The Use of Digital Personal Health Records (PHR) in Occupational Health.

The exact definition of a personal health record (PHR) is not clear, but it is generally defined as an electronic record of an individual's medical examination results and medication history that can be accurately tracked by the individual and family members. There are many opportunities to obtain personal PHR data in the field of occupational health, and the amount of information in a worker's PHR is enormous. It is necessary in this field to comprehensively integrate and accumulate not only information from medical examinations, but also records of the work environment and work records as personal health information.

Relationship between Cancer and Intention to Leave Work among Older Workers: A Cross-Sectional Internet-Based Study.

Background and Objectives: Limited research has focused on the relationship between cancer, job loss, and factors associated with job loss among older workers. Therefore, in this study, we aimed to examine the relationship between cancer and intention to leave and between physical-health-related issues, mental-health-related issues, and cancer-related symptoms and intention to leave among older workers with cancer. Materials and Methods: This cross-sectional internet-based study included 4498 workers aged 60-75 years. Intention to leave was assessed based on whether individuals considered quitting their current jobs in the near future. Results: A multivariate logistic regression analysis showed a significant association between cancer and intention to leave (adjusted odds ratio [aOR]: 1.42, 95% confidence interval [CI]: 1.01-2.00, p = 0.045). In addition, physical-health-related issues (aOR: 2.33, 95% CI: 1.10-4.92, p = 0.026) and mental-health-related issues (aOR: 4.44, 95% CI: 1.80-10.98, p = 0.001) were significantly associated with the intention to leave. Conclusions: Healthcare providers and employers must address the physical- and mental-health-related issues facing older workers with cancer to help them secure their employment.

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.

Measurement of the Workplace Protection Factor of Replaceable Particulate and Powered Air-purifying Respirators in Japanese Dust-generating Occupations.

Although measuring the workplace protection factor (WPF) is important to verify the performance of particulate respirators in a real work environment, there are no reports of such measurements in Japan. The aim of this study was to measure the WPF of a replaceable particulate respirator (RPR) and a powered air-purifying respirator (PAPR). Eight participants were subjected to three conditions: wearing a RPR correctly (C-RPR), wearing a RPR as usual (but incorrectly) (U-RPR), and wearing a PAPR in the same way as U-RPR (PAPR). Subjects performed dust-generating tasks for 15 min, during which the WPF was measured. The WPF was calculated by dividing the concentration of particles outside the particulate respirator (Co) by that inside the particulate respirator (Ci). A fit testing instrument was used to measure the number of particles. Ci was measured by inserting the test guide into the face piece, and Co was measured by fixing the test guide near the breathing area of the subjects. The WPF geometric mean values (standard deviations) for C-RPR, U-RPR, and PAPR were 17.7 (2.59), 27.0 (3.86), and 117.3 (5.25), respectively. It is important to generate knowledge about the performance of particulate respirators to prevent occupational respiratory diseases.

Visualization of Dust Generation in Outdoor Workplaces Using A Wearable Particle Monitor and Global Navigation Satellite System.

We manufactured a wearable particle monitor (WPM), which is a simple and low-cost dust monitor. We aimed to evaluate the usefulness of the device by using it and location information of a Global Navigation Satellite System (GNSS) to measure dust generation in outdoor workplaces. We used nine WPMs and a particle counter KC-52 to measure in parallel the dust concentration diffusing standard particles in a dust exposure apparatus to evaluate the measurability of the WPM, and visualized dust generation in outdoor workplaces to evaluate its usability. We obtained location information using a GNSS in parallel with measuring with the WPM. The measured values of the WPM followed the measured values of the KC-52, with a strong correlation of the values between the KC-52 and each WPM. The discrepancy among devices tended to increase, however, because the measured values of the WPMs increased. For outdoor measurements, we could create a heat map of the relative values of dust generation by combining two data of the WPM and the GNSS. The methods of using the WPM could overview the conditions needed to produce dust emissions in dust-generating workplaces.

Combining Indoor Positioning Using Wi-Fi Round Trip Time with Dust Measurement in the Field of Occupational Health.

Monitoring of personal exposure to hazardous substances has garnered increasing attention over the past few years. However, no straightforward and exact indoor positioning technique has been available until the recent discovery of Wi-Fi round trip time (Wi-Fi RTT). In this study, we investigated the possibility of using a combination of Wi-Fi RTT for indoor positioning and a wearable particle monitor (WPM) to observe dust concentration during walking in a simulated factory. Ultrasonic humidifiers were used to spray sodium chloride solution inside the factory. The measurements were recorded three times on different routes (Experiments A, B, and C). The error percentages, i.e., measurements that were outside the expected measurement area, were 7% (49 s/700 s) in Experiment A, 2.3% (15 s/660 s) in Experiment B, and 7.8% (50 s/645 s) in Experiment C. The dust measurements were also recorded without any obstruction. A heat map was created based on the results from both measured values. Wi-Fi RTT proved useful for computing the indoor position with high accuracy, suggesting the applicability of the proposed methodology for occupational health monitoring.

