Korean Firefighters Research Articles

The risk of insomnia by work schedule instability in Korean firefighters.

Firefighters are exposed to shift work, as well as unpredictable emergency calls and traumatic events, which can lead to sleep problems. This study aimed to investigate the risk of insomnia by work schedule instability in Korean firefighters. This study used the Insomnia Severity Index to assess the insomnia in firefighters. The work schedule stability was classified with the frequency of the substitute work and the timing of notification for work schedule changes. Logistic regression analysis was used to assess the adjusted odds ratio of insomnia by work schedule stability with covariates including sex, age, education, smoking, alcohol, caffeine intake, shift type, job, and underlying conditions. Of the 8,587 individuals, 751 (8.75%) had moderate to severe insomnia (Insomnia Severity Index ≥ 15). The prevalence of insomnia was statistically significantly higher as the frequency of substitute work increased: <1 time per month (6.8%), 1-2 times (9.5%), 3-5 times (13.4%), and more than 5 times (15.7%) (p < 0.001). Additionally, the prevalence of insomnia was statistically significantly higher when the timing of the schedule change notification was urgent or irregular: no change or several weeks before (5.4%), several days before (7.9%), one day before or on the day (11.2%), irregularly notification (11.6%) (p < 0.001). In comparison to the group with good frequency of the substitute work/good timing of schedule change notification group, the adjusted odds ratios of insomnia were 1.480 (95% confidence interval [CI]: 1.237-1.771) for Good/Bad group, 1.862 (95% CI: 1.340-2.588) for Bad/Good group, and 1.885 (95% CI: 1.366-2.602) for Bad/Bad group. Work schedule instability was important risk factor of insomnia in firefighters. It suggests that improving the stability of work schedules could be a key strategy for reducing sleep problems in this occupational group.

Firefighters' medical use and Korean Medicine experience in Korea: A qualitative study protocol.

Firefighters, compared to other occupational groups, are exposed more frequently in their working environment not only to physical issues, such as musculoskeletal disease, respiratory disease, and burns but also to mental health issues, such as PTSD and depression. Specifically, Korean firefighters experience significantly higher rates of work-related injuries compared to those in other countries. Recent statistics from the Korea National Fire Agency indicate a steady increase in the number of firefighting work-related injuries. However, there is a shortage of measures in place to address these issues. This study aims to investigate the health needs, overall healthcare usage, and unmet needs of firefighters in Korea. We also aim to investigate, through in-depth interviews, perceptions and hindering factors for integrative medicine approaches to fulfilling unmet needs. This study was conducted in accordance with the consolidated criteria for reporting qualitative research. Convenience and snowball sampling methods will be used to recruit firefighters to participate in the study, and interviews will be conducted using a semi-structured interview guide. The data will be analyzed in four stages using the qualitative analysis method of Krippendorff. In this study, we examine the state of health issues and healthcare usage among Korean firefighters and investigate their perceptions of and needs for integrative medicine. In this way, we aim to explore how integrative medicine and Korean medicine approaches could improve and assist healthcare services for firefighters. Furthermore, our findings will provide policymakers and healthcare providers with the necessary basic information to develop integrative medicine systems suited to firefighters.

The Effect of Emotional Labor on Psychological Well-Being in the Context of South Korean Firefighters: The Moderating Role of Transformational Leadership.

Drawing on insights from the conservation of resources theory and the job demands-resources theory, our study investigates the association between two types of emotional labor-surface and deep acting-and the psychological well-being of firefighters. In addition, it investigates the moderating effect of transformational leadership within this context. To this end, this study utilizes ordinary least squares models to analyze survey data from 1453 firefighters in Gyeonggi-do, South Korea's largest province by population. The findings reveal a negative association between both types of emotional labor and the psychological well-being of firefighters. The study further demonstrates that transformational leadership mitigates the adverse effects of surface acting on psychological well-being. Our research indicates that transformational leadership plays a pivotal role in replenishing lost emotional resources, thereby enhancing the mental and emotional health of those engaged in demanding roles such as firefighting and emergency medical services. Accordingly, the study highlights a vital strategy for maintaining the psychological well-being of firefighters.

