1. Miyo Takinami Chief of Negotiation Section East Japan Railway Workers’ Union (JREU) “The Mental and Physical Health Care of Employees Ensures the Safety of Railway Transportation” The Current Situation of the Health Care System and the Roles of Medical Facilities under the Direct Management of JR East

2. 2 JR Hokkaido JR Central JR East JR West JR Shikoku JR Kyushu Morioka Nigata Takasaki Omiya Yamagata Sendai Fukushima Akita Nagano Tokyo The general description of JR East Total length 7526.8km 1,702 stations Passengers a day about 16 million 65.380 workers are employed

3. 3 Description of the current health care systems at JR East. Morioka Nigata Takasaki Sendai Akita Nagano Tokyo Mito Chiba TOKYO ： Tokyo General Hospital TOKYO ： Health Promotion Center SENDAI ： Sendai Hospital Health Control Center MORIOKA 、 AKITA 、 NIGATA 、 NAGANO 、 TAKASAKI 、 MITO 、 CHIBA ： Railway Health Check Centers

4. 4 Tokyo General Hospital Sendai Hospital Tokyo General Hospital Sendai Hospital Health Promotion Center （ TOKYO ） Railway Health Check Centers （ MORIOKA 、 AKITA 、 NIGATA 、 NAGANO 、 TAKASAKI 、 MITO 、 CHIBA ） Health Promotion Center （ TOKYO ） Railway Health Check Centers （ MORIOKA 、 AKITA 、 NIGATA 、 NAGANO 、 TAKASAKI 、 MITO 、 CHIBA ） They are essentially general hospitals, and are designated as emergency medical centers and treat not only employees but local residents as well. They are focus on “preventive medicine” such as special health examinations and complete medical checkups. Main service of health care system

5. 5 Health Control and the Medical Care System for Employees More than 60.000 JR East employees Working in the six areas (1) Transport (2) Commercial Operations (3) Facility Management (4) Planning (5) Management (6) Medical Care The working system (1) day shift (2) night shift (3) rotating shift system Regular annual physical checkup Yearly medical examination specified SAS (sleep apnea syndrome), examinations Specific health examination Complete medical checkup etc… If something is found to be amiss, the company recommends a consultation with a doctor, further tests, or treatment. The company’s Safety Principle “Safety Is the Most Important Mission for Transport Operations” “People First Philosophy” based on the fundamental standpoint of both the management and the union.

6. 6 Mental Care Violence by passengers Stable operations Injury accident Under pressure from boss Fear of accident Suicide, Long medical leaves, Mental troubles in on-duty “Counseling Room” Treats problems concerning work, household worries or mental issues.

7. 7 The usage of the “Counseling Rooms” Year ○The number of cases of counseling Consistently risen year by year Total number in the Tokyo metropolitan area

8. 8 ○The contents of the counseling Year ○The number of cases of counseling requested Mental distress Worries at the workplace Personal problems Drinking problems Others by fellow workers by employees Medical Care By families Others The usage of the “Counseling Rooms”

9. 9 Our efforts to tackle PTSD PTSD ・・・ The case of PTSD People can be greatly traumatized by witnessing inescapable, grotesque events. It’s divided into “Acute Stress Disorder” and ”Delayed Stress Disorder” a driver was involved in an Injury accident. Observing the driver’s behavior, the manager began to suspect that the driver was suffering from acute stress disorder. He advised the driver to go see a doctor. Treatment was initiated, with close contact maintained between the driver, the manager, and the staff of the Health Promotion Center. The driver recovered after five months of treatment, and continues to work diligently. Union members who are involved in medical care have a definite awareness that they should “treat patients quickly”

10. 10 The role of directly-managed medical facilities What can we do as workers at directly-managed medical facilities? Discussing our role with all the railway-loving participants here will help us establish a core feature for ensuring railway safety. I hope more union members will come to the health classes organized in order to promote awareness of preventive medicine and of the importance of smoking cessation.