Cohort Profile: Firefighter Research on the Enhancement of Safety and Health (FRESH), a Prospective Cohort Study on Korean Firefighters

Kim, Yun Tae; Kim, Woo Jin; Choi, Jee Eun; Bae, Mun Joo; Jang, Heeseon; Lee, Hye Jeong; Im, Dong Jin; Ye, Byoung Seok; Kim, Mi Ji; Jeong, Yun-Mi; Oh, Sung Soo; Jung, Young Chul; Kang, Eun Seok; Park, Sungha; Lee, Seung Koo; Park, Sun-Hee; Koh, Sang Baek; Kim, Chang-Soo

doi:10.3349/ymj.2020.61.1.103

Cited by 20 publications

(10 citation statements)

References 32 publications

(35 reference statements)

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“…The prevalence rate of poor sleep quality ranges from 52.45% to 86.8% in Korean firefighters. 17 35 36 37 Our study showed that the poor sleep quality group was 59.3%. The result of this study was also similar to those of the poor sleep quality group compared to previous studies in Korea.…”

Section: Discussionmentioning

confidence: 64%

“…In the cohort of firefighters, the average BMI was 24.83 which was not significantly different from this panel composition. 37 In addition, a few studies showed that the sleep problem contributed to weight gain in middle-aged women and men, but it was significant only in women and not in men. 50 Also, in a study conducted in Korea, the association between sleep quality and obesity measured by PSQI was related in women, but not in men.…”

Section: Discussionmentioning

confidence: 99%

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Association between sleep quality and type of shift work in Korean firefighters

Sim

Jang

et al. 2022

Ann Occup Environ Med

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Background Shift work that interferes with normal sleep patterns, is known to be a cause of sleep disturbance and has been studied through various occupational groups. However, it is not known which shift type is better for sleep health. Methods This study included 568 firefighters. Sleep quality was evaluated using Pittsburgh Sleep Quality Index. Sleep quality was categorized into 2 groups; good quality (≤ 5 points) and poor quality (≥ 6 points). Demographic variables, depression, anxiety, type of shift, and job were collected by self-reported questionnaires. The χ 2 test, t-test, and multiple logistic regression analysis were used to evaluate the effect of shift type on the sleep quality of firefighters. Results Three hundred thirty-seven firefighters (59.3%) have poor sleep quality. Compared to day workers, the odds ratios (ORs) of poor sleep quality were 2.169 (95% confidence interval: 1.137–4.134) in 6-day cycle, 2.161 (1.150–4.062) in 9-day cycle, 1.805 (1.087–2.997) in 21-day cycle, and 1.485 (0.718–3.069) in 3-day cycle. The ORs of poor sleep quality were 1.697(1.021–2.823) in fire suppression and 2.325 (1.213–4.455) in emergency medical service compared to administration. Conclusions All shift work type except for the 3-day cycle was associated with poor sleep quality compared to day work.

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Section: Discussionmentioning

confidence: 64%

Section: Discussionmentioning

confidence: 99%

Association between sleep quality and type of shift work in Korean firefighters

Sim

Jang

et al. 2022

Ann Occup Environ Med

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“…Firefighters who had not received psychiatric treatment but complained of PTSD-related symptoms were recruited for voluntary participation. This study's participants were previously included in the Firefighter Research on the Enhancement of Safety and Health (FRESH) cohort 13 and had therefore been assessed for their physical and psychological health status. All participants completed the Korean version of the Posttraumatic Diagnostic Scale (PDS) for PTSD screening.…”

Section: Methodsmentioning

confidence: 99%

Insular activation and functional connectivity in firefighters with post-traumatic stress disorder

Lee

Lee²,

Lee

et al. 2022

BJPsych open

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Background Firefighters are frequently exposed to stressful situations and are at high risk of developing post-traumatic stress disorder (PTSD). Hyperresponsiveness to threatening and emotional stimuli and diminishment of executive control have been suggested as manifestations of PTSD. Aims To examine brain activation in firefighters with PTSD by conducting an executive control-related behavioural task with trauma-related interferences. Method Twelve firefighters with PTSD and 14 healthy firefighters underwent functional magnetic resonance imaging (fMRI) while performing a Stroop match-to-sample task using trauma-related photographic stimuli. Seed-based functional connectivity analysis was conducted using regions identified in fMRI contrast analysis. Results Compared with the controls, the participants with PTSD had longer reaction times when the trauma-related interferences were presented. They showed significantly stronger brain activation to interfering trauma-related stimuli in the left insula, and had weaker insular functional connectivity in the supplementary motor area and the anterior cingulate cortex than the controls. They also showed a significant correlation between left insula–supplementary motor area connectivity strength and the hyperarousal subscale of the Clinician-Administered PTSD Scale. Conclusions Our findings indicate that trauma-related stimuli elicit excessive brain activation in the left insula among firefighters with PTSD. Firefighters with PTSD also appear to have weak left insular functional connectivity with executive control-related brain regions. This aberrant insular activation and functional connectivity could be related to the development and maintenance of PTSD symptoms in firefighters.

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“…We recruited 1,022 participants from the Firefighter Research on Enhancement of Safety & Health (FRESH) cohort, 13 including firefighters and rescue workers, assessed at three university hospitals between 2016 and 2017: Severance Hospital recruited firefighters from Seoul, Gyeonggi, Chungcheongnam-do, Daejeon, and Jeollabuk-do regions; Wonju Severance Christian Hospital recruited firefighters from Gangwon and Chungcheongbuk-do regions; and Gyeongsang National University Hospital recruited firefighters from Gyeongsangbuk-do, Gyeongsangnam-do, and Jeollanam-do regions. To assess psychological characteristics, we conducted several self-reporting questionnaire.…”

Section: Methodsmentioning

confidence: 99%

Regional Gray Matter Volume Related to High Occupational Stress in Firefighters

et al. 2021

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Background Firefighters inevitably encounter emotionally and physically stressful situations at work. Even firefighters without diagnosed post-traumatic stress disorder receive clinical attention because the nature of the profession exposes them to repetitive trauma and high occupational stress. This study investigated gray matter abnormalities related to high occupational stress in firefighters using voxel-based morphometry (VBM) and surface-based morphometry (SBM). Methods We assessed 115 subjects (112 males and 3 females) using magnetic resonance imaging and evaluated occupational stress by the Korean Occupational Stress Scale-26 (KOSS-26). Subjects were classified into highly or lowly stressed groups based on the median value of the KOSS-26. Results In VBM analysis, we found that firefighters with high occupational stress had lower gray matter volume (GMV) in both sides of the insula, the left amygdala, the right medial prefrontal cortex (mPFC), and the anterior cingulate cortex than firefighters with low occupational stress. In SBM analysis based on regions of interest, the GMV of the bilateral insula and right mPFC were also lower in the highly stressed group. Within the highly stressed group, low GMV of the insula was significantly correlated with the length of service (left: r = −0.347, P = 0.009; right: r = −0.333, P = 0.012). Conclusion Our findings suggest that regional GMV abnormalities are related to occupational stress. Regional gray matter abnormalities and related emotional dysregulation may contribute to firefighter susceptibility to burnout.

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Cohort Profile: Firefighter Research on the Enhancement of Safety and Health (FRESH), a Prospective Cohort Study on Korean Firefighters

Cited by 20 publications

References 32 publications

Association between sleep quality and type of shift work in Korean firefighters

Association between sleep quality and type of shift work in Korean firefighters

Insular activation and functional connectivity in firefighters with post-traumatic stress disorder

Regional Gray Matter Volume Related to High Occupational Stress in Firefighters

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