Industry and workplace characteristics associated with the downloading of a COVID-19 contact tracing app in Japan: a nation-wide cross-sectional study.

BACKGROUND: To combat coronavirus disease 2019 (COVID-19), many countries have used contact tracing apps, including Japan's voluntary-use contact-confirming application (COCOA). The current study aimed to identify industry and workplace characteristics associated with the downloading of this COVID-19 contact tracing app. METHODS: This cross-sectional study of full-time workers used an online survey. Multiple logistic regression analysis was used to evaluate the associations of industry and workplace characteristics with contact tracing app use. RESULTS: Of the 27,036 participants, 25.1% had downloaded the COCOA. Workers in the public service (adjusted odds ratio [aOR] = 1.29, 95% confidence interval [CI] 1.14-1.45) and information technology (aOR = 1.38, 95% CI 1.20-1.58) industries were more likely to use the app than were those in the manufacturing industry. In contrast, app usage was less common among workers in the retail and wholesale (aOR = 0.87, 95% CI 0.76-0.99) and food/beverage (aOR = 0.81, 95% CI 0.70-0.94) industries, but further adjustment for company size attenuated these associations. Workers at larger companies were more likely to use the app. Compared with permanent employees, the odds of using the app were higher for managers and civil servants but lower for those who were self-employed. CONCLUSIONS: Downloading of COCOA among Japanese workers was insufficient; thus, the mitigating effect of COCOA on the COVID-19 pandemic is considered to be limited. One possible reason for the under-implementation of the contact tracing app in the retail and wholesale and food/beverage industries is small company size, as suggested by the fully adjusted model results. An awareness campaign should be conducted to promote the widespread use of the contact tracing app in these industries.

Protocol for a Nationwide Internet-based Health Survey of Workers During the COVID-19 Pandemic in 2020.

The ever-changing social implications of the COVID-19 pandemic have resulted in an urgent need to understand the working environments and health status of workers. We conducted a nationwide Internet-based health survey of Japanese workers in December 2020, in the midst the country's "third wave" of COVID-19 infection. Of 33,087 surveys collected, 6,051 were determined to have invalid responses. The 27,036 surveys included in the study were balanced in terms of geographical area, sex of participants, and type of work, according to the sampling plan. Men were more likely than women to have telecommuted, while women were more likely to have resigned since April 2020. Forty percent and 9.1% of respondents had a K6 score of 5 or higher and 13 or higher, respectively, and they did not exhibit extremely poor health. The present study describes the protocol used to conduct an Internet-based health survey of workers and a summary of its results during a period when COVID-19 was spreading rapidly in Japan. In the future, we plan to use this survey to examine the impact of COVID-19 on workers' work styles and health.

A 10-year Follow-up Cohort Study of the Health Effects in Toner-handling Workers.

In this study, we compare the results of a cross-sectional survey and secular changes between toner-handling workers and non-toner-handling workers, focusing on blood tests, urinalysis, respiratory function tests, and chest imaging results as indices of health effects. Of 116 employees who participated in the survey conducted at an office equipment manufacturer in Japan, 65 male employees who could be followed up for 10 years were included in the analysis. Thirty-eight workers engaged in toner-handling operations were considered toner-handling workers, and 27 not engaged in these operations were considered non-toner-handling workers. The blood tests (WBC, CRP, IgE, KL-6, and SP-D), urinalysis (8-OHdG), respiratory function tests (PEFR, VC, %VC, FEV1.0, and FEV1.0%), chest radiography, and chest CT results were compared between both groups. Non-toner-handling workers had significantly higher 8-OHdG/Cre at baseline and KL-6 at year 10 than did toner-handling workers. There were no significant differences between the results of the cross-sectional survey and a longitudinal survey of respiratory function test results. We conclude that there were no adverse health effects due to toner exposure.

Effects of toner-handling work on respiratory function, chest X-ray findings, and biomarkers of inflammation, allergy, and oxidative stress: a 10-year prospective Japanese cohort study.

