Annals of Occupational and Environmental Medicine

Original Article

Factors affecting heat-related illness symptoms among school food service workers: a cross-sectional study in Korea: Nahyun Kim, Dongwhan Suh, Jia Ryu, Woo Chul Jeong, Yun-Keun Lee, Jinwoo Lee, Hyunjoo Kim; Ann Occup Environ Med 2025;37:e30. Published online September 2, 2025; DOI: https://doi.org/10.35371/aoem.2025.37.e30

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

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Research Article

Effects of high occupational physical activity, aging, and exercise on heart rate variability among male workers: Dongmug Kang, Youngki Kim, Jongeun Kim, Yongsik Hwang, Byungmann Cho, Taekjong Hong, Byungmok Sung, Yonghwan Lee; Ann Occup Environ Med 2015;27:22. Published online September 25, 2015; DOI: https://doi.org/10.1186/s40557-015-0073-0

Abstract PDF

Objectives

Effects of aging and leisure time physical activity (LPA) might influence the effect of occupational physical activity (OPA) on risk for cardiovascular disease (CVD). This study was conducted to determine whether OPA affects CVD after controlling the effects of LPA and other risk factors for CVD such as job stress.

Methods

Participants were 131 male Korean manual workers. Tests for heart rate variability (HRV) were conducted for five minutes in the morning at work. We defined OPA as the combined concept of relative heart rate ratio (RHR), evaluated using a heart rate monitor.

Results

Whereas high OPA was not related to any HRV items in the younger age group, high OPA was associated with an increased number of low-value cases among all HRV items in older workers. Exercise had beneficial effects only in the younger group. After controlling for exercise and other risk factors, the odds ratios of the root-mean square of the difference of successive normal R-R intervals (rMSSD) and high frequency band power (HF) among the older age and high OPA group compared with the younger age and low OPA group were 64.0 and 18.5, respectively. Social support and shift work were independent risk factors in HRV.

Conclusions

OPA in aging workers increases CVD risks. This study provides support for the need for protection of aging workers from physical work overload, and indicates the need for further study of optimal limits of OPA.

Citations

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