Association between COVID-19 infection rates by region and implementation of non-pharmaceutical interventions: a cross-sectional study in Japan.

BACKGROUND: During a pandemic, non-pharmaceutical interventions (NPIs) play an important role in protecting oneself and others from infection. There are large regional differences in COVID-19 infection rates in Japan. We hypothesized that the local infection incidence may affect adherence to individual NPIs. METHODS: This cross-sectional study was conducted online among full-time workers in Japan in December 2020. The questionnaire asked the respondents to identify their habits regarding seven common NPIs (wearing masks, washing hands after the bathroom, disinfecting hands when entering indoors, gargling when returning home, ventilating the room, disinfecting or washing hands after touching frequently touched surfaces, carrying alcohol sanitizers when outdoors). RESULTS: A total of 27 036 participants were analyzed. Compared with the region with the lowest infection rate, five of the seven NPIs showed statistically significant trends across regional infection levels, the two exceptions being wearing masks and washing hands after the bathroom. Multivariate adjustment did not change these trends. CONCLUSIONS: This study found that NPIs were more prevalent in regions with higher incidence rates of COVID-19 in Japanese workers. The findings suggest that the implementation of NPIs was influenced not only by personal attributes but also by contextual effects of the local infection level.

Occupational Factors Associated with Telemedicine Use in the Japanese Working-Age Population: A Web-Based Study Conducted during the COVID-19 Pandemic.

Telemedicine has significant potential for helping workers access medical treatment. To improve workers' access to telemedicine, it is important to analyze current utilization rates and influencing factors. Therefore, the purpose of this study is to evaluate the associations between occupational factors and telemedicine use. A 1-year follow-up study of 4,882 full-time workers receiving regular treatment in Japan was conducted from December 2020 to December 2021. Occupational factors associated with the use of telemedicine were evaluated by multivariate logistic regression analysis. In total, 191 participants had experience of using telemedicine (3.9%). The most common comorbidity was hypertension (37.0%), followed by back pain and arthritis (19.8%) and depression and psychiatric disorders (14.5%). Managers and executives [adjusted odds ratio (aOR) = 1.92, 95% confidence interval (CI): 1.68-3.43, P < = 0.026], finance industry workers (aOR = 2.61, 95% CI: 1.24-5.49, P = 0.011), and individuals with experience of teleworking (aOR = 2.08, 95% CI: 1.52-2.85, P < 0.001) were more likely to use telemedicine. Telemedicine usage was least common among workers aged 50-59 years (aOR = 0.35, 95% CI: 0.22-0.57, P < 0.001) and those with long working hours (≥ 9.0 hours/day) (aOR = 0.59, 95% CI: 0.38-0.93, P < 0.022). The utilization rate of telemedicine in Japan is still low. This study identified occupational factors related to the use of telemedicine, such as worker's age, employee status, working hours, and experience of teleworking. Our findings suggest that flexible work arrangements could promote widespread use of telemedicine.

Effect of COVID-19 infection related experiences on social behaviors when a state of emergency is declared: a cohort study.

BACKGROUND: Restricting the movement of the public to gathering places and limiting close physical contact are effective measures against COVID-19 infection. In Japan, states of emergency have been declared in specific prefectures to reduce public movement and control COVID-19 transmission. We investigated how COVID-19 infection related experiences including people with a history of infection, people with a history of close contact, and people whose acquaintances have been infected, affected self-restraint from social behaviors during the second state of emergency in Japan. METHODS: A prospective cohort study was conducted among workers aged 20-65 years using data from an internet survey. The baseline survey was conducted on December 22-25, 2020, and a follow-up survey was on February 18-19, 2021. There were 19,051 participants who completed both surveys and were included in the final analysis. We identified eight social behaviors: (1) eating out (4 people or fewer); (2) eating out (5 people or more); (3) gathering with friends and colleagues; (4) day trip; (5) overnight trip (excluding visiting home); (6) visiting home; (7) shopping for daily necessities; and (8) shopping for other than daily necessities. We set self-restraint regarding each social behavior after the second state of emergency was declared in January 2021 as the dependent variable, and COVID-19 infection related experiences as independent variables. Odds ratios were estimated using multilevel logistic regression analyses nested in the prefecture of residence. RESULTS: Significant differences by COVID-19 infection related experiences were identified: compared to people without COVID-19 related experiences, people with a history of COVID-19 were less likely self-restraint from most social behaviors. People whose acquaintance had been diagnosed with COVID-19 were significantly more likely to refrain from most social behaviors. There was no significant difference in any social behaviors for people with a history of close contact only. CONCLUSION: To maximize the effect of a state of emergency, health authorities should disseminate information for each person in the target population, taking into account potential differences related to the infection related experiences.

