A one-year educational program at the work-site was designed to reassess individual physical activities and acquire knowledge of hyperlipoproteinemia in workers aged 30, 35 and 40 who had increased serum cholesterol (CHO) or triglyceride (TG). A total of 420 subjects were selected in 8 yr. The mean percentage of attendance for the program consisting of measuring maximum oxygen uptake, a lecture on a healthy life, an eating-experience class and measuring serum lipid was 86, 59, 35 and 61%, respectively. The male subjects (214 subjects for 1 yr and 125 subjects for 5 yr) who had mesured maximum oxygen uptake before the program and serum lipids before and after the program were studied. They were divided into three groups according to their lipoprotein phenotypes to compare the effect of the education on their blood lipid levels. In the type IIa group, the CHO value and low density lipoprotein (LDL)-CHO had decreased about 10mg/dl at 1 yr (n=117) and the latter remained decreased at 5 yr (n=69). The CHO value had decreased in the type IIb group (n=44) both at 1 (n=44) and 5 yr (n=25) although the TG value was decreased only at 1 yr. The average HDL value was significantly increased in the type IV group (n=53) although the TG value was not improved in 5 yr (n=32). The type IIb group showed an increase in BMI, increased % fat and decreased estimated maximum oxygen uptake value compared to those in the type IIa group. The number of smokers was the greatest in the type IV group. We observed different effects of the education on the blood lipid values and also different physique and life-habits among groups of three lipoprotein phenotypes in the workers before the middle age. It might be necessary to evaluate the effects of the educational program for ameliorating serum lipids in regard to the individual lipoprotein-phenotypes.

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A self-administered questionnaire study by mail was carried out on 282 enterprises employing occupational health nurses in the Kanto and the Kansai district in 1998. The purposes of this study were to make clear the expectation of enterprises for occupational health nurses and differences by enterprise characteristics. The number of respondents was 149 and 138 were analyzed. The results were as follows: 1. It was suggested that enterprises expected occupational health nurses to perform non professional jobs and to be committed to the organization. 2. On the whole, enterprises had high expectations in occupational health activities except in the area of work and environment. 3. Enterprise size influenced expectations in several activities: health guidance, health education, prevention education and safety education.

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Organizational intervention rather than the individual approach is gaining greater attention in worksite health promotion, but little research has been done on the health promotion environment. The purpose of this study was to investigate the actual conditions in health promotion environments at worksites, and determine which environmental items in each health promotion area at worksites need. A survey was conducted by mailing a questionnaire to occupational physicians at 450 worksites in Japan. The questionnaire contained 182 items including 6 areas in a health promotion environment; tobacco control, healthy diet, physical activity and exercise, stress management, health screening, and health administration. 142 physicians (32.7%) responded to our survey, the number of employees was more than three hundred and 71.1% of respondents were working at manufacturing worksites. The mean rate of positive answers in 6 areas was highest in the ‘health screening’ (72.5%), followed by ‘stress management’. The lowest rate was seen in ‘tobacco control’. Popular facilities for health promotion were a stress counseling room, cafeteria, rest room and outdoor exercise field, but the rate of positive answers to promote utilization of these facilities was relatively low. Among the health education programs, the practice rate for exercise promotion was the highest (63.6%), but those for healthy food and body weight control were relatively low. The number of employees positively correlated with the rate of positive answers to all items and in the stress managing area. Manufacturing worksites had more items for enhancing physical activity than other types of industrial worksites. The results of this survey had determined the environmental intervention items in each health promotion area at worksites.

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The purpose of this paper is to provide information for the development of health and welfare services being offered by health insurance societies (HIS). We analyzed examples of coordinated activities by HISs, the organizations under them (affiliated groups), and regional community self-regulating groups (communities), looking for the shape and direction such coordinated activities should take in the future. We chose 6 cases from public information available from August, 2000 to January, 2001 and visited the parties involved to conduct follow up surveys on the nature of their coordinated activities. Based on a survey conducted by the National Federation of Health Insurance Societies in March, 1999 (Survey of the Current Status of Health and Welfare Services), 36 HISs that were thought likely to be acting in coordination with the community were mailed questionnaires. Of these HISs, 7 that were found to actually be carrying out such coordinated activities were contacted in a telephone survey. We categorized the form and direction of coordinated activities into the following 5 category types: individualized, shared use of facilities, human exchange, shared health management information, and general coordination. The personnel, facilities and institutional capabilities of the affiliated groups are important resources for HISs to carry out health and welfare services, both in general and for coordinated services in the community. In areas where affiliated groups are lacking in resources, communities and other agencies have to actively seek out and make use of external resources. The coordination of services by affiliated groups and the community allows both to make the best use of the capabilities each has and effectively enables them to mutually compensate for their weak points.

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