Study design

This study is part of a larger, exploratory, modular study project that examines the acceptance of SARS-CoV-2-infection control measures in occupational settings [13,14]. Ethical approval was obtained by the Medical Faculty, the University of Tübingen, and the University Hospital of Tübingen in June 2020 (No.: 423/2020BO). The study project was conducted in accordance with the Declaration of Helsinki and relevant institutional guidelines.

For the current study, we applied a mixed-methods approach, commonly used in organizational health services research to consider the complexity of organizations [15,16]. Using the combination of qualitative interviews and a quantitative survey, we aimed to gain insights into organizational pandemic preparedness in work design. Quantitative survey data were collected at multiple timepoints to monitor changes in how the employees’ and managers’ perceived psychosocial demands at work. Findings from the interviews further helped to address how workers of different working fields experienced support from both the German state (e.g., financial aid in the form of temporary short-time work compensation) and their organization (e.g., adjusted work arrangements) during the pandemic. These pluralistic perspectives enable an evaluation of how the organization's responses to the challenges of the pandemic affected the employees’ daily work.

The findings from this study could help design more favorable and sustainable psychosocial working conditions in organizations that are similar to the one investigated. Designing working conditions based on the learnings from the COVID-19 pandemic can help ensure work ability during future challenging times.

Mixed-methods approach

For contextualization, we performed a comprehensive document analysis of prevailing national and federal laws and OSH-regulations for infection control in Germany. In a parallel approach, quantitative (employee survey) and qualitative data (interviews with managers) were gathered and analyzed independently. This allowed us to gain detailed insights into the company-level context in which employees and managers work. Data integration was realized during sampling, as both, quantitative and qualitative data, were collected via convenience sampling from the same working fields to ensure comparability. Further, integration was realized during the exploratory analysis and interpretation phase. The triangulation of methods allowed us to investigate consistent patterns in perceived psychosocial demands within working fields as well as between employees and managers. The contextual insights, mainly provided by the qualitative data, allowed a more nuanced understanding of these patterns. We report following the GRAMMS-guidelines [17].

Study participants

The longitudinal data comes from employees and managers from various working fields from a worldwide leading global supplier of technology and services. The company group can be characterized as financially well-established and having a lot of human resources [10]. For example, regarding the work environment, digitalized solutions and proven communication channels were already used before the COVID-19 pandemic. All employees and managers included were employed at six German company sites in the federal states of Bavaria, Baden-Wurttemberg, and Lower Saxony. Employees for example worked at the assembly line/production, in the office, company medical service, or factory security service of the same company group. We aim to differentiate between those working fields as they show large differences in how working conditions were adapted to ensure as-safe-as-possible workplaces. While office workers were mainly affected by remote work and online meetings where possible, assembly line/manufacturing workers experienced redesigned working conditions to allow for keeping a minimum of 1.5m distance between work stations, frequent cleaning of work equipment, and decoupled break times. Company medical service personnel in comparison were responsible for implementing SARS-CoV-2-infection control measures as well as ensuring testing and vaccination possibilities. All participants were at least 18 years old, had a German language proficiency of at least B1, and provided written informed consent.

Employees were eligible as interview partners if they had been employed for at least six months and were either member of the crisis management team or held an operational management position. No explicit exclusion criteria were defined beyond not meeting the pre-defined inclusion criteria. Due to the limited time frame between the onset of the pandemic and the first wave of data collection, the employee survey was administered solely online [18]. As a consequence, there may have been systematic exclusion of individuals without sufficient time or resources to participate such as internet or email access at work. This was previously discussed in Soeder et al. [18]. Qualitative data were pseudonymized and quantitative data were anonymized prior to analysis.

Quantitative data collection and analysis

Quantitative self-reported employee survey data were generated by distributing an online survey three times after the onset of the COVID-19 pandemic in Germany: August 10 to October 25, 2020 (T0), January 21 to 31, 2021 (T1), and October 15 to November 21, 2021 (T2). The questionnaire was designed using the online survey tool Unipark provided by Questback AS [19]. Survey invitations including an access link and QR code were sent to all employees by the company's corporate communications department via email, newsletter, intranet, postcards, and posters, see Soeder et al. [18] for more details. Participation was voluntary and we used convenience sampling. Multiple observations were linked to the same individual using self-generated anonymized codes. Details on recruiting strategies, surveyed items, and response rate at T0 (22%) are described elsewhere [18].

