Surveys on the competencies of specialist …joh.sanei.or.jp/pdf/E57/E57_2_05.pdfpational physicians...

126 J Occup Health, Vol. 57, 2015

job training (OJT) for 30 items, and case-based learning (CBL) for 29 items. Conclusions: Some competencies should be added to the JSOH list. CBL should be intro-duced in training programs for specialist occupational physicians.(J Occup Health 2015; 57: 126–141)

Key words: Case-based learning, Certification pro-gram, Competencies, On-the-job training, Specialist occupational physicians, Training methods

The occupational physician’s role is to protect and promote workers’ health and working ability1). In previous studies, it was reported that specialist occu-pational physicians who completed residency train-ing2) or were certified3) were associated with a greater diversity of skills and opportunities. A comprehen-sive training program and a certification program to confirm attainment of a certain level of knowledge and skills are necessary to develop specialist occu-pational physicians. A common list of competencies that allow specialist occupational physicians to play their expected roles is required to maintain consis-tency between programs. A training program could be developed to help trainees acquire the competen-cies, and a certification program could be designed to confirm their achievement of them.

The Japan Society for Occupational Health (JSOH) runs a certification program for the country’s special-ist occupational physicians. Currently, to be certi-fied as a specialist occupational physician (certified occupational physician, COP) by the JSOH, one must complete a training program outlined in the trainees’ handbook, which provides a list of 50 competencies, and objective training under the supervision of a certi-fied senior occupational physician (CSOP) and pass a certification examination. The competencies required of special occupational physicians should vary at

Abstract: Surveys on the competencies of special-ist occupational physicians and effective methods for acquisition of competencies in Japan: Koji MORI, et al. Occupational Health Training Center, Univer-sity of Occupational and Environmental Health, Japan—Objectives: The aim of this study was to study the necessary competencies for specialist occupational physicians in Japan and the effective training methods for acquiring them. Methods: A competency list (61 items) was developed for the questionnaires in the study by making use of existing competency lists from the Japan Society for Occupational Health (JSOH) as well as lists from the US and Europe. Certified senior occu-pational physicians (CSOPs) in the certification program of the JSOH completed a questionnaire on the neces-sary competencies. Examiners of the examination for certified occupational physicians (COPs) completed another questionnaire on effective training methods. Results: All 61 competencies in the questionnaires were evaluated as “necessary”. Some of the competen-cies in the list from the JSOH were evaluated lower than the items added from the American and European lists. When the respondents were categorized into a “practi-cal group”, the members of which mainly provided occupational health services, an “academic group”, the members of which belonged to research or education institutes such as medical schools, and all others, the practical group evaluated some competencies signifi-cantly higher than the academic group, particularly those related to work accommodation. Among three options for training methods, the most effective methods were lectures and textbooks for 5 competency items, on-the-

Surveys on the competencies of specialist occupational physicians and effective methods for acquisition of competencies in Japan

Koji MORI1,2, Masako NAGATA1, Mika HIRAOKA1, Megumi KUDO1, Tomohisa NAGATA2 and Shigeyuki KAJIKI2

1Occupational Health Training Center, University of Occupational and Environmental Health, Japan and 2Department of Occupational Health Practice and Management, University of Occupational and Environmental Health, Japan

J Occup Health 2015; 57: 126–141 Journal ofOccupational Health

Received Jul 9, 2014; Accepted Nov 25, 2014Published online in J-STAGE Jan 10, 2015Correspondence to: K. Mori, Department of Occupational Health Practice and Management, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu, Fukuoka 807-8555, Japan (e-mail: [email protected])

127Koji MORI, et al.: Competencies of specialist ops and training methods

different times, and competency lists and attainment targets should be reviewed periodically. The JSOH’s current list was revised by the committee for the certi-fication program for specialist occupational physicians in 2011. However, the validity of this revision is in question because the committee did not seek opinions from CSOPs who actually train the candidate COPs, nor did it consult other stakeholders.

There are two general methods typically used to develop competencies of occupational physicians: 1) lectures and text for acquiring basic knowledge, and 2) on-the-job training (OJT) to gain competencies that occupational physicians use daily. Because existing health risks can vary widely across workplaces, it is difficult to provide adequately comprehensive training programs for each trainee. Various types of work-places must be accessed for OJT, or training methods must be invented to compensate for a lack of appro-priate OJT. As a possible solution, the case-based learning (CBL) method has been introduced in under-graduate and postgraduate training programs in public health and occupational health4−7). CBL is considered an effective method for acquiring competencies that are used less often or only pertain to specific work-places. Maximally effective training programs might be realized through a combination of the three meth-ods.

In this study, we conducted a mail survey of CSOPs to assess the validity of JSOH’s current competency list. Additionally, we asked examiners at the exami-nation for JSOH certified occupational physicians to discuss effective training methods for acquiring competencies in the list.

Methods

Development of the competency list for specialist occupational physicians for the survey

We compared the “ACOEM Core Competencies and Skill Sets Defined”, in ACOEM Competencies—20088) and the “Core Competencies for Specialist Occupational Physicians in Occupational Medicine in Europe: Scope and Competencies” developed by the WHO European Centre for Environment and Health9)

with the JSOH’s competency list for specialist occu-pational physicians. Both of these comparison lists were the newest lists published by authoritative orga-nizations in the US and Europe when we made our research plan. As shown in Table 1a−1e, we judged whether each description in the list could be matched to an existing competency in Japan. Then we exam-ined each competency that did not have an obvious match to see whether it could be combined with one or more other competencies to create a single compe-tency. As a result, 11 competencies were added to the JSOH list of 50 competencies. Finally, we rephrased

each competency to present it in a unified and more understandable format for the survey. The descrip-tions of the competencies were abbreviated as shown in the appendix.

Study 1: Survey on Necessary Competencies for Specialist Occupational Physicians in Japan

The CSOPs had at least 5 year experience in occu-pational health services as COPs and were fulfilling roles as trainers in the system. They were therefore considered appropriate respondents for the survey on necessary competencies for specialist occupational physicians in Japan. As of August 1, 2013, the total number of registered CSOPs in Japan was 315. Excluding those with addresses that were unknown or who were outside of Japan, we sent a questionnaire to 308 CSOPs and asked them to return it without any identifying information by the end of September, 2013. They were asked to rate the necessity of each competency on a scale of 1 to 5 (5=absolutely neces-sary, 4=necessary, 3=somewhat necessary, 2=not so necessary, 1=not necessary), and to write in additional competencies that they thought should have been on the list. They were also requested to report on their experience as occupational physicians as well as their current main job.

We evaluated the necessity of each competency by calculating its mean score across respondents. When multiple respondents suggested similar ideas, we care-fully examined each suggestion to see whether its topic was included in one of the 61 existing compe-tencies.

The respondents were categorized into three groups according to their current main jobs: a “practical group”, the members of which mainly provided occu-pational health services, an “academic group”, the members of which belonged to research or education institutes such as medical schools, and all others. Then, we compared the mean scores of each compe-tency for two of the groups: the “practical group” and the “academic group”. Group comparisons were analyzed by F-test and then the Student’s t-test or Welch’s t-test, using SAS Statistics 19 for Windows and a level of statistical significance of p<0.05.

Study 2: Survey on Effective Training Methods to Acquire Competencies

We developed a second questionnaire to study effec-tive methods for acquisition of competencies. The questionnaire had three options for learning methods: acquisition of knowledge with lectures and textbooks (lectures and textbooks), accumulation of daily experi-ence as occupational physicians (OJT) and experience or discussion of specific cases and measures (CBL). We asked whether each method was effective, and

128 J Occup Health, Vol. 57, 2015Ta

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129Koji MORI, et al.: Competencies of specialist ops and training methodsTa

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ards

-Ide

ntif

icat

ion

of e

xist

ing

heal

th

haza

rds

-Det

erm

ine

the

natu

re a

nd e

xten

t of

pot

entia

l oc

cupa

tiona

l an

d en

viro

n-m

enta

l che

mic

al e

xpos

ures

, con

side

ring

rou

tes

of e

xpos

ure

and

rout

es o

f ab

sorp

tion.

-Cha

ract

eriz

e ex

isti

ng a

nd p

oten

tial

occ

upat

iona

l an

d en

viro

nmen

tal

haza

rds

with

in d

efin

ed p

opul

atio

ns.

-Des

crib

e sp

ecif

ic t

hrea

ts, i

nclu

ding

a b

road

ran

ge o

f ch

emic

al, b

iolo

gi-

cal,

radi

olog

ical

and

phy

sica

l haz

ards

.

-Adv

isin

g on

the

intr

oduc

tion

of n

ew w

orki

ng s

yste

ms

and

tech

niqu

es-R

isk

asse

ssm

ent

of w

orkp

lace

haz

ards

(as

abo

ve)

with

adv

ice

on p

re-

vent

ion

of h

arm

-R

ecog

nizi

ng a

nd i

niti

atin

g th

e in

vest

igat

ion

of w

ork

abil

ity,

hea

lth

dete

rmin

ants

and

dis

ease

in th

e w

orkf

orce

Info

rmat

ion

of e

xist

ing

heal

th h

azar

ds-C

olle

ctio

n an

d un

ders

tand

ings

of

haz

ards

dat

a an

d in

form

atio

n

-Det

ect,

inso

far

as p

ossi

ble,

pre

clin

ical

or

clin

ical

eff

ects

ari

sing

fro

m

chem

ical

exp

osur

e an

d im

plem

ent a

ppro

pria

te p

reve

ntiv

e m

easu

res.

Und

erst

and,

exp

lain

, an

d be

abl

e to

app

ly t

oxic

kin

etic

dat

a (i

nclu

ding

ab

sorp

tion,

met

abol

ism

, st

orag

e, a

nd e

xcre

tion)

to

clin

ical

and

em

ploy

-m

ent-

rela

ted

deci

sion

mak

ing.

-Use

occ

upat

iona

l an

d en

viro

nmen

tal

info

rmat

ion

reso

urce

s to

con

duct

a

lite

ratu

re s

earc

h or

to

rese

arch

the

hea

lth

effe

cts

of a

che

mic

al s

ub-

stan

ce.

