Effect of job satisfaction on depression after adjusting for satisfaction with other life domains.

Background: Studies on the association between job satisfaction and depression have often been reported. However, no study has examined how job satisfaction impacts depression while considering satisfaction with other aspects of life. In this study, we evaluated the effect of job satisfaction on depression after adjusting for satisfaction with other domains of life. Methods: We used data from the 16th wave of the Korean Welfare Panel Study. A total of 3568 current employees without depression who completed a survey were included. Depression was measured using the abbreviated version of the CES-D scale. Various types of satisfaction, including job satisfaction, were measured using single-item questions and a 5-point Likert scale. The association between job satisfaction and depression after considering satisfaction with other life domains was analyzed using a multiple logistic regression model. Results: Crude models showed a significant association between job satisfaction and depression in males (odds ratio [OR]: 7.90; 95% confidence interval [CI]: 4.11-15.23) and females (OR: 7.12; 95% CI: 4.40-11.50). When adjusted for sociodemographic factors, health-related factors, and work-related factors, the association remained significant in males (OR: 6.20; 95% CI: 3.10-12.41) and females (OR: 6.28; 95% confidence interval (CI): 3.79-10.40). However, when satisfaction with other life domains was included, the association remained significant only in females (OR: 3.55; 95% CI: 1.93-6.50). Conclusions: This study shows an association between job satisfaction and depression in Korean employees. However, when satisfaction with other life domains was considered, this association remained significant only in women. Regular screening of job satisfaction should be considered as a means of preventing and managing depression among female employees.

Association between Work-related Communication Devices Use during Work Outside of Regular Working Hours and Depressive Symptoms in Wage Workers.

Background: This study aimed to investigate the relationship between work-related communication devices use during work outside of regular working hours and depressive symptoms in wage workers. Methods: Data from 50,538 workers aged 15 years or older who had participated in the 6th Korean Working Condition Survey (KWCS) were used. The final sample was 32,994 wage workers. The questionnaire asked the respondents how often they used communication devices for work during work outside of regular working hours. Depressive symptoms were assessed using WHO-5 Well-Being Index. Multiple logistic regression analysis was used to analyze the association between work-related communication devices use during work outside of regular working hours and depressive symptoms. Results: The rate of depressive symptoms was highest among workers who did not use work-related communication devices during work outside of regular working hours. After adjusting for socio-demographic and work-related factors, the odds ratio of depressive symptoms among workers who used communication devices when working outside of regular working hours was 1.20 (95% CI: 1.09-1.32); the odds ratio of depressive symptoms in the group not using communication devices for free-time work was 1.66 (95% CI: 1.37-2.00), which was higher than that of the reference group, that is, workers who did not work outside of regular working hours, and was statistically significant. Conclusion: Regardless of whether work-related communication devices are used, working outside of regular working hours increases depressive symptoms. The use of work-related communication devices during work outside of regular working hours can reduce the rate of depressive symptoms.

The relationship between working time mismatch and depression according to actual hours worked.

OBJECTIVES: The effect of the combination of working hours and working time mismatch on depression is unknown. This study was undertaken to confirm the relationship between working time mismatch and depression with respect to hours worked. MATERIAL AND METHODS: The data of 45 514 adult workers that participated in the 6th Korean Working Conditions Survey (KWCS-VI 2020) were reviewed. Depression was defined using the World Health Organization 5 Well-Being Index (WHO-5) cut-off score of 50. Working time mismatch was defined as a difference between actual and desired working hours. To identify associations between working hour mismatch and depression according to weekly hours worked, stratification analysis was conducted by dividing the study subjects into 3 groups based on actual hours worked weekly (<40 h, 40-<52 h, or ≥52 h). Multiple logistic regression analysis adjusted for potential confounders was performed to calculate odds ratios of depression. RESULTS: In the <40 h, 40-<52 h, and ≥52 h groups, the odds ratios (OR) of working more hours than desired were 1.51, 95% CI: 1.20-1.92 (<40 h), 1.70, 95% CI: 1.58-1.84 (40-<52 h), and 1.55, 95% CI: 1.41-1.69 (≥52 h), respectively, compared to a matched actual versus desired working hours group (the matched group). On the other hand, the odds ratios of working fewer hours than desired were 1.17, 95% CI: 1.07-1.27 (<40 h), 1.38, 95% CI: 1.20-1.60 (40-<52 h), and 1.98, 95% CI: 1.24-3.17 (≥52 h), respectively. The risk of depression was found to increase significantly with working time mismatch within all 3 working hour groups. CONCLUSIONS: Working time mismatch increases the risk of worker depression regardless of hours worked. Int J Occup Med Environ Health. 2023;36(6):788-97.

