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ObjectiveThis study examined the relationship between job accommodations for workers with poor health and work functioning impairment during the COVID-19 pandemic.MethodsAn internet survey was conducted in December 2020. We included 24,429 subjects for analysis. One question was used to determine whether subjects needed job accommodations from their company to continue working in their current health condition. The odds ratios (ORs) of the necessity of job accommodations for sick workers associated with work functioning impairment were estimated using multilevel logistic regression analysis.ResultsThe OR of work functioning impairment among sick workers not receiving job accommodations was 5.75 (95% confidence interval (CI) 5.34-6.20, pConclusionsThis study suggests that providing job accommodations to workers with poor health may improve their work functioning impairment.

The purpose of this study is to investigate the frequency of education, knowledge of radiation and workplace anxiety of Fukushima Daiichi Nuclear Power Plant (FDNPP) workers and to analyze what type of words are used for anxiety with a text mining method. An original questionnaire survey was given to FDNPP workers, and a text mining method was used to extract information from free-entry fields. The questionnaires were collected from 1135 workers (response rate: 70.8%). It was found that when workers receive education on radiation, the increased knowledge helps to reduce their anxiety. Among the 1135 workers, 92 of 127 completed the free-entry field with valid entries. Seventy-one words were extracted by the text mining method. The words used differed depending on the degree of anxiety. The text mining method revealed information about the presence or absence of radiation anxiety and the subjects’ working environment and background.

Background The number of people with diabetes is increasing and resulting in major economic losses. Presenteeism accounts for the majority of economic losses, so measures against presenteeism are important. This study investigated the relationship between severity of type 2 diabetes and presenteeism. Methods A cross-sectional study was conducted among workers over 40 years of age. Participants were classified as normal group or diabetic treatment group using their medical examination results and health insurance claims data. Diabetic treatment groups were described by degree of treatment control: Good (HbA1c Results Data on 13,271 workers were analyzed. Presenteeism loss was significantly higher in all treatment control groups compared with the normal group, particularly for the intermediate and poor control groups. The monotherapy group did not differ from the normal group, but presenteeism loss was significantly higher in the combination therapy group than the normal group. Conclusions Presenteeism loss in workers with diabetes may be affected by diabetes severity, and even if treatment control were good, presenteeism loss could occur when the number of anti-diabetic drugs was high. Therefore, it is important to provide early intervention and continuous support as a preventive measure against not only diabetes and diabetes-related complications but also presenteeism.

The purpose of this study was to examine whether Foods with Function Claims (FFC) containing asparagus extract effectively improved sleep quality and work performance in shift workers. An intervention study with a before-and-after intervention design was conducted on nurses engaged in two-shift work at a hospital, ingesting a FFC containing asparagus extract. The evaluation period lasted at least two weeks, including three nights shifts during the period. Before and after ingestion, Pittsburgh Sleep Questionnaire Index (PSQI), Utrecht Work Engagement Scale (UWES), Sleep quality (VAS-rated), impaired work functioning, and psychiatric symptoms were evaluated. A diary record, wearing of an activity meter, and a Psychomotor vigilance test were also performed at baseline and after intervention. Data were analyzed by the paired t-test or the Wilcoxon rank sum test. Among 34 participants, 33 completed the study. The results of the primary outcome measures showed significant improvements in PSQI and Sleep Quality in the night of the day after a night shift (PSQI total score: base line 7.41/ post intervention 6.03: P < 0.001; sleep quality: base line 4.48/post intervention 6.00: P < 0.001). The results of the secondary outcome measures showed significant improvements in UWES and feeling of fatigue. There was also trend of improvement in sleep efficiency and the reaction time. There was no significant improvement in impaired work functioning. This study showed that regular consumption of an FFC containing asparagus extract could improve sleep quality, feeling of fatigue, and work engagement among shift workers. Some caution, however, is needed when interpreting the results because of the before-and-after intervention design without a control group.

Objectives In Japan, the population is aging and there is a declining birth rate. It is an important occupational health issue to support the balance between illness treatment (including nursing care, childcare, etc.) and work. Many patients require mental and financial support to help them with their work-treatment balance. In 2016, the Ministry of Health, Labor and Welfare provided guidelines for supporting employee's work-treatment balance, and in 2018, "Consulting Fee" was approved as an insured medical treatment when clinic doctors supported their patients for continuing to work. The request for the consulting fee requires that the clinician and the occupational physician exchange information on the support necessary for the patient to continue working. Generally, occupational physicians obtain medical information from clinicians to give advice on a worker's employment considerations. However, we do not know what kind of workplace information clinicians hope to know when treating their patients. Therefore, we conducted this survey to clarify how occupational physicians could provide useful information to clinicians. Methods We asked approximately 1,500 occupational physicians from the Occupational Health Subcommittee of the Japan Society for Occupational Health to provide us with a letter sent to their clinician to assist workers. From the collected letters, the structural parts of the letters (titles, greetings, acknowledgments, etc.) were removed. We defined a section as a contextual unit that does not impair the meaning. The prepared sections underwent qualitative inductive analysis using the content analysis method of "Berelson, B." Results A total of 103 cases and 178 documents from 42 people were included in the analysis. Extracting descriptions that could be interpreted as providing information, including descriptions related to treatment, employment, and living environment, and opinions and suggestions from occupational physicians resulted in 596 sections. As a result of the qualitative and inductive classification, the information was classified into three large categories that consisted of information provision, opinions of occupational physicians, and information handling, five middle and eighteen small classifications. In addition, some good practices that were considered significant to clinicians were illustrated. Conclusions We analyzed and categorized the information present in the letters sent by occupational physicians to clinicians. The letter does not need to contain all the information in the category table. However, it is important that it should have the necessary and sufficient information considering the case in question. We believe that this category table will aid occupational physicians in writing letters to clinicians.