-Int

erpr

et a

nd a

pply

the

med

ical

, tox

icol

ogic

al, a

nd e

nvir

onm

enta

l lite

ra-

ture

s.

Mon

itori

ng o

f ex

posu

re to

hea

lth h

az-

ards

-Exp

osur

e m

onito

ring

and

eva

lu-

atio

n

-Mon

itori

ng o

f w

orkp

lace

haz

ards

incl

udin

g ph

ysic

al, c

hem

ical

, bio

logi

-ca

l, er

gono

mic

, psy

chos

ocia

l and

oth

er h

azar

ds-S

elec

ting

biol

ogic

al m

onito

ring

on

the

basi

s of

cri

teri

a of

val

idity

for

th

e pr

otec

tion

of th

e he

alth

of

the

wor

ker

conc

erne

d, w

ith d

ue r

egar

d fo

r th

e se

nsiti

vity

, spe

cifi

city

and

pre

dict

ive

valu

e of

the

test

s co

ncer

ned

-Bio

logi

cal e

xpos

ure

mon

itori

ng-A

dvis

ing

on t

ools

to

be u

sed

for

mon

itori

ng a

nd e

valu

atin

g en

terp

rise

po

licy

outc

ome

-Pro

mot

ing

mul

tidis

cipl

inar

y sc

ient

ific

wor

k on

exp

osur

e da

ta g

athe

ring

Ass

essm

ent o

f he

alth

ris

ks-A

sses

smen

t of

heal

th r

isks

-Ass

ess

clin

ical

, w

orks

ite,

and

envi

ronm

enta

l da

ta,

alon

g w

ith l

itera

ture

re

view

s in

the

perf

orm

ance

of

patie

nt e

valu

atio

ns.

-Det

erm

ine

whe

ther

a p

erso

n ha

s a

heal

th c

ondi

tion

that

inc

reas

es r

isk

from

the

effe

cts

of e

xpos

ure

to c

hem

ical

, phy

sica

l, or

bio

logi

cal a

gent

s.-E

valu

ate

and

inte

rpre

t the

res

ults

of

indu

stri

al h

ygie

ne s

urve

ys.

-Adv

isin

g on

impl

emen

tatio

n of

oth

er p

rofe

ssio

nal r

isk

asse

ssm

ents

JSO

H, J

apan

Soc

iety

for

Occ

upat

iona

l Hea

lth; A

CO

EM

, Am

eric

an C

olle

ge o

f O

ccup

atio

nal a

nd E

nvir

onm

enta

l Hea

lth8); W

HO

Eur

ope,

WH

O E

urop

ean

Cen

tre

for

Env

iron

men

t and

Hea

lth13

) .


ble

1c.

Dev

elop

men

t of

a co

mpe

tenc

y lis

t for

the

ques

tionn

aire

s by

com

pari

ng th

e lis

ts f

rom

Jap

an, t

he U

S an

d E

urop

e

Que

stio

nnai

reJS

OH

AC

OE

MW

HO

Eur

ope

Hea

lth s

urve

illan

ce, d

iagn

osis

and

trea

tmen

t

Indi

cato

rs o

f he

alth

eff

ects

for

hea

lth

surv

eilla

nce

-Set

indi

cato

rs o

f he

alth

eff

ects

-Dev

elop

, im

plem

ent,

eval

uate

, and

ref

ine

scre

enin

g pr

ogra

ms

for

grou

ps t

o id

entif

y ri

sks

for

dise

ase

or in

jury

and

opp

ortu

nitie

s to

pro

mot

e w

elln

ess.

-Des

ign

and

cond

uct

surv

eill

ance

pro

gram

s in

wor

kpla

ce a

nd c

omm

unit

y se

tting

s.

-Bio

logi

cal e

xpos

ure

mon

itori

ng;

-Org

aniz

ing

heal

th s

urve

illan

ce f

or w

orke

rs e

xpos

ed t

o oc

cupa

tiona

l ha

zard

s

Qua

lity

assu

ranc

e pr

ogra

ms

of la

bora

to-

ries

-Und

erst

andi

ngs

of O

H la

bora

-to

ry q

ualit

y co

ntro

l and

sel

ectio

n of

qua

lifie

d la

bora

tori

es

Util

izat

ion

of h

ealth

sur

veill

ance

for

w

orkp

lace

impr

ovem

ent

-Dia

gnos

is o

f he

alth

eff

ects

by

heal

th s

urve

illan

ce-A

pply

ind

ivid

ual-

base

d or

com

mun

ity-

base

d in

terv

enti

ons

to p

reve

nt o

r m

itiga

te e

xpos

ure

and

resu

ltant

hea

lth e

ffec

ts.

Dia

gnos

is o

f he

alth

eff

ects

with

hea

lth

surv

eilla

nce

-Eva

luat

ion

and

impr

ovem

ent

of w

orks

ites

with

spe

cifi

c he

alth

su

rvei

llanc

e

-Cli

nica

l-G

ener

al,

Car

diol

ogy,

Der

mat

olog

y, E

mer

genc

y M

edic

ine

and

Sur

gery

, H

emat

olog

y/O

ncol

ogy,

Inf

ecti

ous

Dis

ease

, M

uscu

losk

elet

al,

Neu

rolo

gy,

Oph

thal

mol

ogy,

Oto

lary

ngol

ogy,

Psy

chia

try,

Pul

mon

ary,

R

epro

duct

ive

Med

icin

e,-E

valu

ate,

trea

t, an

d pr

oper

ly r

efer

per

sons

who

se h

ealth

may

be

affe

cted

by

acut

e or

chr

onic

con

tact

with

occ

upat

iona

l and

env

iron

men

tal c

hem

ical

s.-D

istin

guis

h he

alth

eff

ects

of

expo

sure

to c

hem

ical

s fr

om o

ther

etio

logi

es.

-Dia

gnos

ing

wor

k-re

late

d ill

hea

lth-O

rgan

izin

g ap

prop

riat

e in

vest

igat

ions

for

dia

gnos

is o

f oc

cupa

tiona

l di

seas

e-D

iffe

rent

ial

diag

nose

s of

wor

k-re

late

d an

d en

viro

nmen

t-re

late

d di

s-ea

se-A

pplic

atio

n of

erg

onom

ics

to r

ehab

ilita

tion

Ris

k re

duct

ion

Cau

se a

naly

sis

of in

dust

rial

acc

iden

ts o

r oc

cupa

tiona

l dis

ease

s-P

artic

ipat

ing

in a

naly

sis

of o

ccup

atio

nal a

ccid

ents

and

dis

ease

s

Prio

ritiz

atio

n of

ris

ks f

or r

educ

tion

plan

s-P

rior

itiza

tion

of h

ealth

ris

ks-A

dvis

e em

ploy

ers

and

empl

oyee

s re

gard

ing

indu

stri

al h

ygie

ne c

ontr

ols,

su

ch a

s w

ork

prac

tices

, res

pira

tor

use,

and

eng

inee

ring

con

trol

s.-R

ecom

men

d an

d im

plem

ent

poli

cies

and

con

trol

mea

sure

s to

red

uce

or

miti

gate

saf

ety

and

heal

th h

azar

ds.

-Und

erta

king

wor

kpla

ce a

sses

smen

ts a

nd a

dvis

ing

on c

ontr

ol m

eth-

ods

-Ass

essi

ng c

ontr

ol s

yste

ms

desi

gned

to e

limin

ate

or r

educ

e ex

posu

re-S

elec

ting

appr

opri

ate

pers

onal

pro

tect

ive

equi

pmen

t w

ith t

he a

ssis

-ta

nce

of o

ther

exp

erts

as

requ

ired

Ris

k re

duct

ion

met

hods

and

pla

ns-A

dvic

e on

sel

ectio

n an

d pl

an-

ning

of

risk

con

trol

mea

sure

s

Exe

cutio

n of

ris

k re

duct

ion

plan

s-P

lann

ing

and

exec

utio

n of

trai

n-in

g pr

ogra

ms

on r

isk

cont

rol

-Ass

essi

ng c

ontr

ol s

yste

ms

desi

gned

to e

limin

ate

or r

educ

e ex

posu

re

Ris

k co

mm

unic

atio

n

Edu

catio

n pr

ogra

ms

on r

isk

redu

ctio

n-R

isk

com

mun

icat

ion

base

d on

sc

ient

ific

evi

denc

e

-Com

mun

icat

e to

tar

get

grou

ps i

nclu

ding

hea

lth

prof

essi

onal

s, t

he p

ubli

c,

and

the

med

ia,

in a

cle

ar a

nd e

ffec

tive

man

ner

both

ora

lly a

nd i

n w

ritin

g,

the

leve

ls o

f ri

sk f

rom

rea

l or

pote

ntia

l haz

ards

and

the

ratio

nale

for

sel

ecte

d in

terv

entio

ns.

-Com

mun

icat

e cu

rren

t m

edic

al,

envi

ronm

enta

l, an

d ot

her

scie

ntif

ic k

now

l-ed

ge e

ffec

tivel

y to

tar

get

grou

ps, i

nclu

ding

pat

ient

s, e

mpl

oyee

s, e

mpl

oyer

s,

unio

ns, c

omm

unity

gro

ups,

and

the

med

ia.

-Acc

omm

odat

e cu

ltura

l, et

hnic

, edu

catio

nal,

and

lang

uage

var

iatio

ns a

mon

g w

orke

rs w

hen

prov

idin

g in

form

atio

n on

occ

upat

iona

l ha

zard

pre

vent

ion,

di

seas

e pr

even

tion,

and

hea

lth p

rom

otio

n.

-Com

mun

icat

ing

wit

h pe

ople

fro

m v

ario

us b

ackg

roun

ds a

nd w

ith

diff

eren

t lev

els

of te

chni

cal u

nder

stan

ding

Ris

k co

mm

unic

atio

n to

wor

kers

-Con

firm

atio

n an

d ev

alua

tion

of

risk

con

trol

-Mak

ing

clea

r or

al p

rese

ntat

ions

Wor

k lo

ad a

nd r

ecov

ery

from

fat

igue

Eva

luat

ion

of p

sych

olog

ical

and

phy

si-

cal l

oad

-Ass

essm

ent o

f lo

ad o

f ta

sks

and

wor

k sh

ifts

-App

ly e

rgon

omic

pri

ncip

les

to o

ptim

ize

com

fort

and

red

uce

risk

at

wor

k,

incl

udin

g ev

alua

tion

and

red

esig

n of

haz

ardo

us l

ifti

ng j

obs,

rep

etit

ive

mot

ion

wor

k, a

nd jo

bs w

ith s

peci

al v

isua

l dem

ands

.

