Comparison of the risks of occupational diseases, avoidable hospitalization, and all-cause deaths between firefighters and non-firefighters: A cohort study using national health insurance claims data.

Objectives: National Health Insurance claims data were used to compare the incidence of occupational diseases, avoidable hospitalization, and all-cause death standardized incidence ratio and hazard ratio between firefighters and non-firefighters. Methods: The observation period of the study was from 2006 to 2015 and a control group (general workers and national and regional government officers/public educational officers) and a firefighter group was established. The dependent variables were occupational diseases, avoidable hospitalization (AH), and all-cause death. The analysis was conducted in three stages. First, the standardized incidence ratios were calculated using the indirect standardization method to compare the prevalence of the disease between the groups (firefighter and non-firefighter groups). Second, propensity score matching was performed for each disease in the control group. Third, the Cox proportional hazards model was applied by matching the participants. Results: The standardized incidence ratio and Cox regression analyses revealed higher rates of noise-induced hearing loss, ischemic heart disease, asthma, chronic obstructive pulmonary disease, cancer, back pain, admission due to injury, mental illness, depression, and AH for firefighters than general workers. Similarly, the rates of noise-induced hearing loss, ischemic heart disease, asthma, chronic obstructive pulmonary disease, back pain, admission due to injury, mental illness, depression, and AH were higher in the firefighter group than in the national and regional government officer/public educational officer group. Conclusions: The standardized incidence ratios and hazard ratios for most diseases were high for firefighters. Therefore, besides the prevention and management of diseases from a preventive medical perspective, management programs, including social support and social prescriptions in the health aspect, are needed.

Dynamics of Constructs in Successful Aging of Korean Elderly: Modified Rowe and Kahn's Model.

OBJECTIVES: This study examined components in Rowe and Kahn's successful aging model to investigate their hierarchical order and led to a modification of the previous hierarchical order. METHODS: To examine the hierarchical order of components, we constructed a structural equation model and verified those paths that have discrepancies in studies and/or potential inclusion or omission errors in the model. For this purpose, we analyzed 556 cases out of stratified and purposively sampled 600 elderly people living in the city of Jeonju during the study period (2011). RESULTS: The paths with inclusion errors such as H3 [self-reported health → productive activity (SRH → PA)]: the effect of SRH on PA, and H6 [social network (SN) → PA]: the effect of SN on PA, were not directly but indirectly supported. The path with discrepancy, H4 [SN → physical-cognitive function (PCF)]: the effect of SN on PCFs, was statistically significant. The path with inclusion error and discrepancy, H8 (PCF → PA): the effect of PCF on PA, was not directly but indirectly supported. Also the path with the omission error, H2 [SRH → psychological trait (PT)]: the effect of SRH on PT, was statistically significant. The other paths in the hierarchical order of the model reported in previous studies were statistically significant. CONCLUSION: We verified new dynamics of constructs involved in successful aging, which would provide better understanding of Rowe and Kahn's successful aging model for Korean elderly people living in a medium-sized city.

[Mediating role of empowerment in the relations to job and organizational factors, and job satisfaction and organizational commitment--empirical evidence from national university hospital employees].

OBJECTIVES: The aim of this study was to examined the mediating role of empowerment in relations to job and organizational factors, and job satisfaction and organizational commitment in hospital organizations. METHODS: Job variety, clarity, significance, and fitness were examined as the job factors, and security, reward justice, and organizational support as the organizational factors. Data were collected from 8 national university hospitals with 1,289 data points used for the final analysis. RESULTS: All the job factors were found to positively influence empowerment, as were all the organizational factors, with the exception of reward justice. As hypothesiz -ed, empowerment had significant effects on both job satisfaction and organizational commitment, and was the most influential variable of all those examined. CONCLUSIONS: In the relations to job satisfaction, empowerment completely mediated job significance, security and organizational support, and partially mediated all other variables, with the exception of reward justice. In the relations to organizational commitment, empowerment completely mediated job variety and job fitness, and partially mediated all other variables, with the exception of reward justice. The theoretical and practical implications of these results have been discussed.