Association between Occupational Stress and Gastrointestinal and Dermatological Symptoms : A Longitudinal Study Using the Korean Occupational Stress Scale and Special Health Examination Data
- 주제(키워드) Occupational stress , 직무스트레스
- 주제(DDC) 610
- 발행기관 아주대학교 일반대학원
- 지도교수 Jae Bum Park
- 발행년도 2026
- 학위수여년월 2026. 8
- 학위명 박사
- 학과 및 전공 일반대학원 의학과
- 실제URI http://www.dcollection.net/handler/ajou/000000036182
- 본문언어 영어
- 저작권 아주대학교 논문은 저작권에 의해 보호받습니다.
초록/요약
Occupational stress is a major health concern in modern work environments and has been associated with a wide range of physical symptoms, including gastrointestinal and dermatological manifestations. This study aimed to evaluate the association between occupational stress and gastrointestinal and dermatological symptoms, and to examine the reciprocal mediating effects between these symptom domains. A retrospective longitudinal study was conducted among 3,069 workers who underwent at least two occupational stress assessments and special health examinations at a university hospital health promotion center between January 1, 2014, and December 31, 2022. Occupational stress was measured using the Korean occupational stress scale （KOSS）, and gastrointestinal and dermatological symptoms were assessed using special health examination questionnaires. Generalized estimating equations were applied to account for correlations in repeated measures, and reciprocal mediation effects were analyzed using causal mediation analysis. The results showed that higher levels of occupational stress were significantly associated with an increased risk of both gastrointestinal and dermatological symptoms. Significant associations were also observed across all eight subdomains of KOSS. Mediation analysis revealed reciprocal pathways between the two symptom domains: dermatological symptoms significantly mediated the association between occupational stress and gastrointestinal symptoms, while gastrointestinal symptoms significantly mediated the association between occupational stress and dermatological symptoms. These findings support the gut–brain–skin axis hypothesis and suggest potential pathways through which occupational stress may influence physical symptoms. In conclusion, systematic assessment and management of occupational stress are important not only for mental health but also for protecting gastrointestinal and dermatological health, and may ultimately contribute to improved work productivity.
more목차
I. INTRODUCTION 1
1. Occupational Stress as a Public Health Concern 1
2. Biological Mechanisms of Occupational Stress 4
3. Previous Studies on Occupational Stress and Gastrointestinal/ Dermatological Symptoms 8
3.1 International Studies 8
3.2 Korean Studies Using the Korean Occupational Stress Scale （KOSS） 9
4. Aims of the thesis 14
II. MATERIALS AND METHODS 16
1. Study Design and Data Collection 16
2. Study Population 18
3. Study Variables 21
3.1 Occupational Stress 21
3.2 Gastrointestinal Symptoms 21
3.3 Dermatological Symptoms 23
3.4 Covariates 23
4. Statistical Analysis 25
III. Results 27
1. Baseline Characteristics of Study Participants by Occupational Stress Level 27
2. Associations between Occupational Stress and Gastrointestinal Symptoms 32
3. Associations between Occupational Stress and Dermatological Symptoms 37
4. Reciprocal Mediation Between Gastrointestinal and Dermatological Symptoms in the Association with Occupational Stress 43
5. Sensitivity analysis 47
IV. DISCUSSION 48
1. Occupational Stress and Gastrointestinal Symptoms 49
2. Occupational Stress and Dermatological Symptoms 52
3. The Skin and Gastrointestinal Tract as Barrier Organs 54
4. Reciprocal Gut-Skin Mediation 55
5. Occupational Health Implications 58
6. Strengths 60
7. Limitations 61
V. CONCLUSION 64
REFERENCES 66
APPENDIX 76
국문요약 84