COVID-19 vaccination coverage by company size and the effects of workplace vaccination program in Japan: a cohort study.

BACKGROUND: Vaccination is considered the most effective control measure against COVID-19. Vaccine hesitancy and equitable vaccine allocation are important challenges to disseminating developed vaccines. To promote COVID-19 vaccination coverage, the government of Japan established the workplace vaccination program. However, while it appears that the program was effective in overcoming vaccine hesitancy, the program may have hindered the equitable allocation of vaccines because it mainly focused on employees of large companies. We investigated the relationship between company size and COVID-19 vaccination completion status of employees and the impact of the workplace vaccination program on this relationship. METHODS: We conducted an internet-based prospective cohort study from December 2020 (baseline) to December 2021. The data were collected using a self-administered questionnaire survey. Briefly, 27,036 workers completed the questionnaire at baseline and 18,560 at follow-up. After excluding ineligible respondents, we finally analyzed the data from 15,829 participants. At baseline, the participants were asked about the size of the company they worked for, and at follow-up they were asked about the month in which they received their second COVID-19 vaccine dose and the availability of a company-arranged vaccination opportunity. RESULTS: In each month throughout the observation period, the odds of having received a second COVID-19 vaccine dose were significantly lower for small-company employees than for large-company employees in the sex- and age-adjusted model. This difference decreased after adjusting for socioeconomic factors, and there was no significant difference after adjusting for the availability of a company-arranged vaccination opportunity. CONCLUSIONS: The workplace vaccination program implemented in Japan to control the COVID-19 pandemic may have been effective in overcoming vaccine hesitancy in workers; however, it may have caused an inequitable allocation of vaccines between companies of different sizes. Because people who worked for small companies were less likely to be vaccinated, it will be necessary to enhance support of vaccination for this population in the event of future infectious disease outbreaks. TRIAL REGISTRATION: Not applicable.

Association between willingness to receive the COVID-19 vaccine and sources of health information among Japanese workers: a cohort study.

BACKGROUND: It is important to achieve herd immunity by vaccinating as many people as possible to end the COVID-19 pandemic. We investigated the relationship between willingness to receive vaccination and sources of health information among those who did not want to be vaccinated against COVID-19. METHODS: This prospective cohort study collected data using a self-administered questionnaire survey. The baseline survey was conducted during December 22-25, 2020, and the follow-up survey during February 18-19, 2021. Participants were aged 20-65 years and worked at the time of the baseline survey (N = 33,087). After excluding 6,051 invalid responses, we included responses from 27,036 participants at baseline. In total, 19,941 people responded to the follow-up survey (74% follow-up rate). We excluded 7,415 participants who answered "yes" to the question "If a COVID-19 vaccine becomes available, would you like to get it?" in the baseline survey. We finally analyzed 12,526 participants. RESULTS: The odds ratio for change in willingness to be vaccinated from "no" to "yes" differed by source of health information. Compared with workers that used TV as a source of information, significantly fewer people who reported getting information from the Internet and friends/colleagues were willing to get the vaccine. CONCLUSIONS: It is important to approach workers who do not watch TV when implementing workplace vaccination programs. It is likely that willingness to be vaccinated can be increased through an active company policy whereby the top management recommend vaccination, coupled with an individual approach by occupational health professionals. TRIAL REGISTRATION: Not applicable.

