Incidence of coronary heart disease among remote workers: a nationwide web-based cohort study.

Coronary heart disease (CHD) risk is influenced by socioeconomic status-related parameters, particularly occupation. We investigated occupational gaps in CHD risk and how the introduction of remote work moderated the observed occupational differences in CHD risk during the coronavirus disease 2019 pandemic in Japan. Data from a web-based, nationwide cohort study, comprising 17,640 workers (aged 20-65 years) with baseline data from December 2020, were analyzed. Participants were grouped by occupation as upper-level nonmanual workers (managers/professionals) and others (reference group). The primary outcome was CHD (angina pectoris/myocardial infarction) onset retrospectively confirmed at the 1-year follow-up survey. Upper-level nonmanual workers exhibited a higher CHD incidence than others (2.3% vs. 1.7%). This association was pronounced in the younger (20-49 years) population, with a significant CHD risk (adjusted risk ratio = 1.88). Upper-level nonmanual workers exhibited nearly 15% higher remote work prevalence, with a significant remote work-related CHD risk (adjusted risk ratio = 1.92). The mediating effects of remote work explained an overall disparity of 32% among the younger population. Occupational gaps in CHD incidence in Japan differ from those in Western countries, where upper-level nonmanual workers have lower cardiovascular risk. In Japan, remote work can mediate CHD risk in the younger population of upper-level nonmanual workers.

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 non-exposure 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 non-exposure group. CONCLUSIONS: Vibration tool handlers have potential peripheral nerve lesions at a certain stage without subjective symptoms of the finger.

A Cross-sectional Study on the Impact of Unfair Treatment Associated With COVID-19 Infection and Psychological Distress in Japanese Workers.

OBJECTIVE: Psychological distress is commonly reported sequela in COVID-19-infected people. We investigated the association between experiencing COVID-19 infection and psychological distress in Japan. METHOD: A total of 14,901 persons who participated in a follow-up survey in December 2022 were included in the analysis. Odds ratios and regression coefficients were estimated by statistical analysis, with history of COVID-19 infection as the independent variable and presence of psychological distress as the dependent variable. RESULT: Experiencing COVID-19 infection was associated with psychological distress. In a model adjusted for "feeling treated unfairly," the association between infection experience and a high K6 score was significantly attenuated. CONCLUSIONS: The results showed that the experience of COVID-19 infection is associated with psychological distress. Moreover, most cases of psychological distress among those who experienced COVID-19 infection can be at least partly explained by a perception of unfair treatment.

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 years 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.

Workplace Measures Against COVID-19 and Mistreatment in the Workplace Among Japanese Employees: A 1-Year Prospective Cohort Study.

OBJECTIVE: The purpose of this study was to identify the COVID-19 infection prevention measures that are at risk of being perceived by employees as mistreatment in the workplace. METHODS: This study included full-time workers who enrolled as subjects in a nationwide prospective cohort study. Baseline surveys performed during the pandemic were used to identify the workplace measures against COVID-19. A tracing survey was conducted 1 year later to assess workplace mistreatment. RESULTS: Of the 18,170 participants, 276 judged that they had experienced mistreatment by the measures. "Enforcing daily temperature measurement" and "stopping business trips" were associated with mistreatment. Meanwhile, "requesting that employees refrain from going to work when ill" and "restricting work-related social gatherings and entertainment" had the potential to reduce workplace mistreatment. CONCLUSIONS: Certain measures against COVID-19 can reduce or increase the burden on employees.

Perceived Workplace Health Support and Severe Psychological Distress Among Japanese Workers: A Prospective Cohort Study.

OBJECTIVE: This study aimed to assess the extent to which the intensity of perceived workplace health support (PWHS) affected the incidence of psychological distress. METHODS: At the baseline, data from 4540 eligible participants throughout Japan were obtained using an Internet survey. Among them, 2362 participants who could be followed up 1 year after the initial study were included in the analysis. The intensity of PWHS was determined using an original questionnaire. Psychological distress was assessed using the Kessler Psychological Distress Scale. RESULTS: Participants with high PWHS were less likely to experience severe psychological distress than those with low PWHS even after adjusting for confounding factors including work-related factors. The incidence of severe psychological distress decreased as the intensity of PWHS increased. CONCLUSIONS: Enhanced PWHS reduced psychological distress and positively affected workers' mental health.

Evaluation of workplace infection prevention and control measures for COVID-19: A prospective cohort study in Japan.

