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Original Article
Factors affecting heat-related illness symptoms among school food service workers: a cross-sectional study in Korea
Nahyun Kim, Dongwhan Suh, Jia Ryu, Woo Chul Jeong, Yun-Keun Lee, Jinwoo Lee, Hyunjoo Kim
Ann Occup Environ Med 2025;37:e30.   Published online September 2, 2025
DOI: https://doi.org/10.35371/aoem.2025.37.e30
AbstractAbstract AbstractAbstract in Korean PDFSupplementary Material
Background
School food service workers are highly likely to develop heat-related illnesses because of their work environment. However, studies that have examined the risk of heat-related illnesses among them are limited. The purpose of this study was to investigate the status of heat exposure, implementation of heat wave countermeasures, and prevalence of heat-related illness symptoms among school food service workers in Korea, and to explore the relationship between them.
Methods
A cross-sectional study was conducted through an online survey of school food service workers from May 25 to June 12, 2023, via three labor unions. We analyzed 6,244 valid responses. We assessed general characteristics, heat-related illness symptoms (heat rash, heat cramps, heat edema, heat exhaustion, heat syncope), duration of heat exposure during heat waves, and heat wave preventive measures. Multiple logistic regression analyses were performed, with adjustments for age, occupation, hypertension, diabetes, and school type.
Results
More than one-third of school food service workers reported heat exposure between May and September exceeding 4 hours daily, and 94.6% experienced at least one heat-related illness symptom during the last year. A dose-response relationship was observed between heat exposure duration and heat-related illness symptoms (p for trend < 0.001). School food service workers who did not have increased rest periods or did not reduce high-heat prepared foods showed significantly higher odds ratios for heat-related illness symptoms.
Conclusions
School food service workers experience substantial heat exposure and a high prevalence of heat-related illness symptoms. The risk of heat-related illness symptoms was associated with extended duration of heat exposure. Increasing rest periods and reducing high-heat food preparation were effective preventive measures. These findings underscore the need for improved heat exposure management and implementation of effective preventive measures to protect the health of school food service workers, with particular attention to appropriate rest periods.
학교 급식 종사자의 온열질환 증상 위험요인
목적
학교 급식 종사자는 다수의 열원이 존재하는 협소한 공간에서 근무하기 때문에 온열질환 발생 가능성이 높다. 학교 급식 종사자의 작업 중 열 노출 현황, 폭염 대응책 시행, 온열질환 증상 유병률을 조사하고 이들의 관계를 탐구하고자 하였다.
방법
2023. 5. 25- 6. 12까지 학교 급식 관련 3개 노동조합을 통해 온라인 설문조사를 실시해 6,244개의 유효한 응답을 얻었다. 일반적 특성과 온열질환 증상 경험, 폭염 시 근무 중 고온노출 시간, 폭염피해 예방 조치 경험을 조사했다. 온열질환 증상 경험에 관련된 요인을 확인하기 위해 연령, 직종, 고혈압, 당뇨병, 학교 유형을 보정한 다중 로지스틱 회귀분석을 수행했다.
결과
학교 급식 종사자의 3분의 1 이상이 5월부터 9월 사이 일일 4시간을 초과하는 열 노출을 보고했으며, 94.6%가 지난 1년 동안 적어도 하나의 온열질환 질환 증상을 경험했다. 하루 중 고온 노출 시간에 따라 온열질환 증상 경험의 위험은 양반응 관계로 증가했다(P for trend<0.001). 폭염 피해 예방 조치를 경험한 것에 비해 그렇지 않은 경우 온열질환 증상 경험의 위험은 휴게시간 증가(OR=1.86), 고열 제조 반찬 줄임(OR=1.59)에서 통계적으로 유의하게 증가했다.
결론
학교 급식 종사자들은 상당한 열 노출과 높은 온열질환 증상 유병률을 보였다. 온열질환 증상의 위험은 고온 노출이 심할수록 증가하는 것으로 확인되었다. 휴식시간 증가와 고열 제조 음식 조리 감소가 효과적인 예방 조치였다. 이러한 결과는 학교 급식 종사자들의 건강을 보호하기 위한 개선된 열 노출 관리와 효과적인 예방 조치 시행의 필요성을 강조하며, 특히 적절한 휴식시간에 특별한 주의를 기울여야 함을 시사한다.
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Original Article
Cooking oil fume exposure and Lung-RADS distribution among school cafeteria workers of South Korea
Minjun Kim, Yangho Kim, A Ram Kim, Woon Jung Kwon, Soyeoun Lim, Woojin Kim, Cheolin Yoo
Ann Occup Environ Med 2024;36:e2.   Published online January 31, 2024
DOI: https://doi.org/10.35371/aoem.2024.36.e2
AbstractAbstract AbstractAbstract in Korean PDFSupplementary Material
Background

Cooking oil fumes (COFs) from cooking with hot oil may contribute to the pathogenesis of lung cancer. Since 2021, occupational lung cancer for individual cafeteria workers has been recognized in South Korea. In this study, we aimed to identify the distribution of lung-imaging reporting and data system (Lung-RADS) among cafeteria workers and to determine factors related to Lung-RADS distribution.