Job stress and loneliness among desk workers during the COVID-19 pandemic in Japan: focus on remote working.

BACKGROUND: Previous studies have reported an increase in loneliness since the outbreak of coronavirus disease 2019 (COVID-19), but there are few data on the relationship between job stress and loneliness. This study aimed to assess the relationship between job stress and loneliness among desk workers, with a focus on the impact of remote working. METHODS: This study was part of the Collaborative Online Research on the Novel-coronavirus and Work (CORoNaWork) project in Japan. We extracted data from 13,468 workers who indicated that they were doing desk work. Loneliness was assessed using a single question and job stress was valuated using the Job Content Questionnaire (JCQ). Multiple logistic regression was performed. RESULTS: Participants who worked remotely 4 or more days per week were marginally more likely to report feeling lonely compared with those who did not work remotely (adjusted odds ratio = 1.23, 95% CI: 0.99-5.84, P = 0.066). Remote working did not explain the interaction between JCQ scale scores and loneliness. Among remote workers, the level of support provided by co-workers and supervisors was strongly associated with feelings of loneliness as well as non-remote workers (co-worker support: AOR = 4.06, 95% CI: 2.82-5.84, P < 0.001; supervisor support: AOR = 2.49, 95% CI: 1.79-3.47, P < 0.001). CONCLUSIONS: To reduce loneliness and the risk of associated mental health problems, high-frequency remote workers should interact with supervisors and co-workers using the information and communication technology developed for this purpose.

Association between overtime work hours and preventive dental visits among Japanese workers.

BACKGROUND: This study aimed to examine the association between overtime work and the frequency of preventive dental visits among workers in Japan. METHODS: A self-administered questionnaire was completed by 14,847 daytime-workers. We used a logistic regression model stratified by sex and age and adjusted for marital status, occupation, education, and oral status to investigate the association between overtime work hours and the frequency of preventive dental visits. RESULTS: In total 1037 men (9.3%) and 511 women (13.9%) attended quarterly preventive dental visits, and 2672 men (23.9%) and 1165 women (31.8%) attended annual preventive dental visits. Overtime work was statistically significantly associated with quarterly preventive dental visits among men aged 50-59 years, with adjusted odds ratios (aOR) and 95% confidence intervals (CI) of 0.73 (0.56-0.95), 0.75 (0.54-1.04), and 0.55 (0.34-0.90) for < 20, 20-39, and ≥40 h overtime/month, respectively. No such trends were observed for men aged < 50 years and women of all ages. Overtime work of < 20, 20-40, and ≥40 h overtime/month was statistically significantly associated with annual preventive dental visits among men aged 40-49 years (aOR [95%CI]: 0.76 [0.61-0.95], 0.84 [0.65-1.09], and 0.72 [0.51-1.00], respectively) and 50-59 years (aOR [95%CI]: 0.75 [0.61-0.91], 0.76 [0.59-0.97], and 0.63 [0.45-0.88], respectively). No such trends were observed in men < 40 years and women of all ages. CONCLUSIONS: Our study revealed associations between overtime and preventive dental visits among male workers aged in their 40s and 50s.

Diabetes severity measured by treatment control status and number of anti-diabetic drugs affects presenteeism among workers with type 2 diabetes.

BACKGROUND: The number of people with diabetes is increasing and resulting in major economic losses. Presenteeism accounts for the majority of economic losses, so measures against presenteeism are important. This study investigated the relationship between severity of type 2 diabetes and presenteeism. METHODS: A cross-sectional study was conducted among workers over 40 years of age. Participants were classified as normal group or diabetic treatment group using their medical examination results and health insurance claims data. Diabetic treatment groups were described by degree of treatment control: Good (HbA1c < 7%), Intermediate (7% ≤ HbA1c < 8%), and Poor (8% ≤ HbA1c). Therapy type was also divided into monotherapy and combination therapy. Logistic regression analysis was performed to predict presenteeism loss using the Quantity and Quality method. RESULTS: Data on 13,271 workers were analyzed. Presenteeism loss was significantly higher in all treatment control groups compared with the normal group, particularly for the intermediate and poor control groups. The monotherapy group did not differ from the normal group, but presenteeism loss was significantly higher in the combination therapy group than the normal group. CONCLUSIONS: Presenteeism loss in workers with diabetes may be affected by diabetes severity, and even if treatment control were good, presenteeism loss could occur when the number of anti-diabetic drugs was high. Therefore, it is important to provide early intervention and continuous support as a preventive measure against not only diabetes and diabetes-related complications but also presenteeism.