-Adv

ise

on th

e er

gono

mic

des

ign

of th

e w

orkp

lace

and

wor

king

tool

s

Des

ign

wor

k to

hav

e a

smal

l loa

d-A

dvic

e on

job

desi

gn

Des

ign

of o

ffic

es a

nd f

acili

ties

for

empl

oyee

s' w

elfa

re-A

dvic

e on

des

irab

le w

ork

envi

-ro

nmen

t and

off

ice

amen

ities

Cou

nter

mea

sure

s ag

ains

t psy

chos

ocia

l hea

lth h

azar

ds

Men

tal h

ealth

pro

gram

s-M

enta

l hea

lth p

rogr

ams

-App

licat

ion

of o

rgan

izat

iona

l ps

ycho

logy

to

reha

bilit

atio

n in

situ

a-tio

ns o

f w

ork-

rela

ted

men

tal i

ll he

alth

Prog

ram

s to

com

bat h

ealth

eff

ects

due

to

ove

rwor

k-C

ount

erm

easu

res

for

over

wor

k

JSO

H, J

apan

Soc

iety

for

Occ

upat

iona

l Hea

lth; A

CO

EM

, Am

eric

an C

olle

ge o

f O

ccup

atio

nal a

nd E

nvir

onm

enta

l Hea

lth8); W

HO

Eur

ope,

WH

O E

urop

ean

Cen

tre

for

Env

iron

men

t and

Hea

lth13

) .

131Koji MORI, et al.: Competencies of specialist ops and training methodsTa

ble

1d.

Dev

elop

men

t of

a co

mpe

tenc

y lis

t for

the

ques

tionn

aire

s by

com

pari

ng th

e lis

ts f

rom

Jap

an, t

he U

S an

d E

urop

e

Que

stio

nnai

reJS

OH

AC

OE

MW

HO

Eur

ope

Hea

lth c

are

and

prom

otio

n

Peri

odic

gen

eral

hea

lth e

xam

inat

ion

-Pla

nnin

g an

d ex

ecut

ion

of

gene

ral h

ealth

exa

ms

and

heal

th

mea

sure

men

ts

-Des

ign,

im

plem

ent

and

eval

uate

wor

ksite

hea

lth p

rom

otio

n an

d di

seas

e pr

even

tion

pro

gram

s, i

ncor

pora

ting

Dep

artm

ent

of H

ealt

h an

d H

uman

Se

rvic

es a

nd o

ther

aut

hori

tativ

e gu

idel

ines

as

appr

opri

ate.

-Des

crib

e th

e ap

prop

riat

e us

e an

d lim

itatio

ns o

f he

alth

ris

k as

sess

men

t an

d sc

reen

ing

for

wel

l po

pula

tion

s an

d th

e ap

plic

atio

ns o

f sc

reen

ing,

as

sess

men

t, an

d ea

rly

inte

rven

tion

for

targ

eted

hig

h-ri

sk g

roup

s.

-Per

iodi

c ex

amin

atio

ns-A

naly

sis

of th

e et

hica

l asp

ects

of

heal

th s

cree

ning

-Coo

rdin

atin

g he

alth

sur

veill

ance

and

bio

logi

cal

mon

itori

ng w

ith e

nvi-

ronm

enta

l sur

veill

ance

and

oth

er r

isk

asse

ssm

ents

Eva

luat

ion

of h

ealth

con

ditio

n of

em

ploy

ee g

roup

-Eva

luat

ion

of h

ealth

con

ditio

n as

a g

roup

-Ana

lyzi

ng r

outi

nely

col

lect

ed d

ata,

inc

ludi

ng s

ickn

ess

abse

nce

and

acci

dent

dat

a

Hea

lth c

are

for

elde

r or

fem

ale

empl

oyee

s

-Hea

lth c

are

base

d on

cha

rac-

teri

stic

s, s

uch

as e

lder

age

and

fe

mal

e se

x

-Per

iodi

c ex

amin

atio

ns-E

xit e

xam

inat

ions

on

leav

ing

the

ente

rpri

se-M

anag

emen

t of

wor

kers

with

dru

g or

alc

ohol

pro

blem

s

Hea

lth g

uida

nce

base

d on

hea

lth

exam

inat

ion

-Hea

lth g

uida

nce

acco

rdin

g to

he

alth

exa

m-C

ouns

el e

mpl

oyee

s ab

out h

ealth

ris

ks a

nd li

fest

yle.

-Cou

nsel

ling

Edu

catio

n on

hea

lth p

rom

otio

n fo

r em

ploy

ee g

roup

-Hea

lth e

duca

tion

-Des

ign

and

impl

emen

t pr

oact

ive

syst

ems

of c

are

that

eff

ectiv

ely

reac

h al

l m

embe

rs o

f a

popu

latio

n, i

nclu

ding

tho

se a

t hi

gh r

isk

and

thos

e w

ho

do n

ot n

orm

ally

see

k ca

re.

-Hea

lth p

rom

otio

n ne

eds

anal

ysis

of

the

wor

king

pop

ulat

ion

-Adv

ocat

ing

and

man

agin

g an

agr

eed

wor

kpla

ce h

ealth

pro

mot

ion

pro-

gram

e-S

eeki

ng p

arti

cipa

tion

of

wor

kers

and

em

ploy

ers

in t

he d

esig

n an

d im

plem

enta

tion

of

wor

k-re

late

d he

alth

pro

mot

ion

and

wor

king

abi

lity

m

aint

enan

ce p

rogr

ames

-Eva

luat

ing

and

audi

ting

wor

kpla

ce h

ealth

pro

mot

ion

-Pro

gram

es,

espe

cial

ly w

ith

rega

rd t

o th

eir

rele

vanc

e to

occ

upat

iona

l he

alth

haz

ards

in

the

wor

kpla

ce a

nd t

he c

ontr

ol o

f no

nocc

upat

iona

l de

term

inan

ts o

f he

alth

and

wor

king

abi

lity

Wor

k ac

com

mod

atio

n

Proc

edur

es o

f fi

tnes

s fo

r du

ty a

sses

s-m

ent a

nd w

ork

acco

mm

odat

ion

-Adv

ice

on d

evel

opm

ent o

f pr

o-ce

dure

s of

wor

k ac

com

mod

atio

n

-Des

ign

and

impl

emen

t in

tegr

ated

sys

tem

s of

dis

abili

ty p

reve

ntio

n an

d m

anag

emen

t.-D

esig

n pr

otoc

ols

for

prep

lace

men

t an

d re

turn

-to-

wor

k ev

alua

tion

s.

Impl

emen

t sta

y at

wor

k an

d ea

rly

retu

rn to

wor

k pr

otoc

ols.

-Des

ign

and

impl

emen

t pr

otoc

ols

to e

valu

ate

empl

oyee

s fo

r co

nditi

ons

crea

ting

an u

ndue

ris

k to

sel

f or

oth

ers

in t

he w

orkp

lace

, in

com

plia

nce

with

the

AD

A.

Prof

essi

onal

opi

nion

s on

fitn

ess

for

duty

an

d w

ork

acco

mm

odat

ion

-Adv

ice

of w

ork

acco

mm

odat

ion

acco

rdin

g to

hea

lth e

xam

-Pre

plac

emen

t hea

lth s

cree

ning

and

med

ical

exa

min

atio

ns-A

sses

smen

t of

dis

abili

ty a

nd f

itnes

s fo

r w

ork,

rep

lace

men

t an

d fo

llow

-in

g w

ork-

rela

ted

illne

ss/in

jury

Wor

k ac

com

mod

atio

n up

on r

etur

ning

to

wor

k or

dur

ing

preg

nanc

y

-Adv

ice

of w

ork

acco

mm

odat

ion

at r

etur

ning

to w

ork

and

duri

ng

preg

nanc

y

-Add

ress

em

ploy

men

t con

cern

s fo

r pa

tient

s w

ith m

edic

al c

ondi

tions

.-C

ondu

ct e

valu

atio

ns t

o de

term

ine

fitn

ess

for

duty

in

com

plia

nce

with

ap

plic

able

reg

ulat

ions

incl

udin

g th

e A

DA

.-A

sses

s im

pair

men

t ra

ting

s in

acc

orda

nce

wit

h th

e A

mer

ican

Med

ical

A

ssoc

iatio

n G

uide

s to

the

Eva

luat

ion

of P

erm

anen

t Im

pair

men

t.-I

dent

ify

and

man

age

the

impa

ct o

f ps

ycho

logi

cal

cond

ition

s on

abi

lity

to w

ork

and

on th

e na

tura

l his

tory

of

occu

patio

nal a

nd e

nvir

onm

enta

l ill

-ne

sses

and

inju

ries

.

-Cou

nsel

ling

em

ploy

ees

rega

rdin

g si

ckne

ss a

bsen

ce a

sses

smen

t of

im

pair

men

t, di

sabi

lity

and

hand

icap

in r

elat

ion

to w

ork

-Clin

ical

man

agem

ent i

n re

habi

litat

ion

of d

isab

led

wor

kers

-Adv

isin

g on

reh

abili

tatio

n an

d re

depl

oym

ent

-Adv

isin

g on

mai

ntai

ning

agi

ng a

nd d

isab

led

wor

kers

in w

ork

Impr

ovem

ent o

f w

ork

abili

ties

of e

lder

, ill

or

hand

icap

ped

empl

oyee

s-P

rom

otin

g w

ork

abil

ity:

hea

lth,

ski

lls

and

trai

ning

in

rela

tion

to

the

dem

ands

of

wor

k

Prot

ectio

n of

rep

rodu

ctiv

e fu

nctio

n of

fe

mal

e em

ploy

ees

-Adv

ise

on p

olic

ies

and

proc

edur

es r

elat

ing

to t

he p

rote

ctio

n of

fer

tility

fo

r bo

th m

en a

nd w

omen

and

for

the

pla

cem

ent

of p

regn

ant

or l

acta

ting

wor

kers

.-R

ecom

men

d ap

prop

riat

e ac

com

mod

atio

ns a

nd jo

b pl

acem

ents

for

pre

g-na

nt e

mpl

oyee

s.

