Annals of Occupational and Environmental Medicine

Original Article

The risk of insomnia by work schedule instability in Korean firefighters: Saebomi Jeong, Jeonghun Kim, Sung-Soo Oh, Hee-Tae Kang, Yeon-Soon Ahn, Kyoung Sook Jeong; Ann Occup Environ Med 2024;36:e24. Published online September 10, 2024; DOI: https://doi.org/10.35371/aoem.2024.36.e24

Abstract Abstract in Korean PDF Supplementary Material PubReader ePub: Background
Firefighters are exposed to shift work, as well as unpredictable emergency calls and traumatic events, which can lead to sleep problems. This study aimed to investigate the risk of insomnia by work schedule instability in Korean firefighters.
Methods
This study used the Insomnia Severity Index to assess the insomnia in firefighters. The work schedule stability was classified with the frequency of the substitute work and the timing of notification for work schedule changes. Logistic regression analysis was used to assess the adjusted odds ratio of insomnia by work schedule stability with covariates including sex, age, education, smoking, alcohol, caffeine intake, shift type, job, and underlying conditions.
Results
Of the 8,587 individuals, 751 (8.75%) had moderate to severe insomnia (Insomnia Severity Index ≥ 15). The prevalence of insomnia was statistically significantly higher as the frequency of substitute work increased: <1 time per month (6.8%), 1–2 times (9.5%), 3–5 times (13.4%), and more than 5 times (15.7%) (p < 0.001). Additionally, the prevalence of insomnia was statistically significantly higher when the timing of the schedule change notification was urgent or irregular: no change or several weeks before (5.4%), several days before (7.9%), one day before or on the day (11.2%), irregularly notification (11.6%) (p < 0.001). In comparison to the group with good frequency of the substitute work/good timing of schedule change notification group, the adjusted odds ratios of insomnia were 1.480 (95% confidence interval [CI]: 1.237–1.771) for Good/Bad group, 1.862 (95% CI: 1.340–2.588) for Bad/Good group, and 1.885 (95% CI: 1.366–2.602) for Bad/Bad group.
Conclusions
Work schedule instability was important risk factor of insomnia in firefighters. It suggests that improving the stability of work schedules could be a key strategy for reducing sleep problems in this occupational group.; 한국 교대근무 소방관에서 근무 스케줄 불안정성에 따른 불면증 유병 위험
목적
한국 교대근무 소방관에서 근무 스케줄 불안정성이 불면증 유병 위험을 평가하였다.
방법
한국판 불면증 심각도 평가척도를 이용하여 불면증을 평가하였다. 근무 스케줄 안정성으로는 월별 대체 근무 횟수 및 근무일정 변경 통보 시점으로 분류하였다. 월별 대체 근무 횟수 및 근무일정 변경 통보 시점을 각각 좋음, 나쁨으로 분류하고, 두 요인을 조합하여 좋음/좋음, 좋음/나쁨, 나쁨/좋음, 나쁨/나쁨의 4개 그룹으로 나누었다. 통계분석은 카이제곱검정, t-검정, 로지스틱 회귀 분석을 사용하였다.
결과
8,587명 중 751명(8.75%)은 중등도 이상의 불면증이 있었다. 별 대체근무 일수가 증가할수록, 근무 일정 변화를 미리 고지하지 않을수록 불면증 유병률이 유의하게 높았다. 4개의 그룹으로 나누어 근무 예측 가능성과 불면증의 연관성을 분석한 결과, 대체 근무 빈도가 “좋음”그룹/근무일정 변경 통보 시점이 “좋음” 그룹과 비교하여 불면증의 보정 비차비는 “좋음/나쁨” 그룹은 1.480(95%신뢰구간: 1.237~1.771), “나쁨/좋음” 그룹은 1.862(95% CI: 1.340~2.588), “나쁨/나쁨”그룹은 1.885(95% CI: 1.366~2.602)였다.
결론
근무 스케줄 안정성이 좋지 못할수록 불면증의 위험성이 높았다.

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Original Article

The effect of blood cadmium levels on hypertension in male firefighters in a metropolitan city: Ye-eun Jeon, Min Ji Kim, Insung Chung, Jea Chul Ha; Ann Occup Environ Med 2022;34:e37. Published online November 8, 2022; DOI: https://doi.org/10.35371/aoem.2022.34.e37

Abstract Abstract in Korean PDF Supplementary Material PubReader ePub

Background

This study investigated the effect of dispatch frequency on blood cadmium levels and the effect of blood cadmium levels on hypertension in male firefighters in a metropolitan city.

Methods

We conducted a retrospective longitudinal study of male firefighters who completed the regular health checkups, including a health examination survey and blood cadmium measurements. We followed them for 3 years. To investigate the effect of dispatch frequency on blood cadmium levels and the effect of blood cadmium levels on hypertension, we estimated the short-term (model 1) and long-term (model 2) effects of exposure and hypothesized a reversed causal pathway model (model 3) for sensitivity analysis. Sequential conditional mean models were fitted using generalized estimating equations, and the odds ratios (ORs) and the respective 95% confidence intervals (CIs) were calculated for hypertension for log-transformed (base 2) blood cadmium levels and quartiles.

Results

Using the lowest category of dispatch frequency as a reference, we observed that the highest category showed an increase in blood cadmium levels of 1.879 (95% CI: 0.673, 3.086) μg/dL and 0.708 (95% CI: 0.023, 1.394) μg/dL in models 2 and 3, respectively. In addition, we observed that doubling the blood cadmium level significantly increased the odds of hypertension in model 1 (OR: 1.772; 95% CI: 1.046, 3.003) and model 3 (OR: 4.288; 95% CI: 1.110, 16.554). Using the lowest quartile of blood cadmium levels as a reference, the highest quartile showed increased odds of hypertension in model 1 (OR: 2.968; 95% CI: 1.121, 7.861) and model 3 (OR: 33.468; 95% CI: 1.881, 595.500).

Conclusions

We found that dispatch frequency may affect blood cadmium levels in male firefighters, and high blood cadmium levels may influence hypertension in a dose-response manner.

대도시 남성 소방관에서의 혈중 카드뮴 농도가 고혈압에 미치는 영향
목적
본 연구에서는 대도시 남성 소방관에서 출동빈도가 혈중 카드뮴 농도에 미치는 영향과 혈중 카드뮴 수치가 고혈압에 미치는 영향을 조사하였다.
방법
남성 소방관들을 대상으로 설문조사와 혈중 카드뮴 농도 및 혈압 측정을 포함하는 건강검진을 실시하였다. 2015년부터 2017년까지 3년 간 추적하였으며, 최종 연구 대상자는 215명이었다. 출동빈도가 혈중 카드뮴 농도에 미치는 영향과 고혈압에 대한 혈중 카드뮴 농도의 영향을 조사하기 위해 단기간 노출 효과 (모델1), 장기간 노출 효과 (모델2), 역방향 노출 효과(모델3)를 가정하여 분석하였다. 순차적 조건부 평균 모델 (sequential conditional mean model)을 적용하였고, 일반화 추정 방정식 (generalized estimating equations)을 사용하여 오즈비와 95% 신뢰구간을 계산하였다.
결과
가장 낮은 사분위의 출동 빈도 그룹을 기준으로 가장 높은 사분위수 그룹은 모델 2와 모델3에서 혈중 카드뮴 수치가 각각 1.879 (95% CI 0.673-3.086) μg/dL, 0.708 (95% CI 0.023-1.394) μg/dL 증가하였다. 혈중 카드뮴 농도가 두 배로 증가할 때마다 모델 1과 3 (OR [95% CI] 1.772 [1.046–3.003], 4.288 [1.110–16.554])에서 고혈압 발생 위험이 증가한다는 것을 관찰했다. 혈중 카드뮴 농도가 가장 낮은 사분위수 그룹을 기준으로 할 때, 가장 높은 사분위수 그룹은 모델 1과 3(OR [95% CI] 2.968 [1.121–7.861], 33.468 [1.881–595.500])에서 고혈압 발생 위험이 증가하였다. 혈중 카드뮴 농도와 고혈압 발생 사이의 용량-반응 관계는 모든 시나리오에서 관찰되었다.
결론
본 연구에서는 출동 빈도가 혈중 카드뮴 농도에 영향을 미칠 수 있고, 높은 혈중 카드뮴 농도가 고혈압에 영향을 미칠 수 있다는 것을 발견했다. 다양한 연구모집단에 대해 카드뮴의 다양한 생체지표를 사용하여 추가 연구가 수행되어야 할 것이다. 또한 일반적으로 단일 중금속 노출보다는 복합 중금속 노출의 가능성이 높으므로, 향후 연구에서는 중금속의 상호작용에 대해 평가하여야 할 것이다.