Background: Encouraging the implementation of infection prevention and control (IPC) measures has been necessary to prevent workplace infections caused by the coronavirus disease 2019 (COVID-19). However, the effectiveness of these measures in reducing infections has not been thoroughly evaluated. We evaluated employees' COVID-19 infection rates in relation to the implementation of IPC measures at their workplaces to identify effective workplace measures. Methods: This prospective cohort study was conducted between December 2020 and December 2021 using Internet-based self-assessment questionnaires, with 11,982 participants included from the baseline. To estimate whether implementing workplace IPC measures was associated with COVID-19 incidence rates among participants, we estimated multivariate-adjusted relative risk (RR) using a log-binomial model. Results: After adjusting for sex, age, education, household members, occupation-related factors, and personal preventive behaviors, requesting ill employees to refrain from going to work showed significantly lower COVID-19 infection rates than not requesting it (RR: 0.56, 95% CI: 0.34-0.91, p = 0.019). Conclusions: Employees restricted from reporting to work when ill had significantly lower COVID-19 infection rates than those who did not follow this measure. The results indicated that not coming to work when ill was effective in reducing COVID-19 infections at the workplace. We suggest that companies proactively adopt this policy and encourage their employees to comply with it.

[Evaluation of self-administered questionnaire items used in regular health check-ups at the workplace by occupational health professionals].

OBJECTIVE: Currently, there is no standardized questionnaire for regular workplace health check-ups in Japan. We considered that there are several issues associated with this, including the possibility that the questionnaire items are not useful for occupational health staff. Therefore, our study aimed to examine the questionnaire items required in regular health check-ups from the occupational health practice perspective and prepare a draft of a standardized medical questionnaire. The ultimate goal is to promote integrated management and utilization of the health-related information obtained from the questionnaire in the future. METHODS: This non-interventional study, conducted from February 2018 to November 2020, examined the questionnaire items for the regular health check-up using the Delphi method. Twenty-two occupational health professionals, including occupational physicians and nurses with qualifications in occupational health, participated in the study. The self-administered questionnaires used by contracted industrial health associations across Japan were obtained, and items from all questionnaires were extracted. A survey questionnaire was then developed, consisting of eight primary headings: "personal attributes," "work-related information and work history," "life history and subjective symptoms," "current and past medical history," "family history," and "pregnancy status," with a total of 589 items. Participants were asked to rate the degree of necessity for each item, excluding the items in "personal attributes" and "pregnancy status." The items with low ratings were excluded, and the remaining items were redesigned and distributed to the participants with the tabulated results. This process was repeated three times to allow the participants to rate the necessity of the items consistently. The questionnaire items with a consensus ratio exceeding 70% on the third try were adopted. The final adopted questionnaire items were again reviewed by the participants and agreed upon by all. RESULTS: A total of 85 items were adopted under five primary headings, including 12 items for "work-related information and work history," 11 for "life history," 22 for "subjective symptoms," 37 for "current medical history," and three for "past medical history." CONCLUSION: The items for the regular health check-up were finally adopted under the primary headings of "work-related information and work history," "subjective symptoms," and "current medical history." We assumed that these items provide an overview of health information that can be utilized in occupational health practice. Based on our findings, there is a need to develop a standardized questionnaire for regular health check-ups and to consider the management and utilization of workers' health information.

Factors associated with acceptance of a digital contact tracing application for COVID-19 in the Japanese working-age population.

The working-age population is at the epicenter of coronavirus disease 2019 (COVID-19) infections. Therefore, it is important to increase the acceptance of digital contact tracing apps in this population. Contact-Confirming Application (COCOA) is the only digital contact tracing app in Japan. This study aimed to determine factors associated with acceptance of the COCOA for COVID-19 in the Japanese working-age population. A cross-sectional study was performed for 27,036 full-time workers registered with an internet survey company during December 2020 in Japan. Factors associated with COCOA adoption were evaluated by multivariate logistic regression analysis. The rate of downloading the COCOA was 25.1%. The COCOA was more likely to be accepted by people with married status, university graduation or above, higher income, and occupations involving desk work. Fear of COVID-19 transmission, wearing a mask, using hand disinfection, willingness to be vaccinated against COVID-19, and presence of an acquaintance infected with COVID-19 were also associated with a greater likelihood of adopting the app. The rate of downloading the COCOA in Japan was not very high. The present findings have important implications for widespread adoption of digital contact tracing apps in working-age populations in Japan and elsewhere.

