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2007/02/10発売号 (83巻1号)

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山本真二, 岩本美江子, 井上正岩, 原田規章
暑熱曝露の生体影響評価に関する検討（その１）－心拍変動、尿中カテコールアミンを用いて－
労働科学，83(1),1～6,(2007)

　暑熱曝露の生体影響の評価指標についての検討を目的とし，暑熱曝露による自律神経機能影響を心拍変動（HRV），尿中カテコールアミン(CA)を用いて測定した。健常男子学生６名を被験者とし，快適条件 (湿球黒球温度（WBGT）19℃)及び暑熱条件 (WBGT 30℃)に，座位にて30分間曝露した。快適条件における曝露により体重減少，収縮期血圧低下に有意な変化を認めた。暑熱条件曝露では体重減少，拡張期血圧上昇，体温上昇，高周波成分(HF)%の減少，低周波成分/高周波成分(LF/HF)比の増加，熱感，発汗の変化を認めた。心拍変動解析により交感神経機能の亢進および副交感神経機能の低下が示された。このことはその他の生体反応変化と一致した。以上より心拍変動が暑熱曝露の生体影響の指標となりうることが示唆された。(表5)（自抄）
キーワード：自律神経系；WBGT；暑熱曝露；心拍変動；尿中カテコールアミン

Shinji YAMAMOTO, Mieko IWAMOTO, Masaiwa INOUE , Noriaki HARADA　
Evaluation of The Effect of Heat Exposure on the Autonomic Nervous System (Part 1)
-Using Heart Rate Variability and Urinary Catecholamines-
THE JOURNAL OF SCIENCE OF LABOUR,83(1),1～6,(2007)

　The aim of this study was to investigate the usefulness of heart rate variability (HRV) and urinary catecholamines (CA) as the objective indices of heat stress. We measured physiological responses, subjective symptoms, HRV and urinary CA for evaluating the effect of heat exposure on the autonomic nervous system. Six healthy male students volunteered for this study. They were exposed on different days to either a thermoneutral condition at wet bulb globe temperature (WBGT) 19_C or a heated condition at WBGT 30_C for 30 min, while seated on a chair. In the thermoneutral condition, body weight and systolic blood pressure significantly decreased after 30 min exposure. In the heated condition, body weight significantly decreased where as diastolic blood pressure, body temperature and scores for subjective symptoms (feverishness and sweating) significantly increased after 30 min exposure. Heart rate and breath rate tended to increase. Also, the percent high-frequency component of HRV (HF%) significantly decreased and the low-frequency/high-frequency (LF/HF) ratio significantly increased after 30 min exposure to the heated condition. There were no significant differences between the amounts of urinary CA before and after 30 min exposure. The heat exposure (WBGT 30_C) thus induced an activation of the sympathetic nervous system and a withdrawal of the parasympathetic nervous system. These findings coincided with observed changes of heart rate, breath rate and subjective symptoms. It is concluded that HRV (HF% and LF/HF ratio) is useful as the objective indices of the heat stress and that HRV indices are more sensitive than urinary CA.
Key words: Autonomic nervous system; WBGT; Heat exposure; Heart rate variability;Urinary catecholamine


安達悠子，臼井伸之介，篠原一光，松本友一郎，青木喜子
看護業務における違反事例の収集とその心理的生起要因に関する検討
労働科学，83(1),7～23,(2007)

　本研究では，看護師を対象に，業務中にしたあるいは見た違反内容とその違反理由の記述を求めた質問紙調査を行った。また同時に，その違反をどの程度しているあるいは見かけるという主観的な違反頻度と，違反の生起に関与していると考えられるリスク評価等の心理的要因に関する4件法の質問への回答を求め，違反頻度と心理的要因との関連を検討した。記述された違反内容と違反理由はKJ法により分類し，違反頻度と心理的要因については得点化ののち相関係数を算出した。その結果，違反内容21項目，違反理由13項目が得られた。心理的要因は，リスク評価よりもベネフィットや抵抗感が違反頻度に関与していることが示唆された。(表10)（自抄）
キーワード：医療事故；看護；違反；事例分析；心理的要因
　
Yuko ADACHI, Shinnosuke USUI, Kazumitsu SHINOHARA, Tomoichiro MATSUMOTO, Yoshiko AOKI
Cases of Rule Violations in Nursing and Analyses of their Reasons Based on Psychological Factors
THE JOURNAL OF SCIENCE OF LABOUR,83(1),7～23,(2007)

