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Original Article
The association between occupational stress level and health-related productivity loss among Korean employees
Jonghee Chung, Jin-Hyo Kim, Jae Yoon Lee, Hee Seok Kang, Dong-wook Lee, Yun-Chul Hong, Mo-Yeol Kang
Epidemiol Health. 2023;45:e2023009.   Published online December 28, 2022
DOI: https://doi.org/10.4178/epih.e2023009
  • 5,606 View
  • 258 Download
  • 1 Crossref
AbstractAbstract AbstractSummary PDF
Abstract
OBJECTIVES
Occupational stress management is particularly important for successful business operations, since occupational stress adversely affects workers’ health, eventually lowering their productivity. Therefore, this study aimed to investigate the correlation between occupational stress and health-related productivity loss (HRPL) among Korean workers.
METHODS
In 2021, 1,078 workers participated in a web-based questionnaire survey. HRPL was measured using the Work Productivity and Activity Impairment Questionnaire, and occupational stress was measured using the Korean Occupational Stress Scale-Short Form. The occupational stress level was divided into tertiles (low, intermediate, and high), and the low occupational stress group was used as the reference group. Using a generalised linear model, differences in labour productivity loss according to the level of occupational stress were tested after adjusting for demographic characteristics such as age, gender, education level, household income, occupation, and underlying medical conditions.
RESULTS
Non-parametric regression analysis of HRPL according to occupational stress showed a direct association between occupational stress and HRPL. A statistically significant difference was observed in HRPL between participants with intermediate and high occupational stress and those with low occupational stress.
CONCLUSIONS
Our results support the hypothesis that high occupational stress is associated with decreased labour productivity.
Summary
Korean summary
직무스트레스가 건강에 미치는 영향은 잘 알려져 있으나, 노동생산성에 대해 분석한 결과는 그동안 부족하였다. 한국 노동자 1078명을 분석한 결과, 직무스트레스가 낮은 군에 비해서 중등도이거나 높은 경우, 결근이나 프리젠티즘과 같은 건강관련 노동생산성 손실이 약 20%p 정도 높은 것으로 분석되었다.
Key Message
As a result of analyzing 1078 Korean workers, it was revealed that health-related labor productivity losses such as absenteeism and presenteeism were about 20%p higher when occupational stress was moderate or high compared to the low occupational stress group.

Citations

Citations to this article as recorded by  
  • Association between work from home and health-related productivity loss among Korean employees
    Hyo Jeong Kim, Dong Wook Lee, Jaesung Choi, Yun‐Chul Hong, Mo-Yeol Kang
    Annals of Occupational and Environmental Medicine.2024;[Epub]     CrossRef
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
  • 5,659 View
  • 222 Download
  • 1 Web of Science
  • 1 Crossref
AbstractAbstract AbstractSummary PDFSupplementary 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.

Citations

Citations to this article as recorded by  
  • Associations between Recognition and Behaviors Regarding the Use, Washing and Management of Firefighting Protection Suits and Public Health Awareness of Occupational Exposure Risks among Firefighters
    Soo Jin Kim, Seunghon Ham
    Fire.2024; 7(5): 156.     CrossRef
Original Articles
Application of a joint latent space item response model to clustering stressful life events and the Beck Depression Inventory-II: results from Korean epidemiological survey data
Hyun Joo Kim, Ye Jin Jeon, Hyeon Chang Kim, Ick Hoon Jin, Sun Jae Jung
Epidemiol Health. 2022;44:e2022093.   Published online October 24, 2022
DOI: https://doi.org/10.4178/epih.e2022093
  • 3,463 View
  • 79 Download
  • 1 Web of Science
  • 1 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
According to previous findings, stressful life events (SLEs) and their subtypes are associated with depressive symptoms. However, few studies have explored potential models for these events and incidental symptoms of depression.
METHODS
Participants (3,966 men; 5,709 women) were recruited from the Cardiovascular and Metabolic Diseases Etiology Research Center cohort. SLEs were measured using a 47-item Life Experiences Survey (LES) with a standardized protocol. Depressive symptoms were assessed using the Beck Depression Inventory-II (BDI-II). Joint latent space item response models were applied by gender and age group (<50 vs. ≥50 years old).
RESULTS
Among the LES items, death or illness of close relatives, legal problems, sexual difficulties, family relationships, and social relationships shared latent positions with major depressive symptoms regardless of gender or age. We also observed a gender-specific domain: occupational and family-related items.
CONCLUSIONS
By projecting LES and BDI-II data onto the same interaction map for each subgroup, we could specify the associations between specific LES items and depressive symptoms.
Summary
Korean summary
- 본 연구는 성별, 연령에 따른 생활스트레스 항목과 Beck Depression Inventory-II (BDI-II) 로 측정한 우울증상 사이의 연관성을 Joint Latent space item response model (LSIRM) 방법을 사용하여 탐색하고자 하였다. - 한국 성인 인구집단 (3,966 남성; 5,709 여성)을 대상으로 연구를 수행한 결과, 생활스트레스 항목 중 가족 혹은 가까운 주변인의 죽음 혹은 질환, 법적인 문제, 성적 어려움, 가족 혹은 사회적 관계는 성별, 연령에 무관하게 우울 증상과 연관성이 있었으며, 직업, 일부 가족 관련 항목에서 성별 특이적인 연관성을 관찰하였다.
Key Message
- In this study, we used a joint latent space item response model (LSIRM) to project stressful life events and depressive symptoms as measured by the Beck Depression Inventory-II (BDI-II) onto an interaction map, which represents the interaction of BDI-II items and underlying traits with each SLE, while accounting for heterogeneity by sex and age group. - Among the LES items, death/illness of close relatives, legal problems, sexual difficulties, family relationships, and social relationships shared latent positions with major depressive symptoms regardless of sex or age group. But, in occupational and family-related items, sex-specific associations were observed.