Changes in work/sleep patterns due to the COVID-19 pandemic are associated with psychological distress among Japanese workers.

Objectives: The coronavirus disease 2019 (COVID-19) pandemic has significantly impacted working life quality. This study investigated whether changes in work/sleep patterns due to the pandemic are related to poor psychological status among Japanese workers during the third wave of the COVID-19 pandemic (December 2020). We hypothesized that workers who experienced drastic changes in working hours and sleep duration would be at an increased risk of psychological distress. Methods: A cross-sectional self-administered Internet survey was conducted that included questions regarding socio-demographics, lifestyle, health, and occupational background and conditions. Multivariable logistic regression models were utilized to examine the association between psychological distress and a combination of changes in working hours and sleep duration. Results: Among 25,762 workers, decreased work hours and decreased sleep duration presented 2.59 times higher odds of psychological distress (95% confidence interval [CI] = 2.05-3.28) compared to those who had no changes in work hours combined with unchanged sleep duration (reference group). Increased work hours and decreased sleep duration were associated with 1.98 times higher odds of psychological distress (95% CI = 1.64-2.39). Conclusion: Our observations confirmed that decreased sleep duration could be a key factor for psychological distress, irrespective of working hours. Interestingly, workers with a combination of decreased work hours and sleep duration posed the highest risk of psychological distress. Decreased work hours accompanied by financial difficulties in the early stage of the pandemic may have caused decreased sleep duration, resulting in a high prevalence of psychological distress. Our study underlined the importance of sleep management in maintaining workers' mental health, moreover, the need to consider situations and conditions of other daily tasks, such as work hours, for better sleep management.

Psychological Distress, Japanese Teleworkers, and Supervisor Support During COVID-19.

OBJECTIVE: During the COVID-19 pandemic, teleworking became the new workplace norm, creating a new challenge for workplace communication. This study investigated the association between source-specific workplace social support and psychological distress among Japanese teleworkers and nonteleworkers. METHODS: A total of 15,045 workers were extracted from a cross-sectional web-based survey that assessed psychological distress, workplace social support from supervisors and coworkers. After grouping participants into four groups based on their positions (managers, staff members) and teleworking arrangements (teleworking, nonteleworking), multiple logistic regression analyses were performed separately. RESULTS: Teleworkers with less supervisor support demonstrated the highest risk of psychological distress (adjusted odds ratio = 2.55, P = 0.024). CONCLUSIONS: Insufficient supervisor support for teleworking staff members may be a key occupational risk factor for psychological distress in the postpandemic future.

Personal infection prevention behaviors and campaign to encourage travel during COVID-19: A cross-sectional study.

Introduction: The Go To Travel campaign in Japan was launched to subsidize travel and accommodation costs for tourists through vouchers that could be used at domestic destinations. Infection prevention behavior can lead to refraining from travel owing to infection concerns; conversely, taking preventive action can promote travel. There is a lack of information about the association between infection prevention behaviors and desire to travel. During a pandemic of infection, there is the difficult challenge of balancing the promotion of infection prevention behavior with economic revitalization. Thus, we examined the relationship between personal infection prevention behaviors and using Go To Travel. Methods: We conducted a cross-sectional study of 26,637 workers who responded to a large-scale questionnaire survey about COVID-19 in Japan. We built multilevel logistic regression models adjusted for confounders to assess the association between each personal infection prevention behavior and using Go To Travel. We analyzed the seven infection prevention behavior individually: wearing a mask when among other people; disinfecting hands with alcohol before going indoors; washing hands after using the toilet; gargling upon returning home; opening a window to ventilate a room; carrying an alcohol sanitizer; and disinfecting hands after touching objects outside. Results: Among the 26,637 participants, 7,959 (30%) used Go To Travel. For "wearing a mask in the presence of others" and "washing hands after using the toilet," the majority of respondents answered "almost always: 86.5 and 85.6% respectively. Action "carrying alcohol disinfectant" was the least implemented, with 36.9% of respondents saying "almost never." Two of the seven preventive behaviors ("disinfecting hands with alcohol before going indoors" and "carrying alcohol disinfectant") were positively related to using Go To Travel, that is, the more of these actions they took, the more they used Go To Travel (p for trend <0.001). Conclusions: To balance pandemic preparedness with economic preparedness, it is also necessary to promote travel when the infection situation is calm. However, since human mobility can be a factor that exacerbates the infection situation, it is necessary to promote more infection prevention behaviors among individuals. We confirmed that Go To Travel users were basically doing a good infection prevention behaviors, but they tended not to wash their hands after touching things or carry alcohol sanitizer. It is necessary to encourage these measures to be taken when traveling.

