Division of Cancer Control and Policy, National Cancer Control Institute, National Cancer Center, Goyang-si, Republic of Korea.
Division of Health Administration, College of Software and Digital Healthcare Convergence, Yonsei University, Wonju-si, Republic of Korea.
Front Public Health. 2023 Jan 16;10:1070023. doi: 10.3389/fpubh.2022.1070023. eCollection 2022.
National Health Insurance claims data were used to compare the incidence of occupational diseases, avoidable hospitalization, and all-cause death standardized incidence ratio and hazard ratio between firefighters and non-firefighters.
The observation period of the study was from 2006 to 2015 and a control group (general workers and national and regional government officers/public educational officers) and a firefighter group was established. The dependent variables were occupational diseases, avoidable hospitalization (AH), and all-cause death. The analysis was conducted in three stages. First, the standardized incidence ratios were calculated using the indirect standardization method to compare the prevalence of the disease between the groups (firefighter and non-firefighter groups). Second, propensity score matching was performed for each disease in the control group. Third, the Cox proportional hazards model was applied by matching the participants.
The standardized incidence ratio and Cox regression analyses revealed higher rates of noise-induced hearing loss, ischemic heart disease, asthma, chronic obstructive pulmonary disease, cancer, back pain, admission due to injury, mental illness, depression, and AH for firefighters than general workers. Similarly, the rates of noise-induced hearing loss, ischemic heart disease, asthma, chronic obstructive pulmonary disease, back pain, admission due to injury, mental illness, depression, and AH were higher in the firefighter group than in the national and regional government officer/public educational officer group.
The standardized incidence ratios and hazard ratios for most diseases were high for firefighters. Therefore, besides the prevention and management of diseases from a preventive medical perspective, management programs, including social support and social prescriptions in the health aspect, are needed.
利用国民健康保险理赔数据比较消防员与非消防员之间职业病、可避免住院和全因死亡率的标准化发病比和风险比。
本研究的观察期为 2006 年至 2015 年，设立对照组（一般工人和国家及地区政府官员/教育官员）和消防员组。因变量为职业病、可避免住院（AH）和全因死亡。分析分为三个阶段：首先，采用间接标准化法计算标准化发病比，以比较两组（消防员组和非消防员组）疾病的患病率；其次，对对照组中的每种疾病进行倾向评分匹配；最后，采用 Cox 比例风险模型进行匹配。
标准化发病比和 Cox 回归分析显示，与一般工人相比，消防员患噪声聋、缺血性心脏病、哮喘、慢性阻塞性肺疾病、癌症、背痛、因伤住院、精神疾病、抑郁症和 AH 的比例更高；同样，与国家及地区政府官员/教育官员相比，消防员患噪声聋、缺血性心脏病、哮喘、慢性阻塞性肺疾病、背痛、因伤住院、精神疾病、抑郁症和 AH 的比例更高。
大多数疾病的标准化发病比和风险比均对消防员较高。因此，除了从预防医学角度预防和管理疾病外，还需要管理方案，包括健康方面的社会支持和社会处方。
