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Objectives: To investigate the impact of early intensive in-hospital rehabilitation, initiated within 2 days of surgery and lasting up to 7 days, on the recovery of activities of daily living in patients with and without dementia., Study Design and Setting: Medical claims data from 925 hospitals in Japan were analyzed. We enrolled patients aged ≥50 years who underwent hip fracture surgery within 2 days of admission between April 1, 2018, and December 31, 2019. Low- (20 minutes per day starting on day 2), highest- (60 minutes per day starting on day 1), and gradually increasing (20 minutes on day 1, 40 minutes on days 2-4, and 60 minutes per day thereafter) intensity regimens were used as exposures. The outcomes were Barthel Index (BI) scores at 14 and 30 days postoperatively. For per-protocol analysis, a target trial emulation framework with the sequential doubly robust estimator was used., Results: Among patients without dementia (N = 11,461), no significant differences in BI scores were observed at 14 days postoperatively across regimens. At 30 days postoperatively, significant differences in BI scores were noted between highest- and low-intensity regimens and between gradually increasing intensity and low-intensity regimens, with additive BI scores of 15.2 (95% CI, 10.7-19.7) and 14.7 (95% CI, 9.2-20.2), respectively. In patients with dementia (N = 14,302), significant differences in BI scores were noted at 14 days postoperatively between highest- and low-intensity regimens and between gradually increasing intensity and low-intensity regimens, with additive BI scores of 8.7 (95% CI, 5.2-12.2) and 10.7 (95% CI, 5.8-15.6), respectively. At 30 days postoperatively, a significant difference in BI scores was observed between gradually increasing intensity and low-intensity regimens, with an additive BI score of 17.9 (95% CI, 11.3-24.5)., Conclusion: Early intensive in-hospital rehabilitation is highly relevant and beneficial for dementia patients., Competing Interests: Declaration of competing interest There are no competing interests for any author., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Background and Objectives : Limited research has focused on the relationship between cancer, job loss, and factors associated with job loss among older workers. Therefore, in this study, we aimed to examine the relationship between cancer and intention to leave and between physical-health-related issues, mental-health-related issues, and cancer-related symptoms and intention to leave among older workers with cancer. Materials and Methods : This cross-sectional internet-based study included 4498 workers aged 60-75 years. Intention to leave was assessed based on whether individuals considered quitting their current jobs in the near future. Results : A multivariate logistic regression analysis showed a significant association between cancer and intention to leave (adjusted odds ratio [aOR]: 1.42, 95% confidence interval [CI]: 1.01-2.00, p = 0.045). In addition, physical-health-related issues (aOR: 2.33, 95% CI: 1.10-4.92, p = 0.026) and mental-health-related issues (aOR: 4.44, 95% CI: 1.80-10.98, p = 0.001) were significantly associated with the intention to leave. Conclusions: Healthcare providers and employers must address the physical- and mental-health-related issues facing older workers with cancer to help them secure their employment.

Background and Objective: The benefits of physical rehabilitation for very-low-birth-weight infants (VLBWI) have been reported in previous studies; however, the implementation rate of physical rehabilitation in this population remains to be clarified. This study aimed to examine the implementation rate of physical rehabilitation among VLBWI admitted to the neonatal intensive care unit (NICU) using real-world data. Material and Methods: This observational study obtained data from a nationwide administrative database associated with the diagnostic procedure combination (DPC) system in Japan (2014-2019). The participants were 30,464 infants admitted to the NICU between 2014 and 2019. The overall NICU physical rehabilitation rates and background factors of the participants were examined. Results: The overall physical rehabilitation rate in NICUs was 18%. Infants born at <28 weeks of age and extremely low birth weight infants (ELBWI) were more likely to receive physical rehabilitation interventions. The length of stay at the NICU and hospital, as well as the rate of discharge, were higher in patients who received physical rehabilitation than those in infants who did not. Conclusions: One-fifth of all patients admitted to the NICU received physical rehabilitation interventions. Extremely preterm infants and ELBWI were more likely to receive physical rehabilitation interventions. We need to consider ways to increase physical rehabilitation intervention rates in the NICU.

Purpose: This study examines workplace support and resilience's influence on psychological distress in Japanese employees., Method: A 1-year prospective online cohort study was conducted. Logistic regression analyzed prevalence odds ratios and 95% confidence intervals for psychological distress. Participants were grouped based on their support and resilience levels., Results: Prevalence odds ratios for psychological distress followed this pattern for low and high resilience groups: "necessary but not received" (prevalence odds ratio and 95% confidence interval for low/high resilience: 9.71, 6.88-13.69 and 4.72, 2.97-7.52, respectively), "received" (6.65, 4.29-10.29 and 2.27, 1.21-4.25), and "not necessary" (4.43, 3.30-5.95 and reference). Workplace support had a stronger impact on psychological distress in low-resilience employees., Conclusions: We provided evidence that the combination of the need for support from the workplace and resilience affects psychological distress in employees., Competing Interests: Eguchi, Inoue, Mafune, Tsuji, Tateishi, Ikegami, Nagata, Matsugaki, and Fujino, for the CORoNaWork project have no relationships/conditions/circumstances that present potential conflict of interest., (Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American College of Occupational and Environmental Medicine.)

