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Original Articles
Mediation analysis of chronotype, sleep-related factors, and depressive symptoms among workers: a cross-sectional study
Seo Young Kim, Hyo Jeong Kim, Seong-Sik Cho, Min Young Park, Mo-Yeol Kang
Ann Occup Environ Med 2023;35:e47.   Published online November 20, 2023
DOI: https://doi.org/10.35371/aoem.2023.35.e47
AbstractAbstract AbstractAbstract in Korean PDFSupplementary MaterialPubReaderePub
Background

This study aimed to examine the impact of chronotype on depressive symptoms and explore the mediating effects of sleep quality, pre-sleep cognitive arousal, and social jetlag in a sample of wage earners.

Methods

A total of 3,917 waged workers were surveyed online in July 2022. Logistic regression and mediation analysis were used to assess the relationship between chronotype (morningness, intermediate, and eveningness) and depressive symptoms (Patient Health Questionnaire ≥ 5), and the mediating effects of Insomnia Severity Index (ISI), Pittsburgh Sleep Quality Index (PSQI), and Pre-Sleep Arousal Scale (PSAS). All analyses were adjusted for age, education level, income level, marital status, coffee consumption, alcohol consumption, physical activity, occupation, employment status, and working hours to calculate odds ratios (ORs).

Results

The chronotypes of all the participants were divided into morningness (4.7%), intermediate (93.5%), and eveningness (1.8%). Multiple logistic regression analysis showed an increased risk of depression in the eveningness chronotype (OR: 2.96; 95% confidence interval [CI]: 1.51, 5.86). Regarding the mediation analysis, ISI mediated 28.44% (95% CI: 16.39–40.5), PSQI for 31.25% (95% CI: 19.36, 43.15), and PSAS-Cognitive Score (PSAS-C) for 23.58% (95% CI: 10.66, 36.50) of the association between chronotype and depressive symptoms. However, social jetlag did not significantly mediate this relationship. (percentage mediated = 0.75%, 95% CI: −3.88, 5.39)

Conclusions

Evening chronotypes exhibit an increased risk of depressive symptoms, which ISI, PSQI, and PSAS-C partially mediated. This suggests that interventions to improve sleep quality and maintain adequate sleep habits may effectively prevent and treat depression in employees with an eveningness chronotype.

직장인의 크로노타입이 우울 증상에 미치는 영향과 수면 관련 요인의 매개 분석
목적
본 연구는 국내 임금 근로자를 대상으로 크로노타입이 우울 증상에 미치는 영향과 수면의 질, 수면 전 인지적 각성, 사회적 시차 등의 매개 효과에 대해 분석하고자 한다.
방법
2022년 7월 온라인 설문조사를 통해 모집한 만 19세 이상의 임금 근로자 3917명을 대상으로 분석을 시행하였다. 로지스틱 회귀분석으로 성별을 층화하여 크로노타입 (아침형, 중간형, 저녁형)과 우울증상 간의 관계를 살펴본 후, 매개효과 분석을 통해 불면척도, 수면의 질, 수면 전 각성 척도, 사회적 시차의 각각의 우울 증상에 대한 매개 효과를 계산했다. 모든 분석은 연령, 교육수준, 소득, 결혼 여부, 동거인 여부, 커피, 흡연, 음주, 신체활동, 직종, 고용형태, 근무 시간을 보정하였다.
결과
참가자는 아침형(4.7%), 중간형(93.5%), 저녁형(1.8%)으로 나뉘었다. 인구사회학적 특성 및 업무 관련 요인을 통제한 다중 로지스틱 회귀분석 결과, 저녁형 그룹에서 우울증상 오즈비는 2.95 (95% 신뢰구간: 1.51–5.86)로 아침형 그룹에 비해 높게 나타났다. 매개 분석 결과에서 불면 척도는 28.44% (95% 신뢰구간 16.39–40.5), 수면의 질은 31.25% (95% 신뢰구간 19.36–43.15), 수면 전 인지적 각성척도은 23.58% (95% 신뢰구간 10.66–36.50)를 매개하였다. 그러나 사회적 시차는 매개 효과가 0.75% (95% 신뢰구간 -3.88–5.39)로 유의하지 않은 것으로 나타났다.
결론
본 연구 결과에 따르면 저녁형 크로노타입을 가진 근로자들이 아침형 근로자보다 우울증상의 위험도가 증가하는 것으로 나타났으며, 이에 대한 매개 효과 분석에서는 불면 척도, 수면의 질과 수면 전 인지적 각성이 우울 증상을 부분적으로 매개하는 것으로 나타났다. 이는 저녁형 크로노타입 근로자들과 같은 우울증의 상대적 고위험군에서 수면의 질을 개선하고 수면 습관을 적절히 유지하도록 개입하는 것이 우울증의 예방 및 치료에 효과적일 수 있음을 시사한다.
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Association between exposure to violence, job stress and depressive symptoms among gig economy workers in Korea
Min-Seok Kim, Juyeon Oh, Juho Sim, Byung-Yoon Yun, Jin-Ha Yoon
Ann Occup Environ Med 2023;35:e43.   Published online October 30, 2023
DOI: https://doi.org/10.35371/aoem.2023.35.e43
AbstractAbstract AbstractAbstract in Korean PDFPubReaderePub
Background