Citations

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Internal Flames: Metal(loid) Exposure Linked to Alteration of the Lipid Profile in Czech Male Firefighters (CELSPAC-FIREexpo Study)
Nina Pálešová, Katarína Řiháčková, Jan Kuta, Aleš Pindur, Ludmila Šebejová, Pavel Čupr
Environmental Science & Technology Letters.2024; 11(7): 679. CrossRef
Heavy metal exposure linked to metabolic syndrome in Korean male firefighters: FRESH cohort cross-sectional analysis
Jee Eun Choi, Mun-Joo Bae, Mi-Ji Kim, Sung Soo Oh, Ki Soo Park, Chan Joo Lee, Sungha Park, Sang-Baek Koh, Jaelim Cho, Changsoo Kim
Scientific Reports.2023;[Epub] CrossRef

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Original Article

Association between sleep quality and type of shift work in Korean firefighters: Hyun-Jeong Oh, Chang Sun Sim, Tae-Won Jang, Yeon Soon Ahn, Kyoung Sook Jeong; Ann Occup Environ Med 2022;34:e27. Published online October 11, 2022; DOI: https://doi.org/10.35371/aoem.2022.34.e27

Abstract Abstract in Korean PDF PubReader ePub

Background

Shift work that interferes with normal sleep patterns, is known to be a cause of sleep disturbance and has been studied through various occupational groups. However, it is not known which shift type is better for sleep health.

Methods

This study included 568 firefighters. Sleep quality was evaluated using Pittsburgh Sleep Quality Index. Sleep quality was categorized into 2 groups; good quality (≤ 5 points) and poor quality (≥ 6 points). Demographic variables, depression, anxiety, type of shift, and job were collected by self-reported questionnaires. The χ² test, t-test, and multiple logistic regression analysis were used to evaluate the effect of shift type on the sleep quality of firefighters.

Results

Three hundred thirty-seven firefighters (59.3%) have poor sleep quality. Compared to day workers, the odds ratios (ORs) of poor sleep quality were 2.169 (95% confidence interval: 1.137–4.134) in 6-day cycle, 2.161 (1.150–4.062) in 9-day cycle, 1.805 (1.087–2.997) in 21-day cycle, and 1.485 (0.718–3.069) in 3-day cycle. The ORs of poor sleep quality were 1.697(1.021–2.823) in fire suppression and 2.325 (1.213–4.455) in emergency medical service compared to administration.

Conclusions

All shift work type except for the 3-day cycle was associated with poor sleep quality compared to day work.

한국 소방관에서 수면의 질과 교대근무 유형의 연관성
목적
소방관의 수면의 질에 어떤 교대근무 유형이 적합한지 결정하는 것이다.
방법
이 연구는 568명의 소방관을 포함하여 피츠버그 수면의 질 지수를 사용하여 수면의 질을 평가하였고, 다른 교란 요인은 자기보고형태의 설문지를 통해 수집하였다. 소방관의 수면의 질에 대한 교대근무 유형의 영향을 평가하기 위하여 카이제곱 검정, t-검정, 다중 로지스틱 회귀 분석을 사용하였다.
결과
337명(59.3%)은 나쁜 수면의 질을 가졌다. 주간 근무자와 비교했을 때, 나쁜 수면의 질에 대한 오즈비는 6주기에서 2.161 (95% 신뢰구간 1.137-4.134), 9주기에서 2.161 (1.150-4.062), 21주기에서 1.805 (1.087-2.997), 3주기에서 1.485 (0.718-3.069). 직무별로는 행정에 비해 화재진압 소방관의 수면의 질이 나쁠 오즈비는 1.697 (1.021-2.823)이었고, 구급업무 소방관은 2.325 (1.213-4.455)이었다.
결론
3주기를 제외하고 다른 형태의 교대근무에서 수면의 질은 주간근무에 비해 에서 나쁜 것으로 나타났다.

Citations

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Association of age and night flight duration with sleep disorders among Chinese airline pilots
Ruizi Shi, Fang Wang, Wanying Xu, Li Fu
Frontiers in Public Health.2023;[Epub] CrossRef
Working hours and the regulations for night shift workers
Tae-Won Jang
Annals of Occupational and Environmental Medicine.2023;[Epub] CrossRef

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Original Article

Hospital admissions due to endocrine diseases in Korean male firefighters: Seunghoon Ryu, Yong-Jin Lee, Eun-Chul Jang, Soon-Chan Kwon, KiSeok Kim, Yeon-Soon Ahn, Young-Sun Min; Ann Occup Environ Med 2021;33:e32. Published online October 28, 2021; DOI: https://doi.org/10.35371/aoem.2021.33.e32

Abstract Abstract in Korean PDF PubReader ePub: Background
The aim of this study was to investigate the relationship between occupational exposure to various hazards and hospital admission due to endocrine diseases in Korean male firefighters.
Methods
From 2000 to 2008, former and current male firefighters registered in the Korean National Emergency Management Agency were investigated based on their hospitalized health insurance admission data for the same period. Admission data for endocrine, nutritional, and metabolic diseases were obtained from the Korean National Health Insurance Service database. Standardized admission ratio (SAR) with reference to the general population of Korean men was analyzed.
Results
SAR for firefighters with endocrine, nutritional, and metabolic diseases was 0.56 (95% confidence interval [CI]: 0.49–0.65), which was significantly less than that of the general population of Korean men. For those with endocrine, nutritional, and metabolic diseases, SARs for those with a history of fire suppression tasks and those without experience of fire suppression tasks were 0.58 (95% CI: 0.49–0.68) and 0.53 (95% CI: 0.40–0.70), respectively.
Conclusions
The admission rate of Korean male firefighters due to endocrine, nutritional and metabolic diseases was significantly lower than that of the general Korean men population, the hazardous potential of endocrine disruptors remains an open question. Further studies of firefighters with longer follow-up are needed.; 한국 남성 소방관에서 내분비 질환으로 인한 입원
목적
본 연구의 목적은 남성 소방관들을 대상으로 유해인자 노출과 내분비질환과의 관련성을 조사해보고자 하였다.
방법
2000년부터 2008년까지 소방방재청에 등록된 총 34,875명의 전·현직 남성 소방관들의 건강검진 자료와 동일 기간 건강보험 입원자료를 근간으로 전·현직 남성 소방관들에 대해 조사하였고, 이를 일반인구집단과 비교하여 표준화입원비를 분석하였다.
결과
내분비, 영양 및 대사질환의 표준화입원비는 0.56(95% 신뢰구간: 0.49-0.65)으로 우리나라 일반 남성들에 비하여 통계적으로 유의하게 적게 입원하였다. 또한, 화재진압 유무에 따라 분석하였을 때, 내분비, 영양 및 대사질환의 표준화입원비는 화재진압 유경력자는 0.58(95% 신뢰구간:0.49-0.68), 무경력자는 0.53(95% 신뢰구간: 0.40-0.70)으로 두 집단 모두 우리나라 일반 남성들에 비하여 통계적으로 유의하게 적게 입원하였다.
결론
우리나라 남성 소방관들의 내분비, 영양 및 대사질환의 표준화입원비는 우리나라 일반 남성에 비하여 통계적으로 유의하게 낮았다.

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Research Article

Related factors for preserving firefighter's pulmonary function: Seonggyu Kim, Ye-eun Jeon, Hyeseung Ryu, Mi-Young Lee, Insung Chung; Ann Occup Environ Med 2020;32:e40. Published online December 18, 2020; DOI: https://doi.org/10.35371/aoem.2020.32.e40

Abstract PDF PubReader ePub

Background

Firefighters are constantly exposed to harmful substances in the respiratory tract and require management measures. We comprehensively compared factors affecting the lung function of firefighters to identify management measures that can reduce the deterioration of lung function.

Methods

A cross-sectional study was conducted in 1,108 male firefighters. Subjects were surveyed with self-written questionnaires that included a history of smoking, number of workouts per week, work department, and medical history, including diseases that could affect lung function. Body mass index was calculated using an automatic body measurement instrument and body fat, body fat percentage, muscle mass, and skeletal muscle mass were measured using Inbody 770. Based on the body weight obtained from body measurements, skeletal muscle mass height-adjusted skeletal muscle index (hSMI) compared to height was determined. For lung function, forced expiratory volume in one second (FEV₁), forced vital capacity (FVC), FEV₁/FVC, and peak expiratory flow (PEF) were measured using a spirometer HI-801. Analysis of variance and independent t-tests were performed for univariate analysis of factors that could affect lung function, and multiple regression analysis was performed for multivariate analysis.

Results

When the factors relating lung function were analyzed using regression analysis, FEV₁ was negatively correlated with age, body fat percentage, and duty year, positively with height and hSMI. FVC increased with height and hSMI, decreased with age, body fat percentage, and duty year. FEV₁/FVC was related with age, height, body fat percentage and working history. Height and muscle mass were analyzed as related factors on PEF. When the analysis was conducted on firefighters who exercised more than 3 times a week, working history had lower relation with FEV₁ and body fat percentage had no relation with FEV₁/FVC.

Conclusion

We suggest management measures to reduce body fat percentage and increase skeletal muscle mass to maintain lung function in firefighters.

