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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 Material
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.

Citations

Citations to this article as recorded by  
  • Data profile: Korean Work, Sleep, and Health Study (KWSHS)
    Seong-Sik Cho, Jeehee Min, Heejoo Ko, Mo-Yeol Kang
    Ann Occup Environ Med.2025; 37: e3.     CrossRef
  • Increased risk of herpes zoster associated with stress and sleep deprivation: Evidence from korea health panel survey
    Youjin Kim, Wanhyung Lee
    Journal of Psychiatric Research.2025; 184: 333.     CrossRef
  • The prevalence and clinical correlation factors of cognitive impairment in patients with major depressive disorder hospitalized during the acute phase
    Huiyuan Zhao, Jinhong Chen
    Frontiers in Psychiatry.2024;[Epub]     CrossRef
  • Association between the safety climate and occupational injury in the Korean working population: a cross-sectional study
    Jeehee Min, Tae-Won Jang, Hye-Eun Lee, Mo-Yeol Kang, Seong-Sik Cho
    Epidemiology and Health.2024; 46: e2024082.     CrossRef
  • 973 View
  • 20 Download
  • 4 Web of Science
  • 4 Crossref
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Original Article
Association between exposure to violence, job stress and depressive symptoms among gig economy workers in Korea
Min-Seok Kim, Juyeon Oh, Juho Sim, Byung-Yoon Yun, Jin-Ha Yoon
Ann Occup Environ Med 2023;35:e43.   Published online October 30, 2023
DOI: https://doi.org/10.35371/aoem.2023.35.e43
AbstractAbstract AbstractAbstract in Korean PDF
Background

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

Methods

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

Results

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

Conclusions

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

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

Citations

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  • Psychosocial work conditions and health status of digital platform workers in Taiwan: A mixed method study
    Yen-Ling Liu, Yawen Cheng, Ping-Hsiu Tsai, Yun-Chieh Yang, Ya-Chen Li, Wan-Ju Cheng
    Safety Science.2025; 182: 106722.     CrossRef
  • Mental disorders related to psychosocial factors among delivery workers: results of a web survey in Brazil
    Matheus F. dos Santos, Janaína S. de Siqueira, Fernando R. Feijó, Rita de Cássia P. Fernandes
    International Archives of Occupational and Environmental Health.2025; 98(1): 99.     CrossRef
  • Occupational disease monitoring by the Korea Occupational Disease Surveillance Center: a narrative review
    Dong-Wook Lee, Inah Kim, Jungho Hwang, Sunhaeng Choi, Tae-Won Jang, Insung Chung, Hwan-Cheol Kim, Jaebum Park, Jungwon Kim, Kyoung Sook Jeong, Youngki Kim, Eun-Soo Lee, Yangwoo Kim, Inchul Jeong, Hyunjeong Oh, Hyeoncheol Oh, Jea Chul Ha, Jeehee Min, Chul
    The Ewha Medical Journal.2025;[Epub]     CrossRef
  • Higher anxiety level and associated work-related factors of delivery workers in South Korea: from the 6th Korean working conditions survey
    Sungjin Park, June-Hee Lee
    International Archives of Occupational and Environmental Health.2024; 97(8): 871.     CrossRef
  • Association between precarious employment and the onset of depressive symptoms in men and women: a 13-year longitudinal analysis in Korea (2009–2022)
    Seong-Uk Baek, Jong-Uk Won, Yu-Min Lee, Jin-Ha Yoon
    Epidemiology and Psychiatric Sciences.2024;[Epub]     CrossRef
  • Anxiety, mental health, job insecurity and workplace challenges: exploring the well-being of women gig workers in the gig economy
    Ramya Singh, Archana Sharma, Nimit Gupta, Manish Mishra, Rohit Kushwaha
    Mental Health and Social Inclusion.2024;[Epub]     CrossRef
  • 1,109 View
  • 37 Download
  • 6 Web of Science
  • 6 Crossref
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Original Article
Association between discrimination in the workplace and insomnia symptoms
Suhwan Ju, Seong-Sik Cho, Jung Il Kim, Hoje Ryu, Hyunjun Kim
Ann Occup Environ Med 2023;35:e25.   Published online July 23, 2023
DOI: https://doi.org/10.35371/aoem.2023.35.e25
AbstractAbstract AbstractAbstract in Korean PDF
Background

In Korea, little research has focused on the relationship between discrimination in the workplace and sleep health. Thus, this study aims to investigate the association between such discriminatory experiences and insomnia, a common sleep disorder, using Korean employees’ data.

Methods

This study used data from the 6th Korea Working Conditions Survey. Discrimination experiences due to age, ethnic background, nationality, race, sex, religion, disability, sexual orientation, educational level, hometown, and employment status were investigated. The Minimal Insomnia Symptom Scale estimated insomnia symptoms. The association between discrimination experience and insomnia symptoms were analyzed using survey-weighted logistic regression analysis.

Results

Based on experiences of discrimination over the past 12 months, insomnia symptoms were associated with discrimination experience due to religion (odds ratio [OR]: 3.70; 95% confidential interval [CI]: 1.58–8.69), sex (OR: 2.51; 95% CI: 1.87–3.37), age (OR: 2.30; 95% CI: 1.88–2.81), hometown (OR: 2.07; 95% CI: 1.44–2.97), employment status (OR: 1.69; 95% CI: 1.37–2.10), and educational level (OR: 1.67; 95% CI: 1.31–2.14). Furthermore, the prevalence of insomnia symptoms increased with the number of discrimination experiences.

Conclusions

In this study, discrimination experiences due to religion, sex, age, hometown, employment status, and educational level were significantly associated with insomnia symptoms. Furthermore, as the number of discrimination experiences increased, so did the prevalence of insomnia. Preventing workplace discrimination may improve workers’ sleep health.

직장에서의 차별 경험과 불면증 증상 간의 연관성
목적
한국에서 차별 경험과 수면 장애 간의 연관성에 대한 연구가 거의 없었다. 따라서, 이 연구의 목적은 직장에서의 차별 경험과 불면증 증상의 연관성을 조사하는 것이다.
방법
이 연구는 제6차 근로환경조사의 자료를 활용하였다. 나이, 출신민족, 국적, 인종, 성, 종교, 장애, 성적 지향성, 학벌, 출신 지역, 고용 형태 등 총 11개 종류의 차별에 대한 경험 유무를 조사하였다. 수면 장애는 minimal insomnia symptom scale (MISS)을 사용하여 불면증 증상의 유무를 조사하였다. 둘 사이의 연관성을 평가하기 위해 가중치를 이용한 로지스틱 회귀분석을 사용하였다.
결과
종교(odds ratio [OR], 3.70; 95% confidential interval [CI], 1.58–8.69), 성 (OR, 2.51 ; 95% CI, 1.87–3.37), 나이 (OR, 2.30 ; 95% CI, 1.88–2.81), 출신 지역 (OR, 2.07 ; 95% CI, 1.44–2.97), 고용 형태 (OR, 1.69 ; 95% CI, 1.37–2.10), 학벌 (OR, 1.67 ; 95% CI, 1.31–2.14)에 대한 차별 경험과 불면증 증상 간의 연관성이 확인되었다. 또한, 경험한 차별의 종류가 많을수록 불면증 증상의 유병률이 증가하는 경향이 확인되었다.
결론
이 연구에서 직장에서의 종교, 성별, 나이, 고향, 고용상태, 교육수준에 대한 차별 경험과 불면증 증상 간의 연관성이 확인되었다. 직장에서의 차별을 예방함으로써 근로자들의 수면 건강을 향상시킬 수 있을 것이다.