Objectives: Occupational falls are a significant concern among older workers. Although recent cross-sectional studies have indicated a potential association between frailty and occupational falls among older workers, the causal relationship remains unclear. This longitudinal study aimed to investigate whether frailty is a risk factor for occupational falls among older workers using a longitudinal design., Methods: This was an internet-based prospective cohort study. A total of 5000 older workers (aged 60-75 years) were recruited, with 2873 participants meeting the inclusion criteria for the follow-up survey. Frailty was assessed using a frailty screening index based on the Fried phenotype model. Occupational falls were defined as those that occurred during the follow-up period., Results: Among the participants, 13.9% were frail. The incidence of occupational falls was higher in the frailty group (11.6%) than in the nonfrailty group (4.9%). In the multivariate-adjusted model, frailty was significantly associated with occupational falls (relative risk: 2.10; 95% CI, 1.51-2.94)., Conclusions: Frailty is a significant risk factor for occupational falls among older workers. Employers should consider implementing health-management strategies that focus on frailty to prevent occupational falls in this population., (© The Author(s) 2024. Published by Oxford University Press on behalf of Journal of Occupational Health.)

Objective: Psychological distress is commonly reported sequela in COVID-19-infected people. We investigated the association between experiencing COVID-19 infection and psychological distress in Japan., Method: A total of 14,901 persons who participated in a follow-up survey in December 2022 were included in the analysis. Odds ratios and regression coefficients were estimated by statistical analysis, with history of COVID-19 infection as the independent variable and presence of psychological distress as the dependent variable., Result: Experiencing COVID-19 infection was associated with psychological distress. In a model adjusted for "feeling treated unfairly," the association between infection experience and a high K6 score was significantly attenuated., Conclusions: The results showed that the experience of COVID-19 infection is associated with psychological distress. Moreover, most cases of psychological distress among those who experienced COVID-19 infection can be at least partly explained by a perception of unfair treatment., Competing Interests: Conflict of interest: None declared., (Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American College of Occupational and Environmental Medicine.)

In this study, the relationship between the duration of physical rehabilitation and occurrence of pneumonia after ischemic stroke was examined. We included 426,508 patients aged ≥75 years with acute ischemic stroke. A multilevel logistic regression analysis nested at the hospital level was conducted to examine the association between the duration of physical rehabilitation and occurrence of pneumonia. The duration of physical rehabilitation refers to the hours of physical rehabilitation performed daily until the 7th day of hospitalization. In the multivariable analysis, the intensity of rehabilitation for durations of 20-39 min/day (adjusted odds ratio [aOR]: 0.78, 95% Confidence Interval [CI]: 0.75-0.81, p < 0.001), 40-59 min/day (aOR: 0.68, 95% CI: 0.66-0.71, p < 0.001), 60-79 min/day (aOR:0.56, 95% CI: 0.53-0.58, p < 0.001), and ≥80 min/day (aOR: 0.46, 95% CI: 0.44-0.48, p < 0.001) were significantly associated with a reduced incidence of pneumonia. In addition, the trend identified for duration of rehabilitation was significant ( p < 0.001). The results of this study suggest the usefulness of high-duration physical rehabilitation for preventing pneumonia in older patients with ischemic stroke.

Objectives: In this study, we aimed to examine the association between atrial fibrillation and mortality after ischemic stroke and evaluate the use of anticoagulation therapy for atrial fibrillation before stroke onset in patients who experienced stroke., Methods: In this retrospective observational study, we used a combined database of medical and long-term care insurance claims data from one prefecture in Japan. The data of 25,352 patients aged ≥ 65 years who were hospitalized in acute care hospitals with a diagnosis of ischemic stroke between April 2012 and March 2015 were extracted. Cox proportional hazard modeling, with adjustment for age, sex, comorbidities, and long-term care dependency level (based on the activities of daily living), was performed to evaluate the relationship between mortality and atrial fibrillation., Results: The prevalence of atrial fibrillation was 21.8% in the study population. A significant association was noted between mortality and atrial fibrillation (adjusted hazard ratio: 1.28, 95% confidence interval: 1.16-1.41, p < 0.001). Anticoagulant drugs were used in 32.2% of the patients with atrial fibrillation., Conclusions: These results indicate that atrial fibrillation is associated with mortality after stroke; however, the use of anticoagulation therapy for atrial fibrillation is unsatisfactory. Efforts to improve the use of atrial fibrillation therapy are required in Japan., Competing Interests: Declaration of Competing Interest None., (Copyright © 2023 Elsevier B.V. All rights reserved.)

Objective: The purpose of this study was to identify the COVID-19 infection prevention measures that are at risk of being perceived by employees as mistreatment in the workplace., Methods: This study included full-time workers who enrolled as subjects in a nationwide prospective cohort study. Baseline surveys performed during the pandemic were used to identify the workplace measures against COVID-19. A tracing survey was conducted 1 year later to assess workplace mistreatment., Results: Of the 18,170 participants, 276 judged that they had experienced mistreatment by the measures. "Enforcing daily temperature measurement" and "stopping business trips" were associated with mistreatment. Meanwhile, "requesting that employees refrain from going to work when ill" and "restricting work-related social gatherings and entertainment" had the potential to reduce workplace mistreatment., Conclusions: Certain measures against COVID-19 can reduce or increase the burden on employees., Competing Interests: Conflict of interest: None declared., (Copyright © 2023 American College of Occupational and Environmental Medicine.)