Citations

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A 7-Month Multidisciplinary Healthy Lifestyle Intervention Effectively Improved Cardiometabolic Risk Profile of Firefighters
Daniel Rodrigues Ferreira Saint-Martin, Kevin Alves Barreto, Edgard M. K. Von Koenig Soares, Marcelo Serejo Machado, Cristiana Soares dos Santos Morais, Adriana Mendonça Bonadio Barbosa, Rosenkranz Maciel Nogueira, Susanne D’Isabel, Denise L. Smith, Guilh
Journal of Occupational & Environmental Medicine.2024; 66(8): 605. CrossRef
Longitudinal lung function in urban firefighters: A group‐based multi‐trajectory modelling approach
Catherine Pendergrast, Terry Boyle, Alan J. Crockett, Roger Eston, Kylie N. Johnston
Respirology.2023; 28(3): 247. CrossRef

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Research Article

Psychosocial factors affecting sleep quality of pre-employed firefighters: a cross-sectional study: MyeongSeob Lim, Solam Lee, Kwanghyun Seo, Hyun-Jeong Oh, Ji-Su Shin, Sung-Kyung Kim, Hee-Tae Kang, Kyeong-Sook Jeong, Sung-Soo Oh, Sang-Baek Koh, Yeon-Soon Ahn; Ann Occup Environ Med 2020;32:e12. Published online May 8, 2020; DOI: https://doi.org/10.35371/aoem.2020.32.e12

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Background

There have been no health-related studies of pre-employed firefighters without firefighter-specific job-related factors (FSJRF). This study aimed to evaluate the sleep quality of pre-employed firefighters and to examine the relationship between sleep quality and psychosocial factors.

Methods

We conducted a self-report questionnaire survey for 602 pre-employed firefighters at 3 Fire Service Academies after brief lecture about sleep. Sleep quality and psychosocial variables such as depression, anxiety, stress and social support were evaluated. The independent 2 sample t-test, χ² test and multiple logistic regression analysis were used to evaluate the effect of the variables on the sleep quality of pre-employed firefighters.

Results

Among a total of 602 people, 347 (57.6%) had good sleep quality and 255 (42.4%) had poor sleep quality. Pittsburgh Sleep Quality Index score of them was 3.29 ± 1.41) and 7.87 ± 2.20), respectively. 24 (4.0%) were evaluated to have insomnia by Insomnia Severity Index. Logistic regression analyses showed that the depression (adjusted odds ratio [aOR]: 5.940, 95% confidence interval [CI]: 3.124–11.292), anxiety (aOR: 4.233, 95% CI: 2.138–8.381), stress (aOR: 2.880, 95% CI: 1.915–4.330) and social support (aOR: 0.959, 95% CI: 0.939–0.980) have a significant effect on sleep quality after adjusted by sex, age, smoking status, drinking status, caffeine intake, past shift working and circadian rhythm type.

Conclusions

Depression, anxiety, stress and social support were associated with sleep quality among pre-employed firefighters. Repeated follow-up studies of pre-employed firefighters are needed to further assess their change of sleep quality and identify the FSJRF that may affect the sleep quality of firefighters.

Citations

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Screening for Comorbidity of Sleep Disorders in Career Firefighters
Nancy A. Hamilton, Julia Russell, Kareem Hamadah, Westley Youngren, Addie Toon, Thu A. Nguyen, Kevin Joles
Journal of Occupational & Environmental Medicine.2024; 66(1): 43. CrossRef
Global prevalence and associated factors of sleep disorders and poor sleep quality among firefighters: A systematic review and meta-analysis
Amir Hossein Khoshakhlagh, Saleh Al Sulaie, Saeid Yazdanirad, Robin Marc Orr, Hossein Dehdarirad, Alireza Milajerdi
Heliyon.2023; 9(2): e13250. CrossRef
Prevalence and associated factors of poor sleep quality among industrial workers in Addis Ababa, Ethiopia: findings from a cross-sectional study
Amensisa Hailu Tesfaye, Addisu Genene Masresha, Tirhas Tadesse, Fantu Mamo Aragaw, Belay Desye, Giziew Abere
BMJ Open.2023; 13(10): e073340. CrossRef
Daily Sleep–Stress Reactivity and Functional Impairment in World Trade Center Responders
Brett A Messman, Danica C Slavish, Madasen Briggs, Camilo J Ruggero, Benjamin J Luft, Roman Kotov
Annals of Behavioral Medicine.2023; 57(7): 582. CrossRef
Sleep Quality and Associated Factors among Firefighters in Bangkok, Thailand: A Cross-sectional Study
Nunnapat Piyachaiseth, Pornchai Sithisarankul, Jate Ratanachina
Journal of Preventive Medicine and Public Health.2023;[Epub] CrossRef
Heterogeneity in patterns of posttraumatic stress disorder symptoms and sleep disturbances among firefighters: Latent profile analyses
Elizabeth L. Griffith, Ling Jin, Ateka A. Contractor, Danica C. Slavish, Anka A. Vujanovic
Journal of Psychiatric Research.2022; 153: 64. CrossRef
Association between sleep quality and type of shift work in Korean firefighters
Hyun-Jeong Oh, Chang Sun Sim, Tae-Won Jang, Yeon Soon Ahn, Kyoung Sook Jeong
Annals of Occupational and Environmental Medicine.2022;[Epub] CrossRef
Firefighter sleep: a pilot study of the agreement between actigraphy and self-reported sleep measures
Joel M. Billings
Journal of Clinical Sleep Medicine.2022; 18(1): 109. CrossRef

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Research Article

Pregnancy, childbirth, and puerperium outcomes in female firefighters in Korea: Juha Park, Yeon-Soon Ahn, Min-Gi Kim; Ann Occup Environ Med 2020;32:e8. Published online January 31, 2020; DOI: https://doi.org/10.35371/aoem.2020.32.e8

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Background

Female firefighters are exposed to hazardous environmental (chemical and physical) and working (shift work, psychological, and ergonomic factors) conditions that have reported or are suspected of adverse effects on reproductive health. However, no previous studies have reported on pregnancy, childbirth, and puerperium outcomes (PCPOs) in female firefighters.

Methods

The present study compared hospital admissions for PCPOs, based on 10th revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-10) codes, among Korean female firefighters with those of the general Korean population. Standardized admission ratios (SARs) and their 95% confidence intervals (CIs) were calculated.

Results

The study population included 1,766 female firefighters. Total follow-up duration was 9,659 person-years. Compared to the general female population, the female firefighters' SARs were higher in all admissions for PCPOs (SAR, 1.92; 95% CI: 1.79–2.05); pregnancy and abortive outcomes (SAR, 1.56; 95% CI: 1.12–2.12); other maternal disorders predominantly related to pregnancy (SAR, 2.65; 95% CI: 1.99–3.46); maternal care related to the fetus, amniotic cavity, and possible delivery problems (SAR, 2.13; 95% CI: 1.74–2.57); labor and delivery complications (SAR, 1.55; 95% CI: 1.15–2.06); delivery (SAR, 1.94; 95% CI: 1.80–2.08); and complications predominantly related to puerperium (SAR, 4.68; 95% CI: 2.02–9.23).

Conclusion

The results of this study showed high SARs in all and specific subcategories of PCPOs in female firefighters.

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Florencia Anunziata, Madison Chapman, Erin Delker, Shana Hayes, Miguel Del Campo, Rebecca J. Baer, Gretchen Bandoli
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Ainslie Kehler, Sara Jahnke, Filip Kukić, Aspen E. Streetman, Katie M. Heinrich
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Firefighter occupational factors and the risk of preterm birth: results from a survey of women firefighters in the USA
Alesia M Jung, Sara A Jahnke, Leslie K Dennis, Melanie L Bell, Jefferey L Burgess, Leslie V Farland
Occupational and Environmental Medicine.2023; 80(2): 77. CrossRef
Birth defects associated with paternal firefighting in the National Birth Defects Prevention Study
Miriam R. Siegel, Carissa M. Rocheleau, Brittany S. Hollerbach, Amel Omari, Sara A. Jahnke, Lynn M. Almli, Andrew F. Olshan
American Journal of Industrial Medicine.2023; 66(1): 30. CrossRef
Occupational factors and miscarriages in the US fire service: a cross-sectional analysis of women firefighters
Alesia M. Jung, Sara A. Jahnke, Leslie K. Dennis, Melanie L. Bell, Jefferey L. Burgess, Nattinee Jitnarin, Christopher M. Kaipust, Leslie V. Farland
Environmental Health.2021;[Epub] CrossRef

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Research Article

Descriptive analysis of prevalence and medical expenses of cancer, cardio-cerebrovascular disease, psychiatric disease, and musculoskeletal disease in Korean firefighters: Jeehee Min, Yangwoo Kim, Hye Sim Kim, Jiyoung Han, Inah Kim, Jaechul Song, Sang-Baek Koh, Tae-Won Jang; Ann Occup Environ Med 2020;32:e7. Published online January 30, 2020; DOI: https://doi.org/10.35371/aoem.2020.32.e7

Abstract PDF Supplementary Material PubReader ePub

Background

Firefighters are exposed to many dangerous working conditions. Many studies have identified the risk of disease for firefighters, but only a few studies have addressed the medical expenses of firefighters, which represents a concrete scale of disease. Our purpose in this study was to determine the medical expenditures of firefighters to assess the overall scale of disease in Korea. We focused on cancer, mental disorders, cardio-cerebrovascular disease, and musculoskeletal disease, the prevalence of which was expected to be high in firefighters.

Methods

This study utilized National Health Insurance Service data. We targeted firefighters, police officers, and government officials. We classified disease based on the 10th revision of the International Statistical Classification of Diseases and Related Health Problems codes. We compared prevalence by the age-standardized prevalence rate, considering standard distribution of the population. Medical expenditure of disease was defined as outpatient fees, hospitalization fees, and drug costs. Total medical expenditures were calculated by the sum of those 3 categories.

