˘ˇ - marianna uigakukai.marianna-u.ac.jp/idaishi/www/331/06-33... · smr 3.70 47.44 ˘ smr 19.54...

10
腷腸腩腹腳膂膎膚臒臚 Vol. 33, pp. 4352, 2005 腐腈腂腀腁腆腊腘腀腅腄腋腎腖腃 腕腏腉腍腗腔腃腌腓腒腑腇 腖腉 腊腇 腕腗 腓腘 腑腅 腐腉 腄腆 腖腉 腅腏 : 膇腅 17 2 21 19871999 臉臔膯膸臅膟膻膪膐臉膐膧臔膻臛膯臰腙腜腄臬膯膅膊腛 3,531,354 腃腑臙4,268 腙腱腀腯腧19871989腖膾膣19981999腉腔膑臆腒腐腭腘腩腲膮膉腘腝腐臙膆膠腚膆膭膉膎膩腧膢臮腖腌腐臮膋臙膎腼 SMR腧膩腞腏腗臛膯臰腙膥膙膉至臛膯臰 300 腁膓膒臛膯臰 300999 臛膯 1000 腼臶膯臣腈腔腻腶腭腀腵腮膯膤臔膯腏腙腉腔膺腌腐I. 臉膄腖腙膙膉SMR 腕腚膾膣腧腍腔至腙臯腕臇腈臛膯臰膡腕211 腙膗臌腆腁腣膯臣腕腚腈腔 膯腆臍腟臇腈膅腆臍腟腅腒腐II. 腲腂膾膣腙ῑ῏ 腏腙腙膔膆臙膁腆 腆腨膄腏膍膲臂腕腁腒腐膙膉腕腚臛膯臰腕腏腙腙膔膆臙腖腆腨 腏腗臛膯臰腕腚臻臟膜腏腗腘臻膄腏膍腆膼腢腥膯臣腕腚膤臔膯腖腏腙腙膯臣腕膍腆膼腢腥腐臋膾膸臅膰腬臢臀膏 Healthy Worker’s E#ect: HWE腆臫腕腗腂臇腂 SMR 腧臜腌腐至臛膯臰腈腔膯腠膍膲 臂腙膈膤臔膯腕自臠腌腐臔膯膸膛腆腗腋腥腤腊腖腆腜腥腤ῐῌ῏ 臹膃臛膯臰膥膯臣SMRHealthy Worker’s E#ect 腦腆臉腕腚臹臷腘腄腉腤膰腬臢腙腻腖膸臅腧 腎腤腖腖腟腘腗臹臷膞膬腙膳腕腀腤腊腖腧膚腣腖腌腔膰腬腆膍1972 腘臘 臆腋腥腐臹膃腙臔膯膸膛腙膖自腆腗腋 腥腔腇腐腆 1臋膾腙臔膯膸膛腙腁腣腧膺腌腔腂腈臶腕腏腙膌腚臭腕腁腤臔膯膸膛腙膄腓腙膌臗腖腌腔臏臹臢臙膎膩膞膤腗臸 膫腎腤 25臏臹臢臙膎膩膰腬臢腙膯臣腠臡膐膴臎膆臕腘 腡腣膗臌腆腞腢腥腤腊腖腆膓膔腕腡腈腢腥臷腘腄腉腤腴腪腸腮腬膱腙膌腘腟膞膤腕腁腤 67臉腕腚膤膦臖腘腄腂腔腆腨臊腆 膤臤膄膫腙臛膽臝臑腙臏臹臢臙膎膩NIOSH 腆膖膁臓致腡腣腽腘臇腂腊腖 臈腋腥 3膯腙膰腬臢腘腄腂腔腮腶腮腲腸膯腘腡腤腆腨膑腞腽臱膕 腙臙腸腮腬腆臇腈臔膯膸膛腕腁腤腆臗腋腥腐 8膤臄臛臐膯臢腘腄腂腔腟腩腮腶腮腲膑腞腽臙腙臇腂臙腸腮腬腆臈腋腥腐 2腜腐腫腳腰 腕腚膯臣腘腡腤臌腾腆臈腋腥膨腹腾膢膇腕 膣腊臄腠腐膪臐膯膅腕臃腆腨腖腆腨腷腸腩腹腳膂膎膡膐膂膚膭臞 43 43

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Page 1: ˘ˇ - Marianna Uigakukai.marianna-u.ac.jp/idaishi/www/331/06-33... · smr 3.70 47.44 ˘ smr 19.54 0 ˇ ˘ˆ˙ smr 9.05 0 ˘ ˆ˙ smr 9.93 2.11 ˝ ˛˚ ˜!"#$ 300 999 % smr 0.94 10.98

