Worries About COVID-19 Infection and Psychological Distress at Work and While Commuting.

OBJECTIVE: This study examined the relationship between worry about COVID-19 infection in the workplace and while commuting to work and psychological distress in Japan. METHODS: An 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. K6 was used to assess psychological distress. RESULTS: The OR was significantly higher in association with worry about infection in the workplace at 1.71 (95%CI 1.53 to 1.92) and worry about infection while commuting at 1.49 (95%CI 1.32 to 1.67). CONCLUSIONS: This 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.

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.

[Systems and actual practices of occupational safety and health risk management in the People's Republic of China].

OBJECTIVES: To investigate the systems and actual practices of occupational safety and health risk management in China. METHODS: First, we gathered basic information through a literature review using an academic search engine (Japan Medical Abstracts society, Pubmed, and Google Scholar), as well as a general search on the Internet. Next, we conducted field surveys at a graduate school for public health, providers of occupational health services (e.g. medical examinations, working environment measurements), and local workplaces of a Japanese construction machinery company in China. This information was analyzed in terms of legal framework, professional staff, working environment measurements, medical examinations, occupational diseases, and occupational health service providers. RESULTS: Health and safety-related matters have become codified in Chinese workplaces as a result of safety laws and measures to prevent occupational diseases. While the country does have safety and hygiene officers, they lack official frameworks for occupational physicians and nursing professionals. The employers are not obligated to appoint medical professionals. While general medical examinations are not provided for under Chinese law, businesses are obligated to bring in external providers of occupational safety to perform special medical exams and working environment measurements. Occupational diseases are on the rise; pneumoconiosis comprises roughly 80% of cases. In addition, occupational health technical service providers have specialized staff and are not permitted to perform medical examinations or other services without government accreditation. DISCUSSION/CONCLUSION: There are great disparities in specialist knowledge about health and hygiene between company staff and external organizations, thus running the risk of corporate health and safety policies existing only on paper. This issue demands greater utilization of public health physicians in Chinese workplaces and support from Japanese professionals who understand how occupational safety and health risk management operate in China.

Developing a global occupational health and safety management system model for Japanese companies.

OBJECTIVES: To develop and validate a global occupational health and safety management system (OHSMS) model for Japanese companies. METHODS: In cooperation with a Japanese company, we established a research team and gathered information on occupational health and safety (OHS) practices in nine countries where the target company operated manufacturing sites. We then developed a model hypothesis via research team meeting. The model hypothesis was introduced to local factories in Indonesia and Thailand as trial sites. We evaluated the roles of the company headquarters, the implementation process, and any improvements in OHS practices at the sites. Based on the results, a global OHSMS model was formalized for global introduction. RESULTS: The model consisted of both headquarters and site roles. These roles were well-functioning, and OHS at the sites improved. Two issues concerning the functioning of the headquarters were identified: the need to establish a reporting system to the headquarters and the need to support the improvement of specialized human resources. By improving the model hypothesis to address these issues, the model was formalized for global introduction. CONCLUSIONS: The global OHSMS model was based on the use of methods and specialized human resources relevant to each region and their common objectives, as well as evaluation indicators based on the minimum requirements of the company headquarters. To verify the effectiveness of this model, the experiment should be extended to other countries.

[Systems and human resource development for occupational health in India: Effective occupational health management for Japanese enterprises with overseas branches].

OBJECTIVES: This study aimed to collect and assess information about occupational health in India, for Japanese enterprises. METHODS: We conducted a preliminary survey through literature reviews and internet search engines. We then conducted interview-based surveys at a central government agency, an international organization, the Japanese embassy, educational and research institutions, and Japanese enterprises in India. This information was categorized into: (1) organizations, legal and inspection systems in occupational health, (2) occupational health management and specialists in workplaces, (3) occupational health-related activities in workplaces resulting from legal obligations, and (4) healthcare and workers' compensation systems. RESULTS: The Indian Ministry of Labour and Employment is primarily responsible for occupational safety and health. There are four main acts of legislation covering occupational safety and health in the factories, ports, mines, and construction sites. The Factories Act, 1948, mandates the establishment of an occupational health center and a safety committee in the factories; the appointment of factory medical officers and safety officers. These medical officers must possess an Indian medical degree, and undertake a three months' course to obtain an Associate Fellow of Industrial Health certificate. The rules and regulations under this act differ in each Indian state. Low-wage workers are registered with a medical insurance scheme. Most workers are covered by workers' compensation schemes, although the number of reported occupational injuries are low. CONCLUSIONS: Japanese enterprises should consider the local conditions of occupational health in India because of the different legalities and occupational health status in each state. Regardless of the Factories Act, 1948, stipulating a variety of occupational health-related activities, inadequate legal compliance is suspected to be common because of the ineffective labor inspection requirements and a shortage of specialists on human resources. The study also revealed a deficient social security system. Therefore, the internal educational support for specialists, external support from the company headquarters in Japan, and the local institutions in India; and the systemic support for effective occupational health-related activities are required for improving the status of occupational health in the factories in India.

