Journal of Occupational Health

ObjectivesThe pandemic of the new coronavirus disease (COVID-19) has created a challenging environment for workers. This study aimed to investigate the risk factors for workplace bullying and mental health outcomes during the pandemic among workers. MethodsWe conducted a nationwide online cross-sectional survey from August to September 2020 in Japan (N = 16,384). Workplace bullying was measured by one item from the Brief Job Stress Questionnaire; severe psychological distress (SPD) by K6 ([≥]13); and suicidal ideation by one item. Prevalence ratios were calculated by Poisson regression analyses adjusting for potential confounders such as gender, age, occupational characteristics, and a prior history of depression. ResultsOverall, 15% of workers experienced workplace bullying, 9% had SPD, and 12% had suicidal ideation during the second and third wave of the COVID-19 pandemic in Japan. The results of this study showed men, executives, managers, and permanent employees had a higher risk of bullying compared to women or part-time workers. Increased physical and psychological demands were common risk factors for bullying, SPD, and suicidal ideation. Newly starting working from home was a significant predictor for adverse mental health outcomes, however, it was found to be a preventive factor against workplace bullying. ConclusionsThe results of this study found different high-risk groups for bullying or mental health during the pandemic. When intervening to decrease workplace bullying or mental health problems, we should focus on not only previously reported vulnerable workers but also workers who experienced a change of their working styles or job demands. Key messagesO_ST_ABSWhat is already known about this subject?C_ST_ABSO_LIWorkplace bullying is one of the severe job stressors in the workplace that cause mental health problems. C_LIO_LIHealth care workers, less-educated workers, and non-regular female workers have been reported to have greater psychological distress during the COVID-19 pandemic. C_LI What are the new findings?O_LIAbout 15% of workers experienced workplace bullying, 9% had SPD, and 12% had suicidal ideation during the pandemic in Japan. C_LIO_LIMen, executives, managers, and permanent workers had a higher risk of bullying compared to women or part-time workers. C_LIO_LIIncreased physical or psychological demands were common risk factors for bullying, SPD, and suicidal ideation. C_LIO_LIWhile newly starting working from home was a preventive factor against workplace bullying, it was found to be a significant risk factor for adverse mental health outcomes. C_LI How might this impact on policy or clinical practice in the foreseeable future?O_LIThe results of this study indicate a different pattern of high-risk groups for bullying or mental health during the pandemic. C_LIO_LIWhen intervening to decrease workplace bullying or mental health problems, we should focus on not only previously reported vulnerable workers but also workers who experienced a change of their working styles or job demands. C_LI

ObjectivesThis prospective study aimed to examine the association of job demands, job control, and the lack of supervisor and coworker support with side effects after receiving COVID-19 vaccination in a sample of employees in Japan. MethodsThe data were retrieved from an online panel of full-time employees (E- COCO- J). The analysis included participants who were employed and were not vaccinated at baseline (June 2021) but received vaccination at a four-month follow-up (October 2021). An 11-item scale measured the side effects of COVID-19 vaccines. Four types of psychosocial working conditions (i.e., job demands, job control, and supervisor and coworker support) were measured using the Brief Job Stress Questionnaire (BJSQ). Multiple linear regression analyses were conducted to examine the relationship between the psychosocial working conditions and side effects of COVID-19 vaccines, adjusting for gender, age, educational attainment, marital status, occupation, chronic disease, dose of vaccination, anxiety from potential side effects of vaccines, fear and worry about COVID-19, and psychological distress at baseline. ResultsOverall, 747 employees were included in the analysis. The average number of side effects was 3.78 (SD=2.19): Arm pain (81.1%), fatigues (64.1%), muscle pains (63.3%), and fever (37.5 degrees Celsius +) (53.5%) were reported more frequently. Coworker support score was significantly and negatively associated with the numbers of side effects (standardized {beta}=-0.122, p=0.017). Women, young age, second time vaccination, and high psychological distress were significantly associated with several side effects. ConclusionsEmployees with low coworker support may be more likely to have side effects after COVID-19 vaccinations. The findings of this study could inform employees with low coworker support that increasing workplace support may reduce the side effects. Highlights The effect of poor psychosocial working conditions on side effects after COVID-19 vaccinations was unknown. Poor coworker support at baseline was significantly associated with increased side effects after COVID-19 vaccinations. Informing workers with low coworker support about the findings may help them prepare for the side effect and motivate them to improve coworker support to reduce side effects.

