Effects of participatory organizational interventions on mental health and work performance: A protocol for systematic review and meta-analysis.

INTRODUCTION: Participatory organizational interventions to improve psychosocial working conditions are important for a safe and healthy work environment. However, there are few systematic reviews or meta-analyses investigating the effects of these interventions on workers' mental health and work-related outcomes. We apply the protocol for systematic review and meta-analysis to examine the effect of participatory organizational intervention on mental health and work performance. METHODS AND ANALYSIS: The participants, interventions, comparisons, and outcomes (PICO) of the studies in this systematic review and meta-analysis were defined as follows: (P) inclusion of all workers, (I) participatory organizational intervention, (C) treatment as usual or no intervention (including waitlist control), and (O) mental health and work performance. Published studies will be searched using the following electronic databases: PubMed, EMBASE, PsycINFO, PsycARTICLES, and Japan Medical Abstracts Society. Studies that (1) included participatory organizational intervention, (2) included participants who were working as of the baseline survey period, (3) assessed mental health or work performance outcomes, (4) used a cluster randomized controlled trials design, (5) were published in English or Japanese, and (6) were published in peer-reviewed journals (including advanced online publication) will be included. Study selection and the risk of bias assessment will be performed independently by two reviewers. A meta-analysis will be performed to statistically synthesize the included studies. Publication bias will be assessed for meta-bias using Egger's test as well as visually on a funnel plot. We will assess the heterogeneity by using the Q statistic.

Reliability and validity of the Japanese version of the Overwork Climate Scale.

This study aimed to investigate the validity and reliability of the Japanese version of the Overwork Climate Scale. Japanese workers were invited to participate in online surveys at baseline and 1-month follow-up. The Overwork Climate Scale was translated into Japanese, according to international guidelines. Reliability was assessed using Cronbach's alpha and the intra-class correlation coefficient (ICC), while structural validity was evaluated through confirmatory factor analysis (CFA). Psychological job demands, work engagement, psychological safety, and workaholism were assessed for convergent validity. The number of respondents was 302 at baseline and 169 at follow-up. Results indicated robust Cronbach's alpha values of 0.86 (for overwork endorsement) and 0.80 (for lacking overwork reward) at baseline, complemented by ICC of 0.89 and 0.82, respectively. CFA confirmed the suitability of the two-factor model. Moreover, the Japanese Overwork Climate Scale exhibited significant correlations with anticipated constructs. Structural equation modeling revealed a consistent association between overwork climate and both workaholism and work engagement, similar to the original version. In conclusion, the Japanese version of the Overwork Climate Scale demonstrates acceptable levels of reliability and validity, warranting its potential adoption among Japanese workers.

[Development of the Japanese version of the Public Service Motivation Scale: reliability and validity].

OBJECTIVES: Since the 1990s, overseas research on public service motivation (PSM), a motivation unique to public employees, has been ongoing. However, only recently has empirical studies on PSM in Japan begun, it has been suggested that the PSM scales developed overseas cannot be applied directly to Japan. This study aimed to examine the constructs of PSM in Japan, develop a scale to measure PSM, and verify its reliability and validity. METHODS: Semi-structured interviews were conducted with 21 civil servants holding administrative positions in Japan, and a draft of the PSM scale was developed. Subsequently, an online survey of 402 civil servants in their 20s to 60s (395 valid responses) was conducted, and the factor structure of the PSM scale was confirmed using exploratory factor analysis. In addition, the reliability was assessed by calculating the alpha coefficient, and the validity was verified through correlation analysis with related concepts. RESULTS: The outcomes of the exploratory factor analysis classified PSM into six factors: "social impact orientation," "social justice orientation," "community orientation," "future and evolution orientation," "authority orientation," and "helping the weak orientation," with sufficient alpha coefficients. Regarding validity, significant positive associations between PSM and work engagement, performance, work motivation, and job satisfaction were confirmed. CONCLUSION: The Japanese version of the PSM scale developed in this study was confirmed to exhibit a satisfactory level of reliability and validity and may be used to measure PSM among Japanese public employees.

[Development and validation of the University of Tokyo Occupational Mental Health leadership checklist among occupational health specialists].