Gig workers, also known as platform workers, are independent workers who are not employed by any particular company. The number of gig economy workers has rapidly increased worldwide in the past decade. There is a dearth of occupational health studies among gig economy workers. We aimed to investigate the association between exposure to violence and job stress in gig economy workers and depressive symptoms.

Methods

A total of 955 individuals (521 gig workers and 434 general workers) participated in this study and variables were measured through self-report questionnaires. Depressive symptoms were evaluated by the Patient Health Questionnaire-9 when the score was greater than or equal to 10 points. The odds ratio with 95% confidence interval was calculated using multivariable logistic regression adjusted for age, sex, working hours, education level, exposure to violence and job stress.

Results

19% of gig economy workers reported depressive symptoms, while only 11% of general workers reported the depressive symptoms. In association to depressive symptoms among gig economy workers, the mainly result of odds ratios for depressive symptoms were as follows: 1.81 for workers type, 3.53 for humiliating treatment, 2.65 for sexual harassment, 3.55 for less than three meals per day, 3.69 for feeling too tired to do housework after leaving work.

Conclusions

Gig economic workers are exposed to violence and job stress in the workplace more than general workers, and the proportion of workers reporting depressive symptoms is also high. These factors are associated to depressive symptoms. Furthermore, the gig workers associated between depressive symptoms and exposure to violence, job stress.

한국 긱경제 근로자에서 폭력 및 직무 스트레스 노출과 우울 증상관의 연관성
목적
긱경제 근로자 또는 플랫폼 근로자는 특정 회사에 고용되지 않은 독립적인 근로자들을 말한다. 긱경제는 그 규모가 커지고 있고, 종사하는 근로자들도 많아지고 있으나, 긱경제 노동자들의 산업 보건 연구가 부족한 실정이다. 우리는 긱경제 근로자에서 폭력 노출과 직무 스트레스에 노출되는 것이 우울 증상과 연관성이 있는지 조사하는 것을 목표로 했다.
방법
총 955명(긱 근로자 521명, 일반 근로자 434명)이 본 연구에 참여하였으며, 우울 증상은 PHQ-9(Patient Health Questionnaire-9) 점수가 10점 이상일 때로 평가하였다. 폭력 노출과 직무 스트레스는 자기보고식 설문지를 이용하여 측정하였다. 연령, 성별, 근무시간, 교육수준을 보정한 다변량 로지스틱 회귀분석을 이용하여 Odds Ratio, 95% Confidence Interval를 산출했다.
결과
긱 근로자의 19%가 우울 증상을 보고한 반면, 일반 근로자의 11%만이 우울 증상을 보고했습니다. 긱경제 근로자의 우울상과 관련하여 우울상 Odds ratio의 주요 결과는표3에서 ‘긱경제 근로자’ 1.89, ‘굴욕적 처우 경험’ 3.53, ‘성희롱 경험’ 2.65, ‘하루 세 끼 미만의 식사’ 3.55, ‘퇴근 후 집안일을 하기엔 너무 피곤함’ 3.69로 나타났다.
결론
긱경제 근로자는 일반 근로자에 비해 직장 내 폭력과 직무스트레스에 더 많이 노출되고, 우울 증상을 호소하는 근로자의 비율도 높다. 이러한 요인은 우울 증상과 관련이 있다. 더욱이, 긱경제 근로자들은 우울 증상과 폭력 노출, 직업 스트레스와 관련이 있다.

