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.

Association between menopausal symptoms and work-related factors among female workers in Japan: a cross-sectional study.

OBJECTIVE: Although menopausal symptoms are an important issue for female workers, their association with work-related factors is not well studied. Here, we explored the association between work-related factors and menopausal symptoms in Japan. METHODS: A cross-sectional study was conducted in 2023 among all 1465 female employees of a large Japanese company. Associations between occupational factors and moderate or severe menopausal symptoms, as measured by the Menopause Rating Scale (MRS), were examined using logistic regression analysis. RESULTS: Several workplace-related factors were significantly associated with moderate or severe menopausal symptoms, including company support and number of night shifts. A marginally significant association was also seen for commuting time. CONCLUSIONS: Workplace menopause interventions for the factors identified in this study may satisfy unmet needs.

A prospective cohort study of presenteeism and increased risk of unemployment among Japanese workers during the COVID-19 pandemic.

OBJECTIVES: Presenteeism adversely affects workers' quality of life, leading to further deterioration of their health and affecting their ability to continue working. Unemployment is one of the most serious consequences for workers experiencing presenteeism. A worker's ability to work depends on the degree of mismatch between their health status and job demands and work factors. The COVID-19 pandemic has affected workers' experiences of presenteeism as well as their employment status. We examined the association between presenteeism and risk of job resignations and unemployment among Japanese workers during the COVID-19 pandemic. METHODS: A prospective study of 27 036 internet monitors was conducted, starting in December 2020, with 18 560 (68.7%) participating in the follow-up by December 2021. The Work Functioning Impairment Scale (WFun) was used to measure the degree of work function impairment. RESULTS: The group with the highest WFun scores had higher odds ratios (ORs) for both retirement and unemployment for health reasons than the group with the lowest WFun scores. ORs were 2.99 (95% CI, 2.48-3.62; P < .001) and 1.82 (95% CI, 1.65-2.00; P < .001), respectively. CONCLUSIONS: Workers with work functioning impairment are at increased risk of resignation or unemployment. Management strategies for workers with work functioning impairment are needed to reduce their disadvantages in employment.

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.

Short-term outcomes of pancreatoduodenectomy in older individuals over a 9-year period using real-world data: A multilevel analysis based on a nationwide administrative database in Japan.

BACKGROUND: We aimed to evaluate the short-term outcomes of pancreatoduodenectomy (PD) in older individuals. METHODS: Data from the Japanese Diagnosis Procedure Combination database on 62 275 patients who underwent PD from 1 April 2012 to 31 March 2020 were analyzed. Patients were divided into five age groups: <70, 70-74, 75-79, 80-84, and ≥85 years. The associations between postoperative outcomes and age were investigated using multilevel analysis. The mean differences in length of hospital stay and cost were also compared. RESULTS: The rate of PD in older individuals increased annually. Compared with the youngest age group (< 70 years), the incidence rate ratios for in-hospital mortality were 1.52 (95% confidence interval [CI]: 1.30-1.76), 2.07 (1.82-2.37), 2.29 (1.94-2.71), and 2.92 (2.20-3.87) in the 70-74, 75-79, 80-84, and ≥ 85-year-old age groups, respectively (all p < .001). Postoperative complications, length of postoperative hospital stay, and cost increased significantly with increasing age. CONCLUSIONS: These real-world data emphasize the higher levels of morbidity, mortality, and cost in older patients. Careful attention should be paid when considering the indication for PD in older individuals.

Changes in operative trends and short-term outcomes of surgery for congenital biliary dilatation in adults using real-world data: A multilevel analysis based on a nationwide administrative database in Japan.

Aim: We aimed to evaluate the operative trends and compare the short-term outcomes between open and laparoscopic surgery for congenital biliary dilatation (CBD) in adults using real-world data from Japan. Methods: Data from the Japanese Diagnosis Procedure Combination database on 941 patients undergoing surgery for CBD at 357 hospitals from April 1, 2016, to March 31, 2021, were analyzed. The patients were divided into two groups: open surgery (n = 764) and laparoscopic surgery (n = 177). We performed a retrospective analysis via a multilevel analysis of the short-term surgical outcomes and costs between open and laparoscopic surgery. Results: The rate of laparoscopic surgery has been increasing annually and had almost doubled to 25% by 2021. There were no significant differences in the in-hospital mortality rate or postoperative morbidity between the two groups. The length of anesthesia was significantly longer in the laparoscopic than open surgery group (8.80 vs 6.16 hours, p < .001). The time to removal of the abdominal drain and length of hospital stay were significantly shorter in the laparoscopic than open surgery group (6.12 vs 8.35 days, p = .001 and 13.57 vs 15.79 days, p < .001, respectively). The coefficient for cost was 463 235 yen (95% confidence interval, 289 679-636 792) higher in laparoscopic than open surgery (p < .001). Conclusion: The short-term results were comparable between laparoscopic and open surgery for CBD. Further investigation is needed to validate our findings and long-term outcomes.

