Objectives: Essential workers, particularly in health care and social services, were critical during the peak of the COVID-19 pandemic, yet their mental health outcomes remain understudied. We examined changes in (1) sickness absence (SA) due to common mental disorders (CMDs), and (2) antidepressant prescription in health and social care workers during versus pre-pandemic periods.

Methods: Using Swedish national registers, we included health care and social workers (aged 19-65 years) from 2018 to 2021. We compared quarterly incidence rate (IR) trends for SA >90 days due to CMDs, and for antidepressant prescriptions, across 2 periods: pre-pandemic (January 2018 to February 2020) and during the pandemic (March 2020 to December 2021) using interrupted time-series analysis. Analyses accounted for seasonality and were stratified by age, sex, and education.

Results: There was no evidence of a difference in IR trends for SA >90 days or for antidepressant prescription pre-pandemic versus during the pandemic for the entire sector. However, trends of IR for antidepressant prescription increased among workers in medical laboratories (8.7% per quarter change; 95% CI, 4.4%-13.1%) and hospitals (1.5%; 95% CI, 0.6%-2.5%) and decreased per quarter for ambulance transports (5.4%; 95% CI, 0.4-10.0%). Women (10.9%; 95% CI, 7.2%-14.7%) and highly educated individuals (10.0%; 95% CI, 4.1%-16.1%) working in medical laboratories as well as 19-25-year-olds working in primary and dental care (7.3%; 95% CI, 1.7%-13.1%) also experienced an increase in antidepressant prescription.

Conclusions: Although overall trends in SA >90 days and in antidepressant prescription remained stable, certain occupational and sociodemographic groups were found to be affected in regard to antidepressant prescription. These groups warrant targeted support in future health crises.

Objectives: This study aimed to develop and validate 2 concise measures of workplace loneliness.

Methods: A 3-item scale for loneliness at work (SLAW-3) and a single-item scale for loneliness at work (SLAW-1) were developed by modifying existing scales for general loneliness. A cross-sectional online survey was conducted of 1228 full-time employees in Japan to test the reliability and validity of these scales. Internal consistency of the SLAW-3 was assessed using Cronbach α coefficient, and the construct validity was examined through correlations with established measures of workplace loneliness, psychological distress, well-being, self-rated health, and workplace social support.

Results: The SLAW-3 demonstrated strong internal consistency (Cronbach α = .91) and unidimensionality. It correlated positively with established measures of workplace loneliness and psychological distress measures and negatively with well-being and workplace social support measures. The SLAW-1 also demonstrated significant correlation with the SLAW-3 and with psychological indicators such as distress, well-being, self-rated health, and workplace social support.

Conclusions: The SLAW-3 was found to be a reliable and valid measure of workplace loneliness. The SLAW-1 also demonstrated adequate construct validity, despite its single-item format. Both scales are short and may be effectively used to assess workplace loneliness in large-scale employee surveys or brief screenings.

Objectives: To quantify the short-term impact of an unexpected stay-at-home exposure, caused by a shipment suspension, on body mass index (BMI) and cardiometabolic markers among employees with different levels of occupational physical activity.

Methods: Health-check records from 8307 workers at a large Japanese automobile manufacturer were linked to company attendance data covering a shipment suspension (January to April 2024). An interrupted time-series assessed BMI trajectories before, during, and after the halt. Among 614 employees who underwent an additional examination in April 2024, mixed-effects models related the duration of stay-at-home to changes in BMI and blood pressure within low-, medium-, and high-intensity job categories.

Results: Compared with pre-halt trends, medium-intensity and high-intensity workers showed significant level rises in BMI (0.96 kg/m²; 95% CI, 0.56-1.36; and 0.64 kg/m²; 95% CI, 0.24-1.04, respectively) at the onset of the suspension. Mixed-effects analyses showed a positive dose-response between the duration of stay-at-home and BMI gain in high-intensity jobs (0.47 kg/m² per 20% absent days; 95% CI, 0.37-0.58). Per 20% of scheduled workdays absent, systolic blood pressure was higher in the medium- and high-intensity groups. No significant effects were observed among sedentary workers.