The COVID-19 pandemic infected many people worldwide with SARS-CoV2. Psychological distress is one of the sequelae reported to occur in many of those infected (Choutka et al., 2022). We investigated the association between personal experience of COVID-19 infection and psychological distress in Japan. A total of 18,560 persons participated in the original survey, conducted in December 2020. After excluding unreliable responses, data from 14,901 persons who participated in a follow-up survey in December 2022-were included in the analysis. Odds ratios (ORs) were estimated by univariate and multiple logistic regression analysis with history of COVID-19 infection as the independent variable and presence of psychological distress as the dependent variable. This results showed that the experience of COVID-19 infection is associated with psychological distress. Moreover, most cases of mental distress among those who experienced COVID-19 infection can be at least partly explained by a perception of unfair treatment.

BackgroundLittle is known about the distribution of specific sites where occupational falls frequently occur within the workplace. This study aimed to examine the distribution of occupational falls by sites of occurrence in Japan. MethodsNational data of occupational falls resulting in absences of four or more days in 2023 were extracted from a website managed by the Ministry of Health, Labour and Welfare, Japan. Fall sites were classified as either outdoor or indoor. Indoor sites were further categorized as walkways, work platforms/walking planks, indoor stairs, or other sites. Walkways and work platforms/walking planks were defined as indoor level surfaces. The distribution of occupational fall by sites was described. ResultsAmong all occupational falls, 63.2% occurred at indoor sites (22,780/36,058). The most frequently reported site was indoor level surfaces, accounting for 49.0%, while indoor stairs accounted for 5.9%. When stratified by sex, 65.9% occurred at indoor sites among female workers while 59.0% occurred among male workers. The difference was largely attributable to a higher proportion of falls on indoor level surfaces among females (52.7% in females and 43.5% in males). ConclusionsIn Japan, a substantial proportion of occupational falls occurred at indoor sites, particularly on indoor level surfaces.

ObjectivesTo identify the association between heated tobacco product (HTP) smoking and occupational falls, particularly combined with other lifestyle variables, including sleeping duration and comorbidities. MethodsThis web-based nationwide cross-sectional study (September-November 2023) involved 18,440 current workers (mean age, 43 years; women, 43.9%) in Japan. The primary outcome was occupational fall incidence in the past year. The secondary outcome was fall-related fractures. Smoking status was categorized as never, former, or current smokers; current smokers further classified into exclusive cigarette, exclusive HTP, and dual smokers (both cigarettes and HTPs). Other behavioral factors and covariates included alcohol consumption, sleep duration, physical activity, comorbidities, body mass index, hypnotics/anxiolytics use, and sociodemographic variables. Incidence ratios (IRs) and 95% confidence intervals (CIs) for occupational falls were estimated using multilevel Poisson regression with robust variance. ResultsOccupational falls and fall-related fractures were reported by 7.3% and 2.8% participants, respectively, in the past year. Younger workers were more likely to experience occupational falls. Compared with never smokers, current smokers had higher occupational fall incidence (IR = 1.36, 95% CI: 1.20-1.54), with exclusive HTP (IR = 1.78) and dual smokers (IR = 1.64) showing particularly elevated incidences. Similar patterns were observed for fall-related fractures. Elevated IRs were also observed for other lifestyle variables, including short sleep duration and diabetes, with the strongest associations found among younger workers. ConclusionsCurrent smoking, particularly HTP use, and lifestyle behaviors were significantly associated with occupational falls in Japan. These findings highlight the importance of lifestyle modifications to prevent occupational falls. KEY MESSAGESO_ST_ABSWhat is already known on this topicC_ST_ABSIndividual lifestyle behaviors, including physical activity, sedentary behaviors, and sleep quality, are associated with the risk of falls. However, the association between the risk of falls and smoking habits, including heated tobacco product (HTP) use, which has emerged as a public health concern in Japan, remains poorly understood. What this study addsCurrent smoking, particularly HTP use, is associated with occupational falls. How this study might affect research, practice or policySmoking cessation can be considered a modifiable behavior for occupational fall prevention. Further studies are needed to investigate the relationship between smoking and the incidence of falls.

