This report is a case study of the effectiveness of an occupational health physician’s formal recommendation for improving the working environment at a workplace where the employees work on a contract basis. At the business premises, Office B of Company A, where one of the present authors has been appointed as an occupational health physician, some employees have been performing contract work at a Factory Q run by a Company P. Despite dust, organic solvents, and specified chemical substances having been handled in Factory Q for many years, the Company P had not performed any measurements of the working environment, had not installed all the ventilation devices needed for organic solvents and other regulated chemical substances, and had not posted wall-notices with information about the substances handled. Company P had not made use of any occupational health services at Factory Q. Based on a workplace inspection visit report by the former occupational health physician, the site director of Office B requested Company P to make certain improvements, but no measures had been taken. The site director and the occupational health physician then discussed the situation, and notified the top management of Company A about the potential for making a formal recommendation of an occupational health physician. Subsequently, the chief executive officer of Company A sent Company P a document requesting improvement of the working environment based on the report of the occupational health physician. Company P then improved the working environment on that basis.

Objectives: We investigated the protection performance of whole gloves by developing a straightforward permeability resistance method and evaluating the permeation over 480 min. Methods: The permeation time for toluene was obtained for seven glove types according to the Japanese Industrial Standards. In addition, the permeability resistance of whole gloves was evaluated from the ratio of collected amount of toluene in the passive layered sampler attached to the inside and outside of the glove. Results: The permeation times of the two types of polyurethane gloves evaluated were less than 1 min each. However, the percentages of toluene that permeated through the whole gloves determined by the developed method were 32.5% and 6.8% for the thin and thick gloves, respectively, at 480 min and 71.8% and 24.1% for the thin and thick gloves, respectively, at 1,440 min. Permeation times for all three types of layered films were more than 1,440 min, but the whole glove tests showed differences of 1.7%, 3.1%, and less than 0.1% at 1,440 min. The causes of these differences were assumed to be related to variations in thickness, type of material, and differences in deposition state of the various gloves. Conclusions: It became possible to grasp the permeation performance throughout whole chemical resistant gloves, which could not be known only with material testing, using a straightforward permeability test method.

Objectives: For preventing coronavirus disease 2019 (COVID-19) clusters, avoiding the three C’s, which are closed spaces with poor ventilation, crowded places with many people, and close contact for conversation, is important. The CO₂ concentration in a room indicates the ventilation status, number of persons present in the room, and their kinetic strength or activity intensity. The real-time monitoring of CO₂ concentration in a room will enable instantaneously confirming whether ventilation is sufficient. Methods: This study investigated monitoring CO₂ concentration in real time during a concert and instantly indicating the measurement results on a display. Results: The average CO₂ concentration during the performance was confirmed to be 505.6 ppm with the maximum value 575 ppm, and these values were in line with the estimated value given by the Ventilation Simulator designed by the Occupational Hygiene and Ergonomics Section of the Japan Society for Occupational Health. The CO₂ concentration visualization has the benefit of providing a sense of security to the concert audience, musicians, and concert organizing staff during the performance. Conclusion: For preventing COVID-19 clusters, it is important to take multiple and comprehensive countermeasures considering concert event-specific infection routes; visualizing CO₂ concentration is one effective preventative measure against airborne (droplet nuclei) infection. The CO₂ concentration visualization based on prior estimation is expected to become part of the standard operational procedure of concert venues.

Objectives: This study aimed to reduce the number of sick leaves due to mental disorders using a problem-solving approach as the primary preventive strategy. Methods: We developed the approach referring to evidence-based public health, community-based participatory research, and competencies of occupational health professionals. We then applied the approach step-by-step to occupational health practices in a manufacturing company. Results: For the problem statement (Step 1) and formulating a hypothesis of cause-and-effect relationships (Step 2), we conducted a case-series study and hypothesized several workplace factors as causes of sick leaves. For empirical analysis (Step 3), we performed a retrospective cohort study. We set a department as the intervention target because of the high prevalence of sick leaves. After finding contextual and translational evidence by searching the scientific literature and assessing scientific evidence (Step 4), we identified stakeholders and weak elements in the occupational health management system. We promoted partnership with the stakeholders by sharing our findings (Step 5). We then developed and prioritized intervention options (Step 6) within the partnership. The employer decided to strengthen those weak elements and address the causes of sick leaves by developing an action plan and implementing interventions (Step 7). The incidence of sick leaves has subsequently decreased in the department. Finally, we evaluated the effectiveness of the problem-solving approach on the system, program, and outcomes (Step 8). Conclusion: This study revealed that a problem-solving approach may be effective in preventing sick leaves due to mental disorders in the workplace by building infrastructure for occupational health practice.

