

Citations

Benzophenone-3 is a type of ketone with 2 benzene rings attached to a carbonyl group (C=O) and one benzene ring attached to a hydroxyl group (-OH). As an endocrine-disrupting chemical, benzophenone-3 is known to be associated with reproductive, developmental, thyroid, and endocrine toxicities. Benzophenone-3 is commonly used in hair products, cosmetics, and ultraviolet (UV) filters because of its characteristic property to absorb UV light. This study aims to investigate the association between the use of hair products and urine benzophenone-3 using the data from the Korean National Environmental Health Survey (KoNEHS) cycle 4 (2018–2020), which represents the Korean population.
Using the KoNEHS cycle 4 survey, the data of 3,796 adults aged ≥ 19 years were analyzed. Based on the 75th percentile concentration of urine benzophenone-3, the participants were divided into the low- and high-concentration groups. Chi-square test was conducted to analyze the association of urine benzophenone-3 with distribution of general characteristics, use of personal care products, consumption of marine foods, and use of plastic products as the variable. Logistic regression analysis was conducted to calculate odds ratios (ORs) for the high-concentration group of urine benzophenone-3 based on the use of hair products.
Women with < 6 times or ≥ 6 times of hair product usage had significantly higher adjusted ORs compared to those who did not use hair products. The calculated ORs were 1.24 (95% confidence interval [CI]: 1.12–1.38) for women with < 6 times of usage and 1.54 (95% CI: 1.33–1.79) for women with ≥ 6 times of usage.
This study revealed the association between the use of hair products and the concentration of urine benzophenone-3 in the general Korean population.
Citations

Perfluoroalkyl substances (PFASs) are non-aromatic organic compounds, whose hydrogen atoms in the carbon chain substituted by fluorine atoms. PFASs exhibit developmental toxicity, carcinogenicity, hepatotoxicity, reproductive toxicity, immunotoxicity, and hormone toxicity. PFASs are used in the production of disposable food packages, aircraft and automobile devices, cooking utensils, outdoor gear, furniture and carpets, aqueous film forming foam (AFFF), cables and wires, electronics, and semiconductors. This study aimed to determine the association between crustacean consumption and serum PFASs.
Adult participants (2,993) aged ≥ 19 years were extracted from the 4th cycle data of the Korean National Environmental Health Survey (KoNEHS). Based on the 50th percentile concentrations of serum PFASs, participants were divided into the low-concentration group (LC) and the high-concentration group (HC). General characteristics, dietary factors, coated product usage, and personal care product usage, an independent t-test and χ2 test were analyzed. The odds ratio (OR) of serum PFAS concentration against crustacean consumption was estimated via logistic regression analysis adjusting for general characteristics, dietary factors, coated product usage, and personal care product usage.
The OR for the HC of serum PFASs was higher in individuals with ≥once a week crustacean consumption than in those with < once a week crustacean consumption. Estimated ORs were perfluorohexanesulfonic acid 2.15 (95% confidence interval [CI]: 1.53–3.02), perfluorononanoic acid (PFNA) 1.23 (95% CI: 1.07–1.41), and perfluorodecanoic acid (PFDeA) 1.42 (95% CI: 1.17–1.74) in males, and perfluorooctanoic acid 1.48 (95% CI: 1.19–1.84), perfluorooctanesulfonic acid 1.39 (95% CI: 1.27–1.52), PFNA 1.70 (95% CI: 1.29–2.26) and PFDeA 1.43 (95% CI: 1.32–1.54) in females.
This study revealed the association between the crustacean consumption and concentrations of serum PFASs in general Korean population.
Citations

Plastics are high-molecular-weight materials composed of long carbon chains. They are prevalent in daily life, present in various items such as food containers and microwavable packaging. Phthalates, an additive used to enhance their flexibility, are endocrine-disrupting chemicals. We utilized the data from the Korean National Environmental Health Survey (KoNEHS) cycle 3, representing the general South Korean population, to investigate the relationship between the use of plastics in refrigerator food storage and phthalate exposure.
We assessed 3,333 adult participants (aged ≥ 19 years) including 1,526 men and 1,807 women, using data from KoNEHS cycle 3. Using the 75th percentile concentration, urine phthalate metabolites were categorized into high and low-concentration groups. χ2 test was conducted to analyze variations in the distribution of each variable, considering sociodemographic factors, health-related factors, food intake, the use of plastics, and the concentration of urine phthalate metabolites as the variables. To calculate odds ratios (ORs) for the high-concentration group of urine phthalate metabolites based on the use of plastics in refrigerator food storage, logistic regression analysis was conducted.
In men, the use of plastics in refrigerator food storage had significantly higher adjusted ORs compared to those using the others. The adjusted ORs were calculated as follows: mono-(2-ethyl-5-hydroxyhexyl) phthalate (MEHHP) had an OR of 1.35 (95% confidence interval [CI]: 1.05–1.72), mono-(2-ethyl-5-oxohexyl) phthalate (MEOHP) had an OR of 1.48 (95% CI: 1.16–1.88), mono-(2-ethyl-5-carboxypentyl) phthalate (MECPP) had an OR of 1.32 (95% CI: 1.04–1.66), ∑di(2-ethylhexyl) phthalate (∑DEHP) had an OR of 1.37 (95% CI: 1.08–1.74) and mono-n-butyl phthalate (MnBP) had an OR of 1.44 (95% CI: 1.13–1.84).
The concentrations of urine phthalate metabolites (MEHHP, MEOHP, MECPP, ∑DEHP, and MnBP) were significantly higher in men who used plastics in refrigerator food storage compared to those using the others.
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Although many studies have been conducted on worker fatigue and sickness absence, the association between fatigue and sickness absence is unclear in Korean workers. This study was conducted to investigate the effect of worker fatigue on future sickness absence.
The study was conducted on workers who received medical check-ups at a university hospital for two consecutive years (2014–2015). During check-ups in the first year, the Fatigue Severity Scale (FSS) was used to assess fatigue levels, and during check-ups in the second year, sickness absence was surveyed to determine whether they had been absent from work due to physical or mental illness during previous 12 months. The χ2 test was used to analyze relationships between sociodemographic and occupational characteristics, fatigue levels, and sickness absence. Odds ratios (ORs) were calculated by logistic regression analysis controlled for confounding factors.
A total of 12,250 workers were included in the study, and 396 (3.2%) workers experienced more than one day of sickness absence during the study period. Adjusted ORs for sickness absence were 3.35 (95% confidence interval [CI]: 2.64–4.28) in the moderate-fatigue group and 6.87 (95% CI: 4.93–9.57) in the high-fatigue group versus the low-fatigue group. For men in the moderate- and high-fatigue groups, adjusted ORs for sickness absence were 3.40 (95% CI: 2.58–4.48) and 8.94 (95% CI: 6.12–13.07), and for women in the moderate- and high-fatigue groups, adjusted ORs for sickness absence were 2.93 (95% CI: 1.68–5.10) and 3.71 (95% CI: 1.84–7.49), respectively.
Worker fatigue is associated with sickness absence during the following 12 months, and this association appears to be stronger for men than women. These results support the notion that sickness absence can be reduced by evaluating and managing work-related fatigue.
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The objective of this study is to investigate the differences in incidence rates of targeted diseases by classification of occupations among construction workers in Korea.
In a subject-based cohort of the Korean Construction Worker’s Cohort, we surveyed a total of 1,027 construction workers. As occupational exposure, the classification of occupations was developed using two axes: construction business and job type. To analyze disease incidence, we linked survey data with National Health Insurance Service data. Eleven target disease categories with high prevalence or estimated work-relatedness among construction workers were evaluated in our study. The average incidence rates were calculated as cases per 1,000 person-years (PY).
Injury, poisoning, and certain other consequences of external causes had the highest incidence rate of 344.08 per 1,000 PY, followed by disease of the musculoskeletal system and connective tissue for 208.64 and diseases of the skin and subcutaneous tissue for 197.87 in our cohort. We especially found that chronic obstructive pulmonary disease was more common in construction painters, civil engineering welders, and civil engineering frame mold carpenters, asthma in construction painters, landscape, and construction water proofers, interstitial lung diseases in construction water proofers.
This is the first study to systematically classify complex construction occupations in order to analyze occupational diseases in Korean construction workers. There were differences in disease incidences among construction workers based on the classification of occupations. It is necessary to develop customized occupational safety and health policies for high-risk occupations for each disease in the construction industry.
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Studies conducted so far on the link between commute time and mental health among Koreans remain insufficient. In this study, we attempted to identify the relationship between commute time and subjective mental health using the 6th Korean Working Conditions Survey (KWCS).
Self-reported commute time was divided into four groups: ≤ 30 (group 1), 30–60 (group 2), 60–120 (group 3), and > 120 minutes (group 4). Subjective depression was defined as a score of 50 points or less on the WHO-5 well-being index. Subjective anxiety and fatigue were defined as answering ‘yes’ to the questionnaire on whether they had experienced it over the past year. The analysis of variance,
Long commute times showed increased ORs and graded increasing trends for depression, anxiety, and fatigue. The ORs for depression increased significantly in group 2 (1.06 [1.01–1.11]), group 3 (1.23 [1.13–1.33]), and group 4 (1.31 [1.09–1.57]) compared to group 1 (reference). The ORs for anxiety increased significantly in group 2 (1.17 [1.06–1.29]), group 3 (1.43 [1.23–1.65]) and group 4 (1.89 [1.42–2.53]). The ORs for fatigue increased significantly in group 2 (1.09 [1.04–1.15]), group 3 (1.32 [1.21–1.43]), and group 4 (1.51 [1.25–1.82]).
This study highlights that the risk of depression, anxiety, and fatigue increases with commute time.
Citations