Relationship between financial distress and mistreatment of workers regarding the COVID-19 prevention measures: A 1-year prospective cohort study.

OBJECTIVE: A substantial number of workers' experience mistreatment in the workplace, impacting workers' health and companies' functioning. Vulnerability of those with lower income has been reported, yet little is known about mistreatment during COVID-19. This study aims to examine whether workers in financial distress are particularly prone to mistreatment at the workplace with reference to pandemic-related infection prevention measures. METHODS: An internet-based, year-long prospective cohort study was conducted from 2020 to 2021. Participants were recruited from workers aged 20 and 65 years and currently employed at baseline. In total, 27 036 were included in the analysis and 18 170 responded to the follow-up survey. The odds ratio (OR) of mistreatment at the workplace regarding COVID-19 associated with the financial condition at baseline was estimated using multilevel logistic regression analysis nested by participant residence. RESULTS: Compared with workers in a comfortable financial condition, those under financial stress showed significantly higher ORs of mistreatment (age- and sex-adjusted model: 2.08, 95% confidence interval [CI] 1.75-2.47, P < .001, model adjusted for socioeconomic factors: 2.14, 95% CI 1.79-2.55, P < .001). CONCLUSION: Workers in financial distress were shown to be vulnerable to mistreatment at work regarding infection prevention measures in the COVID-19 pandemic, underscoring a double burden of poverty and mistreatment. The perspective of vulnerable groups needs to be taken into account when implementing countermeasures against emerging infectious diseases, such as COVID-19. As unfair treatment in the workplace might distort vulnerable employees' reactions to infection control (e.g., hiding infection), financial deprivation should be considered a public health issue.

Workplace infection control measures and romantic activities of workers during COVID-19 pandemic: A prospective cohort study in Japan.

Objective: Due to the COVID-19 pandemic, non-married people are at high risk of loneliness. With social interactions restricted, it is important for non-married people to acquire a new romantic partner for their mental health and quality of life. We hypothesized that infection control efforts in the workplace influence people's social interactions, including romantic activities. Methods: We conducted an internet-based prospective cohort study from December 2020 (baseline) to December 2021, using self-administered questionnaires. Briefly, 27,036 workers completed the questionnaires at baseline, and when followed up after 1 year, 18,560 (68.7%) participated. A total of 6,486 non-married individuals with no romantic relationship at baseline were included in the analysis. At baseline they were asked about the implementation of infection control measures in the workplace, and at follow-up they were asked about activities they performed with a view to romantic relationships during the period from baseline to follow-up. Results: Compared to workers in workplaces with no infection control measures, the odds ratio (OR) associated with romance-related activities for those in workplaces with seven or more infection control measures was 1.90 (95% CI: 1.45-2.48, p < 0.001), and the OR associated with having a new romantic partner was 1.79 (95% CI: 1.20-2.66, p = 0.004). Discussion: Under the COVID-19 pandemic, the implementation of infection control measures in the workplace and the expressed satisfaction with those measures promoted romantic relationships among non-married, single individuals.

Presenteeism in front-line physicians involved in COVID-19-related clinical practice: a national survey of employed physician members of the Japan Medical Association.

BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic may have increased the rate of presenteeism among front-line physicians. Presenteeism is the term used to describe attendance at work despite ill health that would normally prompt rest or absence from work. This study aimed to examine the associations between COVID-19 clinical practice and presenteeism among physicians. METHODS: A cross-sectional study was conducted from December 2021 to January 2022. The questionnaires were distributed to 21,737 employed physicians who were members of the Japan Medical Association. Presenteeism was measured by the Work Functioning Impairment Scale. Multiple logistic regression analysis was used to evaluate the association between COVID-19 clinical practice and presenteeism. RESULTS: Overall, 3,968 participants were included in the analysis, and presenteeism was observed in 13.9% of them. The rate of presenteeism significantly increased with both the number of COVID-19 patients treated and the percentage of work time spent treating these patients (both P values for trend < 0.001). In comparison to those not currently engaged in the treatment of COVID-19 patients, presenteeism was significantly higher among front-line (adjusted odds ratio [aOR] = 1.71, 95% confidence interval [CI]: 1.16-2.53) and second-line physicians supporting those in the front-line (aOR = 1.45, 95% CI: 1.17-1.78). There was no association between involvement in COVID-19 vaccination services and presenteeism. CONCLUSIONS: The burden on front-line and second-line physicians in COVID-19 clinical practice must be minimized. Employed physicians also need to recognize the importance of communicating with their workplaces about presenteeism.

