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.

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.

The Impact of COVID-19 Outbreak on Health Emergency and Disaster in Japan

The coronavirus disease 2019 (COVID-19) pandemic highlighted the importance of health emergency and disaster risk management (EDRM) to reduce the risks and impacts of infectious disease outbreaks. We investigated Japan's response to the COVID-19 pandemic, focusing on changes made to the current health EDRM. Findings from document analysis and semi-structured interviews with six experts were integrated to provide insights into Japan's health EDRM to improve outcomes in future health emergencies. Relevant information was extracted from COVID-19 policy documents published by the Japanese government, and the interviews validated and expanded on the data already collected. Challenges faced in the country's response to COVID-19 and the changes made to the health EDRM framework are summarised. Findings were grouped into human resource topics (including essential health EDRM positions and safety of personnel), health service delivery topics (including public health and hospital primary care services), and logistical topics (including vaccination, personal protective equipment, patient transport, and telecommunications). These responses to the pandemic could serve as an example of good practice for other countries developing strategies for future health emergencies and disasters.

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.

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.

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.

Association Between Work Attendance When Experiencing Fever or Cold Symptoms and Company Characteristics and Socioeconomic Status in the COVID-19 Pandemic in Japanese Workers: A Cross-Sectional Study.

OBJECTIVE: This study investigated the association between attending work while experiencing fever or cold symptoms and workers' socioeconomic background and company characteristics during the COVID-19 pandemic. METHODS: A cross-sectional online survey was performed. Of a total of 33,302 participants, 3676 workers who experienced fever or cold symptoms after April 2020 were included. The odds ratios (ORs) of attending work while sick associated with workers' socioeconomic background and company characteristics were evaluated using a multilevel logistic model. RESULTS: The OR of attending work while sick associated with a lack of policy prohibiting workers from working when ill was 2.75 (95% CI: 2.28 to 3.20, P < 0.001). CONCLUSION: This study suggests that clear company policies on work and illness can be effective for preventing employees from attending work while sick.

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.

Disrupted care during the COVID-19 state of emergency and productivity loss attributed to presenteeism in workers: a nationwide cross-sectional study.

OBJECTIVES: The COVID-19 pandemic has caused medical care delays and avoidance around the globe. However, little is known about the relationship between disrupted care and productivity loss attributed to presenteeism during the COVID-19 pandemic. We aimed to investigate whether disrupted care during the COVID-19 state of emergency was associated with health status and productivity loss. METHODS: We used data from a nationwide, cross-sectional, Internet-based, self-administered survey. We performed multiple logistic regression analysis on data from 14 545 participants to investigate the associations among variables related to disrupted care, health status and the Work Functioning Impairment Scale, with a cut-off of 21 points. RESULTS: Participants who experienced exacerbation of underlying disease (adjusted OR (aOR) 2.84; 95% CI 2.28 to 3.53) or any type of disrupted care were more likely to show low productivity at work. Experiencing disruptions in routine and non-routine clinical settings (aOR 4.64; 95% CI 3.64 to 5.92 and aOR 6.29; 95% CI 4.74 to 8.34, respectively), and running out of drugs (aOR 6.13; 95% CI 4.60 to 8.18) were strongly associated with exacerbation of underlying disease. CONCLUSIONS: Workers who experienced disrupted care were much more likely to show productivity loss. Exacerbation of underlying disease is one possible pathway through which disrupted care could affect productivity loss attributed to presenteeism. Our study provides evidence of the importance of early diagnosis and continuous treatment of non-COVID-19 patients to enable them to remain healthy and continue to work during the pandemic.

Association Between the Physical Work Environment and Work Functioning Impairment While Working From Home Under the COVID-19 Pandemic in Japanese Workers.

OBJECTIVE: To examine the relationship between the physical work environment and work function while working from home (WFH). METHODS: A cross-sectional study was conducted. Data from 5760 workers who worked from home at least 1 day a month were analyzed. The physical work environment while WFH was used as an exposure factor. The presence of work functioning impairment was measured using Work Functioning impairment Scale (WFun). Mixed-effects logistic regression was used with the prefecture of residence as a random effect. RESULTS: Work functioning impairment was significantly associated with a "No" response to recommended environments. The highest odds ratio (OR) of work functioning impairment was associated with a "No" response to "There is enough light to do my work" (adjusted odds ratio [aOR]: 2.02, 95% confidence interval [CI]: 1.73 to 2.35, P < 0.01). CONCLUSIONS: Improving work environments may prevent negative health effects and improve productivity while WFH.

Gender differences in the determinants of willingness to get the COVID-19 vaccine among the working-age population in Japan.

Many factors are related to vaccination intentions. However, gender differences in the determinants of intention to get the coronavirus disease 2019 (COVID-19) vaccine have not been fully investigated. This study examined gender differences in the determinants of willingness to get the COVID-19 vaccine among the working-age population in Japan. We conducted a cross-sectional study of Japanese citizens aged 20-65 years using an online self-administered questionnaire in December 2020. Logistic regression analysis was performed. Among 27,036 participants (13,814 men and 13,222 women), the percentage who were willing to get the COVID-19 vaccine was lower among women than among men (33.0% vs. 41.8%). Age and education level showed a gender gap regarding the association with willingness to get the COVID-19 vaccine: men who were older or had a higher level of education were more willing to get the vaccine, whereas women aged 30-49 years and those with a higher level of education showed a relatively low willingness to get the vaccine. For both men and women, marriage, higher annual household income, underlying disease, current smoking, vaccination for influenza during the current season, and fear of COVID-19 transmission were linked to a higher likelihood of being willing to get the COVID-19 vaccine. These findings give important insight into identifying target groups in need of intervention regarding COVID-19 vaccination, especially among women. Providing education about COVID-19 and influenza vaccination in the workplace may be an effective strategy to increase COVID-19 vaccine uptake.