Occupational stress changes and new-onset depression among male Korean manufacturing workers.

Background: Studies on the association between occupational stress and depression have been frequently reported. However, the cross-sectional designs of studies limited insight into causal associations. In this study, we investigated the longitudinal association between occupational stress and new-onset depression among employees in a single manufacturing plant. Methods: The annual health checkup data of employees at a manufacturing plant in Korea were collected. A total of 1,837 male employees without depression who completed a health checkup during two consecutive years were included. Occupational stress was measured using a short form of the Korea Occupational Stress Scale (KOSS-SF), and depression was assessed using a Patient Health Questionnaire-2. The association between occupational stress change over the two years and newly developed depression was investigated using two logistic regression models. Results: Across all sub-factors of KOSS-SF, employees who reported increased occupational stress had a higher risk of new-onset depression. Newly developed depression was significantly associated with job demand (odds ratio [OR]: 4.34; 95% confidence interval [CI]: 2.37-7.96), job insecurity (OR: 3.21; 95% CI: 1.89-5.48), occupational climate (OR: 3.18; 95% CI: 1.91-5.31), lack of reward (OR: 2.28; 95% CI: 1.26-4.12), interpersonal conflict (OR: 2.14; 95% CI: 1.18-3.86), insufficient job control (OR: 1.93; 95% CI: 1.05-3.56), and the organizational system (OR: 1.84; 95% CI: 1.01-3.36). Conclusions: For every sub-factor of the KOSS-SF, occupational stress increase and persistent high stress were associated with the risk of developing new-onset depression. Among the seven sub-factors, job demand had the most significant effect. Our results show that occupational stress should be managed to promote employee mental healthcare.

The relationship between fatigue and sickness absence from work.

Background: 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. Methods: 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. Results: 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. Conclusions: 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.

Impacts of presenteeism on work-related injury absence and disease absence.

Background: Many studies have been conducted on presenteeism and absenteeism, but the relationship between presenteeism and absenteeism is unclear. This study was undertaken to investigate the effect of presenteeism on future absenteeism. Methods: This study was conducted on non-white collar workers that underwent general health examinations in 2014 and 2015. We asked subjects to fill out a questionnaire about their experiences of presenteeism for the past one year in 2014. In 2015, it was checked whether the same subjects had any experience of absence from work due to injury or disease during the past year. The χ2 test was used to analyze relationships between sociodemographic and occupational characteristics, presenteeism, and absence. Odds ratios (ORs) were calculated by logistic regression analysis controlled for confounding factors. Results: A total of 12,572 workers were included in the study. For workers who experienced presenteeism, the OR for injury absence was 2.705 (95% confidence interval [CI]: 2.044-3.581), and the OR for disease absence was 4.906 (95% CI: 3.996-6.024) after adjusting for sociodemographic and occupational confounding factors. For men that experienced presenteeism, the OR for injury absence was 3.035 (95% CI: 2.258-4.081), and the OR for disease absence was 5.508 (95% CI: 4.340-6.989). For women that experienced presenteeism, the OR for injury absence was 1.322 (95% CI: 0.577-3.028), which was not significant, and the OR for disease absence was 3.629 (95% CI: 2.405-5.475). Conclusions: This study suggests that presenteeism can influence future absenteeism. The effect of presenteeism may depend on cause of absence. Men who experienced presenteeism showed greater effects on injury and disease absence than women. For women, experience of presenteeism had a significant effect on disease absence but not on injury absence.

Development of Korean Version Burnout Syndrome Scale (KBOSS) Using WHO's Definition of Burnout Syndrome.

BACKGROUND: Burnout syndrome (BOS) is defined by the World Health Organization (WHO) as a syndrome conceptualized as resulting from chronic workplace stress that has not been successfully managed. This study aims to create the Korean version burnout syndrome scale (KBOSS) that conforms to WHO's definition of BOS and present the cut-off points for screening. METHODS: We developed the KBOSS based on WHO's definition of BOS. An online survey was conducted through a specialized online research company. We recruited 444 workers for this research. The validity of the KBOSS was assessed using factor analysis and Pearson's correlation. The KBOSS reliability was assessed using Cronbach's alpha coefficient. The cut-off points for each of the three dimensions were derived using the upper quartile score. RESULTS: The validity and reliability of the KBOSS were good. Regarding reliability, the scale's overall Cronbach's alpha was 0.813. Cronbach's alpha of each three-dimension was as follows: exhaustion, 0.916; cynicism, 0.865; and professional inefficacy, 0.819. The cut-off points of BOS three dimensions are exhaustion ≧ 21; cynicism ≧ 18; and inefficacy ≧ 15. CONCLUSION: The developed questionnaire (KBOSS) can be a useful tool for screening of BOS.

