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Systematic Review
Non-cancer health risks in firefighters: a systematic review
Jeong Ah Kim, Soo Yeon Song, Wonjeong Jeong, Jae Kwan Jun
Epidemiol Health. 2022;44:e2022109.   Published online November 16, 2022
DOI: https://doi.org/10.4178/epih.e2022109
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  • 202 Download
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
osFirefighters are occupationally exposed to hazardous factors that may increase their risk of disease. However, non-cancer disease risk in firefighters has not been systematically examined. This systematic review aimed to identify non-cancer disease risk in firefighters and determine whether the risk differs according to job characteristics. We searched the Cochrane Library, Embase, PubMed, and KoreaMed databases using relevant keywords from their inception to April 30, 2021. The Risk of Bias Assessment Tool for Non-randomized Studies version 2.0 was used to assess the quality of evidence. Due to study heterogeneity, a narrative synthesis was presented. The systematic literature search yielded 2,491 studies, of which 66 met the selection and quality criteria. We confirmed that the healthy worker effect is strong in firefighters as compared to the general population. We also identified a significant increase in the incidence of lumbar disc herniation, lower back pain, angina pectoris, acute myocardial infarction, and post-traumatic stress disorder (PTSD) in firefighters compared to other occupational groups. Contradictory results for the risk of PTSD and anxiety disorders related to rank were reported. Sufficient evidence for increased risk of lumbar disc herniation, lower back pain, angina pectoris, acute myocardial infarction, and PTSD was available. The risk of non-cancer diseases varied depending on job type, years of service, and rank. However, caution should be exercised when interpreting the results because the classification criteria for firefighters’ jobs and ranks differ by country.
Summary
Korean summary
본 연구는 소방관과 비암성 질환과의 직업관련성을 파악하기 위해 체계적 문헌고찰을 수행하였다. 소방관은 근골격계 질환, 협심증, 심근경색, 외상후 스트레스 장애 등 일부 질환에서 일관된 직업관련성이 보고되었다. 하지만 대부분의 연구에서 연구결과가 건강근로자효과의 영향을 보정하지 못하였고 근무형태, 근무조건, 근무강도 등에 따라 일관되지 못한 결과를 보고하고 있다.
Key Message
In firefighters, risks of lumbar disc herniation, lower back pain, angina pectoris, acute myocardial infarction, and post-traumatic stress disorder were increased constantly. Due to the failure to avoid the healthy-worker effect, consistent relationship between firefighters and non-cancerous diseases has not been reported.
Original Articles
Risk factors for low back pain among elementary school students in western Iran using penalized logistic regression
Forouzan Rezapur-Shahkolai, Elham Gheysvandi, Leili Tapak, Iman Dianat, Akram Karimi-Shahanjarini, Rashid Heidarimoghadam
Epidemiol Health. 2020;42:e2020039.   Published online June 2, 2020
DOI: https://doi.org/10.4178/epih.e2020039
  • 11,079 View
  • 277 Download
  • 7 Web of Science
  • 9 Crossref
AbstractAbstract PDF
Abstract
OBJECTIVES
This study investigated the prevalence of low back pain (LBP) and its risk factors among elementary-school students.
METHODS
In this cross-sectional study, 693 elementary students from Hamadan city, western Iran, were selected by multistage stratified cluster sampling. Data were collected through interviews using questionnaires. Posture and psychosocial elements were assessed using the observational Rapid Upper Limb Assessment (RULA) checklist and the standard Strengths and Difficulties Questionnaire, respectively. Penalized logistic regression with the group smoothly-clipped absolute deviation regularization method was used for variable selection and data analysis (α=0.05). The chi-square test was also used.
RESULTS
In total, 26.6% of the students (7-12 years old) reported LBP in the last month. Older age (odds ratio [OR], 3.08; 95% confidence interval [CI], 1.80 to 5.26), watching TV for more than 3 hours a day (OR, 2.62; 95% CI, 1.46 to 4.68), very short seat backrests (OR, 3.08; 95% CI, 1.61 to 5.90), excessively curved seat backrests (OR, 4.36; 95% CI, 2.08 to 9.13), very short desks (OR, 3.44; 95% CI, 1.61 to 7.35), a family history of LBP (OR, 2.49; 95% CI, 1.58 to 3.91), carrying a school bag on one shoulder (OR, 1.91; 95% CI, 1.03 to 3.54), and RULA scores of 3 (OR, 2.26; 95% CI, 1.13 to 4.50) or 4 (OR, 2.85; 95% CI, 1.37 to 5.91) were associated with LBP.
