Annals of Occupational and Environmental Medicine

Original Articles

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

Abstract PDF Supplementary Material PubReader ePub: Background
Firefighters are exposed to shift work, as well as unpredictable emergency calls and traumatic events, which can lead to sleep problems. This study aimed to investigate the risk of insomnia by work schedule instability in Korean firefighters.
Methods
This study used the Insomnia Severity Index to assess the insomnia in firefighters. The work schedule stability was classified with the frequency of the substitute work and the timing of notification for work schedule changes. Logistic regression analysis was used to assess the adjusted odds ratio of insomnia by work schedule stability with covariates including sex, age, education, smoking, alcohol, caffeine intake, shift type, job, and underlying conditions.
Results
Of the 8,587 individuals, 751 (8.75%) had moderate to severe insomnia (Insomnia Severity Index ≥ 15). The prevalence of insomnia was statistically significantly higher as the frequency of substitute work increased: <1 time per month (6.8%), 1–2 times (9.5%), 3–5 times (13.4%), and more than 5 times (15.7%) (p < 0.001). Additionally, the prevalence of insomnia was statistically significantly higher when the timing of the schedule change notification was urgent or irregular: no change or several weeks before (5.4%), several days before (7.9%), one day before or on the day (11.2%), irregularly notification (11.6%) (p < 0.001). In comparison to the group with good frequency of the substitute work/good timing of schedule change notification group, the adjusted odds ratios of insomnia were 1.480 (95% confidence interval [CI]: 1.237–1.771) for Good/Bad group, 1.862 (95% CI: 1.340–2.588) for Bad/Good group, and 1.885 (95% CI: 1.366–2.602) for Bad/Bad group.
Conclusions
Work schedule instability was important risk factor of insomnia in firefighters. It suggests that improving the stability of work schedules could be a key strategy for reducing sleep problems in this occupational group.

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

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

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Research Articles

Risk factors including night shift work of colorectal polyp: Kanghyun Um, Chung-soo Park, Cheolin Yoo, Yeon-Soon Ahn, Moonchan Kim, Kyoung Sook Jeong; Ann Occup Environ Med 2020;32:e26. Published online July 13, 2020; DOI: https://doi.org/10.35371/aoem.2020.32.e26

Abstract PDF PubReader ePub

Background

The destruction of circadian rhythms by night shift work affects major circadian genes, which are known to play a role in advancing or killing the cell cycle through tumor suppressor genes. To find out whether night shift work affects the incidence of colorectal cancer, which was found to be associated with long-term night shift work in previous studies, we surveyed effect of night shift work on colorectal polyps that have a higher incidence than colorectal cancer and can progress to colorectal cancer.

Methods

To examine the correlation between rotating night shifts and colorectal polyps, a survey was conducted with 299 men aged 40–60 years from two university hospitals. We examined lifestyle, work history, work patterns, and colonoscopy results. The differences in prevalence among the groups was compared, and prevalence ratio (PR) was calculated via generalized linear modeling.

Results

The prevalence of colorectal polyps in night shift and non-shift workers were 53.0% and 33.5%, respectively. After adjusting for age, smoking status, dietary habits, family history of colorectal cancer, obesity, job type, night shift work (PR: 1.13, 95% CI: 1.02–1.25) was a risk factor of colorectal polyps.

Conclusions

The risk of colorectal polyps was greater in night shift workers than non-shift workers. Also risk of colorectal polyp was higher in older group. Our study investigated colorectal polyp instead of colorectal cancer and lacks information about types and gene mutations of colorectal polyps. Further study is needed to clarify effect of night shift work on development of colorectal cancer.