Primary outcome variables are the perceived psychosocial demands in the workplace, see the S1 Table. For each item, we asked for evaluation from two perspectives: retrospectively before and currently during the COVID-19 pandemic. The survey items were self-developed following the GDA recommendations [7] and Copenhagen Psychosocial Questionnaire (COPSOQ) [20]. Each item was to be rated on a 5-point Likert scale, symmetrically anchored with ‘3’, which indicates a neutral perception. Some items were reversed for score computation, see S1 Table for more details. Items were grouped into four scores (three items each) by four experts in occupational medicine and health services research: perceived psychosocial demands from aspects of the work organization, work environment, work content, and social relations at work. Scores were computed following the mean-across-available-item approach (S2 Table) [21]. High values reflect favorable, low values reflect unfavorable perceptions of work-related psychosocial demands. Additional variables included in this analysis were: working field, remote work at the timepoint of the survey (yes/no), occupying a manager position (yes/no), and short-time work (yes/no).

We present the results with number to treat, mean±standard deviation (SD), and median and interquartile range (IQR) for continuous measures including Likert scales; absolute and relative frequencies for categorical variables. Outcome mean scores (work organization, environment, content, and social relations) were non-normally distributed and left-skewed. Friedman-Test was used to assess differences between timepoints. Wilcoxon’s signed-rank test with Bonferroni correction was used for pairwise comparison. We report effect sizes with r < 0.3 (small), r ≥ 0.3 and r ≤ 0.5 (moderate), and r > 0.5 (strong effect) [22]. Wilcoxon rank-sum test was used to compare two groups, e.g., managers vs. non-managers, at the same timepoint. To compare the ‘retrospective’ and ‘current during the pandemic’ ratings at each timepoint, we first computed the within-person differences and second categorized the differences into ‘equal =0’, ‘now better than before >0’, and ‘now worse than before <0’. Due to the exploratory study design, claims of causality are not possible. Statistical significance was set at two-sided p < 0.05. Statistical analyses were performed using R version 4.2.1 using the packages psych, rstatix, and ggplot2 [23]. All packages used for statistical analyses are available on CRAN (Comprehensive R Archive Network, https://cran.r-project.org/web/packages/).

Qualitative data collection and analysis

Semi-structured interviews were conducted from September 28 to October 19, 2020 (t0) and from April 19 to May 6, 2021 (t1) via video call or telephone (24−60 minutes) by author 2 (CP). The interview guides (S3 Table) were drafted by an experienced sociologist (CP) who received feedback from experts in occupational medicine, health services research, and general medicine [24]. We were interested in how work-related challenges elicited by the COVID-19 pandemic were handled in the collaborative company group and how managers experienced these responses [25]. Potential interview partners were suggested by the company's research partners based on a minimum employment time with the company of six months. Interview partners were eligible if they were either members of the crisis management team or holding an operational management position. Author CP arranged interview appointments. All interviews began with a brief introduction, information about data protection, and the interview structure. Audio files were transcribed verbatim by a professional transcription agency (amanu GmbH, Germany). The qualitative data were organized using MAXQDA 2020 (VERBI Software, Germany) and analyzed via qualitative content analysis [26] to identify and structure the main topics and sub-topics of the data (S4 Table). Regarding data saturation, the interviews showed a strong information power [24]. For the first interviews (t0), nine main categories were derived deductively from the interview guide. A definition and exemplifying quote were added to each category for clarification. Then, several interviews were coded. All sections belonging to each main category were paraphrazed to build data-driven subcategories. The coding frame was additionally piloted for the respective interviews, finalized after minor adjustments, and applied to the remaining interviews. All steps were carried out by two researchers working independently and discussing their analyses continuously. For the second data collection period (t1), the coding frame was updated following the same procedure. New interview questions, e.g., concerning the topic of vaccinations, resulted in additional categories. Both coding frames were discussed with the overall research team.

To contrast the qualitative with quantitative findings during the analysis phase, we here focus on the following three categories: pandemic-related changes in working conditions, organizational processes for adapting working conditions, and culture of trust.

Sample characteristics

The here presented survey results are based on a sub-sample of participants (n = 322 out of N = 5,554) for whom all three survey observations were available. A total of 5,554 employees participated in the online survey at one, two, or all three timepoints. For 322 out of them, longitudinal panel data could be ensured. This analysis focuses on panel data, as we were primarily interested in within-person changes in psychosocial demands. The outcome variables and socio-demographic characteristics did not differ substantially between participants who took part three times compared to the overall sample, see S5 Table for an additional sensitivity analysis. See [10], for a pooled analysis of all available repeated cross-sectional and longitudinal panel data investigating the employees’ attitudes toward organizational infection control measures in the workplace. Individual and work-related sample characteristics are shown in Table 1.

