Long working hours and preventive oral health behaviors: a nationwide study in Korea (2007-2021).

BACKGROUND: This study explored the association between working hours and preventive oral health behaviors. METHODS: In total, 48,599 workers (22,992 females) were included from the Korea National Health and Nutrition Examination Survey (2007-2021). Weekly working hours were self-reported. The following three preventive oral health behaviors were set as outcomes: participation in annual dental check-ups; adherence to the recommended toothbrushing frequency (≥twice a day); and use of interdental cleaning devices. We estimated odds ratios (ORs) and 95% confidence intervals (CIs) using logistic regression. RESULTS: In male workers, the adjusted OR (95% CI) of the association between working ≥55 h/week and each outcome was 0.84 (0.77-0.92) for dental check-ups, 0.82 (0.72-0.94) for toothbrushing ≥twice a day, and 0.83 (0.76-0.92) for utilization of interdental cleaning device when compared to 35-40 h/week. In female workers, the adjusted OR (95% CI) of the association between working ≥55 h/week and each outcome was 0.79 (0.70-0.89) for dental check-ups, 0.88 (0.70-1.11) for toothbrushing ≥twice a day, and 0.80 (0.71-0.90) for utilization of interdental cleaning device when compared to 35-40 h/week. Additionally, low socio-economic status, such as low educational attainment, low income level, and blue-collar occupations, were major risk factors associated with non-adherence to preventive oral health behaviors in both male and female workers. CONCLUSIONS: Our study suggests that individuals who work long hours are more likely to exhibit undesirable oral health behaviors.

Association between life satisfaction, self-esteem, and health checkup participation: A population-based longitudinal study in South Korea.

OBJECTIVE: Previous studies have shown that background sociodemographic factors are associated with health checkup participation. However, little is known about the psychological determinants of health checkup participation in longitudinal studies. This study explored the psychological determinants of health checkup participation based on a longitudinal study in South Korea. METHODS: Data were retrieved from a nationwide, longitudinal panel study in South Korea, which included community-dwelling general adults, conducted from 2005 to 2022. Established scales for assessing life satisfaction and self-esteem were employed, and life satisfaction and self-esteem levels were categorized into four groups based on quartile values (lowest, low, high, and highest). Respondents reported whether they had undergone a health checkup in the past year. Fixed effects logistic regressions were fitted to determine within-individual associations between life satisfaction, self-esteem, and health checkup participation (n = 15,771; 171,943 observations). Odds ratios (OR) and 95 % confidence interval (CI) were determined. RESULTS: Compared with the lowest life satisfaction, the highest life satisfaction is associated with increased odds of health checkup participation (OR: 1.17, 95 % CI: 1.13-1.23). Compared to the lowest self-esteem level, the highest self-esteem level was positively associated with health checkup participation (OR, 1.14; 95 % CI: 1.10-1.18). The odds of participating in health checkups were also positively associated with age, income, and educational level. CONCLUSION: Although the effect sizes were modest, high life satisfaction and self-esteem were associated with an increased likelihood of participating in health checkups.

Neighborhood Safety Concerns and the Onset of Depressive Symptoms Among Women: A Population-based Prospective Cohort Study in South Korea.

Neighborhood safety is crucial for the well-being of residents; however, longitudinal evidence is scarce. This study explored the association between neighborhood safety concerns and depressive symptoms among women. A nationally representative sample of 10,008 women was surveyed in 2016. Six dimensions of neighborhood safety concerns were assessed: crime, food, safety at night, traffic accidents, building and facility, and general safety. The total score for neighborhood safety concerns ranged from 6 to 24, with higher scores indicating greater concerns. Depressive symptoms were assessed using the 10-item version of the Center for Epidemiologic Studies Depression. For cross-sectional analyses, we explored how neighborhood safety concerns were associated with concurrent depressive symptoms at baseline. For the longitudinal analyses, we explored how they were associated with depressive symptom onset at the 2-year follow-up (2018) among women without depressive symptoms at baseline (n = 7,643). Logistic regressions were employed. The mean (standard deviation [SD]) of the neighborhood safety concern score was 12.7 (3.3). In the cross-sectional analysis, a 1-SD increase in neighborhood safety concern score was associated with 1.23-fold (95% CI: 1.13-1.35) increase in the odds of concurrent depressive symptoms at the baseline year. In the longitudinal analysis, a 1-SD increase in neighborhood safety concern score was associated with 1.15-fold (95% CI: 1.03-1.29) increase in the odds of experiencing the onset of depressive symptoms at the follow-up year. This study suggests that neighborhood safety concerns are risk factors for the development of depressive symptoms of female residents. Policy efforts are necessary to ensure community safety.