� � ����������Vol. 33, pp. 43�52, 2005

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� �1987�1999 �������������������������� !��"�#$%3,531,354��&'(� 4,268�!)*+,�-�1987�1989�./-�1998�1999���012�,345� �6���7�������85(9: �!�(�"�,;<.=5#<>(�$�SMR� ,?@� �%� �� !A&��B�� 300�'(� ��� 300�999�� ��� 1000�CD�� �E��)*�� +,�F-�G*HI�� J.�/K�0L��� M1#�N!2���01O3=5� �I. ��P4Q5.!$R� A&�!6(� SMR ST�/-,/U1B��!VSWX� B��.��� YS7 2�118!Z[\]^� �E�ST)*�\_`WX� M1#\_`9a45� �II. b�:c��/-!$R�� N!2!d9(� e\f� ;\f� g<�S=�hiS]45� A&�ST� B��� S� N!2!d9(.\f�%S=�� ��� STgjk�%� >�g<�!=�\lmn� �E�ST� J.�/K�0L��.N!2!�ES6(�!=�\lmn5� o/� ��?@pqr �HealthyWorker’s E#ect: HWE� \s�StuWu SMR ,v=5B�A&�� � )*�w� =�hi!J.�/K�0L��S� PAxy=5��B�z�\t{n|}.\C~n|�

������� �� A&� �E� SMR� Healthy Worker’s E#ect

�\�ST� ����0|?@p!��.��,�B�|..`�� �Dt����!��,EF�|}.,GH.=1?@���IJ\ 1972���3{n5� CK� ��!��B�z�!�x\t{n1�5\1�� o/!��B�z�!]^L,O3=1uXDSN!M�T�NS]|� ��B�z�!P�!M��#.=1� ��p(�"TOPt�Q,R��|2�5����p(�"T?@p!�Ew��b�H9 �

�^Z[\S@mn|}.\�dS�XTmn� ����0|���I��!M��`OPS]|6�7��U�ST� �V�0L� ��u1;\f� ¡\f� ;L¢� <W!�£� ¤¥X!��p(�"\P4¦Y �NIOSHIZ[§¨��^O©�Wu}.\Qª{n3�� �V��\�!?@p��u1� �I«I¬]^��|;\f�­�®_�`¢� ¯°!(��I�\WX��B�z�\<s�S]|a\�b{n58�� 0L±�²�p��u1`� c³d� e¢f� �I«I¬;� ­�®_�`¢� ´0(!Wu(��I�\Qª{n52�� ~5� µ�¶ST�E��|[·\Qª{n� �g���h¸S´i¹� jk±wlm²�#Sºn\f.o\f����������� pq��»¼

43

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333333333300000111110000077777����� ����� (((((MMMMMaaaaarrrrrkkkkk11111)))))����� ����� MMMMMLLLLL33333000002222200000CCCCC�����MMMMMaaaaarrrrrkkkkk11111 FFFFFrrrrriiiii����� MMMMMaaaaayyyyy����� 1111133333����� 1111144444:::::3333344444:::::5555511111����� 22222000000000055555PPPPPaaaaagggggeeeee����� 11111������������������������������

Page 2: ˘ˇ - Marianna Uigakukai.marianna-u.ac.jp/idaishi/www/331/06-33... · smr 3.70 47.44 ˘ smr 19.54 0 ˇ ˘ˆ˙ smr 9.05 0 ˘ ˆ˙ smr 9.93 2.11 ˝ ˛˚ ˜!"#$ 300 999 % smr 0.94 10.98

���������� �� ���������� ���������������������� !"#�$%& '�() *+4��,�� -�.�/01 #23�45�2��/�6789%":229�10�� ;%<1 -+"=0># ?%9�@�A��� : B%+C��2$%�6/D EF%� 7( � G<HA� =0>#2IJ:K���789L+ /M%�%��.N<OPQ�RST��NR�/� �.UVQ�RST'�� *9� 8 W�1969 ���.TX Y�2� *+�Z9[\78+RST�11���1� 0] ^_"!`"OPQ� Ia"RS� ^!b �2� �.c#2RS$�2%d2&'� efgh^!bi('/)"& �� 0]2OPQ�2)* j+a"& '," *9%"� &2�NRk��/� -�.��@ l-789L+mnF%0]�A���2,?�op� 0]2N<.Oq/'0ra"s�tuFv�'1wxy12�13��2RS�/� 1987�1999 �2�NRk��'3