Relationship Between Work Engagement and the Onset of Long-term Sickness Absence Due to Mental Disorders: A 4-year Retrospective Cohort Study.

The aim of the present study was to investigate the association between work engagement and long-term sickness absence due to mental disorders such as mood disorders and anxiety, and whether the relationship differs between men and women, during a 4-year follow-up period. Data were obtained from 21,293 workers at four pharmaceutical companies belonging to the Collabo-Health Study Group in 2014. The baseline data were collected by self-administered questionnaires. We obtained information about long-term sickness absence from the personnel records of the surveyed companies from the baseline survey in 2014 until March 2018. Hazard ratios (HRs) and 95% confidence intervals (CIs) using the low work engagement group as a reference were calculated by Cox proportional hazards analysis as the outcome, defined as the period leading to mental health-related sick leave. A total of 12,025 participants had complete data for analysis, and 123 exhibited long-term sickness absence during a 4-year follow-up period. The high work engagement group for men had a significantly lower HR (0.52, 95% CI: 0.31-0.88, P = 0.015) compared with the low work engagement group. Conversely, among women, the moderate work engagement group had a significantly higher HR (2.44, 95% CI: 1.03-5.84, P = 0.043) compared with the low work engagement group. Work engagement in men may predict the occurrence of long-term sickness absence due to mental disorders in the subsequent four years, but this relationship was different in women. Further research is needed to clarify this issue.

Improved Sleep Quality and Work Performance Among Shift Workers Consuming a "Foods with Function Claims" Containing Asparagus Extract.

The purpose of this study was to examine whether Foods with Function Claims (FFC) containing asparagus extract effectively improved sleep quality and work performance in shift workers. An intervention study with a before-and-after intervention design was conducted on nurses engaged in two-shift work at a hospital, ingesting a FFC containing asparagus extract. The evaluation period lasted at least two weeks, including three nights shifts during the period. Before and after ingestion, Pittsburgh Sleep Questionnaire Index (PSQI), Utrecht Work Engagement Scale (UWES), Sleep quality (VAS-rated), impaired work functioning, and psychiatric symptoms were evaluated. A diary record, wearing of an activity meter, and a Psychomotor vigilance test were also performed at baseline and after intervention. Data were analyzed by the paired t-test or the Wilcoxon rank sum test. Among 34 participants, 33 completed the study. The results of the primary outcome measures showed significant improvements in PSQI and Sleep Quality in the night of the day after a night shift (PSQI total score: base line 7.41/ post intervention 6.03: P < 0.001; sleep quality: base line 4.48/post intervention 6.00: P < 0.001). The results of the secondary outcome measures showed significant improvements in UWES and feeling of fatigue. There was also trend of improvement in sleep efficiency and the reaction time. There was no significant improvement in impaired work functioning. This study showed that regular consumption of an FFC containing asparagus extract could improve sleep quality, feeling of fatigue, and work engagement among shift workers. Some caution, however, is needed when interpreting the results because of the before-and-after intervention design without a control group.

Work-Related Factors Affecting the Occurrence of Presenteeism － Recent Research Trends and Future Directions.