Association of low-quality employment with the development of suicidal thought and suicide planning in workers: A longitudinal study in Korea.

BACKGROUND: Employment quality stands as a crucial social determinant impacting workers' health. In this study, we investigate the association between low-quality employment and the emergence of suicidal thoughts and planning. METHODS: We analyzed data from 7,797 Korean workers, amounting to 30,945 observations. Low-quality employment was characterized by three primary dimensions: employment insecurity, income inadequacy, and a lack of rights and protection. We employed a generalized estimating equation to probe the link between experiencing low-quality employment and the occurrence of suicidal thought and planning within the subsequent year. Odds ratios (OR) and 95% confidence intervals (CI) were estimated. RESULTS: The overall incidence rates for suicidal thought and planning were 1.5% and 0.2%, respectively, across the observations. Workers with the lowest employment quality demonstrated higher propensities to develop both suicidal thought (OR: 2.05, 95% CI: 1.37-3.06) and planning (OR: 3.39, 95% CI: 1.08-10.64) at the following year, compared with workers with the highest overall employment quality. Specifically, daily employment exhibited associations with the onset of suicidal thought (OR: 1.64, 95% CI: 1.17-2.31) and suicide planning (OR: 3.49, 95% CI: 1.54-7.92) when compared to permanent employment. Additionally, individuals in the lowest monthly wage quartile displayed a heightened likelihood of developing suicidal thought (OR: 2.09, CI: 1.36-3.23) compared with those in the highest quartile. CONCLUSION: Our findings suggest that low-quality employment is associated with the onset of suicidal thought and suicide planning at follow-up. Therefore, employment quality is a critical social determinant of workers' mental health.

Impact of early economic activity loss on all-cause mortality in gastric cancer survivors following curative treatment: a nationwide study in Korea.

BACKGROUND: The impact of economic engagement on the health of cancer survivors is notable. Our study aims to explore the association between early loss of economic activity (EA) and the risk of all-cause mortality among gastric cancer survivors. METHODS: This retrospective cohort study utilized data from Korea's National Health Insurance Service, focusing on 30-59-year-old gastric cancer patients who received either surgery or endoscopic procedures from January 2009 to December 2013. The primary outcome measure was all-cause mortality. Early loss of EA was identified when a patient's insurance status shifted to dependent within one year following treatment. Adjusted hazard ratios (HRs) and 95% confidence intervals (CI) for all-cause mortality were estimated using multivariable Cox proportional hazards models, conducting separate analyses for surgical and endoscopic groups. RESULTS: Among 24,159 patients (median follow-up, 9.9 years), 2976 (12.3%) experienced all-cause mortality. Specifically, 2835 of these deaths occurred in patients who underwent surgery, while 141 were in the endoscopic procedure group. Early loss of EA was recorded in 14.4% of the surgery group and 7.7% of the endoscopic procedure group. Adjusted HRs (95% CI) for all-cause mortality associated with early loss of EA were 1.39 (1.27-1.54) for the surgery group and 2.27 (1.46-3.52) for the endoscopic procedure group. CONCLUSIONS: This study highlights a significant association between the early loss of EA and an increased risk of all-cause mortality in those who have undergone curative treatments for gastric cancer. It underscores the crucial role of sustaining EA in enhancing the health outcomes of these survivors.

Occupation classification model based on DistilKoBERT: using the 5th and 6th Korean Working Condition Surveys.