-Adv

isin

g on

fitn

ess

for

wor

k an

d ad

apta

tion

of w

ork

to t

he w

orke

r in

th

e sp

ecia

l ci

rcum

stan

ces

of v

ulne

rabl

e gr

oups

and

spe

cifi

c le

gisl

atio

n,

for

exam

ple,

the

EU

Dir

ectiv

e on

Pro

tect

ion

of P

regn

ant

and

Lac

tatin

g M

othe

rs 9

2/85

/EC

JSO

H, J

apan

Soc

iety

for

Occ

upat

iona

l Hea

lth; A

CO

EM

, Am

eric

an C

olle

ge o

f O

ccup

atio

nal a

nd E

nvir

onm

enta

l Hea

lth8); W

HO

Eur

ope,

WH

O E

urop

ean

Cen

tre

for

Env

iron

men

t and

Hea

lth13

) .


ble

1e.

Dev

elop

men

t of

a co

mpe

tenc

y lis

t for

the

ques

tionn

aire

s by

com

pari

ng th

e lis

ts f

rom

Jap

an, t

he U

S an

d E

urop

e

Que

stio

nnai

reJS

OH

AC

OE

MW

HO

Eur

ope

Firs

t aid

and

em

erge

ncy

resp

onse

Firs

t aid

ski

lls a

nd tr

aini

ng f

or

empl

oyee

s-F

irst

aid

ski

lls a

nd tr

aini

ng o

f w

orke

rs-A

dvis

ing

on t

he p

rovi

sion

of

firs

t ai

d fa

cilit

ies

and

emer

genc

y pr

oce-

dure

s

Firs

t aid

pla

n an

d ar

rang

emen

t for

eq

uipm

ent

-Pla

nnin

g of

fir

st a

id a

nd a

rran

gem

ent o

f ne

cess

ary

equi

pmen

t

-App

ly k

now

ledg

e of

per

sona

l pr

otec

tion

and

oth

er a

ppli

ed a

ppro

ache

s to

he

alth

pro

tect

ion

and

the

skill

s to

eva

luat

e th

e ad

equa

cy o

f pr

otec

tion

at t

he

indi

vidu

al le

vel.

-Est

ablis

h em

erge

ncy

proc

edur

es a

nd p

roto

cols

for

the

clin

ical

man

agem

ent

of i

ndiv

idua

ls i

nvol

ved

in d

isas

ter

inci

dent

s, i

nclu

ding

spe

cifi

c m

edic

al m

an-

agem

ent p

roto

cols

.

Em

erge

ncy

resp

onse

pla

n-A

dvic

e du

ring

pla

nnin

g of

em

erge

ncy

resp

onse

pla

n

-Par

ticip

ate

in t

he d

evel

opm

ent

of e

mer

genc

y or

dis

aste

r pl

ans

for

the

wor

k-pl

ace

and

the

com

mun

ity.

-Des

ign

and

impl

emen

t a

plan

for

the

mit

igat

ion

of a

dis

aste

r in

cide

nt a

t a

wor

ksite

or

in th

e ge

nera

l com

mun

ity.

Des

ign

and

impl

emen

t a

med

ical

rec

over

y pl

an f

or m

ass

casu

alty

eve

nts

in

indu

stri

es o

r th

e ge

nera

l com

mun

ity.

-Des

ign

and

cond

uct a

n ou

tbre

ak o

r cl

uste

r in

vest

igat

ion.

-D

esig

n a

pand

emic

pre

pare

dnes

s pl

an f

or a

n or

gani

zatio

n.-M

aint

ain

a th

orou

gh u

nder

stan

ding

of

the

Nat

iona

l R

espo

nse

Pla

n an

d In

cide

nt C

omm

and

Stru

ctur

e.-R

ecom

men

d an

d im

plem

ent p

olic

ies

and

cont

rol m

easu

res

to a

ddre

ss e

mer

g-in

g in

fect

ious

dis

ease

s of

con

cern

.

Env

iron

men

t pro

tect

ion

Wor

ksite

issu

es a

nd a

pplic

able

re

gula

tions

on

envi

ronm

enta

l pr

otec

tion

-Und

erst

andi

ng o

f en

viro

nmen

-ta

l man

agem

ent s

yste

m a

nd

rela

ted

regu

latio

ns-A

dvis

ing

man

ager

s on

the

im

plem

enta

tion

of

heal

th a

nd s

afet

y an

d en

viro

nmen

tal l

aw

Prof

essi

onal

sup

port

for

env

iron

-m

ent p

rote

ctio

n-C

ontr

ibut

ion

to e

nvir

onm

enta

l m

anag

emen

t pra

ctic

es in

the

wor

kpla

ces

-Ide

ntif

y so

urce

s an

d ro

utes

of

envi

ronm

enta

l ex

posu

re a

nd r

ecom

men

d m

etho

ds o

f re

duci

ng e

nvir

onm

enta

l hea

lth r

isks

.-A

dvis

e in

divi

dual

s an

d co

mm

uniti

es a

bout

the

rep

rodu

ctiv

e im

plic

atio

ns o

f en

viro

nmen

tal e

xpos

ure.

-Adv

ise

indi

vidu

als

and

com

mun

ities

abo

ut t

he r

epro

duct

ive

impl

icat

ions

of

envi

ronm

enta

l exp

osur

e.-M

anag

e he

alth

eff

ects

ass

ocia

ted

with

air

, wat

er, o

r gr

ound

con

tam

inat

ion

by

natu

ral o

r ar

tific

ial p

ollu

tant

s.-R

ecom

men

d, in

terp

ret,

and

expl

ain

the

resu

lts o

f en

viro

nmen

tal m

onito

ring

.

-Ide

ntif

ying

, as

sess

ing

and

advi

sing

on

the

prev

entio

n of

env

iron

men

tal

haza

rds

aris

ing,

or

whi

ch m

ay r

esul

t, fr

om o

pera

tions

or

proc

esse

s in

the

ente

rpri

se-R

ecog

nizi

ng a

nd a

dvis

ing

on h

azar

dous

exp

osur

es i

n th

e ge

nera

l en

vi-

ronm

ent a

risi

ng f

rom

oth

er s

ourc

es o

r ac

tiviti

es

Scie

ntif

ic r

esea

rch

Plan

ning

and

exe

cutio

n of

sci

entif

ic

rese

arch

on

occu

patio

nal h

ealth

is

sues

-Des

ign

and

exec

utio

n of

re

sear

ch o

n O

H-R

ecog

nize

and

inve

stig

ate

pote

ntia

l sen

tinel

eve

nts.

-App

ly v

alid

ated

epi

dem

iolo

gic

and

bios

tatis

tical

pri

ncip

les

and

tech

niqu

es to

an

alyz

e in

jury

or

illne

ss d

ata

in a

def

ined

wor

ker

and

com

mun

ity p

opul

atio

ns.

-Org

aniz

ing

data

base

s (i

nclu

ding

com

pute

rize

d da

taba

ses

and

(pos

sibl

y)

web

site

s) f

or t

he d

isse

min

atio

n an

d pu

blic

atio

n of

res

earc

h in

occ

upa-

tiona

l hea

lth a

nd s

afet

y m

atte

rs-P

lann

ing

sim

ple

surv

eys

-Pro

mot

ing

mul

tidis

cipl

inar

y sc

ient

ific

wor

k on

exp

osur

e da

ta g

athe

ring

Exe

cutio

n an

d pr

esen

tatio

n of

re

sear

ch f

ollo

win

g co

des

of e

thic

s-E

xecu

tion

and

pres

enta

tion

of

rese

arch

in c

ompl

ianc

e w

ith

code

s of

eth

ics

-Con

duct

ing

a fo

rmal

sci

enti

fic

inve

stig

atio

n; c

arry

ing

out

a li

tera

ture

se

arch

and

pre

pari

ng a

rep

ort

-Int

erpr

etin

g sc

ient

ific

dat

a in

jour

nals

and

for

m o

wn

rese

arch

-Rec

ogni

zing

and

initi

atin

g an

inve

stig

atio

n of

wor

k ab

ility

, hea

lth d

eter

-m

inan

ts a

nd d

isea

se in

the

wor

kfor

ce

Aud

itO

ccup

atio

nal s

afet

y an

d he

alth

aud

it an

d re

port

ing

-Con

trib

utio

n to

OSH

aud

it an

d re

port

ing

Col

labo

ratio

n w

ith p

artie

s in

side

or

outs

ide

of c

ompa

ny

Com

mun

icat

ion

with

em

ploy

ers

and

unio

ns-C

omm

unic

atio

n w

ith e

mpl

oy-

ers

and

unio

ns-W

ork

effe

ctiv

ely

wit

h bo

th l

abor

and

man

agem

ent

to m

axim

ize

wor

kpla

ce

heal

th, s

afet

y, a

nd p

rodu

ctiv

ity.

-Coo

rdin

atin

g di

scus

sion

s le

adin

g to

agr

eem

ent

by b

oth

man

agem

ent

and

wor

kfor

ce r

epre

sent

ativ

es-E

nsur

ing

wor

kers

are

ful

ly in

form

ed o

f po

licy

and

of th

eir

righ

ts-R

epor

ting

reg

ular

ly t

o m

anag

emen

t an

d th

e w

orkf

orce

ora

lly

and

in

wri

ting

Col

labo

ratio

n w

ith h

uman

res

ourc

es

and

safe

ty d

epar

tmen

ts-C

olla

bora

tion

with

HR

and

sa

fety

dep

artm

ents

Util

izat

ion

of p

ublic

res

ourc

es a

nd

cont

ribu

tion

to c

omm

unity

-Util

izat

ion

of p

ublic

res

ourc

es

and

cont

ribu

tion

to c

omm

unity

-Com

mun

icat

e te

chni

cal

and

clin

ical

inf

orm

atio

n to

pro

fess

iona

l an

d la

y au

dien

ces.