Objective: This study investigated whether workers who practiced unhealthy lifestyles but worked under organizations with insufficient control against coronavirus disease 2019 (COVID-19) would pose a synergistic risk of poor self-rated health (SRH)., Methods: A total of 22,637 workers (men, 48.5%) were extracted from an online survey during the COVID-19 pandemic in Japan (December 2020). Multiple logistic regression analyses were performed to estimate adjusted odds ratio (AOR) against poor (poor, fair) SRH., Results: Accumulation of unhealthy lifestyle behaviors (AOR, 1.49 to 4.40; P < 0.05) and insufficient infection control (AOR, 1.80; P < 0.05) were independently related to poor SRH; however, when these factors were combined, SRH was additively worsened (AOR, 2.14 to 7.72; P < 0.05)., Conclusions: This study highlights that not only unhealthy lifestyle practices but also poor organizational management against infection would worsen workers' SRH during the COVID-19 pandemic., Competing Interests: Conflict of Interest: None declared., (Copyright © 2023 American College of Occupational and Environmental Medicine.)

Objectives: : This study assessed how early postoperative rehabilitation interventions affected the duration of hospital stay in patients with prostate cancer who had radical prostatectomy with robotic assistance., Methods: : From the Japanese Diagnosis Procedure Combination database, we extracted case data for patients discharged between April 2014 and March 2020. Patients were recognized by code C61 from the International Classification of Diseases, 10th Edition. We ran a multilevel linear regression analysis to investigate the impact of early rehabilitation on the duration of hospital stay., Results: : There were 2151 participants in the trial. In patients with prostate cancer who had resection utilizing robotic-assisted devices, early rehabilitation was related to a substantial decrease in duration of hospital stay (coefficient, -0.86; 95% CI, -1.64 to -0.07; P=0.032)., Conclusions: : Early postoperative rehabilitation may contribute to shorter hospital stays in patients with prostate cancer at high risk of both postoperative complications and a decline in their ability to perform activities of daily living., Competing Interests: CONFLICTS OF INTEREST: The authors declare no conflict of interest., (2023 The Japanese Association of Rehabilitation Medicine.)

Background: The present study evaluated the risk of mortality in elderly hip fracture, focusing on comorbidities and nursing care levels., Methods: The present study was an observational cohort study that used a combined database of medical and long-term care insurance (LTCI) claims data from one prefecture in Japan between 2011 and 2016. In total, 6125 patients aged 65 years and older were selected from acute care hospitals with a diagnosis of "hip fracture" between March 2011 and March 2012. The impact of long-term care insurance claim evaluation levels and comorbidities at recruitment time was investigated using this dataset. These patients were followed up monthly until March 2016. Based on this person-month dataset, survival analysis was performed with death as the endpoint. Cases in which receipt data were missing during the middle of the observation period and cases in which the patient survived at the end of the observation period were censored., Results: The number of deaths during the observation period was 635 (10.4%). The impact of comorbidities and nursing care level on mortality were both significant as follows: high nursing care level before the fracture (hazard ratio: 1.09, P < 0.001), comorbidities of malignant diseases (HR: 1.45, P < 0.001), heart disease (hazard ratio: 1.20, P = 0.037), pneumonia (hazard ratio: 1.27, P < 0.001), chronic obstructive pulmonary disease (hazard ratio: 1.28, P = 0.026), renal failure (hazard ratio: 1.44, P < 0.001), and dementia (hazard ratio: 1.27, P = 0.013)., Conclusion: The results of this study showed that a high level of nursing care and presence of comorbidities such as malignant diseases, heart diseases, pneumonia, chronic obstructive pulmonary disease, renal failure, and dementia increased mortality in elderly patients with hip fracture. Furthermore, this study showed the usefulness of a combined database of medical and LTCI claims data for clinical and health service-related research in the field of orthopedics., Competing Interests: Declaration of competing interest The authors have no conflicts of interest to declare., (Copyright © 2022 The Japanese Orthopaedic Association. Published by Elsevier B.V. All rights reserved.)

Aim: This study aimed to determine the impact of dementia on the implementation of intravenous thrombolysis and early rehabilitation as acute care for patients with acute ischemic stroke in Japan., Methods: This retrospective observational study used the Japanese Diagnosis Procedure Combination database. Patients aged ≥75 years with acute ischemic stroke (ICD-10 code: I63) were enrolled (n = 464 710). In this study, dementia was identified using the ICD-10 codes (F00, F01, F02, F03, G30, and G31) for comorbidity. A mixed-effects logistic regression analysis nested at the hospital level was conducted to examine the impact of dementia on the implementation of intravenous thrombolysis and early rehabilitation., Results: Overall, 57 905 patients with ischemic stroke had dementia. The group with dementia was less likely to receive intravenous thrombolysis (5.2% vs. 6.9%) and more likely to undergo early rehabilitation than the group without dementia (76.1% vs. 73.0%). In the mixed-effects logistic regression analysis, dementia was significantly associated with a lower probability of undergoing intravenous thrombolysis (adjusted odds ratio: 0.79, 95% confidence interval: 0.76-0.82, P < 0.001) and a higher probability of early rehabilitation (adjusted odds ratio: 1.06, 95% confidence interval: 1.04-1.09, P < 0.001)., Conclusions: We found that while dementia was associated with fewer opportunities for aggressive treatment, such as intravenous thrombolysis, it was also associated with increased opportunities to receive rehabilitation. It is necessary to examine the reasons why patients with dementia do not receive aggressive treatment and to establish a system that allows older adults with and without dementia to receive equal access to medical care. Geriatr Gerontol Int 2023; 23: 270-274., (© 2023 Japan Geriatrics Society.)

