Association between temporary employment and current smoking and change in smoking behaviors: A prospective cohort study from South Korea (2009-2018).

Background Previous studies have suggested that employment insecurity is associated with adverse health outcomes. We explored the association between temporary employment and smoking behaviors.Methods We analyzed 11,795 workers (51,867 observations) from the Korea Health Panel Study (2009-2018). Employment types were categorized as regular, fixed-term, or daily, based on the duration of labor contract. The outcomes were current smoking status and changes in smoking behavior (initiation or cessation) in the following year. Generalized estimating equations were used to estimate odds ratio (OR) and 95% confidence interval (CI).Results The proportions of fixed-term and daily workers were 41.2% and 16.4% for women and 23.6% and 12.4% for men, respectively. Temporary employment was associated with increased odds of current smoking, while also demonstrating prospective associations with changes in smoking behaviors. For instance, in prospective analyses, male workers with fixed-term and daily employments were associated with a decreased likelihood of smoking cessation (OR:0.77; 95% CI:0.65-0.91 for fixed-term employment and OR:0.66; 95% CI:0.52-0.83 for daily employment) in the following year compared to those with regular employment. Moreover, those experiencing consecutive temporary employment was most inversely associated with smoking cessation in both men (OR:0.56; 95% CI:0.44-0.71) and women (OR:0.37; 95% CI:0.16-0.85) compared to those experiencing consecutive regular employment. However, no clear association between temporary employment and smoking initiation was observed in both men and women.Conclusions Temporary employment is directly associated with current smoking and inversely associated with smoking cessation. Policies are needed to improve job insecurity among temporary employees.

Association between sickness presenteeism and depressive symptoms: a cross-sectional study using the 6th Korean working conditions survey.

PURPOSE: This study aimed to reveal the relationship of the days of experiencing sickness presentism and depressive symptoms among Korean workers. Sickness presenteeism which defined as the act of going to work despite being feeling unhealthy triggers various adverse effects on mental health, including increased risks of depression. Furthermore, Sickness presenteeism is a major social issue causing substantial socioeconomic costs. METHODS: The data of 25120 participants from sixth Korean Working Condition Survey was utilized in this cross-sectional study. Sickness presenteeism was defined using a self-reported questionnaire and depressive symptoms were assessed by WHO well-being index. Multivariate logistic regression analysis was conducted to calculate the odd ratios for depressive symptoms regarding the number of days experiencing sickness presenteeism. We calculated odds ratios (ORs) and 95% confidence interval (95% CI) for depressive symptoms after categorizing participants into three groups based on the duration of experiencing sickness presenteeism, using cut-off values of 3 and 5 days. RESULTS: Workers who have experienced sickness presenteeism for more than 5 days were at highest risk for depressive symptoms than referent group (OR 2.87; 95% CI 2.17-3.76 in male, OR 3.86; 95% CI 3.02-4.91 in female). Furthermore, there was a trend of increasing risk for depressive symptom as the duration of experiencing sickness presenteeism extended. CONCLUSION: This study presents the association between experiencing sickness presenteeism in the previous 12 months and depressive symptoms. Based on the results, we provide individual and organizational strategies of reducing sickness presenteeism. Also, screening for workers who have experienced sickness presenteeism are needed to ensure good mental health.

Self-Esteem Trajectories After Occupational Injuries and Diseases and Their Relation to Changes in Subjective Health: Result From the Panel Study of Workers' Compensation Insurance (PSWCI).

