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

The working-age population is at the epicenter of coronavirus disease 2019 (COVID-19) infections. Therefore, it is important to increase the acceptance of digital contact tracing apps in this population. Contact-Confirming Application (COCOA) is the only digital contact tracing app in Japan. This study aimed to determine factors associated with acceptance of the COCOA for COVID-19 in the Japanese working-age population. A cross-sectional study was performed for 27,036 full-time workers registered with an internet survey company during December 2020 in Japan. Factors associated with COCOA adoption were evaluated by multivariate logistic regression analysis. The rate of downloading the COCOA was 25.1%. The COCOA was more likely to be accepted by people with married status, university graduation or above, higher income, and occupations involving desk work. Fear of COVID-19 transmission, wearing a mask, using hand disinfection, willingness to be vaccinated against COVID-19, and presence of an acquaintance infected with COVID-19 were also associated with a greater likelihood of adopting the app. The rate of downloading the COCOA in Japan was not very high. The present findings have important implications for widespread adoption of digital contact tracing apps in working-age populations in Japan and elsewhere.

Corporate health culture promotes infection control measures against COVID-19 in the workplace.

OBJECTIVES: The present study examined the relationship between health culture evaluated by the Health and Productivity Survey Sheets and the implementation status of infection control measures against COVID-19 in the workplace. METHODS: This was a cross-sectional study using the corporate data (2518 companies) collected for the purpose of selecting the excellent company of health and productivity management by the Japanese government. The explanatory variable was the overall evaluation score, and the outcome was whether or not infection control measures against COVID-19 in the workplace. We used logistic regression analysis and calculated the odds ratio adjusted for the industry sector, the corporation size, and the operating profit ratio by the overall evaluation score category. RESULTS: The odds ratio of all infection control measurements in the workplace increased as the evaluation score increased. CONCLUSIONS: This study revealed a new finding that the presence of a healthy culture in the workplace will lead to the appropriate implementation of infection control measures during a pandemic. The company's ordinary commitment to employee health will be effective even in times of health crisis, such as during the outbreak of the pandemic.

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.

Relationship between alcohol consumption and telecommuting preference-practice mismatch during the COVID-19 pandemic.

OBJECTIVE: This study examined the association between increased alcohol consumption and telecommuting, comparing employees who expressed a preference for telecommuting and those who did not. METHODS: We 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. RESULTS: The ratio of increased drinking in those who telecommuted at least once a week was significantly different (OR = 1.29, 95% CI 1.16-1.43, p < .001). The ratio of increased drinking in participants for whom telecommuting was not preferred was significantly different (OR = 1.08, 95%CI 1.02-1.14, p = .002). Since the interaction term was significant in preliminary analysis, stratification was performed. Participants who telecommuted despite preferring not to do so reported significantly increased alcohol consumption, as revealed by a multivariate analysis (OR = 1.53, 95% CI 1.18-2.00, p < .001). Participants who expressed a preference for telecommuting showed no such increase (OR = 1.12, 95% CI 0.98-1.27, p = .074). CONCLUSIONS: Under 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.

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.

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.

Effectiveness of Infection Preventive Behaviors on COVID-19-Like Illness Symptoms During the Winter Third Wave of the Epidemic in Japan: A 2-Month Follow-up Nationwide Cohort Study.

Although multilayered strategies including preventive behaviors should be adopted to mitigate coronavirus disease 2019 (COVID-19) transmission, evidence on the effectiveness of preventive behaviors against COVID-19 remains limited. This Internet-based prospective cohort study collected baseline data in November 2020 and follow-up data in February 2021, during the third wave of the epidemic in Japan. Among the 19 941 included participants, the percentages reporting that they always used a face mask, practiced hand washing/disinfection, gargling, and ensuring proper room ventilation were 85.4%, 36.0%, 51.1%, and 44.6%, respectively. Multiple logistic regression analyses revealed that less frequently practicing hand washing/disinfection (odds ratio [OR] = 1.20), gargling (OR = 1.20), and ensuring proper room ventilation (OR = 1.38) were significantly associated with self-reported COVID-19-like illness (CLI). These results suggest that personal preventive behaviors may be effective in reducing CLI, even when universal masking is practiced.

Association between loneliness and psychological distress: A cross-sectional study among Japanese workers during the COVID-19 pandemic.

The purpose of this study was to examine the association between loneliness and psychological distress during the COVID-19 pandemic in Japan. We conducted a cross-sectional online study from 22 to 26 December 2020. A total of 27,036 participants, all employed at the time, were included in the analysis. Participants were asked if they felt loneliness in a single-item question. The Kessler 6 (K6) was used to assess psychological distress, defined as mild for K6 scores of 5 to 12 and severe for 13 or higher. The odds ratios (ORs) of psychological distress associated with loneliness were estimated using a multilevel logistic model nested in the prefecture of residence, with adjustment for age, sex, marital status, equivalent income, educational level, smoking, alcohol consumption, job type, number of workplace employees, and cumulative incidence rate of COVID-19 in the prefecture. Communication with friends, acquaintances, and family was strongly associated with psychological distress, so we adjusted for these factors and eating meals alone. Results showed a significant association between loneliness and psychological distress (OR = 36.62, 95% CI = 32.95-40.69). Lack of friends to talk to, lack of acquaintances to ask for help, and lack of people to communicate with through social networking sites were all strongly associated with psychological distress, as were family time and solitary eating. Even after adjusting for these factors, loneliness remained strongly associated with psychological distress (OR = 29.36, 95% CI = 26.44-32.98). The association between loneliness during the COVID-19 pandemic and psychological distress indicates the need for intervention.