Citations

Citations to this article as recorded by  
  • Gender discrimination in the workplace and the onset of problematic alcohol use among female wage workers: A longitudinal study in Korea
    Seong-Uk Baek, Jin-Ha Yoon, Jong-Uk Won
    Social Science & Medicine.2025; 379: 118183.     CrossRef
  • 728 View
  • 8 Download
  • 1 Crossref
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Original Article
Relationship between chronotype and depressive symptoms among newly hired hospital nurses in the Republic of Korea
Semi Lee, Han-Na Jung, Jia Ryu, Woo-Chul Jung, Yu-Mi Kim, Hyunjoo Kim
Ann Occup Environ Med 2022;34:e32.   Published online October 31, 2022
DOI: https://doi.org/10.35371/aoem.2022.34.e32
AbstractAbstract AbstractAbstract in Korean PDF
Background

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

Methods

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

Results

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

Conclusions

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

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

Citations

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  • Relationship between mid-sleep time and depression, health-related quality of life, and sleep deprivation in the 2018 Korea Community Health Survey
    Mee-Ri Lee, Sung Min Jung, Seung Hee Choi, Hyeonji Hwang, Youngs Chang, Young Hwangbo
    Chronobiology International.2024; 41(1): 1.     CrossRef
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    Lijun Li, Xingxing Wang, Jian Zhou, Min Liu, Sha Wang, Yi Zhou, Yuxuan Li, Yue Kang, Jianfei Xie, Andy S. K. Cheng
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Original Article
The effect of job insecurity, employment type and monthly income on depressive symptom: analysis of Korean Longitudinal Study on Aging data
Myeong-Hun Lim, Jong-Uk Won, Won-Tae Lee, Min-Seok Kim, Seong-Uk Baek, Jin-Ha Yoon
Ann Occup Environ Med 2022;34:e24.   Published online September 13, 2022
DOI: https://doi.org/10.35371/aoem.2022.34.e24
AbstractAbstract AbstractAbstract in Korean PDFSupplementary Material
Background

In modern society, depression is serious issue that causes socioeconomic and family burden. To decrease the incidence of depression, risk factors should be identified and managed. Among many risk factors for depression, this study examined socioeconomic risk factors for depression.

Methods

We utilized first (2006), second (2008), and third (2010)-wave data from the Korean Longitudinal Study of Aging (KLoSA). Depressive symptom was measured with the 10-item Center for Epidemiological Studies Depression Scale, Short Form (CES-D-10) in the survey in 2008 and 2010. Three risk factors including job security, employment type and monthly income were measured in the survey in 2006. The association between risk factors and depressive symptom was analyzed by Cox proportional-hazard model.

Results

We analyzed data from 1,105 workers and hazard ratios (HRs) for 3 risk factors were significant entirely. In addition, regular worker with high income group is the most vulnerable group of poor job insecurity on depression among male workers (HR: 1.73; 95% confidence interval [CI]: 1.07–2.81). Finally, HRs for 7 groups who had at least 1 risk factor had higher HRs compared to groups who had no risk factors after stratifying 3 risk factors. In the analysis, significantly vulnerable groups were total 5 groups and the group who had highest HR was temporary/daily workers with poor job security (HR: 2.51; 95% CI: 1.36–4.64). The results concerning women, regardless of job type, were non-significant.

Conclusions

This study presented one or more risk factors among poor job security, low income, temporary/daily employment type increase hazard for depressive symptom in 2 or 4 years after the exposure. These results inform policy to screen for and protect against the risk of depression in vulnerable groups.

직업 안정성, 고용 형태, 월 소득이 우울 증상에 미치는 영향 : 고령화연구 패널조사 분석을 중심으로
목적
우울증은 전세계적으로 사회경제적 부담을 유발하는 심각한 문제로 받아들여지고 있으며 우울증의 위험요인으로는 유전적, 기질적, 환경적, 사회경제적 요인들이 알려져 있으나, 최근 코로나바이러스 감염증-19로 인한 월 소득의 감소, 직업 불안정성을 포함한 사회경제적 요인이 중요하게 다루어지고 있다. 우울증을 스크리닝하기 위한 고위험군을 선정하기 위하여 본 연구에서는 전향적 코호트 내에서 직업 안정성, 고용 형태, 월 소득을 기준으로 8가지 그룹을 나누어 각 그룹의 우울 증상 발생 위험도를 분석하고자 한다.
방법
본 연구는 전향적 코호트 연구인 제 1, 2, 3차 고령화연구패널조사 결과를 분석하였다. 2, 3차 조사에서 적어도 한 번 이상 CES-D-10 점수가 4점 이상인 경우, 우울 증상이 발생하였다고 판단하였으며, 1차 조사에서 응답한 직업 안정성 여부, 고용 형태, 월 소득의 영향을 분석하였다. 분석에는 Cox proportional-hazard regression model이 사용되었으며, 나이, 학력, 월 근무시간, 흡연 및 음주 과거력, 직무 스트레스가 보정 변수로 사용되었다.
결과
먼저, 남성 근로자에서 직업 불안정성, 임시직/일용직 근로자, 낮은 월 소득을 위험요인으로 갖는 경우, 그렇지 않은 경우보다 우울 증상의 위험도가 유의하게 증가하였다. 두 번째로, 남성 근로자에서 월 소득, 고용 형태에 따라 4개의 그룹을 나누어 각 그룹에서 직업 불안정성의 영향을 분석하였으며, 월 소득이 높은 상용직 근로자 그룹에서만 유의한 결과를 보였다. 세 번째로, 직업 안정성, 월 소득, 고용 형태를 기준으로 8개의 그룹을 나누어 각각의 우울 증상의 위험도를 분석하였다. 남성과 여성 근로자에 대하여 각각 분석하였으며, 상용직, 높은 월 소득, 높은 직업 안정성을 가진 근로자를 기준 그룹으로 선정한 후, 위험도 분석을 진행하였다. 세 가지 위험 요소 중, 낮은 직업 안정성만을 위험 요소로 갖는 그룹 (HR [95% CI]: 1.66 [1.05-2.61]), 낮은 직업 안정성과 낮은 월 소득을 갖는 그룹 (HR [95% CI]: 1.76 [1.19-2.61]), 낮은 직업 안정성과 임시직/일용직 근로자를 갖는 그룹 (HR [95% CI]: 2.51 [1.36-4.64]), 낮은 월 소득과 임시직/일용직 근로자를 갖는 그룹(HR [95% CI]: 1.81 [1.02-3.22]) 세 가지 위험 요소를 모두 갖는 그룹 (HR [95% CI]: 2.27 [1.57-3.27])에서 우울 증상의 위험도 증가가 유의하게 나타났다. 세 가지 분석 모두에서 여성 근로자의 경우, 유의미한 결과를 보이지 않았다.
결론
본 연구에서는 직업 불안정성, 임시직/일용직 고용 형태, 낮은 임금에 노출된 경우, 노출 후 2년과 4년 중 1회 이상 우울 증상 발생 위험도가 유의하게 증가한다는 결과를 도출하였다. 본 연구에서 우울 증상에 대한 위험요인이 많은 근로자일수록 우울 증상에 대한 위험도가 큰 것으로 분석되었다. 예외적으로, 임시직/일용직 근로자의 경우, 높은 월 소득의 근로자가 낮은 근로자보다 위험도가 높았다. 마지막으로 월 소득과 고용 형태를 기준으로 그룹을 나누었을 때, 직업 안정성에 의한 위험도 증가가 가장 큰 그룹은 상용직 근로자 중 월 소득이 높은 경우였다. 위 결과를 바탕으로 1개 이상의 위험요인을 갖는 고위험군을 대상으로 우울증에 대한 스크리닝 검사를 2년 간격으로 실시하는 것과 모든 근로자를 대상으로 직업 안정성에 대한 자가 조사가 필요하다는 것을 제안하였다.