Health and Work Performance Consequences of Working From Home Environment: A Nationwide Prospective Cohort Study in Japan.

OBJECTIVES: The physical work environment while working from home (WFH) is a key component of WFH, which, if inadequate, can impair workers' health and work functioning. We investigated environmental factors in WFH and worsening of work functioning. METHODS: A 1-year prospective cohort study was conducted involving 2530 Japanese workers who worked from home. Environment while WFH was assessed using binary subjective assessments based on existing guidelines. Existence of impaired work function was assessed using the Work Functioning Impairment Scale. We performed multilevel logistic regression analysis nested in the prefecture of residence. RESULTS: Lack of room/space for concentration, lack of enough light and foot space, inadequate temperature and humidity, and use of a sitting table were associated with work functioning impairment. CONCLUSIONS: An inappropriate environment while WFH can have a negative impact on workers' health.

Impact of COVID-19 Infection on Work Functioning in Japanese Workers: A Prospective Cohort Study.

Background: The impact of COVID-19 infection on workers' work function persists even after the acute phase of the infection. We studied this phenomenon in Japanese workers. Methods: We conducted a one-year prospective cohort study online, starting with a baseline survey in December 2020. We tracked workers without baseline work functioning impairment and incorporated data from 14,421 eligible individuals into the analysis. We estimated the incidence rate ratio for new onset of work functioning impairment due to COVID-19 infection during follow-up, using mixed-effects Poisson regression analysis with robust variance. Results: Participants reporting infection between January and December 2021 showed a significantly higher incidence of new work functioning impairment (adjusted incidence rate ratio: 2.18, 95% confidence interval: 1.75-2.71, p < 0.001). The formality of the recuperation environment correlated with a higher risk of work functioning deterioration in infected individuals (p for trend <0.001). Conclusion: COVID-19-infected workers may continue to experience work difficulties due to persistent, post-acute infection symptoms. Companies and society must urgently provide rehabilitation and social support for people with persistent symptoms, recognizing that COVID-19 is not just a transient acute infection.

Association of alcohol consumption and frequency with loneliness: A cross-sectional study among Japanese workers during the COVID-19 pandemic.

Background: There are increasing concerns that prevention measures against coronavirus disease 2019 (COVID-19) such as social distancing and telework are leading to loneliness and poor lifestyle habits like increased alcohol consumption. The purpose of this study was to assess whether loneliness reported among workers during the COVID-19 pandemic is associated with changes in alcohol consumption. Methods: The study comprised a cross-sectional, online survey of 27,036 workers between December 22 and 26, 2020. A questionnaire was used to assess loneliness, usual alcohol consumption and whether that consumption had changed. Odds ratios (ORs) were estimated by logistic regression analysis. Results: A total of 2831 (10.5%) workers indicated they had increased alcohol consumption during the pandemic. Increased alcohol consumption was significantly associated with loneliness (OR = 1.94, 95%CI 1.70-2.21). This association held true for those who indicated they drank two or more days per week (OR = 1.98 95%CI 1.71-2.30) and those who drank less than one day per week (OR = 1.51 95%CI 0.71-3.25). In contrast, there was no association between increased alcohol consumption and loneliness among those who indicated they hardly ever drank (OR = 1.22 95%CI 0.55-2.72). Conclusions: Among those drinking more than once a week, increased alcohol consumption is associated with loneliness.

Working hours, side work, and depressive symptoms in physicians: A nationwide cross-sectional study in Japan.