Citations

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Spatial clustering of colorectal cancer in Malaysia
Sharifah Saffinas Syed Soffian, Azmawati Mohammed Nawi, Rozita Hod, Khairul Nizam Abdul Maulud, Ahmad Tarmizi Mohd Azmi, Mohd Hazrin Hasim Hashim, Huan-Keat Chan, Muhammad Radzi Abu Hassan
Geospatial Health.2023;[Epub] CrossRef
Circadian regulation of digestive and metabolic tissues
Zainab Taleb, Phillip Karpowicz
American Journal of Physiology-Cell Physiology.2022; 323(2): C306. CrossRef
Do sleep quality and psychological factors link precancerous conditions of colorectal cancer? A retrospective case-control study
Wei Liu, Huijie Zhang
Expert Review of Gastroenterology & Hepatology.2022; 16(2): 173. CrossRef
Prevalence of Colorectal Polyps Based on Cardiorespiratory Fitness, Muscle Strength, Health Behavior, and Abdominal Obesity in Asymptomatic Elderly
Shiyu Zhang, Junyong Zhang, Yonghwan Kim, Wangyang Zhang
Healthcare.2021; 9(10): 1400. CrossRef
The Circadian Clock Gene, Bmal1, Regulates Intestinal Stem Cell Signaling and Represses Tumor Initiation
Kyle Stokes, Malika Nunes, Chantelle Trombley, Danilo E.F. L. Flôres, Gang Wu, Zainab Taleb, Abedalrhman Alkhateeb, Suhrid Banskota, Chris Harris, Oliver P. Love, Waliul I. Khan, Luis Rueda, John B. Hogenesch, Phillip Karpowicz
Cellular and Molecular Gastroenterology and Hepatology.2021; 12(5): 1847. CrossRef

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Validation of urinary 1,2-dichloropropane concentration as a biological exposure index for workers exposed to 1,2-dichloropropane: Chung-Soo Park, Hyun-Soo Kim, Yeon-Soon Ahn, Jung-Ho Ahn, Kyoung Sook Jeong; Ann Occup Environ Med 2020;32:e24. Published online July 7, 2020; DOI: https://doi.org/10.35371/aoem.2020.32.e24

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Background

The International Agency for Research on Cancer classified 1,2-dichloropropane (1,2-DCP) as a human carcinogen in 2016. It is necessary to establish a health monitoring system for workers exposed to 1,2-DCP. We investigated the correlation between 1,2-DCP concentration in air and urine to determine whether it is appropriate to measure 1,2-DCP in urine as a biological exposure index (BEI).

Methods

Twenty-seven workers from 3 manufacturing industries handling 1,2-DCP participated in this study. Airborne 1,2-DCP was collected by personal air. Urine samples were collected at the end of work and analyzed using gas chromatography-mass spectrometry. Correlation analysis and simple regression analysis were performed to investigate the relationship between 1,2-DCP concentration in urine and air.

Results

Pearson correlation coefficients between total 1,2-DCP in air and urine (uncorrected, creatinine-corrected) were 0.720 and 0.819, respectively. For urine samples analyzed within 2 weeks, the Spearman's rho of 1,2-DCP concentration in urine (uncorrected and creatinine-corrected) was 0.906 and 0.836, respectively. Simple regression analysis of 1,2-DCP in air and urinary 1,2-DCP concentrations within 2 weeks, which showed the highest correlation, revealed that the coefficient of determination of 1,2-DCP concentration in urine (uncorrected and creatinine-corrected) was 0.801 and 0.784, respectively.

Conclusions

As a BEI for workers exposed to 1,2-DCP, urinary 1,2-DCP without creatinine correction better reflects the exposure levels of 1,2-DCP in air.

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Acute 1,2-Dichloropropane Poisoning due to Ingestion of Rubber Cement
Qiuyu Pang, Lexin Zheng, Ruoyu Huang, Heng Xu, Chong Pan, Zhiyong Wang, Tao Wang
American Journal of Forensic Medicine & Pathology.2023;[Epub] CrossRef
Systematic review of the human health hazards of propylene dichloride
Heather N. Lynch, Jordan S. Kozal, Melissa J. Vincent, Rachel D. Freid, Evan M. Beckett, Sarah Brown, Claire Mathis, Rita S. Schoeny, Andrew Maier
Regulatory Toxicology and Pharmacology.2023; 144: 105468. CrossRef

