Occupational health studies have identified positive associations between work duration and presenteeism, but there is limited understanding of this relationship in disaster responders. We examined the relationship between the number of work days and presenteeism and the mediating effect of fatigue in disaster responders deployed after the Noto Peninsula earthquake. This cross-sectional study examined disaster responders deployed after the Noto Peninsula earthquake (Japan, 2024). Data were collected using the health management version of the app for Japanese Surveillance in Post-extreme Emergencies and Disasters, and included days of work, fatigue score, and presenteeism. Structural equation modeling (SEM) was employed to examine the direct and indirect effects of the number of work days on presenteeism, with fatigue as a potential mediator. Sensitivity analysis was also performed. We analyzed 4656 disaster responders who were deployed after the Noto Peninsula earthquake. Presenteeism increased with the number of work days, and ranged from 3.4% (1day) to 16.9% (>7days). However, fatigue decreased as the number of work days increased. SEM demonstrated a significant direct effect of the number of work days on presenteeism, and that fatigue slightly decreased this effect for work durations of 4 to 7days and more than 7days. Sensitivity analyses supported these findings. Working more days led to increased presenteeism in disaster responders, but fatigue decreased as the number of work days increased. Future longitudinal studies should examine additional factors that may affect presenteeism in disaster responders and other individuals exposed to stressful environments.
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