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Table 1. Sample characteristics. Characteristics of the study participants (n = 322) in the repeated employee survey and their perceived psychosocial demands during and retrospectively before the pandemic.

https://doi.org/10.1371/journal.pone.0328410.t001

Eight male and one female managers participated in the interviews. Of these, n = 7 interview partners participated in the initial and follow-up interviews. The following perspectives were presented: factory security service, company medical service, works council, technical operation manager, corporate financial management, human resources, and assembly line/ manufacturing. Employees worked at six company sites in three German federal states of one large company group. This allows differentiation between working fields even with small sample sizes and thereby covering possible differences in safety cultures or local pandemic situations.

COVID-19 pandemic in Germany

Fig 1 provides an overview of the main findings of the document analysis together with the data collection phases [27–29]. For example, the German social security concept included statutory employment-protection systems such as continued payment of wages in the case of temporary short-time work due to economic difficulties already before the COVID-19 pandemic [30,31]. In response to the pandemic, the requirements for companies in Germany to receive compensation for short-time work were eased starting in March 2020. Another relevant regulation by the German Ministry of Health was that, beginning in June 2021, occupational physicians were authorized to vaccinate in the workplace as part of the national vaccination campaign [32].

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Fig 1. COVID-19 pandemic context.

Data collection phases (T0, T1, T2: quantitative employee survey, t0 and t1: qualitative interviews with managers) and the COVID-19 pandemic context in Germany. Key dates and policies during the COVID-19 pandemic in Germany are shown with the 7-day incidence per 100,000 inhabitants.

https://doi.org/10.1371/journal.pone.0328410.g001

Perceived psychosocial demands and adjusted working conditions in autumn 2020

According to the interview partners, some employees perceived existential worries at the beginning of the pandemic due to the sudden and unknown situation (IP8a, Table 2). Impacts on the economy were unclear and increased the employees’ fear of job loss. To reduce the work-related risk of infection, SARS-CoV-2-infection control measures were introduced, requiring re-organization of working processes. One interview partner reported for example, that employees concerned were involved in re-organizing the assembly line to allow as-safe-as-possible workplaces while ensuring that work remained efficient (IP8b).

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Table 2. The organization’s responses to COVID-19 pandemic-related challenges and their impact on the individual’s daily work are presented in the qualitative data and the following quotations from the interview partners (IP).

https://doi.org/10.1371/journal.pone.0328410.t002

Survey results show that at T0, psychosocial demands from aspects of work organization were rated as moderate with 2.7 (1.0) (median (IQR)), Table 1. Particularly noticeable are professionals of the company's medical service, reporting to experience unreasonable workloads that do not match their skills and capacities (1.3 (0.8)). Fig 2a visualizes the perceived psychosocial ratings, differentiated per examined working field. Mean perceived psychosocial demands were rated more unfavorably by managers than non-managers when it came to aspects of work organization. Contrarily, managers rated aspects relating to work environment and content more favorably, and aspects of social relations equally, Fig 2b.

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Fig 2. Perceived psychosocial demand ratings during the COVID-19 pandemic.

a (left): perceived psychosocial demand ratings for each examined working field in contrast to the overall median rating at each survey wave during the COVID-19 pandemic; b (right) perceived psychosocial demand ratings for managers vs. non-managers in contrast to the overall median rating at each survey wave during the COVID-19 pandemic.

https://doi.org/10.1371/journal.pone.0328410.g002

Organizational structures

At the onset of the COVID-19 pandemic, an already existing crisis management team began meeting regularly to make important procedural decisions to successfully navigate the pandemic (IP6a). The team consisted of experts from various fields such as law, occupational medicine and safety, logistics, purchase, human resources, information technology, and communication. The interviews highlighted the benefits of being part of a large company group with a wide range of human resources and expertise. Interview partners also shed light on the company's communication culture. A variety of existing and new communication channels allowed every employee at every workplace to be informed about current procedures very early on after the SARS-CoV-2-outbreak (IP2a). Because of established procurement channels and financial resources within the company group, it was possible to carry out large-scale SARS-CoV-2-testing within a short time frame (IP5b).