ObjectiveTo estimate the prevalence of burnout and occupational stress (OS) among couriers and to identify the main risk factors. MethodWe followed PRISMA guidelines to search studies published in English and Chinese databases before February 2022. ResultsThe search yielded 15 (7 English and 8 Chinese) papers, 12 of which studied Chinese couriers, and three studied French, Israeli and Malaysian couriers. Twelve studies reported OS using various validated measurement tools, and six reported burnout using adapted versions of Maslach Burnout Inventory. Only four included studies suggested cut-off points to define the condition, hence we used the midpoint of the scales to estimate the prevalence (the proportion of the cases that were above the midpoint). The estimated prevalence of burnout (or a dimension of burnout) among couriers ranged from 20% to 73% (median=33%). The prevalence of OS (or a dimension of OS) ranged from 7% to 90% (median=40%). Twelve studies reported risk factors for burnout or OS; the main ones were physical demands, customer behaviour and a range of working and employment conditions, such as employment precarity and financial insecurity. Job resources (i.e. social support and decision latitude) and organizational support had mitigating effects. ConclusionsBurnout and OS are relatively high among couriers. Interventions to prevent or reduce burnout in this occupation are currently limited. The use of platform technology to shift risks, intensify work and tighten managerial controls could be a potential work-related stressor for app-based couriers but remains a knowledge gap.

Background Playing-related musculoskeletal disorders are highly prevalent among musicians, yet no validated The aim of this study was to translate and culturally adapt the MPIIQM into Japanese and to examine its psychometric properties in students of higher music education institutions (HMEIs). Methods Forward-backward translation followed ISPOR guidelines, with linguistic validation through pilot testing. Psychometric evaluation was conducted in instrumental music majors enrolled at nine HMEIs in Japan, combining in-person and online surveys. Exploratory factor analysis, Cronbach's , and Pearson correlations with the Brief Pain Inventory (BPI), QuickDASH, and QuickDASH Performing Arts Module (PAM) were computed in symptomatic respondents (n = 48). Symptom prevalence in the full HMEIs sample (n = 226) was compared with national data (Ministry of Health, Labour and Welfare in Japan, 2022) using binomial tests with Holm correction. Results Exploratory factor analysis yielded a two-factor structure (pain intensity; pain interference) explaining 76.8% of the variance. Cronbach's was .864 (pain intensity), .890 (pain interference), and .903 (total). The pain intensity subscale correlated strongly with BPI pain severity (r = .71), and the pain interference subscale correlated with the QuickDASH PAM (r = .62). Test-retest reliability could not be computed because only 9 of 30 retest respondents met inclusion criteria. HMEIs students reported significantly higher prevalence than national peers in 25 of 41 symptoms, most markedly stiff shoulders and low back pain. Conclusions The MPIIQM-J demonstrated adequate structural validity, internal consistency, and convergent validity, and is expected to be useful in educational and clinical settings.

OBJECTIVETo estimate the reliability and the validity of the single item burnout measure in a sample of nurses in Greece. METHODWe conducted an online cross-sectional study in Greece with 963 nurses. Data were collected during October 2022. We measured demographic and work-related variables of nurses, i.e. gender, age, chronic disease, self-rated health status, years of experience, and working in COVID-19 ward/intensive care unit. We used the single item burnout (SIB) and the Copenhagen Burnout Inventory (CBI) to measure occupational burnout. Moreover, we used the COVID-19 burnout scale (COVID-19-BS) to measure nurses burnout during the pandemic, and the Patient Health Questionnaire-4 (PHQ-4) to measure anxiety and depression among nurses. RESULTSIntraclass correlation coefficient between the two measurements of the SIB during the test-retest study was 0.986 indicating excellent reliability of the SIB. We found a high correlation between CBI factors and SIB (p<0.001), a moderate correlation between PHQ-4 and SIB (p<0.001), and a low to moderate correlation between COVID-19-BS and SIB (p<0.001). Therefore, concurrent validity of SIB was excellent. Moreover, SIB had high discriminant validity. In particular, nurses with a chronic disease, those with a very poor/poor/moderate health status, and those working in COVID-19 ward/intensive care unit had higher levels of burnout according to the SIB (p<0.001 in all cases). Moreover, we found a positive relationship between years of experience and SIB score (r=0.13, p<0.001). CONCLUSIONSThe single item burnout measure is a brief, reliable, and valid tool that we can use as a screening measure to identify individuals at high risk of burnout.