Conclusions: Employees whose daily energy expenditure relies on job-related physical activity are especially susceptible to weight gain and blood pressure elevations during forced work interruptions. Business continuity plans should embed tailored countermeasures-such as structured exercise programs and phased returns to on-site duties-to safeguard metabolic health during future operational disruptions.

Objectives: Various factors influence urinary hippuric acid concentrations; however, the role of climatic factors on such concentrations has not been thoroughly investigated.

Methods: This study examined the correlation between urinary hippuric acid concentrations and climatic factors. Data were obtained from health examinations of 2236 employees at a large manufacturing company who used organic solvents over a 3-year period. Each participant underwent a health examination for organic solvent use during both the summer (June to August) and winter (December to February). Urinary hippuric acid concentrations were log-transformed, and a linear mixed-effects model was applied to assess their association with average temperature, relative humidity, and atmospheric pressure recorded in Nagoya City, Japan.

Results: In a multivariate linear mixed-effects model including all meteorological variables, average temperature showed a significant positive association with log-transformed urinary hippuric acid concentrations (estimate = 0.013; 95% CI: 0.007-0.020; P < .001). This corresponds to an estimated 1.3% increase in urinary hippuric acid concentrations per 1°C rise in temperature. In contrast, neither average atmospheric pressure nor relative humidity showed a statistically significant association (P = .981 and P = .817, respectively). Among the confounding variables, smoking was significantly positively associated with concentration (P = .001), whereas alcohol consumption showed a significant negative association (P = .031).

Conclusions: Urinary hippuric acid concentrations exhibited seasonal variation among workers at a large manufacturing company, with elevated levels observed during the summer. These findings underscore the importance of considering climatic factors when interpreting urinary metabolic biomarkers.

Objectives: Biological exposure monitoring is particularly useful for understanding skin absorption of hazardous substances; however, existing measurement methods for aromatic amines show room for improvement, as they focus only on unchanged compounds. This study aimed to determine urinary concentrations of the unchanged compounds and metabolites of 3 aromatic amines (aniline, 2,4-dimethylaniline [m-xylidine], and 2-methylaniline [o-toluidine]) following enzymatic hydrolysis pretreatment, to calculate their proportions, and to assess markers for occupational biological exposure monitoring.

Methods: Urine samples were collected at the end of work shifts on consecutive days from 11 workers at a plant handling aromatic amines. Samples were enzymatically hydrolyzed using glucuronidase and sulfatase. The urinary concentrations of 25 substances were determined using liquid chromatography-tandem mass spectrometry.

Results: After exposure to the 3 aromatic amines, the major urinary excretion types were benzene ring-hydroxylated compounds, ring-hydroxylated and N-acetylated compounds, and side-chain methyl group oxides. The presence of unchanged and N-acetylated compounds was minor. Metabolism and urinary excretion were relatively different between the workers in our study and reported values from animal studies.

Conclusions: Excluding metabolites with low specificity, the sum of unchanged compounds and primary metabolites in urine could be a useful marker for biological exposure monitoring. Regarding aniline exposure, the relevant markers are the sum of aniline, N-acetyl-4-hydroxyaniline, and 2-hydroxyaniline. For 2,4-dimethylaniline exposure, the markers are the sum of 2,4-dimethylaniline, N-acetyl-4-carboxy-2-methylaniline, and 6-hydroxy-2,4-dimethylaniline. For 2-methylaniline exposure, the markers are the sum of 2-methylaniline, N-acetyl-4-hydroxy-2-methylaniline, 4-hydroxy-2-methylaniline, and 6-hydroxy-2-methylaniline. Urine sampling is recommended at the end of work shifts on consecutive working days.

