Epidemiology and Health

Systematic Review

Non-cancer health risks in firefighters: a systematic review: Jeong Ah Kim, Soo Yeon Song, Wonjeong Jeong, Jae Kwan Jun; Epidemiol Health. 2022;44:e2022109. Published online November 16, 2022; DOI: https://doi.org/10.4178/epih.e2022109

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Abstract Summary PDF Supplementary Material: Abstract
osFirefighters are occupationally exposed to hazardous factors that may increase their risk of disease. However, non-cancer disease risk in firefighters has not been systematically examined. This systematic review aimed to identify non-cancer disease risk in firefighters and determine whether the risk differs according to job characteristics. We searched the Cochrane Library, Embase, PubMed, and KoreaMed databases using relevant keywords from their inception to April 30, 2021. The Risk of Bias Assessment Tool for Non-randomized Studies version 2.0 was used to assess the quality of evidence. Due to study heterogeneity, a narrative synthesis was presented. The systematic literature search yielded 2,491 studies, of which 66 met the selection and quality criteria. We confirmed that the healthy worker effect is strong in firefighters as compared to the general population. We also identified a significant increase in the incidence of lumbar disc herniation, lower back pain, angina pectoris, acute myocardial infarction, and post-traumatic stress disorder (PTSD) in firefighters compared to other occupational groups. Contradictory results for the risk of PTSD and anxiety disorders related to rank were reported. Sufficient evidence for increased risk of lumbar disc herniation, lower back pain, angina pectoris, acute myocardial infarction, and PTSD was available. The risk of non-cancer diseases varied depending on job type, years of service, and rank. However, caution should be exercised when interpreting the results because the classification criteria for firefighters’ jobs and ranks differ by country.; Summary

Korean summary
본 연구는 소방관과 비암성 질환과의 직업관련성을 파악하기 위해 체계적 문헌고찰을 수행하였다. 소방관은 근골격계 질환, 협심증, 심근경색, 외상후 스트레스 장애 등 일부 질환에서 일관된 직업관련성이 보고되었다. 하지만 대부분의 연구에서 연구결과가 건강근로자효과의 영향을 보정하지 못하였고 근무형태, 근무조건, 근무강도 등에 따라 일관되지 못한 결과를 보고하고 있다.

Key Message
In firefighters, risks of lumbar disc herniation, lower back pain, angina pectoris, acute myocardial infarction, and post-traumatic stress disorder were increased constantly. Due to the failure to avoid the healthy-worker effect, consistent relationship between firefighters and non-cancerous diseases has not been reported.

Original Articles

Pain and mortality among older adults in Korea: Chiil Song, Wankyo Chung; Epidemiol Health. 2021;43:e2021058. Published online September 7, 2021; DOI: https://doi.org/10.4178/epih.e2021058

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Abstract Summary PDF Supplementary Material

Abstract

OBJECTIVES
With the increasing elderly population with chronic disease, understanding pain and designing appropriate policy interventions to it have become crucial. While pain is a noted mortality risk factor, limited studies exist due to the various causes of pain and the subjectivity of pain expression. This study aimed to examine the relationship between pain and mortality, controlling for other diseases and socio-cultural factors.

METHODS

We analyzed 6,258 individuals aged 45 years or older, the population with the highest prevalence of pain, using the Korean Longitudinal Study of Aging (2006-2016) data and the Cox proportional-hazards model. Further subgroup analyses were conducted by sex and education level to examine differences in the relationship between pain and mortality.

RESULTS

The adjusted hazard ratios of mortality were 1.16 (95% confidence interval [CI], 1.00 to 1.34, model 1) and 1.12 (95% CI, 0.97 to 1.29, model 2) for the individuals in pain depending on the models used, where additional socio-cultural factors were accounted for in model 2. For individuals in severe pain, ratios were significantly higher with 1.23 (95% CI, 1.08 to 1.41, model 1) and 1.16 (95% CI, 1.02 to 1.32, model 2). Further subgroup analyses showed that severe pain was more associated with mortality for males and more educated individuals, with adjusted hazard ratios of 1.29 (95% CI, 1.08 to 1.55, model 2) and 1.62 (95% CI, 1.15 to 2.28, model 2), respectively.

CONCLUSIONS

Pain showed a statistically significant relationship with mortality risk. Family members or medical staff should pay proper attention to pain, particularly severe pain in males and highly educated individuals.

Summary

Korean summary
우리나라의 고령인구와 만성질환의 증가가 가속화됨에 따라, 통증의 문제를 겪는 인구가 증가하고 통증의 사회경제적 영향도 커지고 있어 통증에 대한 엄밀한 분석이 요구된다. 본 연구는 통증을 주로 겪는 중·고령층을 대상으로 생존분석을 통해, 통증이 객관적 지표인 사망위험과 유의미하게 관련이 있음을 보였다. 따라서 환자의 통증 표현은, 특히 남성과 고학력자의 심한 통증 표현은, 사망과 관련이 있는 중요한 지표로 관리될 필요가 있으며 적절한 정책적 접근이 요구된다.

