Risk of insomnia symptoms according to Work-Family Conflict by workers' characteristics.

Background: Work-Family Conflict means that the demands of work and family roles cannot be met simultaneously, so one cannot concentrate on one's work or family role. This conflict can negatively affect mental health and cause insomnia symptoms. Methods: This study was conducted on 20,442 subjects. Insomnia symptoms were assessed using the Minimal Insomnia Symptom Scale, and other variables were assessed using the questionnaire method. Logistic regression analyses were performed to evaluate the effect of Work-Family Conflict on insomnia symptoms, and subgroup logistic regression analyses were also performed. Results: The number of people with insomnia symptoms was 4,322 (15.1%). Compared with Low Work-Family Conflict, the odds ratios (ORs) for the risk of insomnia symptoms were 1.84 (95% confidence interval: 1.56-2.16) in High work-to-family conflict, 1.16 (1.02-1.32) in High family-to-work conflict, and 3.19 (2.87-3.55) in High Work-Family Conflict. The ORs were higher for men than women in High WFC but higher for women than men in High Work-Family Conflict. Conclusions: The risk of insomnia symptoms was highest in High Work-Family Conflict.

Korea Seroprevalence Study of Monitoring of SARS-COV-2 Antibody Retention and Transmission (K-SEROSMART): findings from national representative sample.

OBJECTIVES: We estimated the population prevalence of antibodies to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), including unreported infections, through a Korea Seroprevalence Study of Monitoring of SARS-CoV-2 Antibody Retention and Transmission (K-SEROSMART) in 258 communities throughout Korea. METHODS: In August 2022, a survey was conducted among 10,000 household members aged 5 years and older, in households selected through two stage probability random sampling. During face-to-face household interviews, participants self-reported their health status, COVID-19 diagnosis and vaccination history, and general characteristics. Subsequently, participants visited a community health center or medical clinic for blood sampling. Blood samples were analyzed for the presence of antibodies to spike proteins (anti-S) and antibodies to nucleocapsid proteins (anti-N) SARS-CoV-2 proteins using an electrochemiluminescence immunoassay. To estimate the population prevalence, the PROC SURVEYMEANS statistical procedure was employed, with weighting to reflect demographic data from July 2022. RESULTS: In total, 9,945 individuals from 5,041 households were surveyed across 258 communities, representing all basic local governments in Korea. The overall population-adjusted prevalence rates of anti-S and anti-N were 97.6% and 57.1%, respectively. Since the Korea Disease Control and Prevention Agency has reported a cumulative incidence of confirmed cases of 37.8% through July 31, 2022, the proportion of unreported infections among all COVID-19 infection was suggested to be 33.9%. CONCLUSIONS: The K-SEROSMART represents the first nationwide, community-based seroepidemiologic survey of COVID-19, confirming that most individuals possess antibodies to SARS-CoV-2 and that a significant number of unreported cases existed. Furthermore, this study lays the foundation for a surveillance system to continuously monitor transmission at the community level and the response to COVID-19.

Nypa fruticans Wurmb inhibits melanogenesis in isobutylmethylxanthine­treated melanoma via the PI3K/AKT/mTOR/CREB and MAPK signaling pathways.

Malignant melanoma is responsible for 3.0 and 1.7% of cases of tumor incidence and tumor-associated mortality, respectively, in the Caucasian population. Melanoma is a type of skin cancer that occurs when melanocytes mutate and divide uncontrollably. Nypa fruticans Wurmb (NF) is abundant in phytochemicals (polyphenols and flavonoids) and is traditionally used to treat diseases of the respiratory tract. The present study investigated the inhibitory effect of the ethyl acetate fraction of NF (ENF) on melanogenesis-related factors in isobutylmethylxanthine-treated B16F10 melanoma cells. Phenolics and flavonoids (caffeic acid, catechin, epicatechin and hirsutine) in ENF were analyzed via liquid chromatography-mass spectrometry. In addition, the main factors involved in melanogenesis were identified using immunoblotting, reverse transcription-polymerase chain reaction (RT-PCR), RT-quantitative PCR and immunofluorescence. ENF significantly suppressed the expression of tyrosinase (TYR) and TYR-related proteins 1 and 2 (TYRP-1/2), which are the main factors involved in melanogenesis. ENF also inhibited the expression of microphthalmia-associated transcription factor (MITF) by phosphorylating the related cell signaling proteins (protein kinase B, mammalian target of rapamycin, phosphoinositide 3-kinase and cAMP response element-binding protein). Furthermore, ENF inhibited the phosphorylation of extracellular signal-regulated kinase and thereby downregulated melanogenesis. In conclusion, ENF inhibited melanogenesis by suppressing MITF, which controls TYRP-1/2 and TYR. These results suggested that ENF may be a natural resource that can inhibit excessive melanin expression by regulating various melanogenesis pathways.

