Objective: The purpose of this study was to identify the current status of operations at community general support centers which provide coordination for elderly care and the correlation of personal traits, work environment and the occupational stress of the staff. Methods: Subjects of the study were 251 staff members of community general support centers. The current status of operations at the community general support centers and the personal traits, work environment, effort-remuneration imbalance model (ERI) and general health questionnaire (GHQ) were surveyed. The initial analysis involved a comparison by a chi-square test on: The effort-remuneration ratio (E/R ratio) of personal traits and work environment, risk of over-commitment (OC), and GHQ score. To explore the correlation between the E/R ratio of the three GHQ groups (low, middle and high score groups) and the OC value, one-way analysis of variance was performed. Results: Out of the four basic functions of the community general support centers, 22.0% of the respondents noted that “establishment of a regional, comprehensive/multi-tiered service network” was functioning, and 50.4% of respondents noted that “comprehensive and continuous care management” was functioning. The average effort score was 15.5 ± 5.3, approximately double the average value of preceding studies. Significant differences found in GHQ scores were related to working hours (p<0.001) and anxiety was related to task content (p<0.001). Moreover, a higher GHQ score was accompanied by a higher E/R ratio and as a result of the multiple comparison, a marked difference was observed between the GHQ low score group and the GHQ high score group (p<0.001), and a significant difference was also found between the GHQ low score group and GHQ medium score group (p=0.012). Items observed to have significant correlation with high E/R ratio were: “Weekly working hours of 50 h or more” (OR: 10.38, 95% CI: 2.52-42.70), “Unstable employment” (OR: 2.75, 95% CI: 1.22-6.21) and “Anxiety related to task content” (OR: 17.04, 95% CI: 3.57-81.24). Items observed to have significant correlation with OC value risk factors were: “Weekly working hours of 50 h or more” (OR: 8.04, 95% CI: 1.99-32.41) and “Anxiety related to task content” (OR: 4.60, 95% CI: 2.04-10.37). Conclusions: We conclude that the basic functions of the community general support centers are not presently very functional. The stress levels of the community general support center staff are high and their health levels are low. This indicates that staff are forced to work with anxiety related to task content under conditions of poor pay and long working hours.
(San Ei Shi 2010; 52: 111-122)

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Objective: In Japan, there is growing concern that employees' health condition has been worsening under the severe labor conditions of the continuing recent deep recession. To determine trends in the prevalence of cardiovascular risk factors among employees, we analyzed 32 yr of systematic surveillance of urban Japanese employed men. Subjects and Methods: The surveyed population included male employees aged 40 to 59 yr who worked for four companies, a trading company, two banks and a company maintaining expressways in Osaka. Surveillance of cardiovascular risk factors was conducted from 1977 to 2008. We examined the annual mean values of systolic blood pressure, diastolic blood pressure, body mass index, and total serum cholesterol, and the prevalence of hypertension, obesity, hypercholesterolemia, smoking, alcohol drinkers, and high risk individuals who had two or more risk factors: (high blood pressure, high glucose and dyslipidemia). Results: The total number of employees aged 40-59 yr increased from 822 in 1977 to 2,651 in 1992, but then declined gradually to 1,455 in 2008. Among men aged 40-49 and 50-59, the prevalence of hypertension decreased from 25% and 39% in 1977 to 14% and 23% in 1992, respectively. However, the respective prevalence of hypertension started to rise thereafter to 29% and 47% in 2008, accompanied by an increase in blood pressure levels and the prevalence of antihypertensive medication use. Mean body mass index and the prevalence of obesity showed significant upward linear trends from the mid-1980's to 2008. Therefore, we speculate that the increase in blood pressure levels seen after the early 1990's associated with an increase in obesity. However the proportion of hypertension among non-overweight men also increased between the early 1990's and 2008, suggesting other factors are also involved in the increase of hypertension. The prevalence of hypercholesterolemia and high-risk individuals with obesity also increased in recent years. Mean total cholesterol level showed a linear increase from 195 mg/dl for men aged 40-49 and 196 mg/dl for men aged 50-59 in 1977 to 204 mg/dl and 207 mg/dl in 2008, respectively. The prevalence of high-risk individuals with obesity was 13% for men aged 40-49 and 15% for men aged 50-59 in 2008. Among men aged 50-59, the prevalence of non-overweight high-risk individuals became higher than that of high-risk individuals with obesity over time. Conclusions: Although these findings were limited to the study companies, our data support evidence that Japanese employees have become increasingly at risk of cardiovascular diseases under the severe working conditions experienced since the 1990's. It is important to improve working conditions as well as personally control risk factors from the point of public health.
(San Ei Shi 2010; 52: 123-132)