CONCLUSIONS
A high prevalence of LBP was found among elementary-school students. This study underscores the importance of recognizing vulnerable children and teenagers and developing interventional health promotion programs to prevent LBP based on an appropriate consideration of its contributory factors.
Summary

Citations

Citations to this article as recorded by  
  • Prevalence of chronic pain and contributing factors: a cross-sectional population-based study among 2,379 Iranian adolescents
    Maryam Shaygan, Azita Jaberi, Marziehsadat Razavizadegan, Zainab Shayegan
    The Korean Journal of Pain.2023; 36(2): 230.     CrossRef
  • Examining the Relationship between Mental Health and Chronic Pain in Children and Adolescents: A Systematic Review Study
    Farzin Bagheri Sheykhangafshe, Hojjatollah Farahani, Mohsen Dehghani, Ali Fathi-Ashtiani
    Journal of Rafsanjan University of Medical Sciences.2023; 22(6): 617.     CrossRef
  • Association between Physical Fitness and Low Back Pain: The Pepe Cross-Sectional Study
    Aina M. Galmés-Panadés, Josep Vidal-Conti
    Children.2022; 9(9): 1350.     CrossRef
  • Prevalence of Low Back Pain among Primary School Students from the City of Valencia (Spain)
    Vicente Miñana-Signes, Manuel Monfort-Pañego, Antonio Hans Bosh-Bivià, Matias Noll
    Healthcare.2021; 9(3): 270.     CrossRef
  • Identification of factors related to behaviors associated with musculoskeletal pain among elementary students
    Forouzan Rezapur-Shahkolai, Elham Gheysvandi, Akram Karimi-Shahanjarini, Leili Tapak, Rashid Heidarimoghadam, Iman Dianat
    BMC Musculoskeletal Disorders.2021;[Epub]     CrossRef
  • Parents' knowledge and attitudes when choosing their children's school bag: An introductory study
    Dijana Laštro, Mirsad Muftić, Nenad Ponorac, Dubravko Bokonjić
    Scripta Medica.2021; 52(2): 124.     CrossRef
  • Designing School Tables and Chairs based on Anthropometry of Elementary School Students in Surabaya
    Riska Ayu Yulianingtyas, Dani Nasirul Haqi
    The Indonesian Journal Of Occupational Safety and Health.2021; 10(1): 97.     CrossRef
  • Unconventional seats for students returning to school during the worldwide COVID-19 pandemic: has Italy taken the right direction?
    Massimiliano Polastri, Julie Swann
    International Journal of Therapy and Rehabilitation.2020; 27(11): 1.     CrossRef
  • Effectiveness of mat Pilates on postural alignment in the sagittal plane in school children: a randomized clinical trial
    Fabíola Unbehaun Cibinello, Jessica Caroliny de Jesus Neves, Mônica Yosino Leão Carvalho, Paola Janeiro Valenciano, Dirce Shizuko Fujisawa
    Motriz: Revista de Educação Física.2020;[Epub]     CrossRef
Association of appendicular skeletal muscle mass with carotid intima-media thickness according to body mass index in Korean adults
Ji Eun Heo, Hyeon Chang Kim, Jee-Seon Shim, Bo Mi Song, Hye Yoon Bae, Ho Jae Lee, Il Suh
Epidemiol Health. 2018;40:e2018049.   Published online October 7, 2018
DOI: https://doi.org/10.4178/epih.e2018049
  • 12,483 View
  • 203 Download
  • 14 Web of Science
  • 13 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
The combined effects of obesity and appendicular skeletal muscle (ASM) on atherosclerosis, especially in middleaged populations, remain poorly understood. This cross-sectional study investigated the effects of ASM on carotid intima-media thickness (IMT) according to body mass index (BMI) in middle-aged Korean adults.
