Health-Related Quality of Life of Post-Stroke Patients in a Public Hospital.

This study aimed to identify the correlation between influencing factors of activities of daily living (ADLs), mental health, and health-related quality of life (HRQoL) among post-stroke patients who enrolled in a transitional care service in a public hospital. This cross-sectional study involved 67 stroke patients who were enrolled in a transitional care service and visited the outpatient clinic at a public hospital in Seoul between March and December 2022. Their general characteristics, ADLs, mental health, and HRQoL were assessed. The data were analyzed using independent samples t-tests, analysis of variance, and Pearson correlation analysis, and the influencing factors were analyzed using regression analysis. HRQoL showed a statistically significant difference between patients living in different types of arrangements (t = 2.50, p = 0.015), and patients scores on the modified Rankin Scale (t = 7.08, p < 0.001). HRQoL was also significantly correlated with ADLs and mental health in stroke patients (r = -0.59, p < 0.001; r = -0.41, p < 0.001, respectively). Meanwhile, stroke severity (ß = -0.30, p = 0.002), living arrangements (ß = -0.30, p = 0.009) and ADLs (ß = -0.45, p < 0.001) were found to influence HRQoL (F = 6.87, p < 0.001, R2 = 0.47). Reduced dependence for ADLs, improvements in symptoms consequent to stroke, and support related to living arrangements contributed to improved HRQoL and interventions for post-stroke patients in the transitional care service of a public hospital.

Cardiometabolic diseases according to the type and degree of hearing loss in noise-exposed workers.

Background: This study aimed to determine the association between cardiometabolic diseases, including metabolic syndrome, hypertension, and diabetes, and the type and degree of hearing loss in noise-exposed workers. Methods: A total of 237,028 workers underwent air conduction pure tone audiometry in 2015 to assess their health and diagnose cardiometabolic diseases. The study defined metabolic syndrome, hypertension, and diabetes using blood pressure, fasting blood sugar, cholesterol, and triglyceride levels. Mid-frequency hearing loss was defined as ≥ 30 dB at 2,000 Hz, whereas high-frequency hearing loss was ≥ 40 dB at 4,000 Hz. The average air conduction hearing thresholds at these frequencies were used to determine hearing loss degrees. Results: The odds ratio (OR) of combined exposure to noise and night-shift work in all cardiometabolic diseases was higher than that of noise exposure alone. The risk of cardiometabolic diseases was dose-response, with higher hearing loss causing higher ORs. The ORs of hypertension compared with the normal group were 1.147 (1.098-1.198), 1.196 (1.127-1.270), and 1.212 (1.124-1.306), and those of diabetes were 1.177 (1.119-1.239), 1.234 (1.154-1.319), and 1.346 (1.241-1.459) for mild, moderate, and moderate-severe hearing loss, respectively. Conclusions: Workers who are exposed to noise tend to demonstrate high risks of hearing loss and cardiometabolic diseases; thus, bio-monitoring of cardiometabolic diseases, as well as auditory observation, is necessary.

Effect of Household Type on the Prevalence of Climacteric Syndrome among Middle-Aged Men.

Research on climacteric syndrome among middle-aged men remains scant compared to the research among women. Research is also lacking on climacteric syndrome among older adults living alone, particularly men, who are more vulnerable than females living alone. This cross-sectional study investigated whether the prevalence of climacteric syndrome is associated with the type of household middle-aged men live in and identified the determinants of climacteric syndrome based on the household type. Six hundred middle-aged men living in multi-person households and six hundred living alone were surveyed about general characteristics, diet-related factors, and climacteric syndrome. Data were analyzed using Pearson's chi-squared test, Fisher's exact test, and logistic regression. The risk of climacteric syndrome in single-person households was found to be 1.6 times higher than that among multi-person households (p = 0.006). In multi-person households, income and breakfast frequency predicted climacteric syndrome (p < 0.05), while age, breakfast frequency, dinner frequency, and weekly eating out frequency predicted climacteric syndrome in single-person households (p < 0.05). Thus, dietary factors are more closely linked to the prevalence of climacteric syndrome in single-person households than in multi-person households. This highlights the need for climacteric syndrome interventions for middle-aged men, whose health concerns may persist into older adulthood.

Psychological Distress and Perceived Burden in Parents of Korean Children With IgE-Mediated Food Allergy.