OBJECTIVES: Recently, occupational health specialists (OHS) are expected to exert leadership to develop high-quality occupational health activities. This study aimed to develop and investigate the reliability and validity of a scale to measure leadership preparation among OHS (The University of Tokyo Occupational Mental Health [TOMH] Leadership Checklist; TLC). METHODS: Based on literature reviews and interviews among OHS, we created potential items consisting of 54 items with six factors (10 items for self-awareness, 10 items for situational awareness, 9 items for vision, 12 items for mindset, 3 items for performance of one's duties, and 10 items for relationship-building). An online survey was conducted with 300 OHS in Japan to verify the scale's reliability and validity. RESULTS: Consequent to the exploratory factor analysis, using the principal factor method and promax rotation, 51 items across the following five factors were identified; "self-awareness", "situational awareness", "vision", "mindset", and "performance of one's duties". The confirmatory factor analysis showed good fit indices; CFI = 0.877, SRMR = 0.050, and RMSEA = 0.072. Cronbach's α ranged from 0.93-0.96. Additionally, the scores of the TLC were significantly positively correlated with work engagement, job satisfaction, and self-efficacy; contrastingly, they were significantly negatively correlated with psychological distress (p < .05). Furthermore, the participants who had experience leadership without authority indicated significantly higher scores of the TLC and its subscales than those who did not (p < .001). DISCUSSION AND CONCLUSIONS: The newly developed TLC appeared to have acceptable levels of reliability and validity. It would be beneficial for OHS to show good leadership.

Corrigendum: What kind of intervention is effective for improving subjective well-being among workers? A systematic review and meta-analysis of randomized controlled trials.

[This corrects the article DOI: 10.3389/fpsyg.2020.528656.].

Work-related psychosocial factors and inflammatory markers: A systematic review and meta-analysis.

OBJECTIVE: We conducted a systematic review and meta-analysis to evaluate the prospective effect of adverse work-related psychosocial factors on increases in inflammatory markers. METHODS: A systematic literature search was conducted in PubMed, Embase, PsycINFO, PsycARTICLES, and the Japan Medical Abstracts Society database. Studies were eligible for inclusion if they examined associations between work-related psychosocial factors and inflammatory markers (interleukin-6, tumor necrosis factor-alpha, and C-reactive protein), used longitudinal or prospective cohort designs, were conducted among workers, were original articles written in English or Japanese, and were published up to 2017 for the first search, October 2020 for the second, and November 2022 for the third. A meta-analysis was conducted using a random-effects model to assess the pooled effect size for the associations. A meta-regression analysis was used to estimate the association between length of follow-up and effect size. The ROBINS-I tool was used to assess risk of bias. RESULTS: Of the 11,121 studies identified in the first search, 29,135 studies from the second, and 9448 studies from the third, eleven were eligible for this review and meta-analysis. The pooled coefficient between adverse work-related psychosocial factors and inflammatory markers was significant and positive (ß = 0.014, 95% confidence interval: 0.005-0.023). However, a clear association was only observed for interleukin-6, and all the studies included had serious risks of bias. Meta-regression showed the effect size decreased depending on the follow-up period. CONCLUSION: This study revealed a weak positive association between adverse work-related psychosocial factors and increases in inflammatory markers. TRIAL REGISTRATION: PROSPERO CRD42018081553 (https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=81553).

Characteristics of long working hours and subsequent psychological and physical responses: JNIOSH cohort study.

OBJECTIVES: This study aimed to examine the prospective association among objectively measured average working hours (AWHs), frequency of long working hours (FLWHs; defined as ≥205 working hours/month (≥45 hours/week)) for 6 months, and workers' self-reported psychological and physical health. METHODS: The study included 15 143 workers from 5 Japanese companies. We collected monthly attendance records over 6 months before distributing a questionnaire survey on psychological/physical stress responses and work-related demographics. We then evaluated the associations of those attendance records with psychological/physical measures using analysis of covariance adjusted for sex, age, employment, job type, working conditions, work site and experience of emergency state due to COVID-19. RESULTS: Irritability, anxiety and depression were significantly greater at ≥180 hours (≥45 hours/week), and fatigue and lack of vigour were greater at ≥205 hours than those of the normal working-hour group (140-180 hours/month [35-45 hours/week]). Psychological indices increased significantly with FLWH, with ≥3 times for irritability, depression and fatigue; ≥2 times for lack of vigour; and ≥1 time for anxiety when compared with no long working hours. No significant associations were observed between AWH or FLWH and physical stress responses. CONCLUSIONS: Longer AWH was associated with higher levels of psychological stress responses. The effects of FLWH in the past 6 months varied among the psychological stress responses and did not occur for physical complaints. Under circumstances requiring long hours, workers' mental health should be protected through minimising the frequency of long work hours.