Citations

Citations to this article as recorded by  
  • Higher anxiety level and associated work-related factors of delivery workers in South Korea: from the 6th Korean working conditions survey
    Sungjin Park, June-Hee Lee
    International Archives of Occupational and Environmental Health.2024;[Epub]     CrossRef
  • Association between precarious employment and the onset of depressive symptoms in men and women: a 13-year longitudinal analysis in Korea (2009–2022)
    Seong-Uk Baek, Jong-Uk Won, Yu-Min Lee, Jin-Ha Yoon
    Epidemiology and Psychiatric Sciences.2024;[Epub]     CrossRef
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Relationship between chronotype and depressive symptoms among newly hired hospital nurses in the Republic of Korea
Semi Lee, Han-Na Jung, Jia Ryu, Woo-Chul Jung, Yu-Mi Kim, Hyunjoo Kim
Ann Occup Environ Med 2022;34:e32.   Published online October 31, 2022
DOI: https://doi.org/10.35371/aoem.2022.34.e32
AbstractAbstract AbstractAbstract in Korean PDFPubReaderePub
Background

This study was conducted to examine the relationship between chronotype and depressive symptoms to provide grounded knowledge in establishing nurses’ health promotion strategies.

Methods

The subjects of this study were 493 newly hired nurses working in 2 general hospitals within the university from September 2018 to September 2020. Sociodemographic and work-related characteristics were collected from a medical examination database and a self-reported questionnaire. These included sex, age, marital status, living situation, education level, alcohol consumption, physical activity, prior work experience before 3 months, workplace, and departments. To analyze the associations between the chronotype and depressive symptoms, multiple logistic regression analyses were performed to calculate odds ratios (ORs).

Results

Among participants, 9.1% had depressive symptoms and 16.4% had insomnia. The subjects are divided into morningness (30.2%), intermediate (48.7%), and eveningness (21.1%). The multiple logistic regression analysis controlling for age, living status, education level, alcohol consumption, physical activity, workplace, prior work experience before 3 months, and insomnia, revealed that the OR of depressive symptoms in the eveningness group was 3.71 (95% confidence interval [CI]: 1.50–9.18) compared to the morningness group, and the R2 value was 0.151. It also can be confirmed that insomnia symptoms have a statistically significant effect on depressive symptoms (OR: 2.16, 95% CI: 1.03–4.52).

Conclusions

Our findings suggest that evening-type nurses are more likely to have depression than morning-type nurses. We should consider interventions in a high-risk group such as the evening type nurses to reduce depressive symptoms in nurses.

신입 간호사에서 일주기리듬 유형과 우울 증상의 관련성
목적
이 연구는 간호사의 건강증진 전략 수립에 기초 지식을 제공하기 위해 일주기리듬 유형(크로노타입)과 우울 증상의 관련성을 살펴보기 위해 수행되었다.
방법
연구대상은 2018년 9월부터 2020년 9월까지 2개 대학병원에 근무하는 신입간호사 493명이었다. 사회인구학적 특성과 업무관련 특성은 건강검진 데이터베이스와 자기보고식 설문지를 통해 성별, 연령, 결혼 여부, 생활 상황, 교육 수준, 음주, 신체 활동, 3개월 내 업무 경험, 직장 및 부서 등에 대한 정보를 수집하였다. 일주기리듬 유형과 우울 증상 간의 연관성을 분석하기 위해 연령, 생활수준, 학력, 음주, 신체활동, 직장, 직장경력, 불면증 등을 통제한 다중 로지스틱 회귀 분석을 수행하였다.
결과
참가자의 9.1%가 우울 증상이 있었고, 16.4%가 불면 증상이 있었다. 일주기리듬 유형은 아침형(30.2%), 중간형(48.7%), 저녁형(21.1%)으로 구분하였다. 앞서 언급한 혼란 변수를 모두 통제한 다중 로지스틱 회귀분석 결과 저녁시간 집단의 우울 증상의 오즈비는 3.71(95% C.I. 1.50- 9.18) 아침형 그룹과 비교하여 R 제곱값은 0.151이었다. 또한 불면증 증상도 우울 증상에 통계적으로 유의한 영향을 미치는 것을 확인하였다 (OR = 2.16(95% C.I. 1.03-4.52)).
결론
우리 연구는 저녁형 간호사가 아침형 간호사보다 우울증에 걸릴 확률이 더 높다는 점을 시사한다. 간호사의 우울 증상을 줄이기 위해 저녁형 일주기리듬유형을 가진 간호사와 같은 고위험군에 대한 개입을 고려해야 한다.