-Com

mun

icat

ing

with

oth

er p

rofe

ssio

nals

to

orga

nize

and

del

iver

tra

in-

ing

appr

opri

atel

y

JSO

H, J

apan

Soc

iety

for

Occ

upat

iona

l Hea

lth; A

CO

EM

, Am

eric

an C

olle

ge o

f O

ccup

atio

nal a

nd E

nvir

onm

enta

l Hea

lth8); W

HO

Eur

ope,

WH

O E

urop

ean

Cen

tre

for

Env

iron

men

t and

Hea

lth13

) .


which was most effective for each of the 61 compe-tencies.

COP examiners are elected from among CSOPs and evaluate the attainment of the competencies of candi-date COPs. They were therefore considered appropri-ate respondents for the survey on effective training methods for acquiring competencies as specialist occupational physicians. We directly asked all 22 COP examiners in 2013 at the examination site to participate, and responses were collected in person or by mail by the end of September, 2013.

Training methods for which half or more of the respondents answered “yes” were considered effective, and the method chosen by the greatest number of respondents as most effective was considered the most effective.

Ethical considerationsThe research procedures were approved by

the ethics review committee at the University of Occupational and Environmental Health, Japan. We obtained a list of CSOPs from the secretary’s office for the certification program in accordance with the official procedures of the JSOH. The list was destroyed once the study was completed.

Results

Study 1: Survey on Necessary Competencies for Specialist Occupational Physicians in Japan

The number of respondents was 172 (response rate 55.8%). After excluding 24 incomplete responses, 148 (effective response rate 48.1%) respondents remained for analysis. The demographic characteristics of the respondents are shown in Table 2. Most respondents (62.2%) were in the “practical” category; 25.6% were

in the “academic” category, and 12.2% in the “other” category. Most respondents (93.9%) had worked for a manufacturing company as a full-time or part-time occupational physician. All had experience as occupational physicians in a company. Among them, 72.3% had experience as a full-time (staff) occupa-tional physician, and 81.8% had experience as a part-time (contract-based) occupational physician.

As shown in Table 3, the mean scores for the all competencies were greater than 3, “somewhat neces-sary”, but those of 18 items were lower than 4, “necessary”. Among the 50 competencies that were included in the JSOH list, 14 received mean scores lower than 4. Of the 11 competencies that were added from the American and/or European lists, 7 received scores greater than 4.

The “practical group” gave significantly higher mean scores for 11 competencies than the “academic group”. This was particularly true for competencies related to work accommodation based on individual health condition, such as “procedures of fitness for duty assessment and work accommodation”, “profes-sional opinions on fitness for duty and work accom-modation”, and “work accommodation at return to work or during pregnancy”.

All of the suggested additional competencies were already included in the 61 competencies or were suggested by only a single respondent, with the excep-tion of “be able to train non-specialist occupational physicians”, which was suggested by 4 respondents.

The rankings of the mean scores among the 61 items are also shown in Table 3. There were 7 items in the JSOH’s current competency list with mean scores in a position lower than 51st. They were “documentation of occupational health procedures”,

Table 2. The demographic characteristics of the respondents in the survey

Employment condition

Practical 92 62.2%

Full time for company 58

Full time for occupational health service institute 16

Private occupational health service 18

Academic 38 25.6%

Academic institute 38

The others 18 12.2%

Mainly clinical practice in hospital or clinic 13

Others 5

Experiences as an occupational physician

Full time occupational physician 107 72.3%

Part time occupational physician 121 81.8%

Either full time or part time 148 100.0%

At a manufacturing worksite 139 93.9%


Table 3. Necessity of competencies for specialist occupational physicians

Items in JSOH list

Mean scores pvalue+ Rank*

Overall Academic Practical

Attitude and ethics for occupational physicians

Position and fundamental roles Y 4.86 4.95 4.85 0.053 1

Code of ethics Y 4.67 4.76 4.64 0.189 3

Personal health data handling Y 4.73 4.84 4.69 0.079 2

Understanding of customers of occupational health services

Analysis of characteristics of companies and workers Y 4.47 4.40 4.52 0.271 13

Assessment of occupational health needs Y 4.64 4.63 4.62 0.899 4

Occupational health services considering social and cultural diversity N 4.10 3.97 4.14 0.237 37

Understanding of related regulations and compliance

Compliance with occupational health regulations Y 4.57 4.47 4.64 0.117 7

Application of amended occupational health regulations N 4.34 4.23 4.40 0.170 19

Application of industrial injury insurance N 4.16 3.87 4.23 0.012 32

Document structures and plans

Policy statement on occupational health Y 4.30 4.11 4.34 0.059 22

Objectives of occupational health programs Y 4.05 3.97 4.05 0.564 41

Plans of occupational health programs Y 4.16 4.08 4.18 0.458 33

Documentation of occupational health procedures Y 3.74 3.63 3.76 0.340 52

Records and reports of occupational health activities N 3.76 3.68 3.76 0.566 51

Information system for occupational health services N 3.70 3.50 3.75 0.074 54

Occupational health organization and roles of occupational physicians

Evaluation of necessary expertise and system Y 4.13 4.11 4.13 0.822 35

Organization of occupational health team N 4.14 3.92 4.22 0.029 34

Cooperation with occupational health staff Y 4.37 4.37 4.34 0.822 18

Quality management of occupational health services N 3.38 3.24 3.38 0.312 61

Budget for occupational health department N 3.51 3.50 3.44 0.721 58

Contribution to health committee Y 4.62 4.71 4.57 0.163 5

Risk assessment

Identification of existing health hazards Y 4.48 4.37 4.49 0.339 11

Information of existing health hazards Y 4.42 4.24 4.47 0.056 15

Monitoring of exposure to health hazards Y 4.28 4.16 4.29 0.337 24

Assessment of health risks Y 4.29 4.13 4.31 0.159 23

Health surveillance, diagnosis and treatment

Indicators of health effects for health surveillance Y 4.02 3.95 4.00 0.705 42

Quality assurance programs of laboratories Y 3.73 3.42 3.83 0.002 53

Utilization of health surveillance for workplace improvement Y 4.52 4.29 4.50 0.070 14

Diagnosis of health effects with health surveillance Y 4.24 4.03 4.26 0.120 27

Risk reduction

Cause analysis of industrial accidents or occupational diseases N 4.34 4.29 4.32 0.807 20

Prioritization of risks for reduction plans Y 3.99 3.92 4.00 0.567 44

Risk reduction methods and plans Y 4.07 3.92 4.10 0.172 38

Execution of risk reduction plans Y 3.94 3.82 3.95 0.346 46

Risk communication

Education programs on risk reduction Y 3.89 3.76 3.90 0.330 47

Risk communication to workers Y 4.19 4.05 4.24 0.172 31

Work load and recovery from fatigue

Evaluation of psychological and physical load Y 4.02 3.97 4.26 0.031 28

Desing of work to have a small load Y 4.11 3.92 4.13 0.117 36

Design of offices and facilities for employees’ welfare Y 3.84 3.74 3.83 0.514 50

Countermeasures against psychosocial health hazards

Mental health programs Y 4.50 4.34 4.53 0.108 10

Programs to combat health effects due to overwork Y 4.48 4.26 4.55 0.017 12


“quality assurance programs of laboratories”, “worksite issues and applicable regulations on environmental protection”, “professional support for environmen-tal protection”, “planning and execution of scientific research on occupational health issues”, “execu-tion and presentation of research following codes of ethics” and “occupational safety and health audit and reporting”. In contrast, there were 7 items with mean scores in a position higher than 40th among the addi-tional items from the lists for the US and Europe. They were “occupational health services considering social and cultural diversity”, “application of amended occupational health regulations”, “application of indus-trial injury insurance”, “organization of occupational health team”, “cause analysis of industrial accidents or occupational diseases”, “improvement of work abilities of elder, ill or handicapped employees” and “protection of reproductive function of female employees”.

Study 2: Survey on Effective Training Methods to Acquire Competencies

As shown in Table 4, among the three training methods suggested, OJT and CBL were judged effec-tive for all competencies. Lectures and textbooks were not judged effective for 10 items.

Lectures and textbooks were the most effective methods for only 5 items. OJT was evaluated as the most effective for 30 items, and many of them were related to legally regulated activities in Japan, such as “contribution to health committees”, “periodic general health examinations” and “programs to combat health effects due to overwork”. CBL were valuated as the most effective for 29 items, and conversely, many of them were related to services based on individual health conditions, such as “mental health programs”, “procedures of fitness for duty assessment and work accommodation” and “work accommodation at return to work or during pregnancy”, and related to ethical

Items in JSOH list

Mean scores pvalue+ Rank*

Overall Academic Practical

Health care and promotion

Periodic general health examination Y 4.26 4.13 4.26 0.381 26

Evaluation of health condition of employee group Y 4.20 4.05 4.24 0.086 30

Health care for elder or female employees Y 4.07 3.87 4.13 0.034 40

Health guidance based on health examination Y 4.39 4.24 4.42 0.197 17

Education on health promotion for employee group Y 4.33 4.16 4.36 0.150 21

Work accommodation

Procedures of fitness for duty assessment and work accommodation Y 4.51 4.29 4.56 0.033 9

Professional opinions on fitness for duty and work accommodation Y 4.59 4.40 4.63 0.047 6

Work accommodation at return to work or during pregnancy Y 4.55 4.37 4.60 0.039 8

Improvement of work abilities of elder, ill or handicapped employees N 4.07 3.87 4.14 0.049 39

Protection of reproductive function of female employees N 4.20 4.18 4.19 0.992 29

First aid and emergency response

First aid skills and training for employees Y 3.95 3.76 4.00 0.157 45

First aid plan and arrangement for equipment Y 3.85 3.58 3.91 0.024 49

Emergency response plan Y 4.01 4.11 3.92 0.199 43

Environment protection

Worksite issues and applicable regulations on environmental protection Y 3.42 3.45 3.31 0.348 60

Professional support for environment protection Y 3.49 3.45 3.42 0.885 59

Scientific research

Planning and execution of scientific research on occupational health issues Y 3.61 3.68 3.56 0.361 56

Execution and presentation of research following codes of ethics Y 3.68 3.71 3.62 0.548 55

Audit

Occupational safety and health audit and reporting Y 3.58 3.56 3.54 0.923 57

Collaboration with parties inside or outside of company

Communication with employers and unions Y 4.28 4.37 4.26 0.425 25

Collaboration with human resources and safety departments Y 4.42 4.34 4.46 0.348 16

Utilization of public resources and contribution to community Y 3.88 3.79 3.91 0.447 48

+p values for the Student’s t-test or Welch’s t-test for comparisons of mean scores between the practical and academic groups. *Rank of the mean score overall.