%9� =0>#'z2:2�/Fw� {|/45}k���,6~$�'�� *+7��#8�Standardized mortality ratio: SMR� '��*9�0]2N<.Oq/'%9" 0r*+� z*9�$% SMR '�*+0] ^_"�����2G<H2:��A�� <1��#� ?%9�() a"& '," *+�

� �

2RS/� 1987��1999� )_9;�� �.N<OPQ�RST�.TX��NR�2�����

'�.2c�<� G<H ��*� W<'=(8+0]~$�op� ����� ��*+G<H ^_"���<�/�� 3,531,354 {�>@ 2,801,644{� �@ 729,710 {��� z2��#>/ 4,268{�0.12���oZ+�>@ 3417 {� �@ 851 {���? o+Z9� &2 1987�1999�2 13��20]~$'� &2�����Z+�@2m�� �� �:�%Y@2m���?'�ps +� z2@)(k��2�A�B,�op� F^)? SMR '8¡a"+¢2{|/45}�C��8¡�L"�'Db� U£" 1� >@�1987�1989�2� �@�1998�1999� *+� >@/ 1988�� �@/ 1999�2{|/45}����E ¤+#�¥F�A #{|10G{9� 20�59¦�� �E§¨ 5¦© �k��'�� *+ SMR 'ª¢� I� �.,6~$ 28¡� II� 0]~$23�45�>@-�@28¡�'��*+� z2«�� ��� G<H2A� �¬G<H 300{HI� @G<H300�999{� �G<H 1,000{­s��� <1 �JK<� LM�®N�¯�°�<� �O�PC�Q±N<� ²R�� z2S�2 3?2��'³Z+� F^� 9´G<H2A� <1 {m ?%9/ Table 1. �*+�I. �.,6~$�{|/45}k��� 28¡

�/� �.,6~$ 28¡��'³�+¢� c#�µ¶m�O� {|/45})(��78"@Tm�E�': *9� SMR z2 95� C�·�'�>@ �@� � ��*+�

Table 1. The Number of Size of Business and Type of Business

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44

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Page 3: ˘ˇ - Marianna Uigakukai.marianna-u.ac.jp/idaishi/www/331/06-33... · smr 3.70 47.44 ˘ smr 19.54 0 ˇ ˘ˆ˙ smr 9.05 0 ˘ ˆ˙ smr 9.93 2.11 ˝ ˛˚ ˜!"#$ 300 999 % smr 0.94 10.98

���� II. �������� �-��������� ������������ SMR � ����������� !� SMR���� ������"�#��$%�&� '�� E2�(� �����"�#)*+% �O1, O2� ��$% �E1,E2� �,-.� /010� SMR �234(� /�SMR 56���/� 95� 789:�� Lentner�14��;<�34( �=�� >?@A� Confidence Interval Analysis

�CIA, Ver 2.1.1 Build 48, Trevor Bryant� Univer-sity of Southampton�15� �B,( � C � DE"FGH&��!�0 IJ���KLM�IJKL�N-.�OP�QRST0� �UVWX�Y��Z[\]� �2002 6 ^_`aVb� cdefb��gh(@A( �

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I. ��������I-1 � �Table 2.�i�jk��#�lm��'n. SMR o 1pRqr� s0�tu�����vpR����%v�iwolm�q-s��x(.-�� lm�oy�0=&n �#�� ��z{oj� |}~�� ���/����#���n � ������ SMRo � 0.50&��� 0.44���&=��oy�0 �

I-2 ������ �Table 3.���zFGH��� SMR o�&n � ���FGH����tu��pRlm��-�#o�r� ��oj� SMR o��#pR�&n � zFGH��i�jk��#�tupRlm�qr� ��|}~��lm�o=&n � ������.������oy�0 �I-3 ��� �Table 4.���Go�' SMR o�r� ���o�'q&n � lm�oy�0=&n �#�� ���������-o��'��� ��`��(.�� ��G���oj�  ¡�¢£�¤¥¦§G��z{oj� ¨©��7�ª«¬G��|}~� ����­®¯� /���G°��z{oj� |}~� r'±�4}� /����#�o�n � lm��&n �� ����G�|}~����n � ������ ��G�  ¡�¢£�¤¥¦§G� ������(.�R� ¨©��7�ª«¬G�/���G°�²³´µoy�0 �II. �����������-�����II-1 � �Table 5.�/����#� �SMR 0.22&� 0.65¶� olm