The results of a survey of radiation workers suggest that they are worried about the effects of radiation exposure on health, and approximately 30% of Fukushima Daiichi Nuclear Power Plant (FDNPP) workers have anxiety. This questionnaire survey reveals that the higher the frequency of radiation education, the higher the knowledge of radiation the workers will have, and that the higher the level of knowledge, the lower the anxiety. To reduce anxiety, it is important to increase knowledge about radiation through radiation education. However, even those workers who had radiation education several times still had anxiety. According to the Ordinance on the Prevention of Ionizing Radiation Hazards, the time spent on education about the effects of radiation on the human body is only about 30 minutes. This education is not enough to reduce anxiety. FDNPP workers needed more effective education to increase their knowledge and to reduce their anxiety.

ObjectivesThe 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.MethodsThis 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 of unemployment were estimated using a multilevel logistic model with adjusted covariates nested in prefecture of residence.ResultsWomen (n = 8,771) 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 odds ratio of unemployment associated with being diagnosed with COVID-19 was 2.18 (95% CI: 1.05–4.55) and that the odds ratio associated with being identified as a close contact was 0.93 (95% CI: 0.29–2.95).ConclusionsThere is an association between workers being diagnosed with COVID-19 and unemployment. Occupational health professionals should follow up closely with workers diagnosed with COVID-19 after they return to work to prevent them from becoming unemployed against their will.

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.

An aerobic bacterium, designated strain 5N-3 (NBRC 113055), that degrades cis-dichloroethene (cDCE) was isolated from a sea sediment in Japan. Strain 5N-3 was able to degrade a certain amount of cDCE in the presence of pyruvate without the action of inducers. In the presence of inducers, such as phenol and benzene, the strain completely removed cDCE. By the application of 16S ribosomal RNA (16S rRNA) gene sequencing and average nucleotide identity analyses, the strain 5N-3 was identified as Marinobacter salsuginis. On the other hand, identified species of Marinobacter are not known to degrade cDCE at all. A draft genome sequence analysis of the strain 5N-3 suggested that the dmp-homologous operon (operon for phenol degradation) may be contributing to the aerobic degradation of cDCE. This is the first report on an aerobic marine bacterium that has been found to degrade cDCE.

A strictly aerobic, bacteriochlorophyll a-containing betaproteobacterium, designated strain W35T, was isolated from a biofilm sampled at Tama River in Japan. The non-motile and rod-shaped cells formed pink-beige pigmented colonies on agar plates containing organic compounds, and showed an in vivo absorption maximum at 871 nm in the near-infrared region, typical for the presence of bacteriochlorophyll a. The new bacterial strain is Gram-negative, and oxidase- and catalase-positive. Phylogenetic analysis based on 16S rRNA gene sequence showed that strain W35T was closely related to species in the genus Aquabacterium. The closest phylogenetic relatives of strain W35T were Aquabacterium commune B8T (97.9 % sequence similarity), Aquabacterium citratiphilum B4T (97.2 %) and Aquabacterium limnoticum ABP-4T (97.0 %). The major cellular fatty acids were C16 : 1ω7c (50.4 %), C16 : 0 (22.7 %), summed feature 8 (C18 : 1ω7c/C18 : 1ω6c; 9.7 %), C18 : 3ω6c (5.5 %), C12 : 0 (5.3 %) and C10 : 0 3OH (2.7 %). The respiratory quinone was ubiquinone-8. Predominant polar lipids were phosphatidylethanolamine, phosphatidylglycerol and diphosphatidylglycerol. The G+C content of the genomic DNA was 70.4 mol% (genome data) and 71.4 mol% (HPLC). The genome size of strain W35T is 6.1 Mbp and average nucleotide identity analysis indicated genome similarities of strain W35T and related Aquabacterium type strains to be 78-79 %. The results of polyphasic comparisons showed that strain W35T was clearly distinguishable from other members of the genus Aquabacterium. Therefore, we propose a new species in the genus Aquabacterium, namely, Aquabacterium pictum sp. nov. The type strain is W35T (=DSM 106757T=NBRC 111963T). The description of the genus Aquabacterium is also emended.

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.

