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.

Relationship between Psychological Distress and Poverty among Japanese Workers during the COVID-19 Pandemic: A Prospective Cohort Study.

OBJECTIVE: This study aimed to examine the relationship between psychological distress and poverty among Japanese workers during the COVID-19 pandemic. METHOD: An internet based prospective cohort study was conducted. A total of 11,081 individuals who were not experiencing poverty at baseline in December 2020 were included. The exposure variable was psychological distress evaluated using the Kessler 6 scale at baseline. The outcome variable was whether participants were experiencing poverty at the one-year follow-up, as defined by household financial distress. RESULT: Compared to individuals without psychological distress, the adjusted odds ratios of household financial distress among those with mild and severe psychological distress were 2.88 (95% CI: 2.47-3.33, p < 0.001) and 3.19 (95% CI: 2.52-4.04, p < 0.001), respectively. CONCLUSION: Workers' psychological distress is a notable public health concern in the context of poverty.

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.

Effect of COVID-19 infection related experiences on social behaviors when a state of emergency is declared: a cohort study.

BACKGROUND: Restricting the movement of the public to gathering places and limiting close physical contact are effective measures against COVID-19 infection. In Japan, states of emergency have been declared in specific prefectures to reduce public movement and control COVID-19 transmission. We investigated how COVID-19 infection related experiences including people with a history of infection, people with a history of close contact, and people whose acquaintances have been infected, affected self-restraint from social behaviors during the second state of emergency in Japan. METHODS: A prospective cohort study was conducted among workers aged 20-65 years using data from an internet survey. The baseline survey was conducted on December 22-25, 2020, and a follow-up survey was on February 18-19, 2021. There were 19,051 participants who completed both surveys and were included in the final analysis. We identified eight social behaviors: (1) eating out (4 people or fewer); (2) eating out (5 people or more); (3) gathering with friends and colleagues; (4) day trip; (5) overnight trip (excluding visiting home); (6) visiting home; (7) shopping for daily necessities; and (8) shopping for other than daily necessities. We set self-restraint regarding each social behavior after the second state of emergency was declared in January 2021 as the dependent variable, and COVID-19 infection related experiences as independent variables. Odds ratios were estimated using multilevel logistic regression analyses nested in the prefecture of residence. RESULTS: Significant differences by COVID-19 infection related experiences were identified: compared to people without COVID-19 related experiences, people with a history of COVID-19 were less likely self-restraint from most social behaviors. People whose acquaintance had been diagnosed with COVID-19 were significantly more likely to refrain from most social behaviors. There was no significant difference in any social behaviors for people with a history of close contact only. CONCLUSION: To maximize the effect of a state of emergency, health authorities should disseminate information for each person in the target population, taking into account potential differences related to the infection related experiences.

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.

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.

Relationship between Psychological Distress and Poverty among Japanese Workers during the COVID-19 Pandemic: A Prospective Cohort Study.

OBJECTIVE: This study aimed to examine the relationship between psychological distress and poverty among Japanese workers during the COVID-19 pandemic. METHOD: An internet based prospective cohort study was conducted. A total of 11,081 individuals who were not experiencing poverty at baseline in December 2020 were included. The exposure variable was psychological distress evaluated using the Kessler 6 scale at baseline. The outcome variable was whether participants were experiencing poverty at the one-year follow-up, as defined by household financial distress. RESULT: Compared to individuals without psychological distress, the adjusted odds ratios of household financial distress among those with mild and severe psychological distress were 2.88 (95% CI: 2.47-3.33, p < 0.001) and 3.19 (95% CI: 2.52-4.04, p < 0.001), respectively. CONCLUSION: Workers' psychological distress is a notable public health concern in the context of poverty.

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.

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.

Workplace Infection Control Measures and Perceived Organizational Support During the COVID-19 Pandemic in Japan: A Prospective Cohort Study.

OBJECTIVE: We investigated whether workplace infection control measures during the COVID-19 pandemic could increase perceived organizational support (POS). METHODS: This prospective cohort study was conducted in Japan from December 2020 to December 2021 using a questionnaire survey. There were 18,560 respondents at follow-up; we investigated 4971 who rated low POS at baseline. The participants were asked a single question about POS and nine about workplace infection control measures. We determined the odds ratios (ORs) of high POS at follow-up using multilevel logistic regression analysis. RESULTS: The groups of 5 to 6 (OR = 1.29, 95% confidence interval = 1.05-1.57, P = 0.014) and 7 to 9 workplace infection control measures (OR = 1.54, 95% confidence interval, 1.28-1.85, P < 0.001) had significantly higher ORs than the group with 0 to 2 measures. CONCLUSIONS: Health support for employees through workplace infection control measures can increase POS.

