Occupational Medicine Advance Access originally published online on January 16, 2007
Occupational Medicine 2007 57(2):126-130; doi:10.1093/occmed/kql157
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Inequality in the health status of workers in small-scale enterprises
1 Department of Environmental Epidemiology, University of Occupational and Environmental Health, Orio, Yahatanishiku, Kitakyushu, Japan
2 Occupational Health Training Center, University of Occupational and Environmental Health, Orio, Yahatanishiku, Kitakyushu, Japan
3 Nishinihon Occupational Health Service Center, Kitakyushu, Japan
4 Fukuoka Institute of Occupational Health, Fukuoka, Japan
5 Saga Occupational Health Association Foundation, Saga, Japan
6 Kyoto Industrial Health Association, Kyoto, Japan
Background Small-scale enterprises (SSEs) usually share poorer resources for promoting occupational health.
Aim To investigate inequality of health status among SSEs in Japan.
Method A cross-sectional, multiple-centred study was carried out using the periodical health check-up data for the fiscal year 2000 to compare the age-adjusted proportions of workers with hypertension (HT), hyperlipidaemia, impaired glucose tolerance (IGT) and obesity and of current smokers by size of enterprise, i.e. 
29, 30–49, 50–99, 100–299, 300–999 and 
1000 employees in Japan.
Results From five leading occupational health organizations, data were collected for 9833 enterprises with a total of 436 729 subjects, 302 383 males and 134 346 females. The proportions of workers in SSEs with 49 employees with HT, IGT and obesity were 8.5, 5.0 and 3.5%, respectively, higher than those in enterprises with 50 male employees. The prevalence of smokers in SSEs with 49 employees was 61%, 2–6% higher than in enterprises with 50 male employees. These proportions showed a significantly increasing tendency with decreasing size of male workforce.
Conclusion Despite the cross-sectional design and only adjusting age as a potential confounder, higher proportions of HT, IGT, obesity and smoking in male workers were found in SSEs compared to larger organizations.
Keywords Health check-up; hypertension; impaired glucose tolerance; obesity; prevalence; small-scale enterprises; smoking
Correspondence to: Tsutomu Hoshuyama, Department of Environmental Epidemiology, University of Occupational and Environmental Health, Orio, Yahatanishiku Kitakyushu City 807-8555, Japan. Tel: +81 93 691 7401; fax: +81 93 601 7324; e-mail: hoshuyam{at}med.uoeh-u.ac.jp