The aim of the present study was to investigate the association between work engagement and long-term sickness absence due to mental disorders such as mood disorders and anxiety, and whether the relationship differs between men and women, during a 4-year follow-up period. Data were obtained from 21,293 workers at four pharmaceutical companies belonging to the Collabo-Health Study Group in 2014. The baseline data were collected by self-administered questionnaires. We obtained information about long-term sickness absence from the personnel records of the surveyed companies from the baseline survey in 2014 until March 2018. Hazard ratios (HRs) and 95% confidence intervals (CIs) using the low work engagement group as a reference were calculated by Cox proportional hazards analysis as the outcome, defined as the period leading to mental health-related sick leave. A total of 12,025 participants had complete data for analysis, and 123 exhibited long-term sickness absence during a 4-year follow-up period. The high work engagement group for men had a significantly lower HR (0.52, 95% CI: 0.31-0.88, P = 0.015) compared with the low work engagement group. Conversely, among women, the moderate work engagement group had a significantly higher HR (2.44, 95% CI: 1.03-5.84, P = 0.043) compared with the low work engagement group. Work engagement in men may predict the occurrence of long-term sickness absence due to mental disorders in the subsequent four years, but this relationship was different in women. Further research is needed to clarify this issue.

Background Musculoskeletal symptoms such as neck and shoulder pain/stiffness and low back pain are common health problems in the working population. They are the leading causes of presenteeism (employees being physically present at work but unable to be fully engaged). Recently, digital interventions have begun to be used to manage health but their effectiveness has not yet been fully verified, and adherence to such programs is always a problem. Objective This study aimed to evaluate the improvements in musculoskeletal symptoms in workers with neck/shoulder stiffness/pain and low back pain after the use of an exercise-based artificial intelligence (AI)–assisted interactive health promotion system that operates through a mobile messaging app (the AI-assisted health program). We expected that this program would support participants’ adherence to exercises. Methods We conducted a two-armed, randomized, controlled, and unblinded trial in workers with either neck/shoulder stiffness/pain or low back pain or both. We recruited participants with these symptoms through email notifications. The intervention group received the AI-assisted health program, in which the chatbot sent messages to users with the exercise instructions at a fixed time every day through the smartphone’s chatting app (LINE) for 12 weeks. The program was fully automated. The control group continued with their usual care routines. We assessed the subjective severity of the neck and shoulder pain/stiffness and low back pain of the participants by using a scoring scale of 1 to 5 for both the intervention group and the control group at baseline and after 12 weeks of intervention by using a web-based form. We used a logistic regression model to calculate the odds ratios (ORs) of the intervention group to achieve to reduce pain scores with those of the control group, and the ORs of the subjective assessment of the improvement of the symptoms compared to the intervention and control groups, which were performed using Stata software (version 16, StataCorp LLC). Results We analyzed 48 participants in the intervention group and 46 participants in the control group. The adherence rate was 92% (44/48) during the intervention. The participants in the intervention group showed significant improvements in the severity of the neck/shoulder pain/stiffness and low back pain compared to those in the control group (OR 6.36, 95% CI 2.57-15.73; P Conclusions This study shows that the short exercises provided by the AI-assisted health program improved both neck/shoulder pain/stiffness and low back pain in 12 weeks. Further studies are needed to identify the elements contributing to the successful outcome of the AI-assisted health program. Trial Registration University hospital Medical Information Network-Clinical Trials Registry (UMIN-CTR) 000033894; https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000038307.

ObjectivesTo examine the relationship between socioeconomic factors and unemployment among workers during COVID-19 pandemic in Japan.DesignA prospective cohort study, follow-up from December 22–25, 2020 through February 18–19, 2021.SettingThe panelists registered with an Internet survey companyParticipantsA cluster random sample of 33,087 workers with stratification by sex, job type, and region among Japan’s working populationMain outcomes and measuresUnemployment between December 2020 and February 2021ResultsAmong the 19,941 participants, 725 (3.6%) had experienced unemployment. Multivariate analysis showed that the significant high unemployment for women (compared to men); younger age (compared to older age); being married (spouse not working), bereaved or divorced, and unmarried (compared to married (spouse working)); annual household income less than 6 million yen, (compared to more than 10 million yen); junior high or high school, vocational school, junior college, or technical school (compared to graduate school); and temporary or contract employees, self-employed, agriculture, forestry, or fishing (compared to general employees).ConclusionsCOVID-19 appears to have created difficulties for the vulnerable groups. This suggests the need for employment and economic support for such individuals.Strengths and limitations of this studyUnder the pandemic of COVID-19, we found that unemployment was associated with socioeconomic factors such as age, sex, marriage, income, education and occupation.Our findings suggest that in the event of a major epidemic, resulting in unemployment among vulnerable segments of the labour market, regardless of whether workers themselves are infected.It was unclear why the participants had experienced unemploymentThis study was conducted as an Internet survey, so the generalizability of our results is limited.

ObjectivesThis study examined the association between perceived organizational support (POS) and COVID-19 vaccine intention and the influence of the implementation of workplace infection prevention measures.MethodsWe analyzed 23,846 workers using data from an Internet survey of workers aged 20–65 years conducted in December 2020, during a period of widespread COVID-19 infection in Japan.ResultsA higher POS was associated with a higher intention to vaccinate. The relationship between POS and vaccine intention was attenuated when adjusted for infection prevention measures in the workplace.ConclusionsIn workplaces where POS is present, a sense of responsibility to the group and altruistic behavior may arise. This means employees act to acquire herd immunity to protect others, which may result in increased vaccine intention. The association between POS and vaccination intention was attenuated by adjusting for workplace infection prevention measures, which suggested that infection prevention measures may be a confounding factor or that POS created a health climate that promoted infection prevention measures. The results suggest that working to improve employee well-being and implementing appropriate workplace infection prevention measures during infectious disease outbreaks may promote vaccination behavior and contribute to the acquisition of herd immunity in the community.

