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.

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.

Farm operations and slips, trips, and falls among corn farm workers in Thailand.

Slips, trips, and falls (STFs) represent a main source of injury among farm workers. The purpose of this study was to evaluate the association between farm operations and STFs among corn farm workers. We conducted a cross-sectional study using a self-administered questionnaire among corn farm workers in Nan and Saraburi provinces, Thailand from July 5 to 23, 2022. Poisson regression analysis was used. Among 338 participants, 122 (36.1%) had experienced an STF in the previous 6 months. Conducting very frequent, frequent, or occasional pest management was associated with a higher incidence rate ratio (IRR) of STFs than never or rarely pest management (adjusted IRR 1.93, 95% confidence interval [CI]=1.23 to 3.04, p=0.004). People with marginal or unsatisfactory work break lengths had a higher incidence rate of STFs than those with satisfactory work breaks (adjusted IRR 1.40, 95% CI=1.03 to 1.89, p=0.030). We found that corn farm workers in our study often experienced STFs, which was associated with a high frequency of pest management practices and inadequate work breaks. Reducing the physical burden of pest management may be effective as an STF prevention strategy.

Association of cigarette smoking with increased use of heated tobacco products in middle-aged and older adults with self-reported chronic obstructive pulmonary disease, asthma, and asthma-COPD overlap in Japan, 2022: the JASTIS study.

BACKGROUND: Smoking cessation is the most important intervention in chronic obstructive pulmonary disease (COPD), asthma, and asthma-COPD overlap (ACO); however, high rates of current cigarette smoking are observed in adults with these respiratory diseases. Meanwhile, rapidly increasing use of heated tobacco products (HTPs) is observed in Japan; however, the status of HTPs use has not been fully understood in adults with COPD, asthma, and ACO. This study aimed to reveal the association between COPD, asthma, and ACO and HTPs use in adults. METHODS: Data on Japanese individuals ≥ 40 years old obtained from the Japan Society and New Tobacco Internet Survey were analyzed. The prevalence of HTPs use in adults with COPD, asthma, and ACO, among individuals categorized into three groups according to cigarette smoking (never, former, and current), was calculated and the relationship between each disease and HTPs use were evaluated. The clinical diagnosis of these diseases was based on the self-reported diagnosis, as obtained from questionnaires. RESULTS: A total of 19,308 individuals were included. The proportions of never, past, and current cigarettes smokers were 10,900 (56.5%), 4,903 (25.4%), and 3,505 (18.2%), respectively, and that of HTPs use was 1,813 (9.4%). In current cigarettes smokers, the adjusted odds ratios (ORs) of HTPs use was 2.88 (95% CI [confidence interval], 1.86-4.47), 1.23 (95% CI, 0.99-1.52), and 5.81 (95% CI, 3.12-10.82) in adults with COPD, asthma, and ACO compared to those without these respiratory diseases, respectively. Meanwhile, in past cigarettes smokers, the adjusted ORs of HTPs use was 0.51 (95% CI, 0.24-1.08), 0.69 (95% CI, 0.53-0.88), and 0.25 (95% CI, 0.06-1.07) in adults with COPD, asthma, and ACO, respectively. CONCLUSIONS: HTPs use is more prevalent among current cigarettes smokers with COPD, asthma, and ACO compared to those without these respiratory diseases. Complete cessation of smoking both cigarettes and HTPs is the only way to achieve complete smoking cessation, therefore, adults with COPD, asthma, and ACO need to make greater efforts to quit smoking.

Workplace factors associated with willingness to undergo human immunodeficiency virus testing during workplace health checkups.

BACKGROUND: To examine workplace factors associated with willingness to undergo human immunodeficiency virus (HIV) testing during workplace health checkups. METHODS: This cross-sectional study used an Internet-based self-administered questionnaire to obtain data from a pool of 24,287 Japanese workers. Binary and multiple logistic regression analyses evaluated the association between workplace factors and HIV testing. Data were adjusted for sex, age, marital status, education, and history of HIV testing. RESULTS: We gathered information from 4,143 (17.1%) respondents, of whom 1,129 (27.3%) were willing to be tested for HIV as part of a workplace health checkup. The participants were 20-59 years old. Approximately half of the participants were male (49.9%), half were married (48.9%), and half had completed higher education (47.6%). Workplace hepatitis testing was offered to 15.6% of the respondents, and most participants underwent health checkups without their colleagues (52.1%) at a medical facility (60.2%). Willingness to undergo HIV testing was positively correlated with having an increased risk of occupational blood exposure (vs. not at risk, adjusted odds ratio [OR]: 1.74, 95% confidence interval [CI]: 1.41-2.15) or working in medical and welfare roles (vs. manufacturing, OR: 1.40, 95% CI: 1.07-1.84). The presence of occupational health staff at the workplace (vs. their absence, adjusted OR: 1.35, 95% CI: 1.16-1.59) and hepatitis testing (vs. not testing, adjusted OR: 2.02, 95% CI: 1.66-2.44) increased willingness to undergo HIV testing. CONCLUSIONS: A pilot HIV-testing program involving individuals at an increased risk of occupational blood exposure and undergoing hepatitis tests in workplaces providing occupational health staff support is recommended.

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.

Association Between Workplace Social Support and Use of Health-Promoting Wearable Devices: A Prospective Cohort Study of Japanese Employees.

