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Background While it is essential to understand how long is sufficient for return-to-work when designing paid sick-leave systems, little attempt has been done to collect cause-specific information on when and how many of sickness absentees returned to work, became unemployed, or passed away. Methods We studied the first sick-leave episode of ≥30 consecutive days in those ≤55 years of age during 2012-2013 among 11 Japanese private companies (n = 1209), which were followed until 2017. Overall and disease-specific cumulative incidences of return-to-work, resignations, and deaths were estimated using competing risk analysis. Results During the 3.5-year period (follow-up rate: 99.9%), 1014 returned to work, 167 became unemployed, and 27 died. Overall, return-to-work occurred within 1 year in 74.9% of all absentees and in 89.3% of those who successfully returned to work. Resignation occurred within 1 year in 8.7% of all absentees and in 62.9% of all subjects who resigned. According to ICD-10 chapters, the cumulative incidence of return-to-work ranged from 82.1% for mental disorders (F00-F99) to 95.3% for circulatory diseases (I00-I99). The cumulative incidence of return-to-work due to mental disorders ranged from 66.7% in schizophrenia (F20) to 95.8% in bipolar affective disorders (F31). Death was rarely observed except for cases of neoplasms (C00-D48), of which the cumulative incidence of death reached 14.2% by 1.5 years. Conclusions Return-to-work and resignations occurred commonly within 1 year of sick leave among long-term sickness absentees in the Japanese private companies. Our findings may assist occupational physicians and employers in developing effective social protection schemes.

BACKGROUND Although previous research has focused on the association between long working hours and several mental health outcomes, little is known about the association in relation to mental health-related sickness absence, which is a measure of productive loss. We aimed to investigate the association between overtime work and the incidence of long-term sickness absence due to mental disorders. METHODS Data came from the Japan Epidemiology Collaboration on Occupational Health Study (J-ECOH). A total of 47,422 subjects were followed-up in the period between April 2012 and March 2017. Information on long-term sickness absence (LTSA) was obtained via a study-specific registry. Baseline information was obtained at an annual health checkup in 2011; overtime working hours were categorized into

Background While much effort has focused on quantifying disease burden in occupational health, no study has simultaneously assessed disease burden in terms of mortality and morbidity. We aimed to propose a new comprehensive method of quantifying the disease burden in the workplace. Methods The data were obtained from the Japan Epidemiology Collaboration on Occupational Health (J-ECOH) Study, a large-scale prospective study of approximately 80,000 workers. We defined disease burden in the workplace as the number of working years lost among the working population during a 6-year period (April 2012 to March 2018). We calculated the disease burden according to consequences of health problems (ie, mortality, sickness absence [SA], and ill-health retirement) and disease category. We also calculated the age-group- (20-39 and 40-59 years old) and sex-specific disease burden. Results The largest contributors to disease burden in the workplace were mental and behavioural disorders (47.0 person-years lost per 10,000 person-years of working years; ie, per myriad [proportion]), followed by neoplasms (10.8 per myriad) and diseases of the circulatory system (7.1 per myriad). While mental and behavioural disorders made a greater contribution to SA and ill-health retirement compared to mortality, the latter two disorders were the largest contributors to the disease burden in the workplace due to mortality. The number of working years lost was greater among younger versus older female participants, whereas the opposite trend was observed in males. Conclusions Our approach is in contrast to those in previous studies that focused exclusively on mortality or morbidity.

Background Metabolic syndrome (MetS) has been associated with various chronic diseases which may lead to long-term sickness absence (LTSA), but there is lacking information on the direct association between MetS and LTSA. The present study aimed to investigate the all-cause and cause-specific associations between MetS and the risk of medically-certified LTSA among Japanese workers. Method We recruited 67,403 workers (57,276 men and 10,127 women), aged 20-59 years, of 13 companies in Japan, during their health check-ups in 2011 (11 companies) and 2014 (2 companies), and followed them up for LTSA events (≥ 30 consecutive days) until March 31, 2020. MetS was defined according to the Joint Interim Statement. A Cox proportional hazards regression model was used to estimate hazard ratio (HR) and its 95% confidence interval (CI) for LTSA associated with MetS and its components. Results During 408,324 person-years of follow-up, 2,915 workers experienced LTSA. The adjusted HR for all-cause LTSA was 1.54 (95% CI, 1.41-1.68) among those with vs without MetS. In cause-specific analysis, HRs associated with MetS significantly increased for LTSA due to overall physical disorders (1.76), cardiovascular diseases (3.16), diseases of the musculoskeletal system and connective tissue (2.01), cancers (1.24), obesity-related cancers (1.35), mental, behavioral and neurodevelopmental disorders (1.28), reaction to severe stress and adjustment disorders (1.46) and external causes (1.46). The number of MetS components were also significantly associated with increased LTSA risk. Conclusion MetS was associated with an increase in the risk of LTSA due to various diseases among Japanese workers.