Prolonged use of visual display terminal (VDT) can cause eyestrain, dry eyes, blurred vision, double vision, headache and musculoskeletal symptoms (neck, shoulder, and wrist pain). VDT working hours among workers have greatly increased during the coronavirus disease 2019 (COVID-19) pandemic. Therefore, this study aimed to investigate the relationship between VDT working hours and headache/eyestrain in wage workers using data from the sixth Korean Working Conditions Survey (KWCS) (2020–2021) conducted during the COVID-19 pandemic.
We analyzed the sixth KWCS data of 28,442 wage workers aged 15 years or older. The headache/eyestrain that occurred in the last year was assessed. The VDT work group included workers who use VDT always, almost always, and three-fourth of the working hours, while the non-VDT work group included workers who use VDT half of the working hours, one-fourth of the working hours, almost never, and never. To analyze the relationship between VDT working hours and headache/eyestrain, the odds ratios (ORs) and 95% confidence interval (CI) were calculated using logistic regression analysis.
Among the non-VDT work group, 14.4% workers experienced headache/eyestrain, whereas 27.5% workers of the VDT work group experienced these symptoms. For headache/eyestrain, the VDT work group showed adjusted OR of 1.94 (95% CI: 1.80–2.09), compared with the non-VDT work group, and the group that always used VDT showed adjusted OR of 2.54 (95% CI: 2.26–2.86), compared with the group that never used VDT.
This study suggests that during the COVID-19 pandemic, as VDT working hours increased, the risk of headache/eyestrain increased for Korean wage workers.
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Phthalates are endocrine disrupting chemicals that are widely used in the production of items of daily life such as in polyvinylchloride plastics, insecticides, and medical devices. This study aimed to determine the association between phthalate exposure and shellfish consumption using data from the Korean National Environmental Health Survey (KoNEHS) cycle 3 (2015–2017), which is a nationally representative survey.
In this study, we analyzed the KoNEHS cycle 3 data of 3,333 (1,526 men and 1,807 women) adults aged more than 19 years. Data related to the variables of sociodemographic factors, health-related behaviors, dietary factors, seafood consumption frequency, and urinary phthalate metabolites concentrations were collected. The concentrations of urinary phthalate metabolites of all the participants were divided into quartiles to define high and low concentration groups based on the 75th percentile concentration. A χ2 test was conducted to analyze the distribution of independent variables. To analyze the relationship between shellfish consumption and phthalate exposure, the odds ratios (ORs) were calculated using logistic regression analysis.
Total adults with shellfish consumption frequency of over once a week showed the following adjusted ORs for high concentrations of the following metabolites compared with the group that consumed shellfish once a week or less: 1.43 (95% confidence interval [CI]: 1.01–2.06) for mono-(2-ethyl-5-oxohexyl) phthalate (MEOHP), 1.43 (95% CI: 1.01–2.03) for mono-(2-ethyl-5-carboxypentyl) phthalate (MECPP), 1.57 (95% CI: 1.10–2.24) for ∑di-2-ethylhexyl phthalate (∑DEHP), 2.01 (95% CI: 1.46–2.77) for mono-carboxyoctyl phthalate (MCOP), 1.56 (95% CI: 1.11–2.18) for mono-carboxy-isononly phthalate (MCNP), and 2.57 (95% CI: 1.85–3.56) for mono (3-carboxypropyl) phthalate (MCPP).
The concentrations of urinary phthalate metabolites (MEOHP, MECPP, ∑DEHP, MCOP, MCNP, and MCPP) were higher in adults with a higher frequency of shellfish consumption.
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Work is an inseparable element of a person’s life, and violence in the workplace has various effects on individual workers and companies. While most studies have focused on specific industries, very few studies have investigated the influence of workplace violence by co-workers. Therefore, this study aimed to evaluate the association between workplace violence and work-related depression/anxiety in various occupations by differentiating the perpetrators of violence as co-workers and clients.
This study was conducted based on data from the 4th and 5th Korean Working Conditions Surveys (KWCS). The experience of workplace violence was classified in terms of the perpetrator: workplace violence by co-workers and that by clients. Work-related depression and anxiety were assessed using questions about health problems related to depression and anxiety and whether the problems were related to work. Descriptive statistics, χ2 tests, and multiple logistic regression analyses were performed using the SPSS 26.0.
After adjusting for sociodemographic characteristics (age, education, income, subjective health status) and occupational characteristics (occupation, weekly working hours, type of employment, size of workplace, and shift work), male workers with experience of workplace violence by co-workers were found to be at a higher risk of work-related depression/anxiety (odds ratio [OR], 11.52; 95% confidence interval [CI], 8.65–15.36). The same was confirmed for female workers (OR, 10.89; 95% CI, 7.90–15.02).
Employees who experienced workplace violence from co-workers were found to be more vulnerable to work-related depression/anxiety. Continuous contact between the victim and the perpetrator may occur, and the possibility of a secondary assault can frighten the victim. Appropriate prevention and intervention measures that focus on the perpetrators of violence are needed.
Citations

As self-employed workers are vulnerable to health problems, this study aimed to analyze mental health problems and sleep disturbances among self-employed workers compared with paid workers in Korea.
A total of 34,750 workers (23,938 paid workers and 10,812 self-employed workers) were analyzed from the fifth Korean Working Condition Survey, which included 50,205 households collected by stratified sampling in 2017. To compare mental health problems and sleep disturbance among self-employed workers and paid workers, multivariate logistic regression analyses were performed.
The odds ratio in self-employed workers compared with paid workers was 1.25 (95% confidence interval [CI]: 1.09–1.42) for anxiety, 1.11 (95% CI: 1.04–1.17) for overall fatigue, 1.11 (95% CI: 1.04–1.20) for difficulty falling asleep, 1.10 (95% CI: 1.02–1.18) for difficulty maintaining sleep and 1.24 (95% CI: 1.16–1.32) for extreme fatigue after waking up.
Self-employed workers in Korea have a higher risk of self-reported mental health problems and sleep disturbances than paid workers. Further studies with a longitudinal design and structured evaluation are required to investigate the causal relationship between health problems and self-employment.
Citations