BACKGROUND: Exposure to toner, a substance used in photocopiers and printers, has been associated with siderosilicosis and other adverse effects. However, these findings are limited, and there is insufficient evidence on the long-term effects of toner exposure. Using longitudinal analysis, this study aimed to examine the effects of work involving toner exposure on the respiratory system over time. METHODS: We conducted a prospective cohort study in a Japanese toner and copier manufacturing enterprise between 2003 and 2013. The cohort included a total of 1468 workers, which comprised 887 toner-handling workers and 581 non-toner-handling workers. We subdivided the toner-handling workers into two groups according to the toner exposure concentration, based on the baseline survey in 2003. We compared the chest X-ray results, respiratory function indicators, and serum and urinary biomarkers of inflammation, allergy, and oxidative stress among the three groups: high-concentration toner exposure group, low-concentration toner exposure group, and non-toner-handling group. To consider the effects of individual differences on the longitudinal data, we used a linear mixed model. RESULTS: Similar chest X-ray results, the biomarkers, and most of the respiratory function indicators were found in the non-toner-handling and toner-handling groups. There were no significant yearly changes in the percentage of vital capacity (%VC) in the high-concentration toner exposure group, while there was a significant yearly increase in %VC in the low-concentration toner exposure group and non-toner-handling group. The yearly change in each group was as follows: high-concentration toner exposure group, - 0.11% (95% confidence interval [CI], - 0.29 to 0.08; P = 0.250); low-concentration toner exposure group, 0.13% (95% CI, 0.09-0.17; P < 0.001); and non-toner-handling group, 0.15% (95% CI, 0.01-0.20; P < 0.001). CONCLUSIONS: In our 10-year prospective study, toner-handling work was not associated with the deterioration of respiratory function and an increase in biomarker values for inflammation, allergy, and oxidative stress. This finding suggests that toner-handling work is irrelevant to the onset of respiratory disease and has minimal adverse effects on the respiratory system under a well-managed work environment.

The Relationship Between Fear-avoidance Beliefs in Employees with Chronic Musculoskeletal Pain and Work Productivity: A Longitudinal Study.

This study aimed to identify risk factors for chronic musculoskeletal pain (CMSP) and sought to examine the effect of fear-avoidance beliefs (FABs) on work productivity in workers with CMSP. We performed a longitudinal study using self-administered questionnaires given to employees in three different industries between April 2016 and March 2017. The questionnaire concerned background characteristics, work-related factors and musculoskeletal pain, the Work Functioning Impairment Scale (WFun), and the Japanese version of the Tampa Scale for Kinesiophobia (TSK-J). We performed logistic regression analysis to evaluate factors affecting CMSP and a multi-way analysis of variance to analyze the relationship between FABs and CMSP and the effect of FABs on the ability to function at work. Age (odds ratio [OR] = 1.02, 95% confidence interval [CI]: 1.00-1.03), mean working hours (OR = 1.18, 95% CI: 1.04-1.33), and changes in working hours (OR = 1.18, 95% CI: 1.02-1.37) were significantly associated with CMSP. Regarding FABs, we found that the stronger the FAB, the greater the WFun score, and that an increase in FABs resulted in a significant increase in WFun scores. This study demonstrated that long or increased working hours may be risk factors for CMSP, and that stronger FABs in those with CMSP are associated with decreased ability to function at work. In addition, measures to reduce FABs in workers with CMSP may be effective.

Health Effects of Toner Exposure Among Japanese Toner-Handling Workers: A 10-Year Prospective Cohort Study.

The main objective of this study was to evaluate the risk of the respiratory diseases, i.e. pneumoconiosis, lung fibrosis, granulomatous pneumonitis, lung cancer and bronchial asthma, which have been reported as related to toner exposure. The second main objective was to clarify the association between toner exposure and parameters related with toner-handling worker's health. We conducted a 10-year prospective cohort study from 2004 to 2013 in 296 Japanese toner-handling workers. The evaluation of toner exposure and medical health check were performed once a year. There was no obvious evidence of occurrence of lung diseases. We also investigated several health parameters to recognize the change of respiratory health before onset of pneumoconiosis, lung fibrosis, lung cancer and bronchial asthma. However there were some sporadic statistically significant findings, to bring all health parameters, we did not find obvious evidence that toner exposure would cause adverse health effects as a whole. We concluded that the possibility that toner exposure would cause adverse health effects was quite low.

Relationships Between Chronic Musculoskeletal Pain and Working Hours and Sleeping Hours: A Cross-sectional Study.