Objectives: Allergic rhinitis (AR) is a prevalent condition in Japan that negatively affects workers by reducing their productivity. However, previous studies primarily focused on patients with severe AR symptoms. This exploratory study aimed to examine the association between AR, including mild cases, and reduced work productivity in the general working population.

Methods: A questionnaire survey was conducted between March and April 2024, recruiting adult workers living in the Kanto region through a health care center and affiliated companies. Absenteeism, presenteeism, and weekly economic costs were compared between individuals with and without AR. Multiple regression analysis was performed to examine the association between AR severity and productivity. A causal mediation analysis was also conducted to explore the indirect effects of depressive symptoms, positive and negative affect, and sleep quality on the association between AR and presenteeism.

Results: Of the 555 participants, 347 (62.5%) reported having AR, whereas 208 (37.5%) reported not having AR or were unsure. No significant differences were observed in absenteeism or presenteeism between the AR and non-AR/unknown groups. In the AR group, AR severity was significantly associated with increased presenteeism (unstandardized partial regression coefficient B = 4.19; 95% CI, 3.48-4.90; P < .001). Causal mediation analysis revealed a significant total natural indirect effect (TNIE) only for depressive symptoms (TNIE = 5.246; 95% CI, 0.059-10.432; P = .047).

Conclusions: In the nonclinical setting, the overall impact of AR on work productivity may be limited among Japanese workforces.

Objectives: To describe the characteristics of incident cases and calculate the standardized incidence ratio (SIR) of kidney cancer in a multicenter cohort study.

Methods: Baseline studies included 601 individuals across 12 factories manufacturing or recycling indium compounds between 2003 and 2006. In total, 341 individuals had undergone at least 1 follow-up health checkup by 2022. Of these, 128 individuals were examined from 2019 to 2022, with a mean follow-up duration of 17.1 years (range 13.3-18.4). The overall SIRs of kidney cancer were calculated.

Results: One female and 2 male incident cases of kidney cancer were identified at 3 different factories. The mean age was 55 years, and they were either smokers or secondhand smokers. The mean duration of indium exposure was 14.6 years, and the mean serum indium concentration at baseline was 2.3 μg/L (range <0.1-4.3 μg/L). One case consistently exhibited undetectable indium concentrations in both serum and kidney tissue. Another case involved double primary cancers of the lung and kidney. The expected number of kidney cancer cases based on the Japanese general population was 0.505. The overall SIR was 5.95 (95% CI, 2.02-17.47). Even after excluding the case with undetectable In-S and In-K levels, the overall and female SIRs remained significantly elevated (overall SIR 3.96; 95% CI, 1.09-14.44; female SIR 56.86; 95% CI, 9.80-314.69).

Conclusions: Indium exposure may contribute to the development of not only lung cancer but also kidney cancer in humans. Continued follow-up in the cohort study is warranted.

Objectives: To synthesize ocular and visual effects caused by occupational exposure to video display terminals (VDTs). Additionally, we aimed to identify the occupational and nonoccupational risk and protective factors related to these effects, and to propose a conceptual mapping to manage affected workers.

Methods: The review protocol was registered in PROSPERO and the systematic review was conducted following PRISMA guidelines. A search of MEDLINE, Scopus, and Web of Science was performed to identify studies published between January 2006 and December 2023. Only primary studies were included. Study quality was assessed using a critical appraisal tool based on STROBE statements for cross-sectional studies and the Scottish Intercollegiate Guideline Network checklist for randomized controlled trials and cohort and case-control studies. Low-quality studies were excluded.

Results: Eighty-five articles were included, 50 of high quality. The main ocular and visual effects were computer vision syndrome, dry eye disease, and other isolated signs and symptoms. The main risk factors were the daily hours of VDT exposure, female gender, use of ophthalmic or contact lenses, increasing age, altered lighting conditions, and job seniority. Breaks, adequate workstation design, and ergonomic improvements were the main protective factors. Psychosocial factors and lifestyle behaviors also may influence ocular and visual health at work.