Impact of Wildfire Smoke Exposure on Health in Korea.

PURPOSE: The characteristic topography and climate often affect the occurrence of large-scale wildfires in the Eastern Gangwon-do region of Korea. However, there are no studies on the health effects of these wildfires in Korea. This study aimed to analyze the differences in medical use between a wildfire-affected area and an adjacent non-affected area before and after a wildfire in 2019 in Gangwon-do, Korea. MATERIALS AND METHODS: We used medical usage data from the Korean National Health Insurance Corporation. Rates of medical use were determined for citizens of a wildfire-affected area in the Eastern Yeongdong region and a non-affected area in the Western Yeongseo region. Logistic regression analysis was performed considering an increase in medical use per individual as a dependent variable; age, sex, income, smoking, drinking, and exercise were included as confounding variables. RESULTS: The odds ratio for medical use in Yeongdong region increased significantly after 3 days, 3 months, and 1 year after a fire occurred, compared with Yeongseo region. CONCLUSION: The results of this study confirmed that the use of medical care increased for residents of a wildfire-affected area, compared with those of an adjacent non-affected area. This is the first study on the relationship between wildfires and inpatient medical use in Korea.

Pesticide Exposure in Relation to the Incidence of Abnormal Glucose Regulation: A Retrospective Cohort Study.

Diabetes and prediabetes (called abnormal glucose regulation (AGR)) are adverse health effects associated with exposure to pesticides. However, there are few epidemiological studies on the relationship between pesticide use and the incidence of AGR. We examined the causal relationship between pesticide use and AGR incidence in a rural population using data from a Korean Farmers' Cohort study of 1076 participants. Poisson regression with robust error variance was used to calculate the relative risks (RR) and 95% confidence intervals (CI) to estimate the relationship between pesticide exposure and AGR. The incidence of AGR in the pesticide-exposed group was 29.1%. Pesticide use increased the RR of AGR (RR 1.32, 95% CI 1.03-1.69). We observed a low-dose effect related to exposure of pesticides to AGR and a U-shaped dose-response relationship in men. Pesticide exposure is related to the incidence of AGR, and the causal relationship differs between men and women.

Relationship between job rotation and work-related low back pain: a cross-sectional study using data from the fifth Korean working conditions survey.

BACKGROUND: Job rotation was introduced in various industries as a strategic form of work for improving workers' job skills and health management. This study aims to examine the relationship between job rotation and work-related low back pain (LBP), one of the typical work-related musculoskeletal symptoms of Korean workers. METHODS: We conducted this study using the data of the 5th Korean Working Conditions Survey (KWCS). As the subject of this study, 27,163 wage workers were selected, and classified into three groups according to occupational type (white-collar, service and sales, and blue-collar). In this study, job rotation means to change the work-related activities with other colleagues periodically and work-related LBP was defined as whether there was work-related LBP in the last 12 months. Chi-square test and logistic regression were used to analyze the relationship between job rotation and work-related LBP. RESULTS: Out of 27,163 workers, 2,421 (8.9%) answered that they had job rotation and 2,281 (8.4%) answered that they experienced work-related LBP. According to the results from logistic regression, job rotation was significantly associated with low prevalence of work-related LBP among blue-collar workers (odds ratio [OR]: 0.71, 95% confidence interval [CI]: 0.58-0.88), whereas no significant relationship was observed among white-collar, service and sales groups. In addition, the negative association between job rotation and work-related LBP among blue-collar workers was more pronounced when exposed to ergonomic risk factors (uncomfortable posture OR: 0.79, 95% CI: 0.64-0.98; heavy work OR: 0.74, 95% CI: 0.57-0.96; repetitive work OR: 0.74, 95% CI: 0.60-0.92). CONCLUSIONS: Job rotation was associated with low prevalence of work-related LBP among workers in the blue-collar occupational group in Korea. It is necessary to evaluate the effect of job rotation by occupational type and introduce an appropriate method of job rotation to reduce workers' work-related musculoskeletal symptoms.