Productivity loss due to presenteeism accounts for a large proportion of economic losses caused by workers' health problems. To reduce presenteeism, it is necessary to identify its causes, but, in contrast to the large amount of research on the effects of diseases and lifestyles, there is not enough research on the effects of work-related factors on presenteeism. In this study, those factors include the work environment and the work-related psychological status of workers. The purpose of this review was to identify research trends in presenteeism, defined as work-related productivity loss, and to examine future directions for presenteeism research. We conducted a search with only the keyword "presenteeism" using MEDLINE/PubMed for the last 5 years and extracted 30 relevant articles, most of which were cross-sectional studies. The articles were categorized into the following themes: 1) studies on the associations of various stress models and factors with presenteeism; 2) studies on the mediators and the pathways of association between stress factors and presenteeism; 3) studies on the relationships between organizational factors and presenteeism; and 4) studies on the link between workers' positive and negative psychological status and presenteeism. Our findings showed that, over the last 5 years, the relationship between psychological stress and presenteeism has been extended to include a variety of stress models and stressors. In addition, by putting many models and factors into a single statistical model and adjusting for their interrelationships, important factors have been examined by ensuring that a significant relationship with presenteeism remains. As there is still a lack of longitudinal studies necessary to discuss causality, more research of higher quality is needed.

Effect of Psychological Distress on the Association of Workplace Social Capital with Presenteeism and Sickness Absence.

Greater workplace social capital (WSC) can be related to workers' health and productivity. We sought to clarify the association between horizontal WSC and presenteeism and sickness absence (SA) and to examine the effects of psychological distress on these associations among Japanese workers. A cross-sectional study was conducted in 2017 at seven large Japanese companies. Logistic regression analysis was performed with presenteeism and SA as the dependent variables, horizontal WSC as an independent variable, and sociodemographic characteristics and psychological distress as covariates. After adjustment for sociodemographic characteristics, the results showed that greater horizontal WSC was associated with lower presenteeism and SA. The odds ratios for the relationship between horizontal WSC and presenteeism and that between horizontal WSC and SA dropped moderately after adjustment for psychological distress but remained significant. Further exploration of the factors underlying the relationship between WSC and productivity is needed to confirm if WSC enhances workers' health and productivity and to inform the development of effective occupational health initiatives.

Changes in Presenteeism Six Months After Returning from Sick Leave Due to Mental Illness.

This study examines how psychological distress (measured by the K10 screening test) and presenteeism (measured by the quality and quantity method) change in the six months after returning to work from having taken a sick leave because of a mental illness. In a manufacturing company with approximately 2,600 employees, 23 employees returned to work after experiencing mental illness between April 2015 and March 2016, and all 23 agreed to participate in the study. We analyzed 18 cases for which we had sufficient data. Two of the employees were absent from work in the sixth month. We performed multilevel analysis for K10 and presenteeism over time on the 16 without recurrence. A significant decreasing trend was observed for both K10 and presenteeism. Eleven of the 16 employees were consistently below the K10 cutoff value of 10 for six months, and 5 had zero presenteeism in the sixth month, whereas 6 employees showed improvement in presenteeism that stopped midway through the study. An occupational physician judged that the employees could work normally with presenteeism of zero. After returning to work, it is important to monitor not only psychiatric symptoms but also presenteeism.

Occupational Health Services Improve Effective Coverage for Hypertension and Diabetes Mellitus at Japanese Companies.

The World Health Organization (WHO) aims to enable all people to receive health services, and has proposed effective coverage (EC) as an index for this aim. EC refers to "the fraction of potential health gain that is actually delivered to the population through the health system, given its capacity," and is used to indicate the percentage of the population whose diseases are well controlled among those who require treatment or are receiving treatment. This study aimed to evaluate the effects of occupational health services on EC. We hypothesized that occupational health services provided to employees by full-time occupational health practitioners, such as occupational physicians and occupational health nurses, improve EC for hypertension, diabetes mellitus and hyperlipidemia compared to those services provided by part-time occupational health practitioners. We conducted a cross-sectional study to analyze the results of general medical examinations, personnel information, and medical expense claims in fiscal year 2011. A total of 91,351 male employees at a company group participated in the study. The EC for hypertension, diabetes mellitus and hyperlipidemia was measured and compared between the employees in workplaces with occupational health practitioners (OH group) and the employees in workplaces without occupational health practitioners (non-OH group). The EC for hypertension and diabetes mellitus was significantly greater in the OH group than in the non-OH group (aOR: 1.41, 95% CI: 1.20 - 1.66 for hypertension; aOR: 1.53, 95% CI: 1.17 - 2.00 for diabetes mellitus), while the EC for hyperlipidemia was comparable (aOR: 1.11, 95% CI: 0.92 - 1.34). Occupational health services provided by full-time occupational health practitioners greatly improve health management after a medical examination.

