Workplace infection control measures and perceived organizational support during the COVID-19 pandemic in Japan: a prospective cohort study (preprint)

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 4,971 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 5-6 (OR=1.29; 95% confidence interval [CI], 1.05-1.57; P=0.014) and 7-9 workplace infection control measures (OR=1.54; 95% CI, 1.28-1.85; P<0.001) had significantly higher ORs than the group with 0-2 measures. Conclusions: Health support for employees through workplace infection control measures can increase POS.

COVID-19 vaccination coverage by company size and the effects of socioeconomic factors and workplace vaccination in Japan: a cohort study (preprint)

BackgroundVaccination 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. MethodsWe 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. ResultsIn 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. ConclusionsThe 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 registrationNot applicable.

Usage of campaign to encourage travel and personal infection prevention behaviors in Japan: a cross-sectional study (preprint)

Background: 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. We examined the relationship between using Go To Travel and infection prevention behaviors.Methods: We conducted a cross-sectional study of 26,637 workers who responded to a large-scale questionnaire survey about COVID-19 under the pandemic in Japan. We undertook logistic regression analysis.Results: Among the 26,637 participants, 7,959 (30%) used Go To Travel. Compared with non-Go To Travel users, we observed statistically significant differences in multivariate analysis with Go To travel users for the following: gargling (odds ratio [OR], 0.91; 95% confidence interval [CI], 0.87–0.97; P = .001); room ventilation (OR, 0.94; 95% CI, 0.88–0.99; P = .017); and washing hands (OR, 0.94; 95% CI, 0.89–1.00; P = .036).Conclusions: We observed the tendency for Go To Travel users not to implement some infection prevention behaviors. It is necessary to continue the encouragement of applying infection prevention behaviors: implementing such travel support policies as Go To Travel during COVID-19 could spread the risk of infection.Trial registration: Not applicable

Workplace infection control measures and romantic activities of workers during COVID-19 pandemic: a prospective cohort study in Japan (preprint)

Background: 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 one 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 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). Conclusions: 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.

Prospective Cohort Study of Sociodemographic Factors, Including Occupation and Subsequent Unemployment, Under COVID-19 in Japan (preprint)

Background: We examined the relationship between sociodemographic factors, including occupation and unemployment, among workers during COVID-19 in Japan. Methods: : We conducted a prospective cohort study using a self-administrated questionnaire. We surveyed the socioeconomic status, personal characteristics, and occupation of recruited workers at baseline (December 22–25, 2020); subsequent unemployment was examined at follow-up (February 18-19, 2021). We determined the odds ratio (OR) of unemployment for sociodemographic status and occupation. The multivariate model was adjusted for sex and age. Results: : Among the 19,941 participants, 725 (3.6%) had experienced unemployment. Multivariate analysis showed that the OR and 95% confidence interval (CI) of unemployment associated with sex were 1.35 (1.14–1.60) for women compared with men. With increasing age, the OR for unemployment was lower (OR, 0.98; 95% CI, 0.97–0.99; P <0.001), adjusted for sex. The OR and 95% CI for the association with marital status were as follows: 1.33 (1.03–1.71) for being married (spouse not working); 2.09 (1.65–2.64) for bereaved or divorced; and 1.29 (1.07–1.56) for unmarried compared with married (spouse working). The respective figures for the association with annual household income were as follows: 4.05 (3.00–5.46) for <2 million yen; 2.12 (1.62–2.78) for 2–4 million yen; and 1.46 (1.11–1.93) for 4–6 million yen, compared with >10 million yen. The figures for the association with education were 1.73 (1.12–2.66) for junior high or high school and 1.83 (1.19–2.83) for vocational school, junior college, or technical school. The association with occupation was 2.01 (1.63–2.48) for temporary or contract employees, 1.35 (1.02–1.78) for self-employed, and 3.02 (1.68–5.42) for agriculture, forestry, or fishing, compared with general employees; it was 0.56 (0.40–0.79) for public employees, faculty members, or non-profit organization employees. The association with job type was 1.25 (1.04–1.51) for jobs mainly involving interpersonal communication and 1.85 (1.55–2.21) for mainly manual or physical labor, compared with mainly desk work. Conclusions: : COVID-19 appears to have created difficulties for previously vulnerable groups. This suggests the need for employment and economic support for such individuals.