Objectives: The aim of the present study was to evaluate the prevalence of burnout among both medical and non-medical workers at a single coronavirus disease 2019 (COVID-19)-dedicated hospital and to find factors significantly associated with burnout. Methods: One hundred seventy-nine respondents (81.4% of the total employees) who answered a questionnaire were included. The questionnaire consisted of 50 questions, including the Maslach Burnout Inventory-General Survey. Multiple logistic regression analyses were performed to calculate the odds ratios for burnout using a non-burnout group as a reference, with adjustment for age, sex, medical or non-medical worker status, presence or absence of work in direct contact with COVID-19 patients, and presence or absence of work without direct contact but which was related to COVID-19 patients. Results: Burnout was equally observed in both medical and non-medical workers; the overall burnout rate was 8.9%. The factors significantly associated with burnout were anxiety in relation to infection with COVID-19, self-quarantine and stress behavior of patients, lack of sleep in comparison to the pre-COVID-19 period, and the desire for more days off, increased staff, hazard pay, and resources for coping with stress. Conclusion: System-level solutions for these factors may be effective for reducing dropout intention, burnout, and resignation of hospital workers.

The Japan Society for Occupational Health (JSOH) recommends the Occupational Exposure Limits (OELs) as reference values for preventing adverse health effects on workers caused by occupational exposure to chemical substances, continuous or intermittent noise, impulsive or impact noise, heat stress, cold stress, whole-body vibration, hand-arm vibration and time-varying electric, magnetic and electromagnetic fields and ultraviolet and ionizing radiation.

Objectives: Propetamphos (PPT) is an organophosphate pesticide (OP) widely used to control insects in public health settings and methylethylphosphoramidothioate (MEPT) is a urinary exposure marker of PPT. The objectives of this study were to develop a biomonitoring method for urinary MEPT using gas chromatography–mass spectrometry (GC–MS) and to measure urinary MEPT concentrations in occupational and non-occupational human populations. Methods: Analytes derivatized with pentafluorobenzyl bromide were analyzed by GC–MS and dibutyl phosphate was used as an internal standard. The validated method was applied to urine samples collected from occupational PPT sprayers (n=15), non-PPT sprayers (n=15) who did not spray PPT but sprayed other OPs, and control subjects (n=80) living in Aichi, Japan. Results: Calibration curves were obtained using standard-spiked pooled urine samples, and the coefficients of determination were ≥0.98. The limit of detection (LOD) was 10 μg/L. The within-run precision and between-run precision ranged from 17.5% to 19.4% and 10.4% to 18.1%, respectively. The detection rates of urinary MEPT in the PPT sprayers, non-PPT sprayers, and control subjects were 26.7%, 6.7%, and 2.5%, respectively. The concentration ranges for creatinine-unadjusted MEPT were <LOD–22.3, <LOD–21.9 and <LOD–13.8 μg/L, and creatinine-adjusted MEPT were <LOD–12.1, <LOD–12.7 and <LOD–7.9 μg/g creatinine, for the respective groups (PPT sprayers, non-PPT sprayers and controls). Conclusions: This study established a biomonitoring method that can measure urinary MEPT in spraying and non-spraying workers with exposure levels ≥10 μg/L.