Key Message
With the increasing elderly population with chronic disease, understanding pain and designing appropriate policy interventions to it have become crucial. This study showed that pain had a statistically significant relationship with mortality risk, thus proper attention should be paid to it.

Citations

Citations to this article as recorded by

Sex-specific effects of neuropathic pain on long-term pain behavior and mortality in mice
Magali Millecamps, Susana G. Sotocinal, Jean-Sebastien Austin, Laura S. Stone, Jeffrey S. Mogil
Pain.2023; 164(3): 577. CrossRef
Spécificités de la prise en charge de la douleur chez la personne âgée
G. Pickering
Bulletin de l'Académie Nationale de Médecine.2023; 207(5): 661. CrossRef

Risk factors for low back pain among elementary school students in western Iran using penalized logistic regression: Forouzan Rezapur-Shahkolai, Elham Gheysvandi, Leili Tapak, Iman Dianat, Akram Karimi-Shahanjarini, Rashid Heidarimoghadam; Epidemiol Health. 2020;42:e2020039. Published online June 2, 2020; DOI: https://doi.org/10.4178/epih.e2020039

11,857 View
281 Download
7 Web of Science
9 Crossref

Abstract PDF

Abstract

OBJECTIVES
This study investigated the prevalence of low back pain (LBP) and its risk factors among elementary-school students.

METHODS

In this cross-sectional study, 693 elementary students from Hamadan city, western Iran, were selected by multistage stratified cluster sampling. Data were collected through interviews using questionnaires. Posture and psychosocial elements were assessed using the observational Rapid Upper Limb Assessment (RULA) checklist and the standard Strengths and Difficulties Questionnaire, respectively. Penalized logistic regression with the group smoothly-clipped absolute deviation regularization method was used for variable selection and data analysis (α=0.05). The chi-square test was also used.

RESULTS

In total, 26.6% of the students (7-12 years old) reported LBP in the last month. Older age (odds ratio [OR], 3.08; 95% confidence interval [CI], 1.80 to 5.26), watching TV for more than 3 hours a day (OR, 2.62; 95% CI, 1.46 to 4.68), very short seat backrests (OR, 3.08; 95% CI, 1.61 to 5.90), excessively curved seat backrests (OR, 4.36; 95% CI, 2.08 to 9.13), very short desks (OR, 3.44; 95% CI, 1.61 to 7.35), a family history of LBP (OR, 2.49; 95% CI, 1.58 to 3.91), carrying a school bag on one shoulder (OR, 1.91; 95% CI, 1.03 to 3.54), and RULA scores of 3 (OR, 2.26; 95% CI, 1.13 to 4.50) or 4 (OR, 2.85; 95% CI, 1.37 to 5.91) were associated with LBP.

CONCLUSIONS

A high prevalence of LBP was found among elementary-school students. This study underscores the importance of recognizing vulnerable children and teenagers and developing interventional health promotion programs to prevent LBP based on an appropriate consideration of its contributory factors.

Summary

Citations

Citations to this article as recorded by

Prevalence of chronic pain and contributing factors: a cross-sectional population-based study among 2,379 Iranian adolescents
Maryam Shaygan, Azita Jaberi, Marziehsadat Razavizadegan, Zainab Shayegan
The Korean Journal of Pain.2023; 36(2): 230. CrossRef
Examining the Relationship between Mental Health and Chronic Pain in Children and Adolescents: A Systematic Review Study
Farzin Bagheri Sheykhangafshe, Hojjatollah Farahani, Mohsen Dehghani, Ali Fathi-Ashtiani
Journal of Rafsanjan University of Medical Sciences.2023; 22(6): 617. CrossRef
Association between Physical Fitness and Low Back Pain: The Pepe Cross-Sectional Study
Aina M. Galmés-Panadés, Josep Vidal-Conti
Children.2022; 9(9): 1350. CrossRef
Prevalence of Low Back Pain among Primary School Students from the City of Valencia (Spain)
Vicente Miñana-Signes, Manuel Monfort-Pañego, Antonio Hans Bosh-Bivià, Matias Noll
Healthcare.2021; 9(3): 270. CrossRef
Identification of factors related to behaviors associated with musculoskeletal pain among elementary students
Forouzan Rezapur-Shahkolai, Elham Gheysvandi, Akram Karimi-Shahanjarini, Leili Tapak, Rashid Heidarimoghadam, Iman Dianat
BMC Musculoskeletal Disorders.2021;[Epub] CrossRef
Parents' knowledge and attitudes when choosing their children's school bag: An introductory study
Dijana Laštro, Mirsad Muftić, Nenad Ponorac, Dubravko Bokonjić
Scripta Medica.2021; 52(2): 124. CrossRef
Designing School Tables and Chairs based on Anthropometry of Elementary School Students in Surabaya
Riska Ayu Yulianingtyas, Dani Nasirul Haqi
The Indonesian Journal Of Occupational Safety and Health.2021; 10(1): 97. CrossRef
Unconventional seats for students returning to school during the worldwide COVID-19 pandemic: has Italy taken the right direction?
Massimiliano Polastri, Julie Swann
International Journal of Therapy and Rehabilitation.2020; 27(11): 1. CrossRef
Effectiveness of mat Pilates on postural alignment in the sagittal plane in school children: a randomized clinical trial
Fabíola Unbehaun Cibinello, Jessica Caroliny de Jesus Neves, Mônica Yosino Leão Carvalho, Paola Janeiro Valenciano, Dirce Shizuko Fujisawa
Motriz: Revista de Educação Física.2020;[Epub] CrossRef

