Journal of Preventive Medicine and Public Health

Original Articles

Associations Between Urinary Metabolites of Polycyclic Aromatic Hydrocarbons and Liver Enzyme Levels Among Korean Firefighters: Jaeyong Lee, Mun-Joo Bae, Mi-Ji Kim, Sung Soo Oh, Ki Soo Park, Chan Joo Lee, Sungha Park, Seung-Koo Lee, Sang-Baek Koh, Hyeon Chang Kim, Changsoo Kim, Jaelim Cho; J Prev Med Public Health. 2025;58(6):563-571. Published online July 12, 2025; DOI: https://doi.org/10.3961/jpmph.25.271

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Abstract Summary PDF: Objectives
Polycyclic aromatic hydrocarbons (PAHs), byproducts of incomplete combustion of organic compounds, have been linked to various adverse health outcomes; however, evidence associating PAHs with liver damage remains inconsistent. This study aimed to investigate the relationship between PAH exposure and liver enzyme levels among firefighters, who have an increased risk of PAH exposure.
Methods
A total of 961 firefighters were included in the study. Urinary concentrations of 4 PAH metabolites (2-naphthol, 2-hydroxyfluorene, 1-hydroxyphenanthrene, and 1-hydroxypyrene) were measured and categorized into quartiles. Serum levels of liver enzymes, aspartate aminotransferase (AST), and alanine aminotransferase (ALT) were evaluated. Age, smoking status, alcohol consumption, body mass index (BMI), job position, and self-reported disease history were adjusted as covariates. Multivariable linear regression analyses were conducted to assess the association between PAH metabolites and serum AST and ALT levels. Logistic regression analyses evaluated associations between PAH metabolites and abnormal AST and ALT levels, defined as 40 IU/L or higher.
Results
Participants in the highest quartile of urinary 2-naphthol had an increased risk of abnormal ALT levels compared to those in the lowest quartile (odds ratio, 2.00; 95% confidence interval, 1.09 to 3.65). No significant associations were observed for the other PAH metabolites. The association between urinary 2-naphthol and abnormal ALT levels did not differ significantly by smoking status, alcohol consumption, or BMI.
Conclusions
Elevated urinary 2-naphthol levels were associated with abnormal liver enzyme levels among firefighters, suggesting that monitoring and managing PAH exposure may help protect liver health in this occupational group.; Summary

Korean summary
이 연구는 한국 소방관을 대상으로 요중 다환방향족탄화수소 대사체와 간 효소 수치의 연관성을 조사하였다. 연구 결과, 요중 2-naphthol 수치가 가장 높은 사분위수에 속하는 참가자들은 가장 낮은 사분위수와 비교하여 비정상 ALT 수치를 보일 위험이 유의하게 높았다. 이러한 결과는 다환방향족탄화수소 노출을 모니터링하고 관리하는 것이 소방관의 간 건강 보호에 중요한 역할을 할 수 있음을 시사한다.

Key Message
This study investigated the association between urinary polycyclic aromatic hydrocarbon (PAH) metabolites and serum liver enzyme levels among Korean firefighters. Results showed that participants in the highest quartile of urinary 2-naphthol had a significantly increased odds of having abnormal ALT levels compared to those in the lowest quartile. These findings suggest that monitoring and managing PAH exposure may play an important role in protecting the liver health of firefighters.

Sleep Quality and Associated Factors Among Firefighters in Bangkok, Thailand: A Cross-sectional Study: Nunnapat Piyachaiseth, Pornchai Sithisarankul, Jate Ratanachina; J Prev Med Public Health. 2024;57(1):83-90. Published online December 9, 2023; DOI: https://doi.org/10.3961/jpmph.23.305