Background: Accurate occupation classification is essential in various fields, including policy development and epidemiological studies. This study aims to develop an occupation classification model based on DistilKoBERT. Methods: This study used data from the 5th and 6th Korean Working Conditions Surveys conducted in 2017 and 2020, respectively. A total of 99,665 survey participants, who were nationally representative of Korean workers, were included. We used natural language responses regarding their job responsibilities and occupational codes based on the Korean Standard Classification of Occupations (7th version, 3-digit codes). The dataset was randomly split into training and test datasets in a ratio of 7:3. The occupation classification model based on DistilKoBERT was fine-tuned using the training dataset, and the model was evaluated using the test dataset. The accuracy, precision, recall, and F1 score were calculated as evaluation metrics. Results: The final model, which classified 28,996 survey participants in the test dataset into 142 occupational codes, exhibited an accuracy of 84.44%. For the evaluation metrics, the precision, recall, and F1 score of the model, calculated by weighting based on the sample size, were 0.83, 0.84, and 0.83, respectively. The model demonstrated high precision in the classification of service and sales workers yet exhibited low precision in the classification of managers. In addition, it displayed high precision in classifying occupations prominently represented in the training dataset. Conclusions: This study developed an occupation classification system based on DistilKoBERT, which demonstrated reasonable performance. Despite further efforts to enhance the classification accuracy, this automated occupation classification model holds promise for advancing epidemiological studies in the fields of occupational safety and health.

Precarious employment and the onset of depressive symptoms and problematic alcohol use in middle-aged or older workers: A Korean longitudinal study (2006-2022).

Although precarious employment (PE) has emerged as a growing public health concern, research on older adults is scarce. This study explored the associations between PE and the onset of depressive symptoms and problematic alcohol use among middle-aged and older workers. A total of 2536 Korean waged workers aged ≥45 years contributed 8486 observations from 2006 to 2022. PE was defined as a multidimensional construct that includes employment insecurity, income inadequacy, and a lack of worker rights and protection. Depressive symptoms and problematic alcohol use were assessed using the Center for Epidemiological Studies Depression Scale and the CAGE questionnaire. Generalized estimating equations were employed to determine the association of PE with depressive symptoms and problematic alcohol use after the two-year follow-up. Risk ratios (RR) and 95% confidence intervals (CI) were estimated. Women, individuals with older age and low educational background, and blue-collar workers were more likely to belong to the high PE group. For individual indicators of PE, daily employment (RR: 1.26, 95% CI: 1.05-1.53), the lowest wage quartile (RR: 1.32, 95% CI: 1.01-1.72), and lack of trade union (RR: 1.55, 95% CI: 1.10-2.17) were positively associated with depressive symptom onset in the follow-up. Compared with the group with the lowest overall PE, the group with the highest PE exhibited increased risks of experiencing the onset of depressive symptoms (RR: 1.62, 95% CI: 1.27-2.08) and problematic alcohol use (RR: 2.45, 95% CI: 1.16-5.17) in the follow-up. This study suggests that PE is a major social determinant of older workers' mental health.

Interaction between old age and precarious employment on poor mental well-being in workers: Evidence from a nationally representative sample in Korea.

OBJECTIVE: This study examined the relationship between precarious employment (PE) and mental well-being, focusing on age-specific interactions. METHODS: Nationally representative Korean workers (N = 29,961) were surveyed between 2020 and 2021 to collect data on multidimensional PE (categorized as low, moderate, or high) and the WHO-5 well-being index. Workers' ages were classified as young (<35 years), middle-aged (35-54 years), and older (≥55 years). Logistic regression was performed to estimate the odds ratios (ORs) and 95% confidence intervals (CIs). The interaction between PE and age on well-being was examined by including interaction terms in the regression models. RESULTS: The prevalence of poor well-being was 25%, 29%, and 39% for low, moderate, and high precariousness, respectively, whereas it was 26%, 30%, and 39% for young, middle-aged, and older workers, respectively. In the overall sample, the OR (95% CI) of the association between PE and poor well-being was 1.24 (1.17-1.32) for moderate and 1.54 (1.43-1.65) for high precariousness, compared with low precariousness. There was a significant interaction between old age and PE on the odds of poor well-being. Compared with young workers with low PE, middle-aged workers with high PE (OR: 1.85, 95% CI: 1.62-2.10) and older workers with high PE (OR: 2.10, 95% CI: 1.83-2.40) exhibited increased odds of having poor mental well-being. CONCLUSION: PE serves as a social determinant of older workers' psychological well-being. Policy interventions are required to protect older workers' psychological well-being.