�²³� |}~ �SMR 0.98&� 0.41¶� olm���(.- �II-2 ��� �Table 6.�� �FGH�300J·¸�

Table 2. Standardized Mortality Ratio�SMR� by Cause of Workers Death

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45

333333333300000111110000077777����� ����� (((((MMMMMaaaaarrrrrkkkkk11111)))))����� ����� MMMMMLLLLL33333000002222200000CCCCC�����MMMMMaaaaarrrrrkkkkk11111 FFFFFrrrrriiiii����� MMMMMaaaaayyyyy����� 1111133333����� 1111144444:::::3333344444:::::5555511111����� 22222000000000055555PPPPPaaaaagggggeeeee����� 33333��������������������

Page 4: ˘ˇ - Marianna Uigakukai.marianna-u.ac.jp/idaishi/www/331/06-33... · smr 3.70 47.44 ˘ smr 19.54 0 ˇ ˘ˆ˙ smr 9.05 0 ˘ ˆ˙ smr 9.93 2.11 ˝ ˛˚ ˜!"#$ 300 999 % smr 0.94 10.98

������� �SMR 3.70�� 47.44� ��� ������ ������ �SMR 19.54�� 0� ������� �SMR 9.05�� 0�� ����� �SMR 9.93�� 2.11� ��������� ��� !"#$�300�999%�������� �SMR 0.94�� 10.98� ��

� ������ ������� �SMR 1.67 ��0.23� ��������� ��� &"#$�1000%'(������ �SMR 0.46�� 0.60�� )����

�SMR 0.45�� 0.72����� ������ ��� �SMR 0.89�� 0.29� ��������� �II-3 ��� �Table 7.�� *+#���II-1�,�-��� ����������. �� ������.��� /0� �0� ���� �12� &30� �45� 67�89����12:� ;<=�12>�? ��� ��@��ABCD#/0� �� E��FGH,I � ���12,=J��K�� �9�� L0� �,����������� MNO�PQ ��� R��ST�UVW#�������� /0� �� ���,XS"

Y����Z��,=�PQ � 67�89�

,[\Z ���� �� ]�^�������� �0� ������� XS"Y� ���� ������ ���12,_M>�? � &30,67�89�����Z=J12>�? ��� ����#`��,a� �=J12a� �45� ��HMQ�� � [\,�9������>�? �

� �

bc��d���6�Zef�Pgh,ij�P�� klm���ZE�no���p�q6� ��rsZef�dmrs �Healthy Worker E#ect:HWE� ,tu?g2�16�� HWE �vwxg�y,��� zl{|}~D���mZzl��.���6� l��ZPg���efmK����l{|}~D���mZ����l��x6� !�����.��x��:��?��g� z#��!�W#�e���pgrs�l��Z� ef��:����.��G���x��7&����xg,�?g17�18�� ���� HWE ����?�� ���� SMR G�xl����g�}�D ¡�¢��Z� £¤.W#�e������K6¥¦�?�� 2�5�� �§¨�Z� &©�l�ª«�Pg�W§¬B­�1987�1999®��G��� SMR G¯°�±²�� ³´���gW#�e��� µG¶Q

Table 3. Standardized Mortality Ratio�SMR� by Size of Business

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46

333333333300000111110000077777����� ����� (((((MMMMMaaaaarrrrrkkkkk11111)))))����� ����� MMMMMLLLLL33333000002222200000CCCCC�����MMMMMaaaaarrrrrkkkkk11111 FFFFFrrrrriiiii����� MMMMMaaaaayyyyy����� 1111133333����� 1111144444:::::3333344444:::::5555511111����� 22222000000000055555PPPPPaaaaagggggeeeee����� 44444��������������������

Page 5: ˘ˇ - Marianna Uigakukai.marianna-u.ac.jp/idaishi/www/331/06-33... · smr 3.70 47.44 ˘ smr 19.54 0 ˇ ˘ˆ˙ smr 9.05 0 ˘ ˆ˙ smr 9.93 2.11 ˝ ˛˚ ˜!"#$ 300 999 % smr 0.94 10.98

�� ���� ��� ��� �� ����HWE ���������������� �15��HWE �!"�#$�%&'�()��*+%,�� -.-/�0� 12345�6�78�9:;�<�;��=�� SMR >?@����4A�B�CD� E�FGHIJ�>K0.�-�L%�A�B�MN�O�PQR��,�S>TU-�$VW4'+/XY>Z[��\A���CD]^��-�%]����_`� $�SMR � 1ab4,�� c�de4fgh>ij�k.j�� ��%Ml�CD]^� $� �mHWE ��nd�op-�$����O�PQR�i,�qr�stkb�uZ-�$�vw8�x[0���5�69:y�TU4%� z5�64%� �5�6�{�s SMR �h�|}j�$�N 4,j�i� SMR 4 11.4 ~�z5�6 4.34 vs �5�60.38�4,j�� }��5�6i 2.8 ~��5�61.07 vs �5�6 0.38���h�,j�� Ml�5�6��4%� z5�6> 300 ���� �5�6>1000 ����-� �� �����4%Ml�z�5�6��������/5�6��V�}��$��i..A0�� ��/ SMR �h���0��L%�`����� 1��� 1000�aW��5�64%a�.0��$O�PQR���A��$��S4� z��5�64%� �� ��i��%�0��$�i���m�R�������4,�L������� ���� ¡]¢£¤�i�4

ssenis

uBfoepyTyb

RMS� oit

aRytil

atroMdezi

dradnatS.4

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Table 5. Adjusted Standardized Mortality Ratio�SMR�

