Occupational health services in Korea have been operated as dual types : one is operated by occupational health care manager and the other is health care agency without their own personnel. The performance of occupational health service should be different due to the variety of characteristics of health care manager and workplace, qualification of health care manager. This study is to analyze performance of occupational health care services with a particular consideration of job performance shape and efficiency, based on comparing those two types of health care management to show on the basic data for the settlement of more qualitative health care management system at workplace. For this study, total 391 places in Seoul and Inchon city area ; 154 places (39.4%) managed by designated health care manager and 237 places (60.6%) by the agency with their commission are selected as research samples. Tools for data collection are questionnares that have been investigated during the period of 20 September 1993-20 December 1993. Those data are compared with percentiles, mean, standard deviation and B/C ratio using SPSS PC program. Conclusions observed from the tests and each comparison could be summerized as follows : 1. Occupational health care have been accomplished at workplaces with designated people than with agencies people, and coverage rate of the occupational health care services has differences, due to management types. The reason of these results is due to visit only one or two times monthly by the agencies, while their own health care manager obsess, at the workplaces all the times. 2. Most of the expense for environmental control of all health care services expenditures shows that there is almost no fundamental improvement because more expenses are needed for procuring personal protective equipment and measuring work environment instead of environmental improvement. 3. It is investigated how much the cost of occupational health care services needs per worker, and calculated how much the cost needs per service hour per worker. The results from this show that the cost of occupational health services at workplaces with their own managers used less than the cost of health care agencies, eventually the former gives better services with less cost than the latter. 4. Benefit/Cost ratio is also produced by total benefit/total cost. The result from the above way reads 4.57 as a whole, while their own manager having workplaces reads 4.82 and the agencies do l.56. Even if their own manager performing workplaces spent more cost, this system produces more benefit than the agencies management. 5. The B/C ratio for medical organization such as local clinic, health care center and pharmacy shows more than or equal to at the workplaces controlled by the agencies. It is inferred that benefit would be much less than the cost used, with so being inefficient. 6. It is assumed that the efficiency ratio of health education is equal to reduction rate of workers medical organization visit. Estimated reduction rate 5%, 10%, 15%, show that the efficiency ratio of health education have an effect on producing benefits. It is estimated that more benefit can be produced if more qualitative education will be provided for enhancing health care efficiency. 7. Results of this study cannot be generalized because there are large scale of deviation in case of workplaces with less than 300 full time workers, but B/C ratio reads 2.69 as a whole and 3.25 at workplaces with their own health care manager are higher than 1.63 at the workplaces manged by the agencies. Finally, all the benefit concerning health care services could not be quantified, measured and shown on the value of money. This is a reason that a considerable part of benefits are so underestimated. This is also thought that measurement tools should be developed for measuring benefits of health care services with a comprehensive quantification. in the future. It is also expected that efficiency of occupational health care services should be investigated using cost-effectiveness analysis.

The purpose of this study was to evaluate the effect of health services on workers with hypertension in small and medium sized enterprises (20-300 employees). One hundred seventy three workers among 296 workers with hypertension were responded to the questionnaire on general and occupational characteristics, health habits and anti-hypertensive medications. Blood pressure was obtained while seated using a calibrated standard manometer before and after 4 months health services. Statistical analysis was performed using $X^2$-test and logistic regression analysis. The results were as follows ; 1. No significant differences were noted in variables of smoking, glucose intake and sleeping time, while significant differences were showed in variables of exercise time, frequency and amount of drinking and intake of salt, protain, lipid, calcium, vegetable and fruits between groups which was provided and not provided health services. 2. The rate of anti-hypertensive medication was increased and the blood pressure was decreased significantly in group which was provided health services compared with those of group which was not provided. 3. With the logistic regression analysis, significant variables affecting blood pressure change were smoking and anti-hypertensive medication. The results of this study suggested that health services on workers with hypertension in small and medium sized enterprises was effective, and the role of health professionals for health promotion movement in enterprises was important.