A proposed definition of participatory organizational interventions.

Participatory organizational interventions offer an effective way to promote occupational safety and health. Despite an increasing number of studies, a common definition of participatory organizational interventions has yet to be established. Therefore, we aimed to form a definition using the following process. First, we developed a tentative draft definition of organizational interventions and participatory elements, based on the relevant literature. The tentative definition was revised in several rounds of an extensive discussion by the authors. This resulted in the draft definition. We asked 15 selected international experts in occupational safety and health to review and comment on the draft definition. We carefully reviewed their comments, and formulated our final proposed definition. To summarize the key points of the final version of the definition, organizational interventions are planned actions that primarily directly target working conditions with the aim of promoting and maintaining of the highest degree of physical, mental, and social well-being of workers in all occupations. In addition, as participatory elements of organizational interventions in the final definition, ideally, all workers participate in every step of the intervention, while participating in part of the steps of the intervention in some cases. Furthermore, in principle, all workers participate in each step of intervention, while it is also acceptable that only elected representatives among workers participate in the intervention.

Usage of the Brief Job Stress Questionnaire: A Systematic Review of a Comprehensive Job Stress Questionnaire in Japan from 2003 to 2021.

The Brief Job Stress Questionnaire (BJSQ) is used widely in occupational health studies and practice. Summarizing scientific production based on measurement is crucial. This study aimed to systematically review observational studies that used the BJSQ and the New BJSQ to show their usability. A systematic search was conducted for studies investigating relationships between the BJSQ or the New BJSQ subscales and other validated measurements on 13 September 2021, in various literature databases. The BJSQ subscales, scoring methods, and other validated measurements in the studies were qualitatively summarized. In total, 145 published reports between 2003 and 2021 were included. Among the BJSQ subscales, job stressors (n = 95) such as quantitative job overload (n = 65) and job control (n = 64) were most often used. The subscales were utilized to investigate the relationships with several other measurements. Five reports used subscales from the New BJSQ. In the last two decades, the BJSQ and the New BJSQ help measure psychosocial factors (PF) at work and contribute to the publication of scientific papers in the occupational health field. This study would encourage the utilization of the questionnaires for future research and practice.

Happiness Detected by the Emotion Cognition System Is Associated with Burnout in an Information Technology Products and Services Trading Company.

(1) Background: Although many previous studies have found an association between burnout and emotions, none have examined the association between emotions detected by an emotion cognition system and burnout. The purpose of this study is to examine the relationship between the emotions detected by the emotion cognition system and burnout among workers. We hypothesized that burnout survivors are less likely to express their emotions as facial expressions. (2) Methods: One hundred and forty-one workers at an Information Technology (IT) products and services trading company were asked to take facial images for three months when they started and left work and responded to a burnout questionnaire once a month. Microsoft Azure was used to detect their emotions. (3) Results: Hierarchical multiple regression analyses revealed that happiness in Period 1 was significantly and negatively associated with burnout at Time 2. This association was also observed after the various covariates were included. However, burnout at Time 3 was not significantly related to any emotions in Period 1. (4) Conclusions: Happiness, as detected by the emotion cognition system, was associated with burnout immediately afterward.

The impact of workplace psychosocial factors on menstrual disorders and infertility: a protocol for a systematic review and meta-analysis.