Citations

Citations to this article as recorded by  
  • Relationship between mid-sleep time and depression, health-related quality of life, and sleep deprivation in the 2018 Korea Community Health Survey
    Mee-Ri Lee, Sung Min Jung, Seung Hee Choi, Hyeonji Hwang, Youngs Chang, Young Hwangbo
    Chronobiology International.2024; 41(1): 1.     CrossRef
  • Factors associated with chronotype, job burnout, and perceived stress among nurses in Chinese tertiary hospitals: A multicenter cross-sectional study
    Lijun Li, Xingxing Wang, Jian Zhou, Min Liu, Sha Wang, Yi Zhou, Yuxuan Li, Yue Kang, Jianfei Xie, Andy S. K. Cheng
    Chronobiology International.2024; 41(7): 1058.     CrossRef
  • Is evening chronotype associated with higher alcohol consumption? A systematic review and meta-analysis
    Rafaela Sirtoli, Gabriel Dionisio Gotardo Mata, Renne Rodrigues, Vicente Martinez-Vizcaíno, José Francisco López-Gil, Camilo Molino Guidoni, Arthur Eumann Mesas
    Chronobiology International.2023; 40(11): 1467.     CrossRef
  • Mediation analysis of chronotype, sleep-related factors, and depressive symptoms among workers: a cross-sectional study
    Seo Young Kim, Hyo Jeong Kim, Seong-Sik Cho, Min Young Park, Mo-Yeol Kang
    Annals of Occupational and Environmental Medicine.2023;[Epub]     CrossRef
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Research Articles
Longitudinal associations between occupational stress and depressive symptoms
Hyung Doo Kim, Shin-Goo Park, Youna Won, Hyeonwoo Ju, Sung Wook Jang, Go Choi, Hyun-Suk Jang, Hwan-Cheol Kim, Jong-Han Leem
Ann Occup Environ Med 2020;32:e13.   Published online May 7, 2020
DOI: https://doi.org/10.35371/aoem.2020.32.e13
AbstractAbstract PDFPubReaderePub
Background

Most of the studies that have examined the association between the sub-factors of occupational stress and depressive symptoms have used cross-sectional data. However, our study has longitudinally measured the occupational stress and depressive symptoms of Korean workers of a semiconductor manufacturing company across six years to intending to investigate the associations between the sub-factors of occupational stress and depressive symptoms using longitudinal data.

Methods

Data collected from the workers of a semiconductor manufacturing company. Out of 1,013 recruited workers, 405 (40.0%) completed the survey questionnaires at 3 and 6-year follow-ups. Occupational stress was measured using a shorter version of the Korean Occupational Stress Scale (KOSS), whereas depressive symptoms were assessed using the Korean version of the Center for Epidemiological Studies-Depressive Symptoms Scale (CES-D). The data of male and female participants independently analyzed. Longitudinal associations were analyzed using panel data analysis with fixed effects.

Results

In panel data analysis with fixed effects, job insecurity (B = 0.048, p-value = 0.004) was associated with depressive symptoms among male workers. In female workers, inadequate social support (B = 0.080, p-value < 0.001), job insecurity (B = 0.039, p-value = 0.004), lack of reward (B = 0.059, p-value = 0.004) and discomfort in occupational climate (B = 0.074, p-value < 0.001) were associated with depressive symptoms among female workers.