BACKGROUND: Food allergy (FA) can have a profound effect on quality of life (QoL), stress, and anxiety in the family. We aimed to validate the Korean version of the Food Allergy Quality of Life-Parental Burden (FAQL-PB) and identify factors related to the parental psychosocial burden of caring for children with FAs. METHODS: Parents of children aged between 6 months and 17 years with immunoglobulin E (IgE)-mediated FAs from the Pediatric Allergy Department of five university hospitals in Korea were enrolled in the study. Parents were asked to complete the FAQL-PB, Food Allergy Independent Measure-Parent Form (FAIM-PF), Child Health Questionnaire-Parents Form 28 (CHQ-PF28), Beck's Anxiety Inventory, Connor-Davidson Resilience Scale, and Patient Health Questionnaire-9 for depression. Statistical analyses included internal consistency, test-retest reliability, concurrent validity, discriminative validity, and logistic regression analyses. RESULTS: A total of 190 parents were enrolled. Social activity limitation was the item with the highest FAQL-PB scores. The Cronbach's α for each item was higher than 0.8. The test-retest reliability was good (intra-class correlation coefficient, 0.716; 95% confidence interval [CI], 0.100-0.935). An increase in the FAQL-PB was significantly associated with an increase in the FAIM-PF (ß = 0.765, P < 0.001) (concurrent validity). There was a positive correlation between parental burden, anxiety, and depression, while resilience was inversely correlated with parental burden (all P < 0.001). The total FAQL-PB score in parents of children who had experienced anaphylaxis was significantly higher than that in parents of children who did not experience it (P = 0.008). When adjusting for age, sex, and underlying diseases, anaphylaxis (ß = 9.32; 95% CI, 2.97 to 15.68), cow's milk (CM) allergy (ß = 8.24; 95% CI, 2.04 to 14.44), soybean allergy (ß = 13.91; 95% CI, 1.62 to 26.20), higher anxiety (ß = 1.05; 95% CI, 0.07 to 1.41), higher depression (ß = 2.15; 95% CI, 1.61 to 2.69), and lower resilience (ß = -0.42; 95% CI, -0.61 to -0.2) were significantly associated with greater parental burden in children with IgE-mediated FAs. CONCLUSION: FAQL-PB is a reliable and valid tool for use in Korea. Anaphylaxis, CM or soybean allergies, more anxiety and depression symptoms, and lower resilience are associated with poorer QoL in parents of children with FAs.

Auditory Working Memory Explains Variance in Speech Recognition in Older Listeners Under Adverse Listening Conditions.

INTRODUCTION: Older listeners have difficulty understanding speech in unfavorable listening conditions. To compensate for acoustic degradation, cognitive processing skills, such as working memory, need to be engaged. Despite prior findings on the association between working memory and speech recognition in various listening conditions, it is not yet clear whether the modality of stimuli presentation for working memory tasks should be auditory or visual. Given the modality-specific characteristics of working memory, we hypothesized that auditory working memory capacity could predict speech recognition performance in adverse listening conditions for older listeners and that the contribution of auditory working memory to speech recognition would depend on the task and listening condition. METHODS: Seventy-six older listeners and twenty younger listeners completed four kinds of auditory working memory tasks, including digit and speech span tasks, and sentence recognition tasks in four different listening conditions having multi-talker noise and time-compression. For older listeners, cognitive function was screened using the Mini-Mental Status Examination, and audibility was assured. RESULTS: Auditory working memory, as measured by listening span, significantly predicted speech recognition performance in adverse listening conditions for older listeners. A linear regression model showed speech recognition performance for older listeners could be explained by auditory working memory whilst controlling for the impact of age and hearing sensitivity. DISCUSSION: Measuring working memory in the auditory modality facilitated explaining the variance in speech recognition in adverse listening conditions for older listeners. The linguistic features and the complexity of the auditory stimuli may affect the association between working memory and speech recognition performance. CONCLUSION: We demonstrated the contribution of auditory working memory to speech recognition in unfavorable listening conditions in older populations. Taking the modality-specific characteristics of working memory into account may be a key to better understand the difficulty in speech recognition in daily listening conditions for older listeners.

Assessment of relationship between the use of household products and atopic dermatitis in Seoul: focused on products with associated risks.