Citations

Citations to this article as recorded by  
  • Efficacy and safety of traditional Chinese medicine nursing intervention in postoperative patients after gastrectomy
    Lizhi Fan, Ying He, Yufeng Li, Xinxin Li, Dan Liu, Rui Wang
    Oncology Letters.2023;[Epub]     CrossRef
The associations of job strain and leisure-time physical activity with the risk of hypertension: the population-based Midlife in the United States cohort study
Xinyue Liu, Timothy A. Matthews, Liwei Chen, Jian Li
Epidemiol Health. 2022;44:e2022073.   Published online September 7, 2022
DOI: https://doi.org/10.4178/epih.e2022073
  • 7,190 View
  • 228 Download
  • 4 Web of Science
  • 4 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
Job strain is positively associated with incident hypertension, while increasing leisure-time physical activity (LTPA) can reduce incident hypertension. However, the joint associations of job strain and LTPA with incident hypertension among United States workers have yet to be investigated. This study examined the independent and joint associations of job strain and LTPA with incident hypertension.
METHODS
This prospective cohort study (n=1,160) utilized data from the population-based Midlife in the United States study. The associations of job strain and LTPA at baseline with incident hypertension during follow-up were examined using Cox proportional hazards models. High job strain was derived from a combination of high job demands and low job control, and high LTPA was defined as engagement in moderate or vigorous LTPA at least once per week.
RESULTS
During 9,218 person-years of follow-up, the hypertension incidence rate was 30.6 (95% confidence interval [CI], 27.3 to 34.3) per 1,000 person-years. High job strain was associated with a higher risk for hypertension than low job strain (adjusted hazard ratio [aHR], 1.29; 95% CI, 1.00 to 1.67). High LTPA was associated with lower hypertension risk than low LTPA (aHR, 0.77; 95% CI, 0.60 to 0.98). Hypertension risk was higher among workers with high job strain and low LTPA than among those with low job strain and high LTPA (aHR, 1.70; 95% CI, 1.18 to 2.43).
CONCLUSIONS
Job strain and LTPA showed positive and inverse associations, respectively, with incident hypertension. The combination of high job strain and low LTPA was associated with the highest risk for hypertension.
Summary
Key Message
High job strain and low leisure-time physical activity are independent risk factors for hypertension among workers, and those with high job strain and low leisure-time physical activity are at the highest risk, so it is critical that policy interventions target job strain and leisure-time physical activity to reduce hypertension.

Citations

Citations to this article as recorded by  
  • Prospective associations of occupational and leisure-time physical activity with risk of diabetes: a cohort study from the United States
    Timothy A Matthews, Xinyue Liu, Liwei Chen, Jian Li
    Annals of Work Exposures and Health.2024;[Epub]     CrossRef
  • 2023 ESH Guidelines for the management of arterial hypertension The Task Force for the management of arterial hypertension of the European Society of Hypertension
    Giuseppe Mancia, Reinhold Kreutz, Mattias Brunström, Michel Burnier, Guido Grassi, Andrzej Januszewicz, Maria Lorenza Muiesan, Konstantinos Tsioufis, Enrico Agabiti-Rosei, Engi Abd Elhady Algharably, Michel Azizi, Athanase Benetos, Claudio Borghi, Jana Br
    Journal of Hypertension.2023; 41(12): 1874.     CrossRef
  • Adulthood Psychosocial Disadvantages and Risk of Hypertension in U.S. Workers: Effect Modification by Adverse Childhood Experiences
    Timothy A. Matthews, Yifang Zhu, Wendie Robbins, Mary Rezk-Hanna, Paul M. Macey, Yeonsu Song, Jian Li
    Life.2022; 12(10): 1507.     CrossRef
  • Associations of COVID-19 Related Work Stressors with Psychological Distress: Racial and Ethnic Disparities in Californian Workers
    Timothy A. Matthews, Megan Guardiano, Negar Omidakhsh, Lara Cushing, Wendie Robbins, OiSaeng Hong, Jian Li
    International Journal of Environmental Research and Public Health.2022; 20(1): 144.     CrossRef
COVID-19: Special Article
Mental health of Korean adults before and during the COVID-19 pandemic: a special report of the 2020 Korea National Health and Nutrition Examination Survey
Hyunsuk Jeong, Suyeon Park, Jihee Kim, Kyungwon Oh, Hyeon Woo Yim
Epidemiol Health. 2022;44:e2022042.   Published online April 25, 2022
DOI: https://doi.org/10.4178/epih.e2022042
  • 15,562 View
  • 534 Download
  • 15 Web of Science
  • 16 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
Coronavirus disease 2019 (COVID-19) and the associated social distancing, limited freedom, and fear of an uncertain future are expected to have substantial mental health effects. We investigated mental health responses in the community during the first year of the COVID-19 pandemic in Korea.
METHODS
We used 2016-2019 and 2020 data from the Korea National Health and Nutrition Examination Survey (KNHANES) to assess pre-pandemic and pandemic mental health status, respectively, in terms of perceived severe stress, depression, and suicidal plans. All analyses were gender-stratified. Pre-specified subgroup analyses were performed according to age, employment status, and household income.
RESULTS
The percentage of Korean adults with suicidal plans increased significantly from 1.3%p (95% confidence interval [CI], 1.1 to 1.5) in 2016-2019 to 1.8%p (95% CI, 1.4 to 2.1) in 2020. Individuals in their 20s and 40s showed a marked increase in suicidal plans (1.2%p; 95% CI, 0.0 to 2.3 and 0.9%p; 95% CI, 0.0 to 1.8, respectively). In men, depression and perceived severe stress increased significantly from pre-COVID-19 to 2020. There was a 2.4%p (95% CI, 0.8 to 4.0) increase in depression among standard workers and a 2.9%p increase in depression in individuals in the second-highest quintile of household income from 2016 and 2018 to 2020.
CONCLUSIONS
As COVID-19 continued, mental health issues such as suicidal plans, depression, and severe stress increased significantly in young men and people in the second-highest quintile of household income. Proactive community mental health efforts are needed to prevent increases in the suicide rate resulting from prolonged exposure to the COVID-19 pandemic.
Summary
Korean summary
코로나19 이전에 비해 코로나19 유행 첫 해 동안에 전체 인구에서 자살 계획 유병율이 유의하게 증가하였고 특히 20대-40대에서 증가 비율이 높았다. PHQ-9으로 측정한 우울증 유병율은 전체 남성에서 증가하였고 특히 30대 남성에서 증가 비율이 높았다. 코로나19 영향으로 자살 계획과 우울증과 같은 정신 건강 문제가 젊은 성인에서 크게 증가하였기 때문에 이러한 정신건강 문제가 자살률 증가로 이어지는 것을 방지하기 위해 국가적 차원의 체계적인 정책과 적극적인 지역사회 정신건강 중재가 필요하다.
Key Message
There was a significant increase in the prevalence of suicidal plan in the overall population during the first year of COVID-19 pandemic compared to pre-COVID-19. In particular, suicide plans increased among those in their 20s and 40s. The prevalence of PHQ-9 detected depression increased in all men, especially among men in their 30s. As mental health problems such as suicide planning and depression have significantly increased among young adults due to the impact of COVID-19, systematic policies at the national level and active community mental health interventions are needed to prevent these mental health problems from leading to an increase in suicide rates.

