=A B S T R A CT S = E ff e c t s of Cig are tt e S m okin g on P s y ch o s o ci al D i s t re s s an d O c cu pat i on al Ri s k s B on g - S uk Ch a, S ei - Jin Ch an g, Jon g - K u P ark, S an g - B aek K o, M y u n g - Gu en K an g, S an g - Y ul K o Departm ent of Pr ev entiv e M edicine and In stitute of Occupational M edicine W onju College of M edicin e, Yon sei Univ er sity, W onju, Korea T h e effect s of cigarette sm okin g on the psy ch osocial distress, th e ab senteeism, the occupational injuries, an d on the prev alence for the accidents w ere a sses sed in 795 m ale w orker s w h o had been employ ed sin ce M arch 1994. T h e result s show that the prev alence of current sm okers w ere higher in y oun g m en, low er edu cational lev el, low er incom e, sin gle m en (unm arried or div orced), alcoh ol drink er s, an d blu e collar w orker s. In th e biv ariate an aly ses, the w orkers w ith the high job dem an d an d low w ork control w ere m ore lik ely to sm oke, although th e relation ship w as n ot strong. T hose w ho reported low er satisfaction on his job ten ded to sm oke m ore. M ean scores of p sy chosocial w ell- bein g In dex (PW I) w ere higher in current sm okers th an n on sm okers. F or the hierarchical multiple regression an aly ses, interaction term s betw een cig arette sm okin g an d job stressor s (job dem an d an d w ork control) w ere not significant. F or sm oker s, th e odds ratios for the occupational injuries, and th e accident s w er e 1.40(95% confiden ce int erv al 0.77-2.57) and 1.96 (95% confiden ce interv al 0.75-5.09), respectiv ely. T h e mean ab sent day w ere 4.13 for sm oker s, 3.65 for n on sm okers, although the differences w ere n ot statistically significant. It seem s that cigarette sm okin g h ad n ot cau sed any crucial effect s on the psy ch osocial w ell- b ein g statu s an d the occupational risk s. Som e con sideration s for the further research on th e relation ship of cig arette sm okin g on the m ental health statu s an d the occupation al risk s w ere also discu ssed. K ey W or d s : Cig a r e t t e s m ok ing, J ob s t r e s s or, P s y chos oc ia l W e ll - b e ing S ta t us, O c c up a t iona l r is k s. - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - * 1995.
I.,,, (US. Departm ent of H ealth and Hum an Serv ices, 1989). 1985 (Surgeon Gen eral) (Surg eon Gen eral, 1985)..,. Fiore (1990) 39, 1/ 6. (1988) 16.60%, 3.51%. (Doll P eto, 1976 ; Rog ot Murray, 1980 ; T sai,1990), (V ogt Schw eitzer, 1983 ; Rice, 1986),,, (P enn er Penner, 1990 ; Bertera, 1991),.,. (Sch w artz, 1981)...,,, (Park es, 1983 ; V an T uinen Lan d, 1986 ; Bertera, 1991 ; Ry an, 1992)., 77% (H aw ker H oltby, 1988). (V an Peenen, 1986) (Nation al In stitute for Occupational Safety an d Health, 1979 ; T sai, 1990 ; Sack s Nelson, 1994)., (M etts, 1981).,., (occupational risk s ).
.?,.,..,.., (Kan del Davis, 1986 ; Glassm an, 1988 ; Anada, 1990). (Sch w artz, 1970),. (P arkes, 1983). (Caplan Cobb, 1975 ; Conw ay, 1981 ; W estm an Shiron, 1985 ; H ou se, 1986). Green John son (1990).,. (w ork disability ) T u omi(1991),.,. (,,,,, ), (job dem an d) (w ork control),.,, (job strain ). ( )
, Pieper (1989)5 (,, ). Albrigt (1992) 1,396.,,,.,.,.., (,,, ) (, ),.,,,,.
. 1. WH 30 1 1,200, 1995 810. 1,172 ( : 801, : 371 ) 4. 801 6 795...,.,,,, (, ),. 2. 1 ). - (,,, ) - (,,,,,, ) - (, ) - 2). - - (,, ) 3. 1.. John son H all(1988) (job content in dicator ). (2 ) (10 ),, 2-1- 0. 0-6, 0-30,
( ) ( ). 0.59 0.82.. (1993) Goldb erg (1979) GH Q- 60 (Gen eral H ealth Qu estionn aire )(P sy chosocial W ell- bein g Index : PW I). PW I 45,,,,,, 4. 0-1- 2-3 3-2- 1-0 PW I. PW I PW I. PW I.94. ( ) 1995.. ( ). 4. SP SS/ PC + (v er sion 4.0) t,, 2, (odds ratio) 95%. (, ) (hierarchical multiple regression )..