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2 Web of Science
1 Crossref

Abstract Summary PDF Supplementary Material

Objectives
Professional firefighters face various health hazards and are required to maintain both physical and mental fitness to effectively mitigate crises and respond to emergencies. Moreover, the long working hours and shift work of this profession impact sleep quality. This study investigated the quality of sleep and its associated factors among firefighters in Bangkok, Thailand.
Methods
This was a cross-sectional study of firefighters affiliated with the Bangkok Fire and Rescue Department, Bangkok Metropolitan Administration, Thailand between January 2023 and March 2023. A cluster random sampling technique was utilized to distribute 600 questionnaires to firefighters in 15 fire stations. The questionnaire addressed demographic, work-related, and environmental factors. Sleep quality was assessed using the Thai version of the Pittsburgh Sleep Quality Index (PSQI). Data analysis involved both descriptive and inferential statistics. Bivariate and multiple logistic regressions were performed.
Results
The response rate was 78.7% (n=472), and 44.1% of the firefighters reported poor sleep quality (PSQI score >5). Sleep quality was statistically associated with conflicting family relationships (odds ratio [OR], 1.8; 95% confidence interval [CI], 1.1 to 2.9), additional part-time jobs (daytime, OR, 2.4; 95% CI, 1.3 to 4.4; or nighttime, OR, 4.3; 95% CI, 1.1 to 16.7), noisy sleeping areas (OR, 1.7; 95% CI, 1.1 to 2.8), and the availability of adequate bedding (OR, 3.0; 95% CI, 1.8 to 4.9).
Conclusions
Poor sleep quality among firefighters was associated with various personal, work-related, and environmental factors. Organizations should promote policies that improve sleep quality through good sleep hygiene practices and facilities.

Summary

Key Message
This cross-sectional study aimed to investigate sleep quality among firefighters in Bangkok, Thailand its associated factors. 44.1% of the firefighters reported poor sleep quality (the Pittsburgh Sleep Quality Index: PSQI score >5). Sleep quality was statistically associated with conflicting family relationships, additional part-time jobs (daytime or nighttime), noisy sleeping areas, and the availability of adequate bedding.

Citations

Citations to this article as recorded by

Burnout, areas of worklife and associated factors among industrial workers: a cross-sectional study from Thailand
Inthuon Hongsiri, Wiroj Jiamjarasrangsi, Jate Ratanachina
Psychology, Health & Medicine.2025; : 1. CrossRef

Effect of Burnout on Post-traumatic Stress Disorder Symptoms Among Firefighters in Korea: Data From the Firefighter Research on Enhancement of Safety & Health (FRESH): Woojin Kim, Munjoo Bae, Sei-Jin Chang, Jin-Ha Yoon, Da Yee Jeong, Dae-Sung Hyun, Hye-Yoon Ryu, Ki-Soo Park, Mi-Ji Kim, Changsoo Kim; J Prev Med Public Health. 2019;52(6):345-354. Published online October 24, 2019; DOI: https://doi.org/10.3961/jpmph.19.116

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284 Download
21 Crossref

Abstract Summary PDF Supplementary Material

Objectives
It is well-known that post-traumatic stress disorder (PTSD) among firefighters contributes to their job-related stress. However, the relationship between burnout and PTSD in firefighters has rarely been studied. This study therefore explored the association between burnout and its related factors, such as trauma and violence, and PTSD symptoms among firefighters in Korea.
Methods
A total of 535 firefighters participated in the Firefighter Research on Enhancement of Safety & Health study at 3 university hospitals from 2016 to 2017. The 535 participants received a baseline health examination, including questionnaires assessing their mental health. A Web-based survey was also conducted to collect data on job-related stress, history of exposure to violence, burnout, and trauma experience. The associations among burnout, its related factors, and PTSD symptoms were investigated using structural equation modeling.
Results
Job demands (β=0.411, p<0.001) and effort-reward balance (β=-0.290, p<0.001) were significantly related to burnout. Burnout (β=0.237, p<0.001) and violence (β=0.123, p=0.014) were significantly related to PTSD risk. Trauma (β=0.131, p=0.001) was significantly related to burnout; however, trauma was not directly associated with PTSD scores (β=0.085, p=0.081).
Conclusions
Our results show that burnout and psychological, sexual, and physical violence at the hands of clients directly affected participants’ PTSD symptoms. Burnout mediated the relationship between trauma experience and PTSD.

Summary

Korean summary
535명의 현직소방관을 대상으로 소방공무원에서 업무관련스트레스, 폭력노출, 외상노출, 소진(번아웃), 외상후 스트레스 장애(PTSD) 증상 설문을 시행하였고, 구조방정식 통해 업무스트레스에 의한 소진이 PTSD에 주는 영향과 다른 요인간의 연관성을 분석하였다. 그 결과, 업무 환경에서의 높은 직무요구수준과 낮은 노력-보상 균형은 소진을 증가시키며, 업무스트레스에 의한 소진과 근무 중 겪게 되는 폭력노출 경험은 PTSD 점수와 양의 연관관계를 보였다. 반면, 업무 도중 외상사건 경험은 PTSD 점수와 직접적으로 유의한 연관관계를 보이지 않았으나, 소진을 통한 간접적으로 영향을 주는 것을 확인하였다.

Citations

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