ObjectiveAt present, there are relatively few studies on the burnout of young doctors in China. This study can enrich the relationship between work pressure, cognitive evaluation(benign and stress)and burnout among young doctors, and help to understand the current situation of burnout among young doctors. MethodsA questionnaire survey was conducted among 116 young doctors from different departments to collect data on career motivation, work stress, cognitive evaluation and burnout. Result(1)The work pressure of young doctors has a predictive effect on burnout.(2)The primary evaluation of young doctors has an independent effect on burnout.(3)The 116 young doctors surveyed in this article are all at a high level of burnout. Conclusion(1)The work pressure of young doctors has a predictive effect on job burnout. Effective intervention on pay-reward can further reduce the sense of burnout of young doctors and reduce occupational stress.(2)The primary evaluation of young doctors has an independent impact on burnout, and positive cognitive evaluation is beneficial to reduce the level of burnout.

BackgroundCOVID-19 pandemic impacted the physical and mental health of Brazilian workers, especially those who started acting in home-office. Changes in the workplace, increased physical inactivity and fear of contracting the disease, known as coronophobia, may be related to increased musculoskeletal pain. ObjectiveTo analyze the prevalence of musculoskeletal pain and coronophobia in home-office workers during the COVID-19 pandemic, as well as evaluating the relationship between these variables. MethodA cross-sectional, observational and descriptive study with 736 participants was conducted through online questionnaire. Sociodemographic data, working conditions, pain, besides the evaluation of coronophobia using COVID-19 Phobia scale (C19P-S) and pain with the Nordic questionnaire of osteomuscular symptoms (NMQ) were collected. ResultsMost participants were female (78%), with an average age of 32.8 {+/-} 10.7 years. During the pandemic, 71% reported some osteomuscular symptoms, and of these, 64% began to have new paintings of pain in the pandemic, with higher incidence in the lower back and neck. Participants who began to perform their functions in home-office presented a higher incidence of pain and, among them, 53% reported that the furniture was not suitable for homework. Most had little fear of Covid-19, but moderate levels of coronophobia increased the chance of musculoskeletal pain (RP=1,74; IC 95%). There was a significant association between coronophobia and musculoskeletal pain. ConclusionsThe pandemic raised the prevalence of musculoskeletal pain, especially in cervical and lumba regions, and the fear of Covid-19 influenced this relationship.

ObjectivesFrom a public health perspective, it is important to clarify the associations between mask usage and the associated reasons in situations when mask usage is promoted or mitigated. Therefore, I clarified the changes in mask usage and the associated reasons before and after the downgrading of the legal status of COVID-19 in Japan, and analyzed the bi-directional associations between the two. DesignLongitudinal study. MethodsOnline surveys were conducted in two waves, between April 18-19, 2023 and June 6-15, 2023, among people aged 20-69 years living in Japan. A total of 291 participants completed both the surveys. The associations between mask usage and beliefs about the reasons for mask usage were analyzed using a cross-lagged panel model. ResultsMask usage decreased slightly, but significantly, from the first to the second wave (P < 0.001, Cohens d = -0.23). Of the eight beliefs regarding mask usage, slight but significant decreases were observed in terms of relief and information effects (P = 0.046, Cohens d = -0.12; P = 0.018, Cohens d = -0.14). There was a significant association between socio-psychological reasons other than infection risk avoidance (such as norm and relief) during the first wave and mask usage during the second wave [standard estimates:0.25 (95% confidence interval (CI):0.06-0.44)]. Contrarily, mask usage during the first wave was significantly associated with the reasons for infection risk avoidance during the second wave [standard estimates:0.13 (0.03-0.24)]. ConclusionsThe impact of downgrading the legal status of COVID-19 in Japan on mask usage and the associated reasons were found to be limited. In terms of promoting or mitigating mask usage, the significance of risk communication based on socio-psychological reasons other than infection risk avoidance, such as norms and relief, was highlighted.