Validity and responsiveness of the work functioning impairment scale (WFun) in workers with pain due to musculoskeletal disorders.

OBJECTIVE: To determine the convergent validity and responsiveness of the work functioning impairment scale (WFun) in workers with musculoskeletal disorder-related pain. METHODS: Participants were extracted from an internet user study and prospectively examined using the pain intensity numerical rating scale (pain-NRS), the work ability numerical rating scale (productivity-NRS), and the WFun at baseline, 2 weeks, 6 weeks, and 3 months. The convergent validity and responsiveness of the WFun were examined by multilevel regression analysis. RESULTS: A total of 786 workers participated and 593 completed all surveys. The WFun score gradually increased and decreased as the pain-NRS and the productivity-NRS increased, respectively. Changes in the WFun score steadily increased and decreased as changes in the pain-NRS and the productivity-NRS increased, respectively. Multilevel analyses showed that all linear associations were significant. CONCLUSIONS: The convergent validity and responsiveness of the WFun were consistent with the expected direction and magnitude.

[The System and Human Resources for Occupational Health in Republic Of Indonesia for Japanese Enterprises to Manage Proper Occupational Health Activities at Overseas Workplaces].

OBJECTIVES: To consider the appropriate occupational health system for Japanese enterprises in Indonesia with information on the regulations and development of the specialists. METHODS: In this study, we used the information-gathering checklist developed by Kajiki et al. Along with literature and internet surveys, we surveyed local corporations owned and operated by Indonesians, central government agencies in charge of medical and health issues, a Japanese independent administrative agency supporting subsidiaries of overseas Japanese enterprises, and an educational institution formulating specialized occupational physician training curricula. RESULTS: In Indonesia, the Ministry of Manpower and the Ministry of Health administer occupational health matters. The act No. 1 on safety serves as the fundamental regulation. We confirmed at least 40 respective regulations in pertinent areas, such as the placement of medical and health professionals, health examinations, occupational disease, and occupational health service agencies. There are some regulations that indicate only an outline of activities but not details. Occupational physicians and safety officers are the two professional roles responsible for occupational health activities. A new medical insurance system was started in 2014, and a workers' compensation system was also established in 2017 in Indonesia according to the National Social Security System Act. DISCUSSION: Although safety and health laws and regulations exist in Indonesia, their details are unclear and the quality of expert human resources needed varies. To conduct high-quality occupational health activities from the standpoint of Japanese companies' headquarters, the active promotion of employing highly specialized professionals and cooperation with educational institutions is recommended.

Diagnostic Accuracy of the Work Functioning Impairment Scale (WFun): A Method to Detect Workers Who Have Health Problems Affecting their Work and to Evaluate Fitness for Work.

OBJECTIVE: This study evaluated the diagnostic accuracy of the Work Functioning Impairment Scale (WFun), a questionnaire to detect workers with health problems which affect their work, using an assessment by an occupational health nurse as objective standard. METHODS: The WFun was completed by 294 employees. The nurse interviewed to assess 1) health problems; 2) effects of health on their work; necessity for 3) treatment, 4) health care instruction, and 5) consideration of job accommodation. RESULTS: The odds ratio in the high work functioning impairment group compared with the low was highly statistically significant with 9.05, 10.26, 5.77, 9.37, and 14.70, respectively. The WFun demonstrated the high detectability with an area under the receiver operating characteristic of 0.75, 0.81, 0.72, 0.79, and 0.83, respectively. CONCLUSIONS: This study suggests that the WFun is useful in detecting those who have health problems affecting their work.

Developing a checklist for collecting information from overseas hospitals.