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

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Background

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

Methods

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

Results

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

Conclusions

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

Citations

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Screening for Comorbidity of Sleep Disorders in Career Firefighters
Nancy A. Hamilton, Julia Russell, Kareem Hamadah, Westley Youngren, Addie Toon, Thu A. Nguyen, Kevin Joles
Journal of Occupational & Environmental Medicine.2024; 66(1): 43. CrossRef
Global prevalence and associated factors of sleep disorders and poor sleep quality among firefighters: A systematic review and meta-analysis
Amir Hossein Khoshakhlagh, Saleh Al Sulaie, Saeid Yazdanirad, Robin Marc Orr, Hossein Dehdarirad, Alireza Milajerdi
Heliyon.2023; 9(2): e13250. CrossRef
Prevalence and associated factors of poor sleep quality among industrial workers in Addis Ababa, Ethiopia: findings from a cross-sectional study
Amensisa Hailu Tesfaye, Addisu Genene Masresha, Tirhas Tadesse, Fantu Mamo Aragaw, Belay Desye, Giziew Abere
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Brett A Messman, Danica C Slavish, Madasen Briggs, Camilo J Ruggero, Benjamin J Luft, Roman Kotov
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Nunnapat Piyachaiseth, Pornchai Sithisarankul, Jate Ratanachina
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Heterogeneity in patterns of posttraumatic stress disorder symptoms and sleep disturbances among firefighters: Latent profile analyses
Elizabeth L. Griffith, Ling Jin, Ateka A. Contractor, Danica C. Slavish, Anka A. Vujanovic
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Association between sleep quality and type of shift work in Korean firefighters
Hyun-Jeong Oh, Chang Sun Sim, Tae-Won Jang, Yeon Soon Ahn, Kyoung Sook Jeong
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Firefighter sleep: a pilot study of the agreement between actigraphy and self-reported sleep measures
Joel M. Billings
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Pregnancy, childbirth, and puerperium outcomes in female firefighters in Korea: Juha Park, Yeon-Soon Ahn, Min-Gi Kim; Ann Occup Environ Med 2020;32:e8. Published online January 31, 2020; DOI: https://doi.org/10.35371/aoem.2020.32.e8

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Background

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

Methods

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

Results

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

Conclusion

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

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Alesia M Jung, Sara A Jahnke, Leslie K Dennis, Melanie L Bell, Jefferey L Burgess, Leslie V Farland
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Occupational factors and miscarriages in the US fire service: a cross-sectional analysis of women firefighters
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Environmental Health.2021;[Epub] CrossRef

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Psychometric properties of the 10-item Conner-Davidson resilience scale on toxic chemical-exposed workers in South Korea: Gab-Sik Shin, Kyeong-Sook Choi, Kyoung Sook Jeong, Young-Sun Min, Yeon-Soon Ahn, Min-Gi Kim; Ann Occup Environ Med 2018;30:52. Published online August 13, 2018; DOI: https://doi.org/10.1186/s40557-018-0265-5

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Background

Resilient individuals have a comprehensive ability to adapt to various life circumstances. Psychological resilience predicts an individual’s physiological response to stress. The 10-item Connor-Davidson Resilience Scale (CD-RISC) is a widely used measure to quantify the level of self-perceived resilience. This study examined the psychometric properties of a Korean version of the 10-item Connor-Davidson Resilience Scale (10-item K-CD-RISC) on workers in Gumi, South Korea, exposed to hydrofluoric acid (HF).

Methods

The questionnaires included the 10-item K-CD-RISC and Beck Anxiety Inventor (BAI), the Impact of Event Scale-Revised-Korean version (IES-R-K), the Rosen-berg Self Esteem Scale (RSES), the Center for Epidemiologic Studies-Depression Scale (CES-D), and the Perceived Stress Scale (PSS). These were randomly distributed at 237 workplaces near the HF-spill site, in the Gumi 4 complex. The responses of 991 (67.3%) workers were analyzed.

Results

The exploratory factor analysis shown that a single-factor model was consistent with the original design of the 10-item CD-RISC. The scale also demonstrated good internal consistency (Cronbach’s alpha = 0.95). Scores on the scale reflected different levels of resilience with respect to personal factors (age, gender, marital status, and education and income levels) that are thought to be differentiated. Differences of resilience were also reflected by psychiatric symptoms (anxiety and depression). Moreover, the total score of scale positively correlated with RSES, whereas the IES-R-K, BAI, CES-D, and the PSS negatively correlated with the 10-item K-CD-RISC.

Conclusions

The 10-item K-CD-RISC has good psychometric properties and is applicable for victims exposed to noxious chemical such as HF.

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Review

A brief review of relationship between occupational benzene exposure and hematopoietic cancer: Jin-Ha Yoon, Woo Seok Kwak, Yeon-Soon Ahn; Ann Occup Environ Med 2018;30:33. Published online May 10, 2018; DOI: https://doi.org/10.1186/s40557-018-0245-9

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We reviewed articles to clarify the current evidence status for 1) types of cancer which related to benzene exposure, and 2) certain benzene exposure level which might cause the hematopoietic cancers. Hematopoietic function of the bone marrow is involved in the production of all blood cells types. The benzene metabolites including benzoquinone and mucoaldehyde affect hematopoietic stem cells as well as differentiation steps of progenitor cells for each blood cell. Hence, we concluded that benzene was associated with all lymphohematic carcinogenesis. First, it is supported by biological plausibility. Second, it is supported by meta-analysis although sing study did not show relationship due to lack of sample size or statistical power. More recent studies show lesser exposed level related to risk of cancer, compare to past studies did. Actually, early studies show the risk of malignancies in workers who exposed more than 200 ppm-years. However, only 0.5 to 1 ppm-year benzene exposed show significant linking to risk of malignancies in recent study. As reviewed research articles, we concluded that the relatively lower exposure level, such as 0.5–1 ppm-year, will be considering at risk of hematopoietic cancer. However, more research needs to be done on dose-response analysis.

