Health status of workers in small and medium-sized companies as compared to large companies in Japan.

The health status of workers in small companies has been noted to be relatively poor, but no actual comparisons of groups of variously sized companies within the same region based on the same methodology have ever been conducted. We undertook this study to clarify differences in health status according to company size. The subjects comprised workers of a Japanese steel company and various subcontractors who received health checkups in 2003. We obtained answers from 83 companies employing 11,844 workers and analyzed the data for 6,480 men aged 40 yr or more, comparing results of the health checkups, health management practices, and number of occupational health personnel according to company size (number of employees). Mean worker age in the various groups ranged from 49.7 to 54.0 yr. Drinking and smoking habits did not differ between them. There was a significant trend to higher prevalences of diabetes and hypertension, and lower prevalences of renal disease and hypercholesterolemia in smaller companies. Mean body mass index and diastolic blood pressure were significantly higher in companies with 1,000-2,999 workers. Health management practices satisfied the legal requirements of the respective company size. Occupational physicians devoted more time per worker in companies with 1,000-2,999 and 50-299 workers. No consistent differences were apparent between small and large companies in worker health status. Inter-company activities for occupational safety and health were undertaken and labor regulations almost equally adhered to. Endeavors to maintain a certain level of hygiene and health management play an important role in maintaining worker health in small companies.