Regional Gray Matter Volume Related to High Occupational Stress in Firefighters

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, Young Chul Jung

Research output: Contribution to journalArticlepeer-review


Background: Firefighters 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). Methods: We 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. Results: In 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). Conclusion: Our 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.

Original languageEnglish
Article numbere335
JournalJournal of Korean medical science
Issue number50
Publication statusPublished - 2021 Dec

Bibliographical note

Funding Information:
This research was supported by the Fire Fighting Safety & 119 Rescue Technology Research and Development Program, funded by the National Fire Agency (MPSS-Firesafety-2015-80).

Publisher Copyright:
© 2021. The Korean Academy of Medical Sciences. This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

All Science Journal Classification (ASJC) codes

  • Medicine(all)


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