BackgroundVaccine hesitancy is an issue for vaccines required for herd immunity. Although various factors such as sociodemographics can affect vaccine hesitancy, the research results differ and it is unclear whether these differences depend on the subjects or the situation, such as the type of infection or vaccine. Therefore, we investigated the relationship between seasonal influenza vaccination behavior and sociodemographic factors under the COVID-19 pandemic. In addition, we analyzed the relationship between individual factors of risk preference and seasonal influenza vaccination on the premise that there is a difference in the association between efficacy and the risk of side effects of the two vaccines. MethodsA cross-sectional study was conducted on workers aged 20-65 years on December 22-25, 2020, using data from an Internet survey. We set the presence or absence of 2020/2021 seasonal influenza vaccination as the dependent variable, and each aspect of sociodemographic factors and risk preference as independent variables. We performed a multilevel logistic regression analysis nested by residence. ResultsIn total, 26,637 respondents (13,600 men, 13,037 women) participated. Significantly more women than men were vaccinated. Both men and women had higher vaccination rates if married, highly educated, with high income, and with underlying disease. Men aged 60-65 had a significantly higher vaccination rate than those aged 20-29, while women aged 40-49 and 50-59 had a significantly lower rate than those aged 20-29. These results differed from those of a previous study on the vaccination intentions of the same subjects for COVID-19. Those with low risk preference had higher vaccination rates than those with high risk preference. ConclusionsOur results suggested that the effect of sociodemographic factors on vaccine hesitancy depends on the situation affecting efficacy of the vaccine and the perception of vaccination risk.

A self-reported daily life note (LN) is an effective tool used by occupational physicians to assess the capacity of workers on sick leave due to mental illness to return to work (RTW). We aimed to clarify whether there were differences in the criteria used to define recovery for RTW between LN users and non-users, whether LN users were satisfied with LN, and whether non-users wanted to use LN. In total, 363 occupational physicians (238 LN users, 125 non-users) completed self-reported questionnaires covering demographic and occupational variables, and RTW assessment criteria. We investigated which of the 10 assessment criteria were considered most important for RTW. The proportion of LN users was higher among women, younger physicians, and occupational physicians with more working days per month. LN users emphasized four criteria in assessing RTW: 1) constant wake-up time, 2) constant bedtime, 3) no midnight waking, and 4) no feeling of drowsiness during the day. LN users regard regular sleep rhythm and the absence of drowsiness during the day as important criteria for RTW. Ninety-seven percent of users regarded LN as useful. Seventy-four percent of non-users had interest in using LN.

Objective A systematic review was performed to study factors of occurrence and improvement methods of presenteeism attributed to diabetes. Methods We set 2 clinical questions; (a) how comorbidities and complications of diabetes induce presenteeism and (b) what interventions or conditions effectively improve presenteeism. Then, we conducted a comprehensive search with MEDLINE/PubMed and Scopus databases and extracted those that met the clinical questions. Results Eighteen papers studied occurrence of presenteeism by comorbidities and complications of diabetes. Most studies were cross‐sectional and had a low quality of evidence. However, the associations of hypoglycemia, diabetic neuropathy, and mood disorders with presenteeism were relatively well studied. The papers that discussed effective interventions or conditions for improving presenteeism were very limited. Conclusions Our review suggests that presenteeism attributed to diabetes is mainly caused by hypoglycemia, diabetic neuropathy, and mood disorders. There are very limited evidences, but available information suggests that improving glycemic control, adjusting treatment regimen by evaluating the impact on work, providing psychological support, and developing suitable work accommodations may effectively reduce presenteeism.

Objectives To clarify the priority given to periodical medical examination items among occupational physicians in Japan. Methods Sixty-two occupational physicians who participated in this study selected statutory and non-statutory items within two types of budget plans: one lower (8,500 yen) than the total fee of statutory medical examinations (9,250 and 11,290 yen), and the other higher (12,000 yen) than the total fee. Medical fee points were used to set the cost of each medical examination item. A three round Delphi method was used from May to July 2016 to clarify the consensus opinion of occupational physicians. Results The statutory items (selection rate: between 66 and 100%), except for waist circumference (15%) and sputum examination (0%), and serum creatinine (58%, non-statutory item) were included in the smaller budget plan (8,500 yen). In the larger budget plan (12,000 yen), the statutory items (selection rate: between 92 and 100%), except for waist circumference (39%) and sputum examination (0%), and some non-statutory items, namely serum creatinine (95%), leukocytes (92%), uric acid (89%), and fecal occult blood reaction (81%), had a selection rate over 80%. In addition, statutory items with higher accuracy were preferred, which included the following: air conduction pure-tone audiometry (92%), imaging diagnosis of thoracic X-ray examinations by a specialist (97%), glycated hemoglobin levels (98%), and electrocardiogram assessment by a specialist (100%). Conclusion The statutory items, except for waist circumference and sputum examination, and some of the non-statutory items (e.g., serum creatinine) were given higher priority among occupational physicians in Japan.