CD� E�9:� �<y�¥¦§�s�¨© 47

47

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Page 6: ˘ˇ - Marianna Uigakukai.marianna-u.ac.jp/idaishi/www/331/06-33... · smr 3.70 47.44 ˘ smr 19.54 0 ˇ ˘ˆ˙ smr 9.05 0 ˘ ˆ˙ smr 9.93 2.11 ˝ ˛˚ ˜!"#$ 300 999 % smr 0.94 10.98

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Table 6. Adjusted Standardized Mortality Ratio�SMR� by Size of Business

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2� Robinson CF, Petersen M, Palu S. Mortality

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5� Stewart SD. E#ect of changing mortality on theworking life of American men and women�1970�1990. Soc Biol. 1997; 44: 153�158.

6� Dahl. E. Social inequality in health -The roleof the Healthy Worker E#ect. Soc. Sci. Med.

1993; 36: 1077�1086.7� Blakely T, Woodward A, Pearce N, SalmondC, Kiro C, Davis P. Socio-economic factors

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tween 1992 and 1996. J Occup Health. 2001; 43:

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12� °?±N� H 39 FncoYt¨©I �ª�²P³f´=5�G� �|�G�:��µ¶OP��=5B·� t¨©I 2000; 548: 29�34.

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Abstract

Analysis of Secular Change of Standardized Mortality Ratios in

Japanese Companies by Size and Type of Business 1987�1999

Chizuko Yoshino, Hiroki Sugimori, Toshiaki Tanaka and Katsumi Yoshida

To elucidate secular change of standardized mortality ratios �SMR� in Japanese companies by size andtype of business between 1987 and 1999. Data of 3,531,354 male workers from the National Industrial Health

Management Study Group �ZENKOKU SANGYO KENKOKNRI KENKYUKAI� were analyzed. Themortality was assessed by SMRs in comparison with the general population in Japan on 20�59 yearsJapanese workers between 1987 and 1999. Demographic data and registered death cases of companies were

assessed by 3 size of business �small scale: under 300 persons, middle: 300�999, large: over 1000� and by 5types of business �manufacturing, sales�financial�service, transport�communication�electric, public service,Other occupations�. We studied from two points of view: I. Comparison with the general population, II.Longitudinal comparison �comparison between the previous term 1987�1989 and the late term 1998�1999�.�I. Comparison with the general population� Among 4,268 deaths, SMRs of colon cancer and leukemia inthe previous term and other extrinsic deaths in the late term were higher than that of the general population.

According to the size of business, SMRs were highest in the small sized business, followed by the medium

sized, and the large sized �from 2.8 to 11.4 times higher in the late term�. According to the type of businesses,SMR of manufacturing industry was the highest, and public service was the lowest. Significant causes of

deaths in SMRs were lung cancer in manufacturing industry, colon cancer in sales�financial�service industry,leukemia in transport�communication�electric industry, cerebral infarction in public service, and coloncancer, leukemia and so on in the other occupations. �II. Longitudinal comparison� SMRs in all deaths, theother extrinsic death, gastric cancer, and lung cancer, heart failure increased, and SMRs in leukemia, tra$c

accident, and colon cancer decreased. In both small and medium scaled businesses, cerebrovascular disease

decreased, and other extrinsic deaths and whole cancer increased. In large scale, whole heart disease,

especially heart failure, increased. All deaths increased in transport�communication�electric industry andother occupations. Increase of gastric cancer in sales�financial�service industry, and increase of suicide intransport�communication�electric industry were recognized. SMR as compared with the vital statistics of thegeneral population is useful to evaluate activity of occupational health service. Since SMRs in small and

medium sized business and in manufacturing industry were quite high, which could not show Healthy

Worker’s E#ect satisfactorily, the importance of intensive occupational health activities in these groups

should be stressed.

Key words

Healthy Worker’s E#ect, size of business, type of business, Japanese worker,

SMR �Standardized mortality ratio�

Department of Preventive Medicine, St. Marianna University School of Medicine

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