The purpose of this study was to evaluate the relationship between the use of certain household products (HPs) at home and atopic dermatitis (AD) in adults. The study was conducted on 1,500 households in Seoul, South Korea. We obtained information on general characteristics, the use of HPs, and AD through an online panel survey in July 2018. HPs were selected as 23 kinds of products with associated risks that are management targets of the Ministry of Environment. The international study of asthma and allergies in childhood was used for the AD questionnaires. Logistic regression analysis was used to identify AD affected by the use of HPs. Average number of used HPs was 13.44 out of 23, and average usage frequency of HPs was 3.52 times a month at home in Seoul for the last 1 year. Compared with subjects with a low number of HPs used (reference), subjects with a high number of used HPs (4th quartile) were more likely to have lifetime diagnosis of AD (odds ratio (OR) = 1.77, 95% confidence interval (CI); 1.23-2.54), symptoms of AD in the last 12 months (OR = 2.66, 95% CI; 1.92-3.70), and treatment of AD in the last 12 months (OR = 2.37, 95% CI; 1.48-3.80). Compared with subjects with a low HPs usage frequency (reference), subjects with a high HPs usage frequency (4th quartile) were more likely to have lifetime diagnosis of AD (OR = 1.88, 95% CI; 1.31-2.70), symptoms of AD in the last 12 months (OR = 2.14, 95% CI; 1.54-2.96), and treatment of AD in the last 12 months (OR = 2.23, 95% CI; 1.39-3.60). Therefore, the use of HPs was significantly associated with AD. The findings of this study might be useful as basic data for managing allergic diseases and establishing preventive measures.

Perception of indoor air quality (IAQ) by workers in underground shopping centers in relation to sick-building syndrome (SBS) and store type: a cross-sectional study in Korea.

BACKGROUND: We examined the indoor air quality (IAQ) perceptions of workers and their relationships with the symptoms of sick-building syndrome (SBS) and store types in underground shopping centers. METHODS: In 2017, 314 store workers in nine underground shopping centers in Seoul, Korea, were assessed. The all participants' stores were partially opened onto a passage. Using questionnaires, they were asked about their demographics, job characteristics, 16 SBS symptoms, and seven IAQ perceptions. The SBS symptoms were categorized as skin, eye irritation, respiratory, or general. An IAQ perception score was calculated by adding the number of positive responses to each type of IAQ and categorized into three levels. RESULTS: The prevalence of SBS symptom groups in the previous month was 43.6% for skin symptoms, 62.4% for eye irritation symptoms, 65.6% for respiratory symptoms, and 64.7% for general symptoms. Participants who perceived IAQ were more likely to have SBS symptoms (odds ratio: 1.81-7.84). The type of store employing the workers was associated with several IAQ perceptions. Subjects who worked in clothing and fashion-accessory stores were more likely to have high IAQ perception scores than those who worked in food services. CONCLUSIONS: About half of the store workers in underground shopping centers had experienced SBS symptom groups in the previous month. The SBS symptom groups were associated with almost all IAQ perceptions. Because IAQ perception was associated with store type, studies of IAQ in working areas might need to improve store workers' health in underground shopping centers.

Relationships Between Secondhand Smoke Incursion and Wheeze, Rhinitis, and Eczema Symptoms in Children Living in Homes Without Smokers in Multi-Unit Housing.

INTRODUCTION: Secondhand smoke (SHS) incursion can occur in units of multi-unit housing (MUH). The purpose of this study was to determine the relationship between SHS incursion and allergic symptoms in children living in MUH without smokers. METHODS: We conducted a cross-sectional study from May to September 2015 in Seoul, Korea. Children were recruited from elementary schools, kindergartens, and daycare centers. In total, 16676 children between 1 and 13 years of age living in MUH without smokers were included in the analysis. Allergic symptoms during the previous 12 months (current wheeze, rhinitis, and eczema) and home environmental factors, including the frequency of SHS incursion during the previous 12 months, were examined using a questionnaire filled out by the parents or guardians of the children. RESULTS: The prevalence of current allergic symptoms in children was 4.9% for wheeze, 42.0% for rhinitis, and 28.1% for eczema. The prevalence of SHS incursion into the children's homes was 61.6%. In a multivariable logistic regression analysis adjusted for demographic and home environmental factors, children living in homes with SHS incursion (either no more than once a month or more than once a month) were more likely to have current wheeze, rhinitis, and eczema than those with no SHS incursion. CONCLUSIONS: More than half of the children's homes in MUH without smokers had SHS incursion. SHS incursion into homes was associated with wheeze, rhinitis, and eczema symptoms in children. IMPLICATIONS: Children living in multi-unit housing (MUH) can be exposed to secondhand smoke (SHS) from smoke transferred from neighboring units with smokers. This study found that more than half of the children's homes without smokers in MUH had SHS incursion. Children living in homes with SHS incursion (either no more than once a month or more than once a month) were more likely to have current wheeze, rhinitis, and eczema than those with no SHS incursion. We confirmed that SHS incursion was associated with allergic symptoms in children.