Ten to twenty percent of the population of Japan has chronic pain. Although studies have confirmed a relationship between sleeping hours and chronic pain, it remains unclear whether there is an association between working hours and chronic pain, especially chronic musculoskeletal pain (CMP), in workers. A self-administered questionnaire that sought information regarding background characteristics and work-related factors was sent to 118 enterprises; finally, 1,747 participants were included in the analysis and were classified into CMP (n = 448) and non-CMP (n = 1299) groups. Logistic regression analysis revealed that age (odds ratio [OR] = 1.02, 95% confidence interval [CI]: 1.01-1.03), sex (reference: female, OR = 0.68, 95% CI: 0.52-0.88), working hours (OR = 1.11, 95% CI: 1.03-1.20), and sleeping hours (OR = 0.84, 95% CI: 0.75-0.95) were significantly associated with CMP. Participants were categorized into four groups according to working hours (long: ≥ 9 hours/day [long-work], short: < 9 hours/day [short-work]) and sleeping hours (long: ≥ 7 hours/day [long-sleep], short: < 7 hours/day [short-sleep]). Furthermore, logistic regression analysis showed that the CMP OR was 2.02 (95% CI: 1.46-2.78) times higher in 'long-work plus short-sleep workers' and 1.47 (95% CI: 0.94-2.30) times higher in 'long-work plus long-sleep workers' than in 'short-work plus long-sleep workers'. Thus, working hours are associated with CMP frequency, but sleeping sufficiently may prevent CMP in workers even if they work for long hours. In conclusion, adequate instructions on sleeping hours should be provided by occupational health staff, as this may be effective in preventing CMP.

Risk Assessment of the Carbon Nanotube Group.

This study assessed the health risks via inhalation and derived the occupational exposure limit (OEL) for the carbon nanotube (CNT) group rather than individual CNT material. We devised two methods: the integration of the intratracheal instillation (IT) data with the inhalation (IH) data, and the "biaxial approach." A four-week IH test and IT test were performed in rats exposed to representative materials to obtain the no observed adverse effect level, based on which the OEL was derived. We used the biaxial approach to conduct a relative toxicity assessment of six types of CNTs. An OEL of 0.03 mg/m(3) was selected as the criterion for the CNT group. We proposed that the OEL be limited to 15 years. We adopted adaptive management, in which the values are reviewed whenever new data are obtained. The toxicity level was found to be correlated with the Brunauer-Emmett-Teller (BET)-specific surface area (BET-SSA) of CNT, suggesting the BET-SSA to have potential for use in toxicity estimation. We used the published exposure data and measurement results of dustiness tests to compute the risk in relation to particle size at the workplace and showed that controlling micron-sized respirable particles was of utmost importance. Our genotoxicity studies indicated that CNT did not directly interact with genetic materials. They supported the concept that, even if CNT is genotoxic, it is secondary genotoxicity mediated via a pathway of genotoxic damage resulting from oxidative DNA attack by free radicals generated during CNT-elicited inflammation. Secondary genotoxicity appears to involve a threshold.

Expression of cytokine-induced neutrophil chemoattractant in rat lungs following an intratracheal instillation of micron-sized nickel oxide nanoparticle agglomerates.

OBJECTIVE: In our previous study, we reported that the micron-sized nickel oxide nanoparticle agglomerates induced neutrophil infiltration and the gene expression of the cytokine-induced neutrophil chemoattractant (CINC)-2αß in a rat lung. In this study, we examined the expression of the CINCs family in the lung using the same rat model exposed to micron-sized nickel oxide nanoparticle agglomerates. METHODS: The count median diameter of nickel oxide nanoparticle agglomerates suspended in saline was 1.34 µm (primary diameter: 8.41 nm). Male Wistar rats received an intratracheal instillation of 1 mg (3.3 mg/kg) of nickel oxide nanoparticles and were dissected at 3 days, 1 week, 1 month, 3 months, and 6 months after the instillation. The negative control group received an instillation of saline. The concentration of CINC-1 in the lung and the bronchoalveolar lavage fluid (BALF), CINC-2αß in the BALF, and CINC-3 in the lung and the BALF was examined. RESULTS: The concentration of CINC-1 was elevated at 3 days, 3 months, and 6 months in the lung tissue and from 3 days to 6 months in the BALF. The concentration of CINC-2αß was elevated from 3 days to 3 months in the BALF. The concentration of CINC-3 was also elevated at 3 days, 1 week, 3 months, and 6 months in the lung tissue. Infiltration of neutrophil and alveolar macrophage was observed mainly in the alveoli during the observed time period. CONCLUSION: These results suggest that CINC-1 to -3 were totally involved in the lung injury caused by micron-sized nickel oxide nanoparticle agglomerates.

Factors affecting the changes in body mass index among emergency workers at the Fukushima Daiichi Nuclear Power Plant.

