[Associations between Self-reported Symptoms, Quality of Life, and Work Productivity Loss among Japanese Workers: A Cross-sectional Analysis of a Large-scale Questionnaire-based Person-reported Outcomes Database (PRO-DB)].

Abstract

Background: Japanese workers face long working hours, mental stress, and caregiving responsibilities, contributing to physical and psychological symptoms (e.g., fatigue, depressive mood, and sleep disturbances). These symptoms adversely affect the quality of life (QOL) and work productivity. Nationwide studies on symptom-QOL-work productivity associations across various occupations remain scarce.

Objective: In this study, we quantitatively assessed the associations between self-reported symptoms, QOL, and work productivity loss using a large-scale person-reported outcomes database (PRO-DB).

Methods: In this cross-sectional analysis, we used data from the first PRO-DB survey (June 2024). Among 192,572 employed respondents, demographic data, 40 self-reported symptoms, QOL (EuroQol 5-Dimension 5-Level questionnaire), and work productivity loss [overall work impairment (OWI), Work Productivity and Activity Impairment questionnaire] were analyzed. Generalized linear regression models, adjusted for demographics, were used to assess the impact of symptoms on QOL and OWI. A weighted analysis was conducted to estimate workforce burden by weighting the effect sizes of symptoms on QOL and OWI by the number of respondents reporting each symptom.

Results: Consciousness disturbance (-0.207 QOL, 29.3 OWI) and hallucinations/delusions/auditory hallucinations (-0.192 QOL, 29.3 OWI) were strongly associated with lower QOL and increased OWI but had a limited population impact due to their low prevalence. In contrast, weighted analysis showed that easy fatigability (-0.0199 QOL, 4.79 OWI) and depressive mood (-0.0135 QOL, 2.44 OWI) had the greatest workforce-wide effects on QOL and productivity loss.

Conclusion: These findings highlight a dual burden of symptoms among Japanese workers. Effective interventions should address both rare severe symptoms and common mild symptoms to improve well-being and productivity.