Hepatitis screening in Japanese individuals of working age and prejudice against infected persons in the workplace.

BACKGROUND: Laboratory confirmation of viral hepatitis infection represents an important issue for working age populations, as early detection and treatment can help ameliorate clinical progression of the disease. On the other hand, prejudice may occur in the workplace against those identified by a positive hepatitis test. This study investigated attitudes towards viral hepatitis testing in Japanese people of working age, including their desire to undergo such testing, and prejudice against persons infected with hepatitis virus. METHODS: A total of 3,129 working age individuals were recruited from a company that conducts Internet surveys in Japan. RESULTS: Of the respondents, 21.3% had previously undergone viral hepatitis testing, most frequently when it was an additional option during a health checkup or health screening for local residents (36.2%) and when it was included in regular health checkups in their workplace (19.2%). Among the respondents with no history of testing, 68.7% expressed a desire to undergo testing, of whom 74.8% wanted to have the test as part of their regular health checkups in the workplace. According to the respondents, if a coworker tested positive for hepatitis, 36.0% reported that they would be anxious about it, 32.0% would try to avoid contact with the infected person as long as circumstances permitted, and 23.7% said they might harbor some kind of bias. CONCLUSIONS: Although further promotion of viral hepatitis testing is needed and this might be achieved during regular health checkups in Japanese workplaces, educational strategies will also be essential to help reduce bias against those who test positive.

Association of knowledge of HIV and other factors with individuals' attitudes toward HIV infection: a national cross-sectional survey among the Japanese non-medical working population.

BACKGROUND: The stigma of and discrimination because of HIV has been described as the most important obstacle to prevention and treatment efforts. The purpose of this study was to investigate negative attitudes and prejudice toward HIV among the Japanese non-medical working population and to explore contributing factors. METHODS: An online anonymous nationwide survey involving approximately 3,000 individuals was conducted in Japan. Questions ranged from background information and HIV knowledge to individuals' attitudes towards HIV infection in the workplace. Descriptive statistics and logistic regression were applied for analysis. RESULTS: Thirty-three percent of participants feared transmission of HIV from infected colleagues, 34% tended to avoid contact with them and 40% had prejudiced opinions about HIV infection. Despite a relatively high level of knowledge of HIV/AIDS overall (11.9 ± 3.3 from 15 points), only 50% of individuals were aware of some issues. Greater knowledge was associated with less negative attitudes towards HIV infection (OR 0.39, 95% CI 0.31-0.48 for prejudiced opinion, high compared with low level of knowledge), whereas greater health consciousness was inversely related to attitude (OR 1.97, 95% CI 1.50-2.58 for prejudiced opinion, high compared with low health consciousness). CONCLUSION: Knowledge neutralizes peoples' negative attitudes towards HIV infection, whereas greater health consciousness may worsen them. Educational programs should balance knowledge with health consciousness to improve the efficacy of HIV interventions.

[A review of assessment of fitness for work and adjustments for health and safety at worksites overseas].

OBJECTIVE: In this research, we reviewed studies about assessment of fitness for work and adjustments for health and safety at worksites overseas. METHODS: We systematically searched PubMed (1980-2010) using keywords related to fitness for work. The collected studies are discussed with respect to the country, timing of medical examinations, health problems of workers, occupations, categories of health level in workers, criteria for assessment of fitness for work, and the decision-making process related to accommodations at work. RESULTS: Seventy articles were identified that met the inclusion criteria. They focused on two key points related to assessing fitness for work: 1) safety and risk to workers themselves, to other workers and the public, and 2) ability to perform in potentially dangerous situations, such as those encountered by the military and firemen. Employers were required to provide reasonable accommodations for disabled or sick workers. The following steps were taken to make accommodation decisions: 1) analysis of job requirements; 2) worker analysis, including evaluation of work limitations or risks related to disabilities or illness; 3) choice of necessary adjustments at work, based on reasonable accommodations decided during talks between the disabled or sick workers and employers, including feasibility, effectiveness, and costs of such adjustments; 4) judgment of fitness for work based on steps 1 to 3, and opinions of specialists in various fields. CONCLUSION: In this investigation, we could not find any clear criteria for judgments about fitness for work or numerical criteria for adjustments at worksites after medical examinations of employees. However, we confirmed the following. Assessing fitness for work should be based on a comparison of workers' health with the risks and demands of the job. In addition, doctors should have the ability to offer opinions on adjustments at worksites. The employer's obligation to provide reasonable accommodations is attracting more attention in Japan. To make adjustments for health and safety at worksites for all workers, the procedures and important issues must be determined as well as criteria of judgments or numerical criteria. Moreover, doctors should provide opinions about adjustments at worksites. Therefore, they need more training in assessing fitness for work.