1. III. 20 30 88%. 486 65% 24%. 58.5%,,,.,, 4. 1.5. 348 (43.8% ) (30.2% ), (26.0% ). 30. 1, 78%. 83.5%. 3 41% 10 14% 5.37 ( 5.01 ). 80 100 21% ( 1). 2..,.... 3, 60 ( 2). 3 95%. 2. 011, 1220,. 3, 2. 3 1.47, 1.40 1.13. 1.72
( 3).,.,,.. 1 2525 ( 4).. 2 (interaction effect ).. 3.,,,,,,.,,,,,,,,.,,,,,,,.,,, ( 5). ( 6). 1 2 32 (R 2 ). 1 8, 2 21%. 3 2. 4.. 7,. 1.59. 1 25 25,
5. PWI - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 1. 0000 0. 0945* 1. 0000-0. 5907** - 0. 0820 1. 0000-0. 2194** - 0. 0502 0. 1458** 1. 0000 0. 0847 0. 0567-0. 1071* - 0. 5129** 1. 0000-0. 1287** - 0. 1017* 0. 0548-0. 0060-0. 0004 1. 0000-0. 1282** - 0. 1040* 0. 0781 0. 1346** - 0. 0668 0. 1512** 1. 0000-0. 2039** - 0. 1121* 0. 1064* 0. 2386** - 0. 1424** 0. 0139 0. 0634 1. 0000-0. 1012* - 0. 0166-0. 0274 0. 0009 0. 0659 0. 0402 0. 0565 0. 2077** 1. 0000 0. 2278** 0. 0134-0. 2355** - 0. 4337** 0. 2819** - 0. 0082-0. 0592-0. 2582** - 0. 0096 1. 0000 0. 4326** 0. 0134-0. 3584** - 0. 1229* 0. 2160** 0. 0183-0. 0582-0. 1787** - 0. 0068 0. 2566** 1. 0000 PWI -0. 1270* - 0. 0564 0. 0774 0. 0846-0. 0232 0. 0388 0. 1107* 0. 3262** 0. 3184** - 0. 2421** - 0. 0923 1. 0000 a : (1:, 0: ) b : (1:,,, 0: ) c : (1:, 0:, ) d : (1:, 0:) e : (1:, 0:) PWI: P sy chosocial W ell- being Index * : P <.01, ** : P <.001
,. 8 ( ) 95%. 1.4 1.96 1 25 1.22 1.05..,,. 4 6.4%.
. 78%..,,,,. (Orlean s, 1987), Rom ano (1991) 1,137. (Hunter, 1987 ; Nelson, 1994). (, ),., N elson (1994) 10 31.7% 24.2%8% 43.7% 39.2% 37.2% 34.5% 2. (Serx ner, 1991 : Serx n er 1992)., (selection m odel) ( ). (stress model)., (Green John son, 1990) (Caplan, 1975 ; Kaplan Cow les, 1978 ; Con w ay, 1981 ; W estm an, 1985 ; Strech er, 1986 ; Hou se, 1986). (culture m odel). (). (Green John son, 1990 ; Serx ner, 1992). (H ou se, 1988 ; John son, 1988 ; Serxn er, 1991 ; Rom ano, 1991)., 1.47, 1.40. Pieper (1989)..
. (Ep stein Perkin s, 1988), (Shiffm an, 1982 ; Benfari, 1982)., (Ep stein Perkin s, 1988).,.,... (, ),.., (1 25 ).,..? (Epstein Perkin s, 1988). (Pomerlean, 1984) (Nesbitt, 1973 ; Pom erlean, 1984), (Epstein Jenning s, 1986). (A shton Stepney, 1982), (Henningfield Goldberg, 1983).. Gilbert (1979) (nicotine paradox ).,..,.
.,, ( )., (T sai, 1990 ; Ry an, 1992 ; Sack s N elson, 1994) (Van T uinen Lan d, 1986 ; Bertera, 1991 ; Ry an, 1992)., T sai (1990) 2.5, Ry an (1991),,,,, 1.4. (Kristein, 1983)....,. (M elam ed, 1989).. V an T uin en Land (1986) ( )...,,.,, (longitudin al)..