Assessment of PAH exposure and health risks among South Korean firefighters based on urinary PAH metabolites

Polycyclic aromatic hydrocarbons (PAHs) comprise a group of compounds resulting from the incomplete combustion of organic matter. Firefighters engaged in fire suppression are highly exposed to PAHs. This study centered on evaluating the exposure levels and health risks of PAHs in South Korean firefighters involved in firefighting activities. The concentrations of 10 PAH metabolites in the urine of firefighters were measured immediately after, and two weeks post their engagement in extinguishing a large tire factory fire. The levels of OH-PAHs in urine samples immediately after fire suppression were elevated by a factor of 1.01–1.84 compared to urine samples from non-exposed period. The median concentration of total PAH metabolites (OH-PAHs) was higher in urine samples immediately after fire suppression (5910 ng/g creatinine) than in urine samples from non-exposed periods (5020 ng/g creatinine). However, the ∑OH-PAH levels in firefighters’ urine were related to personal habits such as smoking. The concentrations of all individual OH-PAHs in the urine samples of nonsmokers exhibited a substantial increase, ranging from 1.37 to 2.3 times, clearly demonstrating that firefighting activities were a substantial source of PAH exposure. The calculated values associated with the health risks stemming from exposure to PAHs, including carcinogenic risk, total estimated daily intake (TEDI), and hazard quotients/index (HQs/HI), all fell within acceptable limits, indicating negligible risk. However, the HQ/HI values and TEDI for individual and total PAH exposures, except those for naphthalene, were 1.36–2.00 times higher in firefighters' samples taken after firefighting operations compared to those during regular duty. This underscores the need for more comprehensive investigations to comprehend the singular impact of firefighting activities due to the diverse sources of PAH emissions in the environment.

Heavy metal exposure linked to metabolic syndrome in Korean male firefighters: FRESH cohort cross-sectional analysis

This study aimed to identify the relationship between blood lead and Cadmium (Cd) concentrations and metabolic syndromes (MetS), including its components (central obesity, hypertriglyceridemia, low high-density lioioritein, hypertension, and hyperglycemia) among Korean firefighters. A total of 965 firefighters of the Enhancement of Safety and Health cohort were analyzed in this study. MetS was defined according to the 2005 revised National Cholesterol Education Program-Adult Treatment Panel III criteria and the Korean Society for the Study of Obesity criteria for waist circumference. The collected data were analyzed using a logistic regression model. Of the 965 participants, 190 (19.7%) had MetS. After adjusting for age, body mass index, smoking, drinking, exercise, shift duty, and main duty position, the Cd level was significantly associated with an increased risk of MetS in the Korean firefighter population (odds ratio [OR] = 1.62, 95% confidence interval [CI] 1.07, 2.46). This association was significant among non-smokers and ex-smokers (OR = 1.58, 95% CI 1.03, 2.43), non-drinkers and ex-drinkers (OR = 1.77, 95% CI 1.06, 2.94), firefighters aged 40 year or older (OR = 1.77, 95% CI 1.10, 2.86), and office administrators (OR = 3.85, 95% CI 1.42, 10.39). This outcome suggests that exposure to Cd is likely to increase risk of MetS among firefighters.

