p<0.000001). The WCB of BC demonstrated a statistical correlation between health and safety in the workplace and the survival of a small business.

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Changes in the world of work in the last few decades have markedly affected questions regarding occupational safety and health (OSH). Jobs in our economy continue to shift from manufacturing to services. Longer hours, shift work, reduced job security, temporary work are realities in the modern workplace, new chemicals, materials, processes are developed at an ever accelerating pace. The workforce is also changing. It will become older and more racially diverse and women are increasing. These changes present new challenges to protect worker safety and health and it was been indispensable to redefine priorities, by consulting all those involved in OSH. The present study therefore made a critical comparative analysis of the main published projects to identify research priorities in the OSH field, comparing methods, approaches and results. Comparison of the priority areas established in each of these studies is inherently difficult due to differences in socio-cultural backgrounds, in the methods employed to identify priority topics, and the many factors involved. However, it is clear that the Delphi technique is widely used as a reliable method, in that it covers a broad range of qualified witnesses, from a variety of backgrounds -such as trade union representatives and researchers- providing different viewpoints. It also takes account of the intrinsic features of OSH which -compared to other disciplines-involves multidisciplinary factors calling into play a range of scientific settings, such as toxicologists, molecular biologists, epidemiologists, occupational hygienists and occupational physicians. This analysis showed how important it is to reach consensus among all those operating in the OSH sector, in order to establish standard methods that can be applied in different contexts, and give results that can be validly compared.

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To clarify the carcinogenicity of acetaldehyde when associated with ALDH (aldehyde dehydrogenase) 2 polymorphism, Aldh2 knock-out (Aldh2-/-) mice and their wild type (Aldh2+/+) mice were exposed to two different concentrations of acetaldehyde (125ppm and 500ppm) for two weeks. Aldh2-/- mice, which have the same genetic background as C57BL/6J (wild mice) except for the Aldh2 gene, were used as models of humans who lack ALDH2 activity. Urinary 8-hydroxydeoxyguanosine (8-OHdG) and plasma malondialdehyde (MDA) levels were measured as indicators of oxidative DNA damage and lipid peroxidation, respectively. At 125 ppm acetaldehyde exposure for 12 d, urinary 8-OHdG levels in Aldh2+/+ mice did not increase. However, urinary 8-OHdG levels in Aldh2-/- mice were slightly increased by the end of the exposure. On the other hand, plasma MDA levels did not increase in either Aldh2-/- or Aldh2+/+ mice. At 500 ppm, urinary 8-OHdG levels in both Aldh2-/- and Aldh2+/+ mice significantly increased after 6 and 12 d, but there was no genetic difference. On the other hand, plasma MDA levels in Aldh2+/+ and Aldh2-/- mice did not increase at either 125 ppm or 500 ppm after two weeks of exposure. In conclusion, it is suspected that DNA was damaged by acetaldehyde inhalation, and that susceptibility to acetaldehyde varies according to Aldh2 genotype.

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We cross-sectionally analyzed the association between duration of physical activity and the presence of selected cardiovascular risk factors in the middle-aged male personnel of the Self-Defense Forces who underwent retirement check-up (n = 974). In a univariate regression analysis, duration of high intensity physical activity but not that of moderate or low intensity physical activity inversely correlated with body mass index (BMI), triglyceride, fasting plasma glucose, white blood cell (WBC) count and systolic blood pressure. No intensity categories of physical activity correlated with total cholesterol. In a multivariate logistic regression analysis adjusted for lifestyle factors and the rank, the odds ratio per 1 h/wk increase in high intensity physical activity was .88 (95% confidence interval (CI) .80-.97; P=.007) for the presence of obesity (BMI 25.0 kg/m²), .88 (95% CI .81-.95; P = .002) for hypertrigly ceridemia, .87 (95% CI .76-.99; P=.034) for type 2 diabetes, and .90 (95% CI .82-.99; P=.037) for hypertension. Neither hypercholesterolemia nor high WBC count (≥6,900 /μl) was associated with high intensity physical activity. High intensity physical activity inversely correlated with traditional cardiovascular risk factors in the middle-aged men.

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The objective of this cross-sectional study was to investigate the prevalence and determinants of respiratory symptoms and lung function and their association with occupational dust exposure in Taiwanese steelworkers. The study was conducted on an integrated-steel company in Taiwan from March 1989 to February 1990. After excluding workers in the coke ovens and ex-smokers, we performed physical examinations on 1,339 male workers in the iron making and steel making factories. Subjects were interviewed regarding respiratory symptoms using a Chinese version of the American Thoracic Society respiratory questionnaire and were examined with respect to their lung function using spirometry. Objective dust exposure was measured using personal air sampling with 277 valid samples. Prevalences of cough frequently, chronic cough, phlegm frequently, chronic phlegm, wheezing occasionally, and breathlessness were 11.4%, 9.3%, 14.6%, 11.9%, 2.6%, and 6.5%, respectively. Duration of employment, smoking, subjective dustiness, and past respiratory illnesses can predict these respiratory symptoms. Average respirable dust exposure significantly decreased the forced vital capacity (FVC) and forced expiratory volume in one second (FEV_1.0) in smoking workers. In the non-smokers, an effect of respirable dust exposure on FEV_1.0/FVC was shown. Since the main ingredients of dust in such a steelworks usually contained mixtures of oxides and silicates other than silica dust, respirable dust exposure in steelworks might impair lung function, especially among smokers.

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This study examined the maximum acceptable weight of carriage (MAWC) for young Taiwanese males experienced in manual load carriage tasks. The elements of the examined load carriage tasks included lifting a box from the floor to the waist height, turning around while holding the box, carrying the box at the waist height for a distance, lowering the box to the floor, turning around, and walking unloaded back to the original position. Subjects performed the load carriage tasks over different levels of carriage distance, frequency, box width (sagittal dimension), and handle according to a response surface design. The results showed that subjects' MAWC decreased with carriage distance, frequency and box width, while heart rate and rate of perceived exertion (RPE) increased with carriage distance, frequency and box width. The MAWC for box with handles was on average 1.5 kg more than that for box without handles, while the effects of handle on heart rate and RPE were very trivial.

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The aim of the present study was to develop a method of urinalysis for trichloroacetic acid (TCA) and trichloroethanol (TCE), and therefore total trichloro-compounds (TTC) as the sum, with least use of hazardous chemicals, being green in that sense. After acid hydrolysis followed by dilution with an ethanol (EtOH)-methanol (MeOH)-water mixture, capillary gas-choromatography with an electron-capture detector can quantify TCA and TCE in the diluted hydrolyzate. Comparison studies showed that the results were identical among three methods, i.e., 1. the method developed in the present study, 2. a head-space GC with acid hydrolysis of conjugated TCE and methyl-esterification of TCA¹⁾, and 3. traditional colorimetry with Fujiwara reaction²⁾. When applied to exposure - excretion analysis, the three methods gave results reproducible to each other. Over-all evaluation therefore was such that the method developed in the present study is as equally reliable as previously developed methods. It should be further noted that the procedures are very simple, with minimum use of occupationally or environmentally hazardous chemicals. In case the determination of only TCA is requested, it is possible to skip the hydrolysis step so that the treatment prior to the GC analysis is even simpler, i.e., just a 60-fold dilution of the urine sample with the EtOH-MeOH-water mixture. It was also demonstrated that correction of urinary analyte levels for urine density in terms of creatinine or specific gravity did not improve the correlation with the intensity of TRI exposure.

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