Table 3. Necessity of competencies for specialist occupational physicians (Continued)


Table 4. Effective methods for acquisition of competencies by specialist occupational physicians

Lectures and textbooks OJT CBL

EffectiveMost

effectiveEffective

Most effective

EffectiveMost

effective

Attitude and ethics for occupational physicians

Position and fundamental roles 12 5 19 11* 12 3

Code of ethics 13 7* 16 4 11 7*

Personal health data handling 12 4 17 4 16 9*

Understanding of customers of occupational health services

Analysis of characteristics of companies and workers 4+ 0 19 16* 14 2

Assessment of occupational health needs 11 1 18 16* 15 2

Occupational health services considering social and cultural diversity 11 1 16 11* 15 7

Understanding of related regulations and compliance

Compliance with occupational health regulations 19 10* 11 5 11 4

Application of amended occupational health regulations 16 3 13 5 11 11*

Application of industrial injury insurance 15 5 7 1 19 13*

Document structures and plans

Policy statement on occupational health 13 5 13 9* 12 5

Objectives of occupational health programs 9 0 17 12* 12 7

Plans of occupational health programs 11 0 17 13* 14 6

Documentation of occupational health procedures 14 0 16 12* 11 7

Records and reports of occupational health activities 13 2 17 11* 13 5

Information system for occupational health services 16 7 12 8 11 3

Occupational health organization and roles of occupational physicians

Evaluation of necessary expertise and system 12 2 16 10* 11 6

Organization of occupational health team 9 0 17 14* 13 4

Cooperation with occupational health staff 7+ 0 17 15* 10 3

Quality management of occupational health services 5+ 4 16 6 12 7*

Budget for occupational health department 11 0 15 13* 12 5

Contribution to health committee 11 0 18 15* 11 3

Risk assessment

Identification of existing health hazards 15 3 16 10* 14 6

Information of existing health hazards 18 5 15 4 15 10*

Monitoring of exposure to health hazards 18 2 16 8 16 9*

Assessment of health risks 17 1 13 7 17 11*

Health surveillance, diagnosis and treatment

Indicators of health effects for health surveillance 18 3 14 6 16 10*

Quality assurance programs of laboratories 18 4 13 5 15 10*

Utilization of health surveillance for workplace improvement 12 0 18 12* 17 7

Diagnosis of health effects with health surveillance 17 3 18 11* 14 5

Risk reduction 14 1 16 5 18 13*

Cause analysis of industrial accidents or occupational diseases

Prioritization of risks for reduction plans 17 2 15 7 17 10*

Risk reduction methods and plans 12 0 16 8 17 11*

Execution of risk reduction plans 11 1 15 9* 16 9*

Risk communication

Education programs on risk reduction 14 3 13 9* 15 7

Risk communication to workers 17 4 13 8* 14 7

Work load and recovery from fatigue

Evaluation of psychological and physical load 16 4 17 6 14 9*

Design of work to have a small load 17 2 16 6 14 11*

Design of offices and facilities for employees’ welfare 16 1 17 11* 14 7

Countermeasures against psychosocial health hazards

Mental health programs 14 0 17 9 19 10*

Programs to combat health effects due to overwork 13 0 18 12* 18 7


considerations, such as “codes of ethics” and “personal health data handling”.

Discussion

The results of these surveys offer some insights concerning the validity and improvement of the current competency list of the JSOH, and the appro-priate training methods for development of specialist occupational physicians in Japan.

Validity of the competency list for specialist occupa-tional physicians

The competency list for specialist occupational physicians used in the study was developed on the basis of the JSOH’s list and the lists generated by analogous institutions in the US and Europe. The required competencies should change with fluctua-tions in social dynamics and issues of occupational health. During performance of the study in 2014,

the ACOEM revised its competencies10), and the European Union of Medical Specialists issued the ATOM Portfolio of Performance-Based Assessments11). Therefore, the lists used in this study as references were not the latest versions. However, because the mean scores for all 61 items were evaluated higher than “somewhat necessary” and only one item was suggested to be added as a necessary competency by more than one respondent as a write-in comment, the list appears to have validity as a set of competencies for special occupational physicians under the current situation in Japan.

Validity of the competency list in the certification program of the JSOH and necessary improvements

All 51 items in the JSOH’s current competency list were judged as necessary, but some items scored lower than competencies added from the lists for the US and Europe. For those items, mean scores in a

Lectures and textbooks OJT CBL

EffectiveMost

effectiveEffective

Most effective

EffectiveMost

effective

Health care and promotion

Periodic general health examination 14 2 19 13* 13 4

Evaluation of health condition of employee group 18 3 15 7 12 9*

Health care for elder or female employees 15 3 16 4 17 12*

Health guidance based on health examination 14 0 17 14* 14 5

Education on health promotion for employee group 15 0 19 14* 16 5

Work accommodation

Procedures of fitness for duty assessment and work accommodation 8+ 0 19 7 18 12*

Professional opinions on fitness for duty and work accommodation 8+ 0 19 12* 17 7

Work accommodation at return to work or during pregnancy 11 0 17 6 18 13*

Improvement of work abilities of elder, ill or handicapped employees 15 1 15 1 19 17*

Protection of reproductive function of female employees 18 4 15 1 16 14*

First aid and emergency response

First aid skills and training for employees 15 4 12 4 17 11*

First aid plan and arrangement for equipment 16 7* 13 4 12 7*

Emergency response plan 15 3 15 4 16 12*

Environment protection

Worksite issues and applicable regulations on environmental protection 18 11* 10 2 10 6

Professional support for environment protection 15 4 12 8* 13 7

Scientific research

Planning and execution of scientific research on occupational health issues 19 5 14 3 15 11*

Execution and presentation of research following codes of ethics 16 7* 12 4 11 7*

Audit

Occupational safety and health audit and reporting 11 3 16 5 13 11*

Collaboration with parties inside or outside of company

Communication with employers and unions 5+ 0 18 15* 13 4

Collaboration with human resources and safety departments 4+ 0 19 17* 13 2

Utilization of public resources and contribution to community 8+ 0 18 15* 11 4

+ Less than half answered that the method is effective. * Highest number for the question asking which method was most effective.

Table 4. Effective methods for acquisition of competencies by specialist occupational physicians (Continued)


position lower than 51st were associated with devel-opment and execution of management systems, such as “documentation of occupational health procedures” and “occupational safety and health audit and report-ing”; with environment protection, such as “worksite issues and applicable regulations on environmental protection” and “professional support for environmen-tal protection”; and with scientific research, such as “plans and execution of scientific research on occu-pational health issues” and “execution and presenta-tion of research following codes of ethics”. These competencies are not always required for occupational physicians in actual health practices. The results are consistent with a report indicating that the item “design and initiate research” was evaluated lowest among 14 items in a survey of ACOEM members3) and a report indicating that necessities of environmental medicine and management competencies were evaluated lower than others in a survey of specialist occupational physicians in Europe12).

In contrast, there were 7 additional items from the lists for the US and Europe with mean scores in posi-tions higher than 40th. Among them, “cause analy-sis of industrial accidents or occupational diseases” is one of the occupational physicians’ roles in the Japanese regulations, and occupational physicians are often requested to play the other roles in actual practice, too. These should be considered for addi-tion to the JSOH’s list. The competencies for work accommodation specifically for vulnerable individuals, such as “improvement of work abilities of elder, ill or handicapped employees” and “protection of repro-ductive function of female employees”, were highly ranked. Arguably, this may be regarded as a part of the competency for “work accommodation at return to work or during pregnancy”, but a more concrete description of the competency would be desirable.

The minimum legal requirement for occupational physicians is completion of a 50-hour diploma level training program, and specialist occupational physi-cians train with occupational physicians at the diplo-ma level13). The write-in comments in this survey that suggested adding “be able to train non-specialist occupational physicians” might reflect this condition, and this competency should also be considered as an addition to the JSOH’s list. The competency list should be reviewed periodically, because the needs for occupational services are affected by changes in soci-ety, technology and other factors.

The practical group evaluated several competencies as more necessary than the academic group. Most of the competencies with significant group differences were related to work accommodation for individual workers based on their health condition. Activities such as evaluating fitness for work with face-to-face

interviews and advising individuals on improvements in lifestyle were recently enhanced as a part of mental health programs or countermeasures for overwork under governmental guidelines14, 15) or regulations16). Respondents in the “practical group”, who had actual experience in dealing with such issues, appear to have evaluated the necessity of those competencies higher.

Training methods to develop specialist occupational physicians

In general, the most frequently used methods for training the necessary competencies as specialist occu-pational physicians are lectures and textbooks and OJT. Lectures and textbooks were judged less effec-tive methods than others to acquire necessary compe-tencies in the study, but they are useful in acquiring basic knowledge. OJT was evaluated as the most effective for many of the items related to legally regu-lated activities in Japan. This method is considered to be useful in acquiring competencies for routine activi-ties under the condition that a senior occupational physician works together with a trainee or in a train-ing program. However, the fact that only one or a few occupational physicians are assigned to the same worksite makes it difficult to train many occupational physicians by OJT.

CBL was evaluated as effective for the all compe-tencies and as the most effective method for 29 of 61 items in the study. Conversely, it was evaluated as most effective for competencies related to services based on individual health conditions and those related to ethical considerations. Recently, CBL has been introduced in various training programs in public health and occupational health fields. For example, the Harvard School of Public Health has a course in which all classes use a “case method”4), and some undergraduate programs that utilize CBL have been reported in Europe6, 7). We also use a “case method” in postgraduate occupational health training courses at the University of Occupational and Environmental Health, Japan17). Given recent conditions in occupa-tional health, we propose that training programs with CBL components such as discussion of actual cases and use of the “case method” should be provided, and CSOPs should encourage trainees to take advantage of such opportunities.