Results

The age-standardized prevalence of cancer, mental disorders, and cardiovascular disease in firefighters was slightly higher than or similar to that of government officials and police officers (no significant difference). However, medical expenditures for stomach cancer, mental disorders, and most cardio-cerebrovascular diseases were higher in firefighters than in others. In particular, firefighters spent 12 times more money for ischemic heart disease than did government officials. Of musculoskeletal diseases, lumbar disc disorder had the highest expenditures among firefighters.

Conclusions

The age-standardized prevalence of most of diseases of firefighters was not as high as in the other groups, but the medical expenses of firefighters were much higher than those of government officials and police officers.

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The global prevalence of musculoskeletal disorders among firefighters: a systematic review and meta-analysis
Amir Hossein Khoshakhlagh, Saeid Yazdanirad, Saleh Al Sulaie, Abdollah Mohammadian-Hafshejani, Robin Marc Orr
International Journal of Occupational Safety and Ergonomics.2024; 30(1): 272. CrossRef
Risk of Cerebro-Cardiovascular Diseases among Police Officers and Firefighters: A Nationwide Retrospective Cohort Study
Jongin Lee, Woo-Ri Lee, Ki-Bong Yoo, Jaelim Cho, Jinha Yoon
Yonsei Medical Journal.2022; 63(6): 585. CrossRef
Non-cancer health risks in firefighters: a systematic review
Jeong Ah Kim, Soo Yeon Song, Wonjeong Jeong, Jae Kwan Jun
Epidemiology and Health.2022; 44: e2022109. CrossRef

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Research Article

Validity assessment of self-reported smoking status in firefighters using the urine cotinine test: Han Cheol Heo, Young Seok Byun, Soo Ho Sohn, Seong Min Jo, Sung Kyu Park, Joon Sakong; Ann Occup Environ Med 2020;32:e2. Published online January 2, 2020; DOI: https://doi.org/10.35371/aoem.2020.32.e2

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Background

In firefighters, smoking management is important because they are exposed to various harmful substances in their occupational environment. Accurate surveys of smoking status are essential to control tobacco use. The main disadvantage of self-report questionnaires, which are commonly used for investigating smoking status, is the possibility that the subjects' response are invalid. If the validity of firefighters' answers on smoking questionnaires is not adequate, different methods will be needed for investigating smoking status in firefighters.

Methods

This study was conducted on 445 male firefighters from 9 fire stations in Daegu (the city in South Korea) who visited a medical institution for medical checkup in 2016. The urine cotinine test strip (DCT-102; CLIAwaived Inc., cut-off value = 200 ng/mL) was used to classify the actual smoking status and to assess the validity of self-reported smoking status on questionnaires. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of the smoking questionnaires were analyzed. Subjects testing positive in the urine cotinine test (assumed the actual current smokers) were selected. The frequency at which actual current smokers were misclassified as current non-smokers by the questionnaire was calculated. Subjects' characteristics were analyzed for possible association with any discrepancy between self-reported smoking status and urine cotinine test results.

Results

The smoking rates among firefighters surveyed using the smoking questionnaire and the urine cotinine test were 22.47% and 51.24%, respectively. Of the all subjects, 29.66% (n = 132) were misclassified. The sensitivity of the smoking questionnaire was 42.98%, the specificity was 99.08%, the PPV was 98.00%, and the NPV was 62.32%. In the 228 subjects classified as current actual smokers by the urine cotinine test, 57.02% (n = 130) were misclassified on the questionnaire. The misclassification rate increased with age. The degree of misclassification also increased when subjects had a history of disease.

Conclusions

In present study, the validity of the smoking questionnaire for firefighters was not suitable for investigating smoking status due to low sensitivity. To increase the validity of smoking status monitoring in firefighters, consideration of the various factors like survey environment, subjects' characteristics, and occupational factors is needed.

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Association between Smoking Status and the Risk of Hip Fracture in Patients with Type 2 Diabetes: A Nationwide Population-Based Study
Se-Won Lee, Jun-Young Heu, Ju-Yeong Kim, Jinyoung Kim, Kyungdo Han, Hyuk-Sang Kwon
Endocrinology and Metabolism.2023; 38(6): 679. CrossRef
Smoking Prevalence and Factors Associated with False Reporting in Korean Adolescents: The Korea National Health and Nutrition Examination Survey (2016-2020)
Seong Jun Park, Yoo Bin Seo, Jungun Lee, Seung Hee Kim, Chung Hwan Kim
Korean Journal of Family Practice.2022; 12(5): 375. CrossRef
Combustible cigarettes, heated tobacco products, combined product use, and periodontal disease: A cross-sectional JASTIS study
Takashi Yoshioka, Takahiro Tabuchi, Stanton A. Glantz
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Biomonitoring of smoke exposure in firefighters: A review
Biban Gill, Philip Britz-McKibbin
Current Opinion in Environmental Science & Health.2020; 15: 57. CrossRef

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Research Article

Emotional labor and job types of male firefighters in Daegu Metropolitan City: Sung Kyu Park, Han Cheol Heo, Joon Sakong, Man Joong Jeon; Ann Occup Environ Med 2019;31:e25. Published online September 26, 2019; DOI: https://doi.org/10.35371/aoem.2019.31.e25

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Background

Research on the emotional labor of firefighters is actively being carried out, but studies that analyze emotional labor separately by job types, working departments, and other conditions of firefighters are insufficient. The purpose of this study is to investigate the difference in emotional labor level between departments and other conditions of firefighters.

Methods

A total of 287 Korean firefighters were included for analysis. The demands of emotional labor and emotional damage were measured using the Korean Emotional Labor Scale. To analyze the conditions and factors affecting the emotional labor level of the firefighters, logistic regression analysis was performed using the emotional labor high risk group as a dependent variable.

Results

The average score of overall emotional labor level of the firefighters was 47.2 ± 17.3, and the prevalence of high risk firefighters with emotional labor was 27.1%. It was found that the emergency medical service and administration departments showed a higher prevalence of high risk emotional labor firefighters than did other departments. The result of multiple logistic regression analysis for the high risk emotional labor firefighters showed that the adjusted odds ratio of emergency medical service department compared to the reference group (the rescue department) was 2.89 (95% confidence interval [CI]: 1.02–8.24).

Conclusions

Among the firefighters, the emergency medical service department is a high risk factor for emotional labor. Therefore, education and prevention training on emotional labor should be more thorough before work shifts.

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Global prevalence and associated factors of sleep disorders and poor sleep quality among firefighters: A systematic review and meta-analysis
Amir Hossein Khoshakhlagh, Saleh Al Sulaie, Saeid Yazdanirad, Robin Marc Orr, Hossein Dehdarirad, Alireza Milajerdi
Heliyon.2023; 9(2): e13250. CrossRef
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Xiao Chen, Xiongliang Xiao, Arpit Bhardwaj
Computational Intelligence and Neuroscience.2022; 2022: 1. CrossRef

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Research Article

An overview of compensated work-related injuries among Korean firefighters from 2010 to 2015: Hyung Doo Kim, Yon Soo An, Dong Hyun Kim, Kyung Sook Jeong, Yeon Soon Ahn; Ann Occup Environ Med 2018;30:57. Published online September 3, 2018; DOI: https://doi.org/10.1186/s40557-018-0268-2

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Background

Although one in two firefighters in South Korea have experienced work-related injuries, there are few studies which show the overview description on work-related injuries and its analysis regarding such causes. Therefore, we aimed to show the overview of compensated work-related injuries in order to serve fundamental data for establishing prevention policies on work-related injuries for Korean firefighters.

Methods

We requested the all claimed work-related injury data of Korean firefighters from 2010 to 2015 to the Korean National Fire Agency (NFA). The data from NFA including 2457 claimed cases was analyzed and we confirmed, 2154 approved work-related injuries for the kinds of job activities, cause of accident and type of injuries. Among 2154 approved cases, we analyzed more variables for the sex, age, and job duration of 1344 compensated cases through served text file on summary of accident.

Results

The Government Employees Pension Service (GEPS) recognized 2154 (87.7%) approved work-related injuries among 2457 claimed cases. The incidence of work-related injuries per 1000 firefighters was 9.8 persons. By region, the incidence of work-related injuries per 1000 firefighters ranged from a maximum of 14.5 to a minimum of 4.0. The most common job activity caused the accident was fire suppression (18.0%), followed by Emergency medical services (EMS) (17.5%) and training (10.7%). The most common cause of these accident was movement imbalance (30.3%), followed by falls (18.9%) and traffic accident (13.4%). In these work-related injuries, sprains and bruises were the most common type of injury (27.2%), and the most commonly injured body site was the upper and lower back (25.3%). Data from identified 1344 firefighters showed that 1264 (94.0%) were male and 80 (6.0%) were female. Age group was the highest in the 40s with 623 cases (46.4%), and job duration was the highest with 650 cases in 5–10 years (48.4%).

Conclusion

In this study, we could obtain the preliminary data necessary to establish preventive measures, including the cause of accident and region with high accident rates. However, the number of applications for compensated injuries was very small compared to the frequency of injuries found in previous studies. The lack of appropriate treatment suggested that many firefighter injuries can become chronic. In this study, we suggest that it is necessary to introduce an injury monitoring system and improve the accessibility of compensated injuries.

Trial registration

CR318031. Registered 20 June 2018.