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Research Article
The association between non-regular work patterns and insomnia among Korean wage workers: the fifth Korean working condition survey
Ho-Yeon Kim, Juho Choi, Hyun-Mook Lim, Chamjin Park, Yun-Chul Hong
Ann Occup Environ Med 2021;33:e9.   Published online March 29, 2021
DOI: https://doi.org/10.35371/aoem.2021.33.e9
AbstractAbstract PDF
Background

Non-regular workers are steadily increasing on account of improving corporate productivity. They are classified as non-permanent, part-time, or non-typical workers. Non-regular work has a negative impact on workers' physical and mental health. This study analyzed the relationship between non-permanent, part-time and non-typical work and insomnia among Korean wage workers, and investigated the differences and interactions between different work patterns.

Methods

The Fifth Korean Working Conditions Survey was used in this study. Non-regular work patterns were classified into 7 types: type 1, sole non-permanent; type 2, sole part-time; type 3, sole non-typical; type 4, part-time-non-typical; type 5, non-permanent-non-typical; type 6, non-permanent-part-time; type 7, all inclusive. Insomnia was measured on a scale from “normal sleep” to “insomnia” based on the 3-item Minimal Insomnia Symptom Scale. Multiple logistic regression was used to analyze the association between non-regular work patterns and insomnia among wage workers.

Results

After multivariate adjustment, a significantly increased odds ratio (OR) for insomnia was found in types 1, 2, 3, 4, 5, 6, and 7 of non-regular work patterns compared to regular work patterns. After stratification for shift and night work, the OR of the group with shift and night work was higher than that of the group without shift and night work.

Conclusions

Insomnia was significantly associated with non-regular work patterns. This association was prominent in workers with shifts and night work. This finding suggests that proper work patterns may be needed to reduce the risk of insomnia among Korean wage workers and workers who initially had insomnia should consider these results before placement.


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Research Article
Longitudinal associations between occupational stress and depressive symptoms
Hyung Doo Kim, Shin-Goo Park, Youna Won, Hyeonwoo Ju, Sung Wook Jang, Go Choi, Hyun-Suk Jang, Hwan-Cheol Kim, Jong-Han Leem
Ann Occup Environ Med 2020;32:e13.   Published online May 7, 2020
DOI: https://doi.org/10.35371/aoem.2020.32.e13
AbstractAbstract PDF
Background

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

Methods

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

Results

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

Conclusions

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


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Research Article
Depressive symptoms among dance artists in South Korea: balance between self- and social identity on job value
Sung-Shil Lim, Jihyun Kim, Seahee Yune, Jin-Ha Yoon
Ann Occup Environ Med 2019;31:e14.   Published online July 31, 2019
DOI: https://doi.org/10.35371/aoem.2019.31.e14
AbstractAbstract PDFSupplementary Material
Background

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

Methods

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

Results

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

Conclusions

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


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Research Article
Working hours and depressive symptoms: the role of job stress factors
Yeogyeong Yoon, Jia Ryu, Hyunjoo Kim, Chung won Kang, Kyunghee Jung-Choi
Ann Occup Environ Med 2018;30:46.   Published online July 13, 2018
DOI: https://doi.org/10.1186/s40557-018-0257-5
AbstractAbstract PDF
Background

South Korea is one of the countries with the longest working hours in the OECD countries. The aim of this study was to evaluate the effect of working hours on depressive symptoms and the role of job stress factors between the two variables among employees in South Korea.

Methods

This study used data from the Korea Working Conditions Survey in 2014. Study subjects included 23,197 employees aged 19 years or older who work more than 35 h per week. Working hours were categorized into 35–39, 40, 41–52, 53–68, and more than 68 h per week. Depressive symptoms were assessed using the WHO’s Well-Being Index with a cut-off score of 13. We calculated prevalence ratios of depressive symptoms according to working hours using log-binomial regression. Through the percentage change in prevalence ratios, we identified the extent of the role of job stress factors that explain depressive symptoms.

Results

The risks of depressive symptoms were significantly higher in people who worked 35–39 h per week (PR: 1.09, CI: 1.01–1.18), 53–68 h/week (PR: 1.21, CI: 1.16–1.25), and more than 68 h/week (PR: 1.14, CI: 1.07–1.21) than 40 h/week, after adjusting for confounding variables. Job stress explained the effects of long working hours on depressive symptoms in about 20–40% of the groups working more than 40 h/week. Among the factors of job stress, social support was 10–30%, which showed the highest explanatory power in all working hours. Reward explained 15–30% in the more than 52 h working group, and reward was the most important factor in the working group that exceeded 68 h.

Conclusions

We showed the working hours could be an independent risk factor for depressive symptoms in employees. To improve workers’ mental health, it is important to strengthen social support in the workplace, to provide adequate rewards as they work, and ultimately to regulate the appropriate amount of working hours.


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    International Journal of Environmental Research and Public Health.2019; 16(9): 1642.     CrossRef
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Research Article
Association between organizational justice and depressive symptoms among securities company workers
HyunSuk Lee, KangHyun Um, YoungSu Ju, Sukkoun Lee, Min Choi, Domyung Paek, Seong-Sik Cho
Ann Occup Environ Med 2019;31:e7.   Published online June 5, 2018
DOI: https://doi.org/10.35371/aoem.2019.31.e7
AbstractAbstract PDF
Background

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

Methods

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

Results

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

Conclusions

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


Citations

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    Seong-Uk Baek, Jin-Ha Yoon
    Journal of Psychiatric Research.2025; 181: 689.     CrossRef
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Research Article
Respiratory symptoms and illnesses related to the concentration of airborne particulate matter among brick kiln workers in Kathmandu valley, Nepal
Seshananda Sanjel, Sanjay N. Khanal, Steven M. Thygerson, William S. Carter, James D. Johnston, Sunil K. Joshi
Ann Occup Environ Med 2017;29:9.   Published online March 27, 2017
DOI: https://doi.org/10.1186/s40557-017-0165-0
AbstractAbstract PDF
Background

Bricks have been manufactured in Nepal for hundreds of years and are seen as a component of Nepalese sculpture and architecture. Large quantities of hazardous materials including high concentrations of particulate matter are emitted on a daily basis from brick kilns. Exposure to these hazardous materials can lead to adverse consequences on the environment and human health. This study was conducted to  estimate the prevalence of respiratory symptoms/illnesses and the magnitude of respirable and total dust exposures among Nepalese brick kiln workers.

