Development of occupational health in Japan.

This paper was presented as a Lucas Lecture 1990 before the Faculty of Occupational Medicine, Royal College of Physicians, United Kingdom. It describes the development of occupational health in Japan including primitive industrialization (mining, smelting and others) back as far as the 8th century. The modern industrialization of Japan began slightly over one hundred years ago, i.e. from the beginning to the middle of the Meiji era. Before World War II, Japanese workers in industry suffered terrible working conditions, represented by a booklet published in 1925 entitled "The Tragic History of Female Workers" by Wakizo Hosoi. At that time a pioneer named Dr. Gito Teruoka was hard at work. He literally became the "Father of Occupational Health" in Japan. He established the Kurashiki Institute of Science of Labour in 1921 in Kurashiki City located in western Honshu, which is the main island of Japan. At the beginning of the Showa era, from 1930 to 1950, various types of occupational diseases were reported and the situation was overviewed by Dr. Juko Kubota. The rapid industrialization immediately after World War II during which workers were exposed to chromium, benzidine, beta 2-naphthylamine, arsenic, vinyl chloride monomer, asbestos, bischloromethyl ether and other chemicals gave rise to occupational cancer. The Ministry of Labour (MOL) was established in 1947 and the Labour Standard Law enacted. As a result, the incidence of tuberculosis decreased rapidly and occupational health emphasized the early detection of tuberculosis. After tuberculosis was nearly eradicated, more complicated working conditions developed in various industries. MOL enacted the Industrial Safety and Health Law in 1972 and occupational health practices improved greatly. Furthermore, in 1988 MOL amended the Law and announced guidelines on maintenance and promotion of health for the work population. However, there is a great disparity in occupational health services between large establishments and small factories. The University of Occupational and Environmental Health, Japan, (UOEH) was established in 1978 to promote occupational health sciences as well as to train and foster occupational health personnel to meet the short supply of occupational health physicians. However, there is no authority that establishes standards for occupational health physicians and nurses. The urgent necessity of establishing an authorized institution for the qualification of occupational health personnel is emphasized.