Benzene is a ubiquitous air pollutant that is well known to cause hematopoietic effects in humans including leukemia. Recently, several studies have discussed its non-carcinogenic effects such as diabetes. This study aimed to investigate the association between diabetes and urinary trans,trans-muconic acid (t,t-MA), one of benzene metabolite, using adult data from Korean National Environmental Health Survey (KoNEHS) cycle 3 (2015–2017).
This study analyzed 3,777 adults (1,645 men and 2,132 women) from the KoNEHS cycle 3 (2015–2017). The distribution and fraction of each independent variable were presented separately according to the urinary benzene metabolite levels (t,t-MA quartiles) and diabetes to determine the general characteristics of the subjects. Odds ratios (ORs) were calculated using logistic regression after stratification by gender and smoking status to identify the association between urinary t,t-MA and diabetes.
Compared with the first quartile (reference), the risk of diabetes significantly increased above the 4th (1.834 [1.107–3.039]) quartile in men and above the 3rd (1.826 [1.095–3.044]) and 4th (2.243 [1.332–3.776]) quartiles in women after adjustment. Stratified analysis based on smoking revealed that the ORs for the 3rd (1.847 [1.146–2.976]) and 4th (1.862 [1.136–3.052]) quartiles in non-smokers and those for the 2nd (1.721 [1.046–2.832]), 3rd (1.797 [1.059–3.050]), and 4th (2.546 [1.509–4.293]) quartiles in smokers were significantly higher.
We confirmed that urinary t,t-MA is significantly associated with diabetes regardless of gender and smoking status. And further studies are necessary to access the clinical impacts of this findings.
Citations

Presenteeism is a phenomenon in which employees go to work, but physical or mental health problems make it impossible for them to properly demonstrate their abilities, and productivity decreases accordingly. Recent studies have considered the behavior of direct supervisors to be an important factor in the pathogenesis of various health-related outcomes. This study aimed to investigate the association between the direct supervisor's behaviors and presenteeism among wage workers in South Korea.
A total of 25,798 participants from the fifth Korean Working Condition Survey conducted in 2017 were included in the analysis. The behaviors of direct supervisor were assessed by 6 questionnaire items. In this study, the distribution of the scores was categorized into 4 categories (very good, good, bad, and very bad). To assess presenteeism, the corresponding questionnaire item was used. χ2 tests and multiple logistic regression analyses adjusted for general, occupational, and psychosocial factors were performed to determine the association between the behaviors of direct supervisor and presenteeism.
Direct supervisor's behavior were significantly associated with presenteeism. The adjusted odds ratios (aORs) of presenteeism in the good, bad, and very bad groups were 1.297 (95% confidence interval [CI]: 1.153–1.458), 1.191 (95% CI: 0.941–1.507), and 1.604 (95% CI: 1.184–2.175), compared with the very good group. Associations between presenteeism and the behaviors of direct supervisor were significant in male workers, but not in female workers. For male workers, the aORs of presenteeism in the good, bad, very bad groups were 1.661 (95% CI: 1.425–1.936), 1.445 (95% CI: 1.053–1.982), 2.340 (95% CI: 1.569–3.491), respectively.
This study suggests that the behavior of a direct supervisor can influence the occurrence of presenteeism, particularly in men. The proper management of senior employee's behaviors is necessary to reduce the risk of presenteeism in the workplace.
Citations

Shift work (particularly split shifts) has been noted among the working conditions that hinder sustainable work. However, little is known regarding the effects of split shifts on health. This study aimed to investigate the association between split shift work and work-related injury and disease absence.
This study used data from the fifth Korean Working Conditions Survey and included 4,042 paid shift workers. Shift work type and self-reported work-related injury and disease absence were investigated using a questionnaire. Logistic regression analysis was performed to investigate the association between split shift work and work-related absence with rotating shift worker as the reference group.
Of the 4,042 shift workers, 980 (24.3%) were split shift workers. The adjusted odds ratio (aOR) of split shift for absence due to work-related injury was high at 2.94 (95% confidence interval [CI]: 1.85–4.68) and the aOR of split shift for absence due to work-related disease was also high at 1.58 (95% CI: 1.09–2.29) compared to rotating shift.
Split shift work leads to an increased risk of absences due to work-related injury and disease.
Citations

The aim of this study is to investigate the relationship between fatigue and occupational injury.
This study was conducted at a university hospital in 2014 and 2015. In 2014, the fatigue severity scale (FSS) was used to evaluate workers' fatigue levels. Later, when the same workers were examined in 2015, a questionnaire survey was conducted to determine whether they had experienced absences or treatment for work-related accidents. The χ2 test was used to analyse the relationship between demographic characteristics, fatigue levels, and occupational injuries. After controlling for confounders, a logistic regression analysis was performed to calculate the odds ratios (ORs).
In 2014, 19,218 workers were screened during health examination and their fatigue level were evaluated using FSS questionnaires. in 2015, workers' occupational injury was evaluated. In result, men in the moderate- and high-fatigue groups, after adjusting for age, smoking and drinking habits, chronic diseases, and occupational factors such as size of company industrial classification and type of work (shift or non-shift), adjusted ORs for hospital treatment due to occupational injury were 1.76 (95% confidence interval [CI]: 1.39–2.24) and 2.61 (95% CI:1.68–4.06), respectively. Among men in the medium- and high-fatigue groups, the adjusted ORs for absence due to occupational injury were 2.06 (95% CI: 1.52–2.80) and 3.65 (95% CI: 2.20–6.05), respectively. No significant association was observed between fatigue and occupational injury in women.
Male workers with high fatigue levels have a higher risk of experiencing work injuries. This study suggests that active intervention be considered to prevent injuries in workers with high scores on workplace fatigue evaluation scales.
Citations

The relationship between smoking status or second-hand smoking and occupational injuries has been the subject of considerable study, but few have studied the relationship between nicotine dependence and occupational injuries. The objective of this study was to investigate the relationship between nicotine dependence and occupational injury among employees at a range of Korean companies.
Initially, the personal and occupational characteristics and nicotine dependences of workers were measured, and 12 months later a survey was used to determine whether subjects had experienced any occupational injury. This study was conducted in several workplaces on 6,893 male workers in manufacturing and service industries that received health screening at Inha University Hospital in Incheon.
The adjusted odds ratios (ORs) of occupational injury in the low, moderate, and high nicotine dependence groups were 1.38 (95% confidence interval [CI]: 1.04–1.84), 1.52 (95% CI: 1.10–2.10), and 1.71 (95% CI: 0.92–3.19), respectively. For smokers only, adjusted ORs tended to increase linearly (
The study shows nicotine dependency might affect occupational injury. From a short-term perspective, addressing worker's nicotine dependence by giving an adequate break time or smoking area might reduce work-related injuries.
Citations

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.
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.
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.
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.
Citations

Job rotation was introduced in various industries as a strategic form of work for improving workers' job skills and health management. This study aims to examine the relationship between job rotation and work-related low back pain (LBP), one of the typical work-related musculoskeletal symptoms of Korean workers.
We conducted this study using the data of the 5th Korean Working Conditions Survey (KWCS). As the subject of this study, 27,163 wage workers were selected, and classified into three groups according to occupational type (white-collar, service and sales, and blue-collar). In this study, job rotation means to change the work-related activities with other colleagues periodically and work-related LBP was defined as whether there was work-related LBP in the last 12 months. Chi-square test and logistic regression were used to analyze the relationship between job rotation and work-related LBP.
Out of 27,163 workers, 2,421 (8.9%) answered that they had job rotation and 2,281 (8.4%) answered that they experienced work-related LBP. According to the results from logistic regression, job rotation was significantly associated with low prevalence of work-related LBP among blue-collar workers (odds ratio [OR]: 0.71, 95% confidence interval [CI]: 0.58–0.88), whereas no significant relationship was observed among white-collar, service and sales groups. In addition, the negative association between job rotation and work-related LBP among blue-collar workers was more pronounced when exposed to ergonomic risk factors (uncomfortable posture OR: 0.79, 95% CI: 0.64–0.98; heavy work OR: 0.74, 95% CI: 0.57–0.96; repetitive work OR: 0.74, 95% CI: 0.60–0.92).
Job rotation was associated with low prevalence of work-related LBP among workers in the blue-collar occupational group in Korea. It is necessary to evaluate the effect of job rotation by occupational type and introduce an appropriate method of job rotation to reduce workers' work-related musculoskeletal symptoms.
Citations

