Background: The Korean Occupational Stress Scale (KOSS) was developed in 2004. During this time, industrial structures have evolved, and societal awareness of occupational stress has changed. This study aims to develop and validate a revised version of the Korean Occupational Stress Scale (KOSS®19), tailored for workers, reflecting these changes. Methods: The KOSS®19 was developed based on the 26-item KOSS–short form (SF) through a review by eight experts. A survey was conducted including 359 service industry workers, comprising the KOSS®19, Burnout, and Depression scales. The KOSS®19 subscales were restructured, and their reliability and validity were evaluated. Results: The KOSS®19 composed of eight subscales: hazardous physical environment (2 items), high job demand (3 items), insufficient job control (2 items), low social support (2 items), job insecurity (2 items), organizational injustice (4 items), lack of reward (2 items), and work-life imbalance (2 items). The reliability and validity of the KOSS®19 were found to be satisfactory. Conclusions The KOSS®19 is a suitable tool for assessing occupational stress, effectively replacing the original KOSS and KOSS-SF.

Background: Emotional labor refers to the management of emotions and expressions to meet the emotional requirements of a job role. This study aimed to develop a revised version of the Korean Emotional Labor Scale (KELS®11), based on the first edition (KELS-24) introduced in 2014, and to provide practical applications and guidelines for its use in the Korean workplace through a validation process. Methods: The revised version of KELS®11 was derived from the 24-item KELS, following a review process involving eight experts. To validate the scale’s reliability and validity, a self-administered survey was conducted among 359 service industry workers using KELS®11, burnout, and depression scales. KELS®11 was reclassified, and its reliability and validity were evaluated. Receiver operating characteristic curve analysis was conducted to establish sex-specific cutoff values (normal vs. high-risk groups). Results: KELS®11 was designed to account for individual, organizational, and cultural contexts. It consists of four subscales and 11 items: “emotional regulation” (2 items), “emotional dissonance” (3 items), “organizational monitoring” (2 items), and “organizational protective system for emotional labor” (4 items). KELS®11 demonstrated good validity (content validity ratio: 0.84; item convergence/discriminant validity success rates: 100%; correlation with burnout: r = 0.185–0.436, p < 0.01; correlation with depression: r = 0.128–0.339, p < 0.05) and reliability (Cronbach’s alpha: 0.597–0.795). Additionally, sex-specific reference values were established to determine risk groups based on the intensity of emotional labor exposure. Conclusions KELS®11 is a validated and reliable measurement tool designed to assess the intensity and magnitude of emotional labor in the workplace. The revised tool reflects critical considerations in the development of emotional labor measurement scales.

Background: Workplace violence refers to any act or threat of physical violence, verbal abuse, harassment, intimidation, bullying, mobbing, or other aggressive and disruptive behaviors that occur at work. This study aims to develop and validate a revision of the Korean Workplace Violence Scale (KWVS®13), based on the first edition of the Korean Workplace Violence Scale (KWVS-24), and to provide practical applications and guidelines for the Korean workplace environment. Methods: The revised KWVS®13 was developed by restructuring the 24-item KWVS through a review process involving eight experts. To validate the reliability and validity of KWVS®13, a self-administered survey comprising KWVS®13, burnout, and depression scales was conducted among 359 service industry workers. KWVS®13 was reclassified, and its reliability and validity were assessed. Receiver operating characteristic curve analysis was performed to establish sex-specific cutoff values (normal vs. risk) of the scale. Results: KWVS®13 consists of 13 items across four subscales: “psychological and sexual violence from customers” (4 items), “psychological and sexual violence from supervisors or coworkers” (4 items), “physical assault from customers, supervisors, or coworkers” (2 items), and “organizational protective system for workplace violence” (3 items). We found that KWVS®13 shows relatively good validity (content validity ratio for content validity: 0.888; success rate of item convergent and discriminant validity: 100%, and significant correlation coefficient with burnout (r = 0.115–0.83, p < 0.05) and depression (r = 0.098–0.348, p < 0.05) with the exception of Organizational Violence Protection System for Workplace Violence) and reliability (Cronbach’s alpha: 0.827–0.860). The reference values for determining risk groups according to the intensity of exposure to workplace violence are presented separately by sex. Conclusions KWVS®13 is a robust and useful measurement tool to objectively and quantitatively assess the intensity and magnitude of workplace violence. It incorporates important considerations for workplace violence assessment and provides a reliable framework for evaluating workplace violence in various professional settings.