Trends in the Prevalence of Childhood Asthma in Seoul Metropolitan City, Korea: The Seoul Atopy ∙ Asthma-friendly School Project.

OBJECTIVES: The project Seoul Atopy ∙ Asthma-friendly School investigated the current status of childhood asthma to enable formulation of a preventative policy. We evaluated the current prevalence of childhood asthma in Seoul and its trends and related factors. METHODS: The project was conducted annually from 2011 to 2016 and involved around 35 000 children aged 1-13 years. Based on the International Study of Asthma and Allergies in Childhood guidelines, the survey involved parents. The associations of the particulate matter (PM10) concentration, and the number of days on which the daily air quality guidance level was exceeded in the 25 districts of Seoul, with the prevalence of asthma were assessed. RESULTS: The age-standardized asthma prevalence in 2011 and 2016 was 6.74 and 4.02%, respectively. The prevalence of lifetime asthma treatment and treatment during the last 12 months tended to decrease from 2011 to 2016. Asthma treatment was significantly correlated with the number of days on which the daily air quality guidance level was exceeded, but not with the PM10 concentration. CONCLUSIONS: This study reports the prevalence of asthma among children in Seoul and confirmed the relationship between childhood asthma and known risk factors in a large-scale survey.

Relationship Between Exposure to Second-Hand Smoke in the Workplace and Occupational Injury in the Republic of Korea.

Background: Most studies in the field of smoking exposure in the workplace linked to occupational safety have only focused on active smoking. Few studies have reported that exposure to second-hand smoke in the workplace is a possible factor increasing the risk of occupational injury without considering occupational characteristics. The aim of this study was to determine the association between occupational injury and level of exposure to second-hand smoke at the workplace among Korean workers, after taking into account occupational characteristics. Method: Using data from the third Korean Working Conditions Survey, levels of exposure to second-hand smoke were categorized as none, moderate, and high. We investigated the influence of exposure to second-hand smoke on occupational injury using logistic regression analysis with stratification by sex, smoking status, smoke-free policy in the workplace, and occupational characteristics. Occupational characteristics (occupational classification, working schedule, length of working day, and co-exposure to occupational hazards in the workplace) were stratified and analyzed using logistic regression models to estimate the risk of occupational injury linked to exposure to second-hand smoke. Results: Among all participants, there was a significant dose-dependent association between risk of occupational injury and level of exposure level to second-hand smoke. After stratification by sex and smoking status, there was a significant association between risk of occupational injury and exposure level to second-hand smoke. Moreover, there was a significant relationship between exposure to second-hand smoke in the workplace and occupational injury, depending on the smoking-free policy at workplace (odds ratio [OR] in completely non-smoking workplace, 4.23; OR in non-smoking workplace with separate smoking area, 2.98; OR in smoking workplace 2.84). Additionally, there was a significant relationship between risk of occupational injury and exposure to second-hand smoke after stratification by occupational classification, working schedule, long working hours, and co-exposure to hazards in the workplace. Discussion: There was a dose-response relationship between occupational injury and exposure to second-hand smoke, even after stratification to reduce the impact of various potential confounders and after taking into account occupational characteristics. These findings provide greater insight into the effects of exposure to second-hand smoke on the working population and may direct further research and policy-making in this field.

Association between Exposure to Traffic-Related Air Pollution and Prevalence of Allergic Diseases in Children, Seoul, Korea.

