Yonsei Med J.  2020 Jan;61(1):103-109. 10.3349/ymj.2020.61.1.103.

Cohort Profile: Firefighter Research on the Enhancement of Safety and Health (FRESH), a Prospective Cohort Study on Korean Firefighters

  • 1Department of Public Health, Yonsei University College of Medicine, Seoul, Korea.
  • 2Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea. preman@yuhs.ac
  • 3Department of Occupational and Environmental Health, Yonsei University Graduate School of Public Health, Seoul, Korea.
  • 4Division of Cardiology, Yonsei Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Korea.
  • 5Department of Radiology, Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul, Korea.
  • 6Department of Neurology, Yonsei University College of Medicine, Seoul, Korea.
  • 7Department of Preventive Medicine and Institute of Health Science, Gyeongsang National University College of Medicine, Jinju, Korea.
  • 8Department of Occupational and Environmental Medicine, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, Wonju, Korea.
  • 9Department of Psychiatry, Yonsei University College of Medicine, Seoul, Korea.
  • 10Division of Endocrinology and Metabolism, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
  • 11Institute of Human Complexity and Systems Science, Yonsei University, Songdo, Korea.


Firefighters have a high risk of developing cardiovascular and mental disorders due to their physical and chemical environments. However, in Korea, few studies have been conducted on environmental risk of firefighters. The Firefighter Research on the Enhancement of Safety and Health (FRESH) study aimed to discover the risk factors for cardiovascular disease and mental disorders among firefighters. Former and current firefighters were recruited from three university hospitals. A total of 1022 participants completed baseline health examinations from 2016 to 2017. All participants were scheduled for follow-ups every 2 years. Baseline health survey, laboratory testing of blood and urine samples, blood heavy metal concentration, urine polycyclic aromatic hydrocarbons (PAHs) metabolites, stress-related hormone test, natural killer cell activity, as well as physical and mental health examinations that focused on cardiovascular and mental disorders, were conducted. In addition, 3 Tesla (3T) brain magnetic resonance imaging (MRI) and neuropsychological tests were also performed to investigate structural and functional changes in the brains of 352 firefighters aged >40 years or new hires with less than 1 year of service.


Firefighters; cohort studies; cardiovascular diseases; mental disorders; magnetic resonance imaging; Republic of Korea

MeSH Terms

Cardiovascular Diseases
Cohort Studies*
Follow-Up Studies
Health Surveys
Hospitals, University
Killer Cells, Natural
Magnetic Resonance Imaging
Mental Disorders
Mental Health
Neuropsychological Tests
Polycyclic Hydrocarbons, Aromatic
Prospective Studies*
Republic of Korea
Risk Factors
Polycyclic Hydrocarbons, Aromatic

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