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.

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

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

Association between preventive measures against workplace infection and preventive behavior against personal infection.

To prevent the spread of infection, it is necessary for each individual to adopt infection prevention behavior. We investigated the effect of infection control measures implemented in the workplace on personal infection prevention behavior. We conducted a self-administered questionnaire survey through the Internet from December 22 to 25, 2020, during which period coronavirus disease 2019 (COVID-19) was spreading. Among respondents aged 20 to 65 years (n=27,036), 21,915 workers were included in the analysis. The results showed that as the number of infection control measures in the workplace increased, implementation of infection prevention behavior by individuals also significantly increased. However, the relationship differed depending on the type of personal infection prevention behavior. Specifically, infection control measures against COVID-19 in the workplace may affect personal infection prevention behavior. Implementation of infection control measures in the workplace increases awareness of the importance of individual infection prevention behavior and its implementation by all individuals. These findings may be applicable not only to COVID-19 measures but also to responses to other emerging infections and seasonal influenza.

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.

Effect of working place infection control practices on workers' psychological distress: A large-scale cohort study during the COVID-19 pandemic in Japan

Background The COVID-19 pandemic has dramatically transformed the work environment and practices worldwide. Long-term infection control practices may increase the psychological distress of workers, and, conversely, inadequate infection control practices in the working place may increase the fear of infection. This study aimed to determine the relationship between infection control practices in the working place and employee mental state 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 a good mental state. 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 15.3% of participants demonstrated psychological distress. This was associated with leave-of-absence instructions, instructions for shortening business hours, and requests to avoid the working place 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 state 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 states.

Job stress and loneliness among desk workers during the COVID-19 pandemic in Japan: focus on remote working.

BACKGROUND: Previous studies have reported an increase in loneliness since the outbreak of coronavirus disease 2019 (COVID-19), but there are few data on the relationship between job stress and loneliness. This study aimed to assess the relationship between job stress and loneliness among desk workers, with a focus on the impact of remote working. METHODS: This study was part of the Collaborative Online Research on the Novel-coronavirus and Work (CORoNaWork) project in Japan. We extracted data from 13,468 workers who indicated that they were doing desk work. Loneliness was assessed using a single question and job stress was valuated using the Job Content Questionnaire (JCQ). Multiple logistic regression was performed. RESULTS: Participants who worked remotely 4 or more days per week were marginally more likely to report feeling lonely compared with those who did not work remotely (adjusted odds ratio = 1.23, 95% CI: 0.99-5.84, P = 0.066). Remote working did not explain the interaction between JCQ scale scores and loneliness. Among remote workers, the level of support provided by co-workers and supervisors was strongly associated with feelings of loneliness as well as non-remote workers (co-worker support: AOR = 4.06, 95% CI: 2.82-5.84, P < 0.001; supervisor support: AOR = 2.49, 95% CI: 1.79-3.47, P < 0.001). CONCLUSIONS: To reduce loneliness and the risk of associated mental health problems, high-frequency remote workers should interact with supervisors and co-workers using the information and communication technology developed for this purpose.

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.

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

OBJECTIVES: Although 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 women's responsibilities for housework and childcare changed during the COVID-19 pandemic in Japan depending on work hours, job type, the number of employees in the workplace, and frequency of telecommuting. METHODS: A 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, presence of spouse who work, work hours, job type, the number of employees in the workplace, frequency of telecommuting, and the incidence rate of COVID-19 by prefecture. RESULTS: More women tended to perceive that their time of housework and/or childcare had been changed (increased housework: OR 1.92, 95% CI [1.71-2.16], P < .001; decreased workhours: 1.66 (1.25-2.19), P < .001: increased childcare: OR 1.58, 95% CI [1.29-1.92], P < .001; decreased childcare: 1.11 (0.62-2.00), P = .719). CONCLUSIONS: The time spent by women on housework and childcare changed significantly compared to men during the COVID-19 pandemic in Japan.

Prospective Cohort Study of Sociodemographic and Work-Related Factors and Subsequent Unemployment under COVID-19 Pandemic.