Methods

Respiratory symptoms/illnesses were evaluated by questionnaire among brickfield workers (n = 400) and a referent group of grocery workers (n = 400) in Kathmandu valley. Work zones (WZs): green brick molding (GBM), green brick stacking/carrying (GBS/C), red brick loading/carrying (RBL/C), coal preparation (CP) and firemen (FM) were the similar exposure groups (SEGs) from where personal air samples and interviews were taken. Among brickfield workers, personal monitoring was conducted across SEGs for total (n = 89) and respirable (n = 72) dust during February–March 2015 and March–April 2016. Applying multi-stage probability proportionate to size sampling technique, 16 kilns and 400 brick workers for interview were selected. Proportions, means, medians and ranges were calculated for the demographics, samples and respiratory symptoms/illnesses. One-way ANOVA was applied to compare the significance differences of the level of particulate matter among SEGs. Bivariate and multivariate logistic regression analysis were performed to evaluate association between respiratory symptoms/illnesses and participants groups, and SEGs among brick kiln workers at 0.05 level. Statistical analyses were performed using IBM SPSS Statistics 21.

Results

Chronic cough (14.3%), phlegm (16.6%) and bronchitis (19.0%) were higher (P < 0.05) among brickfield compared with grocery workers (6.8, 5.8 and 10.8%). Mean respirable (5.888 mg/m3) and total (20.657 mg/m3) dust exposures were highest for red brick loading tasks. The prevalence of chronic cough, chronic phlegm, chronic bronchitis, wheezing and asthma were significantly higher for other WZs workers (p < 0.05) compared with CP; for GBM: 22.9, 34.6, 15.0 and 7.5%; for GBS/C: 13.5, 15.8, 10.0, 8.8 and 7.5%; for RBL/C: 11.1, 17.1, 27.4, 19.0 and 11.9%; for FM: 18.4, 12.5, 28.4, 4.9 and 0.0%; and for CP: 4.9, 6.3, 13.3, 9.3 and 4.0% respectively.

Conclusion

High dust exposures identified in this study may explain the increased prevalence of respiratory symptoms/illnesses among Nepalese brickfield workers, warranting action to reduce exposures.


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    Chelsea Gaviola, Laura Nicolaou, Arun K Sharma, Ram Chandyo, David Parker, Laxman Shrestha, Santa K Das, Gurumurthy Ramachandran, Steven M Thygerson, Laura Beres, William Checkley
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    Nina Brooks, Debashish Biswas, Sameer Maithel, Sonal Kumar, Mohammad Rofi Uddin, Shoeb Ahmed, Moogdho Mahzab, Grant Miller, Mahbubur Rahman, Stephen P. Luby
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Research Article
Self-resilience as a protective factor against development of post-traumatic stress disorder symptoms in police officers
Jong-Ku Lee, Hyeon-Gyeong Choi, Jae-Yeop Kim, Juhyun Nam, Hee-Tae Kang, Sang-Baek Koh, Sung-Soo Oh
Ann Occup Environ Med 2016;28:58.   Published online October 17, 2016
DOI: https://doi.org/10.1186/s40557-016-0145-9
AbstractAbstract PDF
Background

This study was conducted to check whether self-resilience, one of the characteristics known to affect the occurrence of post-traumatic stress disorder (PTSD) symptoms after experiencing traumatic events, could serve as a protective factor for police officers whose occupational factors are corrected.

Methods

We conducted a cross-sectional study in which 112 male police officers in Gangwon Province participated. They visited the Wonju Severance Christian Hospital Occupational Environment Center for medical check-ups from June to December 2015. Their general characteristics were identified using structured questionnaires, and they were asked to fill in the Korean Occupational Stress Scale-Short Form (KOSS-SF). Further, the Center for Epidemiologic Studies-Depression Scale (CES-D), Connor–Davidson Resilience Scale-Korean (CD-RI-K), and Impact of Event Scale-Revised-Korean version (IES-R-K) were used to evaluate their job stress, depression, self-resilience, and PTSD symptoms. Logistic regression analysis was conducted to correct their personal, occupational, and psychological factors to analyze the relationship between self-resilience and PTSD symptoms.

Results

Among 112 respondents who experienced a traumatic event, those with low self-resilience had significantly higher rate of PTSD symptoms than those with high self-resilience even after correcting for the covariate of general, occupational, and psychological characteristics (odds ratio [OR] 3.51; 95 % CI: 1.06–19.23).

Conclusions

Despite several limitations, these results suggest that a high degree of self-resilience may protect police officers from critical incident-related PTSD symptoms.


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Research Article
Risk factors of musculoskeletal symptoms in university hospital nurses
Eunkwang Ryu, Byeongjin Ye, Youngil Yi, Jungwon Kim
Ann Occup Environ Med 2014;26:47.   Published online November 4, 2014
DOI: https://doi.org/10.1186/s40557-014-0047-7
AbstractAbstract PDF
Objectives

The purpose of this study was to investigate musculoskeletal symptom prevalence in university hospital nurses and explore the relation between musculoskeletal symptom prevalence and work related factors.

Methods

A structured questionnaire was conducted with 620 nurses in a university hospital to look into the characters of responsibility and musculoskeletal symptom prevalence. The questionnaire respondents numbered 534, so the response rate was 86.1%. Among the respondents, three who gave insincere answers were excluded. The final study population was 531 respondents. ANSI Z-365 checklist was applied to look into ergonomic characteristics, and Korean Occupational Stress Scale Short Form was employed to measure job stress.

Results

In the case of the whole body, symptom prevalence amounted to 70.8%. Regarding each body region, shoulder symptom prevalence accounted for the highest, or 44.8%, waist 40.7%, and neck 33.3% in order. According to multiple logistic regression analysis, in the case of the whole body, the group with a high ANSI checklist grade had odds ratio of 3.59 (95% CI 1.48 ~ 8.76), and the group with high job stress had 3.19 (95% CI 2.01 ~ 5.07).

Conclusion

Regarding the occupational factors related to musculoskeletal symptoms of university hospital nurses, it was found that ANSI Z-365 checklist high risk group, total job tenure, department, shiftworks, and job stress had high relation with musculoskeletal symptoms. It is necessary to find an ergonomic solution and a stress reduction plan to prevent musculoskeletal disease.


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Research Article
Acute Symptoms after a Community Hydrogen Fluoride Spill
Joo-Yong Na, Kuck-Hyun Woo, Seong-Yong Yoon, Seong-Yong Cho, In-Ung Song, Joo-An Kim, Jin-Seok Kim
Ann Occup Environ Med 2013;25:17.   Published online September 19, 2013
DOI: https://doi.org/10.1186/2052-4374-25-17
AbstractAbstract PDF
Objectives

This study was conducted to describe the demographic characteristics, and clinical signs and symptoms of patients who visited a general hospital because of the release of chemically hazardous hydrogen fluoride that occurred on September 27, 2012 in Gumi City, Korea.

Methods

The medical records at 1 general hospital 9 km from the accident site were reviewed using a standardized survey format. There were 1,890 non-hospitalized and 12 hospitalized patients exposed to hydrogen fluoride between September 27 and October 13 2012.

Results

Among the 12 hospitalized patients, 11 were discharged within 1 week and the other was hospitalized for 10 days. The chief complaints were respiratory symptoms such as hemoptysis and shortness of breath, gastrointestinal symptoms, neurologic symptoms, sore throat, and lip burn.

The number of non-hospitalized patients exhibited a bimodal distribution, peaking on the first and twelfth days after the accident. Their chief complaints were sore throat (24.1%), headache (19.1%), cough (13.1%), and eye irritation (9.2%); some patients were asymptomatic (6.2%). Patients who visited the hospital within 3 days (early patients) of the spill more often had shortness of breath (27.0%) and nausea (6.3%) as the chief complaints than patients who visited after 3 days (late patients) (3.5% and 2.6%, respectively). However, cough and rhinorrhea were more common in the late patients (14.0% and 3.3%, respectively) than in the early patients (5.0% and 0.0%, respectively). Patients who were closer to the accident site more often had shortness of breath and sputum as the chief complaints than patients who were farther away. The mean serum calcium concentration was 9.37 mg/dL (range: 8.4–11.0 mg/dL); none of the patients had a decreased serum calcium level. Among 48 pulmonary function test results, 4 showed decreased lung function. None of the patients had abnormal urine fluoride levels on the eighth day after exposure.