Citations

Citations to this article as recorded by  
  • Associations between discrimination experiences and symptoms of depression and anxiety among transgender adults: a nationwide cohort study of 269 transgender adults in South Korea
    Sungsub Choo, Ranyeong Kim, Hyemin Lee, Yun-Jung Eom, Horim Yi, Rockli Kim, Seung-Sup Kim
    Social Psychiatry and Psychiatric Epidemiology.2024; 59(5): 859.     CrossRef
  • Mental Health Status of New Police Trainees before and during the COVID-19 Pandemic
    Joungsue Kim, Jiyoung Yoon, Inah Kim, Jeehee Min
    Healthcare.2024; 12(6): 645.     CrossRef
  • The Association of Acute Signs and Symptoms of COVID-19 and Exacerbation of Depression and Anxiety in Patients With Clinically Mild COVID-19: Retrospective Observational Study
    Sumi Sung, Su Hwan Kim, Changwoo Lee, Youlim Kim, Ye Seul Bae, Eui Kyu Chie
    JMIR Public Health and Surveillance.2023; 9: e43003.     CrossRef
  • The Risk of Major Depressive Disorder Due to Cataracts among the Korean Elderly Population: Results from the Korea National Health and Nutrition Examination Survey (KNHANES) in 2016 and 2018
    Min-Jin Kang, Kyung-Yi Do, Nayeon Park, Min-Woo Kang, Kyoung Sook Jeong
    International Journal of Environmental Research and Public Health.2023; 20(2): 1547.     CrossRef
  • Prevalence of Mental Disorders and Associated Factors in Korean Adults: National Mental Health Survey of Korea 2021
    Soo Jung Rim, Bong-Jin Hahm, Su Jeong Seong, Jee Eun Park, Sung Man Chang, Byung-Soo Kim, Hyonggin An, Hong Jin Jeon, Jin Pyo Hong, Subin Park
    Psychiatry Investigation.2023; 20(3): 262.     CrossRef
  • The association mental health of adolescents with economic impact during the COVID-19 pandemic: a 2020 Korean nationally representative survey
    Hanul Park, Kang-Sook Lee
    BMC Public Health.2023;[Epub]     CrossRef
  • Obstructive sleep apnea related to mental health, health-related quality of life and multimorbidity: A nationwide survey of a representative sample in Republic of Korea
    Mee-Ri Lee, Sung Min Jung, Frances Chung
    PLOS ONE.2023; 18(6): e0287182.     CrossRef
  • Comparison of Mental Health between the Older People Living Alone and Older People Not Living Alone before and during the COVID-19 Pandemic: Using the 2019-2020 Korea Community Health Survey
    Kyong Sil Park, Yeojoo Chae
    Journal of Health Informatics and Statistics.2023; 48(2): 132.     CrossRef
  • The risk of obstructive sleep apnea is highly correlated with depressive symptoms among the Korean adults population: results from the 2020 Korea National Health and Nutrition Examination Survey
    Mi-Sun Lee, Hooyeon Lee
    BMC Psychiatry.2023;[Epub]     CrossRef
  • Gender Inequalities in Mental Health During the COVID-19 Pandemic: A Population-based Study in Korea
    Minku Kang, Sarah Yu, Seung-Ah Choe, Daseul Moon, Myung Ki, Byung Chul Chun
    Journal of Preventive Medicine and Public Health.2023; 56(5): 413.     CrossRef
  • Mental health status of individuals with diabetes in Korea before and during the COVID-19 pandemic: a comparison of data from the Korean national health and nutrition examination surveys of 2018–2019 and 2020–2021
    Hyejin Jung
    BMJ Open.2023; 13(10): e074080.     CrossRef
  • Assessment of burnout level among clinical dental students during the COVID-19 pandemic
    Cumhur Korkmaz, Sibel Dikicier, Arzu Atay
    BMC Medical Education.2023;[Epub]     CrossRef
  • The mechanisms of nature-based therapy on depression, anxiety, stress, and life satisfaction: examining mindfulness in a two-wave mediation model
    Minjung Kang, Yeji Yang, Hyunjin Kim, Songhie Jung, Hye-Young Jin, Kee-Hong Choi
    Frontiers in Psychology.2023;[Epub]     CrossRef