Assessment of phthalate exposure at a fire site in Korean firefighters

ABSTRACT To determine phthalate exposure in 32 firefighters, the concentrations of urinary phthalate metabolites, immediately (exposure day) and three weeks (control day) after fire suppression, were compared. Mono-(2-ethyl-5-carboxypentyl) phthalate, mono-(2-ethyl-5-hydroxyhexyl) phthalate, mono-(2-ethyl-5-oxohexyl) phthalate, mono-n-butyl phthalate (MBP), mono-n-benzyl phthalate (MBzP), and total phthalates (∑phthalates) levels, and creatinine-adjusted levels of MBP, MBzP, and ∑phthalates were significantly higher on exposure day than on control day. Phthalate concentration was significantly higher in firefighters who performed the fire extinguishing tasks (geometric mean [GM], 149.9 μg/L) than in those who performed other tasks (GM 70.8 μg/L) (p = .012). The GM concentration of firefighters who were active ≤ 50 m from the fire was 119.0 μg/L, and 37.6 μg/L for those who were > 50 m away (p = .012). The GM concentration was significantly different (p = .039) in firefighters with subjective symptoms after fire suppression (151.9 μg/L) compared to those without symptoms (81.6 μg/L). This study showed that firefighters were exposed to phthalate.

Effect of a Kinect-Based Exercise on Improving Job-Related Physical Fitness Tests for Korean Firefighters

OBJECTIVES Firefighters play a critical role in high-temperature environments that demand substantial physical strength for efficient job performance. However, South Korean firefighters face challenges in maintaining optimal fitness levels due to limited opportunities for exercise. Factors that contribute to this issue include shift work, frequent dispatches, and the absence of exercise instructors.METHODS At total of 20 male Korean firefighters were divided into an exercise group (EG) and a control group (CG) with ten participants each. The EG group underwent an 8-week exercise intervention at a fire academy in Busan using a kinect-based exercise device called Virtual Mate (VM), while the CG group maintained their regular lifestyle without any additional exercise. Pre- and post-assessments were conducted, including the Candidate Physical Ability Test (CPAT), a physical fitness evaluation commonly used for firefighting duties in North America, the Korea Firefighter Performance Battery (KFPB), which is a modified version of CPAT, and basic physical fitness tests. The effect of exercise was analyzed using statistical methods, including repeated measures analysis of variance and paired t-tests.RESULTS Significant group-by-time interactions were observed for CPAT completion time (&lt;i&gt;p&lt;/i&gt; = .004) and KFPB completion time (&lt;i&gt;p&lt;/i&gt; = .012). After 8 weeks of exercise, the EG demonstrated a significant decrease in CPAT completion time (543.7 ± 93.0 sec vs. 500.8 ± 64.1 sec, &lt;i&gt;p&lt;/i&gt; = .004) and KFPB completion time (584.1 ± 47.8 sec vs. 525.3 ± 16.2 sec, &lt;i&gt;p&lt;/i&gt; = .001), while the CG did not show significant changes. In terms of basic physical fitness, only in EG, number of sit-ups performed in one minute significantly increased (&lt;i&gt;p&lt;/i&gt; &lt; .001)CONCLUSIONS The Kinect-based exercise device, VM, proves to be a valuable solution for addressing the practical challenges faced by Korean firefighters, ultimately enhancing their physical fitness.

Nonsuicidal Self-Injury and Its Mediation Effect on the Association Between Posttraumatic Stress Disorder, Depression, and Suicidal Behavior in Firefighters.

This study aimed to investigate the prevalence, clinical characteristics, and the correlates of nonsuicidal self-injury (NSSI) in firefighters. We also investigated the mediating role of NSSI frequency in the association between posttraumatic stress disorder (PTSD), depression, and suicidal behavior. A total of 51,505 Korean firefighters completed a web-based self-reported survey, including demographic and occupational characteristics, NSSI, PTSD, depression, and suicidal behavior. Multivariable logistic regression analyses and serial mediation analyses were performed. The 1-year prevalence of NSSI was 4.67% in Korean firefighters. Female gender, the presence of recent traumatic experience, and PTSD and depression symptoms were correlated with NSSI. Serial mediation analyses revealed that NSSI frequency mediated the association between PTSD, depression, and suicidal behavior; it indicates more severe PTSD was sequentially associated with more severe depression symptoms and more frequent NSSI, leading to higher risk of suicidal behavior. NSSI is prevalent and may play a significant mediating role when PTSD is associated with suicidal behavior in firefighters. Our results imply the need for screening and early intervention of NSSI in firefighters.