Conclusions

Patients hospitalized due to chemical hazard release of hydrogen fluoride had acute respiratory, gastrointestinal, and neurologic health problems. Non-hospitalized patients have acute symptoms mainly related to upper respiratory irritation.


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Original Article
Occupational Risk Factors Associated with Musculoskeletal Symptoms in Public Workers
Sei Kyun Noh, Ju Hwan Choi, Dong Hoon Shin, Mi Young Lee, In Sung Chung
Korean Journal of Occupational and Environmental Medicine 2012;24(4):410-419.   Published online December 31, 2012
DOI: https://doi.org/10.35371/kjoem.2012.24.4.410
AbstractAbstract PDF
OBJECTIVES
The purpose of this study was to examine the occupational risk factors associated with musculoskeletal symptoms in public workers.
METHODS
In November 2010, 544 participants anwered a survey that included questions on the participants' general characteristics, job-related factors, health-related behaviors, and psychosocial stress. We measured the relationship of risk factors to musculoskeletal symptoms using a logistic regression analysis.
RESULTS
After adjusting for general characteristics, factors associated with occupational musculoskeletal symptoms were gender (OR=2.858, 95% CI=1.701~4.801), unnatural posture (OR=2.386, 95% CI=1.308~4.354), psychosocial stress (OR=4.051, 95% CI=1.336~12.282) and sleep quality (OR=1.672, 95% CI=1.052~2.660).
CONCLUSIONS
These findings suggest that psychosocial stress levels and physical environment (especially in professions requiring an unnatural posture) are related to musculoskeletal symptoms in public workers.

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Original Article
The Assessment of Pulmonary Function in Dental Technicians
Kyoung Han Kim, Jong In Lee, Min Choi, Jun Pyo Myong, Yong Sang Park, Tae Won Jang, Jung Wan Koo
Korean Journal of Occupational and Environmental Medicine 2012;24(4):356-364.   Published online December 31, 2012
DOI: https://doi.org/10.35371/kjoem.2012.24.4.356
AbstractAbstract PDF
OBJECTIVES
Dental technicians are exposed to various toxic materials in the workplace. The objectives of this study were to assess the pulmonary function of dental technicians and to evaluate the association between work-related factors and pulmonary function of dental technicians.
METHODS
Study subjects were 209 dental technicians in the Korean Dental Technologist Association. A self-report questionnaire including general characteristics, respiratory symptoms, and work-related characteristics was conducted on study subjects, and a pulmonary function test (PFT) was done. Study subjects were classified into two groups(normal and abnormal pulmonary function) based on the pulmonary function test (PFT).
RESULTS
43 subjects (20.6%) among 209 subjects had abnormal pulmonary function. After adjusting for general characteristics such as age, sex, past medical history, familial history, and smoking status, the odds ratio for work duration (per year) was 1.42(95% confidence interval (CI) 1.14~1.83). After adjusting for general and work-related characteristics, the odds ratio for work duration (per year) was 1.48(95% CI 1.18~1.92).
CONCLUSIONS
Dental technicians are exposed to hazardous materials, which might lead to abnormal pulmonary function. A long work duration could increase exposure time, thereby increasing the chance for abnormal pulmonary function. Therefore, pulmonary function tests should be carried out periodically in dental technicians to ensure their pulmonary health.

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Original Article
Association between Job-related Factors and Musculoskeletal Symptoms in University Hospital Healthcare Workers
Yoonbum Choi, Soo Jin Lee, Jae Chul Song, Kyu Jung Bae, Hwanjin Park
Korean Journal of Occupational and Environmental Medicine 2012;24(3):217-228.   Published online September 30, 2012
DOI: https://doi.org/10.35371/kjoem.2012.24.3.217
AbstractAbstract PDF
OBJECTIVES
To investigate the prevalence of musculoskeletal symptoms in university hospital healthcare workers and to evaluate the job-related factors that affect musculoskeletal symptoms.
METHODS
A questionnaire was administered to health care workers who work at the university hospital. The self-reported questionnaire included the following information: general characteristics, health behaviors, job-related factors, depression symptom, ergonomic factor, job stress, and musculoskeletal symptoms. Ergonomic factor was measured by ANSI Z-365, depression symptom by CES-D, job stress by KOSS-26 and musculoskeletal symptoms by NIOSH questionnaire.
RESULTS
A total of 1,198(64.2%) of 1,842 respondents answered and 1,183 were included in the final study population. The prevalence of musculoskeletal symptoms was 53.3%. The prevalence of musculoskeletal symptoms of males and females was 25.6% and 63.9%, respectively. After adjusting for confounding factors, total job stress score(OR=3.05, 95% CI=1.62~5.74), depression symptom(OR=2.18, 95% CI=1.07~4.43), ANSI Z-365 high risk group(OR=5.33, 95% CI=2.08~13.66) in males and total job stress score(OR=2.14, 95% CI=1.53~3.00), three-shift work(OR=1.81, 95% CI=1.26~2.60), nurses(OR=1.82, 95% CI=1.22~2.73), and ANSI Z-365 high risk group(OR=3.33, 95% CI=1.58~7.03) in females were significantly associated with musculoskeletal symptoms.
CONCLUSIONS
Shift work, nurses, ANSI Z-365 high risk group, depression symptom and job stress were related with musculoskeletal symptoms. In order to prevent musculoskeletal disorders, ergonomic improvements and stress reduction are required.

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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
AbstractAbstract PDF
OBJECTIVES
This study was conducted to investigate problem drinking and analyze factors associated with alcohol use among female firefighters, as well as to provide useful data for management of alcohol use by female firefighters.
METHODS
The study includeed 1,587 female firefighters from throught Koea. Data were collected from June to July in 2008 using self-administered questionnaires including a general questionnaire, work related questionnaire, the Alcohol Use Disorders Identification Test (AUDIT), the Korean Occupational Stress Scale Short Form (KOSS-26), and the Center for Epidemiologic Studies Depression Scale (CESD). Among 1,263 female firefighters (75.6%) surveyed, the results of 1,084 qualified questionnaires (70.5%) were analyzed using the chi-square test, Fisher's exact test, and multiple logistic regression.
RESULTS
The prevalence of problem drinking (AUDIT score > or =8) in female firefighters was 12.5%. Multiple logistic analysis showed that being single, smoking and depression were correlated with problem drinking. Single female firefighter, present smokers and individuals positive for symptoms of depression had OR values of 2.11, 17.58 and 1.76, respectively.
CONCLUSIONS
Three factors were found to influnce the occurrence of problem drinking. Accordingly, smoking related education, counseling to cope effectively with depression and health promotion programs that consider psychological effects of job stress are needed to reduce work related factors that lead to problem drinking by female firefighters.