Objectives: The physical work environment while working from home (WFH) is a key component of WFH, which, if inadequate, can impair workers' health and work functioning. We investigated environmental factors in WFH and worsening of work functioning., Methods: A 1-year prospective cohort study was conducted involving 2530 Japanese workers who worked from home. Environment while WFH was assessed using binary subjective assessments based on existing guidelines. Existence of impaired work function was assessed using the Work Functioning Impairment Scale. We performed multilevel logistic regression analysis nested in the prefecture of residence., Results: Lack of room/space for concentration, lack of enough light and foot space, inadequate temperature and humidity, and use of a sitting table were associated with work functioning impairment., Conclusions: An inappropriate environment while WFH can have a negative impact on workers' health., Competing Interests: Conflict of interest: Dr Fujino has the copyright to WFun with royalties paid from Sompo Health Support Inc, outside of this work. The other authors declare no conflicts of interest associated with this manuscript. Okawara, Ishimaru, Igarashi, Matsugaki, Mafune, Nagata, Tsuji, Ogami, and Fujino, for the CORoNaWork project have no relationships/conditions/circumstances that present potential conflict of interest., (Copyright © 2022 American College of Occupational and Environmental Medicine.)

Objectives: The coronavirus disease 2019 (COVID-19) pandemic has significantly impacted working life quality. This study investigated whether changes in work/sleep patterns due to the pandemic are related to poor psychological status among Japanese workers during the third wave of the COVID-19 pandemic (December 2020). We hypothesized that workers who experienced drastic changes in working hours and sleep duration would be at an increased risk of psychological distress., Methods: A cross-sectional self-administered Internet survey was conducted that included questions regarding socio-demographics, lifestyle, health, and occupational background and conditions. Multivariable logistic regression models were utilized to examine the association between psychological distress and a combination of changes in working hours and sleep duration., Results: Among 25,762 workers, decreased work hours and decreased sleep duration presented 2.59 times higher odds of psychological distress (95% confidence interval [CI] = 2.05-3.28) compared to those who had no changes in work hours combined with unchanged sleep duration (reference group). Increased work hours and decreased sleep duration were associated with 1.98 times higher odds of psychological distress (95% CI = 1.64-2.39)., Conclusion: Our observations confirmed that decreased sleep duration could be a key factor for psychological distress, irrespective of working hours. Interestingly, workers with a combination of decreased work hours and sleep duration posed the highest risk of psychological distress. Decreased work hours accompanied by financial difficulties in the early stage of the pandemic may have caused decreased sleep duration, resulting in a high prevalence of psychological distress. Our study underlined the importance of sleep management in maintaining workers' mental health, moreover, the need to consider situations and conditions of other daily tasks, such as work hours, for better sleep management., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Tondokoro, Nakata, Tateishi, Mafune, Tsuji, Ando, Odagami, Matsugaki and Fujino.)

Objective: The aim of this study was to investigate the association between telecommuting environments and shoulder pain in Japanese telecommuters., Methods: We conducted an Internet-monitored, cross-sectional study and analyzed 2537 participants who mainly telecommuted at least 4 days per week. We assessed the presence of shoulder pain using a numerical rating scale and the characteristics of the telecommuting environment by asking eight questions. We used multilevel logistic regression analysis with the city of residence as a random effect., Results: Inadequate desk brightness (odds ratio [OR], 1.39; 95% confidence interval [CI], 1.09-1.78), inadequate foot space (OR, 1.27; 95% CI, 1.02-1.58), and uncomfortable temperature and humidity (OR, 1.41; 95% CI, 1.16-1.72) were associated with shoulder pain in multilevel logistic regression analysis., Conclusions: Inappropriate telecommuting environments were associated with an increase in the prevalence of shoulder pain in Japanese telecommuters., Competing Interests: The authors report no conflicts of interest., (Copyright © 2022 American College of Occupational and Environmental Medicine.)

Objective: This study aimed to evaluate the association between the type of chronic disease and receiving workplace accommodations., Methods: This online cross-sectional study analyzed a self-reported questionnaire administered in Japan. A total of 6775 full-time workers who reported needing work accommodations were included., Results: Workplace accommodations were more likely to be provided for workers with cancer, mental illness, and benign gynecological disorders than for workers with no disease under treatment. In contrast, workplace accommodations were less likely for workers with low back pain and skin diseases., Conclusions: Receiving workplace accommodations depends on the type of chronic disease. Chronic diseases for which workers frequently receive workplace accommodations may be those for which support is encouraged by law. It is necessary to support workers with chronic diseases that do not receive adequate workplace accommodations., Competing Interests: Ishimaru, Harada, Tateishi, Nagata, Eguchi, Tsuji, Ikegami, Matsugaki, and Fujino, for the CORoNaWork Project have no relationships/conditions/circumstances that present potential conflict of interest., (Copyright © 2023 American College of Occupational and Environmental Medicine.)

