• Deokjong Lee, Woojin Kim, Jung Eun Lee, Junghan Lee, Seung-Koo Lee, Sei-Jin Chang, Da Yee Jeung, Dae-Sung Hyun, Hye-Yoon Ryu, Changsoo Kim, and Young-Chul Jung.
• Department of Psychiatry, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, Korea.
• J. Korean Med. Sci. 2021 Dec 27; 36 (50): e335.

BackgroundFirefighters inevitably encounter emotionally and physically stressful situations at work. Even firefighters without diagnosed post-traumatic stress disorder receive clinical attention because the nature of the profession exposes them to repetitive trauma and high occupational stress. This study investigated gray matter abnormalities related to high occupational stress in firefighters using voxel-based morphometry (VBM) and surface-based morphometry (SBM).MethodsWe assessed 115 subjects (112 males and 3 females) using magnetic resonance imaging and evaluated occupational stress by the Korean Occupational Stress Scale-26 (KOSS-26). Subjects were classified into highly or lowly stressed groups based on the median value of the KOSS-26.ResultsIn VBM analysis, we found that firefighters with high occupational stress had lower gray matter volume (GMV) in both sides of the insula, the left amygdala, the right medial prefrontal cortex (mPFC), and the anterior cingulate cortex than firefighters with low occupational stress. In SBM analysis based on regions of interest, the GMV of the bilateral insula and right mPFC were also lower in the highly stressed group. Within the highly stressed group, low GMV of the insula was significantly correlated with the length of service (left: r = -0.347, P = 0.009; right: r = -0.333, P = 0.012).ConclusionOur findings suggest that regional GMV abnormalities are related to occupational stress. Regional gray matter abnormalities and related emotional dysregulation may contribute to firefighter susceptibility to burnout.© 2021 The Korean Academy of Medical Sciences.

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