BACKGROUND: Occupational injuries and diseases are life events that significantly impact an individuals' identity. In this study, we examined the trajectories of self-esteem among victims of occupational injury and disease and their relation to health. METHODS: The Panel Study of Workers' Compensation Insurance conducted annual follow-ups on workers who had experienced occupational injury or disease. A total of 2,000 participants, who had completed medical care, were followed from 2013 to 2017. Growth mixture modeling was utilized to identify latent classes in the self-esteem trajectory. Additionally, logistic regressions were conducted to explore the association between trajectory membership, baseline predictors, and outcomes. RESULTS: Three distinct trajectory classes were identified. Total 65.8% of the samples (n = 1,316) followed an increasing self-esteem trajectory, while 31.1% (n = 623) exhibited a constant trajectory, and 3.1% (n = 61) showed a decreasing trajectory. Individuals with an increasing trajectory were more likely to have a higher educational attainment (odds ratio [OR], 1.86; 95% confidence interval [CI], 1.20-2.88), an absence of a moderate-to-severe disability rating (OR, 0.49; 95% CI, 0.25-0.96), no difficulty in daily living activities (OR, 0.81; 95% CI, 0.75-0.88), and were economically active (re-employed: OR, 2.46; 95% CI, 1.52-3.98; returned to original work: OR, 4.46; 9% CI, 2.65-7.50). Those with a decreasing self-esteem trajectory exhibited an increased risk of poor subjective health (OR, 1.89; 95% CI, 0.85-4.85 in 2013 to OR, 3.17; 95% CI, 1.04-13.81 in 2017), whereas individuals with an increasing trajectory showed a decreased risk (OR, 0.54; 95% CI, 0.43-0.68 in 2013 to OR, 0.44; 95% CI, 0.33-0.57 in 2017). CONCLUSION: Our findings emphasize the diversity of psychological responses to occupational injury or disease. Policymakers should implement interventions to enhance the self-esteem of victims.

Relationship between long working hours and smoking behaviors: Evidence from population-based cohort studies in Korea.

OBJECTIVES: Long working hours and overwork are growing public health concerns in the Western-Pacific region. We explored the relationship between working hours and smoking behaviors of Korean workers. METHODS: This study included 284 782 observations (50 508 workers) from four nationwide cohort studies in Korea. Using generalized estimating equations, we estimated the associations of working hours with current smoking status, smoking initiation, and smoking cessation within each cohort. Cohort-specific estimates were combined through random-effect meta-analysis. Effect sizes were presented as odds ratios (OR) and 95 confidence intervals (CI). RESULTS: The overall smoking prevalence was 26.8% within the cohorts. The adjusted OR (95% CI) of the association between working hours and current smoking were 1.01 (0.94-1.08) for <35 hours/week, 1.04 (1.01-1.09) for 41-48 hours/week, 1.06 (1.01-1.10) for 49-54 hours/week, and 1.07 (1.04-1.10) for ≥55 hours/week compared with 35-40 hours/week. The adjusted OR (95% CI) of the association between working hours and smoking cessation in the follow-up were 0.93 (0.85-1.02) for <35 hours/week, 0.89 (0.83-0.96) for 41-48 hours/week, 0.87 (0.81-0.95) for 48-54 hours/week, and 0.91 (0.85-0.98) for ≥55 hours/week compared with 35-40 hours/week. No clear associations were observed between working hours and smoking initiation. CONCLUSION: Long working hours are associated with high current smoking risk and reduced likelihood of smoking cessation among Korean workers. Policy interventions are required to promote smoking cessation and reduce excess overwork for individuals experiencing long working hours.

Temporary Employment Is Associated with Poor Dietary Quality in Middle-Aged Workers in Korea: A Nationwide Study Based on the Korean Healthy Eating Index, 2013-2021.

Temporary employment is associated with an elevated risk of cardiovascular diseases and mortality. This study explored the association between temporary employment and dietary quality in middle-aged workers. This cross-sectional study included a nationwide sample of middle-aged Korean workers (n = 6467). Employment type was categorized into regular, fixed-term, and daily employment, based on labor contract duration. Dietary quality was assessed using the Korean Health Eating Index (KHEI), which ranges from 0 to 100, with higher scores indicating superior dietary quality. Linear regression was used to estimate beta coefficients (ß) and 95% confidence intervals (CI). The survey-weighted proportion of regular, fixed-term, and daily employment was 79.0%, 14.2%, and 6.8%, respectively. Fixed-term and daily employment were associated with a reduced KHEI compared with regular employment (ß [95% CI]: -1.07 [-2.11, -0.04] for fixed-term and -2.46 [-3.89, -1.03] for daily employment). In sex-stratified analysis, the association between temporary employment and dietary quality was more pronounced in men (ß [95% CI]: -1.69 [-3.71, 0.33] for fixed-term and -2.60 [-4.63, -0.53] for daily employment than in women. In conclusion, this study suggests that temporary employment is a social determinant of dietary quality in middle-aged workers.

Estimated trends in hospitalizations due to occupational injuries in Korea based on the Korean National Hospital Discharge In-depth Injury Survey (2006-2019).