In order to investigate the effects of family nursing intervention on workers' working attitude, the questionnaire survey was carried out on 31 workers who had experienced family nursing intervention and 31 workers who did not have experienced family nursing intervention. The structured questionnaire was constituted of 3 parts of the workers' working attitude, job satisfaction, interpersonal relationship and creativeness. The results were as follows ; 1. Mean score of working attitude for post-intervention was significantly higher in the intervention group(3.48) than in the control group(3.03). However, there was no significant difference that for pre-intervention between two groups. 2. Mean scores of the job satisfaction, interpersonal relationship and creativeness were significantly higher in the intervention group(4.12, 3.58, 4.06) than in control group(3.49, 3.09, 3.34) 3. The major contributing factor to the effect of family nursing intervention was sex(18.2%) and followed by nursing intervention(13.2%) in general. The major contributing factors were sex and working evaluation records in post-intervention in job satisfaction(15.1%), and nursing intervention and sex in creativeness (39.2%).

The purpose of this study was to assess the performance of the role and function of some industrial nurses and to characterize the factors affecting the performance of their activities. Thus the results could be used to suggest the direction in the performance of industrials nurses' activities effectively. During a period from January 10 to March 31, 1994, the data were collected from 87 industrial nurses, who were working as health managers in the plants, in Ulsan city and the vicinity in Kyungnam province, using a structured questionnaire. The results were as follows : 1. The general characteristics of industrial nurses in this study were 82.8% being 30 years old or less, 60.9%, being not married, and 93.1% having eduction levels above junior college. 2. With respect to general work conditions, 94.3% were working in a separate room provided for health care division, 40.2% working under the safety and health department, and 98.9% working as common-level staffs. And 60.9% were working less than 44 hours a week, 70.1% had work experiences less than 5 years, and 50.6% had annual incomes ranging 10 to 14 million wons. 3. As work conditions related to health care activities, 49.4% performed the activities not related to health care as always or occasionally, and 87.4% answered that occupational physicians were appointed in their plant and among them, however, only 6.9% worked on full-time basis and 52.8% perform little activities as occupational physicians. For a decision related to health care activity, 69.0% discussed the problems with the supervisors, and 19.5% made decisions by themselves. 4. As for attitude and perception to their activities as health managers, 66.7% moderately recognized the importance of health manager in the workplace, with 63.2% being satisfied their wages and treatment from the company, 57.5% being satisfied with their job positions and 51.7% having positive attitudes as being health managers. 5. The degree of performance at least in one of health related activities were very high in activities such as general medical care(100%), general health examination(98.0%) and specific health examination(100%), and relatively high in health education(72%), new employee health examination(60.9%), document handling(79.3%) and activity for work environment(70.1%). However, the performance rate was very low in preparing protective equipment (20.8%). 6. The levels of activities related to health care were significantly high when making decisions by themselves, when occupational physicians not being full-time, and when satisfying their job positions, and, on the other hand, significantly decreased as work hours increased. 7. In addition to some kinds of periodic education asked by all of the nurses, 89.7% wanted a specialized licensing system for industrial nurse, and 97.4% wanted to apply for the license test. As a conclusion, it is suggested that industrial nurses should be given more authority and placed in more self-controlled system to perform health care and other activities more efficiently, and the role and function of the occupational physician should be clearly distinguished from that of the industrial nurse as a health manager to avoid an unnecessary overlapping.