Effects of Occupational and Leisure-Time Physical Activities on Insomnia in Korean Firefighters.

Studies have been conducted on the association between physical activity (PA) and sleep, but to the best of our knowledge, a simultaneous analysis of the effects of occupational PA (OPA) and leisure time PA (LTPA) on South Korean firefighters' sleep has never been conducted. This study aims to analyze how OPA and LTPA affect these individuals' risk of suffering from insomnia with-in this specific population of subjects. The study includes data from an online self-report survey in which 9788 South Korean firefighters participated. The survey used the Insomnia Severity Index and the OPA- and LTPA-related characteristics were investigated. The independent two-sample t-test, χ2 test, and multiple logistic regression analysis were performed. Subgroup logistic regression analyses were also completed in accordance with the OPA level. Among 9788 participants, 890 (9.1%) suffered from insomnia. A logistic regression analysis revealed that higher levels of feeling of job loading (FoJL), rising levels of physical strength utilization rate (PSUR), greater frequency levels of occupational activities, and high-intensity LTPA were significantly correlated with an increased risk of insomnia, while execution of LTPA and getting enough rest after LTPA was correlated with a decreased risk. However, the subgroup analysis showed that high-intensity LTPA was correlated with a significantly increased the risk in the group with high OPA, but this did not apply to the group with low OPA. Although the risk of suffering from insomnia was overall significantly higher in the high OPA group, the risk was significantly lower in groups getting enough rest after partaking in LTPA, regardless of the OPA level. Thus, the intensity of exercise programs pre-scribed to groups with high OPA and individuals with higher risks of suffering from insomnia, such as firefighters, police officers, and soldiers, should be considered.

Psychosocial factors affecting sleep quality of pre-employed firefighters: a cross-sectional study.

BACKGROUND: There have been no health-related studies of pre-employed firefighters without firefighter-specific job-related factors (FSJRF). This study aimed to evaluate the sleep quality of pre-employed firefighters and to examine the relationship between sleep quality and psychosocial factors. METHODS: We conducted a self-report questionnaire survey for 602 pre-employed firefighters at 3 Fire Service Academies after brief lecture about sleep. Sleep quality and psychosocial variables such as depression, anxiety, stress and social support were evaluated. The independent 2 sample t-test, χ2 test and multiple logistic regression analysis were used to evaluate the effect of the variables on the sleep quality of pre-employed firefighters. RESULTS: Among a total of 602 people, 347 (57.6%) had good sleep quality and 255 (42.4%) had poor sleep quality. Pittsburgh Sleep Quality Index score of them was 3.29 ± 1.41) and 7.87 ± 2.20), respectively. 24 (4.0%) were evaluated to have insomnia by Insomnia Severity Index. Logistic regression analyses showed that the depression (adjusted odds ratio [aOR]: 5.940, 95% confidence interval [CI]: 3.124-11.292), anxiety (aOR: 4.233, 95% CI: 2.138-8.381), stress (aOR: 2.880, 95% CI: 1.915-4.330) and social support (aOR: 0.959, 95% CI: 0.939-0.980) have a significant effect on sleep quality after adjusted by sex, age, smoking status, drinking status, caffeine intake, past shift working and circadian rhythm type. CONCLUSIONS: Depression, anxiety, stress and social support were associated with sleep quality among pre-employed firefighters. Repeated follow-up studies of pre-employed firefighters are needed to further assess their change of sleep quality and identify the FSJRF that may affect the sleep quality of firefighters.

Increased risk of atherosclerosis associated with pesticide exposure in rural areas in Korea.

Atherosclerosis is a progressive inflammation in systemic vessels, and pesticide exposure has been emerging as its risk factor. This cross-sectional study investigated the association between pesticide exposure and the risk of atherosclerosis in a rural population in Korea using carotid intima-media thickness (CIMT). This study used dataset from the baseline survey of the Korea Farmers Cohort Study between November 2005 and January 2008, and the final analysis included 477 participants. Well-structured questionnaires were used to estimate pesticide exposure. CIMT ≥ 0.9 mm was established for carotid atherosclerosis. Multiple logistic regression analyses were undertaken to evaluate the association between pesticide exposure and atherosclerosis, adjusting demographic and health-related confounders. Even after adjustments, the increased risk of atherosclerosis was significantly associated with pesticide exposure, such as a lifetime history of farming (odds ratio [OR] 3.25 95% confidence interval [CI] 1.51-6.98), a history of using pesticide (OR 3.42 95% CI 1.63-7.16), using pesticide 10 times or more annually (OR 2.55 95% CI 1.21-5.39), and higher cumulative exposure index level (OR 3.63 95% CI 1.65-7.97). Further prospective studies are required to elucidate effects of pesticide exposure on the risk of atherosclerosis.

