Association between body temperature measured at the emergency department with prognosis in septic shock patients

Objective@#Prior studies have explored the relationship between initial body temperature (BT) and mortality in patients with sepsis in the emergency department (ED). However, there has been no study on whether or not changes in BT are associated with prognosis in these patients. We hypothesize that BT measured upon ED arrival and septic shock registry enroll time are related to the prognosis of patients with septic shock. @*Methods@#We conducted a prospective, observational, registry-based study. Each patient was assigned to 1 of 4 groups according to BT upon ED arrival and registry enrollment. Odds ratios for 28-day mortality according to the patient group were estimated using multivariable logistic regression. We also conducted logistic regression sensitivity analysis, except for patients whose time interval between arrival and enrollment was less than 1 hour. @*Results@#A total of 2,138 patients with septic shock were included. The 28-day mortalities were 13.7%, 11.2%, 13.0%, and 25.8% in groups 1, 2, 3, and 4, respectively (P<0.001). After adjusting for age, sex, mean atrial pressure, respiratory rate, Sequential Organ Failure Assessment score, lactate concentration, comorbidity, and suspicious infection focus, the risk of mortality was significantly low in patients from group 1 (adjusted odds ratio [aOR], 0.433; 95% confidence interval [CI], 0.310-0.604) and group 2 (aOR, 0.540; 95% CI, 0.336-0.868) compared with group 4. In the sensitivity analysis, group based on BT measured upon ED arrival and registry enrollment also remained an independent predictor of mortality. @*Conclusion@#Afebrile status upon ED arrival and registry enrollment were strongly associated with higher 28-day mortality in patients with septic shock.

Pulmonary function decline in firefighters and non-firefighters in South Korea

OBJECTIVES: The purpose of this study was to evaluate and compare changes to pulmonary function among firefighters and non-firefighters who were exposed to harmful substances in their work environments. METHODS: Firefighters (n = 322) and non-firefighters (n = 107) in Daegu who received a pulmonary function test in 2008 and 2011 as well as a regular health examination were included. Repeated measures ANOVA was performed to evaluate the pulmonary function of the two groups over the three-year period. RESULTS: After adjusting for age, height, body mass index, duration of exposure, physical activity, and smoking, which were statistically different between the two groups and known risk factors of pulmonary function, the forced expiratory volume in one s FEV1, forced vital capacity FVC, and FEV1/FVC% over the 3 year period were significantly lower among firefighters compared with non-firefighters. CONCLUSIONS: Evaluating the working environment of firefighters is difficult; however, our study revealed that pulmonary function declined in firefighters. Thus, more effort should be made to prevent and manage respiratory diseases early by preforming strict and consistent pulmonary function tests in firefighters.

Occupational Risk Factors Associated with Musculoskeletal Symptoms in Public Workers / 대한산업의학회지

OBJECTIVES: The purpose of this study was to examine the occupational risk factors associated with musculoskeletal symptoms in public workers. METHODS: In November 2010, 544 participants anwered a survey that included questions on the participants' general characteristics, job-related factors, health-related behaviors, and psychosocial stress. We measured the relationship of risk factors to musculoskeletal symptoms using a logistic regression analysis. RESULTS: After adjusting for general characteristics, factors associated with occupational musculoskeletal symptoms were gender (OR=2.858, 95% CI=1.701~4.801), unnatural posture (OR=2.386, 95% CI=1.308~4.354), psychosocial stress (OR=4.051, 95% CI=1.336~12.282) and sleep quality (OR=1.672, 95% CI=1.052~2.660). CONCLUSIONS: These findings suggest that psychosocial stress levels and physical environment (especially in professions requiring an unnatural posture) are related to musculoskeletal symptoms in public workers.