Job insecurity and emotional labor are poor job-related factors that are known to cause sleep disturbances in customer service workers. This study investigates the combined effect of emotional labor and job insecurity on sleep disturbance.
This study used data from the Fifth Korean Working Condition Survey and included 15,147 paid workers who serve customers below 65 years. We re-classified into 6 groups based on whether the degree of emotional labor increased (Rarely/Sometimes/Always) or whether job insecurity (No/Yes) was present. We performed propensity score matching for several covariates and calculated odds ratio (OR) and 95% confidence intervals (CIs) for sleep disturbance by logistic regression models using only matched subjects.
Workers exposed to emotional labor and job insecurity had significantly higher risk for 3 dimensions of sleep disturbance (difficulty falling asleep, waking up repeatedly during the sleep, and waking up with feeling of fatigue) (OR [95% CI]: 1.44 [1.22–1.69], 1.18 [0.99–1.40], 1.52 [1.30–1.79] for emotional labor; and 2.00 [1.75–2.29], 2.20 [1.91–2.53], 1.67 [1.45–1.92] for job insecurity). Compared to those who were exposed to both emotional labor rarely and without job insecurity, when workers had both poor job factors, the OR (95% CI) for sleep disturbance for difficulty falling asleep, waking up repeatedly during the sleep, and waking up with feeling of fatigue were 3.05 (2.42–3.86), 2.89 (2.26–3.69), and 2.60 (2.06–3.29), respectively. The relative excess risk due to Interaction of job insecurity and emotional labor was significant only for difficulty falling asleep, but not the other 2 sleep disturbance dimensions.
Customer service workers suffered from severe sleep disturbances according to the existing degree of emotional labor and job insecurity. The combined effect of both could have an additive influence on serious sleep disturbance among customer service workers.
Citations

We aimed to find the relationship between sleep duration and impaired fasting glucose according to working type in non-regular workers using the 2016 and 2017 Korean National Health And Nutrition Examination (KNHANE, 7th revision).
In the 1st and 2nd year (2016, 2017) of the 7th KNHANE, 16,277 people participated. Minors were excluded because this study was intended for individuals aged 19 years and older. As this study was based on wage workers, unemployment, self-employed workers, employers, unpaid family workers, and those who have insufficient answers such as unknown or no response were excluded. Regular workers were excluded because this study was intended for non-regular workers. Finally, a total of 2,168 people were included in the survey, except those who had been diagnosed with diabetes, had a fasting blood glucose level of 126 mg/dL or higher, or taking hypoglycemic agents or receiving insulin injections. To find the relationship between sleep duration and impaired fasting glucose according to work type in non-regular workers, multiple logistic regression analysis was performed by adjusting the general and occupational characteristics after stratification according to work type. All statistical analyses were performed using the SPSS software (version 26.0; SPSS Inc., Chicago, IL, USA).
In the case of insufficient sleep duration in irregular female workers, the odds ratio (OR) of impaired fasting glucose was statistically insignificant, but in the case of insufficient sleep duration in irregular male workers who have shift work, the odds ratio (OR) of impaired fasting glucose was significantly higher than that of sufficient sleep duration (Model 1, OR: 3.05, 95% confidence interval [CI]: 1.18–7.90; Model 2, OR: 2.81, 95% CI: 1.08–7.29).
Our findings demonstrate that insufficient sleep duration was associated with an increase in fasting blood glucose levels in non-regular male workers working shifts. This means that non-regular workers are in desperate need for adequate sleep and health care. We hope that our study will help improve the health of non-regular workers and more systematic and prospective follow-up studies will be conducted to further improve the health of non-regular workers.
Citations

The purpose of this study was to assess the reliability and validity of the 3-item version of the Work Engagement Scale (WES-3), which is based on the Job Demands-Resources (JD-R) model and was used in the 5th Korean Working Conditions Survey (KWCS).
This study used data from the 5th KWCS (n = 50,205), which was conducted in 2017 with a sample of the Korean working population. The survey gathered comprehensive information on working conditions to define workforce changes and the quality of work and life. The reliability and internal consistency of the WES-3 were assessed using the corrected item-total correlation and Cronbach's alpha coefficient. Confirmatory factor analysis (CFA) was used to test the construct validity of work engagement. The convergent validity was assessed using the correlation with the WHO-5 well-being index. Correlations between work engagement and JD-R factors were also calculated.
The Cronbach's alpha for work engagement was 0.776, indicating acceptable internal consistency. The model comprising 3 work engagement and 2 burnout items showed an excellent fit (χ2: 382.05, Tucker-Lewis index: 0.984, comparative fit index: 0.994, root mean square error of approximation: 0.043). The convergent validity was significant (correlation coefficient: 0.42). Correlations with burnout and job demands were negligible, whereas correlations with job resources and job satisfaction were weakly positive.
The results of our study confirm that the WES-3 has acceptable reliability and validity.
Citations

Change in working time arrangement (WTA) can be harmful to workers' sleep and health. This study aimed to investigate the association between change in working time arrangement and sleep disturbance.
This study used data from the Fifth Korean Working Condition Survey and included 33,203 paid workers. We performed a stratified analysis by sex. After dividing the participants into 6 groups based on whether or not they experienced WTA changes, and their weekly working hours (≤40, 41–52, ≥53 hours), we calculated odds ratio (OR) using the weekly working hours ≤40 hours and with no WTA change as the reference group.
Of the 33,203 paid workers, participants who experienced change in working time arrangement had higher prevalence of all three types of sleep disturbance symptoms (difficulty in falling asleep, waking up repeatedly during sleep, and waking up with a feeling of exhaustion and fatigue) in both sexes. Compared to the reference group at 95% confidence interval (CI), the group with change in WTA showed elevated OR values of 1.91 (95% CI: 1.73–2.11), 1.93 (95% CI: 1.74–2.14), 2.47 (95% CI: 2.26–2.71) for male workers; and 1.93 (95% CI: 1.73–2.16), 2.02 (95% CI: 1.80–2.27), 2.24 (95% CI: 2.01–2.50) for female workers, for difficulty in falling asleep, waking up repeatedly during the sleep, waking up with a feeling of exhaustion, and fatigue, respectively.
Workers who experience change in work time arrangement show a high risk of sleep disturbance in both sexes.
Citations