OBJECTIVES: Long working hours in Japan is a social concern. This is also true for the working hours of physicians, who often do side work in addition to working at their main hospital. New physician work regulations to be implemented in Japan require work-hour management, including side work. This study examined the association between physicians' overtime and side work hours and their health outcomes. METHODS: We conducted a cross-sectional study using data from a survey of working physicians conducted by the Japan Medical Association from 2021 to 2022. Questionnaires completed by 2906 full-time working physicians aged 24-69, excluding junior resident doctors, were analyzed. Depressive symptoms and the presence of thoughts of death or suicide using the Quick Inventory of Depressive Symptomatology - Japanese version was used to assess health outcomes. Logistic regression analysis was performed using overtime at the main place of employment and side work hours as exposure factors. RESULTS: Both depressive symptoms and thoughts of death or suicide increased in the group with longer overtime hours at the main place of work. A similar tendency was observed for side work but adjusting for overtime hours eliminated the association. In other words, total working hours had an impact on health, regardless of whether overtime work at the main place of employment or side work. CONCLUSIONS: Despite the existence of multiple hurdles to managing working hours, including side work, the working environment for physicians needs to be improved to protect their health and quality of medical care.

A Prospective Cohort Study of Presenteeism and Increased Risk of Divorce Among Japanese Workers.

OBJECTIVE: We examined the association between the presenteeism and the risk of divorce among Japanese workers during the COVID-19 pandemic. METHODS: A prospective study of 27,036 individuals was conducted starting in December 2020, with 18,560 (68.7%) participating in the follow-up in December 2021. The Work Functioning Impairment Scale (WFun) was used to measure the degree of work function impairment. RESULTS: Compared with the group with the lowest WFun score, the odds ratio for the group with moderate WFun was 1.16 (95% confidence interval, 0.74 to 1.82; P = 0.525), and the odds ratio for the group with the highest WFun was 1.76 (95% confidence interval, 1.18 to 2.62; P = 0.006). CONCLUSIONS: This study suggests that supporting workers with presenteeism has important implications not only from the perspective of labor productivity in management but also for the individual's quality of life in terms of family relationships.

A prospective cohort study of presenteeism and poverty among Japanese workers during the COVID-19 pandemic.

OBJECTIVES: This study examined the association of presenteeism with experiences of poverty among Japanese workers during the COVID-19 pandemic. METHODS: A prospective cohort study of Japanese workers was conducted using an Internet monitoring survey. The baseline survey was conducted in December 2020, and a follow-up survey in December 2021. Of the 27 036 workers who participated, 18 560 (68.7%) completed the follow-up survey. The 11 081 who reported that they were not in financial difficulty in the baseline survey were included in the analysis. The degree of work functioning impairment was assessed at baseline using the Work Functioning Impairment Scale (WFun). Households' experience of not being able to pay for food and clothing was identified in the follow-up survey. The odds ratios (ORs) of presenteeism determined by WFun associated with poverty were estimated using a multilevel logistic model. The multivariate model included age, sex, marital status, job type, income, education, smoking, alcohol consumption, number of employees in the workplace, and the incidence rate of COVID-19 by prefecture at baseline. RESULTS: In the multivariate model, the odds ratio of experiencing food insecurity increased with high WFun score: compared with WFun scores of 13 or less, the OR was 1.87 (95% CI: 1.43-2.43, P < .001) for WFun scores of 14 or more and 3.26 (95% CI: 2.58-4.12, P < .001) for WFun scores of 21 or more. CONCLUSIONS: In addition to labor productivity, the adverse effects of presenteeism on social security-related concerns such as poverty require further attention.

Postoperative cerebral infarction risk is related to lobectomy site in lung cancer: a retrospective cohort study of nationwide data in Japan.

OBJECTIVES: To determine the incidence of cerebral infarction after lobectomy at different sites using inpatient data from a diagnosis procedure combination database. DESIGN: Retrospective cohort study. SETTING: Data were retrieved from the Japanese diagnosis procedure combination inpatient database for patients who underwent lobectomies for lung cancer between April 2018 and March 2020. PARTICIPANTS: The analysis included 37 352 patients from 556 institutions who underwent lobectomies for lung cancer. MAIN OUTCOMES AND MEASURES: The occurrence of cerebral infarction after lobectomy during hospitalisation was estimated using multilevel logistic regression models adjusted for sex, age, body mass index, smoking history, activity of daily living, surgical approach (thoracotomy or video-assisted), clinical cancer stage, comorbidities and hospital-level factors to describe the association between cerebral infarction and different lobectomy sites. RESULTS: Overall cerebral infarction after lobectomy occurred in 99 patients (0.27%): 29 with left upper lobectomy (0.39%), 19 with left lower lobectomy (0.34%), 32 with right upper lobectomy (0.24%), 6 with right middle lobectomy (0.21%) and 13 with right lower lobectomy (0.16%). The multilevel multivariate logistic regression analysis revealed high ORs for the left upper lobectomy and left lower lobectomy groups. In both univariate and multivariate analyses, left upper lobectomy had the highest OR for the occurrence of cerebral infarction compared with lobectomies at other sites. CONCLUSIONS AND RELEVANCE: Left upper lobectomy had the highest OR for the occurrence of cerebral infarction after lung cancer lobectomy during hospitalisation. There is an urgent need to investigate the specific mechanisms underlying postoperative cerebral infarction after left upper lobectomy and to establish preventive measures such as altering surgical methods, using radiological examinations for early detection and better use of anticoagulants.