Changes in perceived psychosocial demands during and before the COVID-19 pandemic

Significant differences in the median perceived psychosocial demands from aspects of work organization between the three survey timepoints during the pandemic were indicated by the Friedman-Test (X2(2)=7.04; p = 0.03), see Table 1. However, the low effect size (r = 0.01) suggested negligible differences and post-hoc analyses revealed no significant pairwise differences. The median psychosocial demands from aspects of the work environment were perceived as rather favorable and stable (X2(2)=5.47; p = 0.06; r = 0.09), as were the perceived psychosocial demands in terms of work content (X2(2)=0.45; p = 0.08; r < 0.001) and social relations (X2(2)=1.70; p = 0.43; r = 0.003). Differences between managers and non-managers regarding perceived psychosocial demands were evident and remained constant throughout the pandemic, see Fig 2b, e.g., both groups experienced an unreasonable workload during the pandemic, which was slightly more pronounced among managers. Aspects of work environment and content were rated favorably by both, slightly more pronounced by managers. Both groups reported experiencing equally supportive social relationships at work.

According to the interviews, introducing comprehensive infection control measures in the workplace involved new tasks for managers, e.g., implementing SARS-CoV-2-measures and ensuring employee adherence (IP4a). Repeated reminders to employees and face-to-face meetings to clarify expectations seemed to be essential (IP8c). Interviewed managers reported that they trusted their employees to take personal responsibility and to correctly assess health-related safety measures and organizational regulations (IP4b). They further emphasized their strategy of honestly pointing out the general lack of knowledge at that time and the need to test the applied organizational rules for effectiveness (IP4c). Furthermore, remote work was extended where possible to reduce personal contact on-site, especially for office employees. As remote work was already possible before the pandemic, capacities were expanded immediately after the outbreak of the SARS-CoV-2 (IP5c). However, as the pandemic progressed, contrary opinions on remote work evolved: some employees were in favor of the opportunity to work from home while others missed their colleagues and felt frustrated. Feelings of frustration were mainly rooted in the ineffectiveness that employees felt due to missing consultations within working groups and having little face-to-face contact (IP3a, 5a). Regarding the social relations at work, especially the high commitment by the company's medical service professionals was highlighted as well as their constant availability and support (IP7a).

Retrospectively, median perceived psychosocial demands from aspects of work organization did not significantly differ between timepoints (X2(2)=1.52; p = 0.47; r = 0.002), see Table 1. When comparing working fields, see Fig 3a, company's medical service personnel (n = 6) stood out. 67% (n = 4) perceived psychosocial demands from aspects of work organization deteriorated during the COVID-19 pandemic compared to before. Overall, about 25% of employees and managers perceived psychosocial demands from aspects of work organization during the pandemic more favorably than before, see Fig 3b. Overall, psychosocial demands from aspects of work environment were perceived favorably retrospectively and did not significantly differ between timepoints (X2(2)=12.2; p = 0.002; r = 0.02; non-significant post-hoc tests), as were psychosocial demand ratings from aspects relating to work content (X2(2)=1.11; p = 0.58; r = 0.002) and social relations (X2(2)=3.88; p = 0.14; r = 0.006).

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Fig 3. Perceived psychosocial demand ratings before vs. during the COVID-19 pandemic.

a (left): differences in the ratings in terms of perceived psychosocial demands before vs. during the COVID-19 pandemic differentiated per working field; b (right) differences in the ratings in terms of perceived psychosocial demands before vs. during the COVID-19 pandemic differentiated between manager vs. non-manager. Color coding: Light grey: during the COVID-19 pandemic perceived psychosocial demands are perceived equally to retrospectively perceived psychosocial demands at work before the COVID-19 pandemic; grey: during the COVID-19 pandemic, psychosocial demands are perceived more favorable than retrospectively perceived psychosocial demands at work before the COVID-19 pandemic; black: during the COVID-19 pandemic, psychosocial demands are perceived less favorable than retrospectively perceived psychosocial demands at work before the COVID-19 pandemic.

https://doi.org/10.1371/journal.pone.0328410.g003

Practical implications

Our results suggest that the organization’s responses to the challenges posed by the pandemic helped prevent an increase in employees’ work-related psychosocial negative demands during the pandemic. Depending on the overall context of where an employee works, what worked for the organization investigated here may not work in others [35]. To better understand how working conditions can ensure work ability during challenging times, we aimed to derive practical implications for organizational pandemic preparedness from our findings (meso-level (company level)). As interactions between players exist [36], we additionally draw learnings on the macro- (societal level) and micro-level (individual level). While macro-level policies usually provide a certain framework, changes are implemented on the meso-level to ensure health-related preventive behaviors on the micro-level.