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.
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.
In panel data analysis with fixed effects, job insecurity (B = 0.048,
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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This study aimed to identify the relationship between exposure to bisphenol A (BPA) and seafood consumption using a nationally representative data of the general Korean population.
This study was conducted on 5,402 adults aged 19 years and older (2,488 men, 2,914 women) based on the second Korean National Environmental Health Survey (2012–2014). We stratified the data according to gender and analyzed urinary BPA concentrations in terms of sociodemographic characteristics, health behavior, dietary factor, and seafood consumption. In the high and low BPA exposure groups, the odds ratios (ORs) were calculated using logistic regression analysis according to the top 75th percentile concentration.
In men, large fish and tuna and other seafood categories had significantly higher ORs before and after adjustment in the group who consumed seafood more than once a week than in the group who rarely consumed seafood, with an adjusted value of 1.97 (95% confidence interval [CI]: 1.12–3.48) and 1.74 (95% CI: 1.10–2.75), respectively. In the shellfish category, the unadjusted OR was 1.61 (95% CI: 1.00–2.59), which was significantly higher in the group who consumed seafood more than once a week than in the group who rarely consumed seafood. However, the OR after adjusting for the variables was not statistically significant. In women, the frequency of seafood consumption and the concentration of urinary BPA were not significantly associated.
BPA concentration was higher in men who frequently consumed large fish and tuna, shellfish and other seafood in this study.
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We aimed to find the exposure level of environmental harmful substances related to the secondhand smoke (SHS) using a nationally representative data of the general population in Korea.
Total 3,533 people were included in this study. We compared the proportion exceeding 95 percentile of the concentrations of harmful substances by sex according to SHS exposure. 16 kinds of substances related to tobacco smoke were analyzed including heavy metals, polycyclic aromatic hydrocarbons, volatile organic compounds, and environmental phenol. For 16 kinds of substances, the odds ratios (ORs) for exceeding 95 percentile of each harmful substance were calculated by multiple logistic regression according to SHS exposure. Age, education level, marital status, body mass index, drinking, and exercise were adjusted as covariates. Cotinine level was additionally adjusted to increase reliability of our results.
SHS was associated with high exposure of mercury, methylhippuric acid, fluorene, and cotinine. In women, SHS was associated with mercury, methylhippuric acid, fluorene, and cotinine, while in men, it was associated with cotinine. After adjusting covariates, ORs of blood mercury, methylhippuric acid and hydroxyfluorene in the exposed gruop were greater than that in the non-exposed group. Especially in female, methylhippuric acid and hydroxyfluorene showed consistent result.
Our finding demonstrates that SHS is related to several harmful substances. Therefore, to reduce the health effects of SHS, it is necessary to educate and publicize the risk of SHS. Future studies are necessary to more accurately analyze factors such as exposure frequency, time, and pathway of SHS.
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Research on the emotional labor of firefighters is actively being carried out, but studies that analyze emotional labor separately by job types, working departments, and other conditions of firefighters are insufficient. The purpose of this study is to investigate the difference in emotional labor level between departments and other conditions of firefighters.
A total of 287 Korean firefighters were included for analysis. The demands of emotional labor and emotional damage were measured using the Korean Emotional Labor Scale. To analyze the conditions and factors affecting the emotional labor level of the firefighters, logistic regression analysis was performed using the emotional labor high risk group as a dependent variable.
The average score of overall emotional labor level of the firefighters was 47.2 ± 17.3, and the prevalence of high risk firefighters with emotional labor was 27.1%. It was found that the emergency medical service and administration departments showed a higher prevalence of high risk emotional labor firefighters than did other departments. The result of multiple logistic regression analysis for the high risk emotional labor firefighters showed that the adjusted odds ratio of emergency medical service department compared to the reference group (the rescue department) was 2.89 (95% confidence interval [CI]: 1.02–8.24).
Among the firefighters, the emergency medical service department is a high risk factor for emotional labor. Therefore, education and prevention training on emotional labor should be more thorough before work shifts.
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No tool is available for the multidimensional measurement of workplace well-being among Korean workers. In this study, the Workplace Positive emotion, Engagement, Relationships, Meaning, and Accomplishment (PERMA)-Profiler, a multidimensional workplace well-being measure, was translated into Korean, and its validity and reliability were assessed.
The Workplace PERMA-Profiler, including the positive emotion, engagement, relationships, meaning, and accomplishment domains, was translated according to international guidelines. The questionnaires included the Workplace PERMA-Profiler, Mental Health Continuum-Short Form, Utrecht Work Engagement Scale, Maslach Burnout Inventory-General Survey, Psychosocial Well-being Index-Short Form, and Korean Occupational Stress Scale-Short Form. A total of 316 Korean workers completed a web-based survey with adequate response. Cronbach's alpha values were calculated to assess scale reliability, and correlational and confirmatory factor analyses were used to assess validity.
Cronbach's alpha values for the Korean Workplace PERMA-Profiler ranged from 0.70 to 0.95. Confirmatory factor analysis indicated that the 5-factor model had a marginally acceptable fit [χ2(80) = 383.04, comparative fit index = 0.909, Tucker-Lewis index = 0.881, root mean square error of approximation = 0.110, and standardized root mean square residual = 0.054]. The 5-factor PERMA domains were correlated positively with work engagement and mental well-being in life, and negatively with burnout, occupational stressors, and stress responses. These results showed that the Workplace PERMA-Profiler has good convergent and divergent validity.
The Korean version of the Workplace PERMA-Profiler had good reliability and validity. It might be used as an indicator or evaluation tool for positive mental health interventions in the workplace.
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Dependent self-employment is precarious employment, which can be vulnerable to mental health problems. This study aimed to investigate the association of dependent self-employment with depression, anxiety, and sleep disorder in South Korea.
This study used data from the Fourth Korean Working Conditions Survey and included 32,691 paid workers. Dependent self-employment and self-reported depression/anxiety, and sleep disorder were investigated using a questionnaire. Logistic regression analysis was performed to investigate the association between dependent self-employment and mental health problems.
Of the 32,691 paid workers, 2,371 (7.3%) were dependent self-employed workers. The odds ratio (OR) of dependent self-employment for self-reported depression/anxiety was 1.78 (95% confidence interval [CI]: 1.29–2.45) and the OR of dependent self-employment for self-reported sleep disorder was 1.26 (95% CI: 1.01–1.59) compared to other paid workers.
Dependent self-employment is related to an increased risk of self-reported depression/anxiety and sleep disorder in South Korea.
Citations

We investigated the association between long workhours and marital status change from married to divorced or separated status that might have bad health effects.
A total of 40,654 participants with married status in 2014 were followed up in 2015. Weekly workhours were categorized into four groups: ≤ 40, 41–52, 53–60, and > 60 hours per week. Univariate and multivariate logistic regression analyses were performed to determine the relationship between groups of workhours and marital status change after adjusting for age, total monthly household income, working type, and depression with sex stratification.
The study populations consisted of 8,346 (20.5%) females and 32,308 (79.5%) males. Odd ratios (ORs) of marital status change for females working for more than 60 hours per week was 4.26 (95% confidence interval [CI]: 1.25–14.5), when working less than or equal to 40 hours per week was used as reference in the crude model. ORs of working more than 60 hours per week was 4.57 (95% CI: 1.02–20.5) in female workers when considering age, total household earning per month, working type of daytime, and depression in a dose-response manner. However, for male workers, long workhours were not significantly related to change of marriage status.
Long workhours for more than 60 hours per week had significantly higher risk of divorce or separation in females, but not in males. Further follow-up studies are needed to evaluate long term effects of long workhours on divorce risk.
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We aimed to find the exposure level of triclosan (TCS), a known endocrine disruptor, related to the use of personal care products using a nationally representative data of the general population in Korea.
This study included data of 6288 adults aged 19 years and older (2692 men, 3596 women), based on the Second Korean National Environmental Health Survey (KoNEHS 2012–2014). The data were divided according to gender. The frequency and proportion of each variable were determined by dividing participants into two groups based on the top 75th percentile concentration of urinary TCS (male: 1.096 μg/g creatinine, female: 1.329 μg/g creatinine). Odds ratios (ORs) were calculated using logistic regression analysis for the high TCS exposure and low TCS exposure groups.
Overall, the proportion of participants using personal care products was higher in women than in men. There was a significantly higher proportion of participants in the high TCS exposure group with younger age, higher education and income levels and with more frequent use of fragrance products, hair care products, body cleansers, cosmetics, and antimicrobial agents. In both men and women, ORs tended to increase with increased frequency of use of hair care products, body cleansers, and cosmetics before and after adjustment.
Our findings demonstrate that as the frequency of use of personal care products increases, urine TCS concentration increases. Because TCS is a well-known endocrine disruptor, further studies are needed and explore other health effects with exposure to TCS in general population in Korea.
The online version of this article (10.1186/s40557-019-0283-y) contains supplementary material, which is available to authorized users.
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It has been reported that long working hours are hazardous to the workers’ health. Especially, work-related musculoskeletal disorders (WMSDs) have been considered as one of the significant health issues in workplace. The objective of this study was to identify the association between long working hours and work-related musculoskeletal symptoms.
The analysis was conducted using data from the Fourth Korean Working Conditions Survey (KWCS). Subjects of this study were 24,783 wage workers and divided into three groups according to the weekly working hours, which were ≤ 40, 41–52 and > 52 h. The relationship between long working hours and work-related musculoskeletal symptoms was analyzed by multivariate logistic regression method after adjusting for general, occupational characteristics including specific working motions or postures and psychosocial factors.
Approximately 18.4% of subjects worked more than 52 h per week and 26.4 and 16.4% of male subjects and 33.0 and 23.4% of female subjects experienced work-related upper and lower limb pains, respectively, over the last 12 months. Moreover, the prevalence of upper and lower limb pain was increased in both genders as the weekly working hours increased. The odds ratios (ORs) of upper limb pain for those working 41–52 h and more than 52 h per week when adjusted for general, occupational characteristics including specific motions or postures and psychosocial factors were 1.36 and 1.40 for male workers and 1.26 and 1.66 for female workers compared to the reference group, respectively. Furthermore, ORs of lower limb pain for the same weekly working hour groups were 1.26 and 1.47 for male workers and 1.20 and 1.47 for female workers, respectively.
Long working hours were significantly related to work-related musculoskeletal symptoms in Korean wage workers and appropriate interventions should be implemented to reduce long working hours that can negatively affect workers’ health.
Citations