  • Changes in the management of hypertension, diabetes mellitus, and hypercholesterolemia in Korean adults before and during the COVID-19 pandemic: data from the 2010-2020 Korea National Health and Nutrition Examination Survey
    Yoonjung Kim, Suyeon Park, Kyungwon Oh, Hongseok Choi, Eun Kyeong Jeong
    Epidemiology and Health.2023; 45: e2023014.     CrossRef
  • Sadness, counseling for sadness, and sleep time and COVID-19 pandemic in South Korea: Rapid review and a post-hoc analysis
    Jungwoo Choi, Minji Kim, Min Seo Kim, Guillaume Fond, Laurent Boyer, Guillermo F López Sánchez, Elena Dragioti, Samuele Cortese, Ai Koyanagi
    Life Cycle.2023;[Epub]     CrossRef
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    Ji-Young Kwon, Sang-Wook Song
    Epidemiology and Health.2022; 44: e2022101.     CrossRef
COVID-19: Original Article
Depression, anxiety, and stress in Korean general population during the COVID-19 pandemic
Hooyeon Lee, Dongwoo Choi, Jung Jae Lee
Epidemiol Health. 2022;44:e2022018.   Published online January 18, 2022
DOI: https://doi.org/10.4178/epih.e2022018
  • 16,498 View
  • 642 Download
  • 17 Web of Science
  • 17 Crossref
AbstractAbstract AbstractSummary PDF
Abstract
OBJECTIVES
The aim of this study was to investigate the prevalence and risk factors of poor mental health in the general Korean population during the coronavirus disease 2019 (COVID-19) pandemic.
METHODS
This cross-sectional, population-based, online survey-based study was conducted from November 5 to 20, 2020 and included adults aged 20-49 years in Chungnam Province, Korea. A total of 549 adults were included.
RESULTS
In total, 18.8% of the participants had symptoms of depression, 10.6% had symptoms of anxiety, and 5.1% had a high level of perceived stress during the COVID-19 pandemic. Higher levels of stress (odds ratio [OR], 3.13; 95% confidence interval [CI], 1.13 to 8.67), anxiety (OR, 2.33; 95% CI, 1.09 to 4.49), and depression (OR, 3.00; 95% CI, 1.64 to 5.50) were found among never married, widowed, divorced, and separated people than among married/cohabiting/partnered participants. Participants who felt increased stress at home during the COVID-19 outbreak reported more depression (OR, 2.45; 95% CI, 1.49 to 4.05) and anxiety (OR, 2.42; 95% CI, 1.31 to 4.50). Women had higher risks of anxiety (OR, 1.97; 95% CI, 1.09 to 3.58) and stress (OR, 6.40; 95% CI, 2.30 to 17.85) than men. Participants with the highest household income were less likely to report symptoms of stress than those with the lowest household income (OR, 0.24; 95% CI, 0.06 to 0.96).
CONCLUSIONS
The participants in this study exhibited poor mental health index scores, suggesting that some people are at risk for mental health problems during the COVID-19 pandemic. Being married was independently and significantly associated with a lower likelihood of depression, anxiety, and stress.
Summary
Korean summary
이 연구는 코로나-19 유행 기간 동안 정신건강 현황과 위험 요인을 알아보기 위한 단면연구이다. 코로나 19 유행 이후 가정내 스트레스가 증가했다고 응답한 경우 우울증과 불안감의 유병률이 높았다. 반면, 남성인 경우, 결혼했거나 동거인과 같이 살고 있는 경우에는 우울증, 불안 또는 스트레스의 유병률이 통계적으로 유의하게 낮았다. 마스크 착용하기, 비대면 활동 증가, 또는 사회적 거리두기 등 코로나 19의 유행을 통제하기 위한 많은 정책은 개인의 일상생활과 정신건강에 많은 영향을 미쳤다. 이 연구는 취약 집단을 발굴하고, 정신건강 회복을 위한 전략을 개발하는데 기초자료를 제공할 수 있다.
Key Message
This study revealed high prevalence rates of depression, anxiety, and stress in the general population of Korea aged 20-49 years during the COVID-19 pandemic. Participants who felt increased stress at home reported more depression and anxiety. Men and being married were significantly associated with a lower likelihood of depression, anxiety, or stress. The COVID-19 pandemic has been a traumatic event. In addi­tion, the policies created to prevent its spread have disrupted daily living for the general population. Implement­ing strategies to promote resilience and support psychologically vulnerable individuals during the COVID-19 cri­sis is of fundamental importance.