Job stress and work from home during the COVID-19 pandemic among Japanese workers: a prospective cohort study.

Objectives: The work style reforms and the coronavirus disease pandemic in Japan have prompted efforts toward teleworking, mainly work from home (WFH). This study aimed to prospectively evaluate the impact of WFH on job stress among Japanese workers. Methods: This online survey-based prospective cohort study was conducted from December 2020 (baseline) to December 2021 (1-year follow-up) using self-administered questionnaires. At baseline, 27,036 participants completed the questionnaires, whereas 18,560 (68.7%) participated in the 1-year follow-up. After excluding the 11,604 participants who left or changed workplaces within 1 year or who were physical laborers and hospitality workers, data from 6,956 participants were analyzed. We asked participants about WFH frequency at baseline and conducted a follow-up using the Brief Job Stress Questionnaire (BJSQ). Participants were divided into four groups according to WFH frequency. The odds ratios of poor states of the association of the four subscales (job demand, job control, supervisor support, and coworker support) determined by the BJSQ with WFH frequency were estimated using a multilevel logistic model. Results: In both the gender-age adjusted and multivariate models, compared to the non-WFH group, the medium and low WFH groups were less likely to have poor job control, whereas the high WFH group were likely to have similar levels as the non-WFH group. In both models, compared to non-WFH participants, the high WFH group were more likely to have poor supervisor and coworker support. Conclusions: High-frequency WFH requires further attention, because it may increase job stress by exacerbating deficits of social support in the workplace. Medium- and low-frequency WFH workers were more likely to have satisfactory job control; therefore, limiting WFH to three or fewer days per week may lead to better job stress management.

The effects of telecommuting and family cohabiting situation on psychological distress in Japanese workers during the COVID-19 pandemic: A cross-sectional study.

OBJECTIVE: This study aimed to determine whether telecommuting's impact on psychological distress differed depending on the status of workers' cohabiting family members during the COVID-19 pandemic. METHODS: We collected data from 33 302 workers in Japan through an Internet survey, and included 27 036 valid responses in the analysis. The survey included items on family cohabitation and telecommuting status during the COVID-19 pandemic. We assessed workers' psychological distress using the Kessler 6. RESULTS: The psychological distress odds ratios (ORs) were higher for participants who lived with family members requiring care (OR = 1.38, P < .001), and lower for participants living with preschool children (OR = 0.77, P < .001) or a spouse (OR = 0.80, P < .001). Furthermore, odds ratios were higher for participants who worked from home and lived with family members requiring care or preschool children (OR = 1.52, P = .002; OR = 1.28, P = .028). Stratified by the presence or absence of family members living with them, psychological distress was higher for telecommuters with family members requiring care, preschool children, or elementary school children. CONCLUSION: The association between telecommuting and psychological distress varies, depending on workers' living situation with family members.

Relationship among work-treatment balance, job stress, and work engagement in Japan: a cross-sectional study.

There is a drive to support workers in Japan undergoing medical treatment who wish to continue working, known as the work-treatment balance. This support for the work-treatment balance is expected to boost their mental health. This study examines the relationship among the work-treatment balance, job stress, and work engagement. This study was conducted in December 2020 in Japan, with 27,036 participants. We divided the participants into three groups by the receipt state of support for work-treatment balance: control group (do not need support), unsupported group, and supported group. The scores on the parameters of the job content questionnaire and the Utrecht Work Engagement Scale (UWES-3) were compared among groups using a multilevel regression with age-sex or multivariate-adjusted models. In the two models, the job control score of the unsupported group was significantly lower than that of the control group. The two social support scores of the supported group were significantly higher than those of the control group. The scores on the UWES-3 of the unsupported group were significantly lower than those of the control group. The support of work-treatment balance for workers could have a positive impact on their mental health.

Comparison of respiratory protection during exercise tasks between different methods of wearing replaceable particulate respirators and powered air-purifying respirators.