Urinary concentrations of organophosphate esters and associated health outcomes in Korean firefighters

Although firefighters are at an increased risk of occupational exposure to chemicals, such as flame retardants, research on the exposure of Korean firefighters to organophosphate esters (OPEs)—a group of emerging flame retardants—remains limited. Therefore, in the present study, OPE metabolite concentrations in the urine samples of 149 former and current Korean firefighters were measured. Based on the data obtained, the estimated daily intakes (EDIs) of OPEs were calculated. Subsequently, the association between the urinary concentrations of OPE metabolites and the potential determinants of OPE exposure and health outcomes (e.g., obesity and serum lipids) was investigated. We found that bis(1-chloro-2-propyl) phosphate (BCIPP) and bis(2-chloroethyl) phosphate (BCEP) were the most prevalent urinary OPE metabolites, with median concentrations of 2.33 and 1.80 ng/mL, respectively; these concentrations were higher than those reported previously in other countries, such as the USA and China. Moreover, their parent compounds—tris(1-chloro-2-propyl) phosphate (TCIPP) and tris(2-chloroethyl) phosphate (TCEP)—exhibited EDIs of 126 and 94.8 ng/kg bw/day, respectively. Unlike the high detection rate of bis(1,3-dichloro-2-propyl) phosphate (BDCIPP) in other populations, its detection rate in this study was low (6.7%), suggesting regional differences in the exposure pattern of OPEs among countries. Furthermore, occupational characteristics, such as recent participation in firefighting activity, were identified as determinants of the urinary concentrations of OPE metabolites. Total OPE metabolites were inversely associated with body mass index and positively associated with high-density lipoprotein cholesterol. Overall, our findings demonstrate that Korean firefighters are highly exposed to several occupation-related OPEs. Further prospective studies will help elucidate the potential health implications of occupational exposure to OPEs among firefighters.

The Effects of a Self-Disclosure Program Using Expressive Writing on Optimism, Problem-Focused Coping, Deliberate Rumination, and Posttraumatic Growth of Korean Firefighters with Rescue-Firefighting Duties: A Pilot Study

The Effects of a Self-Disclosure Program Using Expressive Writing on Optimism, Problem-Focused Coping, Deliberate Rumination, and Posttraumatic Growth of Korean Firefighters with Rescue-Firefighting Duties: A Pilot Study

Exploring the Effect of Emotional Labor on Turnover Intention and the Moderating Role of Perceived Organizational Support: Evidence from Korean Firefighters.

Synthesizing the conservation of resource theory, proximal withdrawal state theory, and job demands-resources theory, the present study examined the relationships between two dimensions of emotional labor (i.e., surface and deep acting) and turnover intention, as well as the moderating role of perceived organizational support in these relationships, such as the context of Korean firefighters. Using survey data drawn from fire organizations in Gyeonggi-do, the largest province of South Korea, we found that both surface and deep acting are positively related to firefighter turnover intentions. Further analysis indicates that the perceived organizational support of firefighters, vital for public health and safety, attenuates the positive relationship between surface acting and turnover intention but has no significant moderating effect on the relationship between deep acting and turnover intention. Our results suggest that perceived organizational support acts through essential psychological resources to recover the loss of emotional resources and contributes to the retention of firefighter personnel who primarily perform challenging and stressful work, including firefighting and offering emergency medical services. Thus, this study examines a crucial tool to ensure firefighters' public mental health.