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

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

A cross-sectional study of the association between frequency of telecommuting and unhealthy dietary habits among Japanese workers during the COVID-19 pandemic.

OBJECTIVE: Due to the COVID-19 pandemic, telecommuting has become a new way of working that has not only changed individuals' work, but also their health and lifestyle. We examined the relationship between telecommuting frequency and unhealthy dietary habits among Japanese workers. METHODS: A total of 33,302 workers completed an Internet survey about telecommuting and dietary habits. Data from 13,468 office workers who telecommuted were analyzed. Telecommuting frequency during the COVID-19 pandemic was extracted from a questionnaire. The odds ratios (ORs) of four types of dietary habits, namely, skipping breakfast, solitary eating, lower meal frequency, and meal substitution associated with telecommuting frequency were estimated using multilevel logistic regression nested in the prefecture of residence to control for differences in residential area. RESULTS: The multivariate OR of skipping breakfast was 1.15 (95% CI: 1.03-1.29, p = .013) for participants who telecommuted in excess of four days per week compared to those who rarely telecommuted. Similarly, the OR of solitary eating, lower meal frequency and meal substitution were 1.44 (95% CI: 1.28-1.63, p < .001), 2.39 (95% CI: 1.66-3.44, p < .001), and 1.26 (95% CI: 1.04-1.51, p = .015) for those who telecommuted in excess of four days per week compared to those who rarely telecommuted. There was a statistically significant increase in the dose-response trend in ORs of solitary eating (p for trend <.001), lower meal frequency (p for trend <.001), and meal substitution (p for trend = .001) with increasing telecommuting frequency. CONCLUSION: Telecommuters may develop unhealthy dietary habits, indicating the need for strategies to help telecommuters manage their nutrition and diet.

Industry and workplace characteristics associated with the downloading of a COVID-19 contact tracing app in Japan: a nation-wide cross-sectional study.

BACKGROUND: To combat coronavirus disease 2019 (COVID-19), many countries have used contact tracing apps, including Japan's voluntary-use contact-confirming application (COCOA). The current study aimed to identify industry and workplace characteristics associated with the downloading of this COVID-19 contact tracing app. METHODS: This cross-sectional study of full-time workers used an online survey. Multiple logistic regression analysis was used to evaluate the associations of industry and workplace characteristics with contact tracing app use. RESULTS: Of the 27,036 participants, 25.1% had downloaded the COCOA. Workers in the public service (adjusted odds ratio [aOR] = 1.29, 95% confidence interval [CI] 1.14-1.45) and information technology (aOR = 1.38, 95% CI 1.20-1.58) industries were more likely to use the app than were those in the manufacturing industry. In contrast, app usage was less common among workers in the retail and wholesale (aOR = 0.87, 95% CI 0.76-0.99) and food/beverage (aOR = 0.81, 95% CI 0.70-0.94) industries, but further adjustment for company size attenuated these associations. Workers at larger companies were more likely to use the app. Compared with permanent employees, the odds of using the app were higher for managers and civil servants but lower for those who were self-employed. CONCLUSIONS: Downloading of COCOA among Japanese workers was insufficient; thus, the mitigating effect of COCOA on the COVID-19 pandemic is considered to be limited. One possible reason for the under-implementation of the contact tracing app in the retail and wholesale and food/beverage industries is small company size, as suggested by the fully adjusted model results. An awareness campaign should be conducted to promote the widespread use of the contact tracing app in these industries.

A Cross-Sectional Study of the Mismatch Between Telecommuting Preference and Frequency Associated With Psychological Distress Among Japanese Workers in the COVID-19 Pandemic.

OBJECTIVE: To examine how the mismatch between telecommuting preference and telecommuting frequency was associated with psychological distress during the COVID-19 pandemic. METHODS: Data from 33,302 workers throughout Japan were obtained using an Internet survey. Among 33,302 participants, 20,395 who telecommuted were included in the analysis. Participants' telecommuting preference and frequency during the COVID-19 pandemic were determined using a questionnaire. Psychological distress was assessed using Kessler 6 (K6). RESULTS: Among participants who did and did not prefer to telecommute, those who telecommuted four or more days per week had an OR of psychological distress of 0.67 (P < 0.001) and 1.87 (P = 0.001), respectively, compared with those who rarely telecommuted. CONCLUSIONS: The association between telecommuting and psychological distress differs depending on telecommuting preference.

A cross-sectional study of infection control measures against COVID-19 and psychological distress among Japanese workers.