Conclusions: Wide methodological variations were found, making it difficult to compare studies. Nevertheless, an evidence-informed conceptual mapping has been proposed that could be used as a starting point to guide preventive measures in VDT work settings. Further research with appropriate epidemiological designs is needed to establish causal relationships or determine temporal sequences between exposures and outcomes.

Background: Return-to-work (RTW) support has become a growing priority in occupational health. Manual workers-who constitute over half of the global labor force-may face greater RTW barriers due to the physically demanding nature of their jobs. However, few studies have quantitatively compared the perceived RTW barriers between manual and nonmanual workers. This study aimed to compare perceived RTW barriers between manual and nonmanual workers with chronic conditions to inform the development of tailored support strategies.

Methods: We analyzed 219 employed adults, either actively working or on certified leave, who attended consultations at one particular hospital between September 2019 and June 2020 to obtain support for balancing work and medical treatment. Perceived RTW barriers were assessed with a validated 10-category yes/no structured checklist (personal: work ability/psychological/health literacy; workplace: structure/system/support; intersectoral/social). Logistic regression was performed to compare barriers between manual and nonmanual workers.

Results: Manual workers were significantly more likely to report barriers related to psychological impacts (odds ratio [OR] = 2.34) and workplace systems (OR = 2.88). Although work ability did not differ significantly by job type, it was the most frequently reported RTW barrier in both groups.

Conclusions: Manual workers’ RTW challenges are characterized by psychological and organizational barriers. RTW programs should assess psychological readiness before resumption of duties and provide managerial training to address anxiety and loss of confidence, while implementing job-specific accommodations such as phased tasks, ergonomic adjustments, and light duties in coordination with health care providers.

Objectives: This study aimed to investigate the association between the coronavirus disease 2019 (COVID-19) pandemic and sickness presenteeism by directly comparing data collected before, during, and after the pandemic.

Methods: We analyzed data from the fifth (conducted before the pandemic: July 2017 to November 2017), sixth (conducted during the pandemic: October 2020 to April 2021), and seventh (conducted after the pandemic: July 2023 to November 2023) Korean Working Conditions Surveys, comprising 114 140 workers. The primary outcome was self-reported sickness presenteeism, defined as attending work despite illness over the past 12 months. Logistic regression models were used to estimate the association between the COVID-19 period and sickness presenteeism after adjusting for demographic characteristics.

Results: The prevalence of sickness presenteeism significantly decreased from 20.9% (before the pandemic) to 17.2% (during the pandemic), and it further decreased to 6.9% (after the pandemic). After adjusting for demographic and workplace characteristics, the odds of sickness presenteeism were significantly lower during the pandemic (odds ratio [OR] 0.84; 95% CI, 0.80-0.87) than before. Furthermore, the odds further decreased after the pandemic (OR 0.35; 95% CI, 0.33-0.37) relative to during the pandemic.

Conclusions: Sickness presenteeism decreased across the COVID-19 pandemic periods in South Korea. This decrease was observed in relation to the implementation of government-mandated sick leave policies for infectious disease control, suggesting an association between policy enforcement and decreasing sickness presenteeism.

Objectives: The continuity of mental health problems from childhood to adulthood is well acknowledged, as is the impact on work ability. However, knowledge is scarce about individuals who maintain work ability and have no sickness absence (SA), despite mental health problems. The aim was to identify sociodemographic and health-related factors among private and public employees with a history of depression and/or anxiety, and no SA.

Methods: This prospective cohort study included 9039 Swedish twin individuals born between 1975 and 1986, with and without a history of depression and/or anxiety, and employed in the private or public sectors. Survey data from 2005 were used to classify self-rated depression, anxiety, and overall health. Data on SA, education, occupational class, outpatient health care use, and prescribed antidepressants were obtained from national registries. Participants were prospectively followed for SA from 2006 to 2020. Logistic regression analyses were applied to calculate odds ratios (ORs) with 95% CIs.