OBJECTIVES: In recent years, occupational injuries have sparked a huge social and political debate. Thus, in this study, we focused on the characteristics and trends of occupational injuries requiring hospitalization in Korea. METHODS: The Korea National Hospital Discharge In-depth Injury Survey was designed to estimate the annual number and characteristics of all injury-related hospitalizations in Korea. The annual number of hospitalizations due to occupational injuries and the age-standardized rates (ASRs) were estimated from 2006 to 2019. The annual percentage change (APC) and average annual percentage change (AAPC) of ASRs and their 95% confidence intervals (CIs) were calculated using joinpoint regression. All analyses were stratified by gender. RESULTS: In men, the APC of the ASRs of all-cause occupational injuries was -3.1% (95% CI, -4.5 to -1.7) in 2006-2015. However, a non-significant upward trend was observed after 2015 (APC, 3.3%; 95% CI, -1.6 to 8.5). In women, the APC of all-cause occupational injuries was -8.6% (95% CI, -12.1 to -5.1) in 2006-2012. However, a non-significant upward trend was observed after 2012 (APC, 2.1%; 95% CI, -0.9 to 5.2). A recent upward trend in stabbing injuries was observed after 2012 (APC, 4.7%; 95% CI, -1.8 to 11.8) in women. A non-significant overall increasing trend was also observed for occupational injuries caused by exposure to extreme temperatures (AAPC, 3.7%; 95% CI, -1.1 to 8.7) in women. CONCLUSIONS: A recent upward trend in all-cause injury hospitalizations and hospitalizations caused by stabbing injuries was observed. Therefore, active policy interventions are required to prevent occupational injuries.

Working hours and the onset of suicidal ideation and depressive symptoms: A 10-year nationwide longitudinal study in South Korea (2012-2022).

Long working hours are associated with adverse health outcomes. We investigated the association between working hours and suicidal ideation and depressive symptoms. We analyzed a nationally representative sample of 11,116 Korean workers, comprising 64,661 observations from 2012 to 2022, to investigate how working hours were associated with mental health problems. To account for repeated measurements in each participant, we employed a generalized estimating equation to estimate risk ratios (RRs) and 95% confidence intervals (CIs). Of the total observations, 13.1% reported working ≥55 h/week. The RR (95% CI) of the association between long working hours and onset of suicidal ideation in the subsequent year was 1.20 (0.95-1.53) for 41-48 h, 1.35 (1.02-1.78) for 49-54 h, and 1.56 (1.23-1.98) for ≥55 h/week, compared to 35-40 h/week. The RR (95% CI) of the association between long working hours and onset of depressive symptoms in the subsequent year was 1.19 (1.07-1.34) for 41-48 h, 1.11 (0.97-1.28) for 49-54 h, and 1.24 (1.10-1.40) for ≥55 h per week, compared to 35-40 h/week. Those working fewer than 35 h/week also had an increased risk of suicidal ideation and depressive symptoms. Policy interventions are needed to reduce excess working hours and protect workers' mental health.

Multidimensional employment precariousness mediates the association between low educational attainment and poor subjective well-being: results from a nationwide cross-sectional study in South Korea.

OBJECTIVE: This paper explored how multidimensional employment precariousness (MEP) mediates the relationship between educational attainment and subjective well-being. METHODS: A nationwide sample of 46 919 Korean workers participated in surveys between 2017 and 2020. Educational attainment was divided into four categories: elementary school, middle school, high school, and college. Subjective well-being was assessed using the 5-item World Health Organization Well-Being Index, and MEP was evaluated using a modified version of the Employment Precariousness Scale (ERPES-E), with scores ranging from 0 to 100 and higher scores indicating worse employment precariousness. A counterfactual-based logistic mediation analyses were used to estimation. RESULTS: The mean MEP score was 36.0 [standard deviation (SD) 12.1] for college education, 44.3 (SD 11.5) for high school, 49.5 (SD 10.1) for middle school, and 51.1 (SD 10.0) for elementary school. The prevalence of poor subjective well-being was 24.0% for college education, 31.3% for high school, 40.6% for middle school, and 44.8% for elementary school. Odds ratios (OR) for the total effect of education on the poor subjective well-being were 1.44 [95% confidence interval (CI) 1.37-1.53] for high school, 2.19 (95% CI 1.98-2.24) for middle school, and 2.40 (95% CI 2.04-2.82) for elementary school when compared to college education. The OR for the indirect effect mediated through MEP were 1.27 (95% CI 1.25-1.29) for high school, 1.46 (95% CI 1.42-1.51) for middle school, and 1.53 (95% CI 1.48-1.59) for elementary school, accounting for 63.9%, 48.5%, and 48.6% of the total effect, respectively. CONCLUSION: Our study suggests that MEP is an important contributor to the disparities in subjective well-being resulting from educational gradients.