Comparison of the Association Between Presenteeism and Absenteeism among Replacement Workers and Paid Workers: Cross-sectional Studies and Machine Learning Techniques.

Background: Replacement drivers represent a significant portion of platform labor in the Republic of Korea, often facing night shifts and the demands of emotional labor. Research on replacement drivers is limited due to their widespread nature. This study examined the levels of presenteeism and absenteeism among replacement drivers in comparison to those of paid male workers in the Republic of Korea. Methods: This study collected data for replacement drivers and used data from the 6th Korean Working Conditions Survey for paid male workers over the age of 20 years. Propensity score matching was performed to balance the differences between paid workers and replacement drivers. Multivariable logistic regression was used to estimate the adjusted odds ratio (OR) and 95% confidence intervals for presenteeism and absenteeism by replacement drivers. Stratified analysis was conducted for age groups, educational levels, income levels, and working hours. The analysis was adjusted for variables including age, education, income, working hours, working days per week, and working duration. Results: Among the 1,417 participants, the prevalence of presenteeism and absenteeism among replacement drivers was 53.6% (n = 210) and 51.3% (n = 201), respectively. The association of presenteeism and absenteeism (adjusted OR [95% CI] = 8.42 [6.36-11.16] and 20.80 [95% CI = 14.60-29.62], respectively) with replacement drivers being significant, with a prominent association among the young age group, high educational, and medium income levels. Conclusion: The results demonstrated that replacement drivers were more significantly associated with presenteeism and absenteeism than paid workers. Further studies are necessary to establish a strategy to decrease the risk factors among replacement drivers.

Liver Cancer Risk Across Metabolic Dysfunction-Associated Steatotic Liver Disease and/or Alcohol: A Nationwide Study.

INTRODUCTION: New terminologies of metabolic dysfunction-associated steatotic liver disease (MASLD) have been developed. We assessed hepatocellular carcinoma (HCC) risk across MASLD and/or alcohol intake. METHODS: We included participants aged 40-79 years receiving a national health checkup from 2009 to 2010 in the Republic of Korea, classified as follows: non-MASLD, MASLD, MASLD with increased alcohol intake (MetALD; weekly alcohol 210-420 g for male and 140-350 g for female individuals), and alcohol-associated liver disease (ALD; excessive alcohol intake with weekly alcohol ≥420 g for male or ≥350 g for female individuals). The primary outcome was HCC incidence. HCC risk was estimated using multivariable Cox proportional hazard models. RESULTS: Among 6,412,209 participants, proportions of non-MASLD, MASLD, MetALD, and ALD cases were 59.5%, 32.4%, 4.8%, and 3.4%, respectively. During follow-up (median 13.3 years), 27,118 had newly developed HCC. Compared with non-MASLD, the HCC risk increased from MASLD (adjusted hazard ratio [aHR] 1.66, 95% confidence interval [CI] 1.62-1.71) and MetALD (aHR 2.17, 95% CI 2.08-2.27) to ALD (aHR 2.34, 95% CI 2.24-2.45) in a stepwise manner. Furthermore, the older and non-cirrhosis subgroups were more vulnerable to detrimental effects of MASLD and/or alcohol intake, concerning HCC risk. Among the older, female, and cirrhosis subgroups, MetALD poses similar HCC risks as ALD. DISCUSSION: HCC risk increased from MASLD and MetALD to ALD in a stepwise manner, compared with non-MASLD. For an effective primary prevention of HCC, a comprehensive approach should be required to modify both metabolic dysfunction and alcohol intake habit.