The small scale industries which have less than 30 employees occupy 86.5% of total number of industries in Korea. And though they have higher accident rate and lower environmental condition than big industries, it has been not mandatory to appointing health care manager at factory. So, from 1993, government subsidizes to the health care management of small industries. The purpose of this study is to identify the real feature of health care status in small industries, and to evaluate the level of health care management, before and after the subsidiary program. 65 small plating industries which have been managed by the same health care management support institution in 1993 were selected for study. Of the 65 industries, 3 which have not taken both environmental evaluation and health screening in 1994, and 9 which have closed were excluded from study sample. And the remaining 53 were analyzed by using the results of environmental evaluation and health screening, reported to the Ministry of Labor, before and after the subsidiary program, the analysis was done by the comparison of the two year paired data of the same industry. Over-permissible-limit rate, health screening implementation rate, above grade C rate were calculated and compared. The status of health care management ; 1. Of the sample industries, 96.9% provide protective equipment and 80.0% set up ventilating system. Protective gloves (89.2%) and protective clothing (80.0%) are widely provided, but ear plugs (4.6%) are rarely provided. 21.5% of the protective equipment are well put on, and 40.4% of the ventilating systems function well. 2. In 1993, 35 industries, 53.8% of the sample, checked working environment twice. Over-permissible-limit rates of heavy metal (12.2%), suspended particle (11.1%), noise (5.5%) were high. To put on protective equipment and to set up local ventilating system were pointed out by the examiners. 3. General health screening was done at 63.1% of the sample industries and 35.3% of total workers were examined. Specific health screening was done at 93.8% of the sample industries and 75.4% of workers were examined. 15.5% of workers was provided to be above grade C and to have digestive system disease (43.3%), circulatory disease (18.9%), and hematopoietic disease (14.2%), etc. 4. In 1993, the subsidiary program of health care management was provided in forms of health education, health counseling, and rounding check of working field. And 61.5%, 83.0%, 55.4% of sample industries respectively received it. The average visit per industry was 1.8. Comparisons of the level of occupational health before and after the subsidiary program ; 1. Over-permissible-limit rates of hazardous factors of 1993 and that of 1994 were compared. The rates of suspended particle, noise, organic solvent of 1994 (37.5%, 13.4%, 24.2% respectively) were higher than that of 1993 (25.0%, 6.0%, 6.3% respectively). In the case of acid, there was no difference between the rate of 1993 and that of 1994. Only the rate of heavy metal decreased from 12.9% in 1993 to 3.0% in 1994. 2. General health screening was done at 38.7% of the sample industries in 1993 and at 44.6% in 1994. But the implementation rate of specific health screening decreased from 72.4% in 1993 to 64.6% in 1994. 3. The implementation rate of specific health screening was analyzed by some health factors. The rate of suspended particle increased from 61.8% in 1993 to 91.2% in 1994. But the rates of the others-noise, organic solvent, heavy metal, specific chemical substances-decreased. 4. Above grade C rate in health screening increased from 27.8% in 1993 to 35.5% in 1994. But that of endocrine disorders and pulmonary disease decreased.

The periodic health examination have been shown the important role on early detection, early treatment and prevention of disease. Until now, there have been many studies that showed the effectiveness of the periodic health examination on the early detection and early treatment of disease to some extent. But there are few studies about primary prevention before health problem arise. In this case-control study, 29 newly detected hypertensive cases, 31 liver disease cases and 65 controls which are all available for 6-year data in the periodic health examination of a occupational field were compared to investigate the significant increase trend of health status between the groups. The results will be used for the occupational health nurses to provide appropriate primary prevention to the employees. The hypertensive and liver disease cases were divided observation-needed group and treatment-needed group. The data on systolic blood pressure, diastolic blood pressure, Body Mass Index and Broca Index in hypertensive cases and SGOT, SGPT, Body Mass Index and Broca Index in liver disease cases were analyzed by t-test and ANOVA. The specific findings are summarized as follows. 1. In the comparison between the hypertensive cases and controls, SBP and DBP of the observation-needed group and the treatment-needed group were significantly higher than the data of the controls for past 6 years. It was 2-3 years ago showing increase over 140/90mmHg of blood pressure in the hypertensive cases before they are categorized as hypertensive cases. In the observation-needed group and the treatment-needed group, the trend of the blood pressure for 6 years were significantly higher than the one of the controls. 2. In the comparison between the liver disease cases and controls, SGOT and SGPT of the observation-needed group and the treatment-needed group were significantly higher than the data of the controls for past 6 years. It was 2 years ago showing increase within upper normal limit of SGOT and 5 years ago of SGPT in the liver disease cases before they are categorized as liver disease cases. In the observation-needed group and the treatment-needed group, the trend of the liver enzyme for 6 years were significantly higher than the one of the controls. With these results, the author proposed that intervention for the primary prevention such as continuous follow-up, health education and weight control to the population who has over 140/90mmHg of blood pressure and upper normal limit of AST and ALT.