Association between long working hours and physical inactivity in middle-aged and older adults: a Korean longitudinal study (2006-2020).

BACKGROUND: We investigated associations for long working hours in relation to physical inactivity and high-level physical activity among middle-aged and older adults. METHODS: Our study included 5402 participants and 21 595 observations from the Korean Longitudinal Study of Ageing (2006-2020). Logistic mixed models were used to estimate ORs and 95% CIs. Physical inactivity was defined as not engaging in any type of physical activity, while high-level physical activity was defined as engaging in ≥150 min per week of physical activity. RESULTS: Working >40 hours weekly was positively related to physical inactivity (OR (95% CI) 1.48 (1.35 to 1.61)) and negatively related to high-level physical activity (0.72 (95% CI 0.65 to 0.79)). Exposure to long working hours consecutively for ≥3 waves was associated with the highest OR for physical inactivity (1.62 (95% CI 1.42 to 1.85)) and the lowest OR for high-level physical activity (0.71 (95% CI 0.62 to 0.82)). Furthermore, compared with persistent short working hours (≤40 hours → ≤40 hours), long working hours in a previous wave (>40 hours → ≤40 hours) were associated with a higher OR of physical inactivity (1.28 (95% CI 1.11 to 1.49)). Exposure to an increase in working hours (≤40 hours → >40 hours) was also associated with a higher OR of physical inactivity (1.53 (95% CI 1.29 to 1.82)). CONCLUSION: We found that having working long hours was associated with a higher risk of physical inactivity and a lower likelihood of high-level physical activity. Moreover, accumulation of long working hours was associated with a higher risk of physical inactivity.

Performance-Based Pay System and Job Stress Related to Depression/Anxiety in Korea: Analysis of Korea Working Condition Survey.

The adoption rate of performance-based pay systems has increased in recent years, and the adverse effects of systems have been emphasized. However, no study has analyzed the increase in the risk of depression/anxiety symptoms caused by the pay system in Korea. This study aimed to reveal the association between performance-based pay systems and symptoms of depression/anxiety, using data from the fifth Korean Working Conditions Survey. Depressive/anxiety symptoms were assessed using "yes" or "no" questions regarding medical problems related to depression/anxiety. The performance-based pay system and job stress were estimated using self-response answers. Logistic regression analyses were conducted to determine the association between performance-based pay systems, job stress, and symptoms of depression/anxiety using data from 27,793 participants. The performance-based pay system significantly increased the risk of the symptoms. Additionally, risk increments were calculated after grouping by pay system and job stress. Workers with two risk factors had the highest risk of symptoms of depression/anxiety for both sexes (male: OR 3.05; 95% CI 1.70-5.45; female: OR 2.15; 95% CI 1.32-3.50), implying synergistic effect of performance-based pay system and job stress on depression/anxiety symptoms. Based on these findings, policies should be established for early detection and protection against the risk of depression/anxiety.

Association between job satisfaction and current smoking and change in smoking behavior: a 16-year longitudinal study in South Korea.

