Interviews for job and environment
For treatment of those diagnosed with a modern health problem and for further prevention, the grasp of patient lifestyle and environmental factors is not only necessary but indispensable. For workers, this necessarily involves evaluation of the work environment. To get this knowledge, the best method is the "interview". From the point of view of the patient, how this is knowledge is conveyed is important.

First of all, we introduce and center on the cover of our clinic's medical treatment record (the clinical record). We have devised a manner in which a patient can enter information efficiently to the cover. (Photograph right @) Furthermore, there is also a 2nd medical treatment record (photograph right B) that records important patient information other than that in the usual medical interview record form (the 1st medical treatment record photograph right A). Tables 1 and 2 are simple but detailed examples of these " workplace environment check tables".
(Table 1)
Mark boxes positively (and negatively as □) Sendai Nishikicho Clinical Record (Table)
Workplace Environment Present Past Workplace Environment Present Past
1. Powder or dust
2. Harmful materials used
3. Abnormal environmental temperature, pressure, light
4. Noise
5. Night or early morning, shift work
6. Heavy lifting
7. Unnaturally long fixed positions
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 8. Vibrating tools or vibrating environment
9. Hard manual or digital labor
10. VDT work
11. Detailed visual work
12. Work demanding concentration or attention
13. Non-restive, continuous work
14. Other:
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(Table 2)
Work Environment Checklist
Workplace Environment Present Past Workplace Environment Present Past
a. I inhale dust often
b. I use thinners or organic solvents
c. I use heavy metals
d. I use other organic chemicals
e. My area is too bright
f. My area is too dark
g. High pressure environment
h. Elevated environment
i. High temperature environment
j. Cold environment
k. I use ultraviolet rays
l. I use infrared rays
m. Odorous, noisy, or irritating environment
n. I work night or early morning shifts
o. I have heavy loads
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 p. I always stand
q. I always sit
r. There is much squatting
s. I use vibrating tools
t. I have whole body vibration
u. I work manually for long periods
v. I do VDT work
w. I do detailed visual work
x. I mainly work with people
y. I concentrate often
z. I drive long periods
aa. There is little recess
bb. There is no lounge or rest area
cc. Rest is difficult to take
dd. Other not listed above
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When the first medical treatment record is opened, we can enter the contents of "environment and exercise" next to "subjective symptoms" as in Figure 1, to judge in comparison with symptoms.

In the second medical treatment record, there is the table where makes use of: "Symptoms", "Work Experience", "Residence History" as in Figure 2. For diagnosis, we also consider this information chronologically. Also, there information for chronic diseases that require advance treatment like hypertension diseases, and diabetes. We can then contrast labor and life environments as in Figure 3 and judge "deterioration factors" and then work toward improving them.


For hypertensive diseases, "Checkpoints" as in Table 3, is important. For the patient, it is especially important to convey such information that is recent or recently changing.
(Table 3)
Main checkpoints for hypertensive workers' work and living environments
Night shifts, early morning shifts, changing shifts, overtime work, commuting time, commuting method, events, mandatory work-related entertainment Work away from family, business trips (foreign/distant/frequent), low temperature, high temperature, changing temperature, humid, damage from storm and flood accidents, heavy loads, heights, underground work, underwater work, noise, tension (driving, VDT, customer services, troubles, etc.) . Sleep time, infants and babies, alcohol, cigarettes, family illness.

Medical Treatment Interview Record Bibliography (★★ = author Dr. Toshio Hirose, ★☆= editor Dr. Toshio Hirose) (English title, translated, and Japanese title.)

★★"Roudou Seikatu Kankyou wo Saguru Monshinho"
"Interview Methods in Labor and Living Environment Research", Ayumi Publishing

★☆"Anata to Kazoku no tame no Karoushi shinai sasenai Hon"
"Preventing "Fatigue Death (Death Due to Overwork)" for You and Your Family", Noubunkyou

★★"Konnichi no Gairai Shinryou-Dai5shou Shokugyoukiinsei Kankyou Kanrensei Shikan"
"Today's Outpatient Medical Treatment - Chapter 5: Job Related Disease", Igakushoin

★☆"Shirizu;Gendai no Yamai (4) Shokuba no Yamai"
"Series; Contemporary Sicknesses (4) Workplace", Igakushoin

★★"Tokusyu"Sagyou Roudou Kanren"-Sagyou(Roudou) Kanren Shikan ni Gairai de dou Taisho suruka? Kagi ha Monshin to Shinryouroku no Jyujitu"JIM3 (6) P502-5
"Feature: How do I examine work related diseases in outpatients? Key is the improvement of interview and medical treatment records", JIM3 (6) P502-5", Igakushoin




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