Limitations of the studyThe main customers for occupational health services

are employers and employees. Although it has been suggested that the viewpoints of these customers are important when considering the necessary competen-cies of occupational physicans18, 19), they have now been confirmed by specialist viewpoints in this study.

Because we were concerned that a complex ques-


tionnaire with two objectives would make the response rate prohibitively low, validity of the competency list and effective training methods to acquire the compe-tencies were studied with separate questionnaires and different groups. CSOPs were chosen as the subjects for the validity survey because they actually train the candidates of COPs; COP examiners, who were also CSOPs, were chosen for the training method survey because they understand the attainments and weak-nesses of examinees. However, the low response rate of 48.1% for the validity survey and the small sample size of 19 for the training methods survey were factors that limit interpretation of the results.

Acknowledgments: We thank the CSOPs and COP examiners from the JSOH for their cooperation. This study was supported by the Occupational Health Promotion Foundation.

References

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3) Baker BA, Dodd K, Greaves IA, Zheng CJ, Brosseau L, Guidotti T. Occupational medicine physicians in the United States: demographics and core competencies. J Occup Environ Med 2007; 49: 388−400.

4) Harvard School of Public Health. Case-based learn-ing. HSPH News. [Online]. [cited 2014 Oct 24]; Available from: URL: http://www.hsph.harvard.edu/news/magazine/spr09case/.

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6) Braeckman L, Bekaert M, Cobbaut L, Ridder MD, Glazemakers J, Kiss P. Workplace visits versus case studies in undergraduate occupational medicine teaching. J Occup Environ Med 2009; 51: 1455−9.

7) Brackman LA, Fieuw AM, Van Bogaert HJ. A web- and case-based learning program for postgraduate students in occupational medicine. Int J Occup Environ Health 2007; 14: 51−6.

8) A m e r i c a n C o l l e g e o f O c c u p a t i o n a l a n d Environmental Medicine. American College of Occupational and Environmental Medicine compe-tencies—2008. J Occup Environ Med 2008; 50: 712−24.

9) World Health Organization. Global strategy on occu-pational health for all: the way to health at work. Recommendations of the Second Meeting of the

WHO Collaborating Centers in Occupational Health. Geneva(Switzerland): WHO; 1995.

10) Cloeren M, Gean C, Kesler D, et al. American College of Occupational and Environmental Medicine’s Occupational and Environmental Medicine Competencies-2014: ACOEM OEM Competencies Task Force. J Occup Environ Med 2014; 56: e21−40.

11) UEMS Occupational Medicine. Assessment Tool for Occupational Medicine, Portfolio of Performance-Based Assessments. [Online]. 2014 [cited 2014 Oct 24]; Available from: URL:http://www.gla.ac.uk/researchinstitutes/healthwellbeing/research/publichealth/hwlgroup/atom/http://www.uems-occupationalmedicine.org/sites/default/files/Meetings/Dresen/item_5.2.2_-_occupational_medicine_-_ e u r o p e a n _ t r a i n i n g _ r e q u i r e m e n t s _ -_2013.03.11_annex_2_-_for_adoption.pdf

12) Macdonald EB, Ritchie KA, Murray KJ, et al. Requirements for occupational medicine training in Europe—a Delphi study. Occup Environ Med 2000; 57: 98−105.

13) The certificate program for specialist occupational physicians—the details of establishment and the transitions for 12 years. Sangyo Eiseigaku Zasshi 2004; 46: 89−97 (in Japanese) .

14) Ministry of Health, Labor and Welfare. Guidelines for the Maintenance and Promotion of Workers’ Mental Health. [Online]. [cited 2014 Oct 24]; Available from: URL: http://www.mhlw.go.jp/houdou/2006/03/h0331-1.html (in Japanese).

15) Ministry of Health, Labor and Welfare. Overview of “the integrated measure for the health problems prevention caused by overwork”. [Online]. [cited 2014 Oct 24]; Available from: URL: http://www.mhlw.go.jp/english/wp/wp-hw4/dl/working_conditions_labour_relations/2011071911.pdf

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f th

e w

orkp

lace

.

Rec

ords

and

rep

orts

of

occu

patio

nal h

ealth

act

iviti

esB

e ab

le to

kee

p oc

cupa

tiona

l hea

lth r

ecor

ds a

ppro

pria

tely

and

use

them

to d

evel

op a

ctiv

ity r

epor

ts th

at a

re a

s ac

cura

te a

nd q

uant

itativ

e as

pos

sibl

e.

Info

rmat

ion

syst

em f

or o

ccup

atio

nal h

ealth

ser

vice

sB

e ab

le to

cla

rify

the

nece

ssar

y in

form

atio

n fo

r oc

cupa

tiona

l hea

lth s

ervi

ces

and

utili

ze a

n in

form

atio

n sy

stem

for

pro

vidi

ng a

nd a

naly

zing

ser

vice

s.

Occ

upat

iona

l hea

lth o

rgan

izat

ion

and

role

s of

occ

upat

iona

l phy

sici

ans

Eva

luat

ion

of n

eces

sary

exp

ertis

e an

d sy

stem

Be

able

to a

dvis

e an

em

ploy

er o

n ne

cess

ary

expe

rtis

e an

d ap

prop

riat

e sy

stem

s fo

r ef

fect

ive

occu

patio

nal h

ealth

act

iviti

es.

Org

aniz

atio

n of

occ

upat

iona

l hea

lth te

amB

e ab

le to

org

aniz

e an

occ

upat

iona

l hea

lth te

am b

y cl

arif

ying

rol

es o

f ea

ch o

ccup

atio

nal h

ealth

sta

ff a

nd le

adin

g th

e co

oper

ativ

e ef

fort

.

Coo

pera

tion

with

occ

upat

iona

l hea

lth s

taff

Be

able

to g

uide

occ

upat

iona

l hea

lth n

urse

s an

d he

alth

sup

ervi

sors

and

coo

pera

te w

ith th

em e

ffec

tivel

y.

Qua

lity

man

agem

ent o

f oc

cupa

tiona

l hea

lth s

ervi

ces

Be

able

to e

valu

ate

and

impr

ove

the

qual

ity o

f oc

cupa

tiona

l hea

lth s

ervi

ces

with

a q

ualit

y m

anag

emen

t sys

tem

.

Bud

get f

or o

ccup

atio

nal h

ealth

dep

artm

ent

Be

able

to b

udge

t for

the

occu

patio

nal h

ealth

dep

artm

ent a

nd d

evel

op a

n ef

fect

ive

exec

utio

n pl

an.

Con

trib

utio

n to

hea

lth c

omm

ittee

Be

able

to c

ontr

ibut

e to

eff

ectiv

e di

scus

sion

in a

hea

lth c

omm

ittee

and

in o

ther

opp

ortu

nitie

s.

Ris

k as

sess

men

t Iden

tific

atio

n of

exi

stin

g he

alth

haz

ards

Be

able

to id

entif

y ex

istin

g he

alth

haz

ards

in th

e w

orkp

lace

and

add

ress

them

.

Info

rmat

ion

of e

xist

ing

heal

th h

azar

dsB

e ab

le to

col

lect

info

rmat

ion

on e

xist

ing

heal

th h

azar

ds in

the

wor

kpla

ce, a

nd u

nder

stan

d an

d us

e th

e in

form

atio

n fo

r ri

sk a

sses

smen

t.

Mon

itori

ng o

f ex

posu

re to

hea

lth h

azar

dsU

nder

stan

d ex

posu

re m

onito

ring

met

hods

for

hea

lth h

azar

ds a

nd b

e ab

le to

ass

ess

wor

kers

' exp

osur

e.

Ass

essm

ent o

f he

alth

ris

ksB

e ab

le to

ass

ess

heal

th r

isks

with

haz

ard

info

rmat

ion

and

expo

sure

dat

a of

wor

kers

.

Hea

lth s

urve

illan

ce, d

iagn

osis

and

trea

tmen

t

Indi

cato

rs o

f he

alth

eff

ects

for

hea

lth s

urve

illan

ceB

e ab

le to

con

side

r ex

posu

re c

ondi

tions

to h

ealth

haz

ards

and

use

this

info

rmat

ion

to d

ecid

e on

indi

cato

rs f

or h

ealth

sur

veill

ance

.

Qua

lity

assu

ranc

e pr

ogra

ms

of la

bora

tori

esU

nder

stan

d qu

ality

ass

uran

ce p

rogr

ams

and

be a

ble

to s

elec

t a r

elia

ble

labo

rato

ry f

or h

ealth

exa

min

atio

ns.

Util

izat

ion

of h

ealth

sur

veill

ance

for

wor

kpla

ce im

prov

emen

tB

e ab

le to

gra

sp c

ondi

tions

in th

e w

orkp

lace

with

dat

a fr

om h

ealth

sur

veill

ance

, and

use

the

data

for

impr

ovem

ent.

Dia

gnos

is o

f he

alth

eff

ects

with

hea

lth s

urve

illan

ceB

e ab

le to

dia

gnos

e ad

vers

e he

alth

eff

ects

with

hea

lth s

urve

illan

ce a

nd o

ther

met

hods

.

Ris

k re

duct

ion C

ause

ana

lysi

s of

ind

ustr

ial

acci

dent

s or

occ

upat

iona

l di

s-ea

ses

Be

able

to p

artic

ipat

e in

cau

se a

naly

sis

of in

dust

rial

acc

iden

ts o

r oc

cupa

tiona

l dis

ease

s an

d co

ntri

bute

to p

reve

ntio

n of

rec

urre

nce.

Prio

ritiz

atio

n of

ris

ks f

or r

educ

tion

plan

sB

e ab

le to

pri

oriti

ze r

isks

for

red

uctio

n pl

ans

with

ris

k as

sess

men

t.

Ris

k re

duct

ion

met

hods

and

pla

nsB

e ab

le to

adv

ise

an e

mpl

oyer

on

risk

red

uctio

n m

etho

ds a

nd p

lans

acc

ordi

ng to

exi

stin

g ri

sks

in th

e w

orkp

lace

.