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The Impact of Firefighters’ Emotional Labor on Job Performance: The Moderating Effects of Transactional and Transformational Leadership
Hyeong-Su Park, Kuk-Kyoung Moon, Tae-Soo Ha
Fire.2024; 7(8): 291. CrossRef
Peripheral vestibular loss in noise-exposed firefighters
Hillary Anne Snapp, Lindsey Vanlooy, Brianna Kuzbyt, Courtney Kolberg, Denise Laffitte-Lopez, Suhrud Rajguru
Frontiers in Integrative Neuroscience.2023;[Epub] CrossRef
The effects of hospice care on healthcare expenditure among cancer patients
Hoyol Jhang, Wonjeong Jeong, Hyun-Soo Zhang, Dong-Woo Choi, Hyejung Kang, Sohee Park
BMC Health Services Research.2023;[Epub] CrossRef
Scoping review of the occurrence and characteristics of firefighter exercise and training injuries
Noah J. Carr-Pries, Shannon C. Killip, Joy C. MacDermid
International Archives of Occupational and Environmental Health.2022; 95(5): 909. CrossRef
Subclinical Hearing Deficits in Noise-Exposed Firefighters
Hillary A. Snapp, Natasha Schaefer Solle, Barbara Millet, Suhrud M. Rajguru
International Journal of Environmental Research and Public Health.2022; 19(17): 11028. CrossRef
The effects of psychological risk factors at work on cognitive failures through the accident proneness
Milad Abbasi, Mohsen Falahati, Masoumeh Kaydani, Rohollah Fallah Madvari, Ahmad Mehri, Maryam Ghaljahi, Saeid Yazdanirad
BMC Psychology.2021;[Epub] CrossRef
Shifted Firefighter Health Investigation by Personal Health Insurance Record in Taiwan
Wei-Ching Hsu, Chun-Hsiang Wang, Kang-Ming Chang, Li-Wei Chou
Risk Management and Healthcare Policy.2021; Volume 14: 665. CrossRef
Cohort Profile: Firefighter Research on the Enhancement of Safety and Health (FRESH), a Prospective Cohort Study on Korean Firefighters
Yun Tae Kim, Woo Jin Kim, Jee Eun Choi, Mun-joo Bae, Heeseon Jang, Chan Joo Lee, Hye-Jeong Lee, Dong Jin Im, Byoung Seok Ye, Mi-Ji Kim, Yeoju Jeong, Sung Soo Oh, Young-Chul Jung, Eun Seok Kang, Sungha Park, Seung Koo Lee, Ki Soo Park, Sang Baek Koh, Chang
Yonsei Medical Journal.2020; 61(1): 103. CrossRef
Pregnancy, childbirth, and puerperium outcomes in female firefighters in Korea
Juha Park, Yeon-Soon Ahn, Min-Gi Kim
Annals of Occupational and Environmental Medicine.2020;[Epub] CrossRef

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Research Article

Comparison of facet joint degeneration in firefighters and hospital office workers: Dong Hyun Kim, Yon Soo An, Hyung Doo Kim, Kyoung Sook Jeong, Yeon-Soon Ahn, Kun-Hyung Kim, Youngki Kim, Han-Soo Song, Chul-Gab Lee, Young-Jun Kwon, Jin-Ha Yoon; Ann Occup Environ Med 2017;29:24. Published online June 24, 2017; DOI: https://doi.org/10.1186/s40557-017-0180-1

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Background

There are few published studies on the relationship between occupational lumbar load and facet joint degeneration (FJD). This cross-sectional study was conducted to evaluate the effect of physical lumbar load on FJD by comparing magnetic resonance imaging (MRI) findings of firefighters (FFs) and hospital office workers (HOWs).

Methods

We randomly sampled 341 male FFs and 80 male HOWs by age stratification. A questionnaire and clinical examination, including MRI of the lumbar spine (T12-S1), were conducted. FJD was diagnosed and graded by using the classification of Pathria et al., and reclassified into two groups as follows: no FJD (grade 0) and FJD (grades 1, 2, and 3). The prevalence of FJD was analyzed according to occupational group.

Results

The prevalence of FJD ranged from 31% (L1–L2) to 75% (L4–L5) in the FFs, and from 18% (L1–L2) to 69% (L4–L5) in the HOWs. After adjustment for age, body mass index, and frequency of physical exercise, the adjusted odds ratios (OR) for FJD in the FFs were significantly higher than those in the HOWs at all lumbar spinal levels, except for L3–L4 (L1–L2: OR, 2.644; 95% confidence interval [CI], 1.317–5.310; L2–L3: OR, 2.285; 95% CI, 1.304–4.006; L4–L5: OR, 1.918; 95% CI, 1.037–3.544; L5–S1: OR, 1.811; 95% CI, 1.031–3.181).

Conclusion

This study shows that FFs exhibit a greater likelihood of having FJD than HOWs after controlling for other risk factors of FJD. This suggests that the physical occupational demands of FFs affect their risk of developing FJD.

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Non-cancer health risks in firefighters: a systematic review
Jeong Ah Kim, Soo Yeon Song, Wonjeong Jeong, Jae Kwan Jun
Epidemiology and Health.2022; 44: e2022109. CrossRef
Including exercise prescription in the management of non‐specific low back pain
Hamish Osborne, Peter Burt
Emergency Medicine Australasia.2022; 34(5): 833. CrossRef
An overview of compensated work-related injuries among Korean firefighters from 2010 to 2015
Hyung Doo Kim, Yon Soo An, Dong Hyun Kim, Kyung Sook Jeong, Yeon Soon Ahn
Annals of Occupational and Environmental Medicine.2018;[Epub] CrossRef

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33 Web of Science
3 Crossref

Research Article

Factors related to heart rate variability among firefighters: Jae-Hong Shin, Jung-Youb Lee, Seon-Hee Yang, Mi-Young Lee, In-Sung Chung; Ann Occup Environ Med 2016;28:25. Published online June 13, 2016; DOI: https://doi.org/10.1186/s40557-016-0111-6

Abstract PDF PubReader ePub

Objectives

The aim of this study was to investigate factors associated with heart rate variability in firefighters working in a metropolitan city in South Korea.

Methods

Self-administered questionnaires including Korean Occupational Stress Scale (KOSS) as well as surveys collecting socio-demographic characteristics and work-related factors were given to 962 firefighters. After exclusion for missing data, 645 firefighters were included, and analysis of covaiance adjusted for the general risk factors and job characteristics were used to assess the relationship between heart rate variability and associated factors.

Results

SDNN and RMSSD and were decreased in the area of occupational climate of the group with high job stress (p = 0.027, p = 0.036). HF(ln) was decreased in the area of organizational system and occupational climate of the group with high stress that statistically significant level (p = 0.034, p = 0.043).

Conclusions

Occupational climate and organizational system are associated with reduction of heart rate variability. Preventive medical care plans for cardiovascular disease of firefighters through the analysis and evaluation of job stress factors are needed.

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The Influence of Emergency Call Volume on Occupational Workload and Sleep Quality in Urban Firefighters
Jacob D. Jelmini, Phillip A. Gribble, Mark G. Abel, Lauren N. Whitehurst, Nicholas R. Heebner
Journal of Occupational & Environmental Medicine.2024; 66(7): 580. CrossRef
On-Duty Resting Heart Rate Variability at the Fire Station Is Related to Cardiorespiratory Fitness and Physical Activity Levels in Firefighters
Philémon Marcel-Millet, Philippe Gendron
Journal of Occupational & Environmental Medicine.2024; 66(3): e111. CrossRef
Evaluation of the relationship between occupational-specific task performance and measures of physical fitness, cardiovascular and musculoskeletal health in firefighters
Jaron Ras, Elpidoforos S. Soteriades, Denise L. Smith, Andre P. Kengne, Lloyd Leach
BMC Public Health.2024;[Epub] CrossRef
The effect of extended shift work on autonomic function in occupational settings: A systematic review and meta-analysis
Jacob D Jelmini, Jeremy Ross, Lauren N Whitehurst, Nicholas R Heebner
Journal of Occupational Health.2023;[Epub] CrossRef
Heart Rate Variability Assessment of Land Navigation and Load Carriage Activities in Specialist Police Selection
Colin D. Tomes, Elisa F. D. Canetti, Ben Schram, Robin Orr
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Effects of cardiovascular health, musculoskeletal health and physical fitness on occupational performance of firefighters: protocol for a systematic review and meta-analysis
Jaron Ras, Andre Pascal Kengne, Denise Smith, Elpidoforos Soterakis Soteriades, Lloyd Leach
BMJ Open.2022; 12(7): e061435. CrossRef
Effects of Cardiovascular Disease Risk Factors, Musculoskeletal Health, and Physical Fitness on Occupational Performance in Firefighters—A Systematic Review and Meta-Analysis
Jaron Ras, Andre P. Kengne, Denise L. Smith, Elpidoforos S. Soteriades, Rucia V. November, Lloyd Leach
International Journal of Environmental Research and Public Health.2022; 19(19): 11946. CrossRef
Cardiovascular Disease Risk Factors, Musculoskeletal Health, Physical Fitness, and Occupational Performance in Firefighters: A Narrative Review
Jaron Ras, Denise L. Smith, Andre P. Kengne, Elpidoforos E. Soteriades, Lloyd Leach, Ike S. Okosun
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Philémon Marcel-Millet, Alain Groslambert, Philippe Gimenez, Sidney Grosprêtre, Gilles Ravier
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Somkene Igboanugo, Philip L Bigelow, John G Mielke
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Colin Tomes, Ben Schram, Robin Orr
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Philémon Marcel-Millet, Alain Groslambert, Gilles Ravier
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Colin Tomes, Ben Schram, Robin Orr
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Research Article

Minnesota multiphasic personality inventory as related factor for post traumatic stress disorder symptoms according to job stress level in experienced firefighters: 5–year study: In-Sung Chung, Mi-Young Lee, Sung-Won Jung, Chang-Wook Nam; Ann Occup Environ Med 2015;27:16. Published online June 5, 2015; DOI: https://doi.org/10.1186/s40557-015-0067-y

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Objectives

As first responders to an increasing number of natural and manmade disasters, active-duty firefighters are at increased risk for physical and psychiatric impairment as reflected by high rates of posttraumatic stress disorder (PTSD). Because little is known about related factor with PTSD according to job stress level among firefighters, we assessed utility of the Minnesota Multiphasic Personality Inventory (MMPI) using 5-year medical surveillance.