Longitudinal Trajectories of Depressive Symptoms and Their Associations With Risks of Underweight and Obesity in Women: A Population-Based Longitudinal Study in Korea.

Objective: We explored depressive symptom trajectories and their associations with underweight and obesity in Korean women.Methods: This prospective cohort study involved 7,691 women enrolled in the Korean Longitudinal Survey of Women and Families, with a follow-up period spanning from 2014 to 2020. Depressive symptoms were evaluated through the 10-item version of the Center of Epidemiologic Studies Depression Scale. Growth mixture modeling was employed to identify trajectories of depressive symptoms. Multinomial logistic regressions were conducted to investigate the correlation between depression trajectories and the evolving risks of underweight and obesity over the study period.Results: Five distinct trajectory classes were observed ("persistent low symptoms": N = 5,236, 68.1%; "decreasing symptoms": N = 930, 12.1%; "transient high symptoms": N = 421, 5.5%; "increasing symptoms" N = 825, 10.7%; and "persistent high symptoms": N = 279, 3.6%). Those with a low socioeconomic status, comorbidity, and who were divorced or widowed were more likely to follow the persistent high symptom trajectory. Among the 5 trajectories, the risks of underweight and obesity steadily increased in women following the trajectory with persistent high symptoms. For these women, the odds ratio (OR) of underweight increased from 2.27 (95% CI, 1.32-3.92) in 2014 to 3.39 (1.91-6.05) in 2020. They were not associated with obesity in 2014 (OR [95% CI]: 1.38 [0.61-3.11]) but exhibited an elevated risk of obesity in 2020 (3.76 [1.97-7.17]).Conclusion: We observed considerable heterogeneity in the trajectories of depressive symptoms among women, and individuals with persistent high depressive symptoms face an escalating risk of both underweight and obesity.

Temporary Employment Is Associated with Poor Dietary Quality in Middle-Aged Workers in Korea: A Nationwide Study Based on the Korean Healthy Eating Index, 2013-2021.

Temporary employment is associated with an elevated risk of cardiovascular diseases and mortality. This study explored the association between temporary employment and dietary quality in middle-aged workers. This cross-sectional study included a nationwide sample of middle-aged Korean workers (n = 6467). Employment type was categorized into regular, fixed-term, and daily employment, based on labor contract duration. Dietary quality was assessed using the Korean Health Eating Index (KHEI), which ranges from 0 to 100, with higher scores indicating superior dietary quality. Linear regression was used to estimate beta coefficients (ß) and 95% confidence intervals (CI). The survey-weighted proportion of regular, fixed-term, and daily employment was 79.0%, 14.2%, and 6.8%, respectively. Fixed-term and daily employment were associated with a reduced KHEI compared with regular employment (ß [95% CI]: -1.07 [-2.11, -0.04] for fixed-term and -2.46 [-3.89, -1.03] for daily employment). In sex-stratified analysis, the association between temporary employment and dietary quality was more pronounced in men (ß [95% CI]: -1.69 [-3.71, 0.33] for fixed-term and -2.60 [-4.63, -0.53] for daily employment than in women. In conclusion, this study suggests that temporary employment is a social determinant of dietary quality in middle-aged workers.

Association between Dietary Quality and Non-Alcoholic Fatty Liver Disease in Korean Adults: A Nationwide, Population-Based Study Using the Korean Healthy Eating Index (2013-2021).