ObjectiveTo propose and test psychometric models establishing direct, cross-lagged, and reciprocal longitudinal relationships between burnout, depression, and anxiety among occupational physicians during the COVID-19 pandemic. MethodsThis one-year prospective cohort study used repeated online questionnaires at three time points (2020-2022). A convenience sample of occupational physicians was recruited through professional networks and scientific associations. Data collection included a sociodemographic questionnaire, the Stanford Professional Fulfillment Index (PFI), and the Depression, Anxiety, and Stress Scale (DASS-21). Path analysis using Reciprocal Cross-Lagged Panel Models (RCLPM) assessed dynamic, bidirectional relationships among psychological variables over time, controlling for age, sex, and years of practice. Three models were specified, each centered on burnout, anxiety, or depression, to determine the best fit to the data. ResultsOf 540 participants, 124 completed all waves; 435 participated in wave 1, 220 in wave 2, and 265 in wave 3. Most participants were women, with similar age and experience across waves. Burnout declined from T1 to T2 and remained stable at T3. Depression and anxiety scores consistently decreased. All models revealed significant reciprocal cross-lagged effects, with feedback loops indicating mutual reinforcement. Anxiety emerged as particularly influential over time. Model fit indices confirmed model robustness, and stability indices suggested psychological stabilization over time. ConclusionBurnout, depression, and anxiety are reciprocally interrelated and evolve dynamically among occupational physicians. Burnout appears central in these interactions. Findings highlight the need for integrated strategies addressing both individual and organizational contributors to mental distress, especially during crisis contexts such as the COVID-19 pandemic.

BackgroundTeleworking is associated with lifestyle risk factors, such as insufficient physical activity (PA) and increased sedentary time (ST); however, effective interventions tailored to teleworkers are lacking. We aimed to evaluate the effectiveness of a 12-week multicomponent occupational lifestyle intervention on daily step counts among Japanese teleworkers. MethodsThis 12-week, two-arm, parallel-group, cluster randomised controlled trial conducted across 12 clusters in six Japanese companies involved 310 teleworkers (mean age 43.0 years; 72.6% men) randomized to the intervention (6 clusters, n=156) or a waitlist control group (6 clusters, n=154). The multicomponent occupational lifestyle intervention included individual (online lectures, feedback, and email messages), physical (posters and a pop-up), and organizational (encouraging messages from an executive) strategies. The primary outcome was the change in daily step counts, measured using an accelerometer over 14 consecutive days at baseline and at week 12. Analyses were based on the intention-to-treat approach using a generalised estimating equation model. FindingsThe intervention group showed an adjusted mean change in daily step counts of +219 steps (95% confidence interval [CI] -165 to 604), compared with +188 steps (95% CI -183 to 560) in the control group. The adjusted between-group difference was +55 steps (95% CI -550 to 660; p=0.844). No significant effects on the secondary outcomes (ST, light PA, or moderate-to-vigorous PA) were observed. InterpretationThe multicomponent occupational lifestyle intervention did not significantly increase daily step counts among Japanese teleworkers. Therefore, further studies should be done on tailored interventions for teleworkers. Research in contextO_ST_ABSEvidence before this studyC_ST_ABSTeleworking has increased globally, particularly following the coronavirus disease pandemic, and has been associated with reduced physical activity and increased sedentary behaviour, both of which are risk factors for cardiovascular disease. Previous studies have also reported that telework environments may contribute to musculoskeletal and other somatic symptoms. Multicomponent interventions in traditional office settings can effectively increase physical activity and reduce sedentary time. These interventions commonly employ strategies at multiple levels of the social-ecological model, including individual approaches (e.g., lectures or incentives), interpersonal approaches (e.g., team-based activities), environmental modifications (e.g., office rearrangements or sit-stand desks), and organisational support (e.g., leadership encouragement). The applicability of such interventions to teleworking populations remains unclear because teleworkers face distinct challenges such as social isolation, blurred work-life boundaries, and heterogeneous home working environments. These contextual differences highlight the need for interventions specifically tailored to teleworkers. Added value of this studyWe evaluated the effectiveness of a multicomponent occupational lifestyle intervention specifically designed for teleworkers, a population whose work environment differs substantially from traditional office settings. Our findings provide novel evidence that can inform the development of more targeted strategies to promote physical activity in evolving work environments. This study also provides objective measurements of physical activity using accelerometers, enabling detailed evaluation of step counts, sedentary time, and different activity intensities among teleworkers. Additionally, we used daily diaries to distinguish activity patterns across workdays, weekends, teleworking days, and commuting days, providing a nuanced understanding of behavioural patterns in remote work contexts. Implications of all the available evidenceOur findings indicate that low-cost, remotely delivered multicomponent interventions may be insufficient to produce meaningful behavioural change among teleworkers. Similar strategies, including individual, physical, and organisational components, have been effective in traditional workplace interventions; however, their implementation in teleworking environments may not adequately address the specific challenges faced by remote workers. In particular, the lack of strong sociocultural support mechanisms, such as team-based step competitions or workplace champions, may limit engagement and reduce the effectiveness of such programmes. Therefore, further investigation is needed to explore more diverse and targeted intervention strategies, identify the specific needs and behavioural patterns of teleworkers, and apply more precise eligibility criteria to better address heterogeneity within teleworking populations.

