# Occupational physicians’ practices in supporting employees with long COVID: a mixed-methods study

## TL;DR

This study explores how occupational physicians in Japan support employees with long COVID, identifying common practices and areas needing improvement.

## Contribution

The study provides the first empirical classification of occupational physicians' support practices for long-COVID employees in Japan using a mixed-methods design.

## Key findings

- Occupational physicians frequently provided active listening, return-to-work assistance, and lifestyle guidance.
- Telework and workload reduction were commonly advised to employers, while demotion and reassignment were rarely suggested.
- Few physicians reported measures like explaining workers' compensation or connecting with outpatient clinics.

## Abstract

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.

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.

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.

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.

Key Points

What is already known on this topic:
 Occupational health (OH) professionals are recognized as playing a crucial role in supporting workers with long COVID. However, few studies have detailed the specific nature and frequency of such support. No previous empirical research has clarified how occupational physicians (OPs) in Japan are responding to this issue in practice.

Occupational health (OH) professionals are recognized as playing a crucial role in supporting workers with long COVID. However, few studies have detailed the specific nature and frequency of such support. No previous empirical research has clarified how occupational physicians (OPs) in Japan are responding to this issue in practice.

What this study adds:
 This study provides the first empirical classification and frequency analysis of OPs’ support for workers with long COVID in Japan, using a robust mixed-methods design. It identifies both widely adopted practices, such as telework, workload reduction, and flexible work arrangements, as well as less frequent practices, such as collaboration with treating physicians and, in some cases, support related to workers’ compensation. By integrating qualitative and quantitative data, the study offers a comprehensive picture of current OH practice.

This study provides the first empirical classification and frequency analysis of OPs’ support for workers with long COVID in Japan, using a robust mixed-methods design. It identifies both widely adopted practices, such as telework, workload reduction, and flexible work arrangements, as well as less frequent practices, such as collaboration with treating physicians and, in some cases, support related to workers’ compensation. By integrating qualitative and quantitative data, the study offers a comprehensive picture of current OH practice.

How this study might affect research, practice, or policy:
 These findings provide an evidence base to inform the development of practical guidelines, structured assessment tools, and shareable case examples to support OPs’ work. They may contribute to strengthening OH responses to long COVID globally and improve preparedness for future public health crises involving emerging infectious diseases.

These findings provide an evidence base to inform the development of practical guidelines, structured assessment tools, and shareable case examples to support OPs’ work. They may contribute to strengthening OH responses to long COVID globally and improve preparedness for future public health crises involving emerging infectious diseases.