Starting in March 2020, recommended SARS-CoV-2-infection control measures at work were to be introduced according to the hierarchy of prevention and control (macro-level; technical and organizational take precedence over personal measures) [37,38]. In the examined organization, a crisis management team made the most important decisions (meso-level). Our interviews showed that managers struggled with increased workloads from leading measures and ensuring adherence. Implementing specific OSH-measures required one-one meetings and tailored, subgroup-specific solutions (micro-level), as there was no ‘one-size-fits-all’-solution. Decisions had to be made quickly regarding which measures were to be taken in specific situations even when policies at national and state level were uncertain. As managers and employees had, on average, been employed for a long time, they were able to rely on trust and self-personal responsibility (micro-level). To maintain a long-term acceptance of adjusted working conditions, the company presented here was able to draw on many human resources, an established team of occupational health professionals, and a wide variety of communication channels (meso-level). Similar to our findings, it was previously shown in healthcare organizations, that communication was key to making employees feel safe and cared for in their workplaces [39]. Evidence suggests that the larger the organization, the more personnel, structured communication approaches, and formalized procedures are available for managing psychosocial risks at work [40,41]. This limits the generalizability of our findings. The investigated company differs from small or medium-sized companies, where limited financial capacities and lack of experts may restrict organizational resilience [42]. Cooperation between smaller organizations or within employer associations could compensate for this. This suggestion was already stated in a pandemic plan for non-healthcare organizations provided for example by the German Social Accident Insurance in cooperation with the Federal Office for Civil Protection [43].

In December 2020, an increase in SARS-CoV-2-infections among the German population was followed by another severe lockdown in January 2021 [27]. The SARS-CoV-2 Occupational Health and Safety Ordinance [44] was passed by the Federal Ministry of Labor and Social Affairs to underscore the necessity of offering remote work wherever possible (macro-level). Again, the organization studied, benefited from structural resources as remote working possibilities had already been established and capacities could be expanded quickly (meso-level). In June 2021, occupational physicians were allowed to vaccinate in the workplace as part of the national vaccination campaign (macro- and meso-level) [32]. Our data revealed that company’s medical personnel experienced increased stress from aspects of work organization since early 2020 but were highly valued by employees for their expertise and efforts (micro-level). Our findings correspond to a study evaluating pilot COVID-19-vaccination campaigns in multiple companies in Germany [45].

As the German labor system benefited from strong social security measures that were established already prior to the COVID-19 pandemic, the generalizability of our findings to other countries is limited. In countries other than Germany with weaker social security measures, it seems to be even more important for organizations to design and establish resilient work design to protect employees from severe psychosocial demands during future crises. During the COVID-19 pandemic, e.g., company medical personnel played an important role in the organizational context. This established expertise may also be critical in future public health crises.

Strengths and limitations

Regarding strengths, this exploratory longitudinal mixed-methods study used two complementary research methods. This allowed us to comprehensively present the perspectives of different working fields, increasing the credibility of the overall findings. The panel data allowed for analyzing within-person changes between timepoints. When planning our study project in spring 2020, we considered the current state of research and included the latest findings for the COVID-19 pandemic as a new and unknown situation. A strength is that the first period of data collection was carried out during the early stage of the pandemic. As the pandemic progressed, we included a third survey wave in autumn 2021. At that time, the majority of the German population had already been vaccinated at least once. We kept the exploratory study design throughout the study project for mainly two reasons: following the codex of good scientific practice and the framework for developing and evaluating complex interventions [46]. The retrospective perspectives were assessed three times without change. Thus, we assume that subjective perceptions of work-related psychosocial demands remained stable. As the unexpected effects of the COVID-19 pandemic constitute a completely new experience, there may have been a shift in response due to a re-calibration of the person-specific internal evaluation range [47]. We cannot rule out the fact that participants might not accurately recall their perceived state before the pandemic (recall bias). We were mainly interested in how employees subjectively perceived work-related psychosocial demands. Our retrospective survey design could have led employees to rate their psychosocial demands during the pandemic as more stressful than before, e.g., due to negativity bias (focusing more on current negative experiences than on favorable ones) and ‘rosy’ retrospection (viewing the past more positively) [48]. Both recall and negativity bias may have contributed to an overestimation of unfavorably perceived working conditions during the pandemic compared to before, when rating the ‘before’ timepoint retrospectively. Indications of theses biases were apparent in the qualitative findings. For example, one interviewee reflecting on the last year (IP8a), emphasized intense negative emotions related to fear about health and economic uncertainties. This illustrates how strong intense negative emotional experiences might have shaped the retrospective evaluations. However, our results did not show any significant changes over time. In addition, the retrospective evaluations gathered in 2020 and 2021 presented here, seem to show a similar snapshot of the employees’ perceived work-related well-being compared to before the pandemic. According to the internal results of a worldwide employee survey at the collaborating company group with a response rate of 86% (n = 270.000) in 2017, the majority of participants were satisfied with their working conditions and 82% would even recommend their employer to family and friends.