Telemedicine has significant potential for helping workers access medical treatment. To improve workers' access to telemedicine, it is important to analyze current utilization rates and influencing factors. Therefore, the purpose of this study is to evaluate the associations between occupational factors and telemedicine use. A 1-year follow-up study of 4,882 full-time workers receiving regular treatment in Japan was conducted from December 2020 to December 2021. Occupational factors associated with the use of telemedicine were evaluated by multivariate logistic regression analysis. In total, 191 participants had experience of using telemedicine (3.9%). The most common comorbidity was hypertension (37.0%), followed by back pain and arthritis (19.8%) and depression and psychiatric disorders (14.5%). Managers and executives [adjusted odds ratio (aOR) = 1.92, 95% confidence interval (CI): 1.68-3.43, P < = 0.026], finance industry workers (aOR = 2.61, 95% CI: 1.24-5.49, P = 0.011), and individuals with experience of teleworking (aOR = 2.08, 95% CI: 1.52-2.85, P < 0.001) were more likely to use telemedicine. Telemedicine usage was least common among workers aged 50-59 years (aOR = 0.35, 95% CI: 0.22-0.57, P < 0.001) and those with long working hours (≥ 9.0 hours/day) (aOR = 0.59, 95% CI: 0.38-0.93, P < 0.022). The utilization rate of telemedicine in Japan is still low. This study identified occupational factors related to the use of telemedicine, such as worker's age, employee status, working hours, and experience of teleworking. Our findings suggest that flexible work arrangements could promote widespread use of telemedicine.

This study aimed to evaluate the effect of preoperative rehabilitation on postoperative hospital stay in elderly lung cancer patients following lung resection. This was a retrospective observational study using the Japanese Diagnosis Procedure Combination database. Data of patients diagnosed between April 2016 and March 2020 were collected. Patients were identified using the International Statistical Classification of Disease and Related Health Problems Version 10-10 codes, C34.0-C34.3 and C34.8. Multilevel linear regression analysis was performed to evaluate the effect of preoperative rehabilitation on the length of hospital stay. A total of 9,393 patients were included in the study. Univariate analysis showed that preoperative rehabilitation was significantly associated with postoperative length of hospital stay (coefficient: -1.61; 95% confidence interval: -2.42, -0.81; P <0.001). In addition, multivariate analysis showed preoperative rehabilitation to be associated with a significant decrease in postoperative length of hospital stay (coefficient=-1.38; 95% confidence interval: -2.19, -0.58; P =0.001). Preoperative rehabilitation may shorten length of hospital stay in elderly patients with lung cancer.

Objective: A substantial number of workers' experience mistreatment in the workplace, impacting workers' health and companies' functioning. Vulnerability of those with lower income has been reported, yet little is known about mistreatment during COVID-19. This study aims to examine whether workers in financial distress are particularly prone to mistreatment at the workplace with reference to pandemic-related infection prevention measures., Methods: An internet-based, year-long prospective cohort study was conducted from 2020 to 2021. Participants were recruited from workers aged 20 and 65 years and currently employed at baseline. In total, 27 036 were included in the analysis and 18 170 responded to the follow-up survey. The odds ratio (OR) of mistreatment at the workplace regarding COVID-19 associated with the financial condition at baseline was estimated using multilevel logistic regression analysis nested by participant residence., Results: Compared with workers in a comfortable financial condition, those under financial stress showed significantly higher ORs of mistreatment (age- and sex-adjusted model: 2.08, 95% confidence interval [CI] 1.75-2.47, P < .001, model adjusted for socioeconomic factors: 2.14, 95% CI 1.79-2.55, P < .001)., Conclusion: Workers in financial distress were shown to be vulnerable to mistreatment at work regarding infection prevention measures in the COVID-19 pandemic, underscoring a double burden of poverty and mistreatment. The perspective of vulnerable groups needs to be taken into account when implementing countermeasures against emerging infectious diseases, such as COVID-19. As unfair treatment in the workplace might distort vulnerable employees' reactions to infection control (e.g., hiding infection), financial deprivation should be considered a public health issue., (© 2023 The Authors. Journal of Occupational Health published by John Wiley & Sons Australia, Ltd on behalf of The Japan Society for Occupational Health.)

Objective: This study aimed to determine whether telecommuting's impact on psychological distress differed depending on the status of workers' cohabiting family members during the COVID-19 pandemic., Methods: We collected data from 33 302 workers in Japan through an Internet survey, and included 27 036 valid responses in the analysis. The survey included items on family cohabitation and telecommuting status during the COVID-19 pandemic. We assessed workers' psychological distress using the Kessler 6., Results: The psychological distress odds ratios (ORs) were higher for participants who lived with family members requiring care (OR = 1.38, P < .001), and lower for participants living with preschool children (OR = 0.77, P < .001) or a spouse (OR = 0.80, P < .001). Furthermore, odds ratios were higher for participants who worked from home and lived with family members requiring care or preschool children (OR = 1.52, P = .002; OR = 1.28, P = .028). Stratified by the presence or absence of family members living with them, psychological distress was higher for telecommuters with family members requiring care, preschool children, or elementary school children., Conclusion: The association between telecommuting and psychological distress varies, depending on workers' living situation with family members., (© 2023 The Authors. Journal of Occupational Health published by John Wiley & Sons Australia, Ltd on behalf of The Japan Society for Occupational Health.)