Objective This study examined the relationship between worry about COVID-19 infection in general, in the workplace and while commuting to work and psychological distress in the midst of a rapid outbreak of COVID-19 in Japan. Methods This cross-sectional, internet monitor study was conducted on December 22– 26, 2020. Subjects were collected from throughout Japan. Out of a total of 33,302 participants, 26,841 people were included in the study after removing those providing fraudulent responses. 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. The odds ratios (ORs) of psychological distress associated with worry about infection were estimated using a multilevel logistic model nested in the prefecture of residence, with adjustment for sex, age, education, equivalent household income, occupation, number of business establishments, smoking status, alcohol consumption, frequency of telecommuting, use of public transportation, perceived assessment of workplace infection control efforts, presence of infection among acquaintances, and experience of being a close contact. Psychological distress was defined as a K6 score of 5 or higher and 13 or higher. Results Multivariate analysis showed that the OR of severe psychological distress associated with general worry about COVID-19 infection was 1.10 (95% CI 1.00–1.22). The 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). Conclusions The present 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.

Background We previously reported that early alendronate administration accelerated bone formation and improved the quality of repaired cartilage in the donor site in rabbits. To investigate whether alendronate administration has effects in humans similar to those observed in rabbits. Methods The study cohort included 35 patients over the age of 12-years old who underwent mosaicplasty without osteoporotic therapy from March 2011 to October 2012. The donor sites were medial or lateral in the patellofemoral joint. Placebo (P) or Bonalon containing 35 mg of alendronate (A) was administered orally every week for 8 weeks. The cohort comprised 15 male and 20 female, including 14 right and 21 left knees. The mean age at the time of surgery was 57.1 years. Bone formation was examined using computer tomography and lateral knee radiography, and cartilage formation was examined using magnetic resonance imaging (MRI), second-look assessment, and intraoperative acoustic evaluation. The clinical outcomes were assessed using the Japanese Orthopaedic Association knee score and visual analog scale (VAS). Bone and cartilage formation in the donor site and clinical outcomes were assessed at 3, 6, and 12 months after mosaicplasty. Results The ratio of TRAP-5b in group A was significantly smaller than that in group P at 2 and 8 weeks after mosaicplasty. The extent of bone formation in the donor sites in group A was significantly greater than that in group P at 3 and 6 months after mosaicplasty. Cartilage formation did not differ significantly between the two groups as determined by MRI, macroscopic assessment, and intraoperative acoustic evaluation. Clinical outcomes did not differ significantly between the two groups, and no negative clinical outcomes were observed. Conclusion Early alendronate administration accelerated bone formation but not cartilage formation in the mosaicplasty donor site in humans.

Background This study aimed to examine the association between overtime work and the frequency of preventive dental visits among workers in Japan. Methods A self-administered questionnaire was completed by 14,847 daytime-workers. We used a logistic regression model stratified by sex and age and adjusted for marital status, occupation, education, and oral status to investigate the association between overtime work hours and the frequency of preventive dental visits. Results In total 1037 men (9.3%) and 511 women (13.9%) attended quarterly preventive dental visits, and 2672 men (23.9%) and 1165 women (31.8%) attended annual preventive dental visits. Overtime work was statistically significantly associated with quarterly preventive dental visits among men aged 50–59 years, with adjusted odds ratios (aOR) and 95% confidence intervals (CI) of 0.73 (0.56–0.95), 0.75 (0.54–1.04), and 0.55 (0.34–0.90) for Conclusions Our study revealed associations between overtime and preventive dental visits among male workers aged in their 40s and 50s.

Objectives: To identify what types of information were useful and/or difficult to obtain for occupational physicians during the COVID-19 epidemic, and how information should be provided to help occupational physicians in the event of future outbreaks of emerging infectious diseases. Methods: The list was developed by categorizing information about COVID-19 delivered by researchers to a group of occupational physicians after the COVID-19 outbreak. We created a survey and asked the group about the usefulness and ease of obtaining each type of information. Results: In total, 79.1–100% of the occupational physicians said that each type of information was “Useful”. Information on the nature of the virus; clinical course, testing, and treatment; infection prevention measures; regulations in Japan; immigration restrictions in Japan; and guidelines were all considered useful by more than 95%, as was information about the introduction of information aggregation websites by public institutions, academic societies, experts, and others, and sharing of case studies by information distribution group members. These last two items also had a high percentage of respondents who said that they “only obtained the information because it was distributed this way”. Conclusions: Constructing a system for automatic distribution of information that is useful to occupational physicians and difficult to obtain elsewhere may make it easier for occupational physicians to respond more smoothly to emerging infectious disease outbreaks within a company.

