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Original Article
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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Special Issue
Association between irregular working hours and work-related musculoskeletal pain: results from the 6th Korean Working Conditions Survey
Munyoung Yang, Jun-Pyo Myong, Jongin Lee, Min Young Park, Mo-Yeol Kang
Ann Occup Environ Med 2023;35:e21.   Published online July 3, 2023
DOI: https://doi.org/10.35371/aoem.2023.35.e21
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Background

Recently, irregular working hours have become controversial issues in Korea. The health impact of irregular working hours on the work-related musculoskeletal pain (MSP) is scarcely researched before. We sought to investigate the association between irregular working hours and work-related MSP among South Korean workers.

Methods

This study used data from the sixth Korean Working Conditions Survey in 2020. The prevalence of work-related MSP was analyzed using the χ2 test. A multiple logistic regression analysis was conducted to assess the association between irregular working hours and work-related MSP. We conducted stratified analysis by gender, weekly working hours, and workers’ control over their working hours. We calculated the adjusted odds ratios (ORs) of work-related MSP for irregular working hours combined with weekly working hours.

Results

The OR for work-related MSP was significantly higher in the population with irregular working hours than in the population with regular working hours (OR: 1.43, 95% confidence interval [CI]: 1.29–1.58). Irregular and long (> 52 hours/week) working hours have the highest risk of work-related MSP in both genders (in men, OR: 3.48 [95% CI: 2.53–4.78]; in women, OR: 2.41 [95% CI: 1.46–4.00]).

Conclusions

Irregular working hours were associated with work-related MSP in Korea. The association was magnified with long working hours. Reform of the Korean Labor Standards Act leading to increase irregular working hours may induce adverse health outcome.


Citations

Citations to this article as recorded by  
  • Effect of long working hours on psychological distress among young workers in different types of occupation
    Seong-Uk Baek, Jin-Ha Yoon
    Preventive Medicine.2024; 179: 107829.     CrossRef
  • Special Series I: Working hours as a social determinant of workers’ health
    Kyunghee Jung-Choi, Tae-Won Jang, Mo-Yeol Kang, Jungwon Kim, Eun-A Kim
    Annals of Occupational and Environmental Medicine.2023;[Epub]     CrossRef
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  • 2 Web of Science
  • 2 Crossref
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Original Article
Poor worker’s long working hours paradox: evidence from the Korea National Health and Nutrition Examination Survey, 2013-2018
Min Young Park, Jaeyoung Park, Jun-Pyo Myong, Hyoung-Ryoul Kim, Dong-Wook Lee, Mo-Yeol Kang
Ann Occup Environ Med 2022;34:e2.   Published online February 14, 2022
DOI: https://doi.org/10.35371/aoem.2022.34.e2
AbstractAbstract AbstractAbstract in Korean PDFPubReaderePub
Background

Because income and working hours are closely related, the health impact of working hours can vary according to economic status. This study aimed to investigate the relationship between working hours and the risk of poor self-rated health according to household income level.

Methods

We used the data from the Korea National Health and Nutrition Examination Survey VI and VII. The information on working hours and self-rated health was obtained from the questionnaire. After stratifying by household income level, the risk of poor self-rated health for long working hour group (≥ 52 hours a week), compared to the 35–51 working hour group as a reference, were calculated using multiple logistic regression.

Results

Long working hours increased the risk of poor self-rated health in the group with the highest income, but not in the group with the lowest income. On the other hand, the overall weighted prevalence of poor self-rated health was higher in the low-income group.

Conclusions

The relationship between long working hours and the risk of poor self-rated health varied by household income level. This phenomenon, in which the health effects of long working hours appear to diminish in low-income households can be referred to as the ‘poor worker’s long working hours paradox’. Our findings suggest that the recent working hour restriction policy implemented by the Korean government should be promoted, together with a basic wage preservation to improve workers’ general health and well-being.

저소득 근로자의 장시간근무 역설: 2013-2018 국민건강영양조사 자료를 이용하여
목적
소득과 근로시간은 서로 밀접한 관계에 있으며, 이로 인해 근로시간이 건강 상태에 미치는 영향은 경제적 상황에 따라 달라질 수 있다. 본 연구는 가구소득수준에 따른 근로시간과 자가 건강 평가(self-rated health) 악화 위험의 연관성에 대하여 조사하였다.
방법
국민건강영양조사 제 6기 및 제 7기 자료를 이용하여 연구를 수행하였다. 근로시간 및 자가 건강 평가에 대한 정보는 설문조사를 통해 조사되었다. 주당 근로시간 35-51시간 군과 비교하여 주당 근로시간 52시간 이상인 장시간 근로 군의 자가 건강 평가 악화 위험을 가구 소득 수준으로 층화하여 다중 로지스틱 회귀분석을 통해 계산하였다.
결과
소득이 가장 높은 군에서는 근로시간이 길수록 자가 건강 평가 악화의 위험이 증가했으나 소득이 낮은 군에서는 유의한 결과를 보이지 않았다. 반면에 소득이 낮은 군에서는 근로시간에 관계 없이 전체적인 자가 건강 평가 수준이 낮은 것으로 관찰되었다.
결론
장시간 근로와 자가 건강 평가 악화 위험 간의 연관성은 가구소득수준에 따라 다른 것으로 나타났다. 저소득층에서 장시간 근로의 건강 영향이 약화되어 나타나는 이러한 현상을 ‘저소득 근로자 장시간 근로의 역설’이라고 부를 수 있다. 본 연구 결과는 최근 한국 정부가 시행하고 있는 근로시간 제한 정책을 추진할 때 전체 근로자의 건강과 복지를 향상시키기 위해서는 기본 임금 보전이 함께 추진되어야 함을 시사한다.

Citations

Citations to this article as recorded by  
  • Effect of long working hours on psychological distress among young workers in different types of occupation
    Seong-Uk Baek, Jin-Ha Yoon
    Preventive Medicine.2024; 179: 107829.     CrossRef
  • High levels of anxiety and depression in women farmers from Ecuador: A cross-section study in Coastal and Highlands regions
    Aline Siteneski, Viviana Septimia Gómez Mieles, Paola Andrea Romero Riaño, Karime Montes Escobar, German Josuet Lapo-Talledo, Andrea Valeria Dueñas-Rodriguez, María Antonieta Palma Cedeño, Yliana Consuelo Villacis Lascano, Lincon Oliver Echeverria Zurita
    International Journal of Social Psychiatry.2024;[Epub]     CrossRef
  • Multi-Dimensional Comparison of the Impact Mechanism of the Self-Rated Health Status of Urban and Rural Residents in Chinese Social Environments
    Chao Yu, Xinyi Zhang, Junbo Gao
    International Journal of Environmental Research and Public Health.2022; 19(17): 10625.     CrossRef
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