V., WH 30 1 795,,.,,,,,.., ( 25 )..,,...,., () (, ),....
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1. :, ( ):% (% ) (% ) ( ) 29 331(44.7) 523 (79.0) 30 39 320(43.2), 43 ( 6.5) 40 49 66 ( 8.9) 92(13.9) 50 24 ( 3.2) 486 (64.8) 593 (77.6) 85 (11.3), 171(22.4) 180(29.9) 444 (58.5) 135 (17.8) 57 ( 7.5) 644 (83.5) 127 (16.5) 117 (15.4) 6 ( 0.8),, 301(39.0) 470(61.0) 1 3 3 5 5 10 309 (40.9) 135 (17.9) 204 (27.0) 10 15 67 ( 8.9) 15 40( 5.3), 348 (43.8) 240(30.2) 207 (26.0) ( ) 60 60 80 80 100 115 (16.2) 222(31.2) 222(31.2) 100 120 77 (10.8) 120 76 (10.6)
2. :, ( ):%
P ( ) 29 30 39 40 49 50 271(81.9) 241(75.3) 46 (69.7) 17 (70.8) 60(18.1) 79 (24.7) 20(30.3) 7 (29.2) 0.0590 371(78.8) 69 (83.1) 123 (71.9) 100(21.2) 14 (16.9) 48 (28.1) 0.0820 343 (80.3) 88 (68.8) 47 (83.9) 86 (76.1) 84 (19.7) 40(31.2) 9 (16.1) 27 (23.9) 0.0283,, 237 (81.7) 340(75.1) 53 (18.3) 113 (24.9) 0.0333, 281(83.9) 147 (72.8) 145 (72.5) 54 (16.1) 55 (27.2) 55 (27.5) 0.0013, 1 3 3 5 5 10 10 ( ) 60 60 80 80 100 100 120 120 405 (80.4) 25 (64.1) 66 (75.0) 502(80.4) 76 (63.3) 253 (84.6) 93 (73.2) 146 (74.1) 74 (71.2) 81(85.3) 148 (78.7) 145 (78.4) 44 (73.3) 51(78.5) 99 (19.6) 14 (35.9) 22(25.0) 122(19.6) 44 (36.7) 46 (15.4) 34 (26.8) 51(25.9) 30(28.2) 14 (14.7) 40(21.3) 40(21.6) 16 (26.7) 14 (21.5) 0.0392 0.0000 0.0032 0.4811
3. 95 % 95%, 1.47 1.00 1.40 1.00 1.13 1.00 1.72 1.00 0.93-2.32 0.98-2.01 0.78-1.63 1.14-2.61
4., N P 130 490 50.02 39.80 20.69 17.64 0.000 288 305 38.24 45.92 17.65 19.56 0.000 239 352 44.14 40.77 18.26 19.31 0.033, 456 178 38.86 49.88 17.64 19.57 0.000 472 143 43.54 38.64 19.08 17.05 0.006 1 () 24 25 398 74 42.74 47.86 19.09 18.61 0.034
6. 1 2 T T - 0.222-1.419 0.028 0.197 0.300 0.268 0.225 0.221 a 0.141 0.065 1.220 0.612 b 1.218 0.695 0.311 0.195 c 1.953 0.929-2.352-1.172-0.010-0.293 0.024 0.772 d - 1.063-0.419-0.248-0.108 e 4.187 2.047 2.822 1.517 6.123 6.249 * * - 0.812-4.895 * * - 4.290-3.224 * * 46.134 47.158 R 2 0.028 0.208 F 1.735 10.553 R 2 F 27.435 * * a : (1:,,, 0: ) b : (1:, 0: ) c : (1:, 0:, ) d : (1:, 0:) e : (1:, 0:) * : P < 0.05, ** : P < 0.01
7.,, P 4.13 (6.49) 3.65 (4.99) 0.377 1.04 (4.23) 0.95 (2.45) 0.723 1.59 (2.06) 1.59 (2.00) 0.998 ( / ) a > 25 < = 25 P 4.05 (6.52) 4.30(5.64) 0.777 1.05 (4.46) 1.06 (2.63) 0.976 1.59 (2.13) 1.56 (1.63) 0.874 a : 8. 95 % 95% ( ) a, a 1.40 1.96 1.08 1.51 0.77-2.57 0.75-5.09 0.39-2.95 0.57-4.00 (25 24 ) a, a 1.22 1.05 1.34 0.73 0.61-2.44 0.39-2.79 0.59-3.03 0.21-2.50 a :