Conclusions

Temporal changes in the sub-factors of occupational stress were associated with changes in depressive symptoms within the same period. There was a gender difference in occupational stress sub-factors related to depressive symptoms.


Citations

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  • Association of nature of work and work-related characteristics with cognitive functioning, life satisfaction and depression among Indian ageing adults
    P. Padma Sri Lekha, E.P. Abdul Azeez, Arti Singh, C. V. Irshad
    International Archives of Occupational and Environmental Health.2024;[Epub]     CrossRef
  • Job stress and chronic low back pain: incidence, number of episodes, and severity in a 4-year follow-up of the ELSA-Brasil Musculoskeletal cohort
    Fernanda Corsino Lima Hubner, Rosa Weiss Telles, Luana Giatti, Luciana A. C. Machado, Rosane Harter Griep, Maria Carmen Viana, Sandhi Maria Barreto, Lidyane V. Camelo
    Pain.2024;[Epub]     CrossRef
  • Translation and Initial Validation of the Depression Anxiety and Stress Scale (DASS-21) in Ilokano
    Peejay D. Bengwasan, Allan B. I. Bernardo, Sally I. Maximo
    Psychological Studies.2022; 67(4): 594.     CrossRef
  • Prevalence of current and former smoking in industrial workers worldwide: a systematic review and meta-analysis
    Sohrab Amiri, Seyed Morteza Hosseini
    Journal of Addictive Diseases.2021; 39(3): 288.     CrossRef
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Depressive symptoms among dance artists in South Korea: balance between self- and social identity on job value
Sung-Shil Lim, Jihyun Kim, Seahee Yune, Jin-Ha Yoon
Ann Occup Environ Med 2019;31:e14.   Published online July 31, 2019
DOI: https://doi.org/10.35371/aoem.2019.31.e14
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Background

The balance between self- and social identity on job value of Korean dance artists, considered as performing artists, was measured to investigate the relationship between balance and depressive symptoms.

Methods

Data of 139 dance artists were analyzed for depressive symptoms assessed by their responses to questionnaires from the Center for Epidemiologic Studies Depression (CESD) translated into Korean. The balance score of each aspect of social identity compared to that of self-identity on job value was measured and classified as lower, equal, or higher. Following a graphical approach, we performed locally weighted scatterplot smoothing algorithm, simple linear regression, and quadric equation regression.

Results

The mean of CESD was highest in the higher balance group and lowest in the lower balance group. There was a linear relationship between balance score and CESD regarding specific audience, unspecified audience, and unspecified public. Balance score showed no association with other aspects of social identity. In the balance score range of 1 or higher, it was associated with CESD with respect to artist colleague, unspecified audience, and unspecified public.

Conclusions

Dance artists should maintain a balance between self- and social identity in job value to prevent depressive symptoms.


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Association between organizational justice and depressive symptoms among securities company workers
HyunSuk Lee, KangHyun Um, YoungSu Ju, Sukkoun Lee, Min Choi, Domyung Paek, Seong-Sik Cho
Ann Occup Environ Med 2019;31:e7.   Published online June 5, 2018
DOI: https://doi.org/10.35371/aoem.2019.31.e7
AbstractAbstract PDFPubReaderePub
Background

The organizational justice model can evaluate job stressor from decision-making process, attitude of managerial or senior staff toward their junior workers, and unfair resource distribution. Stress from organizational injustice could be harmful to workers' mental health. The purpose of this study is to explore the association between organizational justice and depressive symptoms in a securities company.

Methods

To estimate organizational justice, a translated Moorman's organizational justice evaluation questionnaire (Korean) was employed. Cronbach's α coefficient was estimated to assess the internal consistency of the translated questionnaire. To assess depressive symptoms, the Center for Epidemiologic Studies Depression (CES-D) scale was used. The link between the sub-concepts of the organizational justice model and depressive symptoms was assessed utilizing multiple logistic regression models.

