Objectives: This study investigated whether organizational responses modified the associations between experiencing violence and depressive symptoms among emergency workers. Methods: A nationwide survey of 1966 Korean emergency medical service (EMS) providers was analyzed. Experience of workplace violence (ie, physical violence, verbal abuse) was classified into four groups based on the victims’ reporting and organizational responses: (i) “Not experienced,” (ii) “Experienced, not reported,” (iii) “Experienced, reported, responded by organization,”and (iv) “Experienced, reported, not responded by organization.” Depressive symptoms were assessed by 11-item version of the Centers for Epidemiologic Studies Depression Scale. Results: Compared to “Not experienced” group, physical violence was significantly associated with depressive symptoms among EMS providers responding “Experienced, not reported” (PR: 1.67, 95% CI: 1.37, 2.03) and “Experienced, reported, not responded by organization” (PR: 2.58, 95% CI: 1.75, 3.82), after adjusting for confounders. No significant difference was detected for workers responding “Experienced, reported, responded by organization” group (PR: 1.45, 95% CI: 0.87, 2.41). Similar trends were observed in the analysis with verbal abuse. Conclusions: Our findings suggest that organizational responses could play a critical role in mitigating depressive symptoms among EMS providers who experience violence at work.

Kim SJ, et al. J Korean Med Sci. 2013 May;28(5):658-666. https://doi.org/10.3346/jkms.2013.28.5.658

Firefighters are repeatedly exposed to various pollutants that occur at fire scenes. There are three levels of exposure: primary exposure to pollutants, secondary exposure to pollutants on personal protective equipment (PPE), and tertiary exposure to contaminated fire stations and fire engines due to pollutants on PPE. Therefore, it is important for firefighters to be aware of the risk of exposure to pollutants and to practice health behaviors such as appropriate PPE management. No clear association has been established in the existing literature between firefighters’ risk perception level and their health beliefs about the health impact of awareness of exposure to hazardous substances at fire scenes. This study aims to evaluate the relationship between awareness of the exposure risk to primary, secondary, and tertiary pollutants and health beliefs. It was designed as a cross-sectional study, in which a web-based survey was conducted from 13 May to 31 May 2021. The analysis was conducted in 1940 firefighters working in the Seoul metropolis who agreed to participate in the research. Participants who perceived susceptibility were likely to be aware of the primary (adjusted odds ratio (AOR) = 2.10, 95% confidence interval (CI) 1.16–3.80), secondary (AOR = 2.77, 95% CI 1.77–4.32), and tertiary (AOR = 2.73, 95% CI 1.85–4.03) exposure risks. Participants who perceived barriers were unlikely to be aware of the risk of exposure to primary (AOR = 0.67, 95% CI 0.49–0.91), secondary (AOR = 0.77, 95% CI 0.61–0.96), and tertiary (AOR = 0.75, 95% CI 0.62–0.91) pollutants. Educational intervention is recommended to improve perceived susceptibility and awareness of the risk of exposure to pollutants and reduce perceived barriers. Consequently, educational intervention is expected to positively impact firefighters’ management of appropriate PPE. We confirmed an association between occupational exposure risk and firefighters’ health beliefs. In the health belief model (HBM), health beliefs that affect health behavior also affect awareness of the exposure risk level. Therefore, an intervention for health beliefs can also be used to raise job-related exposure risk awareness. Regular training on the health impacts of fire scenes is necessary for both newcomers and incumbents to enable firefighters to better recognize the risks of each occupational exposure level. Additionally, laws and regulations are necessary for the removal of harmful substances that contaminate PPE, such as self-contained breathing apparatus (SCBA), during exposure to a fire scene. Our research can be used as a basis for improving fire policies and education programs in the future.

Kim CH, et al. J Korean Med Sci. 2014 Jan;29(1):122-128. https://doi.org/10.3346/jkms.2014.29.1.122

Firefighters are known to be exposed to a variety of hazardous materials and combustion products during operational and training activities, as well as in fire stations. However, exposure to diesel exhaust emissions, classified as carcinogenic to humans by the International Agency for Research on Cancer (IARC), is also present in the fire station environment. In this study, concentrations of elemental carbon (EC), which is a surrogate of diesel exhaust and indoor air pollutants, has been measured to compare the effect of an exhaust reduction system (ERS) that was installed in the engine bays of two fire stations to mitigate indoor air pollution levels in the garage, duty offices, and dormitory/shower areas. The levels of most pollutants were reduced after the installation of the ERS. Pollutants may disperse inside of fire stations. Therefore, the ERS is a valuable strategy to mitigate pollutant exposure among firefighters and outdoor air pollution using the filtration ability of an ERS. The results of this study suggest that all truck bays should install an ERS to reduce pollutant exposure and that installation is especially necessary for EURO 3 fire vehicles.

OBJECTIVES: This study examined the association between lack of compensation for COVID-19-related overtime work (LCCOW) and burnout among emergency medical service (EMS) providers in Seoul, Korea.METHODS: We conducted a cross-sectional survey of 693 EMS providers in Seoul, Korea. Participants were classified into 3 groups according to their experience of coronavirus disease 2019 (COVID-19)-related overtime work and LCCOW: (1) “did not experience,” (2) “experienced and was compensated,” and (3) “experienced and was not compensated.” Burnout was measured using the Korean version of the Copenhagen Burnout Inventory, which has 3 subdomains: personal burnout (PB), work-related burnout (WRB), and citizen-related burnout (CRB). Multiple linear regression was applied to examine whether LCCOW was associated with burnout after adjusting for potential confounders.RESULTS: In total, 74.2% of participants experienced COVID-19-related overtime work, and 14.6% of those who worked overtime experienced LCCOW. COVID-19-related overtime work showed a statistically non-significant association with burnout. However, the association differed by LCCOW. Compared to the “did not experience” group, the “experienced and was not compensated” group was associated with PB (β=10.519; 95% confidence interval [CI], 3.455 to 17.584), WRB (β=10.339; 95% CI, 3.398 to 17.280), and CRB (β=12.290; 95% CI, 6.900 to 17.680), whereas no association was observed for the “experienced and was compensated” group. Furthermore, an analysis restricted to EMS providers who worked overtime due to COVID-19 showed that LCCOW was associated with PB (β=7.970; 95% CI, 1.064 to 14.876), WRB (β=7.276; 95% CI, 0.270 to 14.283), and CRB (β=10.000; 95% CI, 3.435 to 16.565).CONCLUSIONS: This study suggests that LCCOW could be critical in worsening burnout among EMS providers who worked overtime due to COVID-19.