소방공무원의 감정노동이 소진에 미치는 영향

A growing body of literature has documented that emotional labor as a newly emergent job stressor leads to burnout. The purpose of this study is to examine the association between emotional labor and burnout in firefighters. A total of 18,075 Korean firefighters who were performing the duties of firefighting, rescue and emergency medical aid were analyzed. Data were obtained from the FRESH (Firefighter Research: Enhancement of Safety and Health) Study, and a structured self-administered questionnaire by using the online survey was performed. Emotional labor was measured using the five sub-scales of K_ELS®24, and Maslach Burnout Inventory (MBI) was used for the measurement of burnout. Multiple linear regression analysis was conducted to examine the relationships of emotional labor to burnout. All statistical analyses were performed using the SPSS/PC (ver. 23), and p&lt;0.05 was considered significant. In the results of multiple regression analyses, five sub-scales of emotional labor (‘emotional demand &amp; regulation’, b=0.133, F=510.223, p&lt;0.001; ‘overload &amp; conflict in customer service’, b=0.111, F=529,442, p&lt;0.001; ‘emotional disharmony &amp; hurt’, b=0.149, F=733.982, p&lt;0.001; ‘organizational surveillance &amp; monitoring’ b=0.130, F=564.316, p&lt;0.001; ‘lack of a supportive &amp; protective system’, b=0.111, F=510.223, p&lt;0.001) were positively associated with firefighters’ burnout after adjustment for sex, age, marital status, educational background, smoking status, subjective health status, main duty and shift work. The results indicate that emotional labor contributes to increase the risk of firefighters' burnout. These results emphasize the importance of stress management program to reduce or alleviate the negative outcomes caused by emotional labor at organizational level, and coping strategies to reinforce the personal potentiality suitable to organizational norms and work settings at individual level.

Exposure and Risk Assessment of Korean Firefighters to PBDEs and PAHs via Fire Vehicle Dust and Personal Protective Equipment.

In this study, the levels of polycyclic aromatic hydrocarbons (PAHs) and polybrominated diphenyl ethers (PBDEs) were characterized in firefighters' personal protective equipment (PPE) (i.e., jackets, pants, hoods, and gloves) and vehicle dust wipe samples to assess the exposure and potential risk of firefighters to these combustion-related toxic pollutants. The mean levels of ∑PBDEs in the fire vehicle dust samples (778 and 449 pg/cm2 for pump trucks and command cars, respectively) were significantly higher than those in the private vehicles (31.2 pg/cm2) (Kruskal-Wallis test, p < 0.05), which was similar to the ∑PAH levels (521, 185, and 46.8 pg/cm2 for pump trucks, command cars, and private vehicles, respectively). In the case of firefighters' PPE, the levels of ∑PBDEs and ∑PAHs in used jackets and pants were found to be, respectively, 70- to 2242-folds and 11- to 265-folds higher than those in their unused counterparts. Biomass/petroleum combustion was found to be the main source of PAH contamination in fire vehicle dust and used PPE in the present study. Both carcinogenic and noncarcinogenic risks via vehicle dust ingestion and dermal absorption from wearing of PPE were within permissible limits, although the relative risk evaluation showed that PAH/PBDE absorption via wearing of PPE could pose a higher likelihood of carcinogenic and noncarcinogenic risks than the ingestion of pollutants via fire vehicle dust, warranting the need for appropriate management of firefighters' personal protective ensembles.

Biological monitoring for exposure assessment of phthalatesby Korean firefighters at the fire site

[BACKGROUND AND AIM]The phthalates metabolites in urine for exposed phthalates were evaluated for firefighters who participated in the actual fire suppression to determine whether firefighters were exposed to hazardous chemicals, which is the basic data on health risk of firefighters [METHODS]The results of comparing the concentration of metabolites of phthalates immediately after fire suppression and after 3 weeks of fire suppression in spot urine. [RESULTS]The concentration of Mono-n-butyl phthalate(MnBP), Mono-benzyl phthalate(MBzP), and total phthalates(Σphthalates) increased significantly immediately after fire suppression than after 3 weeks of suppression. In case of adjusted for creatinine, the concentration of MnBP, MBzP and Σphthalates were equally increased. There was a statistically significant difference in the geometric mean concentration(GM) of firefighters who performed fire suppression tasks as 55.59㎍/g as Cr and 29.69㎍/g as Cr for other tasks. The GM concentration of firefighters who were active within 50m from the fire site was 44.80㎍/g as Cr, and when it fell over 50m, there was a difference of 20.47㎍/g as Cr. The GM concentration of firefighters with subjective symptoms within 7 days after extinguishing the fire was 61.68㎍/g as Cr and without symptoms was 31.62㎍/g as Cr, which was different. [CONCLUSIONS]This study confirmed that fire fighters are exposed to various phthalates during the firefighting process. [KEYWORDS]Fire fighter, Phthalate metabolites