Association between nicotine dependency with occupational injury in Korean men.

BACKGROUND: 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. METHODS: 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. RESULTS: 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 (p for trend < 0.05). When only smokers were included, analysis of continuous FTND (Fagerstrom Test of Nicotine Dependence) scores showed that adjusted OR increased by 1.10 (95% CI: 1.03-1.19) per FTND point. After stratifying the data by working type and working hours per week, the non-shift work group maintained this relationship (OR: 1.13, 95% CI: 1.04-1.24) and OR was higher in the group that works more than 60 hours per week with FTND score as a continuous variable (OR: 1.24, 95% CI: 1.07-1.44). CONCLUSIONS: 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.

Relationship between fatigue severity scale and occupational injury in Korean workers.

BACKGROUND: The aim of this study is to investigate the relationship between fatigue and occupational injury. METHODS: 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). RESULTS: 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. CONCLUSIONS: 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.

Employment Status Change and New-Onset Depressive Symptoms in Permanent Waged Workers.

BACKGROUND: This study aimed to investigate the relationship between changes in employment status and new-onset depressive symptoms through a one-year follow-up of permanent waged workers. METHODS: We analyzed the open-source data from the Korea Welfare Panel Study. Using the 2017 data, we selected 2,314 permanent waged workers aged 19 to 59 years without depressive symptoms as a base group. The final analysis targeted 2,073 workers who were followed up in 2018. In 2018, there were five categories of employment status for workers who were followed up: permanent, precarious, unemployed, self-employed, and economically inactive. Multiple logistic regression was used to determine the association between employment status change and new-onset depressive symptoms. RESULTS: Adjusted multiple logistic regression analysis showed that among male workers, workers who went from permanent status to being unemployed (odds ratio: 4.50, 95% confidence interval: 1.19 to 17.06) and from permanent status to being precarious workers (odds ratio: 3.15, 95% confidence interval: 1.30 to 7.65) had significantly high levels of new-onset depressive symptoms compared with those who retained their permanent employment status. There were no significant increases in new-onset depressive symptoms of male workers who went from permanent status to being self-employed or economically inactive. On the other hand, no significant differences were found among female workers. CONCLUSION: Our study suggests that the change of employment status to precarious workers or unemployment can cause new-onset depressive symptoms in male permanent waged workers.

Obesity potentially protects against systemic bone loss in patients with rheumatoid arthritis treated with tumour necrosis factor inhibitors.

OBJECTIVES: We aimed to investigate how systemic bone metabolism was affected after 1 year of treatment with tumour necrosis factor (TNF) inhibitors in rheumatoid arthritis (RA) patients. METHODS: A total of 29 seropositive RA patients not treated for osteoporosis were enrolled and TNF inhibitors were administered for a year. Bone mineral density (BMD) at the lumbar spine, femur neck, and total hip was measured at baseline and 12 months after anti-TNF treatment. Blood samples were collected at baseline and 6 and 12 months after anti-TNF treatment and osteoclasts were cultured on bone slices. Weight was the strongest factor influencing systemic bone loss. Patients were categorised into two groups: obese (body mass index (BMI) ≥25 kg/m2) and non-obese (BMI <25 kg/m2). RESULTS: All patients showed decreased BMD at all sites. The obese group showed relatively little change in BMD, although the non-obese group showed significant decreases in BMD at all sites after 1 year of treatment with TNF inhibitors. Resorption pits created by osteoclasts decreased at 6 months and increased at 12 months in the non-obese group, while the obese group presented with steadily decreasing sizes of resorption pits at all-time points. Levels of receptor activator of nuclear factor kappa B ligand were significantly decreased at 12 months compared to baseline in the obese group, while they were increased in the non-obese group. CONCLUSIONS: One year of treatment with TNF inhibitors failed to halt systemic bone loss in RA patients, but obesity may have protective effects against bone loss.

Longitudinal associations between occupational stress and depressive symptoms.

