事業運転者への脳検診の現状と活用への展望

Brain Screening for Occupational Drivers: Current Practices and Future Directions

労働安全衛生法により労働者の健康保持は義務付けられているが，事業用車両による健康起因事故は近年増加傾向にあり，令和6（2024）年には約400件発生している。その主因は脳血管疾患，心臓疾患，睡眠障害であり，2018年に脳血管疾患対策ガイドラインが制定されたものの，MRIなどのスクリーニング検査はいまだ推奨レベルで義務化されていない。既に事業運転者の減少と高齢化が深刻な課題となっている。今後の事故防止体制強化に向けては，脳MRI検診による事故削減効果を明確にし，特に高齢運転者においては航空機操縦士と同様の検査必須化を検討していく必要がある。本論では，2018〜20年に国土交通省が実施したモデル事業の成果に基づき，脳MRI検診の有用性と今後の方向性を検証する。

Abstract

While the Industrial Safety and Health Act mandates the maintenance of workers' health, more than 100 health-related accidents involving commercial vehicles occur annually. The primary causes of these accidents include cerebrovascular, cardiovascular, and sleep disorders. Although guidelines were issued in 2018 for the implementation of countermeasures against cerebrovascular disease, screening examinations such as brain MRIs remain recommended rather than mandatory. Furthermore, the declining number and aging of occupational drivers already constitute serious challenges. To strengthen future accident-prevention systems, it is necessary to clarify the effectiveness of brain MRI screenings in reducing accidents and to consider mandating these examinations for older drivers, similarly as in the requirements for aircraft pilots. Based on the results of a pilot project conducted by the Ministry of Land, Infrastructure, Transport and Tourism from 2018 to 2020, this article evaluates the utility of brain MRI screenings and examines future directions for their implementation.