Methods

Data were analyzed from 185 male firefighters without psychiatric disease history and who at assessments in 2006 and 2011 completed all questionnaires on personal behaviors (including exercise, drinking and smoking habits) and job history (including job duration and department). MMPI, Events Scale-Revised-Korean version (IES-R-K) and Korean Occupational Stress Scale-Short Form (KOSS-SF) were used to screen for personality trait, PTSD symptom presence and job stress level, respectively. IES-R-K subgroups were compared using two-sample t- and χ2 tests, and factors influencing IES-R-K according to KOSS-SF were determined using uni- and multivariate logistic regression.

Results

Mean age and job duration were higher in PTSD-positive than negative groups. In multivariate analysis, increased PTSD risk was associated with: job duration (Odds ratio (OR) = 1.064, 95 % CI 1.012–1.118) for firefighters overall; masculinity-femininity (OR = 5.304, 95 % CI 1.191–23.624) and job duration (OR = 1.126, 95 % CI 1.003–1.265) for lower job stress level; and social introversion (OR = 3.727, 95 % CI 1.096–12.673) for higher job stress level.

Conclusions

MMPI relates with PTSD according to job stress level among experienced firefighters. Masculinity-femininity and social introversion were the strongest related factor for PTSD symptom development in low and high job stress levels, respectively.

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Research Article

The effect of organisational system on self-rated depression in a panel of male municipal firefighters: Se-Jin An, Yun Kyung Chung, Bong Hyun Kim, Kyeong Min Kwak, Jun-Seok Son, Jung-wan Koo, Young-Su Ju, Young-Jun Kwon; Ann Occup Environ Med 2015;27:1. Published online January 14, 2015; DOI: https://doi.org/10.1186/s40557-014-0044-x

Abstract PDF PubReader ePub

Objectives

The present study evaluated the effects of job stress, including organisational system to self-rated depression through a panel study of male municipal firefighters in the Republic of Korea.

Methods

A panel of 186 municipal firefighters reported self-rated depressive symptoms according to the Beck Depression Inventory (BDI). The effects of job stress were evaluated using the Korea Occupational Stress Scale, taken one year earlier and classified by the median value. Panel members were classified into Depression or Control groups according to BDI scores, with a cut-off level of ‘over mild depression’ in a follow-up survey.

Results

The Depression group included 17 (9.1%) workers. Firefighters who scored high on occupational system had an 8.3 times greater risk of being assigned to the Depression group than those who had not (adjusted odds ratio [OR] = 8.03, 95% confidence interval (CI) = [1.73–37.22]). In contrast, job stress from a ‘difficult physical environment’ revealed negative risks related to being classified in the Depression group (AOR = 0.20, 95% CI = [0.04–0.92]).

Conclusions

Although the healthy worker effect may be involved, job stress based on perceptions of organisational system was a strong risk factor for depression. A comprehensive approach should be considered that encompasses social issues when assessing or mental health in high-risk groups, as well as the practical issue of physiochemical hazards.

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Research Article

Factors Related to Sleep Disorders among Male Firefighters: Dong-Kyun Lim, Ki-Ook Baek, In-Sung Chung, Mi-Young Lee; Ann Occup Environ Med 2014;26:11-11. Published online May 22, 2014; DOI: https://doi.org/10.1186/2052-4374-26-11

Abstract PDF PubReader ePub

Objectives

The aim of this study was to investigate factors associated with sleep disorders in male firefighters working in a metropolitan city in South Korea.

Methods

Self-administered questionnaires including the Nordic Musculoskeletal Questionnaire, Korean Occupational Stress Scale-Short Form, Psychosocial Well-Being Index-Short Form, Pittsburg Sleep Quality Index, and Beck-Depression Inventory-2 as well as surveys collecting socio-demographic characteristics and work-related factors were given to 730 male firefighters. After exclusion for missing data, 657 male firefighters were included, and logistic regression analysis adjusted for the work-related factors, psychosocial factors, and general risk factors were used to assess the relationship between sleep disorders and associated factors.

Results

The prevalence of sleep disorders was 48.7%. Shift work (adjusted OR 1.58, 95% CI = 1.02-2.45), musculoskeletal symptoms (adjusted OR 2.89, 95% CI = 2.02-4.14), and depression (adjusted OR 7.04 95% CI = 4.03-12.30) were associated with sleep disorders.

Conclusions

Musculoskeletal symptoms, shift work, and depression are associated with sleep disorders. Integrated health management is needed to promote good sleep quality among firefighters.

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Research Article

Pulmonary function decline in firefighters and non-firefighters in South Korea: Ju-Hwan Choi, Jae-Hong Shin, Mi-Young Lee, In-Sung Chung; Ann Occup Environ Med 2014;26:9-9. Published online April 25, 2014; DOI: https://doi.org/10.1186/2052-4374-26-9

Abstract PDF PubReader ePub

Objectives

The purpose of this study was to evaluate and compare changes to pulmonary function among firefighters and non-firefighters who were exposed to harmful substances in their work environments.

Methods

Firefighters (n = 322) and non-firefighters (n = 107) in Daegu who received a pulmonary function test in 2008 and 2011 as well as a regular health examination were included. Repeated measures ANOVA was performed to evaluate the pulmonary function of the two groups over the three-year period.

Results

After adjusting for age, height, body mass index, duration of exposure, physical activity, and smoking, which were statistically different between the two groups and known risk factors of pulmonary function, the forced expiratory volume in one s FEV₁, forced vital capacity FVC, and FEV₁/FVC% over the 3 year period were significantly lower among firefighters compared with non-firefighters.

Conclusions

Evaluating the working environment of firefighters is difficult; however, our study revealed that pulmonary function declined in firefighters. Thus, more effort should be made to prevent and manage respiratory diseases early by preforming strict and consistent pulmonary function tests in firefighters.

Citations

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A new potential biomarker in early diagnosis of firefighter lung function impairment: dynamic thiol/disulphide homeostasis
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Research Article

Acute Symptoms in Firefighters who Participated in Collection Work after the Community Hydrogen Fluoride Spill Accident: Seong-Yong Cho, Kuck-Hyun Woo, Jin-Seok Kim, Seong-Yong Yoon, Joo-Yong Na, Jin-Hyun Yu, Yong-Bae Kim; Ann Occup Environ Med 2013;25:36-36. Published online November 28, 2013; DOI: https://doi.org/10.1186/2052-4374-25-36

Abstract PDF PubReader ePub

Objectives

This study aimed to analyze the relationship between clinical status and work characteristics of firefighters and other public officers who engaged on collection duties in the site of the hydrogen fluoride spill that occurred on September 27, 2012, in Gumi City, South Korea.

Methods

We investigated the clinical status, personal history, and work characteristics of the study subjects and performed physical examination and several clinical examinations, including chest radiography, echocardiography, pulmonary function test, and blood testing in 348 firefighters, police officers, volunteer firefighters, and special warfare reserved force who worked at the hydrogen fluoride spill area.

Results

The subjects who worked near the accident site more frequently experienced eye symptoms (p = 0.026), cough (p = 0.017), and headache (p = 0.003) than the subjects who worked farther from the accident site. The longer the working hours at the accident area, the more frequently the subjects experienced pulmonary (p = 0.027), sputum (p = 0.043), and vomiting symptoms (p = 0.003). The subjects who did not wear respiratory protective devices more frequently experienced dyspnea than those who wore respiratory protective devices (p = 0.013). In the pulmonary function test, the subjects who worked near the accident site had a higher decease in forced vital capacity than the subjects who worked farther from the site (p = 0.019); however, no statistical association was found between serum calcium/phosphate level, echocardiography result, chest radiographic result, and probation work characteristics.

Conclusions

The subjects who worked near the site of the hydrogen fluoride spill, worked for an extended period, or worked without wearing respiratory protective devices more frequently experienced upper/lower respiratory, gastrointestinal, and neurological symptoms. Further follow-up examination is needed for the workers who were exposed to hydrogen fluoride during their collection duties in the chemical plant in Gumi City.