It is well known that ergonomic risk factors and back pain are related. However, few studies have examined the relationship between simultaneous exposure to these risk factors and back pain in a Korean population. We aimed to investigate the relationship between simultaneous exposure to ergonomic risk factors and work-related lower back pain (LBP) based on the fourth Korean Working Conditions Survey (KWCS).
The fourth KWCS (2014) was used for this study. Chi-square tests and logistic regression were used to assess relationship between 5 ergonomic risk factors and work-related LBP. We also analyzed the relationship between simultaneous exposure to 2 risk factors and work-related LBP.
All 5 ergonomic risk factors (fatigue-inducing and painful posture; lifting or moving people; dragging, pushing, or moving heavy objects; standing posture; and repetitive hand or arm movements) were significantly correlated with work-related LBP in the severe exposure group (adjusted odd ratios [aOR] 5.09, 95% confidence interval [CI] 4.46–5.83; aOR 1.98, 95% CI 1.62–2.42; aOR 2.09, 95% CI 1.82–2.40; aOR 1.79, 95% CI 1.60–2.01; aOR 2.04, 95% CI 1.82–2.30, respectively). When exposed to 2 risk factors simultaneously, the relationship between exposure and work-related LBP was not greater than exposure to only 1 risk factor in our study (usually exposed to ‘fatigue-inducing or painful posture’ aOR 2.17, 95% CI 2.02–2.34; high exposure to both ‘fatigue-inducing or painful posture’ and ‘dragging, pushing, or moving heavy objects’ aOR 2.00, 95% CI 1.82–2.20).
There was a strong relationship between severe exposure to each ergonomic risk factor and work-related LBP. However, when exposed to 2 ergonomic risk factors simultaneously, the relationship between exposure and work-related LBP was not stronger than when exposed to only 1 risk factor in our study.
Citations

Although one in two firefighters in South Korea have experienced work-related injuries, there are few studies which show the overview description on work-related injuries and its analysis regarding such causes. Therefore, we aimed to show the overview of compensated work-related injuries in order to serve fundamental data for establishing prevention policies on work-related injuries for Korean firefighters.
We requested the all claimed work-related injury data of Korean firefighters from 2010 to 2015 to the Korean National Fire Agency (NFA). The data from NFA including 2457 claimed cases was analyzed and we confirmed, 2154 approved work-related injuries for the kinds of job activities, cause of accident and type of injuries. Among 2154 approved cases, we analyzed more variables for the sex, age, and job duration of 1344 compensated cases through served text file on summary of accident.
The Government Employees Pension Service (GEPS) recognized 2154 (87.7%) approved work-related injuries among 2457 claimed cases. The incidence of work-related injuries per 1000 firefighters was 9.8 persons. By region, the incidence of work-related injuries per 1000 firefighters ranged from a maximum of 14.5 to a minimum of 4.0. The most common job activity caused the accident was fire suppression (18.0%), followed by Emergency medical services (EMS) (17.5%) and training (10.7%). The most common cause of these accident was movement imbalance (30.3%), followed by falls (18.9%) and traffic accident (13.4%). In these work-related injuries, sprains and bruises were the most common type of injury (27.2%), and the most commonly injured body site was the upper and lower back (25.3%). Data from identified 1344 firefighters showed that 1264 (94.0%) were male and 80 (6.0%) were female. Age group was the highest in the 40s with 623 cases (46.4%), and job duration was the highest with 650 cases in 5–10 years (48.4%).
In this study, we could obtain the preliminary data necessary to establish preventive measures, including the cause of accident and region with high accident rates. However, the number of applications for compensated injuries was very small compared to the frequency of injuries found in previous studies. The lack of appropriate treatment suggested that many firefighter injuries can become chronic. In this study, we suggest that it is necessary to introduce an injury monitoring system and improve the accessibility of compensated injuries.
Citations

The Korean Computerized Neurobehavioral Test (KCNT) is a psychological assessment tool used as part of Workers’ Special Health Examinations in Korea. Due to the spread of mobile technology, this study aimed to compare results of the KCNT administered on a tablet PC versus a desktop computer, and, therefore, assess the clinical applicability of mobile devices.
A total of 72 participants enrolled in this study. Their age, sex, and years of formal education were collected during an interview, as well as their typing speed. The test battery comprised five subtests: Simple Reaction Time test, Choice Reaction Time test, Digit Addition test, Symbol-Digit Substitution test, and Finger Tapping Speed test. Participants repeated the KCNT test battery in a randomly assigned order using four different testing systems: a desktop computer equipped with a conventional 106-key keyboard (System 1), a desktop computer equipped with a simplified keyboard (System 2), a tablet PC with a simplified 17-key on-screen keyboard (System 3), and a tablet PC equipped with a simplified keyboard (System 4).
Results of the Digit Addition test did not differ significantly for different testing systems. In contrast, results of the Simple Reaction Time test, Choice Reaction Time test, Symbol-Digit Substitution test, and Finger Tapping test were lower for the tablet PC (Systems 3 and 4) compared to the desktop computer (Systems 1 and 2). Systems 1 and 2 did not show significantly different results. Performance on System 3 was inferior to that on System 4, only for the Choice Reaction Time test and Finger Tapping Speed test. There were also significant differences in performance by computer familiarity when adjusted for age and education; however, the performance of each group on the test systems showed similar patterns.
It is not recommended to use a tablet PC to administer the KCNT to evaluate neurobehavioral performance for the Simple Reaction Time test and Choice Reaction Time test; however, tablet PCs with an on-screen keyboard may be used to perform the Digit Addition test, and the Symbol-Digit Substitution test and Finger Tapping Speed test to a limited degree.
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Prospective studies on occupational stress and depression among Korean workers are scarce. This study aimed to investigate the causal relationship between changes in occupational stress and the presence of depression.
This study analyzed data from a survey conducted with workers in a large Korean company (2015–2016). Occupational stress was measured using the Korean Occupational Stress Scale, and depression was screened using the WHO-5 Well-being Index. The levels of occupational stress were grouped in quartiles based on subjects’ occupational stress scores in 2015, and changes in occupational stress were measured using the score changes between the 2015 and 2016 surveys. Subjects were divided into four groups according to the presence or absence of depression in 2015 and 2016: a non-depressed group whose mental health did not change, a non-depressed group whose mental health deteriorated, a depressed group that continued to be depressed, and a depressed group whose symptoms of depression were alleviated. Logistic regression analysis was used to calculate the odds ratios (ORs) and confidence intervals (CIs) of the subjects’ deterioration in mood or alleviation of depression by occupational stress levels and changes.
The OR for developing depressive symptoms was 2.51 (95% CI 1.46–4.33) and 2.73 (95% CI 1.39–5.36) in the third and the fourth quartiles of occupational stress, respectively, compared to the first quartile. When the occupational stress score increased by 1 point, the OR for increasing depressive symptoms was 1.07 (95% CI 1.04–1.10). There was no significant difference in the alleviation of depressive symptoms between the groups by level of occupational stress. However, when the occupational stress score decreased by 1 point, the OR for alleviating depressive symptoms was 1.08 (95% CI 1.05–1.11).
The results showed that increased occupational stress increased the presence of depressive symptoms, and that reduced occupational stress suppressed the development of depressive symptoms. More attention should be paid to stress management among workers.
Citations