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Research Articles

Psychological effects of a disastrous hydrogen fluoride spillage on the local community: Seung-Hyun Yoo, Seong-Yong Yoon, Kuck-Hyun Woo, Jin-Seok Kim, Seong-Yong Cho, Sung-Soo Lee, Hyun-Sul Lim, Yeon-Soon Ahn, Won-Ho Yang; Ann Occup Environ Med 2017;29:40. Published online September 11, 2017; DOI: https://doi.org/10.1186/s40557-017-0196-6

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Background

On September 27, 2012, at 3:43 pm, a hydrogen fluoride spill occurred in a manufacturing plant located at the 4th complex of the Gumi National Industrial Complex in Gumi City, South Korea. The present study aimed to evaluate the psychological effects of the hydrogen fluoride spill on the members of the community and to investigate their relationships with physical symptoms and changes in psychological effects occurring as time passed after the accident.

Methods

The 1st phase involved a survey of 1359 individuals that was conducted 1 month after the spill, and the 2nd phase involved a survey of 711 individuals that was conducted 7 months after the accident. The questionnaires included items for assessing demographic characteristics, hydrogen fluoride exposure level, physical symptoms, and psychological status. Physical symptoms were assessed to determine the persistence of irritations. Psychological status was assessed to investigate the impact of event level using the Impact of Event Scale – Revised Korean version (IES-R-K), and the anxiety level was assessed using the Beck Anxiety Inventory (BAI).

Results

As the hydrogen fluoride exposure level increased, the impact of event and anxiety levels increased significantly both 1 and 7 months after the accident (p < 0.05). The mean score of the impact of event levels decreased significantly from 33.33 ± 14.64 at 1 month after the accident to 28.68 ± 11.80 at 7 months after the accident (p < 0.05). The mean score of the anxiety levels increased significantly from 5.16 ± 6.59 at 1 month after the accident to 6.79 ± 8.41 at 7 months after the accident (p < 0.05). The risk of persistent physical symptoms at 7 months after the accident was significantly higher in females. The risk of persistent physical symptoms also increased significantly, with increasing age, hydrogen fluoride exposure, and impact of event levels (p < 0.05).

Conclusions

The present study found that the impact of event level and anxiety level increased with increasing hydrogen fluoride exposure. Anxiety levels persisted even after time passed. The risk of persistent physical symptoms at 7 months after the accident was higher in females, and it increased with increasing age, hydrogen fluoride exposure level, and impact of event levels.

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Microporous and Mesoporous Materials.2023; 351: 112477. CrossRef
Comparative Analysis of Hydrogen Fluoride-Exposed Patients Based on Major Burn Criteria After the 2012 Gumi City Chemical Leak Disaster
Heejun Shin, Se Kwang Oh, Han You Lee, Heajin Chung, Seong Yong Yoon, Sung Yong Choi
Journal of Burn Care & Research.2022; 43(4): 834. CrossRef
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Comparison of facet joint degeneration in firefighters and hospital office workers: Dong Hyun Kim, Yon Soo An, Hyung Doo Kim, Kyoung Sook Jeong, Yeon-Soon Ahn, Kun-Hyung Kim, Youngki Kim, Han-Soo Song, Chul-Gab Lee, Young-Jun Kwon, Jin-Ha Yoon; Ann Occup Environ Med 2017;29:24. Published online June 24, 2017; DOI: https://doi.org/10.1186/s40557-017-0180-1

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Background

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

Methods

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

Results

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

Conclusion

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

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Jeong Ah Kim, Soo Yeon Song, Wonjeong Jeong, Jae Kwan Jun
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Hyung Doo Kim, Yon Soo An, Dong Hyun Kim, Kyung Sook Jeong, Yeon Soon Ahn
Annals of Occupational and Environmental Medicine.2018;[Epub] CrossRef

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