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

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.