Methods

We included 203 female participants who underwent low-dose computed tomography (LDCT) screening at a university hospital and examined the following variables: age, smoking status, second-hand smoke, height, weight, and years of service, mask use, cooking time, heat source, and ventilation. We divided all participants into culinary and non-culinary workers. Binomial logistic regression was conducted to determine the risk factors on LDCT of Category ≥ 3, separately for the overall group and the culinary group.

Results

In this study, Lung-RADS-positive occurred in 17 (8.4%) individuals, all of whom were culinary workers. Binary logistic regression analyses were performed and no variables were found to have a significant impact on Lung-RADS results. In the subgroup analysis, the Lung-RADS-positive, and -negative groups differed only in ventilation. Binary logistic regression showed that the adjusted odds ratio (aOR) of the Lung-RADS-positive group for inappropriate ventilation at the workplace was 14.89 (95% confidence interval [CI]: 3.296–67.231) compared to appropriate ventilation as the reference, and the aOR for electric appliances at home was 4.59 (95% CI: 1.061–19.890) using liquid fuel as the reference.

Conclusions

The rate of Lung-RADS-positive was significantly higher among culinary workers who performed actual cooking tasks than among nonculinary workers. In addition, appropriate ventilation at the workplace made the LDCT results differ. More research is needed to identify factors that might influence LDCT findings among culinary workers, including those in other occupations.

한국 학교 급식소 종사자의 조리흄 노출과 Lung-RADS 분포
목적
2021년부터 한국에서는 개별 학교 급식 종사자의 폐암 산업재해가 인정되고 있다. 본 연구에서는 급식 종사자들의 Lung-imaging reporting and data system ( Lung-RADS ) 분포를 확인하고, Lung-RADS 분포와 관련된 요인을 탐색해보고자 한다.
방법
2020년도에 울산대학병원에서 저선량 CT를 촬영한 여성 참가자 중 203명을 대상으로 나이, 흡연 여부, 간접 흡연 여부, 키, 체중, 근무 년수, 마스크 착용 여부, 조리 시간, 열원, 환기방식 등의 변수를 조사하였다. 참가자를 조리직, 비조리직으로 분류하였다. 범주 3이상에 대한 영향을 확인하기 위해 이분형 로지스틱을 전체집단 조리직 집단에 나누어 실시하였다.
결과
Lung-RADS 양성은 17 (8.4%)명에게서 발생했고 모두 조리직에 해당했다. 이분형 로지스틱 회귀분석을 시행한 결과 전체집단에서 Lung-RADS 결과에 유의미한 영향을 주는 변수는 확인할 수 없었다. Subgroup 분석에서 Lung-RADS 양성, 음성군은 직장 내 환기방식에서만 차이가 있었다. 이분형 로지스틱 회귀분석 결과 직장에서 환기를 철저히 한 것을 참고치로 했을 때 부적절한 환기에 대한 Lung-RADS 양성의 오드비가 14.89이고 가정에서 액화연료 사용을 참고치로 했을 때 전기 요리기구 사용의 오드비는 4.59이였다.
결론
실제 조리업무를 시행하는 조리직의 경우 비조리직에 비해 Lung-RADS 양성 비율이 유의하게 높았다. 또한 조리실 환경에서 환기를 철저하게 하는 것이 Lung-RADS 소견에 영향을 주었다.

Citations

Citations to this article as recorded by  
  • Exposure to cooking fumes in cafeteria workers in Korean schools: a pilot study
    Daesung Lim, Yong Min Cho
    Annals of Work Exposures and Health.2025; 69(1): 109.     CrossRef
  • Lung Cancer Risk in Female School Cooks: A Nationwide Retrospective Cohort Study in the Republic of Korea
    Jungwon Jang, Eun Mi Kim, Jaiyong Kim, Jeehee Min, Inah Kim
    Safety and Health at Work.2025; 16(1): 105.     CrossRef
  • Radiological Changes in Chest Computed Tomography Findings of School Cooks: A Comparative Study With Age-matched Controls
    Jung Hee Hong, Jin Young Kim, Kiook Baek
    Safety and Health at Work.2025; 16(2): 228.     CrossRef
  • Radiologic evaluation of subclinical cardiovascular structural changes in school cafeteria workers: a chest computed tomography study with age-matched controls
    Jung Hee Hong, Jin Young Kim, Kiook Baek
    Journal of Yeungnam Medical Science.2025; 42: 76.     CrossRef
  • Cancer-related Keywords in 2023: Insights from Text Mining of a Major Consumer Portal
    Wonjeong Jeong, Eunkyoung Song, Eunzi Jeong, Kyoung Hee Oh, Hye-Sun Lee, Jae Kwan Jun
    Healthcare Informatics Research.2024; 30(4): 398.     CrossRef
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