BACKGROUND: 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. METHODS: 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. RESULTS: In panel data analysis with fixed effects, job insecurity (B = 0.048, p-value = 0.004) was associated with depressive symptoms among male workers. In female workers, inadequate social support (B = 0.080, p-value < 0.001), job insecurity (B = 0.039, p-value = 0.004), lack of reward (B = 0.059, p-value = 0.004) and discomfort in occupational climate (B = 0.074, p-value < 0.001) were associated with depressive symptoms among female workers. CONCLUSIONS: 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.

The relationship between precarious employment and subjective well-being in Korean wage workers through the Cantril ladder Scale.

BACKGROUND: The global labor market is moving towards increasing job instability. Relatively few studies have examined the relationship between precarious employment and subjective well-being using quantitative scales. We evaluated the association between wage workers' employment status and their subjective well-being through the Cantril ladder scale using Korean Welfare Panel Survey data (KOWEPS). METHODS: This study used KOWEPS data. A total of 4,423 wage workers were divided into permanently employed workers, temporarily employed workers and daily employed workers. The relationship between precarious employment and subjective well-being was analyzed by multiple linear regression adjusted for potential confounding factors. RESULTS: The more unstable the employment status, the lower the subjective well-being, which can be expressed by the Cantril ladder scale. The mean score of both temporarily employed and daily employed workers were statistically significantly lower (B = -0.454, p < 0.001; B = -0.994, p < 0.001, respectively) than permanently employed workers. This appeared to be the same when occupational and sociodemographic factors were adjusted (B = -0.153, p = 0.002 for temporarily employed, B = -0.610, p < 0.001 for daily employed). CONCLUSIONS: The more unstable the employment status, the lower the subjective well-being score according to the Cantril ladder scale.

Mismatch in working hours and workaholism in permanent waged workers.

OBJECTIVES: A cross-sectional study was conducted to investigate whether working hours mismatch is associated with workaholism. MATERIAL AND METHODS: This study used the data from the 17th wave (2014) of the nationwide Korean Labor and Income Panel Study. Workaholism was evaluated using the Workaholism Analysis Questionnaire. The final study involved 3157 subjects who answered questions regarding both workaholism and working hours mismatch. To identify the association between working hours mismatch and workaholism according to weekly working hours, a stratification analysis was conducted by dividing the number of working hours/week into 3 groups (≤40 h, 41-59 h, and ≥60 h). The odds ratios were calculated using a multiple logistic regression model, which was adjusted for potential confounders. RESULTS: The workers working more hours than desired showed the greatest frequency of workaholism. As regards workaholism, in all weekly working hours groups, the odds ratios of the group working more hours than desired were 4.28, 95% CI: 2.29-7.99 (≥40 h), 2.14, 95% CI: 1.34-3.43 (41-59 h), 3.40, 95% CI: 1.60-7.21 (≤60 h), which were statistically significant compared to the reference (matched) group. There was no statistically significant relationship between working hours and workaholism when stratified according to the mismatch in working hours. CONCLUSIONS: The workers' working hours mismatch can be significantly related to workaholism. Int J Occup Med Environ Health. 2020;33(2):187-94.

Relationship between occupational sunlight exposure and the incidence of renal cancer.

BACKGROUND: The risk factors for renal cancer include smoking, obesity, hypertension, and exposure to trichloroethylene. Recent studies have shown that low sunlight exposure increases the risk of developing a range of cancers, including renal cancer. Given that most of the daytime is spent at work, a lack of occupational sunlight exposure can be a risk factor for renal cancer. Therefore, this study examined the relationship between occupational sunlight exposure and the incidence of renal cancer. METHODS: This was a university hospital-based case-control study on renal cancer. Of the 706 newly diagnosed patients with renal cell carcinoma (RCC), 633 cases were selected; 73 who had no occupational history were excluded. In addition, 633 controls were selected from the general population after 1:1 matching with respect to sex, age (within 5 years), and residential area (constituency-level). Information on sunlight exposure by the occupational group was referred to data from France. To estimate the association between occupational sunlight exposure and the RCC risk, the odds ratios (ORs) were calculated using conditional logistic regression analysis. RESULTS: Sunlight exposure was divided into quartiles and the risk of RCC was analyzed. The adjusted OR of RCC (OR: 0.664, 95% confidence interval: 0.449-0.983) was significantly lower for the Q4 group than Q1 group but the Q2 and Q3 groups did not show significant results. The risk of RCC tended to decrease with increasing exposure to sunlight (p for trend < 0.028). CONCLUSIONS: Higher occupational sunlight exposure reduces the risk of RCC.

