The Standardized Prevalence Ratios of Occupational and Chronic Diseases Among Korean Firefighters Compared with the General Population

(1) Background: Firefighters, exposed to diverse and unpredictable occupational environments, face cumulatively increased physical health risks. The purpose of this study was to assess the standardized prevalence ratios (SPRs) of occupational and chronic diseases in firefighters and the general population, categorized into pre-disease and disease stages; (2) Methods: This study was a community-based, retrospective, cross-sectional study. Data sources included the occupational health examination of 7024 firefighters and the National Health and Nutrition Examination Survey of 1485 general populations in 2019. Statistical analyses were performed using SAS version 9.4 SAS Institute Inc., Cary, NC, USA. SPRs of chronic and occupational diseases were calculated for each pre-disease and disease stage, and chi-square tests were performed; (3) Results: Data were analyzed from a cohort of 7024 firefighters who consented to the access and use of their occupational health examination results, 91.9% (n = 6456) were male, the average age was 43 years, the average number of years of service was 15.3 years. Among the five classifications of the occupational health examination results, 26.7% (n = 1877) were A, 19.2% (n = 1352) were C1, 42.4% (n = 2980) were C2, 1.5% (n = 108) were D1, and 10% (n = 705) were D2. As a result of calculating the SPRs compared to the general population, in the pre-disease stage, obesity SPR = 1.29 (95% confidence interval [CI] 1.23 to 1.34), hypertension SPR = 1.52 (95% CI 1.47 to 1.57), diabetes mellitus SPR = 1.07 (95% CI 1.02 to 1.11), and metabolic syndrome SPR = 1.62 (95% CI 1.57 to 1.66) were all higher in the firefighter group. On the other hand, in the disease stage, metabolic syndrome and complex pulmonary ventilation impairment were higher in SPRs than in the general population, but not statistically significant. However, at the disease stage, SPRs for obesity, hypertension, diabetes, and noise-induced hearing loss were higher and statistically significant in the general population; (4) Conclusions: The SPRs for firefighters produced in this study clearly demonstrate the healthy worker effect. The SPRs, derived from a cross-sectional study, highlight the need for future cohort building of firefighters to track and monitor health outcomes, as well as systematic and thorough health management interventions to prevent progression from pre-disease to disease. Therefore, this study can be utilized in the development of mid-to-long-term firefighter health promotion programs and health and safety plans to minimize firefighters’ physical health and occupational exposures.