The association of work-related stress according to the demand-control model with aggravation of pre-existing disease during the first state of COVID-19 emergency in Japan.

Background The job environment has changed a lot during the period of coronavirus disease 2019 (COVID-19) pandemic. This study aimed to investigate the association between work-related stress and aggravation of pre-existing disease in workers during the first state of COVID-19 emergency in Japan. Methods Data were obtained from a large internet survey conducted between August 25 and September 30, 2020 in Japan. Participants who reported that they had a job as well as current history of disease(s) (i.e., pre-existing conditions) were included (n=3090). Aggravation of pre-existing disease during the state of emergency was self-reported. Work-related stress from April 2020 (since the state of COVID-19 emergency) was assessed according to job demand-control model. Multivariable logistic regression models were used to analyze the association. Results Aggravation of pre-existing diseases was reported by 334 participants (11%). The numbers of participants with high demand and low control were 112 (18%) and 100 (14%), respectively. Compared to medium demand, high demand was significantly associated with aggravation of pre-existing diseases (odds ratio: 1.77, 95% confidence interval: 1.30-2.42). Low control compared to medium control was significantly associated with aggravation of pre-existing diseases (odds ratio: 1.39, 95% confidence interval: 1.02-1.92). Conclusion Work-related stress during the first state of COVID-19 emergency was associated with aggravation of pre-existing disease during that period.