Objectives The aim of the present study was to clarify the relationship between work functional impairment levels and three coping behaviors of workers with low back pain, which were about seeking medical attention, taking over‐the‐counter drugs, and taking self‐care. Methods We conducted a cross‐sectional study on 14 Japanese companies in 2016. Work function impairment was measured using the Work Functioning Impairment Scale. Logistic regression analyses were conducted for the three coping behaviors and odds ratios (ORs) calculated for work functional impairment levels. Results We analyzed 2232 subjects; 226 were women and 790 worked on production lines. 688 workers had sought medical attention, 436 had taken over‐the‐counter medication, and 1225 had engaged in self‐care. Those seeking medical attention were associated with severe work function impairment compared with no work function impairment (adjusted OR = 2.84, 95% confidence interval: 1.82–4.45, p

OBJECTIVES Although self-rated health (SRH), the self-evaluation of one's own health status, has been reported to be associated with the immune status, the relationship between three different SRH measures (global, self-comparative, and age-comparative) with inflammatory markers as well as the relative strength of these associations by age are not well understood. The current study investigated the associations between SRH measures and inflammatory markers among nursing home employees. METHODS A sample of 120 Japanese employees at a nursing home (90 women and 30 men), aged 21-68 years (mean, 40.9 years), underwent a blood test for the measurement of inflammatory markers (interferon-γ, interleukin [IL]-4, IL-6, and tumor necrosis factor [TNF]-α, white blood cell count) and SRH during the annual health checkup. Multiple regression analysis adjusted for covariates was performed to analyze the relationship between inflammatory markers and SRH measures stratified by age, that is, aged < 40 years (younger age group) and 40 years and over (older age group). RESULTS Among the participants aged 40 years and over, poor global SRH was significantly associated with an increase in IL-6, while poor age-comparative SRH was significantly associated with an increase in TNF-α among participants aged < 40 years in the fully adjusted model controlling for potential confounders. Age-comparative SRH was also significantly associated with an increase in IL-6 among all participants. Self-comparative SRH was not significantly associated with inflammatory markers. CONCLUSIONS Our results suggest that three SRH measures are not equivalently associated with inflammatory markers, especially when the analyses were performed separately for the younger and older populations. This implies that not only differences in forms of SRH but also in age modify the relationship between SRH and inflammatory markers.

This study investigated the association between the duration of pharmacotherapy treatment for depression, or discontinuation from treatment, and work functioning impairment. This was a retrospective cohort study examining 30,409 workers. Work functioning impairment was assessed using a questionnaire, and treatment status was assessed using medical claims data. Odds ratios (ORs) of workers with severe work functioning impairment compared with healthy workers (control group) were calculated using logistic regression analysis. Continuous medical treatment was associated with severely impaired work functioning regardless of treatment period [continuous medical treatment; 4 months

Objectives The objective of this study was to estimate a risk of cardiovascular and cerebrovascular diseases for each worker and to determine whether this risk is associated with the incidence and costs of presenteeism, absenteeism, and medical/drug treatments. Methods Established risk equations were used to estimate the 10‐year probability of developing coronary artery disease and ischemic stroke in male workers aged 40‐65 years who were recruited from four pharmaceutical companies in Japan. The incidence of presenteeism was defined as existence of presenteeism for the past a month, and the incidence of absenteeism was defined as existence of sick‐leave for the past three months by a self‐administered questionnaire. Each cost was calculated based on the human capital method. Data on medical/drug treatments were collected from health insurance claims. Results The risks were calculated for 6047 workers. Individuals at moderate and high risk of coronary artery disease had a significantly higher rate of presenteeism and absenteeism than workers at low risk. Workers at moderate and high risk of ischemic stroke also had a significantly higher rate of presenteeism and absenteeism than workers at low risk. Mean costs for absenteeism and medical/drug treatments increased with the risk of developing coronary artery disease or ischemic stroke, while costs for presenteeism did not. Conclusions To prevent the costs of presenteeism, workers not only at high risk but also at low and moderate risk of developing cardiovascular and cerebrovascular diseases should receive health care services.

Objective This study aimed to investigate the impact of diabetes status on presenteeism in companies in Japan. Methods A cross-sectional study was conducted among workers aged 40 years or older. Using medical examination results and health insurance claims data, participants were classified as normal, borderline, or diabetic. The diabetic group was further classified as untreated or treated. The Quantity and Quality (QQ) method was used as an evaluation index of presenteeism. Logistic regression analysis was performed to predict presenteeism loss. Results Data on 13,292 people were analyzed. Presenteeism loss was significantly higher in the diabetic group versus the normal group. The untreated group did not differ from the normal group, but presenteeism loss was significantly higher in the treated group. Conclusions Presenteeism loss may occur among diabetic workers in Japan and can be caused by diabetes treatment.

Objective The aim of this study was to evaluate the validity of self‐reported medication use for hypertension, diabetes, and dyslipidemia by comparison with health insurance claims among employees of large‐sized companies in Japan. Methods Participants were 61 676 participants of 13 large‐sized companies in Japan. Self‐reports on medication use were obtained through web‐ or paper‐based questionnaires conducted at the annual health checkup in fiscal year 2016. Health insurance claims for medication were obtained from corporate health insurance associations from April 1, 2016, to March 31, 2017. Agreement rate, sensitivity, specificity, positive and negative predictive values (PPV and NPV), and kappa statistics of self‐reporting were examined for different reference periods (1‐, 2‐, and 3‐ months, and 1‐year). Subgroup analysis was conducted stratified by sex, age, body mass index, smoking, alcohol drinking, blood pressure, hemoglobin A1c, and low‐density lipoprotein cholesterol. Results Agreement, sensitivity, specificity, PPV, and NPV were 0.98, 0.90, 0.98, 0.87, and 0.99 for hypertension, 0.99, 0.89, 1.00, 0.89, and 1.00 for diabetes, and 0.98, 0.86, 0.99, 0.83, and 0.99 for dyslipidemia, respectively, between self‐reports and claims data for 3 months. Kappa statistics were highest with the 3‐month reference period of claims data for hypertension, diabetes, and dyslipidemia. No major concordance was observed between the subgroups. Conclusion This validation of self‐reported medication use for hypertension, diabetes, and dyslipidemia showed almost perfect reliability among employees of large‐sized companies in Japan.