Objectives: Occupational falls are a major problem for older workers, especially those in the tertiary industry. Recently, it has been suggested that frailty is associated with occupational falls, but it is unclear whether this holds true for older workers in the tertiary industry. This study examined the relationship between frailty and occupational falls among older workers in the tertiary industry., Methods: This was an Internet-based cross-sectional study. We recruited 5000 older workers (age, 60-75 years) employed in the tertiary industry who were registered with an Internet research company. Frailty was assessed using the Frailty Screening Index's five items, and participants were classified into robust, pre-frailty, or frailty groups. Occupational falls were defined as falls experienced in the past 12 months while at work. The relationship between frailty and occupational falls was analyzed by logistic regression analysis., Results: It was found that 6.1% of participants had experienced at least one occupational fall in the past 12 months. On the multivariate analysis, the adjusted odds ratio (aOR) for falls was higher with pre-frailty (aOR: 1.95, 95% confidence interval: 1.30-2.94, P = .001) and frailty (aOR: 4.26, 95% confidence interval: 2.74-6.65, P < .001) compared with robust. Similar results were obtained when the outcome was occupational falls with injury., Conclusion: Our findings suggest that frailty is associated with occupational falls among older workers in tertiary industries. We recommend that employers introduce frailty screening, and consider countermeasures based on the screening results to prevent occupational falls among older workers., (© 2023 The Authors. Journal of Occupational Health published by John Wiley & Sons Australia, Ltd on behalf of The Japan Society for Occupational Health.)

The relationship between the Hospital Frailty Risk Score (HFRS)-based frailty risk and outcomes after coronary artery bypass grafting (CABG) is yet unclear. The objective of this study was to investigate the relationship between preoperative frailty risk as assessed by the HFRS and postoperative outcomes in patients undergoing CABG. This observational study used the diagnosis procedure combination (DPC) system in Japan (2014-2017). In total, 35,015 adults aged ≥ 65 years and diagnosed with angina pectoris and acute myocardial infarction who had undergone CABG were enrolled. We investigated the association between the HFRS-based frailty risk and the home discharge rate, as well as the prevalence of complications. Multilevel logistic regression analysis revealed that having an HFRS ≥ 5 was a determinant of lower home discharge rate (odds ratio [OR] 0.60, 95% confidence interval [CI] 0.49-0.74, P <0.01), aspiration pneumonia (OR 2.25, 95%CI 1.27-3.96, P <0.01) and disuse syndrome (OR 1.90, 95%CI 1.23-2.94, P <0.01). Preoperative stratification of frailty risk using HFRS may help in predicting postoperative progress and in planning postoperative rehabilitation.

Although the correlation between perceived organizational support (POS) and work engagement has been investigated in several studies, the relationship between health-focused POS and work engagement has not been clarified. We prospectively evaluated the influence of workers’ POS for infection prevention (POS-IP) on employees’ work engagement. This prospective cohort study was conducted from December 2020 (baseline) to December 2021 (1-year follow-up) using a self-administered internet questionnaire. At follow-up, there were 18,560 respondents, and after excluding 6677 respondents who had changed jobs or retired since baseline or who were self-employed; thus, 11,883 participants were included in the analysis. We asked participants a single question on POS-IP and the three-item Utrecht Work Engagement Scale (UWES-3), and then analyzed the relationship between POS-IP at baseline and UWES-3 at follow-up using multilevel regression analysis. Work engagement at follow-up was significantly higher in the groups with “low”, “high”, and “very high” POS-IP at baseline as compared with the “very low” group (all, p < 0.001). A dose-response relationship was also observed between the POS-IP categories at baseline and work engagement at follow-up (p for trend < 0.001). During the COVID-19 pandemic, POS-IP can increase work engagement after 1 year.

Objective: We investigated whether workplace infection control measures during the COVID-19 pandemic could increase perceived organizational support (POS)., Methods: This prospective cohort study was conducted in Japan from December 2020 to December 2021 using a questionnaire survey. There were 18,560 respondents at follow-up; we investigated 4971 who rated low POS at baseline. The participants were asked a single question about POS and nine about workplace infection control measures. We determined the odds ratios (ORs) of high POS at follow-up using multilevel logistic regression analysis., Results: The groups of 5 to 6 (OR = 1.29, 95% confidence interval = 1.05-1.57, P = 0.014) and 7 to 9 workplace infection control measures (OR = 1.54, 95% confidence interval, 1.28-1.85, P < 0.001) had significantly higher ORs than the group with 0 to 2 measures., Conclusions: Health support for employees through workplace infection control measures can increase POS., Competing Interests: Conflict of interest: None declared., (Copyright © 2022 American College of Occupational and Environmental Medicine.)