This study aimed to analyze environmental tobacco smoking exposure in female nonsmokers by public transportation mode using representative data of Koreans.
Data from the Second Korean National Environmental Health Survey (2012–2014) were analyzed. Urine cotinine was analyzed by public transport behavior, secondhand smoke exposure, socioeconomic factors, and health-related factors. Participants were 1322 adult females; those with the top 75% urine cotinine concentrations were assigned to the high exposure group. A logistic regression analysis was performed considering appropriate weights and stratification according to the sample design of the Second Korean National Environmental Health Survey.
The geometric mean of urine cotinine concentrations differed according to public transportation modes: subway (1.66 μg/g creatinine) bus (1.77 μg/g creatinine), and taxi (1.94 μg/g creatinine). The odds ratio [OR] was calculated for the high exposure group. The OR of the taxi (2.39; 95% confidence interval, 1.00–5.69) was statistically significantly higher than the subway value (reference), and marginally significant after adjusted with life style, sociodemographic factors and involuntary smoking frequency (2.42, 95% confidence interval, 0.97–6.04).
The odds ratio of passengers who mainly used taxis was marginally significantly higher than those of passengers who used subways and buses after adjusted with life style and sociodemographic factors. Implementation of supplementary measures and further studies on exposure to environmental tobacco smoking in taxis are warranted.
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On-call work is a form of work that requires the person to work at any time during the on-call period. Thus, on-call work is often regarded as one of the most severe stress factors. This study investigates the associations between on-call work and health problems, injuries.
This study was based on the 3rd Korean Working Conditions Survey. Total of 29,246 employed workers who had been working for at least 1 year were included. Logistic regression analysis was performed to investigate the association between on-call work and health problems, injuries.
The odds ratios for on-call workers in terms of physical health problems, psychological health problems, and injuries were 1.33 (95% confidence interval [CI] 1.22-1.44), 1.31 (95% CI 1.08-1.60), and 2.76 (95% CI 2.26-3.37), respectively. Analysis of the detailed symptoms revealed odds ratios in on-call workers of 2.06 for hearing problems (95% CI 1.63-2.62); 1.71 for skin problems (95% CI 1.38-2.12); 1.22 for back pain (95% CI 1.08-1.38); 1.23 for muscular pains in upper limbs (95% CI 1.12-1.34); 1.27 for muscular pains in lower limbs (95% CI 1.15-1.40); 1.46 for headache, eye fatigue (95% CI 1.32-1.60); 1.37 for abdominal pain (95% CI 1.02-1.85); 1.43 for depression or anxiety disorders (95% CI 1.07-1.93); 1.36 for fatigue (95% CI 1.24-1.49); and 1.41 for insomnia and general sleep difficulties (95% CI 1.13-1.76).
The present study found that on-call work results in an increased risk of health problems and injuries. This study is the result of analyses of broad range of the job spectrum in Korean employed workers; thus, future studies are necessary to determine the effects of on-call work in various job groups.
Citations

Ambient air pollution has a negative effect on many diseases, such as cardiovascular and respiratory diseases. Recent studies have reported a relationship between air pollution and renal function, but the results were limited to exposure to particulate matter (PM). This study was to identify associations between various air pollutants and renal function among Korean adults.
Nationwide survey data for a total of 24,407 adults were analyzed. We calculated the estimated glomerular filtration rate (eGFR) for each individual to assess their renal function and used this to categorize those with chronic kidney disease (CKD). To evaluate exposure to ambient air pollution, we used the annual mean concentrations of four ambient air pollutants: PM with an aerodynamic diameter ≤ 10 μm (PM10), nitrogen dioxide (NO2), sulfur dioxide (SO2), and carbon monoxide (CO).
We identified significant inverse relationships between the air pollutants PM10 and NO2 and eGFR in all statistical adjustment models (all
Exposures to PM10 and NO2 were significantly associated with decreases in eGFR levels, but not CKD, in Korean adults.
Citations

This study was aimed at finding out the exposure level of bisphenol A (BPA), a well-known endocrine disruptor, in relation to dietary factors using a data representing the Korean general population.
This study was performed on 5402 adults aged 19 years and older based on the Second Korean National Environmental Health Survey (KoNEHS 2012–2014). The data analyzed urinary BPA concentration in relation to socio-demographic variables, health behavior-related variables, and dietary factor-related variables. Odds ratio (OR) was calculated through a logistic regression analysis after dividing the participants into high BPA exposure group and low BPA exposure group based on the top 75 percentile concentration. The logistic regression analysis was carried out considering the appropriate sample weight, stratification, and clustering of the second KoNEHS sample design.
The group drinking bottled water at home and the group using zip-top bags/plastic bags showed significantly higher urinary BPA concentration in female. OR tends to increase as the intake frequency of frozen food increased and OR of frozen food consumption of more than once a week was 1.48 (95% confidence interval (CI) 1.02–2.24) for male and the group drinking bottled water showed significantly higher OR of 1.45 (95% CI 1.06–2.17) after adjusting the related factors for female.
BPA levels were high in female using bottled water and in male consuming frozen food, and therefore bottled water and frozen food need to be avoided to reduce BPA levels.
Citations

In modern society, many workers are stressed. Supervisors’ support or behavior can affect the emotional or psychological part of the worker. The purpose of this study is to investigate the effect of supervisor’s behavior on worker’s stress.
The study included 19,272 subjects following the assignment of weighted values to workers other than soldiers using data from the Fourth Korean Working Condition Survey. Supervisors’ behavior was measured using 5 items: “supervisor feedback regarding work,” “respectful attitude,” “good conflict-resolution ability,” “good work-related planning and organizational ability,” and the encouragement of participation in important decision making. Job stress was measured using 1 item: “I experience stress at work.” Multiple logistic regression analysis was performed to examine the effects of supervisors’ behavioral, general, occupational, and psychosocial characteristics on job stress in workers. Organizational characteristics associated with supervisors’ behavior were also analyzed.
The results showed that supervisors’ provision of feedback regarding work increased workers’ job stress (OR = 1.329, 95% CI = 1.203 ~ 1.468). When a supervisor respect workers (OR = 0.812, 95% CI = 0.722 ~ 0.913) or good at planning and organizing works (OR = 0.816, 95% CI: 0.732 ~ 0.910), workers’ job stress decreased. In particular, the two types of supervisor behaviors, other than feedback regarding work, were high in private-sector organizations employing less than 300 employees.
Supervisors’ behavior influenced job stress levels in workers. Therefore, it is necessary to increase education regarding the effects of supervisors’ behavior on job stress, which should initially be provided in private-sector organizations with up to 300 employees.
Citations

Around the globe, discrimination has emerged as a social issue requiring serious consideration. From the perspective of public health, the impact of discrimination on the health of affected individuals is a subject of great importance. On the other hand, subjective well-being is a key indicator of an individual’s physical, mental, and social health. The present study aims to analyze the relationship between Korean employed workers’ subjective health and their exposure to perceived discrimination.
The Fourth Korean Working Conditions Survey (KWCS, 2014) was conducted on a representative sample of the economically active population aged 15 years or older, who were either employees or self-employed at the time of interview. After removing inconsistent data, 32,984 employed workers were examined in this study. The data included general and occupational characteristics, perceived discrimination, and well-being. Well-being was measured through the WHO-Five index (1998 version). Multiple logistic regression analysis was used to examine the association between perceived discrimination and well-being.
As a group, employed workers who were exposed to discrimination had a significantly higher likelihood of “poor well-being” than their counterparts who were not exposed to discrimination. More specifically, the workers exposed to age discrimination had an odds ratio(OR) of 1.51 (95% CI: 1.36–1.68), workers exposed to discrimination based on educational attainment had an OR of 1.43 (95% CI: 1.26–1.61), and workers exposed to discrimination based on employment type had an OR of 1.68 (95% CI: 1.48–1.91) with respect to poor well-being.
Furthermore, workers exposed to a greater number of discriminatory incidents were also at a higher risk of “poor well-being” than their counterparts who were exposed to fewer such incidents. More specifically, the workers with three exposures to discrimination had an OR of 2.60 (95% CI: 1.92–3.53), the workers with two such exposures had an OR of 1.69 (95% CI: 1.44–1.99), and the workers with one such exposure had an OR of 1.32 (95% CI: 1.20–1.45).
The present study found that discrimination based on age, educational attainment, or employment type put workers at a higher risk of “poor well-being,” and that the greater the exposure to discrimination, the higher the risk of poor well-being.
Citations