Results: Approximately 37% of individuals with previous depression and/or anxiety were not on SA during follow-up, compared with 54% of those without such history. Lower use of antidepressants implied higher odds for no SA among both private (OR: 2.09; 95% CI, 1.64-2.66) and public (OR: 2.38; 95% CI, 1.78-3.19) employees with previous depression and/or anxiety. Having fewer visits to outpatient health care was significantly associated with no SA (ORs: 2.22-3.60). Being a white-collar worker implied higher odds for no SA only among those privately employed (OR: 1.39; 95% CI, 1.10-1.76).

Conclusions: Primarily, health-related factors seemed to play a role in no SA among young employees with previous depression and/or anxiety.

Objectives: This study examined the support provided by occupational physicians (OPs) in Japan to employees with long COVID, a condition that significantly affected workforce health during the pandemic.

Methods: An exploratory cross-sectional mixed-methods design was employed, consisting of qualitative interviews followed by a questionnaire survey targeting OPs certified by the Japan Society for Occupational Health. The interviews explored actual experiences of supporting workers with long COVID, and the findings were used to develop the questionnaire. The survey and interview findings were integrated to describe overall occupational health (OH) practices.

Results: Twenty OPs reported 30 cases of employees with long COVID in the interviews. Based on these findings, a questionnaire survey was conducted, yielding 182 valid responses. The integrated results showed that OPs most frequently reported “Main OH responses” such as active listening, return-to-work assistance, and lifestyle guidance. Measures such as explaining workers’ compensation applications and preparing lists of outpatient clinics were less frequently reported. For “Advice for employers,” limitation of overtime, reduction of workload, and telework were commonly reported, whereas demotion and reassignment were rarely reported.

Conclusions: This study clarified how OPs in Japan supported workers with long COVID through diverse, context-dependent practices. The identified main OH responses and advice for employers provide a framework for understanding current practices. Developing practical case examples, structured assessment tools, and workplace guidelines, together with further research grounded in real-world practice, will enhance OPs’ ability to provide appropriate support and strengthen preparedness for future health crises.

Objectives: The number of people with a chronic condition in the workforce is rising and the majority use medication. Medication self-management at work might be problematic. This study aimed to provide insight into the experiences of employees with balancing medication self-management and work.

Methods: Semi-structured interviews were held with 18 individuals with a variety of chronic health conditions, occupations, and medications. Interviews were guided by a topic list, transcribed, and open-coded. Thematic analysis identified determinants and behaviors that play a role in the interaction between medication self-management and performance and well-being at work.

Results: Fifteen participants used medication at work, mostly as needed and often administered on the go or covertly. Medication use at work was often perceived as doable due to flexibility and already established routines. However, a cumulative complexity of integrating medication use into the workday, the degree of side effects, and people’s attitude towards openness could hinder successful integration of medication self-management at work. Participants adapted their medication schedule, made adjustments during their workday, and/or found ways to cope with these challenges emotionally. Medication often enabled work participation, although side effects of medication could impact workability, and (anticipated) stigma could affect the extent to which people can be themselves at work.

Conclusions: Medication self-management at work requires adaptability from individuals themselves, their colleagues, and employers. Fostering a culture of acceptance and understanding at work while providing practical support can enhance medication self-management practices and well-being at work.

Objectives: Work-time control (WTC) may influence sleep health by allowing workers to align schedules with their personal needs, but findings have been inconsistent. In South Korea, where long working hours and low autonomy are prevalent, further investigation is required. This study aimed to examine the association between WTC, sleep quality, and sleep duration in South Korean workers.

Methods: Cross-sectional data from the fifth wave of the Korean Work, Sleep, and Health Study, a nationwide panel survey of South Korean workers aged 19-70, were used. The analytical sample included 5183 paid employees. WTC was categorized as low or high, and sleep quality was measured by the Pittsburgh Sleep Quality Index, with poor sleep quality defined as a score ≥11. Short sleep duration was defined as <7 hours per night. Poisson regression was used to estimate the prevalence ratios (PRs) after adjusting for age, sex, education, income, occupation, working hours, and shift work.