Exe

cutio

n of

ris

k re

duct

ion

plan

sB

e ab

le to

con

firm

exe

cutio

n of

ris

k re

duct

ion

plan

s an

d ev

alua

te th

eir

effe

ctiv

enes

s.


Cat

egor

yA

bbre

viat

ions

in th

e Pa

per

Des

crip

tions

in th

e Q

uest

ionn

aire

s

Ris

k co

mm

unic

atio

n

Edu

catio

n pr

ogra

ms

on r

isk

redu

ctio

nB

e ab

le to

pla

n an

d co

nduc

t nec

essa

ry e

duca

tion

prog

ram

s on

ris

k re

duct

ion

for

ever

y la

yer

of e

mpl

oyee

s.

Ris

k co

mm

unic

atio

n to

wor

kers

Be

able

to

com

mun

icat

e w

ith w

orke

rs o

n ex

istin

g he

alth

ris

ks w

hile

con

side

ring

the

ir a

nxie

ty, a

nd t

o ad

dres

s qu

estio

ns f

rom

wor

kers

on

the

basi

s of

sci

-en

tific

evi

denc

e.

Wor

k lo

ad a

nd r

ecov

ery

from

fat

igue

Eva

luat

ion

of p

sych

olog

ical

and

phy

sica

l loa

dB

e ab

le to

eva

luat

e ps

ycho

logi

cal a

nd p

hysi

cal l

oads

of

wor

kers

acc

ordi

ng to

thei

r w

ork,

shi

ft p

atte

rn a

nd s

o on

.

Des

ign

of w

ork

to h

ave

a sm

all l

oad

Be

able

to a

dvis

e an

em

ploy

er o

n w

ork

desi

gn th

at m

akes

psy

chol

ogic

al a

nd p

hysi

cal l

oads

as

smal

l as

poss

ible

.

Des

ign

of o

ffic

es a

nd f

acili

ties

for

empl

oyee

s' w

elfa

reB

e ab

le t

o ad

vise

an

empl

oyer

on

desi

gn o

f of

fice

s an

d fa

cilit

ies

for

empl

oyee

s’ w

elfa

re, s

uch

as r

esta

uran

ts a

nd l

oung

es t

hat

faci

litat

e re

cove

ry o

f th

eir

fatig

ue.

Cou

nter

mea

sure

s ag

ains

t psy

chos

ocia

l hea

lth h

azar

ds

Men

tal h

ealth

pro

gram

sB

e ab

le to

mak

e an

app

ropr

iate

pla

n fo

r m

enta

l hea

lth p

rogr

ams,

pro

vide

cou

nsel

ing

to e

mpl

oyee

s an

d ad

vise

an

empl

oyer

on

the

nece

ssar

y ac

tions

.

Prog

ram

s to

com

bat h

ealth

eff

ects

due

to o

verw

ork

Be

able

to

cont

ribu

te t

o pr

ogra

ms

to c

omba

t he

alth

eff

ects

due

to

over

wor

k by

exe

cutin

g fa

ce-t

o-fa

ce i

nter

view

s w

ith e

mpl

oyee

s an

d ad

visi

ng e

mpl

oyer

s to

pre

vent

adv

erse

hea

lth e

ffec

ts.

Hea

lth c

are

and

prom

otio

n

Peri

odic

gen

eral

hea

lth e

xam

inat

ion

Be

able

to p

lan

and

cond

uct p

erio

dic

gene

ral h

ealth

exa

min

atio

ns to

eva

luat

e he

alth

con

ditio

ns a

nd li

fest

yles

of

empl

oyee

s.

Eva

luat

ion

of h

ealth

con

ditio

n of

em

ploy

ee g

roup

Be

able

to e

valu

ate

heal

th c

ondi

tions

, lif

esty

le a

nd o

ther

fac

tors

am

ong

empl

oyee

s as

a g

roup

.

Hea

lth c

are

for

elde

r or

fem

ale

empl

oyee

sB

e ab

le to

dev

elop

a h

ealth

car

e pl

an f

or e

lder

or

fem

ale

empl

oyee

s an

d ha

ndle

indi

vidu

al c

ases

bas

ed o

n da

ta f

or th

eir

heal

th c

hara

cter

istic

s.

Hea

lth g

uida

nce

base

d on

hea

lth e

xam

inat

ion

Be

able

to c

ondu

ct h

ealth

gui

danc

e ba

sed

on h

ealth

exa

min

atio

ns.

Edu

catio

n on

hea

lth p

rom

otio

n fo

r em

ploy

ee g

roup

Be

able

to m

ake

lect

ures

on

heal

th p

rom

otio

n to

em

ploy

ee g

roup

s.

Wor

k ac

com

mod

atio

n

Pro

cedu

res

of f

itne

ss f

or d

uty

asse

ssm

ent

and

wor

k ac

com

-m

odat

ion

Be

able

to g

ive

prof

essi

onal

adv

ice

to a

n em

ploy

er o

n pr

oced

ures

of

fitn

ess

for

duty

ass

essm

ent a

nd w

ork

acco

mm

odat

ion.

Prof

essi

onal

opi

nion

s on

fitn

ess

for

duty

and

wor

k ac

com

mo-

datio

nB

e ab

le to

sub

mit

opin

ions

on

fitn

ess

for

duty

and

wor

k ac

com

mod

atio

n ba

sed

on d

ata

from

hea

lth e

xam

inat

ions

.

Wor

k ac

com

mod

atio

n at

ret

urn

to w

ork

or d

urin

g pr

egna

ncy

Be

able

to g

ive

advi

ce to

an

empl

oyer

on

nece

ssar

y w

ork

acco

mm

odat

ion

for

retu

rnin

g to

wor

k or

dur

ing

preg

nanc

y.

Impr

ovem

ent

of w

ork

abil

itie

s of

eld

er,

ill

or h

andi

capp

ed

empl

oyee

sB

e ab

le to

sup

port

eld

er, i

ll or

han

dica

pped

em

ploy

ees

to im

prov

e th

eir

wor

k ab

ilitie

s.

Prot

ectio

n of

rep

rodu

ctiv

e fu

nctio

n of

fem

ale

empl

oyee

sB

e ab

le to

adv

ise

fem

ale

empl

oyee

s on

pro

tect

ion

of r

epro

duct

ive

func

tion,

esp

ecia

lly d

urin

g pr

egna

ncy.

Firs

t aid

and

em

erge

ncy

resp

onse

Firs

t aid

ski

lls a

nd tr

aini

ng f

or e

mpl

oyee

sH

ave

firs

t aid

ski

lls a

nd b

e ab

le to

trai

n oc

cupa

tiona

l hea

lth s

taff

and

oth

er e

mpl

oyee

s.

Firs

t aid

pla

n an

d ar

rang

emen

t for

equ

ipm

ent

Be

able

to d

evel

op a

fir

st a

id p

lan

and

arra

nge

nece

ssar

y eq

uipm

ent a

nd o

ther

req

uire

men

ts.

Em

erge

ncy

resp

onse

pla

nB

e ab

le to

giv

e pr

ofes

sion

al a

dvic

e to

an

empl

oyer

on

deve

lopm

ent o

f an

em

erge

ncy

resp

onse

pla

n.

Env

iron

men

t pro

tect

ion

Wor

ksite

iss

ues

and

appl

icab

le r

egul

atio

ns o

n en

viro

nmen

tal

prot

ectio

nB

e ab

le to

exp

lain

issu

es o

f w

orks

ites,

app

licab

le r

egul

atio

ns a

nd r

equi

rem

ents

of

a m

anag

emen

t sys

tem

for

env

iron

men

t pro

tect

ion.

Prof

essi

onal

sup

port

for

env

iron

men

t pro

tect

ion

Be

able

to g

ive

prof

essi

onal

sup

port

to a

ctiv

ities

of

envi

ronm

enta

l pro

tect

ion

in th

e w

orkp

lace

.

Scie

ntif

ic r

esea

rch

Plan

ning

and

exe

cutio

n of

sci

entif

ic r

esea

rch

on o

ccup

atio

nal

heal

th is

sues

Be

able

to d

esig

n sc

ient

ific

res

earc

h pl

ans

on o

ccup

atio

nal h

ealth

issu

es a

nd e

xecu

te th

em.

Exe

cuti

on a

nd p

rese

ntat

ion

of r

esea

rch

foll

owin

g co

des

of

ethi

csB

e ab

le to

exe

cute

sci

entif

ic r

esea

rch

and

pres

ent t

he r

esul

ts, f

ollo

win

g a

code

of

ethi

cs.

Aud

it

Occ

upat

iona

l saf

ety

and

heal

th a

udit

and

repo

rtin

gB

e ab

le to

par

ticip

ate

in a

n oc

cupa

tiona

l saf

ety

and

heal

th a

udit

and

cont

ribu

te to

the

repo

rtin

g.

Col

labo

ratio

n w

ith p

artie

s in

side

or

outs

ide

of c

ompa

ny

Com

mun

icat

ion

with

em

ploy

ers

and

unio

nsB

e ab

le to

com

mun

icat

e w

ith e

mpl

oyer

s, u

nion

s an

d ot

her

stak

ehol

ders

, with

und

erst

andi

ng o

f th

eir

posi

tions

.

Col

labo

ratio

n w

ith h

uman

res

ourc

es a

nd s

afet

y de

part

men

tsB

e ab

le to

col

labo

rate

eff

ectiv

ely

with

hum

an r

esou

rce

depa

rtm

ent,

safe

ty d

epar

tmen

t and

oth

er d

epar

tmen

ts.

Util

izat

ion

of p

ublic

res

ourc

es a

nd c

ontr

ibut

ion

to c

omm

unity

Be

able

to u

tiliz

e pu

blic

sec

tors

and

loca

l res

ourc

es e

ffec

tivel

y an

d co

ntri

bute

to lo

cal s

ocie

ty.

App

endi

x. A

bbre

viat

ions

of

com

pete

ncie

s in

the

pape

r (C

ontin

ued)

Surveys on the competencies of specialist …joh.sanei.or.jp/pdf/E57/E57_2_05.pdfpational physicians...

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Transcript of Surveys on the competencies of specialist …joh.sanei.or.jp/pdf/E57/E57_2_05.pdfpational physicians...