INTRODUCTION: Workplace environment, especially psychosocial factors at work such as job strain, workplace social support, and shift work, may affect the menstrual abnormalities and fertility of female workers. However, the association between psychosocial factors at work and menstrual abnormalities or fertility is not well understood. To address this relationship, we will conduct a systematic review and a meta-analysis of the literature that has utilized a longitudinal or prospective cohort design. METHODS AND ANALYSIS: The inclusion criteria for this systematic review and meta-analysis are defined as follows: (P) adult female workers (over 18 years old), (E) the presence of adverse psychosocial factors at work, (C) the absence of adverse psychosocial factors at work, and (O) any menstrual cycle disorders, menstrual-related symptoms, or fertility. The MEDLINE, Embase, PsycINFO, PsycArticles, and Japan Medical Abstracts Society electronic databases will be used to search for published studies. The statistical synthesis of the studies included in the meta-analysis will be conducted to estimate pooled coefficients and 95% CIs. For the main analysis, we will synthesize measures of association between psychosocial factors at work and menstrual-related disorders/symptoms. At least three eligible studies will have to be gathered to conduct a meta-analysis; otherwise (i.e., if only one or two studies will be eligible and included), the results will be presented in a narrative table. We will use the Risk of Bias in Non-randomized Studies of Interventions (ROBINS-I) to determine the quality of selected studies. To assess meta-bias, Egger's test, along with a funnel plot, will be used to check for publication bias. Lastly, we will examine heterogeneity using the χ2 test with Cochran's Q statistic and I2. ETHICS AND DISSEMINATION: The results and findings will be submitted and published in a scientific peer-reviewed journal and will be disseminated broadly to researchers and policymakers interested in the translatability of scientific evidence into good practices. SYSTEMATIC REVIEW REGISTRATION: The study protocol was registered at the UMIN registry (registration number: UMIN000039488). The registration date is on 14 Feb 2020. URL: https://upload.umin.ac.jp/cgi-bin/ctr/ctr_view_reg.cgi?recptno=R000044704.

STRENGTH AND LIMITATIONS OF THIS STUDY: • This systematic review and a meta-analysis will investigate the associations between psychosocial factors at work and menstrual abnormalities or fertility. • This review will include only the literature that has utilized a longitudinal design. • Various outcomes related to reproductive health in female workers will be examined (e.g., fertility, premenstrual symptoms, cycle disorders, menopausal symptoms).

Health problems associated with single, multiple, and the frequency of months of objectively measured long working hours: a cohort study by the National Institute of Occupational Safety and Health, Japan.

PURPOSE: We aimed to examine the prospective associations of monthly working hours measured in a month, the 6-month averaged hours, and the frequency of long working hours (≥ 205 h/month) during the past 6 months with health indicators. METHODS: This study included 6,806 Japanese company workers (response rate = 86.6%). Data on the workers' monthly attendance during the second half of fiscal year 2016 and annual health checkups in fiscal years 2016 and 2017 were collected. We evaluated the association of the above three types of monthly working hours with subsequent health checkup data in fiscal year 2017. We adjusted for the corresponding data in fiscal year 2016. RESULTS: Multivariate logistic regression analyses revealed significant associations between monthly working hours and workers' systolic and diastolic blood pressure as well as aspartate aminotransferase, alanine aminotransferase, low-density lipoprotein cholesterol (LDL), and triglyceride levels. However, the associations were not consistent between months. The average monthly working hours were significantly associated with higher LDL levels for the 220-240 h/mo group (OR: 1.49, 95%CI: 1.07-2.08) and lower triglyceride levels for the < 140 h/mo group (OR: 0.15, 95%CI: 0.03-0.77), compared to the 140-180 h/mo group. The frequency of long working hours was significantly associated with higher LDL levels. CONCLUSIONS: Working hours over several months produced various associations with health indicators compared to those measured in a single month. Our present data suggest that the effects of average or frequency of long working hours during the past 6 months are likely to appear in LDL levels.

Giving social support at work may reduce inflammation on employees themselves: a participatory workplace intervention study among Japanese hospital nurses.

Previously, we reported that the participatory workplace intervention was effective in reducing stress-related inflammatory markers among 31 Japanese female nurses. During the analysis, we recognized that our intervention might have increased prosocial behaviors like giving social support to others in some participants. Based on this assumption, we ran a secondary analysis, which examined the effect of giving social support on inflammatory markers, autonomic nervous activity (ANA), and perceived job stress (PJS) before and after the intervention. A group of participants who had increased scores on giving social support (n=13) showed significant decreases in interferon-γ, interleukin-6, and interleukin-12/23p40 after the intervention. Another group of those who had decreased/unchanged in the scores (n=17) did not show changes in these markers. Regarding ANA and PJS, no significant changes were observed in both groups. This study presented insight that giving social support at work may provide health benefits towards employees themselves, via decreasing inflammation.

Reliability and validity of the Japanese version of the psychological safety scale for workers.