Results: Low WTC was associated with a higher prevalence of poor sleep quality (PR: 1.39; 95% CI: 1.09-1.77), adjusting for age, sex, education, income, occupation, working hours, and shift work. No significant association was found between WTC and short sleep duration. In the stratified analysis of weekly working hours among employees working 40-52 hours per week, there was a significant association between low WTC and poor sleep quality.

Conclusions: Lower WTC was associated with poorer sleep quality. Improving work-time autonomy may enhance sleep, particularly among workers with moderate weekly working hours (40-52 hours).

Objectives: Prolonged sitting time is gradually being recognized as detrimental to health. As technological advances have made workplaces increasingly sedentary, describing sitting time by occupation is useful for identifying at-risk groups and promoting occupational health. This study aimed to elucidate the differences in sedentary time according to occupation using a nationally representative sample.

Methods: Self-reported total sedentary (sitting or lying down during waking hours) time was obtained from the 2013 National Health and Nutrition Survey. Occupations were classified as professionals, managers, clerks, sales, service, protective services, agricultural/forestry/fishery workers, transport/machine operators, manufacturing/construction/cleaning laborers, homemakers, and unemployed individuals. Sedentary time by occupation was compared using an analysis of covariance adjusted for age and sex.

Results: A total of 4071 workers aged 20-64 years were analyzed. Age-adjusted sedentary time was longer in men than in women. The age-adjusted sedentary time among different occupations ranged from 280 to 499 min/d. The longest age-adjusted sedentary time was observed among clerks (499 min/d), followed by managers (437 min/d). In contrast, the shortest sedentary time was observed among agricultural/forestry/fishery workers (280 min/d). Clerks and managers had longer sedentary time on weekdays than on days off, whereas other occupations, including homemakers, did not.

Conclusions: Sedentary time differed substantially among occupations, with a variation of approximately 3.5 h/d. Prolonged sedentary time, a known health risk, may represent a substantial occupational exposure, particularly among clerical workers. Occupational health staff should monitor workers’ sedentary time to promote better occupational health outcomes.

Objectives: To explore the independent associations between serum lipids and low back pain (LBP) among male aircraft maintenance technicians after adjustment for ergonomic exposures.

Methods: This cross-sectional study enrolled 1713 male aircraft maintenance technicians. LBP and ergonomic exposures were assessed using the Chinese Musculoskeletal Questionnaire and Quick Exposure Check, respectively. We measured fasting serum lipids, including total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C). Associations were examined using binary and ordinal logistic regression models with sequential adjustments for personal and occupational covariates.

Results: The prevalence of LBP was 42.4%. After adjustment for potential confounders, the natural logarithm of TG (ln-TG) was positively associated with LBP presence (odds ratio [OR] 1.229; 95% CI, 1.020-1.480; P = .030) and intensity (OR 1.301; 95% CI, 1.097-1.542; P = .003), whereas HDL-C was inversely associated with LBP presence (OR 0.639; 95% CI, 0.438-0.932; P = .020). Categorical analysis identified key factors associated with higher LBP presence, including work experience of 5-9.9 years, high/very high back exposure, moderate/high work pace, high/very high stress, and borderline-high/high TG. The adjusted ORs for these key ergonomic exposures were higher than those for any lipid parameter.

Conclusions: Among male aircraft maintenance technicians, serum TG is an independent correlate of LBP after adjustment for ergonomic exposures. Given that ergonomic exposures are the predominant associated factors, prevention strategies should primarily focus on ergonomic interventions, with the management of serum lipids such as TG an adjunctive measure.

Objectives: Work-related stress is associated with cardiovascular disease (CVD), yet the contributions of specific work-related stressors, support, and satisfaction to CVD incidence are not fully understood. Clarifying whether lifestyle behaviors and physiological factors mediate associations between stressors and CVD is essential for targeted prevention.