Results

The risk of depressive symptoms was significantly higher among workers with higher levels of all subcategory of organizational injustice. In the full adjusted model odds ratio (OR) of higher level of procedural injustice 2.79 (95% confidence interval [CI], 1.58–4.90), OR of the higher level of relational injustice 4.25 (95% CI, 2.66–6.78), OR of higher level of distributional injustice 4.53 (95% CI, 2.63–7.83) respectively. Cronbach's α coefficient of the Korean version was 0.93 for procedural justice, 0.93 for relational justice, and 0.95 for distributive justice.

Conclusions

A higher level of organizational injustice was linked to higher prevalence of depressive symptoms among workers in a company of financial industry.


Citations

Citations to this article as recorded by  
  • Organizational Justice and Health: Reviewing Two Decades of Studies
    Laura Cachón-Alonso, Marko Elovainio, Richard Crisp
    Journal of Theoretical Social Psychology.2022; 2022: 1.     CrossRef
  • Effects of procedural justice on prospective antidepressant medication prescription: a longitudinal study on Swedish workers
    Viktor Persson, Constanze Eib, Claudia Bernhard-Oettel, Constanze Leineweber
    BMC Public Health.2020;[Epub]     CrossRef
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Original Articles
The Problem Drinking and Related Factors in Female Firefighters
Seung Won Yoo, Kyoo Sang Kim, Chung Yill Park, Min Gi Kim
Korean Journal of Occupational and Environmental Medicine 2012;24(2):124-132.   Published online June 30, 2012
DOI: https://doi.org/10.35371/kjoem.2012.24.2.124
AbstractAbstract PDF
OBJECTIVES
This study was conducted to investigate problem drinking and analyze factors associated with alcohol use among female firefighters, as well as to provide useful data for management of alcohol use by female firefighters.
METHODS
The study includeed 1,587 female firefighters from throught Koea. Data were collected from June to July in 2008 using self-administered questionnaires including a general questionnaire, work related questionnaire, the Alcohol Use Disorders Identification Test (AUDIT), the Korean Occupational Stress Scale Short Form (KOSS-26), and the Center for Epidemiologic Studies Depression Scale (CESD). Among 1,263 female firefighters (75.6%) surveyed, the results of 1,084 qualified questionnaires (70.5%) were analyzed using the chi-square test, Fisher's exact test, and multiple logistic regression.
RESULTS
The prevalence of problem drinking (AUDIT score > or =8) in female firefighters was 12.5%. Multiple logistic analysis showed that being single, smoking and depression were correlated with problem drinking. Single female firefighter, present smokers and individuals positive for symptoms of depression had OR values of 2.11, 17.58 and 1.76, respectively.
CONCLUSIONS
Three factors were found to influnce the occurrence of problem drinking. Accordingly, smoking related education, counseling to cope effectively with depression and health promotion programs that consider psychological effects of job stress are needed to reduce work related factors that lead to problem drinking by female firefighters.

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Depressive Symptoms and Their Association with Sleep Quality, Occupational Stress and Fatigue Among Small-Scaled Manufacturing Male Workers
Kyu Sun Lee, Dong Bae Lee, In Sun Kwon, Young Chae Cho
Korean Journal of Occupational and Environmental Medicine 2011;23(2):99-111.   Published online June 30, 2011
DOI: https://doi.org/10.35371/kjoem.2011.23.2.99
AbstractAbstract PDF
OBJECTIVES
To determine the depressive symptoms and their association with sleep quality, occupational stress and fatigue among small-scale manufacturing male workers.
METHODS
A self-administered questionnaire was distributed to 856 workers employed in 62 work places under 50 members of manufacturing industries from April 1st to June 30th, 2010. The questionnaire survey included sociodemographic and health-related characteristics, job-related characteristics, sleep quality (PSQI), occupational stress (KOSS), fatigue symptoms (MFS) and depressive symptoms (CES-D).
RESULTS
Among all subjects, 44.3% were in the depression group (21 points and over in the CES-D score), and it was positively correlated with occupational stress, fatigue and quality of sleep. The adjusted odds ratios for the effect of depression on sleep quality, occupational stress and fatigue were significantly increased in the high risk group compared to that in the normal group. Hierarchial multiple regression analysis revealed that the following factors of influence had combined explanatory powers of 49.3% on depression: marital status, BMI, subjective status of health, leisure time, job position, job tenure, sense of satisfaction in work, quality of sleep, occupational stress and fatigue.
CONCLUSIONS
The study results revealed a very complicated influence exerted on the level of depression by variable factors, as well as sociodemographic characteristics, health related characteristics and job-related characteristics, particularly quality of sleep, occupational stress and fatigue. Especially, the level of depression was more influenced by occupational stress than by quality of sleep and fatigue factors.