This study evaluated the differences in respiratory protection between replaceable particulate respirators (RPRs) and powered air-purifying respirators (PAPRs) based on different wearing methods during exercise tasks. Ten participants wore RPRs and PAPRs alternately in ways comparable to those adopted by workers in actual workplaces. We measured the fit factor of the respiratory protective equipment (RPE) during exercise tasks for each wearing variation. The exercise load was set to 80W using an ergometer. The exercise tasks comprised five actions described in the Japan Industrial Standard T8150 in 2018. We compared the results with experimental data obtained at rest in our previous studies. The fit factor of RPRs during exercise was significantly lower than (p<0.001) and about half that measured at rest, indicating inadequate respiratory protection. On the other hand, the fit factor of PAPRs during exercise tasks was also significantly lower than (p<0.001) and about half that at rest, but respiratory protection was maintained. This suggests that the protection provided by PAPRs is independent of wearing method during exercise. PAPRs may thus be better than RPRs for workers who have to wear RPE inappropriately due to health problems.

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.

A Cross-Sectional Study of the Association Between Telecommuting Environments and Shoulder Pain Among Japanese Telecommuting Workers.

OBJECTIVE: The aim of this study was to investigate the association between telecommuting environments and shoulder pain in Japanese telecommuters. METHODS: We conducted an Internet-monitored, cross-sectional study and analyzed 2537 participants who mainly telecommuted at least 4 days per week. We assessed the presence of shoulder pain using a numerical rating scale and the characteristics of the telecommuting environment by asking eight questions. We used multilevel logistic regression analysis with the city of residence as a random effect. RESULTS: Inadequate desk brightness (odds ratio [OR], 1.39; 95% confidence interval [CI], 1.09-1.78), inadequate foot space (OR, 1.27; 95% CI, 1.02-1.58), and uncomfortable temperature and humidity (OR, 1.41; 95% CI, 1.16-1.72) were associated with shoulder pain in multilevel logistic regression analysis. CONCLUSIONS: Inappropriate telecommuting environments were associated with an increase in the prevalence of shoulder pain in Japanese telecommuters.

Association between Perceived Organizational Support for Infection Prevention and Work Engagement during the COVID-19 Pandemic among Japanese Workers: A Prospective Cohort Study.

Although the correlation between perceived organizational support (POS) and work engagement has been investigated in several studies, the relationship between health-focused POS and work engagement has not been clarified. We prospectively evaluated the influence of workers' POS for infection prevention (POS-IP) on employees' work engagement. This prospective cohort study was conducted from December 2020 (baseline) to December 2021 (1-year follow-up) using a self-administered internet questionnaire. At follow-up, there were 18,560 respondents, and after excluding 6677 respondents who had changed jobs or retired since baseline or who were self-employed; thus, 11,883 participants were included in the analysis. We asked participants a single question on POS-IP and the three-item Utrecht Work Engagement Scale (UWES-3), and then analyzed the relationship between POS-IP at baseline and UWES-3 at follow-up using multilevel regression analysis. Work engagement at follow-up was significantly higher in the groups with "low", "high", and "very high" POS-IP at baseline as compared with the "very low" group (all, p < 0.001). A dose-response relationship was also observed between the POS-IP categories at baseline and work engagement at follow-up (p for trend < 0.001). During the COVID-19 pandemic, POS-IP can increase work engagement after 1 year.

Workplace vaccination opportunity against COVID-19 contributed to high perceived organizational support of employees in Japan: A prospective cohort study.

OBJECTIVES: Perceived organizational support is a broad perception by employees about the extent to which their employer values their contributions and cares about their well-being. We examined the relationship between workplace vaccination opportunities for COVID-19 provided by companies and increases and decreases in perceived organizational support, using a prospective cohort study. METHODS: This study was conducted between December 2020 and December 2021 using a self-administered questionnaire survey in Japan. In total, 18 560 people responded to the follow-up, and were included in this study. The odds ratios (ORs) for the association between company-arranged vaccination opportunities and high perceived organizational support at the follow-up for participants (a) with low perceived organizational support at the baseline (n = 4971), and (b) with high perceived organizational support at the baseline (n = 6912) were separately estimated using a multilevel logistic model. RESULTS: The OR of high perceived organizational support at the follow-up after low baseline levels was significantly higher in participants given a vaccination opportunity than those not given this opportunity (OR 1.49; 95% confidence interval [CI] 1.32-1.67; p < .001). The OR of high perceived organizational support at the follow-up after high baseline levels was also significantly highly in participants given a vaccination opportunity than not (OR 1.38; 95% CI 1.23-1.54; p < .001). These significant differences remained after adjusting for workplace infection control measures. CONCLUSIONS: Employee health support provided through a workplace vaccination program can contribute to high perceived organizational support.