We examined the relationship between workplace environmental factors, including support from supervisors and colleagues, and the continued use of a wearable device meant to promote occupational health. One hundred employees at a Japanese manufacturing company participated in a 3-month study, and information related to their physical health status was recorded by a wearable device. We analyzed the results using the χ2 test and logistic regression analysis. We found that men aged 40-49 years and employees reporting low support from supervisors and colleagues were significantly more likely to be continuing device users. Participants with low workplace support had adjusted odds ratios approximately two to three times higher than those with high levels of support, which was significant. Employees with low workplace support were able to communicate at work, access appropriate support, and enthusiastically participate in occupational health promotion with little psychological difficulty in using the device. Occupational health promotion using wearable devices can complement traditional face-to-face occupational health promotion.

Longitudinal Association of Working From Home on Work Functioning Impairment in Desk Workers During COVID-19 Pandemic: A Nationwide Cohort Study.

OBJECTIVE: This study clarifies the longitudinal association between working from home and work functioning impairment among desk workers. METHODS: Nationwide surveys were conducted from 2020 to 2022, analyzing 3532 desk workers who never worked from home before the COVID-19 pandemic. RESULTS: The adjusted hazard ratio (95% confidence intervals) of working from home at least once a month or more with the composite result (incidence of work functioning or reduced work participation) was 1.22 (1.04-1.43). The cause-specific hazard ratios of work functioning impairment and reduced work participation were 1.30 (1.04-1.61) and 1.13 (0.86-1.47). CONCLUSIONS: Working from home could be longitudinally associated with work functioning impairment, especially for workers who are in higher positions. Workers and policy makers should be aware of the potential risk of working from home regarding presenteeism.

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.

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.

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.

Fear of COVID-19 Among Japanese Workers and Exacerbation of Chronic Pain: A Nationwide Cross-Sectional Study.

OBJECTIVE: To evaluate the association between fear of the coronavirus disease 2019 (COVID-19) and exacerbated chronic pain among workers during the pandemic, as well as productivity loss. METHODS: We collected data using Internet-based self-reported questionnaires, on fear of COVID-19, work productivity status, exacerbation of chronic pain during the pandemic, and several confounding factors. RESULTS: The multivariate logistic regression analysis showed that a high level of fear of COVID-19 was associated with an increased exacerbation of chronic pain (adjusted odds ratio, 2.31; 95% confidence interval, 1.21-4.44). Meanwhile, the presence of fear of COVID-19 and exacerbated chronic pain were associated with productivity impairment (adjusted odds ratio, 2.03; 95% confidence interval, 1.44-2.85). CONCLUSIONS: Our study shows that workers' fear of COVID-19 is correlated with exacerbated chronic pain and risk of presenteeism.

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.

Association Between Types of Chronic Disease and Receiving Workplace Accommodations: A Cross-Sectional Study of Japanese Workers.

OBJECTIVE: This study aimed to evaluate the association between the type of chronic disease and receiving workplace accommodations. METHODS: This online cross-sectional study analyzed a self-reported questionnaire administered in Japan. A total of 6775 full-time workers who reported needing work accommodations were included. RESULTS: Workplace accommodations were more likely to be provided for workers with cancer, mental illness, and benign gynecological disorders than for workers with no disease under treatment. In contrast, workplace accommodations were less likely for workers with low back pain and skin diseases. CONCLUSIONS: Receiving workplace accommodations depends on the type of chronic disease. Chronic diseases for which workers frequently receive workplace accommodations may be those for which support is encouraged by law. It is necessary to support workers with chronic diseases that do not receive adequate workplace accommodations.

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.

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.

[Current status and challenges of supervisory organizations' support for the health and safety of technical intern trainees: Focusing on collaboration with occupational health professionals].

OBJECTIVES: We aimed to clarify the current status and challenges of supervisory organizations' support for the health and safety of technical intern trainees in Japan. We also assessed the effectiveness of collaboration with occupational health professionals at a training site to investigate the potential for such collaboration to help solve related problems. METHODS: In October 2021, we distributed a questionnaire survey by postal mail to 3,262 supervisory organizations. We requested responses from those directly engaged in training technical intern trainees and those connected with training companies. We inquired regarding the frequency and difficulty of providing support for the health and safety of technical intern trainees (based on 22 survey items). Subsequently, we conducted a multiple logistic regression analysis to assess the association between collaboration with occupational health professionals and the difficulty of obtaining support. RESULTS: The analysis included 932 cases (response rate: 28.6%). Vietnam (76.6%) was the most frequent country of origin for trainees, and 10-49 (30.3%) was the most frequent range for the number of trainees. Over the preceding year, 17.0% of the organizations had collaborated with occupational health professionals at the training site. The most frequently indicated items on the survey were "explaining and interpretating for medical checkups," "providing traffic safety education and interpretation," and "accompanying and interpreting for health care facilities." Over 80% of the respondents answered that these actions were easy to implement. In contrast, only 30-40% of respondents answered that "counseling on mental health problems," "counseling on marriage, pregnancy, and childbirth," and "counseling on sexual harassment and power harassment" were easy to implement. The supervisory organizations that had collaborated with occupational health professionals tended to report that "providing traffic safety education and interpretation" (p = .049) and "providing health and safety education and interpretation" (p = .072) were easier than they were for organizations that had no support from occupational health professionals. CONCLUSIONS: The supervisory organizations surveyed faced challenges in dealing with mental health problems, marriage, pregnancy, childbirth, and harassment of technical intern trainees. Those organizations that collaborated with occupational health professionals found it easier to provide education on traffic safety and occupational safety and health education. Thus, the presence of a person in charge of health and safety in the planning of training programs and opportunities for education was considered important for promoting collaboration between supervisory organizations and occupational health professionals.