This study explored the relationship between the Korean Healthy Eating Index (KHEI) and non-alcoholic fatty liver disease (NAFLD). This cross-sectional study included 34,174 Korean adults. The KHEI was composed of three subcomponents (adequacy, moderation, and energy balance) and calculated based on a 24 h dietary recall. The total score ranged from 0 to 100, with a higher score indicating a greater adherence to the Korean dietary guidelines. The total KHEI scores were categorized into quartiles (Q1-Q4). NAFLD was classified using the hepatic steatosis index. Logistic regressions were used to estimate odds ratios (ORs) and 95% confidence intervals (CIs). The adjusted OR (95% CI) of NAFLD was 0.95 (0.87-1.03) for the Q2 group, 0.90 (0.83-0.98) for the Q3 group, and 0.79 (0.72-0.87) for the Q4 group, compared with the Q1 group. Among the subcomponents of the KHEI, individuals with high scores in the adequacy component, characterized by an abundant consumption of fruits, vegetables, and dairy products, exhibited the most pronounced association with NAFLD. A higher KHEI score was negatively associated with NAFLD in Korean adults. Therefore, the promotion of healthy dietary patterns can play a beneficial role in the prevention or management of NAFLD.

Sex differences in the association between social jetlag and hazardous alcohol consumption in Korean workers: A nationwide cross-sectional study.

BACKGROUND: Social jetlag, the misalignment between biological and social rhythms, can lead to adverse health outcomes. This study explored the association between social jetlag and hazardous alcohol consumption, as well as the sex differences in this association. METHODS: This study included a nationally representative sample of Korean workers consisting of 11,462 individuals (5479 women). Social jetlag was calculated as the difference in the mid-point between sleep onset and offset on free days and workdays. Hazardous alcohol consumption was determined using the Alcohol Use Disorder Identification Test-Consumption (range 0-12), with a cutoff of ≥6 for men, ≥5 for women, and ≥3 for those aged ≥65. Logistic regression analysis was used to estimate the odds ratios (ORs) and 95 % confidence intervals (CIs). RESULTS: Among men, 599 out of 5983 individuals (10.0 %) had ≥120 min of social jetlag. Among women, 550 out of 5479 individuals (10.0 %) had ≥120 min of social jetlag. The prevalence of hazardous alcohol use was 56.2 % for men and 27.3 % for women. In the regression analysis, there was a significant sex interaction, where social jetlag ≥120 min was associated with hazardous alcohol consumption in female workers (OR: 1.52, 95 % CI: 1.18-1.96), but not in male workers (OR: 1.04, 95 % CI: 0.84-1.29). CONCLUSION: High social jetlag was associated with an increased likelihood of hazardous alcohol consumption among women. Our findings underscore the importance of considering sex differences in future research and policy interventions regarding social jetlag and its associated behavior outcomes.

Long working hours, work-life imbalance, and poor mental health: a cross-sectional mediation analysis based on the sixth Korean Working Conditions Survey, 2020-2021.

Background There has been growing concern about the negative mental health impact of long working hours and overwork. Our study examined how work-life imbalance (WLI) could be a mediator between working hours and poor mental well-being.Methods We included 34,968 individuals from a nationwide cross-sectional survey in Korea. Self-reported working hours per week was collected, and mental health was assessed by the WHO-5 Well-Being Index. Counterfactual-based mediation models were employed to disentangle the total effects into a direct effect (work hour - poor mental health) and an indirect effect (work hour - WLI - poor mental health).Results Out of 34,968 participants, 52.6% worked 35-40 h/week, 20.0% worked 41-48 h/week, 11.7% worked 49-54 h/week, and 15.6% worked ≥55 h/week. The odds ratios (ORs) of the total impact of working hours on poor mental health were 1.08 (95% CI: 1.01-1.16) for 41-48 h/week, 1.28 (1.17-1.39) for 49-54 h/week, and 1.60 (1.48-1.74) for ≥55 h/week in comparison to 35-40 h/week. The ORs of the indirect effects were 1.04 (1.03-1.05) for 41-48 h/week, 1.08 (1.07-1.09) for 49-54 h/week, and 1.14 (1.12-1.16) for ≥55 h/week, accounting for 51%, 31%, and 28% of the total effects.Conclusion: Our findings suggest that WLI can partially mediate the association of long working hours with mental health deterioration. Policy efforts are required to mitigate the adverse mental health effects of overwork.

Association between sickness presenteeism and depressive symptoms: a cross-sectional study using the 6th Korean working conditions survey.