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Objectives: We measured how much physical exercise of moderate-to-high intensity was performed daily during commuting times by office workers who reside in the Greater Tokyo Area and use a train for commuting. Methods: The physical activity was measured by a portable accelerometer, Omron HJA-350 IT, which records METs (Metabolic Equivalents) every minute. The data were downloaded to a personal computer for calculation of the exercise quantity in specified time intervals. Exercise (Ex) was defined as (METs≥3) × hours. Results: Male commuters using the train (n=74) were found to spend 70 ± 30 and 103 ± 47 minutes for morning and evening commuting, respectively. They expended 3.4 ± 1.7 Ex in the commuting of both morning and evening. This exercise quantity amounts to 64% of the whole day Ex, which was 2.9 times the whole day Ex of car commuters (n=78). The daily walking activity of the train commuters, 9,305 ± 2,651 steps, was 2.7 times that of the car commuters (3,490 ± 1,406 steps). The mean total Ex expended by the train commuters over 5 weekdays was calculated to be 26.5 Ex, which exceeds the weekly 23 Ex recommended by Guideline on Physical Exercise for Good Health, 2006, Japanese Ministry of Health, Labour, and Welfare. Conclusions: Train commuting by office workers residing in the Greater Tokyo Area seems to contribute to their physical health.
(San Ei Shi 2010; 52: 133-139)

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Objective: The present study examined the buffering effect of social support in the workplace on job strain and depressive symptoms by conducting a cross-sectional survey using a self-report. Methods: The subjects were 712 employees (male, over 40 yr old) who worked at a precision machine factory. The questionnaire determined the subjects, ages, types of occupation, scores of depressive symptoms, job strain (job demand and job control), and social support (supervisor support and coworker support). Job strain and social support were evaluated by the Job Content Questionnaire (JCQ). The Center for Epidemiologic Studies Depression Scale (CES-D) score was measured and depressive symptoms were defined as a CES-D score ≥ 16 point. Job strain and social support were calculated and divided into low-score groups (LG) and high-score groups (HG), respectively, by the median value. The mean values of CES-D in the LG and HG of job strain or social support were compared by the t-test. The hierarchical multiple regression was analyzed with the CES-D score as the dependent variable and by the characteristics of the participants, job strain and social support, and the cross-product interaction term of job strain and social support as independent variables. The effect of the degree of social support in the LG and HG of job strain on the CES-D score was evaluated by analysis of covariance adjusted for age. Results: The results showed that 23.2% of the workers had depressive symptoms, and that, the CES-D scores in the job demand group were significantly higher in HG than in LG. The CES-D scores in the job control, supervisor support, and coworker support groups were significantly higher in LG than in HG. The hierarchical multiple regression analysis showed that job demand, job control, supervisor support, and coworker support had significant main effects on the CES-D score. Furthermore, it was shown that there was a significant interaction in the CES-D score between job control and supervisor support, and that, the CES-D score in the supervisor support group was significantly higher in LG than that in HG only when job control was low. Conclusions: These results suggest that supervisor support may have the effect of buffering depressive symptoms related to low job control.
(San Ei Shi 2010; 52: 140-148)

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