The previous studies found that women and low-income households were more likely to experience unemployment prior to the COVID-19 pandemic. However, there is no cohort study to examine the relationship during the COVID-19 pandemic. The aim of this prospective cohort study is to examine the relationship between sociodemographic factors and unemployment during the COVID-19 pandemic in Japan. We surveyed the socioeconomic status, personal characteristics, and occupation of recruited workers at baseline (22-25 December 2020); subsequent unemployment was examined at follow-up (18-19 February 2021). We determined the odds ratio of unemployment by sociodemographic status and occupation. The multivariate model was adjusted for sex and age. Among the 19,941 participants, 725 (3.6%) had experienced unemployment. Multivariate analysis showed significant high unemployment amongst women and participants of younger age, bereaved or divorced, unmarried, of lower income, or with short educational background. By occupation, the unemployment rate of temporary or contract employees and self-employed is high. COVID-19 expelled socially vulnerable groups from employment. 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.

The control of human flow has led to better control of COVID-19 infections. Japan's 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 social behaviors 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 relationship 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.

Low back pain and telecommuting in Japan: Influence of work environment quality.

OBJECTIVES: This study examined the relationship between frequency of working from home and low back pain (LBP), considering the quality of work environment. METHODS: The study was based on a cross-sectional internet-based survey. Of 33 302 respondents, data from 12 774 desk workers were retained for analysis. We used a 0-10 numerical rating scale to assess LBP. Work environment was assessed using five subjective questions. Mixed-effects logistic regression nested by city level was used to analyze the relationship between frequency of working from home and LBP, stratified by work environment condition. RESULTS: The prevalence of LBP was 21.0%. Among those reporting a poor work environment, as opposed to almost never working from home, the multivariate odds ratio (OR) of LBP were as follows: working from home less than 1 day per week: OR = 1.25, 95% CI: 0.89-1.76, p = .190; 2-3 days per week: OR = 1.58, 95% CI: 1.16-2.16, p = .004; and 4 or more days per week: OR = 1.82, 95% CI: 1.38-2.40, p < .001. By contrast, among those reporting a good work environment, the OR of LBP did not increase as the frequency of working from home increased. CONCLUSIONS: The relationship between LBP and frequency of working from home was found to vary with the quality of the work environment; more specifically, LBP was associated with frequency of teleworking in a poor work environment. This study suggests that employers should give more support to their employees in promoting a good work environment to prevent LBP. (Words: 240/250).

Association between willingness to receive the COVID-19 vaccine and sources of health information among Japanese workers: a cohort study.

BACKGROUND: It is important to achieve herd immunity by vaccinating as many people as possible to end the COVID-19 pandemic. We investigated the relationship between willingness to receive vaccination and sources of health information among those who did not want to be vaccinated against COVID-19. METHODS: This prospective cohort study collected data using a self-administered questionnaire survey. The baseline survey was conducted during December 22-25, 2020, and the follow-up survey during February 18-19, 2021. Participants were aged 20-65 years and worked at the time of the baseline survey (N = 33,087). After excluding 6,051 invalid responses, we included responses from 27,036 participants at baseline. In total, 19,941 people responded to the follow-up survey (74% follow-up rate). We excluded 7,415 participants who answered "yes" to the question "If a COVID-19 vaccine becomes available, would you like to get it?" in the baseline survey. We finally analyzed 12,526 participants. RESULTS: The odds ratio for change in willingness to be vaccinated from "no" to "yes" differed by source of health information. Compared with workers that used TV as a source of information, significantly fewer people who reported getting information from the Internet and friends/colleagues were willing to get the vaccine. CONCLUSIONS: It is important to approach workers who do not watch TV when implementing workplace vaccination programs. It is likely that willingness to be vaccinated can be increased through an active company policy whereby the top management recommend vaccination, coupled with an individual approach by occupational health professionals. TRIAL REGISTRATION: Not applicable.

Job stress among workers who telecommute during the coronavirus disease (COVID-19) pandemic in Japan: a cross-sectional study.

OBJECTIVES: The work system reform and the COVID-19 pandemic in Japan have prompted efforts toward telecommuting in Japan. However, only a few studies have investigated the stress and health effects of telecommuting. Therefore, this study aimed to clarify the relationship between telecommuting and job stress among Japanese workers. MATERIAL AND METHODS: This was a cross-sectional study. In December 2020, during the "third wave" of the COVID-19 pandemic, an Internet-based nationwide health survey of 33 087 Japanese workers (The Collaborative Online Research on Novel-coronavirus and Work, CORoNaWork study) was conducted. Data of 27 036 individuals were included after excluding 6051 invalid responses. The authors analyzed a sample of 13 468 office workers from this database. The participants were classified into 4 groups according to their telecommuting frequency, while comparing scores on the subscale of the Job Content Questionnaire (JCQ) and subjective job stress between the high-frequency, medium-frequency, low-frequency, and non-telecommuters groups. A linear mixed model and an ordinal logistic regression analysis were used. RESULTS: A significant difference in the job control scores of the JCQ among the 4 groups was found, after adjusting for multiple confounding factors. The high-frequency telecommuters group had the highest job control score. Further, after adjusting for multiple confounding factors, the subjective job stress scores of the high- and medium-frequency telecommuters groups were significantly lower than those of the non-telecommuters group. CONCLUSIONS: This study revealed that high-frequency telecommuting was associated with high job control and low subjective job stress. The widespread adoption of telecommuting as a countermeasure to the public health challenges associated with the COVID-19 pandemic may also have a positive impact on job stress. Int J Occup Med Environ Health. 2022;35(3):339-51.

