Opinion survey of employers and labor unions on handling workers' personal health information

2003年1月，我们与日本工会联合会合作，向934个工会发送了问卷，询问他们对雇主负责雇员健康信息时隐私保护问题和可取政策的看法。我们收到了353个工会的有效答复。大多数人赞成雇主根据现行法律对健康检查结果进行记录（68.8%）和审阅（61.8%）。有11.0%的体检项目不允许向用人单位透露家族史，16.1%的体检项目不允许向用人单位透露医疗费用，22.0%的体检项目不允许向用人单位透露吸烟情况，28.9%的体检项目不允许向用人单位透露体重。分别有71.7%及45.3%认为修改现行法例，规定雇员或职业健康专业人员备存个人健康纪录有问题，主要是担心雇主保障雇员健康的责任会被削弱。此外，25.2%的工会指出小企业没有配备职业卫生专业人员的问题，21.2%的工会提出专业能力多样化的问题。此外，21.2%的受访者认为雇主利用健康数据，在未经雇员同意的情况下，限制或更改雇员的工作安排，亦有问题。至少有11个工会承认，他们经历了不愿意调动、解雇或信息泄露的情况。这项调查描述了日本雇主保护雇员健康和隐私的相互冲突的法律的责任。职业卫生专业人员应平衡雇主和雇员的利益，并提出有效的策略来处理工作场所的健康信息。

In cooperation with Japanese Trade Union Confederation, we mailed 934 labor unions questionnaire in January 2003, to ask their opinions regarding problems and desirable policy on privacy protection while employers are responsible for health information of employees. We received valid answers from 353 unions. Majority approved the record keeping (68.8%) and the perusal (61.8%) of health examination result by employer, in accordance with the existing laws. Some examination items were disallowed to be disclosed to the employer such as family history 11.0%, receipt of medical expenses 16.1%, smoking status 22.0%, body weight 28.9%. Changing the current legislation by requiring the employees or the occupational health professionals to keep personal health record was regarded problematic by 71.7% and 45.3%, respectively ; mainly for fear that the responsibility of employers to protect health of their employee would be weakened. Additionally, 25.2% pointed out the problems in small enterprises without assigned occupational health professionals, and 21.2% unions raised the issue on variety of professional competence. Meanwhile, the use of health information by employer to restrict or change employees' work assignment without their consent was regarded also problematic by 21.2%. At least 11 unions admitted they experienced cases of unwilling transfer, dismissal, or information leakage. This survey described the conflicting legal liability of Japanese employers to protect both health and privacy of the employees. Occupational health professionals should balance interests of employer and employee and propose an effective strategy for the handling health information at workplace.