The Influence of Knowledge, Trust, and Perceived Risk on Firefighters’ Preparedness and Willingness to Respond to Nuclear Emergencies: The Case of South Korea

At the site of nuclear accidents, firefighters situated near nuclear power plants (NPPs) assume responsibility for suppressing fires and rescuing workers from leaked radiation. Their timely responses to nuclear emergencies can prevent or minimize the catastrophic impacts of these accidents. Despite their important role in nuclear emergency management, little is known about the factors that influence firefighters’ nuclear emergency responses. We recruited 179 Korean firefighters (96% male) situated near NPPs. We examined whether and how knowledge regarding nuclear accidents and trust in the authorities operating nuclear power plants were related to firefighters’ risk perceptions of nuclear accidents to predict their preparedness and willingness to respond to nuclear emergencies. Our results indicate that trust moderated the effect of knowledge on the perceived risk of nuclear accidents, and that the perceived risk mediated the relationship between knowledge and firefighters’ preparedness and willingness to respond to nuclear emergencies. The results revealed a pattern of moderated mediation, in which perceived risk mediated the indirect effect of knowledge on preparedness and willingness when the firefighters’ trust was low, but not when it was high.

Evaluation of Korean Firefighters’ Fitness Using Candidate Physical Ability Test: Pilot Study

OBJECTIVES The Candidate Physical Ability Capability Test (CPAT) is a complex performance test to assess whether firefighters have sufficient ability to meet the physical demands of firefighting, and is widely used in many countries, especially in North America. In South Korea, however, simple basic physical fitness assessments are still used for firefighters’ fitness evaluation. Here, we report the physical fitness of Korean firefighters using the CPAT for the first time in Korea.METHODS Eighteen male Korean firefighters aged between 20 to 30 years participated in this study. All subjects were measured for maximum oxygen consumption (VO2max) by using gas analyzer and cycle ergometer before CPAT. On a separate day, each subject performed CPAT with the best effort. Each subject’s oxygen consumption (VO₂), heart rate (HR) and completion time were measured during the CPAT. The results of CPAT were analyzed based on VO2max and HRmax and compared to the those of previous study from North American firefighter candidates.RESULTS VO2max was significantly (p&lt; .001) lower and HRmax was significantly (p&lt; .05) higher in Korean firefighters (45.4±4.6 ml/kg/min and 194.2±2.1 beat/min) than American firefighter candidates (53.0±7.4 ml/kg/min and 188.0±8.0 beat/min). During CPAT, Korean firefighters showed 69.4±15.8 %VO2max and 87.6±7.8 %HRmax and American firefighter candidates had 73.1±8.0 %VO2max and 90.1±5.3 %HRmax, but these were not statistically significant. However, the completed time of CPAT was significantly slower in Korean firefighters than American firefighter candidates (726.8±84.6 sec vs. 512.0±51.0 sec, p&lt;.001).CONCLUSIONS Korean firefighters have lower cardiorespiratory endurance capacity and CPAT performance than American firefighter candidates. In addition, Korean firefighters did not complete the CPAT within the pass time limit. It suggests that Korean firefighters need to improve more physical ability for physical demands of firefighting.