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Research Article

Relationship between Occupational Stress and Work-related Musculoskeletal Disorders in Korean Male Firefighters: Min Gi Kim, Kyoo-Sang Kim, Jae-Hong Ryoo, Seung-Won Yoo; Ann Occup Environ Med 2013;25:9-9. Published online July 4, 2013; DOI: https://doi.org/10.1186/2052-4374-25-9

Abstract PDF PubReader ePub

Objectives

A growing body of literature has documented that job stress is associated with the development of work-related musculoskeletal disorders (WMSDs). However, the association of WMSDs with job stress has not yet been fully studied in Korean male firefighters. The purpose of this study was to determine the status of WMSDs in almost all Korean male firefighters and to clarify the effect of job stress on the occurrence of WMSDs.

Methods

The study design was cross-sectional, and 21,466 firefighters were recruited. The study design included a structured questionnaire to assess general characteristics, the Korean Occupational Stress Scale (optional KOSS-26), Center for Epidemiologic Studies-Depression Scale (CES-D), and WMSDs. The chi-square test, and univariate and multivariate logistic regression analyses were used to look for a correlation between general characteristics and job stress, and the occurrence of WMSD.

Results

Back pain is the most common WMSD. Among the job stress subgroup, physical environment, job demands, organizational system, occupational climate, lack of reward and job insecurity were related to the occurrence of WMSDs. However, insufficient job control and interpersonal conflict were not related to the occurrence of WMSDs.

Conclusion

Job stress was related to the occurrence of WMSDs in Korean male firefighters. To reduce the occurrence of WMSDs, a job stress management program may be required.

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Original Article

The Relationship between the Korean Occupational Stress Scale and Carotid Intima-Media Thickness among Male Firefighters: Sang Jun Park, Dong Kyun Lim, Mi Young Lee, In Sung Chung; Korean Journal of Occupational and Environmental Medicine 2012;24(4):420-430. Published online December 31, 2012; DOI: https://doi.org/10.35371/kjoem.2012.24.4.420

Abstract PDF: OBJECTIVES
This study examined the relationship between job stress and the common carotid intima-media thickness as an indicator of atherosclerosis (cardiovascular disease) among male firefighters in a metropolitan city.
METHODS
Between November and December 2011, a total of 838 participants were analyzed using a questionnaire, which included the participants' general characteristics, job-related factors, health-related behaviors, and job stress. Job stress was measured using the Korean Occupational Stress Scale-Short Form (KOSS-SF). The job stress data was merged with the clinical laboratory data and common carotid intima-media thickness (CIMT) by a medical examination. The relationship between job stress and the CIMT was examined by multiple logistic regression analysis.
RESULTS
Multiple logistic regression analyses adjusted for the general and cardiovascular risk factors revealed, the organizational system (adjusted OR 1.381 95% CI=1.005~1.898) to be associated with the right CIMT. Multiple logistic regression analyses adjusted for general and cardiovascular risk factors and job types, the occupational climate (adjusted OR 1.392, 95% CI=1.009~1.922) was also associated with the right CIMT.
CONCLUSIONS
The level of job stress, particularly in regard to the organizaional system, shows a correlation with the right CIMT. Therefore, further preventive efforts and studies of firefighters will be needed to reduce job stress and help prevent cardiovascular disease.

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Original Article

Posttraumatic Stress Disorder and Related Factors in Male Firefighters in a Metropolitan City: Deuk Yong Shin, Man Joong Jeon, Joon Sakong; Korean Journal of Occupational and Environmental Medicine 2012;24(4):397-409. Published online December 31, 2012; DOI: https://doi.org/10.35371/kjoem.2012.24.4.397

Abstract PDF

OBJECTIVES
This study was conducted in order to evaluate the prevalence of posttraumatic stress disorder (PTSD) and related factors in male firefighters in Daegu, Korea.
METHODS
A total of 1,261 firefighters from fire stations in Daegu were the subjects of this study. Each firefighter completed a questionnaire on general and occupational matters, experience of traumatic events, and impact of event scale (IES). The IES questionnaire was administered to subjects in order to determine the high risk group for PTSD. We calculated the IES score and determined that an individual was abnormal if the IES score was over 26.
RESULTS
The average IES score of the firefighters was 11.0+/-14.3, and the prevalence of high risk firefighters with PTSD was 15.1%. It was found that 40 years of age, fire sergeant, and emergency medical service personnel showed higher prevalence of PTSD than other groups. The most experienced event among traumatic events was 'witness death of victims or patients'. The results of multiple logistic regression analysis for the high risk PTSD group showed that fire sergeant (OR=2.28, 95% CI: 1.28~4.06), fire lieutenant (OR=2.47, 95% CI: 1.14~5.37), fire captain (OR=2.88, 95% CI: 1.11~7.45), firefighting department (OR=2.04, 95% CI: 1.00~4.17), emergency medical service personnel (OR=3.68, 95% CI: 1.47~9.23), total frequency of traumatic events experienced (OR=1.01, 95% CI: 1.00~1.02), and total type of traumatic event experienced (OR=1.35, 95% CI: 1.25~1.46) were significant variables with regards to the reference group (fire fighter and administration department).
CONCLUSIONS
These findings indicate that the prevalence of PTSD in firefighters is higher than that in the general population, and fire sergeant, fire lieutenant, fire captain, emergency medical service personnel, firefighting department, total frequency of traumatic events experienced, and total type of traumatic event experienced were significant variables for the PTSD high risk group.

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Original Article

PTSD and Related Factors among Dispatched Firefighters to Rescue Sites after the Great Japanese Earthquake (Running head: Dispatched Firefighters' PTSD): Mihyun Yang, Eunil Lee, Jae Wook Choi, Hae Joon Kim; Korean Journal of Occupational and Environmental Medicine 2012;24(2):167-179. Published online June 30, 2012; DOI: https://doi.org/10.35371/kjoem.2012.24.2.167

Abstract PDF

OBJECTIVES
This study aims to investigate the risk of posttraumatic stress disorder (PTSD) and its related factors among firefighters dispatched to the rescue sites after the Great Japanese Earthquake in 2011.
METHODS
Among 104 male firefighters dispatched to rescue sites after the Great Japanese Earthquake, 73 firefighters were assessed. The 73 firefighters completed questionnaires, which include general characteristics, an impact of event scale-revised Korean version (IES-R-K), a coping checklist, a scale of perceived social support, and a post-traumatic stress diagnostic scale (PDS). The data was analyzed to find factors related to PTSD risk.
RESULTS
The mean value of age and work tenure in this study were 38.6 years (SD=5.7) and 11.6 years (SD=6.0), respectively. The number and rate of the PTSD high-risk group in dispatched firefighters in this study was 7 cases and 9.6% using IES-R-K, with an over 25-point cutoff score. The mean rank of tenure, 53.5 in the PTSD high-risk group (n=7), was significantly higher than that of 32.2 in the PTSD low-risk group (n=66). The mean rank of assessable support, 20.2 in the PTSD high-risk group was significantly lower than that of 38.7 in the PTSD low-risk group. In logistic analysis of model 1 including PDS in independent variables, were associated with being a PTSD high-risk group as in the following: higher PDS score (OR 2.18, 95% CI: 1.07~4.46), longer tenure (OR 3.42, 95% CI: 1.01~11.89), more using coping method (OR 1.35, 95% CI: 1.00~1.81), and lower perceptions of social support (OR 0.84, 95% CI: 0.72~0.97). In logistic analysis of model 2 without PDS in independent variables, more using coping method (OR 1.14, 95% CI: 1.01~1.28) and lower perceptions of social support (OR 0.95, 95% CI: 0.91~0.98) were associated with being a PTSD high-risk group.
CONCLUSION
The PTSD high-risk group in dispatched firefighters indicated that their odds ratios were increased when they used more coping methods under specific stress conditions and had lower perceptions of social support. Therefore, for those, who might be dispatched to overseas, the psychological support approach should be considered to produce effective coping methods against traumatic events and to be aware of abundant resources for social support regarding the problem.

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Original Article

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

Abstract 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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Original Article

The Relationship between the Korean Occupational Stress Scale and Pulse Wave Velocity among Male Firefighters: Hyun Jun Jeon, Sang Jun Park, Dong Hoon Shin, In Sung Chung, Mi Young Lee; Korean Journal of Occupational and Environmental Medicine 2011;23(4):450-462. Published online December 31, 2011; DOI: https://doi.org/10.35371/kjoem.2011.23.4.450

Abstract PDF

OBJECTIVES
The aim of this study was to investigate the relationship between job stress and the pulse wave velocity as an indicator of vessel stiffness among male firefighters in a metropolitan city.
METHODS
In November and December 2008, a total of 404 participants were analyzed. The questionnaire survey included the participants' general characteristics, job-related factors, health-related behaviors, and job stress. Job stress was measured using the Korean Occupational Stress Scale (KOSS). We merged the job stress data with clinical laboratory data and brachial-ankle Pulse Wave Velocity (baPWV) by conducting medical surveillance. We measured the relationship of job stress to baPWV by using a logistic regression analysis.
RESULTS
After adjusting for cardiovascular risk factors, the baPWV was significantly higher in the groups possessing high levels of job insecurity (OR=2.17, 95% CI=1.06~4.42).
CONCLUSIONS
Our findings suggest that the level of job stress, especially in regards to job insecurity, was directly related to the baPWV. Therefore, further preventive efforts and studies in regards to firefighters are needed in order to reduce job stress and thereby help to prevent cardiovascular disease.