Differences in suicidal behaviors between self-employed and standardly employed workers.

BACKGROUND: Although self-employed persons have greater autonomy, schedule flexibility, and control over their work than employees, they may be among the most vulnerable workers due to the lack of social benefits and protection from labor law and regulations. We compared suicidal behaviors between the self-employed and standardly employed workers. METHODS: This study used the 2008 Korean Community Health Survey data and included a total of 64 802 working population. Self-employed persons were classified into "small business self-employed persons" with zero to four employees and "middle to large business" with more than five employees. The outcomes were suicidal ideation and suicide attempts. RESULTS: Of the 64 802 participants, 40 422 were engaged in standard employment, and 24 380 were self-employed, with almost 90% (n = 21 970) being engaged in small businesses. Persons self-employed, compared with standard workers, were more likely to report suicidal ideation in both small (odds ratio [OR] = 1.25; 95% confidence interval [CI], 1.15-1.35) and middle to large businesses (OR = 1.32; 95% CI, 1.09-1.61). On the other hand, the likelihood for suicide attempt was only significant in persons self-employed in small businesses (OR = 1.67; 95% CI, 1.11-2.45). CONCLUSION: Self-employed persons were associated with greater odds of reporting suicidal behaviors than workers with standard employment. Among the self-employed, small business owners were particularly vulnerable to suicide attempts.

Determinants of Compliance of Travelers with Vaccination and Malaria Prophylaxis at a Travel Clinic.

BACKGROUND: Pre-travel medical consultation is essential to reduce health impairment during travel. Yellow fever vaccination (YFV) is mandatory to enter some endemic countries. In this study, we evaluated the factors that affect compliance with appropriate prevention of infectious diseases in travelers who visited clinic for YFV. METHODS: For this retrospective study, chart reviews for 658 patients who visited a travel clinic for YFV before travel were conducted. The period of this study was from January 2016 to September 2018. The associations between appropriate vaccination and factors such as travel duration, destination, time of visiting clinic before departure, and purpose of travel were analyzed. RESULTS: Among 658 patients who got YFV during the study period, 344 patients (52.3%) received additional vaccination or malaria prophylaxis following a physician's recommendation. Travelers who visited the clinic more than 21 days before departure were more compliant than those who visited 14 days or fewer before departure (odds ratio [OR], 1.90; 95% confidence interval [CI], 1.23-2.93; P = 0.004). Travelers visiting Africa were more compliant than were those traveling to South and Central America (OR, 1.97; 95% CI, 1.34-2.90; P = 0.001). Travelers in age groups of 40-49 years and over 70 years were less compliant than the 18-29 years old population (OR, 0.51; 95% CI, 0.28-0.93; P = 0.027 and OR, 0.19; 95% CI, 0.04-0.84; P = 0.03, respectively). Also, those who traveled for tour or to visit friends or relatives were more compliant than those who departed for business (OR, 0.77; 95% CI, 1.03-3.56; P = 0.04). CONCLUSION: For appropriate vaccination, pre-travel consultation at least 3 weeks before departure is crucial. Travelers should be aware of required vaccination and malaria prophylaxis before visiting South and Central America and Asia. Plans to enhance compliance of the elderly and business travelers should be contrived.

Comparison of endoscopic papillary large balloon dilation with or without endoscopic sphincterotomy for the treatment of large bile duct stones.

BACKGROUND: Endoscopic papillary large balloon dilation (EPLBD) without prior endoscopic sphincterotomy (EST) produces excellent outcomes for the treatment of large common bile duct (CBD) stones. However, it remains unclear how the outcomes of EPLBD alone compare with those of EPLBD with EST. In this study, we assessed the safety and therapeutic outcomes of EPLBD with vs. without EST for the removal of large bile duct stones. METHODS: This prospective, multicenter study was conducted on 200 patients with bile duct stones of ≥ 10 mm in diameter. Patients were randomly assigned to an EPLBD alone group (n = 100) or an EPLBD with EST group (n = 100). These two groups were compared with respect to overall procedure-related adverse events, overall stone removal success rate, number of endoscopic sessions required for complete stone removal, need for mechanical lithotripsy, and total procedure time. RESULTS: The incidence of adverse events was not significantly different between the groups (EPLBD alone vs. EPLBD with EST: overall adverse events 6 % vs. 4 %, P = 0.75; pancreatitis 1 % vs. 3 %, P = 0.62). Overall success (P = 0.35), initial success (P = 0.28), and the need for mechanical lithotripsy (P = 0.39) were also similar between groups. Median total procedure time tended to be greater in the EPLBD alone group (20.5 minutes) than in the EPLBD with EST group (18 minutes; P = 0.08). CONCLUSION: The therapeutic outcomes and adverse events of EPLBD alone for the removal of large bile duct stones were comparable to those of EPLBD with EST.

