[ 1 8 5] Enviro nme ntal Manage me nt
and He alth 8 / 5 [1997] 1 8 5 –1 8 7 © MCB Unive rs ity Pre s s [ISSN 0956-6163]
Epidemiology
Kazutaka Kogi
Ins titute fo r Sc ie nc e o f Labo ur, Kawas aki, Japan
Tsuyoshi Kawakami
Ins titute fo r Sc ie nc e o f Labo ur, Kawas aki, Japan
Introduction
Resea r ch in e p id em iology is ga in in g m om en t u m in t h e Asia P a cifi c r e gion for est a blish -in g t h e cop -in g st r a t e gies -in d ea l-in g w it h r a p id ly in cr ea sin g wor k -r ela t ed h ea lt h r isk s a m on g wor k er s[1]. Occu p a t ion a l e p id em iol-ogy, n ow w id ely a p p lied in t h e r e gion , is w id en in g it s scop e fr om a con ven t ion a l sin gle t oxicologica l fa ct or a n a ly sis t ow a r d s t h e a ssessm en t of t h e com b in ed effect s of d iffer -en t wor k -r ela t ed a g-en t s. Occu p a t ion a l st r ess, wor k or ga n iza t ion , socia l a n d fa m ily fa ct or s, cr oss-cu lt u r a l d iffer en ces a s w ell a s t h e w ell k n ow n ch em ica l or p h y sica l a gen t s h ave in cr ea sin gly b een r ecogn ized a s im p or t a n t r isk s a ffect in g t h e h ea lt h con d it ion s of va r i-ou s wor k er s in t h e r e gion .
Roles of epidemiology in the
Asia-Pacific
E p id em iology is exp ect ed t o p lay som e im p or -t a n -t r oles in u p gr a d in g occu p a -t ion a l h ea l-t h m ea su r es in t h e Asia -P a cifi c r e gion . T h e fi r st im p or t a n t r ole of e p id em iology in t h e Asia P a cifi c con t ext is t o fa cilit a t e t h e id en t ifi ca -t ion of occu p a -t ion a l d isea ses a n d -t h e w id er cover a ge of occu p a t ion a l h ea lt h m ea su r es. Wh ile m a n y cou n t r ies in t h e r e gion h ave m a d e t r em en d ou s effor t s in d iscover in g t h e m a gn it u d e of occu p a t ion a l d isea ses, it is u n for t u n a t ely t r u e t h a t t h e exist in g occu p a -t ion a l d isea ses s-t a -t is-t ics in m a n y cou n -t r ies a r e b a sed on gr ossly u n d er -r e p or t ed d a t a . T h e sy st em a t ic a p p r oa ch es for id en t ify in g exist -in g occu p a t ion a l d isea ses t h r ou gh e p id em io-logica l r esea r ch m et h od s a r e r eq u ir ed .
T h e secon d im p or t a n t r ole of e p id em iology in t h e Asia -P a cifi c r e gion is it s con t r ibu t ion t o t h e p r ior it y set t in g in occu p a t ion a l h ea lt h p olicy [2]. It is im p or t a n t t o k n ow t h e m a gn i-t u d e of va r iou s occu p a i-t ion a l r isk fa ci-t or s a n d t h e sy n er gist ic effect s of t h e t wo or m or e a gen t s, so t h a t a clea r t a r get for con t r ollin g t h ese r isk fa ct or s ca n b e est a blish ed .
T h e t h ir d r ole of e p id em iology exp ect ed in t h e r e gion is t h e m on it or in g a n d in vest iga -t ion of n ew ly em er gin g wor k -r ela -t ed h ea l-t h r isk s. Beca u se of w id e r a n ge of wor k -r ela t ed h ea lt h r isk s a r isin g in t h e r e gion , u n k n ow n
r isk fa ct or s or wor k -r ela t ed illn ess m igh t occu r som e t im e[3]. E p id em iologic r esea r ch ca n h elp cla r ify som e loca l fa ct or s ch a r a ct er -izin g t h e p eop le’s life-st y le su ch a s t r op ica l clim a t ic con d it ion s, n u t r it iou s fa ct or s, p sy -ch o-socia l fa ct or s, loca l in fect iou s d isea ses or gen et ic effect s of t h e loca l p op u la t ion t h a t m igh t in cr ea se t h e a dver se effect s of t h ese r isk s.
Health risks revealed by
epidemiological research in the
Asia-Pacific
Resea r ch d evelop m en t in e p id em iology h a s r evea led t h e r isk s of sever a l occu p a t ion a l d isea ses in t h e r e gion . E p id em iologist s in t h e r e gion h ave b een set t in g a w id e va r iet y of occu p a t ion s a s t h eir r esea r ch t a r get s.
M anufacturing and service sectors
E xist in g st a t ist ica l r ecor d s m igh t b e a u sefu l sou r ce for k n ow in g t h e ch a r a ct er ist ics of occu p a t ion a l d isea ses. In Sin ga p or e, in d u st r ia l d er m a st ist is ca ses com p iled in st h e com -p en sa t ion fi les w er e a n a ly sed fr om e -p id em io-logica l v iew p oin t s[4]. T h e a n a ly sis of t h e r e p or t ed 429 ca ses sh ow ed t h a t m or e t h a n h a lf of t h e ca ses occu r r ed in m et a l p r od u ct s, m a ch in er y a n d eq u ip m en t fa ct or ies u sin g solven t s a n d coola n t s w h ile t h e secon d h igh r isk gr ou p s w er e t r a n sp or t in d u st r y wor k er s in con t a ct w it h oils a n d gr ea ses. It w a s of p a r t icu la r in t er est t h a t t h e r e p or t ed ca ses of in d u st r ia l d er m a t it is in cr ea sed a ft er it b eca m e a n ot ifi a ble d isea se u n d er t h e F a ct or y Act . T h is r esea r ch in d ica t ed t h a t sy st em a t ic r e gist r a t ion of occu p a t ion a l d isea ses cou ld p r ov id e va lu a ble d a t a for t h e r isk ch a r a ct er i-za t ion of occu p a t ion a l d isea ses.
T h e cot t on t ext ile in d u st r y is gr ow in g in t h e Asia -P a cifi c r e gion . Ma n y wor k er s a r e exp osed t o cot t on d u st a n d t h u s su b ject t o a h igh r isk of con t r a ct in g by ssin osis. A six-yea r follow -u p st u dy con cer n in g t h e wor k er s exp osed t o cot t on d u st w a s con d u ct ed in T h a i-la n d [5]. T h e st u dy r evea led t h a t a m on g t h e ob ser ved 300 wor k er s, 60 ca ses of by ssin osis w er e ob ser ved d u r in g t h e six-yea r in t er va l. Over a ll six-yea r in cid en ce of t h e on set of by ssin osis w a s 20 p er cen t (28.3 p er cen t in
[ 1 8 7] Kazutaka Ko gi and
Ts uyo s hi Kawakami Curre nt re se arc h – Epide mio lo gy
Enviro nme ntal Manage me nt and He alth
8 / 5 [1 9 9 7 ] 1 8 5 –1 8 7
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