OBJECTIVE: Expatriate workers and their families may encounter difficulties and uncertainties when visiting local hospitals. These problems include differences in the medical system, higher healthcare costs, and language problems. Occupational health staff in companies need to know about the healthcare system, including emergency transportation arrangements, to reduce anxiety in workers and families attending hospitals. This study was designed to create a checklist to allow occupational health staff to collect information from overseas hospitals efficiently and effectively. METHODS: We used documentary searches and the knowledge and experience of researchers to identify the support requirements of expatriate workers and drafted a checklist for information collection from overseas hospitals. The validity of the checklist was assessed in two stages. First, we interviewed health specialists caring for expatriate workers and their families and then tested the draft in international hospitals. We revised the draft based on our findings and again tested the new version in different overseas hospitals, enabling us to create a final version of the checklist. RESULTS: Our checklist contains 12 major categories: reception, administration, inpatient wards, available tests, outpatient clinics, emergency services, pediatrics, gynecology, dentistry, general health check-ups, vaccination services, and precautions against infection. These categories cover a total of 51 subcategories, each of which is further divided into a total of 131 smaller categories. DISCUSSIONS: Occupational health staff can use this checklist to gather information in order to provide comprehensive and effective support for expatriate workers attending hospitals. We recommend that the staff gather all possible information from hospital websites before visiting and use the visiting time to gather information available only on site. In order to gather as much information as accurately as possible, the staff are recommended to visit the facilities related to the checklist categories, that is, Japanese language reception, outpatient services, inpatient wards, emergency services, pediatrics, gynecology, general health check-up centers, and cardiac catheterization labs, and obtain information directly from doctors, nurses, and specialists working at the hospitals.

Prospective Cohort Study of Work Functioning Impairment and Subsequent Absenteeism Among Japanese Workers.

OBJECTIVE: This study examined the association of work functioning impairment as measured by work functioning impairment scale (WFun) and subsequent sick leave. METHODS: A prospective cohort study was conducted at a manufacturer in Japan, and 1263 employees participated. Information on sick leave was gathered during an 18-month follow-up period. RESULTS: The hazard ratios (HRs) of long-term sick leave were substantially increased for those with a WFun score greater than 25 (HR = 3.99, P = 0.003). The incidence rate ratios (IRRs) of days of short-term absence gradually increased as scores of WFun increased (IRR = 1.18, P < 0.001 in the subjects with WFun of over 25 comparing with those with WFun of 14 or less). CONCLUSIONS: Assessing work functioning impairment is a useful way of classifying risk for future sick leave among employees.

Development of a check sheet for collecting information necessary for occupational safety and health activities and building relevant systems in overseas business places.

OBJECTIVES: This study aimed to develop an information gathering check sheet to efficiently collect information necessary for Japanese companies to build global occupational safety and health management systems in overseas business places. METHODS: The study group consisted of 2 researchers with occupational physician careers in a foreign-affiliated company in Japan and 3 supervising occupational physicians who were engaged in occupational safety and health activities in overseas business places. After investigating information and sources of information necessary for implementing occupational safety and health activities and building relevant systems, we conducted information acquisition using an information gathering check sheet in the field, by visiting 10 regions in 5 countries (first phase). The accuracy of the information acquired and the appropriateness of the information sources were then verified in study group meetings to improve the information gathering check sheet. Next, the improved information gathering check sheet was used in another setting (3 regions in 1 country) to confirm its efficacy (second phase), and the information gathering check sheet was thereby completed. RESULTS: The information gathering check sheet was composed of 9 major items (basic information on the local business place, safety and health overview, safety and health systems, safety and health staff, planning/implementation/evaluation/improvement, safety and health activities, laws and administrative organs, local medical care systems and public health, and medical support for resident personnel) and 61 medium items. We relied on the following eight information sources: the internet, company (local business place and head office in Japan), embassy/consulate, ISO certification body, university or other educational institutions, and medical institutions (aimed at Japanese people or at local workers). CONCLUSIONS: Through multiple study group meetings and a two-phased field survey (13 regions in 6 countries), an information gathering check sheet was completed. We confirmed the possibility that this check sheet would enable the user to obtain necessary information when expanding safety and health activities in a country or region that is new to the user. It is necessary in the future to evaluate safety and health systems and activities using this information gathering check sheet in a local business place in any country in which a Japanese business will be established, and to verify the efficacy of the check sheet by conducting model programs to test specific approaches.