Background: The effect of cardiac rehabilitation (CR) on patients undergoing device implantation (DI) for arrhythmias has been reported; however, the implementation status of these patients has not been clarified. This study aimed to verify the implementation status of CR for patients with heart disease who have undergone DI using real-world data., Methods: This was an observational study using a nationwide administrative database associated with the diagnosis procedure combination (DPC) system in Japan (2014-2018). Subjects were patients with heart disease (70 667 cases) who underwent DI during the above scheduled hospitalization period. The overall rate of CR and the background factors of the subjects were verified., Results: The CR rate for patients with heart disease who underwent DI during hospitalization was 23%, and the CR rate for patients with comorbid heart failure who underwent DI was only 32%. It was confirmed that progressing age was associated with a higher CR implementation rate. The lower the Barthel index score at the time of admission, the higher the CR implementation rate., Conclusions: CR was performed for only one-quarter of all the patients during admission for DI and just one-third of the patients for DI with heart failure. Most of these patients were elderly and had a decreased ability to perform activities of daily living. The DPC data are subject to various limitations, and further research is necessary., Competing Interests: The authors have no conflicts of interest to disclose., (© 2022 The Authors. Journal of Arrhythmia published by John Wiley & Sons Australia, Ltd on behalf of Japanese Heart Rhythm Society.)

The purpose of this study was to conduct a self-reported questionnaire survey of work-related musculoskeletal disorders (WMSDs) among Japanese radiological technologists (RTs) and to report on the relationship between wearing a lead apron and WMSDs. Between February and April of 2021, RTs in Okayama Prefecture, Japan, were surveyed by mail and through a website. Information on individual characteristics, physical factors at work, and the presence of WMSDs were collected. All participants were also asked whether they frequently wore lead aprons. A multiple logistic regression analysis was used to assess the relationship between wearing a lead apron and WMSDs. The model was adjusted for age, sex, body mass index (BMI), and working hours. Of the 123 participants, 67 (54.5%) had WMSDs. Multiple logistic regression analysis revealed that WMSDs were significantly associated with wearing a lead apron. Compared to the "Never wear" group, the odds ratios for the "Always/Frequently wear" and "Sometimes/Rarely wear" groups were 7.87 (95% confidence interval [CI]=1.28-48.46; p=0.026) and 7.80 (95% CI=1.43-42.44; p=0.017), respectively. Our analysis suggests that wearing a lead apron is associated with WMSDs, and thus design modifications in lead aprons may improve the occupational health management of RTs., Competing Interests: No potential conflict of interest relevant to this article was reported.

Limited information is available regarding the association between workplace psychosocial factors and general mental health status among workers during the coronavirus disease 2019 pandemic. This study examined how working from home affected the association between job demands and psychological distress (PD). A cross-sectional online survey was conducted in December 2020 (N = 27,036). The dependent variable (PD) was assessed using the Kessler Psychological Distress Scale. Job demands were assessed using the Job Content Questionnaire. Working from home was determined by participants' responses to the question, "Do you currently work from home?" We used a two-level regression analysis adjusted for prefecture. Each individual-level variable at Level 1 was nested into each prefecture at Level 2, stratified by working from home or not. Overall, 21.3% of participants worked from home. The interaction between working from home and job demands was significant. Job demands were positively associated with PD. The stratified analysis indicated that the associations were weaker among employees who worked from home compared with those among employees who did not. The association between job demands and PD may be weakened by working from home.

Objective: This study examined the relationship between job accommodations for workers with poor health and work functioning impairment during the COVID-19 pandemic., Methods: An internet survey was conducted in December 2020. We included 24,429 subjects for analysis. One question was used to determine whether subjects needed job accommodations from their company to continue working in their current health condition. The odds ratios (ORs) of the necessity of job accommodations for sick workers associated with work functioning impairment were estimated using multilevel logistic regression analysis., Results: The OR of work functioning impairment among sick workers not receiving job accommodations was 5.75 (95% confidence interval (CI): 5.34 to 6.20, P  < 0.001) and those receiving job accommodations was 1.88 (95% CI: 1.69 to 2.08, P  < 0.001) compared to healthy workers., Conclusions: This study suggests that providing job accommodations to workers with poor health may improve their work functioning impairment., Competing Interests: The authors report no conflicts of interest., (Copyright © 2022 American College of Occupational and Environmental Medicine.)

Objectives: This study examined the relationship between frequency of working from home and low back pain (LBP), considering the quality of work environment., Methods: The study was based on a cross-sectional internet-based survey. Of 33 302 respondents, data from 12 774 desk workers were retained for analysis. We used a 0-10 numerical rating scale to assess LBP. Work environment was assessed using five subjective questions. Mixed-effects logistic regression nested by city level was used to analyze the relationship between frequency of working from home and LBP, stratified by work environment condition., Results: The prevalence of LBP was 21.0%. Among those reporting a poor work environment, as opposed to almost never working from home, the multivariate odds ratio (OR) of LBP were as follows: working from home less than 1 day per week: OR = 1.25, 95% CI: 0.89-1.76, p = .190; 2-3 days per week: OR = 1.58, 95% CI: 1.16-2.16, p = .004; and 4 or more days per week: OR = 1.82, 95% CI: 1.38-2.40, p < .001. By contrast, among those reporting a good work environment, the OR of LBP did not increase as the frequency of working from home increased., Conclusions: The relationship between LBP and frequency of working from home was found to vary with the quality of the work environment; more specifically, LBP was associated with frequency of teleworking in a poor work environment. This study suggests that employers should give more support to their employees in promoting a good work environment to prevent LBP. (Words: 240/250)., (© 2022 The Authors. Journal of Occupational Health published by John Wiley & Sons Australia, Ltd on behalf of The Japan Society for Occupational Health.)