　Rule violations have been indicated as causes of medical accidents. It is crucial to clarify what kinds of rule violations are made in hospitals. We conducted a questionnaire survey asking 155 nurses to report cases of rule violations and the reasons for the violations in order to assess what was really going on. In the questionnaire, the nurses were requested to verify the relation between violations and psychological factors using a 4-point scale. As a result, 169 cases of rule violations and 97 reasons for the violations were collected. These replies were classified by means of the KJ method and 21 items on violations and 13 items on reasons were identified. In the replies on reasons for violating a rule, there were many descriptions of psychological factors such as underestimating the risk or overestimating the benefit. The results of the questionnaire showed that rule violations positively correlated with a psychological factor, benefit and showed an inverse correlation between a psychological factor, aversion to rules.
Key words：Medical accident；Nursing；Violation；Case analysis；Psychological factors


堀口俊一､寺本敬子､西尾久英､林 千代
小児科学教科書等における鉛毒性脳症(所謂脳膜炎)に関する記述の変遷について
労働科学，83(1),24～32,(2007)

　京都大学初代小児科学教授平井毓太郎博士はわが国でかつて原因不明であった乳幼児の所謂脳膜炎が母親の用いていた白粉中の鉛に起因することを究明した｡この業績はその後に起った砒素ミルク事件等の社会的中毒研究の魁をなし，今日的意義を有する｡しかし，最近の小児科学教科書等における平井の業績の記述は乏しく，忘れ去られた感がある｡著者らは1914年から2003年に至るまでに発刊された小児科学教科書等38冊を対象として，所謂脳膜炎と鉛中毒に関する記載を調べ，その変遷について検討した｡その結果，1967年頃を境に，当該記述の乏しくなっていることを認めた｡鉛による環境汚染がなお危惧されている現在，平井の業績は後世に伝えてゆくべきである。(表2)（自抄）
キーワード：鉛中毒；鉛毒性脳症；所謂脳膜炎；平井毓太郎；小児科学教科書

Shun’ichi HOIGUCHI, Keiko TERAMOTO, Hisahide NISHIO, Chiyo HAYASHI
Changes of the Description of Lead Encephalopathy (So-Called Meningitis)
in Pediatrics Textbooks.
THE JOURNAL OF SCIENCE OF LABOUR,83(1),24～32,(2007)

　Ikutarou Hirai, the first professor of the Department of Pediatrics at Kyoto University, clarified in 1923 that “so-called meningitis named tentatively” of infants was caused by lead-contained face powder being used by mothers. This work of Hirai led to serial studies of socially induced poisonings that occurred in later periods. Prominent examples were arsenic poisoning due to contaminated milk, Minamata disease, "itai-itai" disease and "yusho" (poisoning due to rice oil contaminated by polychlorinated biphenyl and poly chlorinated dibenzofuran ). The work of Hirai is of important significance still in these days. The description of so-called meningitis or lead poisoning, however, is either only very brief or lacking in pediatrics textbooks and materials recently published, This is deplorable in view of the relevance of the work of Hirai to public health .The present authors conducted a survey of 38 books of pediatrics and found that the description of so-called meningitis or lead poisoning had come to be scarcely cited since around 1967.On the other hand, textbooks of occupational health or public health described precisely in no small way the work of Hirai still in these days. This is relevant to the fact that Japan today continues to suffer from the fear of environmental pollution due to lead. It is highly suggested to publicize the work of Hirai so as not to be forgotten forever.
Key words：Lead poisoning；Lead encephalopathy；So-called meningitis；Ikutarou Hirai； Pediatrics textbook

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