Citations

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  • Pandemic stressors and mental health indicators in eight countries
    Salma M Abdalla, Shaffi Fazaludeen Koya, Samuel B. Rosenberg, Isaac B. Stovall, Olivia Biermann, Zahra Zeinali, Gregory H. Cohen, Catherine K. Ettman, Sandro Galea
    Social Psychiatry and Psychiatric Epidemiology.2024; 59(4): 585.     CrossRef
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    Ho-Jun Cho, Kyeong-Sook Choi, Jin-Young Lee, Ji-Ae Yun, Je-Chun Yu
    Psychiatry Investigation.2024; 21(1): 74.     CrossRef
  • The Impact of the Successive Outbreaks of COVID-19, Vaccination, and Physical Activity on Mental Health in the Argentine Population: A Repeated Cross-Sectional Study
    Alejo Ramiro Barbuzza, Fabricio Ballarini, Celina Goyeneche, Victoria Reppucci, Pedro Benedetti, Franco Moscato, Jorge H Medina, Cynthia Katche, Diego Moncada, Haydeé Viola
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    Youngsook Kwon, Jina Park, Eunkyoung An, Sukyoung Jung, Kukju Kweon
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  • Factors Associated With Negative Life Changes due to COVID-19 Among Older Adults Residing in an Urban Low-Income Neighborhood in Korea: Focused on Gendered Differences
    Jae Yoon Yi, Hongsoo Kim
    Journal of Applied Gerontology.2024;[Epub]     CrossRef
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Original Articles
Associations of regional-level perceived stress and depression with health-related quality of life in Korean adults: a multilevel analysis of 2017 Korea Community Health Survey data
Eunsu Kim, Min-Ho Shin, Jung-Ho Yang, Soon-Ki Ahn, Baeg-Ju Na, Hae-Sung Nam
Epidemiol Health. 2021;43:e2021062.   Published online September 8, 2021
DOI: https://doi.org/10.4178/epih.e2021062
  • 9,094 View
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  • 1 Web of Science
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AbstractAbstract AbstractSummary PDF
Abstract
OBJECTIVES
We examined the associations of individual and regional-level perceived stress and depression with health-related quality of life (HRQOL) in Korean adults.
METHODS
We used data from the 2017 Korea Community Health Survey, which included 216,713 adults living within 254 municipal districts. As individual-level independent variables, perceived stress (higher vs. lower) and depression (Patient Health Questionnaire-9 ≥10) were defined. Regional-level age-adjusted rates of perceived stress (%) and depression (%) were created for 254 municipal districts and categorized into quartiles to generate regional levels of stress and depression. HRQOL was defined as the individual-level EuroQol 5-dimensional index×100. A multilevel analysis was performed to identify the relationship between individual or regional-level independent variables and individual HRQOL.
RESULTS
In the null model, the proportions of individual variation in the HRQOL explained by region were 1.7% and 2.7% for men and women, respectively. When adjusted with all individual-level variables, regional stress and depression, as well as individual-level perceived stress and depression, were significantly related to HRQOL for both genders. In the full model including all variables, the decrease in HRQOL from the first to the fourth quartile group of regional stress was greater in women (-1.09; 95% confidence interval [CI], -1.87 to -0.31) than in men (-0.65; 95% CI, -1.04 to -0.26).
CONCLUSIONS
Our results suggest that regional-level perceived stress and depression, as well as individual-level perceived stress and depression, are inversely associated with individual HRQOL.
Summary
Korean summary
시군구 단위 스트레스 인지율과 우울 유병률이 개인 단위 건강관련 삶의 질 수준과 연관성을 갖는지 파악하고자 지역사회건강조사 자료를 이용하여 다수준 분석을 수행하였다. 개인 수준에서 인지된 스트레스와 우울은 건강관련 삶의 질 감소와 관련이 있었다. 스트레스와 우울 수준이 높은 시군구일수록 개인의 건강관련 삶의 질은 낮아지는 관계를 보였는데, 이는 남성보다는 여성에서 더 저명하였다.
Key Message
This study examined the associations of regional-level perceived stress and depression with individual HRQOL measured in terms of the EQ-5D using a multilevel model. Individual-level perceived stress and depression were significantly related to individual HRQOL. Regional stress and depression were also significant factors and both had greater negative impacts on HRQOL among women than among men.