Relationship between shift work and liver enzymes: a cross-sectional study based on the Korea National Health and Examination Survey (2007-2015).

BACKGROUND: Shift work has well-known adverse effects on health. However, few studies have investigated the relationship between shift work and hepatic disorders. This study aimed to evaluate the association between shift work and abnormal level of liver enzymes. METHODS: The aggregated data from the 2007-2009, 2010-2012, and 2013-2015 cycles of the Korea National Health and Nutrition Examination Survey was used for this study. The χ2 test and multiple logistic regression analysis were used to assess relationship between shift work and abnormal level of liver enzymes stratified by gender. RESULTS: The odds ratio (OR) of abnormal serum level of alanine aminotransferase (abnormal ALT) in female shift workers was higher with 1.31 (95% confidence interval: 1.00-1.71) compared with day workers after adjusting for covariates. After dividing into subgroups of the shift work pattern, the ORs of abnormal liver enzymes for each pattern compared with day work were not significantly higher. CONCLUSIONS: This study provides limited support for the hypothesis that shift work is related to liver enzyme abnormalities, but offers some evidence in favor of the idea that shift work affects female workers more than males on abnormal ALT. Further studies are needed to define the relationship between shift work and abnormal liver enzymes to be carried out as well as the gender difference in the association.

Correction: Pesticide exposure and cognitive decline in a rural South Korean population.

[This corrects the article DOI: 10.1371/journal.pone.0213738.].

Long Working Hours and Poor Self-Rated Health in the Young Working Population in Korea.

: This cross-sectional study investigated the association between long working hours and prevalence of poor self-rated health (SRH) in Korean young workers using data from the 6th Korea Youth Panel Survey 2007. A total of 3317 young wage workers were included. Weekly working hours were divided into four groups (36 to 40 hours, 41 to 52 hours, 53 to 60 hours, and more than 60 hours per week). Multiple logistic regression was performed to investigate the association between long working hours and SRH, adjusting for demographic and work-related factors. Long working hours were associated with increased risk of poor SRH, in both the men and women. Legal restriction on working hours should be suitably applied to help improve the health status of Korean young workers.

Pesticide exposure and cognitive decline in a rural South Korean population.

We aimed to investigate the relationship between pesticide exposure and cognitive decline in a rural South Korean population. From July 2015 to December 2017, 200 randomly selected Korean Farmers Cohort study participants were recruited and of these, 169 participants were analyzed. Pesticide exposure was investigated using a standardized questionnaire, and the Korean-Montreal Cognitive Assessment (K-MoCA) was conducted. Cognitive decline was more frequent among those directly exposed to pesticides (P = 0.057). Pesticide exposure and cognitive decline were positively correlated in the group with direct exposure versus no exposure (crude odds ratio [OR], 2.66; 95% confidence interval [CI], 1.17-6.04); this relationship was insignificant after adjustment (adjusted OR, 1.50; 95% CI, 0.57-3.92). There was a significant difference in the K-MoCA scores for each group based on pesticide exposure (P = 0.003). When we stratified by age, differences in the K-MoCA scores depending on the degree of pesticide exposure in the those aged 60 to 69 years were identified. Overall, there was a tendency towards an association between pesticide exposure and cognitive decline in rural Korean adult farmers. In our study, chronic pesticide exposure tended to have a greater impact in certain age group (60-69 years) than in those under 60 and over 70.

Exposure to pesticides and the prevalence of diabetes in a rural population in Korea.

