A study on the validity of the workplace health examinations and proposals for the reform
| Project/Area Number |
09670411
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| Research Category |
Grant-in-Aid for Scientific Research (C)
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| Allocation Type | Single-year Grants |
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| Section | 一般 |
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| Research Field |
Public health/Health science
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| Research Institution | Teikyo University |
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Principal Investigator |
YANO Eiji Teikyo University School of Medicine, Professor, 医学部, 教授 (50114690)
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| Co-Investigator(Kenkyū-buntansha) |
YAMAOKA Kazue Tekyo University School of Jurisprudence, Associate Professor, 法学部, 助教授 (50091038)
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| Project Period (FY) |
1997 – 1998
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| Project Status |
Completed (Fiscal Year 1998)
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| Budget Amount *help |
¥3,500,000 (Direct Cost: ¥3,500,000)
Fiscal Year 1998: ¥1,200,000 (Direct Cost: ¥1,200,000)
Fiscal Year 1997: ¥2,300,000 (Direct Cost: ¥2,300,000)
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| Keywords | Workyplace health examinations / Screening test / Liver function test / Sensitivity / Specificity / Urine glucose test / Ankle-arm index (AAI) / Atherosclerosis / 職域健診 / 定期健康診断 / スクリーニング検査 / ROC曲線 / 鋭敏度 |
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| Research Abstract |
In order to evaluate the validity of the workplace health examinations, we performed the following investigations.
1. Validity of liver function tests : Three thousand male workers aged 40 y.o. or older were investigated to evaluate the validity of mandatory annual liver function tests. Results of HBs antigen, HCV antibody, abdominal ultrasound, and a detailed interview on alcohol intake were used for the diagnostic tests for HBV and HCV infection, fatty liver and excessive drinking, respectively. As a result, abnormal value of AST, ALT and gamma-GTP indicated target conditions with high specificities but non of the tests reached the sensitivity level of 50%. These tests were found to detect only less than half of the workers with these abnormal conditions.
2. Timing of urine glucose test : We surveyed industrial physicians by a questionnaire for the timing of urine glucose test as a screening for diabetes. Of the 107 responded industrial physicians, 58% collected urine sample when the examinee were fasting and only 3% collected after meal. In a separate study in 455 male glucose tolerance test examinee, urine sample collected at fasting showed sensitivity of only 10% to detect diabetes. This results indicate that only one out of 10 patients with diabetes were detected by urine sample collected at fasting.
3. AAI : Atherosclerosis is the most prevalent ailment among the working population in Japan. To develop more valid screening test for atherosclerosis, we examined 446 male workers for the ankle-arm index for its validity and most appropriate cutoff level. As a result, the best cutoff level was found to be 1.0 and with that level both sensitivity and specificity were about 80% to detect atherosclerosis diagnosed by fundoscopy.
4. Conclusion : Suggested by the results of above studies, we made several proposals to improve current regular health examinations.
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Report
(3 results)
Research Products
(9 results)