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  • Association between seafood intake and depression in Korean adults: analysis of data from the 2014–2020 Korea National Health and Nutrition Examination Survey
    Hyemin Shin, Won Jang, Yangha Kim
    Journal of Nutrition and Health.2023; 56(6): 702.     CrossRef
  • Depression before and during-COVID-19 by Gender in the Korean Population
    Won-Tae Cha, Hye-Jin Joo, Yu-Shin Park, Eun-Cheol Park, Soo-Young Kim
    International Journal of Environmental Research and Public Health.2022; 19(6): 3477.     CrossRef
  • Association Between Regional Levels of Particulate Matter and Recurrent Falls in Korea
    Jung-Ho Yang, Ji-An Jeong, Sun-Seog Kweon, Min-Ho Shin
    Journal of Korean Medical Science.2022;[Epub]     CrossRef
Stressful life events and serum triglyceride levels: the Cardiovascular and Metabolic Diseases Etiology Research Center cohort in Korea
Naharin Sultana Anni, Sun Jae Jung, Jee-Seon Shim, Yong Woo Jeon, Ga Bin Lee, Hyeon Chang Kim
Epidemiol Health. 2021;43:e2021042.   Published online June 9, 2021
DOI: https://doi.org/10.4178/epih.e2021042
  • 11,281 View
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  • 6 Web of Science
  • 6 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
Elevated serum triglyceride levels are a risk factor for developing cardiovascular disease. A number of studies have demonstrated a positive association between psychological stress and serum triglyceride levels. However, there is limited evidence regarding the impact of stressful life events (SLEs) on serum triglyceride levels in the healthy population. Therefore, we evaluated the independent association between SLEs and serum triglyceride levels in a middle-aged Korean population.
METHODS
We analyzed a sample of 2,963 people (aged 30-64 years; 36% men) using baseline data from the Cardiovascular and Metabolic Diseases Etiology Research Center (CMERC) cohort study. The Korean version of the Life Experience Survey questionnaire was used to measure the presence and positive/negative impact of SLEs. Hypertriglyceridemia was defined as a fasting serum triglyceride level of ≥ 150 mg/dL.
RESULTS
Of the 2,963 participants, 33.1% reported at least 1 SLE over the past 6 months and 24.8% had hypertriglyceridemia. Even after adjusting for potential confounders, the serum triglyceride level was significantly associated with the total number of SLEs in men (3.333 mg/dL per event; p= 0.001), but not in women (0.451 mg/dL per event, p= 0.338). Hypertriglyceridemia was also associated with having 4 or more SLEs with positive effects (odds ratio [OR], 2.57; 95% CI, 1.02 to 6.46) and 4 or more SLEs with negative effects (OR, 1.99; 95% CI, 1.16 to 3.41) in men.
CONCLUSIONS
Our findings suggest that SLEs may increase the risk of hypertriglyceridemia in middle-aged men.
Summary
Korean summary
30-64세 중년 남성에서 스트레스성 생활 사건(stressful life events)를 많이 경험한 경우 혈청 중성지방 농도가 높은 경향이 관찰되었다. 스트레스성 질환의 적절한 관리가 이상지질혈증같은 만성대사질환 예방에 도움이 될 수 있음을 시사하는 결과이다.
Key Message
Stressful life events can be linked to hypertriglyceridemia among middle-aged men. This suggests that proper management of stressful events can help prevention of metabolic disorders such as abnormal blood lipids.

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Ambient air quality and subjective stress level using Community Health Survey data in Korea
Myung-Jae Hwang, Hae-Kwan Cheong, Jong-Hun Kim, Youn Seo Koo, Hui-Young Yun
Epidemiol Health. 2018;40:e2018028.   Published online June 28, 2018
DOI: https://doi.org/10.4178/epih.e2018028
  • 13,212 View
  • 209 Download
  • 8 Web of Science
  • 9 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
Air pollution causes various disease in exposed populations, and can lead to premorbid health effects manifested as both physical and psychological functional impairment. The present study investigated the subjective stress level in daily life in relation to the level of air pollution.
METHODS
Data from the Community Health Survey (2013), comprising 99,162 men, and 121,273 women residing in 253 healthcare administrative districts, were combined with air pollutant concentration modelling data from the Korean Air Quality Forecasting System, and were stratified by subjective stress levels into five strata for multiple logistic regression. Levels of exposure were divided into five quintiles according to the annual concentration of nitrogen dioxide (NO2), and were analyzed using a single-pollutant model using NO2 concentration only, and a multi-pollutant model adjusted for the concentration of particulate matter <10 μm in diameter.
RESULTS
Analysis of men and women in various age groups showed the highest odds ratio (OR) for subjective stress level at the highest NO2 concentration quintile in men and women aged 30–64 years (men: 2.91; 95% confidence interval [CI], 2.12 to 4.01; women: 1.82; 95% CI, 1.32 to 2.51). As the NO2 concentration quintile increased, the OR increased. Men showed higher ORs than women in all strata.
CONCLUSIONS
In the present study, annual NO2 concentrations were found to be associated with subjective stress levels. This association was especially clear among socioeconomically active men and women aged 30-64 years.
Summary
Korean summary
2013년 지역사회건강조사를 이용하여 253개 보건행정지역단위로 Korean Air Quality Forecasting System (KAQFS) 대기물질농도 모델링자료를 결합하여 주관적 스트레스 정도에 따라 5분위로 범주화하여 다항로지스틱회귀을 하였다. 본 연구에서는 연평균 NO2농도와 주관적 스트레스 정도가 관련이 있는 것으로 나타났다. 특히, 사회 경제적 활동이 활발한30세 이상 65세 미만의 남성과 여성에서 관련성이 뚜렷하게 나타났다.

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Secondhand smoke exposure and mental health problems in Korean adults
Na Hyun Kim, Hansol Choi, Na Rae Kim, Jee-Seon Shim, Hyeon Chang Kim
Epidemiol Health. 2016;38:e2016009.   Published online March 14, 2016
DOI: https://doi.org/10.4178/epih.e2016009
  • 18,424 View
  • 239 Download
  • 17 Web of Science
  • 18 Crossref
AbstractAbstract PDF
Abstract
OBJECTIVES
To evaluate the association between secondhand smoke exposure (SHSE) and mental health problems among Korean adults.
METHODS
We analyzed data from the 2011 Korean Community Health Survey. From the total of 229,226 participants aged 19 years or above, we excluded 48,679 current smokers, 36,612 former smokers, 3,036 participants with a history of stroke, 2,264 participants with a history of myocardial infarction, 14,115 participants who experienced at least one day in bed per month due to disability, and 855 participants for whom information regarding SHSE or mental health problems was not available. The final analysis was performed with 22,818 men and 100,847 women. Participants were classified into four groups according to the duration of SHSE: none, <1 hr/d, 1-<3 hr/d, and ≥3 hr/d. The presence of depressive symptoms, diagnosed depression, and high stress were measured by questionnaire.
RESULTS
After adjusting for demographic factors, lifestyle, and chronic disease, the odds ratio (OR) and 95% confidence interval (CI) of depressive symptoms with 1-<3 hr/d and ≥3 hr/d SHSE were 1.44 (95% CI, 1.14 to 1.82) and 1.59 (95% CI, 1.46 to 1.74), respectively. However, SHSE ≥3 hr/d had a higher OR of 1.37 (95% CI, 1.20 to 1.58) for diagnosed depression. SHSE was also associated with high stress (1-<3 hr/d: OR, 1.56; 95% CI, 1.38 to 1.76; ≥3 hr/d: OR, 1.33 95% CI, 1.28 to 1.40). However, the association between SHSE and symptoms of depression and stress did not differ significantly by region.
CONCLUSIONS
SHSE may be associated with mental health problems such as depression and stress in Korean adults.
Summary