BACKGROUND: Among the adverse health effects of exposure to pesticides, an association with diabetes has been reported. However, there is a lack of epidemiologic studies on the health effects of exposure to pesticides, particularly investigating the association between occupational pesticide exposure and diabetes prevalence. PURPOSE: The present study examined the association between pesticide exposure and prevalence of diabetes in a rural population in Korea. METHODS: This cross-sectional study used data from the Korea Farmers Cohort study, and included 2559 participants in the baseline survey between November 2005 and January 2008. We performed a clinical examination including blood sampling and assessed data on diabetes diagnosis, demographics, and pesticide exposure. Logistic regression was performed to evaluate the association between pesticide exposure and diabetes prevalence, adjusting for age, sex, monthly income, and marital status. In addition, a stratified analysis by body mass index (BMI) was conducted, with two categories: normal weight (<25 kg/m2) and overweight or obese (≥25 kg/m2). RESULTS: At baseline, the prevalence of diabetes was 9.30%. Pesticide exposure was associated with the risk of diabetes after adjustment for covariates. In the analysis stratified by BMI, all the variables related to pesticide exposure were associated with prevalence of diabetes in the overweight or obese group, whereas no significant association was found in the normal weight group. CONCLUSION: Exposure to pesticides was associated with diabetes, and this association was stronger in overweight or obese individuals than in normal weight individuals. Further longitudinal studies that consider information on BMI are necessary.

Relationship between simultaneous exposure to ergonomic risk factors and work-related lower back pain: a cross-sectional study based on the fourth Korean working conditions survey.

BACKGROUND: It is well known that ergonomic risk factors and back pain are related. However, few studies have examined the relationship between simultaneous exposure to these risk factors and back pain in a Korean population. We aimed to investigate the relationship between simultaneous exposure to ergonomic risk factors and work-related lower back pain (LBP) based on the fourth Korean Working Conditions Survey (KWCS). METHOD: The fourth KWCS (2014) was used for this study. Chi-square tests and logistic regression were used to assess relationship between 5 ergonomic risk factors and work-related LBP. We also analyzed the relationship between simultaneous exposure to 2 risk factors and work-related LBP. RESULTS: All 5 ergonomic risk factors (fatigue-inducing and painful posture; lifting or moving people; dragging, pushing, or moving heavy objects; standing posture; and repetitive hand or arm movements) were significantly correlated with work-related LBP in the severe exposure group (adjusted odd ratios [aOR] 5.09, 95% confidence interval [CI] 4.46-5.83; aOR 1.98, 95% CI 1.62-2.42; aOR 2.09, 95% CI 1.82-2.40; aOR 1.79, 95% CI 1.60-2.01; aOR 2.04, 95% CI 1.82-2.30, respectively). When exposed to 2 risk factors simultaneously, the relationship between exposure and work-related LBP was not greater than exposure to only 1 risk factor in our study (usually exposed to 'fatigue-inducing or painful posture' aOR 2.17, 95% CI 2.02-2.34; high exposure to both 'fatigue-inducing or painful posture' and 'dragging, pushing, or moving heavy objects' aOR 2.00, 95% CI 1.82-2.20). CONCLUSIONS: There was a strong relationship between severe exposure to each ergonomic risk factor and work-related LBP. However, when exposed to 2 ergonomic risk factors simultaneously, the relationship between exposure and work-related LBP was not stronger than when exposed to only 1 risk factor in our study.

Perception of Hair Loss and Education Increases the Treatment Willingness in Patients With Androgenetic Alopecica: A Population-Based Study.

BACKGROUND: Androgenetic alopecia (AGA) has a negative impact on self-image and decrease in quality of life. However, relatively few men have sought treatment for AGA. Improvement in treatment willingness is important for maintaining long-term management in patients with AGA. OBJECTIVES: We aimed to identify the prevalence of patients' perception of hair loss and evaluate various factors that affect the treatment willingness in patients with AGA. METHODS: We conducted a population-based cross-sectional survey of 503 patients with AGA (329 men, 174 women). We collected the various demographic data, family history of AGA, history of past treatment, self-perception of hair loss and treatment willingness using structured questionnaires. Then, we provided the knowledge about AGA to the half of subjects and compared the treatment willingness between educated group and nond-educated group. RESULTS: Two-hundred and forty-seven out of 503 patients (49.1%) did not have illness perception and 262 out of 503 patients (52.1%) did not have treatment willingness in future. The patients with perception of hair loss, accurate information on hair loss and severe hair loss showed 1.745-fold, 1.700-fold, and 2.078-fold higher tendency of receiving treatment in future. CONCLUSION: Our findings imply that patients with perception and greater understanding of AGA tend to pursue treatment for AGA. Thus, these elements should be taken into account when treating patients. In addition, emphasis on education is needed to increase public awareness of the AGA.

Association between occupational clusters and allergic rhinitis in the Korean population: analysis of the Korean National Health and Nutrition Examination Survey data.