The Effect of Work Department, Income and Job Status on the Workplace Injury Rates in One Car Manufacturing Factory.: Mi A Son; Korean J Epidemiol. 2001;23(2):52-63.

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Abstract PDF: Abstract
PURPOSE
There has been little research into socio-economic factors and work condition s as risk factors for workplace injuries in Korea. Separating work from social class is difficult as the social division of labour is at the origin of social class (1). The objective of this study is to investigate the relationship of working conditions and socio-economic factors with workplace injury rates.
METHODS
Three year-follow up data sets for workplace injury data analysis for retrospective cohort study were obtained linking the total workforce and workplace injuries between 1995 and 1997. The Proportional Hazards Model (Cox regression) is used to estimate the hazard ratios for workplace injury by different possible risk factors: work department, income, job status, age and tenure.
RESULTS
The press, body and engine departments have higher hazard rates for severe injuries; the press, engine, and supporting departments for lower-back pain; and the assembly line (with wider confidence interval) and supporting departments for Herniated Intervertebral Discs. Lower waged workers have higher rates of workplace injuries, especially for lower-back pain. Workers with low job status have higher rates than foremen or supervisors. Thus, socio-economic factors and work department contribute independently to workplace injury rates.
CONCLUSIONS
Even though this study could not fully investigate the relationship between socio-economic factors and working conditions, the working conditions as well as socioeconomic factors need to be considered as risk factors of workplace injuries in the workplace.; Summary

Incidence Density and Risk Factors of Low Back Pain among the Workers in a Welding Material Manufacturing Factory.: Ju Tae Park, Hyun Sul Lim; Korean J Epidemiol. 1999;21(1):36-52.

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Abstract PDF: Abstract
This study was performed to understand the incidence density and detect the risk factors of occupational low back pain. A cross-sectional study was conducted with a questionnaire in a welding material manufacturing factory in October, 1993. Therefore, we selected 140 workers who had never complained of low back pain as cohorts. Also, we added 236 newly entered persons who had never complained of low back pain. The total number of cohorts were 376 workers. And then we continued with a questionnaire survey in October, 1996 and with a questionnaire survey and medical examinations by a specialist in October, 1997. Follow-ups were done for 337 workers. The number of newly developed low back pain among workers were 127. The characteristics of low back pain were as follows. The durations of pain were less than or equal to 2 days (42.6%), from 3 days to less than 1 week (8.7%), from 1 week to less than 1 month (11.0%), 1 month or more (6.2%). The frequency was everyday (7.9%), once per week (21.3%), once per month (14.2%), once per 2-3 months (9.4%), once per 5 months (11.0%). The severity of pain was slight (9.4%), mild (33.1%), moderate (13.4%), severe (10.2%) and very severe (1.6%). The onset of most low back pain was insidious (41.7%). The diagnosis of low back pain was muscle strain (37.8%), lumbar sprain (23.6%) and myofacial pain syndrome (3.9%). The number of newly developed low back pain among workers were 127, their incidence density was 15.7 per 100 person-years. In univariate analysis, age, marital status, educational level, smoking habit, category of job, tenures and frequency of stretching exercises showed a statistical significance. The multivariate logistic regression analysis confirmed that category of job and tenures (p<0.05) were independent risk factors for low back pain among workers. The number of newly developed occupational low back pain among production workers were 71, their incidence density was 11.3 per 100 person-years. In univariate analysis, age, marital status, educational level, regular exercise, tenures, posture of waist and lifting of heavy materials showed a statistical significance. The multivariate logistic regression analysis confirmed that posture of waist (p<0.05) and lifting of heavy materials (p<0.1) were independent risk factors for occupational low back pain among production workers.; Summary

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