Evaluation of cholecystectomy in older individuals using real-world data: a multilevel analysis based on a nationwide administrative database in Japan.

BACKGROUND: In the present study, we aimed to evaluate the clinical outcomes of cholecystectomy in older individuals. METHODS: In this retrospective study, data from the Japanese Diagnosis Procedure Combination database on 96,620 patients who had undergone cholecystectomy at 1060 hospitals from 2018 to 2020 were analyzed. Patients were divided into five age groups: < 75, 75-79, 80-84, 85-89, and ≥ 90 years. Associations between postoperative outcomes and age group were investigated by logistic regression analysis. Mean differences between age groups in time to postoperative recovery and cost were also compared. RESULTS: Older patients had higher rates of poor scores for activities of daily living and preoperative comorbidity. Compared with the youngest age group (< 75 years), the odds ratios for in-hospital mortality were 3.00 (95% confidence interval, 1.74-5.19), 7.54 (4.73-12.01), 13.47 (8.21-22.14), and 27.64 (15.56-49.09), in the 75-79, 80-84, 85-89, and ≥ 90-year-old age group, respectively (all p < 0.001). Furthermore, the length of postoperative hospital stay and rates of postoperative complications, postoperative reintubation, and reoperation with general anesthesia increased significantly in parallel with increasing age, the highest rates being in the ≥ 90 year-old age group. CONCLUSIONS: Our real-world data highlight the worse postoperative outcomes, including a higher mortality rate, in older patients undergoing cholecystectomy. Care should be taken when considering the indications for surgery in such patients.

Treatment interruption is a risk factor for sickness presenteeism: A large-scale cross-sectional study during the COVID-19 pandemic.

OBJECTIVES: This study examined the relationship between interruption to routine medical care during the coronavirus disease 2019 pandemic and sickness presenteeism among workers in Japan. METHODS: A cross-sectional study using data obtained from an internet monitor questionnaire was conducted. Interruption to medical care was defined based on the response "I have not been able to go to the hospital or receive treatment as scheduled." The fraction of sickness presenteeism days in the past 30 days was employed as the primary outcome. A fractional logit model was used for analysis to treat bounded data. RESULTS: Of the 27 036 participants, 17 526 (65%) were workers who did not require routine medical care, 8451 (31%) were using medical care as scheduled, and 1059 (4%) experienced interrupted medical care. The adjusted odds ratio (aOR) of sickness presenteeism was significantly higher among workers who experienced interrupted medical care (3.44; 95% confidence interval [CI]: 3.04-3.89) than those who did not require routine medical care. In terms of symptoms, the highest aOR was observed among workers with mental health symptoms (aOR: 5.59, 95% CI: 5.04-6.20). CONCLUSIONS: This study suggests the importance of continuing necessary treatment during a pandemic to prevent presenteeism.

Association between work-related changes caused by the COVID-19 pandemic and severe psychological distress among Japanese workers.

This study aimed to evaluate the association between work-related changes caused by COVID-19 and psychological distress among Japanese workers. The cross-sectional study was conducted from August 25 to September 30, 2020. The participants were 15,454 employees who were registered as panelists with an online survey company. The Kessler psychological distress scale with a 13-point cutoff was used to measure psychological distress. Multiple logistic regression was performed. Of the respondents, 8.9% were evaluated as having severe psychological distress. Among five examined work-related changes, being laid off and changing jobs (adjusted odds ratio [aOR] = 5.43; 95% confidence interval [CI]: 4.18-7.05), experiencing temporary workplace closure (aOR = 1.94; 95% CI: 1.67-2.25), being forced to visit the workplace for paperwork (aOR = 1.84; 95% CI: 1.58-2.15), and starting telework from home (aOR = 1.18; 95% CI: 1.01-1.37) were associated with increased psychological distress; no significant association was found for participation in work-related online meetings. The impact on psychological distress was greater among men, especially for being laid off and changing jobs because of COVID-19. It is important to assess and reduce negative mental health effects among workers experiencing work-related changes caused by the COVID-19 pandemic, taking gender differences into account.