Methods: In this prospective cohort study, a cohort of 4820 Japanese workers (3876 men and 944 women) aged 35-65 years was followed up for CVD incidence from 2007 to 2022. Work-related stressors (eg, quantitative job overload), support (eg, supervisor support), and satisfaction (eg, family life satisfaction) were assessed using the 57-item Brief Job Stress Questionnaire. Multivariable Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% CIs for CVD risk. Mediation analysis evaluated the role of lifestyle behaviors (eg, smoking, alcohol consumption) and physiological factors (eg, systolic blood pressure, obesity) in the association between stressors and CVD incidence.

Results: Quantitative job overload, low supervisor support, and low family life satisfaction were independently associated with increased CVD incidence (HRs ranging from 1.69 to 2.33). A proportion (24.9%) of the association of quantitative job overload with CVD was significantly mediated by obesity (P = .007).

Conclusions: Quantitative job overload, lack of supervisor support, and low family life satisfaction were significant predictors of CVD among Japanese civil servants. These findings suggest that both reducing excessive workload and strengthening support systems inside and outside the workplace may be important for CVD prevention among Japanese civil servants.

Objectives: Inappropriate telework environments, including work-from-home (WFH) settings, have been linked to physical and mental health problems. However, no systematic assessment has been conducted regarding the WFH environment (WFH-E). The aim of this study was to clarify the current methods used to assess the WFH-E and its association with health- and work-related outcomes through a scoping review.

Methods: We searched PubMed, Web of Science, and Ichushi for literature published since 2010 on WFH-E assessment. Based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews guidelines, assessment methods were summarized using 18 items categorized into 9 domains. Additionally, associations between the WFH-E and health- and work-related outcomes were reviewed.

Results: Of 1669 articles collected, 37 studies published from 2020 were ultimately included in this review. Thirty-four articles involved subjective assessments, and 9 involved objective assessments. The most frequently assessed item was artificial lighting, followed by thermal conditions and noise. Items such as color, greenery, building materials, and odor were rarely assessed. Most studies showed significant associations between the WFH-E and health- and work-related outcomes.

Conclusions: Studies on the WFH-E increased following the COVID-19 pandemic, showing significant associations between the WFH-E and health- and work-related outcomes. However, most assessments were subjective, with objective assessments remaining rare. Additionally, the assessment items were limited and biased, indicating that interior design elements were insufficiently assessed. Developing additional objective and comprehensive methods for assessing the WFH-E is needed.

Objectives: To determine the prevalence and correlates of COVID-19 vaccine hesitancy among Canadian health care workers (HCWs) and identify motivators for COVID-19 vaccination, compared with the general population (GPop).

Methods: As part of the iCARE study, 4 cross-sectional age-, sex-, and province-weighted population-based samples of 12 009 Canadians aged 18+ years were recruited between May 2021 and February 2022. Participants self-reported HCW and vaccine status.

Results: A total of 738 participants identified as HCWs, with 8.5% being vaccine hesitant, versus 12.6% of the GPop (P = .005). In multivariate analyses, those with a chronic disease were less likely (HCW odds ratio [OR] = 0.34; GPop OR = 0.77) and parents with children <18 years of age in the household were more likely (HCW OR = 2.29; GPop OR = 1.39) to be vaccine hesitant. Needing only a single-dose vaccine (86%; 82.6%), and vaccine safety (46%; 42%) and effectiveness (38%; 37%) were most likely to motivate hesitant HCWs and GPop to get vaccinated.

Conclusions: Our findings highlight less vaccine hesitancy in HCWs compared with the GPop, despite demographic and motivator correlates being similar. In terms of policy implications, shared interventions emphasizing vaccine safety, reduced illness severity, shorter disease duration, and the advantages of single-dose options may benefit all groups.

Objectives: Special health examinations in Japan lack standardized judgment guidelines, potentially leading to wide variation in outcomes. This study quantified inter-institutional differences in abnormal-finding rates for examinations targeting specified chemical substances and organic solvents, and examined whether institutional judgment criteria are associated with these rates.

