Objectives: Unemployment or job change due to treatment for a disease is affected by various factors such as disease type, degree of disability, and workplace patient support. This study aimed to clarify the factors affecting the unemployment/job-change rate among workers who had designated intractable diseases. Methods: A questionnaire survey was administered to 3,210 designated patients with intractable diseases who underwent applications for renewal of medical care subsidies at the Hirakata City Public Health Center during fiscal year 2019 (July–December). Of these patients, 539 workers aged 20–59 years who were employed as regular workers, temporary contract worker/dispatched workers, and part-time workers when they became designated intractable diseases were subjects of the analysis. Unemployment/job-change due to the treatment for a designated intractable disease was treated as an event occurrence, while the absence of unemployment/job-change due to disease at the time of the survey were considered censored cases. The Kaplan–Meier method was used to determine the trend of the unemployment/job-change rate associated with the duration of work. The Cox proportional hazard model was used to examine the relationship between unemployment/job-change and factors such as gender, age at onset, disease groups, activities of daily living, types of employment, experienced workplace supports (e.g., reduced working hours and hourly paid leave), and existence of insoluble medical difficulties at the workplace. Results: The unemployment/job-change rate due to treatment for designated intractable disease was 19.4%. Significantly independent factors of unemployment/job-change were the following: 50s at onset (compared to those in their 30s, HR = 2.55, 95% CI (1.21–5.37)), requiring outing assistance (compared to going out alone, 2.31 (1.13–4.71)), being a temporary contract worker/dispatched worker (compared to a regular worker, 2.66 (1.20–5.89)), existence of insoluble medical difficulties at workplace (4.15 (2.43–7.09)). Experienced workplace support was not a significant factor in preventing unemployment/job-change. Conclusions: Age at onset, degree of disability, form of employment, and existence of insoluble medical difficulties at the workplace were significantly associated with unemployment/job change due to treatment for designated intractable diseases. The relationship between workplace patient supports and unemployment/job-change was not clear, but to reduce medical difficulties in the workplace, workplace supports must be expanded. Given that workplace support is not an obligatory effort for employers, it is necessary to establish a system where employers can easily promote workplace support.

Objectives: The number of workers dispatched to developing countries has increased recently. The sanitary conditions in these countries are different from those in developed countries and from what the workers are used to. Therefore, health control, especially infection control, is an important consideration for working there. In this study, we investigate workers’ needs as well as the occupational physicians’ skills concerning working in developing countries. We propose a more effective education system for health control. Methods: Regarding workers who have lived in developing countries, we surveyed the company profiles, duration of stay, vaccination status, infectious education, medical assistance, and satisfaction with infection control strategies of their employer companies. Regarding occupational physicians, we surveyed their profiles, their experiences in consultation, and advice from/to the workers dispatched to developing countries as well as their suggestive advice for staying there. Results: Factors that contributed to workers’ satisfaction with their employment companies were prior education and health consulting services in addition to company size. Many occupational physicians believed that this kind of information should be supplied but they did not have the confidence to provide it. Conclusions: Workers who are dispatched overseas should receive prior education and access to health consulting services. It is necessary for information providers such as occupational physicians to be knowledgeable in travel medicine.

Objectives: This study aimed to clarify the health of technical intern trainees and factors that affect their health and examine the necessary support. Methods: Articles related to the health of technical intern trainees, published between January 2010 and September 2019, were extracted from databases (Ichushi-Web, CiNii Articles, and news archives) using the keywords “technical intern training” and “health.” Additional articles were extracted by hand-searching related reports and magazines. The articles were sorted using the partial Bernard Berelson method of content analysis and classified into the components of the International Classification of Functioning, Disability, and Health (ICF). Results: There were 24 categories, 71 subcategories, and 422 recording units extracted from 127 documents. Using the ICF classification, the 【Environmental factors】 component had the largest number of recording units, with the “support from supervising and implementing organizations” (n = 108) and “inadequate enforcement of labor-related laws” (n = 48) categories. This was followed by the 【Health condition】 component, with the “death of technical intern trainees” (n = 27) and “increase of tuberculosis cases” (n = 24) categories. Conclusions: It is assumed that while some technical intern trainees are in a high-risk situation because of the difficulty of receiving medical care and severe working conditions that may worsen their health, including the development of brain and heart disease and tuberculosis, some receive positive effects such as early detection and treatment of diseases through health checks. In addition to improving the working environment, it is important to translate the results of health checks into trainees’ understandable languages, provide supplementary explanations of the results, and support the promotion of multicultural coexistence.