Nishiyama K, Johnson J V
Department of Preventive Medicine, Shiga University of Medical Science, Otsu, Japan.
Int J Health Serv. 1997;27(4):625-41. doi: 10.2190/1JPC-679V-DYNT-HJ6G.
There is considerable international interest in Japanese production management (JPM), known in the West as "lean production." Advocates of this new form of management argue that it improves both economic productivity and health. In Japan, however, the relationship between JPM and sudden death due to cardiovascular and cerebrovascular disease has been an important topic of debate since the 1970s. Japanese have named these types of deaths karoshi, which means "death from overwork." In North America and Western Europe a number of studies have demonstrated a significant relationship between high job strain (high production demands and low levels of control and social support) and cardiovascular disease. This article reviews the elements of JPM and examines their potential health consequences. The authors present an overview of karoshi, discuss its possible connections to specific ideological and organizational characteristics of JPM, and suggest the job strain mechanism as a possible pathway between karoshi and JPM. They conclude by discussing the need for comparative research that examines the health effects of work organization and management methods cross-culturally.
国际上对日本生产管理（JPM）有着浓厚兴趣，在西方它被称为“精益生产”。这种新的管理形式的倡导者认为，它既能提高经济生产率，又有益健康。然而，自20世纪70年代以来，在日本，JPM与心脑血管疾病导致的猝死之间的关系一直是一个重要的辩论话题。日本人将这类死亡称为过劳死，意思是“过度劳累导致的死亡”。在北美和西欧，一些研究表明高工作压力（高生产需求以及低控制和社会支持水平）与心血管疾病之间存在显著关系。本文回顾了JPM的要素，并审视了它们对健康的潜在影响。作者概述了过劳死，讨论了它与JPM特定思想和组织特征的可能联系，并提出工作压力机制可能是过劳死与JPM之间的一条途径。他们最后讨论了开展跨文化研究工作组织和管理方法对健康影响的必要性。