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Predictors of job satisfaction and burnout among tuberculosis management nurses and physicians
Hae-Suk Seo, Hyunjoong Kim, Se-Min Hwang, Soo Hyun Hong, In-Young Lee
Epidemiol Health. 2016;38:e2016008.   Published online March 9, 2016
DOI: https://doi.org/10.4178/epih.e2016008
  • 21,725 View
  • 311 Download
  • 12 Web of Science
  • 10 Crossref
AbstractAbstract AbstractSummary PDF
Abstract
OBJECTIVES
This study examined job satisfaction, empowerment, job stress, and burnout among tuberculosis management nurses and physicians in public healthcare institutions.
METHODS
This was a cross-sectional study analyzing survey data collected from 249 nurses and 57 physicians in 105 public health centers, three public tuberculosis hospitals, and one tertiary hospital. The survey questionnaire comprised general characteristics, work-related characteristics, and four index scales (job satisfaction, empowerment, job stress, and burnout). The two-sample t-test was used to estimate the mean differences in the four index scales. Multiple regression analysis was used to determine whether general and work-related characteristics affected the four index scales.
RESULTS
The job satisfaction and empowerment scores of the nurses were lower than those of the physicians. Except for the tuberculosis-specialized hospitals alone, the average job satisfaction scores of nurses were higher than those of physicians. Moreover, the nurses reported more job stress and burnout than did the physicians in tuberculosis departments in public healthcare institutions in Korea; in particular, the burnout reported by nurses was significantly higher than that reported by physicians at the National Medical Center. Marital status, nursing position, number of coworkers, the average number of days of overtime work per month, self-rated health, and hospital type were associated with the four index scales.
CONCLUSIONS
Overall, nurses were more vulnerable to job stress and burnout than physicians. Reducing the workload of nurses by ensuring the presence of sufficient nursing staff and equipment, as well as by equipping facilities to prevent tuberculosis infections, should be considered priorities.
Summary
Korean summary
"본 연구에서는 직무만족도, 임파워먼트, 직무스트레스와 업무소진을 결핵관리 의사와 간호사에서 살펴 보았다. 전반적으로 결핵관리 간호사들의 업무관련 심리적 지표가 의사들에 비해 안좋았으나 결핵전문병원 간호사들의 직무만족도가 예외적으로 의사보다 좋았다. 이러한 간호사들의 업무관련 심리적 지표는 결혼상태, 간호사들의 서열, 동료간호사들의 수, 월별 평균초과근무일수, 주관적 건강상태와 근무하는 병원형태에 따라 영향을 받았고, 향후 이에 대한 심층연구가 필요할 것으로 생각된다.”

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Community mental health status six months after the Sewol ferry disaster in Ansan, Korea
Hee Jung Yang, Hae Kwan Cheong, Bo Youl Choi, Min-Ho Shin, Hyeon Woo Yim, Dong-Hyun Kim, Gawon Kim, Soon Young Lee
Epidemiol Health. 2015;37:e2015046.   Published online October 23, 2015
DOI: https://doi.org/10.4178/epih/e2015046
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AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
The disaster of the Sewol ferry that sank at sea off Korea’s southern coast of the Yellow Sea on April 16, 2014 was a tragedy that brought grief and despair to the whole country. The aim of this study was to evaluate the mental health effects of this disaster on the community of Ansan, where most victims and survivors resided.
METHODS
The self-administered questionnaire survey was conducted 4 to 6 months after the accident using the Korean Community Health Survey system, an annual nationwide cross-sectional survey. Subjects were 7,076 adults (≥19 years) living in two victimized communities in Ansan, four control communities from Gyeonggi-do, Jindo and Haenam near the accident site. Depression, stress, somatic symptoms, anxiety, and suicidal ideation were measured using the Center for Epidemiologic Studies-Depression Scale, Brief Encounter Psychosocial Instrument, Patient Health Questionnaire-15, and Generalized Anxiety Disorder 7-Item Scale, respectively.
RESULTS
The depression rate among the respondents from Ansan was 11.8%, and 18.4% reported suicidal ideation. Prevalence of other psychiatric disturbances was also higher compared with the other areas. A multiple logistic regression analysis revealed significantly higher odds ratios (ORs) in depression (1.66; 95% confidence interval [CI], 1.36 to 2.04), stress (1.37; 95% CI, 1.10 to 1.71), somatic symptoms (1.31; 95% CI, 1.08 to 1.58), anxiety (1.82; 95% CI, 1.39 to 2.39), and suicidal ideation (1.33; 95% CI, 1.13 to 1.56) compared with Gyeonggi-do. In contrast, the accident areas of Jindo and Haenam showed the lowest prevalence and ORs.
CONCLUSIONS
Residents in the victimized area of Ansan had a significantly higher prevalence of psychiatric disturbances than in the control communities.
Summary
Korean summary
본 연구는 2014년 4월 16일 발생한 세월호 침몰 사고가 지역사회의 정신건강 수준에 미친 영향을 평가하기 위해 실시하였다. 2014년 지역사회건강조사를 활용, 사고 후 6개월 시점에 조사를 시행하였다. 대부분의 희생자가 발생한 안산시 대상자의 11.8%가 우울군으로 분류되었으며, 18.4%가 자살생각을 호소하였고, 그 밖의 유병률도 대조 지역에 비해 높았다.