OBJECTIVES: This study examined the relationship between the status of infection control efforts against COVID-19 in the workplace and workers' mental health using a large-scale Internet-based study. METHODS: This cross-sectional study was based on an Internet monitoring survey conducted during the third wave of the COVID-19 epidemic in Japan. Of the 33 302 people who participated in the survey, 27 036 were included in the analyses. Participants answered whether or not each of 10 different infection control measures was in place at their workplace (eg, wearing masks at all times during working hours). A Kessler 6 (K6) score of ≥13 was defined as mild psychological distress. The odds ratios (ORs) of psychological distress associated with infection control measures at the workplace were estimated using a multilevel logistic model nested in the prefectures of residence. RESULTS: The OR of subjects working at facilities with 4 or 5 infection control measures for psychological distress was 1.19 (95% confidence interval [CI]: 1.05-1.34, P = .010), that in facilities with 2 or 3 infection control measures was 1.43 (95% CI: 1.25-1.64, P < .001), and that in facilities with 1 or no infection control measures was 1.87 (95% CI: 1.63-2.14, P < .001) compared to subjects whose workplaces had ≥6 infection control measures. CONCLUSION: Our findings suggest that proactive COVID-19 infection control measures can influence the mental health of workers.

Intensity of Home-Based Telework and Work Engagement During the COVID-19 Pandemic.

OBJECTIVE: The present study examined the relationship between the intensity of home-based telework and work engagement. METHODS: This cross-sectional study using a self-administrated questionnaire survey was conducted from December 22 to 25, 2020, in Japan. The subjects were asked single-item questions about the intensity of telework and three-item questions about work engagement using the Utrecht Work Engagement Scale. Coefficients were estimated using a multilevel regression model nested by the prefecture of residence and adjusted for covariates. RESULTS: High-intensity (4 or more days per week) telework was not associated with high work engagement for men or women. In contrast, low and moderate intensity (3 days per week to once per month) were associated with high work engagement. The results were consistent when stratified by sex. CONCLUSIONS: Reasonable-intensity telework may have beneficial effects on work engagement.

Workplace measures against COVID-19 during the winter third wave in Japan: Company size-based differences.

OBJECTIVES: Little is known about workplace measures against coronavirus disease 2019 (COVID-19) in Japan during the winter of 2020, especially in micro-, small-, and medium-sized enterprises (MSMEs). This study aimed to provide an overview of the current situation of anti-COVID-19 measures in Japanese enterprises during the winter, considering company size. METHODS: This study was an Internet-based nationwide cross-sectional study. Individuals who were registered as full-time workers were invited to participate in the survey. Data were collected using an online self-administered questionnaire in December 2020. The chi-squared test for trend was performed to calculate the P-value for trend for each workplace measure across company sizes. RESULTS: For the 27 036 participants, across company sizes, the most prevalent workplace measure was encouraging mask wearing at work, followed by requesting that employees refrain from going to work when ill and restricting work-related social gatherings and entertainment. These measures were implemented by approximately 90% of large-scale enterprises and by more than 40% of micro- and small-scale enterprises. In contrast, encouraging remote working was implemented by less than half of large-scale enterprises and by around 20% of micro- and small-scale enterprises. There were statistically significant differences in all workplace measures by company size (all P < .001). CONCLUSIONS: We found that various responses to COVID-19 had been taken in workplaces. However, some measures, including remote working, were still not well-implemented, especially in smaller enterprises. The findings suggest that occupational health support for MSMEs is urgently needed to mitigate the current wave of COVID-19.

Anticipated health effects and proposed countermeasures following the immediate introduction of telework in response to the spread of COVID-19: The findings of a rapid health impact assessment in Japan.

OBJECTIVES: The health effects of telework, which was introduced extensively in the immediate context of the COVID-19 pandemic crisis in Japan, on teleworkers, their families, and non-teleworkers, are unknown. Accordingly, we developed a rapid health impact assessment (HIA) to evaluate positive and negative health effects of telework on these groups and recommended easily implementable countermeasures. METHODS: Immediately after an emergency was declared in Japan, we implemented a rapid, five-step HIA. We screened and categorized health effects of telework for the three above-mentioned groups, extracting their content, directionality, and likelihood. Following a scoping exercise to determine the HIA's overall implementation, five experienced occupational health physicians appraised and prioritized the screened items and added new items. We outlined specific countermeasures and disseminated the results on our website. A short-term evaluation was conducted by three external occupational health physicians and three nurses. RESULTS: Following screening and appraisal, 59, 29, and 27 items were listed for teleworkers, non-teleworkers, and family members of teleworkers, respectively, covering work, lifestyle, disease and medical care, and home and community. Targeted countermeasures focused on the work environment, business management, communications, and lifestyles for teleworkers; safety and medical guidelines, work prioritization, and regular communication for non-teleworkers; and shared responsibilities within families and communication outside families for family members of teleworkers. CONCLUSION: The HIA's validity and the countermeasures' practical applicability were confirmed by the external evaluators. They can be easily applied and adapted across diverse industries to mitigate the wider negative effects of telework and enhance its positive effects.