Objectives At the Fukushima Daiichi Nuclear Power Plant, run by the Tokyo Electric Power Company, new procedures were introduced as part of the fitness for duty program in July 2016. These were designed to ensure that treatment and further investigations identified as necessary during health examinations were carried out. This study aimed to assess the effectiveness of the initiative by testing whether workers who needed further health examinations obtained them promptly, and whether the number with unmet health needs decreased and the number of workers being treated increased. Methods The primary contractors reported aggregated quarterly results of health examinations of both their own and their subcontractors’ employees, and follow‐up visits to medical institutions were also reported over the next two quarters. The study used data for the period from July 2016 to December 2018. Incident rate ratios were estimated using a multilevel Poisson regression model, including the logarithm of the number of workers who took health examination for each primary contractor company as offset. The linear trend was assessed by treating the number of periods as a continuous variable. Results The incident rate ratio for workers who needed treatment having a follow‐up examination promptly showed a significant decrease over time. The incident rate ratio for those with unmet needs decreased, and those being treated increased over time. Conclusions The findings showed that the initiative was effective, with the number of early visits for further health examinations increasing and a decrease in the number of people with unmet health needs.

Objectives To elucidate the factors that influence occupational physicians’ decision to issue an employer warning. Methods The interview was conducted with 10 Japan Society for Occupational Health certified occupational physicians (COPs) and certified senior occupational physicians (CSOPs) to create nine fictive scenarios in which an occupational physician may need to consider issuing a warning. Sixteen CSOPs assessed the seriousness of the problem in each of nine scenarios where they may need to consider issuing an employer warning. Next, using a survey questionnaire, 597 COPs and CSOPs were asked to rate how likely they were to issue a warning in each of the nine scenarios, and answer items on their characteristics and number of previously issued warnings. A multilevel logistic regression analysis nested for various scenarios was used to assess the odds ratio (OR) of being likely to issue a warning. Results Valid questionnaires were obtained from 117 participants (19.6%). The ORs and 95% confidence intervals (CIs) were as follows: mean score of seriousness of the problem, 5.90 (4.50‐7.75); years of experience as occupational physician, 1.04 (1.02‐1.06); women, 1.75 (1.20‐2.54); being a part‐time occupational physician without in‐house experience, 2.08 (1.31‐3.29); and having previously issued two or more times warnings, 1.99 (1.29‐3.06), compared with those who had never issued a warning. Conclusions Occupational physicians’ likelihood to issue a warning was associated with the seriousness of the problem as assessed in various scenarios, years of experience as occupational physician, gender, employment type, experience as in‐house occupational physician, and number of past warnings.

Objective This study aimed to examine a detailed breakdown of costs (absenteeism, presenteeism, and medical/pharmaceutical expenses), of the employees in four pharmaceutical companies in Japan. Methods This is a cross-sectional study. Absenteeism and presenteeism were measured by a self-administered questionnaire for workers, and their costs were estimated using the human capital approach. Presenteeism was evaluated by the degree affected quality and quantity of work. Medical and pharmaceutical expenses were obtained by insurance claims. Results The monetary value due to absenteeism was $520 per person per year (11%), that of presenteeism was $3055 (64%), and medical/pharmaceutical expenses were $1165 (25%). Two of the highest total cost burdens from chronic illness were related to mental (behavioral) health conditions and musculoskeletal disorders. Conclusion A total cost approach can help employers set priorities for occupational health, safety, and population health management initiatives.

We aimed to quantitatively investigate the relationship between amplitude-based pulse-echo ultrasound parameters and early degeneration of the knee articular cartilage. Twenty samples from six human femoral condyles judged as grade 0 or 1 according to International Cartilage Repair Society grading were assessed using a 15-MHz pulsed-ultrasound 3-D scanning system ex vivo. Surface roughness (Rq), average collagen content (A1) and collagen orientation (A12) in the superficial zone of the cartilage were measured via laser microscopy and Fourier transform infrared imaging spectroscopy. Multiple regression analysis with a linear mixed-effects model (LMM) revealed that a time-domain reflection coefficient at the cartilage surface (Rc) had a significant coefficient of determination with Rq and A12 (RLMMm2=0.79); however, Rc did not correlate with A1. Concerning the collagen characteristic in the superficial zone, Rc was found to be a sensitive indicator reflecting collagen disorganization, not collagen content, for the early degeneration samples.

