The coronavirus disease 2019 (COVID-19) pandemic drastically modified the occupational system wherein telecommuting has risen as the major form of work. Few studies have incorporated Karasek’s job demand-control (JDC) model into explaining the health effects of telecommuting. This study aimed to investigate the health risk in South Korean telecommuters during the pandemic, and its distribution according to the job stress-related factors.

A nationwide population-based cross-sectional study of South Korean laborers was conducted, utilizing the 6th Korean Working Conditions Survey (2020–2021). Following the previously described concept of telecommuting, 14,478 white-collar employees were eligible study participants. Telecommuting, job demand, job control, and various health indicators were measured by the responses to the survey. Participants were stratified into 4 job profiles classified by the JDC model. We conducted multiple logistic regression analyses between telecommuting and health-related outcomes to estimate the odds ratio (OR) with a 95% confidence interval (CI).

One hundred forty-six low-strain, 223 active, 69 passive, and 148 high-strain workers were screened as telecommuters. Compared to office workers, telecommuters had a higher proportion in high job control groups. Subgroup analysis demonstrated different relationships between telecommuting and health, where only active telecommuters showed a higher prevalence of depression (OR: 1.980, 95% CI: 1.126–3.481), and high-strain telecommuters were affected in most outcomes including insomnia (OR: 2.555, 95% CI: 1.473–4.433), musculoskeletal pain (OR: 2.786, 95% CI: 1.719–4.517), headache/eye strain (OR: 3.074, 95% CI: 1.992–4.745) and presenteeism (OR: 1.932, 95% CI: 1.193–3.131).

This study revealed significantly increased odds of multiple health outcomes among South Korean telecommuters during the COVID-19 pandemic era. High-strain job holders were prominently susceptible to the negative health impacts of telecommuting. Occupational health management towards telecommuters should approach mitigating high job demand and low job control.