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Original Article
The Relationship of Physical and Psychosocial Risk Factors to Work-related Musculoskeletal Upper Extremity Symptoms amongst Male Automobile Manufacturing Workers
Ki Hyun Lee, Jin Ha Yoon, Sung Kyung Kim, In Jung Cho, Sung Soo Oh, Sung Hoon Kim, Sei Jin Chang, Bong Suk Cha, Sang Baek Koh
Korean Journal of Occupational and Environmental Medicine 2012;24(1):72-85.   Published online March 31, 2012
DOI: https://doi.org/10.35371/kjoem.2012.24.1.72
AbstractAbstract PDF
OBJECTIVES
The objective of this study was to determine the relationship of physical and psychosocial risk factors to work-related musculoskeletal upper extremity symptoms amongst automobile manufacturing workers.
METHODS
The cross-sectional study was conducted using male automobile manufacturing workers in order to examine the relationship of physical and psychosocial risk factors to work-related musculoskeletal upper extremity symptoms. A total of 1,793 male workers were asked to complete a self-administered questionnaire. The questionnaire consisted of questions regarding general characteristics, health related behaviors, work-related characteristics, job stress, ergonomic risk factors, and the presence of musculoskeletal symptoms (neck, shoulder, arm, and hand). Work-related musculoskeletal symptoms were evaluated using the National Institute of Occupational Safety and Health (NIOSH) surveillance criteria. In order to measure the physical risk factors, the American National Standard Institute (ANSI) Z-365 Quick checklist was incorporated into the questionnaire. Job stressors were measured using the Korean Occupational Stress Scale (KOSS). A binary logistic regression analysis was performed that examined the relationship of physical and psychosocial risk factors to musculoskeletal symptoms.
RESULTS
The result showed that the physical and psychosocial risk factors were associated with musculoskeletal upper extremity symptoms. The workers with high physical risk factors reported more musculoskeletal symptoms than those having low physical risk factors (OR: 2.37, 95% CI: 1.56~3.62). The workers with high job stress were more likely to have an increased risk of musculoskeletal upper extremity symptom compared to those with normal job stress (OR: 2.65, 95% CI: 2.03~3.47). A significant relationship between the combined effects of physical and psychosocial risk factors on musculoskeletal upper extremity symptoms was also found. The workers exposed to high physical risk factors, high job stress, and long working hours were more likely to report musculoskeletal symptoms than those having low physical risk factors, normal job stress and moderate working hours(OR: 2.37, 95% CI: 1.56~3.62).
CONCLUSIONS
The results suggest that some physical and psychosocial risk factors increase the risk of work-related musculoskeletal upper extremity symptoms amongst automobile manufacturing workers. In order to prevent or reduce musculoskeletal disorders amongst automobile manufacturing workers, it is strongly recommended to manage the physical psychosocial risks occurring in the workplace.

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

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Original Article
Relationship between Musculoskeletal Symptoms and Non-fatal Occupational Injuries in Construction Workers in Korea
Seung Won Yoo, Hye Eun Lee, Dong Hee Koh, Kyoo Sang Kim, Tae Woo Kim, Min Gi Kim, Kyeong Yeol Yu
Korean Journal of Occupational and Environmental Medicine 2011;23(1):9-17.   Published online March 31, 2011
DOI: https://doi.org/10.35371/kjoem.2011.23.1.9
AbstractAbstract PDF
OBJECTIVES
This study aimed to assess the relationship between musculoskeletal symptoms and non-fatal injuries in construction workers.
METHODS
This was a cross-sectional study involving 1,836 male construction workers in petrochemical plants in Korea. For this study, a structured self-reported questionnaire(KOSHA CODE H-30-2003) was used. Musculoskeletal symptoms were defined as symptoms that affect the operation of the musculoskeletal system, for longer than one week or a frequency of more than once per month. To evaluate the association between musculoskeletal symptoms and non-fatal occupatioanl injuries, multiple logistic-regressions were used after adjusting for age, exercise, smoking status, alcohol consumption, work time, work duration, and income.
RESULTS
A total of 140 workers were involved in non-fatal injuries cases, representing 7.6% prevalence. After adjusting for confounding variables, the logistic regression analyses indicated the group with musculoskeletal symptoms(OR 1.73 95% CI:1.21~2.47) and intensity criteria of musculoskeletal symptoms as related to 'moderate' criteria(OR 1.82 95% CI:1.18~2.81) or 'severe' criteria(OR 2.57 95% CI:1.43~4.63). This identified group was more likely to experience non-fatal occupational injuries. However, a 'mild' criteria(OR 1.00 95% CI:0.51~1.99) was not associated with non-fatal occupational injuries.
CONCLUSIONS
The results indicated a possible association between musculoskeletal symptoms and non-fatal injuries. Hence, strengthening of laws and regulations, effective ergonomic programs and training is necessary to prevent musculoskeletal symptoms.

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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
AbstractAbstract PDF
OBJECTIVES
To investigate the relationship between job stress and depressive symptoms among field firefighters.
METHODS
We carried out a survey of 17,457 field firefighters using the KOSS-24 (Korean Occupational Stress Scales-24) and CES-D (Center for Epidemiological Studies-Depression Scale).
RESULTS
The mean CES-D score was 12.2+/-9.6 and 19.2% of subjects had depressive symptoms. Job insecurity (OR=2.70, 95% CI=2.45~2.98) and lack of reward (OR=2.41, 95% CI=2.18~2.65), occupational climate (OR=2.38, 95% CI=2.15~2.63) were strongly associated with depressive symptoms. Job demand (OR=1.89, 95% CI=1.69~2.10), insufficient job control (OR=1.14, 95% CI=1.03~1.25), interpersonal conflict (OR=2.05, 95% CI=1.87~2.26) and organizational system (OR=1.83, 95% CI=1.66~2.02) were also significantly associated with depressive symptoms. Alcohol dependence had a stronger association than with normal subjects (OR=2.39, 95% CI=2.07~2.77).
CONCLUSIONS
In field firefighters, job stress factors and alcohol dependence were associated with depressive symptoms. An intervention to reduce job stress and alcohol among field firefighters is needed to reduce depression in this population.

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Original Article
Current Status of Sickness Absences and Early Leaves from Work among Workers with Work-related Musculoskeletal Symptoms in Each Body Part, and Relevant Factors
Dong Hoon Lee, Shin Goo Park, Jong Han Leem, Hwan Cheol Kim, Dong Hyun Kim, Jeong Hoon Kim, Seung Jun Lee, Gee Woong Kim
Korean Journal of Occupational and Environmental Medicine 2010;22(4):364-370.   Published online December 31, 2010
DOI: https://doi.org/10.35371/kjoem.2010.22.4.364
AbstractAbstract PDF
OBJECTIVES
The purpose of this study was to identify current status of sickness absence and early leaves from work as a result of work-related musculoskeletal symptoms.
METHOD
From January to December in 2007, 4,975 workers were recruited into this study and surveyed over this time period; workers came from 116 small and medium sized companies in Incheon. Among the study populations, only those who met the NIOSH criteria for work-related musculoskeletal symptoms on each symptom locations were included in the final analysis. The survey used a structured self-administered questionnaire, which asked questions about musculoskeletal symptoms regarding locations, sickness absences and early leaves from work. Other information gathered from participants included sociodemographical characteristics, and work-related characteristics.
RESULTS
The rates of sickness absences and early leaves in each symptom locations were highest (14.9%) among workers with waist symptoms. Men had higher rates of sickness absences and early leaves form work than women; manufacturing workers had higher rates of sickness absences and early leaves form work than office workers. After confounding variables that had significant difference in univariate analysis on each symptom locations were adjusted, the odds ratios for sickness absence and early leaves divided by pain intensity were 4.361(neck), 4.140(shoulder), 3.151(arm/wrist), 3.085(leg/foot), and 2.731(waist), respectively; these differences were statistically significant.
CONCLUSIONS
The rates of sickness absence and early leaves in each work-related musculoskeletal symptom locations were highest among workers with waist symptoms, and the intensity of pain was identified to have a considerable effect on the rates of sickness absences and early leaves. Based on these results, we think that there are needs to be early interventions on workers with waist symptoms.