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: This 2-month cohort study aimed to investigate the changing prevalence and factors associated with COVID-19-related workplace bullying among the general workers in Japan. Methods: A baseline survey was conducted of 4,120 full-time workers at Time 1 (March 2020) and they were invited to a follow-up survey at Time 2 (May 2020) after the outbreak of COVID-19 in Japan. The prevalence of COVID-19-related workplace bullying was compared between Time 1 and Time 2 by using McNemar’s test. Multiple logistic regression analysis was conducted to investigate the associations between occupation (health care and non-health care workers), socioeconomic status, living in areas under the national emergency announcement, workplace measures against COVID-19, occupational class, chronic physical comorbidities, chronic mental comorbidities, and COVID-19-related workplace bullying at Time 2, adjusting for that at Time 1. Results: A total of 1,421 responded to the survey at Time 2. Data from 996 respondents after excluding 36 who retired during the follow-up were analyzed. The prevalence of COVID-19-related workplace bullying increased more than double from Time 1 (2.8%) to Time 2 (6.5%). Being a manual worker (OR=3.80), having higher education (OR=2.37), and having chronic physical comorbidity (OR=2.11) was significantly associated with the COVID-19-related workplace bullying at Time 2. Conclusions: COVID-19-related workplace bullying increased during the outbreak of COVID-19 in Japan. A lower-class occupation (manual workers) and having chronic physical comorbidity may be associated with greater victimization of COVID-19-related workplace bullying, while those with high educational attainment may be more sensitive to it.

Objectives: We investigated whether playing background music (BGM) in the workplace had any effects on overtime hours. Methods: In 15 workplaces, we used a crossover design and alternated between 2 months with and without BGM for 8 months. Using the attendance management records of the company, we documented overtime hours during the observation and the previous year. BGM was played at the end of working hours (A), from 15:00 to the end of work (B), and from beginning to the end (C) in each of the five arbitrarily selected offices. To evaluate the effect on overtime hours, we used a paired t-test to compare the mean overtime between periods with and without BGM and repeated analysis of variance to compare the changes in the trend of overtime in the same months between the observation year and the previous year by an interaction effect. Results: Patterns A, B, and C consisted of 625, 536, and 573 employees, respectively. The mean overtime hours for 4 months were significantly decreased in one (−4.3%), two (−19.2% and −10.7%), and three (−11.8%, −16.8%, and −4.4%) offices, respectively. Furthermore, the trend of overtime between the observation year and the previous year significantly changed in one (1/5), one (1/5), and three (3/5) offices, in patterns A, B, and C, respectively. Conclusions: There were offices that showed less overtime when playing BGM, particularly the entire day, than when BGM was not played. This pilot study suggests that conducting more extensive research in this area is worthwhile.

Objectives: This study aimed to objectively assess sedentary time (ST) and physical activity (PA) time during work performed by older adults and investigate the relationship between work and ST/PA in daily life of this population. Methods: Participants were recruited from members of a Silver Human Resources Center and their families and friends. Data for 194 participants (131 workers and 63 non-workers) were included in the analysis. ST/PA during work (workers only) and daily life (all participants) were assessed using an accelerometer. ST/PA during work were defined according to the Japan Standard Occupational Classification. Associations between work and ST/PA in daily life were analyzed by covariance analysis adjusted for confounders. Results: ST during work was longest in clerical workers (35±16.0 min/h). Light-intensity PA during work was shortest in clerical workers (23.2±15.6 min/h), whereas this value was similar among the other occupational classes. Moderate-to-vigorous PA during work was relatively longer in construction and mining workers (15.3±11.9 min/h). Workers were found to have shorter sedentary and longer PA time in their daily life than non-workers. Moreover, workers with longer weekly work hours (≥14 h/wk) were found to have significantly shorter sedentary and longer PA time, and this trend was apparent in blue-collar workers. Conclusions: This study demonstrated objectively assessed ST/PA during work in older adults according to occupational classifications. Furthermore, it investigated the associations between work and ST/PA in daily life and showed the potential contribution of work, particularly blue-collar work, in decreasing ST and increasing PA.

Objectives: This study aimed to examine the factors for reducing monetary loss due to presenteeism by using a tailored healthcare web-application among office workers with chronic neck pain. Methods: The study was single-arm pre-post comparison study using secondary data of 130 Japanese office workers with chronic neck pain who used a tailored healthcare web-application (web-app) over 12 weeks. This data was obtained from BackTech Inc. (Kyoto, Japan), which manages the healthcare web-app. The primary outcome measure was the monetary loss due to presenteeism based on the quality and quantity method. Secondary outcome measures were intensity of physical symptoms measured by the Visual Analog Scale, frequency of web-app use obtained from the database, and the risk of depression score assessed by the Depression and Suicide Screen. Results: Eighty-six participants were included in the complete-case analysis. Monetary loss due to presenteeism and the risk of depression reduced, while physical symptoms improved significantly (p<0.01) after using the web-app. After covariate adjustment, decrease in neck pain intensity (β=0.25, confidence interval=2.34 to 32.66) and high frequency of web-app use (β=−0.24, confidence interval=−10.29 to −0.63) were significantly associated with a reduction in monetary loss due to presenteeism. Conclusion: Neck pain intensity and frequency of web-app use may be important factors for reducing monetary loss due to presenteeism among office workers with chronic neck pain who used a tailored health care web-app.