Background: Webtoon, a digital form of comics created in the Republic of Korea, has spread widely with advantages that anyone can become a cartoonist and that autonomy of creation is guaranteed. The purpose of this study is to identify the working conditions of webtoon writers and analyze the relationship between these conditions and depressive symptoms. Methods: A survey was carried out on webtoon writers and a survey data of 312 webtoon writers were analyzed. The questionnaire included basic socio-demographic characteristics, webtoon writers’ contractual type, fields of activity (webtoon creator, story writer, illustrator), and working environment (labor discretion etc.). We investigated depressive symptoms and analyzed its relation to the work environment of webtoon writers. Results: Webtoon writers were exposed to long working hours, high labor intensity, limited labor discretion, negative comments from readers, and had a high prevalence of depressive symptoms. Compared to story writers who contracted directly with platforms, story writers and the illustrators who contracted with content providers (CPs) were 9.51 times (OR = 9.51, 95% CI = 1.47 - 61.33) and 6.47 times (OR = 6.47, 95% CI = 1.08 – 38.75) more likely to have depressive symptoms, respectively. Conclusions This study emphasizes the urgent necessity to improve the overall working environment in the webtoon industry and implement measures to tackle the escalating mental health challenges faced by illustrators and story writers contracted with CPs, especially given the increasing popularity of novel comics.

Background: We conducted a case-control study to identify high-risk occupations and exposure to occupational hazards for acute myeloid leukemia (AML). Methods: When patients with AML admitted to the Department of Hematology in the study hospital for the first time are referred to the Department of Occupational and Environmental Medicine, data on occupation are collected by investigators to evaluate work-relatedness. Community-based controls were recruited through an online survey agency, and four controls per case were matched. Occupational information was estimated using structured questionnaires covering 27 specific occupations and 32 exposure agents. Conditional logistic regression analysis was performed by pairing cases and controls. Results: In the analysis of the risk of AML according to occupational classification, a significant association was found in paint manufacturing or painting work (OR = 2.22, 95% CI: 1.03–4.81) and aircrew (OR = 6.00, 95% CI: 1.00–35.91) in males, and in pesticide industry (OR = 6.89, 95% CI: 1.69–28.07) and cokes and steel industry (OR = 2.00, 95% CI: 1.18–22.06) in ≥60 years old. Moreover, the risk of AML increased significantly as the cumulative exposure to thinners increased. In the analyses stratified by sex and age, the association between pesticide exposure and AML was significant in males (OR = 3.28, 95% CI: 1.10–9.77) and in ≥60 years old (OR = 6.22, 95% CI: 1.48–26.08). Conclusion This case-control study identified high-risk occupational groups in the Republic of Korea including paint manufacturers and painters, aircrew, and those who are occupationally exposed to pesticides or paint thinners.

OBJECTIVES: While issues related to mental health, including suicide, have been frequently reported among finance workers, no formal investigation has been undertaken. This study was conducted to analyze correlations between indicators of performance pressure, which is a characteristic of the finance sector, and mental health. METHODS: An online survey was administered to 1,181 participants. Brief questionnaires were employed to ask general questions about participant characteristics, work environment, and the presence of performance pressure, suicidal thoughts/plans/attempts, depression (indicated by the Patient Health Questionnaire-9), and anxiety (measured with the Generalized Anxiety Disorder-7). Frequency analysis, chi-square testing, and multivariate logistic regression analysis were performed. RESULTS: Of the 1,181 respondents, 797 (83.5%) reported feeling pressure to perform at work, while 252 (26.4%) admitted to occasional willingness to achieve results even through illegal activities. Multivariate logarithmic regression analysis was employed to examine the correlation between performance pressure and mental health. This analysis revealed that those expressing willingness to achieve results through illegal activities exhibited higher levels of suicidal ideation (adjusted odds ratio [aOR], 1.63; 99% confidence interval [CI], 1.04 to 2.55), plans (aOR, 1.75; 99% CI, 1.01 to 3.01), and attempts (aOR, 2.72; 99% CI, 1.06 to 6.98). Additionally, these individuals demonstrated higher levels of depression (aOR, 2.02; 99% CI, 1.34 to 3.06) and anxiety (aOR, 2.84; 99% CI, 1.81 to 4.46). CONCLUSIONS Performance pressure is prevalent within the finance industry. This pressure serves as a major source of stress for employees and is evident in 3 representative indicators of mental health: suicide, depression, and anxiety.

Background: In the event of an industrial accident, the appropriate choice of hospital is important for worker health and prognosis. This study investigates whether the choice of hospital by the employer in the case of industrial accidents affects the prognosis of injured employees. Methods: Data from the 2018 Panel Study of Workers’ Compensation Insurance in Korea were used in an unmatched case-controlled study. The exposure variable is “hospital selection by an employer,” and the outcome variable is ‘worker’s disability.” Odds ratios (ORs) were estimated by modified Poisson regression and adjusted for age, gender, underlying disease, injury severity, and workplace size and stratified by industrial classification. The group at increased risk was analyzed and stratified by age, gender, and area. Results: In the construction industry, hospital selection by the employer was significantly associated with increased risk of disability (adjusted OR 1.26; 95% confidence interval [CI]: 1.20–1.32) and severe disability (adjusted OR 1.38; 95% CI: 1.08–1.76) among the injured. Female and younger workers not living in the Seoul capital area were more at risk of disability and severe disability than those living in the Seoul capital area. Conclusions Hospital selection by employers affects the prognosis of workers injured in an industrial accident. For protecting workers’ health and safety, workplace emergency medical systems should be improved, and the selection of appropriate hospitals to supply treatment should be reviewed.

