What is the role of occupational physicians in the workplace during the COVID-19 pandemic in Japan? A qualitative interview study.

BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic has had various impacts on businesses and workers worldwide. The spread of infection has been reported through cluster outbreaks in the workplace, and World Health Organization has emphasized workplace infection control measures. Occupational physicians (OPs) are expected to actively support employers' efforts to minimize the damage of the pandemic. However, there is little research on the role of these specialists during a pandemic. Clarification of the contributions of OPs to health and safety at the workplace in the COVID-19 pandemic would be beneficial to ensure that OPs can be effectively deployed in the next pandemic. METHODS: We employed semi-structured interviews and qualitative content analysis of the interview transcripts. Twenty OPs were selected as priority candidates from among 600 OPs certificated of the JSOH, and thirteen who met the eligibility criteria agreed to participate. The online interviews were conducted in November and December 2020 with thirteen OPs. We extracted meaning units (MUs) from interview transcripts according to the research question: "What was the role of OP in the COVID-19 pandemic?" and condensed and abstracted them into codes and categorized them. Validity was confirmed by additional 5 OPs interviews. RESULTS: A total of 503 MUs were extracted from the transcripts. These were abstracted into 10 sub-categories and two categories. Categories 1 and 2 dealt with "Role in confronting the direct effects of the pandemic" and "Role in confronting the indirect effects of the pandemic" and accounted for 434 (86.3%) and 69 (13.7%) MUs, respectively. These results were validated by another 5 interviews. CONCLUSION: This study identified the role of OPs in Japan in the COVID-19 pandemic. The results showed that they made a wide range of contributions to the direct and indirect effects of the pandemic. We hope our findings will help OPs during future pandemics or other long-term emergency situations.

Developing a checklist for collecting information from overseas hospitals.

OBJECTIVE: Expatriate workers and their families may encounter difficulties and uncertainties when visiting local hospitals. These problems include differences in the medical system, higher healthcare costs, and language problems. Occupational health staff in companies need to know about the healthcare system, including emergency transportation arrangements, to reduce anxiety in workers and families attending hospitals. This study was designed to create a checklist to allow occupational health staff to collect information from overseas hospitals efficiently and effectively. METHODS: We used documentary searches and the knowledge and experience of researchers to identify the support requirements of expatriate workers and drafted a checklist for information collection from overseas hospitals. The validity of the checklist was assessed in two stages. First, we interviewed health specialists caring for expatriate workers and their families and then tested the draft in international hospitals. We revised the draft based on our findings and again tested the new version in different overseas hospitals, enabling us to create a final version of the checklist. RESULTS: Our checklist contains 12 major categories: reception, administration, inpatient wards, available tests, outpatient clinics, emergency services, pediatrics, gynecology, dentistry, general health check-ups, vaccination services, and precautions against infection. These categories cover a total of 51 subcategories, each of which is further divided into a total of 131 smaller categories. DISCUSSIONS: Occupational health staff can use this checklist to gather information in order to provide comprehensive and effective support for expatriate workers attending hospitals. We recommend that the staff gather all possible information from hospital websites before visiting and use the visiting time to gather information available only on site. In order to gather as much information as accurately as possible, the staff are recommended to visit the facilities related to the checklist categories, that is, Japanese language reception, outpatient services, inpatient wards, emergency services, pediatrics, gynecology, general health check-up centers, and cardiac catheterization labs, and obtain information directly from doctors, nurses, and specialists working at the hospitals.

[Development of a Crisis Management Manual for Occupational Health Experts].

When crises such as natural disasters or industrial accidents occur in workplaces, not only the workers who are injured, but also those who engage in emergency or recovery work may be exposed to various health hazards. We developed a manual to enable occupational health (OH) experts to prevent health hazards. The manual includes detailed explanations of the characteristics and necessary actions for each need in the list of "OH Needs During Crisis Management" developed after an analysis of eight cases in our previous research. We changed the endings of explanatory sentences so that users could learn how often each need occurred in these eight cases. We evaluated the validity of the manual using two processes: 1) Providing the manual to OH physicians during an industrial accident; 2) Asking crisis management experts to review the manual. We made improvements based on their feedback and completed the manual. The manual includes explanations about 99 OH needs, and users can learn how and what to do for each need during various crisis cases. Because additional OH needs may occur in other crises, it is necessary to collect information about new cases and to improve the comprehensiveness of the manual continuously. It is critical that this crisis management manual be available when a crisis occurs. We need to inform potential users of the manual through various media, as well as by posting it on our website.

What Occupational Health Needs Arise in Workplaces Following Disasters? A Joint Analysis of Eight Cases of Disaster in Japan.

OBJECTIVE: To identify occupational health needs arising after disasters. METHODS: Using semistructured interviews with expert informants, we jointly analyzed the needs arising in eight disaster cases that threatened the lives or health of workers in Japan. RESULTS: Various types of health issues occurred in a wide range of employees. In total, we identified 100 needs in six phases after disasters and classified them across nine categories of worker characteristics. The proportion of health needs on the list that were applicable in each case varied from 13% to 49%. More needs arose when the companies were responsible for the disaster and when employee lives were lost. We also assessed the list as fairly comprehensive. CONCLUSIONS: The list developed in this study is expected to be effective for anticipating occupational health needs after disasters.