A Cross-Sectional Study of the Relationship Between Exercise, Physical Activity, and Health-Related Quality of Life Among Japanese Workers.

Background: Studies have determined that exercise and physical activity positively affect physical and mental health, and that healthy workers contribute to increased work performance. The relationship between the time spent on exercise during leisure time and physical activity, including work, with health-related quality of life (HRQOL) in workers is unclear, with variations observed between occupational types. This cross-sectional study examined these associations among Japanese workers from various occupations during the COVID-19 pandemic. Methods: An Internet-based national health survey-Collaborative Online Research on Novel-coronavirus and Work-study (CORoNaWork study)-was conducted among 33,087 Japanese workers in December 2020. After excluding invalid responses, 27,036 participants were categorized into four and five groups according to exercise and physical activity time, respectively. Each group's scores were compared on each of the four questions on the Japanese version of the Centers for Disease Control and Prevention Health-Related Quality of Life (CDC HRQOL-4) using generalized linear models. Age-sex adjusted and multivariate models were used to compare each index of the CDC HRQOL-4. Results: Compared to the reference category (almost never), any level of exercise (ORs 0.56-0.77) and physical activity (ORs 0.93-0.88) were associated with better self-rated health in the multivariate model. Any exercise was also associated with significantly reduced odds for physically or mentally unhealthy days; however, high levels of physical activity (≥120 min/day) were associated with significantly increased odds for these outcomes (ORs = 1.11 and 1.16, respectively). Conclusions: The results suggest that exercise habits are more critical to workers' HRQOL than physical activity. Interventions that encourage daily exercise even for a short time are likely to be associated with better workers' health and work performance.

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.

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.

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.

A Cross-Sectional Study of Psychosocial Factors and Sickness Presenteeism in Japanese Workers During the COVID-19 Pandemic.

BACKGROUND: We examined the association between socioeconomic and health status, and lifestyle and sickness presenteeism among Japanese workers during the COVID-19 epidemic. METHODS: A cross-sectional study using an Internet-monitor survey was conducted in December, 2020 in Japan. Of 33,302 survey participants, we analyzed 27,036 participants (13,814 men and 13,222 women) who reported experience with sickness presenteeism. RESULTS: The odds ratio (OR) of sickness presenteeism associated with unmarried versus married status was 1.15. Respective figures for other variables were 1.11 for manual laboring work compared to desk work; 1.79 and 2.29 for loss of employment at the time the pandemic began and continuation of unemployment compared with maintaining employment during the pandemic; and 3.34 for a feeling of financial instability compared with stability. CONCLUSION: The issue of sickness presenteeism has become more prominent under the COVID-19 epidemic.

Association Between Telecommuting Environment and Low Back Pain Among Japanese Telecommuting Workers: A Cross-Sectional Study.

OBJECTIVES: We evaluated the relationship between telecommuting environment and low back pain (LBP) among desk-based workers in Japan. METHODS: This cross-sectional study included 3663 desk-based, telecommuting workers. LBP was assessed using a 0 to 10 numerical rating scale. The telecommuting environment was evaluated using subjective questions. Mixed-effects logistic regression analysis was used to evaluate this association. RESULTS: The results of mixed-effects logistic model revealed that not having a place or room to concentrate on work, desk not well-lit enough for work, lack of space on the desk to work, not having enough legroom, and uncomfortable temperature and humidity conditions in the workspace were significantly associated with higher odds of LBP. CONCLUSIONS: Our findings suggest that telecommuting environment is associated with the prevalence of LBP.

Association Between Time Spent With Family and Loneliness Among Japanese Workers During the COVID-19 Pandemic: A Cross-Sectional Study.

Background: The 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. Methods: We 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, number of employees in the workplace, 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. Results: Ten 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). Conclusion: Loneliness 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.