Development and validity of a work functioning impairment scale based on the Rasch model among Japanese workers.

OBJECTIVES: The purpose of this study was to develop a new work functioning impairment scale (WFun) and examine its validity. METHODS: The WFun was developed based on the Rasch model, which consists of seven items. We conducted a pilot study (n=1,000) using an Internet investigation and a field study (n=1,294) in a manufacturing industry, and we additionally collected data from six workplaces from other industries. This series of studies was examined with a Rasch model analyses including item fit statistics as well as hypothesis testing. Convergent validity was used to examined the association of the WFun with the Stanford Presenteeism Scale, SF-8, Work Ability Index, and several types of job disruptions. We also examined differential test functioning. RESULTS: All the items showed adequate fit (infit mean-square statistics <1.5). The item reliability was 0.98, and the item separation index was 6.37. The person reliability was 0.86, and the person separation index was 2.32. All tests for convergent validity showed significant differences. All p values derived from ANOVA were highly significant (p<0.001). No differential test function was observed between groups by age, sex, or job type or between various samples from different workplaces. The intraclass correlation of the estimated Rasch measurements from these groups was 0.99 (95% CI: 0.976-0.992). CONCLUSIONS: The WFun was confirmed to show good fit to a Rasch model and construct validity. Given that its good fit indicates specific objectivity, this tool will be useful in assessing the ability of individuals to function at work and in evaluating group levels for benchmarking.

A 4-Year Follow-up Cohort Study of the Respiratory Functions in Toner-handling Workers.

BACKGROUND: Focusing on the respiratory function for health effect indices, we conducted a cross-sectional study on workers who did and did not handle toner to compare the longitudinal changes. METHODS: Among 116 individuals who worked for a Japanese business equipment manufacturer and participated in the study, the analysis included 69 male workers who we were able to follow up for 4 years. We categorized the 40 workers engaged in toner-handling work as the exposed group and the 29 workers not engaged in these tasks as the referent group, and compared their respiratory function test results: peak expiratory flow rate (PEFR), vital capacity (VC), predicted vital capacity (%VC), forced expiratory volume in 1 second (FEV1), and forced expiratory volume in 1 second as a percent of forced vital capacity (FEV1%). RESULTS: The cross-sectional study of the respiratory function test results at the baseline and at the 5(th) year showed no statistically significant differences in PEFR, VC, %VC, FEV1, and FEV1% between the exposed and referent workers. Also, respiratory function time-course for 4 years was calculated and compared between the groups. No statistically significant differences were shown. CONCLUSION: Our study does not suggest any toner exposure effects on respiratory function. However, the number of subjects was small in our study; studies of larger populations will be desired in the future.

[Health impact assessment of occupational health policy reform at a multinational chemical company in Japan].

A health impact assessment (HIA) was conducted to identify potential health impacts arising from policy reform of occupational health and safety at S-chemical company, a multinational global company that employs about 13,000 workers. A multidisciplinary team of health professionals including occupational physicians, an epidemiologist, and public health researchers oversaw the HIA. A project manager from S-company was also involved in the whole HIA process. A literature review, profiling using annual health examination data and interviews with stakeholders and key informants were undertaken in order to identify possible impacts. A range of positive and negative health impacts were identified and develop recommendations for implementation of the new occupational health policy were proposed. The HIA added value to the planning process for the occupational health policy reform.

Geographical correlation between ambient UVB level and mortality risk of leukemia in Japan.

As a preliminary epidemiological study, we evaluated the geographical correlation between estimated ambient ultraviolet B (UVB) levels and the mortality risk of leukemia in Japan. Ambient UVB levels were estimated from meteorological data for several successive periods. The standardized mortality ratio (SMR) was calculated for the 11 regions or 38 large cities and different times for nine types of leukemia [the International Classification of Diseases, ninth revision (ICD-9), ICD 200-208]. The ecological relationship was assessed by calculating Spearman's correlation coefficient. Among the nine types of leukemia, geographical correlation was found for two types of leukemia: "other malignant neoplasms of lymphoid and histiocytic tissue" (ICD 202) and "lymphoid leukemia" (ICD 204). The correlation coefficients between the SMR and UVB levels were statistically significant and ranged from 0.4 to 0.7 for the former and from 0.3 to 0.6 for the latter type of leukemia. This ecological study generated the hypothesis that UVB exposure may increase the risk of leukemias of lymphatic origin.