˧ͅƷĸ¾ɕòÞ Ʒĸ¾ɕĜȇ̡Þĳ³Šǹ§µÞ2004.6.10

ȱȩ̢ėǇÂ
Ʒĸɕʛ×òŠĨȎ Ʒĸ̷ŜĄͿò ̈́Ɗɔʱ1Ʒĸ̷Ŝö˛N/5cˊɔ˹ʳPɆɀ1) Ξ˚¾ɕP͞ˉJoint ILO/WHO Committee on Industrial Hygiene Report, 1950, 1995
It was agreed that “occupational health” should aim at: the promotion and maintenance of the highest
degree of physical, mental and social well-being of workers in all occupations; the prevention amongst
workers of departures from health caused by their working conditions; the protection of workers in theiremployment from risks resulting from factors adverse to health; the placing and maintenance of the worker
in an occupational environment and, to summarize: the adaptation of work to man and of each man tohis job. The main focus in occupational health is on three different objectives: (i) the maintenance andpromotion of workers’ health and working capacity; (ii) the improvement of working environment and work
to become conducive to safety and health; and (iii) development of work organizations and working
cultures in as direction which supports health and safety at work and, in doing so, also promotes a positivesocial climate and smooth operation, and may enhance the productivity of the enterprises.
2) Ξ˚¾ɕwzPĖ˲ILO161 ƔȬͤ, 1985
Article 1 For the purpose of this Convention- the term “occupational health services” means services
entrusted with essentially preventive functions and responsible for advising the employer, the workers andtheir representatives in the undertaking on- (i) the requirements for establishing and maintaining a safeand healthy working environment which will facilitate optimal physical and mental health in relation to work;(ii) the adaptation of work to the capabilities of workers in the light of their state of physical andmental health.
3) Ξ˚ǨPŜƈwkzPC]PΏͿĜȇqkkILO, 1998

5.2 When the results of workers’ health surveillance are used for assessing the fitness of the worker
for a specific job or type of work, the principles below should be followed: (i) within an occupational healthperspective, there is no such thing as fitness for employment in general; fitness can be defined only interms of a particular job or type of work; similarly, there is no such case as absolute “unfitness” foremployment; (ii) fitness reflects the relationship between the demands of the specific work and theabilities of the worker who is to do the work; as both the work and the worker’s health status are
subject to change, any assessment of fitness for employment should be open to review, since it relates to
one point in time; (iii) caution should be exercised when a diseased or physically disabled person is
examined for fitness for employment, when two major risks should be avoided: the first is tooverestimate functional disability by failing to allow for any adaptation of the job to the worker, while thesecond is to underestimate an intelligent and determined person’s ability to overcome a disability
and produce satisfactory results in a job that might be considered to be beyond such determination; (iv)fitness for employment should be viewed in the light of the interactions between fitness,ergonomics, functional and vocational rehabilitation.
5.3 The establishment of fitness criteria is often an oversimplification which may not be
consistent with sound occupational health practice. In practice, it is preferable to express fitness in termsof “no medical contra-indication” to a specific job or work and to express “unfitness” in terms of the kinds ofjobs and conditions of work and exposure to hazards which are medically contra-indicated, temporarily or
permanently.
5.4 The shift from a “fitness” to “adaptation” approach implies that the result of the healthassessment should also be used for the objectives of advising the worker and the employer on themeasures that they should take to overcome the problem; on which lifestyle might minimize work-related
problems; the use of individually adapted protective equipment; and advising the employer,
management, workers’ representatives and the safety and health committee, where it exists, onmeasures (collective, individual or both) to adapt the working environment or the workorganization to the physiological and psychological needs of workers.

-1-˧ͅƷĸ¾ɕòÞ Ʒĸ¾ɕĜȇ̡Þĳ³Šǹ§µÞ2004.6.10

4̰ƗȧéǨ̾ Americans with Disabilities Act=ADA, 1990
̰ƗˣJ 15 Ɂ¤Ȩ1994 ˭ 6 Ś 26 ˧¤ɯQ 25 ɁPΞ˚Ǩg 20 Ǽ¤ȨŲͳ=cƼͳǨNʘ;I
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É̺;Cȱ¥N/5cͅǤˉĖ˲essential functionsPȱ͓gɊƍ=c˲ΎNG,IP[ɂOc7K1J2c1
éP̅¦

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ɑǤ ȃȠ˒NG,IɂOc7KQĽ<adI,cdisability: someone who has a physical or mental impairment that substantially limits them in somemajor life activityRehabilitation Act, 1973
qualified individual with a disability: an individual with a disability who, with or without reasonableaccommodation, can perform the essential functions of the employment position that such individual holds
or desires
examples of discrimination: 1) segregating, limiting, or classifying disabled employees, 2) not making"reasonable accommodations" for an employee's disability (unless they cause "undue hardship"), and 3)
using any employment criteria (such as medical exams before employment or during the duration of theworker's employment) that intentionally or unintentionally discriminate against disabled persons. If medical
exams are to be given, they must be of "business necessity," and be given to all applicantsreasonable accommodations: Any change in the work environment or in the way things arecustomarily done that enables an individual with a disability to enjoy equal employment opportunities. A
gray area that includes, but is not limited to: 1) restructuring of work responsibilities (such as part-time or
modified work schedules) 2) making existing facilities accessible to and usable by disabled persons, 3)
acquiring or modifying equipment or other work related devices, and 4) providing any readers orinterpreters necessary for the employee to function properly. These modifications may not, however,impose "undue hardship" on the employer.
undue hardship: any accommodation that would be unduly costly, extensive, substantial, or disruptive,or that would fundamentally alter the nature or operation of the business
unduly costly”: cost factors will most likely be made on a case-by-case basis taking into account thesize and nature of the employer-2-˧ͅƷĸ¾ɕòÞ Ʒĸ¾ɕĜȇ̡Þĳ³Šǹ§µÞ2004.6.10

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- 12 -

Ɔ̤Pɾ΢幸福˧ͅƷĸ¾ɕòÞ Ʒĸ¾ɕĜȇ̡Þĳ³Šǹ§µÞ2004.6.10

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再適応
医学的治療
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