Methods: We conducted a cross-sectional questionnaire survey of 115 facilities affiliated with the National Federation of Industrial Health Organizations (Zen-Eiren). Facilities reported abnormal-finding rates for fiscal years 2022-2024. Physicians’ judgment criteria were assessed using case vignettes addressing the use of exposure information and biological monitoring. Associations between rates and judgment criteria were evaluated using nonparametric tests (Spearman rank correlation; Wilcoxon rank-sum).

Results: Valid responses were obtained from 45 facilities (39.1%). Abnormal-finding rates for specified chemical substances and organic solvent examinations were strongly correlated within facilities. For organic solvent examinations, facilities that did not emphasize the exposure-finding association reported higher abnormal-finding rates than those that did. A similar, but nonsignificant trend was observed for specified chemical substance examinations (P = .066). Abnormal finding rates tended to rise when biological monitoring alone triggered abnormalities and nonoccupational factors were not excluded in both examinations.

Conclusions: Major special health examinations in Japan show substantial inter-institutional variation in abnormal-finding rates, partly explained by differences in judgment criteria-particularly the weight placed on linking clinical findings to workplace exposure. Establishing standardized national guidelines is essential to improve consistency, reliability, and system effectiveness.

Objectives: To develop and validate a predictive model for mental health-related sick leave using data from Japan’s Stress Check program linked with personnel records (demographics and sick-leave history), and to evaluate its predictive performance compared with the conventional high-stress classification.

Methods: We conducted a retrospective cohort study of employees (2020-2024) in a 14-company corporate group spanning diverse occupations. A mixed-effects logistic regression model was developed using data from 2020-2023, with company and year as random intercepts. Variable robustness was confirmed through least absolute shrinkage and selection operator (LASSO) logistic regression. Model calibration and discrimination were evaluated using the Brier score and area under the curve (AUC), respectively. The model was temporally validated on 2024 data.

Results: Among 87 138 person-years in the development phase, 695 employees took mental health-related sick leave (0.8%). Seven predictors-younger age, anxiety, depression, sleep disturbance, low job control, poor job suitability, and low coworker support-were significantly associated with sick leave. The recalibrated model showed good discrimination (AUC = 0.708) and calibration (Brier score = 0.0079) in development, and higher performance in validation (AUC = 0.819; Brier score = 0.0026). The conventional high-stress classification performed poorly.

Conclusions: The proposed model demonstrated robust predictive validity and outperformed the conventional high-stress classification. By providing quantitative and continuous risk stratification within the Stress Check framework, it offers a practical approach to support risk-based prioritization and decision-making in occupational health practice.

Objectives: Firefighters face a disproportionately high risk of developing cancer due to occupational exposure to carcinogens, including combustion byproducts, diesel exhaust, and per- and polyfluoroalkyl substances (PFAS) found in firefighting foams and protective gear. This study aimed to systematically review existing literature on cancer risks among firefighters, with particular attention to exposures, prevention strategies, and decontamination practices, and to propose a novel model addressing current gaps.

Methods: A systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Peer-reviewed articles, international reports, and high-quality training materials were included. A total of 37 records were included in the final review. Data were synthesized across thematic areas relevant to firefighter cancer risk.

Results: Five key themes were identified: (1) cancer incidence and mortality, (2) occupational exposure sources, (3) basic prevention practices, (4) gear hygiene, and (5) station decontamination models. The review also identified a critical gap in current decontamination protocols for volunteer firefighters in rural areas, who often respond to emergencies using personal vehicles. To address this, we proposed a novel, volunteer-specific decontamination framework, the Schutte Model, adapting existing best practices to minimize carcinogen transfer during gear transport.

Conclusions: This study provides both an evidence-based synthesis and a novel intervention model. Findings underscore the urgent need for inclusive, low-cost, and culturally tailored prevention strategies to reduce cancer risks among all firefighters, particularly volunteers operating in under-resourced and decentralized contexts.