Objectives: In Japan, as a result of legislation, the role of occupational physicians and the function of occupational health have been strengthened. Employers are now required to provide information to occupational physicians. This study explored what information occupational physicians considered should be available to them. Methods: We conducted a focus group discussion with eight professional occupational physicians and developed a draft list of the information that occupational physicians should obtain from employers. To assess the validity of the list, we conducted a questionnaire survey of 777 occupational physicians in the training and certification system of the Japan Society of Occupational Health. Results: We obtained valid responses from 155 occupational physicians. In total, over 80% agreed or somewhat agreed that all 24 categories were required, indicating that a consensus had been reached. In two of the eight categories for which fewer than 80% responded “agree”, more senior or specialized physicians were significantly more likely to respond “agree” than others. Conclusion: The results of the survey suggest specific experiences and systematic education influence decisions about whether certain types of information are considered necessary. Finally, based on the opinions in the open-ended section of the questionnaire, we recommend a list with 26 categories of information collecting from an employer. We believe the key to sharing information is to have a common understanding with employers and develop a good relationship so that additional information will be disclosed voluntarily. Occupational physicians need to be mindful of this need to develop relationships with employers.

Introduction: This study aims to clarify whether the competencies required of occupational health professionals for disaster management, identified from experiences in a single disaster, can be agreed upon by occupational health professionals with experience in other disaster responses. Methods: This study employed a quantitative study design using a questionnaire. The participants were occupational health professionals. The questionnaire included 29 competencies identified from the experiences of occupational health activities conducted during the Kumamoto earthquake. Items were rated from 1 (not necessary at all) to 5 (very necessary) by the participants. Exploratory factor analysis of the responses was performed. Result: The participants were 334 (29.9%), of which 97 (29.0%) answered that they had disaster response experience. Factor analysis was performed by setting three factors for 22 items. Factors 1, 2, and 3 were labeled “skills about coordinating within the organization,” “practical ability to respond to changing situations,” and “consistency as occupational health professionals,” respectively. Discussion: In the event of a disaster, occupational health professionals are required to ensure their own safety, grasp the occupational health needs changing over time, and make decisions based on changing situations. The study suggests that a disaster response is a rare experience even for specialists in occupational health. To enable them to appropriately play their roles in occupational health response during disasters, a system of education aimed at maintaining coherence as the occupational health profession and demonstrating coordinating and practical skills in the event of a disaster should be established.

In Japan, over 6,000 workers commit suicide every year, and the Japanese government has taken several countermeasures to prevent Karoshi (death due to overwork) and mental health disorders among workers. Risk factors for suicide among workers include long working hours, adverse psychosocial job characteristics, economic recession or financial crisis, job insecurity, and workplace harassment. Depressive symptoms are supposed to play a vital role in mediating mechanisms. Owing to the coronavirus disease (COVID-19) pandemic, economic crises continue and seemingly deepen, and the risk of unemployment increases. Workers with low socioeconomic status and who do not enjoy occupational health services are considered vulnerable, and essential workers (including health care workers) require special attention. Little evidence prevails with respect to workplace suicide prevention measures in a population approach, and hence, suicide prevention should be integrated into the existing workplace mental health activities. Although evidence of secondary prevention, such as screening for depression, is scarce for workplace mental health, such measures, including regular psychological counseling, should be applicable during this crisis. Research is thus crucial for preventing suicide in the workplace using surrogate outcomes, such as suicidality, help-seeking, stigma, access to means, and improving workplace support. Prevention of suicide among temporary workers, freelancers, foreign workers, and self-employed individuals who lack support from regional and occupational healthcare domains remains an untackled issue.

