Objectives: To clarify the current status and challenges of radiation dose management in medical institutions participating in the Radiation Management System (Radiation MS) Implementation Support Project and to provide insights for establishing and improving radiation management systems. Methods: A web-based questionnaire was administered to medical institutions nationwide that participated in the Radiation MS Implementation Support Project in 2022. Responses from 143 institutions that provided valid data and consent were obtained and analyzed. The survey assessed the structure of the radiation management system (comprising five elements), verification status and management of radiation workers, and implementation of awareness-raising activities regarding proper personal dosimeter use. Each questionnaire item was analyzed using descriptive statistics and chi-squared tests. To determine the optimal sequence for implementing the five elements of the radiation management system, correlation, logistic regression, decision tree (CART), and path analyses were conducted. Results: Among the 143 institutions, 46.9% had established a radiation exposure management organization (e.g., a committee), and 55.9% had administrators who clarified radiation management policies and guidelines. Regarding radiation workers, only 32.6% of radiation management personnel were aware of whether their institution’s radiation workers were also engaged in radiation work at other facilities (referred to as “dual employment”), whereas 35.0% were aware of confirmed cases of employees from other institution receiving dual employment. Additionally, 33.6% of the institutions did not conduct sufficient awareness-raising activities regarding proper personal dosimeter use. A comparison between clinics and hospitals revealed that Occupational Safety and Health Management Systems (OSHMS) were more widely implemented in clinics than in hospitals. Additionally, clinics demonstrated a better understanding of whether radiation workers were engaged in dual employment compared to hospitals. The establishment of a radiation exposure management organization was found to be crucial for building a radiation management framework. To facilitate implementation, clarifying policies and guidelines and establishing audit mechanisms were identified as priority measures. Conclusions: This study identified several challenges related to the development of radiation management systems, appointment of radiation control personnel, and personal dose management of radiation workers. Moreover, priority measures were clarified for establishing a robust radiation management framework. Addressing these issues requires medical administrators to clarify policies and guidelines related to radiation management, develop audit mechanisms, and promote the establishment of radiation exposure management organizations. Furthermore, strengthening the leadership of medical administrators and implementing Radiation MS are effective strategies for maintaining and improving management frameworks.

Objective: Since the outbreak of SARS-CoV-2, there is an increased opportunity for occupational health professionals to conduct online interviews. However, to the best of our knowledge, research regarding adaptation to online interviewing is limited. Therefore, we developed a checklist as a reference for decision-making regarding the adaptation of online interviews. Subjects and Methods: Through online interview-adaptation group work, we identified considerations for adaptation of online interviews, including promoters and barriers. Based on our findings, a prototype version of a checklist was created. Public comments on the prototype version were collected, and a survey was conducted to verify the validity of the checklist. Results: Seventy-one volunteers participated in the group work, resulting in a prototype version consisting of eight major categories and 32 sub-categories. We received 15 public comments on the prototype version and 64 responses to the survey. More than 50% of the respondents indicated that online interviews should be avoided or that they would face difficulties if conducted. Based on public comments and additional opinions from the survey, the final version of the checklist was completed. Discussion and Conclusion: The final version of the online interview-adaptation checklist was confirmed as valid by experienced occupational health professionals. The checklist will guide appropriate decision-making regarding adaptation to online interviews.

Objectives: There are few reports of chemical-related illnesses in the Reports of Worker Casualties in Japan. Using these reports from 2020, this study analyzed the relationship between illnesses caused by chemical handling stratified by male or female sex, using the Japan Standard Industrial Classification (JSIC). Methods: Our study included 244 patients from the Reports of Worker Casualties submitted to the Competent Labor Standards Inspection Office in 2020 with chemical-related illnesses resulting in at least 4 days of absence. Patients were classified into major and minor industrial groups using the JSIC. Simple and cross-tabulations were performed to assess characteristics. Results: Of the 244 included patients, 236 were absent from work, with a male-to-female ratio of 4:1. The substances or product names of chemicals handled by the case group included one substance in 216 patients (88.5%) and two or more substances in 28 patients (11.5%). Dangerous and harmful materials other than those specified in special regulations accounted for 52.9% of the total. Of the 244 patients, 100% were reclassified into industrial divisions of the JSIC; 94.7% into major industrial groups and 63.9% into minor industrial groups. By industrial division, most workers were in manufacturing (43.9%), followed by construction (18.0%), services, N.E.C (9.0%), and wholesale and retail trade (7.4%). All workers in construction were males. The experience period was less than 1 year in 30.3% of the cases across a wide range of age groups ≤ 70 years old. The most frequently encountered disease sites (expected closure period of ≥ 1 month) were the lower limbs, followed by the upper limbs and the head. The most common diseases were integumentary diseases (67.2%), followed by poisoning (24.6%) and respiratory diseases (7.8%). The most common categories for health hazard classification (globally harmonized system of classification and labelling of chemicals) were specific target organ toxicity (single exposure) (36.5%), specific target organ toxicity (repeated exposure) (25.4%), serious eye damage/irritation (25.4%), skin corrosion/irritation (23.0%), and acute toxicity (21.3%). All eight deaths occurred in workplaces with ≤ 49 employees. Conclusions: To reduce the number of sick people and the expected period of absence from work, it is necessary to regularly check chemical safety after starting work, taking into account employee’s years of experience and selecting appropriate protective equipment for the integumentary system (especially the upper limbs, lower limbs, and head [eyes]) based on chemical risk assessment; additionally, support should be provided for chemical management in small businesses.

Objective: Participatory workplace environmental improvement programs have proven to be effective in addressing mental health issues in the workplace. However, their implementation remains challenging. This study aimed to identify the facilitators and barriers faced by part-time occupational health physicians in proposing and implementing such programs and to develop effective implementation strategies. Methods: A web-based questionnaire survey was conducted among part-time occupational health physicians between September and October 2023. This survey examined their experiences in proposing workplace environment improvements, their knowledge of participatory workplace environmental improvement programs, and their experience in proposing and introducing such programs. It also assessed the facilitators and barriers to the introduction and implementation of such programs. Respondents who had proposed such a program to their client companies were asked to connect the research team with the individual responsible for workplace environmental improvement at those companies. After obtaining consent, we interviewed these individuals in November and December 2023 to explore the facilitators and barriers to introducing participatory workplace environmental improvement programs. The questionnaire and interview data were analyzed using the occupational health version of the Consolidated Framework for Implementation Research (CFIR), and implementation strategies were developed with reference to expert recommendations for implementing change (ERIC). Result: We received 57 responses overall. Of the 49 respondents who were familiar with participatory workplace environmental improvement programs, 33 (67.8%) had proposed them. Of those with the proposed experience, 11 (33.3%) reported successful implementation. Interviews were conducted with representatives from two workplaces that implemented the program after receiving a proposal from their occupational health physicians and one that had yet to implement it. The analysis identified “Relative Advantage, Tension for Change,” and “Implementation Climate” as high-priority facilitators and barriers during the Pre-Proposal Internal Setting phase. During the proposal, additional factors such as “trialability,” “formally appointed internal implementation leaders,” “self-efficacy,” and “relative priority” were extracted. Based on the ERIC framework, “Create a Learning Collaborative,” “Make Training Dynamic,” “Shadow Other Experts,” and “Identify and Prepare Champions” were selected as feasible implementation strategies. Conclusion: This study identified facilitators and barriers to introducing participatory workplace environmental improvement programs. Findings suggest that part-time occupational health physicians should provide educational materials and opportunities to build confidence among internal implementation leaders in client companies. Further research should incorporate more on-site practitioner feedback to refine implementation strategies and evaluate their effectiveness.