Sociodemographic factors and self-restraint from social behaviors during the COVID-19 pandemic in Japan: a cross-sectional study (preprint)

The control of human flow has led to better control of COVID-19 infections. Japans state of emergency, unlike other countries, is not legally binding but is rather a request for individual self-restraint; thus, factors must be identified that do not respond to self-restraint, and countermeasures considered for those factors to enhance its efficacy. We examined the relationship between sociodemographic factors and self-restraint toward going out in public during a pandemic in Japan. This cross-sectional study used data for February 18-19, 2021, obtained from an internet survey; 19,560 participants aged 20-65 were included in the analysis. We identified five relevant behaviors: (1) taking a day trip; (2) eating out with five people or more; (3) gathering with friends and colleagues; (4) shopping for other than daily necessities; (5) shopping for daily necessities. Multilevel logistic regression analyses were used to examine the association between sociodemographic factors and self-restraint for each of the behaviors. Results showed that for behaviors other than shopping for daily necessities, women, those aged 60-65, married people, highly educated people, high-income earners, desk workers and those who mainly work with interpersonal communication, and those with underlying disease reported more self-restraint. Older people had less self-restraint than younger people toward shopping for daily necessities; an underlying disease had no effect on the identified behavior. Specialized interventions for these groups that include recommendations for greater self-restraint may improve the efficacy of the implementing measures that request self-restraint.

Relationship Between Alcohol Consumption and Telecommuting Preference-Practice Mismatch During the COVID-19 Pandemic. (preprint)

IntroductionThis study examined the association between increased alcohol consumption and telecommuting, comparing employees who expressed a preference for telecommuting and those who did not. MethodsWe conducted an internet monitor survey. Responses from 20,395 of the 33,302 participants were included in the final sample. Participants were asked about their desire for and frequency of telecommuting, and about changes in alcohol consumption under the COVID-19 pandemic. Data were analyzed by logistic regression analysis. ResultsParticipants who telecommuted despite preferring not to do so reported significantly increased alcohol consumption, as revealed by a multivariate analysis (OR=1.62, 95% CI 1.25-2.12). Participants who expressed a preference for telecommuting showed no such increase. ConclusionsUnder the COVID-19 pandemic, telecommuting that involves a mismatch with employee preference for way of working may be a new risk factor for problematic drinking.

Internet-based health survey on loneliness and sleep-related problems among the working-age population in Japan during COVID-19 (preprint)

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 OR was much weaker after adjusting for factors related to interpersonal connections, such as family and friendships, than after adjusting for factors related to socioeconomic status. Conclusions 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. Keywords Loneliness, sleep, COVID-19

Association of alcohol consumption and frequency with loneliness: A cross-sectional study among Japanese workers during the COVID-19 pandemic (preprint)

BackgroundThere 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. MethodsThe 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. The odds ratios (ORs) were estimated by logistic regression analysis. ResultsA 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 were drinking 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 drinking and loneliness among those who indicated they hardly ever drank (OR=1.22 95%CI 0.55-2.72). ConclusionsAmong those with a drinking habit, increased alcohol consumption is associated with loneliness.

Association between long working hours and psychological distress: The effect of sick leave criteria in the workplace during the COVID-19 pandemic (preprint)

Objective: This study investigated the effect of sick leave criteria on the association between long working hours and psychological distress. Methods: We conducted a cross-sectional survey in December 2020, and 27,032 workers completed the questionnaire. First, after testing the interaction effect of overtime work hours and sick leave criteria on psychological distress, we conducted stratified analyses using sick leave criteria. Results: A significant interaction effect was found. When we conducted stratified analyses, the odds ratios increased with longer working hours, both with and without sick leave criteria groups; however, the risk was greater in the without sick leave criteria group, compared with the criteria group. Conclusion: We revealed that working without sick leave criteria could strengthen the association between long working hours and psychological distress during the COVID-19 pandemic.