Objectives: We evaluated the relationship between telecommuting environment and low back pain (LBP) among desk-based workers in Japan., Methods: This cross-sectional study included 3663 desk-based, telecommuting workers. LBP was assessed using a 0 to 10 numerical rating scale. The telecommuting environment was evaluated using subjective questions. Mixed-effects logistic regression analysis was used to evaluate this association., Results: The results of mixed-effects logistic model revealed that not having a place or room to concentrate on work, desk not well-lit enough for work, lack of space on the desk to work, not having enough legroom, and uncomfortable temperature and humidity conditions in the workspace were significantly associated with higher odds of LBP., Conclusions: Our findings suggest that telecommuting environment is associated with the prevalence of LBP., Competing Interests: Conflict of interest: The authors declare no conflict of interests for this article., (Copyright © 2021 American College of Occupational and Environmental Medicine.)

Objectives: Pre-transplant rehabilitation for hematological malignancy patients undergoing allogeneic hematopoietic stem cell transplantation (allo-HSCT) helps improve physical capacity. However, its benefit with respect to post-transplant hospital length of stay (LOS) is unclear. Consequently, the aim of this study was to investigate the effect of pre-transplant rehabilitation on post-transplant LOS for hematological malignancy patients undergoing allo-HSCT., Methods: Data on patients diagnosed between April 2014 and March 2017 were collected from the Japanese Diagnosis Procedure Combination database. The patients were identified using the ICD-10 codes C81-85, C90-94, C96, and D46. Multilevel linear regression analyses were conducted to identify the effects of pre-transplant rehabilitation on post-transplant LOS (log transformed)., Results: In total, 3614 patients were included in the study. Pre-transplant rehabilitation was associated with a significant reduction in post-transplant hospital LOS (β=-0.134, P<0.001)., Conclusions: Pre-transplant rehabilitation may be an effective strategy for shortening the post-transplant hospital LOS in hematological malignancy patients undergoing allo-HSCT. Consequently, it may be necessary to consider starting rehabilitation before transplantation., Competing Interests: CONFLICTS OF INTEREST: The authors declare that there are no conflicts of interest., (©2021 The Japanese Association of Rehabilitation Medicine.)

Objective: Workplace fitness programs are used to improve worker physical capacity. We aimed to evaluate the effectiveness of physical therapist (PT) led personal-fitness management programs (PP) on manufacturing worker physical performance assessed using a 30-second chair stand (CS-30) test., Methods: This assessor-blinded, randomized controlled trial enrolled 60 manufacturing workers allocated to a workplace PP group (PPG) or control group (CG). The PPG received monthly, PT managed, individualized PP for 6 months. The CG received a 90-minute group-fitness management course once during the study period., Results: CS-30 significantly improved in both groups (PPG and CG, P < 0.001) following the intervention. There were significant group-time interaction effects, and the PPG experienced a significantly greater improvement in CS-30 results compared with CG (P < 0.001)., Conclusions: Individualized PT-led workplace PP may be more effective in improving worker physical performance.

[Purpose] To verify the immediate effects of exercise therapy on cancer-related fatigue (CRF) in cancer patients. [Subjects and Methods] Eighteen cancer patients who performed exercise therapy targeting a rating of 4 (somewhat strong) on the Borg category-ratio scale (CR-10) were enrolled. CRF was evaluated using the Cancer Fatigue Scale (CFS). CFS was evaluated in clinical practice immediately before and after exercise therapy on the 1st or 2nd day of physiotherapy for CRF management. CFS scores before and after exercise were compared to determine how CRF changed due to exercise therapy. [Results] CFS physical, CFS affective, CFS cognitive, and CFS total all decreased following exercise therapy, and the changes in CFS physical and CFS total were statistically significant. The effect sizes for CFS physical and CFS total were "medium", and for CFS affective and CFS cognitive "small." [Conclusion] These findings suggest that exercise therapy targeting a rating of 4 (somewhat strong) on the CR-10 can immediately reduce CRF in cancer patients.

Objectives: This study aimed to evaluate the effectiveness of supervised exercise among nurses conducting shift work for health promotion., Methods: A total of 30 healthy female nurses conducting shift work participated in this study and they were randomly assigned to one of the following 2 groups: The supervised exercise group (SG; participants exercised under the supervision of a physical therapist (PT)) and the voluntary exercise group (VG; participants exercised without supervision). The study participants were asked to exercise twice/week for 12 weeks for 24 sessions. The primary outcome was aerobic fitness, and the secondary outcomes were muscle strength, anthropometric data, biochemical parameters, and mental health. We compared all the outcomes before and after the intervention within each group and between both groups at follow-up., Results: Aerobic fitness increased in the SG whereas it decreased in the VG, but these changes were not statistically significant (p=0.053 and 0.073, respectively). However, the between-group difference was significant in the intervention effect (p=0.010). Muscle strength, high-density lipoprotein cholesterol and metabolic profile (high-molecular weight adiponectin), and depressive symptom significantly improved in the SG over time, even though the SG exercised less as compared with the VG. Moreover, significant differences in muscle strength, and low-density lipoprotein cholesterol and reactive oxygen metabolite levels were observed between both groups, and these parameters were better in the SG than in the VG., Conclusions: Our data-suggest the effectiveness of exercise supervised by a PT at the workplace of nurses conducting shift work for health promotion.