After further amendment in 2005, employers are no longer obliged to have a full contract with an external OHS provider. Under the condition of an appropriate collective agreement between employers and employees, employers are allowed to arrange NU7441 legally required OH activities by themselves. If the results are not PF-6463922 price satisfactory, however, they should contract with an external OHS provider. A contract with an OP is still compulsory for pre-employment examinations, periodical health examinations, and

medical sickness absence guidance activities (Ministry of Social Affairs and Employment, the Netherlands 2006). Thus, although OHSs for SSEs are not similar, the two countries have established universal OHS for all employees including those in SSEs. The present study was initiated to investigate the activities of OPs in Japan and the Netherlands, with additional foci of collecting suggestions from OPs in the two countries for improvement in OHS in SSEs. It was expected that such study should be valuable for the improvement

of the quality of OHS for SSEs not only in the two countries but also in other countries. Methods Study subjects Participants of the present study in the two counties were OPs who were working in SMEs, and not associated with in-company OHS. A questionnaire survey was conducted in December 2006. Subjects in Japan were OPs who belonged to member external OHS organizations of National Federation of Industrial Health Organizations, Japan (NFIHO). Full-time OPs for large companies Fludarabine in vitro and practitioners in clinic/hospital facilities were not affiliated to NFIHO member organizations, and they were automatically excluded from this study. Questionnaires (for details, see below) were mailed to all 461 physicians in NFIHO. Subjects in the Netherlands were selected from 1,780 physicians who were the members of the Netherlands Society of Occupational Liothyronine Sodium Medicine (Nederlandse Vereniging voor Arbeids—en Bedrijfsgeneeskunde, NVAB). Based on the post codes, the country was grouped into 4 regions and

20% of all OPs from each region were selected. A stratified random sampling strategy by decade of years of age and gender was employed for the selection. After exclusion of apparently non-active physicians (e.g., retired, or exclusively researching or teaching), questionnaires were sent to 335 physicians. Reminder letters were sent only to OPs in the Netherlands and only once. In practice, 107 Japanese (23%) and 106 Dutch physicians (32%) replied, respectively. Of these physicians, 28 Japanese and 17 Dutch physicians were non-active as an OP and they were excluded. In addition, 19 Dutch OPs were full-timers for large companies and were also excluded from the analysis. Thus, effective replies from remaining 79 Japanese (17%) and 70 Dutch OP cases (21%) were employed for analysis.