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Relationship between serum gamma-glutamyltransferase and metabolic syndrome among Korean non-diabetic adults.
Wee Hyun Park, Shung Chull Chae, Byung Yeol Chun, Kyung Eun Lee, Bo Wan Kim, Jung Guk Kim, Ji Seun Lim, Sun Kyun Park
Korean J Epidemiol. 2008;30(2):206-215.   Published online December 31, 2008
DOI: https://doi.org/10.4178/kje.2008.30.2.206
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AbstractAbstract PDF
Abstract
PURPOSE
This study was conducted to investigate the association of gamma-glutamyltransferase (GGT) with metabolic syndrome among non-diabetic adults.
METHODS
This study was conducted in a rural area, South Korea from August, 2003 to November, 2003. The study subjects were 1,023 sampled persons aged from 40 years and older (male 377, female 646). We analyzed the association between GGT with metabolic syndrome by multiple logistic regression analysis using SAS 9.1 version.
RESULTS
The prevalence of metabolic syndrome in this study was 28.8%. The prevalence of metabolic syndrome was increased by quartiles of serum GGT level (P for trend <0.05). The prevalence of metabolic alterations fitting the criteria of the metabolic syndrome by quartiles of serum GGT level were almost significantly increased except for the criterion of low high density lipoprotein (HDL) cholesterol with adjustment for age and alcohol intake. Among 5 components of metabolic syndrome, the criterion of high serum triglyceride was most powerfully associated with serum GGT level in both gender.
CONCLUSIONS
This study shows that serum GGT level was significantly associated with metabolic syndrome even after excluding diabetic adults.
Summary

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  • Relations between Normal Serum Gamma-glutamyltransferase and Risk Factors of Coronary Heart Diseases according to Age and Gender
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A Trial for Association between Oxidative Stress in Midterm Pregnancy and Postnatal Growth during the First Year of Life.
Hyesook Park, Young Ju Kim, Hwa Young Lee, Eun Ae Park, Nam Soo Chang, Eun Hee Ha, Bo Hyun Park, Bo Eun Lee, Ju Hee Hong
Korean J Epidemiol. 2004;26(1):17-26.
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AbstractAbstract PDF
Abstract
OBJECTIVES
We aims to construct Infant Growth Cohort for evaluating whether oxidative stress in midterm pregnancy has an adverse effect on postnatal growth.
METHODS
AND MATERIALS: From September 2001 to April 2004, we constructed an Ewha Infant Growth Cohort connected with the Ewha Pregnant Women Cohort. We excluded mother-and-child pairs in which the mother had experienced hypertension or diabetes during pregnancy and had multiple births for this study, which gave us 233 mother-and-child pairs for analysis. We measured maternal serum homocysteine and urinary 8-hydroxyguanosine (8-OHdG) and malondialdehyde (MDA) at 24~28 weeks of pregnancy, and infant weights at birth and at 6 and 12 months postnatally. We applied repeated measures ANOVA with PROC MIXED to assess the significance of differences.
RESULTS
We followed 64 and 85 infants at 6 and 12 months respectively. The mean body weights were 3146.4 g at birth, 8229.7 g at 6 months, and 1006.47 g at 12 months. The mean birth weight of infants was lower in mothers with higher homocysteine levels (third and fourth quartiles), but body weights from the first- and fourth-quartile groups of maternal homocysteine levels were lower than the others even though it was not statistically significant. Body weights at birth and at 6 months in third- and fourth-quartile groups of 8-OHdG levels were lower than the others. The body weights in the fourth quartile MDA group were significantly lower than the others at all time points.
CONCLUSIONS
Maternal oxidative stress in midterm pregnancy may cause postnatal growth retardation. But, there were high rate of follow up loss and various measurement errors. Therefore, we need to have efforts for compete follow up and valid and reliable measurements.
Summary
Review
The Effects of Psychosocial Factors in the Stress Process.
Sei Jin Chang
Korean J Epidemiol. 2002;24(2):148-163.
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AbstractAbstract PDF
Abstract
For the past three decades, considerable attentions have been paid to the search for stressors, stress outcomes and stress modifiers that may reduce the impact of exposure to environmental stressors. Especially medical sociologists and psychologists in medical parts, had an intellectual contribution to the development of stress research. They have presented an excellent opportunity to examine how deeply well-being is affected by the socially structured arrangements of people's lives and by the continuous experiences that result from these arrangements. The predominant concern has been with the role of coping resources, especially social support, coping and so on. The majority of studies report modest but significant positive association between life event levels and physical and mental symtomatology. In particular, the importance of considering psychosocial factors that may modify the effects of stressors on the risk factors for diseases or onset of illness has been emphasized increasingly. Clearly, stress is a complex process in which social, psychological and physiological environments simultaneously affect well-being. This study was performed to document the effect of psychosocial factors such social support, coping, personality traits which had been well known as stress modifiers in the stress process.
Summary

Epidemiol Health : Epidemiology and Health