Occupational safety and health aspects of corporate social responsibility reporting in Japan from 2004 to 2012.

BACKGROUND: A number of companies publish corporate social responsibility (CSR) reporting in booklets and other publicly available formats. The purpose of this paper is to clarify the nine-year (2004-2012) trend of occupational safety and health (OSH) activities as described in CSR reporting (by industry sector and company size). METHODS: We investigated CSR reporting on the website in all Japanese companies listed on the first section of the Tokyo Stock Exchange. The data were extracted from CSR reporting of each company every year from 2004 to 2012. We counted the pages dedicated to information on OSH activities by industry sector and company size and calculated the rate of OSH divided by total CSR-related activities. RESULTS: The number of companies publishing CSR reports increased in all industry sectors, although the rate of inclusion of OSH activity within CSR reports increased only among sectors such as construction, manufacturing, transportation, and commerce. Among all company size, CSR reporting increased constantly throughout all observed years. The proportion of companies that had described OSH in CSR reporting increased from 2004 to 2012, and 76.5% companies had described OSH activities in 2012. The average number of pages of CSR-related report was 34.2 in 2004, increasing to 43.1 in 2012. The proportion of described pages of OSH activities in total CSR reporting increased gradually, and 2.7% in 2012. The focus of CSR reporting gradually shifted from 'environment' to 'social activity including OSH'. CONCLUSIONS: Majority of companies are putting more emphasis on OSH in CSR reporting in Japan.

The Effectiveness of Specific Risk Mitigation Techniques Used in the Production and Handling of Manufactured Nanomaterials: A Systematic Review.

Many kinds of manufactured nanomaterials (MNMs) have been developed and used as basic materials of industrial products, and they may pose health risks for workers in not only developed countries but also in developing countries. Few studies have looked at the evidence for effects of controls that mitigate the risk of exposure to MNMs. Therefore, we systematically searched the literature from the year 2000 to 2015. We included studies that compared the use of an exposure control to the situation without such a technique and those that measured the exposure to MNMs as the outcome. In order to evaluate the effectiveness of these controls, we used their "protection factor", defined as the ratio between concentrations without and with the control. We located 1,131 references in PubMed and other lists, and out of these references, 41 studies fulfilled our inclusion criteria. We categorized them as engineering controls such as enclosure, local exhaust ventilation or process automation, and as personal protective equipment (PPE). For enclosure systems we found a protection factor beyond 100. For other engineering controls, the better controls scored 10 to 20, but many cases of local exhaust ventilation had a protection factor of less than 10 and some cases even increased exposure. PPE such as N95 or equivalent filtering respirators had a protection factor of approximately 10 tested with nano-sized aerosols. We conclude that there is low quality evidence that specific engineering controls can reduce exposure to MNMs but that enclosure is considerably more effective. For respiratory protection the evidence is of very low quality due to the lack of field studies. This information can be used to decide about controls when exposure to MNMs exceeds proposed occupational exposure limits or when no toxicological information is available for a MNM.

Bridging perceived organizational support with learning motivation and work engagement: the mediating role of focus on opportunity.