METHODS
Herein, 595 men and 1,274 women aged 30-64 years completed questionnaires and underwent health examinations as part of the Cardiovascular and Metabolic Disease Etiology Research Center cohort. ASM was measured via bioelectrical impedance analysis and adjusted for weight (ASM/Wt). IMT was assessed using B-mode ultrasonography; highest quartile of IMT was defined as gender-specific top quartile of the IMT values. Higher BMIs was defined as a BMI over 25.0 kg/m2 .
RESULTS
Compared to the highest ASM/Wt quartile, the lowest ASM/Wt quartile was significantly associated with highest quartile of IMT in men with lower BMIs (adjusted odds ratio [aOR], 2.78; 95% confidence interval [CI], 1.09 to 7.13), but not in those with higher BMIs (aOR, 0.59; 95% CI, 0.24 to 1.91). In women, there was no significant association of low skeletal muscle mass with highest quartile of IMT, regardless of BMI.
CONCLUSIONS
Low appendicular skeletal muscle mass is associated with carotid arterial wall thickening in men with lower BMIs, but not in men with higher BMIs. Our findings suggest that the risk of atherosclerosis may be low in middle-aged Korean men with appropriate body weight and skeletal muscle mass maintenance.
Summary
Korean summary
한국 중년 성인을 대상으로 사지근육양과 죽상경화증(경동맥 내중막 두께≥75 percentile)의 관련성을 체질량지수(≥25, <25 kg/m2)로 층화하여 평가하였다. 체질량지수 25 kg/m2 미만인 남자에서는, 사지근육양이 낮으면 죽상경화증의 위험이 유의하게 높았으나, 체질량지수 25 kg/m2 이상인 남자에서는 관련성이 없었다. 반면 여자에서는 체질량지수에 상관없이 사지근육양과 죽상경화증의 독립적인 관련성이 관찰되지 않았다.

Citations

Citations to this article as recorded by  
  • Contribution of low skeletal muscle mass in predicting cardiovascular events: A prospective cohort study
    Yiting Xu, Tingting Hu, Yun Shen, Yufei Wang, Yuqian Bao, Xiaojing Ma
    European Journal of Internal Medicine.2023; 114: 113.     CrossRef
  • Low appendicular skeletal muscle index increases the risk of carotid artery plaque in postmenopausal women with and without hypertension/hyperglycemia: a retrospective study
    Yayun Lu, Jianguang Tian, Liangyu Wu, Qing Xia, Qinzhong Zhu
    BMC Geriatrics.2023;[Epub]     CrossRef
  • Relationship between neck vessel abnormalities and sarcopenia: results of a study examining trends in health and aging in western China
    Huaying Ding, Xiaoyan Chen, Sha Huang, Birong Dong
    European Geriatric Medicine.2023; 15(1): 253.     CrossRef
  • A new paradigm in sarcopenia: Cognitive impairment caused by imbalanced myokine secretion and vascular dysfunction
    Danbi Jo, Gwangho Yoon, Oh Yoen Kim, Juhyun Song
    Biomedicine & Pharmacotherapy.2022; 147: 112636.     CrossRef
  • Low serum creatinine to cystatin C ratio is independently associated with sarcopenia and high carotid plaque score in patients with type 2 diabetes
    Jang Yel Shin
    Nutrition, Metabolism and Cardiovascular Diseases.2022; 32(6): 1454.     CrossRef
  • Association of High Muscle Mass with Carotid Atherosclerosis: A Community-Based Population Cohort Study
    Y. Xu, T. Hu, Y. Shen, Y. Wang, Xiaojing Ma, Yuqian Bao
    The Journal of nutrition, health and aging.2022; 26(12): 1087.     CrossRef
  • Sarcopenia, sarcopenic overweight/obesity and risk of cardiovascular disease and cardiac arrhythmia: A cross-sectional study
    Ming-Feng Xia, Ling-Yan Chen, Li Wu, Hui Ma, Xiao-Ming Li, Qian Li, Qiqige Aleteng, Yu Hu, Wan-Yuan He, Jian Gao, Huan-Dong Lin, Xin Gao
    Clinical Nutrition.2021; 40(2): 571.     CrossRef