Background/Aims: Workers who are exposed to dust in the workplace tend to show a higher incidence of gastric cancer. Nevertheless, scientific evidence to support an association between dust exposure and the risk of gastric cancer is inadequate. This study aimed to investigate whether or not occupational dust exposure influences the risk of gastric cancer. Methods: We collected the electronic data from the Pneumoconiosis Health Examination (PHE) program, provided by the Ministry of Employment and Labor and the Korea Workers’ Compensation and Welfare Service from 2002 to 2017. The PHE database was linked to the National Health Insurances databases. The age-standardized incidence ratio (SIR) and 95% confidence intervals (CIs) of the risk of gastric cancers were evaluated in workers with occupational dust exposure, and the results were compared to those in the general population. Results: From 2004 to 2015, 1,543 cases of gastric cancer were observed in the male participants, as compared with 1,174 of expected cases, which yielded an SIR of 1.314 (95% CI, 1.249 to 1.380). Under dust exposure, the risk of gastric cancer was increased 23.9% in the male participants (95% CI, 19.9 to 27.5), and the degree of impairment of lung function was inversely related to the risk of gastric cancer. Conclusions Workers with occupational dust exposure were at higher risk of developing gastric cancer than the general population. Thus, future efforts for the prevention of gastric cancer are necessary for dust exposed workers.

BACKGROUND: Individual particulate respirator use may offer protection against exposure to particulate matter < 2.5 µm in diameter (PM(2.5)). Among elderly Korean women, we explored individual particulate respirator use and cardiopulmonary function.METHODS: Recruited in Seoul, Korea, 21 elderly, non-smoking women wore particulate respirators for six consecutive days (exlcuding time spent eating, sleeping, and bathing). We measured resting blood pressure before, during, and after respirator use and recorded systolic and diastolic blood pressure, mean arterial blood pressure, pulse pressure, and lung function. We also measured 12-hour ambulatory blood pressure at the end of the 6-day long experiment and control periods. Additionally, we examined physiological stress (heart rate variability and urinary 8-hydroxy-2′-deoxyguanosine) while wearing the particulate respirators. Person- and exposure-level covariates were also considered in the model.RESULTS: After the 6-day period of respirator use, resting blood pressure was reduced by 5.3 mmHg for systolic blood pressure (P = 0.013), 2.9 mmHg for mean arterial blood pressure (P = 0.079), and 3.6 mmHg for pulse pressure (P = 0.024). However, particulate respirator use was associated with changes in physiological stress markers. A parasympathetic activity marker (high frequency) significantly decreased by 24.0% (P = 0.029), whereas a sympathetic activity marker (ratio of low-to-high frequency) increased by 50.3% (P = 0.045). An oxidative stress marker, 8-hydroxy-2′-deoxyguanosine, increased by 3.4 ng/mg creatinine (P = 0.021) during the experimental period compared with that during the control period. Lung function indices indicated that wearing particulate respirators was protective; however, statistical significance was not confirmed.CONCLUSION: Individual particulate respirator use may prevent PM(2.5)-induced blood-pressure elevation among elderly Korean women. However, the effects of particulate respirator use, including physiological stress marker elevation, should also be considered.TRIAL REGISTRATION: Clinical Research Information Service Identifier: KCT0003526

Background: It is well known that the prevalence of obesity in Korea is increasing over time, however it is not known how the trends among occupational groups and sex differ in such increasing trends. This study was designed to provide recent trends of obesity among workers in Korea and to identify whether there were differences among occupational groups. Methods: We used data from the Korean National Health and Nutrition Examination Survey, Phases I to VI (1998–2015), to analyze trends in the prevalence of obesity in adult Korean workers. Obesity was defined as a body mass index of 25 kg/m2 or higher. Occupations were classified into 3 groups: (a) nonmanual workers, (b) service/sales workers, and (c) manual workers. Results: During the period of the Korean National Health and Nutrition Examination Survey Phases I to VI, the prevalence of obesity in male workers increased in all occupations (31.1% to 39.5% in manual workers, 32.3% to 38.2% in service/sales workers, and 25.3% to 39.7% in manual workers). However, female workers did not show any particular tendency toward obesity, except for a significant decrease in the prevalence rate in service/sales workers (30.8% to 23.9%, p for trend = 0.0048). Conclusion The trends of obesity prevalence by sex and occupation were different. For male manual workers, the prevalence rate increased steadily during the data period, while it decreased steadily in female sales/service workers.