Satisfaction with life and the risk of occupational injury.

BACKGROUND: Occupational injuries increase burden on society as well as personal health. Low satisfaction with life may not only increases the risk of occupational injuries directly, but also influences other factors that increase the risk of occupational injury. Along with previous studies on the risk of occupational injury, we sought to explore the relationship between satisfaction with life and occupational injury. METHODS: The study participants were 6234workers health screened at a university hospital in Incheon. Information on occupational injury and satisfaction with life scale (SWLS) was obtained in a self-report format. Participants were allocated to one of four SWLS groups; the dissatisfied group, the slightly dissatisfied group, the slightly satisfied group, and the satisfied group. The analysis was performed using the chi-square test primarily and by logistic regression adjusted for potential confounders. RESULTS: In men, the un-adjusted and adjusted odds ratios (ORs) of low satisfaction with life (SWLS< 20) were 1.98(CI1.55-2.53) and 1.81(CI 1.41-2.32), respectively. When the SWLS were divided into four groups, the adjusted ORs of the slightly satisfied (20-25), slightly dissatisfied(15-19), and dissatisfied(≤14) groups were 1.21, 1.72, and 2.70, respectively. That is ORs tended to increase linearly with decreasing SWLS score (p for trend < 0.001). In women, this relation was of borderline significance at best.When subjects were dichotomized based on SWLS scores, for males, the cured and adjusted RRs of occupational injury in the low satisfaction with life group were1.91 (95% CI: 1.50-2.42) and 1.66 (95% CI: 1.30-2.13), and for females, the adjusted-RR was marginally significant (1.67; 95% CI: 0.93-2.99).When subjects were divided into four groups by SWLS scores, adjusted RRs tended to increase linearly with decreasing SWLS score for males (slightly satisfied: 1.18, 95% CI: 0.77-1.82; slightly dissatisfied: 1.65, 95% CI: 1.08-2.52; dissatisfied: 2.22, 95% CI: 1.44-3.42; p for trend < 0.001) and for females (slightly satisfied: 1.17, 95% CI: 0.42-3.30; slightly dissatisfied: 1.56, 95% CI: 0.56-4.36; dissatisfied: 2.38, 95% CI: 0.84-6.74; p for trend = 0.040). CONCLUSIONS: This study suggests that the risk of occupational injury was higher in workers not satisfied with life, and indicates attention to satisfaction with life may promote the health of workers.

Frequency of Self-Monitoring of Blood Glucose during the School Day Is Associated with the Optimal Glycemic Control among Korean Adolescents with Type 1 Diabetes.

BACKGROUND: This study aimed to evaluate the relationship between the frequency of self-monitoring of blood glucose (SMBG) and glycosylated hemoglobin (HbA1c) levels among Korean adolescents with type 1 diabetes mellitus (T1DM). Factors affecting the SMBG frequency were analyzed in order to improve their glycemic control. METHODS: Sixty-one adolescents aged 13 to 18 years with T1DM were included from one tertiary center. Clinical and biochemical variables were recorded. Factors associated with SMBG frequency were assessed using structured self-reported questionnaires. RESULTS: Average total daily SMBG frequency was 3.8±2.1 and frequency during the school day was 1.3±1.2. The mean HbA1c level was 8.6%±1.4%. As the daily SMBG frequency increased, HbA1c levels declined (P=0.001). The adjusted odds of achieving the target HbA1c in participants who performed daily SMBG ≥5 significantly increased 9.87 folds (95% confidence interval [CI], 1.58 to 61.70) compared with those performed SMBG four times a day. In the subjects whose SMBG frequency <1/day during the school day, an 80% reduction in the adjusted odds ratio 0.2 (95% CI, 0.05 to 0.86) showed compared to the group with performing two SMBG measurements in the school setting. The number of SMBG testing performed at school was significantly high for individuals assisted by their friends (P=0.031) and for those who did SMBG in the classrooms (P=0.039). CONCLUSION: Higher SMBG frequency was significantly associated with lower HbA1c in Korean adolescents with T1DM. It would be necessary to establish the school environments that can facilitate adequate glycemic control, including frequent SMBG.