Spread of infection and treatment interruption among Japanese workers during the COVID-19 pandemic: A cross-sectional study.

Background: The COVID-19 pandemic has resulted in treatment interruption for chronic diseases. The scale of COVID-19 in Japan has varied greatly in terms of the scale of infection and the speed of spread depending on the region. This study aimed to examine the relationship between local infection level and treatment interruption among Japanese workers. Methods: Cross-sectional internet survey was conducted from December 22 to 26, 2020. Of 33,302 participants, 9,510 (5,392 males and 4,118 females) who responded that they required regular treatment were included in the analysis. The infection level in each participant's prefecture of residence was assessed based on the incidence rate (per 1,000 population) and the number of people infected. Age-sex and multivariate adjusted odds ratios (ORs) of regional infection levels associated with treatment interruption were estimated by multilevel logistic models, nested by prefecture of residence. The multivariate model was adjusted for sex, age, marital status, equivalent household income, educational level, occupation, self-rated health status and anxiety. Results: The ORs of treatment interruption for the lowest and highest levels of infection in the region were 1.32 [95 % confidence interval (CI) were 1.09-1.59] for the overall morbidity rate (per 1,000) and 1.34 (95 % CI 1.10-1.63) for the overall number of people infected. Higher local infection levels were linked to a greater number of workers experiencing treatment interruption. Conclusions: Higher local infection levels were linked to more workers experiencing treatment interruption. Our results suggest that apart from individual characteristics such as socioeconomic and health status, treatment interruption during the pandemic is also subject to contextual effects related to regional infection levels. Preventing community spread of COVID-19 may thus protect individuals from indirect effects of the pandemic, such as treatment interruption.

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.

COVID-19 vaccination coverage by company size and the effects of workplace vaccination program in Japan: a cohort study.

BACKGROUND: Vaccination is considered the most effective control measure against COVID-19. Vaccine hesitancy and equitable vaccine allocation are important challenges to disseminating developed vaccines. To promote COVID-19 vaccination coverage, the government of Japan established the workplace vaccination program. However, while it appears that the program was effective in overcoming vaccine hesitancy, the program may have hindered the equitable allocation of vaccines because it mainly focused on employees of large companies. We investigated the relationship between company size and COVID-19 vaccination completion status of employees and the impact of the workplace vaccination program on this relationship. METHODS: We conducted an internet-based prospective cohort study from December 2020 (baseline) to December 2021. The data were collected using a self-administered questionnaire survey. Briefly, 27,036 workers completed the questionnaire at baseline and 18,560 at follow-up. After excluding ineligible respondents, we finally analyzed the data from 15,829 participants. At baseline, the participants were asked about the size of the company they worked for, and at follow-up they were asked about the month in which they received their second COVID-19 vaccine dose and the availability of a company-arranged vaccination opportunity. RESULTS: In each month throughout the observation period, the odds of having received a second COVID-19 vaccine dose were significantly lower for small-company employees than for large-company employees in the sex- and age-adjusted model. This difference decreased after adjusting for socioeconomic factors, and there was no significant difference after adjusting for the availability of a company-arranged vaccination opportunity. CONCLUSIONS: The workplace vaccination program implemented in Japan to control the COVID-19 pandemic may have been effective in overcoming vaccine hesitancy in workers; however, it may have caused an inequitable allocation of vaccines between companies of different sizes. Because people who worked for small companies were less likely to be vaccinated, it will be necessary to enhance support of vaccination for this population in the event of future infectious disease outbreaks. TRIAL REGISTRATION: Not applicable.

Effect of Working from Home on the Association between Job Demands and Psychological Distress.