  • Muscle mass and grip strength in relation to carotid intima-media thickness and plaque score in patients with type 2 diabetes
    Jang Yel Shin, Jung Soo Lim
    Nutrition, Metabolism and Cardiovascular Diseases.2021; 31(10): 2935.     CrossRef
  • Low muscle mass is associated with carotid atherosclerosis in patients with type 2 diabetes
    Da Hea Seo, Yong-ho Lee, Young Ju Suh, Seong Hee Ahn, Seongbin Hong, Young Ju Choi, Byoung Wook Huh, Seok Won Park, Eunjig Lee, So Hun Kim
    Atherosclerosis.2020; 305: 19.     CrossRef
  • Associations of skeletal muscle mass with atherosclerosis and inflammatory markers in Korean adults
    Soon-Kyu Yoon, Ha-Na Kim, Sang-Wook Song
    Archives of Gerontology and Geriatrics.2020; 90: 104163.     CrossRef
  • Impact of sarcopenia on glycemic control and atherosclerosis in Japanese patients with type 2 diabetes: Cross‐sectional study using outpatient clinical data
    Shuhei Nakanishi, Masahiro Iwamoto, Hisanori Shinohara, Hideyuki Iwamoto, Hideaki Kaneto
    Geriatrics & Gerontology International.2020; 20(12): 1196.     CrossRef
  • Quantification of Plasma Kynurenine Metabolites Following One Bout of Sprint Interval Exercise
    Ada Trepci, Sophie Imbeault, Victoria L Wyckelsma, Håkan Westerblad, Sigurd Hermansson, Daniel C Andersson, Fredrik Piehl, Tomas Venckunas, Marius Brazaitis, Sigitas Kamandulis, Lena Brundin, Sophie Erhardt, Lilly Schwieler
    International Journal of Tryptophan Research.2020; 13: 117864692097824.     CrossRef
  • Cohort Profile: The Cardiovascular and Metabolic Diseases Etiology Research Center Cohort in Korea
    Jee-Seon Shim, Bo Mi Song, Jung Hyun Lee, Seung Won Lee, Ji Hye Park, Dong Phil Choi, Myung Ha Lee, Kyoung Hwa Ha, Dae Jung Kim, Sungha Park, Won-Woo Lee, Yoosik Youm, Eui-Cheol Shin, Hyeon Chang Kim
    Yonsei Medical Journal.2019; 60(8): 804.     CrossRef
Correlation Between Muscle Amounts and Grasp Power in the Elderly People, Jejudo.
Hojun Lee, Minsung Park, Yeoju Go, Yeong Ja Yang, Jong Myon Bae
Korean J Epidemiol. 2006;28(2):182-188.
  • 65,535 View
  • 33 Download
AbstractAbstract PDF
Abstract
OBJECTIVES
This study was conducted to examine the relationships between muscle mass and hand strength in elderly people.
METHODS
The study subjects were 659 volunteers aged older than 65 in Jejudo, south Korea. The anthropometric information such as weight, body mass index (BMI) and muscular mass was collected by the body composition analyzer. The hand strength was obtained by the digital grip dynamometer. The fasting blood sugar index called as potential diabetes mellitus (DM) was defined as the condition over 120 mg/dL of the blood sugar. The BMI was classified into under 23, 23-25 and over 25 to analyze the relationships of BMI and muscle mass, hand strength.
RESULTS
The factors affecting muscle mass were sex (p<0.001), age (p<0.001) and BMI (p<0.001). The factors affecting hand strength were sex (p<0.001), age (p<0.001) and BMI (p=0.003). And there was a weak association between muscle mass and hand strength after controlling with the affected factors (r2=0.15, p<0.001).
CONCLUSIONS
The hand strength is weekly correlated with the muscle mass. So we recommend to use digital grip dynamometer combining with other measurements for diagnosis the sarcopenia in epidemiologic study.
Summary

Epidemiol Health : Epidemiology and Health