PURPOSE: This study aimed to reveal the relationship of the days of experiencing sickness presentism and depressive symptoms among Korean workers. Sickness presenteeism which defined as the act of going to work despite being feeling unhealthy triggers various adverse effects on mental health, including increased risks of depression. Furthermore, Sickness presenteeism is a major social issue causing substantial socioeconomic costs. METHODS: The data of 25120 participants from sixth Korean Working Condition Survey was utilized in this cross-sectional study. Sickness presenteeism was defined using a self-reported questionnaire and depressive symptoms were assessed by WHO well-being index. Multivariate logistic regression analysis was conducted to calculate the odd ratios for depressive symptoms regarding the number of days experiencing sickness presenteeism. We calculated odds ratios (ORs) and 95% confidence interval (95% CI) for depressive symptoms after categorizing participants into three groups based on the duration of experiencing sickness presenteeism, using cut-off values of 3 and 5 days. RESULTS: Workers who have experienced sickness presenteeism for more than 5 days were at highest risk for depressive symptoms than referent group (OR 2.87; 95% CI 2.17-3.76 in male, OR 3.86; 95% CI 3.02-4.91 in female). Furthermore, there was a trend of increasing risk for depressive symptom as the duration of experiencing sickness presenteeism extended. CONCLUSION: This study presents the association between experiencing sickness presenteeism in the previous 12 months and depressive symptoms. Based on the results, we provide individual and organizational strategies of reducing sickness presenteeism. Also, screening for workers who have experienced sickness presenteeism are needed to ensure good mental health.

Association between precarious employment and the onset of depressive symptoms in men and women: a 13-year longitudinal analysis in Korea (2009-2022).

AIMS: Increasing social concern surrounds the potential adverse health effects of precarious employment (PE). In this study, we explored the association between PE and the onset of depressive symptoms. METHODS: A total of 11,555 Korean waged workers (5700 females) contributed 62,217 observations from 2009 to 2022. PE was operationalized as a multidimensional construct, including employment insecurity, income inadequacy and lack of rights and protection. Depressive symptoms were evaluated using the Center for Epidemiological Studies-Depression Scale (11-item version). The association between PE and the onset of depressive symptoms in the subsequent year was estimated using generalized estimating equations. Effect sizes were reported as odds ratio (OR) and 95% confidence interval (CI). RESULTS: The overall incidence of depressive symptoms was 8.3% during the study period. In cross-sectional analysis, daily employment, disguised employment, lower monthly wages and lack of social insurance coverage were associated with concurrent depressive symptoms in both men and women. Longitudinally, fixed-term employment (OR: 1.17, 95% CI: 1.07-1.29), daily employment (OR: 1.64, 95% CI: 1.45-1.85) and disguised employment (OR: 1.36, 95% CI: 1.17-1.57) were associated with the onset of depressive symptoms among the overall sample. Among men, the lowest quartiles of wage were associated with the onset of depressive symptoms (OR: 1.34, 95% CI: 1.13-1.60), while the absence of a trade union was associated among women (OR: 1.18, 95% CI: 1.01-1.39). CONCLUSIONS: Employment insecurity, inadequate income and lack of rights and protection may contribute to depressive symptoms. Therefore, PE serves as a significant social determinant of mental health among workers in Korea. Active policy efforts are warranted to improve the overall quality of employment in the workforce.

Investigation of Working Conditions and Health Status in Platform Workers in the Republic of Korea.