Although an increasing number of studies on psychological safety at workplaces has been conducted in both western and eastern countries, there are few empirically validated measures in Japan. Our purpose was to investigate the validity and reliability of the Japanese version of the Psychological Safety Scale. Japanese workers were invited to participate in online surveys at baseline and at one-month follow-up (N=320). The Psychological Safety Scale was translated into Japanese according to international guidelines. Social support at workplace, work engagement, organization-based self-esteem, organizational justice, and job satisfaction were measured. Cronbach's alphas and intra-class correlation coefficient (ICC) were examined for reliability, and its validity was tested by confirmatory factor analysis and correlational analyses. The results of the survey showed that respondents were 287 at baseline and 236 at follow-up. Cronbach's alphas of the Psychological Safety Scale were 0.91 (baseline) and 0.88 (follow-up), and ICC was 0.87. Confirmatory factor analysis demonstrated a marginally acceptable fit. Overall, the Japanese Psychological Safety Scale had moderate to strong correlations with other scales. In conclusion, the Japanese version of the Psychological Safety Scale had acceptable levels of reliability and validity, and may be applicable for use in Japanese workers.

Effects of participatory workplace improvement program on stress-related biomarkers and self-reported stress among university hospital nurses: a preliminary study.

Although participatory workplace improvement programs are known to provide favorable effects on high stress occupations like nursing, no studies have confirmed its effect using biomarkers. The aim of this study was to determine whether a participatory workplace improvement program would decrease stress-related symptoms as evaluated by biomarkers and self-reported stress among hospital nurses. Three actions to alleviate job stress, which were determined through focus group interviews and voting, were undertaken for two months. A total of 31 female Japanese nurses underwent measurement of inflammatory markers, autonomic nervous activity (ANA), and perceived job stress (PJS) at three-time points; before the program (T1), within a week after the completion of the program (T2), and three months after the program (T3). A series of inflammatory markers (Interferon-γ, Interleukin (IL)-6, and IL-12/23p40) decreased significantly at T2, and IL-12/23p40 and IL-15 significantly decreased at T3 compared to T1, while ANA and PJS remained unchanged. Our participatory program exerted beneficial effects in reducing inflammatory responses, but not for ANA and PJS. Further investigations with a better study design, i.e., a randomized controlled trial, and a larger sample size are warranted to determine what exerted beneficial effects on inflammatory markers and why other outcomes remained unchanged.

What Kind of Intervention Is Effective for Improving Subjective Well-Being Among Workers? A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

Objectives: This study aimed to conduct a systematic review and meta-analysis of randomized controlled trials (RCTs) to improve subjective well-being (SWB), including evaluative, hedonic, and eudemonic well-being, and the mental component of quality of life (QOL) of working population. Methods: A literature search was conducted, using PubMed, Embase, PsycINFO, and PsycARTICLES. Eligible studies included those that were RCTs of any intervention, conducted among healthy workers, measured SWB as a primary outcome, and original articles in English. Study characteristics, intervention, outcomes, and results on SWB outcomes were extracted by the investigators independently. After a brief narrative summarizing and classifying the contents of the interventions, the included outcomes were categorized into each aspect of SWB (evaluative, hedonic, and eudemonic well-being, and the mental component of QOL). Finally, the characteristics of the effective interventions for increasing each aspect were summarized, and the pooled effect of interventions on SWB was investigated by a meta-analysis. Publication bias was investigated by drawing a funnel plot and conducting Egger's test. Results: From the 5,450 articles found, 39 met the inclusion criteria for the systematic review. The interventions included in this review were classified into six categories (physical activity, ergonomics, psychological, environmental, multicomponent intervention, and others). The meta-analysis from 31 studies showed that the pooled effect of included interventions on SWB was significantly positive (standardized mean difference (SMD) = 0.51; standard error (SE) = 0.10). A funnel plot showed there were extremely large or small SMDs, and Egger's test was significant. Thus, we conducted sensitivity analysis, excluding these extreme SMDs, and confirmed that the estimated pooled effect was also significantly positive. Subgroup analyses for separate types of interventions showed the effects of psychological interventions (e.g., mindfulness, cognitive behavioral based approach, and other psychological interventions) were also significantly positive. Conclusion: The current study revealed the effectiveness of interventions for increasing SWB. Specifically, psychological interventions (e.g., mindfulness, cognitive behavioral based approach, and other psychological interventions) may be useful for improving SWB.

Objective and Subjective Working Hours and Their Roles on Workers' Health among Japanese Employees.

