Effectiveness of worksite visit by occupational health nurses

Introduction
Although worksite visit is an important task for occupational health (OH) professionals, worksite visit by occupational health nurse (OHN) is not stipulated by Industrial Safety and Health (ISH) Law in Japan. The objective of this study was to examine the situation of worksite visit by OHN and to investigate opinion of OHN and other OH professionals on this service.

Methods
Questionnaires on situation and opinion of worksite visit by OHN were mailed in 2010 to 270 OHN in Kyoto prefecture. Questionnaires on opinion of worksite visit by OHN were also mailed to 532 occupational physicians (OP) and 566 hygiene managers (HM). In practice, 111 OHN (41%), 187 OP (35%), and 282 HM (50%) replied, respectively.

Results
OHN (66%) visited worksite regularly. Remaining OHN did not visit worksite mainly because it was excluded from tasks of OHN in their enterprises (49%) due to the condition in ISH law. OHN (80%) thought worksite visit was effective to improve health condition of employees. They considered understanding of work of employees and enterprise itself through worksite visit improves the level of health guidance and worksite visit supports communication between OH professionals. A large number of HM considered worksite visit by OHN was more effective than OP (HM: 63% vs. OP: 53%, p<0.05). OHN usually acquired knowledge of worksite visit from internet, lectures, or publications (66%), and seldom asked OP for the knowledge (5%). Forty eight OHN gave concrete opinion for worksite visit by OHN. A legal basis for worksite visit (25%) and support from other OH professionals (21%) were requested.

Discussion
Although most of OHN thought worksite visit by OHN was effective for improvement of health of employees, implementation rate was not high in Japan. Revision of legislation and further support by OP should be considered to improve the situation.