Limited information is available regarding the association between workplace psychosocial factors and general mental health status among workers during the coronavirus disease 2019 pandemic. This study examined how working from home affected the association between job demands and psychological distress (PD). A cross-sectional online survey was conducted in December 2020 (N = 27,036). The dependent variable (PD) was assessed using the Kessler Psychological Distress Scale. Job demands were assessed using the Job Content Questionnaire. Working from home was determined by participants' responses to the question, "Do you currently work from home?" We used a two-level regression analysis adjusted for prefecture. Each individual-level variable at Level 1 was nested into each prefecture at Level 2, stratified by working from home or not. Overall, 21.3% of participants worked from home. The interaction between working from home and job demands was significant. Job demands were positively associated with PD. The stratified analysis indicated that the associations were weaker among employees who worked from home compared with those among employees who did not. The association between job demands and PD may be weakened by working from home.

Association between Long Working Hours and Psychological Distress: The Effect Modification by Request to Stay Home When Sick in the Workplace during the COVID-19 Pandemic.

The effect of workplace infection control measures required by the COVID-19 pandemic on the association between long working hours and psychological distress has not yet been fully revealed. This study investigated the effect of requesting to stay home when sick (RSH) on the association between long working hours and psychological distress. We conducted a cross-sectional survey in December 2020 among participants who had previously registered with a Japanese web survey company. A total of 27,036 workers completed a self-administered questionnaire which assessed usual daily overtime work hours. RSH was assessed using an original single-item scale, while psychological distress was measured with the K6 scale. After the interaction effect of overtime work hours and RSH on psychological distress was tested, we conducted stratified analyses using RSH. The statistical analysis demonstrated a significant interaction effect (p for interaction < 0.001). When we conducted stratified analyses, the odds ratios increased with longer working hours, both with and without RSH groups; however, the risk of long working hours causing psychological distress was greater in the latter group (odds ratio = 1.95 [95% confidence interval: 1.62-2.36] than in the former group (odds ratio = 1.73 [95% confidence interval: 1.55-1.93]). We found that working without RSH could strengthen the association between long working hours and psychological distress. Our findings contribute to preventing the deterioration of mental health during the COVID-19 pandemic.

Association Between Loneliness and Sleep-Related Problems Among Japanese Workers During the COVID-19 Pandemic.

Background: The coronavirus disease 2019 (COVID-19) pandemic has been linked to a rise in loneliness. Loneliness is associated with sleep-related problems, which in turn can be a risk factor for various psychiatric disorders. However, it is unclear whether loneliness is linked to sleep-related problems during the pandemic. Here, we studied the association between loneliness and sleep-related problems during the COVID-19 pandemic in Japan. Methods: A total of 33,302 individuals who indicated they were employed were surveyed online. The survey responses of 27,036 participants were analyzed. Odds ratios (ORs) were estimated using univariate and multiple logistic regression analyses. Results: Of those analyzed, 2,750 (10.2%) experienced feelings of loneliness. Further, sleep-related problems were significantly more common among those who felt lonely both in the short term (more than 3 days) and the long term (more than 3 months). The ORs were much weaker after adjusting for factors related to interpersonal connections, such as family and friendships, than after adjusting for factors related to socioeconomic status. Conclusion: Loneliness may be a risk factor for sleep-related problems in the COVID-19 pandemic. Having connections with family and friends may have a moderating effect on the occurrence of sleep-related problems.

Prospective cohort study of workers diagnosed with COVID-19 and subsequent unemployment.

OBJECTIVES: The purpose of this study was to investigate the relationships of workers being diagnosed with coronavirus disease 2019 (COVID-19) and being identified as close contacts of infected persons with unemployment in Japan. METHODS: This was a prospective cohort study using questionnaires about COVID-19 administered to Japanese workers. A baseline survey conducted on December 22-25, 2020, was used to determine history of being diagnosed with COVID-19 or being identified as a close contact of an infected person. Unemployment since the baseline survey was ascertained with a follow-up survey on February 18 and 19, 2021. The odds ratios (ORs) of unemployment were estimated using a multilevel logistic model with adjusted covariates nested in prefecture of residence. RESULTS: Women (n = 8771) accounted for 44% of the total sample (n = 19 941), and the mean age was 48.0 years. In terms of unemployment because of negative reasons, the multivariate analysis showed that the OR of unemployment associated with being diagnosed with COVID-19 was 2.40 (95% CI: 1.15-5.01) and that the OR associated with being identified as a close contact was 0.98 (95% CI: 0.31-3.11). CONCLUSIONS: There is an association between workers being diagnosed with COVID-19 and unemployment. The reason is not clear, but if the unemployment is unwanted by the individual, workplace adjustment may help prevent unwilling unemployment.