The notebook of personal health record system in Japan: framework of post-retirement health checkups for those formerly employed in hazardous occupations

Our plain-English summary of The notebook of personal health record system in Japan: framework of post-retirement health checkups for those formerly employed in hazardous occupations, by M. Eitoku, N.A. J-P, L.H. Indriyati, et al (Environmental and Occupational Health Practice, 2026).

The study

• Authors: M. Eitoku, N.A. J-P, L.H. Indriyati, B. Maharjan, L.T. Sato, K. Yasumitsu-Lovell, T. Murakami, H. Kanayama, T. Yoshikawa, S. Kajiki, T. Tamura, N. Suganuma
• Journal: Environmental and Occupational Health Practice
• Published: 2026;8(1)
• Cited by: 5 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

Objective: Japan is seeing a rapid increase in the numbers of migrant workers from Asian countries amidst a rapidly aging population and declining birthrate. The notebook of personal health record (nPHR) system is a Japanese occupational health service that supports those formerly employed in hazardous work, including migrant workers. This review outlines the structure, scale, and importance of the nPHR scheme and explores Japanese medical institutions that conduct health checkups for former workers with nPHR, offering insights into the potential applicability of similar systems in migrant workers' home countries.

Methods: Information on Japanese and international laws and Japanese statistical data was obtained from government websites. Studies of workers with nPHRs were reviewed using the ICHUSHI database.

Results: This review outlines the nPHR scheme established under Japanese legislation, summarizing its framework, issuance requirements, and post-retirement health checkups for 15 designated agents/works. In terms of scale, a gradual decline in newly issued nPHRs for major agents/works has been observed in recent years. The system's importance is highlighted through a review of studies involving former workers with nPHRs and an international comparison of post-retirement health checkup systems.

Conclusion: Because of the relatively small number of patients with nPHRs, public hospitals are candidates that could be contracted as medical institutions in migrant workers' home countries. Over the past 2 decades, three additional agents/works have been included in the system, and the requirements for asbestos-related nPHRs have been expanded, indicating that the system is actively adapting to evolving occupational health needs.

© 2026 The Authors.

In plain English

This article reviewed Japan's notebook of personal health record (nPHR) system. Former workers from certain hazardous work, including asbestos and dust-exposed work, who meet set requirements can be issued an nPHR, entitling them to government-paid checkups at designated contracted institutions. The authors described the governing laws, 15 covered agents or types of work, national statistics, four Japanese studies and similar systems abroad. The reported 2018 total of nPHRs, defined as cumulative issuance minus notebooks returned when holders died, was 71,414: 35,382 (49.5%) for asbestos and 25,804 (36.1%) for dust-exposed works. Newly issued asbestos nPHRs declined from 2018 to 2022 while asbestos-related compensation cases stayed stable. In reviewed studies of asbestos-exposed workers, lung cancer proportions ranged from 0.1% (one suspected case) to 2.6% (in 2,080 former asbestos-nPHR holders plus 50 current workers), and mesothelioma proportions from 0.1% to 0.4%. The authors reported that no migrant workers had been issued nPHRs. The authors concluded that fewer nPHRs appear to be issued than there are eligible former workers, and that public hospitals in migrant workers' home countries are candidates to provide the checkups.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Review: a review of Japanese laws and regulations and national statistics, a narrative review of four Japanese studies, and an international comparison of post-retirement health checkup systems
• Who was studied: Japan's nPHR system for former workers in 15 designated hazardous agents or types of work (as of 2024). It drew on national statistics, four Japanese studies of former workers with nPHRs published after 2000 (found in the ICHUSHI database, October 2025), and the systems of seven other countries.
• Exposure: The 15 agents or types of work covered by nPHRs, with emphasis on asbestos and on dust-exposed works. Dust-exposed works include drilling, mining, tunneling, quarrying, welding and asbestos handling. The article states that Japan used chrysotile, crocidolite and amosite.
• Main results:
  • An nPHR is granted if the Prefectural Labour Bureau confirms that the former worker meets the issuance requirements. Holders may then receive periodic checkups at designated contracted medical institutions, with costs covered by the Japanese government.
  • The reported total number of nPHRs issued by 2018 was 71,414. Of these, 35,382 (49.5%) were for asbestos and 25,804 (36.1%) were for dust-exposed works.
  • The article defines this total as the cumulative number of nPHRs issued minus those returned. Notebooks must be returned when their holder dies.
  • Newly issued nPHRs for asbestos declined from 2018 to 2022, while compensation cases for asbestos-related diseases remained stable.
  • According to one Japanese study cited by the authors, after the 2005 Kubota Shock the total number of asbestos nPHRs issued rose from 593 in June 2005 to 1,495 in December 2005 and 4,390 in June 2006.
  • In a reviewed study (Tabata, 2012) of 1,083 former workers with asbestos nPHRs, 19 (1.8%) had lung cancer and 4 (0.4%) had mesothelioma.
  • In a reviewed study (Kishimoto and Fujimoto) of 2,130 asbestos-exposed workers (2,080 former workers with asbestos nPHRs and 50 current workers), the proportions with lung cancer and mesothelioma, reported for the combined group, were 2.6% and 0.3%, respectively.
  • In a reviewed study (Tabata et al., 2008) of 976 former workers with asbestos nPHRs, there was 1 (0.1%) case of suspected lung cancer and 1 (0.1%) case of mesothelioma.
  • According to information from the Overseas Health Checkup Initiative project, no migrant workers had been issued nPHRs.
  • In the international comparison, only four of the eight countries with post-retirement health checkup systems covered multiple hazardous substances.
• The authors' conclusion: The authors concluded that issuance trends suggest fewer nPHRs are issued than there are eligible former workers, likely because information about the system has not reached them. They also concluded that public hospitals in migrant workers' home countries could be more realistic candidates to serve as contracted institutions for nPHR-based checkups.
• Limitations the authors state:
  • The number of nPHRs issued is not systematically reported or publicly available.
  • The authors noted that comparisons between groups in one reviewed study (Yamauchi et al.) may be affected by selection bias, surveillance bias and case-mix differences.
  • The literature search was limited to articles published after 2000, because relevant literature before then was extremely limited.

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