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

ObjectiveThis study aimed to determine factors associated with acceptance of a Digital Contact Tracing (DCT) app for Coronavirus Disease 2019 (COVID-19) in the Japanese working-age population. MethodsA cross-sectional study was performed for 27,036 full-time workers registered with an internet survey company during December 2020 in Japan. ResultsThe rate of downloading the DCT app was 25.1%. The DCT app 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. ConclusionsThe present findings have important implications for widespread adoption of DCT apps in working-age populations in Japan and elsewhere.

Effect of workplace infection control practices on workers’ psychological distress: a large-scale cohort study during the COVID-19 second state of emergency in Japan (preprint)

Background The COVID-19 pandemic has dramatically transformed the work environment and work practices worldwide. Long-term infection control practices may increase the psychological stress on workers, and conversely, inadequate infection control practices at the working place may increase the fear of infection. This study aimed to determine the relationship between infection control practices at the workplace and employee mental health during the COVID-19 pandemic in Japan. Methods This study was conducted in December 2020 and February 2021. The participants had undergone a preliminary survey, which revealed that they were in good mental health. Their psychological distress was investigated via a second survey, and the factors associated with distress were studied using a logistic model. Results The results of the second survey indicated that 15.1% of participants demonstrated psychological distress. This was associated with leave-of-absence instructions, instructions for shortening business hours, and requests to avoid the workplace in case of any symptoms. Conclusion The study found that while some infection control practices reduce workers’ distress, others worsen it. Employers need to consider infection control practices as well as the worsening mental health of employees following a decrease in income caused by such measures. Follow-up studies may be necessary to clarify the long-term effects on workers’ mental health.

Association between time spent with family and loneliness among Japanese workers during the COVID-19 pandemic: a cross-sectional study (preprint)

BackgroundThe current coronavirus (COVID-19) pandemic has had large impacts on society, including people practicing social distancing. This behavioral response has increased loneliness. Loneliness not only increases the risk of psychiatric disorders, but also affects occupational mental health. To avoid the negative effects of isolation, it is important to have social contact with other people, especially family members. Employment and economic instability caused by COVID-19 may have also affected family relationships. It is important to understand the association between family relationships and loneliness in workers under the pandemic. MethodsWe collected usable data from 27,036 Japanese workers who completed an online survey during the COVID-19 pandemic. Participants were asked how long they spend with members of their family during mealtimes or at home, and if they experienced loneliness; the latter was assessed by a single question. Other questions included whether participants lived with their spouse, or with someone in need of care. To estimate the odds ratios (ORs) of time with family associated with loneliness we used a multilevel logistic model nested in the prefecture of residence, with adjustments for age, sex, marital status, presence of a cohabitant requiring care, equivalent income, educational level, frequency of remote work, availability of someone for casual chat, smoking, drinking, time for leisure interests, and cumulative rates of COVID-19 in the prefecture. ResultsTen percent (2,750) of the 27,036 participants reported loneliness. The survey showed a significant negative correlation between time spent with family and loneliness (p<0.001): participants who spent more time with family were less likely to feel loneliness. In addition, not living with a spouse and living with someone in need of care were associated with loneliness (not living with a spouse: p<0.001; living with someone in need of care: p<0.001). ConclusionLoneliness under COVID-19 pandemic conditions was negatively associated with time spent with family members, with the converse result found for participants cohabiting with someone in need of care. These associations suggest the potential value of changes to working practices and interventions to combat loneliness.

