Telework-related health outcomes in Japan and globally: Implications for avatar-based work standards

BackgroundThe COVID-19 pandemic has driven a global shift in teleworking, serving as a real-world experiment in remote labor. As workplaces advance toward technologically mediated environments, including avatar-based systems for remote interaction, understanding the health implications of teleworking is crucial for future occupational health standards.ObjectiveThis review examined the health-related outcomes of teleworking during the pandemic, comparing Japan and other countries to inform health-supportive remote work systems.MethodsA structured narrative review was conducted using MEDLINE (PubMed) and IEEE Xplore through January 9, 2026. Studies were included if they examined teleworking in adult workplace environments and reported physical, mental, behavioral, or performance-related outcomes. Data from 67 eligible studies (12 from Japan and 55 from other countries) were analyzed for the physical health, mental health, lifestyle factors, and work performance domains. Cultural and institutional factors were examined to understand the regional differences.ResultsTelework has been linked to musculoskeletal discomfort, sedentary behavior, psychological stress, and unhealthy lifestyle choices. Japanese and international studies have identified these challenges, although the manifestations vary by context. In Japan, inflexible teleworking, inadequate home infrastructure, and an office-centric culture exacerbate negative outcomes, particularly for women and caregivers. International studies have highlighted the benefits of flexible scheduling and organizational support. Cultural norms and institutional readiness mediated these effects.ConclusionsThis review demonstrates the need for evidence-based health standards for next-generation remote work environments including avatar-based systems. We propose recommendations incorporating ergonomic design, health monitoring, organizational flexibility, and cultural adaptation. As remote work technologies evolve, policy frameworks must prioritize worker well-being.