OBJECTIVES: Perceived organizational support (POS) represents the extent to which employees believe their organization values their contributions and well-being. Although higher POS is associated with increased work engagement and learning motivation, the intricacies of this relationship, especially the mediation by occupational future time perspective (OFTP), are not well understood. METHODS: We conducted an online survey of 2046 working individuals aged 20-69 to assess the relationships between POS and 2 outcome variables, learning goal orientation (LGO) and work engagement, with multiple regression analyses for all ages and in the younger age group (under 45). Then, the mediating effects of focus on opportunity (FOO)-a primary component of OFTP-on these relationships were examined. RESULTS: Of 2046 participants, 887 were younger than 45 years. Younger participants, predominantly more educated and inclined toward professional jobs, exhibited higher LGO but lower work engagement compared with their older counterparts. POS showed positive correlations with LGO, and FOO significantly mediated the relationship, especially in the young group. Furthermore, a positive relationship between POS and work engagement was noted, with FOO as a partial mediator. CONCLUSIONS: POS correlates positively with both LGO and work engagement across various age demographics, with FOO critically mediating this relationship. To enhance employee engagement and learning motivation, organizations should emphasize bolstering both POS and FOO.

Role of Supervisor Consultation Toward Work Engagement: A Prospective Cohort Study.

Background: We examined the association between supervisor consultation, as an actual practice representing supervisor support, and work engagement. Methods: This was a prospective cohort study in Japan, involving 14,026 participants who met the requirement for a one-year follow-up. Supervisor consultation was measured using a single question, and work engagement was defined using the Japanese version of the nine-item Utrecht Work Engagement Scale (UWES-9). Associations were examined using linear regression analysis. Results: Supervisor consultation was positively associated with work engagement after adjusting for gender, age, education, income, and industry (ß = 3.474; p < 0.001). The relationship remained significant after adjustment for perceived supervisor support, although the coefficient decreased (ß = 1.315; p < 0.001). Conclusion: Supervisor consultation probably acted on work engagement in different ways than perceived supervisor support.

Role of perceived organization support to promote diabetes treatment among workers.

This study investigated association of Perceived Organization Support (POS) with diabetes treatment among workers. This prospective cohort study was conducted online, and parts of nations wide study stratified similarly with workers' characteristic in Japan. Samples were screened to those who had diabetes in the baseline years. Binary regression analysis and p for trend were used for statistical analysis. There were 1,203 participants with diabetes followed up regarding their treatment behavior. Higher POS were likely to seek appropriate diabetes treatment after adjustment with personal and occupational factors (p=0.032) but became marginally significant when adjusted with night shift status (p=0.051). Further analysis found that POS was only associated with diabetes treatment among workers with night shift. Higher POS was likely associated with proper diabetes treatment specifically among workers with night shift.

Relationship between the company's adequate response to near-misses and occupational accidents: a one-year prospective cohort study.

BACKGROUND: Near-misses in the workplace indicate potential safety hazards and their adequate management is considered extremely important in preventing occupational accidents. However, the impact of a company's response to near-misses on the occurrence of subsequent accidents remains unclear. This study examines the relationship between the adequacy of company's responses to near-misses and the occurrence of occupational accidents. METHODS: We conducted a one-year prospective cohort study using an online self-administered questionnaire, targeting workers in Japan. The study included 2755 participants who had experienced and reported near-misses. We categorized company responses to these near-misses as adequate, inadequate, or no response. The outcome was the incidence of occupational accidents over the past year. We calculated odds ratios (ORs) and 95% confidence intervals (CIs) using multilevel logistic regression adjusting for covariates. RESULTS: Among all participants, 59.0% were adequate response group, 30.1% were inadequate response group, and 10.8% were no response group. In the multivariate-adjusted model, the ORs of the inadequate response and the no response group were 1.53 (95%Cl: 1.25-1.88, p < 0.001) and 1.75 (95%Cl: 1.32-2.33, p < 0.001), respectively. CONCLUSIONS: Our results suggest that the adequacy of a company's response to near-misses reported by workers can be significantly related to the occurrence of subsequent occupational accidents. Companies need to thoroughly respond to near-misses reported by workers and adequately inform workers about the company's safety activities. This may lead to a reduction in the number of subsequent occupational accidents.