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 (preprint)

ObjectiveThis 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. MethodsA cross-sectional online survey was performed. Of a total of 33,302 participants, 3,676 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. ResultsThe OR of attending work while sick associated with a lack of policy prohibiting workers from working when ill was 2.75 (95%CI: 2.28-3.20, P<0.001). ConclusionThis study suggests that clear company policies on work and illness can be effective for preventing employees from attending work while sick.

Dietary differences by job type and industry among workers in Japan during the COVID-19 pandemic: A cross-sectional study (preprint)

BackgroundThe COVID-19 pandemic requires people to change their lifestyles. This study aimed to examine the differences in dietary behaviors during the pandemic across job types and industries. MethodsA cross-sectional study was conducted using data from the Novel-coronavirus and Work Project. Job type and industry were classified into 3 and 22 groups, respectively. Dietary behaviors were assessed using self-reported questionnaires regarding eating breakfast, frequency of meals, and eating fast foods. Changes in eating breakfast during the pandemic were also evaluated. Logistic regression analysis nested in the workplace prefecture was carried out and adjusted for gender, age, body mass index, presence of family members, educational background, and household income. ResultsWorkers involved in jobs that require communicating with people were more likely to skip breakfast (OR 1.17, 95%CI 1.10-1.24) and had a lower frequency of meals (OR 1.25, 95%CI 1.17-1.34) than workers engaged in desk work. Manual workers were more likely to eat fast food or meals (OR 1.10, 95%CI 1.03-1.17) than workers engaged in desk work. Workers engaged in newspaper, magazine, television, radio, advertising, and other mass media industries were more likely to skip breakfast (OR 2.43, 95%CI 1.82-3.24) and have a lower frequency of meals (OR 3.90, 95%CI 2.87-5.28) than workers in public offices and organizations. ConclusionThe tendencies of dietary behaviors across job types/industries during the pandemic were shown, partially consistent with a trend reported before the pandemic. Further studies should clarify the causes of differences in dietary behaviors among workers.

Effect of familiarity with COVID-19 infection--history of infection or close contact--on outing behaviors when a state of emergency is declared (preprint)

BackgroundRestricting 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 familiarity with the COVID-19 infection affected self-restraint related to outing behaviors during state of emergency declarations in Japan. MethodsA 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 19,941 participants who completed both surveys and were included in the final analysis. We set self-restraint regarding outing behaviors after the second state of emergency was declared in January 2021 as the dependent variable, and levels of familiarity with COVID-19 infection as independent variables. Odds ratios were estimated using multilevel logistic analyses. ResultsSignificant differences by familiarity with COVID-19 infection were identified: compared with people without a history of COVID-19 or close contact with cases of confirmed COVID-19, and those whose acquaintances had not been diagnosed with COVID-19, people with a history of COVID-19 did not refrain from most outing behaviors. People with an acquaintance diagnosed with COVID-19 were significantly more likely to refrain from most outing behaviors. There was no significant difference in any outing behavior for people with a history of close contact only. ConclusionsTo maximize the effect of emergency declarations, health authorities should disseminate information for each person in the target population, taking into account potential differences related to the familiarity with the infection.

Association between interruption to medical care and sickness presenteeism during the COVID-19 pandemic: a cross-sectional study in Japan (preprint)

ObjectiveThis study examined the relationship between interruption to routine medical care during the coronavirus disease 2019 pandemic and sickness presenteeism in Japan. MethodsAn internet monitor questionnaire was conducted. Data from 27,036 people were analyzed. 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 number of sickness presenteeism days in the past 30 days was employed as the primary outcome. A zero-inflated negative binomial model was used for analysis. ResultsThe incidence rate ratio was significantly higher among workers who experienced interrupted medical care (2.26; 95% confidence interval: 2.03-2.52) than those who did not require routine medical care. ConclusionsThis study suggests the importance of continuing necessary treatment during a pandemic to prevent presenteeism.

