健保検診よりみた東京都の中小企業における肺結核の実態(第7報)

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Following the previous reports, a study was made on the trend of tuberculosis prevalence during the period from 1966 to 1968 among employees of smaller enterprises in relation to the size of enterprise and the status of response to the mass chest X-ray survey. The total number of enterprises examined during this period was 1, 645, 1, 849 and 2, 513 in 1966, 1967 and 1968, respectively, and they were divided into the following 3 groups according to their status of response to the mass chest X-ray survey: Group I was examined firstly, group it received mass survey twice during this period, and group III was examined once a year and altogether 3 times during this period. Proportion of group I increased from 23.9% in 1966 to 26.6% in 1967 and 35.4% in 1968, and the increase in the number of enterprise firstly examined during this period was obtained through our intensive efforts to invite new enterprises. The increase was most markedly seen in smaller enterprises with less than 30 employees. (Table 1) The prevalence of active tuberculosis was higher among smaller enterprises, but i n group III, no significant difference was found in the prevalence of active cases according to the size of enterprise. (Table 2) Comparing the prevalence among groups I, II and III, it was highest in group I, next in group II, and lowest in group III. (Table 3) The prevalence increased with age. (Table 4) As the age distribution of persons examined was similar in all the enterprises, the most important factor which influences the prevalence of active tuberculosis was the status of response to the mass survey. The prevalence of active cases, however, has been decreasing even among firstly examined enterprises with less than 30 employees. The prevalence of newly detected active cases showed no decline during the period from 1965 to 1968. (Tables 5, 6 and 7) The proportion of newly detected cases to the total active cases has been increasing and it was 51.7% in 1968. (Table 8) The proportion was higher in younger age groups, and the increase of this proportion was also marked in younger age groups. The prevalence of cavitary tuberculosis, as well as the prevalence of inactive cases and that of operated cases, has been decreasing during this period. Among operated cases, 25% continued to work in the same enterprise after the surgical treatment, and the remaining 75% moved to the other enterprise. Out of the latter, 55% moved to the enterprise smaller than before. The detailed examination including radiography and bacteriologic examination was conducted for about 75% of suspicious cases, and the follow-up was made for persons not receiving the detailed examination. Among them, 33.7% has already been under treatment, 25.4% has been examined at the other medical institutions, 5.6% moved out, and the remaining 35.4% refused to be examined. The facts mentioned above indicate that the prevalence of tuberculosis among smaller enterprises can be reduced by continuing the mass chest X-ray survey and the treatment for detected cases.
日本結核病学会の論文

健保検診よりみた東京都の中小企業における肺結核の実態(第7報)

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