Background: The present study aimed to analyze several aspects of the working conditions and health status of platform workers in the Republic of Korea, such as ergonomic and emotional hazards. We also compared the health status of the platform workers with that of the general population. Methods: A total of 1,000 platform workers participated in this survey from August 7 to August 17, 2022. The participants included 400 designated drivers, 400 food-delivery drivers, and 200 housekeeping managers. A face-to-face survey with a structured questionnaire was conducted by researchers who had received specific instructions. The focus of the survey extended to the work environment, encompassing factors such as workplace violence, as well as physical, chemical, and ergonomic hazards. Health-related data for the previous year were also collected, covering a range of issues such as hearing problems, skin problems, musculoskeletal symptoms, headaches, injuries, mental health issues, and digestive problems. Subsequently, we compared the health symptom data of the responders with those of the general population in the Republic of Korea. Results: Platform workers, including designated drivers, food-delivery drivers, and housekeeping managers, existed in the blind spot of social insurance, facing frequent exposure to physical and chemical hazards, ergonomic risk factors, and direct or indirect violence. The prevalence of health problems, including musculoskeletal symptoms, general fatigue, and depressive symptoms, in each occupational group was statistically higher than that in the general population after standardization for age and gender. Conclusion: The results revealed unfavorable working environment and inferior occupational health of platform workers compared with those of the general population.

Association between temporary employment and current smoking and change in smoking behaviors: A prospective cohort study from South Korea (2009-2018).

Background Previous studies have suggested that employment insecurity is associated with adverse health outcomes. We explored the association between temporary employment and smoking behaviors.Methods We analyzed 11,795 workers (51,867 observations) from the Korea Health Panel Study (2009-2018). Employment types were categorized as regular, fixed-term, or daily, based on the duration of labor contract. The outcomes were current smoking status and changes in smoking behavior (initiation or cessation) in the following year. Generalized estimating equations were used to estimate odds ratio (OR) and 95% confidence interval (CI).Results The proportions of fixed-term and daily workers were 41.2% and 16.4% for women and 23.6% and 12.4% for men, respectively. Temporary employment was associated with increased odds of current smoking, while also demonstrating prospective associations with changes in smoking behaviors. For instance, in prospective analyses, male workers with fixed-term and daily employments were associated with a decreased likelihood of smoking cessation (OR:0.77; 95% CI:0.65-0.91 for fixed-term employment and OR:0.66; 95% CI:0.52-0.83 for daily employment) in the following year compared to those with regular employment. Moreover, those experiencing consecutive temporary employment was most inversely associated with smoking cessation in both men (OR:0.56; 95% CI:0.44-0.71) and women (OR:0.37; 95% CI:0.16-0.85) compared to those experiencing consecutive regular employment. However, no clear association between temporary employment and smoking initiation was observed in both men and women.Conclusions Temporary employment is directly associated with current smoking and inversely associated with smoking cessation. Policies are needed to improve job insecurity among temporary employees.

Relationship between long working hours and smoking behaviors: Evidence from population-based cohort studies in Korea.

OBJECTIVES: Long working hours and overwork are growing public health concerns in the Western-Pacific region. We explored the relationship between working hours and smoking behaviors of Korean workers. METHODS: This study included 284 782 observations (50 508 workers) from four nationwide cohort studies in Korea. Using generalized estimating equations, we estimated the associations of working hours with current smoking status, smoking initiation, and smoking cessation within each cohort. Cohort-specific estimates were combined through random-effect meta-analysis. Effect sizes were presented as odds ratios (OR) and 95 confidence intervals (CI). RESULTS: The overall smoking prevalence was 26.8% within the cohorts. The adjusted OR (95% CI) of the association between working hours and current smoking were 1.01 (0.94-1.08) for <35 hours/week, 1.04 (1.01-1.09) for 41-48 hours/week, 1.06 (1.01-1.10) for 49-54 hours/week, and 1.07 (1.04-1.10) for ≥55 hours/week compared with 35-40 hours/week. The adjusted OR (95% CI) of the association between working hours and smoking cessation in the follow-up were 0.93 (0.85-1.02) for <35 hours/week, 0.89 (0.83-0.96) for 41-48 hours/week, 0.87 (0.81-0.95) for 48-54 hours/week, and 0.91 (0.85-0.98) for ≥55 hours/week compared with 35-40 hours/week. No clear associations were observed between working hours and smoking initiation. CONCLUSION: Long working hours are associated with high current smoking risk and reduced likelihood of smoking cessation among Korean workers. Policy interventions are required to promote smoking cessation and reduce excess overwork for individuals experiencing long working hours.