Recently, the emergence of long working hours and the associated conditions such as coronary heart disease (CHD) and stroke have gained attention. The aim of this study was to investigate the association between long working hours and the 10-year-risk of CHD and stroke, estimated by Jee’s health risk-appraisal model for ischemic heart disease.
We analyzed data from Koreans who randomly enrolled in Korean National Health and Nutrition Examination Survey 2008–2012 and finally included 13,799 participants. The participants were classified as per their working hours: 0–30 h/week, 31–39 h/week, 40 h/week, 41–50 h/week, 51–60 h/week, 61–70 h/week, 71–80 h/week, and >80 h/week. The risks for CHD and stroke were determined using Jee’s health risk-appraisal model. Multiple logistic regression was used to analyze the association between working hours and 10-year risk for CHD.
The 10-year risks for CHD and stroke were significantly and positively associated with working hours in both men and women. Furthermore, higher risks for CHD and stroke were associated with longer working hours in women.
Long working hours are significantly associated with the risks of CHD and stroke, estimated by Jee’s health risk-appraisal model. This study suggests the need for proper management of working hours to reduce CHD risk and stroke risk in the Korean population.
The online version of this article (doi:10.1186/s40557-016-0149-5) contains supplementary material, which is available to authorized users.
Citations

The present study analyzed relationship of workplace violence and perpetrators of violence on sleep disturbance among wage workers in Korea.
The present study used data from the 4th Korean Working Conditions Survey (KWCS) of 2014 in selecting a total of 25,138wage workers as the study population, which excluded those who failed or refused to respond to questions required for the present study. The workplace violence experience group included people who satisfied at least one of six relevant criteria (verbal abuse, unwanted sexual attention, threatening or humiliating behavior, physical violence, bullying/harassment, and sexual harassment) and the group was divided according to whether the perpetrator of violence was a client or colleague. Presence of sleep disturbance was determined based on subjective symptoms felt within the past 12 months by each individual. A multiple logistic regression analysis was performed to identify the effects on sleep distance according to general, occupational, and psychosocial characteristics, as well as the types of workplace violence and perpetrators of violence.
Workplace violence was found as a factor affecting sleep disturbance (OR = 3.773, 95 % CI = 3.058–4.655), and with respect to perpetrators of violence, complaint of sleep disturbance symptoms was higher when the perpetrator was a colleague or boss (OR = 5.688, 95 % CI 4.189–7.723) than a client (OR = 2.992, 95 % CI 2.301–3.890).
Workplace violence had an effect on occurrence of sleep disturbance and when the perpetrators of violence was a boss or colleague at work, the risk for symptoms such as sleep disturbance increased, which indicated the need for appropriate intervention from a workplace healthcare perspective, including preventive education of workplace violence among employees.
Citations

This research was conducted with an aim of determining the association between employment status and self-rated health.
Using the data from the Third Korean Working Conditions Survey conducted in 2011, We included data from 34,783 respondents, excluding employers, self-employed workers, unpaid family workers, others. Self-rated health was compared according to employment status and a logistic regression analysis was performed.
Among the 34,783 workers, the number of permanent and non-permanent workers was 27,564 (79.2 %) and 7,219 (20.8 %). The risk that the self-rated health of non-permanent workers was poor was 1.20 times higher when both socio-demographic factors, work environment and work hazards were corrected.
In this study, perceived health was found to be worse in the non-permanent workers than permanent workers. Additional research should investigate whether other factors mediate the relationship between employment status and perceived health.
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Presenteeism, a concept that has recently undergone active study, is the act of attending work while sick. This study investigates the association between presenteeism and various psychosocial factors within workplaces.
This study analyzed 29246 wage earners from the third Korean Working Conditions Survey (KWCS, 2011) data using the logistic regression analysis to investigate the association between presenteeism and various psychosocial factors within workplaces.
Among the 29246 wage earners, 6347 (21.7 %) showed presenteeism. Those who experienced age discrimination at work (adjusted odds ratio (aOR) 1.77: 95 % CI 1.56–2.00), educational background discrimination (aOR 1.35: 95 % CI 1.22–1.51), regional discrimination (aOR 1.55: 95 % CI 1.31–1.83), sexual discrimination (aOR 1.65: 95 % CI 1.41–1.94), employment type discrimination (aOR 2.13: 95 % CI 1.89–2.40), physical violence (aOR 1.92: 95 % CI 1.45–2.55), sexual harassment (aOR 2.90: 95 % CI 2.01–4.19), job insecurity (aOR 1.36: 95 % CI 1.18–1.56), work–life imbalance (aOR 1.38: 95 % CI 1.29–1.47), low job satisfaction (aOR 2.04: 95 % CI 1.91–2.17), no colleague support (aOR 1.11: 95 % CI 1.02–1.21), job stress (aOR 1.89: 95 % CI 1.76–2.02), emotional labor (aOR 1.50: 95 % CI 1.41–1.60), high work intensity (aOR 1.31: 95 % CI 1.23–1.38), and 3 groups of job strain that are passive group (aOR 1.09: 95 % CI 1.00–1.18), active group (aOR 1.39: 95 % CI 1.28–1.51), and high strain group (aOR 1.35: 95 % CI 1.24–1.46) showed an increased risk of presenteeism compared to their respective counterparts (
The study results confirmed the association between presenteeism and various psychosocial factors within workplaces. Considering that presenteeism negatively affects productivity and the mental and physical health of individuals, managing various psychosocial factors within workplaces is proposed to reduce presenteeism.
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The present study investigated the prevalence of depressive symptoms in older Koreans and identified associations between depressive symptoms and occupational factors.
Data from the Korean National Health and Nutrition Examination Survey V (2010–2012) were used to analyze 7320 participants aged 55 years or older. Complex sample logistic regression analysis was performed after adjusting general characteristics to determine associations between depressive symptoms and occupational factors.
Among older Korean men, the prevalence of depressive symptoms in the employed and the non-employed groups were 9.9 % and 13.7 %, respectively. Employment status was significantly associated with depressive symptoms after adjusting for general factors (OR: 0.69, 95 % CI: 0.49–0.97). Among older Korean women, the prevalence of depressive symptoms in the employed and the non-employed groups were 17.4 % and 20.3 %, respectively, but employment status was not significantly associated with depressive symptoms. Second skill level occupational groups (clerks, plant and machine operators) in particular showed significantly lower prevalence of depressive symptoms than the non-employed group of men (9.3 % vs 13.7 %). By occupation type, the odds ratios were 0.31 (95 % CI: 0.10–0.97, clerks) and 0.47 (95 % CI: 0.23–0.86, plant and machine operators) adjusting for general factors.
The employed group showed lower late-life depressive symptom prevalence than the non-employed group among older Korean men. In addition some second skill level occupations (clerks, plant and machine operators) were significantly associated with a lower risk of depressive symptoms after adjusting for general factors in older Korean men.
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This study was conducted to investigate the relationship between night work and cardiovascular diseases among wage workers in Korea.
The study was based on the 3rd Korean Working Conditions Survey (KWCS; 2011). This study included 29,711 wage workers. We used the chi-squared test and logistic regression to examine the association between cardiovascular diseases and night work and cumulative night work.
Among all of the paid workers, 12.5% reported doing night work ≥ 1 day per month. Night work was significantly associated with an increased risk of cardiovascular diseases (odds ratio [OR] 1.58, 95% confidence interval [CI] 1.11-2.25). Also, compared to the group that did not do night works, the group with higher cumulative night work demonstrated an increased risk for cardiovascular diseases (OR 1.81, 95% CI 1.19-2.74).
This study suggests that night work is significantly associated with cardiovascular diseases.
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Presenteeism has become a public concern recently. Thus, we aimed to understand the relationship between self-employed workers and presenteeism using a nationally representative sample of Korean workers.
Using data from the Korean Working Conditions Survey conducted in 2011, a total of 43,392 workers including paid employees and self-employed workers were analyzed. The effect of employment status on presenteeism was analyzed using logistic regression analysis. The independent variables were socioeconomic characteristics, working conditions, and working environments.
Among the 43,392 workers, 34,783 were paid and 8,609 were self-employed. Self-employed workers were more likely to exhibit presenteeism than were paid workers. An elevated odds ratio of 1.27 (95% CI 1.19-1.36) was found for presenteeism among self-employed workers.
Being self-employed was significantly related with exhibiting presenteeism. Additional research should investigate whether other factors mediate the relationship between employment status and presenteeism as well as ways to reduce presenteeism among self-employed workers.
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