Objectives: Little is known about the specific prognosis of cancer among workers in different industrial sectors. The aim of this study is to demonstrate cancer survival inequality by industry sectors. Methods: Using multicenter inpatient data (1984−2017) and a regional cancer registry in Japan (1995–2018), we merged these two anonymized datasets. Based on standardized national classifications, cases were grouped according to the longest-held employment in primary, secondary, or tertiary industrial sectors. Data regarding smoking, alcohol consumption, and tumor staging at diagnosis were also extracted. We estimated the 5-year survival rates for common cancers using the Kaplan-Meier method to identify inequalities among industrial sectors. Cox proportional hazard model was used to calculate the hazard ratio (HR) of industry sectors. Results: A total of 13,234 cases were merged from two datasets. Among these, 8,794 cases were defined as common cancers (prostate, kidney, bladder, esophagus, stomach, liver, pancreas, colon, breast, and lung). Five-year survival was significantly (p=0.025) shorter for primary industrial sector (43.1%) compared with secondary sector (54.5%) and tertiary sector (56.9%). The adjusted HR for secondary and tertiary sectors versus primary sector was 0.963 (95% confidence interval [CI], 0.649–1.429). Bladder cancer in secondary and tertiary sectors showed a significantly higher survival rate than in the primary sector (p<0.0001), but the HR of secondary and tertiary sectors was 0.049 (95% CI, 0.021–0.153). Conclusions: This study revealed the potential of industrial sector inequalities with regard to the prognosis of cancers in Japan.

Objectives: Increasing attention has been paid to pelvic incidence (PI) as a potential parameter related to low back pain. However, little knowledge exists regarding potential anthropometric landmarks specialized for the estimation of PI. This study aimed to examine the inter- and intra-examiner reliability of potential anthropometric landmarks applicable to estimate PI. Methods: Twenty healthcare workers were recruited as participants. Three were experienced physiotherapists for more than 5 years in clinical practice. Eight anatomical landmarks were selected: (1) the acromion, (2) the upper edge of the iliac crest, (3) the posterior superior iliac spine (PSIS), (4) the anterior superior iliac spine (ASIS), (5) the upper edge of the greater trochanter, (6) the coccyx, (7) the lateral joint space of the knee, and (8) the lateral malleolus. Photographs of the right-side view of the subjects were used to determine the two-dimensional (x, y) coordinates of the landmarks. Results: Most landmark measurements reached acceptable levels for intra-examiner (ICC₁, 0.64 to 0.98) and inter-examiner reliability (ICC₃, 0.71 to 0.97). However, as possible anatomical landmarks, the PSIS (ICC₁ 0.65, ICC₃ 0.48), acromion (ICC₃ 0.66), and coccyx (ICC₁ 0.64) tended to have relatively low ICCs. Conclusions: Our study suggests that potential anthropometric landmarks on the body surface examined on palpation have acceptable intra- and inter-examiner reliability; however, identifying the acromion, PSIS, and coccyx as anatomical landmarks using the measurement method in this study remain difficult to be considered reliable.

Objectives: This study aimed to investigate workplace measures implemented in response to COVID-19 during the outbreak in Japan from T1 (March 2020) to T2 (May 2020), focusing on the disparities by company size and industry. Methods: A longitudinal study was conducted using a cohort of full-time employees, starting with the baseline online survey on March 19–22, 2020 (T1). An online follow-up survey was conducted on May 22–26, 2020 (T2). The McNemar test was used to assess differences between T1 and T2 in the proportion of implemented measurements. Analysis of covariance was performed to compare the differences in the number of implemented measures across groups classified by company size or industry, adjusting for sex and age. Results: A total of 1,032 participants (response rate: 72.6%) completed the follow-up questionnaire. The final analytic sample comprised n=987. The workplace measures involving the delivery of information on COVID-19 were 88.4% at T2, which significantly increased from T1 (increased 8.6%, p<0.001). As well as the T1 survey, respondents in the smaller companies reported a significantly smaller number of measures, but the disparity compared to large companies became small. The same trend was observed in the type of industry. Conclusions: This study showed an improvement in the implementation of preventive measures in response to COVID-19 in the workplace in Japan through the first wave outbreak. The disparity between companies of different sizes and from different industries decreased at T2, suggesting that company groups that initially implemented fewer measures caught up.