Although there has been suggestive evidence of the association between TRAP and ADs, findings remained inconsistent possibly due to limited population. We investigated the association between TRAP and ADs in a large population of children with rich spatial coverage and expanded age span in Seoul, Korea. TRAP exposures were estimated by categorized proximity to the nearest major road (≤150, 150-300, 300-500, and >500 m) and density of major roads within 300 meters from children's residences. We estimated the association between two TRAP exposures and three ADs using generalized mixed model after adjusting for individual characteristics. We also investigated whether the association varied by household and regional socioeconomic status. We found associations of atopic eczema with road density [OR = 1.08; 95% CI = 1.01-1.15] and road proximity [1.15, 1.01-1.32; 1.17, 1.03-1.34; and 1.16, 1.01-1.34 for ≤150, 150-300, and 300-500 m, resp., compared to >500 m]. There was no association with asthma and allergic rhinitis. Effect estimates were generally the highest in the low socioeconomic region. Children living in areas surrounded by large and busy roads were likely to be at greater risks for atopic eczema, with increased vulnerability when living in deprived areas.

Factors associated with secondhand smoke incursion into the homes of non-smoking residents in a multi-unit housing complex: a cross-sectional study in Seoul, Korea.

BACKGROUND: In a multi-unit housing (MUH) complex, secondhand smoke (SHS) can pass from one living space to another. The aim of this study was to determine the prevalence of SHS incursion, and to establish the relationship between SHS incursion and socio-demographic and built environmental factors in MUH in Korea. METHODS: A population-based sample of 2600 residents (aged ≥19 years) living in MUH from across the city of Seoul, Korea, was obtained through a web-based selection panel. The residents completed a questionnaire detailing socio-demographic factors, smoking status, frequency of SHS incursion, and built environmental factors. The presence of a personal smoke-free home rule was determined by residents declaring that no one smoked inside the home. RESULTS: Of the 2600 participants, non-smoking residents who lived in homes with a personal smoke-free rule were selected for further analysis (n = 1784). In the previous 12 months, 74.7% of residents had experienced SHS incursion ≥1 times. A multivariate ordinal logistic regression analysis indicated that residents who spent more time at home, lived with children, supported the implementation of smoke-free regulations in MUH, lived in small homes, lived in homes with natural ventilation provided by opening a front door or the windows and front door, and lived in homes with more frequent natural ventilation were more likely to report SHS incursion into their homes. CONCLUSIONS: The majority of the non-smoking residents experienced SHS incursion, even with a personal smoke-free rule in their homes. A smoke-free policy in MUH is needed to protect residents from SHS exposure when they are at home.

Air Pollution Monitoring Design for Epidemiological Application in a Densely Populated City.

Introduction: Many studies have reported the association between air pollution and human health based on regulatory air pollution monitoring data. However, because regulatory monitoring networks were not designed for epidemiological studies, the collected data may not provide sufficient spatial contrasts for assessing such associations. Our goal was to develop a monitoring design supplementary to the regulatory monitoring network in Seoul, Korea. This design focused on the selection of 20 new monitoring sites to represent the variability in PM2.5 across people's residences for cohort studies. Methods: We obtained hourly measurements of PM2.5 at 37 regulatory monitoring sites in 2010 in Seoul, and computed the annual average at each site. We also computed 313 geographic variables representing various pollution sources at the regulatory monitoring sites, 31,097 children's homes from the Atopy Free School survey, and 412 community service centers in Seoul. These three types of locations represented current, subject, and candidate locations. Using the regulatory monitoring data, we performed forward variable selection and chose five variables most related to PM2.5. Then, k-means clustering was applied to categorize all locations into several groups representing a diversity in the spatial variability of the five selected variables. Finally, we computed the proportion of current to subject location in each cluster, and randomly selected new monitoring sites from candidate sites in the cluster with the minimum proportion until 20 sites were selected. Results: The five selected geographic variables were related to traffic or urbanicity with a cross-validated R² value of 0.69. Clustering analysis categorized all locations into nine clusters. Finally, one to eight new monitoring sites were selected from five clusters. Discussion: The proposed monitoring design will help future studies determine the locations of new monitoring sites representing spatial variability across residences for epidemiological analyses.

Nationwide firefighter survey: the prevalence of lower back pain and its related psychological factors among Korean firefighters.