Objectives This study aimed to determine the effects of participatory workplace improvement (PWI) -based provision of ergonomic training and ergonomic action checklists (ACLs) to on-site managers on workplace improvement activities for low back pain (LBP). Methods A randomized controlled trial (RCT) was conducted at a manufacturing company in Japan. Teams entered in the study were randomly assigned to a control and an intervention group. A total of three interventional training sessions on methods of ergonomics were provided to on-site managers in the intervention group, with 1-month intervals between sessions. Ergonomic ACLs were provided at the same time. After completion of the training sessions, each team then provided a report of improvements each month for the next 10 months. Two people in charge of safety and health chose two major objectives of the implemented activities from the five categories. The reported number of improvements was analyzed using a Poisson regression model. Results In the intervention group, although the incident rate ratio (IRR) of PWIs in countermeasures for the LBP category was significantly elevated after the training sessions, the IRR of improvements decreased over time during the 10-month follow-up period. No significant difference was observed in the IRR of total PWIs in either the control or intervention group. Conclusions PWI-based provision of ergonomic training sessions and ergonomics ACLs to on-site managers was shown to be effective for workplace improvement activities targeted at LBP. However, because the effects decrease over time, efforts should be made to maintain the effects through regular interventions.

The consultation rate for uterine cervical cancer screening in Japan is markedly low in comparison with other developed countries. The purpose of this study is to investigate the trends in uterine cervical cancer screening during regular company checkups and to identify potential problems. Questionnaires were sent to occupational health physicians through Sansuiken (Alumni Association of the University of Occupational and Environmental Health, Japan). Overall, 127 valid responses showed that Papanicolaou (Pap) tests are conducted in 100 companies (79%). The detailed information from 50 of the 100 responses was analyzed. Mandatory cervical cancer screenings are performed at just 6 companies (12%). Pap test are started at 30 years of age at 9 of 49 companies, and only 18 of 49 companies (37%) start Pap tests for employees at 20 years old. Of the 86,695 women, 31,294 (36%) received cervical cancer screening. Abnormal Pap test results were detected in 3.0%. Although cervical cancer screening rates have slightly increased compared to our previous studies (17% in 2004, 23% in 2008), it remains at a low level. Complete examinations with colposcopy and punch biopsy were carried out in 70% (61 of 87 women) of those with an abnormal Pap test. Twelve of 26 companies had no information about detailed examination results. It is important to note that cervical cancer incidence and mortality are increasing among young women in Japan. Occupational physicians and health nurses should manage female health education and care at the workplace, by including uterine cervical cancer screening in the growing female working population.

The World Health Organization (WHO) aims to enable all people to receive health services, and has proposed effective coverage (EC) as an index for this aim. EC refers to "the fraction of potential health gain that is actually delivered to the population through the health system, given its capacity," and is used to indicate the percentage of the population whose diseases are well controlled among those who require treatment or are receiving treatment. This study aimed to evaluate the effects of occupational health services on EC. We hypothesized that occupational health services provided to employees by full-time occupational health practitioners, such as occupational physicians and occupational health nurses, improve EC for hypertension, diabetes mellitus and hyperlipidemia compared to those services provided by part-time occupational health practitioners. We conducted a cross-sectional study to analyze the results of general medical examinations, personnel information, and medical expense claims in fiscal year 2011. A total of 91,351 male employees at a company group participated in the study. The EC for hypertension, diabetes mellitus and hyperlipidemia was measured and compared between the employees in workplaces with occupational health practitioners (OH group) and the employees in workplaces without occupational health practitioners (non-OH group). The EC for hypertension and diabetes mellitus was significantly greater in the OH group than in the non-OH group (aOR: 1.41, 95% CI: 1.20 - 1.66 for hypertension; aOR: 1.53, 95% CI: 1.17 - 2.00 for diabetes mellitus), while the EC for hyperlipidemia was comparable (aOR: 1.11, 95% CI: 0.92 - 1.34). Occupational health services provided by full-time occupational health practitioners greatly improve health management after a medical examination.

To clarify the subjective and objective impacts of a change in a 12-h shift schedule, involving a reduction in the number of crews, on workers at an electronic parts production company. Forty-two workers participated in this study. Subjective indicators (e.g. questionnaires) and objective indicators [e.g., psychomotor vigilance task (PVT)], as well as an activity monitor-based sleep assessment, were measured during a > 1-year period that encompassed the shift schedule change. The study outcome was a comparison of work-related injury rates measured 1 year before and after the change in shift schedule. After the shift schedule change, questionnaire scores regarding work-related burdens and PVT performance parameters, including mean response time and number of lapses, increased significantly. However, we also observed divergences in the trends of the subjective and objective measures 1 year after the change. Despite these variations in both types of measures, we observed no significant differences in work-related injury rates measured before and after the shift schedule change. This study revealed that a reduction in the number of crews in a 12-h shift schedule has a negative impact on the subjective and objective indicator after the change in shift schedule; only indicators of alertness did not recover at 1 year after the change. Assessments of the workers’ performances and the regular implementation of health and safety programs for more than 1 year are needed to maintain workers’ health after the change in shift schedule.

Objective The current study aimed to quantify the overall sickness absence and sickness presence in five Japanese companies. Methods Two indicators were calculated: worktime lost rates and average working days lost per employee per annum. Results In total, 1.1% of working days per annum were lost due to sick leave. The average number of annual sick-leave days per employee was 2.58. Sickness presence accounted for a total worktime loss of 6.55% and an average of 15.36 work days lost per employee per annum. Overall, employees lost 7.65% of their total working days, or an average of 17.92 days were lost per employee per annum, due to sickness leave and sickness presence combined. Conclusion Sickness-absence rate among Japanese workers is quite lower than other countries; however, sickness presence is more critical than absenteeism, which is in line with other countries.