Objectives: We investigated the working behavior of part-time occupational physicians using practical recording sheets to clarify issues of occupational physicians' activities according to industrial groups or size of business. Methods: We collected 561 recording sheets in 96 industries from 11 part-time occupational physicians as collaborators, who volunteered to be a part of this research. We collected a variety of information from the practical recording sheets, including the industry in which each occupational physician was employed, the annual number of times of work attendance, occupational physician-conducted workplace patrol, and employee health management. We investigated their annual practices regarding work environment management, work management, health management, and general occupational health management. In addition, we analyzed the differences between the secondary and tertiary industry groups and between the group of offices employing 100 people or fewer (≤100 group) and 101 people and above (≥101 group) in each industry group. Results: The median work attendance by all occupational physicians was four times a year; the tertiary industry group had a significantly lower rate of work attendance than the secondary industry group. The occupational physicians' participation in risk assessment, mental health measures or overwork prevention, and the formulation of the occupational health management system and the annual plan were significantly lower in the tertiary industry group than in the secondary industry group. We observed that for the annual number of times of work attendance, occupational physician-conducted workplace patrol was significantly lower in the ≤100 group than in the ≥101 group in each industry group. Conclusions: These findings show that occupational physicians' activities have not been conducted enough in tertiary industries and small-sized offices employing ≤100 people. It would be necessary to evaluate how to provide occupational health service or appropriate occupational physicians' activities for small-sized offices or tertiary industries. Thereafter, it would likely be beneficial to construct a system to support the activities of part-time occupational physicians as well as the activity of occupational health at workplaces.

Objectives: To study the occupational safety and health systems used for emergency response workers in the USA, we performed interviews with related federal agencies and conducted research on related studies. Methods: We visited the Federal Emergency Management Agency (FEMA) and National Institute for Occupational Safety and Health (NIOSH) in the USA and performed interviews with their managers on the agencies' roles in the national emergency response system. We also obtained information prepared for our visit from the USA's Occupational Safety and Health Administration (OSHA). In addition, we conducted research on related studies and information on the website of the agencies. Results: We found that the USA had an established emergency response system based on their National Incident Management System (NIMS). This enabled several organizations to respond to emergencies cooperatively using a National Response Framework (NRF) that clarifies the roles and cooperative functions of each federal agency. The core system in NIMS was the Incident Command System (ICS), within which a Safety Officer was positioned as one of the command staff supporting the commander. All ICS staff were required to complete a training program specific to their position; in addition, the Safety Officer was required to have experience. The All-Hazards model was commonly used in the emergency response system. We found that FEMA coordinated support functions, and OSHA and NIOSH, which had specific functions to protect workers, worked cooperatively under NRF. These agencies employed certified industrial hygienists that play a professional role in safety and health. NIOSH recently executed support activities during disasters and other emergencies. Discussion: The USA's emergency response system is characterized by functions that protect the lives and health of emergency response workers. Trained and experienced human resources support system effectiveness. The findings provided valuable information that could be used to improve the occupational safety and health function in the Japanese system.

Objective: The objective of this study is to elucidate the influence on sleep and burden on visiting nurses engaged in on-call service during the night. Methods: A questionnaire survey was conducted among 614 visiting nurses, with the contents being as follows: outline of each subject, on-call night service schedule, mental and physical burden of such on-call service, and the state of sleep. The state of sleep on days when the subject was in charge of the on-call service and on days when the subject was not in charge was compared. In addition, to analyze the burden factors of on-call service and their influence on the state of sleep, a logistic regression analysis was performed, setting the target variables as "mental burden," "physical burden," and "imperfect sleep". Results: In total, 187 respondents were targeted for analysis (response rate: 30.5%). A total of 81.3% of the subjects felt mental burden when in charge of the on-call service and 69.4% felt physical burden. The sleep time was shorter and the occurrence of interrupted sleep was more frequent on days when the subject was in charge of the on-call service compared with the days when the subject was not in charge. Furthermore, the following worsened: depth of sleep, comfort of sleep, refreshed feeling, satisfaction of sleep, and difficulty in falling asleep. The logistic regression analysis revealed that mental and physical burden on nurses who received more than three calls in a month were significantly higher in comparison with those who did not [adjusted odds ratio and 95% confidence interval: 2.51 (1.05-6.00) and 2.44 (1.20-5.00), respectively]. Conclusions: We found that more nurses who received more than three calls in a month felt mental and physical burden. The state of sleep was worse on the days when the subjects were in charge of the on-call service than on the days when they were not in charge. It is necessary to properly establish clear policies for extra pay, sufficient breaks, and days off.