『保健医療科学』第57巻 第3号, p.196－205 （2008年9月）
特集：災害時に保健医療従事者は何をすべきか ―期待と現実の Gap ―
災害における保健福祉行政部局の役割
鈴木幸雄
厚生労働省労働基準局安全衛生部労働衛生課
抄録
新潟県において連続的に発生した豪雨と 2 度の地震に対する保健福祉行政部局の対応を通じて改善された健康危機管理体制を時系列的に比較し，平常時に取り組むべき研修や訓練のあり方について考察した．行政としては人事異動があっても対応ができるよう，自治体間の協定や医療関係団体との具体的な規定を定め，図上訓練等により反復して確認することが重要である．
また，各災害において新潟県が果たした業務を市町村との役割分担という観点から整理した．都道府県の役割を大きく分類すると，広域的調整，専門的役割及び先導的役割が重要であった．
キーワード:? 災害，健康危機管理，こころのケア，医療救護，DMAT，エコノミークラス症候群
Abstract
This article described the responses of the health and welfare department to a downpour and two earthquakes that consecutively occurred in Niigata Prefecture, compared the emergency preparedness systems improved based on the experiences of the emergency responses, and discussed how training and exercising were conducted in the routine arrangement. It is important to make a definite agreement with other local governments, medical service providers, or healthrelated organizations, and to ensure a coordinated response repeatedly through exercises and simulations, in order to achieve an appropriate response regardless of personnel changes in local governments.
As the results that the activities carried out by Niigata prefectural government in each disaster were categorized and analyzed from the point of view of a share of the role with municipal governments, it was suggested that a prefectural government needed to play three important roles, that is, a role as a wide-area coordinator, a role as an expert, and a role as a leader.
keywords: disaster, emergency preparedness, mental care, medical relief activity, DMAT（disaster medical assistant team, economy class syndrome