Understanding the effects of lifestyle and radiation on health is important for the health management of disaster recovery workers. International research has demonstrated the relationship between natural disasters and diseases. The lifestyle and working conditions following the Great East Japan Earthquake potentially increased the incidence of cardiovascular disease and obesity among affected individuals. The aim of this study was to analyze the body mass index (BMI) of 1,341 emergency workers who responded to the accident at the Fukushima Daiichi Nuclear Power Plant. The BMI of each emergency worker was measured immediately after the accident and compared with that measured at the initial survey conducted 5 yr later to determine the effect of lifestyle habits on BMI. Awareness of the frequency of eating out and caloric intake helped maintain their BMI, while evacuation contributed to the increase in BMI. Prevention of obesity, which can trigger or exacerbate certain health conditions, such as heat exhaustion, infection, and cerebro-cardiovascular disease, requires diet counseling, with a focus on maintaining adequate caloric intake; moreover, special consideration should be provided to evacuated workers.

Association between Physical Work Environment during Work from Home and Sleep during the COVID-19 Pandemic: A Prospective Cohort Study in Japan.

OBJECTIVE: The work environment during work from home (WFH) may have a negative impact on workers' health. We investigated the effects of the physical work environment during WFH on sleep. METHODS: We conducted a one-year cohort study of 2,099 Japanese WFH workers. We used eight questions about the physical work environment during WFH as independent variables and the Athens Insomnia Scale as the dependent variable. We performed multilevel logistic regression with residence as a random effect. RESULTS: With the exception of one item, non-conformity with recommendations for the physical work environment during WFH was significantly associated with sleep problems. Further, the number of non-conformities and sleep problems showed a graded relationship. CONCLUSION: An inappropriate physical work environment during WFH may be associated with sleep problems.

Association Between Telecommuting Preference-frequency mismatch and Insomnia among Japanese Workers in the COVID-19 Pandemic: A Prospective Cohort study.

OBJECTIVE: We hypothesized that telecommuting's impact on sleep varied based on preference-frequency mismatch. Here, we evaluated this relationship in a large cohort of Japanese workers. METHODS: We collected data from 33,302 Japanese workers through an online survey, and analyzed participant preferences and frequency of telecommuting in 9,425 individuals who responded to a follow-up survey. We evaluated sleep using the Athens Insomnia Scale, and estimated odds ratios of insomnia using multilevel logistic regression. RESULTS: Workers preferring telecommuting had a higher risk of insomnia as telecommuting frequency decreased. OR for insomnia was 1.87 (p < 0.001) in those who telecommuted less than once per week. CONCLUSION: Telecommuting's impact on workers' sleep depends on preference mismatch, with a higher risk of insomnia among those who prefer telecommuting but are unable to utilize it.

Evaluation of Hand-Arm Vibration Syndrome Owing to Nerve Conduction Study and Cumulative Exposure Index-A 2.5-Year Cohort Study.

OBJECTIVE: This study aims to clarify the relationship between peripheral neuropathy in hand-arm vibration syndrome and cumulative exposure index. METHODS: 68 participants without symptoms were surveyed. The participants were divided into three groups based on past and current vibration exposure (VE). RESULTS: Comparison among groups according to past VE showed that the median and ulnar sensory nerve conduction velocities and median sensory nerve action potential (SNAP) amplitude were significantly lower in past high and low exposure groups than in the past nonexposure group. Comparison among groups according to current VE showed that the median and ulnar SNAP amplitudes were significantly lower in the current high exposure group than in the current low or nonexposure group. CONCLUSIONS: Vibration tool handlers have potential peripheral nerve lesions at a certain stage without subjective symptoms of the finger.

Relationship Between Infection or Close Contact With COVID-19 and Workplace Mistreatment Among Japanese Workers: A Cross-sectional Study.

OBJECTIVE: Discriminatory treatment against those with emerging infection is a long-standing problem. The present study investigates whether workers infected or in close contact with COVID-19 were susceptible to workplace mistreatment during the pandemic in Japan. METHODS: This Internet-based cross-sectional study analyzed a total of 18,170 workers aged 20 to 60 years in Japan in December 2020. Odds ratios (ORs) for workplace mistreatment were estimated. RESULTS: For workers with close contact or infection, ORs for workplace mistreatment in a model adjusted for socioeconomic factors were 7.64 (95% CI: 5.52-10.6, P < 0.001) and 10.7 (95% CI: 8.44-13.6, P < 0.001), respectively. CONCLUSIONS: Workers with infection or close contact were significantly more likely to experience workplace mistreatment. Actions against workplace mistreatment for workers with emerging infection are still required.