Prospective cohort study of socioeconomic status and subsequent unemployment under COVID-19 in Japan (preprint)

BackgroundThis study examined the relationship between socioeconomic status (SES) and subsequent unemployment. MethodsThis prospective cohort study was conducted using a self-administrated questionnaire in Japan. SES, personal characteristics, and occupation of recruited workers were surveyed at baseline (December 22-25, 2020); subsequent unemployment was examined at follow-up (February 18-19, 2021). We determined the odds ratios (ORs) of unemployment for SES and other variables using a multilevel logistic model. ResultsAmong all 19,941 participants, 2.3% reported experience of unemployment through negative reasons. Multivariate analysis showed the OR and 95% confidence interval for unemployment associated with age to be 0.66 (0.47-0.92) for 30-39 years, 0.36 (0.25-0.51) for 40-49, 0.36 (0.25-0.53) for 50-59, and 0.43 (0.27-0.67) for more than 60 compared with 20-29 years. The association with annual household income was 2.96 (1.94-4.50) for <2 million yen and 1.51 (1.03-2.22) for 2-4 million yen compared with >10 million yen. The association with marital status was 1.43 (1.04-1.98) for bereaved/divorced compared with married (working spouse). The association with occupation was 1.75 (1.35-2.29) for temporary or contract employees and 2.11 (1.04-4.30) for agriculture, forestry, or fishing compared with general employees. The association with job type was 1.69 (1.34-2.15) for mainly manual labor. ConclusionWe observed a relationship between SES and subsequent unemployment under COVID-19. It is necessary to provide broad, ongoing support in the form of both short-term assistance and long-term job training and health care.

Gender differences in housework and childcare among Japanese workers during the COVID-19 pandemic. (preprint)

ObjectivesAlthough gender stereotypes regarding paid work and unpaid work are changing, most wives are responsible for taking care of the family and home in Japan. It is unclear how time spent on housework and childcare has changed between working men and women during the COVID-19 pandemic in Japan. The purpose of this study is to investigate how working men and womens responsibilities for housework and childcare changed during the COVID-19 pandemic in Japan depending on occupation, job type, and the number of employees in the workplace. MethodsA cross-sectional analysis (N=14,454) was conducted using data from an internet monitoring study (CORoNa Work Project), which was conducted in December 2020. A multilevel logistic model with nested prefectures of residence was conducted to estimate the odds ratio (OR) for change in time devoted to housework and childcare among men and women adjusting for age, household income, frequency of telecommuting, presence of spouse who work, occupation, job type, the number of employees in the workplace, and the incidence rate of COVID-19 by prefecture. ResultsRegardless of occupation related factors, more women than men reported increased time spent on housework and childcare. Furthermore, women were significantly more likely to experience an increase in time spent on those activities than men (housework: OR 1.97, 95% CI [1.75, 2.21], p < 0.001; childcare: OR 1.66, 95% CI [1.37, 2.02], p < 0.001). ConclusionsThe time spent by women on housework and childcare increased significantly compared to men during the COVID-19 pandemic in Japan.

Association between COVID-19 infection rates by region and implementation of non-pharmaceutical interventions: A cross-sectional study in Japan (preprint)

Background: During a pandemic, non-pharmaceutical interventions (NPIs) play an important role in protecting oneself from infection and preventing the spread of infection to others. 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. Data from a total of 27,036 participants were analyzed. The questionnaire asked the respondents to identify their habits regarding seven well-known NPIs. Results: Compared to the region with the lowest infection rate, the odds ratios for the region with the highest infection rate were 1.24 (p<0.001) for wearing a mask in public, 1.08 (p=0.157) for washing hands after using the bathroom, 1.17 (p=0.031) for disinfecting hands with alcohol sanitizers when entering indoors, 1.54 (p<0.001) for gargling when returning home, 1.45 (p<0.001) for ventilating the room, 1.33 (p<0.001) for disinfecting or washing hands after touching frequently touched surfaces, and 1.32 (p<0.001) for carrying alcohol sanitizers when outdoors. Five of the seven NPIs showed statistically significant trends across regional infection levels, the two exceptions being wearing a mask in public and washing hands after using 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.