OBJECTIVES: This study aimed to investigate the association between occupational clusters and allergic rhinitis (AR). METHODS: The study was based on data from the Korean National Health and Nutrition Examination Survey (KNHANES: 2007-2015). This study included 46,965 individuals: 20,491 men and 26,474 women. AR was defined as having been diagnosed by a physician. Occupations were classified according to occupational characteristics and skill levels into white (chief executives, senior officials, legislators, managers, professionals, and technicians), pink (clerks, clerical support workers, services and sales workers), blue (craft and related trades workers, drivers, plant and machine operators, assemblers, elementary occupation workers), and green (skilled agricultural, forestry, and fishery workers) categories. We calculated the odds ratios (ORs) and 95% confidence intervals (CIs) of AR according to the occupational clusters by using the chi-squared test and logistic regression. RESULTS: In the study population, 10.7% of the men and 13.5% of the women had AR. The prevalence of AR was highest among white-collar workers, followed by pink, blue, and green-collar workers. Compared to green-collar workers, among men the adjusted ORs of the blue, pink, and white-collar workers were 2.00 (95% CI 1.58-2.53), 2.46 (95% CI 1.91-3.15), and 2.78 (95% CI 2.20-3.51), respectively; and among women were 2.45 (95% CI 1.99-3.02), 2.64 (95% CI 2.15-3.25), and 3.63 (95% CI 2.96-4.47), respectively. CONCLUSIONS: This study suggests that AR prevalence is significantly associated with occupational clusters.

Gender-specific risk factors for androgenetic alopecia in the Korean general population: Associations with medical comorbidities and general health behaviors.

BACKGROUND: The relationships between androgenetic alopecia (AGA) and various factors related to metabolic syndrome have been demonstrated in previous studies. However, it remains unclear because of inconsistent results. We investigated the associations between AGA and various risk factors related to metabolic syndrome according to gender. METHODS: We conducted a population-based cross-sectional survey of 2028 Koreans (1050 men, 978 women). The basic and specific (BASP) classification was used for diagnosis of AGA. We collected information on risk factors though questionnaires and medical records. RESULTS: AGA was significantly associated with age, family history of AGA, hypertension, diabetes mellitus, and waist circumference in both genders. Female subjects with AGA were more likely to have cerebrovascular disease, dyslipidemia, and obesity; however, these associations were not observed in the male subjects. When multiple regression analysis was applied, there was a significant relationship between hypertension and AGA in male subjects. However, there was no statistically significant association in female subjects. CONCLUSION: The different results according to gender might arise from different mechanisms of AGA. There was a significant relationship between hypertension and AGA in male subjects. Evaluation of blood pressure in male patients with AGA might facilitate interventions for hypertension.

Factors increasing the risk for psychosocial stress among Korean adults living in rural areas: using generalized estimating equations and mixed models.

BACKGROUND: This study was conducted to analyze the distribution of the psychosocial well-being index among adults living in two rural communities in Korea and to examine its correlation with lifestyle variables such as sleep duration, regular exercise, and sedentary time. METHODS: Using the cohort data of the Atherosclerosis Risk of a Rural Area Korean General Population, this study examined 3631 participants living in Wonju and Pyeongchang in Gangwon Province; their preliminary data were established from 2005 to 2007 while their follow-up data were collected 3 years later. This study investigated demographic characteristics, lifestyle habits, disease history, Psychosocial Well-being Index-Short Form (PWI-SF) scores, sleep duration, regular exercise, and sedentary time during work. Using repeated measures ANOVA, this study examined how the variables and PWI-SF scores changed over the course of 3 years and identified the correlation between them based on mixed model analysis. Afterwards, using the generalized estimation equation, this study identified each variable's risk towards the PWI-SF high-risk group and performed a stratified analysis by occupation after dividing the participants into farmers and non-farmers. RESULTS: The PWI-SF high-risk group was found to be 18.9% of the participants from preliminary data and 15.5% from follow-up data. The odds ratio towards the PWI-SF high-risk group was 1.503 (95% CI 1.241-1.821) in the short sleep duration group and 1.327 (95% CI 1.136-1.550) in the non-regular exercise group. A stratified analysis by occupation showed that middle and long sedentary time in the white-collar group increased the risk toward the PWI-SF high-risk group. CONCLUSIONS: Short sleep duration, no regular exercise, and long sedentary time in the white-collar group were identified as risk factors toward the PWI-SF high-risk group in the rural communities, and policy interventions are needed to address this issue.