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

ObjectiveWe investigated whether workplace infection control measures during the COVID-19 pandemic could increase perceived organizational support (POS). MethodsThis 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. ResultsThe 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. ConclusionsHealth 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

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.

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.

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

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.

Relationship among work-treatment balance, job stress, and work engagement in Japan: A cross-sectional study

There is a drive to support workers undergoing medical treatment who wish to continue working in Japan, known as the work-treatment balance. It is hoped that this support for the work-treatment balance could boost their mental health. This study examines the relationship among the work-treatment balance, job stress, and work engagement. This study was conducted in December 2020 in Japan, with 27,036 participants. We divided the participants into three groups by the receipt state of support for the work-treatment balance: control group (no need the support), unsupported group, and supported group. The scores of the parameters of the job content questionnaire and the Utrecht Work Engagement Scale (UWES-3) were compared among groups using a multilevel regression with age-sex or multivariate-adjusted models. In the two models, the job control score of the unsupported group was significantly lower than that of the control group. The two social support scores of the supported group were significantly higher than those of the control group. The scores of the UWES-3 of the unsupported group were significantly lower than those of the control group. The support of work-treatment balance for workers could have a positive impact on their mental health.

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

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.

A cross-sectional study of socioeconomic status and sickness presenteeism in Japanese workers during the COVID-19 pandemic

BackgroundWe examined the association between socioeconomic and health status, and lifestyle and sickness presenteeism among Japanese workers during the COVID-19 epidemic. MethodsA 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. ResultsThe 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 to maintaining employment during the pandemic; and 3.34 for a feeling of financial instability compared to stability. ConclusionThe issue of sickness presenteeism has become more prominent under the COVID-19 epidemic.

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

BackgroundIt 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. MethodsThis 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. ResultsThe 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. ConclusionsIt 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 registrationNot applicable.

Association between Preventive Measures against Workplace Infection and Preventive Behavior against Personal Infection

ObjectivesTo prevent the spread of coronavirus disease 2019 (COVID-19) 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. MethodsWe conducted a self-administered questionnaire survey through the Internet from December 22 to 25, 2020, during which period COVID-19 was spreading. Among respondents aged 20 to 65 years (n=27,036), a total of 21,915 workers were included in the analysis after excluding self-employed workers (n=2,202), workers in small/home offices (n=377), and agriculture, forestry, and fisheries workers (n=212), etc., whose personal infection prevention behavior was almost the same as infection control measures taken in the workplace. ResultsThe 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. ConclusionImplementation of infection control measures in the workplace appears to deepen personal understanding of infection prevention behaviors, and 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.

Telecommuting intensity among Japanese workers according to regional cumulative COVID-19 incidence: a cross-sectional study

This study aimed to examine the relationship between telecommuting and the regional cumulative COVID-19 incidence. This was a cross-sectional study analyzing 13,468 office workers. The participant groups, according to the level of cumulative COVID-19 incidence by prefecture, were used as the predictor variable, and telecommuting frequency and preference were used as outcomes. We employed an ordinal logistic regression analysis. In regions with a high cumulative COVID-19 incidence, the proportion of participants who telecommuted more than two days per week was 34.7%, which was approximately 20% higher than in other regions. Telecommuting preference was stronger in areas with higher COVID-19 influence. However, in other regions, the proportion of participants who did not want to telecommute was higher than that of those who wanted to telecommute. We found that telecommuting frequency and preference were higher in regions with high cumulative COVID-19 incidence.