BackgroundDisease reporting is often unreliable and faces many challenges, making it difficult to estimate the true burden of occupational diseases, defined as any disease that is caused by the work activity or environment. This study aimed to assess the global reporting and underreporting rate of occupational diseases, and to identify the factors affecting the underreporting of occupational diseases. MethodsFollowing the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines, this study searched Medline (PubMed), CINAHL, EMBASE, Scopus, Web of Science, WHO Institutional Repository for Information Sharing (IRIS) database, Dimensions, and Google Scholar. We used search terms related to reporting and underreporting of occupational diseases or illnesses. The selected records were screened, and data extracted using the Covidence software tool. Screening and quality assessment were conducted by two independent researchers and finalized by a third researcher. The quality of the evidence was assessed with the Mixed Methods Appraisal Tool. This study is registered on PROSPERO, number CRD42023417814. ResultsA total of 121 studies from 29 countries were identified, all coming from high-income and upper-middle-income countries. The incidence rate of occupational disease varied widely, ranging between 1.71 to 1,387 per 100,000 employees yearly. The highest number of annual cases was reported in the agricultural sector (ranging from 33 to 6,431), followed by the health sector (146 to 5,508), and then the construction sector (264). Two studies evaluated rates of underreporting, which varied from 50% to 95%. The main factor contributing to underreporting was employee concerns about job security. ConclusionsThe results reveal a significant gap in the reporting of occupational diseases among high-income and low-middle-income countries. This review also identifies variations in reporting mechanisms across different countries. Our findings highlight the need to establish a national system for reporting occupational diseases that engages employers, employees, and healthcare providers.

ObjectiveThis study aimed to determine factors associated with acceptance of a Digital Contact Tracing (DCT) app for Coronavirus Disease 2019 (COVID-19) in the Japanese working-age population. MethodsA cross-sectional study was performed for 27,036 full-time workers registered with an internet survey company during December 2020 in Japan. ResultsThe rate of downloading the DCT app was 25.1%. The DCT app was more likely to be accepted by people with married status, university graduation or above, higher income, and occupations involving desk work. Fear of COVID-19 transmission, wearing a mask, using hand disinfection, willingness to be vaccinated against COVID-19, and presence of an acquaintance infected with COVID-19 were also associated with a greater likelihood of adopting the app. ConclusionsThe present findings have important implications for widespread adoption of DCT apps in working-age populations in Japan and elsewhere.