Table 3 of the above paper appeared incorrectly in print. Percentage figures on the table were inadvertently listed as negative values. These errors were corrected in online versions of this paper, as shown below.

Servant Leadership in Japan: A Validation Study of the Japanese Version of the Servant Leadership Survey (SLS-J).

PURPOSE: The purpose of this study is to develop and validate a Japanese version of the Servant Leadership Scale and to clarify the relationship between servant leadership (SL) and well-being among Japanese workers. METHODS: After the Japanese version of the SLS (SLS-J) and of its short form (SLS-J-short) were developed in conformity with the guidelines (Wild et al., 2005), a web-based survey was administered to 516 Japanese employees (20 or older and have a supervisor). Confirmatory factor analysis (CFA) was conducted to evaluate a construct validation of the SLS-J and the SLS-J-short. Convergent validity was estimated with theoretically related constructs (e.g., transformational leadership, supervisory support, and interpersonal justice) and potential consequences of SL (e.g., affective commitment, work engagement, job satisfaction, organizational citizenship behavior (OCB), psychological distress, and work performance). Intraclass correlation coefficient (ICC) using the test-retest method was conducted with 104 of the initial respondents to assess internal consistency reliability. Additionally, the effects of SL on employees' work engagement and the mediating role of employees' affective commitment were estimated. RESULTS: CFA confirmed that an eight-factor model (SLS-J) and a five-factor model (SLS-J-short) had the most satisfactory fits for the two scales with Japanese workers. Tests of convergent validity and reliability showed sufficiency for each of the dimensions of SLS-J and SLS-J-short. Additionally, it was revealed that SL has an impact on employees' work engagement through a mediation of affective commitment at a cross-sectional level, and the indirect association between SL and work engagement via affective commitment remained afterward. CONCLUSION: SLS-J and SLS-J-short were confirmed to have good reliability and validity for Japanese workers. Also, this study found that SL has an important role in enhancing the engagement of workers.

Measuring eudemonic well-being at work: a validation study for the 24-item the University of Tokyo Occupational Mental Health (TOMH) well-being scale among Japanese workers.

Although the eudemonic perspective seems to be a promising in considering vocational identity among working population, well-being at work has been discussed primarily in terms of subjective/hedonic well-being. This study aimed to develop a new tool to measure eudemonic well-being at work (The University of Tokyo Occupational Mental Health [TOMH] well-being 24 scale)and investigate its validity in a collectivist culture. Two online surveys were conducted with a total of 1,760 workers in Japan. We created 89 potential items from existing scales. An exploratory factor analysis indicated eight factors for the dimensions of measurement. After item selection based on item response theory, the factor structure with three items from each of the eight dimensions indicated an excellent fit for another sample. Cronbach's α and intra-class coefficients ranged from 0.671 to 0.845. The scores of the tool were more strongly associated with subjective well-being in the work context rather than well-being in general. In addition, the participants in the group demonstrating a higher risk for mental illness and a more stressful work environment indicated significantly lower scores, even after adjusting for general eudemonic well-being. The new measurement may be useful both for academic and practical applications for measuring eudemonic well-being at work, independent from general eudemonic well-being.

Objective and subjective working hours and their roles on workers' health among Japanese employees.

This study investigated the correlation between objective and subjective working hours (OWH and SWH, respectively) and their relation to the workers' health. The study included 6,806 workers of a Japanese company (response rate=86.6%). OWH were collected as the monthly data during fiscal year 2017 from the company record. SWH were self-reported as the weekly data during the past month in November 2017. Both OWH and SWH corresponded to the same period of one month (October 2017). Additionally, the data for the annual health checkup in fiscal year 2017 and self-reported mental health in November 2017 were collected. The results indicated that the longer OWH was related to more underestimation of SWH. The analyses of covariance adjusted for the selected variables showed that irrespective of OWH or SWH, significant relationships were found for stress responses but not for body mass index, aspartate and alanine aminotransferase, fasting blood glucose, hemoglobin A1c, high-density lipoprotein cholesterol, or triglyceride. However, significant relationships with only OWH were noted for systolic and diastolic blood pressure, low-density lipoprotein cholesterol, gamma-glutamyl transpeptidase, and positive work-related state of mind. The present findings show that SWH should be used carefully when assessing the health effects of long working hours.