Effect of commuting on the risk of COVID-19 and COVID-19-induced anxiety

BackgroundTo prevent the spread of coronavirus disease (COVID-19), it is important to avoid 3Cs (closed spaces, crowded places, and close-contact settings). However, the risk of contact with an unspecified number of people is inevitable while commuting to and from work. In this study, we investigated the relationship between commuting, and the risk of COVID-19 and COVID-19-induced anxiety. MethodsAn internet-based questionnaire survey was conducted to obtain a dataset from 27036 respondents. One-way commuting time was evaluated using a five-case method. The commuting distance was estimated using zip codes of the home and workplace. Logistic regression analysis was performed with the following outcomes: COVID-19 risk, close contact, infection anxiety, and infection anxiety due to commuting. Commuting distance and commuting time were analyzed separately in the model. We excluded participants with incalculable commuting distance, commuting distance exceeding 300 km, commuting distance of 0 km, or who telecommuted at least once a week. ResultsThe total number of participants included in the analysis was 14038. The adjusted odds ratios (aORs) of using public transportation for severe acute respiratory syndrome coronavirus 2 infection were 4.17 (95% confidence interval [CI]: 2.51-6.93) (commuting time) and 5.18 (95% CI: 3.06-8.78) (commuting distance). The aOR of COVID-19 diagnosis decreased significantly with increasing commuting distance. The aORs of using public transportation to infection anxiety were 1.44 (95% CI: 1.31-1.59) (commuting time) and 1.45 (95% CI: 1.32-1.60) (commuting distance). The longer the commuting time, the more the aOR increased.. ConclusionsCOVID-19 risk, close contact, and infection anxiety were all associated with the use of public transportation during commuting. Both commuting distance and time were associated with infection anxiety due to commuting, and the strength of the association increased with increase in commuting time distance. Since transportation by commuting is associated with COVID-19 risk and anxiety, we recommend the use of telecommuting and other means of work.

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

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

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

ObjectivesThe work system reform and the COVID-19 pandemic in Japan have prompted efforts toward telecommuting in Japan, and there has been little research regarding the stress and health effects of telecommuting. This study aimed to clarify the relationship between telecommuting and job stress among Japanese workers. Study DesignThis was a cross-sectional study. MethodsIn December 2020, during the third wave of the COVID-19 pandemic, an Internet-based nationwide health survey of 33,087 Japanese workers (CORoNaWork study) was conducted. Data for 27,036 individuals was included as 6,051 individuals provided invalid responses. We analysed a sample of 13,468 office workers from this database. We classified participants into four groups according to telecommuting frequency and compared the subscale of the Job Content Questionnaire and subjective job stress among these groups: high-frequency, medium-frequency, and low-frequency telecommuters group and non-telecommuters group. We used a linear mixed model and ordinal logistic regression analysis. ResultsThere was a significant difference in the score of job control of the JCQ among the four groups after adjusting for multiple confounding factors. The high-frequency telecommuters group had the highest job control score. Regarding the fluctuation score of subjective job stress, the high- and medium-frequency telecommuters groups were significantly lower than those of the non-telecommuters group after adjusting for multiple confounding factors. ConclusionWe found that high-frequency telecommuting was associated with high job control. This study suggests that 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.

Worries about COVID-19 infection and psychological distress at work and while commuting

ObjectiveThis study examined the relationship between worry about COVID-19 infection in the workplace and while commuting to work and psychological distress in Japan. MethodsAn internet monitor study was conducted. Out of a total of 33,302 participants, 26,841 people were included. The subjects were asked single-item questions about whether they were worried about COVID-19 infection in general, at work and while commuting to work. Kessler 6 (K6) was used to assess psychological distress. ResultsThe OR was significantly higher in association with worry about infection in the workplace at 1.71 (95%CI 1.53-1.92) and worry about infection while commuting at 1.49 (95%CI 1.32-1.67). ConclusionsThis study suggests the need for psychological intervention to reduce worry about infection in response to public mental health challenges associated with the COVID-19 pandemic.

Factors Required by Japanese Residents in Postgraduate Clinical Training / 医学教育

1)The factors Japanese residents consider most important in postgraduate clinical training are: "relationship with supervising physicians," "well-developed training programs," and "guidance of supervising physicians."2)Items showing a large discrepancy between their importance to residents and residents' satisfaction were: "well-developed training program," "experiencing a large number of cases,""guidance of supervising physicians," and "guidance of senior residents."3)Multiple regression analysis showed that factors significantly influencing residents' satisfaction with training were "quality of the medical service" (r=0.59) and "consideration for accepted residents" (r=0.42).