Prevalence of Sleep Problems and Its Impact on Anxiety, Depression and Quality of Life in Korean Fire Fighters

Prevalence of Sleep Problems and Its Impact on Anxiety, Depression and Quality of Life in Korean Fire Fighters

Differences in salient beliefs associated with voluntary exercise training among South Korean firefighters before and after COVID-19

BackgroundParticipating in voluntary exercise training is important to meet occupational requirements as well as firefighters’ health and safety. The purpose of this study is to identify salient beliefs associated with voluntary exercise training among firefighters in the pandemic era by comparing outcomes with those from a previous elicitation study, which was carried out before the COVID-19 outbreak.MethodsA total of 57 firefighters are recruited to participate in an elicitation study. Participants are requested to respond to six open-ended questions related to voluntary exercise training. Content analysis is used to create categories that combine similar factors in each belief. Beliefs mentioned by more than 30% of participants are used for comparison with the results of the previous research.Results“Improves my physical ability” (n = 44) and “cause injury” (n = 17) are identified as behavioral beliefs in the present study, whereas “makes me tired” and “takes too much time” were also elicited in Lee’s study. Normative beliefs are “family members” (n = 45) and “colleagues” (n = 27) and these results are consistent with those in Lee’s study. “Lack of time” (n = 28), “exercise facilities” (n = 19), and “COVID-19” (n = 19) are elicited as control beliefs in the present study, whereas “physical condition” (n = 21) and “exercise partners” (n = 14) were elicited as other control beliefs, and “COVID-19” was not mentioned in Lee’s study.ConclusionThis study can contribute valuable information about salient beliefs associated with exercise training behavior among firefighters, particularly under pandemic conditions. Future researchers should develop tailored exercise training programs for firefighters based on current elicited beliefs.

Association between sleep quality and type of shift work in Korean firefighters.

Shift work that interferes with normal sleep patterns, is known to be a cause of sleep disturbance and has been studied through various occupational groups. However, it is not known which shift type is better for sleep health. This study included 568 firefighters. Sleep quality was evaluated using Pittsburgh Sleep Quality Index. Sleep quality was categorized into 2 groups; good quality (≤ 5 points) and poor quality (≥ 6 points). Demographic variables, depression, anxiety, type of shift, and job were collected by self-reported questionnaires. The χ2 test, t-test, and multiple logistic regression analysis were used to evaluate the effect of shift type on the sleep quality of firefighters. Three hundred thirty-seven firefighters (59.3%) have poor sleep quality. Compared to day workers, the odds ratios (ORs) of poor sleep quality were 2.169 (95% confidence interval: 1.137-4.134) in 6-day cycle, 2.161 (1.150-4.062) in 9-day cycle, 1.805 (1.087-2.997) in 21-day cycle, and 1.485 (0.718-3.069) in 3-day cycle. The ORs of poor sleep quality were 1.697(1.021-2.823) in fire suppression and 2.325 (1.213-4.455) in emergency medical service compared to administration. All shift work type except for the 3-day cycle was associated with poor sleep quality compared to day work.

Process and Outcome Evaluations of Interventions to Promote Voluntary Exercise Training Among South Korean Firefighters.

The main aim of the present study is to evaluate reach, dose, fidelity, and outcomes of the interventions for promoting voluntary exercise training among South Korean firefighters. Four interventions for promoting voluntary exercise training among firefighters (i.e., virtual reality exercise system intervention, poster intervention, monitor intervention, and wearable health device intervention) were performed in a fire station located in Seoul, South Korea. To evaluate reach and dose received related to each intervention, participants were asked to answer several simple questions. Three process evaluators completed a 20-item survey to share their impressions related to the quality of intervention delivery. Paired t test was used to examine mean changes in primary (i.e., mean minutes of exercise training per week) and secondary outcomes (i.e., beliefs and intention) between pre- and postinterventions. More than 60% of participants experienced monitor and wearable health device interventions. Process evaluators tend not to agree with a statement saying that the number of the virtual reality exercise equipment was appropriate. Among firefighters who participated in exercise training less than 150 min per week at 1-month follow-up, mean minutes of exercise training per week increased by 67.95 min after interventions. Future studies need to examine whether the monitor and wearable health device interventions effectively increase exercise training participation among firefighters in other fire stations located in Seoul, South Korea.