BackgroundWork-related musculoskeletal symptoms such as pain, stiffness, and swelling are a common occupational health issue that affect well-being and increase healthcare costs. Continuous physical effort, long hours of sitting, and poor awareness of proper ergonomics often lead to or worsen these conditions. ObjectiveThis study determined the frequency of musculoskeletal symptoms and the associated risk factors with musculoskeletal symptoms among field health workers in Bin Qasim Town, Karachi. Material & MethodsA cross-sectional study was employed and collected data from Karachi based pre-urban communities i.e.: Ibrahim Hydri, Rehri Goth and Bhains Colony. Study duration was 9 months. MSK symptoms were assessed using the standardized Nordic Musculoskeletal Questionnaire (NMQ). Prevalence of MSK symptoms was assessed over 12 months and 7 days. Participants with pain in [&ge;]2 regions of the upper or lower limbs were classified as having upper or lower limb symptoms, respectively. Multivariable logistic regression was used to identify associated factors for MSK symptoms in last 12 months. Results132 participants were recruited. Most frequently reported pain region in the last 12 months was lower back 111(84%) and shoulder 81(61%). Similarly, the most affected region in the last 7 days was also lower back 39(29%) followed by shoulder 33(25%). Upper limb MSK symptoms were significantly associated with bachelors or higher educated (OR=3.38; 95% CI: 0.67-7.42), sitting 3-4 h/day (OR=3.46; 95% CI: 1.11-10.75), and walking 3-4 h/day (OR=2.88; 95% CI: 1.05-7.85). In lower limb, married workers had 2 times higher odds of lower limb MSK symptoms (OR=2.36; 95% CI:1.04 - 5.35), while those who worked > 30 hours/week had 67% lower odds of having lower limb MSK symptoms (OR=0.33, 95% CI:0.15 - 0.72). ConclusionField health workers frequently reported MSK symptoms in both limbs. Preventive strategies such as ergonomic training, task rotation, and targeted support for married female workers are recommended to reduce the long-term impact.

ObjectivesCompared to long-term expatriates, the health issues of short-term international business travellers are less clear. Particularly, there are no reports on the impact of the COVID-19 pandemic. We explored the changes in health challenges faced by Japanese international business travellers owing to the COVID-19 pandemic. DesignCross-sectional survey research using questionnaires SettingWe surveyed 3,845 listed public companies in Japan in September 2021. ParticipantsA total of 251 companies responded (response rate: 6.5%), of which 131 (52%) had foreign travel requirements for their business. Primary and secondary outcome measuresThe survey included questions regarding company size, business type, necessity for foreign travel, destination and number of trips, common health issues that arise, and the importance of business travel before and after the COVID-19 pandemic. ResultsAmong the companies, 44% replied that they could not predict the number of foreign business trips after the pandemic. However, 64% of companies responded that business travel would continue to be important in the future. Before the COVID-19 pandemic, the most important health concerns faced by business travellers were illness during travel (42%), followed by the prevention of infectious diseases and lifestyle disease management. Post-pandemic, 48% of the responses were for infectious diseases, including COVID-19, followed by 40% for travel-related diseases, and 25% for lifestyle-related diseases. ConclusionsOwing to global economic and social activities, business travel will continue to be necessary in the post-COVID-19 era. Comprehensive health management including prevention of infectious diseases is desirable for business travel. Strengths and limitations of this studyO_LIThis study provides valuable insights into the health problems of short-term expatriates, an area which has been left relatively unexplored compared to its long-term counterparts. C_LIO_LIThe potentially transformative effects of the COVID-19 pandemic on the health and well-being of expatriates are also considered. C_LIO_LIThis study will form a foundational document for reviewing the impact of the pandemic and establishing a healthcare system designed for business travellers in preparation for future pandemics. C_LIO_LIThe survey was exclusively conducted among Japanese firms, which restricts its scope and generalisability. C_LIO_LIBecause the survey was conducted from managers perspective, it did not provide an accurate assessment of the actual health status of business travellers. C_LI

ObjectivesThe aim of this study was to clarify which workers symptoms led to unemployment during the COVID-19 pandemic. MethodsThis was a prospective cohort study using questionnaires about COVID-19 administered to Japanese workers. A baseline survey conducted in December 2020 was used to determine workers health history. Unemployment since the baseline survey was ascertained with a follow-up survey in December 2021. The odds ratios (ORs) of unemployment were estimated using a multilevel logistic model with adjusted covariates nested in prefecture of residence. ResultsMales (n = 8,682) accounted for 58.2% of the total sample (n = 14,910), and the mean age was 48.2 years. Multivariate analysis showed that workers with "pain-related problems," "limited physical movement and mobility," "fatigue, loss of strength or appetite, fever, dizziness, and moodiness," "mental health problems," or "sleep" had a greater probability of resigning for health reasons, resigning for all reasons other than retirement, and being unemployed. Those with "skin, hair, and cosmetic concerns" or "eye-related matters" had a greater probability of becoming unemployed. ConclusionsWe identified an association between workers symptoms and resignation or unemployment, with different symptoms having different ORs. Furthermore, there were differences in the associations among the effects of symptoms, work dysfunction, resignation/unemployment, and attitudes of others. Preventive interventions to help workers resolve or improve their symptoms could prevent their becoming unemployed or resigning.