Regarding limitations, we examined the perceived psychosocial demands among the employees of a large company group characterized by a well-established safety culture and large financial and human resources. The company group made it possible to produce disinfectants and protective equipment in-house at the pandemic's beginning to reduce supply shortages by equipping suppliers and own employees appropriately. Therefore, our findings may not fully be generalizable to small or medium-sized organizations with more constrained financial, technical, and human resources, as already discussed in further detail in Soeder et al. [10]. Office and assembly line work areas generally represent the largest groups of employees within a company, whereas groups such as the company medical service are naturally smaller. However, the sample size in some work areas was too small to draw statistical conclusions or generalize the results. Another limitation is the reliance on a small number of recommended dimensions for implementing a comprehensive psychosocial risk assessment at work by the GDA [7]. Results are limited in the transferability to other countries as the GDA-scheme refers to the German legislation and context. Cronbach’s alpha (α = 0.5) of the aspect of work content shows a low homogeneity of the three test items. Here, different response patterns of employees of different working fields should be considered. This aligns with the findings of Wagner et al. [49], who similarly observed different response patterns when investigating psychosocial demands among nurses compared to physicians. The low Cronbach’s alpha highlights the importance of interpreting results working field-specifically, considering the work context of each. In terms of methodological limitations, the quantitative data relied on a self-reported survey; hence, common method biases may exist, including, e.g., possible sample bias.

Future work

Following the framework for developing and adapting complex interventions [46], our findings can contribute to the development of future pandemic preparedness interventions and their implementation in occupational settings. From our point of view, the here presented findings can be transferred to other current and future global challenges requiring a high level of employee-engagement in organizations. Global challenges such as climate change, economic downturns, or topics related to demographic change have in common that they disrupt established routines and require decision-making under uncertain and dynamic conditions. In our opinion, pandemic preparedness plans not only strengthen organizational resilience during pandemic-like situations. Developed and established structures and strategies further allow faster and solution-driven reactions during other future crises. On April 17, 2025, the WHO member states finalized a draft regarding pandemic preparedness to strengthen global collaboration such as ensuring stable supply chains of medical products and to highlight the importance of developing pandemic preparedness plans on a national level [50]. This draft regarding pandemic preparedness was adopted on May, 20, 2025, and is to be ratified by all member states [51].

Demographic change and its implications for the world of work are already very prominent in Germany. Previous study findings for a representative German population sample revealed that the majority of study participants, born in 1959 or 1964, reported that they were not willing to work until retirement age [52]. The findings additionally showed that when employees perceived improved working conditions and favorable safety culture, they were more likely to delay retirement. Examined aspects of work design included, e.g., feeling appreciated for their work or a perceived personal responsibility in terms of work-time organization. Topics for future research on the topic of demographic changes could deal for example with how managers address digital competency gaps among older workers or how to support those workers’ lifelong learning in rapidly changing work environments.

As previously stated [43], aspects such as extensive and transparent risk communication, employee participation via works council, management training, and personal responsibility of employees should be considered in pandemic preparedness of non-healthcare organizations. Our findings confirmed that a crisis management team, a wide variety of communication channels, a certain culture of trust, and participatory approaches in designing working conditions were beneficial during the unprecedented situation of the COVID-19 pandemic. Thus, organizations can shape employees’ experiences during a global crisis and influence their perceptions of psychosocial demands. Derived practical implications are particularly relevant for policymakers, managers, and company's medical service personnel. On an organizational level, for managers, derived practical implications highlight the importance of transparent communication, trust-based leadership styles, and participatory approaches in change processes. For company's medical service personnel, it again became clear that they played a key role in creating a certain culture of trust by contributing to decisions of the crisis management team and managing internal testing and vaccination campaigns as part of the national vaccination strategy. The hereby established culture of trust and expertise may also be helpful during future public health crises.