Background: Evidence linking working hours and the risk of type 2 diabetes mellitus (T2DM) is limited and inconsistent in Asian populations. No study has addressed the combined association of long working hours and sleep deprivation on T2DM risk. We investigated the association of baseline overtime work with T2DM risk and assessed whether sleep duration modified the effect among Japanese. Methods: Participants were Japanese employees (28,489 men and 4,561 women) aged 30–64 years who reported overtime hours and had no history of diabetes at baseline (mostly in 2008). They were followed up until March 2014. New-onset T2DM was identified using subsequent checkup data, including measurement of fasting/random plasma glucose, glycated hemoglobin, and self-report of medical treatment. Hazard ratios (HRs) of T2DM were estimated using Cox regression analysis. The combined association of sleep duration and working hours was examined in a subgroup of workers (n = 27,590). Results: During a mean follow-up period of 4.5 years, 1,975 adults developed T2DM. Overtime work was not materially associated with T2DM risk. In subgroup analysis, however, long working hours combined with insufficient sleep were associated with a significantly higher risk of T2DM (HR 1.42; 95% CI, 1.11–1.83), whereas long working hours with sufficient sleep were not (HR 0.99; 95% CI, 0.88–1.11) compared with the reference (

Background Long-term sick-leave is a major public health problem, but data on its incidence in Japan are scarce. We aimed to present reference data for long-term sick-leave among private sector employees in Japan. Methods The study population comprised employees of 12 companies that participated in the Japan Epidemiology Collaboration on Occupational Health Study. Details on medically certified sick-leave lasting ≥30 days were collected from each company. Age- and sex-specific incidence rate of sick-leave was calculated for the period of April 2012 to March 2014. Results A total of 1422 spells in men and 289 in women occurred during 162,989 and 30,645 person-years of observation, respectively. The three leading causes of sick-leave (percentage of total spells) were mental disorders (52%), neoplasms (12%), and injury (8%) for men; and mental disorders (35%), neoplasms (20%), and pregnancy-related disease (14%) for women. Incidence rate of sick-leave due to mental disorders was relatively high among men in their 20s–40s but tended to decrease with age among women. Incidence rate of sick-leave due to neoplasms started to increase after age 50 in men and after age 40 in women, making neoplasms the leading cause of sick-leave after age 50 for women and after age 60 for men and the second leading cause after age 40 for women and after age 50 for men. Pregnancy-related disease was the second leading cause of sick-leave among women aged 20–39 years. Conclusions These results suggest that mental disorder, neoplasms, and pregnancy-related disease are the major causes of long-term sick-leave among private sector employees in Japan., Highlights • Incidence rate of sick-leave lasting ≥30 days was studied in 12 Japanese companies. • The major causes were mental disorder, neoplasms, and pregnancy-related disease. • Mental disorder and pregnancy-related disease were common in women aged 30–39 years.

Background We prospectively examined the association of diabetes risk with the number of metabolic abnormalities, as well as their combinations, according to the presence or absence of impaired fasting glucose (IFG) in a large-scale Japanese working population. Methods Participants included 55,271 workers at 11 companies who received periodic health check-ups between 2008 and 2013. The metabolic syndrome (MetS) components were defined using the 2009 Joint Interim Statement. IFG was defined as fasting plasma glucose 5.6–6.9 mmol/L. Diabetes newly diagnosed after the baseline examination was defined according to the American Diabetes Association criteria. We calculated the hazard ratios (HRs) for diabetes incidence using the Cox proportional hazards model. Results During the follow-up period (median 4.95 years), 3183 subjects developed diabetes. In individuals with normal fasting glucose levels, the risk of diabetes increased steadily with the increasing number of MetS components; the multivariable-adjusted HRs for incident diabetes for the number of MetS components were 2.0, 4.3, 7.0, and 10.0 for one, two, three, or four MetS components, respectively, compared with the absence of components. A similar association was observed among individuals with IFG; the corresponding HRs were 17.6, 23.8, 33.9, and 40.7. The combinations that included central obesity appeared to be more strongly associated with diabetes risk than other combinations with the same number of MetS components within the same glucose status. Conclusions Our findings indicate that risk stratification of individuals by the presence or absence of IFG and the number of MetS components can detect individuals with a high risk of diabetes., Highlights • We examined diabetes risk by the number and combination of metabolic abnormalities. • Diabetes risk increased with the number of abnormalities for a given glucose status. • The combinations that included central obesity were strongly associated with diabetes.