BackgroundThe healthcare sector has a shortage of physicians. Strategies to better retain medical professionals in the workforce in General Internal Medicine must rely on an in-depth understanding of factors associated with wanting to quit their job. Here, we investigated sex-specific associations of workplace-related and personal factors associated with wanting to quit work among physicians. MethodsIn a cross-sectional questionnaire among physicians working in General Internal Medicine in Switzerland, we assessed personal and workplace-related factors in association with the desire to quit their job. The outcome variable of wanting to quit ones job was dichotomized from a 6-point Likert scale. We performed sex-stratified analyses by Wilcoxon rank sum test, Chi-square test and multiple logistic regression adjusting for demographic variables. ResultsThis study included 682 physicians, 278 (41%) men and 404 (59%) women aged 37{+/-}11 years (mean {+/-} standard deviation). A majority of 78% men and 75% worked in hospitals. Overall, a desire to quit their job was prevalent in 33% of respondents of either sex. Almost all workplace-related items were associated with the probability of wanting to quit among both sexes: Having a good network, mentoring or supervisors support were associated with a lower probability of wanting to quit, whereas having a bad work-life balance or dissatisfaction with autonomy at work. Problematic or workplace inclusiveness and experienced gender-related discrimination at work were associated with a higher probability of wanting to quit in univariable analysis in both sexes. The main sex difference was that the associations of workplace inclusiveness or gender discrimination with wanting to quit were robust to adjustment by type of workplace and language region in men, whereas in women upon multivariable adjustments the associations disappeared. Finally, in men (but not women) having no adequate childcare was more likely to desire quitting their job. ConclusionThis study identified several factors of which some may exert a causal relationship with the desire to quit a physician job. Modifying such factors by interventions may ultimately increase the likelihood of a physician continuing working in his profession.

Background: Work-related musculoskeletal pain (MSP) is a prevalent concern among factory workers, impacting productivity, absenteeism, and overall quality of life. Factory workers, who perform repetitive tasks and engage in physically demanding work, are particularly susceptible to work-related MSP. Methods: This descriptive cross-sectional quantitative study included 148 factory workers (29 females and 119 males) from two factories in Kigali, surveyed between November 2023 and January 2024. Data were collected using a structured questionnaire that included demographic items, the Modified Nordic Musculoskeletal Questionnaire (M-NMQ) to assess work-related musculoskeletal pain (MSP) symptoms in nine body regions over the previous 12 months and seven days, and questions regarding interference of symptoms with normal work activities. The Coping Strategies Questionnaire (CSQ) was administered to identify coping practices among factory workers. Data analysis comprised descriptive statistics, including mean, frequency, Wilson 95% confidence intervals, and percentage values, calculated using SPSS version 25.0. Results: Participants were predominantly male (119/148, 80.4%), and 98/148 (66.2%) had worked at the factory for more than five years. Overall, 113/148 reported symptoms in at least one body region during the previous 12 months (76.4%, 95% CI 68.9-82.5). The lower back (90/148, 60.8%), shoulders (71/148, 48.0%), neck (61/148, 41.2%), and knees (58/148, 39.2%) were most frequently affected. Symptoms prevented normal work for 41/148 (27.7%, 95% CI 21.1-35.4), and 57/148 reported symptoms during the previous seven days (38.5%, 95% CI 31.1-46.5). Among 113 participants with 12-month symptoms, the most frequent Always responses were seeking medical help (78/113, 69.0%), rest and recovery (75/113, 66.4%), and medication use (59/113, 52.2%); ergonomic adjustment was least frequent (10/113, 8.8%). Conclusion: Self-reported work-related MSP symptoms were common, particularly in the lower back and shoulder, while ergonomic adjustments were uncommon. Frequent medication use highlights the need for comprehensive interventions combining ergonomic training, physiotherapy, and adequate recovery; however, these findings do not establish causation or intervention effectiveness.