BACKGROUND AND AIMS: Previous studies have found that job satisfaction is closely associated with various health outcomes of workers. Our study measured the association between job satisfaction and current smoking and change in smoking behavior. DESIGN: Data from the longitudinal Korea Labor and Income Panel Study (KLIPS) that consist of nationally representative samples were used. The repeated measures analysis was conducted. SETTING: South Korea, 2005-2021. PARTICIPANTS: In total, 21 154 workers in Korea followed from 2005 to 2021 (145 120 observations) were included as study participants. MEASUREMENTS: The main predictor variable, job satisfaction, was assessed using a five-item general job satisfaction questionnaire. Job satisfaction was classified into 'dissatisfied', 'neutral' and 'satisfied', according to the tertiles of the sum of scores. The outcomes of interest were current smoking and initiation and cessation of smoking in the subsequent year. FINDINGS: Compared with those with a neutral level of job satisfaction, those who reported dissatisfaction with their job had an increased risk of smoking initiation [odds ratio (OR) = 1.11, 95% confidence interval (CI) = 1.01-1.22)]. Workers satisfied with their jobs were associated with a decreased likelihood of current smoking (OR = 0.96, 95% CI = 0.94-0.98) and smoking initiation (OR = 0.90, 95% CI = 0.81-0.99). There was a positive relationship between cumulative years of job dissatisfaction and smoking risk: > 4 years of experiencing job dissatisfaction was positively related to current smoking (OR = 1.14, 95% CI = 1.06-1.24) and smoking initiation (OR = 1.22, 95% CI = 1.00-1.49) and negatively related to smoking cessation (OR = 0.84, 95% CI = 0.72-0.99). CONCLUSIONS: In Korea, job dissatisfaction appears to be associated with an increased risk of smoking initiation.

Characteristics and Socio-Demographic Distribution of Precarious Employment Among Korean Wage Workers: A Proposition of Multidimensional Approach Using a Summative Score.

Introduction: There is a growing global interest in the issue of precarious employment. We aimed to analyze the characteristics and socio-demographic distribution of precarious employment using a summative score approach. Methods: To operationalize precarious employment, we utilized data from the Korean Working Conditions Survey and focused on three distinct dimensions: employment insecurity, income inadequacy, and a lack of rights and protections. By constructing a summative scale ranging from -16 to 2, with lower scores indicating higher precariousness, we measured employment precariousness among Korean wage workers. To compare employment precariousness according to survey participant characteristics, we employed the Wilcoxon Rank Sum Test. Results: We analyzed a weighted number of 38,432 workers. The overall sample showed a median (Q1, Q3) summative scale score of -3 (-6, -1). The median summative score was lower for women compared to men (men: -2; women: -5; p < 0.001), as well as for young or older workers compared to middle-aged workers (young: -4; middle-aged: -2; older: -5; p < 0.001). Similarly, workers with lower educational levels (middle school or below: -8; high school: -5; college or above: -2; p < 0.001) and non-white collar workers (blue collar: -5; service/sales worker: -6; white collar: -2; p < 0.001) experienced higher levels of employment precariousness. Conclusion: Our findings indicate that certain vulnerable groups, such as women, young or older adults, workers with low educational attainment, and caregiving or low-skilled elementary workers, are disproportionately exposed to high employment precariousness. Active policy interventions are needed to improve the employment quality of vulnerable groups.

The effect of job insecurity, employment type and monthly income on depressive symptom: analysis of Korean Longitudinal Study on Aging data.

Background: In modern society, depression is serious issue that causes socioeconomic and family burden. To decrease the incidence of depression, risk factors should be identified and managed. Among many risk factors for depression, this study examined socioeconomic risk factors for depression. Methods: We utilized first (2006), second (2008), and third (2010)-wave data from the Korean Longitudinal Study of Aging (KLoSA). Depressive symptom was measured with the 10-item Center for Epidemiological Studies Depression Scale, Short Form (CES-D-10) in the survey in 2008 and 2010. Three risk factors including job security, employment type and monthly income were measured in the survey in 2006. The association between risk factors and depressive symptom was analyzed by Cox proportional-hazard model. Results: We analyzed data from 1,105 workers and hazard ratios (HRs) for 3 risk factors were significant entirely. In addition, regular worker with high income group is the most vulnerable group of poor job insecurity on depression among male workers (HR: 1.73; 95% confidence interval [CI]: 1.07-2.81). Finally, HRs for 7 groups who had at least 1 risk factor had higher HRs compared to groups who had no risk factors after stratifying 3 risk factors. In the analysis, significantly vulnerable groups were total 5 groups and the group who had highest HR was temporary/daily workers with poor job security (HR: 2.51; 95% CI: 1.36-4.64). The results concerning women, regardless of job type, were non-significant. Conclusions: This study presented one or more risk factors among poor job security, low income, temporary/daily employment type increase hazard for depressive symptom in 2 or 4 years after the exposure. These results inform policy to screen for and protect against the risk of depression in vulnerable groups.