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Firefighters’ occupational stress and its correlations with cardiorespiratory fitness, arterial stiffness, heart rate variability, and sleep quality
Young-Sook Yook, Kiyoshi Sanada
PLOS ONE.2019; 14(12): e0226739. CrossRef

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Review

Occupational Cancer Update: Yeon Soon Ahn; Korean Journal of Occupational and Environmental Medicine 2011;23(3):235-252. Published online September 30, 2011; DOI: https://doi.org/10.35371/kjoem.2011.23.3.235

Abstract PDF

This article reviews newly available knowledge regarding occupational cancer based on an assessment of International Agency for Research on Cancer (IARC) Monograph program from 2006 to 2010. The IARC reviewed the agents to evaluate the carcinogenicity in humans according to their priority. During the last five years, the IARC has reviewed many kinds of agents, including all of the Group 1 carcinogenic agents. Agents belonging to groups other than Group 1 were also reviewed. A few agents, such as shiftwork and firefighting, were reviewed for the first time after introducing the IARC Monograph Program. Most of the reassessed Group 1 agents were reaffirmed, showing that there was sufficient evidence to prove their carcinogenicity to human beings. However, some carcinogens were correlated to the new cancer site, since it was deemed that sufficient evidence was present. For example, larynx and ovary cancer deemed to have sufficient evidence of carciongenicity relating to asbestos exposure, joining lung cancer and mesothelioma. Some agents, such as benzo(a)pyrene, ortho-toluidine, 1,3-butadiene, and others belonging to Group 2A were upgraded to Group 1 based on newly identified epidemiologic findings, along with sufficient animal and mechanistic evidence. Benzo(a)pyrene and benzidine-based dyes were classified as human carcinogens based on sufficient animal and pervasive mechanistic evidence. This new data shows that not only chemical agents but also working conditions, such as stress and shiftwork were found to apply to human carcinogenicity. The IARC listed these agents in order to prioritize their review regarding their carcinogenicity to humans. There is a great need to study these newly emerging agents suspected to relate human carcinogenicity, and deem they are worthy of notice.

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Original Article

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

Abstract 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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Original Article

Association between Job Stress and the Minnesota Multiphasic Personality Inventory in Firefighters: Dong Hyul Lee, Hyun Jun Jeon, Dong Hoon Shin, In Sung Chung, Mi Young Lee; Korean Journal of Occupational and Environmental Medicine 2009;21(4):324-336. Published online December 31, 2009; DOI: https://doi.org/10.35371/kjoem.2009.21.4.324

Abstract PDF

OBJECTIVE: To investigate the relationship of job stress and scores on the Minnesota Multiphasic Personality Inventory (MMPI) clinical scales in firefighters.
METHOD
A total of 648 firefighters from Daegu Metropolitan City were given 2 sets of questionnaires, the Korean Occupational Stress Scales (KOSS) and the MMPI. The results of 428 qualifying questionnaires were analyzed using ANOVA, correlation, and multiple regression.
RESULTS
The study demonstrated that job stress differed by age, department, amount of exercise, and duty period. MMPI clinical scales differed by age, smoking, and amount of exercise. Job stress correlated with MMPI clinical scales and in particular with 2 MMPI clinical scales, -Depression and Social introversion-. In addition, job stress subscales were related. On multiple regression analysis, some MMPI clinical scales were affected by job stress subscales.
CONCLUSION
This study suggests that job stress is associated with psychogenic factors in firefighters. The effective management for job stress might be helpful for the overall mental health of firefighters. Further study is required to determine which psychogenic factors are related to job stress.

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Original Article

Posttraumatic Stress Symptoms and Related Factors in Firefighters of a Firestation: Soon Chan Kwon, Jaechul Song, Soo Jin Lee, Inah Kim, Jaewoo Koh, Hyunchul Ryou, Seok Hyun Kim, Daeho Kim, Seung Ah Jung; Korean Journal of Occupational and Environmental Medicine 2008;20(3):193-204. Published online September 30, 2008; DOI: https://doi.org/10.35371/kjoem.2008.20.3.193

Abstract PDF

OBJECTIVES
To investigate the factors related with posttraumatic symptoms and to estimate the prevalence of posttraumatic disorder of urban male firefighters.
METHODS
From a study sample comprising 260 male firefighters from one fire station, the responses from 146 who had experienced one or more traumatic events, responded to the 'Impact of Event Scale-Revised Korean version' (IES-R-K) and didn't show any evidence of depression were analyzed. We surveyed the firefighters using a self-administered questionnaire including general characteristics, job-related characteristics, IES-R-K, and a 'Firefighters and paramedics' incident stressor'.
RESULTS
The mean value of IES-R-K in this study was 11.3 and it was higher in the married firefighters than in the unmarried firefighters (p=0.005) and in the 24-hr shift workers than in the ordinary day shift workers (p=0.032). The frequency of posttraumatic stress disorder (PTSD) of the firefighters in this study using IES-R-K was 13.7%, with a cutoff point of 24/25. The overall number of experiences of 25 traumatic events was larger in emergency medical personnel and rescue workers than in other work functions (p=0.000).
CONCLUSIONS
The prevalence of PTSD symptoms in firefighters was estimated to 13.7% using IES-RK and was higher than the prevalence of PTSD in the general population. A program to manage the mental health and provide early detection for mental illness for firefighters is needed.

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Original Article

Job Stress and Psychosocial Stress among Firefighters: Jaehyeok Ha, Dong Il Kim, Byung Sung Seo, Won Sool Kim, Seungho Ryu, Soo Geun Kim; Korean Journal of Occupational and Environmental Medicine 2008;20(2):104-111. Published online June 30, 2008; DOI: https://doi.org/10.35371/kjoem.2008.20.2.104

Abstract PDF

OBJECTIVES
This study was performed to assess the level of job and psychosocial stresses in Korean firefighters, and to evaluate the determinants of psychosocial stress.
METHODS
The study subjects comprised 1,712 male firefighters working in Seoul, Busan, and Kyungnam in 2006. We collected information about demographic and job-related characteristics, healthrelated behaviors, Korean Occupational Stress Scale (KOSS), and psychosocial Well-being Index (PWI) through self-administered questionnaires. Statistical analyses were done by using the chi-square-test and logistic regression model.
RESULTS
The multiple logistic regression analyses indicated that the proportion of high-risk psychosocial stress is significantly higher in the groups with high job stress level in 'lack of rewards' (OR=2.90, 95% CI=2.18-3.85), 'occupational climate' (OR=1.92, 95% CI=1.47-2.51), 'job demand' (OR=1.72, 95% CI=1.32-2.23), 'job insecurity' (OR=1.53, 95% CI=1.17-2.01), 'interpersonal conflict' (OR=1.53, 95% CI=1.16-2.01), 'physical environment' (OR=1.45, 95% CI=1.11-1.89), and 'organizational injustice' (OR=1.38, 95% CI=1.04-1.85).
CONCLUSIONS
Psychosocial stress might be adversely influenced by job stressors for the most part. Firefighters need job stress management to minimize their psychological problems.

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Original Article

Influences of Job Stressors on Psychosocial Well-being, Fatigue and Sleep Sufficiency among Firefighters: Kun Hyung Kim, Jung Won Kim, Sung Hoon Kim; Korean Journal of Occupational and Environmental Medicine 2006;18(3):232-245. Published online September 30, 2006; DOI: https://doi.org/10.35371/kjoem.2006.18.3.232

Abstract PDF

OBJECTIVES
To measure the job stressors and stress responses among firefighters.
METHODS
We created a structured, self-reported questionnaire about job stressors using Karasek's Job Content Questionnaire (JCQ), psychosocial stress using Psychosocial Well-being Index, Short Form(PWI-SF) and fatigue using Multidimensional Fatigue Scale (MFS). The questionnaire also included sociodemographic data, job-related factors, and health-related behaviors. We collected questionnaires from 104 male firefighters, 35 male emergency medical service (EMS) rescuers and 28 male administrators in three different municipal fire departments in Busan from September 23 to October 2, 2003. Chi-square test and multiple logistic regression analysis were used to examine the job stressors using SPSS (10.0). The statistical significance level was 0.05.
RESULTS
Both PWI-SF and MFS scores increased in the order of EMS rescuers, firefighters and administrators. Using multiple logistic regression analysis, sleep insufficiency showed statistically significant effects on both PWI-SF (OR=5.19, 95% CI=2.14~12.57) and MFS (OR=2.13, 95% CI=1.02~4.46). Alcohol drinking (OR=0.28, 95% CI=0.10~0.75) had a protective effect on MFS. The odds ratios in job loss and shiftwork were 3.44 (95% CI=1.25~9.42) and 8.69 (95% CI=2.87~26.36) on MFS. Monthly income showed a statistically significant effect on both MFS (OR=5.09, 95% CI=1.34~19.41) and sleep sufficiency (OR=7.27, 95% CI=1.62~32.61). However, there was no statistical significance among the JCQ items on either PWI-SF or MFS.
CONCLUSIONS
Firefighters in this study had potential psychosocial stress and moderate level of fatigue scale. As a causal factor for these outcomes, sleep insufficiency and job loss, lower monthly income and shiftwork were statistically significantly, which confirm the need for countermeasures to ensure optimal sleep time and to raise monthly income. Further follow-up study using more in-depth interview is also required to identify the effects of both alcohol consumption and job loss.

Citations

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