The main objective of this study was to assess the prevalence of lower back pain (LBP) and clarify the effect of work-related psychological factors on LBP. Nationwide survey data collected from male Korean firefighters (FIFS) were used. To identify the risk factors (work-related psychological factors such as job stress and depression) affecting LBP, the χ2 test and multivariate logistic regression analyses were conducted. The prevalence of LBP was 19.3% and was highest in the emergency medical service (31.8%) part of FF job types. Within job stress, an uncomfortable physical environment, high mental job demand and organizational injustice were associated with LBP. However, inadequate social support inversely associated with LBP. Depression and high-risk alcohol drinking were related to LBP. LBP was closely related to job stress, depression and alcohol intake. Proper interventions of psychological factors should therefore be addressed to control LBP in FIFS.

Association between Secondhand Smoke in Hospitality Venues and Urinary 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol Concentrations in Non-Smoking Staff.

The purpose of this study was to determine the relationship between urinary cotinine and total 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL) concentrations in non-smoking staff and the indoor levels of fine particles (PM2.5) in hospitality venues that allow smoking, with respect to demographic and indoor environmental factors. We evaluated 62 hospitality venues that allowed smoking in Seoul, Korea. A real-time aerosol monitor was used to measure indoor PM2.5 concentrations. Field technicians recorded indoor environmental characteristics. One non-smoking staff member in each hospitality venue was tested for urinary cotinine and total NNAL concentrations. Demographic characteristics were obtained from self-reported staff questionnaires. Natural-log (ln)-transformed PM2.5 concentrations were significantly correlated with the ln-transformed cotinine (r = 0.31) and the total NNAL concentrations (r = 0.32). In multivariable regression analysis, the urinary cotinine concentrations of the staff members were significantly correlated with indoor PM2.5 concentrations; those with the highest concentrations were more likely to be women or staff members that worked in venues with a volume <375 m³. Total NNAL concentrations were significantly correlated only with indoor PM2.5 concentrations. Indoor PM2.5 may be used as an indicator for urinary cotinine and total NNAL concentrations in non-smoking staff members in hospitality venues that allow smoking.

Association between job stress and occupational injuries among Korean firefighters: a nationwide cross-sectional study.

OBJECTIVE: We aimed to assess the nature of association between job stress and occupational injuries among firefighters in Korea. DESIGN: Cross-sectional study. SETTING: We conducted a nationwide survey using self-reported questionnaires in South Korea. PARTICIPANTS: A survey was conducted among 30 630 firefighters; 25 616 (83.6%) responded. Our study included firefighters who were 20-59 years old. Individuals with <12 months of current job experience and those with missing data were excluded; ultimately, 14 991 firefighters were analysed. RESULTS: Among fire suppression personnel, high job demands (OR=1.49, 95% CI 1.25 to 1.77), high interpersonal conflicts (OR=1.18, 95% CI 1.02 to 1.37), a poor organisational system (OR=1.33, 95% CI 1.14 to 1.55), and a negative workplace environment (OR=1.41, 95% CI 1.21 to 1.64) were associated with the occurrence of occupational injury; high job demands (OR=1.22, 95% CI 1.01 to 1.47) were also associated with the frequency of injuries. Among emergency medical services personnel, high job demands (OR=1.26, 95% CI 1.03 to 1.54), high interpersonal conflicts (OR=1.40, 95% CI 1.19 to 1.66), a poor organisational system (OR=1.55, 95% CI 1.30 to 1.85), lack of reward (OR=1.43, 95% CI 1.21 to 1.69) and a negative workplace environment (OR=1.30, 95% CI 1.10 to 1.54) were associated with the occurrence of occupational injury; low job control (OR=1.20, 95% CI 1.04 to 1.38), high interpersonal conflicts (OR=1.18, 95% CI 1.03 to 1.36), lack of reward (OR=1.17, 95% CI 1.02 to 1.35) and a negative workplace climate (OR=1.16, 95% CI 1.01 to 1.34) were also associated with a greater number of injuries. Among officers, high job demands (OR=1.96, 95% CI 1.35 to 2.85) and a negative workplace environment (OR=1.54, 95% CI 1.13 to 2.10) were associated with the occurrence of occupational injuries; however, there was no significant correlation between job stress and the number of injuries. CONCLUSIONS: High job stress among firefighters was associated with both the occurrence of occupational injury, and also with an increased frequency of injuries. Therefore, job stress should be addressed to prevent occupational injuries among firefighters.

The effects of a newsletter on bedding control on house dust mite allergen concentrations in childcare centers in Korea.

