Job strain factors and stress management for workers in the manufacturing industries were reviewed in this article. Major job stress factors included high job demands, low job control, low social support, role ambiguity and conflict, the physical, chemical and ergonomics of the work environment, work patterns with work schedule and shift work, and job insecurity regarding future employment. In considering effective stress management plans which counteract the job stress factors mentioned above, it is essential to use an organizational approach in the work environment. For workers in the manufacturing industry, through this approach, it is important to promote more autonomy and activities with increasing job control, to give more clarified roles and responsibilities, to provide a more mutually supportive system with better ways to communicate and to introduce a system giving additional rewards, such as paid holidays for refreshment. Plans are also needed for individuals and groups, such as workers, managers, supervisors and workgroups, regarding education, skill training and mutual training according to the personnel characteristics of each target. In order to make these stress management plans successful in the long term, an actual system for stress management is required, with recognition and support by top management. It is also important to assess the effectiveness and method of each stress management plan with proper measurements.

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In recent years, employees who complain about too much stress have been increasing, and stressmanagement and coping with stress in the workplace have emerged as one of the important subjects in Occupational Health. There are two approaches to measures for stress. One is to decrease the stressors, and the other is to promote employees’ tolerance of the stress reaction. Therefore the roles and duties of Occupational Health Nurses (OHNs) have been described for each approach. OHNs who are close to the employees as first line professionals support each employee to live healthily and independently, and aim at contributing to the employees’ QOL. For that reason OHNs’ roles in measures for stress must become much more important in the future.

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In 1996, the need for the clinical guidelines for the management of hyperuricemia and gout was proposed of the consensus conference held at the 29th annual meeting of the Japanese Society of Purine and Pyrimidine Metabolism (president Yuji Matsuzawa). At the consensus conference, the following announcement was made.
1. Because the majority of patients with hyperuricemia are in the condition of multiple risk factor clustering syndrome, hyperuricemia per se should be counted as one of the typical lifestyle related diseases.
2. Medical management should be directed independently for the treatment of gouty arthritis and for control of the serum uric acid level.
3. The serum uric acid level should be taken into account as a possible cardiovascular risk factor.
4. Urine alkalization should be started if there is no symptom indicating hyperuricemia for the prophylaxis of urinary stones and renal dysfunction.
5. All the medical management should be considered under the consensus of the many expert physicians dealing with hyperuricemia and gout.
This principal announcement was made by the consensus conference and the simple management recommendation of a 6-7-8 rule was proposed through the consensus of expert physicians. Recently, a guideline committee was organized in the Japanese Society of Gout and Nucleic Acid Metabolism (previous by the Japanese Society of Purine and Pyrimidine Metabolism) and the Guidelines for the Management of Hyperuricemia and Gout were prereleased in February and published in August 2002. In the new guidelines, the above policy was introduced and evidence was collected to give the guidelines contemporary clinical usefulness and value. It will help in the proper management of hyperuricemia in apparently healthy persons in occupational health, having multiple risk factors.

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Based on the conceptual model of “healthy work organizations”, we conducted a questionnaire survey of 612 Japanese workers in an information service industry company to investigate the effect of work stressors and organizational characteristics on workers’ health status, job dissatisfaction and turnover intentions from July to August 2001. The response rate was 96.2%. For the statistical analysis, data on 488 computer technical support staff were used. To grasp the occupational stressors, we used a focus group to clarify work stressors and organizational characteristics. After factor analysis, we identified seven factors composed of 29 items and created seven scales of work and organizational characteristics. As scales of “organizational characteristics”, “insufficient evaluation system”, “undeveloped management system”, and “career and future ambiguity” were used. The remaining scales, “poor coworker support”, “poor supervisor support”, “insufficient office amenities” and “high job demands and control”, were used as scales of “work and workplace characteristics”. The results of multiple regression analysis showed significant relevance of organizational characteristics to health status, job dissatisfaction and turnover intentions of workers. They supported “healthy work organizations” as useful conceptual tools for the study of organizational health.

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