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    Gi-Yeol Kim, Jung-Lim Oh, Kyoung-Ok Hwang
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Original Article
Association between Emotional Labor and Symptoms of Depression among Bankers
Sanghyo Chu, Hyunchul Ryou, Kyujeong Bae, Jaechul Song, Soojin Lee, Inah Kim
Korean Journal of Occupational and Environmental Medicine 2010;22(4):316-323.   Published online December 31, 2010
DOI: https://doi.org/10.35371/kjoem.2010.22.4.316
AbstractAbstract PDF
OBJECTIVES
We focused on the relationship between symptoms of depression and emotional labor to investigate the mental health status of workers.
METHODS
In this cross-sectional study, a total of 2,346 workers among bankers were our study subjects. A self-administered questionnaire was used to assess the socio-demographics, job characteristics, emotional labor and, the Center for Epidemiologic Studies-Depression scale (CES-D). We used multiple logistic regression analysis to estimate the relationship between emotional labor and the symptoms of depression.
RESULTS
The prevalence of symptoms of depression among the survey subjects was 20.6%. After adjusting for confounding factors, emotional effort (OR: 1.7, 95% CI=1.28~2.31) and, emotional disharmony (OR: 4.5, 95% CI=3.13~6.44) in men and emotional effort (OR: 1.9, 95% CI=1.33~2.75), emotional disharmony (OR: 6.1, 95% CI=4.12~9.09) in women showed a statistically significant association with symptoms of depression.
CONCLUSIONS
These results suggest that emotional disharmony and emotional effort are related to symptoms of depression. Managing emotional disharmony is important in managing symptoms of depression.

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Original Article
The Relationship between Job Stress and Musculoskeletal Symptoms in Migrant Workers
Min Heui Jo, Kyoo Sang Kim, Sun Wung Lee, Tae Gyun Kim, Hyang Woo Ryu, Mi Young Lee, Yong Lim Won
Korean Journal of Occupational and Environmental Medicine 2009;21(4):378-387.   Published online December 31, 2009
DOI: https://doi.org/10.35371/kjoem.2009.21.4.378
AbstractAbstract PDF
OBJECTIVE: To investigate the musculoskeletal symptoms of migrant workers. We focused on the relationship between job stress and musculoskeletal symptoms.
METHOD
A questionnaire was administered to 502 migrant workers who visited NGO migrant worker centers located in Gyung-gi province. A structured, self-reported questionnaire was administered to participants in order to capture the following information: sociodemographics, health factors including past medical history, work related characteristics, job stress, and musculoskeletal symptoms. The job stress questionnaires were used according to KOSS-26 and musculoskeletal symptoms were measured using KOSHA Code H-30-2003. We used multiple logistic regression analysis to assess the relationship between risk factors which included job stress, and musculoskeletal symptoms.
RESULTS
The prevalence rate of musculoskeletal symptoms in survey subjects was 35.1%. Other than job stress factors, past medical history was the only factor that had a statistical relationship to musculoskeletal symptoms (P<0.01). In the domains of job stress, physical environment (OR 1.62, 95% CI: 1.03~2.54), job demand (OR 2.43, 95% CI: 1.46~4.03), job insecurity (OR 1.59, 95% CI: 1.03~2.47), occupational climate (OR 2.30, 95% CI: 1.27~4.19) were most likely experience musculoskeletal symptoms.
CONCLUSION
The job stress factor appeared to correlate more with musculoskeletal symptoms than with sociodemographics or other factors. Hence, in order to prevent migrant worker's musculoskeletal symptoms, we believe that intervention in job stress (physical environment, job demand, job insecurity, occupational climate) is necessary.

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Original Article
The Relationship between Job Stress and Depressive Symptoms in Migrant Workers in Kyung-gi Province in Korea
Sun Wung Lee, Kyoo Sang Kim, Tae Gyun Kim, Hyang Woo Ryu, Mi Young Lee, Yong Lim Won, Yoon Hee Song
Korean Journal of Occupational and Environmental Medicine 2009;21(1):76-86.   Published online March 31, 2009
DOI: https://doi.org/10.35371/kjoem.2009.21.1.76
AbstractAbstract PDF
OBJECTIVES
To investigate the mental health status of migrant workers. We focused on the relationship between depressive symptoms and job stress. METHEOD: A questionnaire was administered to 488 migrant workers who visited NGO migrant worker centers located in Kyung-gi province. A structured, self-reported questionnaire was used to assess each responder's sociodemographics, work related characteristics, health behaviors, past medical history, job stress and depression symptoms. The job stress questionnaire was used according to KOSS-26 and depression symptoms were measured using CES-D, which was translated into Korean. We used multiple logistic regression analysis to assess the relationship between risk factors included job stress and depression symptoms.
RESULTS
The prevalence of depression symptoms in survey subjects was 25.2%, but the prevalence of non-Chinese nationalities and illegal workers were 32.1% and 32.8%, respectively. Adjusting for confounding factors, job stress (OR 2.55, 95% CI=1.30-4.99) had a statistical meaningful relationship with depression symptoms. Among job stress domains, physical environment (OR 2.97, 95% CI=1.59-5.53), job demand (OR 2.33, 95% CI=1.26-4.32) and occupational climate(OR 3.10, CI=1.49-6.48) were most likely to experience depression symptoms.
CONCLUSIONS
The prevalence of depressive symptoms among the study subjects was similar to the prevalence among the general population in Korea, but higher than that among the Korean workers. In particular, the prevalence among non-Chinese and illegal workers was higher. However, the job stress factor appeared to have a more direct correlation with depressive symptoms than the sociodemographic factors of nationality or residential status. Hence, in order to prevent depressive symptoms of the migrant workers, we believe that intervention on job stress is necessary.

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Original Article
Relationship of Shift Work to Cardiovascular and Gastrointestinal Symptoms in Korean Female Workers
Kyung Jae Lee, Joo Ja Kim
Korean Journal of Occupational and Environmental Medicine 2008;20(4):362-371.   Published online December 31, 2008
DOI: https://doi.org/10.35371/kjoem.2008.20.4.362
AbstractAbstract PDF
OBJECTIVES
We wanted to investigate the relationship of shift work to the cardiovascular and gastrointestinal symptoms of Korean female workers.
METHODS
The data was analyzed from a cross-sectional survey of 1,875 Korean female workers. Information was obtained about the shift work, the cardiovascular and gastrointestinal symptoms and the background characteristics. Multiple regression analysis was used to test for the relationship between the cardiovascular and gastrointestinal symptoms and the shift work variables, while controlling for the covariates.
RESULTS
Shift work was more common for blue-collar workers than for office workers. A higher proportion of current smokers and drinkers was observed for shift workers than for day workers. A full-time job was more popular for shift workers than for day workers, while more day workers worked over 8 hours per day than did the shift workers. The mean scores of the cardiovascular and gastrointestinal symptoms were significantly higher for shift workers than for day workers. Shift work was associated with 0.54 more cardiovascular symptoms and with 0.38 more gastrointestinal symptoms on a multiple regression analysis (p=0.001; p=0.020, respectively).
CONCLUSIONS
Our findings suggest that shift work may increase the risks for cardiovascular and gastrointestinal disturbances. Therefore, preventive strategies are needed to control the negative effects of shift work in the workplace.