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Relationship between Job Stress and Depressive Symptoms among Field Firefighters
Tae Woo Kim, Kyoo Sang Kim, Yeon Soon Ahn
Korean Journal of Occupational and Environmental Medicine 2010;22(4):378-387.   Published online December 31, 2010
DOI: https://doi.org/10.35371/kjoem.2010.22.4.378
AbstractAbstract PDF
OBJECTIVES
To investigate the relationship between job stress and depressive symptoms among field firefighters.
METHODS
We carried out a survey of 17,457 field firefighters using the KOSS-24 (Korean Occupational Stress Scales-24) and CES-D (Center for Epidemiological Studies-Depression Scale).
RESULTS
The mean CES-D score was 12.2+/-9.6 and 19.2% of subjects had depressive symptoms. Job insecurity (OR=2.70, 95% CI=2.45~2.98) and lack of reward (OR=2.41, 95% CI=2.18~2.65), occupational climate (OR=2.38, 95% CI=2.15~2.63) were strongly associated with depressive symptoms. Job demand (OR=1.89, 95% CI=1.69~2.10), insufficient job control (OR=1.14, 95% CI=1.03~1.25), interpersonal conflict (OR=2.05, 95% CI=1.87~2.26) and organizational system (OR=1.83, 95% CI=1.66~2.02) were also significantly associated with depressive symptoms. Alcohol dependence had a stronger association than with normal subjects (OR=2.39, 95% CI=2.07~2.77).
CONCLUSIONS
In field firefighters, job stress factors and alcohol dependence were associated with depressive symptoms. An intervention to reduce job stress and alcohol among field firefighters is needed to reduce depression in this population.

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A Study on the Relationship between Emotional Labor and Depressive Symptoms among Korean Industrial Service Employees
Soo Youn Kim, Sei Jin Chang, Hyoung Ryoul Kim, Jae Hoon Roh
Korean Journal of Occupational and Environmental Medicine 2002;14(3):227-235.   Published online September 30, 2002
DOI: https://doi.org/10.35371/kjoem.2002.14.3.227
AbstractAbstract PDF
OBJECTIVES
This study was designed to identify the relationship between emotional labor and depressive symptoms among Korean industrial service employees.
METHODS
The case group consisted of 331 employees who were performing emotional labor at department stores, hotels, and family restaurants in Seoul. The control group in this study consisted of 150 employees (90 officers in Seoul and 60 manufacturing workers in Incheon) who were not expected to perform emotional labor. A structured questionnaire was used to estimate each participants level of emotional labor, general characteristics, job content, job satisfaction, and any depressive symptoms. The measurements for emotional labor were performed only on the case group and not the control group.
RESULTS
While the mean values of job satisfaction, job insecurity, and the level of depressive symptoms of the employees who were working in the area of emotional labor were higher than the others, the mean values of job demand, and job control in the same group were lower than those who were not performing emotional labor. Overall, it was found that performing emotional labor and having high levels of job insecurity were related to increased depressive symptoms, and conversely, job satisfaction played a role in reducing depressive symptoms. Similarly, in the sub-sample of the emotional labor group, high levels of job insecurity, and performing high degrees of emotional labor, and low job satisfaction were associated with depressive symptoms.
CONCLUSIONS
These results suggest that performing emotional labor is related to an increase in depressive symptoms. In other words, involuntary emotional expression and low job satisfaction in the workplace may influence the level of depressive symptoms in workers. It is, therefore, imperative that further research be undertaken, which considers the importance of emotional labor, and its adverse effect on the mental health of service workers.

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