OBJECTIVES: Bedding in childcare centers (CCCs) can hold house dust mite (HDM) allergens. This study examined whether HDM allergen levels can be reduced through the distribution of an educational newsletter on bedding control to parents of CCC children in Korea. METHODS: All 38 CCCs were measured for Der 1 (sum of Der f 1 and Der p 1) concentrations on classroom floors and bedding before the intervention. Educational newsletters on children's bedding control were sent to 21 CCCs by mail, and teachers were asked to distribute the newsletters to the parents of the children (intervention group). The remaining 17 CCCs were not sent newsletters (control group). The measurement of Der 1 concentrations in 38 CCCs was repeated after the intervention. Dust samples were collected with a vacuum cleaner and analyzed using enzyme-linked immunosorbent assay methods. RESULTS: The Der 1 concentrations on the bedding were significantly higher than those on the floors in 38 CCCs at baseline (p<0.05). Although changes of the Der 1 concentrations for the control group (n=17) were not significant, Der 1 concentrations for the intervention group (n=21) decreased significantly from 2077.9 ng/g dust to 963.5 ng/g dust on the floors and from 3683.9 ng/g dust to 610.4 ng/g dust on bedding (p<0.05). CONCLUSIONS: The distribution of educational newsletters on bedding control to parents may be an effective means of controlling HDMs in CCCs.

Air Quality, Biomarker Levels, and Health Effects on Staff in Korean Restaurants and Pubs Before and After a Smoking Ban.

INTRODUCTION: The Korean government implemented a smoking ban at square floor area of ≥150 m(2), rather than <150 m(2), restaurants and pubs from July 2013. This study examined the effects of the smoking regulations in restaurants and pubs in terms of the air quality, biomarker levels and health effects on staff. METHODS: Particulate matter smaller than 2.5 µm (PM2.5) was measured in 146 facilities before and 1 month after the ban. The urinary cotinine and 4-(methylnitrosamino)-1-(3-pyridyl)-1- butanol (NNAL) levels were measured in 101 staff members at 77 facilities before and 1 month after the ban. We also measured self-reported respiratory and sensory symptoms on both phases. RESULTS: Of the 146 facilities, 121 facilities were included in the PM2.5 analysis. In ≥150 m(2) pubs, the indoor PM2.5 concentration was significantly reduced after the ban (p < .05). While the urinary cotinine concentrations of the staff in all facilities were not changed after the ban, the total NNAL concentrations of the staff in ≥150 m(2) pubs were significantly reduced after the ban (p < .05). The health effects on staff show that only sensory symptoms significantly improved in ≥150 m(2) facilities after the ban (p < .05). CONCLUSIONS: The smoking ban significantly reduced the levels of PM2.5 and total NNAL concentrations in ≥150 m(2) pubs and improved sensory health among staff in ≥150 m(2) facilities. The results of this study can be useful in supporting an expansion of the smoking ban in all indoor places, including <150 m(2) restaurants and pubs.

Association between exposure to antimicrobial household products and allergic symptoms.

OBJECTIVES: Antimicrobial chemicals are used in a variety of household and personal care products. Exposure to antimicrobial household products has been hypothesized to lead to allergic diseases in children. METHODS: We investigated antimicrobial household product exposure and allergic symptoms in Korean children. An antimicrobial exposure (AE) score was derived. To examine the symptoms of allergic diseases (current wheeze, current rhinitis, and current eczema) in the past 12 months, we used a questionnaire based on the core module of the International Study of Asthma and Allergies in Children. Complete data for the analysis were available for 25,805 of the 35,590 (72.5%) children. RESULTS: The prevalence of current allergic diseases was as follows: wheeze, 5.6%; allergic rhinitis, 32.6%; and eczema, 17.7%. The mean (standard deviation) AE score was 14.3 (9.3) (range: 0-40). Compared with subjects with a low AE score (reference), subjects with a high AE score (fourth quartile) were more likely to have symptoms of wheezing and allergic rhinitis (adjusted odds ratio [aOR] for wheezing 1.24, 95% confidence interval [CI], 1.05-1.45, p for trend=0.24; aOR for allergic rhinitis 1.30, 95% CI, 1.20-1.40, p<0.01). CONCLUSIONS: These findings suggest that frequent use of antimicrobial household products was associated with current wheeze and current allergic rhinitis.