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    Eun Ok Yang, In Ryung Choi, Seong-Min Kim
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    Jae-Seok Oh, Won-Jun Choi, Min-Kee Lee, Sung-Woo Han, Seung-Ho Song, Jong-Wan Yun, Sang-Hwan Han
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    Eun-Ju Kim, Hye-Sun Jung, Eun-hi Choi
    Korean Journal of Health Promotion.2014; 14(4): 172.     CrossRef
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Original Article
The Relationship between Depressive Symptoms, Job Stress and Intensity of Labor among Security Firm Workers
Yoon Hee Song, Jung Ok GongYoo, Inah Kim, Won Jun Choi
Korean Journal of Occupational and Environmental Medicine 2008;20(4):283-294.   Published online December 31, 2008
DOI: https://doi.org/10.35371/kjoem.2008.20.4.283
AbstractAbstract PDF
OBJECTIVES
To investigate the mental health status of security firm workers focusing on job stress, depressive symptoms, and overall psychosocial stress and to determine the relationship between depressive symptoms and the level of distress with changes in labor conditions and intensity.
METHODS
Using a cross-sectional design, a formal survey including basic sociodemographic factors, job-related characteristics, job stress, psychosocial stress, depressive symptoms, and changes in labor conditions and intensity was conducted on workers employed in nine security firms. A total of 1,313 workers replied to the survey. We estimated the relationship between psychosocial stress and depressive symptoms with job stress, and changes in labor conditions and intensity by multivariate logisitic regression analysis.
RESULTS
Severe and intermediate level of depressive symptoms occurred in 18.5% (209) of the workers, and the high risk psychosocial distress groups accounted for 44.2% or the workers. Based on multivariate analysis, the Borg scale (OR=2.43 95%, CI=1.72-3.45), relative labor intensity (OR=1.05, 95% CI=1.00-1.09), high job demand (OR=1.47, 95% CI=1.06-2.06) were significantly associated with depressive symptoms. For psychosocial stress, the Borg scale (OR=2.39, 95% CI=1.84-3.10), relative labor intensity (OR=1.06, 95% CI=1.02-1.09), low job control (OR=1.80, 95%CI=1.38-2.35), and high job instability (OR=1.53, 95%CI=1.02-2.29) were significantly associated with high risk groups.
CONCLUSIONS
This study showed that a large proportion of security firm workers encountered depressive symptoms and psychosocial stress. Also, labor intensity and changes in labor condition (relative work intensity) were influential factors for depressive symptoms and psychosocial stress. Therefore, we conclude that not only an intervention for job stress should be offered, but also a policy toward the systemic problem of labor intensification should be considered.

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    Ji Yun Lee, Kyung Jin Hong
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Original Article
Musculo-skeletal Symptoms of Municipal Sanitation Workers and Ergonomic Evaluation on Upperlimb
Jun Pyo Myong, Hyang Ki Lee, Hyoung Ryoul Kim, Hye Sun Jung, Eun Hee Jeong, Woong Nam, Jung Wan Koo
Korean Journal of Occupational and Environmental Medicine 2008;20(2):93-103.   Published online June 30, 2008
DOI: https://doi.org/10.35371/kjoem.2008.20.2.93
AbstractAbstract PDF
OBJECTIVES
The aim of this study was to estimate musculo-skeletal symtoms of municipal sanitation workers and to evaluate working conditions of municipal sanitation workers to search for the factors related to musculo-skeletal symptoms.
METHODS
We conducted a descriptive cross-sectional survey. The study subjects were comprised of 543 municipal sanitation workers in some divisions of Seoul and the Gyeonggi province. Musculo-skeletal analysis was done by using the modified criteria of NIOSH musuclo-skeletal symptoms, RULA and, REBA. Statistical analysis was done by using the chi-square test, multiple logistic regression analysis.
RESULTS
72.2% of the subjects complained musculo-skeletal symptoms (39.6% on the upperlimbs, 30.0% on the lumbar region, 27.4% on the legs). For the musculo-skeletal symptoms criteria (1~3), street cleaners complained of more musculo-skeletal symptoms than the solid waste collectors, after classifying the jobs of sanitation workers. On logistic regression analysis of the musculo-skeletal "symptoms criteria1" positive groups, age was related to the criteria positive (prevalence odds ratio=1.018, 95% CI: 0.993-1.046). The worktime was significantly related to 'criteria positive 1 and, 2' (prevalence odds ratio=2.165 (95% CI: 1.156-4.131), 2.187 times (95% CI: 1.071-4.651)). The RULA score, the subtotal A score of RULA, the REBA score and , the total A REBA score of the upperlimbs of solid waste collectors were higher than those of the street cleaners.
CONCLUSIONS
In spite of the lower ergonomic evaluation score of the street cleaner, the street cleaners complained of more musculo-skeletal symptoms than did the solid waste collectors due to more frequent repetitive motions, a longer work time (over 10 hours) etc. It is suggested that the sanitation workers need to use the proper methods to avoid musculo-skeletal disease.

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    Journal of the Ergonomics Society of Korea.2011; 30(3): 427.     CrossRef
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    Kyung-Sun Lee, In-Seok Lee, Hyun-Joo Kim, KyungHee Jung-Choi, Jin-Wook Bahk, Myung-Chul Jung
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Original Article
Dose-Response Relationships between Work-Related Musculoskeletal Neck Symptom and Physical Risk Factors (2 year follow-up study)
Jingon Sul, Dongmug Kang, Suill Lee, Youngki Kim
Korean Journal of Occupational and Environmental Medicine 2007;19(2):145-155.   Published online June 30, 2007
DOI: https://doi.org/10.35371/kjoem.2007.19.2.145
AbstractAbstract PDF
OBJECTIVES
To estimate the association of work-related musculoskeletal neck symptom and occupational risk factors, and to identify the dose-response relationships between work-related musculoskeletal neck symptom and physical condition.
METHODS
Workers from four metal industry companies were enrolled in the study. General characteristics, psyhcosocial and physical risk factors and work-related musculoskeletal neck symptom were investigated by questionnaire in the baseline study. At the follow-up study 2 years later, the neck symptom was surveyed. Workers who did not complain neck symptom at baseline and complain at follow-up, and workers who did complain neck symptom at baseline and follow-up were defined as case. The adjusted odds ratios (ORs) of physical risk factors were estimated for these subjects. Additionally, subjects who did not change their work at follow-up were analysed.
RESULTS
Among the cohort of 251, 199 (79.3%) were used in the analysis, of which 71 (35.7%) were classified as cases. The adjusted ORs and the ORs of the subjects who did not change their work were increased with exposure to the following kinds of work: 'repetitive', 'lift', 'push/pull', 'neck/shoulder (overhead/bend)', 'hand/wrist (bend/pinch)', 'trunk (twist/bend)', 'pressure point', and 'incentive work'. Finally, with increasing exposure to 'repetitive', 'lift', 'push/pull', 'awkward postures', 'pressure point', and 'incentive work', the risks of work-related musculoskeletal neck symptom were increased.
CONCLUSIONS
Work-related musculoskeletal neck symptom was increased with increasing exposure time of certain physical risk factors, and a dose-response relationship was observed.

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